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This Solicitation opportunity from Texas was posted on March 7, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Self-Insured Workers' Compensation Third Party Claims Administration and Related Medical Cost Containment Services

Closed
BLZ24-00023989State & Local

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
Medicaid Medication Risk Reduction Initiative
Solicitation # RFP-2027-DMS-01-MEDIC
The New Hampshire Department of Health and Human Services, Division of Medicaid Services, is soliciting proposals for a statewide Medicaid Medication Risk Reduction Initiative (MMRRI). This program will be led by New Hampshire licensed clinical pharmacists to reduce medication-related problems, adverse drug events, polypharmacy, over-prescribing, and risks associated with opioids and behavioral health medications. The selected vendor will implement a technology solution to analyze pharmacy claims and encounter data to identify high-risk beneficiaries, conduct comprehensive medication reviews, and generate actionable medication safety reports for patients and providers. The contract has an anticipated total funding value of approximately 33,553,391 dollars, distributed across five budget periods through September 2031, and is supported by federal funds under the Rural Health Transformation Program. Key performance requirements include a guaranteed positive return on investment by the end of the third contract year, measured by a reduction in total cost of care on a per member per month basis. Vendors must possess at least three years of experience in pharmacy data analysis and medication review. Award decisions will be based on a point system evaluating technical and cost responses, with a minimum technical score of 1,600 points required to avoid disqualification. The contractor must adhere to strict data security standards, including maintaining an Information Security Management System and ensuring all data processing occurs within the United States. Compliance with Title VI of the Civil Rights Act, the Americans with Disabilities Act, and 2 CFR Part 200 is mandatory. Proposals are due by October 28, 2026, and must be submitted as separate technical and cost documents.
Dhhs-Department Of Health & Human Services

POSTED

3 days ago

DEADLINE

in 3 days
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

4 days ago

DEADLINE

in 25 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

4 days ago

DEADLINE

in 19 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

5 days ago

DEADLINE

in 25 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

5 days ago

DEADLINE

in 19 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

6 days ago

DEADLINE

in 19 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

6 days ago

DEADLINE

in about 1 month
NAICS: 524292
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

9 days ago

DEADLINE

in 22 days
NAICS: 524292
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

9 days ago

DEADLINE

in 19 days

AI Contract Overview

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The City of Dallas is seeking to establish a contract with a qualified Workers’ Compensation Third Party Administrator to oversee the administration of its self-insured workers’ compensation claims and implement related medical cost containment strategies. The selected contractor will be responsible for managing all aspects of workers’ compensation claims across the city’s various operations, requiring extensive expertise in workers’ compensation processes, medical cost containment techniques, and familiarity with the Workers’ Compensation Healthcare Network. This comprehensive scope aims to ensure efficient claims management, reduce costs, and improve outcomes for injured workers. The solicitation, identified as BLZ24-00023989, was posted on March 7, 2024, with a response deadline of April 12, 2024. The contract falls under NAICS code 524292, which pertains to claims administration and related services, and is managed by the City of Dallas, Texas. Interested parties can contact Adenia Clark via email for further details. The contract emphasizes the importance of extensive experience in workers’ compensation and medical cost containment, reflecting the city’s commitment to effective claims management and cost control within its self-insured framework.

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Organization & Contact Information

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AgencyTexas → City of Dallas
Contacts1 person available
OfficeN/A
Organization / AgencyTexas → City of Dallas
Office AddressN/A
Contacts

Full Description

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The CITY is seeking a contract with a Workers’ Compensation Third Party Administrator for its self-insured workers’ compensation claims administration and related cost containment services. The scope of the work will encompass all aspects of City operations and requires extensive experience in worker’s compensation, medical cost containment and knowledge of the Workers’ Compensation Healthcare Network.

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NAICS: 561611
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The City of Dallas is soliciting proposals for background check system services, specifically for Level 1 screening of volunteers under solicitation number IFS PKR B6000073. The contract will be performed in Dallas County, Texas, with all goods considered FOB Dallas delivery site. Award decisions will be based on the lowest responsive and responsible bidder or the most advantageous proposal. Evaluation criteria include the supplier's responsiveness to mandatory requirements and their overall responsibility, which considers financial stability, past performance with the City, and the capacity to complete the work without hindrance. Local preference provisions per Dallas City Code may apply, and tie bids will be resolved according to state and local laws. Selected suppliers must adhere to strict compliance and administrative standards, including the Federal Fair Labor Standards Act, the Occupational Safety and Health Act of 1970, and Executive Order 11246. Required documentation for submission includes a Business Information Form and a Conflict of Interest Questionnaire. Awardees are mandated to provide a valid certificate of insurance within 15 days of notification. Invoicing must be submitted to the appropriate City billing address and must include the written delivery order number. The City retains the right to reject any services that do not meet the specified quality standards, acting as the final judge of product acceptability.
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Purchase of MPH-Gemini Light Sound & Video *222464
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Purchase of Landscaping Flowers, Bulbs and Shrubs *222278
Solicitation # IFS PKR B1700036
The City of Dallas is soliciting bids for the purchase of landscaping flowers, bulbs, and shrubs under solicitation number IFS PKR B1700036. The award will be granted to the lowest responsive and responsible vendor. All products must be new, unopened, in original packaging, and meet minimum specifications, as no alternatives or substitutes are permitted. Bids must be submitted online via the Bonfire hub by the deadline of November 2, 2026. Delivery is designated as FOB delivery site to the Fair Park Administration Tower Building in Dallas, Texas, and vendors must include all freight costs in their pricing. The contract is governed by the General Conditions for Informal Solicitations of the City of Dallas. Vendors must provide a Conflict of Interest Questionnaire and, if work is performed on city property, certificates for general liability and workers compensation insurance. The City of Dallas is exempt from federal excise, state, and local sales and use taxes, which should not be included in the quotes. Vendors are subject to disqualification based on collusion, poor contract performance history, financial instability, or outstanding liabilities with the city. All deliveries must be authorized by the city's purchasing agent and are subject to inspection and rejection if they do not meet quality standards.
Flower, Nursery Stock, and Florists' Supplies Merchant Wholesalers

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Solicitation # CIZ26-BON-30609
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10 days ago

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