City of Canton Quote

Title: City of Canton Stop-Loss Insurance

Deadline: 1/7/2025 4:00 PM   (UTC-05:00) Eastern Time (US & Canada)

Status: Awarded

Quote Number: 2024-86

Description: City of Canton Stop-Loss Insurance


Documents:

Documents as of 12/18/2024
City_of_Canton_Stop_Loss_RFP_2024_Specifications.pdf
Form_of_Proposal_Stop_Loss_Insurance.xlsx
Stop_Loss_RFP_Appendices_I_IV.zip
Addition 2

Posted: 12/31/2024

Type of Addition: Addendum 2

Overview: Addendum 2

Deadline: 1/7/2025 4:00 PM

Documents:

Addition 3

Posted: 2/28/2025

Type of Addition: Jefferson Health Plan

Overview: Final award is subject to the City's contracting process and the Auditor's certification of funds.

Question 1

Posted: 12/19/2024

Question: Please provide a separate PBM report from OptumRx (or Aultcare since they were the once who placed it) for the following years: 2/2022 - 1/2023; 2/2023 - 1/2024; 2/2024 - 11/2024. Report should include member names or ID numbers, Rx cost details; and include drugs greater than $5k. Ken knows this report structure.

Response: Please see Addendum 1

Question 2

Posted: 12/20/2024

Question: Please provide a high cost claimant report for 2/2022 - 1/2023. The report should have medical diagnoses included. Thank you.

Response: Please see Addendum 1

Question 3

Posted: 12/30/2024

Question: - Please provide final plan document for all medical/rx plans effective 2/1/2024 - HCC Report ran 2/23-1/24 please provide true diagnosis/IDC10 code, treatment plan, staging for claimants 1,3,4,8 - HCC Report ran 2/24-11/24 please provide true diagnosis/IDC10, treatment plan, staging and projected claims costs for claimant 6

Response: Please see addendum 2.

Question 4

Posted: 12/30/2024

Question: Please provide a high-cost claimant report ran 2/2022 - 1/2023 to include medical diagnosis and ICD10 codes.

Response: Please see addendum 2.

Posted: 12/31/2024

Type of Addition: Addendum 2

Overview: Addendum 2

Deadline: 1/7/2025 4:00 PM

Documents:

Posted: 2/28/2025

Type of Addition: Jefferson Health Plan

Overview: Final award is subject to the City's contracting process and the Auditor's certification of funds.

Posted: 12/19/2024

Question: Please provide a separate PBM report from OptumRx (or Aultcare since they were the once who placed it) for the following years: 2/2022 - 1/2023; 2/2023 - 1/2024; 2/2024 - 11/2024. Report should include member names or ID numbers, Rx cost details; and include drugs greater than $5k. Ken knows this report structure.

Response: Please see Addendum 1

Posted: 12/20/2024

Question: Please provide a high cost claimant report for 2/2022 - 1/2023. The report should have medical diagnoses included. Thank you.

Response: Please see Addendum 1

Posted: 12/30/2024

Question: - Please provide final plan document for all medical/rx plans effective 2/1/2024 - HCC Report ran 2/23-1/24 please provide true diagnosis/IDC10 code, treatment plan, staging for claimants 1,3,4,8 - HCC Report ran 2/24-11/24 please provide true diagnosis/IDC10, treatment plan, staging and projected claims costs for claimant 6

Response: Please see addendum 2.

Posted: 12/30/2024

Question: Please provide a high-cost claimant report ran 2/2022 - 1/2023 to include medical diagnosis and ICD10 codes.

Response: Please see addendum 2.