Public-Sector Health Plan Third-Party Administrator Services
Tennessee > Department of Finance and Administration > Division of Benefits Administration > State Insurance Committee > Local Education Insurance Committee > Local Government Insurance Committee
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Description
The State of Tennessee seeks up to two third-party administrators to support its self-funded State, Local Education, and Local Government Insurance Plans. Selected contractor(s) must provide efficient and broad PPO networks serving all 95 Tennessee counties and members residing or traveling nationally, along with network administration, utilization management, prior authorization, claims adjudication and payment, member services and navigation, appeals, call-center operations, benefits communications, plan websites and mobile capabilities, reporting, fraud and abuse prevention, data integration, and coordination with other health-plan contractors. The opportunity covers approximately 306,000 employees, retirees, dependents, and other covered lives. Respondents must submit separate technical and cost proposals, including required certifications, financial and credit documentation, licenses, technical responses, network and claims analyses, cost proposal, and customer references. The contract anticipates nine months of implementation, five years of service delivery beginning January 1, 2028, and an 18-month claims runout period.
Classification Codes
Smart Codes
Specifications
Timeline
Join WebexRequirements
- Commercial General Liability — $1,000,000.00
- Workers' Compensation and Employer Liability
- Professional Liability — $1,000,000.00
- Medical Malpractice — $3,000,000.00
- Cyber Liability — $3,000,000.00
- Minimum 3 references
- Within the last 2 years
- Client point of contact required for each reference
Documents
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