State Employee Health Benefit Plan Audit Services

The Kansas State Employee Health Benefit Plan (SEHP) in Topeka, Kansas is seeking a vendor to provide comprehensive health benefit plan audit services. The agency requires an audit team that can devote dedicated time to the account, including availability for telephone and on-site consultations as needed. The project aims to evaluate and verify the administration of the state's employee benefit programs through multiple specialized audits. The scope of work covers a medical and dental claims audit for self-funded plans, which requires the vendor to document, evaluate, and comment on administrative procedures, accuracy of plan provision applications, and coordination of benefits. This audit also includes assessing the accuracy of claims payments, claims processing timeliness, membership processing timeliness and accuracy, and compliance with performance guarantees. Additionally, the selected vendor must perform a pharmacy benefit manager audit, a dependent eligibility verification audit, and a premium payroll deduction reconciliation audit. Eligible bidders must be onshore organizations based in the United States. The agency allows the performance of the work to take place both onsite and offsite. Bidders must submit their proposals digitally via email or through the designated online portal, and the agency is currently open to receiving budget proposals for these services.