13-26RFP020 Stop Loss Insurance.pdf

This solicitation is a request for proposals for services under Texas Education Code 44.031.

Request for Proposals

26RFP020

Stop Loss Insurance

Date Event

October 10, 2025 and October 17, 2025

Dates of public advertisement

October 21, 2025 Due date for questions submitted in Bonfire platform by 5:00 pm CST

October 24, 2025 Questions and answers posted in Bonfire platform

October 28, 2025 RFP opening / Vendor proposal due date at 2:00 pm CST

December 18, 2025 Tentative AISD Board meeting for review/approval

Contact:

David Martinez-Gutierrez Procurement Specialist Contract & Procurement Services francisco.d.martinez@austinisd.org

To ensure a fair and transparent solicitation process and the integrity of submissions:

• Proposals received after the specified due date and time shall not be considered.

• Proposals must be submitted in the specified format and all Required Forms must be signed and submitted with response.

• Question and Answer Protocol: Proposers seeking clarification or have questions pertaining to this

RFP must submit questions in writing through the AISD Bonfire Portal no later than the date and time shown above.

• Questions & Answers and all Addenda will be posted on the AISD Bonfire Portal:

https://austinisd.bonfirehub.com/portal/ mailto:francisco.d.martinez@austinisd.org https://austinisd.bonfirehub.com/portal/

Austin ISD – Request for Proposals 26RFP020 Stop Loss Insurance

Virtual Bid Opening Details

A virtual bid opening for this solicitation will take place on Tuesday, October 28, 2025 at 2:15pm via the Google Meet Platform

Virtual Bid Opening Details

Meeting ID: meet.google.com/vus-zvhn-gtk

Phone Numbers (US):

0365-701-+1 774

PIN: 614 128 416#

https://www.google.com/url?q=http://meet.google.com/vus-zvhn-gtk&sa=D&source=calendar&ust=1760391522820471&usg=AOvVaw3pqSxIVONNfNbfA0_nk0_X

Checklist and Submission Guidelines

This checklist is provided to help you conform to all form/document requirements stipulated in this solicitation and attached herein. This is not a required form and it is not necessary to return this checklist with your proposal.

I. Understanding the Proposal

Completed

Read entire RFP document, appendices and attachments

Review AISD Policy and Provisions (available on the AISD website)

Submit questions properly before deadline

Review addenda, Q&A and other additional attachments

Review Proposal Format section of RFP

II. Forms

Completed

Bid Certification

Notification of Criminal History of Contractor

Debarment, Suspension and Ineligibility Certification

Conflict of Interest Questionnaire (CIQ) – electronic submission

Stop Loss Workbook

Edgar Certifications Addendum for Contract Funded by U.S. Federal Grant

III. Submitting the Proposal

Completed

Prepare the proposal in the format specified and sign all required forms

Submit RFP through the AISD Bonfire Portal no later than the due date and time.

Table of Contents

Section I

Section II

Section III

Section IV

Section V

Section VI

Section VII

Introduction

Historically Underutilized Business (HUB) Program Requirement

Proposal Format

Initial Review of Proposals

Competitive Selection / Evaluation

Scope of Service and Performance Requirements

Appendices and Attachments

I. INTRODUCTION

The Austin Independent School District (herein after referred to as “AISD” or the “district”) is seeking proposals from firms/vendors/contractors qualified and experienced in providing Stop

Loss Insurance for the AISD Employment Benefit Plan. Austin ISD has a self-insured Medical benefit program administered by Blue Cross Blue Shield. AISD offers one High-Deductible

Health Plan (HDHP) and one Health Maintenance Organization (HMO) plan. These plans differ by deductible, copay and co-insurance amounts.

Proposers may make written inquiries through the AISD Bonfire Portal concerning this solicitation to obtain clarification of the proposal requirements. Inquiries shall be submitted no later than the time and date specified on the cover page. Questions received by this deadline, and corresponding answers, will be included in an

Addendum. All addenda will be posted in the AISD Bonfire Portal.

Each Bidder, by submitting its proposal, agrees that the proposal is subject to the

Austin ISD Policies and Provisions and agrees to comply with those conditions. Acceptance of a proposal will occur only when a contract is executed. Any contract will incorporate the Austin ISD Policies and Provisions and Standard Terms and Conditions and no commitment exists until a contract is executed by both parties.

Austin ISD is subject to the Texas Public Information Act. All documents submitted as part of the Contractor’s Proposal response will be deemed confidential during the evaluation process, and will not be available for review by anyone other than Austin

ISD staff or its designated agents. Following an award of contract or termination of the procurement, Proposals may be subject to release as public information. If a Proposer believes that its Proposal response, or parts of it, may be exempted from disclosure under Texas law, the Proposer clearly must specify page-by-page and/or line-by-line the parts of the Proposal response which it believes are confidential or otherwise exempt. Austin ISD assumes no obligation or responsibility relating to the disclosure or nondisclosure of information submitted by Proposers.

II. HISTORICALLY UNDERUTILIZED BUSINESS (HUB) PROGRAM REQUIREMENTS

The HUB Program promotes and strongly encourages the involvement and participation of Historically Underutilized Businesses in District-wide procurements. According to AISD policies CH (LOCAL) and CV (LOCAL), the HUB Program guidelines are not applicable for this type procurement.

III. PROPOSAL FORMAT

A. Preface The vendor/contractor shall provide an executive summary of two (2) pages or less, which gives in brief, concise terms, a summation of the proposal.

B. Proposal The vendor/contactor’s proposal itself shall be organized in the following format and informational sequence:

Section I – Summary of Experience

This section shall contain the full name and address of the vendor/contractor submitting the proposal and a brief summary of the vendor/contractor’s experience and individual experience for personnel who will provide this product or service.

Section II - Scope of Service

A description of services and capabilities as outlined in the Scope of Service and

Performance Requirements sections of this RFP, in the order shown. Clearly state any exceptions taken to the specifications of this RFP, or any conditions of the proposal.

Section III - Financial Proposal

This section shall contain a straightforward, concise delineation of the vendor/contractor’s fees to satisfy the requirements of this RFP. It is the vendor/contractor’s responsibility to specify all costs (i.e. administrative fees, processing fees, etc.) associated with providing the products or services required herein.

Section IV – References

References are to be from government agencies and/or firms, which are substantially serviced by the vendor (references most similar to Austin ISD should be provided). Each reference must contain the reference’s name, address, telephone number, and point of contact (including email address). A list of at least three (3) references from current customers must be provided.

C. Required Forms

Forms are required to be completed and submitted with proposal response. Bidders shall execute the following required forms. A link is provided for the CIQ below. All other forms can be found in the AISD Bonfire Portal for download.

• Bid Certification

• Notification of Criminal History of Contractor

• Debarment, Suspension and Ineligibility Certification

• EDGAR Vendor Certification

• Stop Loss Workbook

• Conflict of Interest Questionnaire (CIQ). The CIQ is prepared by the Texas Ethics Commission, in compliance with Chapter 176 of the Texas

Local Government Code. The form should be submitted on-line at:

https://www.austinisd.org/cp/ciq-online

The District reserves the right to tender its own contract which shall incorporate the requirements of this RFP and the successful Proposer’s response. A preview / reference only copy of AISD’s Agreement is posted on the AISD website and should not be submitted with proposals.

IV. INITIAL REVIEW OF PROPOSALS

Any vendor/contractor determined non-responsible or any proposal determined non-responsive will not be evaluated further. The vendor/contractor will be notified of a non-responsible or non-responsive determination.

Responsive

In order for a proposal to be responsive:

• ALL required forms listed above shall be signed and included with proposal;

• Proposal shall be received prior to the RFP opening date at the address listed on the cover page;

• Proposal shall respond to the entire scope of service and performance requirements as requested.

Responsible

In order for a proposal to be responsible, the vendor/contractor shall be in good financial standing with the Texas Comptroller of Public Accounts.

V. COMPETITIVE SELECTION / EVALUATION

A. This is a NEGOTIATED procurement and as such, award will not necessarily be made to the offeror submitting the lowest priced proposal. Award will be made to the firm submitting the best responsive proposal satisfying AISD’s requirements, price and other factors considered.

Consistent with state law and district policy, this RFP does not commit the district to award a contract. The district reserves the right to accept or reject any or all proposals and/or award in whole or in part any proposal if the district determines it is in the best interest of the district to do so. The district also reserves the right to waive any minor informalities in order to take the action which it deems to be in the best interest of the district.

B. The district anticipates that the evaluation process may include multiple levels of evaluation, as for example, but not limited to:

Phase 1: Initial review of the proposal by the district’s evaluation team.

https://www.austinisd.org/cp/ciq-online

Phase 2: Interviews and/or presentations of top proposals from Phase 1, followed by administrative review of finalist(s) and award recommendation.

PHASE 1

Points Item Detailed Description

20 Points Proposed Plan The adequacy and completeness of the plan offered addressing the Scope of Service.

15 Points Contractor's

Capabilities

The demonstrated ability of the vendor/contractor to provide services, including references.

25 Points Proposed Products

Quality of items as well as their ability to meet specifications and sustainability requirements and preferences.

40 Points Financial Proposal Start-up costs, fixed product costs as well as rebate incentives to determine best value.

PHASE 2 (optional)

Points Item Detailed Description

35 Points Interview / Presentation The adequacy and completeness of the plan offered addressing the Scope of Service.

35 Points Vendor/Contractor's

Capabilities

The demonstrated ability of the contractor to provide services, including references.

30 Points Financial Proposal Start-up costs, fixed product costs, ongoing maintenance fees, etc.

C. The committee evaluating the proposals submitted in response to this RFP may require any or all contractors to give an oral presentation in order to clarify or elaborate on their proposal as well as to provide a demonstration. Upon completion of oral presentations or discussions, contractors may be requested to revise any or all portions of their proposals and submit a best and final offer (BAFO) for consideration.

D. If the district determines that additional evaluation steps are required to determine the best value between Vendors/Contractors, the district reserves the right to consider any or all of the following additional criteria; the proposed price, vendor/contractor’s experience, references and record for responsibility, or any other relevant factor that the district deems necessary to determine best value.

VI. SCOPE OF SERVICE AND PERFORMANCE REQUIREMENTS

A. Term The agreement(s) resulting from this solicitation will be in effect for an initial term of one (1) year from the date of award by the Board of Trustees, or such date established by the agreement. The parties by mutual consent may renew the agreement for up to four (4) additional one (1) year periods. In addition, the district reserves the right to extend the contract for an additional time beyond the final expiration date if necessary to ensure no lapse in service.

B. The following gives general information and describes the service and performance requirements that selected vendor(s) will be required to perform. Failure to address or to fully describe capabilities to accomplish all elements of this section will result in a loss of evaluation points.

General Information:

1. Effective Date: January 1, 2026

2. Contract Duration: 1 Year

3. Vendor History: Aetna since 2016-2024, No Stop Loss Coverage for 2025

4. Full Time Employees (EEs) as defined by the Client and variable EEs working

ACA 30 Hours/week; Retirees are not covered. Full-time professional and para-professional - coverage is effective the first of the month following the employment date - i.e. employees hired on February 15th, will receive coverage as of March 1st.

5. District Plan is a PPACA is a "non-grandfathered" plan.

6. The District currently has 2 BCBS Plans, but will be moving to 3 BCBS plans for

2026. Please refer to the exhibits for further information. The client will consider these three (3) models for weighted average scoring. Proposals will be scored on these three (3) models. For purposes of developing your cost, network, utilization management, modeling strategies, please see the new plans being offered in 2025 under Blue Cross Blue Shield.

7. Vendors are to propose all fees and premiums net of broker/agent commissions;

the client is not requesting services of an agent/broker.

8. All reporting files and other supporting documentation can be found attached to the bid posting.

9. The District will not accept competing multiple proposals from the same vendor.

The vendor must manage their internal proposal process to assure that one (1) proposal is presented.

Scope of Services and Proposal Specifications:

1. Please reference ATTACHMENT B for all proposal specifications.

a. Specifically, the Proposal Specifications tab and Questionnaire tab

2. The District is requesting multiple deductible levels for comparative evaluation purposes only. The District intends to select and award coverage based on a single deductible level that provides the best overall value. Vendors should provide pricing for all requested deductible tiers, understanding that only one level will be selected for the awarded coverage.

C. Criminal History Background Checks (Use for direct services to students)

Vendor/Contractor is directly responsible to obtain all required criminal history record information through the Texas Department of Public Safety’s Fingerprint-based Applicant Clearinghouse of Texas (“FACT”). The cost of the background checks is the responsibility of the Vendor/Contractor. Vendor/Contractor must ensure that there is no criminal history record that would prevent the Vendor/Contractor or its employees from working in the District’s facilities. Vendor/Contractor must ensure that national criminal history record certification is filed with the District. Vendor/Contractors can only be present at district campuses or may provide online services once the criminal history process (including forms and fingerprinting) has been properly completed and approved. For more information, please refer to AISD District Policy CJA (REGULATION) and CJA (LEGAL).

D. Insurance Requirements (Use for direct services to students)

The Contractor may provide proof and maintain the following insurance coverage applicable to liability which could be incurred in conjunction with its employees providing of services to the district:

• General Liability (minimum limit of $1,000,000 per occurrence and $2,000,000 aggregate). This policy should cover injury of a participant and include the following provisions: waiver of subrogation, endorsement to provide Austin ISD as additional insurance, and notice of cancellation.

• Sexual Molestation & Child Abuse (SAM) endorsement of $100,000 minimum (either specifically stated as included as part of General Liability or purchased separately in addition to the General Liability policy).

• Full Malpractice Coverage: professional liability coverage at a minimum limit of $1,000,000 to pay on behalf of the assured all sums which the assured shall become legally obligated to pay as damages by reason of any negligent act, error, or omission arising out of the performance of professional services under a contract. Professionals required to be licensed or registered by the state. Examples: architecture, landscape architecture, land surveying, medicine, nursing, engineer, optometry, real estate appraising.

• Workers’ Compensation: coverage should be consistent with statutory benefits outline in the Texas Worker’s Compensation Act Section 401. The minimum policy limits for Employer’s Liability are $500,000 bodily injury each accident, $500,000 bodily injury by disease policy limit, and $500,000 bodily injury by disease each employee. The company’s policy shall apply to the State of Texas and include a waiver of subrogation in favor of Austin ISD.

A current, industry-standard ACORD Certificate of Insurance (COI) for each of the above policies shall be delivered to the AISD before any work is started. Certificates shall be sent to the AISD Contract & Procurement Services office at each change or renewal during the term of the contract.

If transporting Austin ISD students, the vendor must have Automobile Liability as follows: Owned, Non-Owned, Hired or Rented with $1,000,000 Single Limit and Additional Insured in favor of Austin Independent School District. Questions about the district’s insurance requirements should be directed to the Office of Risk Management.

E. Award Terms and Conditions

There are multiple steps required for AISD to award and execute agreements issued pursuant to this RFP. Important information and general action steps pertaining to the post-RFP/post-award process is included below.

• Any agreement resulting from this solicitation is contingent upon the continued availability of appropriations and is subject to cancellation, without penalty, either in whole or in part, if funds are not appropriated by the AISD Board of Trustees or otherwise not made available to the District.

• Any agreement issued as a result of this RFP does not guarantee any minimum amount of service or payment. A Service Agreement with AISD will not be issued unless requested by campuses and/or department initiates a request for services. A provider shall not perform services for AISD without a fully executed agreement and the issuance of a Purchase Order.

• A provider will be compensated by AISD for services actually performed and satisfactorily rendered in accordance with contract requirements. A sample of AISD’s Service Agreement is available on our website for your review only but should not be submitted with your proposal.

• Payment will be made according to the District Comptroller’s published Accounts Payable schedule. Typically, payment is net 30 days after receipt of accurate and verifiable invoice. Service rates per hour charged should be reasonable and customary.

Mileage and travel expenses will not be reimbursed by AISD.

• The District reserves the right to terminate all or any part of the undelivered portion any order resulting from this solicitation with thirty (30) days written notice; upon default by the vendor, for delay or non-performance by the Vendor, or, if it is deemed in the best interest of the District, for convenience.

• Recommended vendors will receive a Notice of Award. If a Service Agreement is issued, the vendor will receive the document via email for electronic signature using the DocuSign routing system. Once complete, vendors will receive a fully-executed copy of the service agreement via email. Non-awarded vendors will receive a “Notice of Non-Award” via email.

• Upon approval, vendors will receive a Purchase Order (PO) and this is the notice to proceed to begin services. Under no circumstance should vendors begin to provide services to the district without a valid Purchase Order. AISD is not responsible for payment for unauthorized services rendered in advance of a valid PO being issued.

• Conflict of Interest – Employment Restrictions Any person who has been employed as a full-time employee of the District may not perform services for the District for compensation as a vendor or consultant or on behalf of a vendor or consultant for 18 months after the termination of the person’s employment relationship with the District. This restriction does not apply to former employees who are hired as classroom teachers, campus-based professional employees, or campus principals. AISD Policy DBD (LOCAL)

• Pricing Adjustments:

Pricing provided by Proposers in response to this RFP will remain firm for the initial term of the agreement. Should market conditions prevail which dictate an increase, the vendor may request permission to increase pricing no later than 30 days after receiving notice from Austin ISD of its intent to extend the agreement. Pricing adjustments may only occur at the time of renewal and only upon securing approval in writing from Austin ISD’s Contract & Procurement office. Requests for price adjustments must be solely for the purpose of accommodating an increase in the vendor's cost, not profits. Price adjustment is limited to up to a five percent (5%) increase per renewal period. Such requests must be submitted in writing detailing the requested adjustments. Justification for the request to adjust pricing must be industry-driven and further substantiated by including supporting documentation, such as a letter from suppliers.

Austin ISD may, in its sole discretion, accept or reject the price increase in whole or in part. Austin ISD shall have authority, in its reasonable discretion, to determine the validity of any change in vendor’s rates. If a properly submitted increase is rejected, the Proposer may request cancellation of such items from the contract prior to renewing by giving AISD written notice. Prices must be honored on orders dated up to the official date of the approval and/or cancellation of the requested price adjustments.

VII. APPENDICES AND ATTACHMENTS

➢ Appendices (Documents included within this proposal are available for download with in

Bonfire):

▪ Appendix 1 – Purchasing and Acquisition Vendor Relations Policy CHE-LOCAL

▪ Appendix 2 – AISD Policy and Provisions

➢ Attachments (Separate documents available to download within Bonfire):

Group Document Title/File Name Required

Attachment A Required Forms Yes

Attachment B Stop Loss Workbook Yes

Attachment C 2026 Proposed Medical Plan Designs N/A

Attachment D Employee Census Data N/A

Attachment E Medical HDHP Benefits Program N/A

Attachment F Medical Blue Essentials Benefits Program N/A

Attachment G 2023 YTD Claim Analysis N/A

Attachment H 2024 YTD Claim Analysis N/A

Attachment I 2025 YTD Claim Analysis N/A

Attachment J BCBS Summary of Benefits and Coverage - Blue

Essentials HMO N/A

Attachment K BCBS Summary of Benefits - HSA Plan N/A

Attachment L Aetna Stop Loss Renewal Plan N/A