Employee Benefits Services

The Vendor is required to provide employee benefit consulting, brokerage, administration support, compliance assistance, and strategic advisory services for a comprehensive benefits program serving approximately 400 employees (980 lives), across the north central and east state.
- Requirement:
1. Strategic benefits consulting and program design
•    Conduct an annual benefits program assessment (plan performance, competitiveness, cost trends, utilization drivers). 
•    Provide market benchmarking (plan design, employer and employee contributions, and coverage levels). 
•    Recommend plan design options aligned to organization goals: cost control, recruitment and retention, equity, wellbeing. 
•    Support multi-year benefits strategy (1-3 year roadmap). 
•    Provide guidance on vendor consolidation, voluntary benefits strategy, and wellbeing initiatives.
2. Marketing, renewal and vendor procurement support
•    Develop and execute annual renewal and RFP strategy for medical, stop loss, and ancillary lines.
•    Prepare marketing materials: claims and utilization summaries (as available), plan specs, census requirements. 
•    Coordinate carrier bids, manage timelines, and facilitate Q&A. 
•    Present bid results with total cost modeling and coverage comparisons. 
•    Support negotiations on rates, performance guarantees, administrative fees, and contract terms. 
•    Oversee assist with vendor selection and contracting.
3. Implementation and open enrollment (OE) support
•    Provide end-to-end implementation management for new and renewed plans (carrier setup, eligibility rules, file feeds).
•    Support OE planning and execution:
o    OE timeline and work plan
o    Employee communications (print and digital)
o    Enrollment platform coordination (if applicable)
o    Employee education sessions (live and virtual)
•    Ensure accurate plan materials and configuration:
o    SBC review support
o    Benefit guides, FAQs
o    Payroll and workday HRIS integration coordination
•    Provide post-OE reconciliation support and issue resolution.
4. Ongoing plan administration support (year-round service)
•    Provide a dedicated account team with defined roles (account executive, account manager, compliance and analytics support).
•    Assist HR with day-to-day benefit administration and district program expertise support:
o    Eligibility questions and escalations
o    Carrier issue resolution (claims escalation, billing disputes)life event and enrollment corrections
•    Conduct quarterly check-ins to review issues, trends, and upcoming needs.
5. Data analytics, reporting and financial stewardship
•    Provide financial modeling and cost projections for renewal and plan design changes.
•    Provide utilization insights and trend analysis (as available):
o    High-level utilization patterns
o    Cost drivers and mitigation recommendations
•    Recommend cost containment strategies (e.g., network optimization, pharmacy benefit strategy, care management).
•    Support budgeting and forecasting in partnership with human resources.
6. Employee communication and engagement
•    Develop employee-friendly communication materials (plain-language, inclusive).
•    Offer support for:
o    New hire benefits orientation content
o    OE campaigns
o    Targeted communications
•    Provide access to decision-support tools and communication templates.