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This Solicitation opportunity from Texas was posted on April 10, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Medical Plan, Pharmacy Benefit Management (PBM), and Third-Party Administrator (TPA) / Claims Payor Services

Closed
26-04-01 Addendum 2State & Local

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
RFP-746-2500000254-4 | Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684
Solicitation # RFP-746-2500000254-4
The Commonwealth of Kentucky Cabinet for Health and Family Services, Department for Medicaid Services, is soliciting proposals for Financial Management Services (FMS) to support Participant-Directed Services (PDS) across five 1915(c) Medicaid waiver programs: Acquired Brain Injury, ABI Long Term Care, Home and Community Based, Michelle P. Waiver, and Supports for Community Living. Serving approximately 15,640 participants, the selected vendor will be responsible for critical operational tasks including electronic visit verification, claims processing, payroll, tax assistance, and financial reporting. The contract requires a seamless transition from the current vendor and mandates adherence to PMI standards for project management. Technical requirements include integration with the Kentucky Online Gateway for identity and access management using SAML 2.0, OIDC/OAuth 2.0, and WS-Fed protocols. Vendors must comply with Commonwealth Office of Technology standards, ensuring all data remains within the contiguous United States and adheres to HIPAA, HITECH, and GDPR regulations where applicable. Performance is strictly monitored through pre-operational and operational report cards, with monetary penalties ranging from 100 to 10,000 dollars for non-compliance in areas such as call center support, billing accuracy, and disaster recovery. Additionally, the vendor must maintain cyber insurance or a performance bond and notify the agency of any suspected data breaches within 30 minutes of discovery. Proposals are evaluated based on technical and cost criteria, with a 15 percent preference given to qualified bidders. The final deadline for submission via the Kentucky Vendor Self Service site is December 9, 2026, with an anticipated contract start date of April 1, 2027. Awardees must certify they are not debarred from federal or state contracts and agree to maintain staffing levels at 90 percent or more of the agreed-upon Project Staffing Plan.
275 E.Main St.,Fkt, Ky

POSTED

about 19 hours ago

DEADLINE

in about 1 month
NAICS: 524292
New
SLED
712589: Third Party Liability Claims Administrator Services
Solicitation # 54879
The City of Chicago Department of Law is soliciting proposals for Third Party Liability Claims Administrator Services under solicitation number 54879. The selected contractor will provide general claims administration, inside claims specialist services, and outside claims adjuster services, with a primary focus on managing tort claims. Key responsibilities include conducting physical inspections, securing evidence, and providing litigation support. The contract is structured as a Blanket Purchase Agreement with a base term of 60 months and options for two 12-month extensions or a single 24-month extension. Performance is measured by strict processing timelines, requiring routine claims to be resolved within 70 days and complex claims within 182 days, with a mandatory 80 percent adherence rate. Proposals are due by December 18, 2026, and will be evaluated based on professional and technical competence (70 percent), the implementation and management plan (20 percent), and the schedule of compensation (10 percent). Several pass/fail criteria apply, including financial stability, insurance compliance, and the submission of a sexual harassment policy affidavit. The contractor must provide on-site coverage Monday through Friday from 8:00 am to 6:00 pm and Saturdays from 8:00 am to 12:00 noon. Additionally, the City will provide a 100,000 dollar Claims Payment Fund for the contractor to manage and replenish monthly. Compliance with MBE, WBE, and VBE goals is required, and the contractor must adhere to stringent data protection requirements for all protected information.
Department of Law

POSTED

1 day ago

DEADLINE

in about 2 months
NAICS: 524292
New
Federal
TRICARE Medicare Eligible Program Second Generation (TMEP2)
Solicitation # HT940226R0001
The TRICARE Medicare Eligible Program Second Generation (TMEP2) is a full and open competitive acquisition issued by the Defense Health Agency to provide health care claims processing, customer support, and administrative services for dual-eligible Medicare and TRICARE beneficiaries. The scope of work covers medical services received across the United States, Puerto Rico, Guam, the US Virgin Islands, American Samoa, and the Northern Mariana Islands. This Firm Fixed-Price contract features a potential total period of performance of 8.5 years, consisting of a 12-month transition-in period, seven 1-year healthcare delivery periods, a 12-month transition-out period, and a possible 6-month extension of services. The government will utilize a best value trade-off source selection process, where technical approach and past performance are equal in importance and collectively significantly more important than price. A rating of acceptable for small business participation is required for award eligibility. Key requirements include CMMC Level 2 certification, adherence to FedRAMP Moderate security standards for cloud providers, and the implementation of a Quality Assurance Surveillance Plan to monitor performance metrics. Proposals must be submitted electronically via DoD SAFE by December 03, 2026, at 5 p.m. MST, organized into six separate electronic volumes.
Defense Health Agency

POSTED

1 day ago

DEADLINE

in about 1 month
NAICS: 524292
New
SLED
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 Third-Party Administrators (TPA) to manage medical health benefits for approximately 103,000 covered lives. The selected contractor(s) will be evaluated by region and must administer the existing Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP plan designs without exception. The contract term runs from the date of signature through June 30, 2030, with the contractor assuming responsibility for all claims incurred on or after July 1, 2027. Key responsibilities include seamless data integration with pharmacy, behavioral health, and population health management vendors, as well as daily reconciliation of plan accumulators. The procurement process requires a two-part electronic submission via OhioBuys, consisting of a technical proposal and a separate cost proposal. Mandatory requirements include agreement to existing plan designs and the execution of a nondisclosure agreement to access specific provider data. Pricing is structured around per employee per month (PEPM) administrative services only (ASO) fees, with additional costs for file feeds, communications, and disease management. Performance is monitored through strict Service Level Agreements (SLAs), including a requirement to mail ID cards within five days of enrollment. Contractors must also provide a Benefits Fund of $75,000 per awarded region for the initial three-year period and maintain compliance with State IT policies and HIPAA regulations via a Business Associate Agreement.
Administrative Services

POSTED

1 day ago

DEADLINE

in 15 days
NAICS: 524292
New
SLED
TPA Workers' Compensation
Solicitation # 127-2026
The Southwest Ohio Regional Transit Authority (SORTA), also known as Cincinnati Metro, is soliciting proposals for a Third-Party Administrator (TPA) to manage its self-insured Workers' Compensation program. The scope of work includes comprehensive claims administration, medical management, cost containment, legal support, and regulatory compliance in accordance with Ohio Bureau of Workers' Compensation and Ohio Industrial Commission requirements. Additionally, the selected vendor will provide safety consulting, OSHA/VSSR review services, and various reporting deliverables, including quarterly claims reports and bi-weekly payment forecasts. The contract is intended to begin in March 2027 and utilizes a firm-fixed price structure for a five-year term. Proposals must be submitted electronically via the OpenGov portal by November 4, 2026, and must be divided into two volumes to keep pricing separate from technical and business qualifications. Evaluation will be based on a points-based system focusing on price, project approach, and firm and staffing qualifications, specifically looking for public-sector or transit-related experience. Award decisions will be made based on the most advantageous proposal to SORTA. The successful contractor must adhere to NET 30 payment terms and comply with various federal and state non-discrimination and equal employment opportunity regulations.
Human Resources

POSTED

2 days ago

DEADLINE

in 6 days
NAICS: 524292
SLED
Pharmacy Drug Benefits
Solicitation # HHS0017240
The Texas Department of State Health Services (DSHS) is soliciting proposals under solicitation number HHS0017240 for a Pharmacy Benefits Manager (PBM) to support the Texas HIV Medications Program (THMP). The selected PBM will act as a secondary payor to manage prescription drug benefits, premium payments, and copayments through three primary programs: the State Pharmacy Assistance Program (SPAP) for Medicare Part D costs, the Texas Insurance Assistance Program (TIAP) for medication copayments and COBRA premiums, and the Texas Insurance Assistance Program-PLUS (TIAP-PLUS) for private and federal marketplace plan assistance. The scope of work involves processing medication claims and monthly invoice premium payments, with historical data indicating the management of over 15,000 claims for approximately 2,764 participants. The contract features an initial one-year term with the possibility of four additional one-year extensions and one final option period at the discretion of DSHS. Award selection is based on best value, evaluated through a weighted scoring system consisting of the Project Workplan (45%), Cost Proposal (35%), and Qualifications and Experience (20%). Proposals must be submitted by November 19, 2026, via either USB drive or an online bid room. Requirements include a narrative proposal limited to 40 pages, a separate Excel-based cost proposal, and a VetHUB Subcontracting Plan. The contract is governed by Texas Government Code Section 2155.144 and incorporates various HHS uniform terms, additional provisions, and a Data Use Agreement.
Department of State Health Services

POSTED

8 days ago

DEADLINE

in 21 days
NAICS: 524292
SLED
DAS Behavioral Health Third-Party Administrator RFP
Solicitation # SRC0000040548
The State of Ohio, through the Department of Administrative Services, is soliciting proposals for a Third-Party Administrator to manage its self-insured Behavioral Health Benefit Plan. Starting July 1, 2027, the selected contractor will provide administrative services for approximately 43,800 employees and 104,600 total lives. Key responsibilities include managing eligibility, claims history, prior authorizations, utilization management, and data integration with the State's data warehouse. The contract runs from the date of signature through June 30, 2030, with the possibility of a one-month discretionary renewal and further mutual renewals for up to four additional years. To be eligible, offerors must be NCQA accredited and comply with the Mental Health Parity and Addiction Equity Act. The evaluation process is based on a total score derived from technical requirements, cost, and presentations, with the highest-ranking responsible offeror recommended for award. Financial terms utilize a not-to-exceed unit cost fee structure, and the contractor must provide a Benefits Fund of at least 150,000 dollars. Strict compliance is required regarding HIPAA through a Business Associate Agreement, State IT policies, and secure data transfer protocols via SFTP. Proposals must be submitted electronically through the OhioBuys portal, consisting of separate technical and cost volumes.
Administrative Services

POSTED

8 days ago

DEADLINE

in 15 days
NAICS: 524292
SLED
Employee Benefits- Life/STD/FSA/HSA/COBRA
Solicitation # 27-011CH-32RFP
The Tempe Union High School District is soliciting proposals under solicitation number 27-011CH-32RFP to secure a provider for the administration of employee benefits, including Basic and Voluntary Life and Accidental Death and Dismemberment, Short-Term Disability, Flexible Spending Account, Health Spending Account, and COBRA administration. The intended contract period runs from July 1, 2027, through June 30, 2032. Key requirements include the waiver of pre-existing condition limitations for initially enrolled employees and dependents, the elimination of active-at-work restrictions, and a guarantee that no employee suffers a loss of benefits during a carrier change. The selected vendor must provide a designated account management team, bilingual educational materials, and attendance at four days of annual open enrollment meetings in Tempe, Arizona. The award process utilizes a point formula system across three phases: initial evaluation, vendor interviews, and a best and final offer. Evaluation factors include responsiveness, cost, and past performance, with a minimum of 500 technical points required to proceed to price evaluation. The District intends to award the least number of vendors necessary, with contracts potentially awarded by individual product lines. Proposals must be submitted via the OpenGov portal by November 19, 2026. The contract is subject to Arizona Revised Statutes and School District Procurement Rules, featuring a zero-tolerance gift policy and net 30-day payment terms. Implementation must be completed 60 days prior to open enrollment, with a required 45-day support period following the July 1 effective date.
Business Services

POSTED

9 days ago

DEADLINE

in 21 days
NAICS: 524292
SLED
RFP-2026-21 Voluntary Benefits, Section 125 Flexible Benefit Plan, Enrollment and Related Employee Services
Solicitation # RFP-2026-21
Harnett County Schools is soliciting proposals under RFP-2026-21 for a qualified partner to provide voluntary employee benefits, Section 125 Flexible Benefit Plan administration, and related enrollment and support services. The scope of work includes the coordination of voluntary insurance benefits such as dental, vision, disability, and life insurance, as well as the administration of medical and dependent care flexible spending accounts. The selected provider will be responsible for open enrollment delivery, employee education, telemedicine services, and critical administrative tasks including payroll deduction files, billing reconciliation, and IRS-compliant nondiscrimination testing and tax filings. The contract will be awarded to the lowest responsible and responsive bidder based on the total base bid, though the agency may also consider overall value, service quality, and employee impact. Proposers must submit three signed physical copies and one electronic PDF copy via thumb drive by November 13, 2026. Required documentation includes a detailed pricing schedule, implementation and transition plans, North Carolina licenses, and various certifications regarding non-collusion, conflict of interest, E-Verify compliance, and the Iran Divestment Act. Vendors must also provide evidence of cybersecurity and privacy controls and adhere to North Carolina Department of Labor safety standards. Payment terms are set at net 30 days following the receipt of a correct invoice.
Harnett County Board of Education

POSTED

10 days ago

DEADLINE

in 15 days

AI Contract Overview

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The Houston Independent School District (HISD) is soliciting proposals under project number 26-04-01 for Medical Plan, Pharmacy Benefit Management (PBM), and Third-Party Administrator (TPA)/Claims Payor Services. This Request for Proposals (RFP) invites qualified vendors to become HISD Approved Vendors by responding to the solicitation and meeting all requirements, including compliance with liability insurance and Minority/Women Owned Business Enterprises (MWBE) program policies. The resulting contract is anticipated to start on July 1, 2027, for a one-year term with four automatic annual renewals extending up to June 30, 2032, plus a possible 90-day extension for business continuity at HISD’s discretion. Vendors are encouraged to participate in a virtual pre-proposal conference scheduled for April 22, 2026, and to submit all questions and proposals electronically by the May 20, 2026 deadline. The evaluation of proposals will focus primarily on price (50 points), with consideration given to the vendor’s quality, reputation, experience (30 points), schedule and plan performance capabilities (15 points), and safety record (5 points). HISD follows a best value trade-off approach rather than awarding solely on lowest price. Contract administration will be coordinated through HISD’s Purchasing Services department, with Luis Hardy serving as the primary contact. The contract documents include general conditions, specifications, insurance requirements, and conflict of interest questionnaires, with all required submittals and lien waivers due prior to final payment. Packaging and delivery must follow manufacturer guidelines to ensure product integrity, with clear marking and labeling for easy identification. No federal acquisition regulation clauses or specific socioeconomic certifications are mandated. Vendors must submit proposals in the City of Denton’s Ionwave portal and comply with all HISD procurement policies. Upon Board approval, awarded vendors will receive a Notice of Award letter and become part of HISD’s approved vendor list for this vital healthcare service contract.

General Info

HISD seeks vendors for medical, pharmacy, TPA services; contract starts July 2027, five-year term.

Documents

11

00 42 44 - Unit Price Proposal for Hickory Substation Transmission Reels Storage

XLSX, High priority: read this first7 pages · unit-price-proposal
High

CSP 9040 Hickory Substation Transmission Reels Storage

OCTET-STREAM, High priority: read this firstrfp
High

CSP 9040 - Hickory Substation Transmission Reels Storage

PDF, High priority: read this firstrfp
High

CSP 9040 Hickory Substation Transmission Reels Storage Public Q&A

OCTET-STREAM, High priority: read this firstq-and-a
High

DME22247 - Hickory GIS Reel Relocation Plans

PDF, High priority: read this first12 pages · specifications
High

Key Personnel Resume Form for Project Staffing

PDF, High priority: read this first4 pages · key-personnel-resume-form
High

RFP 9040 Hickory Spool Storage Building Technical Specification

DOCX, High priority: read this first22 pages · technical-specification
High

RFP 9040 Hickory Substation Transmission Reels Storage Project Manual

PDF, High priority: read this first200 pages · rfp
High

Conflict of Interest Questionnaire - City of Denton

PDF, Low priority2 pages · conflict-of-interest-questionnaire
Low

CSP 9040 - Hickory Substation Transmission Reels Storage Q&A

PDF, Low priorityq-and-a
Low

CSP Past Experience Form

PDF, Low priority3 pages · past-performance
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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AgencyTexas → Houston ISD
Contacts1 person available
OfficeTX, USA
Organization / AgencyTexas → Houston ISD
Office AddressTX, USA

Full Description

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REQUEST FOR PROPOSALS (RFP) INVITATION FOR VENDOR RESPONSE Dear Vendor, The Houston Independent School District is interested in receiving proposals from qualified individuals and/or organizations ("Vendor") for the procurement of select goods and/or services, as specified within this Request for Proposals ("RFP" or "Solicitation"). HISD Project Number: 26-04-01 Project Name: Medical Plan, Pharmacy Benefit Management (PBM), and Third-Party Administrator (TPA) / Claims Payor Services. In accordance with Houston ISD policies and procedures, HISD schools and/or departments are authorized to engage with "Approved Vendors" only. An HISD Approved Vendor is one that has been authorized for use upon having met a set of pre-determined criteria through a formal procurement process and awarded a contract ("Contract", "Agreement", or "Project") upon approval by the HISD Board of Managers. The first step in obtaining Approved Vendor status is to respond to this solicitation and submit all required information and documentation. Upon completion of the Project evaluation process and verification of compliance with HISD's liability insurance requirements and Minority/Women Owned Business Enterprises (MWBE) Program, one or more Vendors will be recommended to the Board of Education for contract award. Once the HISD Board of Education formally approves the selected Vendor(s) for award, the HISD Purchasing Services department will issue a Notice of Award letter, affirming the awarded Vendor(s) status as an Approved Vendor for this specific Project. The tentative term of this Project is from July 1, 2027 , through June 30, 2028, (subject to change) with four (4) automatic annual renewals, not to extend beyond June 30, 2032 . Thereafter, HISD at its sole discretion may elect to either extend the Project for a term not to exceed ninety (90) days for business continuity purposes, if needed. Pre-Proposal Conference: A Pre-Proposal conference will be held virtually via Microsoft Teams at (11:00 - AM) CST on Wednesday, April 22 , 2026 . Vendors interested in participating in the Pre-Proposal Conference must RSVP by registering with the link provided below. Please include the following information in your registration: Vendor company name, attendee first and last name, and email address. Click this link to register for the Pre-Proposal Meeting The HISD Category Specialist assigned to this solicitation is listed below. Any questions or concerns arising out of this RFP are to be directed to such individual in writing. Questions pertaining to the solicitation process or related to the scope or specifications contained in this RFP should be submitted via the electronic bidding portal by the deadline specified within the RFP. Answers to all questions received will be posted as an Addendum to this RFP within the electronic bidding portal. Thank you in advance for your participation in this solicitation. Sincerely, Category Specialist Name : Luis Hardy Email Address: luis.hardypecina @HoustonISD.org Office Main Number: +1 (555) 000-0000 Direct Line: 713-556 - 5110 Purchasing Services Department Houston Independent School District Hattie Mae White Educational Support Center 4400 West 18th Street Houston, TX 77092 Keep up with the latest news from HISD: www.HoustonISD.org

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