31786-00187_Digital_Submission_Instructions.pdf

This document contains digital submission instructions for RFP #31786-00187 issued by the State of Tennessee, Department of Finance and Administration, Division of Benefits Administration. The RFP seeks administrative services from a third-party administrator (TPA) for The Tennessee Plan, a self-insured supplemental medical insurance program for Medicare-eligible state retirees. The TPA will provide comprehensive administrative functions including claims processing, member communications, call center services, HIPAA compliance, weekly claims payment processing, subrogation recovery, and enrollment management. Responses are due by December 10, 2025, with a Notice of Award expected on February 26, 2026. Implementation activities will occur from April through December 2026, and the contract term runs from January 1, 2027, through December 31, 2031, with a claims run-out period extending through December 31, 2033.

Respondents must submit their proposals through a secure file-sharing link (https://tncloud.tn.gov/owncloud/index.php/s/C5qzfnbGh0sf2Rj) and comply with all filing requirements specified in RFP #31786-00187, including file naming conventions and formatting standards. The evaluation methodology allocates 10 points for general qualifications and experience, 40 points for technical qualifications and approach, and 50 points for cost proposals. Compensation will be structured through monthly per-member-per-month (PMPM) rates, with contract liability determined by the best-evaluated cost proposal. The current incumbent is UMR, Inc., whose contract expires June 30, 2028. The plan covers approximately 48,059 members as of July 2025, with consistent annual growth of 1,500–2,000 members. Annual claims costs have increased approximately 4% historically, with total annual claims volumes in the tens of millions of dollars, indicating a substantial contract opportunity.