Comprehensive Benefits Program

The Vendor is required to provide for certain benefits and services regarding its Employee Health and Welfare program.
- Proposer Assumptions
•    Assume a January 1, 2027 effective date.
•    Assume that approximately 1,000 active employees will be eligible for coverage.
•    Provide a responsive and proactive service team and direct access to the underwriter.
•    Senior management provides significant support to ensure high quality service (e.g., availability to participate in quarterly meetings).
•    Offer cost effective and competitive fees with 3-year guarantees with 2 – 2 year renewal options.
•    Ability to administer requested plan designs and ability to adopt ongoing plan design changes.
•    Ability to administer customized plan designs (i.e. "build your own", "multi-tier").
•    Positive references for account management and service representatives.
•    Effective internet capabilities (employer site and employee site).
•    Effective case management (demonstrated return on investment results, fully integrated information systems and claim office, and substantiated savings).
•    Effective customer service, claim and eligibility systems.
•    Willingness to be full claims fiduciary.
•    The successful bidder will embrace the city objective to create a seamless patient management experience by actively participating in integration efforts on behalf of the city and working to integrate with their other vendor partners.
•    Confirm your willingness to actively participate in integration conference calls with other the city vendors at a frequency to be determined by the city.
•    Confirm that your organization will actively participate in an annual wellness event, as requested.
•    Confirm your ability to monitor inbound/outbound referrals to/from other vendor partners and track these referrals with the ability to report metrics to the city monthly.
- All eligibility information is entered onto the benefit plan's system within 2 business days of data receipt.