ESBD_521004_1780955049911_RFP 2605-004 Amendment 2 - Updated Exhibits A--4.pdf

This is an amendment to a Request for Proposals issued by Travis County Healthcare District d/b/a Central Health for comprehensive HR benefits services. Amendment 2, issued June 8, 2026, updates Exhibits A-4 for RFP 2605-004. The solicitation seeks proposals for medical administrative services only (ASO), prescription drug benefits, fully-insured dental coverage, and fully-insured vision insurance. Central Health serves approximately 2,000 eligible lives across multiple family composition tiers. Vendors may quote on any or all lines of coverage without restriction to single incumbent or set-aside bidding. Proposals are due June 11, 2026 at 2:00 PM Central Time. The initial contract term runs one year effective January 1, 2027, with optional renewals for up to four additional one-year periods.

Medical services encompass three plan options: Seton ACO, Texas Medical Neighborhood EPO, and HDHP plans, with pharmacy benefits available as carve-out or bundled arrangements. Dental coverage includes Basic and Premium PPO tiers, while vision coverage offers Basic and Plus plans. Current medical claims experience (March 2025-February 2026) includes 18 claimants exceeding $150,000 with $4.68 million in aggregate catastrophic claims. Dental claims totaled $2.62 million against $2.85 million in premiums (92% cost ratio), and vision claims totaled $273,767 against $363,687 in premiums (75% cost ratio). Aetna currently serves as the incumbent carrier for medical, dental, and vision coverage, with CVS Caremark administering pharmacy benefits. 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 finalist interviews worth up to 20 additional points. Central Health encourages good-faith efforts to include certified minority, women, and veteran-owned businesses as subcontractors and reserves the right to request Best and Final Offers or reject any or all proposals.