This Solicitation opportunity from Illinois was posted on December 3, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Sole Source - BPCSS Medicare Part D Reimbursement Claim Processing

Closed

26-444DHS-444OC-B-50260State & Local

Submission Closed12/17/2025, 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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State of South Dakota Account Based Plans (HRA, HSA and FSA)

Solicitation # 26RFP19879

The State of South Dakota Bureau of Human Resources and Administration is seeking a qualified vendor under solicitation 26RFP19879 to provide comprehensive administration services for its Account Based Plans. The scope of work includes the management of Health Savings Accounts (HSA), Health Reimbursement Arrangements (HRA), and Medical and Dependent Care Flexible Spending Accounts (FSA). The state aims to secure a partnership that leverages innovative technology and exceptional service to ensure a positive participant experience while supporting the long-term Tidal Rewards strategy. Proposals must be submitted electronically in MS Word or PDF format to Peggy Carter by October 28, 2026, at 5:00 PM CDT, with a total email size limit of 20MB. All submissions must be signed by an authorized representative and reference the solicitation number. The state will not award contracts to entities in arrears on obligations to South Dakota or those deemed irresponsible. Additionally, all IT-related purchases associated with the contract require approval from the Bureau of Information and Technology. An award decision and contract negotiation are anticipated by December 14, 2026.

South Dakota State Government

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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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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

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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

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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

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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.

POSTED

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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

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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

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

9 days ago

DEADLINE

in 19 days

AI Contract Overview

The Illinois Department of Human Services intends to award a sole source contract to Public Consulting Group for Medicare Part D Reimbursement Claim Processing, recognizing that this is the only economically feasible option for fulfilling the required services. The contract, with a value estimated between 500,000 and 2,000,000 dollars, is designated to support the processing of Medicare Part D claims, ensuring accurate reimbursement and compliance with relevant regulations. The solicitation was posted on December 3, 2025, with a response deadline of December 17, 2025, and the contract is associated with NAICS code 524292, which pertains to claims processing and related services. Interested parties are invited to submit written comments or requests for a public hearing by December 12th at 4 P.M., after which the hearing will be canceled if no such requests are received. The primary contact for inquiries is Shannon Tribble from the DHS Office of Clinical Support, reachable via email or phone. Additional details about the procurement process and hearing specifics are available through the provided online link. The documentation related to the hearing and approval process appears to be inaccessible or corrupted, providing no further substantive information. Overall, this procurement aims to streamline Medicare Part D claim processing through a sole source arrangement with a qualified provider, ensuring continuity and efficiency in the state's healthcare reimbursement operations.

General Info

Agency

Illinois Department of Human Services

NAICS

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

Place of Performance

IL, USA

Set-Aside

NONE

Documents

Sole Source Hearing Details form - Bid-50260

1 page · other

Low

SSJF Medicare Part D Claims - Bid-50260 approved

other

Low

AI Contract Breakdown

Uniform Contract Format

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Timeline

PhaseClosed

PostedDec 3

Solicitation

Response DeadlineDec 17

Deadline has passed

Submission Closed

12/17/2025, 12:00:00 AM UTC

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Organization & Contact Information

AgencyIllinois Department of Human Services

Contacts1 person available

OfficeN/A

Organization / AgencyIllinois Department of Human Services

Office AddressN/A

Contacts

Administrative and Program Support DHS Office of Clinical

contact@example.gov

+1 (555) 000-0000

Full Description

This is a notice of intent to award a contract as a sole economically feasible source to Public Consulting Group for Medicare Part D Reimbursement Claim Processing. See attachment for details. The hearing will be canceled unless an interested party submits written comments or makes a written request for public hearing by Friday, December 12th at 4 P.M. to the info contact above.

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