University of New Mexico Sciquest #RFP-2652-27

Stop-loss coverage for UNMH’s self-funded employee health plan

The University of New Mexico Hospitals is seeking an insurance carrier to provide stop-loss coverage for its self-funded employee health plan. - Government buyer: University of New Mexico Hospitals (UNMH), University of New Mexico, UNM Health Sciences Center. - Requested service: Stop-loss insurance coverage for the self-funded plan, which offers PPO and High Deductible Health Plan (HDHP) options. - Eligible participants are active benefits-eligible employees with at least 0.5 FTE; retirees are excluded. - The notice does not provide coverage limits, quantities, or detailed insurance terms. - Existing plan-related providers: Community Care Partners (claims administration), Blue Cross and Blue Shield of New Mexico (claims run-out for pre-transition plan years), and Prime Therapeutics (pharmacy benefits). These are identified as existing providers, not as requested bidders. - Notable plan arrangement: UNMH plans to directly manage a proprietary provider network as part of the plan transition. - OEMs: No product manufacturers or OEMs are identified; this is a request for insurance coverage.

Description

The University of New Mexico Hospital seeks a qualified insurance carrier to provide stop-loss coverage for its self-funded health plan. The plan currently offers a PPO and a High Deductible Health Plan, and beginning January 1, 2027, will transition to a proprietary network managed directly by UNMH, with claims administration handled by Community Care Partners. Blue Cross and Blue Shield of New Mexico will manage claims run-out for plan years before 2027, and Prime Therapeutics will provide pharmacy benefits. Eligible participants are active benefits-eligible employees with a 0.5 FTE or higher; retiree coverage is not provided.

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