RFP 26-007 PEEHIP Ad Hoc Health Insurance 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 26-007
Issue Date: April 17, 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. Preferred 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. Sample Business Associate Agreement
H. IRS Form W-9
I. Non-Disclosure Agreement
J. IT Security Questionnaire
K. Certification of Bidder or Proposer

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 $ 77 $ 57 $ 203
HMO - VIVA $ 20 $ 18 $ 19
Optionals - CDIV - Southland $ 63 $ 60 $ 66
Flex $ 8 $ 9 $ 10
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 35,297 52,286 3,753 5,580 39,050 57,866 96,916 230,639
Supplemental 188 1,537 546 770 734 2,307 3,041 8,596
Total Hosp/Med 35,485 53,823 4,299 6,350 39,784 60,173 99,957 239,235
Humana - - 40,442 20,437 40,442 20,437 60,879 80,907
Viva Health 727 518 133 90 860 608 1,468 2,747
Total Hospital/Medical 36,212 54,341 44,874 26,877 81,086 81,218 162,304 322,889

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 19,788 39,054
Dental 24,340 45,564 28,777 30,718 53,117 76,282 129,399 272,384
Vision 8,585 13,678 7,071 9,488 15,656 23,166 38,822 81,865
Indemnity 2,608 3,825 2,503 2,249 5,111 6,074 11,185 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 applicable 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 titled:
*
* 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 included
w ithin the above documents unless a proposer provides RSA with a document clearly stating its exceptions
tOot haenry d toecrumm oern tcso tnhdati taioren c, oanlosnidge wreidt ha sa p daertt aoifl etdhi jsu RstFifPi cmataiyo nb et hloecraetfeodr .v ia the internet as follows:
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 26-007
Opening June 18, 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 June 18, 2026. Proposals
will not be accepted after this date and time. Proposals will be opened after 2:00 p.m. CST on June 18, 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 May 1, 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 the proposer states in
detail the specific grounds and applicable laws which support treatment of the entire proposal as protected from
disclosure.
H. Key Dates:
RFP 26-007 KEY DATES
Activity Date
RFP to be Issued/Posted on RSA's website April 17, 2026
Deadline to Submit Questions May 1, 2026 @ 2:00 p.m. CST
Responses to Questions posted to RSA's website May 6, 2026 @ 5:00 p.m. CST
Responses Due by June 18, 2026 @ 2:00 p.m. CST
Bid Opening Date June 18, 2026
Finalist Conferences Week of June 22, 2026
Award of Bid June 26, 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(s) may provide ad hoc consulting, actuarial, compliance, and strategic advisory
services to PEEHIP, as specifically assigned by PEEHIP. Proposers are not required to provide every
service listed below. Please provide an explanation for the items below where your firm has expertise.
PEEHIP reserves the right to make one or more awards accordingly. Services may include, but are not
limited to, the following:
1. Compliance and Regulatory Support
a. Advise and assist PEEHIP in maintaining compliance with 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. Advise PEEHIP on proposed and passed legislation impacting employee health benefits program.
6. 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.
C. Submission Requirements
Proposals must be concise and include sufficient information for PEEHIP to evaluate the proposer's
qualifications, experience, staffing, capabilities, and pricing for the service areas for which the proposer
seeks consideration.
Proposers are not required to provide a detailed narrative response for every service area listed in the Scope
of Services. Instead, proposers may respond only to the service categories for which they have expertise.
PEEHIP may make one award or multiple awards by service category or combination of service categories.
The proposal should include the following:
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 60,000 covered lives).
c. Identify key personnel who might lead each service area and describe their qualifications and relevant
experience.
Format:
Responses should be organized by the service areas proposed and should include sufficient information for
PEEHIP to evaluate the proposer's relevant experience and general approach to providing those services.

J. Payment Schedule:
Payments will be made no more frequently than monthly based upon the firm's actual hours worked. Invoices
should include detailed billing including an accounting of hours billed by approved project.
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. Preferred Qualifications:
Proposals will be accepted from firms that demonstrate substantial experience providing actuarial, consulting,
compliance, and/or strategic advisory services to large, complex self-funded public employer health plans.
Experience with statewide public plans or other large multi-employer or governmental health plans is preferred. For
key personnel proposed for this engagement, PEEHIP prefers:

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. Two or more engagements in the last 5 years serving as Primary Actuary for a statewide or public sector
plan of greater than 50,000 lives (medical and pharmacy combined) with at least $200 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. Two or more engagements in the last 5 years serving as consulting or engagement lead for a statewide
or public sector plan of greater than 50,000 lives (medical and pharmacy combined) with at least $200
million in total claims costs.
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 HIPAA Privacy/Security, HITECH, and CMS governance.
Vendor shall provide documentation supporting the firm's and proposed personnel's qualifications and relevant
experience, including resumes of the primary consultant(s) assigned to the account and resumes or bios of other
staff proposed to support this contract.
Q. Agents:
No agent fees will be payable by PEEHIP or successful bidder. PEEHIP will respond only to parties interested in
proposing and performing the services.
SECTION II
Information Required from Bidders
Proposals must be submitted in the format outlined below:
A. Qualifications of the Firm:
1. Business Organization
Provide the full legal name and address of the firm, including the office that will perform or support the
work under this RFP, and indicate the firm's legal structure and state of incorporation, if applicable. State
whether the firm is authorized to do business in the State of Alabama. Describe any material organizational
changes, mergers, acquisitions, or key personnel departures within the past twelve months that may affect
the firm's ability to perform the services proposed.