25RFPMAPD0523C-MH Medicare Advantage & Prescription Drug Plan Services

Fulton County, Georgia is seeking proposals for Medicare Advantage and Prescription Drug (MAPD) Plan Services through a Request for Proposal (RFP) issued on May 23, 2025. The procurement aims to select vendors to provide fully insured national passive PPO MAPD services for Medicare-eligible county retirees and their dependents, effective January 1, 2026. The county is requesting proposals for two existing plan options: a Basic and an Enhanced MAPD plan, targeting a current population of 3,119 Medicare-eligible participants across three existing plans. The RFP includes a comprehensive evaluation process using a 100-point scale, with points allocated to various criteria including local and service-disabled veteran preferences, experience, account management, plan administration, Star Rating strategies, network and formulary quality, and cost proposal. Key dates include a pre-proposal conference scheduled for June 10, 2025, with final proposals due by June 24, 2025 at 11:00 A.M. The contract term is initially one year, with options to renew for up to four additional one-year terms through December 31, 2030. The county seeks a vendor capable of providing comprehensive benefits, minimizing member disruption, offering innovative solutions, and demonstrating strong capabilities in medical management, communications, and CMS regulatory compliance.

The current MAPD plan participants are distributed across Anthem BCBS self-funded plans (1,003 subscribers), Kaiser Senior Advantage (177 members), and Aetna MAPD Basic and Enhanced plans (1,939 members). While the RFP does not explicitly mention specific set-aside designations or restrictions for disadvantaged enterprises, it does indicate a preference for local and service-disabled veteran vendors in its evaluation criteria. The procurement appears open to qualified national MAPD service providers with demonstrated experience in managing Medicare Advantage and Prescription Drug plans for large public sector clients. Though a specific budget range is not detailed in the provided documentation, the scale of the current participant base suggests a significant contract value. The successful vendor will be expected to provide a comprehensive MAPD solution that meets the complex healthcare needs of Fulton County's Medicare-eligible retirees, with a focus on maintaining continuity of care, minimizing disruption, and providing high-quality, cost-effective health coverage.