Benefit Administration Services

The vendor required to provide third-party administrator (TPA) to comprehensive, fully integrated benefits administration solution.
•    A solution that is efficient, secure, compliant, and has user-friendly benefits ecosystem that supports the district’s employees, HR team, and strategic goals. 
•    An end-to-end technology and service delivery, including implementation, data integration, ongoing support, participant services, and regulatory compliance. 
•    A single-source platform is preferred, however at a minimum the solution shall streamline enrollment, provide eligibility management, account administration, and regulatory documentation while ensuring data security and accuracy. 
•    Contractor shall have capabilities to deliver all necessary software platforms, administrative services, and compliance support related to:
o    Employee benefits administration
o    Cobra continuation coverage administration
o    Flexible spending account (FSA) administration
o    Health savings account (HSA) administration, should it be required in the future.
- Benefits administration software platform
•    Secure and fully hosted software platform for enrollment, eligibility, and ongoing benefits management. 
•    Employee self-service portal that is mobile-responsive for benefits enrollment, updates, document uploads, and regulatory notices. 
•    Configurable eligibility rules for all benefit group types. 
•    Configurable evidence of insurability (EOI) rules for all event types and applicable insurances. 
•    Automated custom or semi-custom and branded notices, including eligibility, enrollment window available, reminders, and confirmations. 
•    Participant customer service via phone, live chat, email, and secure message portal. 
•    Enrollment support
o    Guided enrollment workflows with custom text options. 
o    Plan comparison tools. 
o    Data change triggered automation. 
o    Temporal change automation, such as an employee or dependent reaching a particular age.
o    Pend coverage levels requiring evidence of insurability (EOI), and update guaranteed coverages. 
o    Annual enrollment period as specified by district. 
o    Qualified medical child support order (QMCSO)
•    Store online beneficiary designations by employee. 
•    Store and send dependent data to carriers in weekly integrations.
•    Receive, process, and store approved and denied EOI records. 
•    Calculate all benefit deductions and credits for employee and employer. 
•    Employer administrative portal with configurable real-time dashboards and reporting capabilities. 
•    Standard scheduled and on-demand reports for enrollment, utilization, compliance, and audits.
- Cobra administration
•    Tracking of qualifying events in compliance with cobra regulations. 
•    Preparation and distribution of all cobra required notices, including initial, qualifying event, termination, and other notices within regulatory timelines. 
•    Collect premiums, track payments, send reminders, and process reinstatements. 
•    Premium remittance to district and carriers. 
•    Ongoing eligibility monitoring and termination of cobra coverage. 
•    Customer support for cobra participants. 
•    Maintenance of required cobra documentation and audit logs. 
•    Participant customer service via phone, email, and secure message portal.
•    Cobra standard reporting for event logs, payment history, participant status, compliance timelines. 
•    Weekly eligibility and enrollment integrations with district insurance carriers. 
•    Ongoing software updates, maintenance, and security monitoring
o    Provide notifications of system updates or outages. 
o    Maintain software functionality and compliance. 
•    Protect all confidential and personal data:
o    Act-compliant data storage, transmission, and processing. 
o    Annual penetration testing and ongoing vulnerability monitoring
o    Secure data encryption (in transit and at rest). 
o    Multi-factor authentication or single sign-on (SSO) required for both employees and administrators.
- Flexible spending account (FSA) account administration
•    Automated creation and management of healthcare FSA and dependent care FSA accounts. 
•    Issuance and support of FSA debit cards with auto-substantiation features. 
•    Claims intake, adjudication, and reimbursement processing via mobile upload, web upload, mail, fax, or debit card processing. 
•    Substantiation processes and document storage for IRS compliance. 
•    Process auto-substantiation files from carriers. 
•    Participant contributions management, including payroll integration. 
•    Reporting for plan utilization, forfeitures, and year-end reconciliation. 
•    Participant customer service via phone, live chat, email, and secure message portal 
o    Ongoing software updates, maintenance, and security monitoring.
o    Provide notifications of system updates or outages.
•    Maintain software functionality and compliance. 
•    Protect all confidential and personal data
o    Act-compliant data storage, transmission, and processing. 
o    Annual penetration testing and ongoing vulnerability monitoring. 
o    Secure data encryption (in transit and at rest). 
o    Multi-factor authentication or SSO required for both employees and administrators.
•    Business continuity plan and disaster recovery processes.

- Contract Period/Term: 5 years
- Questions/Inquires Deadline: January 6, 2026