Attachment_A.pdf

Attachment A

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 1 of 6

AGENCY SOLICITATIONS

SOLICITATION NO. EV00000906

This solicitation is a contract document and is a request for proposal in connection with the contract awarded on behalf of the Oklahoma Health Care Authority Employees Group Insurance Division (EGID) by the Office of Management and Enterprise Services as more particularly described below. Any defined term used herein but not defined herein shall have the meaning ascribed in the General Terms or other contract document.

I. PURPOSE

The Office of Management and Enterprise Services (OMES) Central Purchasing division is seeking responses on behalf of the Oklahoma Health Care Authority Employees Group Insurance Division from potential suppliers to provide a contract for the purchase of an HSA Administrator to offer HSA administrative services and account access for members enrolled in the HealthChoice High Deductible Health Plan (HDHP) and elect to establish an individual trust agreement. A contract resulting from this solicitation may be designated for use as a statewide contract. See 74 O.S. § 85.5(G)(3).

The contract is awarded on behalf of the Oklahoma Health Care Authority Employees Group Insurance Division for a Health Savings Account (HSA) Administrator to provide HSA account administration, custodial services, and member support for individuals enrolled in the HealthChoice High Deductible Health Plan (HDHP).

1. Contract Term and Renewal Options

1.1. The initial contract term, which begins on the effective date of this contract, is one year, and there are four one-year options to renew the contract.

2. Solicitation Criterion

2.1. The bid will be evaluated using a best value criterion, based on the following:

2.1.1. Quality of Response regarding Requirements and Exhibit(s)

2.1.2. Mandatory Requirements – Exhibit 4

2.1.3. Experience performing specifications and possible demonstrations

2.1.4. Response to Executive Summary and Company Information

2.1.5. References

2.1.6. Price and Cost

3. Scope and description

3.1. Objective:

3.1.1. Title 74 O.S. §1329 provides that, “The Oklahoma Health Care Authority shall contract with a vendor to make available a health savings account to all enrollees in the HealthChoice qualified high-deductible health plan. Any employer or employee contributions to the health savings account shall be allowable as a remittance to the vendor through payroll deduction in conjunction with the employer's Section 125 Plan and shall not be subject to any assessment of administrative fees by the Oklahoma Health Care Authority or any state agency for remittance to the vendor. The State of Oklahoma and the Oklahoma Health Care Authority shall take necessary measures to make any employer or employee health savings account contributions permissible under the state's Section 125 Plan.

3.2. Identification and Overview:

3.2.1. Employees Group Insurance Division (EGID)

3.2.1.1. EGID is a division of the Oklahoma Health Care Authority. EGID was established by, and operates pursuant to, the Oklahoma Employees Insurance and Benefits Act, 74 O.S. § 1301, et seq., hereinafter (Act). The Act was established for the benefit of state and education employees, employees of other state governmental entities, and quasi-state governmental entities authorized by the Act to participate in the insurance plans offered by EGID. EGID

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 2 of 6 makes decisions on all policy matters affecting the group insurance plans, including member benefits, premium rates and the investment of premiums.

EGID also maintains its own network of providers for the HealthChoice plans, DOC, and DRS.

3.2.1.2. EGID serves over 900 employer groups with multiple retirement systems. This population includes approximately 124,051 state employees, education employees, and other eligible employees (excluding all dependents). See https://oklahoma.gov/egid.html for more information about EGID and plans offered.

3.2.1.3. Pursuant to legislative authority, EGID Administrative Rules set forth the eligibility, type of participation, and benefits guidelines for all participating employers. A copy of the official Administrative Rules is on file with the Office of the Secretary of State, beginning at Oklahoma Administrative Code Title 317:145, or the Rules may be found at https://oklahoma.gov/egid/about/resources-and-notices.

3.2.2. HealthChoice

3.2.2.1. The state of Oklahoma’s self-funded health, dental, and life insurance plans administered by EGID are known as the HealthChoice plans.

3.2.2.2. HealthChoice members are all persons covered by one or more of the

HealthChoice insurance plans offered by EGID, including eligible current and qualified former employees of participating entities and their eligible covered dependents.

3.2.2.2.1. Total covered lives on HealthChoice: 180,202

3.2.2.3. The HealthChoice High Deductible Health Plan (HDHP) is a qualified high-deductible health plan administered by EGID and offered as part of the HealthChoice plans. The HDHP complies with applicable federal and State requirements and allows eligible members to establish and fund a Health Savings Account (HSA), subject to statutory and regulatory limitations. Eligibility, benefits, and plan design are governed by EGID rules, policies, and applicable law.

3.2.2.3.1. For plan year 2025, there are 15,292 primary Members and 11,296 dependents enrolled in the HealthChoice HDHP.

3.2.2.3.2. For 2025, the HealthChoice HDHP Plan had 258,000 medical claims representing $115,000,000 in allowed claims.

3.2.2.3.3. For 2025 the HealthChoice HDHP plan had 239,000 pharmacy claims representing $37,000,000 in allowed charges.

3.2.2.3.4. Note: Statistical information contained in the Exhibits and throughout this document reflects the best information available to EGID as of the date specified and is not intended as, and must not be considered, an express or implied warranty by EGID.

3.2.2.4. HealthChoice medical and dental benefits are administered by a contracted Third-Party Administrator (TPA) responsible for claims adjudication, customer service, and related administrative functions in accordance with applicable state and federal requirements.

3.2.2.4.1. The current TPA for plan year 2026 is UMR, a UnitedHealth Group company.

3.2.2.5. HealthChoice pharmacy benefits are administered by a contracted Pharmacy

Benefit Manager (PBM), which also administers EGID’s Medicare Part D Employer Group Waiver Plan (EGWP) prescription drug program under a direct contract with the Centers for Medicare & Medicaid Services (CMS).

3.2.2.5.1. The current PBM for plan year 2026 is CVS Caremark.

3.2.2.6. EGID administers member eligibility in a multi-employer environment. Eligibility and Enrollment rules are outlined in the EGID Administrative Rules and HealthChoice member handbook(s). EGID is responsible for applying these rules

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 3 of 6 to determine eligibility and process enrollments. Member demographic and enrollment information is maintained by the EGID Member Accounts units within the EGID Eligibility and Premium Accounting system.

3.2.2.6.1. EGID maintains eligibility and enrollment at the employer group level within its multi-employer environment.

3.3. Mandatory Requirements

3.3.1. The Bid Response shall include an acknowledgement of the Bidder’s willingness and ability to comply with all requirements below, outline the ability of the Bidder to meet or exceed the mandatory specifications, and indicate the Bidder’s experience with each. Bidder’s compliance with the requirements in this section shall be determined according to the sole unrestricted discretion of EGID. Additionally, Bidder’s shall respond to each of the questions contained in Exhibit 4 to ensure the State has sufficient information to evaluate and score each bid.

3.3.1.1. License

3.3.1.1.1. To be eligible to submit a proposal under this solicitation, an organization must meet all legal requirements for doing business in the State of Oklahoma. Bidder must provide a copy of its current Certificate of Good Standing or other official documentation evidencing authority to conduct business in Oklahoma, including any required regulatory licensure applicable to HSA administration.

3.3.1.1.2. Supplier shall be compliant with State and federal laws and regulations, including but not limited to the Health Insurance Portability Accountability Act (HIPAA) and other relevant enacted legislation, executive orders, or regulations.

3.3.1.2. Financial Information

3.3.1.2.1. Bidder must demonstrate its financial stability by providing EGID with copies of audited financial statements for the Bidder's three (3) fiscal years previous to the date of its response and its most recent SSAE 18 SOC1 audit report as outlined in 7.10 – Section Ten of the Bidder Instructions. EGID shall exercise its sole discretion in evaluating such information.

3.3.1.2.2. The contracted Supplier shall continue to provide such financial information and an SSAE 18 SOC1 report to EGID on an annual basis, if requested. If Bidder is a wholly owned subsidiary of a parent organization, this requirement may be fulfilled by the audited financial statement of the parent organization, provided that the parent organization agrees to have the same legal and financial responsibilities under the contract as the Supplier.

3.3.1.3. General Terms

3.3.1.3.1. Supplier shall have no interest, direct or indirect, that could be perceived to conflict in any manner or degree with the performance of services required under this contract. Supplier shall not engage in any conduct that violates or induces others to violate provisions in the Oklahoma Statutes regarding the conduct of public employees. See The Anti-Kickback Act of 1974 at 74 0.S. (2011), § 3401, et seq., and the Conflict of Interest provision in the Oklahoma Central Purchasing Act at 74 0. S. (2011), § 85.3.

3.3.1.3.2. EGID is not interested in, nor will it consider, allegations of lack of qualification or of impropriety made or initiated by any Bidder concerning another Bidder at any point during the competitive bid process. Inclusion of such information in the Bid or communication of such information to any state officials, state staff or its contractors after Bid submission shall be grounds for disqualification. This clause

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 4 of 6 in no way limits the right to file a protest or appeal under the laws or rules governing the State of Oklahoma.

3.3.1.4. Customer & Account Services

3.3.1.4.1. EGID shall provide general administration of the HDHP. The HSA

Administrator shall provide individual HSA account management services for eligible members enrolled in the HealthChoice HDHP who execute Trust Agreements, such as secure account access, transaction processing, debit card functionality, investment options (if applicable), and member customer support.

3.3.1.4.2. Supplier shall provide robust HSA customer service and engagement support, including multi-channel communication methods, educational resources, decision-support tools, and accessible service options for all eligible members.

3.3.1.4.3. Supplier shall provide HSA administrative services for participating employers, including required tax reporting, employer documentation support, payroll contribution coordination, and compliance assistance related to applicable IRS requirements, including IRC Section 4980G.

3.3.1.4.4. Supplier shall assist eligible members in the HSA enrollment process, including providing educational information and toll-free customer assistance. Members retain the option of choosing another qualified HSA account administrator.

3.3.1.4.5. Supplier shall provide HSA custodial and banking services, including account statements, investment reporting (if applicable), and required tax documentation (e.g., Forms 1099-SA and 5498-SA), and shall clearly disclose any associated administrative fees and applicable timelines for fund availability.

3.3.1.4.6. Supplier shall provide financial administration services to support the receipt, allocation, and reconciliation of pre-tax and post-tax HSA contributions, including pWhicayroll deduction contributions under Section 125 plans, and shall accommodate multiple employer payroll systems and contribution transmission methods.

3.3.1.5. Marketing & Communications

3.3.1.5.1. Supplier shall support each annual Option Period by providing timely communications, educational materials, and enrollment resources to enable informed HSA participation decisions.

3.3.1.5.2. Supplier must receive approval for its marketing and communications plan with EGID prior to distribution to employees during Option Period. EGID reserves the right to have the Suppliers amend or modify such information to meet its requirements.

3.3.1.5.3. All requests for any marketing and communication by the Suppliers must be submitted to EGID at least ten (10) business days in advance of the scheduled advertising date using the Advertising Approval Form in Exhibit 2.

3.3.1.5.3.1. If the item is not an advertising piece, please note that this is a standard member communication piece and no advertising form is necessary.

3.3.1.5.4. In all marketing material, Supplier shall clearly indicate which products are provided as part of the OEIBA Program pursuant to this contract and which are not.

3.3.1.5.5. Supplier will not be allowed to make presentations during employee meetings for active employees unless pre-approved by EGID and

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 5 of 6 as permitted by law; however, Supplier may participate in education, county, and local government employee scheduled and organized meetings as directed by EGID.

3.3.1.5.6. Supplier shall not market itself as a representative of EGID or the OEIBA Program when making presentations to OEIBA Program Members.

3.3.1.6. Reporting

3.3.1.6.1. Supplier shall prepare and deliver reports to the Employer group setting forth information including, but not limited to contribution and reconciliation data. Such reports may be delivered electronically to the extent permitted by law and agreed upon by the Employer and HSA Administrator.

3.3.1.6.2. Supplier shall provide an Employee Account Detail Summary Report to EGID on a quarterly basis. Refer to Exhibit 1 – Employee Account Summary.

3.3.1.6.2.1. The Supplier shall deliver Exhibit 1 in the exact format, frequency and timeframe to EGID as noted in the exhibit.

3.3.1.7. Right to Audit

3.3.1.7.1. EGID, or its designated representatives, including the State Auditor and Inspector and independent third parties, shall be authorized to examine all records, data and systems of the HSA Administrator which are directly related to the performance of this contract. All records and data, without regard to form or media, shall be available during normal business hours upon five (5) business days' notice.

Included in this right to audit shall be the following provisions:

3.3.1.7.1.1. EGID, or its designated representative, is authorized to visit the HSA Administrators premises and have full access to all records and data including paper documents, electronic documents, policies and procedures, benefit documents, imaged and magnetically-stored data which relate to this contract.

3.3.1.7.1.2. EGID, or its designated representative, is authorized to perform claims review and/or a review of the operational procedures and adjudication process. An operational review includes a review of the policies and procedures, workflow, staffing and training, system capabilities and edits, and disaster recovery plans

3.3.1.7.1.3. The HSA Administrator shall assist EGID by promptly providing requested records and data and reasonable access to the HSA Administrator's personnel.

3.3.1.7.1.4. The findings of the audits performed by EGID or its designated representative shall be conclusive. The HSA Administrator shall cooperate with EGID and implement the recommendations of the audit findings.

3.3.1.8. Commissions

3.3.1.8.1. Absolutely no commissions or finder's fees shall be paid to anyone or any organization resulting from the State of Oklahoma's contract, either arising from an agreement to pay a commission or finder's fee prior to or during the term of this contract; and, to provide a statement as part of its response to this RFP, and prior to each contract renewal, that absolutely no commissions or finders fees are to be paid to any

OMES Central Purchasing | October 2025 Attachment A: Agency Solicitations | Page 6 of 6 subcontractor, broker, agent or other individual, organization or entity.

3.3.1.9. Pricing & Cost

3.3.1.9.1. EGID intends to benefit from this Contract by providing uniform HSA

Administrative services, simplifying the enrollment process for its HDHP Members thereby increasing its HDHP enrollment. EGID shall not incur costs or pay fees associated with this Contract. All fees established by and pursuant to this Contract shall be included in an agreement executed with HDHP members utilizing the HSA Administrators services and shall be the responsibility of the Member.

3.3.1.9.2. The HSA Administrator shall benefit from this Contract by gaining access to HDHP Members who choose to contract with the HSA Administrator.

3.3.1.9.3. The HDHP Member shall not be assessed fees that are not identified in this Contract.

3.3.1.10. Termination

3.3.1.10.1. The HSA Administrator shall give EGID at least one hundred eighty

(180) days written notice prior to cancellation. The HSA Administrator shall also provide one hundred eighty (180) days written notice prior to non-renewal.

3.3.1.11. Health Insurance Portability and Accountability Act (HIPAA) Requirements

3.3.1.11.1. The HSA Administrator agrees that it maintains internal practices, policies, books and records, including policies and procedures relating to the use and disclosure of EGID confidential and protected health information and will provide EGID a summary description of those policies and procedures upon request. All EGID Member information concerning this Contract is the sole property of the State of Oklahoma and shall remain confidential. It shall not be used by the HSA Administrator nor transmitted to others for any reason whatsoever, except as shall be required to administer and implement the Administrator’s obligations under the Contract, or with prior written approval from EGID.

3.3.1.11.2. In the event the HSA Administrator receives, manages, or possesses any individual protected health information as that term is defined by HIPAA, then the HSA Administrator agrees to the terms of the EGID Business Associate Agreement.

3.3.1.12. Facilities

3.3.1.12.1. The Bidder will make any of its facilities available to EGID if it is determined that an on-site visit would be beneficial and utilized as part of the final evaluation process.