The vendor is required to provide proactive assistance with data driven solutions on relevant compliance topics and other regulatory services required to obtain and maintain a competitive benefits program.
- Methodology and benchmarking:
• Advise and assist the county in creating comprehensive, data-driven benefits strategies that are versatile and agile.
• Ensure the county remains competitive among local and regional peers as listed below.
• Recommend changes based on national, regional, and local benefit market trends to ensure the comprehensive benefits programs support the county’s total compensation strategy and goals.
• This includes providing annual benchmarking and benefits comparisons with the county’s established competitive markets, plan utilization, claims data, and wellness program data, as well as assessing overall program design and identifying suitable trends and benchmarks for consideration.
- Plan design and budget:
• Evaluate and review existing benefit plans for recommendations that enhance benefit options.
• Assist the county in developing premium models and propose changes in benefit design and premium contribution cost to support the long-term benefit strategy.
• Present alternative plan design considerations and associated cost based on identified objectives.
• Provide recommendations for establishing annual premium equivalency rates.
• Provide fiscal year and plan year forecasts for multi-year strategic budget to set and maintain financial policy limits.
- Communication materials and open enrollment support:
• Advise and assist the county with benefit plan communications throughout the year and during benefits events, including annual open enrollment.
• Examples of communication tools include, but are not limited to, digital benefits booklets, multimedia content and other educational resources related to benefits.
- Vendor support and annual renewal services:
• Evaluate and monitor all vendor partnerships and their effectiveness, service delivery, and ROI for all current benefits vendors and carriers.
• Assist and advise the county in resolving service delivery issues, disputes, and contract negotiations with benefit carriers.
• Evaluate proposed renewal actions of all carriers, negotiate contracts on behalf of the county to obtain the most favorable terms, and review contracts to limit the county’s liability exposure.
• Aid and advise the county in drafting, reviewing, issuing, evaluating and negotiating new agreements, including review for accuracy of coverage, compliance, terms and conditions.
• Analyze vendors’ proposals and provide a written assessment and recommendation based upon the county’s selection criteria and timeframe.
- Compliance:
• Provide proactive and timely notification of, and assistance with, understanding and implementing new, updated and revised benefits, tax regulations, laws, federal/state regulations, ordinances, and programs.
• Provide ongoing communication and notifications alerting the county regarding any relevant compliance deadlines, employee communication deadlines, or communication issues as a result of new or updated information.
• The consultant may be asked to provide sample documents that would be used to notify employees and retirees of these changes. research and provide guidance for employer benefits questions and issues as they arise.
- Planning meetings and executive presentations:
• Participate in scheduled and ad-hoc meetings to review the current state of the offered benefit programs and to assist staff in determining budget, goals, and objectives for the upcoming year with persons as deemed necessary.
- Reporting:
• Produce ad hoc, monthly, quarterly and annual claims, utilization, and financial reports.
• This includes, but is not limited to, annual fiscal year and plan year budget development reports for the county’s self-insured plans, incorporating claim history as well as marketplace trends in the projection.
• Functionality of the county’s data warehouse and must have access to data warehousing services to provide clear, transparent pricing information for these services to ensure effective predictive analytics, data management and cost clarity.
- Claims review and auditing services:
• Provide ongoing auditing and analysis of claims (including performance guarantees, RX, and specific stop loss reimbursement), vendor administrative fees, and other expenditures for accuracy and return on investment by type of service received.
• Provide analysis of claims expenditures by plans/tiers offered. provide detailed review of high claims trends and costs drivers.
• Work with plan administrators to ensure continued provision of high-quality benefit plan designs and efficient administration of the programs.
- Employee clinic and wellness program consulting services:
• Review employee clinic usage, cost and impact on lifestyle behaviors, high-cost drivers, and overall claims experience.
• Review wellness programs and EAP usage, cost, and impact on lifestyle behaviors, high-cost drivers, and overall claims experience to determine effectiveness of the programs.
• Provide multi-year wellness program strategies, recommend program elements, performance metrics, and provide support as needed to ensure the county’s program is effective.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: July 30, 2025