MB-10406 - USA (Virginia) - Medical Plan Administration Service - Deadline September 16,2026

(1) Vendor needs to provide medical plan administration service. – Provide administration of their Medical Insurance TPA program for active employees and pre–65 retirees only.– Medical administration arrangements:• Medical ASO option with pharmacy carved in (integrated)o Pharmacy services will be provided by the medical TPA.• Medical ASO option with pharmacy carved out– General Administrative Services the Administrator shall provide comprehensive administration of the medical benefit program, including:• Provide full–service administration of the agency's self–funded medical plan.• Administer benefits in accordance with plan documents, summary plan descriptions, amendments, and applicable federal and state regulations.• Ensure comprehensive compliance and regulatory support, to include requirements• Maintain adequate staffing, operational controls, and quality assurance programs.• Assign a dedicated account management team.• Conduct regular account reviews and strategic planning meetings.• Provide monthly claims and utilization reporting.• Provide comprehensive, well–organized communication of wellness and ancillary programs to ensure employees are fully aware of available resources.– The Administrator shall provide comprehensive administration of the medical benefit program, including:• Maintain eligibility files and enrolment records.• Process eligibility additions, terminations, and status changes.• Support electronic eligibility transmission and data exchange.• Provide online enrolment and eligibility verification capabilities.• Reconcile enrolment data with payroll and benefit administration systems.– The Administrator shall provide comprehensive administration of the medical benefit program, including:• Adjudicate medical claims accurately and timely.• Apply plan provisions, deductibles, copayments, coinsurance, and out–of–pocket maximums.• Coordinate benefits with other coverage.• Manage recovery activities.• Process appeals and grievances in accordance with regulatory requirements.• Provide claim payment funding and disbursement options.– The Administrator shall provide comprehensive administration of the medical benefit program• Provide toll–free telephone support.• Offer secure online and mobile access.• Respond to participant inquiries regarding(2) All the questions must be submitted no later than September 11, 2026.