Fully Insured Medical Plans for PEBB and SEBB
Washington > Health Care Authority
Original Solicitation Links
2025HCA5
]Fully-Insured Medical Plans
Contact
Submission Instructions
Description
The Washington State Health Care Authority is soliciting proposals from licensed carriers to provide up to three fully insured medical health plans for each of the Public Employees Benefits Board and School Employees Benefits Board programs. Plans offered to the two programs must have identical designs, with separate rating for each program, and must maintain a federal actuarial value between 80% and 92%. Carriers must provide coverage in at least two Washington counties, with broader statewide coverage evaluated favorably. The scope includes plan design and administration, enrollment and eligibility processing, claims adjudication and payment, member services, provider-network management, prescription and medical drug benefits, utilization and prior authorization management, care coordination, health equity and social-determinants-of-health initiatives, value-based purchasing, implementation, secure data exchange, and detailed reporting. Proposals must address mandatory attestations, Phase 1 and conditional Phase 2 written responses, PEBB and SEBB cost proposals, service area, plan design, Bree Collaborative requirements, subcontractors, and supporting actuarial and data materials. Minimum qualifications include Washington insurance licensure, at least 10,000 fully insured lives, NCQA health-plan accreditation, an AM Best rating of A- or better, and United States-based administrative services.
Classification Codes
Smart Codes
Specifications
Timeline
Requirements
- Commercial General Liability — $1,000,000.00
- Business Automobile Liability — $1,000,000.00
- Professional Liability Errors and Omissions — $1,000,000.00
- Industrial Insurance
Documents
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