Exhibit_F_-_Professional_Paid_Claims.xlsx

Exhibit F - Professional Paid Claims is a spreadsheet associated with Marion County Public Schools' (MCPS) Request for Proposal (RFP) #4115RC for a Third-Party Administrator (TPA) to manage their self-funded medical plan with Administrative Services Only (ASO) capabilities. The RFP seeks a vendor to administer claims processing for four existing plan designs serving 4,184 subscribers and 5,611 members, with proposals due by 2:00 PM EST on March 6, 2025, and an anticipated board award date of June 24, 2025. The contract term is initially set for three years (January 1, 2026 through December 31, 2028) with potential renewal options for up to three additional one-year periods.

The RFP requires vendors to provide detailed per-employee-per-month (PEPM) pricing for medical administration fees, including broad and narrow network configurations. The evaluation will comprehensively assess proposers across categories such as network access, claims repricing, utilization management, customer service, and technology capabilities, with a total possible score of 100 points. The current medical administrative services provider is Florida Blue, and a simultaneous Pharmacy Benefit Manager (PBM) procurement is occurring. Three previous vendors - Aetna Life Insurance Company, Blue Cross and Blue Shield of Florida, Inc., and United HealthCare Services, Inc. - have submitted proposals, with Blue Cross and Blue Shield of Florida, Inc. previously receiving the highest evaluation score of 92.00 points. Performance guarantees will be critical, with potential financial penalties for non-compliance in areas like claims processing accuracy and customer service metrics.