Ocean County Opengov #295453

Ocean County HRA Administration and Optional Stop-Loss Reinsurance

Ocean County is seeking qualified providers to administer employee HRA benefits and offer integrated stop-loss coverage. - Buyer and office - Ocean County Board of Commissioners, through the Employee Relations department; the attachment identifies the County of Ocean and the Director of Employee Relations. - The County is seeking qualifications from vendors; no service provider or OEM is named in the opportunity. - Services requested - Third-party administration of a Health Reimbursement Arrangement (HRA) to address differences between the New Jersey State Health Benefits Plan local-government Direct 2035 and Direct 10 medical and prescription benefit levels. - Administration of applicable in-network and out-of-network deductibles, coinsurance percentages and limits, out-of-pocket maximums, medical copays, and pharmacy deductibles and copays. - Employee education delivered in person and electronically, plus staffed assistance with questions about claims and procedures. - An optional integrated stop-loss reinsurance policy to limit the County’s exposure between targeted plan funding and actual costs. - Notable qualifications and requirements - Providers must have at least five years of relevant HRA third-party administration experience. - Submissions should describe assigned personnel, relevant experience and references, available support staff, and the ability to perform the work promptly. - Items and quantities - No physical products, part numbers, or fixed service quantities are specified. - Term - The initial term runs from award through the stated base-term end, with two optional one-year extensions.

Description

Ocean County Board of Commissioners requests vendor qualifications for Third-Party Administrator Health Reimbursement Arrangement services covering differences between the NJ State Health Benefit Plan local government Direct 2035 plan and Direct 10 levels for medical and prescription services. The scope includes establishing Health Reimbursement Account services, providing employee education and member inquiry support, and offering an integrated stop-loss reinsurance policy to cap the County’s cost exposure. Vendors must have at least five years of experience providing third-party administration of Health Reimbursement Arrangement services. The initial contract term runs from award through December 31, 2027, with two optional one-year extensions.

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