RFP - Third-party Health Plan Claims Administration Service

Notice is hereby given that the Board of County Commissioners of Lewis and Clark County, Montana are soliciting competitive proposals from interested parties to provide claims administration services for its self-funded health benefit plan. Such services include, but are not limited to, claims processing, “value-added” services that assist the County in measuring the quality and cost of care provided to plan participants, plan analysis, and other administrative services.

The complete solicitation is available under the Related Information section of this webpage . Questions related to this solicitation must be directed only to the designated point of contact for this solicitation: Casey Hayes, Purchasing Officer, chayes@lccountymt.gov. A cone of silence is established for this solicitation which prohibits any offeror, or entity with financial interest in the contract award, from communicating regarding the solicitation with any Lewis and Clark County elected official, employee, or agent other than the designated point of contact.

The deadline for proposals to be delivered to the Lewis and Clark County Commissioner’s Office, located at the City-County Administrative Building, 316 North Park Avenue, Room 345, Helena, MT is on or before 4:00 PM local time on February 18, 2025 . The sealed envelope containing the proposal must be labeled, “Third-party Health Plan Claims Administration Services Proposal Enclosed.” Late proposals are not accepted.

The County reserves the right to reject any or all proposals received, to waive informalities, to postpone the award of the contract for a period not to exceed 60 days, and to accept the proposal that is in the best interest of the County. Offerors shall be bound to the terms and conditions listed in the solicitation.

This solicitation is being offered in accordance with federal and state statutes and county regulations governing procurement. Proposals become the property of Lewis and Clark County. The County is not responsible for costs associated with preparing a proposal.

• Third-party-Health-Plan-Claims-Administration-Services-RFP.pdf (PDF, 786KB)
• Exhibit-A-Summary-Plan-Description-and-Amendments-1-2-and-3.pdf (PDF, 27MB)
• Exhibit-B-Paid-Claims-and-Enrollment-by-Month.xlsx (XLSX, 15KB)
• Exhibit-C-Census.xlsx (XLSX, 40KB)
• Exhibit-D-Paid-Claims-Data-Sample-for-Pricing.xlsx (XLSX, 74KB)
• Exhibit-E-Top-Providers-List.xlsx (XLSX, 18KB)
• Exhibit-F-Top-25-CPT-Codes.xlsx (XLSX, 12KB)