McAllen ISD To Award TPA Contract – Proposed ASO Agreement Made Public

missionimpo

Mr. Phelps of Mission Impossible

Your mission Jim, should you decide to accept it, is to review all documents to ensure best value for the McAllen Independent School District. As always, should you or any of your staff be caught or killed, the Secretary will disavow any knowledge of your actions. This pdf will self-destruct in five seconds. Good luck Jim.

By Molly Mulebriar

McAllen Independent School District initiated a competitive Request for Proposal process for third party administrator for the district’s self-funded employee health & welfare plan several months ago.

The Board of Trustees is expected to approve the proposal submitted by Blue Cross & Blue Shield this week. Once the contract award is made, the RFP process ends unless ended sooner through a RFP addendum or declaration. 

It is unclear whether the RFP process is still active in this case. If it is, the contents of vendor’s RFP responses would necessarily be kept confidential as is the custom under RFP protocols as we understand them.

We assume the RFP process has been concluded since the McAllen ISD website has posted details of the winning proposal to be recommended to the Board of Trustees later this week.

https://v3.boardbook.org/Public/PublicItemDownload.aspx?ik=39165920

https://v3.boardbook.org/Public/PublicItemDownload.aspx?ik=39165922

Some of these documents provide a warning against breach of confidential documents:

“Confidential Information of Claim Administrator. Not for use or disclosure outside Claim Administrator, Employer, their respective affiliated companies and third party representatives, except with written permission of Claim Administrator.”

One could assume BCBS provided McAllen ISD with permission to place these documents in the public domain. Smart money finds that unlikely, giving 10 to 1 odds.

The City of McAllen, on the other hand, keeps their public records closely guarded. For example, the city kept secret how much taxpayer money it paid for singer Enrique Iglesias to perform at a holiday concert.

http://www.star-telegram.com/opinion/opn-columns-blogs/other-voices/article93333662.html

A quick comparison of documents brings more questions than answers. Do pricing spreadsheets accurately reflect fees to be charged via the Agreement? Are some fees such as shared savings fees, provider incentive fees, non-specified surcharge fees, supplemental charges, provider access fees, and the $10 supplemental charge ” for each qualified beneficiary apart from service charges detailed in the fee schedule” reflective in the spreadsheets?

Have the pricing of competing vendors been accurately displayed?

Pricing spreadsheets are useful in the evaluation process. Other considerations such as contract language is equally important. For example, how does the BCBS ASO Agreement compare to the other vendors? What was the evaluation criteria used for the PPO re-pricing exercise? Were 100% of historical claims compared, or a small sample? Were PPO contracts reviewed and compared by each vendor? We can’t determine based on the information upon which the Board of Trustees will make a decision.

The McAllen Independent School District is to act on awarding TPA services on Monday, August 7.

 

 

 

 

 

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