Benefits Consultant Services

The Vendor is required to provide a broad range of employee healthcare and benefits consulting services in support of the city’s employee and retiree benefits program and in accordance with the terms.
- Projects top priority and appoint a lead management consultant with a staff of supporting consultants who will respond timely and effectively to perform the work required by the City.
- Benefit plan design and analysis
• Analyze and evaluate the city’s current and proposed employee benefit plans.
• Recommend plan designs, funding strategies, and cost-containment measures based on actuarial analysis, benchmarking, and industry best practices.
• Provide annual recommendations regarding claims control, plan design changes, employer subsidies, and premium adjustments.
- Contract and document review
• Review and evaluate all plan documents, amendments, vendor contracts, and insurance policies to ensure accuracy, completeness, and legal compliance.
• Review and recommend revisions to existing agreements, including administrative service agreements, business associate agreements, and stop-loss policies.
- Procurement and vendor management
• Conduct formal solicitations for benefit plans, including development of scopes of services, evaluation criteria, and proposal analysis.
• Perform network evaluations, fee comparisons, contract negotiations, and provide written recommendations.
• Recommend performance standards and service guarantees for vendors and monitor compliance with agreed-upon terms.
- Plan implementation and administration
• Assist in the implementation and ongoing oversight of all benefit programs, including self-funded and fully insured plans (medical, dental, vision, life, AD&D, ltd, COBRA, FSA, etc.).
• Provide annual actuarial analysis of all benefit programs, including trends in claims, utilization, and contribution rates.
• Evaluate stop-loss coverage and recommend measures to protect the city from catastrophic losses.
- Financial and actuarial services
• Provide guidance on annual benefit budgets, reserve requirements, payroll deductions, and cost forecasting.
• Prepare financial reports and assist with compliance with governmental accounting standards (e.g., GASB 75) and other applicable standards.
• Support filings required under and the federal retiree drug subsidy program, including provision of actuarial attestations.
- Compliance and regulatory support
• Advise the city on compliance with all applicable laws and regulations, including the affordable care act (aca), HIPAA, COBRA, medicare part d, and GASB.
• provide timely updates regarding legislative and regulatory changes and assess their impact on city benefit programs.
- Wellness and ancillary programs
• Assist in the development, implementation, and evaluation of wellness and disease management initiatives.
• Recommend and evaluate innovative ancillary benefits to enhance the city’s total rewards package.
• Provide a dedicated wellness advisor to support ongoing initiatives and employee engagement.
- Communication and training
• Review and approve all employee communication materials for accuracy, compliance, and effectiveness.
• Provide training for city staff on benefit plan provisions, compliance, and internal control requirements.
• Coordinate the development and execution of open enrollment, including presentation materials, communications, and meeting facilitation.
- Technology and administration platform
• Provide access to a benefits administration platform that supports onboarding, enrollment, eligibility tracking, reporting, analytics, retiree administration, compliance, document storage, and technical support.
- Meetings and reporting
• Conduct quarterly meetings with human resources, finance, and budget staff to review claims experience, plan performance, and projections.
• Attend city commission, employee, and committee meetings as requested to present benefit related information and recommendations.
• Prepare and deliver market analyses and reports on benefit trends and market conditions.
- Dispute resolution and litigation support
• Assist the city in resolving disputes related to vendors, providers, or carriers, including claim adjudication and appeals.
• In the event of litigation related to benefit programs or procurement processes, provide necessary documentation and expert testimony upon request.
- Personnel assignment
• Designate a qualified project manager at no additional cost to oversee all services provided under this agreement and to serve as the primary liaison with the city.
- Additional consulting services
• Provide additional health and benefit plan consulting services as deemed necessary by the city.
• Maintain fiduciary liability coverage, including defense costs and errors and omissions coverage, to protect the city and its fiduciaries against potential claims.
- Contract Period/Term: 5 years
- Questions/Inquires Deadline: July 31, 2025