Exhibit_F_-_Professional_Paid_Claims.xlsx

Exhibit F - Professional Paid Claims is an Excel spreadsheet associated with the 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 initial contract term is set for three years (January 1, 2026 through December 31, 2028) with potential renewal options for up to three additional one-year periods.

The procurement emphasizes a comprehensive evaluation process across multiple categories including network access, claims repricing, utilization management, customer service, and technology capabilities, with a total possible score of 100 points. 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. The current medical administrative services provider is Florida Blue, and a simultaneous Pharmacy Benefit Manager (PBM) procurement is occurring. Vendors must provide detailed per-employee-per-month (PEPM) pricing for medical administration fees and meet standard government contracting requirements, with performance guarantees subject to potential financial penalties for non-compliance.