RFP_31786-00187_Amendment_5.pdf
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- Solicitation number
- RFP 31786-00187
- Issued by
- Davidson County, Tennessee
About this file
This is Amendment Five to Request for Proposals #31786-00187 issued by the State of Tennessee Department of Finance and Administration, Division of Benefits Administration, for administrative services to perform as a third-party administrator (TPA) for The Tennessee Plan, a self-insured supplemental medical insurance program for Medicare-eligible state retirees. The amendment updates the RFP schedule and clarifies provisions related to system security, audit rights, disaster recovery objectives, and subrogation procedures. The pre-response conference is scheduled for September 30, 2025, at 1:00 p.m. central time. Written questions and comments are accepted in three rounds, with deadlines of October 8, 2025, November 6, 2025, and January 16, 2026, respectively, with the third round limited to five questions maximum. The initial response deadline is December 10, 2025, at 2:00 p.m., with an optional second response deadline of February 6, 2026, at 2:00 p.m. The State will complete technical evaluations by February 26, 2026, and open and score cost proposals on February 27, 2026. Cost negotiations are scheduled for March 3-5, 2026, followed by the Notice of Intent to Award on March 26, 2026, with the protest period ending April 2, 2026. The contract will be sent to the selected contractor on April 3, 2026, with a signature deadline of April 10, 2026. The contract term covers benefits coverage from January 1, 2027, through December 31, 2031, with a claims run-out period extending through December 31, 2033.
Amendment Five addresses specific contractor concerns regarding operational requirements while maintaining the State's essential protections. The amendment confirms the Recovery Time Objective (RTO) standard of 72 hours specified in the pro forma contract but declines to revise the Recovery Point Objective (RPO) to 168 hours, retaining the modified 24-hour standard. The State amended language in Section A.11.i(1) regarding unsuccessful access attempts to allow a maximum of five attempts before automatic lockout, providing greater flexibility than initially proposed while maintaining security standards. The State declined to modify subrogation provisions to require mutual agreement on policy changes but committed to addressing subrogation policy details during implementation. The State also declined to remove the provision allowing referral of subrogation cases to the Tennessee Attorney General but agreed to provide clarity in the subrogation policy. The current incumbent is UMR, Inc., with the plan covering approximately 48,059 members as of July 2025. Annual claims costs have been increasing by approximately 4%, with the contract compensation structured through monthly per-member-per-month (PMPM) rates. The evaluation methodology allocates 10 points for general qualifications and experience, 40 points for technical qualifications and approach, and 50 points for the cost proposal.
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Text version
RFP #31786-00187 – Amendment Five Page 1 of 4
STATE OF TENNESSEE
DEPARTMENT OF FINANCE & ADMINISTRATION, BENEFITS ADMINISTRATION
REQUEST FOR PROPOSALS #31786-00187
AMENDMENT #FIVE
FOR ADMINISTRATIVE SERVICES ONLY TO
PERFORM AS THIRD-PARTY ADMINISTRATOR FOR
THE STATE’S THE TENNESSEE PLAN
DATE: January 30, 2026
RFP #31786-0087 IS AMENDED AS FOLLOWS:
1. This RFP Schedule of Events updates and confirms scheduled RFP dates. Any event, time, or date containing revised or new text is highlighted.
EVENT TIME
(central time zone)
DATE
1. RFP Issued
September 23, 2025
2. Disability Accommodation Request Deadline 2:00 p.m. September 29, 2025
3. Pre-response Conference 1:00 p.m. September 30, 2025
4. Notice of Intent to Respond Deadline 2:00 p.m. October 1, 2025
5. Written “Questions & Comments” Deadline
NOTE: Submit written questions and comments on Appendix 7.6 the written questions and comments template.
2:00 p.m.
October 8, 2025
6. State Response to Written “Questions & Comments”
October 30, 2025
7. Written “Questions & Comments” Deadline
ROUND 2
NOTE: Respondents may submit no more than five (5) questions to the State in the 2 nd round of Written Questions and Comments
November 6, 2025
8. State Response to Written “Questions & Comments” Round 2
December 3, 2025
9. Response Deadline 2:00 p.m. December 10, 2025
10. Written “Questions & Comments” Deadline
ROUND 3
NOTE: Respondents may submit no more than five (5) questions to the State in the 3rd round of Written Questions and Comments
January 16, 2026
11. State Response to Written “Questions & Comments” Round 3
January 30, 2026
RFP #31786-00187 – Amendment Five Page 2 of 4
12. Response Deadline (Optional) 2:00 p.m. February 6, 2026
10. State Completion of Technical Response Evaluations
February 26, 2026
11. State Opening & Scoring of Cost Proposals 2:00 p.m. February 27, 2026
12. Cost Negotiations (Optional) 4:30 p.m. March 3-5, 2026
13. State Notice of Intent to Award Released and RFP Files Opened for Public Inspection
2:00 p.m.
March 26, 2026
14. End of Protest Period
April 2, 2026
15. State sends contract to Contractor for signature
April 3, 2026
16. Contractor Signature Deadline 2:00 p.m. April 10, 2026
2. State responses to questions and comments in the table below amend and clarify this RFP.
Any restatement of RFP text in the Question/Comment column shall NOT be construed as a change in the actual wording of the RFP document.
Section E.4 1.
As a Contractor, we maintain audit rights with our subcontractors. It is a widely accepted industry standard for audits of a contractor and its subcontractors to be conducted through the contractor, as this approach supports effective and efficient auditing of services. The Contractor remains legally responsible for the performance of its subcontractors and is committed to working collaboratively with the State to ensure appropriate audit access and transparency.
Accordingly, can the Pro Forma Contract be amended to reflect this audit process?
The State may consider limited negotiations after the notice of intent to award has been issued but prior to contract signing pursuant to RFP Section 5.3.6. but cannot agree to anything that would impair the audit rights of the State and Comptroller's Office.
In Section E.5.c.1of the pro forma
2.
Recovery Time Objectives (RTOs) and Recovery Point Objectives (RPOs) vary by data type and system across the industry. These variances are consistent with established industry standards and safeguards, including HITRUST.
Accordingly, we request that the Pro Forma Contract be amended to allow flexibility in RTO and RPO timeframes based on the data and systems used by the Contractor to provide services to the State.
Alternatively, the Pro Forma Contract could be amended to establish RTO and RPO timeframes that are consistent across all systems. In that case, the Contractor would initially recommend an
The RTO standard specified in Section E.5.b(1) of the pro forma contract is 72 hours, which aligns with your request.
The State declines to revise the RPO standard to 168 hours. Under the current TN Plan contract, the RPO standard is one hour; this standard has already been modified to 24 hours as part of the release of this RFP.
RFP #31786-00187 – Amendment Five Page 3 of 4
RTO of seventy-two (72) hours and an RPO of one hundred sixty-eight (168) hours.
Section A.11.i.1
3.
Contractors have numerous systems and the unsuccessful attempt lock out logic can vary by system. These variances are consistent with established industry standards and safeguards, such as HITRUST. Can the Pro Forma Contract be amended to reflect, as follows:
“Restrict unsuccessful attempts to access system functions to maximum of ten (10), commensurate to the risk, sensitivity, and confidentiality of the information in each system, with a system function that automatically prevents further access attempts and records these occurrences.”
The State does not accept the proposed revision; however, the State has amended the language in Section A.11.i(1) of the pro forma contract to provide greater flexibility.
See amendment item #3.
Section A.10.t
4.
The State has added new, detailed language on subrogation to the Pro Forma Contract. The Contractor maintains extensive, well-documented subrogation policies and procedures that apply across its entire book of business.
We are open to collaborating with the State to review and discuss potential enhancements or modifications to these policies and procedures; however, we recommend that the Pro Forma Contract be amended to specify that any proposed changes will be evaluated jointly, taking into consideration operational feasibility, system capabilities, and functional requirements. Certain limitations may affect implementation, and any changes should be subject to the mutual agreement of the parties. Is the State willing to make these changes?
There is an additional provision that grants the State the right to refer subrogation cases to the Tennessee Attorney General for recovery. This provision may disrupt the Contractor’s established subrogation processes and adversely impact recoveries. Accordingly, we request that this provision be removed from the Pro Forma Contract. Is the State willing to remove this provision?
Regarding the proposed language requiring changes to be “mutually agreeable,” the State cannot agree to this limitation. However, the State is committed to working through subrogation policy details during implementation to ensure clarity and operational feasibility.
The State cannot agree to remove the provision allowing referral of subrogation matters to the Tennessee Attorney General but will address the process in more detail in the subrogation policy to ensure clarity and operational feasibility.
3. Delete Pro Forma Contract Section a.11.i(1) in its entirety and insert the following in its place.
i. System and Information Security and Access Management Requirements
1) The Contractor’s systems shall employ an access management function that restricts
RFP #31786-00187 – Amendment Five Page 4 of 4 access to varying hierarchical levels of system functionality and information. The access management function shall:
• Restrict access to information on a “least privilege” basis, e.g., users permitted inquiry privileges only shall not be permitted to modify information;
• Restrict access to specific system functions and information based on an individual user profile, including inquiry only capabilities and the ability to create, change or delete certain data (global access to all functions shall be restricted to specified staff jointly agreed to by the State and the Contractor);
• Restrict unsuccessful attempts to access system functions to five (5), with a system function that automatically prevents further access attempts and records these occurrences; and
• Ensure that authentication credentials are not passed in clear text or otherwise displayed or presented.
4. Delete RFP #31786-00187, Release #4 in its entirety, and replace with RFP #31786- 00187, Release #5. Revisions of the original RFP document are emphasized within the new release. Any sentence or paragraph containing revised or new text is highlighted.
5. RFP Amendment Effective Date. The revisions set forth herein shall be effective upon release. All other terms and conditions of this RFP not expressly amended herein shall remain in full force and 10effect.
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