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This Solicitation opportunity from Nevada was posted on October 21, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Managed Care Organization (MCO)

Closed
40DHHS-S3037State & Local

Contract Overview

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

Active Opportunities Like This One

NAICS: 524114
New
Federal
PILOT PROGRAM TO ASSIST CERTAIN MEMBERS OF THE ARMED FORCES AND DEPENDENTS WITH ADDITIONAL SUPPLEMENTAL COVERAGE RELATING TO CANCER HT9402-26-RFI-0255
Solicitation # HT9402-26-RFI-0255
The Defense Health Agency is conducting market research via Request for Information HT9402-26-RFI-0255 to establish a pilot program for supplemental cancer insurance. In accordance with Section 734 of the National Defense Authorization Act for Fiscal Year 2026, the program aims to provide members of the Army, Navy, Marine Corps, Air Force, and Space Force, along with their dependents enrolled in TRICARE, with fixed indemnity supplemental benefits for non-covered cancer screening, diagnosis, and treatment expenses. The pilot program must be established by September 30, 2027, and any resulting agreements will be limited to a maximum duration of three years without the possibility of renewal. A critical requirement of this initiative is that the Government will not subsidize the cost of the insurance plans; therefore, the program must be financially viable as a 100 percent beneficiary-paid group plan. The DHA is seeking detailed information from potential carriers regarding plan types, coverage scopes, eligibility verification, premium structures, and claims processing. Evaluation factors for future awards will include technical and management functions, past performance, price, financial viability, and small business participation. Interested vendors are requested to submit written responses and may request one-on-one virtual meetings with the Government to provide further market intelligence.
Defense Health Agency

POSTED

6 days ago

DEADLINE

in about 1 month
NAICS: 524114
SLED
yearly service contract for international travel insurance last day for questions 11/3/2026
Solicitation # 50013-btb3014
The University of New Orleans is soliciting bids for a yearly service contract to provide international travel insurance for students, faculty, staff, and other participants in study abroad and international educational travel programs. The contract covers an estimated 350 to 450 participants annually with stays ranging from two weeks to one year. Required coverage includes medical benefits up to 500,000 dollars with no deductible, emergency medical evacuation, repatriation, disrupted travel arrangements, and remote mental health and telemedicine services. The selected provider must maintain a financial rating of at least A- and an A.M. Best Financial Size Category of at least VI, and must ensure a communication response time of no more than 24 hours. The award will be made on an all-or-none basis to the lowest responsible and responsive bidder. The initial contract may be extended for four additional twelve-month periods, with a maximum total duration of 60 months. Bids must be submitted in a sealed envelope to the Purchasing Office by November 12, 2026, at 2:00 PM, with the deadline for questions set for November 3, 2026. The agreement is governed by Louisiana law and includes provisions for termination for convenience with 60 days notice or for non-performance with 30 days notice. Additionally, other Louisiana governmental agencies may piggyback on the contract terms if the awarded bidder agrees.
University of New Orleans

POSTED

7 days ago

DEADLINE

in 17 days
NAICS: 524114
SLED
215269588BA - Student Health Plan
Solicitation # 215269588BA
Virginia Commonwealth University is soliciting proposals for a comprehensive, ACA-compliant Student Health Insurance Plan, requesting both fully-insured and self-insured options. The scope of work requires the provision of medical coverage that meets or exceeds current university benefits, specifically emphasizing 100% coverage for preventive services and parity compliance for mental health and substance use disorder treatments. The selected firm must maintain specific financial ratings from Moody’s, Fitch, and Standard & Poor’s and adhere to strict performance metrics, including 99% billing accuracy, 90% first-call resolution for inquiries, and 99.5% website availability. The contract includes rigorous administrative and legal requirements, including compliance with the Federal Civil Rights Act of 1964, the Americans with Disabilities Act, and FERPA for the protection of student education records. Proposals are evaluated based on technical capabilities, financial structures, and a 10% weighting for the utilization of Virginia Small Business and Supplier Diversity certified businesses. Key deliverables include the annual submission of Summary Plan Descriptions and Benefit Booklets by July 1, and the assignment of a dedicated account team with a 24-hour response time guarantee. The university reserves the right to make multiple awards and may inspect a firm's physical facilities prior to the final award.
Virginia Commonwealth University

POSTED

10 days ago

DEADLINE

in 23 days
NAICS: 524114
SLED
RIteSmiles 4-ALL Medicaid Managed Care Dental Services
Solicitation # QLV27007063
The Rhode Island Executive Office of Health and Human Services is soliciting proposals from qualified Managed Care Organizations to administer the RIteSmiles 4-ALL Medicaid Managed Care Dental Program. This initiative transitions adult Medicaid members from a fee-for-service model to a capitated risk-bearing managed care system to improve oral health outcomes and administrative efficiency. The initial contract term runs for three years from July 1, 2027, through June 30, 2030, with options for three additional one-year renewals. The state intends to select up to three qualified bidders based on technical proficiency, with a minimum passing score of 85 percent required to advance to the Impact Small Business Enterprise evaluation phase. Selected vendors must implement comprehensive care coordination, including Initial Health Assessments for new members within 90 days of enrollment and the maintenance of a Quality Assessment and Performance Improvement program guided by NCQA standards. Financial reimbursement is based on PMPM capitation rates set by state actuaries, and bidders must demonstrate the ability to establish a robust provider network through non-binding Letters of Intent. Compliance requirements are extensive, encompassing HIPAA privacy and security rules, federal non-discrimination mandates, and Rhode Island state purchasing laws. Contractors are also subject to strict oversight, including quarterly dental health record reviews and audits by the EOHHS Office of Program Integrity to prevent fraud, waste, and abuse.
State of Rhode Island

POSTED

10 days ago

DEADLINE

in 18 days

AI Contract Overview

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The Nevada Department of Health and Human Services, Division of Health Care Financing and Policy, is seeking proposals from qualified vendors to provide risk-based capitated Managed Care Organization (MCO) services. These services are intended to support the Medicaid programs under the Social Security Act Titles XIX and XXI, specifically focusing on medical assistance programs such as the State Children’s Health Insurance Program. The solicitation, titled "Managed Care Organization (MCO)," was posted on October 21, 2024, with a deadline for responses set for January 3, 2025. The contract is expected to be valued between $500 million and $1 billion, reflecting its significant scope and importance. The solicitation is managed under NAICS code 524114, which pertains to direct health and medical insurance carriers, and is categorized as a State and Local Government (SLED) procurement. Interested vendors are encouraged to review the detailed bid information through the Nevada eProcurement portal. The primary point of contact for inquiries is the Carson City Office of the Department, accessible via email at [email hidden] or by phone at [phone hidden]. This contract aims to enhance managed care services across Nevada, ensuring the delivery of comprehensive health coverage to eligible populations under the state's Medicaid and CHIP programs.

General Info

Documents

18

40DHHS-S3037 Attachment F - Technical Proposal Questions

DOCX, High priority: read this firstrfp
High

40DHHS-S3037 RFP Medicaid Managed Care Organizations

DOCX, High priority: read this firstrfp
High

40DHHS-S3037 Terms and Conditions for Goods

PDF, High priority: read this firstspecifications
High

40DHHS-S3037 Terms and Conditions for Services

PDF, High priority: read this firstspecifications
High

Attachment D - Insurance Schedule (RFP 40DHHS-S3037)

DOC, High priority: read this firstspecifications
High

Attachment E - Scope of Work

DOCX, High priority: read this firstsow
High

Attachment G - Technical Proposal Point Allocations

XLSX, High priority: read this firstevaluation-criteria
High

Attachment L - Medicaid MCO Qualifications Attestation

DOCX, High priority: read this firstrfp
High

Exhibit 18.1 Geographic Service Areas

XLSX, High priority: read this firstspecifications
High

Exhibit 18.3 System of Care Principles

DOCX, High priority: read this firstspecifications
High

Solicitation 40DHHS-S3037 - Attachment I Planned 2026 Medicaid Policy Updates

DOCX, High priority: read this firstsow
High

Solicitation 40DHHS-S3037 Attachment K Submission Checklist

DOCX, High priority: read this firstother
High

State of Nevada Contract for Services of Independent Contractor

DOCX, High priority: read this firstcontract-document
High

Vendor Information Response Form for RFP

PDF, High priority: read this firstvendor-information-response
High

Attachment R - Business Associate Agreement

DOCX, Low prioritycontract-document
Low

Exhibit 18.2 Reporting Requirements

XLSX, Low priorityexhibit
Low

Exhibit 18.4 Standard Member Material Definitions

DOCX, Low priorityother
Low

Reference Questionnaire for Nevada RFP Vendor

DOCX, Low priorityother
Low

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Timeline

PhaseClosed
Posted

Solicitation

Response Deadline

Deadline has passed

Submission Closed

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Organization & Contact Information

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AgencyNevada State of Nevada - Other
Contacts1 person available
OfficeN/A
Organization / AgencyNevada State of Nevada - Other
Office AddressN/A
Contacts
Ship To ADSD Carson City Office

Full Description

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Department of Health and Human Services Division of Health Care Financing and Policy is seeking proposals from qualified Vendors to provide risk-based capitated Managed Care Organization services designed in support of the Social Security Act Title XIX and Title XXI State Children Health Insurance Program medical assistance programs,

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