Self-Insured Medical Third Party Administration Services

The County of Bergen has awarded a contract to Horizon Blue Cross Blue Shield of New Jersey for self-insured medical third-party administration services. The contract is for a period of 2 years, starting from January 1, 2024, and ending on December 31, 2025. The contract includes a range of services such as claims administration, care management, and wellness programs. The vendor has proposed a range of administrative fees, including a base cost per member per month, and has also offered performance guarantees, including a 25% fee at risk for performance guarantees. The contract also includes a range of reporting requirements, including monthly experience reports and ad hoc reporting capabilities. • The contract includes a range of services such as claims administration, care management, and wellness programs. • The vendor has proposed a range of administrative fees, including a base cost per member per month. • The contract includes performance guarantees, including a 25% fee at risk for performance guarantees. • The contract includes a range of reporting requirements, including monthly experience reports and ad hoc reporting capabilities. • The vendor has also offered a range of wellness programs, including a wellness start program, a wellness improve program, and a wellness engage program. • The contract includes a range of discounts, including a $100,000 annual wellness credit, and a 5% rate cap on administrative fees for years 4 and 5.