15-15 - Flexible Spending Account (FSA).pdf

This is a pricing quotation form for Flexible Spending Account (FSA) administration services submitted to the City of Lewisville, Texas Purchasing Division as part of a competitive sealed proposal process for Employee Health and Welfare Benefits. The City of Lewisville is soliciting proposals for comprehensive benefits administration services including third-party administrators for medical and dental coverage, pharmacy administration, medical and pharmacy stop-loss coverage, fully insured vision plans, life and accidental death and dismemberment insurance, long-term disability, Employee Assistance Programs, Health Savings Accounts, and Flexible Spending Accounts. The contract award will be determined in accordance with Texas Local Government Code Chapter 252, and all successful bidders must certify compliance with the Americans with Disabilities Act and related regulations.

The FSA quotation form requests detailed pricing information including monthly maintenance fees, one-time setup charges, annual fees, bank account setup costs, plan document and Summary Plan Description renewal fees, enrollment material expenses, and claims processing fees. Additional services to be priced include online account access, email claim submission capabilities, 24-hour internet and voice response systems, toll-free customer support, direct deposit and check claim disbursement options, and communication and meeting report services. Bidders must provide per-participant monthly costs, estimated first-year administration fees based on eligible participant counts, and rate guarantee effective dates. All pricing submissions must be accompanied by a separate detailed quote document as required by the City's purchasing procedures.