St. Charles County Government (The County) is seeking Proposals for its self-insured employee Health (Medical & Pharmacy) benefit program effective January 1, 2025. A stop-loss program is an integral part of this RFP. Currently the County’s self-funded program is administered by CVS Aetna. A Stop Loss Program, underwritten by Aetna Life, includes both a specific and aggregate feature. The Plan includes Mental health benefits. A Plan outline for both In-Network and OON is attached. Coverage is available to all permanent full and percentage time employees (60% or greater), their dependents, retirees, and Elected Officials. The Pharmacy benefit program, including specialty medications, is administered by CVS Aetna. Pharmaceutical expenses are not applied to either the Specific or Aggregate stop loss policies. A vision benefit is currently included with the health plan for purposes of employee contributions. Although it is a standalone, fully insured plan, an employee may not opt for the health program without vision. However, employees are allowed to enroll for vision benefits without having to subscribe to the health plan.
