What happened to the insurance company that used to provide my benefits and why did the insurance carrier change?

The State has procurement rules and procedures that Benefits Administration (BA) must follow when we want to enter into a contract to provide services to our members, such as health or dental or vision insurance. BA uses this competitive bid process for all of the insurance benefits that we offer to our members. This is called, in our state government terms, a Request for Proposal or RFP.

 The State procurement rules say that a contract length may not extend beyond five years, unless we specifically seek an exception to this rule, and provide sufficient justification. BA follows the five-year rule for the majority of contracts and schedules procurements to allow for a new insurance carrier or company to be in place without disrupting member services. Sometimes the insurance carrier or company is the same and sometimes it is different.

 All  of the following are procured through a Request for Proposal (RFP):

  • Medical
  • Vision
  • Dental
  • Pharmacy
  • Behavioral Health/EAP
  • Wellness Program
  • Health Savings Account (HSA)/Flexible Spending Accounts (FSA)
  • Supplemental Medical Insurance for Retirees with Medicare

 For State and Higher Education members only:

  • Life Insurance
  • Short and Long-term Disability
  • ParTNers Employee Health Center

An overview of the RFP process:

All RFPs are posted on the Central Procurement Office (CPO) website and companies are invited to submit a proposal.  Each proposal is evaluated by a team based on the experience and technical qualifications of the company. In addition to a technical score from the evaluation team, the State also requires the company to submit a cost proposal which is scored.  The technical evaluation score and the cost proposal score are summed for an overall score. The State, Local Education, and Local Government Insurance Committees vote on awarding the contract to the best evaluated responder.

Any procurement may result in a new contractor for any of the services and benefits offered by BA. In addition, it is possible that with each new contract for insurance services there may be changes in the provider (doctors, facilities) network. Reviewing all material provided by Benefits Administration, including any provider network information, during the Annual Enrollment Period is always recommended.

 

 

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