Employee Benefits - Self Funded Plan: Third Party Administrator (TPA
ID: RFP# 26-06-32 , Utilization Review, Preferred Provider Organization and Health Maintanence Organization Network Access)
• State: Texas
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Description
Background
Weslaco Independent School District (ISD) is seeking proposals for a comprehensive Employee Benefits program that includes a Self-Funded Plan, Third Party Administrator (TPA), Utilization Review, Preferred Provider Organization (PPO), and Health Maintenance Organization (HMO) Network Access.
The goal of this contract is to provide effective employee benefits management that aligns with the district's mission to support its employees' health and well-being.
Work Details
The selected contractor will provide the following services:
1. Administration of a self-funded employee benefits plan including claims processing and management.
2. Access to a network of healthcare providers through PPO and HMO arrangements.
3. Utilization review services to ensure appropriate use of healthcare resources.
4. Compliance with all applicable regulations and reporting requirements, including ACA reporting under IRS sections 6055 and 6056.
5. Claims adjudication in accordance with district policies and agreements with direct provider agreements.
6. Regular reporting on claims status, utilization trends, and financial performance of the benefits program.
7. Support for COBRA administration and other related services as needed.
Period of Performance
The contract will commence upon award and is expected to last for one year, with options for renewal based on performance and mutual agreement.
Place of Performance
Services will be performed primarily at the Weslaco ISD Business Office located at 312 West 5th Street, Weslaco, TX 78599, with potential for remote service delivery as necessary.
Bidder Requirements
Bidders must demonstrate experience in providing TPA services specifically for school districts in Texas. They must also provide proof of current insurance coverage as specified in the proposal documents.
Additionally, bidders are required to submit various forms including a compliance form, references from previous clients, and a narrative detailing their business capabilities.
Weslaco Independent School District (ISD) is seeking proposals for a comprehensive Employee Benefits program that includes a Self-Funded Plan, Third Party Administrator (TPA), Utilization Review, Preferred Provider Organization (PPO), and Health Maintenance Organization (HMO) Network Access.
The goal of this contract is to provide effective employee benefits management that aligns with the district's mission to support its employees' health and well-being.
Work Details
The selected contractor will provide the following services:
1. Administration of a self-funded employee benefits plan including claims processing and management.
2. Access to a network of healthcare providers through PPO and HMO arrangements.
3. Utilization review services to ensure appropriate use of healthcare resources.
4. Compliance with all applicable regulations and reporting requirements, including ACA reporting under IRS sections 6055 and 6056.
5. Claims adjudication in accordance with district policies and agreements with direct provider agreements.
6. Regular reporting on claims status, utilization trends, and financial performance of the benefits program.
7. Support for COBRA administration and other related services as needed.
Period of Performance
The contract will commence upon award and is expected to last for one year, with options for renewal based on performance and mutual agreement.
Place of Performance
Services will be performed primarily at the Weslaco ISD Business Office located at 312 West 5th Street, Weslaco, TX 78599, with potential for remote service delivery as necessary.
Bidder Requirements
Bidders must demonstrate experience in providing TPA services specifically for school districts in Texas. They must also provide proof of current insurance coverage as specified in the proposal documents.
Additionally, bidders are required to submit various forms including a compliance form, references from previous clients, and a narrative detailing their business capabilities.
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Overview
Agency
Opportunity Type
Request for Proposal
Opportunity ID
RFP# 26-06-32 , Utilization Review, Preferred Provider Organization and Health Maintanence Organization Network Access)
Response Deadline
May 19, 2026
Past Due
Date Posted
April 27, 2026
Source
Est. Value Range
Experimental
$500,000 - $2,000,000
(AI estimate)
Agency Distribution
Moderate
On 4/27/26 TX in Texas issued Request for Proposal Employee Benefits - Self Funded Plan: Third Party Administrator (TPA with ID RFP# 26-06-32 , Utilization Review, Preferred Provider Organization and Health Maintanence Organization Network Access) due 5/19/26.
Contacts
Documents
Posted documents for Employee Benefits - Self Funded Plan: Third Party Administrator (TPA
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