41NHA-S3992 - PEBP- Attachment 4.6.5. - DOI TPA Registration Attestation.docx
DOCX document 53 KB Posted
- Attached to
- Nevada State Pharmacy Benefit Manager
- Solicitation number
- 41NHA-S3992
- Issued by
- Nevada
About this file
This is an attestation form included in the Request for Proposal (RFP) for Solicitation 41NHA-S3992, issued by the Nevada Department of Administration on behalf of the Nevada Health Authority for a Nevada State Pharmacy Benefit Manager. The document, titled "PEBP DOI TPA Registration Attestation," establishes mandatory compliance requirements for all qualified vendors participating in this procurement. As a condition of contracting with the Public Employees' Benefits Program (PEBP), any entity performing Third-Party Administrator (TPA) services—including claims administration, utilization management, member services, or pharmacy benefit management—must be registered with the Nevada Division of Insurance (DOI) as a licensed TPA in accordance with NRS 683A.025 and applicable DOI regulations.
Vendors must attest that they either currently hold an active DOI TPA Certificate of Registration for the proposed services or will obtain such registration no later than 45 calendar days after receiving notice of intent to award, and in all cases prior to performing any TPA functions for PEBP. Contractors are required to maintain all required licenses, certificates, and registrations in good standing throughout the contract term. The document explicitly warns that failure to obtain or maintain DOI TPA registration may result in suspension of work, withholding of payments, or contract termination. The attestation must be signed by an individual legally authorized to bind the vendor per NRS 333.337 and submitted as part of the technical proposal, with the document revised as of October 2026.
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Text version
Request for Proposal for Medicaid Managed Care Organizations Attachment C—Technical Proposal Questions
STATE OF NEVADA
DEPARTMENT OF ADMINISTRATION
Solicitation 41NHA – S3992 for the Nevada State Pharmacy Benefit Manager
Release Date: 10/22/2026
Attachment 4.6.5. - PEBP DOI TPA Registration Attestation
All Qualified Vendors must meet all requirements as outlined in the Request for Proposal (RFP) Section 9—Mandatory Minimum Requirements. This includes compliance with the following.
1. The Contractor acknowledges that, as a condition of contracting with PEBP, any entity performing Thid-Party Administrator (TPA) services, including but not limited to, claims administration, utilization management, member services, or pharmacy benefit management, must be registered with the Nevada Division of Insurance (DOI) as a licensed TPA, in accordance with NRS 683A.025 and all applicable DOI regulations.
2. The Contractor attests that, as of the proposal due date, it either currently holds an active DOI TPA Certificate of Registration for the services proposed under this contract or will obtain such registration no later than 45 calendar days after notice of intent to award and in all cases prior to performing any TPA functions for PEBP.
3. The Contractor agrees to maintain all required licenses, certificates, and registers in good standing throughout the duration of its PEBP contract.
4. The Contractor acknowledges that failure to obtain or maintain DOI TPA registration may result in suspension of work, withholding of payments, or termination of the contract.
| Question |
| Response |
| Does your company comply with the above requirements? |
| Yes |
No
The proposal shall be signed by the individual(s) legally authorized to bind the vendor per NRS 333.337.
Company Name:
Print Name:
Signature:
Date:
Revised: 2026-10 Page 1 of 45 Solicitation #41NHA-S3992 image1.jpg
File details come from the government source that posted it. Updated .