Employee Assistance Program (EAP) and Behavioral Health Organization (BHO) Services - UPDATED

The State of Tennessee, through its Department of Finance and Administration, is procuring Employee Assistance Program (EAP) and Behavioral Health Organization (BHO) services for state, local education, and local government insurance plans. The procurement seeks a contractor to provide comprehensive network administration, utilization management, claims adjudication, call center services, and benefits communication for approximately 300,000 covered lives across three financially independent self-funded public sector plans. The successful vendor must maintain NCQA accreditation as a Managed Behavioral Healthcare Organization and URAC accreditation for utilization management programs, with specific performance guarantees and associated liquidated damages ranging from $1,000 to $75,000 per incident. Key deliverables include processing claims for 147,000 covered lives in the State Plan, 128,000 in the Local Education Plan, and 26,000 in the Local Government Plan. The RFP was issued on October 8, 2025, with written questions due October 22, 2025, and November 19, 2025, and a response deadline of December 19, 2025. The state anticipates completing technical evaluations by January 29, 2026, with cost proposal scoring on January 30, 2026, and negotiations scheduled for February 9-11, 2026.

The state demonstrates a commitment to diverse vendor participation, encouraging responses from minority-owned, women-owned, service-disabled veteran-owned, and small business enterprises. Contractors must demonstrate financial stability, with relevant experience managing large employer populations exceeding 10,000 members and claims adjudication experience of over $10 million annually for at least two clients. The incumbent contractor will be responsible for transitioning existing members and services at no additional cost to the state. The contract will be structured with a per-employee-per-month (PEPM) administrative fee model, covering a total contract period of 86 months, including eight months of implementation, 60 months of service delivery (January 1, 2027 through December 31, 2031), and an 18-month claims runout period. While a specific award value is not explicitly stated, the state self-funds medical, pharmacy, and behavioral health claims totaling approximately $976 million annually across all three plans. Additional requirements include carrying $5 million in cyber liability insurance and complying with HIPAA, HITECH, and state security requirements, including annual SOC 2 Type 2 examinations and penetration testing.