Description
The State of Ohio’s Department of Administrative Services seeks a contractor to deliver comprehensive health‑care navigation services for roughly 103,000 covered members (employees, spouses, and dependents). The contractor will provide benefit education, provider selection, appointment scheduling, claims and billing assistance, cost‑transparency tools, clinical support, and integration with existing TPAs and HR platforms. The award will be a not‑to‑exceed per‑employee‑per‑month ASO fee with performance‑based “fees at risk” and requires robust reporting, SLA compliance, and a benefits fund. Key points include:
• Mandatory experience: must have delivered health‑care navigation to a public‑sector self‑insured employer covering at least 25,000 lives in the last five years.
• Scope of work covers member‑centric services, utilization management, AI/ML tools, portal integration, 24/7 toll‑free support, and quarterly reporting.
• Contract term runs through June 30 2030 (initial four‑year term) with possible renewals up to four additional years, contingent on performance.
• Evaluation combines technical (4,735 pts), cost (1,375 pts), and presentation (270 pts) scores; a technical minimum of 2,841 pts is required.