Cape Girardeau County Ionwave #RFP #04-04NOV26 Addendum 1

Integrated administration for Cape Girardeau County’s self-funded employee health benefits plan

Cape Girardeau County, Missouri is seeking an integrated administrator for its self-funded employee health benefits plan. - Government buyer: Cape Girardeau County, Missouri; County Commission and County Clerk. - Scope and population: One coordinated proposal for administration of a plan serving approximately 262 employees and 315 covered lives. - Services requested: Claims administration, including prior-plan claims run-out if needed; provider-network management; eligibility and enrollment support; member and employer service; coordination of benefits; utilization and case management; reporting; stop-loss reinsurance; and pharmacy benefit management. The County also needs transition support, employee meetings and training, ongoing plan administration and support, benefits consulting, wellness-plan and healthcare-reform support, process-improvement recommendations, and in-house repricing for locally contracted providers outside the national network. - Named vendors in existing or reference materials: Express Scripts (ESI) is identified in the plan materials; Symetra is also named; and McGriff, a Marsh & McLennan Agency LLC, is the current employee-benefits broker of record. McGriff representatives named in the addendum are Jonathan Frisch and James Broglen. - Notable requirements: Public-sector self-funded plan experience; compliance with applicable laws, including HIPAA and the ACA; a dedicated service team, toll-free member support, and a secure online portal; and demonstrated technical, organizational, and financial capacity. The County requests a coordinated solution with transition-cost information, service and response-time details, governmental references, and assigned personnel qualifications. - Performance timing: The selected provider is expected to begin in 2027. Contract duration and option periods are not specified.

Description

Cape Girardeau County, Missouri is seeking proposals from qualified third-party administrators to administer its self-funded employee health benefits program. The selected TPA is expected to provide an integrated solution including 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 covers transition support, ongoing plan administration, and claims run-out when needed. Proposals are due November 4, 2026, at 10:30 AM CT; optional electronic sealed-bid submission is available through the County bid portal, and fax or email proposals are not accepted.

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