Third Party Administrator for Dental Services 2027-2032

Background

The Central New York Regional Transportation Authority (CNYRTA) is seeking proposals from qualified firms for the third-party administration of dental benefits. This contract aims to ensure effective management and compliance with relevant regulations while providing quality dental services to CNYRTA employees.

Work Details

The selected proposer will be responsible for: 1. Receiving and reviewing all claims and provider billing information generated by CNYRTA personnel. 2. Conducting timely investigations of claims and invoices, ensuring compliance with HIPAA regulations. 3. Evaluating claims to determine appropriateness and coverage under the plan provisions. 4. Issuing instruments for claim settlements and utilizing CNYRTA legal services for third-party claims. 5. Answering inquiries from claimants and adjusting claims to divert activities from CNYRTA personnel. 6. Providing monthly written and verbal reports to CNYRTA personnel, complying with designated claim reporting provisions. 7. Managing payments for claims from CNYRTA’s claim account, including furnishing a monthly check registry to the VP of Finance. 8. Collecting, storing, and organizing data related to claims exposure for risk management reporting, ensuring confidentiality of all data.

Period of Performance

The contract term is five years, commencing on April 1, 2027, and expiring on March 31, 2032.

Place of Performance

The services will be performed in accordance with the operational needs of the Central New York Regional Transportation Authority.

Bidder Requirements

Proposers must demonstrate sufficient financial strength and capability to complete the performance required under this contract. They must also have experience providing similar services to entities of comparable size.