Specifications include, but are not limited to: 1. The City of Suffolk seeks a provider who can sufficiently mirror current plan designs and provide best and final pricing. 2. The City of Suffolk is interested in reviewing proposals that mirror the current plan designs under a “group policy” model versus an individual model. 3. All offerors should assume full replacement of each of the current plans offered. 4. All offerors benefit policies shall include language that allows employees and their dependents to continue voluntary worksite coverage at the same rate after they leave employment by paying the carrier directly. 5. The selected provider will need to provide high quality, efficient program administration and services, including, but not limited to: a. Maintaining central claims and membership files (including the identification number or other identifying number, dates of coverage, type of coverage, etc.) for each covered member. b. Maintaining payment records. c. Having the capability of wire transfer of funds, paying members directly, providing state-of-the-art data tracking and claims payment services. d. Maintaining separate accounts or sub-groups as required by the City of Suffolk. • Provide accurate payroll deduction data to the City of Suffolk on a timely basis. Be responsible for all reconciliation of premium/payroll records. • Prepare and send bills to the City of Suffolk monthly for their respective employees and eligible dependents. The City of Suffolk deducts payroll deductions the same month as as due, thus payments to provider will be made during the month as billed and not in advance. e. Provide the option of online services for eligibility, billing, enrollment, and member services. f. Allow the City of Suffolk to pay monthly premiums and other expenses as reflected in the City’s payroll records. The City may not pay as billed, may self-bill, or list bill at the City of Suffolk’s choice. The City of Suffolk will audit bill eligibility records quarterly and allow the Offeror to audit records as necessary. g. Demonstrate capability to communicate, enroll, and administer voluntary worksite programs at no cost to the City of Suffolk. h. Provide detailed data required by the City of Suffolk’s Provider to support annual strategies and other reports upon request. The data required is a detailed extraction of eligibility, monthly enrollment, premium and claims by line of coverage...
