The vendor required to provide experienced employee benefits brokerage firms (each, a “respondent”) to manage and administer executive and specialized benefits programs for approximately 45-50 employees, including senior-level administrators, clinicians, and scientists.
- Administrative services
• Full program implementation and onboarding support, including complete participant record setup, creation of a detailed administration manual outlining all procedures and workflows, development of required reports, and coordination of all tasks necessary to ensure a seamless launch or transition from any prior administrator.
• Ongoing maintenance and management of all participant insurance records, ensuring accuracy, timely updates for eligibility changes, life events, beneficiary updates, salary adjustments, and secure data stewardship consistent with organizational and regulatory requirements.
• Annual preparation and submission of all executive life insurance (ELI) and long-term care (LTC) participant premium and enrollment information to center, ensuring data accuracy, timely delivery, and responsive follow up on any data validation needs.
• Comprehensive annual analysis of ELI and LTC plan coverage and premium adequacy, including review of plan performance, claims trends, pricing assumptions, market conditions, and recommendations for future plan adjustments or enhancements.
• Active monitoring and reconciliation of all premium billing for ELI and LTC plans, including review of carrier invoices, reconciliation against internal records, correction of discrepancies, handling of retroactive adjustments, and preparation of periodic billing summaries.
• Development and distribution of annual participant benefit statements, ensuring clarity, accuracy, and timely delivery, along with support for participant questions or clarification requests.
• End to end communication and enrollment administration for newly eligible executives, including eligibility notifications, distribution of plan materials, management of enrollment and application processes, and coordination of all underwriting requirements with carriers.
• Preparation and administration of termination and conversion packages, ensuring departing executives receive complete and accurate information on coverage changes, continuation options, and any required forms or deadlines, while coordinating all related updates to internal records and billing.
• Comprehensive claims coordination services, acting as the liaison between participants or beneficiaries and the carrier, assisting with claim initiation, documentation, submission, follow up, and escalation as needed to support timely and accurate resolution.
• It is essential for each respondent to demonstrate that it is authorized to operate as an insurance agent and broker in state and is currently in good standing with state.
- Commission-based services
• Assist with the continuous review and monitoring of center ancillary benefits for financial and risk management strategies.
• Advise the center regarding statutory, regulatory and market developments in employer mandated and employee benefits.
• Review and assist with marketing and negotiating contract renewals with third party administrators, insurance carriers and other vendors.
• Assist with the resolution of service delivery issues by third party administrators or other vendors, not limited to accounting and payment issues, communication of plan changes, merger and acquisitions of insurance carriers, etc.
• Review of plan communications, contracts and management reports from vendors with center.
• Evaluate vendor performance, including benchmarking performance against contractual obligations or guarantees.
• Provide recommendations and pricing for alternative plan designs and other cost management strategies within some collectively bargained parameters for 2026 and beyond.
• Provide recommendations on implementation of creative and targeted benefit plans for non-unionized employee population.
• Assistance with reviewing and where necessary, obtaining benefits for out-of-state workers to ensure compliance with state laws and regulations.
• Regular review of out of state benefits to ensure compliance with state laws and regulations, notification of new state mandated benefits and establishment of such policies if needed.
• Respondent must prepare all necessary bid specifications, in the event the coverage is marketed, evaluate all bids that are received and make recommendations to HR-pay and benefits team.
• Respondent must assist center in evaluating and settling all issues relating to the insurance provided, including regular reviews of loss reports.
• It is essential for respondents to demonstrate they are authorized to operate as an insurance agent and broker in state and are in good standing.
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