Employee Benefits Consultant Services

The vendor required to provide consultant services to assist with the evaluation, procurement, and ongoing administration of employee benefit programs.
- Requirement:
•    Manage RFP processes for city benefit programs including, but not limited to, medical, pharmacy, dental, life, std, ltd, benefit administration, flexible benefits administration, clinic administration, wellness incentives, excess insurance, etc.
•    Coordinate annual marketing of excess insurance coverage for medical benefits and recommend coverage. 
•    Coordinate annual marketing of firefighter cancer benefits and recommend coverage. 
•    Facilitate annual review of summary plan descriptions (SPD) with the administrators to ensure SPD reflects administrators’ system of record to process claims and contract requirements. 
•    Facilitate annual review of benefits summaries with the administrators to ensure summaries reflect administrators’ system of record to process claims and contract requirements.
•    Proactively identify areas for improvement and recommend action plan(s) to achieve improvements
•    Regularly gather and review claims data for trending purposes; make recommendations for responding to identified trends, when indicated. 
•    Prepare annual premium recommendations for self-funded benefit programs including cobra. 
•    Prepare and present periodic reports, as requested, which include complete accounting of fees and claims charged to the city, relevant observations regarding changes in the benefits industry, recommendations for changes and/or improvements, if applicable. 
•    Provide performance updates throughout the year, with detailed analyses and evaluation of costs. 
•    Provide thorough analysis and recommendations for cost saving and benefit enhancement options, to include scope of plan design changes (both new and nontraditional approaches), impact on plan cost, value-added services, etc. 
•    Conduct periodic benchmarking (at least every two years) of the city benefit plan designs, employee/employer contributions, and vendor fees against comparable public sector employers, and provide written recommendations based on benchmarking results to maintain competitiveness and cost effectiveness. 
•    Maintain active, ongoing relationships with city service vendors to ensure smooth operation, delivery of services, and facilitating prompt review and resolution of benefit and/or claims administration issues. 
•    Make regularly scheduled visits to city to work with staff to solve problems and assist with benefit administration. 
•    Review annual actuarial reports for OPEB and make any necessary recommendations to be considered/included
•    Must be knowledgeable regarding all federal and state laws that impact benefits or other services/products offered by the city must be readily available and serve as a consistent resource to the city regarding same. 
•    Review billing (weekly, bi-weekly, and/or monthly) from vendors, for purposes of reconciliation. Assure correct terms are applied and make recommendations regarding issuance of payment. 
•    Advise the city on wellness programs and services. 
•    Serve as liaison with city onsite clinic administrator as well as coordinate data integration with benefit vendors. 
•    Develop and maintain an annual benefit planning calendar that outlines key milestones for renewals, vendor procurements, plan design decisions, communications, and open enrollment, and facilitate at least one annual strategic planning meeting with the city leadership to review performance, trends, and strategic recommendations. 
•    Annually disclose to the city all direct and indirect compensation received in connection with the city benefit programs, including but not limited to fees, commissions, overrides, bonuses, and any other remuneration from insurers, vendors, or third parties, and promptly disclose any actual or potential conflicts of interest, along with a proposed mitigation plan if applicable. 
•    Upon request, must perform any tasks that are reasonably associated with services required by city
•    Develop and maintain a multi-year population health and wellness strategy, including identifying priority health risks, recommending and assisting with implementation of wellness initiatives (onsite and virtual), and providing annual outcome reporting (participation, risk factor trends, and impact on claims and absence where measurable).
- Voluntary benefits administration
•    Identify products and insurance companies to be offered to employees, submit for city of approval. 
•    Communicate voluntary benefits information to employees at bi-weekly orientation meetings and at any group meetings planned for annual enrollment. 
•    Enroll participants in voluntary benefits. 
•    Submit applications to insurance companies and follow-up on policy issuance or rejection, and delivery. 
•    Receive payment from city and distribute to insurance vendors (including past supplemental benefit vendors). 
•    Reconcile deductions to premiums paid on a monthly basis. 
•    Provide telephone customer service for administrative benefits and claims inquiries. 
•    Act as contact person for monies paid to other vendors. 
•    All plans must be guaranteed renewable and portable to the employee. 
•    Wellness benefits shall be paid directly to the employee. 
•    Provide electronic texted file for reconciled annual enrollment changes (including additions and terminations) in the format provided by the employer for all benefits – core and supplemental. 
•    During enrollment, maintain and verify dependent eligibility with verification documents for medical, dental, and dependent life. 
•    Submit benefit elections electronically.
- Benefit enrollment administration
•    Provide core and supplemental annual enrollment support for active, cobra, new hires, and retired employees. 
•    Provide platform for benefit enrollment and the total compensation statement. 
•    Enrollment support shall include call center and onsite support. 
•    Work with city o\to support enrollment strategies, as requested. 
•    This will be an annual positive enrollment. 
•    Annual enrollment is tentatively scheduled for a two-week window, but an additional week may be added. 
•    A call center is a necessary component of annual enrollment. 
•    The call center shall have availability Monday - Friday from 8:00 am – 8:00 pm est. 
•    Benefit counselors shall support core and supplemental elections for active, cobra, and retirees. 
•    Face-to-face onsite enrollment support shall be available each business day during annual enrollment at one or multiple locations. 
•    City of may provide the onsite counselors with access to an enrollment platform
•    There will be no commissioned benefit counselors. 
•    Benefit counselors shall explain all benefits but are not to actively sell any benefit offered. 
•    Provide or support a benefits administration and employee engagement platform that includes an online benefits portal, mobile accessible resources, decision support tools, and employee self-service capabilities for plan information and enrollment. 
•    Maintain portal content (plan documents, summaries, educational materials, communications) and provide periodic utilization and satisfaction reporting (e.g. Portal usage, call center metrics, and common issue trends) to support continuous improvement of the employee benefits experience.