Specifications include, but are not limited to: SCOPE OF SERVICES: The contractor shall provide the following at a minimum: 1. Online Enrollment during OE period and on an ongoing basis for new hires and qualifying events 2. Decision Support Tool 3. At least weekly electronic data interchange (EDI) with various vendors (described below) 4. At least weekly bi-directional electronic data interface with the client’s HRIS 5. Ongoing administration and reporting 6. Billing support 7. Performance Management Tool 8. Dedicated customer service and ongoing support for a dynamic workforce and eligibility criteria • The contractor or system shall have the ability to go into the administrative system and make retroactive adjustments to benefit elections, eligibility and start and end-dates (up to the limit defined by each insurance contract, typically 90 days). The contractor shall indicate if the system has the ability to notify insurance companies (via EDI) of these retroactive adjustments. • The system must have the ability to track beneficiaries both primary and contingent. • The contractor’s system must be easy to use and flexible reporting capabilities with the ability to run both standardized and customized reports, preferably in excel format as an option. • The contractor’s system shall allow employees to utilize a Decision Support Tool during open enrollment. • While not required, the City prefers that City employees have the ability to enroll via a mobile app in addition to a web-based option in the contractor’s system.
