SLED Opportunity · NEW YORK · NEW YORK
AI Summary
Ulster County requests proposals for a Broker of Record to manage employee health care benefits, including plan negotiation, cost analysis, compliance advising, wellness program administration, and enrollment support for approximately 1,400 employees and retirees.
1.0 PURPOSE Ulster County is requesting proposals to obtain the services of a Broker of Record to consult with the County in the management of health care benefits. The broker will assist the County in the following areas: · Negotiating and securing medical plans, prescription plans, vision plans, dental plans, stop loss plans, flexible spending account(s) and any other plans as needed for the County. · Furthering the County’s efforts to reduce the total cost of health care and all costs associated with the health insurance program. · Defining specific factors and trends driving health care costs and reporting such information in a reasonable and timely manner. · Analyzing health plan cost trends in relation to peer groups and national benchmarks. · Investigating, evaluating, and recommending innovative programs and improvements to enhance Ulster County’s health care insurance offerings for employees and retirees. · Providing advisement in a unionized environment regarding the best course of action to implement incremental changes that support employees, dependents, and overall program costs. · Reviewing demographic and clinical information of the covered population and providing predictive analysis. · Providing monthly status reports of expenses compared to budget, including reports demonstrating the breakdown and review of health plan expenditures. · Conducting large-claims analysis, including predictability of future costs, claim-lag studies, and regular utilization reporting. · Preparing all reports mandated by Federal and State laws, as applicable. · Coordinating and participating in open enrollment sessions. · Preparing and editing the yearly Ulster County Benefits Book. · Coordinating and participating in employee and dependent education on effective health insurance utilization. · Administering and coordinating wellness initiatives supporting the County Executive’s Healthy Ulster Program, including preparation of monthly wellness newsletters. · Monitoring the regulatory environment and providing timely notification to Ulster County regarding compliance requirements, as well as notifying employees and retirees when necessary. · Educating Ulster County personnel regarding any changes, required implementations, or available options related to health insurance topics. · Administering the Retiree HRA. · Retiree billing for health insurance premiums. · Administering monthly billing for COBRA enrollees, including high-volume processing during layoffs. · Administering the Flexible Spending Accounts program. · Coordinating with coverage providers such as CanaRx/UlsterScripts to implement best practices for administering drug programs and sharing data as requested. · Reconciling monthly health insurance billings and enrollments for all employees and retirees, including individual employee contributions and the County contribution by department/division, and providing subsequent documentation. Ulster County currently has approximately 1,400 employees, with approximately 1,200 retiree and current employee health insurance plans, and an additional 1,100 Medicare retirees. Companies currently providing coverage include but may not be limited to: Medical: Self-Insured Prescription: Self-Insured Dental: MetLife Vision Davis 2.0 SCOPE OF WORK The following outlines the minimum responsibilities expected of the Responder. Each should be addressed in a narrative format in sufficient detail within the proposal to explain how each will be structured and accomplished: · Provide all tasks as provided under Section 1.0 PURPOSE. · Provide all support necessary for the administration of Ulster County’s Self-Funded Medical and Prescription programs and fully insured products. · Provide a mechanism to update the County, its employees and retirees on any health insurance changes including benefit changes, authorization requirement changes, and changes in laws and regulations. · Advise the County on compliance issues related to the regulatory environment, identify any associated financial impacts, and educate employees and retirees on required changes and actions. · Assist the County in ensuring that all insurance carriers have policies in place to demonstrate the least fiscal impact to the County. · Assist and advise the County, as necessary, for a medical review by an independent auditor of all claims paid to determine that such policies, as stated previously, are in the best interest of the County. · Ensure compliance for Ulster County with transfer funds for payment of claims in accordance with Ulster County privacy laws. · Provide for an online enrollment system and program and assist in the implementation, training and monitoring of the program. · Keep the County informed of market changes. · Bring new products to the County for consideration including suggesting, vetting, and implementing additional voluntary programs. · Analyze and advise potential cost savings with the expansion of telemedicine programs and assist in the implementation and monitoring of the programs. · Develop and demonstrate programs that will result in cost savings to the County. · Continually keep the County apprised of market and County trends, expenses, and overall performance of the health insurance program. Business enterprises awarded an identical or substantially similar procurement contract within the past five years: None
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
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