Health Care and Benefits Consulting Services

The vendor is required to provide health care and benefits consulting services and actuarial analysis for its group employee health (includes medical, dental and prescription drug, flexible spending and reinsurance) benefits program.
 
•    Provide information on employee benefit issues, trends, assist with strategy development, and proposed or new legislation.
•    Conduct annual reviews of claims administrators for quality of benefits, cost effectiveness and competitiveness and plan administration. 
•    Consult with client to ensure plan documents are accurate and compliant due to regulatory changes. 
•    Complete a quarterly analysis of the key drivers of the city’s health and dental plan costs and the cost-effectiveness of the current plan designs. benchmark with comparable groups. 
•    Meet monthly and quarterly with either or both the human resources department and, city Benefits team and the city benefits committee, to review results and discuss plan implications. 
•    conduct and provide the city with benchmarking data as needed.
- Medical, pharmacy and dental plan renewals including plan negotiations and other voluntary benefits including vision, flexible spending, and aca reporting.
•    Assist in the development of an annual renewal strategy and conduct a prerenal analysis of health and dental plan utilization, claims history and census data to determine if the calculation provided by the carrier is consistent. 
•    Aggressively negotiate with the carriers on the city’s behalf to achieve desired contract terms for the city, including favorable pricing and compliance with any applicable legal and policy requirements of the city. 
•    Assist in the evaluation of the city’s stop loss insurance to ensure appropriate coverage level and plan design. 
•    Assist in the annual rate structure development, employee and employer contribution, taking into account any plan design changes (cause and effect), administration fees and or other related underwriting services. 
•    Assist in the marketing of plan coverage for medical, prescription, dental, and other voluntary benefits.
•    Assist in pharmacy benefit marketing services and pharmacy auditing services. 
•    Assist in individual vision plan marketing services and implementation.
•    Assist the city with suggestions on wellness initiatives
- Actuarial analysis for annual budget forecasting and OPEB
•    Provide financial and data analytics.
•    Provide annual actuarial analysis of health and dental insurance claims, including health insurance projections for upcoming fiscal years, as well as IBNR and OPEB analysis to ensure appropriate fund balances.
- Strategic plan design and management of changes
•    Evaluate and determine innovative plan design alternatives based on the city’s member demographic, utilization and budget.
•    Determine the potential impact on the city’s health and dental plans costs including risks as a result of recommended plan design changes.
- Special projects
•    The awarded firm will be requested to assist or lead special projects which could include procurement of health, dental, vision, flexible spending, annual enrollment services, voluntary benefits or new benefit programs.
- Annual enrollment
•    Assist the city in creation of communication plan and materials including but not limited to benefits guides for the plan year.
•    Provide implementation support, facilitate carrier-client calls and meetings for new carriers and enrollment support for the city employees.

- Contract Period/Term: 3 years
- Pre-Proposal Conference (Optional) Date: August 13, 2025
- Questions/Inquires Deadline: August 14, 2025