Medical / Rx Stop Loss Insurance

Assumptions are as follows: The proposal is to be based on the proposed plan of benefits. The quote is to be based upon the census provided in the RFP. All participants enrolled in the Employee Benefits Plan as of December 31, 2025 are to receive immediate coverage under the new plan. All health services incurred on or after January 1, 2026, for currently enrolled participants are to be eligible expenses. The City’s enrollment records are to be the basis for “take-over.” All Respondent proposal offerings will comply with the Patient Protection and Affordability Care Act. Coverage for employees (full time) becomes effective on the 1 st day of employment. Medical terminates at the end of the month in which the employees separates from employment. Retirees are eligible for continued coverage up to Medicare eligibility, provided they were enrolled in benefits the day preceding the date of retirement. This RFP is for a five-year contract. A three-year contract with two one-year renewal options with caps, a two-year contract with three one-year renewal options with caps or a one-year contract with options for four one-year renewal options with caps will be considered. If it is the respondent’s intent to increase rates at the renewal date, the City must be notified of the maximum increase for each renewal period and the basis for calculating the increase. The City must be notified of renewal rates at least 120 days prior to the effective date of the rate change.