Medicare Advantage PPO Plan for Retirees

Fairfax County Public Schools is seeking proposals for a fully insured Medicare Advantage PPO plan providing medical and vision benefits for eligible Medicare retirees and dependents, coordinated with an existing self-insured prescription drug wrap program and beginning January 1, 2028.

Fairfax County Public Schools > Department of Facilities and Capital Programs

General

Status:Open

Solicitation Identifier:2000004432

Due Date:Nov 06, 2026 10:00 PM

Posted Date:Oct 12, 2026 04:00 PM

Contract Period:5 years base + 3 × 1 year options

Type:Request for Proposal (RFP)

Level:Local

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Original Solicitation Links

[

RFP-129822

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rfp 2000004432 group medicare advantage plan

rfp1012267

[

2000004432

]

group medicare advantage plan

Contact

Name:Adrien Walker

Email:awalker@fcps.edu

Phone:+15714233593

Address:8115 Gatehouse Road, Falls Church, VA, USA

Submission Instructions

Method:Online

Portal:https://fcps.bonfirehub.com

Description

Fairfax County Public Schools is soliciting proposals for a fully insured, passive preferred provider organization/open-access Medicare Advantage plan providing medical and vision benefits to eligible Medicare retirees and covered dependents. The selected vendor must provide a national Medicare Advantage PPO network meeting Centers for Medicare and Medicaid Services network adequacy standards and directly administer provider network development and management, claims adjudication and payment, utilization management, member services, compliance, implementation, reporting, care management, prior authorization, grievances and appeals, and related participant communications. The plan must coordinate with FCPS’s existing self-insured Employer Group Waiver Plan prescription drug wrap program administered by SilverScript; proposals covering only part of the required services will be rejected. The contract is scheduled to begin January 1, 2028, or the award date, whichever is later, and terminate December 31, 2032, with up to three additional one-year renewal periods. Minimum qualifications include experience serving at least three public-entity plans with 5,000 or more participants each, at least eight years of national Medicare Advantage PPO experience, coverage of at least 100,000 lives, CMS compliance, a minimum four-star CMS rating over the prior three years, required Virginia and Fairfax County licensing, and specified financial strength and insurance standards. The response requires extensive completed technical, cost, security, accessibility, HIPAA, confidentiality, network-analysis, utilization-analysis, premium-development, and performance-guarantee materials, including supporting exhibits and financial statements.

Title	Date Posted
rfp1012267	Oct 12, 2026 01:13 PM
APPENDIX C - Confidentiality Provisions - Employee.doc	-
APPENDIX E - FCPS Vendor Acceptance Questionnaire.xlsx	-
APPENDIX F - FCPS Security Assessment Questionnaire.xlsx	-
APPENDIX H - Technical Proposal.xlsx	-
APPENDIX L - Attestation of Digital Accessibility Form.docx	-
APPENDIX G - Minimum Qualifications.xlsx	-
APPENDIX J - Premium Development MA.xlsx	-
DPMM COVER SHEET.pdf	-
APPENDIX D - Non Disclosure Agreement.docx	-
Announcement Sheet.pdf	-
APPENDIX A - GCIB.pdf	-
APPENDIX B - Forms.pdf	-
APPENDIX I - Cost Proposal.xlsx	-
APPENDIX K - HIPAA Business Associate Agreement.docx	-