# Cape Girardeau County Ionwave #RFP #04-04NOV26

Integrated TPA, Stop-Loss, and Pharmacy Benefit Management for Cape Girardeau County

**Posted:** October 21, 2026
**Respond By:** November 04, 2026
**Identifier:** RFP #04-04NOV26
**NAICS:** 524292, 524130, 524298

Cape Girardeau County, Missouri, is seeking an integrated administrator for its self-funded employee health benefits plan.
- **Government buyer:** Cape Girardeau County, Missouri (County of Cape Girardeau); County Commission and Office of the County Clerk are identified in the materials.
- **Scope:** One integrated proposal for third-party administration (TPA), stop-loss reinsurance, and pharmacy benefit management (PBM) for about 262 full-time employees and 315 covered lives.
- **Requested services:** Claims processing and prior-plan claims run-out; network management; eligibility and enrollment support; member and employer customer service; coordination of benefits; utilization and case management; detailed reporting; and prescription drug management.
- **Provider coordination:** Reprice claims for locally contracted providers, apply agreed rates, support direct or employer-negotiated provider contracts, and perform claim edits.
- **Transition and advisory support:** Analyze existing plans and systems, recommend improvements, support implementation and enrollment, conduct employee information meetings and training, provide ongoing assistance, and advise on healthcare reform compliance and wellness planning.
- **Notable requirements:** Relevant public-sector self-funded plan experience, sufficient technical and financial capacity, compliance with applicable requirements including HIPAA and the ACA, a dedicated customer-service team with toll-free support and a secure online portal, and appropriate liability and errors-and-omissions insurance.
- **Named vendors in reference materials:** **Express Scripts (ESI)** and **Symetra** are mentioned in supporting plan materials; neither is identified as the selected or required provider. No specific OEM, commercial product, part number, or product quantity is requested.
- **Timing:** The anticipated start is in 2027; contract length and renewal options are not stated.

### Description

Cape Girardeau County is seeking proposals from qualified third-party administrators to administer its self-funded employee health benefits program. The requested integrated services include claims processing, network management, eligibility and enrollment support, customer service, coordination of benefits, utilization and case management, data reporting, stop-loss reinsurance, and pharmacy benefit management. The scope also includes transition assistance, ongoing plan support, and administration of claims run-out where needed. Proposals are due November 4, 2026, at 10:30 a.m. CT; fax and email submissions will not be accepted, and electronic submission through the county bid portal is optional.

[View original listing](https://capecountybids.ionwave.net/PublicDetail.aspx?bidID=59&SourceType=1)