3-MDOT-MTA Medical/Vision Plan Admin&Svcs, Functional Areas 5 (Medical PPO-SF/HMO-SF) & 6 (Vision)

The Maryland Department of Budget and Management, Office of Personnel Services and Benefits and Maryland Department of Transportation Maryland Transit Administration are soliciting proposals for medical PPO and HMO plan administration and vision plan services for MDOT-MTA represented employees under Functional Areas 5 and 6, Solicitation AGY-24-026-SR-A / BPM053905, with technical proposals due December 18, 2025 at 3:00 PM.

The scope encompasses self-funded medical PPO and HMO plan administration and self-funded vision plan administration for approximately 2,510 benefit-eligible employees and 2,200 retirees. Medical PPO services must include claims administration, network management, member services, and disease management; HMO services add primary care provider coordination and referral management. Vision services include routine eye exams, frames, lenses, and contact lens administration with 24/7 customer service and Maryland county network coverage (Anne Arundel, Baltimore City, Baltimore County, Carroll, Frederick, Harford, Howard, Montgomery, and Prince George's). Contractors must meet performance guarantees including 98% telephone answer rate within 30 seconds, 95% claims accuracy within 10 business days, and 90% member satisfaction, with liquidated damages for non-compliance. Contractors must hold Maryland insurance licensure, provide three employer references with minimum 25,000 covered lives, and maintain minimum $10 million cyber security insurance. HIPAA compliance, breach notification protocols, and coordination of benefits administration are mandatory.

The contract term is five years plus two three-year renewal options, effective January 1, 2027. Financial proposals will be evaluated on a cumulative eleven-year basis. Administration and network access fees must be quoted on a fully-loaded per-employee-per-month (PEPM) basis, held flat for the first three years, with annual increases not to exceed 4% thereafter. MBE subcontractor participation goals range from 1% to 6.1% of administrative fees; VSBE goals range from 0.1% to 1%. Current incumbents include CareFirst of Maryland, Inc., United Health Care Services, Inc., and Kaiser Foundation Health Plan. The Maryland Living Wage Affidavit is required; exemptions apply to contractors with ten or fewer employees and contract values under $500,000. Only technical proposals are due by December 18; qualified offerors will receive separate notification regarding financial proposal submission procedures and timing.