TPA Services for HMO

The State of Florida, Department of Management Services' Division of State Group Insurance is issuing an Invitation to Negotiate (ITN) to establish a contract for Third Party Administrative (TPA) Services for Health Maintenance Organization (HMO) coverage. The Department is seeking proposals from interested Respondents to provide administrative services for the State of Florida's HMO medical plan, which covers employees across the state, including in Leon County and the city of Tallahassee. The ITN outlines detailed requirements for the HMO medical, disease management, clinical programs, pharmacy benefit management, customer service, implementation support, account management, and other administrative services. Respondents must provide detailed information on their qualifications, networks, programs, and capabilities to meet the Department's needs. Proposals are due by September 27, 2022, and the selected Respondent will be awarded a contract for an initial three-year term with potential renewal options.

The ITN does not indicate any set-aside designations or restrictions on the types of organizations that can respond. The current TPA provider is not specified. The Department will consider the Respondent's proposed pricing and ability to meet the defined scope of services when evaluating and selecting the successful Respondent for contract award. Funding for this opportunity will be provided through the State Employees Health Insurance Trust Fund, but the ITN does not provide any details on the potential award value or budget range.