Insurance Broker Services

The Vendor is required to provide insurance broker services include, but are not limited to, the following:
- Analysis and reporting
• Evaluate the current plan design considering industry trends and labor market conditions, claims cost trends, alternative delivery systems, and legal requirements.
• Evaluate eligibility, cost-sharing, benefit structure, and network savings.
• Inform the water authority of local and national trends.
• Provide educational materials and support regarding legislative changes that impact benefit plans, emerging plan designs, and trends within the health care and employee benefits market.
• Collect, report, and analyze data critical in measuring and comparing plan and carrier performance.
• This may include semi-annual review and report on employee benefits programs for quality and adequacy of benefits provided, cost effectiveness, competitiveness, plan administration, and recommendations concerning changes in terms and conditions of limits.
• Regularly evaluate and improve contractor's process as needed to ensure necessary performance data is collected in the most efficient and cost- effective manner, including quarterly evaluative reports tracking utilization, paid premiums, and emerging trends; and special studies and reports as requested.
• Identify, research, analyze and implement efficiency measures such as employee benefit public entity risk pools, employee partnerships, electronic benefit provider administration, and other concepts that reduce costs associated with employee benefit programs without reducing services to employees.
• Financial and performance reviews of self-funded or fully insured plans and programs.
• Recommend the most cost-efficient funding methods for benefit programs.
• Review and analyze claims experience data, claims service, efficiency, and accuracy of claims administration to ensure the water authority is receiving optimum services and benefits from all carriers and vendors.
• Semi-annual estimates of renewal rates, cost trends, and assistance to authority staff in preparation of budget figures.
- Liaison and problem intervention
• Resolve employee benefits, contract administration, and service provisions issues.
• Claims adjudication support with insurance carriers on an as- needed basis for all policies.
• Assist with resolving disputes regarding coverage, billing questions, and service delivery.