District Healthcare Benefits Program Services

The Vendor is required to provide administrative services only (ASO) medical, by an insurance carrier or medical third-party administrator, administrative services only (ASO) prescription drug services, fully-insured stop loss coverage and group medicare plan offerings for county schools’ employees, dependents and retirees.
- Self-insured (ASO) medical plans (for active employees, non-medicare eligible retirees, COBRA participants and eligible dependents) with the components described below:
• Broad network plan (extended network), narrow network plan, tri-county narrow-network plan
- Self-insured (ASO) pharmacy benefit management (PBM) services (for active employees, non-medicare eligible retirees, cobra participants and eligible dependents)
- Fully-insured, customized group medical advantage HMO, medicare advantage PPO, POS or private fee for-service (PFFS), medicare supplement, and prescription drug plan (PDP)
- Fully-insured stop loss coverage (specific – individual stop loss)
- Providing an eligibility file to the onsite clinic vendor
- Accepting claim files from the onsite clinic vendor
- Collaboratively working to establish onsite clinic providers as participating in the carrier’s network with full referral capabilities.
- Contract Period/Term: 5 years
- Pre-Proposal Conference Date: June 26, 2025
- Questions/Inquires Deadline: July 3, 2025