To support the ongoing administration of its employee benefit plans, WCPS requires its Consulting Services Contractor to provide prompt, responsive, and comprehensive guidance that is clear, accurate, and actionable. The Consultant shall offer expert advice across a range of topics necessary for the effective and compliant administration of WCPS’s benefit offerings. These areas include, but are not limited to, legal and regulatory compliance, plan design, cost containment strategies, data analysis, GASB-related actuarial support and reporting, and procurement processes. The Consultant will work collaboratively with WCPS staff to supplement internal resources in the areas of plan administration, issue resolution, and service delivery. Specific responsibilities include: ● Document Review and Consistency: Review Summary Plan Descriptions (SPDs), Summary of Benefits and Coverage (SBCs), contracts, and policies to ensure alignment with the terms and provisions of the benefit plans. ● Timely Document Execution: Ensure that all contracts, plan documents, and summary materials are prepared, reviewed, and executed in a timely manner. Advise WCPS on whether the final documents accurately reflect negotiated terms. ● Stop-Loss Coordination: Coordinate reimbursement processes with stop-loss vendors, including establishing ongoing file feeds or electronic reporting mechanisms, where available. ● Claims Assistance: Provide support for escalated claims issues, serving as a liaison between WCPS, employees, and insurance providers to facilitate resolution and recommend long-term solutions. ● Vendor Issue Support: Assist in resolving plan provision discrepancies, claims, eligibility, and billing concerns with benefit vendors. ● Network Guidance: Address inquiries and issues related to provider networks. ● Performance Reporting: Report on performance metrics negotiated with vendors, if applicable.
