RQ6057: Medical & Prescription Drug 3rd Party Adm

This solicitation seeks a third‑party administrator to manage Cuyahoga County’s self‑funded medical and prescription‑drug benefit plans for the 2022 plan year. The scope includes claims adjudication, enrollment support, ID‑card issuance, wellness‑program integration, extensive reporting, and coordination of benefits, as well as 340B drug program administration and data‑analytics deliverables. Vendors must provide detailed methodology for claim repricing, disruption analysis, and must be capable of interfacing with the County’s OneDrive data repository and TruBid submission platform. The contract is a one‑year term with two optional one‑year renewals, demanding compliance with extensive insurance requirements and a robust customer‑service operation. • Provides full TPA services: claims processing, enrollment, ID cards, wellness integration, and reporting. • Requires data‑intensive repricing and disruption analysis, including 340B adjudication and TruGuard monitoring. • Mandatory delivery of weekly claim files, periodic management reports, and adherence to strict insurance and cyber‑risk coverage limits.