Medical and Pharmacy Reinsurance

Northside Independent School District (NISD) in Bexar County, Texas is requesting sealed proposals for Medical and Pharmacy Reinsurance services through this procurement opportunity posted on October 22, 2025, with a submission deadline of November 13, 2025. The District seeks reinsurance coverage for its medical and pharmacy benefit programs across multiple plan designs, including Choice Plan HDHP, Choice Plan Primary Advantage, Choice Plus Plan HDHP, Choice Plus Plan PPO, and NexusACO R Plan offerings at various deductible levels (HMO 2000, PPO 2000, HDHP 4000). Proposals must include comprehensive reinsurance solutions with cost of shipping and handling incorporated for delivery to San Antonio, Texas. The procurement package includes detailed plan documents, eligible census data for 2025, historical claims data from January 2024 through September 2025, premium versus claims analysis, benefit type breakdowns, top drug utilization information, and a 2026 stop loss workbook to enable respondents to understand the District's current medical and pharmacy benefit structure and experience. Award determination will be based solely on the needs of the District, with evaluation criteria and specific technical requirements detailed in the Request for Proposal document (15-2025-133, RFP Medical and Pharmacy Reinsurance.pdf).

The procurement documents provided do not explicitly identify set-aside designations, disadvantaged enterprise restrictions, incumbent vendors, or current contractors for this reinsurance opportunity. No specific budget range or award value is listed in the posted opportunity materials; however, the District has provided comprehensive historical claims data and utilization analysis spanning multiple plan designs and over 20 months of payment history to enable vendors to develop accurate pricing and coverage recommendations. Respondents should consult the detailed RFP document and supporting financial worksheets to understand the full scope of claims experience, participant census, and stop loss structure that will inform proposal evaluation and potential award values.