Health and Pharmacy Benefits

The City of Round Rock, Texas is soliciting proposals for Health and Pharmacy Benefits administration services through Request for Proposal 26-008, seeking qualified firms to provide comprehensive third-party administrator (TPA) services for self-insured medical and dental benefits, prescription drug claims administration, or bundled medical and pharmacy services. The City currently serves approximately 2,400 active employees, retirees, and dependents and is seeking enhanced program recommendations, options, and alternatives through internal or external sources and third-party agreements. Respondents may propose solutions for Third Party Administration Services for Self-Insured Medical Benefits, Prescription Drug Claims Administration, or both, with pricing submitted as fixed costs covering all work including labor, overhead, equipment, insurance, and risk management, net of commissions. The RFP solicitation was released April 17, 2026, with questions due April 28, 2026, at 3:00 PM CST, written responses from the City due May 1, 2026, at 5:00 PM CST, and final proposals due May 19, 2026, at 3:00 PM CST via the City's Bonfire electronic bidding platform. The contract will commence January 1, 2027, and consist of an initial three consecutive twelve-month period with two optional renewal options, and respondents must meet minimum qualifications including being firms or corporations normally engaged in providing employee benefits with adequate organization, facilities, equipment, and financial capability; providing audited financial statements upon request; disclosing litigation from the prior three years; and maintaining a home office inside the United States with regional representation within 120 miles of Round Rock. Evaluation criteria are weighted as follows: Account Management/Local Support (20 points), Benefit Administration Platform (20 points), Communication Support (10 points), Company Work Experience and Personnel (10 points), and Cost (40 points), with a maximum of 100 points.

The solicitation contains no specific set-aside designations for disadvantaged enterprises or restrictions on organizational types eligible to respond. The incumbent vendor is United Healthcare, which currently administers health, dental, vision, and prescription drug claims benefits through an existing self-insured medical and dental benefit program, with the current contract expiring December 31, 2026. Respondents must demonstrate familiarity with the City's existing infrastructure, including integration with current plan designs such as the United Healthcare Choice Plus and EPO plans, existing provider networks with 67,000+ pharmacies in the broad network, pharmacy benefit structures with three-tier copay designs ($0/$30/$50 retail; mail order at three times retail), and established clinical programs including step therapy, prior authorization, and quantity limits. The RFP documentation specifies that respondents must match the in-force plan design and quote the broadest available network at 0% commissions on a mature Administrative Services Only (ASO) basis with fixed fees guaranteeing rates for a minimum of three years, with 100% pass-through of pharmacy rebates and no carrier retention. Additional requirements include a one-time $15,000 implementation fee for the Holmes Murphy Data Warehouse and ongoing consulting fees of $3.25 per member per month (PMPM) payable to Holmes Murphy & Associates, the City's benefits consultant. No specific award value or budget range is disclosed in the RFP documentation, though the City's current pharmacy spend is documented at approximately $7.5 million annually across 1,050 covered pharmacy lives and historical medical claims data ranges from approximately $225,000 to $1.29 million monthly.