Group Medical Administration Services

The vendor required to provide group medical services, effective January 1, 2027.
- Sliced proposal options
•    Replacement of select health only: operating alongside regence BCBS as the remaining administrator.
•    Replacement of regence BCBS only: operating alongside select health as the remaining administrator.
- Optional full replacement proposal
•    Intermountain healthcare (IHC)–aligned network 
•    Non-IHC network
- Core administrative requirements
•    Process all medical claims accurately and in compliance with applicable laws.
•    Maintain a robust provider network with strong access statistics across state and nationwide.
•    Provide dedicated account management, including a state -based or regionally accessible account manager with demonstrated experience supporting self-funded plans, and submit a brief resume or statement of qualifications.
•    Support implementation and ongoing administration in partnership with the district.
•    Deliver comprehensive utilization, financial, and performance reporting.
•    Participate in a claims repricing process if selected as a finalist.
•    Exchange eligibility and enrollment data with employee navigator.
•    Coordinate claims, accumulator, and eligibility information with the district’s pharmacy benefit management (PBM).
•    Deliver a single, combined id card and consolidated member communications.
•    Provide monthly medical claims data feeds to the district or its designee (cedar gate technologies).
•    Attend and support annual employee benefit fairs.
•    Draft summary plan descriptions (SPDS) and provide printed copies upon request.
•    Confirm review and acceptance of current plan design.
•    Coordinate with the district’s stop-loss carrier (to be determined).
•    Demonstrate ability to operate effectively within a dual-administrator model.

- Contract Period/Term: 3 years
- Intent to Bid Due Date: January 22, 2026
- Questions/Inquires Deadline: January 8, 2025