Health Insurance Plan Review (RFP)

1 Request for Proposals # 274-HR202201-HIPR Title: Health Insurance Plan Review Issue Date: January 10, 2022 Due Date: February 10, 2022 not later than 5:00PM ET LATE PROPOSALS WILL NOT BE ACCEPTED Issuing Department: Human Resources Direct all inquiries concerning this RFP to: Catherine Franklin Benefits Manager Email: catherine.franklin@raleighnc.gov 2 Table of Contents 1. Introduction ...............................................................................................3 1.1 Purpose ..............................................................................................3 1.2 Background ........................................................................................3 1.3 RFP Timeline ......................................................................................6 1.4 Proposal Question ..............................................................................6 1.5 Proposal

Submission Requirements & Contact Information ...............7 1.6 Rights to Submitted Material ..............................................................8 1.7 Communications .................................................................................8 1.8 Lobbying .............................................................................................8 1.9 Conflicts of Interest .............................................................................8 1.10 Proposer Expenses ............................................................................9 1.11 Proposer Acceptance ....................................................................... 10 2. Proposals ................................................................................................ 11 2.1 Request for Proposals Required Document Format ......................... 11 2.2 RFP Documents ............................................................................... 12 3. Proposal Evaluation ............................................................................... 12 3.1 Proposal Evaluation Criteria (Stage 1) ............................................. 12 3.2 Interview/Demonstration (Stage 2) ................................................... 13 3.3 Final Selection .................................................................................. 14 3.4 Notice to Proposers Regarding RFP Terms & Conditions ................ 14 4. Contract Terms ....................................................................................... 14 5. Scope of Services ................................................................................... 14 Appendix I – Proposal Cost Form .................................................................... 18 Appendix II – Proposer Questionnaire ............................................................ 19 Appendix III – Reference Questionnaire .......................................................... 20 Appendix IV – Contract Standard Terms & Conditions ................................. 23 Appendix V – Exceptions to RFP ..................................................................... 31 3 1 Introduction 1.1 Purpose The City of Raleigh (COR) is solicitating proposals from one or more firm(s) with which to contract for the following services: The City of Raleigh is seeking a consulting firm to evaluate the existing health benefits plans (medical, dental, vision, pharmacy, wellness, telemedicine) for active employees and retirees, including but not limited to structure, value, and cost of these existing benefit plans. The selected consultant will evaluate active and retiree health insurance plans for the City of Raleigh, provide an assessment of and recommendations for plan design, determine whether premium equivalents are in alignment with cost drivers, and provide alternative plan options, as well as suggestions to enhance employee wellness. The consultant will perform and present benchmarking results from peer cities both locally and nationwide to ensure the city remains competitive and is able to attract, recruit and retain employees, and is able to administer the health insurance program in a cost-efficient manner that is equitable and sustainable. The consultant may also assist in presenting information to the City Council and to other stakeholders. A detailed scope of services is provided in Section 5 of this solicitation. All information related to this solicitation, including any addenda, will be posted to the North Carolina Interactive Purchasing System (IPS) at: https://www.ips.state.nc.us/IPS/. 1.2 Background The City of Raleigh, the Capital City of North Carolina, remains one of the fastest growing areas in the country. A great economy, top educational institutions, and exceptional health care facilities are some of the characteristics that attract people to the triangle area. The mild climate, diverse work force and proximity to Research Triangle Park combine to make Raleigh a great place to live. The City of Raleigh operates under a council-manager form of government, and currently employs approximately 4,000 benefits-eligible employees. Currently, the City provides benefits to more than 4,700 participating employees and retirees, with nearly 10,000 total covered members. Current Health Coverage Background Information The City’s medical insurance program ranks as one of the most important components of an employee’s total compensation package. The medical insurance program is self-funded for active and retired employees. Stop-loss insurance is purchased by the City to cover catastrophic claims that exceed $375,000 per individual in a calendar year. The City uses third-party claims administrators to provide medical management services and pay medical and prescription drug claims. Blue Cross Blue Shield of North Carolina is the medical claims administrator. https://www.ips.state.nc.us/IPS/ 4 The City offers two PPO health insurance plans offering both in-network and out-of-network services through BCBSNC. The Monthly Medical Premiums for the health plan year beginning January 1, 2022 are outlined below. Active employee compliant monthly premiums are: Plan Type Plan A Plan B Employee Only $50.00 $0.00 Employee + Spouse $442.00 $306.00 Employee + Child $212.00 $133.00 Employee + Children $282.00 $177.00 Family $667.00 $468.00 Split Family $235.00 $169.00 • For retirees, the compliant monthly premiums are: Per City Council resolutions, the rates and dependent subsidies offered to retirees from the City of Raleigh are dependent on their date of hire and years of service. Service Retiree Coverage o For those hired before July 1, 2008, retirees are eligible for health insurance paid by the City until age 65. o For those hired on or after July 1, 2008, those who retire with 15 years of service, will be eligible to have 50% of their medical plan premium cost covered by the City until age 65. With 25 years’ service, retirees will receive full coverage paid by the City until age 65. At intervals between 15 years and 25 years, there will be a 5% per year additive to the 15-year 50% amount. o Once retirees reach the age of 65, they are offered a Medicare supplement through Blue Cross and Blue Shield of North Carolina. The City pays the retiree $100.00 per month toward the cost of the Medicare supplement premium. Medical Coverage for Retiree Spouse and Dependents o For retirees hired before July 1, 2007, the City pays a portion of the cost for spousal and dependent medical coverage. Plan Type Plan A Plan B Employee Only $56.00 $0.00 Employee + Spouse $460.00 $306.00 Employee + Child $234.00 $140.00 Employee + Children $311.00 $186.00 Family $698.00 $468.00 5 o For those hired on or after July 1, 2007, retirees must fund 100% of the cost to the City for elected spousal or dependent medical coverage. To be eligible for the wellness compliant premium rates, employees, retirees and covered spouses must complete the Annual Wellness Assessment requirements and submit the Non-Tobacco Use Attestation or agree to participate in the tobacco cessation program. • The wellness non-compliant rate for Plan A and Plan B is $50 per month. A spousal surcharge of $50 per month is charged for covered spouses who have access to other health insurance coverage but choose to take the City’s health insurance as primary coverage. Dental Plans The City offers two self-insured dental plans offering both in-network and out-of-network services through Delta Dental. The employee monthly Dental premiums beginning January 1, 2022 are outlined below. Plan Type Core Buy-Up Employee Only $0.00 $10.25 Employee + Spouse $13.10 $34.33 Employee + Child $7.15 $25.74 Employee + Children $9.52 $28.88 Family $27.20 $63.04 Vison Benefit Vision benefits are currently offered through the City medical plans. An annual routine eye exam is provided at no cost to the participant provided they utilize an in-network BCBS provider. A $130 hardware allowance is also provided and then the plan pays 10% of any additional hardware expenses that are incurred. Other Health Benefit Information In addition to the PPO medical plans, phone and video-based telemedicine services are offered through a third-party vendor (Teladoc). Employees also have the option to participate in flexible spending health, dependent care, and parking programs. The City extends COBRA coverage to employees who are no longer benefits eligible. The plan year for the benefit programs begins January 1 of each year with the open enrollment period being held in October/November time frame. For several years the City has offered a wellness program. An employee or spouse of employee is provided an opportunity to complete the Annual Wellness Assessment which consists of the completion of an online Health Assessment, Tobacco Attestation, 6 and biometric screening. If all three components are completed, employees are provided with the maximum discounted rates for medical coverage. The program is voluntary and administered through the Virgin Pulse portal. Additional wellness events are held throughout the year to engage employees and focus on key health drivers. 1.3 Request for Proposal (RFP) Timeline Provided below is a list of the anticipated schedule of events related to this solicitation. The City of Raleigh reserves the right to modify and/or adjust the following schedule to meet the needs of the service. All times shown are Eastern Time (EST): *All times EST/EDT 1.4 Proposal Question It is the Proposer's responsibility to ensure that all addenda have been reviewed and considered in the preparation of its proposal. Requests for clarification and questions to this RFP must be received by the City not later than the date shown above in Section 1.3, entitled “RFP Timeline” for the submittal of written inquires. The firm’s failure to request clarification and submit questions by the date in the RFP Timeline above shall be considered to constitute the firm’s acceptance of all City’s terms and conditions and requirements. The City shall issue addenda reflecting questions and answers to this RFP, if any, and shall be posted to North Carolina Interactive Purchasing System (IPS). No information, instruction or advice provided orally or informally by any City personnel, whether made in response to a question or otherwise in connection with this RFP, shall be considered authoritative or binding. Respondents shall be entitled to rely only on written material contained in an Addendum to this RFP. It is important that all Respondents submitting to this RFP periodically check the North Carolina Interactive Purchasing System (IPS) for any Addenda. It is the Respondents responsibility to ensure that all addenda have been reviewed and, if required signed and returned. All questions related to this solicitation must be submitted in writing (via email) to the following individual: RFP Process Date Time RFP Advertisement Date 01/10/2022 Deadline for written questions 01/21/2022 by 3:00 pm City Response to questions (anticipated) 01/28/2022 Proposal Due Date and Time 02/10/2022 by 5:00 pm Interview/ Demonstrations Feb 21,22, 24, 25 2022 Virtual Vendor Awarded Announced Late March 2022