MB-10579 - USA (New York) - Dependent Eligibility Verification Audit Services - Deadline November 18,2026

(1) Vendor needs to provide dependent eligibility verification audit services. – Provide all labor, technology, communications, call center support, document management, reporting, and project management necessary to complete a full medical dependent eligibility verification audit.• Protecting medical plan assets and controlling unnecessary claims cost; • Enforcing medical plan eligibility rules consistently and fairly; • Improving medical enrollment data integrity for the district, its medical TPA/carrier, and consultants; • Supporting fiduciary and compliance obligations associated with a public–school employer–sponsored medical plan. – Project kick off with District HR/Benefits, the medical TPA (UMR), and Gehring Group; confirm medical eligibility rules, populations, data feeds, and communication approvals. – Receive and securely process District medical enrollment/eligibility files – Secure collection, review, and storage of eligibility documentation for each medical Dependent. – Employee affidavit / attestation component – Web portal available 24/7 during the audit response window, plus mobile–friendly document upload. – Weekly (or more frequent) status reporting and dashboards during the project; final results report and executive presentation. – Secure transmission of medical termination/reinstatement files to the District and/or medical TPA in agreed formats and timelines. – HIPAA Business Associate Agreement (BAA) with the District.(2) All questions must be submitted no later than November 10, 2026.