50001-2878.pdf

INVITATION TO BID BID DUE DATE AND TIME

BOARD OF SUPERVISORS OF

LOUISIANA STATE UNIVERSITY

AND AGRICULTURAL & MECHANICAL COLLEGE

08/18/2026 11:00 AM CT

SOLICITATION RFQ-0000002878

SUPPLIER #

SUPPLIER NAME AND ADDRESS

RETURN BID TO

Buyer Jene Troxclair Ledet

Buyer Phone

Buyer Email jeneledet@lsu.edu Issue Date 07/28/2026

TITLE: Fully Insured LSU First Retiree Medicare Advantage Plan

To Be Completed By Supplier

1. _______"No Bid" (sign and return this page only).

2. _______My Company does not wish to receive future solicitations for this spend category.

3. Specify your Delivery: To be made within ____________________ days after receipt of order.

4. If applicable, Supplier's Addendum Acknowledgement/Response:

As an authorized agent/signatory of the supplier, I/we acknowledge receipt of this Addendum, and _______submit no alterations/clarifications to our original bid.

_______submit superseding revisions/clarifications to our original bid as written herein or attached hereto.

General Instructions to Suppliers

1. Sealed bids for furnishing the items and/or services specified are hereby solicited, and will be received by LSU Procurement at the "Return Bid To" address stated above, until the specified due date and time.

2. Read the entire solicitation, including all terms, conditions and specifications.

3. All bid information and prices must be typed or written in ink. Any corrections, erasures or other forms of alteration to unit price are to be initialed by the supplier.

4. Bid prices are to be quoted FOB LSU/Destination and inclusive of any and all applicable shipping and handling charges unless otherwise specified in the solicitation. Any invoiced delivery charges not quoted and itemized on the LSU purchase order are subject to rejection and non-payment.

5. Payment is to be made within 30 days after receipt of properly executed invoice, or delivery and acceptance, whichever is later.

6. By signing this solicitation, the supplier certifies compliance with all general instructions to suppliers, terms, conditions and specifications; and further certifies that this bid is made without collusion or fraud.

SUPPLIER NAME MAILING ADDRESS

AUTHORIZED SIGNATURE CITY, STATE ZIP

PRINTED NAME PHONE #

TITLE FAX #

E-MAIL FEDERAL TAX ID #

LSU IS AN EQUAL OPPORTUNITY/ACCESS UNIVERSITY Rev. 2/25 lsubids@lsu.edu

SPECIAL TERMS & CONDITIONS INVITATION TO BID Page 2

SOLICITATION RFQ-0000002878 DUE DATE 08/18/2026 DUE TIME 11:00:00 AM

1. Bid Submission Information

All bids must be submitted electronically to LSU Procurement Services. Bids must be received at the "Return Bid To" email address no later than the due date and time specified herein. Bids must be emailed to lsubids@lsu.edu (This email address should be used for bid submissions only). Any bids sent directly to the Buyer of record will not be forwarded to the “Return Bid To” email.

When submitting electronically, the RFQ number and solicitation title should be listed in the subject line of the email. An original and redacted copy (if applicable) must be submitted electronically. Hard copies of bids will not be accepted; therefore, they will not be evaluated.

It is the responsibility of the Supplier to ensure the bid is received by LSU Procurement by the indicated due date and time. Any delays that may occur in transmission of the bid is the responsibility of the supplier. A bid will be considered late if it is not received at the “Return Bid To” email address by the indicated due date and time.

The maximum email attachment size accepted is 125 MB. It is the supplier’s responsibility to ensure bid submission is sized such that it is successfully transmitted and received by LSU. If the bid response is too large to be emailed as one document, the bid must be sent as separate documents. Each submittal should be labeled. (Example – Bid Submittal 1 out of 3 for RFQ-000000XXXX - Title; Bid Submittal 2 out of 3 for RFQ-000000XXXX - Title, etc.). If any submittal is received late, LSU will not consider the late submittal(s).

Only the submittal(s) received by the due date and time will be considered. Late bids will not be accepted per LAC 34:XIII.515.B.

2. Bid Opening Information

Bid openings are held electronically. There are no in-person bid openings. To electronically attend the bid opening, use the below link to register in advance:

https://lsu.zoom.us/meeting/register/QLfFfBZmRqio9DF9ESf0QA

After registering, a confirmation email will be provided containing information about joining the bid opening.

No information or opinions concerning the ultimate contract award will be given at bid opening or during the evaluation process.

If an unforeseen circumstance beyond LSU’s control prevents bid opening, the Bid will open at the next scheduled bid opening date.

3. Supplier Inquiries

Written inquiries must be received no later than 4:30 pm CST on 8/7/26. Written inquires shall be sent to Jené Ledet via email at jeneledet@lsu.edu.

mailto:lsubids@lsu.edu mailto:lsubids@lsu.edu

STANDARD TERMS & CONDITIONS INVITATION TO BID Page 3

These standard terms and conditions shall apply to all LSU solicitations, unless otherwise specifically amended and provided for in the special terms and conditions, specifications, or other solicitation documents. In the event of conflict between the General Instructions to Suppliers or Standard Terms & Conditions and the Special Terms & Conditions, the Special Terms & Conditions shall govern.

Bids submitted are subject to provisions of the laws of the State of Louisiana, including but not limited to: the University Procurement Code (LAC 34:XIII. Chapters 3-25) and the terms, conditions, and specifications stated in this solicitation.

1. Supplier Enrollment Suppliers providing a bid/quote in response to a LSU solicitation must be setup in the University's new procurement system (Workday) for bid tabbing and award of a purchase order. Suppliers should complete the online supplier registration form prior to submitting a bid response and/or the bid due date and time to ensure bid tabbing can be done timely after the bid deadline.

This website is used in place of a paper form and must be accompanied with an IRS Request for Taxpayer Identification Number and Certification form (W-9 or W-8 if foreign) to collect the required business and tax information that support the University's reporting and compliance requirements. To inquire if you or your company is setup or for questions regarding setup, email suppliers@lsu.edu. The supplier enrollment form can be located at: http://www.lsu.edu/administration/ofa/procurement/ supplier_registration.php

2. Bid Delivery and Receipt Bids must be received and time-stamped at the "Return Bid To" address no later than the due date and time specified herein.

To assure consideration, your bid must be submited in a sealed envelope or package and should be clearly and prominently marked with the solicitation number and bid due date, or may be submitted in the special bid return envelope if one was furnished for that purpose.

Supplier are advised that the U.S. Postal Service does not make deliveries to our physical location. USPS mail is delivered to the University's mail center and is redelivered using internal resources. Suppliers may deliver bids by hand or by a courier service to the Procurement Office. The University shall not be responsible for any delays caused by the supplier's chosen means of bid delivery. Supplier is solely responsible for the timely delivery of its bid, and failure to meet the bid due date and time shall result in rejection of the bid. Late bids cannot be accepted per LAC 34:XIII.515.B.

3. Bid Forms Bids are to be submitted on the LSU solicitation forms provided, and must be signed by an authorized agent of the supplier in accordance with LAC 34:XIII.517. Bids submitted on other forms or in other price formats may be considered informal and may be rejected in part or in its entirety. Bids submitted in pencil and/or bids containing no original signature indicating the supplier's intent to be bound will not be accepted. Bid submissions should not be spiral bound.

4. Interpretation of Solicitation/Supplier Inquiries If supplier is in doubt as to the meaning of any part or requirement of this solicitation, supplier may submit a written request for interpretation to the Buyer-of-Record at the address and/or fax number shown above. Written inquiries must be received in the Procurement Office no later than 4:30 pm CST four (4) business days prior to the opening of bids, and shall be clearly crossreferenced to the relevant solicitation/specification in question.

No decisions or actions shall be executed by any supplier as a result of oral discussions with any LSU employee or consultant.

Any interpretation of the documents will be made by formal addendum only, issued by the Procurement Office, and mailed or delivered to all suppliers known to have received the solicitation. LSU shall not be responsible for any other interpretations or assumptions made by supplier.

5. Bid Addenda Bid Addendum is to be signed and returned with your bid. If you have already submitted your bid, and this Addendum creates a need to revise/clarify your original response in any way, you are required to submit such in writing. To be considered, your addendum response must be submitted to and received by LSU Procurement at the “Return Bid To” address stated above.

Submittals for price alterations and addenda to bids must be clearly marked with the solicitation number and the bid due date/ time and returned via fax, email, courier service, hand delivery, or USPS mail. Bid revisions received after bid opening cannot be considered, whereupon the supplier must either honor or withdraw its original bid.

6. Bid Opening Suppliers may attend the public bid opening of sealed bids. No information or opinions concerning the ultimate contract award will be given at bid opening or during the evaluation process. Written bid tabulations will not be furnished.

7. Special Accommodations Any "qualified individual with a disability" as defined by the Americans with Disabilities Act, who has submitted a bid and desires to attend the public bid opening, must notify the Procurement Office in writing not later than seven days prior to the bid opening date of their need for special accommodations. If the request cannot be reasonably provided, the individual will be informed prior to the bid opening.

Rev. 2/25 mailto:suppliers@lsu.edu mailto:suppliers@lsu.edu http://www.lsu.edu/administration/ofa/procurement/supplier_registration.php http://www.lsu.edu/administration/ofa/procurement/supplier_registration.php http://www.lsu.edu/administration/ofa/procurement/supplier_registration.php http://www.lsu.edu/administration/ofa/procurement/supplier_registration.php

STANDARD TERMS & CONDITIONS INVITATION TO BID Page 4

8. Standards of Quality Any product or service bid shall conform to all applicable federal, state and local laws and regulations, and the specifications contained in the solicitation. Any manufacturer’s name, trade name, brand name, or catalog number used in the specification is for the purpose of describing the standard of quality, performance, and characteristics desired; and is not intended to limit or restrict competition. Supplier must specify the brand and model number of the product offered in his bid. Bids not specifying brand and model number shall be considered as offering the exact product specified in the solicitation.

9. New Products/Warranty/Patents All products bid for purchase must be new, never previously used, of the manufacturer’s current model and/or packaging, and of best quality as measured by acceptable trade standards. No remanufactured, demonstrator, used or irregular products will be considered for purchase unless otherwise specified.

The manufacturer’s standard published warranty and provisions shall apply, unless more stringent warranties are otherwise required by LSU and specified in the solicitation. In such cases, the supplier and/or manufacturer shall honor the specified warranty requirements, and bid prices shall include any premium costs of such coverage.

Supplier guarantees that the products proposed and furnished will not infringe upon any valid patent or trademark; and shall, at its own expense, defend any and all actions or suits charging such infringement, and shall save LSU harmless.

10. Descriptive Information Suppliers proposing an equivalent brand or model are to submit with the bid descriptive information (such as literature, technical data, illustrations, etc) sufficient for LSU to evaluate quality, suitability, and compliance with the specifications. Failure to submit descriptive information may cause bid to be rejected. Any changes made by supplier to a manufacturer's published specifications shall be verifiable by the manufacturer. If items bid do not fully comply with specifications, supplier must state in what respect items deviate. Supplier’s failure to note exceptions in its bid will not relieve the supplier from supplying the actual products requested.

11. Bids/Prices/F.O.B. Point

• The bid price for each item is to be quoted on a “net” basis and F.O.B. LSU Destination, i.e. title passing upon receipt and inclusive of all delivery charges, any item discounts, etc.

• Bids other than F.O.B. LSU Destination may be rejected.

• Bids indicating estimated freight charges may be rejected.

• Bids requiring deposits, payment in advance, or C.O.D. terms may be rejected.

• Suppliers who do not quote “net” item prices and who separately quote an overall “lump sum” freight cost or discount for all items shall be considered as submitting an “all-or-none” bid for evaluation and award purposes; and risk rejection if award is made on an item or grouped basis.

• Prices shall be firm for acceptance for a minimum of 30 days, unless otherwise specified. Bids conditioned with shorter acceptance periods may be rejected.

• Prices are to be quoted in the unit/packaging specified (e.g. each, 12/box, etc), or may be rejected.

• In the event of extension errors, the unit price bid shall prevail.

12. Taxes Supplier is responsible for including all applicable taxes in the bid price. LSU is exempt from all Louisiana state and local sales and use taxes. By accepting an award, resident and non-resident firms acknowledge their responsibility for the payment of all taxes duly accessed by the State of Louisiana and its political subdivisions for which they are liable, including but not limited to:

franchise taxes, privilege taxes, sales taxes, use taxes, ad valorem taxes, etc.

13. Terms and Conditions This solicitation contains all terms and conditions with respect to the purchase of the goods and/or services specified herein.

Submittal of any contrary terms and conditions may cause your bid to be rejected. By signing and submitting a bid, supplier agrees that contrary terms and conditions which may be included in its bid are nullified.

14. Supplier Forms/LSU Signature Authority The terms and conditions of the LSU solicitation and purchase order/contract shall solely govern the purchase agreement, and shall not be amended by any supplier contract, form, etc.

The University’s chief procurement officer, or authorized designee, is delegated sole authority to execute/sign any supplier contracts, forms, etc, on behalf of LSU. Departments are expressly prohibited from signing any supplier forms. Any such supplier contracts/forms bearing unauthorized signatures shall be null and void, shall have no legal force, and shall not be recognized by LSU in any dispute arising therefrom. Suppliers who present any such forms to department users for signature without regard to this strict LSU policy may face contract cancellation, suspension, and/or debarment.

15. Awards Award will be made to the lowest responsible and responsive supplier. LSU reserves the right: (1) to award items separately, grouped, or on an all-or-none basis, as deemed in its best interest; (2) to reject any or all bids and/or items; and (3) to waive any informalities.

All solicitation specifications, terms and conditions shall be made part of any subsequent award as if fully reproduced and included therein, unless specifically amended in the formal contract.

Rev. 2/25

STANDARD TERMS & CONDITIONS INVITATION TO BID Page 5

16. Acceptance of Bid Only the issuance of an official LSU purchase order/contract, a Notification of Award letter, or a Notification of Intent to Award letter shall constitute the University’s acceptance of a bid. LSU shall not be responsible in any way to a supplier for goods delivered or services rendered without an official purchase order/contract or award letter. Bid tabulations may be requested after acceptance of bid.

17. Applicable Law All contracts shall be construed in accordance with and governed by the laws of the State of Louisiana.

18. Awarded Products/Unauthorized Substitutions Only those awarded brands and numbers stated in the LSU contract are approved for delivery, acceptance, and payment purposes. Any substitutions require prior approval of the Procurement Office. Unauthorized product substitutions are subject to rejection at time of delivery, post-return at supplier's expense, and non-payment.

19. Testing/Rejected Goods Supplier warrants that the products furnished will be in full conformity with the specification, drawing or sample, and agrees that this warranty shall survive delivery, acceptance, and use. Any defect in any product may cause its rejection. LSU reserves the right to test products for conformance to specifications both prior to and after any award. Supplier shall bear the cost of testing if product is found to be non-compliant. All rejected goods will be held at supplier's risk and expense, and subject to supplier's prompt disposition. Unless otherwise arranged, rejected goods will be returned to the supplier freight collect.

20. Delivery Supplier is responsible for making timely delivery in accordance with its quoted delivery terms. Supplier shall promptly notify the LSU Department and/or Procurement Office of any unforeseen delays beyond its control. In such cases, LSU reserves the right to cancel the order and to make alternative arrangements to meet its needs.

21. Default of Supplier Failure to deliver within the time specified in the bid/award will constitute a default and may be cause for contract cancellation.

Where the University has determined the supplier to be in default, LSU reserves the right to purchase any or all goods or services covered by the contract on the open market and to surcharge the supplier with costs in excess of the contract price.

Until such assessed surcharges have been paid, no subsequent bids from the defaulting supplier will be considered for award.

22. Supplier Invoices Invoices shall reference the LSU purchase order number, supplier's packing list/delivery ticket number, shipping/delivery date, etc. Invoices are to be itemized and billed in accordance with the order, and submitted on the supplier's own invoice form.

Invoices submitted by the supplier's third party supplier are not acceptable.

23. Delinquent Payment Penalties Delinquent payment penalties are mandated and governed by Louisiana R.S. 39:1695. Supplier penalties to the contrary shall be null and void, shall have no legal force, and shall not be recognized by LSU in any dispute arising therefrom.

24. Assignment of Contract/Contract Proceeds Supplier shall not assign, sublet or transfer its contractual responsibilities, or payment proceeds thereof, to another party without the prior written consent and approval of the Procurement Office. Unauthorized assignments of contract or assignments of contract proceeds shall be null and void, shall have no legal force, and shall not be recognized by LSU in any dispute arising therefrom.

25. Right to Piggyback Where this solicitation may name one department as the primary contract user, LSU reserves the right to authorize additional departments/campuses to use the contract as their needs arise; and Vendor shall honor all such purchase orders.

26. Contract Cancellation LSU has the right to cancel any contract for cause, in accordance with procurement rules and regulations, including but not limited to: (1) failure to deliver within the time specified in the contract; (2) failure of the product or service to meet specifications, conform to sample quality or to be delivered in good condition; (3) misrepresentation by the supplier; (4) fraud, collusion, conspiracy or other unlawful means of obtaining any contract with the University; (5) conflict of contract provisions with constitutional or statutory provisions of state or federal law; (6) any other breach of contract. LSU has the right to cancel any contract for convenience at any time by giving thirty (30) days written notice to the supplier. In such cases, the supplier shall be entitled to payment for compliant deliverables in progress.

27. Prohibited Contractual Arrangements Per Louisiana R.S. 42:1113.A, no public servant, or member of such a public servant’s immediate family, or legal entity in which he has a controlling interest shall bid on or enter into any contract, subcontract, or other transaction that is under the supervision or jurisdiction of the agency of such public servant. See statute for complete law, exclusions, and provisions.

Rev. 2/25

STANDARD TERMS & CONDITIONS INVITATION TO BID Page 6

28. Equal Employment Opportunity Compliance By submitting and signing this bid, supplier agrees to abide by the requirements of the following as applicable: Title VI and VII of the Civil Rights Act of 1964, as amended by the Equal Opportunity Act of 1972; federal Executive Order 11246; federal Rehabilitation Act of 1973, as amended; the Vietnam Era Veteran’s Readjustment Assistance Act of 1974; Title IX of the Education Amendments of 1972; the Age Act of 1975; the Americans with Disabilities Act of 1990. Supplier agrees not to discriminate in its employment practices, and will render services under any contract entered into as a result of this solicitation without regard to race, color, religion, sex, age, national origin, veteran status, political affiliation, handicap, disability, or other non-merit factor. Any act of discrimination committed by supplier, or failure to comply with these statutory obligations when applicable, shall be grounds for termination of any contract entered into as a result of this solicitation.

29. Mutual Indemnification Each party hereto agrees to indemnify, defend, and hold the other, its officers, directors, agents and employees harmless from and against any and all losses, liabilities, and claims, including reasonable attorney’s fees arising out of or resulting from the willful act, fault, omission, or negligence of the indemnifying party or of its employees, contractors, or agents in performing its obligations under this agreement, provided however, that neither party hereto shall be liable to the other for any consequential damages arising out of its willful act, fault, omission, or negligence.

30. Certification of No Suspension or Debarment By signing and submitting this bid, supplier certifies that its company, any subcontractors, or principals thereof, are not suspended or debarred under federal or state laws or regulations. A list of parties who have been suspended or debarred by federal agencies is maintained by the General Services Administration and can be viewed on the internet at www.sam.gov.

31. Right to Audit The University shall be entitled to audit the books and records of a supplier or any subcontractor under any negotiated contract or subcontract to the extent that such books and records relate to the performance of such contract or subcontract. Such books and records shall be maintained by the supplier for a period of five (5) years from the date of final payment under the prime contract and by the subcontractor for a period of five (5) years from the date of final payment under the subcontract, pursuant to

LAC 34:XIII.1603.

32. Data Privacy By signing and submitting this bid, I hereby authorize that all information provided in this solicitation, including any and all personal or company data may be shared with LSU departments, suppliers and other governmental agencies to facilitate procurement transactions. This data will be retained according to LSU’s retention schedule. To learn more about privacy at LSU, please see the LSU Privacy Statement.

Rev. 2/25 https://www.sam.gov https://www.sam.gov http://www.lsu.edu/privacy/ http://www.lsu.edu/privacy/

Specifications for Solicitation RFQ-0000002878

Purpose:

The purpose of this Invitation to Bid (ITB) is to solicit bids from qualified insurance carriers to provide high-quality, cost-effective Medicare coverage solutions for Medicare-eligible retirees and Medicare-eligible dependents of the LSU System and eligible employers.

LSU is soliciting bids for the following fully insured plan options:

• Option 1: A national Medicare Advantage Prescription Drug (MAPD) passive PPO plan with the same benefits for services rendered both in-network and out-of-network; and/or

• Option 2: A fully insured Medicare Advantage (MA) medical plan offered in conjunction with a fully insured standalone Prescription Drug Plan (PDP). The MA and PDP must be offered by the same supplier.

Bidders may bid on either option or both options.

The plan designs, copays, and member experience should closely mirror the current LSU First Retiree Medicare Plan Current Benefit Design (See Exhibit 1), while remaining compliant with all applicable Centers for Medicare & Medicaid Services (CMS) requirements and guidelines.

Method of Award:

Award shall be made to the lowest responsive and responsible bidder for either Option 1 or Option 2 for Plan Year 2027. Total cost shall be calculated using the per member per month (PMPM) premium times the member count of 4,078 times 12. LSU reserves the right to select either option. Bidders are advised to submit their best pricing. No opportunity to revise pricing or submit a Best and Final Offer will be provided.

Contract Term:

Initial term of one (1) year with the option to renew for two (2) additional one-year periods. The contract will commence on January 1, 2027.

Background:

The Louisiana State University System is a comprehensive public higher education system serving students, faculty, staff, retirees, and communities throughout Louisiana. The LSU System includes flagship academic institutions, regional campuses, health sciences centers, healthcare facilities, and specialized educational and research entities dedicated to advancing education, research, healthcare, and public service. As one of Louisiana’s largest public employers, the LSU System maintains a diverse workforce spanning academic, clinical, research, public safety, skilled trades, and administrative functions. LSU is committed to providing competitive, sustainable, and high-quality benefits programs that support the health, financial security, and overall well-being of employees and retirees, including comprehensive healthcare coverage and Medicare Advantage options for Medicare-eligible participants and dependents.

Goals and Objectives:

The objective of the Louisiana State University (LSU) System is to secure the services of a qualified Supplier to provide administration and insurance services for the LSU First Retiree health plan in alignment with the benefits, coverage provisions, and program objectives established under the LSU First Plan.

LSU seeks a Supplier capable of delivering a high-quality, cost-effective Medicare Advantage solution that maintains continuity of care and minimizes disruption for enrolled retirees and covered dependents. The selected Supplier must provide competitive premium rates while preserving benefit value, network access, and member satisfaction.

LSU expects the Supplier to deliver exceptional customer service through responsive member support, timely issue resolution, clear communications, and effective advocacy for plan participants. The Supplier must also serve as a strategic partner to LSU and any participating vendors or partner suppliers by providing timely consultation, data analysis, reporting, and recommendations that support informed decision-making and long-term program sustainability.

Additionally, LSU seeks a Supplier committed to collaboration and continuous improvement in developing and administering a high-value retiree healthcare program that balances affordability, quality, compliance, and member experience while supporting LSU’s broader commitment to retiree health and well-being.

Data:

LSU First Retiree Medicare Plan Enrollment Enrollment Type 2026 2025 2024

Retiree 2,919 2,773 2,631 Spouse/Dependent 1,159 1,110 1,050

Total 4,078 3,883 3,681

Upon written request via email to jeneledet@lsu.edu, LSU will make the following data available:

• Net Pd Medical & Pharmacy Claims

• Detailed Pharmacy Claims

• Provider Utilization 2025

• CMS Rev PMPM & Risk Scores

The data provided is intended solely for the purpose of evaluating and preparing a response to this ITB and may not be used for any other purpose.

LSU First Retiree Plan Eligibility Provisions:

The Supplier shall provide a group fully insured Medicare Advantage plan certified by the Centers for Medicare & Medicaid Services (CMS) with a coverage effective date of January 1, 2027. All retirees, retiree spouses, surviving spouses, disabled dependents, and other Medicare-primary members who have Medicare Parts A & B primary and are currently enrolled in the self-insured LSU First plan, and who do not have covered dependents who are not Medicare-primary, will be required either to enroll in the LSU First Retiree Medicare Plan, move to a plan offered by the Office of Group Benefits, or disenroll from all state-sponsored coverage. Retirees and other eligible members who cancel state-sponsored coverage will not be permitted future participation in state health plans except under limited exceptions. Only those Medicare-primary members of LSU First who have covered family members without Medicare A&B primary will be allowed to remain enrolled in self-insured LSU First. The LSU First Retiree Plan will continue to receive new membership as Medicare-eligible employees retire and as retirees and retiree spouses become Medicare-eligible; the LSU First Retiree Plan will not be a closed class. The Supplier must cover eligible retirees and retiree dependents as noted above, regardless of whether the member has attained age 65. Currently the plan has 23 members that are pre-65.

The eligibility provisions of the LSU First Retiree Plan are such that retirees of the Louisiana Legislative Branch, comprised of but not limited to, the House of Representatives, the Senate, the Office of the Legislative Auditor, the Legislative Fiscal Office, and the Louisiana Budgetary Control Council (“Participating Successor Agencies”) are permitted to enroll in the LSU First Retiree Plan. In addition, covered employees who change employment from LSU or one of these Participating Agencies to another OGB-eligible employer (“Successor Employer”) are permitted to retain LSU First Plan coverage, provided the Successor Employer agreed to similar provisions related to LSU First as entered into between LSU and the Participating Agencies. Retirees moving from the LSU First Health Plan and OGB Health Plan have creditable coverage per requirements of the Medicare Modernization Act and members will be certified by LSU upon moving to the LSU First Retiree Medicare Plan. A full list of participating agencies is provided in Exhibit 2: Participating Agencies of the LSU First Health Plan.

Requirements:

1. Supplier must have five (5) continuous years of experience providing and implementing Medicare Advantage plans with a group size of three thousand (3,000) or more covered lives.

2. Supplier must be authorized to transact business in the State of Louisiana.

3. Supplier must be Approved by the Center for Medicare and Medicaid Services (CMS) to offer one or more Medicare Advantage Plans in the State of Louisiana and must be licensed by the Department of Insurance in accordance and compliance with La. R.S. 22:1651.

4. The Supplier shall provide a national passive PPO Medicare Advantage network available in all fifty

(50) states and U.S. territories. The plan shall not restrict members to a proprietary provider network.

Members must have access to any hospital, physician, laboratory, or other provider that participates in Medicare and is willing to accept the plan and submit claims on the member's behalf. Bids that limit access to a proprietary network or otherwise restrict members from utilizing Medicare-participating providers nationwide shall be deemed non-responsive and rejected.

5. The Supplier must have an overall rating of four (4) stars or higher as determined by the Centers for Medicare & Medicaid Services (CMS) Star Ratings Program. Bidders must provide documentation of their current CMS Star Rating and disclose any pending sanctions, corrective action plans, or compliance issues that could impact plan performance or future ratings.

6. The Supplier must provide a plan design equal to or better than the current plan design as shown in Exhibit 1: LSU First Retiree Medicare Plan Current Benefit Design and have the flexibility to alter plan design each plan year to meet the needs of its covered population and the changing landscape of healthcare. The Supplier may offer supplemental benefits and/or enhanced benefits as long as your bid would not otherwise have a lower cost to LSU and its membership. The plan shall comply with all CMS requirements, and any benefits not delineated in the plan design must be covered at least at the minimum requirement set by CMS.

7. Supplier must co-brand this product with LSU.

8. Supplier must assign a dedicated implementation team to manage the implementation process and the transition of services from the incumbent Supplier United Healthcare.

9. Supplier must work with LSU and incumbent Supplier to transfer competencies and operational expertise essential to administering LSU’s benefits program with minimal interruption to Plan Participants.

10. Supplier must submit a comprehensive implementation and transition plan, including key milestones, staffing assignments, communication strategy, escalation procedures, and risk mitigation processes.

11. Supplier shall be responsible for mailing identification cards (“ID Cards”) to the homes of Plan Participants within ten (10) calendar days of receipt of the eligibility for the 2027 plan year and to newly enrolled participants each plan year. Supplier shall be responsible for cost of reproducing ID Cards and priority mail shipping in the event of Supplier errors and/or initiated changes.

12. Supplier will provide knowledgeable staff to attend state-wide annual (approximately 10-15) and special enrollment meetings that may be held virtual or in person at LSU System campuses and hospital at no cost to LSU.

13. Supplier shall provide open enrollment ADA compliant materials such as videos, and flyers for open enrollment meetings at no cost to LSU.

14. Supplier must provide multiple access points to accept eligibility updates and changes. If Supplier requires file mapping and/or subsequent updates, this service shall be provided by Supplier at no additional cost to LSU.

15. Supplier must meet with the LSU staff onsite, or via teleconference bi-annually to review and evaluate Plan performance.

16. Supplier must maintain identical eligibility requirements and continued coverage provisions as LSU.

LSU shall determine eligibility of Plan Participants.

17. Supplier must notify the applicable state authority and escheat any unclaimed property upon the expiration of the statutory time period for escheatment.

18. Supplier must provide Physician and Hospital Provider Network to LSU Plan Participants, including but not limited to inpatient and outpatient hospital services (including hospital based ancillary services), ambulatory surgical services (including ASC based ancillary services), physician services, mental/behavioral health, substance abuse services, prescription drugs, utilization management and medical management, and disease management.

19. Supplier must provide an overview of the benefits that will be provided under this contract that are in addition to those outlined in Exhibit 1.

20. Supplier must include either an equivalent formulary to the current plan design or the Supplier’s best available formulary offering, including the identification of any applicable enhanced coverage options such as “bonus drugs.” Bids shall clearly outline any differences in formulary structure, tiering, utilization management, and member cost share impacts, as well as any anticipated disruption to current member drug coverage. Suppliers must also describe how bonus drug offerings are determined, administered, and maintained, and the financial or CMS considerations associated with such enhancements.

21. Supplier shall provide at least 45 days advance written notification to LSU and its participants of any change in provider networks that will affect a 1% or greater change in the number of providers in the network or a disruption that would impact 3% or greater of participants.

22. Supplier shall provide a network of primary, specialty, and ancillary care providers within CMS network adequacy within sixty (60) miles of participant’s address.

23. Supplier shall provide 21-day disenrollment notices to Plan Participants as required by CMS.

24. Supplier shall consult with LSU with regard to benefits provided under the Plan. No changes to plan design shall be made during the term without the written consent of LSU.

25. Supplier shall staff and maintain a dedicated toll-free customer service unit and phone line to assist plan participants and their authorized representatives with questions on claims, benefits, and networks in compliance with PPACA Section 1557 and any other applicable laws. The customer service unit must include telephone technology for the hearing impaired and multi-lingual support. The customer service unit must be located within the United States and be available for annual and any special enrollment periods.

26. Supplier shall appoint a dedicated account manager and eligibility specialist to the LSU account.

27. Supplier shall design, update, print, and/or mail all plan participant communication materials (i.e., provider directories, summary plan documents, Plan Participant education materials, annual notices of change, etc.), advertisements and marketing materials. All such materials shall be subject to LSU’s approval prior to distribution and shall be in compliance with all applicable laws, including but not limited to PPACA Section 1557. The cost of preparation and distribution of any and all Plan Participant communications or promotional materials must be included in the quoted premium.

28. Supplier shall facilitate the management of the health care services provided to LSU’s Plan Participants under the Plan, including but not limited to authorization services, discharge planning, verification of provided services, utilization management, and quality assurance.

29. Supplier shall maintain a website for Plan Participant access to their claims information, benefits, order replacement ID cards, provider directories, self-care information, drug formulary lookup, and other program information necessary to manage their health care needs, in compliance with all applicable laws, including but not limited to PPACA Section 1557.

30. Supplier shall provide 24/7 access to online portals for Plan Participants and LSU plan administration for activities such as claim submission, account monitoring, reporting, communications requested and approved by LSU, etc., in compliance with PPACA Section 1557 and any other applicable laws. This portal must include adequate encryption to guarantee protection of the Plan Participant’s privacy and confidential data (e.g., PHI, personal data, and banking information, as applicable). All outages in excess of one (1) hour must be reported to the LSU Plan Administration.

31. Supplier shall provide comprehensive pharmacy benefit and Prescription Drug Plan (PDP) administration services in compliance with all applicable Centers for Medicare & Medicaid Services (CMS) requirements. Responsibilities shall include formulary management, pharmacy network administration, mail-order and specialty pharmacy services, medication therapy management programs, claims processing, member communications and customer service, appeals and grievance administration, reporting and analytics, rebate and financial transparency, and implementation support.

The Supplier shall maintain nationwide pharmacy access, support clinical programs that promote medication adherence and cost-effective utilization, and provide dedicated account management and ongoing coordination with LSU to ensure high-quality service, regulatory compliance, and minimal disruption to Medicare-eligible retirees and dependents.

32. Supplier must offer their most broad retail network for its prescription drug program with both retail and mail order options that maximizes the number of participating pharmacies.

33. Supplier shall maintain a service disruption plan or procedure to continue customer service, portal access, and other business operations when existing service is temporarily unavailable because of scheduled or unforeseen events.

34. Supplier shall provide Medical Claims Administration services in compliance with all applicable laws.

Such services shall include, but not be limited to the following:

processing claims and remitting timely payment to providers; furnishing to any claimant notices of payment, explanation of benefits, and/or denials for claims; providing review of Plan Participants’ appeals and grievances; maintaining medical and carved out pharmacy claims for integrated Medical/Rx out-of-pocket maximum accumulation; and adjudicating and processing all claims with service dates prior to termination date.

35. Supplier shall provide standardized reports and/or data to LSU for the purpose of evaluating Plan Participant demographics, utilization, financial experience, and other aspects of Supplier performance.

The Supplier shall also provide monthly and quarterly plan performance reports in a format and layout subject to LSU approval. At a minimum, reporting shall include:

a) Full Eligibility Report: Monthly

b) Weekly Changes Report: Reports all adds, changes, and terms

Upon Request the following reports must be provided:

c) Aggregate monthly net paid medical and pharmacy claims with associated membership data for the most recent two (2) calendar years;

d) Aggregate monthly CMS revenue Per Member Per Month (PMPM) and risk scores for the most recent two (2) calendar years;

e) Detailed pharmacy claims data for the most recent two (2) calendar years; and

f) Provider utilization and disruption reporting for the most recent one (1) calendar year, provided upon request.

LSU reserves the right to request additional data elements, reporting frequency, and ad hoc analyses as needed to support plan oversight, financial monitoring, and vendor performance evaluation at no cost to

LSU.

36. Supplier shall prepare and distribute, at a minimum, the following required membership materials to each new Plan Participant within thirty (30) days of receipt of confirmation from LSU as to the validity of the enrollment application at no cost to LSU:

a. A member handbook, which includes information on all covered services, including, but not limited to: benefits, limitations, exclusions, copayments, coinsurances and deductibles, policies and procedures for utilizing clinical and administrative services, conditions under which an individual’s membership may be terminated, procedures for registering complaints or filing grievances against the Supplier or any providers participating in a contractual agreement with the Supplier.

b. Directions to access an online directory of providers, which includes all physicians, hospitals, and specialty facilities. Hard copies of provider directories and certificates of coverage must be available upon request.

c. Identification card(s) to each Plan Participant for individual coverage or two cards for all other classes of coverage. Additional cards for family members or replacement cards shall be provided upon request and at no additional charge to LSU or the Plan Participant.

d. Summary of Benefits and Coverage and Uniform Glossary, as required by the federal Patient Protection Affordable Care Act (PPACA) and/or applicable state law and/or rules and regulations promulgated pursuant thereto, and including PPACA Section 1557. Provide printed SBC documents to LSU for distribution to eligible but not enrolled employees/retirees.

e. Provide all required federal and state plan notices to plan members.

37. Supplier shall provide measurable performance guarantees with associated financial penalties for failure to meet agreed-upon service standards. Supplier shall be required to provide detailed reporting and documentation supporting summary performance metrics within 90 days of end of each plan year. Note performance guarantees may be subject to verification by audit.

38. The Supplier must provide LSU with a complete renewal package no later than one hundred eighty-five

(185) calendar days prior to the beginning of each Plan Year (January 1). The renewal package shall include, at a minimum, the proposed premium rates, a detailed explanation of any premium increase or decrease, all assumptions and supporting documentation used in the rate development, and a description of any proposed changes to benefits, coverage, formularies, provider or pharmacy networks, cost-sharing, CMS Star Ratings, or other material plan provisions.

39. The Suppler is expected to enter into a contract which is substantially the same as the Sample Contract attached (See Exhibit 5).

Invoicing Requirements:

The Supplier must provide flexibility, accuracy, and diligence in premium billing, invoicing, and reconciliation processes to support the administrative structure of the LSU First Retiree Medicare Plan. Premium payments may originate from multiple LSU campuses, payroll systems, and participating successor agencies; therefore, the Supplier must maintain billing capabilities that accommodate multiple remittance sources and varying payment processes.

The Supplier shall prepare and distribute detailed monthly invoices reflecting the total premium amount due by plan member. Invoice files must include an itemized listing of each covered member and clearly identify covered dependents in a manner that directly associates each dependent with the corresponding LSU retiree subscriber. Invoice reporting must provide sufficient detail to support eligibility verification, premium validation, and audit requirements.

The Supplier shall be responsible for reconciling all monthly premium remittances against Supplier-issued invoices and identifying any discrepancies, exceptions, enrollment inconsistencies, payment variances, or other reconciliation issues. The Supplier must timely notify the appropriate LSU campus, participating employer, or successor agency of discrepancies requiring resolution and work collaboratively toward correction.

LSU and participating employers shall retain responsibility for billing retirees for their applicable premium contributions in accordance with Louisiana Revised Statute § 42:851.

Insurance Requirements:

LSU requires Supplier to procure the minimum limits of insurance coverage set forth below. The insurance must be maintained for the duration of the services performed for or on behalf of LSU, and for the duration of the term. Failure to maintain the required insurance throughout the term shall constitute a material breach of this Agreement and shall entitle LSU to all remedies provided for in the Agreement or by operation of Law. The minimum insurance requirements described herein do not in any way limit the Supplier’s financial responsibilities. Therefore, the Supplier may opt to have broader coverage and limits to satisfy its financial obligations.

Workers' Compensation

Workers' Compensation insurance shall be in compliance with the laws of the state in which the Supplier is domiciled.

Employer's Liability shall be included with a minimum limit of $1,000,000 per accident/per disease/per employee. If Supplier is exempt from workers’ compensation or fails to provide appropriate coverage, then the Supplier shall be solely responsible and hold harmless LSU for the Injuries of any owners, agents, volunteers, or employees during the Term.

Commercial General Liability (CGL)

Commercial General Liability insurance shall be maintained on an "occurrence" basis, including property damage, bodily injury, products & completed operations, and personal & advertising injury with limits not less than $1,000,000 per occurrence and $2,000,000 aggregate on Insurance Services Office Form CG 00 01, ISO 2007 edition or equivalent.

Automobile Liability

Automobile Liability Insurance shall have a minimum combined single limit per accident of $1,000,000 on ISO form number CA 00 01 or equivalent. This insurance shall include third-party bodily injury and property damage liability for owned, hired and non-owned vehicles.

Cyber Liability Insurance

Cyber liability insurance, including first-party costs, due to an electronic breach that compromises LSU's confidential data shall have a minimum limit per occurrence of $1,000,000. Claims-made coverage is acceptable. The date of the inception of the policy must be no later than the first date of performance of the Services hereunder. The policy shall provide coverage for the duration of the Term and shall have an expiration date no earlier than 30 days after the anticipated termination date of this Agreement.