Pinellas County Opengov #26-0655-REQ

Pinellas County Medicare Advantage Plan Administration Services Solicitation

Pinellas County Board of County Commissioners, Florida, is seeking qualified firms to provide third-party administration services for its fully-insured Medicare Advantage medical and pharmacy plan for retired county employees and their dependents. - Government Buyer: - Pinellas County Board of County Commissioners, Human Resources Department, Purchasing Division, Office of Management and Budget - Scope of Services: - Administration of a group Medicare Advantage insurance plan with prescription drug coverage - Claims processing, customer service (local/toll-free and secure online platforms), and network access - Distribution of identification cards and informational materials - Assistance with communication and enrollment meetings - Wellness programs, case and chronic condition management, nurse lines - Annual experience reports and dedicated account management team - Technology integration for file acceptance, collection of late enrollment penalties, payment of low income subsidies - Compliance with CMS guidelines, federal and state laws (including E-Verify and public records requirements) - Products/Services Requested: - Medical Rate per member per month for Medicare Advantage plan (approx. 2,500 retirees and dependents) - Pharmacy Rate per member per month for Medicare Advantage plan (approx. 2,500 retirees and dependents) - Third-party administrative services for Medicare Advantage plan - Unique/Notable Requirements: - Pricing based on per member per month rates - Financial stability and strong operational capabilities required - Contract term is 60 months with two optional 24-month extensions; rates established annually and may adjust based on CMS rate announcements - No specific OEMs or vendors are named; opportunity is open to qualified firms capable of meeting requirements.

Description

Pinellas County Board of County Commissioners, Florida is requesting proposals from qualified firms to provide third-party administration services for the County-sponsored medical and pharmacy fully-insured Medicare Advantage Plan for retired county employees and dependents. The scope includes providing a group Medicare Advantage insurance plan with prescription drug coverage, customer service via call-in and online platforms, communication materials, enrollment assistance, claims processing, wellness programs, and dedicated account management. The contract term is 60 months with options for renewal, and proposals must comply with federal and state laws and include detailed vendor questionnaire responses. The solicitation includes a pre-proposal meeting and requires electronic submission via OpenGov.

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