31786-00188_Amendment_Two.pdf

STATE OF TENNESSEE

DEPARTMENT OF FINANCE & ADMINISTRATION, BENEFITS ADMINISTRATION

REQUEST FOR PROPOSALS #31786-00188

AMENDMENT #TWO FOR EMPLOYEE ASSISTANCE

PROGRAM (EAP) AND BEHAVIORAL HEALTH

ORGANIZATION (BHO) SERVICES

DATE: December 12, 2025

RFP #31786-00188 IS AMENDED AS FOLLOWS:

1. This RFP Schedule of Events updates and confirms scheduled RFP dates. Any event, time, or date containing revised or new text is highlighted.

EVENT

TIME

(central time zone)

DATE

1. RFP Issued October 8, 2025

2. Disability Accommodation Request Deadline 2:00 p.m. October 14, 2025

3. Pre-response Conference 1:00 p.m. October 15, 2025

4. Notice of Intent to Respond Deadline 2:00 p.m. October 16, 2025

5. Written “Questions & Comments” Deadline

NOTE: Submit written questions and comments on Appendix 7.12 the written questions and comments template.

2:00 p.m. October 22, 2025

6. State Response to Written “Questions & Comments”

November 12, 2025

7. Round 2 Written “Questions & Comments” Deadline

NOTE: Respondents may submit no more than five (5) questions to the State in the 2nd round of Written Questions and Comments.

November 19, 2025

8. State Response to Written “Questions & Comments” Round 2

December 12, 2025

9. Response Deadline 2:00 p.m. December 19, 2025

10. State Completion of Technical Response Evaluations

January 29, 2026

11. State Opening & Scoring of Cost Proposals 2:00 p.m. January 30, 2026

12. Negotiations 4:30 p.m. February 9-11, 2026

13. State Notice of Intent to Award Released and RFP Files Opened for Public Inspection

1:00 p.m. February 26, 2026

14. End of Protest Period March 5, 2026

15. State sends contract to Contractor for signature

March 6, 2026

16. Contractor Signature Deadline 2:00 p.m. March 13, 2026

2. State responses to questions and comments in the table below amend and clarify this RFP.

Any restatement of RFP text in the Question/Comment column shall NOT be construed as a change in the actual wording of the RFP document.

RFP

SECTION

QUESTION / COMMENT

1.

How many mandatory referrals to EAP for drug and alcohol violations in the last 3 years? How many were Substance Abuse Professional cases?

There were 96 mandatory referrals for drug and alcohol violations and 38 Substance Abuse Professional cases.

2.

Will the State need to provide annual Reasonable Suspicion Drug and Alcohol for supervisors and managers?

The Contractor is not required to provide annual Reasonable Suspicion Drug and Alcohol training for supervisors and managers. It is helpful if this training is available in the training catalog for agencies that may wish to use this training.

A.10, A.14, A.18, Contract Att B.12.

Accreditati on

3.

The RFP states that URAC accreditation must be in place prior to go-live. Could the State please confirm whether organizations that currently hold NCQA accreditation

— a nationally recognized and comparable standard across many of the same domains — would be considered as meeting the intent of this requirement?

If NCQA accreditation is not accepted in lieu of URAC, could the State clarify whether there is any flexibility to obtain URAC accreditation post–go-live, within an agreed-upon transition period?

No. Only having NCQA accreditation does not fulfill the requirement.

The Contractor shall be fully accredited by NCQA as a Managed Behavioral Healthcare Organization and URAC accredited for its Utilization Management program as specified in Contract Section A.12.f. and A.10.b.

respectively.

The State is agreeable to a post go-live acquisition of accreditation.

See amendment item #5.

D.32.c.3 4.

The Pro Forma Contract currently specifies insurance limits of $3 million per claim and $3 million aggregate. Upon review, our internal reference to $2 million/$6 million was a typographical error.

We respectfully request that the State consider adjusting the requirement to $1 million per claim and $3 million aggregate, which aligns with prevailing industry standards for behavioral health administrative services contracts of

Yes, the adjustment is acceptable. See amendment item #9.

similar scope. Could the State confirm whether this adjustment is acceptable?

The requested limits reflect industry-standard coverage levels for behavioral health administrative vendors and would ensure that qualified respondents can provide compliant proof of insurance without unnecessary premium increases.

This clarification helps maintain competitive pricing while preserving adequate protection for the State.

D.32.e 5.

Section D.32.e requires Crime Insurance to include a “Social Engineering Fraud Endorsement” with a limit of $250,000. Our crime insurance policy does not include a separate Social Engineering Fraud endorsement; however, coverage for social-engineering incidents is included under our Cyber Liability Insurance policy. Would the State accept this existing Cyber Liability coverage as meeting the intent of the Social Engineering Fraud requirement?

Our Cyber Liability policy provides coverage equivalent to or greater than a stand-alone Social Engineering Fraud endorsement, ensuring full protection against fraudulent fund-transfer or deception-based loss events.

Clarification will confirm that this coverage approach satisfies the State’s insurance intent without requiring redundant or duplicative endorsements.

Yes, as long as the limit applicable to the social engineering fraud coverage meets or exceeds $250,000 that would be acceptable.

3. Add pro forma contract section A.2.gggg and renumber any subsequent sections as necessary.

gggg. Subrogation: Unless the context indicates otherwise, Ssubrogation shall mean the process used to seek reimbursement from the responsible party for a claim paid by the Plan.

4. Add pro forma contract section A.5.l and renumber any subsequent sections as necessary.

l. The Contractor shall not retain counsel to appear on behalf of the State in a judicial or administrative proceeding without written approval of the State.

5. Delete pro forma contract section A.10.b in its entirety and replace with the following.

b. The Contractor shall ensure that its utilization management program for this Contract is fully accredited by URAC. If the Contractor meets this requirement as of the start date of this Contract, the Contractor shall maintain such accreditation throughout the period of this Contract. If the Contractor does not currently meet this requirement, the Contractor shall obtain such accreditation by December 31, 2027, or a later date as specified by the State, and shall maintain it thereafter throughout the period of this Contract. The Contractor shall review and comply with Contract Attachment B, Performance Guarantees and Liquidated Damages and Contract Attachment C, Reporting Requirements.

6. Delete pro forma contract section A.18.u in its entirety and replace with the following.

u. Within 45 days of the contract effective date, the Contractor shall provide the State with a copy of all Contractor and subcontractor online terms and conditions, online service agreements, privacy policies, notices of privacy policy, or other documents required to be accepted by Members of the State of TN health plans when they access online accounts, services, or programs being delivered by Contractor or subcontractors pursuant to this Contract.

Contractor and its subcontractors shall not require Members of the State of TN health plans to agree to online Terms of Use, Privacy Policies, Notices of Privacy Policies, or other similar documents that contain provisions which conflict with the terms of the Contract or Business Associate Agreement (BAA) between the State of TN and Contractor, or with the terms of the contract or BAA between Contractor and its subcontractors in order to access services provided pursuant to this contract. Any terms contained in such online documents which violate this prohibition shall be deemed void and not applicable to or binding upon the State of TN plan members.

The Contractor shall be responsible for ensuring compliance with this provision and non-compliance with this provision by the Contractor or its subcontractor is a material breach of this Contract for which the Contractor shall be directly responsible.

Under no circumstances will disputes between the Contractor or its subcontractors and a Member of the State of TN health plan arising from services provided pursuant to this contract be governed by law other than Tennessee law and applicable federal law or adjudicated in forums other than those in the State of Tennessee with subject matter jurisdiction over the dispute.

7. Delete pro forma contract section A.20.ff in its entirety and replace with the following.

ff. The Contractor shall implement a process to govern all recoveries to the Plan, including but not limited to Subrogation recoveries, and report recovery activities to the State. The

Contractor’s process shall incorporate all procedural steps required by the State and must be approved by the State, In Writing, prior to Go-Live and proposed subsequent changes, if any. The Contractor shall submit to the State a monthly recoveries report of all recoveries including, but not limited to, Subrogation recoveries, in a format prior approved by the State and as provided in Contract Attachment C, Reporting

Requirements.

The components of the Contractor’s process specific to Subrogation and reimbursement shall include provisions for the recovery of claims paid for treatment of work-related illnesses or injuries and illnesses or injuries resulting from actions of non-employer third parties. The Contractor’s process shall comply with the State’s directions regarding

Subrogation recovery and shall implement new or revised requirements received from the

State within sixty (60) calendar days of receipt of the requirements from the State, unless otherwise directed by the State.

The Contractor shall actively identify claims with Subrogation potential within the timeframe specified in the Contractor’s approved process and pursue Subrogation recovery or reimbursement of all sums paid for Member claims that are subject to

Subrogation or reimbursement provisions in the Plan, as specified in the Contractor’s approved process. Notwithstanding the foregoing and at the sole discretion of the State, the State may refer any identified Subrogation interests or reimbursement claims to the

Tennessee Office of Attorney General and Reporter for recovery and collection.

If payment has not been recovered within the timeframe specified in the Contractor’s approved process, after the initial demand for payment or Subrogation claim has been submitted, the Contractor shall refer the account to the State with a recommendation either requesting additional time with a specific target date range of completion or requesting that the matter be referred to the Tennessee Office of Attorney General and

Reporter for additional legal action. It shall be at the sole discretion of the State to close an account.

All Subrogation or reimbursement settlements for reductions exceeding the threshold specified in the Contractor’s approved Subrogation process must be approved by the

State, In Writing, and shall be at the sole discretion of the State. The Contractor shall not approve workers’ compensation Subrogation settlements that permit future related medical claims to be paid by the Plan without written approval by the State, which shall be at the sole discretion of the State.

The Contractor shall share claims data and work with the State’s TPAs, as needed and as requested, in their work related to Subrogation.

8. Delete pro forma contract section C.3.e in its entirety and replace with the following.

e. Unless otherwise agreed to by the State, In Writing, in all Subrogation recoveries or collections handled by the Contractor, the State authorizes the Contractor to retain monies received through Subrogation, on a per patient basis, of no more than 5% of the gross recovery for administrative expenses, including in-house attorney fees. When Subrogation recovery is made by a subcontractor(s) and/or outside attorney(s), Contractor shall retain up to 20% of the gross recovery but shall not retain an amount greater than the actual amount paid to the subcontractor(s) and/or outside attorney(s) for their services. The gross Subrogation recoveries will be remitted to the State within 90 days of final settlement and receipt of funds by payment as agreed on by the State.

For purposes of this Section C.3.e, “gross recovery” shall mean the total amount of Subrogation recovery due to the State after deducting litigation expenses and/or attorney(s) fees that the Member’s attorney is legally entitled to receive.

9. Delete pro forma contract section D.32.c(3) in its entirety and replace with the following.

3) If the Contract involves the provision of services by medical professionals, a policy limit not less than one million ($1,000,000) per claim and three million dollars ($3,000,000) in the aggregate for medical malpractice insurance.

10. Delete RFP #31786-00187 Release #2 in its entirety, and replace with RFP #31786-

00187, Release #3. Revisions of the original RFP document are emphasized within the new release. Any sentence or paragraph containing revised or new text is highlighted.

11. RFP Amendment Effective Date. The revisions set forth herein shall be effective upon release. All other terms and conditions of this RFP not expressly amended herein shall remain in full force and effect.