CSP020709_-_Rev_Contract.pdf
PDF 78 KB Posted
- Attached to
- Competitive Selection OH|CSP020709
- Contract number
- CSP020709
- Issued by
- Ohio
About this file
This document is a Mandatory Use Contract issued by the State of Ohio's Department of Administrative Services (DAS), General Services Division, Office of Procurement Services for COBRA Administration services. The contract is with iTEDIUM Inc., located in Overland Park, Kansas, and is designated as Contract Number CSP020709 with an initial effective period from 07/01/24 to 09/30/25, with a mutual renewal through 09/30/27.
The contract covers COBRA administration for the medical plan, exempt dental, and vision plans, with pricing structured on a Per Employee Per Month (PEPM) basis. The core COBRA administration fee is $0.25 PEPM for employees enrolled in the medical plan. Additional services are priced at $200 per hour for ad-hoc reporting and professional services (with a two-hour minimum), and a new amendment adds a $5 fee for mailing revised notices to qualified beneficiaries. The contract is available to the State Human Resources Division, Office of Benefits Administration Services, with payment terms of Net 30 Days. The state makes no guarantees about the volume of services that will be purchased under this requirements contract.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CSP020709_Amendment_2.pdf | ||
| CSP020709_-_Contract.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Index No.: DAS009
Eff. Date: 10/01/25
STATE OF OHIO
DEPARTMENT OF ADMINISTRATIVE SERVICES
GENERAL SERVICES DIVISION
OFFICE OF PROCUREMENT SERVICES
4200 SURFACE ROAD, COLUMBUS, OH 43228-1395
MANDATORY USE CONTRACT FOR: COBRA ADMINISTRATION OF THE MEDICAL PLAN, EXEMPT DENTAL AND
VISION PLANS
CONTRACT NUMBER: CSP020709 EFFECTIVE DATES: 07/01/24 TO 09/30/25
* Renewal through 09/30/27
The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.
SRC0000013470 that opened on 02/28/24. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed.
The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.
This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.
This Requirements Contract is available to the Department of Administrative Services, State Human Resources Division, Office of Benefits Administration Services as applicable.
The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.
This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:
https://procure.ohio.gov/
*Indicates mutual renewal through 09/30/27, per amendment 1.
Eff. Date: 10/02/25
MUTUALLY AGREED TO CLARIFICATIONS / MODIFICATIONS TO THE RFP
1. Cost Summary Form Revised, dated 04/01/24.
2. *The Cost Summary and OhioBuys Price list are updated to add the cost to mail a revised notice to a qualified beneficiary, effective 10/02/25.
*Denotes a mutually agreed upon addition to the Cost Summary and OhioBuys Price list, per amendment 2.
COST SUMMARY
COBRA ADMINISTRATION OF THE MEDICAL PLAN, EXEMPT DENTAL AND VISION PLANS
UNSPSC CATEGORY CODE: 80100000
DESCRIPTION UNIT OF
MEASURE
COST
COBRA Administration Fee Per Employee Per Month (PEPM) basis for employees enrolled in the medical plan
PEPM $0.25
Ad-Hoc Reporting (reports not identified in the Scope of Work, minimum of two hours) Hour $200
Professional Services (minimum of two hours) Hour $200
*Cost to mail revised notice to qualified beneficiary Each $5
*Denotes a mutually agreed upon addition to the Cost Summary, per amendment 2.
Eff. Date: 10/01/25
CONTRACTOR INDEX
CONTRACTOR AND TERMS: CONTRACT NO.: CSP020709
0000000352 (OHALL) TERMS: Net 30 Days iTEDIUM Inc.
6717 Shawnee Mission Parkway Overland Park, KS 66202
PAYMENT ADDRESS:
iTEDIUM Inc.
Customer (Group) Billing P.O. Box 504265 St. Louis, MO 63150-4265
*CONTRACTOR’S CONTACT: Ms. Debra Mootz Telephone: 913-499-4869 Fax: 913-438-8385 Email: debra.mootz@itedium.com
*Indicates update to Contractor’s contact information, per amendment 1.
SUMMARY OF AMENDMENTS
Amendment
Number Effective
Date Description
2 10/02/25
This amendment is issued to update the Cost Summary and OhioBuys Price list by adding a line item for the cost to mail a revised notice to a qualified beneficiary.
All other prices, terms and conditions remain unchanged.
1 10/01/25
As a result of mutual agreement between the State of Ohio and the Contractor, this amendment is issued to renew the subject contract an additional 24 months, effective 10/01/25 through 09/30/27. This amendment is also issued to update the Contractor’s contact information and to add a Summary of Amendments page.
All other prices, terms and conditions remain unchanged.
CONTRACT FOR: COBRA ADMINISTRATION OF THE MEDICAL PLAN, EXEMPT DENTAL AND VISION PLANS
File details come from the government source that posted it. Updated .