Employee Benefits and Group Insurance Services

The vendor is required to provide prospective proposers with information and detailed requirements that will enable them to prepare and submit proposals for employee benefits and group insurance.
- Group medical insurance
• Plan design and benefits, including prescription plan and formulary, wellness program that includes mental health, a tobacco cessation program, and an employee assistance plan (EAP) design and benefits;
• Provider network, including facilities, physicians, and coordination of EAP and mental health network of providers;
• Cost, including rates and renewal guarantees;
• Contract period;
• Deductible period;
• Renewal information;
• Online access to carrier portal and database;
• Data import and export options;
• Dependent eligibility verification support and audit;
• Renewal information;
• Monthly and quarterly utilization, large claims, and loss ratio reports;
• Quarterly meetings to discuss claims (including large claims), loss ratio, trends, changes, and general administrative matters;
• Affordable care act (aca) compliance;
• Customer service support, including on-line services, available to employees and their dependents;
• Open enrollment services and timeline - prior to, or in conjunction with, open enrollment conducts up to twenty (20) virtual and or onsite benefits education seminars for employees at various authority locations to explain plan designs and benefits utilization;
• Wellness program support, including initiatives offered to address and control future claims costs via improved health and/or management services including utilization review and case management services;
q) Health savings account (HSA) services, including administrative costs and availability of debit cards;
• Financial stability;
• The administration services requested include: plan design, development of administrative procedures, coordination with authority payroll and personnel functions, conducting employee education seminars, enrollment, ongoing communications, reporting, etc.; and
• The successful proposer shall be required to develop a system that will coordinate with authority desires regarding the offering of, administration of, and accounting for benefits.
- Group dental insurance
• Plan design and benefits;
• Provider network – including facilities and physicians;
• Cost, including rates and any renewal guarantees;
• Contract period;
• Deductible period;
• Customer service, including on-line services available to employees and their dependents;
• Open enrollment services and timeline - prior to, or in conjunction with, open enrollment conducts up to twenty (20) virtual and or onsite benefits education seminars for employees at various authority locations to explain plan designs and benefits utilization;
• The administration services requested include: plan design, development of administrative procedures, coordination with authority payroll and personnel functions, conducting employee education seminars, enrollment, ongoing communications, reporting, etc.; and
• The successful proposer shall be required to develop a system that will coordinate with authority desires regarding the offering of, administration of, and accounting for benefits.
- Vision insurance
• Plan design and benefits;
• Provider network – including facilities and physicians;
• Cost, including rates and any renewal guarantees;
• Contract period;
• Customer service, including on-line services available to employees and their dependents;
• Open enrollment services and timeline - prior to, or in conjunction with, open enrollment conducts up to twenty (20) virtual and or onsite benefits education seminars for employees at various authority locations to explain plan designs and benefits utilization;
• The administration services requested include: plan design, development of administrative procedures, coordination with authority payroll and personnel functions, conducting employee education seminars, enrollment, ongoing communications, reporting, etc.; and
• The successful proposer shall be required to develop a system that will coordinate with authority desires regarding the offering of, administration of, and accounting for benefits.
- Disability insurance (long-term and short-term)
• Plan design and benefits;
• Cost, including rates and any renewal guarantees;
• Contract period;
• Customer service, including on-line services available to employees and their dependents;
• Open enrollment services and timeline - prior to, or in conjunction with, open enrollment conducts up to twenty (20) virtual and or onsite benefits education seminars for employees at various authority locations to explain plan designs and benefits utilization;
• The administration services requested include: plan design, development of administrative procedures, coordination with authority payroll and personnel functions, conducting employee education seminars, enrollment, ongoing communications, reporting, etc.; and
• The successful proposer shall be required to develop a system that will coordinate with authority desires regarding the offering of, administration of, and accounting for benefits.
- Life and accidental death and dismemberment (AD&D) insurance (including basic and voluntary coverage)
• Plan design and benefits;
• Cost, including rates and any renewal guarantees;
• Contract period;
• Customer service, including on-line services available to employees and their dependents;
• Open enrollment services and timeline - prior to, or in conjunction with, open enrollment conducts up to twenty (20) virtual and or onsite benefits education seminars for employees at various authority locations to explain plan designs and benefits utilization;
• The administration services requested include: plan design, development of administrative procedures, coordination with authority payroll and personnel functions, conducting employee education seminars, enrollment, ongoing communications, reporting, etc.; and
• The successful proposer shall be required to develop a system that will coordinate with authority desires regarding the offering of, administration of, and accounting for benefits.
- The administrator is expected to provide authority with at least the following professional services:
• Assistance with preparing, modifying and updating plan documents and communications to assure compliance with applicable law, regulations, etc.
• A declining balance debit and credit card for direct payment of eligible expenses as permitted by IRS regulations.
• Employee group seminars and individual enrollments.
• preparation of enrollment communications materials, including a letter explaining the program, FSA questions and answers, examples of the benefits of FSAS, a worksheet for employees to determine amounts to place in their FSAS, and an enrollment form.
• A local area telephone number or “800” number that employee may call throughout the year for counseling, information or service regarding the flexible benefits plans.
• Establishment of all records necessary for maintaining account balances.
• Forms for reimbursement of claims, change of status, direct deposit, disbursement statements, etc.
• Payment of claims.
• The expected frequency will be bi-weekly.
• Quarterly individual account status reports to participants.
• Bi-weekly participation and account status reports to authority.
• A summary annual report for employees.
• An annual forfeiture report to authority.
• Federal report filing requirements, including issuing 1099s to providers.
• Discrimination testing as required by applicable laws and regulations.
• Compliance with federal law, state statutes and act.
- Cobra administration services
• Promote efficiency, accuracy and a superior customer experience for representatives of authority and cobra participants by providing state-of-the-art business tools, processes and services.
• Accurate and timely cobra administration, including enrollment, billing, and premium collection and reporting;
• Accurate administration of individual billing enrollment, billing, premium collection and reporting;
• Facilitate a seamless transition of services;
• Distribution of all notices;
• Premium billing, collection and reconciliation;
• Accessible designated representative knowledgeable in all aspects of cobra;
• Experienced personnel with access to expertise that can effectively address all legislative and legal cobra questions;
• Ability to comply with current and future cobra regulations;
• Ability to receive and transmit enrollment and tracking information electronically;
• Reporting;
• Maintenance of all cobra eligibility;
• Provide customer service and complaint resolution;
• Provide an open enrollment opportunity;
• Manage open enrollment communication;
• Remit cobra payment to authority.;
• Notify authority of non-payment;
• Notify authority of cobra enrollment;
• Take over existing cobra participants;
• Receipt and maintenance of rejection forms
- Employee assistance program (EAP) services:
• Master’s level counselors;
• 24 hours per day, 7 days per week availability of services;
• In-person, telephonic, and online EAP services;
• EAP services for dependents up to age 26 and household members of active employees;
• Coordination of EAP referrals in conjunction with in-network providers on authority medical plan to facilitate a seamless transition between covered EAP services under your program and to medical insurance coverage; and
• Periodic utilization reports.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: April 14, 2025