Employee Benefits Consulting Services

The Vendor is required to provide employee benefits consulting services for the department.
- Account relationship management
• Be readily accessible via phone, email, and on-site attendance.
• Participate in monthly insurance committee meetings and monthly school board meetings, as requested.
• Coordinate meeting schedules, develop agendas, and manage post-meeting follow-up.
- Strategic guidance and technical advisory
• Conduct market analysis and benchmarking against similar employer groups.
• Provide regulatory interpretation, including affordable care act updates and applicable state statutes.
• Develop plan design optimization strategies, carrier incentive strategies, and wellness integration opportunities.
• Recommend cost-containment initiatives such as high-performance network design, reference based pricing, and integrated care management.
- Communications and training materials
• Draft and review benefit guides, enrollment packets, FAQs, and vendor brochures.
• Create recorded presentations or webinars and QR-enabled postcards linked to digital resources.
• Provide templates and design assistance for printed and electronic distribution.
- Plan document review and regulatory compliance
• Annual audit and update of the cafeteria plan, summary plan description (SPD), and summary of benefits and coverage (SBC).
• Compliance review under IRS, ERISA, HIPAA, cobra, and applicable state law.
• Preparation of form 5500 filings, nondiscrimination testing documentation, and wrap plan amendments.
• Coordination with legal counsel to finalize document revisions and regulatory submissions.
- Insurance committee engagement
• Financial assessment of the health plan with a 12-month forecast delivered two weeks prior to each meeting.
• Presentation of forecast assumptions, facilitation of questions and answers, and alternative scenario modeling upon request.
• Fulfillment of data requests (claims extracts, utilization reports, etc.) within one week.
• Resolution of technical disputes and clarification of policy issues during meetings.
• Delivery of meeting agendas, slide decks, and handouts one week in advance.
- Actuarial analysis and reporting
• Monthly and quarterly claims performance analyses with trend summaries.
• Data extrapolation to support OPEB valuations, reserve setting, and budget forecasting.
• Utilization of actuarial modeling tools for rate forecasting and funding requirement projections.
- Benefits negotiation and procurement solicitation support
• Assisting in the development of technical specifications, scope of services, evaluation criteria, and other solicitation-related documents for medical, dental, vision, life, disability, FSAS, HRAS, employee assistance programs (EAPS), voluntary accident and critical illness coverage, and identity-protection programs.
• Providing market intelligence, carrier information, benefit plan options, and comparative analyses to support the district's procurement and renewal decisions.
• Supporting renewal and benefit negotiations with carriers and vendors, with an emphasis on rate stabilization, plan design enhancements, network improvements, and value-added services.
• Reviewing and summarizing carrier responses, rates, and benefit offerings for district evaluation and consideration.
• Preparing comparative analyses of renewal and proposal scenarios that identify cost-saving opportunities and program enhancements.