The City is seeking to name a Broker of Record for the City's employee insurance benefits. The City is particularly interested in a broker who can offer creative, innovative approaches with a proven track record that allows the City to maintain quality programs and contain or reduce costs. The City is a member of PRISM and participates in the PRISMHealth and PRISM Employee Benefits programs. The selected broker should be readily familiar with government employee benefit programs and Joint Power Authorities (JPAs) such as PRISM. The selected broker will perform a full range of benefit program services related to the acquisition, implementation, maintenance, communication, and improvement of the City's employee benefits program. The selected broker shall provide services, including, but not limited to, the following types of coverage/benefits: medical, dental, vision, life, long term disability, cafeteria plan, employee assistance and wellness, and supplemental insurance. A. Analysis and Reporting 1. Analyze existing coverage and identify or develop cost-saving alternative benefit strategies and plans. 2. Assist in the development of long-range goals and strategies, including making projections of potential savings. 3. Provide analysis and recommendations based on utilization and performance reports, statistical and/or financial reports, and plan specific data. 4. Assist the City in monitoring and analyzing experience trends and providing timely alerts on changing patterns and appropriate recommendations. 5. Provide financial and/or performance reviews of self-funded and fully insured plans and programs. 6. Be available to provide various types of reports as needed, such as cost analysis for benefit changes, and other statistical, financial, forecasting, trend, labor negotiations, or experience reports. 7. Regularly monitor and evaluate performance measures and guarantees for providers. 8. Maintain full and accurate records with respect to all matters and services provided on behalf of the City's benefit plans and programs. Provide City staff or officials with all spreadsheets, assumptions, and calculations upon completion of any project performed on behalf of the City's benefit plans and programs. B. Liaison and Problem Intervention 1. Act as liaison between the City and insurance providers. 2. Provide consultation on plan interpretation and problem resolution. 3. Provide timely customer service and assistance to staff regarding enrollment, issues involving provider billing, claims, vendor service issues/problems, advocacy for services, disputes, interpretation of contracts and services, changes and general troubleshooting. 4. Act as an advocate or ombudsman in appeal, arbitration, or court process between the City and the providers on unresolved issues if needed; provide advice when needed to enforce City, employee, retiree, or their dependents' rights. 5. Assist the City in proactive mitigation of negative impacts or disruption of services to employees and retirees from benefit and/or provider network changes. C. Compliance 1. Assist with ongoing plan administration and ensure that programs are in compliance with State and Federal legislation and regulations. 2. Provide training to City staff, as needed, regarding regulatory updates and/or best practice seminars for the effective administration of benefit plans.
