University of New Mexico Sciquest #RFP-2661-27

UNMH seeks stop-loss insurance for its self-funded employee health plan

The University of New Mexico Hospitals (UNMH) is seeking stop-loss insurance 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 coverage for the plan’s PPO and High Deductible Health Plan (HDHP) options; no carrier, coverage limits, quantities, or part numbers are specified. - Eligible participants: Active benefits-eligible employees with at least 0.5 FTE; retiree coverage is excluded. - Named organizations: Community Care Partners (claims administration), Blue Cross and Blue Shield of New Mexico (claims run-out for pre-2027 plan years), and Prime Therapeutics (pharmacy benefits). No stop-loss carrier is named. - Plan administration: UNMH will directly manage its proprietary provider network beginning with the 2027 plan year. - Performance period: Coverage is associated with FY27; the contract term, start and end dates, and options are not specified.

Description

The University of New Mexico Hospital (UNMH) seeks a qualified insurance carrier to provide stop-loss coverage for its self-funded health plan, in accordance with the requirements in the Scope of Work. The plan includes a PPO and a High Deductible Health Plan (HDHP), and is scheduled to transition to a proprietary UNMH-managed network effective January 1, 2027. Claims administration will be handled by Community Care Partners, while Blue Cross and Blue Shield of New Mexico will manage claims run-out for plan years before 2027. Pharmacy benefits are provided by Prime Therapeutics; retiree coverage is not provided.

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