COBRA, FSA and Transportation Benefits Services

The Vendor is required to provide third-party administrators (TPAs) for:
•    Transportation benefits
•    Flexible spending accounts 
•    Cobra continuation coverage.
- FSA and transportation benefits (TRP and commuter program)
1. Administer pre-tax contributions for:
•    Health FSA
•    Dependent care FSA
•    Transit and parking TRP programs
2. Key requirements include:
•    Year-round enrollments and changes
•    Semi-monthly contributions; reimbursements and EFT
•    Debit card support (fraud resolution, lost and stolen cancellation)
•    Nondiscrimination testing assistance
•    Compliance monitoring and notifications
•    Claims processing; auto-substantiation; debit cards (no fees, fraud controls)
•    Robust communication capability, at the discretion of the county, for substantiation, due dates for claims submission, plan year ending (county to approve language)
•    User friendly portal and app for filing claims, checking prior and current year balances
- Cobra administration
•    Notices ≤14 days; enrollments, monthly billing and remittances
•    Collaboration on special enrollment and exceptions
•    Portal support for open enrollment; coverage tracking
•    Portal enrollment for members
•    Remit premium payments to vendors
•    Bill county for county-paid cobra
- General requirements
1. Transition:
•    Detailed plan
•    Data transfer (csv/xml)
•    60-day run-out and claims processing at no cost
•    Minimal disruption
2. Technology:
•    99% uptime portal
•    SFTP integration
•    Multilingual support
3. Support and communications:
•    Toll-free helpline
•    Materials
•    Call monitoring
4. Reporting and audits:
•    Monthly performance guarantee reports
•    Independent audit rights
•    County access ≤30 days' notice
5. Security and compliance:
•    HIPAA safeguards
•    Breach notice ≤10 days (per baa) and 48 hours mitigation
•    Cyber insurance $10m min
6. Indemnification:
•    Mutual
•    Cap 2x annual fees (excl. gross negligence)
•    Oregon tort claims act limits
7. Account management:
•    Dedicated local team
•    No subcontracting without consent
8. Funding:
•    Vendor retains FSA and TRP funds and pays claims
•    No prefunding by employer.