Vendor Questions - State Responses.xlsx
XLSX spreadsheet 20 KB Posted
- Solicitation number
- 26-84388
- Issued by
- Indiana
About this file
The file is a Vendor Questions - State Responses spreadsheet from the Indiana State Personnel Department (INSPD) for Request for Information (RFI) 26-84388, focused on a Nonprofit Hospital System Direct to Employer Health Care Arrangement. The RFI seeks comprehensive information from nonprofit hospital systems about potential direct-to-employer healthcare arrangements for state employees, with responses due by October 20, 2025. The state is exploring innovative healthcare models for its employee health plans, with an anticipated RFP release in late 2025 or early 2026 for a January 1, 2027 effective date. The current health plan covers 26,792 subscribers and 57,343 total members across three plan types: CDHP 1, CDHP 2, and a Traditional PPO.
The RFI does not specify a contract value but indicates total medical spending of $417,029,104 in 2024. Key requirements include pricing at or below 260% of Medicare rates, demonstrating network adequacy, and providing detailed information about healthcare provider capabilities. The state is open to various approaches, including exclusive provider networks, on-site/near-site clinics, and specialty pharmacy services. Potential respondents can include multiple nonprofit hospital systems or representatives, and the state is particularly interested in proposals that offer significant cost savings to both the state and its employees. The procurement is specifically directed at hospitals complying with Indiana Code 27-1-46.5-5, with the state currently having no existing direct-to-employer arrangements with healthcare providers.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A - Zip Code.xlsx | XLSX spreadsheet | |
| RFI Main Document.pdf | ||
| Att A - Q&A Template.xlsx | XLSX spreadsheet |
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Q&A
| Attachment A | ||||
| Questions and Answers Template | ||||
| RFI 26-84388 Nonprofit Hospital System Direct to Employer Health Care Arrangement | ||||
| Please submit your questions in the blue shaded areas by the date and time established in the RFI. | ||||
| # | DOC NAME (RFI or Attachment) | PAGE # AND/OR SECTION # | RESPONDENTS QUESTION | STATE'S RESPONSE |
| 1 | RFI 26-84388 | Page 3 - Background | Can the State provide zip code level data on where the state employees live? | Yes. Zip Code file is attached as Exhibit A. |
| 2 | RFI 26-84388 | Page 3 - Background | To access the best rates, is the state willing to contract with exclusive provider networks in specific geographic areas? | Yes |
| 3 | RFI 26-84388 | Page 4 #2 | Is the state willing to work with a provider owned health plan to serve as the TPA for a health system's proposal? | Yes |
| 4 | RFI 26-84388 | Page 3 - General Information | If a hospital system provides specialty pharmacy services, would they be allowed to fill prescriptions for state employees? (PBMs typically control this.) | Please include information about that in your response. The State will be releasing RFPs for both a medical TPA and a PBM in late 2025, early 2026. |
| 5 | RFI 26-84388 | Page 3 - General Information | Is the state willing to consider the use of on-site / near-site clinics for their employees? | Yes |
| 6 | RFI | page 3 | Is the State of Indiana ("SOI") planning to establish a benefits structure to drive health plan members to use contracted services, either because use is mandatory or is strongly incentivized by the SOI? | The State is open to changing our benefits structure to accommodate new models that offer significant savings to both the State and its employees. |
| 7 | RFI | page 3 | How many subscribers are enrolled in each of the three SOI Health plans? | As of August 2025: |
CDHP 1 - 19,820
CDHP 2 - 5,487
Traditional PPO - 892 8 RFI page 3 How many total members are enrolled in each plan? As of August 2025: (total members including subscribers)
CDHP 1 - 43,637
CDHP 2 - 11,275
Traditional PPO - 1,357
| 9 | RFI | page 3 | If participation in a DTE program is incentivized via low/no cost to the member, or other incentives, would only those members on the traditional plan be eligible to participate? | The State is open to changing our benefits structure to accommodate new models that offer significant savings to both the State and its employees. |
| 10 | RFI | page 3 | Does the SOI plan to continue use of the Anthem HealthSync network for 2026? If yes, will differentials between deductibles and Max-out-of-pocket amounts stay the same or be adjusted to drive use of any new DTE program offerings? | Plan designs for 2026 have not been finalized at this time, but the current intent is to use the HealthSync network through 2026. |
| 11 | RFI | page 3 | Will the SOI issue a single award per service line offering (for example, orthopedic, oncology, etc.), or does the SOI plan to split awards regionally or in some other way? | The State is interested in all options. We are seeking innovative approaches to health care that provide significant savings to both the State and its employees. |
| 12 | RFI | page 3 | Does the SOI prefer to focus on information on fee-for-service programs, or should we include clinical programs priced in other ways? | The State is interested in all options. We are seeking innovative approaches to health care that provide significant savings to both the State and its employees. |
| 13 | RFI | Is there a current vendor providing this service? Or is it a new requirement? | There are no current direct to employer arrangements between the State and providers in Indiana. | |
| 14 | And if there is a current vendor, could you please provide the current contract documents/information? | N/A | ||
| 15 | If this RFI greenlights a solicitation, what is the estimated timeframe for procurement? | If the response would require the State to issue an RFP, that will be released in late 2025, early 2026 for a January 1, 2027 effective date. If the response can be implemented mid-year within existing contracts the State is willing to do so. | ||
| 16 | Does the State have an estimated contract value for this service? | No. | ||
| 17 | Nonprofit Hospital System Direct to Employer Health Care Arrangement (RFI 26-84388) | Page 3 | Is response to this RFI limited to nonprofit hospital systems as defined by IC 27-1-46.5-5? Or can any nonprofit hospital system, regardless of net patient revenue, respond to this RFI? Does the State have guidance on whether county/municipal hospitals fall within the designation of nonprofit hospital system as well? | This RFI is specifically directed at hospitals that must comply with IC 27-46.5-5; however, we will accept responses from any hospital system or you can outline a direct to employer arrangement by responding to RFI 26-85114 |
| 18 | Same As Above | Page 3 | Can multiple nonprofit hospital systems respond to the RFI together so long as each of the questions included in the RFI are addressed? | Yes. |
| 19 | Same As Above | Page 3 | Can a representative (e.g., an attorney or trade association) respond to the RFI on behalf of multiple nonprofit hospital systems so long as each of the questions included in the RFI are addressed?” | Yes. |
| 20 | Same As Above | Page 3 | Is this RFI only in relevance to providing a direct to employer arrangement to the State Employee Health Plan? | Yes. RFI 26-84388 is specific directed toward nonprofit hospital systems direct to employer offers as mandated by IC 27-1-46.5-5. RFI 26-85114 seeks to understand innovative solutions that may or may not include direct to employer arrangements. |
| 21 | Same As Above | Page 3/4 | Does the RFI require a proposed rate to be submitted? | IC 27-1-46.5-9(c) outlines the minimum requirements of the offer, that it is at or below a benchmark of two hundred sixty (260%) of full Medicare. Your proposal needs to state how you plan to comply with that and if your offer is below 260% of Medicare. |
| 22 | Same As Above | Page 3/4 | Does the State want to understand a nonprofit hospital system's network adequacy as a part of this RFI response? | Yes. |
| 23 | Same As Above | Page 3 | Will the State eventually provide data on the State Employee Health Plan volumes / procedures per hospital (i.e., where the SEPH members are located and what services are being provided)? Such information would be helpful when responding to an eventual RFP. | Yes. |
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