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Health Benefit Consultant Services


Location
Tennessee
Publication Date
05/10/2019 02:44 PM EDT
Closing Date
05/31/2019 03:00 PM EDT
Issuing Organization
Davidson Transit Organization
Solicitation Number
Description

Specifications include, but are not limited to: The mission of the Nashville Metropolitan Transit Authority (MTA) is to provide public transportation services to our community and its visitors so they can achieve greater mobility and experience a cleaner, healthier environment with less traffic congestion. A total of 710 lives are covered under DTO’s current health benefit plan, including medical, dental, vision, and prescription drugs. DTO seeks the services of an insurance agent/ consultant (Agent) to provide the following services: 1. Annual Stop-Loss Policy Marketing a. Each year Agent will quote the reinsurance market and recommend the most competitive product(s) to DTO management. The Agent will negotiate carrier’s deliverables and oversee any required transition. 2. Pursue DTO’s Interest with Third Party Health Benefits Claims Administrator (TPA) a. Ensure DTO’s management team, HR staff, and employees are receiving all contractual deliverables from TPA; monitor and report network discount and performance guarantees. 3. Compliance a. Monitor Plan compliance with Affordable Care Act legislation and changing regulations. Agent will also assist with planning related to COBRA, HIPAA, Section 125, FMLA and other state and federal mandates affecting DTO benefits and programs. b. Evaluate election notices and applications for enrollment. c. Evaluate Notice of Termination as well as Termination of Continuance of Coverage Letters/Documentation. d. Evaluate Conversion Notices if required. e. Evaluate HIPAA Certificates of Creditable Coverage (COCCs) for COBRA coverage participants. 4. Plan Management Support a. Agent will assist DTO’s Human Resources staff with employee communications, new hire packets, benefits guides, payroll stuffers and education material as needed. 5. Plan Strategy a. Agent will make recommendations to help enhance DTO’s plan offering while remaining competitive and reducing overall plan costs. b. Provide a comprehensive provider network (meaning both breadth of services and geographic coverage) that offers the most competitive discounts for participants in Middle Tennessee along with a network throughout Tennessee and the remainder of the United States. c. Ensure the availability of quality measurement standards and metrics that enable participants to compare and contrast various providers relative to quality scores and cost efficiencies. d. Provide a network that balances choice of providers with effective cost management of claims and unit pricing transparency. e. Provide all DTO participants the lowest available unit cost rate available pursuant to any provider contract. 6. Communication and Educational Services a. Working in conjunction with DTO, prepare and sometimes distribute benefit materials, reports or presentations as well as attendance at open enrollment meetings. b. Provide HIPAA compliant web based access to authorized DTO employees and designated business associate(s) for claims data, financial and statistical reports and any other data readily available to employers relative to your standard reporting tools and resources. 7. Data Reporting a. Provide enrollment, demographic and eligibility data at least monthly in a report format.

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