Description
The State of Ohio is seeking a single contractor to administer tele‑health benefits for its self‑insured medical plan (Ohio Med) covering roughly 103 k lives. The contractor will manage 24/7 virtual primary, urgent, behavioral‑health, and specialty care, handle data integration with multiple TPAs, process eligibility files, operate member‑service channels, and provide extensive reporting and quality‑assurance activities. The award will be a unit‑cost, per‑employee‑per‑month ASO fee with a benefits fund, and the contract runs until June 30 2030 with possible one‑month and multi‑year renewals.
• Administer tele‑health claims, enrollment, and member services for PPO, Select, and HDHP plan designs (no exceptions).
• Provide 24×7 access, member portal/mobile app, and multilingual support meeting strict wait‑time SLA metrics.
• Integrate eligibility (834) and claim data via OAKS SFTP interface, deliver quarterly analytics, and maintain a nationwide provider network with annual audits.