Exhibit_13_MSP_Premium_Rate.docx
DOCX document 39 KB Posted
- Attached to
- OEIBA Program Commercial HMO, MSP, and MAPD Plans State and local contract opportunity
- Solicitation number
- EV00000681
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This document is an Exhibit for Medicare Supplement Premium Quotes for the OEIBA Program for Plan Year 2026, covering Medicare supplement plan pricing and requirements. The document outlines that bidders must submit estimated premium quotes with their bid submission, with final Medicare Supplement Premium (MSP) rates due by August 1, 2025, or two business days after CMS deadline calculations. The contract period covers January 1, 2026 through December 31, 2026, with suppliers required to provide annual renewal rates by May 1st for subsequent plan years (May 1, 2026 for Plan Year 2027 and May 3, 2027 for Plan Year 2028).
The premium quote requirements include specific pricing guidelines: rates must be a fixed dollar amount, with cents quoted as an even number divisible by two, and include an administrative cost rate of $4.477 Per Member Per Month (PMPM). Bidders must complete Table 1 ("PY2026 Quote with No Plan Changes") as a mandatory submission, with Table 2 ("PY2026 Quote with Proposed Plan Changes") optional only for current health contract holders. The document also requires a Low Income Subsidy Table with quotes for different subsidy percentage levels (100%, 75%, 50%, 25%), to be submitted with final MSP rates in August. The quote must be signed by the supplier's President, Chief Executive Officer, or an authorized representative.
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Text version
Exhibit 13 Medicare Supplement Premium Quote [Supplier Name] Plan Year 2026
1. Estimated premium quote(s) for a Medicare supplement plan will be due with the bid submission.
2. The due date for the final MSP rate(s) of PY2026 will be the later date of:
a. August 1, 2025; or
b. Two business days following CMS deadlines for rebate allocation calculations based upon the release of the CMS national average monthly bid amounts
3. Anything other than a fixed dollar amount will not be accepted and may cause the Bidder’s bid to be rejected. Any cents quoted in the Bidder’s rates shall be an even number and shall be divisible by two.
4. The rate sheet shall include the plan name.
5. Administrative cost rate ($4.477 PMPM) for PY2026 should be included in the premium quote. This fee is determined annually by EGID and is subject to change either up or down in pricing. Refer to OEIBB Commercial Contracting Policy.
a. In the event of renewals, any change in the administrative assessment will be communicated to the Supplier no later than May 1st of the year preceding the following Plan Year.
6. Anything other than a fixed dollar amount will not be accepted and may cause the Bidder’s bid to be rejected. Any cents quoted in the Bidder’s rates shall be an even number and shall be divisible by two.
7. The MSP benefits shall be those specified in Exhibit 12 for reference.
8. “PY2026 Quote with No Plan Changes” for MSP is required for all Bidders to complete. (Table 1)
a. “PY2026 Quote with Proposed Plan Changes” for MSP is optional and only for Bidders with current health contracts with the OEIBA Program. (Table 2)
9. Low Income Subsidy Table 3 is due with the final MSP rates in August.
10. PY2026 MSP Premium Quotes must be signed by the Supplier’s President, Chief Executive Officer or authorized representative)
Supplier agrees to provide annual renewal rates for each contracted option no later than the first business day in May preceding the Plan Year for which the rates apply:
1. May 1, 2026 for Plan Year 2027 (January 1, 2027 through December 31, 2027)
2. May 3, 2027 for Plan Year 2028 (January 1, 2028 through December 31, 2028)
TABLE 1 – Medicare Supplement Plan Monthly Premium Quote No Plan Changes (January 1, 2026 through December 31, 2026)
| Plan Name |
| Per Member Monthly Rate |
PY2026 Quote with No Plan Changes (Required)
TABLE 2 – Medicare Supplement Plan Monthly Premium Quote With Plan Changes
| Plan Name |
| Per Member Monthly Rate |
PY2026 Quote with Plan Changes (Optional only for current Suppliers)
TABLE 3 – Medicare Supplement Plan Low Income Subsidy
| Low Income Subsidy (LIS) % |
| Quote for Medicare-eligible members |
| 100% |
| $ |
| 75% |
| $ |
| 50% |
| $ |
| 25% |
| $ |
Signature Printed Name Date
Title Supplier Name (To be signed by the Supplier’s President, Chief Executive Officer or authorized representative.)
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