Specifications include, but are not limited to: ADOA is requesting proposals from vendors to offer the following medical plan options; award will be based on ADOA’s ability to meet program goals as outlined in Section 4.2. It is the intent of the State to offer cost-efficient provider network options through two or more plan options, including plan options available in only specific counties: 3.1.1 Triple Choice Plan 3.1.2 Economy Narrow HMO Network Plan 3.1.3 Broad PPO Network Plan 3.1.4 High Deductible Health Plan (HDHP) with Health Savings Account (HSA); 3.2 Triple Choice Plan 3.2.1 Multi-tiered national network medical and behavioral health providers, hospitals, and facilities: 3.2.1.1 Contractor shall determine which providers meet the requirements for the tiered provider network; however, ADOA reserves the right to collaborate with the Contractor to determine which provider will meet requirements for each tier level. 3.2.1.2 Tier 1 networks include local, community-based medical providers who are invested in the health of their communities. Providers in these plans have demonstrated their ability to practice and deliver economic, cost-efficient care by focusing on health outcomes instead of more services. 3.2.1.3 Tier 2 broad PPO network providers may have the majority of physicians, hospitals, and facilities participating in the service area 3.2.1.4 Tier 3 is the out-of-network providers 3.2.2 Benefits – Deductibles and Out-of-Pocket Maximums. ADOA may determine it is beneficial to change accumulators in the future and reserves the right to do so at no charge to ADOA 3.2.2.1 Tier 1 will accumulate and satisfy Tier 1 levels 3.2.2.2 Tier 2 will accumulate and satisfy Tier 2 levels 3.2.2.3 Tier 3 will accumulate and satisfy Tier 3 levels...
