This Subcontract opportunity from Missouri was posted on August 7, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Health Insurance Case Management & Coordination

Closed

State & Local

Submission Closed09/09/2024, 07:00:00 PM CDT

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

Active Opportunities Like This One

NAICS: 524292

New

SLED

Paid Family and Medical Leave (PFML) Administration Services

Solicitation # RFI-063

Isle of Wight County, Virginia, has issued a Request for Information (RFI-063) to identify qualified vendors capable of administering and ensuring compliance with the statewide Paid Family and Medical Leave (PFML) insurance program enacted in spring 2026 under SB 2 / HB 1207. The scope of work encompasses comprehensive leave administration, including intake, eligibility tracking, and coordination between federal FMLA, Virginia PFML, and company policies. Additionally, the county seeks support for state program coordination with the Virginia Employment Commission (VEC), the potential design and underwriting of a private employer plan, and the provision of technology solutions such as employee and manager portals for case management. This procurement is strictly for market research and planning purposes and does not commit the county to a formal contract award. Interested respondents must submit their technical proposals through the procurement portal by November 30, 2026, utilizing a specific template that covers corporate profiles, technical approaches, and non-binding budgetary pricing. Key deliverables include training materials, reporting on utilization and costs, and regulatory monitoring to ensure alignment with evolving VEC rules. All submissions are subject to public disclosure laws, and the county advises against including trade secrets unless essential to the response.

POSTED

DEADLINE

Voluntary Dental Insurance Program DPPO

Solicitation # RFP-2026-0019

The City of Houston is seeking proposals for a qualified Dental Plan Administrator to manage voluntary dental insurance programs for city employees, eligible dependents, and non-Medicare eligible retirees. The objective is to secure a single partner to provide fully insured DHMO and DPPO dental plans while improving member experience, operational efficiency, and overall dental health outcomes. The contract is structured for an initial three-year term with two optional one-year renewals, for a maximum total duration of five years. The selected administrator will be responsible for plan administration, claims processing, member services, and the delivery of robust data reporting and cost containment strategies. Proposers must meet strict minimum requirements, including licensing and a proven track record of administering public sector plans with at least 25,000 lives for at least five years. Evaluation is based on a 105-point scale, heavily weighting technical competence (75 points) across experience, team qualifications, and technical approach, alongside cost proposals (25 points) and local preference points (10 points) via the Hire Houston First program. Key compliance mandates include HIPAA adherence, City of Houston Cloud Governance policies, and the submission of a Women and Small Business Enterprise participation plan. Performance will be monitored through specific guarantees regarding ID card delivery and reporting cadences, with the City maintaining the right to conduct unannounced audits of records and equipment.

POSTED

DEADLINE

Employee Benefits- Life/STD/FSA/HSA/COBRA

Solicitation # 27-011CH-32RFP

The Tempe Union High School District #213 is soliciting proposals under RFP 27-011CH-32RFP for the procurement and administration of employee benefits for approximately 1,123 eligible employees. The scope of work includes Basic and Voluntary Life and Accidental Death and Dismemberment (AD&D), Short-Term Disability (STD), Flexible Spending Account (FSA), Health Savings Account (HSA), and COBRA administration. The intended contract period runs from July 1, 2027, through June 30, 2032, with an initial term from March 15, 2027, to March 14, 2028. Key requirements include the waiver of pre-existing condition limitations for initially enrolled participants, the elimination of active-at-work restrictions, and a guarantee that no employees or dependents suffer a loss of benefits due to a change in carriers. The District will award contracts by individual product lines, seeking the fewest number of vendors possible. Evaluation is based on a point formula system considering responsiveness, qualifications, cost, and past performance, though award is not based on price alone. Proposals must be submitted via the OpenGov portal by November 19, 2026, with technical responses and cost proposals uploaded separately to ensure a blind review. Required documentation includes a notarized Non-Collusion Affidavit, W-9, Certificate of Insurance, and a completed vendor questionnaire. Selected providers must provide a designated account management team and a toll-free call and claim unit, with strict delivery timelines for welcome packets and eligibility updates.

POSTED

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Employee Benefits- Medical/Rx/EAP RFP

Solicitation # 27-012CH-32RFP

The Tempe Union High School District #213 is soliciting proposals for Employee Health Benefits, specifically covering Medical, Pharmacy (Rx), and Employee Assistance Program (EAP) services. The procurement seeks a Third-party Administrator (TPA) for claims and network management, a Pharmacy Benefit Manager (PBM), and EAP services for approximately 11,000 students and eligible employees. The District intends to maintain an Administrative Services Only (ASO) arrangement and is considering the addition of a qualified High Deductible Health Plan (HDHP). The initial contract term is scheduled from March 15, 2027, through March 14, 2028, with options for four additional one-year renewals, though PBM services are specifically requested for a five-year initial term effective July 1, 2027. Proposals are due by November 19, 2026, and will be evaluated based on responsiveness (35%), qualifications (30%), cost (25%), and past performance (10%). Awards will be made by individual product lines to the least number of vendors necessary. Key requirements include the provision of a designated account management team, bilingual communication materials, and a customer service unit operating Arizona time. Performance guarantees include a 98% error-free claims coding target, with significant penalties for failure to resolve escalations or meet member satisfaction rates. Compliance mandates include adherence to Arizona state procurement rules, non-discrimination laws, and certifications against the use of forced labor.

POSTED

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FY2027 Maryland Member Assistance Fund Program Administration

Solicitation # BPM059326

The Maryland Department of Service and Civic Innovation (DSCI) is soliciting proposals for a third-party administrator to manage the Maryland Member Assistance Fund. The selected contractor will be responsible for the end-to-end administration of a financial assistance program, including the operation of a secure, cloud-based, mobile-friendly application portal, eligibility review, applicant communications, and the disbursement of approved funds. Key deliverables include an implementation and onboarding plan and monthly activity reports. Disbursements must be processed via secure electronic methods within two to five business days or via physical checks within seven to fourteen business days. The contract has an estimated value not to exceed $100,000, with assistance funds treated as pass-through funds that cannot be marked up. Award will be based on best value, evaluating technical merit and price, with a focus on relevant experience in administering hardship or grant programs, the qualifications of key personnel, and the proposed portal architecture. The contractor must adhere to strict confidentiality and data security standards, including a Data Use Agreement and compliance with the Protection of Information by Government Agencies provisions. Furthermore, the contractor must comply with various federal and state regulations, including the Rehabilitation Act of 1973, the Civil Rights Act of 1964, and the Pro-Children Act of 1994. All final approvals and disbursements require DSCI authorization unless otherwise delegated in writing.

POSTED

DEADLINE

RFP 2027-283 PHARMACY BENEFIT CONSULTING SERVICES

Solicitation # BD-26-1145-1145C-1145L-135168

The City of Chelsea, Massachusetts, has issued solicitation BD-26-1145-1145C-1145L-135168 for Pharmacy Benefit Consulting Services. This open market solicitation, categorized under UNSPSC Code 84-13-00 for insurance and retirement services, seeks a provider to deliver specialized consulting services. The RFP was posted on November 5, 2026, and interested parties must submit their responses by the deadline of December 3, 2026, at 3:30 PM. The project is managed by the City of Chelsea Purchasing Department, with Ledia Koco serving as the primary point of contact. Performance of the services will take place within Chelsea, Massachusetts. While the solicitation specifies a quantity of one for the consulting services, the specific unit costs and total contract value have not been disclosed. Further details regarding the RFP are available on the City of Chelsea's official purchasing website.

POSTED

DEADLINE

Notice of Intent to Solicit Proposals: Employee Health Plan Benefits Administration

Solicitation # 27-018-1

Charles County Government is soliciting proposals under solicitation number 27-018-1 for qualified firms to provide comprehensive benefit administration and support services for its employee and retiree medical, pharmacy, dental, and vision benefit plans, including stop-loss reinsurance. The selected vendor or vendors will be responsible for delivering cost-effective, high-quality services. Proposals will be evaluated based on pricing, regulatory compliance, administrative services and programs, and provider networks. Interested firms must submit a Notice of Intent Form via the OpenGov portal by 8:00 am on November 23, 2026, to be eligible to receive the full RFP. Final proposals are due electronically by 11:00 am ET on December 9, 2026. All communications must be directed solely to Shanna Reese, the Chief of Purchasing, as any unauthorized contact with the County or its consultants may result in disqualification. Only electronic submissions are accepted; physical delivery methods are strictly prohibited.

POSTED

DEADLINE

Flexible Spending Account and COBRA Administration

Solicitation # 3-1226

The Phoenix Union High School District is soliciting proposals for the administration of Flexible Spending Accounts (FSA)—specifically Health Reimbursement, Dependent Care, and Limited Purpose accounts—and COBRA administration for the plan year running from July 1, 2027, through June 30, 2028. The selected contractor will be responsible for claims administration, including providing debit cards for health care reimbursement and weekly check runs for dependent care, as well as managing COBRA billing, premium collection, and the issuance of W2 and 1099 forms. All services must be performed within the United States, and the contractor must adhere to the District's Benefit Plans and Section 4980B(b) of the Revenue Code. Award decisions will be based on a points-based evaluation to determine the most qualified firm rather than relying solely on the lowest price. Proposals must be submitted electronically via the OpenGov E-Bid system by December 10, 2026, and must include a vendor introduction letter, a financial workbook in Excel format, and a vendor questionnaire. The contract mandates compliance with the Davis-Bacon Act, the Contract Work Hours and Safety Standards Act, and various state executive orders regarding non-discrimination. Payment terms are set at net 30 days, with all billing directed to the District's Accounts Payable Department.

POSTED

DEADLINE

DAS TELEHEALTH ADMINISTRATION

Solicitation # SRC0000042016

The State of Ohio, through the Department of Administrative Services, is soliciting proposals for a contractor to administer telehealth benefits for approximately 103,000 covered lives, including employees and their dependents. The selected contractor will manage telehealth services across three plan options: Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP. Key responsibilities include claims management, member services, and the delivery of urgent care, primary care, behavioral health, and specialty services. The contract runs from the date of signature through June 30, 2030, with potential for mutual renewals up to four additional years. A critical milestone is the requirement for a full implementation plan to be ready for open enrollment by May 1, 2027, with a formal go-live date of July 1, 2027. The contractor must adhere to strict technical and security standards, including the State IT Policy, OAKS General Interface File and Transfer Requirements, and HIPAA compliance via a Business Associate Agreement. Performance will be measured by a 99.9 percent availability rate for digital platforms and a minimum 60 percent member satisfaction score. Compensation is based on a per enrolled employee per month administrative fee, alongside specific claim costs for various visit types. Award selection is based on the highest total score derived from technical, cost, and presentation evaluations, with a minimum technical threshold of 1,620 points required to avoid disqualification. Amendment 1 specifically removed the requirement to work with the State's data warehouse and updated the required specialty services and fees at risk.

Administrative Services

POSTED

DEADLINE

ASRS Long-Term Disability Program Administration

Solicitation # BPM007853

The Arizona State Retirement System (ASRS) is seeking qualified companies under solicitation BPM007853 to provide comprehensive administration for its Long-Term Disability (LTD) Program. The scope of work includes managing participant eligibility based on prevailing medical standards, handling financial management and overpayment collections, and providing offset services for benefits such as Social Security and workers' compensation. Key performance requirements include maintaining a call abandonment rate of 10% or less and providing a dedicated account representative and toll-free call center. The selected contractor must deliver an implementation plan to ensure operational readiness by a target date of July 1, 2027, and provide annual comprehensive analyses, financial accountings, and independent operational audits such as SSAE-18. The contract will be awarded based on the best advantage to the ASRS, with evaluation focusing on methodology, administrative capability, and the competitiveness of the proposed fee structure. Strict cybersecurity and data protection standards are required, including GovRAMP certification and compliance with Arizona Department of Homeland Security standards. The initial contract term is twelve months from the effective date. Offerors must submit a detailed proposal via the Arizona Procurement Portal by December 3, 2026, including a pricing schedule, security audit reports, and a disaster recovery plan. Payments will be processed via ACH or purchasing card in accordance with Arizona Revised Statutes.

Arizona State Retirement System

POSTED

DEADLINE

EMPLOYEE HEALTH PLAN BENEFITS ADMINISTRATION

Solicitation # 27-018

Solicitation 27-018 is a procurement opportunity issued by the state of Maryland for Employee Health Plan Benefits Administration. The solicitation was posted on November 4, 2026, with a response deadline of November 23, 2026, at 1:00 PM. The project is designated as a SLED organization procurement and will be performed within the state of Maryland. The procurement includes a specific minority business enterprise goal of 0.25. Shanna Reese serves as the primary point of contact and Procurement Officer for this action. While the solicitation establishes the administrative framework for health plan benefits, specific details regarding the statement of work, contract value, and evaluation factors were not provided in the available documentation.

POSTED

DEADLINE

26-70009-000 - Statewide Integrated Health Care Provider Network RFP

Solicitation # 26-70009-000

The California Department of State Hospitals is soliciting proposals for a Statewide Integrated Health Care Provider Network to provide community-based specialty medical services. The selected single service provider will be responsible for managing a Health Care Provider Network along with Third Party Administration and a Utilization Management system, including Prior Authorization services. The contract is anticipated to begin on March 1, 2027, for an initial term of three years, with the option to extend for up to two additional one-year terms. Performance requirements include the delivery of business continuity, disaster recovery, and transition-out plans within 60 days of the effective date, as well as the provision of all necessary shipping and labeling materials for biological and pathological specimens. Proposals are due by December 7, 2026, and will be evaluated through a three-phase process consisting of responsiveness and responsibility checks, technical scoring, and interviews for the top three candidates. The award is based on a maximum score of 150 points, divided between technical capabilities and cost. Qualified proposers must meet minimum requirements, including providing three professional references and proof of the legal right to do business. The contractor must adhere to strict clinical and regulatory standards, including HIPAA, CMIA, and NCQA guidelines, and is required to maintain performance and payment bonds not less than the total contract price.

California Department of State Hospitals

POSTED

4 days ago

DEADLINE

in about 1 month

AI Contract Overview

The Health Insurance Case Management and Coordination subcontract, issued by Jefferson County, Missouri, focuses on the comprehensive coordination of health care services for juvenile beneficiaries. The scope of work includes critical administrative and clinical support tasks such as verifying insurance eligibility, processing claims, scheduling appointments, and tracking care plans to ensure consistent health service delivery. This opportunity was posted on August 7, 2024, with a response deadline of September 10, 2024. Classified under NAICS code 524292, the contract seeks a provider capable of managing the complex intersection of insurance navigation and patient care coordination within the county's juvenile health framework.

General Info

Agency

Missouri → Jefferson County

NAICS

524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Place of Performance

MO, USA

Set-Aside

NONE

Documents

This scope was carved out of 24-0059.

The full solicitation package (3 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Health Care Services - Juvenile 2024

AI Contract Breakdown

Uniform Contract Format

No documents to break down

The breakdown needs solicitation documents. None were found from this contract's source.

Timeline

PhaseClosed

PostedAug 7

subcontract

Response DeadlineSep 9

Deadline has passed

Submission Closed

09/09/2024, 07:00:00 PM CDT

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Organization & Contact Information

AgencyMissouri → Jefferson County

ContactsNo contacts available

OfficeN/A

Organization / AgencyMissouri → Jefferson County

Office AddressN/A

ContactsNo contact information available

Full Description

Coordination of health care services including insurance eligibility verification, claims processing, appointment scheduling, and care plan tracking for juvenile beneficiaries.