State Employee Health Benefit Plan Audit Services

The Kansas Department of Administration, State Employee Health Benefit Fund is requesting proposals for audit services covering the State Employee Health Plan for 2027–2029, with proposals due July 22, 2026 at 2:00 p.m. Central Time. Questions are due June 24, 2026.

The scope encompasses mandatory annual medical and dental claims audits, pharmacy benefit manager (PBM) audits, and dependent eligibility verification audits (DEVA) for a sample of 250 covered dependents and spouses each year. The plan administers four medical designs (Plans A, C, J, and N) through Aetna and Blue Cross and Blue Shield of Kansas, with dental coverage through Delta Dental of Kansas. The State Employee Health Benefits Plan office is located at 109 SW 9th Street, Mills Building, Suite 600, Topeka, Kansas 66612. Auditors must achieve 95% confidence levels in statistical sampling for claims audits. Additional optional audits include premium payroll deduction reconciliation and pre- or post-implementation audits available on a per-audit basis. All work must be performed within the United States; any offshore work or offshore worker access to U.S. data requires disclosure.

Bidders must have a minimum of five years of continuous experience providing comparable audit services to self-funded health plans of similar size and complexity and must be fully qualified with designated account executives, lead auditors for PBM and medical/dental plans, a DEVA lead auditor, and a premium reconciliation lead auditor. Vendors must submit a current Type II SSAE18 or SSAE16 audit report, the most recent two years of audited financial statements, and documentation of professional liability and cyber insurance coverage. All proposals must comply with HIPAA requirements, Kansas security and encryption standards, and Kansas Open Records Act provisions. Proposals are submitted electronically to procurement@ks.gov in three separate files: Technical Proposal (Exhibit 1), Cost Proposal (Exhibit 2), and Confidential Information (Exhibit 3).

Evaluation criteria include cost, experience and capacity, proposal adequacy and completeness, bidder's understanding of the project, compliance with RFP terms, experience with similar services, qualified staff, and methodology. The Kansas State Employees Health Care Commission will conduct evaluation and award. The State reserves the right to award to the lowest responsive bid without formal negotiations or to reject any or all proposals. No pre-proposal conference is scheduled. Bonnie L. Edwards, procurement officer, manages inquiries at bonnie.edwards@ks.gov or 785/296-3125.