ESBD_521004_1780595757286_RFP 2605-004Amendment 1 - Updated Exhibits A-10 & A-11.pdf

This is an amendment to a Request for Proposals (RFP 2605-004) issued by Travis County Healthcare District d/b/a Central Health for comprehensive HR benefits administration. The amendment, issued June 4, 2026, updates Exhibits A-10 and A-11 to the original solicitation. The RFP solicits proposals for medical administrative services only (ASO), prescription drug benefits, fully-insured dental coverage, and fully-insured vision insurance. Central Health maintains approximately 2,000 eligible lives across multiple family composition tiers. The scope includes administration of three medical plan options (Seton ACO, Texas Medical Neighborhood EPO, and HDHP), pharmacy benefits management available as either carve-out or bundled services, fully-insured dental coverage in Basic and Premium PPO tiers, and fully-insured vision coverage in Basic and Plus plans. Proposals are due June 11, 2026 at 2:00 PM Central Time, with submission via Bidnet (preferred) or sealed mail to Central Health's Purchasing Office in Austin. The initial contract term is one year effective January 1, 2027, with optional renewal for up to four additional one-year periods.

Vendors may quote on any or all lines of coverage without restriction to incumbent carriers or set-aside categories, though Central Health encourages good-faith efforts to include certified minority, women, and veteran-owned businesses as subcontractors. The incumbent carriers are Aetna for medical, dental, and vision coverage, with CVS Caremark serving as the PBM. Recent claims experience shows medical claims with significant catastrophic exposure (18 claimants exceeding $150,000 with $4.68 million in aggregate catastrophic claims for the rolling 12-month period March 2025-February 2026), dental claims totaling $2.62 million against $2.85 million in premiums (92% cost ratio), and vision claims of $273,767 against $363,687 in premiums (75% cost ratio). Evaluation criteria include account management (10%), customer service (10%), claims administration (20%), technical and reporting capabilities (10%), implementation planning (10%), fee structure (20%), and underwriting processes (20%), with potential interviews of short-listed finalists worth up to 20 additional points. All vendors must execute Central Health's standard contract template, provide a Certificate of Interested Parties (Form 1295), complete a Conflict of Interest Questionnaire, and execute a HIPAA Business Associate Agreement.