Dickenson County Public Schools Seeking Proposals from Qualified Providers of Healthcare and Prescription Drug

Background

Dickenson County Public Schools (DCPS), located in Clintwood, Virginia, is seeking proposals for its healthcare and prescription drug programs. The goal is to secure a provider that can effectively manage these services with an effective date starting July 1, 2026. DCPS is currently partially self-funded and has 237 employees. The agency aims to enhance its employee benefits offerings through this RFP process.

Work Details

The selected provider will be responsible for the following services: - Automated processing and payment of medical and prescription drug claims - Utilization review - Case management - Stop loss reporting - Third-party recovery - Coordination of medical coverage Specific tasks include maintaining a master file of plan documents, verifying eligibility for benefits, designing and updating forms related to claims processing, reviewing claims submitted by participants or providers, determining reasonableness of charges, preparing checks or electronic payments, managing customer service inquiries, coordinating with a transparent pass-through pharmacy benefit manager (PBM), providing utilization review services, and ensuring compliance with federal/state laws regarding coordination of benefits. Additionally, the provider must handle subrogation efforts for recoveries related to third-party liabilities and manage overpayments.

Period of Performance

The contract will commence on July 1, 2026, following the selection process which concludes on June 23, 2026.

Place of Performance

The services will be performed primarily in Clintwood, Virginia, with potential considerations for surrounding areas as specified in the proposal guidelines.

Bidder Requirements

Proposals are accepted from licensed healthcare providers including Third Party Administrators (TPAs), reinsurers, and fully insured carriers. Bidders must demonstrate expertise in employee benefit services and maintain sufficient staffing resources. They are required to execute a Bid Proposal Form included in the RFP documentation.