Health and Pharmacy Benefits RFP

The County of Hennepin and Hennepin Healthcare System, Inc. are seeking competitive proposals for health plan administration and pharmacy benefit management. Proposers may submit a response for one, some, or all products/services. The County and Hennepin Healthcare intend to implement the services selected as a result of this award effective January 1, 2028. The scope of services includes general administrative services, eligibility and enrollment administration, claims administration, provider network services, customer service, care management programs, pharmacy coordination, stop-loss coordination, and reporting. Proposers must provide a comprehensive proposal that includes a cover letter, company overview, references, and exhibits. The proposal must also include details on vendor guarantees, provider disruption report, claims repricing file, geo-access report, and sample reporting and member communication materials. Some key points to consider: • The County and Hennepin Healthcare reserve the right to contract directly and separately with the awarded vendor(s) based on the proposals provided in response to this RFP. • The estimated contract period will be January 1, 2028, through December 31, 2030, with two optional one-year renewal periods. • Proposers must clearly state the scenario each proposal represents in their response. • The County and Hennepin Healthcare will evaluate proposals based on criteria such as customer and member services, network strength, claims processing and administrative flexibility, and cost containment programs. • The County reserves the right to use any or all ideas, concepts, or other information provided in any proposals. • Proposers must not submit trade secret material as part of their proposal. • The County does not consider cost or prices to be trade secret material. • Proposals should match the current level of the benefit plans in place. • The County may choose to add HHS to its vendor contracts for both Medical TPA and PBM effective January 1, 2028. • Proposers are invited to submit an option for each of the scenarios outlined in the RFP.