North Orange County Regional Occupational Program Opengov #MA-017-23011289

Award for Medicare Retiree Health Plan Services (Kaiser HMO) for County of Orange, CA

This opportunity involves the County of Orange, California awarding a contract for Medicare Retiree Health Plan Services, specifically Kaiser HMO Benefits for Retirees. - Government Buyer: - County of Orange, Human Resource Services/Employee Benefits division - OEMs and Vendors: - Kaiser Foundation Health Plan, Inc. (primary OEM and service provider) - Subcontractors: Accenture, Tata Consulting Services (for staff augmentation and software support) - Products/Services Requested: - Administration and provision of group health plan benefits for post-65 retirees - Full-service administration, coordination, monitoring, and implementation of Medicare Retiree Health Plan Services - Includes claims auditing, coordination of benefits, clinical review, grievances and appeals, software development and support, and staff augmentation - No specific product line items or part numbers; this is a comprehensive service contract - Unique or Notable Requirements: - Performance guarantees for financial accuracy, claim processing, customer service, and eligibility processing, with penalties for non-compliance - Compliance with all RFP requirements and state regulatory approvals - Insurance provisions: general liability, automobile, workers compensation, cyber liability, and professional liability - Annual reporting and quarterly account management - Compensation based on monthly premiums with wellness credits - Place of Performance: - County of Orange, Santa Ana, California (primary government facility) - Kaiser Foundation Health Plan offices in Oakland and Santa Ana, CA

Description

The County of Orange is soliciting proposals for Kaiser HMO Benefits for Retirees under a Request for Proposal (RFP) format. The contract involves providing Medicare Retiree Health Plan Services effective January 1, 2024, through a Group Services Agreement approved by the State of California Department of Managed Health Care. The selected contractor, Kaiser Foundation Health Plan, Inc., will offer health benefits to former county enrollees with agreed performance guarantees. The estimated contract value is $200,000,000, and the place of performance is Santa Ana, California.

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