Ext 5.TechProp FA5 Attachments List (Medical HMO-PPO Plans) 2025.8.9.pdf
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- Attached to
- 3-MDOT-MTA Medical/Vision Plan Admin&Svcs, Functional Areas 5 (Medical PPO-SF/HMO-SF) & 6 (Vision)
- Solicitation number
- BPM053905
- Issued by
- Anne Arundel County, Maryland
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Text version
MDOT MTA REPRESENTED HEALTH BENEFITS
RFP NUMBER AGY-24-026-SR-A
ATTACHMENTS LIST
FUNCTIONAL AREA (FA) 5 – MEDICAL HMO-PPO PLANS TECHNICAL
PROPOSAL
ATTACHMENT NUMBER & NAME ATTACHMENT TYPE:
REFERENCE DOCUMENT OR
SUBMIT WITH PROPOSAL
FA5 Attachment 1: Medical HMO and PPO Technical Proposal
Submit
FA5 Attachment 2: Plan Designs Submit
FA5 Attachment 3 (and 3a, if needed): Explanations and Deviations
Submit
FA5 Attachment 4: Transitional Care Information. Submit
FA5 Attachment 5: Service Area Map Submit
FA5 Attachment 6a: Medical Census Reference
FA5 Attachment 6b: Medical HMO Claim File Submit
FA5 Attachment 6c: Medical PPO Claim File Submit-
FA5 Attachment 7: Medical HMO and PPO Network Match/Disruption Report
Submit
FA5 Attachment 8: Management Reporting Package
Submit
FA5 Attachment 9: Claims Appeal Protocol Submit
FA5 Attachment 10: Medical HMO EOC Reference
FA5 Attachment 11: Medical PPO EOC Reference
FA5 Attachment 12: Compliance Checklist Submit
FA5 Attachment 13: Performance Guarantees Submit
FA5 Attachment 14: Questionnaire Submit
FA5 Attachment 15: Certificates of Insurance Submit
FA5 Attachment 16: Member Communications Package
Submit
FA5 Attachment 17: Provider Satisfaction Survey Submit
FA5 Attachment 18: Medical Management Staff Biographies
Submit
FA5 Attachment 19: Member Satisfaction Survey Submit
FA5 Attachment 20: Sample Financial Reports Submit
FA5 Attachment 21: Implementation Team Submit
FA5 Attachment 22: Implementation Plan Submit
FA5 Attachment 23: Account Management Team Organizational Chart and Resumes.”
Submit
FA5 Attachment 24 Account Management Plan Submit
FA5 Attachment 25: Subcontractors Questionnaire Submit
FA5 Attachment 26: Network Management Organization Chart
Submit
| FA5 Attachment 10: Medical HMO EOC |
| FA5 Attachment 14: Questionnaire |
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