Medical Plan, Pharmacy Benefit Management, Third-Party Administrator and Claims Payroll Services

The Vendor is required to provide medical plan, pharmacy benefit management, third-party administrator and claims payroll services for include:
- Group life insurance
1. Coverage design and eligibility
•    Basic and voluntary group life insurance
•    Coverage for full-time and eligible part-time employees
•    Coverage for spouses and dependent children
•    Coverage based on flat dollar amounts and multiples of annual base salary
2. Guaranteed issue (GI) provisions
•    Employees: up to $600,000 or 5x annual salary, whichever is less
•    Spouses: up to 3x employee salary or $100,000, whichever is less
•    Evidence of insurability required only for amounts exceeding GI limits
•    Evidence of insurability required for late entrants or elections outside enrollment windows
3. Rate structure and financial guarantees
•    Five-year rate guarantee
•    Clearly defined initial rate structure
•    Transparent renewal methodology
•    Disclosure of pooling or experience-rating components
4. Proposal requirements
•    Company background and financial strength
•    Detailed plan design options
•    Rates and five-year guarantee terms
•    GI and EOI administration details
•    Enrollment and claims service model
•    References from comparable employer groups
5. Bidder checklist
•    Five-year rate guarantee provided
•    Guaranteed issue limits meet requirements
•    No age-based reductions or limits
•    EOI required only above GI limits
•    Open enrollment increase without EOI permitted
•    Dedicated account management provided
•    Defined claims turnaround standards
•    Annual reporting included
•    Am best rating a- or higher
- Group disability insurance
1. Eligible population
•    Full-time employees working 15 or more hours per week
•    Optional coverage for eligible part-time employees
•    30-day new hire waiting period
2. Short-term disability (STD)
•    Up to 66.67% weekly income replacement
•    Carrier-proposed maximum weekly benefit
•    Elimination period options (7 or 14 days)
•    Benefit duration up to 12 weeks
•    Coverage includes illness, injury, pregnancy, and maternity
3. Long-term disability (ltd)
•    Income replacement options of 66.6%, 50%, and 40%
•    Elimination period options of 30, 60, 90, and 180 days
•    Carrier-proposed maximum monthly benefit
•    Benefit duration to social security normal retirement age preferred
•    Alternative durations of five years, ten years, or to age 65
4. Bidder checklist
•    Five-year rate guarantee provided
•    Guaranteed issue with no EOI required
•    Multiple elimination period options provided
•    Multiple income replacement options provided
•    SSDI assistance included
•    Dedicated account management team
•    Defined claims turnaround standards
•    Quarterly reporting included
- Prepaid legal plan
1. Plan structure
•    Core plan – employee only
•    Family plan – employee + spouse + dependents
•    Extended plan – employee + family + parents
2. Core services
•    Unlimited legal consultations
•    Document preparation and review
•    Estate planning fundamentals
•    Traffic offense representation
•    Consumer protection services
3. Extended services
•    Elder law and Medicaid planning
•    Advanced estate planning and trusts
•    Healthcare directives and powers of attorney
•    Family and domestic relations services
4. Bidder checklist
•    Five-year rate guarantee provided
•    Multiple plan tiers offered
•    Licensed attorney network provided
•    HRIS integration capability
•    Dedicated account management
•    Monthly and quarterly reporting included
•    Errors and omissions insurance maintained.