Medical, Prescription Drug, Specific Stop-Loss Coverage Plans

Frederick County, Maryland is seeking a Medical, Prescription Drug, and Specific Stop‑Loss plan administrator/insurer capable of delivering competitive coverage supported by high‑quality administrative and member services.

Project Details

• Reference ID: 26-413
• Department: Division of Human Resources
• Department Head: TBD (TBD)

Important Dates

• Questions Due: 2026-05-01T20:00:31.011Z
• Pre-Proposal Meeting: 2026-04-29T19:00:06.509Z — Microsoft Teams

Evaluation Criteria

• Technical Evaluation: Medical (35 pts)
• Technical Evaluation: Drug (20 pts)
• Technical Evaluation: Stop-Loss (10 pts)
• Price Evaluation - Medical (15 pts)
• Price Evaluation - Drug (10 pts)
• Price Evaluation - Stoploss (5 pts)
• Best and Final Offers (5 pts)
• Interview Evaluation (10 pts)

Submission Requirements

• Technical Proposal Signature Page (required) —

  Please download the below document, complete, and upload.

• Acknowledgement of Addenda (required) —

  Please download the below document, complete, and upload.

• Affidavit Form (required) —

  Please download the below document, complete, and upload.

• Two (2) Certifications of Compliance (required) —

  Please download the below document, complete, and upload.

• Insurance Requirements (required) —

  Please download the below document, complete, and upload.

• MEDICAL & SL RFP BIDFORMS (required) —

  Please download the below document, complete, and upload.

• DRUG RFP BIDFORMS (required) —

  Please download the below document, complete, and upload.

• STOP-LOSS RFP BIDFORMS (required) —

  Please download the below document, complete, and upload.

• DRUG RFP Pharmacy Exhibit (required) —

  Please download the below document, complete, and upload.

• DRUG RFP Repricing File (required) —

  Please download the below document, complete, and upload.

• Additional RFP Attachments (required) —

  Upload the below attachments as requested per the Bid Forms:

  Medical/Stop-Loss Form
  Form #	Q #	Description
  TF 1.0	A	Prepare a detailed schedule and time frame to implement this program by the effective date.
  TF 1.0	B	Attach a description of premium or administrative fee billing procedures.
  TF 1.0	C	Describe your criteria and process for network provider selection.
  TF 1.0	11	Please provide a full listing of proposed team members, inclusive of implementation, wellbeing, & member support
  TF 1.0	17	Provide a copy of the most recent member satisfaction survey and corporate results.
  TF 1.0	24	Provide a sample file layout and specifications
  TF 1.0	42	How often do you audit the accuracy of plan program pricing and overall adjudication accuracy?  Describe how this will be shared with the client.  Please provide the results of your most recent audit.
  TF 1.2	12	Provide samples of your standard reporting package. Include samples for all product lines you are proposing.
  TF 1.2	49	Provide a sample annual client wellness calendar  listing specific initiatives and events for each month of the year.
  TF 1.2	50	Provide samples of the wellness management reports you would typically provide as part of your basic services. Indicate which reports are available online.
  TF 1.2	57	Please provide sample client report(s) showing results of Case Management, Disease Management and other health management programs on a year-to-year comparison and against a benchmark.
  FF 1.0	A	Performance Guarantees
  FF 1.0	B	Clinical/Disease Management Performance Guarantees
  FF 1.0	C	In-Network Utilization Guarantee
  FF 1.0	D	Trend OR Discount Guarantee
  FF 1.0	E	Description of any Cross Sell Discounts (i.e. stop loss, etc.)
  FF 1.0	F	Descriptions of any other guarantees or financial offers should be attached
  FF 1.0	G	Provide a sample contract.
  FF 1.0	H	Formal fee and rates proposed on company letterhead
  Pharmacy Form
  TF 1.3	4	Describe your Clinical Prior Authorization (PA) programs. Please provide your standard PA list.
  TF 1.3	31	Please provide a detailed list of real-time utilization review elements at retail and mail.
  TF 1.3	32	Please provide a detailed list of retrospective DUR areas examined at retail and mail.
  TF 1.5	1	Please provide a detailed description and copy of the data elements required for the initial eligibility file upload.
  TF 1.6	16	Please list the number of manufacturers with whom you have rebate agreements.
  TF 1.8	7	Provide samples of new member information materials that will be included with the mailing of ID cards – include a description of all data elements that appear on ID cards.
  TF 1.10	1	Describe your standard reporting package and include samples.
  TF 1.10	15	Provide an example of reports that will document the impact of clinical interventions.
  TF 1.12	4	Provide a list of your Exclusive specialty products.
  TF 1.13	4	If a program is manual, please provide a flow chart that illustrates the steps involved and responsibilities associated with each step for both the member and plan sponsor.
  TF 1.13	14	What reporting is provided for each program after implementation? Please include examples and frequency.
  Stop-Loss Only Form
  TF 1.0	A	Please describe the implementation process for a January 1, 2027 effective date. Please outline key dates and which parties are responsible for each step in the implementation process.
  TF 1.0	B	Detail your general and professional liability coverage currently in place to protect Frederick County Government from losses or negligence.
  TF 1.0	C	Describe any services you provide that are located in the Frederick County service area.
  TF 1.0	D	Describe your organization’s resources in and around the Frederick County service area.
  TF 1.0	E	Provide a copy of your most recent SOC1 and SOC2 reports. If not available, please indicate when the report(s) will be ready.
  TF 1.0	F	Assuming a contract award date of August 1st, 2026, provide a detailed schedule and time frame to implement this program by the effective date. Please indicate the implementation responsibilities of your organization and Frederick County Government.
  TF 1.0	G	Please provide an organizational chart identifying the role of the account team that will be responsible for providing the administrative services to Frederick County Government.

• Is this project for Services or Commodities? (required)
• Pricing (required) —
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    • This is a quote for goods or commodities.
    • This is a public works bid, with a pricing table that can be uploaded into OpenGov Procurement from an Excel spreadsheet.
    • Seeking services for hourly rate schedules.
  • Choose Option 2 when you need vendors to provide you with the line items.
• Will there be a Pre-Proposal Conference? (required)
• Attendance for Pre-Proposal Conference (required)
• Phone Number for Vendors to Call-In for Pre-Proposal Conference (required)
• Will there be a Site Visit for this project? (required)
• Attendance for Site Visit (required)
• Date of Site Visit (required)
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• Tentative Presentation/Interview Dates (required)
• Agreement Term (required)
• Is a Bid Deposit applicable to your project? (required)
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• Can you provide the Estimated Contract Value Group for the resulting contract? (required)
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• Description of items/services (required)
• Minimum Years of Experience (required) —

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• How the County is going to award this project (required) —
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• Length of Contract Period (required) —

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• Contract Start Date (required)
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• Number of Years Prices are protected from increase (Spelled out) (required)
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• Type of Item/Service being solicited (required)