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U.S. Health Insurer Case Study

Victura professionals assisted one of the largest U.S. health insurers prepare its proposal to the Defense Health Agency for the TRICARE Managed Care Support (MCS) contract.   The MCS contracts are to provide health care insurance coverage to active duty military service members, their dependents and retired military personnel/dependents.  The TRICARE MCS contracts are five year contracts that cover a specific geographic region of the United States and territories and typically there are multiple contract awards to different contractors, each awarded a region.  The TRICARE MCS contracts would trigger full CAS coverage upon contract award.

Our client had limited experience with contracting with the federal government and no experience with the CAS.  Accordingly, they required assistance with designing and implementing a CAS compliant cost accounting structure from the ground up.

First, Victura professionals conducted a CAS compliance assessment to identify compliance gaps.  Based on the outcome of the assessment, we then designed and implemented a comprehensive CAS compliant cost accounting structure, including: corporate home office allocations, CAS segment indirect rate structure, unallowable cost identification, etc.  Our professionals also assisted in drafting the applicable CAS Board Disclosure Statements.  We next provided extensive assistance in the preparation of the Client’s TRICARE MCS proposal Cost Volume.  Victura professionals’ proposal assistance included: developing the detailed staffing estimates, developing the detailed cost estimates and cost/pricing build up models, and drafting the Basis of Estimate (BOE) narrative.

Our professionals worked side-by-side with the client’s technical proposal team to ensure the proposed cost/price proposal mirrored the proposed technical (i.e., operational) solution.    Our client was awarded the 5-year contract worth over $16.6 billion.

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