|In 2014, CMS began offering Medicare Advantage plans with prescription drug coverage to annuitants and survivors in these programs. In FY2015, CMS awarded a contract to Health Alliance to offer an HMO plan. This award was the result of a second RFP for HMO coverage in counties without an MA-PD HMO plan in place. CMS is seeking to renew this contract for CY2018. CMS is satisfied with the service provided by this vendor.|
The contract provides for annual adjustment to the per member per month premium rates based upon verified demographics, other documented actuarial factors and projected health care cost trends. The contract allows for rate negotiations annually under the initial term and for each renewal term.
The vendor receives revenue from the federal government in order to operate the plan. In order to maximize federal revenue, the State offers these plans on a calendar year basis to retirees. The estimated value of the contract for CY2018 is approximately $4,385,646.