RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 1 of 49 Medically Underserved Persons in Muscogee County

FINANCE DEPARTMENT

PURCHASING DIVISION 1111 1st AVENUE – 1ST FLOOR, COLUMBUS, GEORGIA 31901

P. O. BOX 1340, COLUMBUS, GEORGIA 31902-1340

706-225-4087 | www.columbusga.org Date: January 20, 2026

REQUEST FOR

PROPOSALS:

RFP No. 26-0023

Qualified firms are requested to submit proposals, subject to conditions and instructions as specified, for the furnishing of:

THIRD-PARTY ADMINISTRATION SERVICES

FOR THE COMMUNITY CARE PROGRAM SERVICING

MEDICALLY UNDERSERVED PERSONS IN MUSCOGEE

COUNTY (ANNUAL CONTRACT)

GENERAL SCOPE Columbus Consolidated Government (CCG) is seeking proposals from qualified Third-

Party Administrator (TPA) to manage administrative services for the Community Care

Program, which serves medically underserved persons in Muscogee County.

The requested administrative services include the management of claims related to medical, pharmaceutical, and mental health services. These services may include, but are not limited to, claims for acute inpatient and outpatient hospital care, x-ray, laboratory, and primary medical care. The TPA will be responsible for processing and managing claims, verifying eligibility, coordinating payments, and reporting to the

City.

DUE DATE FEBRUARY 20, 2026 - 5:00 PM (Eastern)

SUBMISSION

REQUIREMENTS

See Appendix A for information and instructions on how to register and submit a proposal through DemandStar.

ADDENDA The Purchasing Division will post addenda (if any) for this project at https://www.columbusga.gov/finance/Bid-Opportunities. Vendors are responsible for periodically checking the webpage for addenda, before the due date and prior to submitting a response.

NO SUBMITTAL If you are not interested in this solicitation, complete and return page 3.

Andrea J. McCorvey, Purchasing Manager

COLUMBUS CONSOLIDATED GOVERNMENT

Georgia’s First Consolidated Government http://www.columbusga.org/ https://www.columbusga.gov/finance/Bid-Opportunities

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 2 of 49

IMPORTANT INFORMATION

E-Notification

The City uses the Georgia Procurement Registry e-notification system. You must register with the Team

Georgia Marketplace to receive future procurement notifications at https://doas.ga.gov/state-purchasing/getting-started-supplier.

If you have any questions or encounter any problems while registering, please contact the Team Georgia

Marketplace Procurement Helpdesk:

Telephone: 404-657-6000

Fax: 404-657-8444

Email: procurementhelp@doas.ga.gov https://doas.ga.gov/state-purchasing/getting-started-supplier https://doas.ga.gov/state-purchasing/getting-started-supplier mailto:procurementhelp@doas.ga.gov

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 3 of 49

STATEMENT OF "NO PROPOSAL SUBMISSION"

Notify the Purchasing Division if you do not intend to submit a Proposal:

Email: BidOpportunities@ColumbusGa.org

Attn: Heather Biddle, Buyer

Mail: Columbus Consolidated Government

Purchasing Division

P. O. Box 1340

Columbus, Georgia 31902-1340

We, the undersigned decline to submit a proposal for RFP No. 26-0023 for Third-Party

Administration Services for the Community Care Program Serving Medically Underserved

Persons in Muscogee County (Annual Contract) for the following reason(s):

Specifications are too “tight”, i.e., geared towards one brand or manufacturer (explain below)

There is insufficient time to respond.

We do not offer this product and/or service.

We are unable to meet specifications.

We are unable to meet bond requirements.

Specifications are unclear (explain below).

We are unable to meet insurance requirements.

Other (specify below)

Comments:

COMPANY NAME:

REPRESENTATIVE:

DATE:

TELEPHONE:

EMAIL:

mailto:BidOpportunities@ColumbusGa.org

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 4 of 49

PROPOSALS WILL BE EVALUATED IN ACCORDANCE WITH THE PROCEDURES AS

OUTLINED BELOW IN SECTION 3-110 OF THE PROCUREMENT ORDINANCE. ALL

PROPOSALS WILL BE KEPT CONFIDENTIAL UNTIL AFTER AWARD.

3-110 Competitive Sealed Proposals (Negotiations)

(1) Conditions for Use

When the purchasing manager determines that the use of competitive sealed bidding for any procurement is either not practicable or not advantageous to the city, a contract may be entered into using the competitive sealed proposals (negotiation) method. In addition, the competitive sealed proposal process shall be used for the procurement of professional services, specialized equipment or supplies.

The competitive sealed proposal process may be used for procurements with an estimated total cost less than $50,000.00, if deemed to be in the best interest of the City. If the total cost can be determined, the authority to approve such solicitations will be as prescribed by article 3-104, purchasing limits. If, due to the required services, a total cost cannot be determined then the award recommendation will be approved by Council.

A. Request for Proposals

Proposals shall be solicited through Request for Proposals. The Purchasing Division shall establish the specifications with the using agency and set the date and time to receive proposals. The request for proposal shall include a clear and accurate description of the technical requirements for the service or item to be procured.

B. Public Notice

The public will be given adequate notice of the request for proposals, provided that, adequate notice shall mean at least 15 business days before the due date, which is stated in the request. The City reserves the right to seek request for proposals in a shorter period, if necessary, as determined by the Purchasing Manager.

Notice shall be published in a reasonable time before due date, contain a description of the procurement in general terms, as well as, the place and due date for proposals, and appear in a newspaper(s) of general circulation, specifically the city's legal organ. In addition to publication in newspapers, notice shall also be made by electronic means, including posting on the internet and on the city's government access television channel.

Public works construction projects shall be advertised in accordance with Georgia State Law.

The City reserves the right to mail or e-mail invitations directly to vendors under the following circumstances:

− Solicitations for specialized equipment/supplies.

− Solicitations for specialized services.

− Re-bid of solicitations where normal advertising procedures netted no responses.

− Whenever deemed necessary by the purchasing manager.

https://library.municode.com/ga/columbus/codes/code_of_ordinances?nodeId=PTICH_ARTIIILEBR_CH1THCO_S3-104POCO

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 5 of 49

C. Receipt of Proposals

Proposals must be received by the deadline date established. No public opening will be held.

No proposals shall be handled to permit disclosure of the identity of any offeror or the contents of any proposal to competing offerors during the process of discussion. A register of proposals shall be prepared as part of the contract file, and shall contain the name of each offeror, the number of modifications received (if any), and a description sufficient to identify the item offered. The register of proposals shall be open for public inspection only after contract award.

D. Evaluation Factors

The request for proposals shall identify the relative importance of cost (when applicable) and other evaluation criteria.

E. Evaluation Process

An odd number of voting members of a Selection or Evaluation Committee shall evaluate all proposals received based upon the criteria stated in the request for proposals. Each voting committee member shall grade each submitted proposal based upon the evaluation criteria.

F. Discussion with Responsible Offerors and Revisions to Proposals

As provided in the Request for Proposals, discussions (negotiations) may be conducted with responsible offerors who submit proposals determined to be reasonably susceptible of being selected for award, to assure full understanding of and conformance to the solicitation requirements. All qualified, responsible offerors shall be given fair and equal treatment with respect to any opportunity for discussion and revision of proposals, and such revisions may be permitted after submissions and prior to award for the purpose of obtaining best and final offers. In conducting discussions, there shall be no disclosure of the identity of competing offerors or any information derived from proposals submitted by competing offerors. If only one proposal response is received, then the award recommendation shall be to the single offeror, if the offeror meets all requirements.

G. Award

After negotiations, the award recommendation must be presented to Columbus City Council for final approval. Award will be made to the responsible offeror whose proposal is determined to be the most advantageous to the City, taking into consideration total cost (if determined) and all other evaluation factors set forth in the Request for Proposals.

After council approval, a contract based on the negotiations (if negotiations were necessary) will be drawn and signed by all necessary parties. If Council does not approve the award, it may direct that further negotiations may take place with the recommended offeror, or that negotiations begin with the next most qualified offeror. Council may also exercise the option to reject all offers and instruct the Purchasing Manager to begin the procurement process again.

The contract file shall contain the basis on which the award is made.

After contract award, the contract file, will be made public. Unsuccessful offerors will be afforded the opportunity to make an appointment with the purchasing division for a debriefing.

After the award, the contract file and the unsuccessful proposals will become subject to disclosure under the Georgia Open Records Act.

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DO YOU HAVE QUESTIONS, CONCERNS OR NEED

CLARIFICATION ABOUT THIS SOLICITATION?

COMMUNICATION CONCERNING ANY SOLICITATION CURRENTLY

ADVERTISED MUST TAKE PLACE IN WRITTEN FORM AND ADDRESSED TO

THE PURCHASING DIVISION.

ALL QUESTIONS OR CLARIFICATIONS CONCERNING THIS SOLICITATION

SHALL BE SUBMITTED IN WRITING. THE CITY WILL NOT ORALLY OR

TELEPHONICALLY ADDRESS ANY QUESTION OR CLARIFICATION

REGARDING BID/PROPOSAL SPECIFICATIONS. IF A VENDOR VISITS OR CALLS

THE PURCHASING DIVISION WITH SUCH QUESTIONS, HE OR SHE WILL BE

INSTRUCTED TO SUBMIT THE QUESTIONS IN WRITING.

ALL CONTACT CONCERNING THIS SOLICITATION SHALL BE MADE

THROUGH THE PURCHASING DIVISION. BIDDERS SHALL NOT CONTACT

CITY EMPLOYEES, DEPARTMENT HEADS, USING AGENCIES, EVALUATION

COMMITTEE MEMBERS OR ELECTED OFFICIALS WITH QUESTIONS OR ANY

OTHER CONCERNS ABOUT THE SOLICITATION. QUESTIONS,

CLARIFICATIONS, OR CONCERNS SHALL BE SUBMITTED TO THE

PURCHASING DIVISION IN WRITING. IF IT IS NECESSARY THAT A TECHNICAL

QUESTION NEEDS ADDRESSING, THE PURCHASING DIVISION WILL FORWARD

SUCH TO THE USING AGENCY, WHO WILL SUBMIT A WRITTEN RESPONSE.

THE PURCHASING DIVISION WILL FORWARD WRITTEN RESPONSES TO THE

RESPECTIVE BIDDER OR IF IT BECOMES NECESSARY TO REVISE ANY PART OF

THIS SOLICITATION, A WRITTEN ADDENDUM WILL BE ISSUED TO ALL

BIDDERS.

THE CITY IS NOT BOUND BY ANY ORAL REPRESENTATIONS,

CLARIFICATIONS, OR CHANGES MADE TO THE WRITTEN SPECIFICATIONS BY

CITY EMPLOYEES, UNLESS SUCH CLARIFICATION OR CHANGE IS PROVIDED

TO THE BIDDERS IN A WRITTEN ADDENDUM FROM THE PURCHASING

MANAGER.

BIDDERS ARE INSTRUCTED TO USE THE ENCLOSED

“QUESTION/CLARIFICATION FORM” TO FAX OR EMAIL QUESTION.

ANY REQUEST, AFTER A SOLICITATION HAS CLOSED AND PENDING

AWARD MUST ALSO BE SUBMITTED IN WRITING TO THE PURCHASING

DIVISION.

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 7 of 49

QUESTION/CLARIFICATION FORM

Date:

To: Heather Biddle, Buyer

Email: BidOpportunities@ColumbusGA.org

Re: Third-Party Administration Services for the Community Care Program Serving Medically

Underserved Persons in Muscogee County (Annual Contract) – RFP No. 26-0023

Questions and requests for clarification must be submitted at least five (5) business days before the due date:

From:

Company Name Website

Representative Email Address

Complete Address City State Zip

Telephone Number Fax Number mailto:BidOpportunities@ColumbusGA.org

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 8 of 49

COLUMBUS CONSOLIDATED GOVERNMENT

GENERAL PROVISIONS FOR REQUEST FOR PROPOSALS

Third-Party Administration Services for the Community Care Program Serving

(Annual Contract)

Columbus Consolidated Government is seeking proposals for third-party administrative services to support the Community Care Program, which serves medically underserved persons in Muscogee

County. The requested administrative services will support the processing of healthcare claims submitted by contracted providers delivering medical, pharmaceutical, and mental health services through the program.

Administrative responsibilities may include, but are not limited to, the receipt and processing of provider claims, verification of participant eligibility, and maintenance of documentation related to claims activity.

The funding for these services is provided by property taxes levied for this specific purpose to ensure that all residents of Columbus, GA have access to quality health care. Providing quality health care improves the quality of life for all residents. A Third-Party Administrator (TPA) will be utilized to process provider claims and ensure compliance with program guidelines.

A. PROPOSAL SUBMITTAL DATE:

PROPOSALS ARE DUE: FEBRUARY 20, 2026, NO LATER THAN 5:00 PM (Eastern). Submit one electronic response via DemandStar.

The City shall not be held liable for any expenses incurred by the respondent in preparing and submitting the proposal and/or attendance at any interviews, final contract negotiations or applicable site visits. The

City reserves the right to award this project or to reject any and all proposals; whichever is in the best interest of the City.

B. RECEIPT OF PROPOSALS:

Unless otherwise stated in the technical specifications of the RFP, the City will accept one, and only one, proposal per Offeror. In the event a team of firms is entering into a joint venture to respond to the RFP, one firm shall be named the prime contractor and the proposal shall be submitted in the name of the prime contractor. All correspondence concerning the RFP will be between the City and prime contractor.

C. SUBCONTRACTING:

Should the offeror intend to subcontract all or any part of the work specified, names and address of subcontractors must be provided in proposal response. The offeror shall be responsible for subcontractors’ full compliance with the requirements of the RFP specifications. If awarded the contract, payments will only be made to the offerors submitting the proposal. The Columbus Consolidated Government will not be responsible for payments to subcontractors.

D. QUESTIONS ABOUT THE RFP:

Communication concerning any solicitation currently advertised must take place in writing and addressed to the Purchasing Division. See page titled “Do You Have Questions …” within this proposal package.

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Questions and Requests for Clarification will be received until five business days prior to the proposal due date.

E. PUBLIC INFORMATION:

All information and materials submitted will become the property of the Columbus Consolidated

Government, Columbus, Georgia; and shall be subject to the provisions of the Georgia public records law.

If awarded the contract, the proposal submission, in its entirety, will be included as part of the contract documents and filed, as public record, with the Clerk of Council.

F. ADDENDA:

The proposer shall include acknowledgment of receipt of addenda (if any) in their sealed proposal. The proposer should include an initialed copy of each addendum in the proposal package. It is the proposer’s responsibility to contact the City for copies of addenda if they receive the proposal document from any other source other than the City.

G. CONTRACT:

Each proposal is received with the understanding that an acceptance in writing by the City of the offer to furnish any or all of the services and materials described shall constitute a contract between the proposer and the City. This contract shall bind the proposers to furnish and deliver the services and materials quoted, at the prices stated and in accordance with the condition of said accepted proposal.

It is agreed that the successful respondent will not assign, transfer, convey or otherwise dispose of the contract or its right, title or interest in or to the same, or any part thereof, without previous consent of the

City and any sureties.

H. NON-COLLUSION:

Proposer declares that the proposal is not made in connection with any other proposer submitting a proposal for the same commodity or commodities, and that the proposal is bona fide and is in all respects fair and without collusion or fraud.

I. INDEMNITY:

The Contractor covenants to save, defend, hold harmless, and indemnify the City, and all of its officers, departments, agencies, agents, and employees (collectively the "City") from and against any and all claims, losses, damages, injuries, fines, penalties, costs (including court costs and attorney’s fees), charges, liability, or exposure, however caused, resulting from, arising out of, or in any way connected with the Contractor’s intentional, negligent, or grossly negligent acts or omissions in performance or nonperformance of its work called for by the Contract Documents.

J. DISADVANTAGED BUSINESS ENTERPRISE CLAUSE:

Disadvantaged Business Enterprises (minority or women owned businesses) will be afforded full opportunity to submit proposals in response to this invitation and will not be discriminated against on the grounds of race, color, creed, sex, sexual orientation, gender identity or national origin in consideration for an award. It is the policy of the City that disadvantaged business enterprises and minority business enterprises have an opportunity to participate at all levels of contracting in the performance of City contracts to the extent practical and consistent with the efficient performance of the contract.

K. AFFIRMATIVE ACTION PROGRAM - NON-DISCRIMINATION CLAUSE:

The City has an Affirmative Action Program in connection with Equal Employment Opportunities. The successful vendor will comply with all Federal and State requirements concerning fair employment and employment of the handicapped, and concerning the treatment of all employees, and will not discriminate

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 10 of 49 between or among them by reason of race, color, age, religion, sex, sexual orientation, gender identity, national origin or physical handicap.

L. SPECIFICATION DESCRIPTIONS:

The specifications detailed herein represent the quality of equipment, goods or services required by the

City. Whenever in this invitation any particular process, service or equipment is indicated or specified by patent, proprietary or brand name of manufacturer/developer/inventor, such wording will be deemed to be used for the purpose of facilitating descriptions of the process, service or equipment desired by the City. It is not meant to eliminate offerors or restrict competition in any RFP process. Proposals that are equivalent or surpass stated specifications will be considered. Determination of equivalency shall rest solely with the

City.

M. TAXES:

The City is exempt from State Retail Tax and Federal Excise Tax. Tax Exemption No. GA Code Sec. 48-

8-3. Federal ID No. 58-1097948.

N. DRUG-FREE WORKPLACE:

Per Ordinance No. 93-55, in compliance with Federal and State Drug Free Workplace Acts, the Council of

Columbus, Georgia adopted a drug free Workplace Policy. Consequently, any vendor providing goods or services to Columbus Consolidated Government must comply with all applicable Federal and State Drug

Free Workplace Acts.

O. FEDERAL, STATE, LOCAL LAWS:

All respondents will comply with all Federal, State and Local laws, ordinances, rules and regulations relative to conducting business in Columbus, Georgia and performing the prescribed service. Ignorance on the part of the respondent shall not, in any way, relieve the respondent from responsibility for compliance with said laws and regulations or any of the provisions of these documents.

P. PROVISIONS OF THE PROCUREMENT ORDINANCE:

The provisions of the Procurement Ordinance for the Consolidated Government of Columbus, Georgia as adopted and amended by Council shall apply to all invitations to respond to Requests for Proposals and is specifically incorporated herein by this reference. The Procurement Ordinance is codified on Section 2-

3.03 of the Columbus Code and can be accessed through the City’s website at https://library.municode.com/ga/columbus/codes/code_of_ordinances.

Q. INSURANCE:

All respondents shall maintain, and if requested, show proof of insurance applicable for services described in these specifications.

R. HOLD HARMLESS AGREEMENT:

The successful respondent hereby agrees to indemnify, hold free and harmless Columbus Consolidated

Government (The City), its agents, servants, employees, officers, directors and elected officials or any other person(s) against any loss or expense including attorney fees, by reason of any liability imposed by law upon the City, except in cases of the City’s sole negligence, sustained by any person(s) on account of bodily injury or property damage arising out of or in the consequence of this agreement.

S. TERMINATION OF CONTRACT:

1. Default: If the contractor refuses or fails to perform any of the provisions of this contract with such diligence as will ensure its completion within the time specified in this contract, or any extension thereof, otherwise fails to timely satisfy the contract provisions, or commits any other substantial breach of this contract, the Purchasing Division Director may notify the contractor https://library.municode.com/ga/columbus/codes/code_of_ordinances

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 11 of 49 in writing of the delay or nonperformance and if not cured within ten (10) days or any longer time specified in writing by the Purchasing Division Director, such director may terminate the contractor’s right to proceed with the contract or such part of the contract as to which there has been delay or a failure to properly perform.

In the event of termination in whole or in part the Purchasing Division Director may procure similar supplies or services, from other sources, in a manner and upon terms deemed appropriate by the Purchasing Division Director. The contractor will continue performance of the contract to the extent it is not terminated and will be liable for excess costs incurred in procuring similar goods or services.

2. Compensation: Payment for completed supplies or services delivered and accepted by the City will be at the contract price. The City may withhold from amounts due the contractor such sums as the Purchasing Director deems to be necessary to protect the City against loss because of outstanding liens or claims of former lien holders and to reimburse the City for the excess costs incurred in procuring similar goods and services.

3. Excuse for Nonperformance or Delayed Performance. Except with respect to defaults of subcontractors, the contractor shall not be in default by reason of any failure in performance of this contract in accordance with its terms (including any failure by the contractor to make progress in the prosecution of the work hereunder which endangers such performance) if the contractor has notified the Purchasing Division Director within 15 days after the cause of the delay and the failure arises out of causes such as: acts of God; acts of public enemy; acts of the

City and any other governmental entity in its sovereign or contractual capacity; fires; floods;

epidemics; quarantine restrictions; strikes or other labor disputes; freight embargoes; or unusually severe weather, If the failure to perform is caused by the failure of a subcontractor to perform or to make progress, and if such failure arises out of causes similar to those set forth above, the contractor shall not be deemed to be in default, unless the supplies or services to be furnished by the subcontractor was reasonably obtainable from other sources in sufficient time to permit the contractor to meet the contract requirements.

Upon request of the contractor, the Purchasing Division Director shall ascertain the facts and extent of such failure, and, if such director determines that any failure to perform was occasioned by anyone or more of the excusable causes, and that, but for the excusable cause, the contractor’s progress and performance would have met the terms of the contract, the delivery schedule shall be revised accordingly.

T. TIME FOR CONSIDERATION:

Due to the evaluation process, proposals must remain in effect for at least 180 days after date of receipt.

U. CONTRACT AWARD:

Award of this contract will be made in the best interest of the City.

V. REQUEST FOR EVALUATION RESULTS:

Per the City’s Procurement Ordinance, evaluation results cannot be divulged until after the award of the contract. After contract award, proponents desiring to review documents relevant to the RFP evaluation results shall submit a written request to the Purchasing Division.

W. GOVERNING LAW:

The parties agree that this Agreement shall be governed by the laws of Georgia, both as to interpretations and performance.

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X. FINAL CONTRACT DOCUMENTS:

It is understood that the final contract shall include the following: 1) The RFP; 2) Addenda; 3) Awarded

Vendors(s) response; 4) Awarded Vendor(s) Clarifications; 5) Negotiated Components; and 6) Awarded

Vendor(s) Business Requirements.

After award of the contract by Columbus Council, awarded vendor will be notified to provide one identical hard copy of submitted proposal with original signatures. The awarded vendor will receive a digital copy of the executed contract.

Y. PAYMENT DEDUCTIONS:

The City reserves the right to deduct, from payments to awarded vendor(s), any amount owed to the City for various fees, to include, but not limited to: False Alarm fees, Ambulance fees, Occupation License

Fees, Landfill fees, etc.

Z. PAYMENT TERMS:

The City's standard payment term is usually net 30 days, after successful receipt of goods or services.

Payment may take longer if invoice is not properly documented or not easily identifiable, goods/services are not acceptable, or invoice is in dispute.

AA. RIGHT TO PROTEST:

A. Right of Protest. Any actual or prospective bidder offeror, or contractor who is aggrieved in connection with a solicitation or award of a contract may protest to the

Purchasing Manager initially. All protests shall be filed in the manner prescribed herein. Protests that do not comply with the following rules shall be deemed invalid and of no effect.

B. The protest must be in writing, executed by a company officer that is authorized to execute agreements on behalf of the bidder or offeror or provided by an authorized legal representative of the protestor.

C. A protest with respect to an invitation for Bids or Request for Proposals shall be submitted in writing no less than five (5) business days prior to the opening of bids or the closing date of proposals or qualification statements.

D. Stay of Procurement During Protests. If there is a timely protest submitted as described above, the Purchasing Manager shall not proceed further with the solicitation or award of the contract until all administrative remedies have been exhausted or until the City

Council, Mayor, or City Manager makes a determination on the record that the award of the contract without delay is necessary to protect substantial interests of the City.

NOTICE TO VENDORS

Sec. 2-3.05. - Submitting bids to Consolidated Government, etc.—By mayor or councilmembers.

Neither the mayor nor any member of the Columbus Council shall submit any bid to the consolidated government, nor shall the mayor or any member of the Columbus Council own or have a substantial pecuniary interest in any business that submits a bid to the consolidated government. (Ord. No. 92-60, 6-23-92)

Sec. 2-3.06. - Same—By members of boards, authorities, commissions.

No member of any board or authority or commission or other independent or subordinate entity of the consolidated government shall submit any bid to the consolidated government or have a substantial pecuniary interest in any business that submits a bid to the consolidated government if such bid pertains to the board or authority or commission on which such person holds such membership. (Ord. No. 92-61, 6-23-92)

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GENERAL SPECIFICATIONS

Third-Party Administration Services for the Community Care Program Serving

Medically Underserved Persons in Muscogee County

I. SCOPE

support the Community Care Program, which serves medically underserved persons in Muscogee

County. The selected TPA provider will be responsible for processing healthcare claims submitted by contracted providers delivering medical, pharmaceutical, and mental health services through the program.

Administrative responsibilities may include, but are not limited to:

• Receipt and processing of provider claims

• Verification of participant eligibility

• Maintenance of documentation related to claims activity

• Support for provider inquiries and reporting

Medically underserved persons are defined as residents of Muscogee County who are not covered under a private or governmental insurance plan and meet the income requirements of the Community Care

Program. The income requirements are defined as having a total yearly income below 125% of the poverty income guidelines for family units in the United States, as set by the U.S. Department of Health and Human Services. The 2025 Poverty Guidelines are outlined below:

# in Household Annual Income

1 $15,988

2 $21,538

3 $27,088

4 $32,638

5 $38,188

6 $43,738

7 $49,288

8 $54,838

Each additional person Add $5,550

The funding for these services is provided by property taxes levied for this specific purpose to ensure that

RFP No. 26-0023 Third-Party Administration Services for the Community Care Program Serving Page 14 of 49 all residents of Columbus, GA have access to quality health care. Providing quality health care improves the quality of life for all residents.

Technical Specifications begin on page 22.

II. TERM OF CONTRACT

A. The initial term of the contract will be for one (1) year, with the option to renew for four (4) additional twelve-month periods. Contract renewal shall be contingent upon the mutual agreement of the City and the

Contractor.

Notice of intent to renew will be given to the contractor in writing by the City Purchasing Manager, normally sixty days before the expiration date of the current contract period.

It should be noted that multi-year contracts may be continued each fiscal year only after funding appropriations and program approvals have been granted by the Council of the Consolidated Government of Columbus, Georgia. In the event that the necessary funding is not approved, then the affected multi-year contract becomes null and void, effective July 1st of the fiscal year for which such approval has been denied.

B. Termination for Convenience:

For the protection of both parties, either party giving 60 days prior notice, in writing, to the other party, may cancel this contract.

III. PRICE ADJUSTMENT CLAUSE

Contract pricing shall remain fixed for the initial one-year term of the contract. After the initial term, Contractor may request a price escalation by submitting a fully documented request for a review of the pricing. Such escalation shall not exceed a 5% increase. Price escalation requests must be submitted by

January 30th so as to allow Departments to factor the increases into their budgets for the next fiscal year, which will begin July 1.

The using agencies and Purchasing Manager will review the request and shall approve or disapprove the increases based on budget constraints and other price comparisons. If approved, the price increase shall not commence until the next fiscal year, which will begin July 1.

IV. INDEMNITY CLAUSE

The Provider covenants to save, defend, hold harmless, and indemnify the City, and all of its officers, departments, agencies, agents, and employees (collectively the “City”) from and against any and all claims, losses, damages, injuries, fines, penalties, costs (including court costs and attorney’s fees), charges, liability, or exposure, however caused, resulting from, arising out of, or in any way connected with the Provider’s intentional, negligent, or grossly negligent acts or omissions in performance or nonperformance of its work called for by the Contract Documents.

Additionally, the Provider shall indemnify, defend and hold harmless the Columbus Consolidated

Government, its elected officials, officers, agents and employees, from and against any claims, loss, injury, damages or other liability arising out of the Provider’s performance or non-performance of its obligations hereunder specifically including, but not limited, to personal injury and death; provided that the Provider will not be responsible for any claim arising out of the gross negligence or willful misconduct of the

Columbus Consolidated Government.

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The Contractor shall be responsible from the execution date or from the time of the beginning of the Work, whichever shall be the earlier, for all injury or damage of any kind resulting from the Work to persons or property. The Contractor shall exonerate, indemnify, and save harmless the Columbus Consolidated

Government, its elected officials, officers, employees, and agents hereinafter collectively referred to in this section as “Columbus Consolidated Government indemnitees,” from and against all claims or actions based upon or arising out of any damage or injury (including without limitation any injury or death to persons and any damage to property) caused by or sustained in connection with the performance of this Contract or by conditions created thereby or arising out of or any way connected with Work performed under this Contract, as well as all expenses incidental to the defense of any such claims, litigation, and actions. Furthermore, Contractor shall assume and pay for, without cost to the Columbus Consolidated Government Indemnitee’s, the defense of any and all claims, litigation, and actions suffered through any act or omission of the Service

Provider, or any Subcontractors, or anyone directly or indirectly employed by or under the supervision of any of them. Notwithstanding any language or provision in this Contract, Service Provider shall not be required to indemnify any Columbus Consolidated Government indemnitee against claims, actions, or expenses based upon or arising out of the Columbus Consolidated Government indemnitee’s sole negligence. As between the Columbus Consolidated Government indemnitees and the Contractor as the other party, the Contractor shall assume responsibility and liability for any damage, loss, or injury, including death, of any kind or nature whatever to person or property, resulting from any kind of claim made by

Contractor’s employees, agents, vendors, Suppliers or Subcontractors caused by or resulting from the performance of Work under this Contract, or caused by or resulting from any error, omission, or the negligent or intentional act of the Contractor’s, vendors, Suppliers, or Subcontractors, or any of their officers, agents, servants, or employees. The Contractor shall defend, indemnify, and hold harmless the

Columbus Consolidated Government indemnitees from and against any and all claims, loss, damage, charge, or expense to which they or any of them may be put or subjected by reason of any such damage, loss, or injury. The Contractor expressly agrees to provide a full and complete defense against any claims brought or actions filed against the Columbus Consolidated Government indemnitees, where such claim or action involves, in whole or in part, the subject of the indemnity contained in this Contract, whether such claims or actions are rightfully or wrongfully brought or filed. The Columbus Consolidated Government has the sole discretion to choose the counsel who will provide the defense. No provision of this Contract and nothing herein shall be construed as creating any individual or personal liability on the part of any elected official, officer, employee, agent or servant of the Columbus Consolidated Government, nor shall the Contract be construed as giving any rights or benefits hereunder to anyone other than the parties to this

Contract. The parties' obligations pursuant to this Section shall survive any acceptance of Work, or termination or expiration of this Contract.

V. ERRORS AND OMISSIONS

If, due to an error or omission in the scope of work, a particular requirement is not specifically included but is necessary to provide the City with required services, then said requirement is considered to be included in the scope of work just as if it had been listed in detail herein.

VI. E-VERIFY AFFIDAVIT

Pursuant to O.C.G.A. § 13-10-91, a public employer shall not enter into a contract for the performance of services unless the contractor registers and participates in the federal work authorization program. If a supplier is providing services under a contract with a total compensation amount of $2,500 or greater, (even if such services will be performed outside of the State of Georgia), Columbus Consolidated Government requires a notarized affidavit from the supplier attesting to the following:

(A) The affiant has registered with, is authorized to use, and uses the federal work authorization program;

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(B) The user identification number and date of authorization for the affiant;

(C) The affiant will continue to use the federal work authorization program throughout the contract period; and

(D) The affiant will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the same information required by subparagraphs (A), (B), and (C) of this paragraph.

Additional information regarding the State’s E-Verify requirements can be found at https://www.audits2.ga.gov/wp-content/uploads/2021/10/13-10-91.pdf. A completed, notarized E-Verify

Affidavit must be included with proposal; failure to do so will render the firm’s or individual’s proposal non-responsive and ineligible for award consideration.

VII. INSURANCE

The vendors shall be required, at their own expense, to furnish to the City of Columbus Purchasing Division, evidence showing the insurance coverage to be in force throughout the term of the contract.

Insurance requirements are listed on the attached Insurance Checklist. The limits shown are minimum limits. Vendor shall indicate the actual limit they will provide for each insurance requirement. The bidder shall complete the Insurance Checklist and include with bid response. Certificate of Insurance is acceptable. The Insurance Checklist will indicate to the City, the bidder’s ability and agreement to provide the required insurance, in the event of contract award.

The successful candidate shall provide the required Certificates of Insurance within 10 business days after award notification. The Certificates of Insurance will name Columbus Consolidated Government as an additional insured, as well as list the applicable project or annual contract name, and/or Solicitation name and number. The Certificate of Insurance will be included with the contract documents prior to signing.

VIII. PROPOSAL PREPARATION AND SUBMISSION

See Appendix A for information and instructions on how to register and submit proposals through

DemandStar.

A. With the exception of the E-Verify Affidavit, the form titled “Communication Concerning This

Solicitation”, and the Conflict of Interest Affidavit, the City reserves the right to request any omitted information. Firms shall be notified, in writing, and shall have two (2) days, after notification, to submit the omitted information. If the omitted information is not received within two (2) days, the firm shall be deemed non-responsive, and the proposal will not receive further consideration.

B. Proposals shall be as thorough and detailed as possible so that the Columbus Consolidated

Government may properly evaluate the proposer’s capabilities to provide the required services.

C. Proposals shall be prepared simply, providing a straightforward, concise description of capabilities to satisfy the requirements of the RFP. Emphasis should be placed on completeness and clarity of content.

D. Offerors shall submit the following items as a complete proposal:

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Submit the information in the order listed below; include a header for each item, e.g., Section 1, Item

A, Section 1, Item B, etc.

Section 1: Transmittal Letter

The transmittal letter shall:

A. Introduce the business; describe the ownership; include complete address, phone, and fax numbers (if applicable), and include the name and email address(es) of contact person(s) during this proposal process.

B. List the complete address, telephone number and fax number for the corporate office as well as for the office/branch that will administer the contract.

C. Include a statement to the effect that the proposal is binding for at least 180 days from the proposal date. An authorized agent of the business must sign the transmittal letter.

Section 2: E-Verify Affidavit (Form 1)

A properly completed, notarized E-Verify Affidavit must be included with proposal;

failure to do so will render the firm’s proposal non-responsive and ineligible for further consideration. Additional information regarding the State’s E-Verify requirements can be found at: https://www.audits2.ga.gov/wp-content/uploads/2021/10/13-

10-91.pdf.

Section 3: Communication Concerning This Solicitation

Complete the form titled Communication Concerning This Solicitation (Form 2)

Form 2 must be signed and returned with the vendor’s proposal. Failure to include the form will automatically render vendor’s response non-responsive.

Section 4: Federal Compliance

Complete the form titled Federal Compliance (Form 3)

Section 5: Conflict of Interest Affidavit (Form 4)

Form 4 must be signed and returned with the vendor’s proposal. Failure to include the form will automatically render vendor’s response non-responsive.

Section 6: Addenda Acknowledgement

Use Form 5 to acknowledge receipt for all addenda (if any). The Purchasing Division will post addenda (if any) for this project at https://www.columbusga.gov/finance/Bid-

Opportunities. Vendors are responsible for periodically visiting the web page for addenda, before the due date and prior to submitting a response.

Section 7: Exceptions to RFP

A. List ANY AND ALL exceptions to the RFP specifications in this section of proposal submission. Exceptions listed in other areas of the vendor’s submission will not be considered. All exceptions will be vetted during the RFP process, and if found unacceptable, the vendor’s proposal will be rejected and no longer considered for award. Exceptions shall be considered by the Evaluation Committee. The vendor’s proposal may not receive further consideration if exceptions are not acceptable and/or cannot be clarified to the Committee’s satisfaction. Vendors shall be notified in writing if exceptions are not acceptable. PLEASE NOTE: EXCEPTIONS TO THE RFP

GENERAL PROVISIONS WILL NOT BE CONSIDERED, AND IF

SUBMITTED WILL AUTOMATICALLY RENDER THE RESPONSE NON-

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RESPONSIVE.

B. VENDOR AGREEMENT/CONTRACT FORM: Exceptions also include the terms of any contract or other agreements which the vendor or any subcontractors will require to be executed by the City.

C. If there are no exceptions, vendor must include a statement for this Section stating the following: No Exceptions.

Section 8: Qualifications and Experience

A. Summarize your company’s strengths and how its experience particularly with similar third-party administrative responsibilities, will benefit the Community Care Program and the medically underserved population it serves.

B. Include the date your company was established to provide third-party administrative services, your company’s relevant experience, number of employees, and any certifications or accreditations held by your organization. If applicable, include the name of the accrediting agency.

C. Highlight achievements in administering programs that support healthcare access for medically underserved populations, including any innovations, efficiencies, or outcomes your company has contributed to.

D. Indicate if your company is registered and authorized to perform business in the state of

Georgia.

E. Describe how your company meets the specified minimum abilities and qualifications.

Section 9: Client Work History

Use Form 6 to provide three (3) references that can attest to the quality of the services provided on previous or similar contracts.

Section 10: Management Summary

Provide a brief response for the following:

A. State in succinct terms your understanding of the major objectives of this RFP.

B. Briefly describe your company’s qualifications, intended processes and responsibilities to address these objectives.

C. Identify important steps that will be taken to meet the Columbus Consolidated

Government's expectations.

Section 11: Recommendation

Provide a comprehensive recommendation for the required third-party administrative services, with focus on the scope, general specifications, and technical specification.

Emphasis on clarity and detail is an important consideration in evaluation of the responses:

A. Describe how your organization will provide administrative services to support the processing of healthcare claims submitted by contracted providers within the

Community Care Program. The Respondent must demonstrate a clear understanding of each administrative task outlined in the RFP. Each task should be identified and accompanied by a detailed explanation of how the Respondent plans to approach and execute that task. Restating tasks directly from the RFP will not be considered responsive..

B. Describe how your organization will provide administrative services related to the processing of pharmaceutical claims submitted by contracted providers within the

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Community Care Program. If applicable, include any experience your organization has with processing claims associated with the Section 340B program under the Public

Health Services Act.

C. Provide details of any proposed innovations in claims processing, eligibility verification, provider support, reporting, or other administrative functions that will enhance the effectiveness of the Community Care Program.

D. Identify your existing relationships in Muscogee County and describe the nature of those relationships. Include information about your experience working with local providers and community organizations.

E. . Describe your organization’s expertise in administering programs that serve medically underserved populations, including any relevant experience with public health or community-based healthcare initiatives.

F. Explain how your organization will support the qualification process for medically underserved persons, including tools, forms, or systems used to verify eligibility in accordance with program guidelines.

G. If applicable, describe your organization’s role in managing or supporting co-payment collection procedures in coordination with contracted providers.

H. Provide a description of the staff who will be assigned to this contract, including the number of hours, shifts, and roles. Include an organizational chart showing lines of authority and communication and provide a brief description of each staff member’s responsibilities as they relate to the contract.

I. Identify any funding your organization currently receives from other sources to support administrative services for programs serving medically underserved populations.

Section 12: Program Support Services

A. Describe the method your organization will use to establish and maintain a secure database for tracking eligibility and enrollment of medically underserved persons within the Community Care Program. Include details on access, data integrity, and how contracted providers will utilize the system to verify eligibility.

B. Specify the guidelines and structure of your proposed Quality Improvement Program as it relates to administrative services, such as claims processing accuracy, timeliness, provider support, and system performance.

C. Describe your proposed reporting methodology for required daily and monthly administrative statistics. Include the types of data that will be tracked (e.g., claims processed, eligibility verifications, provider inquiries) and…