Administrative Support Services for the State of Nebraska Employee Health Care Medical Benefit Plans

The State of Nebraska Department of Administrative Services is seeking a third-party administrator for its Employee Health Care Medical Benefit Plans through Request for Proposal (RFP) #122435 O5. The procurement aims to secure comprehensive administrative support services for the state's self-insured medical plans, covering approximately 17,500 employees and 13,600 enrolled members, including active employees, pre-65 retirees, and COBRA participants. The contract will run from execution through June 30, 2029, with options to renew for two additional one-year periods. Required services include member services, claims processing, network management, medical management, wellness programs, and comprehensive reporting across three current health plan options: Regular Plan, Consumer Focused Health Plan (with Health Savings Account), and WellNebraska. Vendors must have at least five years of self-funded medical administration experience, serve public sector groups with a minimum of 15,000 lives, and be licensed to offer solutions in all 50 states and U.S. territories. The evaluation process will award a maximum of 100 points (with potential for an additional 20 points for vendor demonstrations), distributed across Corporate Overview (25 points), Technical Response (55 points), and Cost (20 points). The RFP was released on June 9, 2025, with proposals due by July 17, 2025, at 2:00 p.m. Central Time, targeting implementation before the annual Open Enrollment period in May and a benefit plan year beginning July 1, 2026.

The solicitation does not explicitly mention specific set-aside designations or restrictions for disadvantaged enterprises. The RFP does not provide details about the incumbent vendor or specify existing infrastructure requirements for integration. Cost considerations are outlined in the attached cost sheet, which provides a detailed breakdown of potential fees across five contract periods, including per employee per month (PEPM) fees for standard services, pass-through charges, and Health Savings Account (HSA) services. The state emphasizes innovative strategies for cost reduction, quality care, and performance guarantees, with administrative fees to be paid starting July 1, 2026, and run-out claims administration for 12 months following contract termination. The Performance Guarantees attachment indicates financial penalties ranging from 0.50% to 1.50% of annual fees for non-compliance across various service categories. While specific budget ranges are not explicitly stated, the comprehensive nature of the services and the size of the covered population suggest a significant contract value. The state requires vendors to provide comprehensive reporting, performance metrics, and continuous improvement across multiple operational domains, including member services, claims processing, and clinical program engagement.