This Solicitation opportunity from Texas was posted on September 13, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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RFP - Group Medical, Stop Loss Coverage, Administration Services Only (ASO), and Pharmacy Benefit Management (PBM) for Harris Health

Closed

24/0248State & Local

Submission Closed10/28/2024, 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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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

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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.

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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

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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 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

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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.

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Vehicle Assistance and Claims AdministratorThe Vehicle Assistance and Claims Administrator subcontract, issued by the US Embassy Paris for the Department of State, involves providing roadside assistance and third-party insurance claims management for prime contractors in France. The selected provider will manage assistance for 112 vehicles, settle third-party claims, and recover expenses related to personnel and equipment. Key deliverables include the resolution of claims, the recovery of funds, and detailed documentation of all roadside assistance events. To be eligible, the contractor must possess a Kbis registration and appoint a Project Manager who is fluent in both English and French. The work will be performed in Paris, France, under NAICS code 524292. Responses for this opportunity are due by November 6, 2026.

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Announcement of RFP for Retirement Plan Administration and Record Keeping Services

Solicitation # LC26028

Lane County is seeking proposals from qualified firms to provide comprehensive administration, record keeping, education, and investment-related services for its 457 Deferred Compensation Plans and 401(a) Defined Contribution Plan. The primary objectives of this solicitation are to enhance participant retirement outcomes, improve education and communication, and implement robust online transaction capabilities. Additionally, the County aims to reduce expenses, evaluate competitive pricing structures, and streamline administrative functions through automation and integrated reporting. Interested parties must request solicitation documents from the designated consultants by November 12, 2026, at 5:00 PM. The final deadline for proposal submissions is November 20, 2026. The selected firm will be expected to ensure an orderly transition of assets and services while maintaining a strong working relationship with the Deferred Compensation Advisory Committee.

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Nevada State Pharmacy Benefit Manager

Solicitation # 41NHA-S3992

The Nevada Health Authority Director's Office is seeking proposals for a Nevada State Pharmacy Benefit Manager under solicitation number 41NHA-S3992. This state-level procurement opportunity is managed by the Nevada Health Authority in Carson City and is open for responses until December 29, 2026. Interested parties should coordinate with the primary purchaser, Heather Moon, or the designated administration contact for further inquiries. All detailed requirements and submission guidelines are contained within the official solicitation attachments provided through the Nevada ePro portal.

410 - Nevada Health Authority Director's Office

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DEADLINE

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

DEADLINE

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

DEADLINE

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.

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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

Harris Health is issuing a request for proposals from qualified vendors to provide a comprehensive suite of health insurance services, including Group Medical coverage, Stop Loss insurance, Administration Services Only (ASO), and Prescription Drug Benefit Management (PBM). The contract aims to secure a partner capable of managing these complex benefits, ensuring efficient administration, risk management, and pharmacy services for Harris County in Texas. The solicitation emphasizes the need for vendors with proven experience and capabilities in these areas, with a contract value estimated between 50 million and 150 million dollars. The response deadline is set for October 28, 2024, and interested parties can find additional details and submit proposals through the designated online portal.

General Info

Agency

Texas → Harris County

NAICS

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

Place of Performance

TX, USA

Set-Aside

NONE

Documents

7-Marketing Services Advertising Scope of Work

sow

High

KISD Terms and Conditions 04.23.24

terms-and-conditions

High

Klein ISD EDGAR Certifications Addendum for Federal Grant Contracts

edgar-certifications

High

Klein ISD Required Forms and Certifications 4.23.24

required-forms

High

Klein ISD RFP# 25-144 Marketing Services & Advertising

rfp

High

Klein ISD Vendor Certification Forms

certification-forms

High

IRS Form W-9 Request for Taxpayer Identification Number and Certification

tax-form

Low

Klein ISD District Campus Directory and Map

other

Low

AI Contract Breakdown

Uniform Contract Format

Timeline

PhaseClosed

PostedSep 13

Solicitation

Response DeadlineOct 28

Deadline has passed

Submission Closed

10/28/2024, 12:00:00 AM UTC

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Organization & Contact Information

AgencyTexas → Harris County

ContactsNo contacts available

OfficeN/A

Organization / AgencyTexas → Harris County

Office AddressN/A

ContactsNo contact information available

Full Description

Harris Health is seeking proposals from qualified vendors with the experience, capabilities and proven qualifications to provide comprehensive Group Medical, Stop Loss Coverage, Administration Services Only (ASO), and Prescription Drug Benefit Administration Services (PBM).