122435 O5 - Medical Evaluation Criteria.docx

DOCX document 23 KB Posted

Attached to
Administrative Support Services for the State of Nebraska Employee Health Care Medical Benefit Plans
Solicitation number
122435 O5
Issued by
Lancaster County, Nebraska

About this file

The document is an evaluation criteria file for Request for Proposal (RFP) #122435 O5 issued by the State of Nebraska Department of Administrative Services for Administrative Support Services for Employee Health Care Medical Benefit Plans. The RFP seeks a third-party administrator for the state's self-insured medical plans, covering approximately 17,500 employees and 13,600 enrolled members, including active employees, pre-65 retirees, and COBRA participants. The contract will run from execution through June 30, 2029, with options to renew for two additional one-year periods. Proposals are due by July 17, 2025, at 2:00 p.m. Central Time, with the target implementation before the annual Open Enrollment period in May and a benefit plan year beginning July 1, 2026.

The evaluation process will award a maximum of 100 points (with potential for an additional 20 points for vendor demonstrations), distributed across Corporate Overview (25 points), Technical Response (55 points), and Cost (20 points). Vendors must have at least five years of self-funded medical administration experience, serve public sector groups with a minimum of 15,000 lives, and be licensed to offer solutions in all 50 states and U.S. territories. The state requires comprehensive services including member services, claims processing, network management, medical management, and wellness programs across three health plan options. Cost considerations include per employee per month (PEPM) fees, pass-through charges, and Health Savings Account (HSA) services, with administrative fees starting July 1, 2026. Performance Guarantees attachment indicates financial penalties ranging from 0.50% to 1.50% of annual fees for non-compliance, emphasizing the state's focus on innovative strategies for cost reduction and quality care.

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Other files

File Type Posted
122435 O5 - Cost Sheet.xlsx XLSX spreadsheet
122435 O5 - Medical Benefits RFP.pdf PDF
Intent to Award.pdf PDF
122435 O5 - Attachment B - Business Associate Agreement.doc DOC document
122435 O5 - Medical Benefits RFP.docx DOCX document
122435 O5 Solicitation List of Respondents.pdf PDF
122435 O5 - Attachment A - Intent to Propose.docx DOCX document
122435 O5 UHC STACKED.pdf PDF
122435 O5 - Addendum One- Questions & Answers and Updated Attachment C.docx DOCX document
Medical 122435 O5- Addendum Two- Questions and Answers- Round Two V2.pdf PDF
FinalEvaluationDocument.pdf PDF
122435 O5 - Attachment C1 - Questionnaire.xlsx XLSX spreadsheet
122435 O5 BCBSNE STACKED.pdf PDF
122435 O5 - Attachment D - Performance Guarantees.xlsx XLSX spreadsheet
122435 O5 - Medical Evaluation Criteria.docx DOCX document
122435 O5 - Attachment A - Intent to Propose.docx DOCX document
122435 O5 - Attachment C1 - Questionnaire.xlsx XLSX spreadsheet
122435 O5 - Attachment D - Performance Guarantees.xlsx XLSX spreadsheet
122435 O5 - Medical Evaluation Criteria.docx DOCX document
122435 O5 - Attachment B - Business Associate Agreement.doc DOC document
122435 O5 Solicitation List of Respondents.pdf PDF
122435 O5 - Medical Benefits RFP.pdf PDF
122435 O5 - Cost Sheet.xlsx XLSX spreadsheet
Medical 122435 O5- Addendum Two- Questions and Answers- Round Two V2.pdf PDF
122435 O5 - Medical Benefits RFP.docx DOCX document
122435 O5 - Addendum One- Questions & Answers and Updated Attachment C.docx DOCX document
Medical 122435 O5- Addendum Two- Questions and Answers- Round Two V2.pdf PDF
122435 O5 - Attachment D - Performance Guarantees.xlsx XLSX spreadsheet
122435 O5 - Medical Evaluation Criteria.docx DOCX document
122435 O5 - Cost Sheet.xlsx XLSX spreadsheet
122435 O5 - Medical Benefits RFP.docx DOCX document
122435 O5 - Attachment A - Intent to Propose.docx DOCX document
122435 O5 - Medical Benefits RFP.pdf PDF
122435 O5 - Attachment C1 - Questionnaire.xlsx XLSX spreadsheet
122435 O5 - Attachment B - Business Associate Agreement.doc DOC document
122435 O5 - Addendum One- Questions & Answers and Updated Attachment C.docx DOCX document
122435 O5 - Medical Benefits RFP.pdf PDF
122435 O5 - Cost Sheet.xlsx XLSX spreadsheet
122435 O5 - Addendum One- Questions & Answers and Updated Attachment C.docx DOCX document
122435 O5 - Attachment C1 - Questionnaire.xlsx XLSX spreadsheet
122435 O5 - Attachment D - Performance Guarantees.xlsx XLSX spreadsheet
122435 O5 - Attachment A - Intent to Propose.docx DOCX document
122435 O5 - Attachment B - Business Associate Agreement.doc DOC document
122435 O5 - Medical Benefits RFP.docx DOCX document
122435 O5 - Medical Benefits RFP.pdf PDF
122435 O5 - Cost Sheet.xlsx XLSX spreadsheet
122435 O5 - Attachment C - Questionnaire.xlsx XLSX spreadsheet
122435 O5 - Attachment D - Performance Guarantees.xlsx XLSX spreadsheet
122435 O5 - Attachment B - Business Associate Agreement.doc DOC document
122435 O5 - Medical Benefits RFP.docx DOCX document
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Text version

SOLICITATION EVALUATION CRITERIA

SOLICITATION NUMBER: 122435 O5

Administrative Support Services for the State of Nebraska Employee Health Care Medical Benefit Plans Opening Date: July 17, 2025

Mandatory Requirements The solicitation responses will first be examined to determine if all mandatory requirements listed below have been addressed to warrant further evaluation. Responses not meeting mandatory requirements will be excluded from further evaluation. The mandatory requirement items are as follows:

Contractual Agreement Form signed manually in ink or by DocuSign.

Corporate Overview;

Completed Sections II through IV;

Completed Technical Response, including Attachment C - Questionnaire;

Completed Attachment A - Intent to Propose Form;

Completed Attachment B - Business Associate Agreement;

Completed Attachment D - Performance Guarantee Sheet;

Completed Attachment E - Claims Repricing File;

Completed Attachment F - By County Network Access Analysis; and Completed Cost Sheet Evaluation Criteria All responses to this solicitation, which fulfill all mandatory requirements, will be evaluated. Each category will have a maximum possible point potential. Areas that will be addressed and scored during the evaluation include:

Evaluation Criteria
Possible Points
Part 1 Corporate Overview
25
Part 2 Technical Response
55
Part 3 Cost
20
Total Points without Vendor Demonstrations
100
Vendor Demonstrations, (if required)
20
Total Points with Vendor Demonstrations
120

Part 3 – Cost Cost points should be calculated as follows, accounting for cost realism and reasonableness:

0. Establish lowest realistic cost submitted – lowest cost submitted receives the maximum points.

0. To assign points to all others, the following formula should be followed:

Lowest Cost Submitted Cost Submitted x Maximum Possible Cost Points = Cost Points to Award (see samples below)

Formula

Sample

Sample

Sample

Lowest Cost Submitted

$100,000

$100,000

$100,000

Cost Submitted

$100,000

$200,000

$150,000 x Maximum Possible Cost Points

= Points To Award

20.00

10.00

13.33

122435 O5 Evaluation Criteria

File details come from the government source that posted it. Updated .