Service Area Match Document for Medicare Advantage Plans Bid Solicitation

This is a Service Area Match spreadsheet for Bid Solicitation 25DPP01075, issued by the Massachusetts state health benefits programs (State Health Benefits Program and School Employees Health Benefits Program) for Medicare Advantage plan coverage. The document identifies 2,156 distinct service areas across 50 U.S. states and territories, with bidders required to mark coverage availability for proposed Medicare Advantage Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans. As of April 2025, the current enrollment snapshot shows approximately 194,237 Medicare Advantage members and 34,856 Medicare Supplement members distributed across the identified service areas. The spreadsheet includes geographic zones spanning from Puerto Rico through the continental United States to Alaska and Hawaii, with service area concentration particularly dense in New Jersey, New York, Pennsylvania, Florida, and California, where member populations exceed 1,000 in individual zip codes.

The document serves as a critical tool for evaluating bidder responsiveness regarding geographic coverage capacity for the state programs' Medicare Advantage offerings. Bidders are instructed that failure to properly mark applicable service areas with an "X" in the designated yellow columns for both PPO and HMO products may result in responsiveness review determinations. The largest member concentrations appear in New Jersey's mid-state region (including Rutherford, Wayne, Paterson, and Hackensack service areas with populations ranging from 300 to 1,020 members), select New York counties, southern Florida markets, and central Pennsylvania areas. This service area mapping directly correlates member distribution with plan design requirements and establishes the geographic scope within which plans must demonstrate network adequacy and provider access to maintain contract compliance with state health benefits administration.