Flexible Spending Account and COBRA Administration Services

The vendor is required to provide flexible spending account and consolidated omnibus budget reconciliation act (COBRA) with two benefits administration services:
•    Internal revenue code (IRC) healthcare and dependent care flexible spending accounts (FSA) (group 1);
•    The act -like continuation coverage for domestic partners is not governed by act law but is a city-offered continuation option that parallels act administrative functions (group 2).
- Group 1
•    Flexible spending accounts (healthcare and dependent care) currently administered by TASC and be able to have the plan(s) in place by October 1, 2025, in preparation for the open enrollment period for a benefit effective date of January 1, 2026.
•    At the beginning of each plan year, prepare and distribute new welcome kit to include, the FSA debit card (if applicable for new enrollments) and information regarding online and mobile tools and the registration process.
•    the member information to be mailed by January 1st to the member's home address assuming Enrollment file is delivered and accepted no later than the third week of December.
•    Mail debit and credit cards to participants who selected an FSA during all other enrollment processes. 
•    Cards must be mailed directly to plan participants within 10 business days of receipt of enrollment information.
•    Provide secured fax and website and electronic submissions of claims reimbursements and an 800 toll-free customer service line where participants will get help regarding their individual accounts.
•    Prepare and deliver communications to participants to explain how to utilize the account(s), plan rules and administrative options for submitting claims. 
•    The city must be provided with the opportunity to review the draft document prior to mailing.
•    Provide enrollment support for the city’s annual open enrollment conducted every fall for the following year’s plans effective January 1, which will include funding $500 for printing and distribution of city’s benefit brochure and $1000 applied towards the cost of the online benefit administrative system.
•    Accept city enrollment processes, including electronic eligibility file transfers in the required format for initial implementation enrollment process and annual reenrollment.
•    Provide plan documents and summary plan descriptions for the plans approved by firm’s legal counsel provided to the city within 90 days of execution of contract and prepare timely required amendments due to legislative changes.
•    Provide secured and dedicated employer portal with member account and enrollment data accessible in accordance with HIPAA including access to monthly or on-demand reporting.
•    Provider will set up an internal accounts receivable arrangement with the city for receipt of bi-weekly payment of employee enrolled healthcare and dependent care FSA premiums, which will be electronically wired from the city to an interest-bearing account for the payment of claims.
•    Provide participants with outstanding account balances available on demand online or via mobile application and monthly via email communication.
•    Administer a grace period of January 1 through march 15 for the prior plan calendar year with a claim filing deadline of April 15, unless any change is permissible by IRS.
•    Provide a company representative to attend onsite or virtual annual benefits open enrollment and worksite meetings to promote FSAs and related services.
•    Administer and adjudicate manual claim processing within 3 days of claims receipt via direct deposit, or check.
•    Administer substantiation of claims and provide an appeal process for denied claims.
•    Implement one (1) administration fee for enrollment in medical and dependent care FSA.
•    Establish an account management and servicing relationship with the city that emphasizes proactive, regular contact, timely responses to administrative issues and employee complaints.
•    Provide reasonable access to city-appointed auditor(s) to perform audits to determine accuracy of claims payments and appropriate grievance administration for firm and subcontractors.
- Group 2
•    Have an online act system for the city to provide names and relevant information (qualifying event, monthly premiums less the 2% administrative charge, addresses, dates, personal information, etc.) upon the employee and dependent becoming eligible, and where city staff has access act records including eligibility, notices, correspondence, payment history, comprehensive reports, etc. 
•    The act system should allow city staff to enter manually enter act enrollment information in time-sensitive situations.
•    Prepare and mail (certified) notices to newly eligible and enrolled employees and dependents and act qualified beneficiaries. 
•    Issue monthly invoices to act participants and administer entire act accounts receivable process. 
•    Administer the act annual benefits open enrollment process, including providing annual mailing of notification of premium rate changes and open enrollment election forms. 
•    Provide and process continuation of coverage election forms to employees and dependents based on type of qualifying event as mandated by department of labor (separation from employment, divorce, death, disability,18-month extensions due to a second qualify event, etc.). 
•    Provide a web-based portal for act members to access their account information. 
•    Establish an account management and service relationship with the city that emphasizes proactive, regular contact, timely responses to administrative issues and employee complaints. firm will assign an identified account manager who will be the main point of contact for benefit staff.
•    Provide reasonable access to city-appointed auditor(s) to perform audits to determine accuracy of claims payments and appropriate grievance administration for firm and subcontractors.
•    Provide appropriate notifications, including, but not limited to cancellation, late premium due, expiration of act rights, early termination, term for nonpayment, conversion options, national emergency, etc.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: August 05, 2025