Appendix_7.6_Written_Q_and_C_template.pdf

This is a Written Questions and Comments Template document prepared by the State of Tennessee, Department of Finance and Administration, Division of Benefits Administration, for use in the Request for Proposals (RFP) #31786-00187 for Third-Party Administrator services. The template is structured to facilitate organized submission of inquiries related to the RFP across three categories: General Questions (rows 1-10), RFP Questions covering the Introduction through the Score Summary Matrix (rows 11-20), and Contract Questions addressing Section A Scope through HIPAA BAA compliance requirements (rows 21-30). Bidders are instructed to add additional rows as needed to accommodate their questions. The RFP seeks a single contract for comprehensive administrative services for The Tennessee Plan, a self-insured supplemental medical insurance program for Medicare-eligible state retirees. The RFP responses are due December 10, 2025, with a Notice of Award expected 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 claims run-out extending through December 31, 2033.

The evaluation process 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 as monthly per-member-per-month (PMPM) rates with maximum contract liability determined by the best-evaluated cost proposal. The current incumbent is UMR, Inc., whose contract expires June 30, 2028. The plan serves 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 paid amounts indicating a contract opportunity in the tens of millions of dollars. The selected contractor must demonstrate HIPAA compliance and establish a Business Associate Agreement, with responsibilities including weekly claims payment processing, member communications, call center services, subrogation recovery, and enrollment management in accordance with a detailed Service Level Agreement Scorecard.