This Solicitation opportunity from Washington was posted on September 8, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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UMP Pharmacy Benefit RFI

Closed

2026HCA6State & Local

Submission Closed10/09/2026, 08:00:00 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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The California Department of State Hospitals (DSH) is soliciting proposals for a Statewide Integrated Health Care Provider Network (HCPN) to provide community-based specialty medical services. The contract includes the implementation of a Third Party Administration (TPA) and Utilization Management (UM) system, featuring Prior Authorization (PA) services. The anticipated performance period begins March 1, 2027, for an initial term of up to three years, with the possibility of two one-year extensions. Award selection is based on the best overall value, utilizing a three-step scoring process that evaluates technical capabilities and cost, provided the proposer meets minimum qualifications including legal right to do business, three professional references, and agreement to insurance requirements. The selected contractor must adhere to strict professional standards, including NCQA PA/UM standards, The Joint Commission requirements, and HIPAA and CMIA privacy regulations. Key deliverables include the submission of business continuity, disaster recovery, and transition-out plans within 60 calendar days of the contract effective date. The contractor is responsible for providing all necessary laboratory supplies and specimen transport materials, such as sterile containers and locked transport bags, at no additional cost. Financial requirements include the maintenance of performance and payment bonds not less than the contract price, with invoicing submitted monthly in arrears. The agreement is subject to a 30-day cancellation notice by the DSH and requires signed acceptance from the DSH Contract Manager for payment processing.

California Department of State Hospitals

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RFP-171-260000002410-2 | Behavioral Health and Substance Use Disorder Benefits Admin

Solicitation # 260000002410

The State of Michigan Department of Technology, Management and Budget is soliciting proposals for the administration of Behavioral Health and Substance Use Disorder benefits for the State Health Plan PPO. This hybrid contract covers Active Employee, Non-Medicare Retiree, and Medicare Supplemental Retiree plan designs, providing comprehensive services including inpatient and residential care, Applied Behavioral Analysis for autism, and various outpatient and specialized treatments. The contract is scheduled to be effective May 1, 2027, and expire December 31, 2031, with the option for seven additional one-year renewals. The selected contractor must adhere to strict performance and security standards, including a 99.98 percent software availability requirement and compliance with HIPAA, FedRAMP, and NIST SP 800-53. All state data must be hosted within the continental United States in Tier 3 data centers. Award decisions will be based on best value, requiring bidders to meet a minimum technical threshold of 80 points. Evaluation factors include pricing, prior performance with the state, total cost of ownership, and the bidder's status as a qualified disabled veteran owned business. Bidders are required to provide detailed claims repricing, disruption analysis, and GeoAccess reporting to ensure network adequacy and cost-effectiveness.

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DAS Healthcare Navigation Services

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The State of Ohio Department of Administrative Services is soliciting proposals for a contractor to provide comprehensive healthcare navigation services for approximately 103,000 members. The primary objective is to improve the quality of care and reduce overall costs by simplifying access to care, increasing engagement in existing programs, and improving healthy outcomes. The scope of work includes providing guidance on healthcare benefits, supporting provider selection and appointment scheduling, assisting with claims and billing, and offering cost transparency tools. The selected contractor must integrate with existing Third Party Administrators and HR technology platforms and provide data insights via reporting capabilities. The contract utilizes a not-to-exceed unit cost fee structure with an initial term running from the date of signature through June 30, 2030, with potential renewals for up to four years. To qualify, offerors must meet a mandatory requirement of having provided navigation services to at least one public sector self-insured employer with at least 25,000 covered lives within the past five years. Award selection is based on the highest total score combining technical, cost, and presentation evaluations, provided a minimum technical threshold is met. The contractor must adhere to strict service level agreements, including answering calls within 20 seconds and maintaining 99.9 percent web portal availability, while complying with State IT policies and HIPAA regulations via a Business Associate Agreement.

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Q517--PHARMACY BENEFITS SERVICES | WICHITA |

Solicitation # 36C25527Q0015

The Department of Veterans Affairs, Network Contracting Office 15, is soliciting quotations to establish a single-award, Indefinite Delivery/Indefinite Quantity (IDIQ) contract with fixed unit pricing for Pharmacy Benefit Services. This contract supports the First Fill Prescription Voucher Program at the Robert J. Dole VA Medical Center in Wichita, Kansas, including its associated Community Based Outpatient Clinics and Home-Based Primary Care programs. The program is designed to provide eligible Veterans with first or urgent fill prescriptions, typically limited to a 10-day supply or 14 days for antibiotics, in scenarios where VA pharmacies are impractical, such as after telehealth appointments or emergency room visits. The period of performance is scheduled from January 4, 2027, to January 3, 2030. This procurement is a total set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB), and all offerors must be registered in the SBA VetCert database to be considered. The selected contractor must maintain a geographically accessible pharmacy network with 24-hour and extended holiday coverage, adhere to VA-provided emergency medication formulary lists, and maintain strict HIPAA and Privacy Act compliance. Award will be based on best value, with technical capability and past performance combined being weighted more heavily than price. Quotations must include a dispensing fee per prescription, a discount from the Average Wholesale Price, and an administration fee per prescription, and must be submitted electronically to the contracting officer by November 23, 2026.

255-NETWORK Contract Office 15 (36C255)

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Flexible Spending Account (FSA) Account Services

Solicitation # RFP 27P0026MOS

The University of Alaska is soliciting proposals under RFP 27P0026MOS to secure a qualified third-party administrator for its Flexible Spending Accounts program. This five-year contract aims to establish a modern, scalable, and compliant administration solution for benefit-eligible employees across the entire UA System. The selected contractor will be responsible for providing intuitive participant experiences through mobile apps and online portals, ensuring seamless automated data integration with university systems, and maintaining strict adherence to HIPAA and IRC Section 125 regulations. Key requirements include the delivery of responsive customer support tailored to Alaska time zones, real-time balance tracking, and simplified claim submission workflows. The university seeks a partner capable of enhancing overall benefit value while ensuring error-free financial accounting and robust auditability. Interested parties must submit their responses by November 25, 2026, to be considered for this comprehensive service agreement.

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Flexible Spending Accounts (FSA) Administration Services RFP Number: UA 27P0036MOS

Solicitation # 225712

The University of Alaska has issued Request for Proposals No. 27P0036MOS seeking qualified vendors to provide Flexible Spending Accounts (FSA) Administration Services. This solicitation was officially issued on October 30, 2026, and all relevant documentation, including potential amendments and award notices, is hosted on the University's Bonfire hub portal. Interested parties must adhere to a strict timeline, with the deadline for submitting questions set for November 18, 2026, at 5:00 PM AKDT. Final proposals must be submitted by November 25, 2026, at 12:00 PM AKDT. The University specifies that proposals must be submitted through the designated portal, as any submissions sent via fax or other unauthorized methods will be rejected as non-responsive.

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Employee Benefits- Life/STD/FSA/HSA/COBRA

Solicitation # 27-011CH-32RFP

The Tempe Union High School District #213 is soliciting proposals under RFP 27-011CH-32RFP for the administration of employee benefits for the plan years spanning July 1, 2027, through June 30, 2032. The scope of work includes Basic and Voluntary Life and Accidental Death and Dismemberment, Short-Term Disability, Flexible Spending Accounts, Health Savings Accounts, and COBRA administration. Key requirements include the provision of a 24/7 participant website, comprehensive online reporting for the District, and the waiver of pre-existing condition limitations for initially enrolled employees and dependents. The District intends to ensure no loss of benefits during carrier transitions and requires the elimination of active-at-work restrictions or deferred effective dates in the master contract. Proposals must be submitted via the OpenGov portal by November 19, 2026, with questionnaires and financial tabs provided strictly in Excel format. The evaluation process utilizes a point formula system across three phases: a technical proposal (weighted on responsiveness, qualifications, cost, and past performance), potential interviews or demonstrations, and a best and final offer. A minimum of 500 technical points is required to proceed to price evaluation. The District may make multiple awards by individual product line. Contractual terms include Net 30 payment terms, a five-year records retention requirement, and compliance with various state and federal non-discrimination and labor laws. Implementation must be completed 60 days prior to open enrollment, with the implementation manager providing support for 45 days following the July 1 effective date.

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Employee Benefits- Medical/Rx/EAP RFP

Solicitation # 27-012CH-32RFP

The Tempe Union High School District #213 is soliciting proposals under RFP 27-012CH-32RFP for the provision of Medical, Pharmacy (Rx), and Employee Assistance Program (EAP) benefits for its eligible employees and their household members. The scope of work includes Third-party Administrator (TPA) services for claims and network access, bundled Pharmacy Benefit Management (PBM), and EAP services, with the potential addition of a qualified High Deductible Health Plan (HDHP). The intended contract term begins March 15, 2027, and runs through March 14, 2028, with the possibility of four one-year renewals, while the plan years for the services are scheduled from July 1, 2027, through June 30, 2032. All direct services must be performed within the United States. The selection process utilizes a point formula system where technical proposals must score at least 500 out of 1,000 points to proceed to price evaluation. Evaluation factors include responsiveness, qualifications, cost, and past performance, followed by vendor interviews and a potential Best and Final Offer phase. Awarded contractors must comply with Arizona Law, the Arizona School District Procurement Code, and federal regulations including the Affordable Care Act and the Davis-Bacon Act. Key requirements include maintaining comprehensive general liability insurance of at least 1 million dollars per occurrence and 2 million dollars aggregate, as well as adhering to strict cybersecurity and data confidentiality standards. Proposals were due by November 19, 2026, via the OpenGov portal.

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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, as well as compliance with Commonwealth Office of Technology standards and HIPAA regulations via a Business Associate Agreement. Vendor performance will be 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. Security is a high priority, requiring immediate data breach notification within 30 minutes of discovery and the maintenance of cyber insurance or performance bonds. Proposals are evaluated based on technical and cost criteria, with a 15 percent preference given to qualified bidders. The final deadline for proposal submission is December 9, 2026, with an anticipated contract start date of April 1, 2027. Payments are processed within 30 working days of invoice acceptance, provided all specific documentation and Personal Service Contract forms are submitted.

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.

POSTED

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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 Contractors to serve as Third-Party Administrators (TPA) for its self-insured medical plans, including Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP. The selected Contractor(s) will be evaluated by region and will be responsible for administering existing plan designs for approximately 103,000 covered lives starting July 1, 2027. Key responsibilities include the seamless delivery of medical health benefits, daily reconciliation of plan accumulators with behavioral health and prescription drug contractors, and the integration of data feeds with pharmacy, population health management, and data warehouse vendors. The contract term runs from the date of signature through June 30, 2030, with the State maintaining the option for one-month renewals. Proposals are evaluated based on a maximum of 8,800 points, with a mandatory requirement that the Contractor administer existing plan designs without exception. Financial terms include monthly ASO fees paid Net 30 and claims reimbursement within ten business days, with claims billed no more than weekly via ACH. Contractors must provide a Benefits Fund of 75,000 USD per awarded region for the initial three-year period and at least 25,000 USD per region for subsequent renewals. Performance is monitored through strict Service Level Agreements, including a 100 percent success rate for mailing ID cards within five days of enrollment. Additionally, Contractors must comply with State IT policies, HIPAA regulations via a Business Associate Agreement, and maintain licensure with the Ohio Department of Insurance.

Administrative Services

POSTED

6 days ago

DEADLINE

in 10 days

AI Contract Overview

The Washington State Health Care Authority issued Request for Information 2026HCA6 to conduct market research for a potential future procurement of self-insured pharmacy benefits. This initiative aims to serve approximately 435,000 members enrolled in the Public Employees Benefits Board and School Employees Benefits Board programs. The agency is seeking detailed information from Pharmacy Benefit Administrators, PBMs, and TPAs regarding administrative models, benefit design, cost containment strategies, and the administration of Medicare Part D. The solicitation was posted on September 8, 2026, with a response deadline of October 9, 2026. A subsequent amendment issued on September 25, 2026, clarified that the scope includes Medicare EGWP lives and specified that the Medicare retiree plan operates as a Part D arrangement. The RFI also provides guidance on security compliance and public records requests to ensure all participating vendors are aligned with state requirements.

General Info

Washington State RFI for self-insured pharmacy benefits serving 435,000 members by October 2026.

Agency

Washington → Health Care Authority

NAICS

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

Place of Performance

Multiple Counties, WA, USA

Set-Aside

NONE

Documents

amendment

High

rfi

High

AI Contract Breakdown

Uniform Contract Format

Contract not broken down yet

CLEATUS splits the solicitation into Uniform Contract Format (UCF) sections: scope, pricing, deliverables, and evaluation criteria.

Timeline

PhaseClosed

PostedSep 8

Solicitation

Response DeadlineOct 9

Deadline has passed

Submission Closed

10/09/2026, 08:00:00 AM UTC

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Organization & Contact Information

AgencyWashington → Health Care Authority

Contacts1 person available

OfficeWA, USA

Organization / AgencyWashington → Health Care Authority

Office AddressWA, USA

Contacts

Jerry NicholsContact

contact@example.gov

+1 (555) 000-0000

Full Description

HCA is gathering information that may be used in consideration of a future procurement for a self-insured pharmacy benefit for approximately 435,000 members between the Public Employees Benefits Board (PEBB) and the School Employees Benefits Board (SEBB) Programs.