HMO Services for MPSERS

The State of Michigan Department of Technology, Management and Budget has issued a Request for Proposal (RFP No. 190000002803) seeking Health Maintenance Organization (HMO) services for the Michigan Public School Employees' Retirement System (MPSERS). The procurement aims to secure comprehensive health coverage for approximately 233,500 MPSERS members, including both Non-Medicare and Medicare eligible retirees, their beneficiaries, and dependents. The contract will cover approximately 201,000 members in a self-funded plan and 32,500 participants in HMO plans, with services beginning January 1, 2020, following a 69-day transition period. Bidders must be HMO-licensed in Michigan and NCQA-accredited, offering plans that are actuarially equivalent to the existing MPSERS self-funded plan. The RFP requires vendors to provide detailed customer service capabilities, including a call center, web-based support, and communication services, while complying with CMS requirements for Medicare Advantage plans. The proposal was posted on July 31, 2019, with a submission deadline of August 7, 2019, and vendors must electronically submit proposals through www.michigan.gov/SIGMAVSS. Evaluation will be conducted on a pass/fail basis across multiple criteria including the Statement of Work, Vendor Questions Worksheet, and Standard Contract Terms.

The RFP does not explicitly outline specific set-aside designations or restrictions for disadvantaged enterprises. The contract allows for potential multiple vendor awards and is open to HMO providers capable of meeting comprehensive healthcare coverage requirements. While no incumbent vendors are directly identified, the solicitation emphasizes Michigan-specific economic considerations such as job creation and potential employment of Michigan citizens. The contract includes provisions for a one-year initial term with four potential one-year renewal options, suggesting flexibility for continued service. The pricing structure will be detailed in Schedule B, with premium rates firm for the initial contract year and subsequent rates to be determined annually by August 1st. The contract will be funded through public school employer contributions and contract holder premiums, with contracts valued at $500,000 or more requiring approval from the State Administrative Board. The final award will not be complete until a fully executed contract is received by the awarded contractor.