This Subcontract opportunity from Texas was posted on January 7, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Insurance and Risk Management Services

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State & Local

Submission Closed01/12/2025, 06:00:00 PM CST

Contract Overview

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

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NAICS: 524292

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DAS Medical Plan Third-Party Administrator

Solicitation # SRC0000038100

The State of Ohio, through the Department of Administrative Services, is soliciting proposals for one or more Contractors to serve as Third-Party Administrators (TPA) for its self-insured medical plans, including Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP. The selected Contractor(s) will be evaluated by region and will be responsible for administering existing plan designs for approximately 103,000 covered lives starting July 1, 2027. Key responsibilities include the seamless delivery of medical health benefits, daily reconciliation of plan accumulators with behavioral health and prescription drug contractors, and the integration of data feeds with pharmacy, population health management, and data warehouse vendors. The contract term runs from the date of signature through June 30, 2030, with the State maintaining the option for one-month renewals. Proposals are evaluated based on a maximum of 8,800 points, with a mandatory requirement that the Contractor administer existing plan designs without exception. Financial terms include monthly ASO fees paid Net 30 and claims reimbursement within ten business days, with claims billed no more than weekly via ACH. Contractors must provide a Benefits Fund of 75,000 USD per awarded region for the initial three-year period and at least 25,000 USD per region for subsequent renewals. Performance is monitored through strict Service Level Agreements, including a 100 percent success rate for mailing ID cards within five days of enrollment. Additionally, Contractors must comply with State IT policies, HIPAA regulations via a Business Associate Agreement, and maintain licensure with the Ohio Department of Insurance.

Administrative Services

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DAS Healthcare Navigation Services

Solicitation # SRC0000040927

The State of Ohio Department of Administrative Services is soliciting proposals for a contractor to provide comprehensive healthcare navigation services for approximately 103,000 members. The primary objective is to improve the quality of care and reduce overall costs by simplifying access to care, increasing engagement in existing programs, and improving healthy outcomes. The scope of work includes providing guidance on healthcare benefits, supporting provider selection and appointment scheduling, assisting with claims and billing, and offering cost transparency tools. The selected contractor must integrate with existing Third Party Administrators and HR technology platforms and provide data insights via reporting capabilities. The contract utilizes a not-to-exceed unit cost fee structure with an initial term running from the date of signature through June 30, 2030, with potential renewals for up to four years. To qualify, offerors must meet a mandatory requirement of having provided navigation services to at least one public sector self-insured employer with at least 25,000 covered lives within the past five years. Award selection is based on the highest total score combining technical, cost, and presentation evaluations, provided a minimum technical threshold is met. The contractor must adhere to strict service level agreements, including answering calls within 20 seconds and maintaining 99.9 percent web portal availability, while complying with State IT policies and HIPAA regulations via a Business Associate Agreement.

Administrative Services

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Services in Support of the SSDC and its Programs for Medicaid Supplemental and Other Drug Rebate

Solicitation # 03410-255-27

The Department of Vermont Health Access is seeking a contractor to provide administrative support services for the Sovereign States Drug Consortium (SSDC), a multi-state collaboration focused on negotiating Medicaid supplemental drug rebates to lower costs for beneficiaries. The selected provider will be responsible for maintaining and executing the SSDC Consortium Agreement, overseeing collective services contracts, assisting member states with Medicaid State Plan Amendments and CMS negotiations, and coordinating the annual business meeting. The contract is designed for a base period of three years with an option to renew for two additional twelve-month periods, with a maximum annual payment of $60,000.00. Work is expected to average 15 to 25 hours per month at a fixed hourly rate. Applicants should possess three to five years of experience in administrative support for government entities, with a preference for expertise in pharmacy, drug rebates, or Medicaid. Evaluation is based on a 100-point scale, weighing technical responsiveness, organizational experience, and program cost, with preferences given to resident bidders and those promoting clean energy. Key performance milestones include delivering Consortium Agreement updates by November 1st and ensuring the rebate procurement contract is active by April 1st. Payment terms are Net 30, and all invoices require a two-thirds majority vote of approval from SSDC Member States. Bidders must submit a single, digitally searchable PDF by December 1, 2026, including a technical response, price schedule, and signed certifications.

Department of Economic Development

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South Dakota State TPA Workers' Compensation

Solicitation # 26RFP19880

The State of South Dakota, Bureau of Human Resources and Administration, is soliciting proposals under RFP 26RFP19880 for a licensed business partner to provide Third Party Claims Administration for its Workers Compensation Program. The scope of work includes comprehensive claims administration, medical case management, medical bill review, and Medicare, Medicaid, and SCHIP Extension Act of 2007 reporting. The selected vendor will act as a strategic partner to implement cost-containment strategies, provide risk mitigation and workplace safety guidance, and deliver real-time reporting and analytics to improve claim outcomes and employee return-to-work efforts. The contract is structured for three 12-month periods beginning July 1, 2027, and ending June 30, 2030. Proposals are due by November 25, 2026, and must be submitted electronically via email, with additional hardcopy requirements. Offerors must provide a detailed cost breakdown covering administration, implementation, legacy claim transfers, and various per-claim and service fees. Due to the nature of the data involved, the contract mandates strict adherence to Information Technology Security Policies, including HIPAA compliance, a Business Associate Agreement for protected health information, and rigorous vulnerability scanning and media sanitization protocols. Vendors must also complete a detailed security and vendor questionnaire and provide resumes for all key personnel.

South Dakota State Government

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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.

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Voluntary Dental Insurance Program DPPO

Solicitation # RFP-2026-0019

The City of Houston is seeking a qualified Dental Plan Administrator to manage voluntary dental insurance programs for its 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. Proposers must demonstrate significant experience with public sector plans of at least 25,000 lives and a minimum of five years of experience in the field. The selection process is based on a 105-point evaluation system, with 75 points allocated to technical competence, 25 points to the cost proposal, and 10 points for local preference via the Hire Houston First Program. Mandatory requirements include HIPAA compliance, adherence to the City's Cloud Governance Policy for data protection, and the submission of a WSBE Participation Plan. Key deliverables involve comprehensive plan administration, claims processing, and the provision of member materials in both English and Spanish. 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.

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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.

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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.

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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.

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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.

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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.

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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.

Procurement

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6 days ago

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in 30 days

AI Contract Overview

The City of Austin is seeking a subcontractor to provide comprehensive liability insurance and risk management services. The primary objective of this engagement is the issuance of insurance policies that specifically name the City of Austin as an additional insured party to mitigate organizational risk. This opportunity was posted on January 7, 2025, with a response deadline of January 13, 2025. The services fall under NAICS code 524292, focusing on specialized insurance and risk management expertise to support the city's operational requirements.