The vendor is required to provide that benefits consulting services to railroad in the united states, with a route that runs from seward and whittier at tidewater to the interior of just beyond fairbanks.
- Agency averages approximately 680 employees (year-round and seasonal), with employment reaching 750 in the summer season.
- Seventy- five percent (75%) of agency employees are represented by one of five (5) unions: railroad workers (ARW), american train dispatchers (ADTA), international brotherhood of teamsters (IBT), transportation communications union (TCU), and the united transportation union (UTU).
- The remaining employees are non-represented and management personnel.
- The railroad bargains benefit matters with all five labor organizations.
- Agency to procure the services of a professional consulting firm that is capable and qualified to assist the agency in its efforts to:
• Improve the cost-effectiveness of the benefit plans
• Improve the level of statutory compliance of the benefits plans
• Improve employee communications regarding the content and value of agency benefits plans
• Improve the quality of contract administration of the benefits plans
• Improve the level of benefits data and plan analysis
• Improve the overall efficiency and design of the benefits plans
• Identify and assist in modernization of current plans and administering benefit plans
• Development of data analytics
- Service:
• Strategic planning
o Establish short and long-term goals for benefits plans
o Evaluate agency health plan accounting and employee rate setting
o Conduct introductory meetings at the onset of the contract with all benefits plan vendors, review and clarify the services they offer
o Develop a benefits philosophy specific to agency
o Assess current employee communication practices (written, email and website), provide comparative analysis and recommendations
o Review workforce trends and identify how the benefits program supports agency
o Compare current benefits programs to national and state peer benchmarks, provide Comparative analysis and recommendations
o Analyze the impact of healthcare legislation on current benefits plan designs and funding, provide comparative analysis and recommendations
o Facilitate an annual face-to-face strategic planning meeting
• Program design
o Review current funding models and alternatives, and provide recommendations  
o Conduct an analysis of the benefits programs and identify opportunities to:
o Reduce current cost trends
o Optimize vendor performance and vendor cooperation
o Improve the health and productivity of the workforce
o Improve clinical outcomes
o Determine how to best utilize benefits programs to influence recruitment and retention
o Analyze how members utilize healthcare (by demographics, risk factors, etc.)
o Identify benefits program operational/administrative inefficiencies and gaps in best practices
• Enhance employee appreciation and satisfaction of benefits programs
o Identify missed opportunities
o Plan design alternatives, review and make recommendations
o Recommendations on contribution models (employee rate setting) for employees & employers and retirees
o Budgets and economic impact measurements of proposed changes
o Assess the impact of proposed plan designs on employee satisfaction, and conduct employee surveys
o Meet with senior executives, key stakeholders, human resource (HR) to discuss current and future plan options/changes
• Communications
o Assist the railroad with the development of communications for new programs/benefits or changes to existing programs/benefits, to include print-ready:
o Employee emails, home mailings and web content, for example
1.The current health plan coverage and terms
2.Understanding preventive care benefits
3.Pharmacy benefits and why it is essential to have a formulary
4.To use the plan effectively and the employee’s role in controlling costs
o Open enrollment material
o Open enrollment presentations
o Retirement plan benefit books
o Unique ways to connect with employees who do not have internet access
• Renewal, marketing and vendor selection
o Representing the railroad in negotiations, as needed, with providers on a wide range of issues, including those related to fees, benefit levels, plan design, and contracts
o Quantify the financial impact of renewals and negotiate any variance between renewal rates and budget projections for healthcare, pharmacy benefit, vision care, life and accidental death and dismemberment (AD&D), and other lines of coverage (as applicable)
o Reviewing contracts with vendors to ensure accuracy and comprehensiveness of coverage; provide guidance in contract interpretation as needed
o Assist in coordinating benefits changes with vendors
o Analyze health plan, historical cost trend analysis vs. peer and national benchmarks. facilitate the selection of the most relevant survey tools for healthcare, pharmacy benefit, dental care, vision care, life/AD&D, and PTO
o Update the financial reporting package to include:
o Month-by-month paid claims segregated by the line of coverage
o Month-by-month enrollment
o Actual plan expenses compared to budget
o High claimant activity report including plan option elected, relation, diagnosis, paid claims amount, and increase in the most recent month
o Develop an executive dashboard of key plan metrics
o Assist with marketing of benefits programs to potential vendors
o Identify vendors as part of the request for proposal (rfp) process
o Assist in responding to vendor questions to the rfp’s and data requests
o Assist in the negotiation of best and final offers
o Prepare and present a detailed analysis of RFP responses and financial proposals for healthcare, pharmacy benefits, wellness services, flexible spending account (FSA), etc. for example:
o Rates and their financial impacts
o Network discount analysis and disruption
o Provider disruption analysis
o Formulary analysis
o Service capabilities
o Performance guarantees
o Benefits designs and variances from current plans
o Carrier financial ratings, performance and their scope of services
o Cost analysis associated with program changes and employee disruption
• Actuarial services
oIdentify emerging national, state and plan trends and project costs based on historical paid claims and current market trends
o Develop annual employee rates:
o Active, cobra and retiree rate development
o Plan design change valuation
o Employee out-of-pocket outlay analysis by plan options
o Post-enrollment analysis
o Provide high claimant probability modeling
o Provide enrollment migration modeling as plans are changed
o Annual attestation for the retiree drug subsidy (rds) program
o annual actuarial valuation creditable coverage requirements (cms medicare part d)
• Data warehousing and analytics
o Provide centralized data warehouse tool with identified staff to design, run queries, analyze results in such areas as:
o Health/risk status
o Disease management
o Preventive care adherence
o Health plan trends
o Pharmacy benefit trends
o Chronic gaps in care for members with chronic conditions
o The data analysis will be primarily driven by the consultant in response to questions from agency as well as state and national legislative/regulation changes.
o The primary interest with predictive modeling is to identify participants that could be on the verge of developing a chronic condition. once identified, the next step would be to develop interventions that may help turn the course of their illness.
oIdentify the population’s state of health and develop interventions that may help turn the course of the population’s state of health.
• Clinical and health risk management services
o Provide a medical director and staff to support agency with the management of their health plans in such areas as:
o Clinical interpretation of utilization data
o High-cost claimant review and treatment protocols
o Recommend interventions to contain/reduce cost
• Compliance management assistance
o Research legislative/regulatory issues – both national and regional
o Provide updates and periodic topical seminars and webcasts on trends and developments for health & welfare legislative guidance
o Conduct a technical review of vendor proposed revisions to contracts, summary plan descriptions (SPDS), agreements, benefits handbook, etc. for compliance with terms and plan requirements
o Annual medicare part d creditable coverage determination
o Assistance with the annual retiree drug subsidy (RDS) filing
• Ongoing services / stakeholders support
o Make presentations and provide updates to the cost containment committee and others as required, typical presentation topics could include:
o Review and recommend plan design changes and pricing in such areas as
o Demographic analysis by plan
o Enrollment and cost by plan
o Discount analysis
o Pharmacy cost and utilization
o Health status and chronic disease burden
o Wellness and disease management opportunities
o Benchmarking
o Make presentations and provide updates to the cost containment committee and others as required, typical presentation topics could include:
o Best practices in plan design and management
o Regulation updates and compliance
o Cost control measures
o Other issues and projects to help control costs and improve the sustainability of the health, pharmacy, vision, and wellness plans
- Contract Period/Term: 1 year