Arkansas Ionwave #RFP-26-006 Addendum 1

Pulaski County Solicits Medical TPA and PBM Services for Employee Health Benefits

Pulaski County, Arkansas is seeking proposals for Medical Third Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) services to manage its employee health benefits program. - Government Buyer: - Pulaski County Human Resources (Arkansas Government) - Office: Human Resources - OEMs and Vendors Mentioned: - United HealthCare Services, Inc. (current provider for health insurance and administrative services) - Brian Hutchings Concrete Construction (construction change order, not relevant to TPA/PBM scope) - Products/Services Requested: - Medical TPA Services: - Claims administration, provider network management, clinical and care management, customer service, eligibility, billing, reporting, compliance, and implementation - Administrative services fees (ASO), payment integrity services (coordination of benefits, pre-pay, post-pay, subrogation) - Stop loss insurance (individual and aggregate options with various deductibles and rates) - Health management programs (behavioral coaching, maternity, second opinion, transplant cost negotiation, Naviguard) - Pharmacy Benefit Manager (PBM) Services: - Pharmacy claims administration, formulary management, pharmacy network management (retail, mail, specialty), clinical programs, rebate and financial transparency, member experience, reporting, compliance, and implementation - Unique or Notable Requirements: - Bidders must be fully licensed and operational TPAs or PBMs at proposal submission - No custom software development required - Price transparency required for PBM vendors (financials submitted separately) - Coordination with the County's Human Resources Information System (UKG) - HIPAA compliance and robust reporting required - Performance guarantees and sample service agreement submission - Contract term is three years with an option for a three-year renewal; prices firm for first year, with up to 5% annual escalation allowed - The County reserves the right to accept/reject proposals and request additional pricing information after technical evaluation - No specific part numbers or product quantities for TPA/PBM services, as this is a service procurement - United HealthCare Services, Inc. is the incumbent provider for current administrative services and stop loss insurance

Description

Pulaski County is soliciting proposals for medical claims administration services (Third Party Administrator, TPA) and pharmacy benefit management services (PBM). Vendors may respond to the Medical TPA scope, the PBM scope, or both. The solicitation focuses on ongoing operational administration including claims administration, provider/pharmacy network management, clinical programs, member services, and benefits administration. No custom software development is included, but bidders must provide reporting, member portals, data migration, and data transfer capabilities.

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