Health and Welfare Consultant Services

The Vendor is required to provide to engage a qualified health insurance advisor for the purpose of providing direction and support to the town for fiscal years 2026-2027, 2027-2028 and 2028-2029.
- The Town is seeking an advisor for assistance with at minimum the following areas:
•    Compliance with all relevant state and federal laws and regulations;
•    Assistance with healthcare reform regulations;
•    Two-way employee communications about health care benefits;
•    Collective bargaining related to employee health care benefits;
•    Procurement of health, dental, life, stop-loss, and Medicare supplemental insurance;
•    Health risk management (including: wellness programs, incentives, adjusted premiums based on wellness efforts, cost containment, and other similar ideas); and
•    Monthly claims and expense reporting, ad hoc reports, budget projections.
- Additionally, medical insurance for eligible, over 65 retirees is provided through a fully-insured medicare advantage plan provided by anthem as its third party administrator.
- Annual Cost Modelling
•    Prepare and/or review and advise on provider contract renewals. Assist the Town with provider benefit renewals.
•    Assist the Town with its budget planning for health care costs by providing a preliminary estimate not later than February 1st of each plan year, with final renewal figures prior to the annual budget adoption
•    Assist the Town with reviewing claims data and determining cost impact of any coverage changes.
•    Should the Town elect to change carriers following the marketing process; manage services ensuring that the selected consultant provides benefits that are equivalent to or better than those currently in effect.
- Advisement
•    Analyze and report utilization trends and cost. Provide ongoing recommendations for plan design changes, cost containment strategies, and cost sharing alternatives.
•    Assist the Town during collective bargaining with its employees. Provide supportive materials for collective bargaining and, if necessary, testimony before an arbitration panel or similar agency. Ensure accurate follow-through on all negotiated changes.
•    Advise and assist the Town in evaluating and selecting among coverage alternatives such as plan coverages, deductibles, co-payments, out of pocket payments, etc.
•    Make recommendations regarding stop-loss coverage and provide periodic alternative funding analyses.
•    Make presentations to various boards, commissions and employee groups regarding plan designs and/or plan changes, or as needed.
•    Assist in the selection and management of voluntary benefit plans made available to employees.
•    Provide routine group benefit and general healthcare consulting advice. Assist in establishing strategic plan for employee benefits.