Health Benefit Coverage Strategy and Platform Services for State Health Plan
ID: Doc2062115700 • State: North Carolina
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Description
Background
The North Carolina State Health Plan for Teachers and State Employees seeks a Vendor to execute its health benefit coverage strategy. The goal is to align financial, health, and experience-based incentives among Members, providers, and the Plan. The Vendor will provide a platform aimed at improving health outcomes and delivering an excellent experience for both Members and providers while ensuring financial sustainability for the Plan.
The Plan serves approximately 750,000 individuals including teachers, state employees, retirees, and their dependents.
Work Details
The Vendor will be responsible for providing Third Party Administrative Services which include:
1. Operations management including claims adjudication and network development.
2. Implementation of best-in-class technology to support emerging provider payment models.
3. Enhancing Member experience through dedicated teams focused on health improvement.
4. Population health management services may be managed by other vendors to allow the TPA partner to focus on core operations.
5. Achieving specific goals by 2032 such as accessible healthcare in every county, annual physicals for all Members, measurable health improvements, cost containment strategies, and consumerism initiatives.
Period of Performance
The contract has an initial term of 53.5 months starting from July 13, 2026, with services beginning on January 1, 2028. There are options to renew for two additional one-year terms until December 31, 2032.
Place of Performance
The services will primarily be performed in North Carolina.
Bidder Requirements
Vendors must be registered in good standing with the North Carolina Electronic Vendor Portal (eVP). They must comply with all applicable state laws including verification of work authorization through the federal E-Verify system for employees.
The North Carolina State Health Plan for Teachers and State Employees seeks a Vendor to execute its health benefit coverage strategy. The goal is to align financial, health, and experience-based incentives among Members, providers, and the Plan. The Vendor will provide a platform aimed at improving health outcomes and delivering an excellent experience for both Members and providers while ensuring financial sustainability for the Plan.
The Plan serves approximately 750,000 individuals including teachers, state employees, retirees, and their dependents.
Work Details
The Vendor will be responsible for providing Third Party Administrative Services which include:
1. Operations management including claims adjudication and network development.
2. Implementation of best-in-class technology to support emerging provider payment models.
3. Enhancing Member experience through dedicated teams focused on health improvement.
4. Population health management services may be managed by other vendors to allow the TPA partner to focus on core operations.
5. Achieving specific goals by 2032 such as accessible healthcare in every county, annual physicals for all Members, measurable health improvements, cost containment strategies, and consumerism initiatives.
Period of Performance
The contract has an initial term of 53.5 months starting from July 13, 2026, with services beginning on January 1, 2028. There are options to renew for two additional one-year terms until December 31, 2032.
Place of Performance
The services will primarily be performed in North Carolina.
Bidder Requirements
Vendors must be registered in good standing with the North Carolina Electronic Vendor Portal (eVP). They must comply with all applicable state laws including verification of work authorization through the federal E-Verify system for employees.
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Overview
Opportunity ID
Doc2062115700
Response Deadline
April 8, 2026
Past Due
Date Posted
March 20, 2026
Est. Value Range
Experimental
$50,000,000 - $150,000,000
(AI estimate)
Agency Distribution
High
Source
Source Notes
North Carolina recently changed its procurement system. Old procurements are available at https://www.ips.state.nc.us/IPS/BidNumberSearch.aspx.
On 3/20/26 STATE OF NC - STATE HEALTH PLAN FOR TEACHERS AND STATE EMPLOYEES in North Carolina issued Health Benefit Coverage Strategy and Platform Services for State Health Plan with ID Doc2062115700 due 4/8/26.