The vendor is required to provide a package of insurance benefits, including health insurance options, flexible spending and health savings accounts, life insurance, dental insurance, and other supplemental insurance products for state employees and retirees, cobra participants, and covered spouses and/or children.
- Approval from the department, shall determine the methodology (IES) for determining the quality of a healthcare provider or facility, the price for eligible services, and the reward payment by utilizing department-approved information from reliable, industry-accepted sources.
- An enrollee’s eligibility for a reward payment is based on the household’s use of the online transparency website, mobile app, or the contractor’s member’s services, and selection of a rewardable service from a high-quality provider.
- Verify whether a member received a rewardable service from a high-quality provider.
- The online transparency program shall include all eligible services and providers that provide each eligible service, which shall be updated on a frequency approved by the department and made available to members 24 hours a day, 7 days a week, except for approved downtimes.
- Program development and management, including updating transparency cost and quality data available to members.
- Regularly monitor claims utilization and costs in order to develop, recommend, and implement program enhancements.
- Provide, maintain, and update (1) a website and (2) a mobile application or a mobile-optimized website, both of which must provide 24/7 access for members to log in and shop online for eligible services.
- The website will include data aggregated from various sources in a data file format used by all sources, including the department and its contracted vendors.
- Make available a toll-free telephone number, website, and mobile-optimized website that members may access to obtain information about the online transparency program, including but not limited to provider-related cost information for eligible services and reward payments.
- The website and mobile application or mobile-optimized website shall:
• Require all users to login securely as mutually agreed upon by the parties;
• Contain a comprehensive list of eligible services;
• Display all eligible services and providers that provide each eligible service under a member’s health plan.
- The account management team shall be able to devote the time and resources needed to successfully manage the account including being available for frequent telephonic, email, and on-site consultations, if necessary.
- Contract Period/Term: 4 years
- Questions/Inquires Deadline: April 28, 2025