RFP No. DMS-2425-312 MAPD

The Florida Department of Management Services, Division of State Group Insurance, has issued Request for Proposal (RFP) No. DMS-2425-312 seeking fully-insured Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) Medicare Advantage and Prescription Drug plans for state group insurance. The procurement targets Medicare-eligible state retirees, with an anticipated contract implementation date of January 1, 2026, and aims to establish coverage for the state's 25,192 Medicare-eligible retirees, of whom 3,622 were enrolled in MA-PD plans as of February 2025. Vendors must provide uniform MA-PD coverage with consistent plan design and cost-sharing across all Florida counties, with plans available for nationwide or county-specific coverage. The evaluation methodology will score proposals based on 40% technical proposal and 60% cost proposal, with points awarded for premium costs, CMS Star Ratings, and services/benefits affordability. Proposal submissions are due by July 9, 2025, with minimum qualifications including current healthcare accreditation, a minimum 3.5 CMS Star Rating, registration with Florida regulatory bodies, and experience covering at least 80,000 lives. Key deliverables include comprehensive reporting requirements, performance guarantees, and adherence to strict administrative and technical standards outlined in multiple attachment documents.

The solicitation does not explicitly mention specific set-aside designations or restrictions for disadvantaged enterprises. The state intends to award contracts to multiple respondents to ensure coverage in all Florida counties, with sixteen counties currently lacking HMO MA-PD coverage. The estimated annual contract amount is approximately $8,000,000, with monthly premiums not exceeding $430 per member per month. Vendors must provide detailed cost proposals across three coverage tiers: Tier I (Benchmark Plan with $500 annual out-of-pocket maximum), Tier II (Moderate Coverage Plan with $1,000 annual out-of-pocket maximum), and Tier III (High Cost-Share Plan with $2,000 annual out-of-pocket maximum). The contract will have an initial three-year term from January 1, 2026, to December 31, 2028, with the option for the Department to renew for up to three additional years. Vendors must maintain commercial general liability insurance of $5 million, workers' compensation insurance, and professional indemnity insurance of $5 million. The procurement requires comprehensive compliance with HIPAA, HITECH Act, and Florida Statutes, with strict data protection and privacy protocols.