Benefits Brokerage and Consulting Services

The Vendor is required to provide benefits brokerage and consulting services for include: 
1. Strategic benefits planning
•    Develop and maintain a strategic benefits plan aligned with county goals, workforce needs, budget realities, recruitment and retention priorities, and risk tolerance.
•    Provide annual and multi-year recommendations on plan design, contribution strategy, cost-sharing, wellness initiatives, voluntary benefits, and employee communication.
•    Benchmark the county's benefits against relevant public-sector and regional comparators when useful and available.
•    Identify cost-containment opportunities without degrading employee value or creating avoidable administrative burden.
2. Annual renewal, marketing, and negotiation
•    Lead or assist with annual renewal strategy for all applicable benefits lines, including medical, dental, vision, life, disability, stop-loss, and ancillary or voluntary benefits.
•    Prepare market analyses, specifications, bid packages, and carrier or vendor requests when benefits are marketed.
•    Identify appropriate markets, analyze proposals, compare coverage, evaluate service terms, summarize financial impact, and provide written recommendations.
•    Assist in negotiating rates, fees, guarantees, contract provisions, performance standards, implementation requirements, and renewal terms.
•    Audit resulting contracts, policies, agreements, amendments, and benefit summaries for accuracy of coverage, terms, conditions, and negotiated provisions.
3. Self-funded plan analytics and risk management
•    Analyze claims history, utilization, large claims, high-cost conditions, pharmacy trends, network performance, stop-loss exposure, and other cost drivers at least quarterly or as requested.
•    Develop renewal projections, funding recommendations, budget scenarios, and executive summaries for human resources, finance, and county leadership.
•    Competitively market stop-loss coverage as needed and provide recommendations on specific deductibles, aggregating specific deductibles, laser provisions, contract basis, and disclosure requirements.
•    Monitor third-party administrator, pharmacy benefit manager, network, and vendor performance against contract terms, service expectations, claims administration standards, and reporting obligations.
•    Support plan audits, eligibility reviews, dependent verification strategy, claims review discussions, and corrective action planning when appropriate.
4. Compliance and document support
•    Provide timely information on employee benefits laws, regulations, agency guidance, and compliance deadlines that affect the county's benefits program.
•    Review or assist with plan documents, summary plan descriptions, summaries of benefits and coverage, employee notices, open enrollment materials, policies, procedures, and vendor agreements.
•    Assist the county in maintaining a benefits compliance calendar and identifying responsible parties for required notices, filings, reporting, and documentation.
•    Support compliance discussions related to aca, HIPAA, cobra, cafeteria plans, flexible spending accounts, wellness programs, nondiscrimination considerations, and other applicable benefits requirements. 
•    Legal advice must be provided by the county's legal counsel or other qualified legal advisor.
5. Employee communication, enrollment, and education
•    Develop clear, customized communications for open enrollment, new hire orientation, benefit changes, wellness initiatives, and employee education.
•    Participate in or facilitate open enrollment meetings, benefits fairs, webinars, recorded presentations, and other employee-facing sessions as requested.
•    Describe available enrollment technology, benefits websites, decision-support tools, call center support, toll-free numbers, printed materials, and translation or accessibility support, if applicable.
•    Provide sample materials, including enrollment guides, benefits summaries, election forms, employee presentations, and communication timelines.
6. Ongoing account service and administration support
•    Provide a dedicated primary contact and backup contact for routine questions, urgent issues, claims escalation, vendor coordination, and administrative support.
•    Meet with county staff as needed and provide regular status meetings, open item logs, renewal calendars, and action plans.
•    Assist with vendor issue resolution, eligibility or billing questions, employee escalations, claims concerns, implementation issues, and service failures.
•    Provide or coordinate services related to cobra administration, flexible spending accounts, single billing, voluntary benefits administration, and other related services if proposed. 
•    Identify any third-party provider and related cost.
•    Perform other benefits consulting services reasonably related to the county's employee benefits program as requested.
7. Transition and implementation support
•    Provide a transition plan for assuming the county account, including data needs, vendor introductions, timeline, responsibilities, risks, and immediate priorities.
•    Coordinate with outgoing consultants, carriers, vendors, and county staff to prevent service disruption.
•    Identify any county resources, data files, system access, business associate agreements, confidentiality agreements, or authorizations needed to begin work.
•    Confirm that no carrier or market contact will occur before written county authorization.