The vendor required to provide healthcare benefits brokerage and consulting and ancillary services for include:
- Strategic benefits planning
1. Develop or update multi-year healthcare benefits strategies aligned with organizational goals and budget priorities:
• Conduct benchmarking and market analysis to evaluate competitiveness of benefit offerings.
• Advise on plan design, funding models (fully insured vs. self-funded), and cost containment strategies.
2. Cost containment strategies:
• Negotiating favorable rates
• Fiduciary alignment and governance support
3. Utilization management strategies:
• Alternative payment models and support for value-based care (including cash-based models)
• Network adequacy and broad provider access
• Strong provider relationships
4. Effective communication strategies:
• Accurate billing practices and inclusive services
5. Clinical and population health management:
• Robust analytics and gap identification in care
• Prevention, wellness, and member engagement
• Members experience enhancement
5. Technology, data integration, and online portals:
• Care coordination and member responsibility estimation
- Regulatory compliance and risk management
• Ensure compliance with aca, ERISA (where applicable), HIPAA, cobra, and other applicable laws.
• Conduct compliance audits and maintain documentation to demonstrate adherence.
• Advise on fiduciary responsibilities and strategies to mitigate legal, financial, and operational risk.
- RFP development and procurement support
• Assist members in developing RFPs for healthcare-related services by defining scope, objectives, and evaluation criteria.
• Support evaluation of vendor responses and scoring methodologies.
• Provide recommendations for contract awards based on strategic fit, service quality, and value.
- Vendor and carrier management
• Evaluate vendor and carrier performance using key performance indicators (KPI), service level agreements (SLA), member satisfaction surveys, and claims accuracy.
• Support implementation and transition planning with detailed timelines, stakeholder coordination, and operational risk mitigation.
• Advise on SLAs and performance guarantees.
- Data analytics and reporting
• Analyze claims data, utilization trends, and cost drivers.
• Provide dashboards and detailed reporting tools for HR, finance, and leadership teams.
• Model financial impact of plan design changes or wellness initiatives through scenario analysis.
- Employee engagement and communication
• Develop communication strategies and materials for open enrollment and year-round education through multi-channel campaigns.
• Support employee surveys, feedback mechanisms, and analysis.
• Advise on wellness, disease management, and incentive programs to improve participation and member outcomes.
- Contract Period/Term: 2 years
- Non-Mandatory Pre-Proposal Conference Date: January 8, 2026
- Questions/Inquires Deadline: January 12, 2026
