Arkansas Ionwave #RFP-26-006

Pulaski County Medical TPA and PBM Services Solicitation

Pulaski County is seeking proposals for Medical Third Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) services to manage employee health insurance benefits. - Government Buyer: - Pulaski County Human Resources - Pulaski County Purchasing Department - OEMs and Vendors: - United HealthCare Services, Inc. (current provider and referenced in renewal documents) - Brian Hutchings Concrete Construction (construction change order, not health benefits) - Products/Services Requested: - Medical claims administration (TPA) services - Claims processing, customer service, plan administration - ASO medical fees (approx. $48-$50 PEPM for 895 employees) - Payment integrity services (coordination of benefits, pre-pay, post-pay, subrogation) - Disease management, wellness programs, behavioral coaching, second opinion services, transplant cost negotiation, Naviguard program - Pharmacy benefit management (PBM) services - Formulary management, claims processing, rebate administration, network management - Stop loss insurance administration - Individual stop loss options ($250k-$300k deductible, unlimited liability) - Aggregate stop loss options (125% corridor, $1M liability limit) - Unique/Notable Requirements: - Vendors may bid on either or both TPA and PBM scopes - Compliance with HIPAA, federal, and local laws - Performance guarantees, robust reporting, data security - Implementation plans, sample agreements, and completed questionnaires required - No automatic contract renewals; written confirmation required - Exclusion of financial/pricing information at initial proposal stage - Current contract with United HealthCare Services, Inc. includes detailed fees, credits, and guarantees - Construction change order for Providence Park facility is unrelated to health benefits procurement - Contract Details: - Initial term: one to three years, with renewal options - Annual service period for health plan administration - Stop loss coverage and pharmacy pricing guarantees extend up to three years - Estimated contract value: likely in the multi-million dollar range, based on employee count and service scope - Primary OEMs highlighted: United HealthCare Services, Inc. (health benefits administration) - Pulaski County emphasizes performance, compliance, and transparency in vendor selection.

Description

This solicitation is a Request for Proposal (RFP) issued by Pulaski County for medical claims administration services (Third Party Administrator, TPA) and pharmacy benefit management services (PBM). Vendors may respond to either the Medical TPA scope, the PBM scope, or both. The procurement is assisted by Marsh as the consultant. Proposals must be submitted through the specified application by the deadline and must not include financial/pricing/cost information at this stage. The contract term and detailed service requirements are outlined in the solicitation documents.

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