This Solicitation opportunity from South Carolina was posted on July 29, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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PBA adjudicate POS Claims & Pay Pharmacy

Closed

5400028537State & Local

Submission Closed08/15/2025, 12:00:00 AM UTC

Contract Overview

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

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NAICS: 524292

New

SLED

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410 - Nevada Health Authority Director's Office

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Medicaid Medication Risk Reduction Initiative

Solicitation # RFP-2027-DMS-01-MEDIC

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Solicitation # HHS0017240

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Solicitation # SRC0000040548

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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.

POSTED

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COBRA Administration, Retiree Billing & FSA Administration

Solicitation # RFP 2435

The Township of Wayne, New Jersey, issued Request for Proposal RFP 2435 to secure a qualified organization for comprehensive COBRA Administration, Retiree Billing, and Flexible Spending Account (FSA) Administration services. With an effective start date of January 1, 2027, the selected vendor will manage notice generation, election tracking, premium administration, and direct billing for retirees, as well as provide regulatory compliance support and vendor integration. The contract duration is up to two years, with the possibility of two additional one-year extensions. Proposals must be submitted electronically via the ProcureNow portal by October 29, 2026, at 11:00 am. Award selection may be based on the lowest responsive bid or a points-based evaluation focusing on qualifications, method statement, history and experience, resource availability, and references. Mandatory submission requirements include a Statement of Ownership Disclosure, a notarized Non-Collusion Affidavit, and certifications regarding affirmative action and prohibited activities in Russia, Belarus, and Iran. The successful contractor must maintain specific insurance coverages, including a minimum of 1,000,000 dollars for Business Automobile and Umbrella liability, and at least 2,000,000 dollars per occurrence for certain data losses. Additionally, the vendor must ensure strict adherence to HIPAA regulations and New Jersey state statutory requirements.

Purchasing Division

POSTED

8 days ago

DEADLINE

in 1 day

AI Contract Overview

The South Carolina Department of Health & Human Services (SCDHHS) is seeking responses from Pharmacy Benefit Administrators (PBAs) to assess their capabilities and experience in managing Medicaid pharmacy benefits. Specifically, the contract focuses on adjudicating point-of-sale claims, making direct payments to pharmacies, and handling reimbursement processes from Medicaid. The solicitation, titled "PBA adjudicate POS Claims & Pay Pharmacy," was posted on July 29, 2025, with a response deadline of August 15, 2025. The contract is anticipated to be valued between five million and twenty million dollars, indicating a significant scope of work. The project is managed under the NAICS code 524292, which pertains to third-party administration of insurance and employee benefit plans, and is organized through the South Carolina Law Enforcement Division (SLED). Interested parties are encouraged to contact Rena Aarons via email or phone for further information. The contract aims to enhance the efficiency and accuracy of pharmacy benefit management within South Carolina’s Medicaid program, ensuring timely and reliable payments to pharmacies and proper claim adjudication. The opportunity is open to qualified PBAs with relevant experience in Medicaid or similar healthcare benefit programs, emphasizing the importance of proven operational capabilities in handling large-scale pharmacy benefit transactions.

General Info

Agency

South Carolina Department of Health and Human Services

NAICS

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

Place of Performance

SC, USA

Set-Aside

NONE

Documents

No documents available

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Timeline

PhaseClosed

PostedJul 29

Solicitation

Response DeadlineAug 15

Deadline has passed

Submission Closed

08/15/2025, 12:00:00 AM UTC

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Organization & Contact Information

AgencySouth Carolina Department of Health and Human Services

Contacts1 person available

OfficeN/A

Organization / AgencySouth Carolina Department of Health and Human Services

Office AddressN/A

Contacts

Rena Aarons

contact@example.gov

+1 (555) 000-0000

Full Description

The South Carolina Department of Health & Human Services (SCDHHS) is requesting information from Pharmacy Benefit Administrators (PBAs) regarding their capabilities and experience in adjudicating point-of-sale (POS) claims, paying pharmacies directly and receiving reimbursement from Medicaid.