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General Information
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Department for this solicitation:
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Procurement
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Date Prepared:
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12/10/18
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Types:
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RFI
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Advertisement Type:
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Solicitation/Project#:
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000730
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Solicitation/Project Title:
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State Police Auditing
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Description:
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Vendor to perform an audit of the medical claims paid by the Commonwealth of Pennsylvania for Pennsylvania State Police Enlisted Members and applicable dependents. Claims are paid pursuant to the State Police Health Program, which is a self-insured benefit plan administered by Highmark Blue Shield acting as a Third Party Administrator for the Commonwealth. There are two contracts between the Commonwealth and Highmark Blue Shield, and the State Police Health Program must be administered according to the Pennsylvania State Police Benefits Handbook and comply with the collective bargaining agreement between the Commonwealth and the Pennsylvania State Troopers Association.
The audit will be a total, one-for-one claim audit (not a sampling) of claims incurred and paid from January 1, 2013 through December 31, 2017. The audit will also include a one year eligibility audit for the timeframe January 1, 2017 through December 31, 2017. The total number of insureds varies from month to month throughout the five year timeframe but is typically in the range of 12,000 to 14,000 (includes active enlisted members and dependents).
A final report detailing the findings of the audit will be provided to the Commonwealth of Pennsylvania and to Highmark Blue Shield. The Final Report should be detailed enough to clearly justify any findings. To the extent necessary to clearly communicate the findings to the Commonwealth and Highmark, the selected Offeror will participate in conference calls, meetings and presentations regarding the Final Report. Should any findings be disputed by Highmark Blue Shield, the selected Offeror shall provide documentation to substantiate the finding that is under dispute.
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Go to Solicitation Tabulations
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No Tabulations exist for 000730.
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Go to Awards
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No Awards exist for 000730.
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Go to Contracts
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No Contracts exist for 000730.
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