Third Party Administrator

The Arkansas Department of Transformation and Shared Services Office of State Procurement is seeking a Third Party Administrator (TPA) to manage health insurance and medical management programs for approximately 160,000 total covered lives, including 70,716 individual employees from state and public school systems. The solicitation (S000000375) requires a comprehensive TPA to administer health insurance, medical management, and an optional Employee Assistance Program (EAP) for roughly 128,000 members. Contractors must maintain provider networks, process claims, coordinate care, and provide medical management services with specific technical requirements including SOC-2 Level II and SSAE-18 compliance, URAC accreditation, and a minimum of five years experience with large public sector health plans. The evaluation will be based on a 1,000-point system, with 600 points allocated to technical scoring and 400 points to cost considerations. A pre-bid conference is scheduled for January 16, 2025, with proposals due through ARBuy by February 10, 2025, at 10:00 AM Central Time. The initial contract term is three years with four optional one-year renewals, potentially extending the contract to seven years total.

There are no specific minority or women-owned business enterprise (MWBE) set-aside requirements for this procurement. Contractors must certify they will not boycott Israel, knowingly employ illegal immigrants, or engage with scrutinized companies. The state may award the contract to a single contractor or multiple contractors by geographic regions. While no incumbent vendor is explicitly named, the solicitation suggests current services are provided by Arkansas Blue Cross Blue Shield. The contract requires providers to maintain an Any Willing Provider compliant network and integrate with the state's existing benefits infrastructure. Though specific budget ranges are not disclosed, the pricing structure allows for per-member-per-month (PMPM) fees across multiple service categories, with pricing scenarios for varying enrollment levels from 10% to 90% of total membership. Implementation credits and potential service adjustments are permitted, with initial rates to be held firm for the first three years of the contract.