Medical TPA

12 March 2024 Medical TPA The State seeks a partner who can meet current and future needs of the State Plan by serving members who rely on the Plan for affordable, reliable, and effective health insurance coverage. 12 March 2024 Open 3/11/2024 4:30 PM MDT Type Request for Proposal Close 4/24/2024 2:00 PM MDT Number DOA-RFP-2024-0203GU Currency US Dollar Sealed Until 4/24/2024 2:00 PM MDT 12 March 2024 Contacts John Thomas jthomas@mt.gov Phone +1 406-444-0110 Gwenette Ungerman Gwenette.Ungerman@mt.gov Phone +1 406-444-9159 Lauren Spatzierath Lauren.Spatzierath@mt.gov Phone +1 406-444-0118 12 March 2024 Commodity Codes Commodity Code Description 1810 Financial Services - Insurance 2618 Health Related - Services 12 March 202412 March 202412 March 202412 March 202412 March 202412 March 202412 March 202412 March

202412 March 2024 mailto:jthomas@mt.gov mailto:Gwenette.Ungerman@mt.gov mailto:Lauren.Spatzierath@mt.gov The State of Montana, Department of Administration, Health Care & Benefits Division (State) is responsible for the administration of the State of Montana Benefit Plan (State Plan), including the self-funded medical plan. 2-18-809(5), MCA regulates the individuals eligible for State Plan coverage. Currently, the State provides health benefits to State employees, retirees (non-Medicare and Medicare), legislators, Consolidated Omnibus Budget Reconciliation Act (COBRA) enrollees, and their respective dependents, collectively referred to as plan members. The benefit plans, which include medical, prescription drug, dental, and vision, are collectively known as the State Plan and are self-funded by the State. The State wishes to partner with an Offeror who can meet the current and future needs of the State Plan by serving the plan members who rely on the State Plan for affordable, reliable, and effective health insurance coverage. Description Required to View Event Prerequisites Required to Enter Bid 12 March 2024 1. Review and accept the Single Point of Contact information. 2. Please review and accept the RFP Schedule of Events. 3. Please review and accept the pre-proposal conference information. 4. Review and accept the Q & A Board information. 5. Review and accept the contract as provided. 6. Offerors requesting additions or exceptions to the contract terms shall submit them to the Q&A Board. Offerors must use the Contract Exception template attached to this prerequisite. Offerors must detail why the exception is being sought and what specific effect it will have on the offeror's ability to respond to the RFP. Exceptions submitted after deadline will not be considered. 7. Review and accept the RFP Evaluation Process information. 8. Review and accept the Interview/Product Demo information. 9. Review and accept the Vendor Registration information. 10. Review and accept the Montana Time Zone information. 11. Review and accept the Registration with the Secretary of State information. 12. Review and accept the Debarment information. 13. Review and accept the RFP General Information. 14. Review and accept the Submitting a Proposal information. 15. Please review and accept the eMACS Handbook - Responding to Events. Additional resources are available at https://spb.mt.gov/eMACS-Resource 12 March 202412 March 202412 March 202412 March 202412 March 202412 March 202412 March 2024 Buyer Attachments 1. #2 Plan Design Deviation Form.xlsx 2. #3 Claim Edit Deviation Form.xlsx 3. #4 State Plan Census File_January 2024.xlsx 4. #1 WRAP Plan Document 1-1-24 - Final.pdf 5. MEDICAL PLAN TPA RFP - SCORING COMMITTEE.pdf 6. EO-12-2016_Equal+Pay+for+Montana+Women.pdf 7. #1 Administrative Fees Pricing Sheet.xlsx 8. State of Montana Geo Access 0311-2024 Summary - Final.xlsx 9. StateOfMontana_ProviderDisruption_0311-2024 - Final.xlsx 1 0. State of Montana Repricing Workbook 0311-2024 Final.xlsb 12 March 202412 March 202412 March 202412 March 202412 March 202412 March 2024 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDgwMDkjMiBQbGFuIERlc2lnbiBEZXZpYXRpb24gRm9ybS54bHN4&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDczOTAjMyBDbGFpbSBFZGl0IERldmlhdGlvbiBGb3JtLnhsc3g%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDc4MjkjNCBTdGF0ZSBQbGFuIENlbnN1cyBGaWxlX0phbnVhcnkgMjAyNC54bHN4&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDg0MTgjMSBXUkFQIFBsYW4gRG9jdW1lbnQgMS0xLTI0IC0gRmluYWwucGRm&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDg5MTdNRURJQ0FMIFBMQU4gVFBBIFJGUCAtIFNDT1JJTkcgQ09NTUlUVEVFLnBkZg%3D%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEyMDkyNzVFTy0xMi0yMDE2X0VxdWFsK1BheStmb3IrTW9udGFuYStXb21lbi5wZGY%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODEzNzU3MjgjMSBBZG1pbmlzdHJhdGl2ZSBGZWVzIFByaWNpbmcgU2hlZXQueGxzeA%3D%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODE5Njk2MTlTdGF0ZSBvZiBNb250YW5hIEdlbyBBY2Nlc3MgMDMxMS0yMDI0IFN1bW1hcnkgLSBGaW5hbC54bHN4&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODE5Njk4MTlTdGF0ZU9mTW9udGFuYV9Qcm92aWRlckRpc3J1cHRpb25fMDMxMS0yMDI0IC0gRmluYWwueGxzeA%3D%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 https://bids01.jaggaer.com/apps/Router/PublicEventDownload?file=U291cmNpbmdldmVudC8xMjE1NzgzLTE1ODIwODY2ODBTdGF0ZSBvZiBNb250YW5hIFJlcHJpY2luZyBXb3JrYm9vayAwMzExLTIwMjQgRmluYWwueGxzYg%3D%3D&auth=MDpBRVMyI0NQNVp4a2IvSnkxZDNIUm81TGpka2h4M0V4bkpBZDlVSkVFUnk5WnZrK2l5eGZjOVRGNkRHUlU9 Questions Required Questions Group 1: Mandatory Requirements Instructions: To be eligible for consideration, an offeror must meet all mandatory requirements. The State will determine whether an offeror's proposal complies with the requirements. Offerors receiving a Fail in any of the mandatory requirements will be removed from further consideration. 1.1 Provide your full company name, address, and phone number. In addition, list the contact(s) for your company who can answer questions regarding your submitted response. Include contact(s) name, phone number, and email address. 1.2 Offerors must provide their response to SECTION 1 - SCOPE OF SERVICES MEDICAL attached to this question. 1.3 Offerors must upload their response to SECTION 2 - OFFEROR QUALIFICATIONS MEDICAL attached to this question 1.4 Offerors must upload their response to SECTION 3 - Cost Proposal attached to this question. 1.5 Amendment #1: Documents Geo Access 0311-2024 Summary AND Provider Disruption 0311-2024, Have been added to the Buyer Attachments. 1.6 Amendment #2: State of Montana Repricing Workbook 0311-2024 has been added to the Buyer Attachments. Group 2: Confidential Information Instructions: The State of Montana is required by both the Montana Constitution and its laws to permit the public to examine documents that are kept or maintained by the public agencies, other than those legitimately meeting the provisions of Montana Constitution, Mont. Code Ann. §§2-6-1001, et seq, Montana Procurement Act §§18-4-401, et seq., and Montana’s Uniform Trade Secrets Act, Mont. Code Ann. §§ 30-14-401, et seq 2.1 Does your proposal contain confidential information? If you select Yes, another question will be generated, requiring an upload of your Trade Secret Affidavit. Offerors MUST also upload a copy of the response with all areas claimed as confidential or proprietary redacted under Supplier Attachments. 2.2 Offerors must upload a completed Trade Secret Affidavit. Group 3: Equal Pay for MT Women Instructions: 3.1 Equal Pay for Montana Women. Offerors who agree and certify compliance to Executive Order No. 12-2016, Equal Pay for Montana Women, will receive a bonus of 5% of the total points available. Offerors who do not comply will not receive bonus points. Group 4: Verification of Nondiscrimination Against Firearms Entities/Trade Associations Instructions: Instructions: Offeror’s certification is made in compliance with and in reference to 30-20-301, MCA and the terms defined therein. If Offeror determines the provisions of 30-20-301, MCA do not apply to Offeror or the contract to be awarded under this RFP, Offeror shall submit a statement setting forth in detail the basis for such determination. 4.1 Offeror does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association during the term of any contract it is awarded under this solicitation; and b. Offeror will not discriminate against a firearm entity or firearm trade association during the term of any contract it is awarded as a result of this solicitation. 4.2 The Offeror certifies and affirms that they are unable to make both of the certifications in part 1, either now or during the anticipated term of the contract to be awarded as a result of this RFP. Offeror shall upload a statement setting forth in detail the basis for such determination. 12 March 202412 March 202412 March 202412 March 202412 March 2024 Product Line Items Product Line Items 1. # Item Name, Commodity Code, Description Allow Alternates Qty. UOM Requested Delivery P1 Lump Sum Total 1 LS - Lump Sum Lump Sum Total - Product Line Items 12 March 202412 March 202412 March 202412 March 2024 Service Line Items Service Line Items 1. # Item Name, Commodity Code, Description Allow Alternates Qty. UOM Requested Service Delivery S1 Lump Sum Total 1 LS - Lump Sum Lump Sum Total - Service Line Items 12 March 202412 March 202412 March 2024