Supplemental Benefits Administration and Insurance Services

The Vendor is required to provide insurance carriers and third-party administrators capable of providing comprehensive supplemental benefits administration services for city employees.
- Provide life insurance, accidental death and dismemberment (AD&D) coverage, short-term disability (STD) administration, medical review services, and consultation on optional voluntary benefit programs.
- Life insurance and accidental death and dismemberment (AD&D)
•    Employee life – maximum benefit of $100,000.*
•    City manager contractual employee life – maximum benefit of $250,000.* 
•    Spouse and domestic partner life – maximum benefit of $10,000.* 
•    Dependent child life – maximum benefit of $5,000.*
- Accidental death and dismemberment (AD&D)
•    Provide AD&D coverage equal to the basic life insurance benefit amount consistent with current coverage levels
•    The city is interested in exploring potential benefit enhancements that may be available for a negligible rate increase, such as, but not limited to, child education benefits, exposure and disappearance benefits, line of duty benefits, repatriation benefits, seat belt benefits, airbag benefits, and rehabilitation benefits.
- Rate structure and guarantees
•    Provide detailed premium rate schedules for all coverage options.
•    Provided on both an employer-paid and employee-paid basis.
•    Specify rate guarantee period (minimum three years recommended).
•    Provide the rate development methodology and claims experience reporting that will be used for future rate determinations.
•    Identify any rate caps or maximum rate increase provisions.
•    Age-banded rates, composite rates, or other rating methodologies shall be clearly explained.
- Short-term disability (STD) administration
•    Provide short-term disability insurance administration services in accordance with the city’s short-term disability policy.
•    Responsible for claim adjudication and advice on disability matters. 
•    The city currently issues benefit checks directly to employees, so the contractor is not required to hold reserves or provide other fiduciary-related services.
•    All claim and plan fiduciary responsibilities and, therefore, has full discretion and final authority on all claim decisions
- Claims administration services
•    Claims intake and processing: multiple methods for claim submission recommended (online portal, telephone, etc.).
•    Initial claim decision timeline: initial claim decisions rendered within 3 – 5 business days of receipt of all necessary documentation.
•    Claimant communication: regular communication with claimants regarding claim status, required documentation, and return-to-work planning.
•    Employer reporting: regular reporting to the city regarding open claims, claim status, and return-to-work dates (with appropriate privacy protections).
•    Customer service: dedicated customer service line with reasonable hold times and knowledgeable representatives.
- Medical review and clinical services
•    Licensed medical professionals: medical reviews conducted by licensed physicians, nurses, or other appropriate healthcare professionals.
•    Medical records review: thorough review of medical documentation to support claim decisions.