State Employee Health Benefit Plan Audit Services

The Kansas government authority is seeking a qualified audit firm to conduct audits of the self-insured portion of the State Employee Health Plan. The agency needs to ensure that claims processing accuracy and timeliness standards are met, and that membership processing is handled accurately, timely, and efficiently. The review must determine whether claims are processed and paid in accordance with plan provisions and industry standards. The scope of work covers audits of the self-insured portion of the health plan and a Pharmacy Benefit Manager audit. The Pharmacy Benefit Manager audit requires a review of plan limits, prior authorizations, point of sale rebates, and drug exclusions. The agency is requesting these services for a contract period of two years, though the audit coverage spans a period of three years for 2027, 2028, and 2029, with the right to extend the contract as mutually agreed upon. Eligibility is restricted to onshore, USA-only organizations. The agency requires the performance of the work to be completed offsite. Bidders must submit all questions no later than June 24, 2026. The agency accepts digital response submissions via email or online, and the evaluation will consider proposals based on the submitted budget details.