Fully Insured, Level Funded Medical Benefits Service

The agency is seeking a vendor to provide a fully insured, level-funded medical benefits service for its employees. The agency needs to solve the administrative burden of managing healthcare claims by outsourcing these operations to an external provider. This initiative aims to limit the county's involvement in day-to-day inquiries from plan participants and healthcare providers. The scope of work requires the selected provider to maintain a fully automated claims adjudication system in compliance with all HIPAA electronic transmission standards and security regulations. The provider must offer web access for plan participants to check claim status and access customer service functions. Additionally, the provider will maintain records, deliver utilization reports, and offer online access to standard or ad hoc reports for the county. The provider must also prepare and print summary plan documents, claim forms, and other communication materials in consultation with county staff. The provider will print and mail employee insurance identification cards directly to employees' home addresses. Furthermore, the provider must meet with county representatives as necessary and attend the annual Open Enrollment event each year. Eligible bidders must be onshore organizations based in the United States. The selected provider will perform all work offsite. The county is looking for budget proposals to determine the cost of these services. The contract period will span one year. Bidders must submit all questions regarding this opportunity no later than July 2, 2026.