The vendor required to provide 2026 benefit broker services for include:
- Strategic planning and objective setting
• Design benefit plans with all parties involved.
• Quarterly reviews and regular meetings with carriers, if required.
• Long term planning for healthcare and wellness plans
• Development of annual or multiyear calendars
- Marketing, negotiation, consulting, and implementation
• Assist with request for proposal development, including marketing, negotiation, advice, and implementation with various insurances and benefits.
o Medical and RX carriers
o Stop-loss
o Dental, vision, life, disability, and worksite benefits.
o FSA, HSA, cobra, FMLA and other leave administration
o Telehealth, advocacy, and pricing transparency tools
o Wellness, onsite medical clinics, and disease management programs
• Using industry standards, advise expectations from various providers.
- Account management services
• Handle relationships with insurance providers.
• Ensure that services meet employee needs.
• Act as knowledge base for industry standards.
• Access to dedicated day to day team.
- Human resource education service
• HR and benefits support
• Job description and salary benchmarking support
- Compliance and legislation education
• Provide guidance on compliance with healthcare regulations, including timely updates to these regulations.
• Ensure wellness programs comply with laws protecting privacy and prohibit discrimination.
• Client-specific program review informed by general topics, reporting under the employer mandate, cobra, wellness plans, self-insured plans, and HIPAA privacy and security through internal compliance team.
- Employee communication and education
• Develop educational materials for employees, including but not limited to:
o Creation of customized open enrollment brochures.
o Creation of digital presentations with more detailed explanations of the benefit plan.
o Conduct workshops to inform employees about healthcare benefits, especially at open enrollment.
o Benefit plan information.
o Virtual id cards, and all carrier information on mobile app or online.
• Assist throughout the year educate employees on how to access healthcare services effectively and efficiently.
- Health and wellness consultation
• Design benefit plans that encompass various aspects of employee well-being, including:
o Healthcare coverage
o Wellness initiatives
o Behavioral health support
o Predictive modeling for health risks
• Provide support during the implementation phase and during the year of new benefit programs, ensuring smooth integration into existing systems and processes.
• Assist in designing wellness programs that reward employees who achieve specific health outcomes or participate in health-promoting activities.
• Evaluate wellness vendors to ensure they are aligned with the city’s goals.
• Use data to see if the wellness programs are achieving the goals laid out.
- Medical plan design management
• Designing healthcare plans that offer comprehensive coverage while balancing cost considerations for the employee and employer.
• Evaluate different plan options, negotiate with insurers, and analyze utilization data to inform plan design decisions.
• Monitor and report on current and potential high-cost claims, while maintaining employee privacy.
• Model alternative plan offerings to consider different levels of coverage, network structures, and wellness initiatives.
• Actuarial analysis to manage employee benefit plans efficiently.
- Financial analytics
• Analytics bundle, including but not limited to:
o Tracking loss ratios
o Comparing year to date figures
o Budget vs actual costs
o Monitoring city employee contributions, including retirees and cobra participants.
o Reporting should be tailored to client requirements.
• Demographic analysis of employee population, with pre and post enrollment migration
• Forecasting, including trends and budget analysis
• Specific stop-loss analysis
• Annual IBNR expenses calculation
- Predictive modeling and claims data analytics
• Annual claims review and report.
• Use KPIs to provide insight regarding the performance of the healthcare plan, areas of high utilization, and cost drivers.
• Utilizing the johns Hopkins risk adjustment model dataset, develop predictive models to assess risk to the city.
• Simulate the impact of different medical and pharmacy plan designs using actual claim data.
• Accept, scrub, and synthesize datasets from various vendors to utilize in decision making.
- Prescription drug program management
• Use contract modeling to analyze and advise on a PBM contract.
o Identify coverage gaps and align pharmacy benefits with city healthcare goals.
o Use healthcare data to improve medication management and outcomes.
o Tailor pharmacy plan and medication lists to meet city healthcare goals.
• Negotiate, and oversee PBM contract to ensure compliance with terms.
• Annual pricing validation to ensure PBM contract compliance.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: January 14, 2026
