State Employee Health Benefit Plan Audit Services

The Kansas government authority is seeking a qualified audit firm to conduct comprehensive 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. Through this review, the agency aims to determine whether claims are processed and paid in accordance with plan provisions and industry standards. The scope of work includes auditing the self-insured portion of the health plan and conducting a Pharmacy Benefit Manager audit. This pharmacy 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, with the audit firm covering a three-year period for 2027, 2028, and 2029, including the right to extend the contract upon mutual agreement. Only onshore organizations based in the United States are eligible to bid on this opportunity. The agency requires the performance of the work to be conducted offsite. Bidders must submit any questions regarding the solicitation no later than June 24, 2026. The agency is looking for proposals to establish the budget for this project. Bidders may submit their responses digitally via email or through the online system. The evaluation criteria will focus on the bidder's ability to meet the specified audit requirements and standards.