Medicare Plans Broker and Consultant and Enrollment and Call Center Administrator Services

The Vendor is required to provide brokerage, consulting, enrollment, and call center services for a closed group of medicare-eligible retired employees, as well as spouses or surviving spouses enrolled in the city board medicare medical and prescription drug programs (EGWP, RDS, and/or commercial plans).
- Responsibilities will include assisting the city board in selecting carriers or third-party administrators for medicare medical and prescription drug plans, as well as providing enrollment, communication, call center services for medicare-eligible retirees, and consulting services for retiree benefits related to medicare.
- Conduct long-range planning analyses with regard to plan evolution and benefit designs for both medical and prescription drug plans.
- Notifications include but are not limited to change of carrier announcements, review, preparation and issuance of plan summaries, and notifications pertaining to creditable coverage under the prescription plan where necessary by law.
- Operate and staff a toll-free call center the purpose of which is to assist retirees, dependents, holders of power-of-attorney, plan providers, (including physicians, hospitals, nursing homes, pharmacies, and others) in resolving a broad range of problems and issues related to medical and prescription plan coverage, including but not limited to, claim denials, enrollment issues, network access problems, helping Medicare members access low-income subsidy programs, obtaining identification cards and other matters of concern to plan participants.
- All call center staff will be duly licensed and certified to discuss Medicare products with plan members and providers.
- The call center will be staffed by live representatives, with bilingual capabilities, during regular business hours, fully licensed, well-qualified, and possessing strong customer service skills in serving a Medicare population. 
- Voice messaging systems (phone trees) may only be used during extreme peak periods, after hours, or during mechanical breakdowns.
- Provide confirmation of coverage, process address changes, accept death notifications, and obtain replacement identification cards for members.
- Responsible for preventing or minimizing disruptions in prescription coverage by staying abreast of prescription formulary changes.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: November 25, 2025