Employee Benefits - Self Funded Plan: Third Party Administrator (TPA), Utilization Review, Preferred Provider Organization (PPO) and Health Maintanence Organization (HMO) Network Access

The Weslaco Independent School District (Weslaco ISD) is seeking a Third Party Administrator (TPA) to provide utilization review, preferred provider organization (PPO), and health maintenance organization (HMO) network access for its employee benefits self-funded plan. The TPA will be responsible for processing claims, providing customer service, and ensuring compliance with relevant laws and regulations. The contract is expected to be awarded at the WISD public school board meeting, and the selected TPA will be required to provide a range of services, including claims processing, network management, and reporting. • Key services required: claims processing, utilization review, PPO and HMO network access, customer service, and compliance with relevant laws and regulations • The TPA will be required to provide a range of reports, including claims reports, network reports, and financial reports • The TPA will be expected to have experience in providing TPA services to school districts in Texas • The TPA will be required to have a strong network of providers in Hidalgo County and surrounding areas