DAS Medical Plan Third-Party Administrator

The State of Ohio is seeking one or more third‑party administrators to manage its self‑insured medical plans (Ohio Med PPO, Select, and HDHP) for all state employees, retirees, dependents, and COBRA participants. The contractor must process claims, maintain eligibility data, provide member‑service call centers, generate quarterly dashboards, and meet strict service‑level agreements for claim turnaround, complaint resolution, and network stability. The award will be a not‑to‑exceed ASO fee per enrolled employee per month, with a benefits fund of $75,000 per region and performance‑based fee adjustments. The contract runs from the award date through June 30 2030 (approximately four years). • Administer three plan options exactly as designed, with no changes, for ~103,000 covered lives. • Provide full claims processing, eligibility file transfers, member‑service hotlines, ID‑card issuance, and quarterly financial/reporting deliverables. • Meet rigorous SLA metrics (e.g., 94 % of claims within 10 business days, 24‑hour complaint acknowledgement, 99 % network‑access availability). • Submit separate technical and cost proposals; cost proposal must use a PEPM model based on regional enrollment estimates.