Health Insurance and Prescription Benefit Services

The vendor is required to provide health insurance and prescription benefit services to a variety of options to include, stand-alone plans, plans with the use of the difference card, and plans through a health insurance fund.
• Assist agency with benefit renewals through ensuring that all providers that meet agency needs receive proposals and seek alternative coverage, if requested.
• Assist the agency with setting up the renewals timing schedule annually; assist with writing, reviewing, analyzing and presenting during renewals; provide side-by-side reporting for the agency review; prepare and/or review and advise on contract renewals.
• Provide prompt responses to questions and request that may be asked during the course of the contract by agency staff.
• Analyze and report utilization trends and cost; help to provide management and staff overview education on how best to utilize and limit premium increases.
• Provide an analysis of all of the components of the health benefit plan, offering recommendations for cost containment and/or cost savings on each component.
• Assist the agency with transition to any new health plans, e.g. conduct employee meetings, and assist with employee enrollments.
• Develop strategies to contain costs and maximize benefit effectiveness.
• Identify plans with nationwide networks.
• Negotiate rates, coverage terms, and contracts with insurance companies.
• Assist in the evaluation of vendors, providing recommendations on value-added services such as wellness programs and/or health management tools. - Communication, education and ongoing support and service
• Develop communication materials to help employees and retirees understand benefit options.
• Conduct open enrollment meetings and provide support for employee inquiries
• Offer training for HR teams on benefit administration and compliance.
• Provide year-round support for resolving claims, billing issues, and employee disputes with insurance companies.
• Provide regular reporting on plan performance, claims utilization and cost trends
• Conduct periodic reviews to ensure that the health benefits program continues to meet organizational needs.
- Contract Period/Term: 2 years