North Orange County Regional Occupational Program Opengov #MA-017-23011286

County of Orange Awards HMO Services Contract to Kaiser Foundation Health Plan, Inc.

The County of Orange has awarded a major contract for Health Maintenance Organization (HMO) services for its Active and Non-Medicare Retiree Health Plan: - Government Buyer: - County of Orange, Human Resource Services/Employee Benefits - OEM/Vendor: - Kaiser Foundation Health Plan, Inc. - Products/Services Requested: - Comprehensive HMO services for active employees and non-Medicare retirees - Full-service administration, claims auditing, coordination of benefits, clinical review, grievances and appeals - Software development and support for plan administration - Wellness program support, including wellness credits and health classes - Open enrollment communication support - Quantities: - Services cover all eligible County enrollees (exact number not specified) - Unique/Notable Requirements: - Performance guarantees for financial accuracy, claims processing, customer service, and account management - Annual evaluation of performance metrics and penalties for non-performance - Strict compliance with California Department of Managed Health Care regulations - Detailed insurance, confidentiality, and indemnification provisions - Option to renew for two additional one-year terms beyond the initial three-year contract - Estimated contract value: $320,000,000 - Primary locations: County of Orange government offices in Santa Ana, CA, and Kaiser offices in Oakland and Santa Ana, CA

Description

This solicitation is a Request for Proposal (RFP) issued by the County of Orange for the provision of Health Maintenance Organization (HMO) services under the Active and Non-Medicare Retiree Health Plan. The contract is awarded to Kaiser Foundation Health Plan Inc. and covers a period from January 1, 2024, to December 31, 2026, with a total funding amount of $320,000,000. The scope includes providing HMO benefits to county enrollees, with performance guarantees as specified in the contract. The procurement is managed by Karen Alvarez, Procurement Manager, within the County Executive Office - Human Resources department.

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