PRE-ISSUANCE CONFERENCE

Introduction:

The Commonwealth of Kentucky is seeking qualified vendors to provide administration services to the Commonwealth’s Public Employee Health Insurance Program, commonly referred to as the Kentucky Employees’ Health Plan. A Request for Proposal (RFP) will be issued by the Commonwealth of Kentucky, Finance and Administration Cabinet on behalf of the Personnel Cabinet, Department of Employee Insurance. Aonhewitt has been retained by the Personnel Cabinet to assist with this procurement. The Commonwealth seeks vendors that can administer the Program’s medical benefits, pharmacy benefits, and/or healthcare reimbursementplans to approximately 270,000 active employees, retirees and dependents effective January 2015. The purpose of this RFP is to secure an administrator for the statewide medical plans which consist of Consumer Driven Health Plan (CDHP) and PPO plan offerings. The Commonwealth is also seeking a Pharmacy Benefits Manager. Please note that a separate Pharmacy RFP will be distributed.The Commonwealth of Kentucky is also seeking a wellness provider (which can be either bundled or unbundled with the medical provider).

Selected vendors shall offer leading, valued-based solutions for the administration and management of the plans. Benefits are currently provided by Humana and Express Scripts on an integrated basis. The Commonwealth of Kentucky’s procurement and contracting strategy encompass the provision of the following services.

1.) Medical Claims Third Party Administration (on a self-funded basis), including network service and the administration of Health Reimbursement Arrangements

2.)Pharmacy Benefits Management and Claims Administration (on a self-funded basis), including retail (point-of-sale), mail order and specialty pharmacy services

3.)Wellness Programs

4.)Medical Management (disease management, case management, behavioral health management, utilization review/certification, etc.)

5.)Flexible Spending Account and Health Reimbursement Arrangement Administration

6.)COBRA Administration

The Commonwealth of Kentucky is interested in receiving proposals from vendors experienced in utilizing the most innovative, state-of-the-art services and technology available in the industry today, to drive healthier behaviors and outcomes while minimizing costs. The objectives of the programs are to provide better than average benefits administered in a very cost-effective manner with excellent service to enrollees, so that state agencies can recruit and retain high quality employees.The Commonwealth of Kentucky is ultimately seeking to assemble the above suite of program offerings into “Best in Class” services that provide a value-based health benefits program for its members.

Time and Location:

RFP Pre-Issuance Conference has been scheduled for October 15, 2013 at the State Office Building, 501 High Street, 1ST Floor, Auditorium, Frankfort, KY 40601. Additional information will be provided on October 15, 2013.

Pharmacy Benefits Management and Claims Administration- 2-3 PM

Medical Claims Third Party Administration- 3-4 PM

  • Wellness Programs
  • Medical Management (disease management, case management, behavioral health management, utilization review/certification, etc.)
  • Flexible Spending Account and Health Reimbursement Arrangement Administration
  • COBRA Administration