(1) Vendor needs to provide medical and dental third-party administrator service.
- The City's medical plans include complexities requiring a third-party administrator capable of administering multiple plans and sub-entities as well as multiple retiree classes.
- To find an administrator who is highly competent in care management and claims administration, regulatory compliance, with a focus on high quality customer service, and a comprehensive network.
- The third-party administrator will handle all utilization and large case management using an integrated national network.
1. Hometown Health
- 1,440 total active employees and 260 retirees
2. Prominence administrative services
3. Dental administered by prominence
- 2,630 active and retiree for dental administration
- Guardian dental access fee
- Dental enrollment is higher than medical enrollment due to post-65 retirees who have Medicare, but retain city dental
4. Other vendors and integration and files and fixed costs and information
- Prominence currently retains full enrollment data including Hometown medical enrollment.
- Prominence pays vision, stop loss, Included Health and other fixed cost vendors
- Flexible spending account is with hr simplified
- Dependent Care and Medical Reimbursement with rollover
- Currently enrolled: 169 in medical reimbursement and 33 in dependent care
(2) All questions must be submitted no later than May 30, 2023.
(3) The contract will be one year.
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