The Waco Independent School District (WISD) is soliciting bid responses from qualified firms or individuals for the purpose of entering into a consulting services contract to review and analyze our selffunded plan for group health and prescription drug plans. Assistance in benefit plan design, analyzing claims data, advising on opportunities available to increase benefits and/or lower cost to the district, advising the district on trends in the medical and pharmaceutical industry, and assisting the district in evaluating bids for health insurance, prescription drug plans, and stop loss coverage are all required services under the scope of work. The awarded consultant will be expected to perform the following services: Monthly Plan Financial Reports, to include but not limited to: • Summary of plan costs • Analysis of actual vs. budget • Employee contributions • Large claims tracking • Identification of costs for specific line of coverage: • Comparison of plan costs to aggregate stop-loss projections, if applicable Purchasing Department 501 Franklin Avenue, Waco, TX 76701 Voice: 254-755-9458 Fax: 254-755-9688 • Utilization review • Comparison to prior claim period • Plan trends • Provide monthly performance reporting of the Medical/Rx plan in person at Waco ISD Annual Financial Reports (End of Year Accounting), to include but not limited to: • Executive summary of program expenses • Comparison of current costs to renewal costs • Incurred but Not Reported (IBNR) claims analysis • Overview of specific stop-loss projections • Future plan costs projections • Dollars saved by contract negotiation • Percent of benefit dollars paid by employee • Claims by size • Physician visit details • Benefits paid by type of service • Plan funding/budget comparison • Fixed expense comparison Renewal Analysis, Benefit Design, and Vendor Negotiations: • Review and evaluate benefit plan • Review and evaluate carrier projections • Prepare “shadow” renewal projection • Create financial modeling reports • Create employee contribution modeling reports • Help WISD evaluate/review current scope of benefits package – e.g., types & levels of coverage • Work with WISD to develop funding and contribution strategies • Assist with budget projections for design alternatives • Review identified benchmarks of projected plan costs • Develop “working” rates for WISD analysis and approval • Assist with budget projections • Provide renewal alternatives with cost impact of benefit plan changes • Contract/Plan Document Review • Assist in preparing plan design with cost recommendations • Work with WISD to develop a strategy to identify goals, analyze program costs and review both current and alternative funding arrangements • Manage the renewal process with the current carrier to control costs • Implement carrier renewal strategies with WISD • Provide in-depth pre-renewal projections and analysis of proposed alternatives. Assist with the process of selecting the most favorable annual renewal options. • Develop timeline covering every aspect from RFP preparation to the delivery of employee communications • Provide analysis of employee disruption report and preparation of geo-access report • Provide analysis of discounts offered by various carriers by using Current Procedures Terminology (CPT) codes and carrier pricing data • Provide coverage comparison analysis and recommendations as to plan design, carrier selections and funding mechanisms
