Edit by LM 4/13/22 Not Apprvd


TPA Documents


Related documents for Third Party Administrators (TPA) of the employee and retiree health plans.

2021

Intent to Award Contract Long Term Care Third-Party Administrator – CHCS Services Inc.

April 30, 2021

The Division of Retirement and Benefits issued public Notice of Intent to Award the Long-Term Care Plans Administrator contract for the State of Alaska retiree long-term care plans to CHCS Services, Inc. on Friday, April 30, 2021. A 10-day protest period will follow before the contract is awarded.

  • This contract was competitively bid through a Request for Proposals (RFP) issued on March 5, 2021.
  • The new CHCS contract will take effect July 1, 2021.
  • The contract is for an initial three-year term.
  • The terms of the plans are not changing, and members will continue to receive the same benefits they do today.
  • Because the vendor is remaining the same, members should experience a seamless transition from one contract term to the next.

Background
The State of Alaska provides health insurance, including medical insurance, through the AlaskaCare plans to certain state employees, retirees, and their dependents, including persons vested in the Public Employee Retirement System (PERS), Teachers Retirement System (TRS), and Judicial Retirement System (JRS).

The AlaskaCare health plans provide medical, dental, vision, audio, and long-term care benefits for an estimated 90,000 policies with an annual combined spend of over $700 million. The plans are self-insured, meaning the state is responsible for paying the claims incurred, and are managed in the Division of Retirement and Benefits (Division). The Division hires contractors, or Third-Party Administrators, to administer the benefits including adjudicating claims, developing a network of providers, establishing the systems necessary to process claims, providing a call center for members, and other activities necessary to carry out the functions of a health plan.

Resources
More information including the proposal materials are available online here .

2019

Intent to Award Contract Medical Third-Party Administrator—Aetna

October, 17 2019

The Department of Administration intends to award Aetna the Medical Third-Party Administrator, Benefit Manager services contract for the State of Alaska employee and retiree medical plans. A 10-day protest period will follow before the contract is awarded.

  • Medical, vision, and audio services are currently provided by Aetna.
  • This is a competitive bidding process.
  • The new Aetna contract will take effect January 1, 2020.
  • The contract is for an initial 5-year term with 5 years of optional renewal periods.
  • The estimated annual cost of the contract is around $21 million.
  • The selected bidder will process an estimated 2 million claims annually for nearly 90,000 policies.

Background
The State of Alaska provides health insurance, including medical insurance, through the AlaskaCare plans to certain state employees, retirees, and their dependents, including persons vested in the Public Employee Retirement System (PERS), Teachers Retirement System (TRS), and Judicial Retirement System (JRS).

The AlaskaCare health plans provide medical, dental, vision, audio, and long-term care benefits for an estimated 90,000 policies with an annual combined spend of over $700 million. The plans are self-insured, meaning the state is responsible for paying the claims incurred, and are managed in the Division of Retirement and Benefits (Division). The Division hires contractors, or Third-Party Administrators, to administer the benefits including adjudicating claims, developing a network of providers, establishing the systems necessary to process claims, providing a call center for members, and other activities necessary to carry out the functions of a health plan.

Resources
Copies of the Request for Proposals and the official notice of intent to award are available at here .

Dental Third-Party Administrator—Delta Dental of Alaska (MODA)

August 7, 2019

The Department of Administration intends to award Delta Dental of Alaska the Dental Third-Party Administrator, Benefit Manager services contract for the State of Alaska employee and retiree dental plans. A 10-day protest period will follow before the contract is awarded.

  • These services are currently provided by Delta Dental of Alaska (MODA).
  • The new Delta Dental of Alaska contract will take effect January 1st, 2020.
  • The contract was competitively bid via a Request for Proposals issued in October 2018.
  • The contract is for an initial 5-year term with an additional 5-year optional renewal period.

Background

The State of Alaska provides health insurance, including dental insurance, through the AlaskaCare plans to certain state employees, retirees, and their dependents, including persons vested in the Public Employee Retirement System (PERS), Teachers Retirement System (TRS), and Judicial Retirement System (JRS).

The AlaskaCare dental plans provide insurance for an estimated 71,000 covered lives and have a combined annual spend of around $37 million. The plans are self-insured, meaning the state is responsible for paying the claims incurred, and are managed in the Division of Retirement and Benefits. The Division hires contractors to administer the benefits including adjudicating claims, developing a network of providers, establishing the systems necessary to process claims, providing a call center for members, and other activities necessary to carry out the functions of a health plan.

Resources
Copies of the Request for Proposals and the official notice of intent to award are available here .

New Pharmacy Benefit Manager – OptumRx

January 1, 2019

Background
On January 1, 2019, AlaskaCare changed its pharmacy benefit manager (PBM) to OptumRx. OptumRx now manages the pharmacy benefit for all our members, including retail, mail order and specialty prescription drugs, claims processing, and prior authorization requests for prescription medications.

Page Last Modified: 05/12/22 18:52:06