HHS Spends $77.8M on Insurance Activities with Group Health Inc., Awarded Without Competition

Contract Overview

Contract Amount: $77,813,365 ($77.8M)

Contractor: Group Health Incorporated

Awarding Agency: Department of Health and Human Services

Start Date: 2012-09-06

End Date: 2014-02-18

Contract Duration: 530 days

Daily Burn Rate: $146.8K/day

Competition Type: NOT COMPETED

Number of Offers Received: 1

Pricing Type: COST PLUS AWARD FEE

Sector: Healthcare

Official Description: IGF::OT::IGF

Place of Performance

Location: NEW YORK, NEW YORK County, NEW YORK, 10004

State: New York Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $77.8 million to GROUP HEALTH INCORPORATED for work described as: IGF::OT::IGF Key points: 1. Significant contract value of $77.8 million awarded to a single vendor. 2. Lack of competition raises concerns about potential overpricing and value for money. 3. The contract type (Cost Plus Award Fee) can incentivize cost overruns. 4. Sector context: Insurance-related activities are critical for healthcare program administration.

Value Assessment

Rating: questionable

The contract's Cost Plus Award Fee structure, combined with a lack of competition, makes it difficult to assess value. Without benchmarks or competitive bids, it's hard to determine if the $77.8 million price was reasonable.

Cost Per Unit: N/A

Competition Analysis

Competition Level: sole-source

This contract was awarded on a sole-source basis ('NOT COMPETED'), indicating no formal competition was sought. This limits price discovery and may lead to higher costs for taxpayers.

Taxpayer Impact: The absence of competition suggests taxpayers may have paid more than necessary for these insurance-related activities.

Public Impact

Taxpayers funded a significant contract without exploring competitive options. The specific insurance activities performed are not detailed, limiting public understanding of the spending. The long contract duration (530 days) and cost-plus structure warrant scrutiny.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Positive Signals

Sector Analysis

This contract falls within the 'All Other Insurance Related Activities' category for the Centers for Medicare and Medicaid Services (CMS). Spending in this area is crucial for program operations, but benchmarks are difficult to establish due to the specialized nature of the services.

Small Business Impact

There is no indication in the provided data whether small businesses were involved in this contract, either as prime contractors or subcontractors. The sole-source nature suggests limited opportunity for small business participation.

Oversight & Accountability

The sole-source award and cost-plus structure necessitate robust oversight to ensure costs are reasonable and performance meets expectations. Without competitive pressure, accountability relies heavily on the agency's monitoring capabilities.

Related Government Programs

Risk Flags

Tags

all-other-insurance-related-activities, department-of-health-and-human-services, ny, dca, 10m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $77.8 million to GROUP HEALTH INCORPORATED. IGF::OT::IGF

Who is the contractor on this award?

The obligated recipient is GROUP HEALTH INCORPORATED.

Which agency awarded this contract?

Awarding agency: Department of Health and Human Services (Centers for Medicare and Medicaid Services).

What is the total obligated amount?

The obligated amount is $77.8 million.

What is the period of performance?

Start: 2012-09-06. End: 2014-02-18.

What specific insurance-related activities were performed under this contract, and how did they align with CMS's mission?

The data indicates the contract covered 'All Other Insurance Related Activities' for CMS. While essential for program operations, the lack of specific service details makes it challenging to assess direct alignment with CMS's core mission of administering Medicare and Medicaid without further documentation. The significant value suggests a substantial scope of work.

What was the justification for awarding this contract on a sole-source basis, and were alternatives considered?

The provided data simply states 'NOT COMPETED' without detailing the justification. Typically, sole-source awards require a compelling reason, such as unique capabilities or urgent need. Without this justification, it's impossible to assess if alternatives were appropriately considered or if competition was unnecessarily bypassed.

How was the 'award fee' component determined, and what performance metrics were used to justify payments beyond direct costs?

The 'Cost Plus Award Fee' (CPAF) structure implies that the contractor received reimbursement for allowable costs plus a fee that included a base amount and an award amount based on performance. The specific metrics and evaluation process for determining the award fee are not detailed in the provided data, making it difficult to assess the effectiveness of performance incentives.

Industry Classification

NAICS: Finance and InsuranceAgencies, Brokerages, and Other Insurance Related ActivitiesAll Other Insurance Related Activities

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT)MANAGEMENT SUPPORT SERVICES

Competition & Pricing

Extent Competed: NOT COMPETED

Solicitation Procedures: ONLY ONE SOURCE

Offers Received: 1

Pricing Type: COST PLUS AWARD FEE (R)

Evaluated Preference: NONE

Contractor Details

Parent Company: Emblemhealth, Inc. (UEI: 075199265)

Address: 441 9TH AVE FRNT, NEW YORK, NY, 90

Business Categories: Category Business, Corporate Entity Tax Exempt, Nonprofit Organization, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $77,813,365

Exercised Options: $77,813,365

Current Obligation: $77,813,365

Contract Characteristics

Cost or Pricing Data: YES

Timeline

Start Date: 2012-09-06

Current End Date: 2014-02-18

Potential End Date: 2014-02-28 00:00:00

Last Modified: 2013-10-07

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