Attachment I - Cost Proposal.xlsx

This is a Cost Proposal attachment for RFP #25RFP17863 issued by the State of South Dakota Bureau of Human Resources and Administration seeking an Administrative Services Organization (ASO) to provide Medical Network and Pharmacy Administration Services for the State Employee Health Plan. The RFP targets comprehensive claims administration, enrollment services, provider network management, medical management, and Pharmacy Benefit Manager (PBM) services for approximately 12,435 active employees across four medical plans and one pharmacy plan. The proposal submission deadline is December 15, 2025, at 5:00 p.m. CDT, with a Letter of Intent and Offeror Privacy and Security Agreement due by November 7, 2025. The contract period spans five years from July 1, 2026, through June 30, 2031, with potential for two five-year renewal options. Implementation must be completed 60 days prior to the FY27 Annual Enrollment period beginning April 15, 2026, with final vendor selection anticipated by January 16, 2026.

The cost proposal template requires vendors to submit detailed pricing across five contract years on a per-employee-per-month (PEPM), annual, or included fee basis, covering implementation fees, pre- and post-implementation audit fees, administrative service fees for claims processing, network access, utilization review, disease management, claims fiduciary services, eligibility reporting, standard and draft reporting, summary plan description preparation, subrogation services, ID card services, communication materials, benefit fair preparation, and runout fees. The State is self-insured for all medical plans and currently operates without stop-loss coverage, meaning the selected contractor bears no specific or aggregate stop-loss risk. CVS Caremark currently administers pharmacy services, though incumbency status for comprehensive services is not explicitly stated. No specific set-aside designations for disadvantaged enterprises are mentioned, and while no specific contract value is stated, the comprehensive nature of services and employee population size indicate substantial contract value.