Summary of Specifications:
The School District of Escambia County, Florida (hereinafter referred to as “ECSD” or “The School District”) desires to receive proposals to provide group employee medical and prescription drug insurance benefits for ECSD employees, employee dependents, retirees and retiree dependents. ECSD is soliciting proposals for group medical and prescription drug insurance and/or ASO arrangements. The RFP addresses two types of funding programs (Fully-Insured and Self-Insured). The proposer may quote on all delivery models for all employees and retiree groups. The objective of this RFP is to determine and secure the highest quality Program(s) and funding method for the School District of Escambia County. ECSD prefers service providers that meet or exceed the current levels of service, offer comparable funding and a network that is comparable to the current network and would provide the least amount of employee disruption. ECSD currently has a self-funded program health insurance program that offers a Preferred Provider (PPO) and two (2) Managed Choice (MCP/POS) plans. The health insurance program has been administered through United HealthCare. The prescription drug program is administered through Caremark (Formerly Advance PCS). The prescription drug plan is available for all active employees and retirees and has a structured co-pay for a 30-day supply of: (1) Generic-$10, (2) Formulary-$25, (3) Name Brand-$40. The 90-day supply is available on a mail order basis and also at participating pharmacies, but currently (3) co-pays apply. Currently premiums for both plans are combined into a single premium and either paid entirely by the ECSD, paid by the employee/retiree, or a combination of each. ECSD currently pays 100% of the employee premium (Single coverage only) for the Base (EPO) plan for all active employees, and contributes toward the total cost of the single premium for the other (2) plans, but not at 100%. Currently ECSD contributes towards dependent and most retiree premiums. Proposers shall bid on the Current Plan Designs or a plan design that most closely matches the current plan design. Explain all deviations from current plan(s) in Attachment C. Additionally, proposers may include two additional plan designs for each delivery model quoted. An alternative plan design should represent the proposer’s best effort to maintain the value of the current plan without a substantial increase in the premium of that plan. The District also desires to have carriers/vendors submit an alternative plan design that would represent a decrease in benefits and premium. (Refer to Attachment C) ECSD permits employees to opt out of the medical plans with proof of coverage from another source, or enrollment in a self-administered In-Hospital Indemnity Plan.
