This Government Contract opportunity from Department Of Veterans Affairs was posted on September 16, 2020. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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R499--FSC Medical Claims Processing Bridge (June-Sept)

Awarded

36C10G20Q0059Federal

Submission Closed06/11/2020, 12:00:00 AM UTC

Contract Overview

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

Active Opportunities Like This One

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 for its self-insured medical plans, known as Ohio Med. The scope includes the administration of three plan options: the Ohio Med PPO, Ohio Med Select, and the Ohio Med HDHP, covering approximately 103,000 lives. The selected contractor will be responsible for administering all claims incurred on or after July 1, 2027, and must ensure a seamless transition of care and eligibility verification. Key requirements include providing case, care, disease, and utilization management, while behavioral health remains a carved-out service. The contractor must also integrate with the state's data warehouse vendor, Merative, and adhere to strict IT security standards, including HIPAA compliance via a Business Associate Agreement and various recognized security certifications such as SOC 2 Type 2 or HITRUST. The contract term runs from the date of signature through June 30, 2030, with options for short-term monthly renewals and potential mutual extensions for up to four additional years. Performance is measured by specific Service Level Agreements, such as mailing ID cards within five days of enrollment and maintaining zero errors in initial eligibility files. Financial terms involve weekly claims billing paid via ACH, with a cost proposal structure based on per employee per month fees for core and disease management services. Award selection is based on a total score combining technical, cost, and presentation evaluations. Proposals must be submitted electronically through the OhioBuys portal, with technical and cost components submitted as separate, non-password-protected electronic envelopes.

Administrative Services

POSTED

DEADLINE

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

DEADLINE

Provision of flexible Benefits Administration Services and Platform

Solicitation # COM00163

Ofcom is seeking a provider for an end-to-end flexible benefits administration service and platform for an initial five-year term starting July 1, 2027, with the possibility of two 12-month extensions through June 30, 2034. The estimated contract value is 350,000 GBP excluding VAT. This open procedure solicitation, identified as COM00163, is particularly suitable for small and medium-sized enterprises and voluntary, community, and social enterprises. The award will be based on a weighted scoring system, with 20 percent of the evaluation focused on the quality of administration, reconciliation processes, helpdesk support, and colleague communication. The required service is divided into three core areas: scheme administration, platform management, and customer services. Administration duties include managing annual and open enrolment, monthly payroll and provider reporting, and pension re-enrolment on a three-year cycle. The provider must maintain a secure cloud-based platform featuring Single Sign On capability, Total Reward Statements, and the ability to model the cost effects of benefits, including tax and National Insurance implications. Additionally, the supplier must provide a responsive customer support service with a telephone helpdesk and detailed analytics reporting. All technical specifications must align with Ofcom Security Requirements and the Government Procurement Agreement.

POSTED

DEADLINE

Stop Loss - Healthcare & Medical

Solicitation # RFP-2027-394

The Board of Regents of The University of Oklahoma, through the Oklahoma University Health Sciences Center, is seeking a qualified vendor for the administration of its Stop Loss program under solicitation RFP-2027-394. The objective is to secure a provider capable of delivering high-quality, cost-effective program management to maximize value for the University and its partners. While the University prefers to award the contract to a single supplier, it maintains the right to award to multiple suppliers if it serves the institution's best interests. Interested vendors must adhere to a strict submission timeline, with the proposal deadline set for November 16, 2026, at 2:00 PM CST. A critical preliminary step requires vendors to sign and return a Non-Disclosure Agreement to Melody Carder by October 27, 2026, which serves as the formal Intent to Bid and is mandatory to receive the necessary census data and vendor questionnaire. Proposals must include a company overview, a signed Business Associate Agreement, and at least three references from projects of similar scope and complexity completed within the last five years, preferably within the public sector or higher education. Additionally, bidders must provide certifications regarding the absence of conflicts of interest and confirmation that they are not currently debarred or suspended from receiving federal funds.

Oklahoma University Health Sciences Center

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 state employees and their dependents. The selected contractor will manage the delivery of telehealth services across three plan options: Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP. The scope of work includes providing a provider network, proactive account management, and comprehensive claims management with accurate coding and timely submission to medical third-party administrators. Key operational requirements include maintaining 99.9% availability for the mobile app and web portal, achieving at least a 60% member satisfaction rating per visit, and implementing a written satisfaction improvement plan by the second contract year. The contractor must also ensure ADA compliance, maintain closed-loop referral tracking, and adhere to strict HIPAA and HITECH privacy standards. The contract will be awarded based on the highest total score, combining technical, cost, and presentation evaluations. Financial terms are structured as Administrative Services Only fees charged per enrolled employee per month, with payment terms set at Net 30. The contractor must be prepared for open enrollment activities by May 1, 2027. Proposals must be submitted via the OhioBuys Supplier Portal in two distinct volumes: a technical proposal and a cost proposal. Mandatory documentation includes a wide array of certification forms, a Business Associate Agreement, and evidence of security controls such as HITRUST or CMMC certification. Performance is monitored through a formal inspection and acceptance process where deliverables must be approved by an Agency Representative.

Administrative Services

POSTED

DEADLINE

Preferred Drug Program / Pharmacy Benefits Management C020463 X-12

Solicitation # 2139982

The New York State Department of Health, specifically the Office of Health Insurance Programs, intends to award a single-source contract to Prime Therapeutics State Government Solutions LLC for the provision of Preferred Drug Program and Pharmacy Benefit Management Services. This procurement is exempt from competitive advertising because a competitive process was not feasible within the required timeframe, as this extension represents the minimum period necessary to complete a new competitive procurement for these services. The contract is scheduled for a period of performance from December 1, 2026, through November 30, 2027, with the services being performed statewide across New York. Administrative oversight for the contract is managed by Health Program Administrator Kevin Noonan, based in Albany, New York. The solicitation is identified by number 2139982 and was posted on October 16, 2026.

NYS Department of Health

POSTED

DEADLINE

South Dakota State TPA Workers' Compensation

Solicitation # 26RFP19880

The State of South Dakota, through the Bureau of Human Resources and Administration, is soliciting proposals for a licensed business partner to provide Third Party Claims Administration for its Workers' Compensation Program. The selected vendor will be responsible for core services including medical case management, medical bill review, and MMSEA reporting. Key objectives include implementing cost-containment strategies, providing risk mitigation guidance, and delivering real-time analytics and benchmarking to improve claim outcomes and employee return-to-work efforts. The contract is structured over three twelve-month periods, beginning July 1, 2027, and ending June 30, 2030. Proposals will be evaluated on a 500-point scale, with the highest-ranked offeror invited to negotiate terms and compensation. Technical approval from the Bureau of Information and Technology is required, and vendors must meet strict IT standards, including Web Content Accessibility Guidelines 2.1 Level AA and compatibility with major web browsers. Security is a critical component, requiring the disclosure of third-party software libraries and the maintenance of cyber liability insurance for three years post-completion. The State will utilize User Acceptance Testing and performance load testing to ensure system effectiveness. Proposals must be submitted electronically to Peggy Canter by November 25, 2026, and must not be solely generated by artificial intelligence.

South Dakota State Government

POSTED

DEADLINE

Workers' Compensation & General Liability Claim AdministrationThis subcontract for the Maryland Office of Risk Management involves providing comprehensive end-to-end claim administration for prime contractors working on County insurance projects. The selected provider will manage Workers Compensation, Auto Liability, General Liability, and First Party Property Damage claims utilizing online internet-based reporting systems. Key deliverables include the management of claim files, the processing of settlements, and the delivery of regular claim status reports. To be eligible, providers must hold the necessary state and federal licenses for insurance adjusting and administration. The opportunity is categorized under NAICS code 524292, with a response deadline set for December 1, 2026.

Office of Risk Management

POSTED

DEADLINE

Third Party Administrative Services

Solicitation # 27-186

Frederick County, Maryland, through its Office of Risk Management, is seeking a third-party claim administrator to manage its self-insured workers compensation program and other lines of coverage. The selected contractor will provide comprehensive claim administration services, including specialized OSHA and MOSH reporting support, the calculation of lost and restricted duty days, and the provision of updated OSHA 300, 300A, and 301 reports. Key requirements include the ability to offer Medicare Set-aside services, interface with the County's risk management and safety systems, and maintain a rigorous information security program to protect confidential data. The contract is scheduled to commence on or about July 1, 2027, for an initial one-year term with the option for four additional one-year renewals at the County's discretion. Award selection is based on a points-weighted evaluation of the work proposal, provider qualifications, and the transition schedule. Successful bidders must provide evidence of general liability insurance and adhere to Net30 payment terms via electronic funds transfer. The procurement process is managed electronically through the OpenGov portal, with a response deadline of December 1, 2026.

Office of Risk Management

POSTED

DEADLINE

Q517--36C25527Q0015 | Pharmacy Benefits Services | Wichita |

Solicitation # 36C25527Q0015

The Department of Veterans Affairs Network Contracting Office 15 intends to award a single-award, Indefinite Delivery/Indefinite Quantity (IDIQ) contract for third-party pharmacy benefit services to support the First Fill Prescription Voucher Program. This program serves eligible Veterans assigned to the Robert J. Dole VA Medical Center in Wichita, Kansas, as well as associated Community Based Outpatient Clinics and Home-Based Primary Care programs. The contractor will provide the personnel, systems, and pharmacy network necessary to dispense new or urgent prescriptions when VA pharmacies are impractical, such as during telehealth appointments or after-hours emergency room visits. Services are limited to a maximum day supply of 10 days for most medications and 14 days for antibiotics, with a requirement for 24-hour network availability including weekends and federal holidays. This procurement is designated as a VOSB/SDVOSB set-aside under NAICS code 524292, with a size standard of 4.5 million dollars. The anticipated period of performance includes a base year from January 4, 2027, to January 3, 2028, with two subsequent one-year options. The contractor must maintain strict compliance with HIPAA, the Privacy Act of 1974, and Joint Commission standards, and will be subject to a Quality Assurance Surveillance Plan monitoring network availability and dispensing accuracy. The formal solicitation is expected to be publicized on or about November 1, 2026, via SAM.gov. All interested vendors must be active in the System for Award Management and, if applicable, registered in the SBA VetCert database.

255-NETWORK Contract Office 15 (36C255)

POSTED

DEADLINE

MDOC is seeking a contractor to serve as a COBRA Administrative Services provider.

Solicitation # 3140004700

The Mississippi Department of Corrections (MDOC) is soliciting quotes for a contractor to provide COBRA Administrative Services. The selected independent contractor will be responsible for the administration, application, and interpretation of COBRA rules and regulations, including consulting with the agency on regulations, managing enrollment and disenrollment in compliance with HIPAA and ERISA, and sending required notifications via Accountable Mail. Key deliverables include managing qualifying event eligibility notices and ensuring an orderly transition of data and records upon contract expiration. The contract will be awarded to the responsible bidder providing the lowest total evaluated quote based on a pricing structure that includes implementation fees, monthly administration fees based on participant tiers, and various optional ancillary services. The contractor must maintain a documented quality control program and provide the MDOC with unimpeded access to relevant records during normal business hours. Payments will be made electronically in US currency, with undisputed amounts typically paid within 45 calendar days of invoice receipt. The contractor is permitted to charge a two percent administrative-cost premium to COBRA Continuants. All responses must be submitted by October 29, 2026, at 14:00 CST. Bidders must certify that they have not retained any person or agency on a contingent fee arrangement to secure the contract and must adhere to the Mississippi Public Records Act of 1983.

MS DEPT of CORRECTIONS

POSTED

DEADLINE

Request for Proposals: C043525 Pharmacy Benefit Management Services

Solicitation # 2139865

The New York State Department of Health, Office of Health Insurance Programs, is soliciting proposals under contract C043525 to administer the Medicaid Fee-for-Service Pharmacy Benefit Management program. The selected contractor will be responsible for operating the Preferred Drug Program and Clinical Drug Review Program, managing prior authorizations for the Preferred Drug and Preferred Diabetic Supply Programs, and overseeing the Mandatory Generic Drug and Brand Less Than Generic programs. A critical component of the scope includes the development and maintenance of generic pricing files via the State Maximum Acquisition Cost list to drive state savings and revenue. The contract is scheduled for a performance period from December 1, 2027, through November 30, 2033, with statewide performance in New York. This procurement includes a Minority and Women Business Enterprise goal of 30 percent. Interested bidders must submit their proposals by December 8, 2026, to Andrew Lynch at the Office of Health Insurance Programs in Albany. It is noted that Prime Therapeutics State Government Solutions LLC was awarded a substantially similar contract within the previous five years.

NYS Department of Health

POSTED

7 days ago

DEADLINE

in about 2 months

AI Contract Overview

The Department of Veterans Affairs Office of Acquisition Operations Strategic Acquisition Center is awarding a non-competitive, Firm-Fixed-Price contract to ATP2 LLC, a verified Service-disabled Veteran-owned small business. This direct award provides essential medical claims support services for the Veterans Affairs Financial Services Center located in Austin, Texas. The acquisition is authorized under the Veterans First Contracting Program and FAR 6.302-5, utilizing NAICS code 524292. The contract, identified by solicitation number 36C10G20Q0059 and award number 36C10G20C0017, has an estimated value of 3,395,967.74 dollars. The performance period for this bridge requirement spans from June 13, 2020, to September 12, 2020. This action was processed as a justification for other than full and open competition to ensure continued support for medical claims processing operations.

General Info

Agency

Department Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)

Contract Value

$3,328,028.76

NAICS

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

Place of Performance

VA, USA

Set-Aside

NONE

Awardee

ATP2 LLC

Award Issued Date

06/13/2020, 12:00:00 AM UTC

Documents

Justification and Approval Notice - 36C10G20C0017

2 pages · justification-and-authorization

Low

VA Justification for Other Than Full and Open Competition - ATP2 LLC

justification-and-authorization

Low

AI Contract Breakdown

Uniform Contract Format

Contract not broken down yet

CLEATUS splits the solicitation into Uniform Contract Format (UCF) sections: scope, pricing, deliverables, and evaluation criteria.

Timeline

1 update

PhaseAwarded

PostedJun 12

Justification (J&A)

Justification (J&A)Sep 16

Justification & Approval published

AwardedJun 13

Contract was awarded

Submission Closed

06/11/2020, 12:00:00 AM UTC

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Organization & Contact Information

AgencyDepartment Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)

Contacts1 person available

OfficeFREDERICKSBURG, VA, 22408, USA

Organization / AgencyDepartment Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)

Office AddressFREDERICKSBURG, VA, 22408, USA

Contacts

Supervisory Contracting OfficerSharon Redman

contact@example.gov

+1 (555) 000-0000

Full Description

SOURCE SELECTION SENSITIVE IN ACCORDANCE WITH FAR 2.101 AND 3.104 Page 1 of 4 JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION Contracting Activity: Department of Veterans Affairs (VA) Office of Acquisition Operations Strategic Acquisition Center 10300 Spotsylvania Ave, Suite 400 Fredericksburg, VA 22408 Description of Action Being Approved: This proposed acquisition is for medical claims support services for the Veterans Affairs Financial Services Center (VA-FSC) in Austin, Texas. This requirement will result in the issuance of a Firm-Fixed-Price contract as a direct award to a Service-disabled Veteran-owned small business (SDVOSB).