Third-Party Administrator (TPA) Services for a Self-Funded Health Plan Featuring Preferred Provider Organization Networks and Wellness & Disease Management Program options

The Brownsville Independent School District (BISD) is seeking a Third-Party Administrator (TPA) to provide services for its self-funded health plan, which features preferred provider organization networks and wellness & disease management program options. The selected TPA will be responsible for administering the plan, including claims processing, eligibility determination, and customer service. The contract is expected to be for a 3-year term, with the option for renewal. The proposal should include information on the TPA's experience, qualifications, and fees, as well as a description of the services to be provided. Some of the key services required include: * Claims administration * Eligibility determination * Customer service * Provider network management * Wellness and disease management programs * Actuarial services * Cobra administration * Subrogation investigation and recovery The proposal should also include information on the TPA's internal control procedures, key personnel, and references. * The TPA must be licensed in Texas and have at least 5 years of experience in administering self-funded health plans. * The TPA must have a strong network of providers and be able to negotiate competitive rates. * The TPA must have a robust customer service program, including 24/7 support and Spanish-speaking representatives. * The TPA must be able to provide detailed reports and analytics on plan performance and utilization.