Medicare Advantage Third Party Administrative Services

The County is seeking a vendor to provide third-party administration services for its sponsored medical and pharmacy fully-insured Medicare Advantage Plan. This plan serves retired county employees and their dependents. The selected administrator must manage the plan in strict compliance with agency specifications, applicable laws, and regulations. The scope of work requires the administrator to provide plan brochures, member reports, and member identification cards at no charge to the County or the members. The administrator must maintain stable contractual relationships with practicing providers and deliver timely, accurate claims processing. Required clinical services include case management for complex cases, clinical management for chronic conditions, wellness programs, and a responsive nurse inquiry line. The agency requires the administrator to participate in monthly service calls and provide annual experience reports to the County and its consultant. The administrator must provide an annual communication allowance of up to $5,000.00 for communication-related expenses. Additionally, the administrator must provide a first-year implementation budget of up to $5,000.00 to cover costs associated with transitioning to a new vendor or revising eligibility files. Eligibility is restricted to onshore organizations based in the United States. The agency permits the performance of all work to occur offsite. Bidders must submit their proposals digitally via email or through the designated online portal. The agency is currently looking for proposals to establish the budget for these services. The key dates for this procurement include a pre-bid meeting scheduled for July 8, 2026. Bidders must submit all questions regarding the opportunity no later than July 14, 2026.