Medical Claims Third Party Administrator and Provider Network Services

The Vendor is required to provide third party administrator (TPA) must demonstrate extraordinary flexibility to administer state public entity business, provide creative and contemporary administrative and care management options, and offer flexible solutions that allow the fund to operate a high performance, self-funded plan that can partners with other best in breed providers and partners.
- The fund is seeking proposals for a medical claims third party administrator (TPA) and provider network services to provide cost efficient claims processing, aggressive network access and discounts, exceptional customer service, timely and accurate reporting, and other associated administrative functions.
- The funds offers medical, prescription, dental and vision plans.
- The request for services specific to TPA services for the fund’s health plans
- Below are other key requirements of the TPA:
•    Provide access to a seamless national network that offers broad access to network providers in state and nationally. 
•    Said network should provide at least a 95% match to the providers’ plan members use at the present time. 
•    Provide access to a seamless platform of services, including member services, care management, utilization management, eligibility administration, comprehensive reporting, and strong account management. 
•    Match the benefits in place today on an “equal to or better than basis” with guarantees in writing.