FULLY INSURED AND LEVEL FUNDED MEDICAL AND RX COVERAGE SERVICES

IDEA Public Schools is seeking proposals from qualified and experienced firms to provide Fully Insured or Level Funded Medical and RX Coverage services for eligible IDEA employees and their enrolled dependents. The selected vendor will be required to administer comprehensive medical, pharmacy, wellness, and behavioral health benefit programs in compliance with applicable federal and state regulations. The proposal should include a detailed description of the proposed service model, key assumptions and exclusions, and any deviations from the requirements outlined in the RFP. • Fully Insured or Level Funded Medical and RX Plan Administration • Behavioral Health • Diabetes Management • Fertility/Pregnancy Programs • Wellness Program / Biometric Screenings • Musculoskeletal Programs • Weight Management • Mobile App • Pharmacy Containment Solutions • Telehealth • Network access and provider management • Claims processing and adjudication • Member services and customer support • Eligibility and enrollment administration • Reporting, analytics, and compliance support • Onsite/Virtual Dedicated Representative • Wellness Funds • Implementation Funds • 2nd Year Rate Cap