RFP 26-002 - Ad hoc Health Benefits Consulting for Fiscal Years 2027 - 2031

REQUEST FOR PROPOSALS
FOR
AD HOC HEALTH BENEFITS CONSULTING
FOR
THE
PUBLIC EDUCATION EMPLOYEES' HEALTH
INSURANCE PLAN
FOR
FISCAL YEARS
2027 through 2031
RFP 26000000002
Issue Date: February 27, 2026

This RFP Contains Information Under the Following Headings:
SECTION I
General Information for the Bidder
A. Purpose
B. Background
C. Description of PEEHIP's Management
D. Operations
E. Funding
F. Other Information
G. Proposal Opening
H. Key Dates
I. Scope of Services and Submission Requirements
J. Payment Schedule
K. Selection of Firm(s)
L. Economy of Preparation
M. News Releases
N. Addenda to the RFP
O. Contact Point
P. Minimum Qualifications
Q. Agents
SECTION II
Information Required from Bidders
A. Qualifications of the Firm
B. Cost and Price Analysis
SECTION III
Criteria for Evaluation
A. General
B. PEEHIP's Rights
C. Termination
D. Cost and Price Analysis
E. Proposal Evaluation Form
SECTION IV
Additional Documents
A. State of Alabama Disclosure Statement (Pursuant to the Code of Alabama 1975, Title 41,
Chapter 16, Article 3B)
B. Sample PEEHIP State Contract
C. Immigration Compliance Certificate
D. Proposer Profile Form
E. Proposer References Form
F. PEEHIP Statement on HIPAA Compliance Documentation
G. Third Party Vendor Checklist
H. Business Associate Agreement
I. IRS Form W-9

SECTION I
General Information for the Bidder
A. Purpose:
This Request for Proposals (RFP) solicits vendor proposals for ad hoc health benefits consulting services
to support the Public Education Employees' Health Insurance Plan (PEEHIP) on an as-needed basis for
fiscal years 2027 through 2031. PEEHIP's fiscal year begins October 1 and ends September 30. Services
to be provided under this RFP are expected to begin October 1, 2026. Upon the award of this RFP, the
PEEHIP will work with the Vendor(s) to further develop the scope of the contract.
B. Background:
The PEEHIP provides hospital medical health insurance benefits for all full-time employees and certain
part-time employees of the Alabama public educational institutions, which provide instruction at any
combination of grades K-14. These insurance benefits are also available to retired employees with a portion
of the retiree's cost paid through the employer premium for active employees. Coverage is also offered to
eligible dependents.
Members have the following choices for health insurance coverage as follows:
* Hospital medical administered by Blue Cross and Blue Shield of Alabama - Actives and Non-
Medicare eligible retirees and eligible dependents.
* Prescription Drug coverage administered by Express Scripts - Actives and Non-Medicare eligible
retirees and eligible dependents.
* Health Maintenance Organization - Viva - Actives and Non-Medicare eligible retirees.
* Medicare Advantage Prescription Drug Plan (MAPDP) - Humana - Medicare eligible retirees and
Medicare eligible dependents of retirees
* Optional Coverage administered by Southland Benefit Solutions, LLC, - consisting of Dental,
Hospital Indemnity, Vision, and Cancer.
* Supplemental Hospital Medical administered by Blue Cross and Blue Shield of Alabama-
supplemental coverage for Actives and Non-Medicare eligible retirees
Members electing one of the hospital medical plans must pay a small amount each month for single
coverage plus an additional amount if the member elects family coverage. Additionally, members may
select the optional coverage plans or supplemental plan in lieu of the hospital medical coverage. Members
electing hospital medical coverage may also elect to pay an additional amount to acquire one or more of
the optional plans.
C. Description of PEEHIP's Management:
The PEEHIP's self-insurance plan and administrative responsibility for this fund is with the Retirement
Systems of Alabama (RSA) administrative staff. The Chief Executive Officer (CEO) of the Teachers'
Retirement System (TRS) also serves as CEO for the PEEHIP. All matters relating to the PEEHIP have
been assigned to staff who serve under the direction of the Deputy Director for Administration. Currently,
Carr, Riggs & Ingram, LLC, performs the annual audit of the financial statements of the PEEHIP. CavMac
Consulting, LLC, prepares the annual OPEB valuation and GASB 74 and 75 reports.

D. Operations:
The Accounting Division of the RSA is responsible for budgeting projected claims and working with the
insurance consultant to estimate premium rates necessary to fund the claims and maintain adequate reserves
for unreported and unpaid claims.
The PEEHIP Division maintains insurance records for the approximately 360,000 active and retired
members and eligible dependents via Member Online Services. All changes are reported to the third-party
administrators via electronic file transfer.
In March 2007, the Alabama Retired Education Employees' Health Care Trust, a multiple-employer cost-
sharing defined benefit post-employment healthcare plan, was established to provide healthcare benefits to
retirees of state and local educational institutions. As of September 30, 2025, the assets totaled $2.7 billion.
Claims paid by third party administrators and payments to HMOs for Fiscal Years 2023-2025 are
summarized as follows (cash basis):
(Amount in Millions)
TPA 2023 2024 2025
Medical - BCBS of AL $ 1,013 $ 1,043 $ 1,119
Drug - ESI $ 254 $ 288 $ 247
MAPDP $ 7 7 $ 5 7 $ 203
HMO - VIVA $ 2 0 $ 1 8 $ 1 9
Optionals - CDIV - Southland $ 6 3 $ 6 0 $ 6 6
Flex $ 8 $ 9 $ 1 0
Other (e.g., ADPH) $ 5 $ 6 $ 5
Total Claims $ 1,440 $ 1,481 $ 1,669
Number of Members with medical contracts and number of dependents enrolled in PEEHIP Medical
Coverage and Optional Coverage as of January 31, 2026:
As of January 31, 2026 Active Retired Total Total Covered
Hospital/Medical Single Family Single Family Single Family Contracts Persons
Hosp/Med 3 5,297 5 2,286 3 ,753 5 ,580 3 9,050 5 7,866 9 6,916 2 30,639
Supplemental 1 88 1 ,537 5 46 7 70 7 34 2 ,307 3 ,041 8 ,596
Total Hosp/Med 3 5,485 5 3,823 4 ,299 6 ,350 3 9,784 6 0,173 9 9,957 2 39,235
Humana - - 4 0,442 2 0,437 4 0,442 2 0,437 6 0,879 8 0,907
Viva Health 7 27 5 18 1 33 9 0 8 60 6 08 1 ,468 2 ,747
Total Hospital/Medical 3 6,212 5 4,341 4 4,874 2 6,877 8 1,086 8 1,218 1 62,304 3 22,889
As of January 31, 2026 Active Retired Total Total Covered
Optional Plans Single Family Single Family Single Family Contracts Persons
Cancer 3,850 6,175 4,636 5,127 8,486 11,302 1 9,788 39,054
Dental 24,340 45,564 28,777 30,718 53,117 76,282 1 29,399 272,384
Vision 8,585 13,678 7,071 9,488 15,656 23,166 3 8,822 81,865
Indemnity 2,608 3,825 2,503 2,249 5,111 6,074 1 1,185 22,141
All optional plans are with Southland
PEEHIP also implemented a MAPDP effective January 1, 2017. The member count for this program is
approximately 81,000 (included above), and the plan is currently administered by Humana.

E. Funding:
Employer paid health insurance premiums, member payments for family coverage, and additional selected
optional coverage are submitted to the PEEHIP each month from the employer school systems for active
employees and the retirement payroll process for retirees. There are approximately 200 local employer
systems participating in PEEHIP.
F. Other Information:
Additional terms and conditions appliable to, and hereby incorporated within, this RFP and all
proposals submitted in response to this RFP are located at https://www.rsa-al.gov/about-rsa/itb-
rfp/ and titl*e d:
*
* RSA Reservation of Rights and Requirements for ITBs and RFPs
RSA Standard Terms and Conditions for Solicitations and Contracts
RSA Procedure for Resolution of Controversies
By submitting a proposal, all proposers are deemed to have agreed to all terms and conditions
i ncluded within the above documents unless a proposer provides RSA with a document clearly
sOttahteinr gd oitcsu emxecnetps ttihoants a troe aconnys tiedremre do ra sc opanrdt iotifo tnh,i sa lRoFnPg wmiatyh bae d leotcaaitleedd v juias tthifeic ianttieornne tth aesr efofollro.w s:
RSA's website - www.rsa-al.gov
PEEHIP information on RSA's website - www.rsa-al.gov/index.php/members/peehip/
Alabama Secretary of State's website - www.sos.alabama.gov
PEEHIP Law - Code of Alabama 1975, Title 16, Chapter 25A
Flexible Benefits Plan Law
G. Proposal Opening:
Please submit one printed non-redacted and one printed redacted copy of your proposal, and a digital copy
(non-redacted and redacted) on a USB drive in a sealed envelope with the following plainly marked on the
front:
PEEHIP
Ad-Hoc Health Benefits Consulting Proposal
RFP 26-002
Opening March 30, 2026
Proposals sent via UPS or FedEx: Proposals sent via U.S. Mail:
Taylor Benefield Taylor Benefield
Accounting Dept. Accounting Dept.
Retirement Systems of Alabama Retirement Systems of Alabama
201 South Union Street P.O. Box 302150
Montgomery, AL 36104 Montgomery, AL 36130-2150

Proposals may be hand delivered to Taylor Benefield of the Retirement Systems Building, 7th floor, 201
South Union Street, Montgomery, Alabama. Proposals will be accepted until 2:00 p.m. CST on March 30,
2026. Proposals will not be accepted after this date and time. Proposals will be opened after 2:00 p.m. CST
on March 30, 2026. PEEHIP reserves the right to reject any and all responses to this RFP.
Any questions regarding this RFP must be submitted electronically via email by March 9, 2026, at 2:00
p.m. CST to Taylor Benefield at Taylor.Benefield@rsa-al.gov.
All responses to this solicitation may be subject to public disclosure upon request. Proposers should
be aware of the Open Records Act (Ala. Code 36-12-40), the Alabama Trade Secrets Act (Ala. Code
8-27-1 and 8-27-6), and the Public Record Status of Certain Procurement Information statute (Ala.
Code 41-4-115).
Any confidential, trade secret, or proprietary commercial information contained in a proposal must
be clearly marked as such. Identification of an entire proposal as confidential is not acceptable unless
t he proposer states in detail the specific grounds and applicable laws which support treatment of the
Hen. t iKree yp rDoapteoss:a l as protected from disclosure.
RFP 26-000 KEY DATES
Activity Date
RFP to be Issued/Posted on RSA's website February 27, 2026
Deadline to Submit Questions March 9, 2026 @ 2:00 p.m. CST
Responses to Questions posted to RSA's website March 11, 2026 @ 5:00 p.m. CST
Responses Due by March 30, 2026 @ 2:00 p.m. CST
Bid Opening Date March 30, 2026
Finalist Conferences Week of April 6, 2026
Award of Bid Week of April 23, 2026
I. Scope of Services and Submission Requirements
A. Ad Hoc Service Delivery
Services provided under this RFP shall be provided on an as-needed ad hoc basis for the fiscal years
2027 through 2031. PEEHIP does not guarantee any minimum volume of work or specific
frequency of assignments. All work will be authorized by PEEHIP:
1. PEEHIP Initiation
a. PEEHIP will initiate a request for service via email, phone call or meeting to discuss an
emerging need.
2. Collaborative Scoping
a. The Vendor and PEEHIP will work together to define the necessary depth of analysis.

3. Vendor Task Summary
a. For each request, the Vendor shall provide a brief, informal Project Confirmation (via email).
This summary shall include an outline of agreed-upon tasks, the expected outcome and
anticipated staff members assigned.
b. The Vendor shall include, as part of the Vendor Task Summary, a "good faith" estimate of
the hours required to complete the task based upon the hourly rate in the Fee Schedule.
4. Task Approval
a. The Vendor shall commence work once a PEEHIP representative provides authorization of
the Vendor Task Summary
5. Ongoing Collaboration
a. For complex or evolving requests, the Vendor and PEEHIP may adjust the tasks as the
project progresses, provided any significant changes to the estimated hours are
communicated.
B. Scope of Services
The successful proposer may provide ad-hoc consulting, actuarial, compliance, and strategic
advisory services to PEEHIP as specifically assigned by PEEHIP. Services may include, but are not
limited to, the following:
1. Compliance and Regulatory Support
a. Advise and assist PEEHIP in maintaining compliance with all applicable federal and state
laws and regulations governing self-insured health benefit plans, including HIPAA, ACA,
and COBRA.
b. Conduct annual compliance audits and provide gap analysis reports with actionable
recommendations.
2. Rate and Contract Review
a. Review, analyze, and make recommendations regarding policy contracts proposed by
PEEHIP and its third-party administrators.
b. Ensure rates, contracts, amendments, and riders are complete, accurate, and actuarially sound.
c. Benchmark rates and contract terms against peer public plans and industry standards.
3. Vendor Oversight and Performance Management
a. Assist in monitoring vendor performance to ensure compliance with contractual obligations.
b. Lead vendor performance management initiatives when requested by PEEHIP
4. Procurement Support
a. Prepare bid specifications and assist in soliciting proposals from third-party administrators
and other vendors as needed.
b. Evaluate proposals based on administration capabilities, claims payment procedures,
customer service, network adequacy, financial soundness, and overall cost-effectiveness.
c. Provide technical expertise in medical and pharmacy benefit evaluation.
5. Special Reports and Analyses
a. Prepare special reports on matters of interest or concern to PEEHIP as requested.
b. Conduct trend analysis, utilization studies, and impact modeling of legislative or regulatory
changes.

6. Claims Audit Support
a. Assist in developing a claims audit schedule and selecting qualified vendors to perform
audits.
b. Support audits of medical and pharmacy claims, eligibility, and vendor compliance.
7. Legislative Monitoring and Advisory
a. Advise PEEHIP on proposed and approved legislation impacting employee health benefits
programs.
8. Strategic Benefits Planning
a. Assist PEEHIP in developing strategic benefits plan.
b. Identify strategies, goals, and objectives to provide quality, cost-effective benefits to
employees, retirees, and dependents.
9. Operational Efficiency Review
a. Review current benefits administration workflows and recommend opportunities for
improved efficiency and service delivery.
10. Reporting and Billing
a. Provide detailed monthly billing, including an accounting of hours worked by project and
area.
b. Deliver regular reports and dashboards summarizing key metrics, financial projections, and
compliance status.
C. Submission Requirements
Proposers must provide a detailed synopsis of their planned approach and relevant experience for
each of the service areas listed above. At a minimum, the response should include:
1. Approach
a. Describe your methodology for delivering the potential services, including tools, processes,
and resources.
b. Explain how your approach ensures compliance, cost-effectiveness, and timely delivery.
c. Identify any innovative strategies or best practices your firm will employ.
2. Experience
a. Summarize your firm's experience in providing similar services to large, self-insured public
employer health plans.
b. Include specific examples of past engagements, highlighting scope, outcomes, and client type
(e.g., statewide public plans, plans with greater than 100,000 covered lives).
c. Identify key personnel who might lead each service area and describe their qualifications and
relevant experience.
3. Value-Added Services
a. Outline any additional capabilities or services your firm can provide beyond the stated
requirements that would benefit PEEHIP.

Format:
Responses should be organized by the numbered service areas listed in Section A (Scope of
Services). Each section should clearly address both approach and experience.
J. Payment Schedule:
Payments will be made no more frequently than monthly based upon the firm's actual hours worked.
K. Selection of Firm(s):
PEEHIP reserves the right to make no award under this RFP. PEEHIP expects to enter into a contract with
the successful proposer(s). PEEHIP also reserves the right to award all or part of required services under
this RFP to one or more proposers, and this decision will be at the sole discretion of PEEHIP. PEEHIP
makes no guarantee that the successful proposer(s) will be the exclusive provider(s) of the services during
the term of any resulting contract. All firms submitting a proposal under this RFP will be notified in writing
within a reasonable length of time following the selection. Prior to an award of contract(s), two or more
proposers who submit proposals determined to be reasonably susceptible of being selected for award may
be requested to make oral presentations to the evaluation committee; however, proposals may be accepted,
and a final selection made, without such oral presentations. All proposals shall become the property of the
PEEHIP.
Internet and/or website links will not be accepted in responses as a means to supply any requirements stated
within this solicitation. Unless stated elsewhere in this solicitation, PEEHIP will accept and evaluate
alternate submittals on this RFP provided that the response meets all published requirements. PEEHIP
reserves the right to waive minor discrepancies or errors within proposals or to request clarification from a
proposer to the extent allowed by law.
The failure of PEEHIP to require performance of any provision of the solicitation or resulting contract shall
not affect PEEHIP's right to require performance at any time thereafter, nor shall a waiver of any breach or
default constitute a waiver of any subsequent breach or default nor constitute a waiver of the provision
itself.
L. Economy of Preparation:
Proposals should be prepared simply and economically and provide a concise description of the bidder's
response to the requirements of this RFP. Emphasis should be on clarity. PEEHIP will not be responsible
for any costs incurred by any bidder in the preparation of a proposal.
M. News Releases:
News releases pertaining to this RFP, the service, or the audits to which it relates will be made only with
prior written approval of the CEO or his representative.
N. Addenda to the RFP:
RSA may, at any time prior to the deadline for proposals, modify this RFP, including the timeline associated
with the RFP. Any modifications made to the RFP prior to the proposal's due date will be provided in
writing to all solicited vendors.

O. Contact Point:
Any questions that arise concerning this RFP may be directed to Taylor Benefield at Taylor.Benefield@rsa-
al.gov.
P. Minimum Experience Qualifications:
Proposals will be accepted from firms where both the firm and assigned consultants have the following
minimum experience qualifications:
1. The primary (supervising) actuary qualifications:
a. A Fellow of the Society of Actuaries (FSA) and Member of the American Academy of
Actuaries (MAAA), in good standing.
b. Ten years or more of health actuarial experience, including rate setting, reserve estimation,
trend analysis, benefit design pricing, and financial forecasting for large, self-funded public
employer health plans.
c. Three or more engagements in the last 5 years serving as Primary Actuary for a statewide or
public section plan of greater than 100,000 lives (medical and pharmacy combined) with at
least $500 million in total claims costs.
d. Demonstrated experience with pharmacy benefit pricing and trend management (e.g. rebates,
specialty, biosimilars), and network/provider reimbursement analytics.
e. Familiarity with ACA market reforms, mental health parity, price transparency rules, and their
financial implications for self-funded public plans.
2. The consulting or engagement lead qualifications:
a. Ten years or more of leading complex health plan consulting engagements for large, self-
funded public employer plans.
b. Three or more engagements in the last 5 years serving as consulting or engagement lead for a
statewide or public section plan of greater than 100,000 lives (medical and pharmacy
combined) with at least $500 million in total claims costs.
c. Proven responsibility for strategic plan design (medical/RX/dental/vision/indemnity),
procurement support, vendor management (TPA/PBM/wellness/MA/EGWP), and
implementation oversight.
d. Experience with benefit affordability and sustainability strategies (e.g., contribution policy,
tiering, centers of excellence, reference-based pricing, VBC arrangements).
e. Experience with data governance, performance dashboards, KPIs (trend, PMPM, avoidable
utilization), and financial stewardship (budget cycles, reserve policy, IBNR).
3. The health policy/regulatory compliance lead qualifications:
a. Ten years or more healthcare compliance experience supporting self-funded public employer
health plans.
b. Experience designing compliance frameworks, policies/procedures, training programs, and
conducting audits (internal/external), including remediation plans.
c. Demonstrated working knowledge of HIPPA Privacy/Security, HITECH, and CMS
governance.
Vendor shall provide documentation to verify that the minimum qualifications have been met, the resume(s)
of primary consultant(s) who will be assigned to the account and the resumes and bios of other staff assigned
to support this contract.