Employee Benefit Plans Services

The City of Mission, Texas, is seeking employee benefit plans services to support its self-funded group health plan. The agency requires a Third Party Administrator to manage claims, call center operations, ID card issuance, appeals, eligibility, and reporting. The selected administrator must match or exceed the current Base Plan and Buy-Up Plan designs, with any deviations clearly identified and explained. The scope of work includes establishing a Selerix-compatible enrollment data interface and providing measurable service performance guarantees. These guarantees must cover claims turnaround time, call center response standards, ID card issuance, appeals processing, eligibility processing, reporting accuracy, and claims payment accuracy. The agency requires these performance standards to include financial penalties or fee-at-risk provisions for any failure to meet the stated metrics. Bidders must be onshore United States organizations, and the requested work will be performed offsite. Proposals must include historical claims administration performance metrics, such as claims processing accuracy, turnaround times, overpayment recovery rates, internal audit procedures, and associated performance guarantees. The agency is looking for budget proposals to cover a contract term of three years. The agency will host a pre-proposal conference meeting on July 6, 2026. Bidders must submit all questions no later than July 13, 2026. Responses must be submitted digitally via email or online.