MB-10443 - USA (Arizona) - Medical Third-Party Administrator Services - Deadline October 2,2026

(1) Vendor needs to provide medical third–party administrator services.• Medical TPA solution that includes claims administration, medical case management and utilization review/disease management (UM/CM/DM), medical network access, COBRA administration, telemedicine, and wellness services. • Claims Administrators that support independent claims accuracy/audit services and can identify firms that are pre–approved, pre–authorized, or pre–integrated into their claims administration system.• Provide claims forms.• Receive claims and process payments of benefits in accordance with the plan designs.• Correspond with participants and providers if additional information is necessary to complete processing of claims.• Determine, based on the district’s medical necessity guidelines, benefits payable under the Plan, pursuant to the terms and conditions of the district’s Benefit plan.• Provide a designated Account Manager and Account Management Team.• Provide 24/7 telemedicine services.• Access to claims administration portal for employees to view claim status, EOB’s, etc.• Employer and designated consultant access to claims data reporting portal to view and download online reports.• Provide customer service to answer inquiries on claims, eligibility, provider network, services, coverage, or other inquiries Monday through Friday from 8:00 AM to 6:00 PM (AZ time).• Prepare and provide Benefit presentations in collaboration with District, as requested.• Attend open enrollment meetings, as requested.• Provide identification card generation, mailing, and associated costs, including Pharmacy Benefit Management (PBM) and EAP provider’s information.• Administer eligibility based on the district’s eligibility criteria.• Accept electronic eligibility files from the Benefits Administration system (Employee Access, previously known as iVisions).(2) All questions must be submitted no later than September 14, 2026.