Third Party Administrator for Employee Medical Plan

The City of Toledo is seeking a Third-Party Administrator (TPA) to provide administrative services for its self-funded medical benefits plan. The selected TPA will be responsible for claims administration, compliance, member support, reporting, and other related services. The contract is expected to be for 3 years, with the option for two 1-year renewals. The TPA will need to provide a range of services, including claims processing, eligibility and enrollment management, customer service, and provider network integration. The City is looking for a TPA with experience in providing administrative services for public sector employers and a strong understanding of local, state, and federal standards and regulations. • Claims administration • Eligibility and enrollment management • Customer service • Provider network integration • Compliance and regulatory services • Reporting and data management • Technology and security • Performance standards and service levels • Implementation and transition support • Account management and governance