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This Sources Sought opportunity was posted on February 20, 2013. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Renewal TRIP Claims Management

Closed
TRIP-2Federal

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
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

about 23 hours ago

DEADLINE

in 28 days
NAICS: 524292
New
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

about 23 hours ago

DEADLINE

in 22 days
NAICS: 524292
New
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

1 day ago

DEADLINE

in 28 days
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 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

2 days ago

DEADLINE

in 22 days
NAICS: 524292
New
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

2 days ago

DEADLINE

in 22 days
NAICS: 524292
New
International
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.
Ofcom

POSTED

3 days ago

DEADLINE

in about 1 month
NAICS: 524292
New
SLED
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

6 days ago

DEADLINE

in 25 days
NAICS: 524292
New
SLED
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

6 days ago

DEADLINE

in 22 days
NAICS: 524292
New
SLED
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

7 days ago

DEADLINE

in about 1 month

General Info

Agency

N/A

NAICS

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

Place of Performance

Not specified

Set-Aside

NONE

Documents

0

No documents available

Documents will appear here when they are available.

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Uniform Contract Format

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Timeline

1 update
PhaseClosed
Posted

Sources Sought

Notice updated

The notice description changed.

Response Deadline

Deadline has passed

Submission Closed

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Organization & Contact Information

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AgencyN/A
Contacts1 person available
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Organization / Agency
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Office AddressN/A
Contacts

Full Description

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The Department of the Treasury's (Treasury), Internal Revenue Service's (IRS) Office of Treasury Procurement Services (OTPS), on behalf of the Terrorism Risk Insurance Program (TRIP) Office anticipates the competitive renewal of an Indefinite Delivery Indefinite Quantity (IDIQ) award with a one-year base period plus (4) one-year option periods. The IDIQ is to provide, maintain at the ready of terrorism, and operate, as required, a computer system and facility able to meet the requirements of the Terrorism Risk Insurance Act of 2002 (TRIA), as amended by the Terrorism Risk Insurance Extension Act of 2005, and the Terrorism Risk Insurance Program Reauthorization Act of 2007, as well as relevant Treasury and other regulations. The contractor is to "translate" the Act and regulations into a tested and documented operating systems and procedures that will be maintained in readiness throughout the period of the contract for the processing of insurer claims for the Federal Share of Compensation under the Terrorism Risk Insurance Program (Program); and upon notice, the contractor is to activate the system and process claims. This notice is an attempt by the Government to perform market research to identify potential sources within the market. In managing the Program authorized by TRIA, Treasury is guided by several goals. First, Treasury strives to implement the Act in a transparent and effective manner that treats comparably those insurers required to participate in the Program and provides necessary information to policyholders in a useful and efficient manner. Second, in accordance with the Act's stated purposes, Treasury seeks to rely as much as possible on the State insurance regulatory structure. In that regard, Treasury has coordinated the implementation of all aspects of the Program with the National Association of Insurance Commissioners (NAIC). Third, to the extent possible within statutory constraints, Treasury seeks to allow insurers to participate in the Program in a manner consistent with procedures used in their normal course of business. Finally, Treasury is guided by the Act's goal for insurers to develop their own capacity, resources, and mechanisms for terrorism insurance coverage when the Program expires. Further information on the TRIP/TRIA can be found at the following link: http://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx . At the link there is further information on the original TRIA Act of 2002, the TRIA Extension Act of 2005, and the TRIA Reauthorization Act of 2007. The Treasury on June 29, 2004, issued a final Claims Procedures Rule, effective July 31, 2004, as part of its implementation of title I of TRIA; 69 FR 39296. TRIA also contains specific provisions designed to manage litigation arising out of, or resulting from, a certified act of terrorism. On July 28, 2004, Treasury issued a final rule concerning litigation management, 69 FR 44932. TRIA, the Claims Procedures Rule, the Litigation Management Rule and related rules found in 31 C.F.R. Part 50 contain certain definitions, requirements, and procedures for insurers filing claims with Treasury for payment of the Federal share of compensation for insured losses under the TRIP. The Claims Procedures Rule, in particular, specifically addresses requirements for Federal payment, the submission of an initial notice of insured loss, loss certifications, the timing and process for payment, associated recordkeeping requirements, as well as Treasury's audit and investigation authority. These procedures apply to all insurers that wish to receive their payment of the Federal share of compensation for insured losses under TRIA. On December 26, 2007, the President signed into law the Terrorism Risk Insurance Program Reauthorization Act of 2007 which extends the TRIA through December 31, 2014. The law extends the temporary federal Program that provides for a transparent system of shared public and private compensation for insured losses resulting from acts of terrorism. The contractor under this IDIQ will provide services both prior to and following a certified act of terrorism including: 1) make ready for operation, a facility for the management and payment of TRIP claims; 2) provide periodic review and testing of the facility and other activities, including the information technology Certification and Accreditation process, needed to assure its security and readiness and compliance with The Federal Information Security Management Act (FISMA); 3) provide expert and analytical support to the Program in anticipation of, or in response to Program changes and may be awarded prior to or following an act of terrorism; 4) provide activation and operation of the facility and would be issued only after certification of an act of terrorism; 5) the transition or development and testing of a "statistical agent" analysis and reporting capability; 6) provide periodic review and testing of the statistical agent capability, typically expected to be performed in conjunction with task 2; 7) provide the actual statistical agent reporting and analysis following activation of the TRIP facility and the payment of claims; 8) the Recoupment process called for under the Program. Detailed descriptions of the tasks are attached to this Sources Sought notice. As intended by this Sources Sought Notice, the Government is attempting to gather market research information from contractors regarding their capabilities to the requirements stated within this notice. Therefore, interested parties should provide their statement of capabilities inclusive of relevant experience and level of staff available to successfully ensure adherence to the requirements of the TRIA of 2002, as amended and operating efficiency and financial integrity of the TRIP. Interested parties should identify if its firm subcontracts any parts of this requirement. If so, provide details of the areas subject to subcontracting. Interested parties should provide requested information via e-mail to Sheketia Nettles, Contract Specialist, by February 26, 2013 at 1:00pm to the following email address: sheketia.nettles@irs.gov .Responses shall be limited to no more than 10 pages, standard margins, and 12pt. font. THE SUBMISSION OF THIS INFORMATION IS INTENDED FOR PLANNING PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS A COMMITMENT BY THE GOVERNMENT TO PROCURE ANY SERVICES, NOR DOES THE IRS INTEND TO AWARD A CONTRACT ON THE BASIS OF THe SOURCES SOUGHT NOTICE OR OTHERWISE PAY FOR THE INFORMATION SOLICITED.

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