Fully Insured Medical Plans for PEBB and SEBB

The Washington State Health Care Authority is seeking licensed carriers to provide up to three fully insured medical health plans each for the Public Employees Benefits Board and School Employees Benefits Board programs, including administration, clinical management, claims processing, data reporting, and provider-network services.

Washington > Health Care Authority


General
Open
2025HCA5
Jan 14, 2027 12:00 PM
Oct 12, 2026 12:00 PM
5 years base + 7 × 1 year options
Request for Proposal (RFP)
State
Ask AI about this solicitation
Original Solicitation Links
Contact
sean.gregory@hca.wa.gov
+13607251348
Submission Instructions
Email
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
NAICS524114Direct Health and Medical Insurance Carriers
PSCG007Government Health Insurance Programs
Smart Codes
fully insured health planshealth plan administrationhealth insurance claims processing
Specifications
Service
Timeline
Oct 20, 2026 06:00 PM-Pre-Proposal Conference (optional)
Meeting ID: 229 427 348 778 832; Passcode: Ea6Zs9Li; dial in: +1 564-999-2000,,284006060#; toll-free: (833) 322-1218,,284006060#; conference ID: 284 006 060#
Oct 23, 2026 11:00 PM-Letter of Intent to Propose Due
Oct 29, 2026 04:30 PM-Finance Rate Instruction Conference (required)
Held via a video-conferencing tool at HCA's discretion; invitation provided to bidders that submit a Letter of Intent to Propose.
Nov 6, 2026-Bidder Round 1 Questions Due
Nov 13, 2026-HCA Answers Posted
Dec 4, 2026-Bidder Round 2 Questions Due
Dec 15, 2026-Interested Subcontractor Responses Due
Jan 7, 2027-Complaints Due
Jan 14, 2027 11:00 PM-Proposal Due
May 28, 2027-Apparent Successful Bidder(s) Announcement
Requirements
Required
  • 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
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