Third Party Administrator for HOPS and PA Programs

The Public School Employees' Retirement System (PSERS) is seeking a third-party administrator to provide recordkeeping and administrative services to the Health Options Program (HOP) and Premium Assistance Program (PAP). The selected administrator will be responsible for claims adjudication, eligibility and administrative services, and other related tasks. The contract is expected to be a fixed-price and/or unit-price contract with a term of 5 years. The selected administrator will be required to meet Small Diverse Business (SDB) and Veteran Business Enterprise (VBE) participation goals. Some key features of the program include: • HOP provides group health insurance coverage for eligible members, with various plans and services available, including Medicare supplement plans, Medicare Rx plans, and Medicare Advantage plans. • PAP provides a health insurance premium subsidy of up to $100 per month for eligible annuitants. • The selected administrator will be responsible for providing customer service, claims processing, and other administrative tasks. • The contract will include performance guarantees with financial penalties for non-performance. • The selected administrator will be required to submit utilization reports and comply with SDB and VBE participation requirements.