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 a self-funded health plan featuring 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 TPA will also be required to provide performance guarantees, including customer service and claims administration performance guarantees. The contract will be for a period of three years, with the option to renew for an additional two years. • The TPA must be licensed in Texas and have 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 to the District. • The TPA must be able to administer all plan design components, including wellness and disease management programs.