Re-Issue Group Medical Insurance Services

Bernalillo County, New Mexico's Procurement and Business Services Department is issuing Request for Proposals No. 35-26-NH to solicit proposals for Administrative Services Organization (ASO) medical claims administration and related services for the County's self-insured group medical plan, effective July 1, 2026, through June 30, 2027. The County seeks vendors capable of providing comprehensive medical claims administration, provider network services, medical management, utilization review, disease management, and wellness services on both sole carrier and slice carrier arrangements, with the primary objective of offering members access to Lovelace, UNM, and Presbyterian networks. Proposals must include fully integrated medical solutions with established provider networks in the Bernalillo County area; vendors without existing networks will not be considered. The County currently covers approximately 2,370 eligible employees and offers two plan design options: an Exclusive Provider Organization (EPO) plan and a Preferred Provider Organization (PPO) plan, currently administered by Presbyterian Health Plan and Blue Cross Blue Shield of New Mexico. Evaluation criteria totaling 1,025 maximum points include organizational strength (225 points), client management team (200 points), network accessibility (300 points), and costs (300 points). Prospective vendors must submit sealed proposals in OCR-searchable PDF format limited to 400 pages of text and graphic material through the County's eProcurement system (Bonfire) by 4:00 p.m. MST on January 29, 2026; a non-mandatory pre-proposal conference is scheduled for January 21, 2026, at 10:00 a.m. MST via MS Teams. The anticipated agreement term is four years with options to extend two additional two-year periods, not to exceed eight years total.

Vendors must be licensed to provide insurance or ASO services in New Mexico and must guarantee ASO fees for a minimum of two years with no increases permitted in Year 2, though a three-year guarantee is preferred; all fees must be quoted on a per-employee-per-month (PEPM) basis net of commissions. State and County business preferences may apply, including Resident Business Preference (5%), Native American Resident Business Preference (8%), State Resident Veteran Business Preference (10%), Local Business Preference (5%), Small Business Preference (5%), and Pay Equity Business Preference (5%), provided total preferences do not exceed 18% with County preferences capped at $180,000. The current incumbent vendors are Presbyterian Health Plan and Blue Cross Blue Shield of New Mexico, and selected vendors must integrate with the County's existing prescription benefit manager (ClearScript) and human resources information system (Workday); vendors must also comply with federal and state civil rights requirements, the Americans with Disabilities Act, and produce Summary Plan Descriptions within 60 days of the effective date. All required supporting documentation including certificates of insurance, campaign contribution disclosure forms, unfair business practices disclosure forms, and pay equity reporting forms must be submitted with proposals. No specific award value or budget range is disclosed in the RFP documentation; however, vendors should note that the County is a self-insured public sector employer with approximately 2,370 eligible employees, suggesting a moderate to large contract opportunity.