The Vendor is required to provide benefits consulting firm to provide comprehensive brokerage and consulting services.
- Provide professional guidance and brokerage services for, but not limited to, the following benefit programs: medical/health, pharmacy/Prescription Benefit Management (PBM), dental, vision, life insurance, short-term and long-term disability insurance, voluntary benefits, employee assistance programs (EAP), Flexible Spending Accounts (FSA), Dependent Care Accounts (DCA), Consolidated Omnibus Budget Reconciliation Act (COBRA) administration, retiree offerings/billing, stop-loss coverage, wellness initiatives/programs, benefit administration systems, onsite or near-site clinics, and population-health programs.
- Provide comprehensive strategic advisory, brokerage, analytical, actuarial, and administrative support for all agency employee benefit programs.
¬- Benefits team in administering all group insurance plans, responding to questions from and providing information to staff, and providing other related consulting services during the plan year.
- Shall deliver strategic, data-driven recommendations using in-house actuarial, underwriting, and clinical staff who can analyze claims experience, cost drivers, population-health trends, and financial projections.
- Support annual renewals and negotiations; assist in evaluating carriers and vendors; monitor performance guarantees; provide ongoing problem resolution; produce monthly and quarterly reports, and ensure agency benefits remain competitive, compliant, and financially sustainable.
- Shall assist with the development, design and planning of employee benefit programs, including strategic planning, benchmarking, and modeling to reduce risk and achieve cost efficiencies.
- Conduct benchmarking using national, regional, and peer-district data to inform plan competitiveness.
- Advise on innovative plan models, cost-containment opportunities, alternative funding strategies, and health plan optimization.
- Provide expert guidance on benefit plan design, cost-sharing strategies, contribution structures, and plan performance including analysis of plan efficiency, member outcomes, and sustainability.
- Coordinate and manage all marketing, bidding, and procurement activities with insurance carriers and vendors in accordance with agency policies and applicable procurement regulations.
- Analyze claims data to identify cost drivers, utilization trends, chronic condition patterns, and financial risks.
- Prepare annual cost projections, budget impacts, and alternative plan scenarios.
- Monitor and report performance of stop-loss coverage, including large claims analysis and reporting.
- Provide in-house actuarial and underwriting support for rate development, renewal validation, and plan modeling.
- Provide access to a secure analytics platform capable of drill-down analysis and benchmarking.
- Assist in projections and actuarial analysis.
- Provide routine claims reporting, including monthly, quarterly, and annual reports.
- Deliver dashboards showing network utilization, high-cost claimants, pharmacy trends, risk scoring, and population health metrics.
- Monitor and enforce carrier service standards and performance guarantees.
- Contract Period/Term: 3 years
