Health Insurance Broker Services

The Vendor is required to provide for a professional Insurance Broker to find health, prescription, dental, vision, life, term life, whole life, weekly short-term disability, long term disability, along with other supplemental coverages such as accident, hospital indemnity, and critical illness insurance for the City and its employees.
- The City has approximately 162 employees, 113 employees have medical coverage, 111 have dental coverage, 112 have vision coverage, 118 have short term disability, 157 have basic life with AD&D, and 17 have supplemental life insurance.
- The City wants to offer its employees a competitive insurance package that will cover employees, spouses, children, and domestic partners.
- Services Required
• Conduct a thorough analysis of current health insurance plans and recommend improvements or alternatives based on the needs of city employees.
• Assist in the renewal process of existing health insurance plans and support negotiations with insurance carriers to obtain the best possible rates and terms.
• Provide ongoing consultation and advice on regulatory compliance with the affordable care act (ACA), HIPAA, and other applicable laws.
• Assist in the creation and dissemination of open enrollment materials, including educational resources for employees to help them understand their options.
• Offer year-round support for employee inquiries regarding benefits, plan details, and claim issues.
• Facilitate meetings with employees to educate them about health insurance coverage, benefits, and any proposed changes to plans.
• Provide regular market analysis to keep the city informed of trends in health insurance and employee benefits.
• The broker will provide a dedicated account manager who will serve as the primary contact for the city and its employees.
• The broker must maintain prompt and responsive communication, ensuring that inquiries are addressed within 24 hours.
• The broker will be required to attend meetings as needed with city officials to provide updates, discuss strategies, and gather feedback.
• The broker must prepare an annual strategic plan outlining goals, action steps, and anticipated benefits for the upcoming year.
• The broker shall assist in addressing any grievances or issues that arise concerning health insurance coverage and benefits.
- Marketing, Negotiation, Consulting, And Implementation
• Medical/Rx carriers
• Stop-Loss
• Dental, vision, life, disability, and worksite benefits.
• FSA, HSA, COBRA, FMLA and other leave administration
• Telehealth, advocacy, and pricing transparency tools
• Wellness, onsite medical clinics, and disease management programs
- 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.
- 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 Section 125, ACA general topics, reporting under the Employer Mandate, COBRA, wellness plans, self-insured plans, and HIPAA Privacy and Security through internal compliance team.
- Medical Plan Design Management
o Designing healthcare plans that offer comprehensive coverage while balancing cost considerations for the employee and employer.
o Evaluate different plan options, negotiate with insurers, and analyze utilization data to inform plan design decisions.
o Monitor and report on current and potential high-cost claims, while maintaining employee privacy.
o Model alternative plan offerings to consider different levels of coverage, network structures, and wellness initiatives.
o Actuarial analysis to manage employee benefit plans efficiently.