Enrollment and Billing Platform Request for Proposal (RFP) for Texas Health Benefits Pool
ID: K0045-EB.2025
• State: Texas
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Description
Background
The TML MultiState Intergovernmental Employee Benefits Pool, doing business as TX Health Benefits Pool, is a political subdivision risk pool established in 1979. It operates under the Texas Uniform Benefits Program and is governed by a Board of Trustees. The Pool consists of approximately 750 political subdivisions that provide health benefits to around 22,000 active employees and 33,000 total covered members.
The mission of TX Health Benefits Pool is to deliver quality healthcare benefits at exceptional value while ensuring fiscal responsibility and transparency.
Work Details
TX Health Benefits Pool is seeking proposals for a comprehensive, multi-employer enrollment and billing platform. The system must handle complexities related to managing enrollment, eligibility, and billing for diverse member groups with year-round renewals.
Key features required include:
1. User Interface & Access Management: Self-service enrollment features for mobile and PC, Single Sign-On capabilities, configurable user roles.
2. Benefits Administration: Eligibility management for all member types (Active, COBRA, Retiree), full COBRA administration capabilities, customizable Consumer-Directed Healthcare (CDH) management.
3. Document & Communication Management: Automated generation of personalized communications.
4. Data Management & Analytics: Comprehensive reporting tools, advanced data validation, robust API architecture.
5. System Administration & Configuration: Separate environments for testing and demonstrations.
6. Security & Compliance: Full HIPAA compliance and strict data segregation.
Period of Performance
The migration of membership into the new system is expected to begin between Q4 2025 and Q1 2026.
Place of Performance
The contract will be performed at the TX Health Benefits Pool's location in Austin, Texas.
The TML MultiState Intergovernmental Employee Benefits Pool, doing business as TX Health Benefits Pool, is a political subdivision risk pool established in 1979. It operates under the Texas Uniform Benefits Program and is governed by a Board of Trustees. The Pool consists of approximately 750 political subdivisions that provide health benefits to around 22,000 active employees and 33,000 total covered members.
The mission of TX Health Benefits Pool is to deliver quality healthcare benefits at exceptional value while ensuring fiscal responsibility and transparency.
Work Details
TX Health Benefits Pool is seeking proposals for a comprehensive, multi-employer enrollment and billing platform. The system must handle complexities related to managing enrollment, eligibility, and billing for diverse member groups with year-round renewals.
Key features required include:
1. User Interface & Access Management: Self-service enrollment features for mobile and PC, Single Sign-On capabilities, configurable user roles.
2. Benefits Administration: Eligibility management for all member types (Active, COBRA, Retiree), full COBRA administration capabilities, customizable Consumer-Directed Healthcare (CDH) management.
3. Document & Communication Management: Automated generation of personalized communications.
4. Data Management & Analytics: Comprehensive reporting tools, advanced data validation, robust API architecture.
5. System Administration & Configuration: Separate environments for testing and demonstrations.
6. Security & Compliance: Full HIPAA compliance and strict data segregation.
Period of Performance
The migration of membership into the new system is expected to begin between Q4 2025 and Q1 2026.
Place of Performance
The contract will be performed at the TX Health Benefits Pool's location in Austin, Texas.
Overview
Agency
Opportunity ID
K0045-EB.2025
Response Deadline
Sept. 18, 2024
Past Due
Date Posted
Aug. 19, 2024
Source
Est. Value Range
Experimental
$5,000,000 - $15,000,000
(AI estimate)
Agency Distribution
High
On 8/19/24 Texas in Texas issued Enrollment and Billing Platform Request for Proposal (RFP) for Texas Health Benefits Pool with ID K0045-EB.2025 due 9/17/24.
Contacts
Documents
Posted documents for Enrollment and Billing Platform Request for Proposal (RFP) for Texas Health Benefits Pool
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Additional Details
Class Codes
94843-Health Information Services;
94610-Accounting And Billing Services (Including Payroll Services, 3Rd Party Reimbursement For Medicare, Medicaid, Private Insurance, Etc);