Posted Date : April 25,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : EXTRA-5160
Government Authority located in Middletown, Connecticut; USA based organization looking for expert vendor for independent employee benefits consulting services.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide independent employee benefits consulting services to the government authority located in Middletown, CT.
● Ensure accurate follow through on all negotiated contractual arrangements made between the city and any administrators or insurance carriers utilized by the city. Assist with transitions or implementations involved with a change in insurance carrier and administrator.
● Ensure that all arrangements with any administrator and insurance carriers are strictly adhered to.
Monitor stop-loss thresholds and ensure compliance when thresholds are met. Advise as to recommended stop loss attachment points, and seek alternative quotes as needed.
● Provide current information on managed care delivery systems, including, PPO, HSA’s and other current and emerging systems and any other general health care consulting advice.
● Perform a rate analysis; evaluate and negotiate all renewals for each fiscal year.
● Monitor and maximize management information available through all providers.
● Intervene and resolve claim issues.
● Monitor claim performance according to any performance standards contracts the city may have with any provider. Recommend the establishment of additional performance standard agreement with vendors if there are service problems.
● Monitor and coordinate services including: claim processing, trend analysis, booklet, identification
cards and administrative and premium payments. Review plan documents and summary plan descriptions as required. Provide summary of benefits and coverages and other plan information for the city website.
● Provide consulting advice for union negotiations before, during and after the negotiations to include the impact of changing health care benefit levels and advice on implementing the new changes.
● Assist and provide recommendations in order to fulfil compliance requirements of state and federal regulations, statutes and mandates. (ACA, COBRA, HIPAA, Healthcare Reform, etc.) Prepare and manage “RFP’s” for employee health care benefits and incentive programs, pharmacy programs and stop loss as desired by the city.
● Provide routine group benefit and general health care consulting advice. Assist the city establishing a strategic plan for employee health care benefits. Provide ongoing analysis and planning of new approaches to employee health care benefits. Take the initiative to bring new ideas to the city. Work with the city team to develop and provide policy direction.
● Provide ongoing analysis of plan designs, cost containment strategies and cost sharing alternatives available to the city while maintaining integrity of union contracts.
● Develop strategies for implementation of new health care benefit programs to employees through two-way communication and educational programs. Assist employees in decisions related to their
employee health care benefits during open enrollment. Coordinate employee communication and
conduct employee information meetings as new programs are implemented and about existing
benefits and how to use them properly. Vendor should plan on attending health fair and assisting with organization of such fair.
● Inform the city of changing legislation and legal decisions affecting employee health care benefits. Advise and discuss methods to comply with these changes.
- Assist city with implementation of wellness programs. Provide assistance, materials and resources for wellness program, employee education materials for healthy lifestyles and participation in health fairs.
● Provide advice on data practices, records retention and privacy issues
● Assist the city with its budget planning for employee health care benefit costs by providing renewal estimates not later than mid-December for health insurance with updated rate cost in march of each year
- Upon request, meet with the city to present analysis of experience and budget projections for
upcoming year
- Provide a team of qualified servicing representatives available to the city on an on-going basis. Representatives must be available during the day and evening as required.
- Prompt response to questions and requests is an absolute requirement. It is expected that there will be more than one individual within the firm capable of addressing possible concerns of the City.
● Analyze and report utilization trends and cost with recommendations.
● Prepare an annual stewardship report for the city including, but not limited to observations on relevant changes in the health care insurance market, view on loss exposures facing the city, loss control activities and insurance health care policy summaries.
- If the city changes consultants as a result of this RFP the successful firm will need to have a transition plan. Proposin
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Not Applicable
Budget :
Deadline to Submit Proposals: May 23,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
![]()
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : EXTRA-5160
Government Authority located in Middletown, Connecticut; USA based organization looking for expert vendor for independent employee benefits consulting services.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide independent employee benefits consulting services to the government authority located in Middletown, CT.
● Ensure accurate follow through on all negotiated contractual arrangements made between the city and any administrators or insurance carriers utilized by the city. Assist with transitions or implementations involved with a change in insurance carrier and administrator.
● Ensure that all arrangements with any administrator and insurance carriers are strictly adhered to.
Monitor stop-loss thresholds and ensure compliance when thresholds are met. Advise as to recommended stop loss attachment points, and seek alternative quotes as needed.
● Provide current information on managed care delivery systems, including, PPO, HSA’s and other current and emerging systems and any other general health care consulting advice.
● Perform a rate analysis; evaluate and negotiate all renewals for each fiscal year.
● Monitor and maximize management information available through all providers.
● Intervene and resolve claim issues.
● Monitor claim performance according to any performance standards contracts the city may have with any provider. Recommend the establishment of additional performance standard agreement with vendors if there are service problems.
● Monitor and coordinate services including: claim processing, trend analysis, booklet, identification
cards and administrative and premium payments. Review plan documents and summary plan descriptions as required. Provide summary of benefits and coverages and other plan information for the city website.
● Provide consulting advice for union negotiations before, during and after the negotiations to include the impact of changing health care benefit levels and advice on implementing the new changes.
● Assist and provide recommendations in order to fulfil compliance requirements of state and federal regulations, statutes and mandates. (ACA, COBRA, HIPAA, Healthcare Reform, etc.) Prepare and manage “RFP’s” for employee health care benefits and incentive programs, pharmacy programs and stop loss as desired by the city.
● Provide routine group benefit and general health care consulting advice. Assist the city establishing a strategic plan for employee health care benefits. Provide ongoing analysis and planning of new approaches to employee health care benefits. Take the initiative to bring new ideas to the city. Work with the city team to develop and provide policy direction.
● Provide ongoing analysis of plan designs, cost containment strategies and cost sharing alternatives available to the city while maintaining integrity of union contracts.
● Develop strategies for implementation of new health care benefit programs to employees through two-way communication and educational programs. Assist employees in decisions related to their
employee health care benefits during open enrollment. Coordinate employee communication and
conduct employee information meetings as new programs are implemented and about existing
benefits and how to use them properly. Vendor should plan on attending health fair and assisting with organization of such fair.
● Inform the city of changing legislation and legal decisions affecting employee health care benefits. Advise and discuss methods to comply with these changes.
- Assist city with implementation of wellness programs. Provide assistance, materials and resources for wellness program, employee education materials for healthy lifestyles and participation in health fairs.
● Provide advice on data practices, records retention and privacy issues
● Assist the city with its budget planning for employee health care benefit costs by providing renewal estimates not later than mid-December for health insurance with updated rate cost in march of each year
- Upon request, meet with the city to present analysis of experience and budget projections for
upcoming year
- Provide a team of qualified servicing representatives available to the city on an on-going basis. Representatives must be available during the day and evening as required.
- Prompt response to questions and requests is an absolute requirement. It is expected that there will be more than one individual within the firm capable of addressing possible concerns of the City.
● Analyze and report utilization trends and cost with recommendations.
● Prepare an annual stewardship report for the city including, but not limited to observations on relevant changes in the health care insurance market, view on loss exposures facing the city, loss control activities and insurance health care policy summaries.
- If the city changes consultants as a result of this RFP the successful firm will need to have a transition plan. Proposin
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Not Applicable
Budget :
Deadline to Submit Proposals: May 23,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$