DAS Behavioral Health Third-Party Administrator RFP
Open State & local contract opportunity Posted
- Solicitation number
- SRC0000040548
- State
- Ohio
- Responses due
Opportunity facts
Opportunity details come from ohiobuys.ohio.gov. Updated .
About this opportunity
The State of Ohio Department of Administrative Services is soliciting proposals for a Behavioral Health Third-Party Administrator to manage the State's self-insured Behavioral Health Benefit Plan, with proposals due November 13, 2026 and contract performance beginning July 1, 2027. Scoring preferences of 5 percent for the first preference and 2 percent for subsequent preferences apply per Ohio Administrative Code.
The scope encompasses claims administration and weekly payment processing, member services with 24-hour availability, eligibility data processing via 834 HIPAA files, web portal development and maintenance (99.9% uptime), provider network management, utilization and case management, and appeals administration including external independent reviews. The contractor must integrate with multiple third-party administrators, deliver quarterly financial and operational reporting, and attend at least four annual site visits to DAS offices in Columbus at no additional cost. The plan currently covers approximately 43,800 enrolled employees and 104,600 total lives.
The contractor must hold NCQA accreditation and Third-Party Administrator licensure or certificate of authority per Ohio Administrative Code 3901-8-05, and must comply with Mental Health Parity and Addiction Equity Act requirements. Administrative fees are structured on a per-employee, per-month basis; no additional reimbursement is available for travel or expenses beyond those detailed in the cost proposal.
Evaluation uses a competitive sealed proposal process with technical scoring worth 3,425 points, cost scoring worth 1,450 points, and potential presentations worth 125 points, for a maximum of 5,000 points. Technical proposals must achieve a minimum raw score of 2,055 points to advance to cost evaluation. Separate cost proposals must be submitted electronically. The contractor must be prepared for open enrollment activities by May 2027.
The initial contract term includes renewal options at the State's discretion for one month at the end of the initial term and each renewal term, with further renewals subject to mutual agreement and dependent on General Assembly appropriation of funds. All proposals become State property and will be retained for at least six years.
Opportunity text
Purpose and Background
The purpose of this RFP is to solicit Proposals for one Contractor to work with DAS Benefits Administration Services (BAS), and the Joint Healthcare Committee, to help the State of Ohio meet its goals for the Behavioral Health (BH) Benefit Plan. Pursuant to Sections 124.81, 124.82, and 124.87 of the ORC and Chapter 123:1-71 of the OAC, DAS is responsible for contracts pertaining to health benefits. Benefits Administration Services (BAS) is part of the DAS State Human Resources Division (SHRD). BAS explores and implements innovative, cost-effective approaches to maximize the value of State benefit programs. These programs promote healthy lifestyles to improve the productivity of the workforce and improve the health of State of Ohio employees and their families. BAS's mission is to assist employing agencies to increase employees' and their families' understanding of the State's benefit programs through integrated training and communications, in an endeavor to encourage more effective benefit program utilization. The State, in cooperation with its employee unions, has met the challenge of managing rising costs of health care while maintaining quality employee benefit programs. The JHCC is a labor-management committee that collaborates with the State program and project managers to provide strategic direction regarding employee health benefit plans. This includes conducting on-going employee education and information programs, evaluating quality improvement and cost effectiveness. The JHCC Administrative Subcommittee makes recommendations regarding: behavioral health benefits, behavioral health benefit management selection, and the future strategy of the behavioral health benefit program. The State's BH Benefit Plan is administered on a self-insured basis. Approximately 43,800 employees are currently enrolled in the State's BH Benefit Plan. The plan covers approximately 104,600 lives. Employees who are not enrolled in a health care plan are not eligible for behavioral health coverage.
The Third-Party Administrator's (TPA) fees are currently structured so that administrative fees are billed on a per-employee, per-month basis and claims are paid weekly. This RFP requires execution of a nondisclosure agreement for access to Exhibit 8: A potential Offeror must send its completed and signed nondisclosure agreement (NDA) (Exhibit 9) to Tom Nelson at tom.nelson@das.ohio.gov by November 4, 2026, to gain access to Exhibit 8. The template will be provided upon confirmation of proper execution of the NDA. The State will not accept any proposed changes to this NDA. It is the Offeror's responsibility to sign the NDA and submit it in a timely manner to obtain Exhibit 8. The State is not responsible for any delay in execution of the NDA that results in an Offeror not submitting a timely Proposal.
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