REQUEST FOR PROPOSAL
FOR THE STATE OF WISCONSIN
Department of Employee Trust Funds (ETF)

Medicare Advantage Plans for Medicare-Enrolled Participants in the
State of Wisconsin Group Health Insurance and Wisconsin Public Employer Programs

ETH0020


Request for Proposal (RFP) ETH0020 is issued by the Wisconsin Department of Employee Trust Funds (ETF) on behalf of the State of Wisconsin Group Insurance Board (Board). The purpose of the RFP is to provide interested and qualified vendors with information to enable them to prepare and submit competitive proposals to administer Medicare Advantage plans for Medicare-enrolled participants in the State of Wisconsin Group Health Insurance Program (GHIP) and the Wisconsin Public Employer (WPE) programs for local government employees and retirees. ETF intends to use the results of this solicitation to award a contract(s) for such services.

The contract(s) will be administered and managed by ETF, with oversight by the State of Wisconsin Group Insurance Board (Board). The RFP documents and the awarded proposal(s) will be incorporated into the contract(s).

ETF administers retirement, health, life, long-term disability, income continuation, and long-term care insurance programs for over 570,000 State and local government employees and annuitants.
The contract term for providing services for group Medicare Advantage health coverage will commence on the contract start date and extend through December 31, 2021. The Board retains the option, by mutual agreement of the Board and the contractor, to renew the contract for two (2) additional two (2) year periods extending the contract through December 31, 2025, subject to the satisfactory negotiation of terms, including pricing.

The RFP details the procedures proposers must follow to submit a proposal for Medicare Advantage services, and the minimum requirements that proposers must meet to be eligible for consideration. There are several different submission requirements proposers must follow in order to submit a proposal. Proposers must submit a form to ETF in order to receive data files from the Board’s consulting actuary to complete proposals. Proposers must submit their written proposal (and other documents) to ETF, while the cost proposal (and other documents) must be submitted to Segal. Please review the specific requirements in Sections 2 and 8 in the RFP for further details and instructions.

This solicitation is authorized under Chapter 40 of the Wisconsin State Statutes. All decisions and actions under regarding this solicitation are solely under the authority of the Board. Procurement statutes and rules that govern other State agencies may not be applicable.

Any news releases or release of broadcast e-mails pertaining to this solicitation, any resulting contract, or to the acceptance, rejection, or evaluation, or review of proposals shall not be made without the prior written approval of the State of Wisconsin or ETF.

The deadline for receipt of proposals for this solicitation is Tuesday, November 28, 2017 at 2:00 p.m. CST. Late submissions will not be considered. Questions may be submitted as indicated in the RFP via email to ETFSMBProcurement@etf.wi.gov.

RFP# RFP Title
ETH0020 Medicare Advantage Plans for Medicare-Enrolled Participants in the State of Wisconsin Group Health Insurance and Wisconsin Public Employer Programs

NOTE: All modifications and other information associated with this RFP will be posted on this web site. Interested vendors are encouraged to check this web site for updates frequently. No other notification regarding modifications will be provided.

Revision History

Date Item
August 17, 2023 Contract ETH0020 Amendment #7
September 21, 2022 Contract ETH0020 Amendment #6
January 17, 2022 Contract ETH0020 Amendment #5
August 27, 2021 Contract ETH0020 Amendment #4
October 1, 2020 Contract ETH0020 Amendment #3
August 25, 2020 Contract ETH0020 Amendment #2
September 7, 2018

Contract ETH0020 Amendment #1

May 18, 2018 Contract ETH0020

March 22, 2018

ETH0020 Notice of Intent to Award and Bid Abstract released

November 14, 2017

ETH0020 RFP Addendum No. 1 released

October 17, 2017

ETH0020 RFP Released

Request for Proposals Documents

Background Information

Title

Web Address

It’s Your Choice Open Enrollment Materials

http://www.etf.wi.gov/members/IYC2018/IYC_home.asp

It’s Your Choice 2018 Decision Guide for Retired State Employees

http://www.etf.wi.gov/publications/18et2108.pdf

Benefit Consultant November 10, 2015 Report to the Board (Second Report)

http://etf.wi.gov/boards/agenda-items-2015/gib1117/item3ar.pdf

Office of Strategic Health Policy February 9, 2016 Memo to the Board for Implementation of Benefit Consultant Recommendations

http://etf.wi.gov/boards/agenda-items-2016/gib0217/item5c.pdf

Office of Strategic Health Policy April 28, 2017 Memo to the Board on Medicare Advantage Proposals

http://etf.wi.gov/boards/agenda-items-2017/gib0524/item3e.pdf

Wisconsin Administrative Code: Chapter ETF 11 Appeals

http://docs.legis.wisconsin.gov/code/admin_code/etf/11

Wisconsin State Statutes Chapter 40

http://www.legis.state.wi.us/statutes/Stat0040.pdf

ETF Insurance Complaint Information

http://etf.wi.gov/publications/et2405.pdf

Information regarding registration and the sign-in process for the Wisconsin Department of Administration’s eSupplier portal

https://vendornet.wi.gov/GenProcurement/StrategicSourcing.aspx