The vendor is required to provide to assist the county staff in obtaining, evaluating, recommending and securing insurance coverages to include health, dental, life, long-term disability, vision and any other applicable insurance coverages for the county employee benefits program.
- Benefits consultation services:
• Serve as designated insurance broker of record for county's health and wellness benefit programs.
• Negotiate all health and wellness benefit plan renewal options and premium rates.
• Meet directly with insurance company underwriters as required.
• Present county with the most economical options and rates; negotiate changes and additions to contracts as required.
• Negotiate and place employee benefit plans as directed by county.
• Provide annual review and report of health and wellness benefits programs.
• Participate in the development, negotiation, and implementation of plans with providers and administrators on matters such as, but not limited to, premium rates, service, benefit levels, plan design, special terms and conditions, etc.
• Determine and recommend the most economical options and rates for the benefit program; negotiate changes and additions to contracts when required.
• Provide open enrollment support, including, but not limited to, developing timelines, assisting with the development of open enrollment materials, coordination of contractor’s and health carriers’ attendance and participation in open enrollment meetings/fairs as reasonably requested.
• Provide a quarterly and annual review and summary of employee/retiree health benefits including analysis of the quality of benefits provided, cost and service effectiveness, competitiveness and recommendations.
• Assist with objective setting, strategic planning and development of long-range goals.
• Recommend and establish plan designs.
• Provide day-to-day consultation, research, and responses on matters such as, but not limited to, plan interpretation, and other matters that may arise during the normal course of business.
• Assist in the resolution of claims and billing issues as requested.
• Advice, on a continuing basis, of any and all significant matters and developments regarding carrier/provider service issues.
• Assist in the settling of out-of-court disputes and other issues with carriers/providers.
• Provide local and national market trends; advise county human resources staff on changing benefit issues and experience trends.
• Conduct special studies and prepare reports as requested by county, including annual accounting report of all plan operations.
• Upon request, prepare specifications and solicit competitive proposals/bids from insurance markets that specialize in group benefit plans. evaluate proposals/bids and proposers/bidders, including claims procedures, abilities, experience and history, service, financial policies and stability and identify the most beneficial package that meets county’s needs.
• Present the results of such analysis to county for review and selection.
• Review and analyze all benefit plan provider agreements for compliance with all applicable federal and state laws, statutes and regulations; accuracy in rates, benefits, eligibility, coverage definitions.
• Review all insurance, benefit, and administrative service documents for accuracy and adherence to prior agreements (but not perform a legal review).
• Assist county’s human resources department in the review, preparation, and updating of benefit plan documents, to include summary plan descriptions.
• Provide assistance and support with developing and implementing wellness initiatives.
• Provide an alternate option for an online benefits enrollment and administration system for government entities.
• Review evidence of coverage (EOC) for accuracy, make recommendations regarding changes, modifications and/or benefit enhancements, and negotiate changes with carriers.
- Communication services:
• Develop a comprehensive communication plan for membership with providers, and county’s human resources staff for dissemination of benefits information and materials to employees/retirees to include multiple work site locations.
• In the event of plan design changes, it is expected that multiple sessions would be conducted by the contractor with the greater employee population for the purpose of education and answering questions.
• Assist in the development and reproduction of benefits program materials (i.e., booklets, benefits summaries, rate sheet summaries) designed to increase employee awareness of benefits plan options as a represented or non-represented employee. (Please provide samples of materials).
• Attend and/or participate in the county’s annual health and wellness fair, and annual open enrollment event(s).
• Participate in annual renewal-related meetings, during certain times of the year, possibly weekly, to provide county with status of negotiations with benefit providers.
• Update benefits summaries and rate sheets to coincide with changes in coverage due to negotiations.
• Provide communication materials for use at new employee orientations. (Please provide samples of materials).
• Attend ongoing meetings with county staff to implement plan changes and updates.
• Frequency of meetings will vary as benefit programs are addressed during the year.
• Meet and communicate with insurance carriers as needed to assist county in the resolution of difficulties associated with the benefit programs.
• Prepare annual reports, in any reasonable format requested in advance by county, for each line of coverage; analyzing financial developments, network utilization, insurance cost structures, etc. make recommendations regarding changes, modifications and/or benefit enhancements.
• Assist county with the implementation and communication of new programs or changes to existing programs.
• Meet and provide reports and updates to county as needed and provide estimates of renewal rates to assist county in forecasting and budgeting.
• Develop and/or assist in developing surveys and tools for evaluating employee needs.
• Upon request, provide assistance, technically and creatively, in the on-going development and preparation of various employee communication materials.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: April 15, 2025