TRICARE Dual-Eligible Contract Awarded to Wisconsin Physicians Service for $72.2M, Serving Defense Health Agency
Contract Overview
Contract Amount: $72,229,627 ($72.2M)
Contractor: Wisconsin Physicians Service Insurance Corp.
Awarding Agency: Department of Defense
Start Date: 2016-12-20
End Date: 2020-12-31
Contract Duration: 1,472 days
Daily Burn Rate: $49.1K/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: MADISON, DANE County, WISCONSIN, 53713
Plain-Language Summary
Department of Defense obligated $72.2 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 claims processing and customer support for TRICARE beneficiaries. 2. Wisconsin Physicians Service Insurance Corp. is the incumbent contractor. 3. The contract was awarded under full and open competition. 4. The sector is Defense Health, a critical area for military healthcare services.
Value Assessment
Rating: good
The contract value of $72.2 million over four years appears reasonable for comprehensive claims processing and customer support services within the TRICARE program. 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 award was made under full and open competition, suggesting a robust process for soliciting bids and ensuring fair pricing. This method typically leads to competitive pricing as multiple vendors vie for the contract.
Taxpayer Impact: Full and open competition generally benefits taxpayers by driving down costs through market forces, ensuring the government receives the best value for its spending.
Public Impact
Ensures continued healthcare claims processing for dual-eligible TRICARE beneficiaries. Supports the operational efficiency of the Defense Health Agency. Maintains continuity of service for a critical government healthcare program.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Positive Signals
- Full and open competition utilized
- Clear contract scope for claims processing and support
Sector Analysis
This contract falls within the Defense Health sector, specifically focusing on third-party administration of insurance for military beneficiaries. Spending in this area is substantial, driven by the need for efficient and accurate healthcare claims management.
Small Business Impact
The data does not indicate any specific provisions or set-asides for small businesses in this contract award. Further analysis would be needed to determine if small businesses were involved as subcontractors or if opportunities were missed.
Oversight & Accountability
The contract is managed by the Defense Health Agency, a component of the Department of Defense. Oversight would involve monitoring performance, ensuring compliance with contract terms, and managing any modifications or disputes.
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 specific performance metrics in provided data
- Absence of government cost estimate for comparison
- No explicit mention of small business participation
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 $72.2 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 $72.2 million.
What is the period of performance?
Start: 2016-12-20. End: 2020-12-31.
What is the specific performance metric for claims processing accuracy and timeliness under this contract?
The provided data does not specify the performance metrics for claims processing accuracy and timeliness. These details are typically outlined in the contract's statement of work and performance work statement. Understanding these metrics is crucial for evaluating the contractor's effectiveness and the overall value delivered to the government and beneficiaries.
How does the awarded price compare to the government's independent cost estimate for this service?
The data does not include the government's independent cost estimate, making a direct comparison impossible. However, the contract was awarded under full and open competition, which generally suggests that the final price reflects market rates and competitive pressures. A post-award review of the cost estimate versus the awarded price would be beneficial.
What is the potential impact of vendor lock-in given Wisconsin Physicians Service Insurance Corp. is the incumbent?
While the incumbent's presence might suggest a degree of familiarity, the use of full and open competition mitigates significant vendor lock-in. This process allows new entrants to compete, fostering innovation and preventing complacency. However, the agency should still monitor for any potential over-reliance or barriers to future competition.
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: $72,229,627
Exercised Options: $72,229,627
Current Obligation: $72,229,627
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: 2016-12-20
Current End Date: 2020-12-31
Potential End Date: 2024-08-23 00:00:00
Last Modified: 2025-04-26
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