Administrative Services Only to Perform as Third-Party Administrator for the...

Location:	Tennessee
Posted:	Oct 29, 2025
Due:	Dec 10, 2025
Agency:	State Government of Tennessee
Type of Government:	State & Local
Category:	R - Professional, Administrative and Management Support Services
Solicitation No:	RFP 31786-00187
Publication URL:	To access bid details, please log in.

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03-05-25 RFP

STATE OF TENNESSEE

DEPARTMENT OF FINANCE AND ADMINISTRATION

REQUEST FOR PROPOSALS FOR

ADMINISTRATIVE SERVICES ONLY TO PERFORM AS

THIRD-PARTY ADMINISTRATOR FOR THE STATE’S

THE TENNESSEE PLAN (A self-insured supplemental

medical insurance plan for retirees with Medicare)

RFP # 31786-00187

RFP CONTENTS

SECTIONS:

INTRODUCTION

RFP SCHEDULE OF EVENTS

RESPONSE REQUIREMENTS

GENERAL CONTRACTING INFORMATION & REQUIREMENTS

EVALUATION & CONTRACT AWARD

ATTACHMENTS:

6.1. Response Statement of Certifications & Assurances

6.2. Technical Response & Evaluation Guide

6.3. Cost Proposal & Scoring Guide

6.4. Reference Questionnaire

6.5. Score Summary Matrix

6.6. Pro Forma Contract

RFP #31786-00187

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APPENDICES:

7.1 Plan Document for The Tennessee Plan

7.2 Enrollment History

7.3 Benefits Administration 834 Guidance Manual

7.4 HIPAA Business Associate Assessment

7.5 Claims History

7.6 Written Questions & Comments Template

03-05-25 RFP

RFP #31786-00187

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INTRODUCTION

The State of Tennessee, State Insurance Committee; hereinafter referred to as “the State,” issues this

Request for Proposals (RFP) to define minimum contract requirements; solicit responses; detail response

requirements; and outline the State’s process for evaluating responses and selecting a contractor to

provide the needed goods or services.

Through this RFP, the State seeks to procure necessary goods or services at the most favorable,

competitive prices and to give ALL qualified respondents, including those that are owned by minorities,

women, service-disabled veterans, persons with disabilities and small business enterprises, an

opportunity to do business with the state as contractors, subcontractors or suppliers.

1.1 Statement of Procurement Purpose

The State is issuing this RFP through the Department of Finance and Administration, Division of Benefits

Administration (Benefits Administration), with the intent to secure a single contract for administrative

services as a Third-Party Administrator (“TPA”) for the State’s self-insured The Tennessee Plan (“Plan”),

supplemental medical insurance for retirees covered by Medicare. The awarded contract will be effective

mid-year 2026 for required implementation while the delivery of services to Members shall begin on

January 1, 2027. Presently the State has a contract with UMR, Inc. The current contract with UMR

expires on June 30, 2028, with the period January 1, 2027, through June 30, 2028, being a claims runout

period only.

The State wishes to continue, through this competitive procurement process, offering the Plan to qualified

retirees and their dependents. The benefits for the Plan are similar to those found in NAIC Medigap

Model D. Benefits and eligibility criteria for retirees and their dependents to participate in the Plan may be

found in the PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION FOR THE TENNESSEE PLAN

(Supplemental Medical Insurance for Retirees with Medicare) at Appendix 7.1 to this RFP.

1.1.2. The maximum liability for the resulting contract will be determined through the best evaluated cost

proposal and estimated cost associated with this service. The maximum liability will exceed one dollar

($1.00).

1.2. Scope of Service, Contract Period, & Required Terms and Conditions

The RFP Attachment 6.6., Pro Forma Contract details the State’s requirements:

▪ Scope of Services and Deliverables (Section A);

▪ Contract Period (Section B);

▪ Payment Terms (Section C);

▪ Standard Terms and Conditions (Section D);

▪ Special Terms and Conditions (Section E);

▪ Attestation Re Personnel Used in Contract Performance (Attachment A);

▪ Liquidated Damages (Attachment B);

▪ Reporting Requirements (Attachment C);

▪ Service Level Agreement Scorecard (Attachment D); and

▪ HIPAA Business Associate Agreement with Privacy and Security Rules (Attachment E).

The pro forma contract substantially represents the contract document that the successful Respondent

must sign.

1.3. Nondiscrimination

No person shall be excluded from participation in, be denied benefits of, or be otherwise subjected to

discrimination in the performance of a Contract pursuant to this RFP or in the employment practices of the

RFP #31786-00187

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Contractor on the grounds of handicap or disability, age, race, creed, color, religion, sex, national origin,

or any other classification protected by federal, Tennessee state constitutional, or statutory law. The

Contractor pursuant to this RFP shall, upon request, show proof of such nondiscrimination and shall post

in conspicuous places, available to all employees and applicants, notices of nondiscrimination.

1.4. RFP Communications

1.4.1. The State has assigned the following RFP identification number that must be referenced in all

communications regarding this RFP:

RFP # 31786-00187

1.4.2. Unauthorized contact about this RFP with employees or officials of the State of Tennessee

except as detailed below may result in disqualification from consideration under this

procurement process.

1.4.2.1. Prospective Respondents must direct communications concerning this RFP to the

following person designated as the Solicitation Coordinator:

Heather Pease

Director of Procurement and Contracts

Tennessee Department of Finance & Administration, Division of Benefits Administration

312 Rosa L. Parks Avenue, Suite 1900

Nashville, Tennessee 37243

heather.pease@tn.gov

cc: vanessa.watson@tn.gov

Telephone: 615.253.1652

Fax: 615.253.8556

1.4.2.2. Notwithstanding the foregoing, Prospective Respondents may alternatively contact:

The following individual designated by the State to coordinate compliance with

the nondiscrimination requirements of the State of Tennessee, Title VI of the

Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, and

associated federal regulations:

Lucian Geise, General Counsel

Tennessee Department of Finance & Administration

312 Rosa L. Parks Avenue, Suite 1900 Nashville, Tennessee 37243

Phone Number: 615-532-9617

Fax:615-532-8532

FA.CivilRights@tn.gov

1.4.3. Only the State’s official, written responses and communications with Respondents are binding

with regard to this RFP. Oral communications between a State official and one or more

Respondents are unofficial and non-binding.

1.4.4.

Potential Respondents must ensure that the State receives all written questions and comments,

including questions and requests for clarification, no later than the Written Questions &

Comments Deadline detailed in the RFP Section 2, Schedule of Events. Respondents should

submit written questions and comments on Appendix 7.6 the written questions and comments

template.

1.4.5.

Respondents must assume the risk of the method of dispatching any communication or response

to the State. The State assumes no responsibility for delays or delivery failures resulting from the

Respondent’s method of dispatch. Actual or digital “postmarking” of a communication or

response to the State by a specified deadline is not a substitute for the State’s actual receipt of a

RFP #31786-00187

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communication or response. It is encouraged for Respondents to submit bids digitally.

1.4.6. The State will convey all official responses and communications related to this RFP to the

prospective Respondents from whom the State has received a Notice of Intent to Respond (refer

to RFP Section 1.8).

1.4.7.

The State reserves the right to determine, at its sole discretion, the method of conveying official,

written responses and communications related to this RFP. Such written communications may

be transmitted by mail, hand-delivery, facsimile, electronic mail, Internet posting, or any other

means deemed reasonable by the State. For internet posting, please refer to the following

website: https://www.tn.gov/generalservices/procurement/central-procurement-office--cpo-

/supplier-information/request-for-proposals--rfp--opportunities1.html.

1.4.8. The State reserves the right to determine, at its sole discretion, the appropriateness and

adequacy of responses to written comments, questions, and requests related to this RFP. The

State’s official, written responses will constitute an amendment of this RFP.

1.4.9.

Any data or factual information provided by the State (in this RFP, an RFP amendment or any

other communication relating to this RFP) is for informational purposes only. The State will make

reasonable efforts to ensure the accuracy of such data or information, however it is the

Respondent’s obligation to independently verify any data or information provided by the State.

The State expressly disclaims the accuracy or adequacy of any information or data that it

provides to prospective Respondents.

1.5. Assistance to Respondents With a Handicap or Disability

Prospective Respondents with a handicap or disability may receive accommodation relating to the

communication of this RFP and participating in the RFP process. Prospective Respondents may contact

the Solicitation Coordinator to request such reasonable accommodation no later than the Disability

Accommodation Request Deadline detailed in the RFP Section 2, Schedule of Events.

1.6. Respondent Required Review & Waiver of Objections

1.6.1.

Each prospective Respondent must carefully review this RFP, including but not limited to,

attachments, the RFP Attachment 6.6., Pro Forma Contract, and any amendments, for questions,

comments, defects, objections, or any other matter requiring clarification or correction (collectively

called “questions and comments”).

1.6.2. Any prospective Respondent having questions and comments concerning this RFP must provide

them in writing to the State no later than the Written Questions & Comments Deadline detailed in

the RFP Section 2, Schedule of Events.

1.6.3. Protests based on any objection to the RFP shall be considered waived and invalid if the

objection has not been brought to the attention of the State, in writing, by the Written Questions &

Comments Deadline.

1.7. Pre-Response Conference

A Pre-response Conference will be held at the time and date detailed in the RFP Section 2, Schedule of

Events. Pre-response Conference attendance is not mandatory, and prospective Respondents may be

limited to a maximum number of attendees depending upon overall attendance and space limitations.

The conference will be held at:

Join from the meeting link

https://tn.webex.com/tn/j.php?MTID=m9a36411bde2acbed8a4fe7a5db0322c6

Join by meeting number:

RFP #31786-00187

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This is the opportunity summary page. It provides an overview of this opportunity and a preview of the attached documentation.

Document ID & Hyperlink:	RFP 31786-00187 Cost Proposal Digital Submission Instructions Amendment 1 Appendix 7.1 Appendix 7.2 Appendix 7.3 Appendix 7.4 Appendix 7.5 Appendix 7.6
Event Start - Response Due:	09/23/2025 12/10/2025
Event Name:	Administrative Services Only to Perform as Third-Party Administrator for the State's The Tennessee Plan (a self-insured supplemental medical insurance plan for retirees with Medicare) - UPDATED
Last Updated:	10/29/2025

Administrative Services Only to Perform as Third-Party Administrator for the State's The Tennessee Plan (a self-insured supplemental medical insurance plan for retirees with Medicare) - UPDATED

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