Columbus City Schools Columbuscityschools #065

Columbus City Schools Seeks Managed Care Organization for Medical Plan Administrative Services (PPO, EPO, HDHP)

Columbus City Schools, Ohio's largest school district, is seeking proposals from qualified managed care organizations for comprehensive medical administrative services: - Government Buyer: - Columbus City Schools (CCS), serving approximately 8,200 benefits-eligible employees and 46,000 total students and staff - Products/Services Requested: - Administrative services for six union-based medical benefit plans, including PPO, EPO, and High Deductible Health Plans (HDHP) - Claims processing, managed care, clinical services, network management, utilization review, disease management, and member services - Pharmacy administration, including network management and transparent pricing for discounts and rebates - Wellness program management and support for CCS's staff wellness initiatives - Geo-access reporting for provider network adequacy by zip code - Electronic data exchange and detailed claims data delivery (monthly, quarterly, annual) - Unique or Notable Requirements: - Vendors must closely match current plan designs based on union agreements; any deviations must be clearly indicated - No stop loss coverage is currently purchased - Pharmacy network must exclude Kroger - Pharmacy rebates must be passed directly to the district - Transparent pricing for all discounts and rebates is required - Compliance with CCS's Outreach Program, targeting 20% participation by Local Economically Disadvantaged Enterprise (LEDE) vendors, with documentation of good faith efforts - Support for electronic data exchange and geo-access reporting - Proposals must include both a complete and a redacted version (if necessary) for public records compliance - OEMs and Vendors: - No specific OEMs or vendors are named in the solicitation; the district uses Munis for payroll and HR - Period of Performance: - Initial contract period of 3 years, with two optional one-year renewals; rates/fees must be guaranteed for the first 3 years - Place of Performance: - Columbus City Schools, Columbus, OH - Main administrative address: 3700 South High Street, Columbus, OH 43207 - Aon Health Solutions (consultant): 8940 Lyra Drive, Suite 250, Columbus, OH 43240

Description

Columbus City Schools is seeking proposals from qualified managed care organizations to provide medical administrative services for their PPO, EPO, and HDHP benefit plans. The RFP covers administrative services for the district's medical plans along with related managed care and clinical services. The district serves approximately 8,200 benefits-eligible employees and plans to enter into a contract effective January 1, 2025, for an initial period of three years with optional renewals. Proposals are due by January 5, 2024, and vendors must comply with the district's outreach program to include Local Economically Disadvantaged Enterprise (LEDE) participation goals.

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