Benefits Consulting and Actuarial Services

The Vendor is required to provide comprehensive employee benefits consulting, actuarial, and brokerage support services to assist the district in the strategic planning, procurement, administration, and ongoing evaluation of its self-funded health plan and fully insured voluntary benefit programs.
1. Strategy
• Provide a strategic plan linking business objective, benchmark design and costs, healthcare reform assessment, cost containment tactics, plan cost forecasting, executive and board summary reports, annual stewardship report, annual service review and action plan and service schedule.
2. Financial management
• Develop budget projections, monitor and communicate budget variances, large claim probability and contribution modeling, cobra rate development, stop loss deductible and attachment level analysis, alternate funding arrangement analysis, actuarial impact of design changes, health care reform modeling, IBNR calculations, financial reporting including dashboards, and comprehensive medical and RX utilization analysis.
3. Renewal/marketing
• Pre-renewal projections, detailed marketing and renewal report, market selection and approval, total and itemized costs, independent network discount analysis, network access and provide disruption analysis, carrier, vendor performance and rate guarantees, funding methodology evaluation, carrier financial ratings and market review and participating in procurement solicitations review and evaluation as requested by the district.
4. Consulting services
• Finalist meetings and scorecard analysis, best and final negotiations, vendor site visits and disclosure of all proposals and compensation.
5. Implementation
• Carrier application preparation assistance, enrollment meeting support and coordination, contract review, and review vendor created employee communications, administrative arrangements (billing, banking, reporting, and data), pre-implementation audits and executive summary of final decisions.
6. Ongoing services
• Scheduled vendor service meetings, issue resolution (claim, billing, eligibility) and work plan for ongoing tasks.
7. Compliance and regulatory support
• Compliance review of SPD provisions, contracts, agreement documents and other applicable documents, web-based compliance dashboard, compliance assessment and scorecard, section 125 non-discrimination testing and ongoing webcasts and legislative alerts.
8. Communications
• Assistance with strategy, open enrollment guide, retiree OE communications and guide, and plan comparisons.
9. Wellness
• Provide wellbeing program assessment and annual evaluation, review vendor data, develop a wellbeing program roadmap, champion network, and provide wellness council of America (ELCOA) resources and tools.
10. Insurance task force meetings
• In-person participation with monthly joint labor-management benefit committee meetings.