Pasco County School District Ionwave #26-046-DM Addendum 1

Management Services for Self-Funded Group Health Insurance for Pasco County Schools

The School Board of Pasco County, Florida, is seeking an administrator to manage its self-funded group health insurance program for nearly 10,000 covered individuals. - Government Buyer: - School Board of Pasco County, Purchasing Services - Contact: Deb Mateo - Services Requested: - Health Plan Administrative Services Only (ASO) - Group Medical Plans Administration - Medicare Advantage Plan Administration - Behavioral Health and Wellness Program Administration (integrated model preferred) - Key Requirements: - Direct contract with administrator (no agent or broker services) - Administrator must be licensed in Florida and own their provider network in the state - Must demonstrate financial stability and experience with similar large public sector clients - Compliance with HIPAA, federal, and state regulations - Ability to coordinate with District and its vendors - Administration of run-out claims for 12 months post-termination and annual audits - Preference for integrated behavioral health and wellness programs - Notable Details: - Current administrator is Florida Blue - Gallagher Benefit Services, Inc. is assisting with procurement - Contract may be used by other Florida public agencies with consent - No specific OEMs or product part numbers are named; focus is on administrative and management services

Description

This Request for Proposal (RFP) aims to establish a contract with an administrator to provide improved care management and achieve significant reductions in the total cost of care per member without sacrificing quality for the District's group health program. The program's core components include Health Plan Administrative Services Only (ASO), Group Medical Plans, and a Medicare Advantage Plan. The RFP excludes agent or broker services, but requires the administrator to coordinate all applicable services with the District and its vendors throughout the contract term. The District prefers direct contracts with proposing companies and does not utilize independent agents.

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