1-2026-2027 METRO Stop Loss RFP Workbook .pdf
PDF 149 KB Posted
- Solicitation number
- RFP 2026000008
- Issued by
- Harris County, Texas
About this file
This is a Stop Loss Insurance Request for Proposal (RFP) workbook for the Metropolitan Transit Authority of Harris County (METRO) in Houston, Texas. METRO is requesting stop loss insurance quotes effective October 1, 2026, with proposals due by June 16, 2026. The RFP requires proposers to submit quotes for medical and prescription drug paid stop loss coverage with multiple deductible options ($275,000, $300,000, and $325,000 individual stop loss limits) on a 24-month contract basis. The client has approximately 4,789 regular, full-time non-union employees working at least 30 hours per week, plus retirees and dependent children. Additionally, METRO is considering transitioning its union population to a self-funded medical plan with Cigna for 2026-2027, and proposers must provide two separate quote options: one for the non-union population currently under stop loss coverage and one for a combined quote including the newly self-funded union population. Medical and Rx administration will remain under contract with Cigna/OptumRx. All proposals must be firm for 60 days pending board approval.
Pricing quotes must be submitted net of commissions and include an annual medical and Rx paid stop loss premium of $160.69 per employee per month (PEPM) for individual stop loss and $130.57 PEPM for aggregate stop loss, based on 2024-2025 historical data. Current carriers include Voya and Cigna. All quotes must include a no-laser option with a 50 percent renewal rate cap, and proposers are required to confirm that Spec Advance Funding is included in proposals with the AAW requirement waived. LASERED members must be identified with adjusted deductibles noted. The RFP strictly prohibits any mention of renewal language or renewal dates in the final contract, and proposers must provide a corporate office blanket statement confirming whether the employer's plan document will be used for claims determination purposes. Marketing contacts are Nick Vartabedian (Account Manager) and Joe Sarabia (Account Coordinator) at Gallagher Benefit Services, Inc.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-METRO Stop Loss RFP Scope of Work FY2027 Final.pdf |
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Text version
Proposed Effective Date:
Proposal Distribution Date:
Proposal Due Date:
Name:
Address:
City, State, Zip:
Description:
SIC Code:
Active Employees:
Retirees:
Dependent Children:
Active Employees:
Retirees:
Dependent Children:
Primary Contact:
Phone / Email Address:
Secondary Contact:
Phone / Email Address:
Consultant/Producer:
50% 45% 45%
2025-2026
$250,000
$130.57 $152.27 24/12 24/12
N/A N/A N/A
4 Please quote a FIRM contract or note any restrictions or updated information needed to FIRM quote at a later date.
6 Please note any LASERED members and adjusted deductible applicable.
9 Please include Spec Advance Funding in your proposal and confirm AAW requirement is waived.
As a reminder, we will include in the client's marketing analysis the blanket statement provided by your corporate office in response to whether the employer’s plan document, included in this RFP, will be used for claims determination purposes. Please let me know if you have any questions regarding this statement.
RFP Marketing Contacts (Gallagher Benefit Services, Inc.)
Please be advised that any mention of renewal language or renewal date(s) is strictly prohibited in the 10.1.26 agreement between the winning proposer and METRO. Proposers are required to adhere to this stipulation to ensure compliance with METRO's contractual guidelines. Failure to comply may result in disqualification from the bidding process.
5 To ensure adequate time for METRO's board approval of the winning proposer, all pricing quotes received must be firm for (60) day(s).
RFP Marketing Objectives
Renewal Rate Cap Included?
Proposal Effective Date / Due Date
Client's Name and Address
Much effort has been made to provide all necessary and accurate information in this Request for Proposal. It is the sole responsibility of the proposers to ensure that they have all information necessary to complete submission of their proposals. If more information is needed, contact your Gallagher Benefit Services representative.
(832) 477-5201 Nick_Vartabedian@ajg.com Joe Sarabia Account Coordinator
(713) 358-5772 Joe_Sarabia@ajg.com Annie Bridges
8 ALL quotes must also include a no laser option WITH a 50% renewal rate cap.
Nick Vartabedian Account Manager
2 Provide a quote matching their current specific stop loss policy ($275K ISL) as well as $300K and $325K.
Metropolitan Transit Authority of Harris County
3 Please quote a 24/12 contract.
7 Please quote net of commissions.
Stop Loss Request for Proposal
October 1, 2026 May 17, 2026 June 16, 2026
Metropolitan Transit Authority of Harris County 1900 Main Street Houston, TX 77002
Transportation Services
Regular, full-time non-union employees working at least 30 hours per week, and employees receiving LTD benefits.
1 Quote should include Medical and Rx
PAID
$160.69ISL Premium (PEPM)
ASL Premium (PEPM)
Pre-65 retirees and grandfathered retirees are included in ISL/Agg coverage.
Post-65 retirees are excluded from coverage.
Up to age 26, including any child for whom they are legal guardian
Year
Specific Deductible $275,000 $275,000 Carrier Voya Cigna Cigna
2023-2024 2024-2025
- Medical/Rx administration is currently under contract with Cigna/OptumRx and will remain under contract for 2026-2027.
- No plan design changes have been finalized for 2026-2027. As decisions become finalized, we will provide updates to the market.
Contract Type (e.g. Paid, 12/12, 12/15, 15/12)
Please submit your intent to quote to Nick Vartabedian and Joe Sarabia at Gallagher. Plan documents, historical data, and Census reports will be shared via secure email once an intent to quote has been received.
Type of Industry
Non-Union Employee Eligibility Provisions
Information / Executive Summary
Stop Loss History
Union Employee Eligibility Provisions Regular, full-time union employees working at least 40 hours per week.
Retirees and Surviving spouses are eligible for Medical coverage. Once classified as a Retiree or Surviving spouse, if coverage is terminated they will not be eligible for coverage at any future date.
Up to age 26, including any child for whom they are legal guardian
- METRO has a large Union population that is considering moving to a self-funded medical plan with Cigna for the 2026-2027 plan year.
Currently the group is fully-insured with Cigna. As part of the RFP process, we will be requesting a quote option that includes coverage of this group. Proposers who submit an intent to bid will be provided with the corresponding plan documents, historical data, and census reports for the METRO Union.
- Please provide 2 proposal options as part of your RFP response: (1) A standalone quote for the Non-Union population that has current ISL coverage through Cigna, and (2) a combined quote for both the Non-Union population and the newly brought on Union population.
mailto:Nick_Vartabedian@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Joe_Sarabia@ajg.com
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