Third Party Administrator (TPA) — Management of HIS Reimbursement Requests and Actuarial Services and Administration of Preventive Medicine

Description

Lot 1: the objective is to select a service provider acting as a Third Party Administrator (TPA) i.e. an organisation that administers the HIS scheme for the EIB, processing reimbursement requests, determining eligibility of medical costs, facilitating access to medical care, and more generally improving the price-quality ratio of care. The TPA will also provide actuarial services related to the IFRS accounting and actuarial studies on the HIS financial sustainability. Lot 2: the objective is to select a service provider for administering and centralising the provision of full medical examinations to the beneficiaries lot II, i.e. an organisation that administers the preventive medicine assessments for EIB Group. The service provider shall also provide a network of health care institutions where the beneficiaries will be able to undergo harmonised and high quality preventive medical examinations. The objective is to select a service provider acting as a Third Party Administrator (TPA) i.e. an organisation that administers the HIS scheme for the EIB, processing reimbursement requests, determining eligibility of medical costs, facilitating access to medical care, and more generally improving the price-quality ratio of care. The TPA will also provide actuarial services related to the IFRS accounting and actuarial studies on the HIS financial sustainability. The TPA will have to interact efficiently with the various stakeholders of the health insurance: the provider of medical assistance (PMA), the insurer of work-related medical expenses (IWME), the provider of the preventive medicine services (PPM), the EIB internal team Caisse de Maladie (CDM), the EIB internal and external actuaries, the EIB accounting team and the dedicated EIB contract manager within the HR Operations Department. The objective is to select a service provider for administering and centralising the provision of full medical examinations to the beneficiaries lot II, i.e. an organisation that administers the preventive medicine assessments for EIB Group. The service provider shall also provide a network of health care institutions where the beneficiaries will be able to undergo harmonised and high quality preventive medical examinations. This service provider will have to interact efficiently with EIB Group’s OHP and the dedicated EIB contract manager within the employee relations and wellbeing division.