Hennepin County established a self-insured medical and pharmacy benefit plan in 2011. In 2014, the county added two accountable care organization (ACO) plans, named Advantage, to the health plans offered to employees. In 2015, a third ACO plan was added. These narrow network plans have held down health insurance costs for the county, while offering employees lower premiums and better benefits.

The county solicited proposals for the administration of the county self-insured medical benefit plan administration and navigation/advocacy services on April 15, 2022, and for the administration of the county self-insured pharmacy benefit plan on May 6, 2022. The county sought proposals that would lead to high-quality, prevention-led, evidence-based, consumer-driven, cost-effective care using leading industry standards of performance and that embed principles of diversity, equity and inclusiveness in care delivery. Evaluation considerations included quality and range of services, flexibility, and cost.

Proposals to serve as administrator of the medical plan were solicited from three medical third party administrators (TPA) and three advocacy companies and the request for proposals was published on the county's website; proposals were received from two TPA companies and three advocacy organizations. Proposals to serve as administrator of the pharmacy benefit plan were solicited from three insurance companies and the request for proposals was published on the county's website; proposals were received from five companies.

The county utilized external consultants to assist in the collection, analysis, and evaluation of proposals. An internal evaluation panel consisting of representatives from Human Resources, Labor Relations, the County Attorney’s Office, the Labor Management Healthcare Committee, the Office of Budget and Finance and other departments reviewed the proposals. The internal panel recommended awarding agreements to UMR for administration of the health plan, which agreement will include built-in navigation and advocacy services, and to OptumRx for administration of the pharmacy benefit plan. After consideration of all recommendations, the County Administrator seeks authority to negotiate and enter into agreements with UMR and OptumRx.

Current Request: Delegation of authority to the County Administrator to negotiate and finalize agreements with UMR to serve as the third party administrator of the county’s self-insured medical plan, and with OptumRx to serve as the third party administrator of the county’s self-insured pharmacy benefit plan.