ESBD_486865_1771627457725_SBA-26-274 Addendum 1.pdf

THE TEXAS A&M UNIVERSITY SYSTEM

Office of Procurement & HUB Program

ADDENDUM NO. 1

Date: February 20, 2026

RFP Due Date: March 16, 2026

RE: RFP01-SBA-26-274 – Self-Insured Employee Group Health Plan

Respondents shall acknowledge receipt of addendum(s) on the Execution of Offer (Exhibit A).

Questions/Responses:

1. Are you happy with your existing Health Advocate Services?

So far, we are happy with the new Health Advocacy Services provided by our current vendor. However, we just started the program on 9/1/2025

2. In the Healthcare Innovation section of the RFP questionnaire you mention you are looking for “innovative, unique solutions to health care quality and cost.” As an independent navigation and care coordination company we become the front door for TAMUS members. Through a single point of contact, we guide members through every step of their healthcare journey with empathy and clinical expertise. The result?

Simplified care, improved outcomes and lower costs. We are a vendor agnostic independent navigation company and will fully integrate with the selected TPA or carrier vendor of choice. Please confirm if TAMUS would be open to accepting an independent navigation response?

The scope of the RFP is to solicit proposals from qualified vendors to provide claims and network administration for a self-insured Preferred Provider Organization (PPO) employee group health plan and a fully insured Medicare Advantage Plan. This type of response would not meet the requirements of the

RFP.

3. Can the A&M System include the CMS Place of Service information to the claims data file? If not, please provide guidance on assumptions that all respondents should use, as the place of service has a significant impact on the price per service?

The Place of Service has been added to the revised detail claim file “Detail Claims A&M Addendum.xlsx”.

Please follow this link: https://www.tamus.edu/procurement/hub-procurement/rfps/. The file can be found under SBA-26-274 Self-Insured Employee Group Medical Plan Administration Detail Claims Addendum.

4. Can the A&M System include the Unit Count to the claims data file? If not, please provide guidance on any assumptions regarding unit count per service, which all respondents should use in their analysis?

The Number of Services has been added to the revised detail claim file “Detail Claims A&M Addendum.xlsx”. Please follow this link: https://www.tamus.edu/procurement/hub-procurement/rfps/.

The file can be found under SBA-26-274 Self-Insured Employee Group Medical Plan Administration Detail Claims Addendum.

5. Can the A&M System include Patient Date of Birth or Age to the claims data file? If not, please confirm all respondents should assume all members are >18 years of age.

We’re unable to provide the date of birth or age for privacy concerns. Please reprice the claims using the information that is available.

https://www.tamus.edu/procurement/hub-procurement/rfps/

6. We note that Anesthesia Minutes are not included in the claims data extract. In lieu of this data, can we confirm that all respondents should default to a provider-specific discount?

Anesthesia minutes are not available. Please reprice the claims using the information that is available.

7. We note that Ambulance Miles are not included in the claims data extract. In lieu of this data, please confirm that all respondents should default to a provider-specific discount?

Ambulance miles are not available. Please reprice the claims using the information that is available.

8. We note that Ambulance Pick Up Zip is not included in the claims data extract. In lieu of this data, please confirm that all respondents should default to a provider-specific discount?

Ambulance Pick Up Zip is not available. Please reprice the claims using the information that is available.

9. Can the A&M System add Patient Gender to the claims data file? If not, please confirm all respondents should assume all members are female?

We’re unable to provide the patient gender for privacy concerns. Please reprice the claims using the information that is available.

10. Can the A&M System share all 25 possible diagnoses on the claims data file? If not, please confirm which approach all respondents should use:

The first three diagnosis code have been provided. Please reprice the claims using the information that is available.

• Option 1: Use DRG provided on file for pricing vs. re-grouping to current DRG?

• Option 2: Regroup claim using only the available data elements?

11. Can the A&M System share the Present on Admission Indicator on the claim data file? If not, please confirm that all respondents should assume that the “condition is Present on Admission” value should be “No”.

The Admit Indicator and Number of Admit Days have been added the detail claim file “Detail Claims A&M Addendum.xlsx” . The Admit Indicator (1) is populated for an inpatient facility claim and will be populated for all claim lines. The Number of Admit Days represent the number of inpatient days. Please follow this link: https://www.tamus.edu/procurement/hub-procurement/rfps/. The file can be found under SBA- 26-274 Self-Insured Employee Group Medical Plan Administration Detail Claims Addendum.

12. Can the A&M System share a line disposition code (Paid/Denied) for each claim line on the claim data file?

If not, please confirm that all respondents should assume all claim lines are paid?

The detail claim file has been filtered to only include claims where disposition code = paid.

13. As some claims are missing lines, please confirm that respondents should re-price only the claim lines included in the file?

Confirmed. Respondents should re-price all the claims provided.

14. Please confirm that all respondents should reprice all claims in the claims data file, including those labeled “Retirees,” using commercial reimbursement rates?

Confirmed. Respondents should re-price all the claims provided. The detail claim file has been filtered to only include claims where Medicare is non-primary.

15. There are multiple data elements in the claims data file where there are records with invalid lengths. This may have been caused by a leading zero or zeroes being dropped when the data was moved into MS Excel.

Please confirm that respondents can assume that adding leading zeros to the data elements with invalid lengths will produce a valid value for repricing?

Confirmed. Some of the fields are provided in numeric format and leading zeroes will be dropped. For example, the five digit zip code “01234” will be “1234” in the data provided. Similarly, the nine digit provider tax id “012345678” will be “12345678” in the data provided.

16. Please confirm that updated claims file(s) will be provided by Friday, February 13, 2026, so that respondents have sufficient time to conduct their analyses by the current submission deadline (March 16, 2026).

Alternatively, if updated claims files will be provided later, please confirm an extension will be granted for submissions of the repricing files.

We will provide all additional information by February 20, 2026, as noted in the RFP.

17. Please confirm when we will receive an updated claims file, so that respondents have sufficient time to conduct their analyses by the current submission deadline (March 16, 2026). Please confirm if an extension will be granted for submissions of the repricing files.

We will provide all additional information by February 20, 2026, as noted in the RFP.

18. On question 6 of Exhibit D, bullets f. and g. reference “Pathology Drawing Stations.” Please confirm that “Pathology Drawing Stations” are equivalent to independent lab providers such as Quest, LabCorp, or Clinical Pathology Laboratories (CPL).

Confirmed.

19. For the GeoAccess report information requested in question # 6 of Exhibit D, please confirm that Medicare Advantage Plan respondents should use the data in both the ‘ESBD_486865_1770154774348_Benefit Eligible.xlsx’ and ‘ESBD_486865_1770154776343_AM Care Plans.xlsx’ files. Alternatively, specify if only data from one of the two files should be used.

Question #6 refers to ESBD_486865_1770154774348_Benefit Eligible.xlsx. You can assume all members with an “R” status for retired and over 65 are in the Medicare Advantage plan.

• Please also confirm that Medicare Advantage Plan respondents should only use the tab labeled “65 plus MAP” of the ‘ESBD_486865_1770154776343_AM Care Plans.xlsx’ file for the GeoAccess Analysis, if using that data. This is correct for question #7.

• Please also confirm that Medicare Advantage Plan respondents should filter the “Employee Status” column by “R” for Retirees of the ‘ESBD_486865_1770154774348_Benefit Eligible.xlsx' file for the GeoAccess Analysis, if using that data. See above.

20. Within questions (21, 22, 23, 25, 26, 27, 29, 30, 31) the RFP requests separate information for Texas and Book of Business (BOB). Should respondent assume Book of Business (BOB) metrics should show information based on all networks available in Texas?

The RFP is requesting proposals for PPO networks. The response should only be in relation to the relevant network.

21. In the ‘ESBD_486865_1770151667310_Provider Reimbursement.xlsx’ file, please confirm that respondents can add a row for “Other Specialists” to capture provider counts for those specialist types not currently listed in Form 1 between rows 22 and 28.

Confirmed.

22. Please confirm how respondents should indicate use of a shared site, such as Dropbox, to upload final responses. We anticipate the repricing exercise and several other documents will be too large to send via email.

Please send an email to soprocurement@tamus.edu letting us know what shared site you will be using to submit your response. We also encourage you to send a test file prior to sending your complete response.

END OF ADDENDUM NO. 1

mailto:soprocurement@tamus.edu