Behavioral Health and Substance Use Disorder Benefits Admin

The contractor will administer the BH/SUD benefit for the State Health Plan PPO on an ASO basis for active employees, non-Medicare retirees, dependents and COBRA participants, including inpatient behavioral health and substance use care, outpatient psychotherapy, intensive outpatient programs, partial hospitalization programs, residential treatment, autism ABA, ECT, TMS, neuropsychological testing and telehealth. Work includes per-contract-per-month pricing inclusive of ABA case fees with pass-through pricing, repricing of FY2024-FY2025 active and retiree claims, Plan Sponsor, Member and Provider portals, claims processing, HIPAA 834 eligibility files, data security and privacy controls, 99.98% service availability, service level credits, and transition assistance, for services January 1, 2028 through December 31, 2030 for a projected 2028 population of 97300 active members and 19072 retirees.