State Employee Health Benefit Plan Audit Services

The Kansas State Employee Health Benefit Plan (SEHP) in Topeka, Kansas is seeking a qualified vendor to provide comprehensive health benefit plan audit services. The agency requires an audit team that can dedicate sufficient time to the account, including availability for both telephone and on-site consultations as needed. The project aims to evaluate and verify the administration, accuracy, and compliance of the state's employee benefit programs. The scope of work covers several distinct audit areas, including a medical and dental claims audit, a pharmacy benefit manager audit, a dependent eligibility verification audit, and a premium payroll deduction reconciliation audit. For the self-funded plans, the selected vendor must document, evaluate, and comment on administrative procedures, the accuracy of plan provision applications, and the coordination of benefits with other coverage. The agency also requires evaluation of claims payment accuracy, claims processing timeliness, membership processing timeliness and accuracy, and compliance with performance guarantees. Eligible bidders must be onshore organizations based in the United States. The agency allows the performance of the work to take place both onsite in Topeka and offsite. Bidders must submit their proposals digitally via email or through the designated online system. The agency has not disclosed a specific budget and is currently looking for proposals to determine the cost of these services.