The Vendor is required to provide administration services for the following self-insured lines of coverage for the city's employees, officials, retirees, COBRA participants and their families.
- Directed toward the highest professional level of service while delivering access to a quality network of providers at an affordable cost.
• Medical ASO self-insured
• Flexible spending accounts (FSA)
• The medical and prescription drug plan consists of 3 PPO plans and one in-network only EPO plan.
• As of April 2025, the city has 2348 employees/city officials, retirees and cobra participants enrolled in a medical plan:
• Active: 1818
• COBRA: 4
• Retiree: 526
• Active employees who are covered under the city's medical insurance plan have access to the employee wellness clinic at no cost.
- Employees that complete a health risk assessment and are deemed compliant by the clinic are eligible for reduced premium.
- Other services provided by the clinic include episodic and chronic care, limited prescription medication dispensing, and lab testing.
- Employees are not required to use the employee wellness clinic and may still use the medical network at their choosing.
- Most specialty care is received outside of the clinic as well as brand pharmaceutical dispensing.
- The city has 2325 active employees, 38 part-time employees, 4 cobra, and 600 retirees for a total 2658 benefits eligible.
- Ability to effectively prove all services and have proven superior administrative skills, communication skills and automated benefit management tools to enforce quality and access for care.
- Provide all labor, materials, supervision, travel, facilities and equipment to provide a group medical plan and flexible spending accounts.
- Provide administrative services and documentation including, but not limited to, plan brochures, member identification cards and reports, and shall administer the plan in compliance with the city's specifications and other applicable laws and regulations.
- Provide skilled customer service and claims team that are well trained and monitored to ensure accurate and quality assistance is provided to city members.
- Timely and accurate claims processing.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: May 28, 2025