Miami-Dade County is on the verge of a significant decision that could impact the health coverage of approximately 30,000 employees. During a special meeting on August 13, 2025, the Miami-Dade Board of County Commissioners discussed a crucial contract, potentially the largest they will vote on, valued at $4 billion over five years. The focus of the meeting was the procurement process for health insurance services, particularly the proposals from Aetna and AvMed.

Commissioners expressed concerns about the procurement timeline and adherence to established guidelines. The RFP (Request for Proposals) process was criticized for not starting two years in advance as mandated, leading to a rushed decision-making process. This has raised questions about the transparency and fairness of the bidding process, especially since Aetna, the incumbent provider, was allowed to submit incomplete data while two other competitors were disqualified for similar omissions.

The discussion highlighted the importance of following procurement rules to maintain predictability for the business community. A significant point of contention was the lack of oral presentations from bidders, which are required for contracts exceeding $25 million. Instead, a Q&A session was held, which some commissioners felt undermined the competitive nature of the procurement.

The meeting also revealed discrepancies in the scoring of proposals. AvMed initially received the highest score, but after applying local preference rules, Aetna was favored. Gallagher, a consulting firm involved in the process, was questioned about its role in adjusting the scoring and pricing analysis after the proposals were submitted. This led to confusion regarding the final numbers presented to the commissioners, particularly a $45 million savings claim attributed to Aetna.

As the board prepares to make a decision, the implications of this contract extend beyond financial savings. The outcome will affect the health benefits of thousands of county employees and set a precedent for future procurement processes. The commissioners are expected to deliberate further on these issues before reaching a conclusion, emphasizing the need for clarity and adherence to established procurement protocols.