This Solicitation opportunity from Tennessee was posted on July 18, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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RFP Pharmacy Benefit Manager

Closed

97169State & Local

Submission Closed08/08/2024, 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

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TRICARE Medicare Eligible Program Second Generation (TMEP2)

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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.

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DAS Medical Plan Third-Party Administrator

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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.

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Solicitation # 2025-RFP-127

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TPA Workers' Compensation

Solicitation # 127-2026

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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

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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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Solicitation # 2611-KP

The Sacramento Housing and Redevelopment Agency (SHRA) is soliciting proposals under RFP 2611-KP for a qualified actuarial services firm to manage its Other Post-Employment Benefits (OPEB) program. The selected contractor will be responsible for measuring liabilities, supporting funding decisions, and providing essential data for financial reporting and long-term planning. Key deliverables include GASB 75 reporting packages for fiscal year ends 2026 through 2030 and full actuarial valuations as of December 31 for 2026, 2027, and 2028. The scope also encompasses advisory services for prefunding strategies, scenario modeling, and the development of Actuarially Determined Contributions (ADCs) to ensure the fiscal sustainability of retiree medical and dental benefits. The contract is structured for an initial one-year term with options to extend for up to four additional periods, not to exceed five years in total. Proposals are due by October 29, 2026, via the OpenGov portal, with an anticipated start date of December 7, 2026. Evaluation follows a two-stage process where technical proposals must score at least 70% to be considered responsive before cost proposals are reviewed. Award criteria emphasize technical expertise in public-sector OPEB valuations, past performance with similar governmental agencies, and the qualifications of the project team. The agreement requires strict adherence to GASB 75 standards, the Federal Privacy Act of 1974, and applicable Actuarial Standards of Practice.

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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.

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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.

Business Services

POSTED

8 days ago

DEADLINE

in 22 days

AI Contract Overview

The City of Knoxville, Tennessee, is seeking proposals from qualified firms or teams to serve as the Pharmacy Benefit Manager (PBM) responsible for administering pharmacy benefits for its employees, retirees, and their dependents. The contract is initially planned for a three-year term, beginning on January 1, 2025, with the potential for two additional one-year extensions, allowing for continued partnership based on performance and mutual agreement. The project scope and requirements are detailed in the solicitation specifications, which outline the expectations for service delivery, cost management, and compliance. The contract value is estimated to range between 5 million and 20 million dollars, reflecting the scale of the pharmacy benefits program. Interested parties are encouraged to submit their proposals by August 8, 2024, with the primary point of contact being James McKeehan via email. The procurement process is open and managed through the Tennessee State and Local Government Electronic Procurement System, with additional information available through the provided online link. The selected PBM will play a critical role in managing pharmacy benefits efficiently, ensuring cost-effectiveness, and maintaining high service standards for the city's eligible populations.

General Info

Agency

Tennessee → City of Knoxville

NAICS

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

Place of Performance

TN, USA

Set-Aside

NONE

Documents

No documents available

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Timeline

PhaseClosed

PostedJul 18

Solicitation

Response DeadlineAug 8

Deadline has passed

Submission Closed

08/08/2024, 12:00:00 AM UTC

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Organization & Contact Information

AgencyTennessee → City of Knoxville

Contacts1 person available

OfficeN/A

Organization / AgencyTennessee → City of Knoxville

Office AddressN/A

Contacts

James McKeehan

contact@example.gov

Full Description

The City of Knoxville in Tennessee is seeking proposals from firms or teams to administer pharmacy benefits for their employees, retirees, and dependents. The contract period is intended to be three years initially, with the possibility of two additional one-year extensions. The enclosed specifications provide the requirements for proposals, and the services would commence on January 1, 2025.