Medicare Retiree Medical Benefits Plan Provider (RFP 2904)

The County of Marin is seeking a qualified health‑insurance provider to administer a Medicare Advantage Preferred‑Provider Organization (PPO) plan for its retirees and eligible dependents beginning January 1 2027. The contractor will be responsible for full plan underwriting, enrollment processing, claims administration, member‑service support, network management, wellness programming, and reporting to the County. The solicitation emphasizes compliance with California labor and prevailing‑wage rules, performance guarantees, and a one‑year initial term with up to two one‑year extensions. • Provide a fully‑insured MAPD PPO covering medical and prescription benefits, with no deductible and a $1,500 OOP maximum. • Deliver enrollment, eligibility, and ID‑card services within 7 days, maintain 24‑hour eligibility feeds, and supply monthly utilization and cost‑driver reports. • Operate a dedicated call center (8 AM‑6 PM PST) achieving ≤5 % abandonment and ≥80 % calls answered within 30 seconds. • Meet performance guarantees (e.g., ≥97 % claim accuracy, ≥99 % pharmacy system availability) with penalties capped at 2 % of annual premium.