2026 Benefit Broker Services

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