TRICARE Dual-Eligible Contract Awarded for $71.9M to Wisconsin Physicians Service for Claims Processing
Contract Overview
Contract Amount: $71,937,428 ($71.9M)
Contractor: Wisconsin Physicians Service Insurance Corp.
Awarding Agency: Department of Defense
Start Date: 2015-12-18
End Date: 2016-12-31
Contract Duration: 379 days
Daily Burn Rate: $189.8K/day
Competition Type: FULL AND OPEN COMPETITION
Pricing Type: FIRM FIXED PRICE
Sector: Healthcare
Official Description: IGF::OT::IGF TRICARE DUAL-ELIGIBLE FISCAL INTERMEDIARY CONTRACT (TDEFIC) PROVIDES CLAIMS PROCESSING AND ASSOCIATED CUSTOMER SUPPORT SERVICES.
Place of Performance
Location: MONONA, DANE County, WISCONSIN, 53713
Plain-Language Summary
Department of Defense obligated $71.9 million to WISCONSIN PHYSICIANS SERVICE INSURANCE CORP. for work described as: IGF::OT::IGF TRICARE DUAL-ELIGIBLE FISCAL INTERMEDIARY CONTRACT (TDEFIC) PROVIDES CLAIMS PROCESSING AND ASSOCIATED CUSTOMER SUPPORT SERVICES. Key points: 1. The contract supports critical claims processing for TRICARE beneficiaries. 2. Wisconsin Physicians Service Insurance Corp. is the sole awardee. 3. The contract was awarded under full and open competition. 4. The fixed-price contract type aims to control costs. 5. The sector is Defense Health Agency, a key area of government spending.
Value Assessment
Rating: good
The contract value of $71.9M for a one-year period appears reasonable for comprehensive claims processing services. Benchmarking against similar large-scale health insurance administration contracts would provide further context.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The contract was awarded through full and open competition, suggesting a robust price discovery process. This method allows multiple qualified vendors to bid, driving competitive pricing.
Taxpayer Impact: The competitive award process is expected to ensure taxpayer funds are used efficiently for essential healthcare claims processing.
Public Impact
Ensures timely and accurate processing of healthcare claims for TRICARE beneficiaries. Supports the operational efficiency of the Defense Health Agency. Provides essential customer support services related to claims. Impacts a significant number of military personnel and their families.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Contract duration is relatively short (379 days), potentially leading to future re-competition costs.
- No small business participation noted, which could be a missed opportunity for economic development.
Positive Signals
- Awarded under full and open competition.
- Firm fixed-price contract type helps manage cost certainty.
- Awardee has a specific designation (WI) suggesting potential regional focus or expertise.
Sector Analysis
This contract falls within the healthcare administration sector, specifically supporting the Defense Health Agency's mission. Spending in this area is substantial, focusing on efficient and effective management of healthcare services for military personnel and their dependents.
Small Business Impact
The data indicates no specific set-aside for small businesses (sb: false). This suggests that the contract was not targeted towards small business participation, which could be an area for future consideration to promote economic diversity.
Oversight & Accountability
The contract was awarded by the Defense Health Agency, which is subject to standard federal procurement oversight. The use of full and open competition and a firm fixed-price contract suggests adherence to good procurement practices.
Related Government Programs
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
- Department of Defense Contracting
- Defense Health Agency Programs
Risk Flags
- Lack of small business participation.
- Short contract duration may lead to future re-competition costs.
- No specific mention of performance metrics or oversight mechanisms in the provided data.
- Potential for vendor lock-in if not managed carefully.
Tags
pharmacy-benefit-management-and-other-th, department-of-defense, wi, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Defense awarded $71.9 million to WISCONSIN PHYSICIANS SERVICE INSURANCE CORP.. IGF::OT::IGF TRICARE DUAL-ELIGIBLE FISCAL INTERMEDIARY CONTRACT (TDEFIC) PROVIDES CLAIMS PROCESSING AND ASSOCIATED CUSTOMER SUPPORT SERVICES.
Who is the contractor on this award?
The obligated recipient is WISCONSIN PHYSICIANS SERVICE INSURANCE CORP..
Which agency awarded this contract?
Awarding agency: Department of Defense (Defense Health Agency).
What is the total obligated amount?
The obligated amount is $71.9 million.
What is the period of performance?
Start: 2015-12-18. End: 2016-12-31.
What is the historical performance of Wisconsin Physicians Service Insurance Corp. in managing similar large-scale government healthcare contracts?
Information on Wisconsin Physicians Service Insurance Corp.'s historical performance with similar government contracts is crucial for assessing reliability and effectiveness. Past performance data, including contract adherence, quality of service, and financial stability, would provide insights into their capability to successfully execute this TRICARE contract and manage taxpayer funds responsibly.
How does the per-unit cost of claims processing under this contract compare to industry benchmarks for similar services?
A detailed analysis of the per-unit cost of claims processing is essential for determining value for money. Comparing this metric against established industry benchmarks for government and private sector healthcare claims administration will reveal whether the contract is cost-effective or if there are opportunities for savings through negotiation or alternative service providers.
What are the key performance indicators (KPIs) and service level agreements (SLAs) in place to measure the effectiveness of this contract?
Understanding the specific KPIs and SLAs is vital for evaluating the contract's effectiveness. These metrics should cover aspects like claims processing accuracy, turnaround time, customer satisfaction, and data security. Robust KPIs and SLAs ensure accountability and provide a clear framework for assessing whether the contractor is meeting the required performance standards.
Industry Classification
NAICS: Finance and Insurance › Agencies, Brokerages, and Other Insurance Related Activities › Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
Product/Service Code: MEDICAL SERVICES › OTHER MEDICAL SERVICES
Competition & Pricing
Extent Competed: FULL AND OPEN COMPETITION
Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE
Pricing Type: FIRM FIXED PRICE (J)
Evaluated Preference: NONE
Contractor Details
Address: 1717 W BROADWAY, MADISON, WI, 53713
Business Categories: Category Business, Corporate Entity Not Tax Exempt, Nonprofit Organization, Not Designated a Small Business, Special Designations, U.S.-Owned Business
Financial Breakdown
Contract Ceiling: $71,937,428
Exercised Options: $71,937,428
Current Obligation: $71,937,428
Contract Characteristics
Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED
Cost or Pricing Data: NO
Parent Contract
Parent Award PIID: HT940214D0003
IDV Type: IDC
Timeline
Start Date: 2015-12-18
Current End Date: 2016-12-31
Potential End Date: 2016-12-31 00:00:00
Last Modified: 2025-04-26
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