Insurance Broker Services

The Vendor is required to provide insurance broker will be expected to secure competitive coverage, manage relationships with insurance carriers, and provide ongoing consultation and support related to insurance strategy, claims, compliance, and employee engagement.
- Broker responsibilities:
1. Benefits plan design and consulting
•    City reviewing the current benefits offerings and make recommendations for improvements or adjustments based on employee needs, industry best practices, economic changes, and cost considerations. 
•    Assist in the development of benefits packages tailored to the city’s diverse employee population, including active employees, retirees, coverage-eligible dependents, and adult designees. 
•    Provide ongoing benefits consulting to ensure plans remain competitive, compliant, and aligned with city and city employee needs.
2. Plan administration and management
•    Support benefits plans included in the contract resulting
•    Provide accurate eligibility determination, enrollment, and plan changes. 
•    Oversee compliance with the affordable care act (ACA), HIPAA, ERISA, and other applicable state and federal regulations. 
•    Provide quarterly reports summarizing enrollment data, claims experience, plan utilization, and other key metrics.
3. Employee benefits plan communication and education
•    Develop and distribute clear, concise communication materials such as benefits guides, enrollment packets, newsletters, and other media for employees. 
•    Provide on-site and virtual employee benefits plan orientations, webinars, Q&A sessions, and other engagement opportunities during open enrollment periods, as well as year-round educational sessions on benefits plan utilization, wellness programs, and health care decision-making. 
•    Assist in the creation of custom communication strategies for both active employees and retirees to ensure understanding and engagement with their benefits options.
4. Open enrollment and year-round support
•    Provide full support for open enrollment periods, including coordination of open enrollment meetings, collection of elections, processing of changes, and ensuring timely communications. 
•    Provide year-round support to answer employee questions, resolve claims issues, and assist with changes in benefits status such as marriage, divorce, birth, or adoption of a child. 
•    Provide ongoing benefits counseling to employees for assistance with benefits plan options.
5. Claims resolutions and support
•    Serve as a liaison between city, city employees, and insurance carriers to facilitate claims resolutions. 
•    Provide support to employees in resolving billing errors, claims denials, and other issues related to benefits claims
•    Monitor claims performance and provide proactive recommendations for improving outcomes and lowering costs through wellness initiatives, claims management strategies, and other opportunities.
6. Vendor management and relationships
•    Manage relations with third-party vendors, including insurance carriers and claims administrators. 
•    Regularly review and audit the performance of vendors to ensure delivery of the highest quality services. 
•    Negotiate contracts and renewals with benefits providers to secure competitive rates and terms.
7. Compliance and reporting
•    Ensure full compliance with federal, state, and local laws and regulations regarding employee benefits programs, including aca, HIPAA, ERISA, COBRA, and other applicable mandates. 
•    Provide regular compliance updates and alerts regarding changes to benefits laws and regulations. 
•    Submit required filings and documentation in a timely manner, including annual reports and other filings as required by law. 
•    Provide annual audits of benefit plans and ensure that all required notices, such as summary plan descriptions and cobra notifications, are distributed on time.
8. Voluntary benefits and supplemental offerings
•    Assist in offering and managing voluntary benefit programs such as supplemental life insurance, long-term care insurance, legal services, pet insurance, and other optional benefits. 
•    Provide educational materials and communication strategies to help employees understand and take advantage of these offerings.