Health Benefits Plan TPA For Third Party Administrator Services

The County of Cape Girardeau is seeking a qualified Third‑Party Administrator (TPA) to manage its self‑funded employee health benefits program. The TPA will provide full administrative services—including claims processing, network management, enrollment, customer service, stop‑loss reinsurance, and pharmacy benefit management—for approximately 315 covered lives (262 employees plus dependents/retirees). The contract is expected to commence on or after January 1 2027, with proposals due by November 4 2026. The County requires demonstrable experience with public‑sector health plans, compliance with HIPAA/ACA, and the ability to maintain required insurance coverage. • Scope covers claim adjudication, run‑out claims, in‑house claim repricing, and transition support. • Must provide 24/7 customer service, a secure online portal, and detailed data reporting. • Proposers must submit a single integrated proposal, include references, and certify compliance with Missouri statutes. • Evaluation criteria include technical competence, cost‑saving controls, service quality, and overall value. • No electronic email submissions; sealed bids accepted in‑person, by mail, or via the county e‑procurement portal.