Administrative Services for COBRA, Flexible Spending Accounts and Health Savings Accounts

The vendor is required to provide o administer the city’s consolidated omnibus budget reconciliation act (Cobra) continuation coverage, flexible spending accounts (FSA) and health savings accounts (HSA) programs for active employees and cobra continuants.
- Provides an overview of the current FSA and HSA plan designs, eligibility requirements and contribution strategy.
A. Current plan design
• Dependent care FSA – no minimum, and pre-tax contributions by employees with maximums as defined by the IRS. current maximum is $5,000.
• Health care FSA - no minimum, and pre-tax contributions by employees with maximums as defined by the IRS. current maximum is $3,300 (includes debit card).
• Health savings account – funded by the city and pre-tax contributions from employees with limitations as defined by the IRS (includes debit card). - Current plan structure & participation
• Reimbursement frequency (FSA and HSA): weekly.
• Reimbursement method (FSA and HSA): direct deposit and debit card.
• FSA grace period and rollover: grace period.
• FSA run-out period: 90 days.
• Annual turnover is estimated to be 7.08% (not all are benefits eligible employees).
• Current number of benefits eligible employees: 3,151.
• Estimated monthly cobra qualifying events are 30 per month.
• Current number of cobra beneficiaries: 7.
• Number of health care FSA participants: 411.
• Number of dependent care FSA participants: 55.
• Number of HDHP participants (receive city and or employee contributions): 721. b. Plan eligibility requirements
1. Active full-time or benefit eligible employees:
• Full-time employees are employees of city whose positions are authorized as full-time.
• New employees have 31 days from date of employment to enroll.
• Coverage is effective the 1st day of the month following 30 days of employment.
2. Active full-time employees of the airport commission
• Full-time employees are employees of city airport commission whose positions are authorized as full-time.
3. Retirees and their covered dependents
• Post-retirement benefits offered to retirees includes medical, dental or vision insurance for retirees who meet the state retirement system (VRS) or city news employees’ retirement fund (NNERF) criteria for age, years of service and are vested in either of the respective retirement plans.
• Airport retirees are also eligible for post-retirement coverage. cobra administration services may be necessary as the law requires for retirees and their covered dependents.
c. Plan dependent age limits
• Children are covered until the end of the month in which they reach age 26
d. Plan changes
• No plan changes were made to the benefit plans for 1/1/25, other than increasing the maximum and rollover limits as allowable by the IRS.
- Provide and/or make available necessary, appropriate, and high-quality benefits to each eligible employee, dependent, and cobra beneficiary.
- For cobra continuation coverage:
• provide a full-service cobra administration contract.
• Prepare and issue all appropriate documentation and notices.
• Administer and monitor all new and current cobra accounts.
- For FSA accounts, provide high quality, efficient program administration and services including, but not limited to:
• Maintaining central claims and membership files for each covered member.
• Maintaining claims payment records.
• State-of-the-art data tracking and claims payment services.
• Furnishing periodic (minimum quarterly) statements and detailed list of transactions and account balances
- For HSA accounts, provide high quality and efficient program administration and services, including but not limited to:
• Maintaining central claims and membership files for each covered member.
• Maintaining claims payment records.
• State-of-the-art data tracking and claims payment services.
• Furnishing periodic (minimum quarterly) statements and detailed list of transactions and account balances.
- For premium conversion: flexible spending and health savings accounts:
• Provide plan document and periodically update the said plan document as necessary.
• Perform annual discrimination testing.
• Provide support and guidance to entities with questions.
• Salary reduction agreement forms and change forms
- Provide on-line services that will allow the city to increase the transactions that can be completed online
- Allow the city to pay monthly expenses as reflected in the city payroll records
- Provide prompt, responsive and effective customer service for employees related to billing, eligibility and claims issues.
- The city requires that the contractor's customer service representatives respond to questions and resolve issues and problems directly with members rather than referring the members back to the city
- Meet with the city's team promptly after contract establishment to review benefits, present the proposed communication material, and to jointly establish a preliminary implementation plan and open enrollment program.
- Provide staff to participate in annual open enrollment meetings when requested
- Provide open enrollment materials in hard copy and pdf format for internet and intranet posting.
- Provide the city any contractual documents necessary for coverages, no later than September 1-st in each year during the contract period.
- Designate a point of contact with responsibility for answering claims questions and administrative or billing issues, and expediting services related to overall performance of the contract.
- Commit to resolving enrollment and billing discrepancies within one billing cycle.
- Provide an organizational chart and list of contacts (with phone numbers, departments and titles) in relevant functional areas.
- Provide updates no later than ten (10) business days from the time any changes occur.
- Provide an administrative procedures manual to the city to be used to administer the program, including necessary forms and instructions.
- Contractor shall be licensed to do business in the commonwealth of state.
- Maintain a toll-free customer service number for covered employees.
- Provide a systematic procedure for appeal of claims.
- Provide specific performance guarantees, including financial penalties for non-performance.
- In the event of termination or expiration of the contract, transfer all data and records to the city or new contractor within thirty (30) days of the city’s request; such transfer shall be accomplished electronically.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: March 14, 2025