Group Benefits Consultant Services

The vendor is required to provide a full range of actuarial and consulting services related to the design, implementation, maintenance, communication and strategic improvements of the following benefits programs: medical, dental, vision, prescription, flexible spending account, life, AD&D, short and long-term disability, employee assistance program and wellness programs.
- Requirement:
• Recommendations on plan design changes and financial analysis of the cost impact.
• Determination of premium level charged on self-funded plans.
• Assistance in budget preparation and projections.
• General benefit consulting advice including updates on state health benefits legislative changes and federal law, rules or regulations affecting benefit plans as requested.
• Assist in analysis of pending legislation during the legislative session.
• Consultant will provide notification on benefits and funding trends that may affect benefits programs during the legislative session.
• The employee benefits program to a competitive proposal process to add or change benefit programs, the consultant will shall be responsible to draft RFPs that provide complete information for offerors and will result in responses that provide meaningful information for the city’s use in the selection process.
• Analyze the master contract presented by the benefits provider, or if required, draft a master contract to ensure that the contract complies with the specifications for review by the city
• The city of informed of emerging trends in benefits plan designs, drafting plan modifications, amendments, and new plans.
• Provide recommendations for benefit improvements and enhancements as dictated by emerging plan costs or benefit practice trends, along with our business needs.
• Assist in the preparation and review of benefit program communication materials for open enrollment.
• The consultant must have the ability to provide benchmarking information on the benefits programs and their components as necessary and requested.
• Consultant shall prepare appropriate fund analysis and claims analysis, as requested.
• Consultant shall participate in the preparation and presentation of any necessary and requested reports, including cost projections for upcoming years and provide Ad-Hoc reports upon requests.
• Provide a long-term solvency projection that allows extrapolation of the impact of plan design and funding changes.
• Provide database warehousing and data mining tasks, as requested.
• Provide recommended reserve balance, including fixed costs, by line of business, calculated in accordance with applicable actuarial standards of practice.
• Consultant shall advise and assist in the determination of employee attitudes, needs, and expectations concerning benefit programs by use of surveys, questionnaires, meetings, or other communication methods, as requested.
• Provide employee wellness consulting to include health risk assessment (HRA) and personal health profile (php), biometric health screenings and any other additional wellness services, as requested.
• Provide services including, but not limited to: self-funded claim audits, claims utilization analysis and reporting, actuarial services, benchmarking, budget projection, assistance with implementation and renewals, marketing services, plan design recommendations, assistance with communication strategies, and on-going account management.
• Provide updates and education related to the abovementioned services.
• Consultant must be proficient in handling all phases of fully insured and self-funded medical, dental, vision, and prescription drug plans, to include establishing employee contribution amounts.
• Consultant shall be knowledgeable about flexible spending accounts, group and supplemental life and AD&D insurance, retiree life insurance, and short and long-term disability insurance.
• Consultant shall be knowledgeable about assessing, designing, implementing, and evaluating employee wellness programs to include on-site health clinics.
• Provide annual fiscal year actuarial certification of required incurred but not reported (IBNR) reserves for all self-funded plans at a statistical confidence level determined by individual participating agencies. certification to be issued by a credentialed health actuary.
• Provide cost projections to meet required funding at participating agencies based on budgeted funding levels for all self-funded plans for each plan year, and set the contribution rates for employer and employee cost share, including recommended reserve funding.
• Annual updates to fair market value to determine the imputed income related to domestic partner coverage.
• Prepare and present benefits plan year recommendations, cost projections, and any other necessary and requested reports to the leadership team or participating agency governing authorities.
• Consultant shall utilize a database combining all data (medical, prescription drug, and available biometric screening and health risk assessment data) for reporting and to analyze trends and make recommendations.
• Consultant should be proactive in advising participating agencies regarding the future direction of their employee benefits plans.
• Provide benchmarking information on the benefits programs and their components on an annual basis.
• Consultant shall be required to support in the assessment, design, development, evaluation, and growth of employee wellness programs.
• Provide employee wellness support to include analysis and reporting of population health management, and any other additional services required for successful wellness programming.
• Provide continuous updates and education on wellness programming to include newsletters and communications.
• During all legislative sessions, the consultant shall provide notification to the city of bills that are introduced that may affect benefits programs.
• During all legislative sessions, the consultant shall provide analysis and advice on the implications of proposed state legislation relating to employee benefits and wellness programs.
• Assist with providing educational tools and resources, such as videos, print materials, and website publications, to promote benefit awareness.
• Provide assistance with evaluating and implementing value-based initiatives.
• Provide other benefits and wellness-related services as may be requested or identified.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: July 11, 2025