2025-010_City_of_Edinburg_-_Stop_Loss_Insurance.pdf

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City of Edinburg

Request for Proposal (RFP# 2025-010)

Stop Loss Insurance (Medical & Rx)

Effective Date: October 1, 2025

Deadline for Proposals: 03:00 P.M., July 15, 2025

Prepared by: Roger Garza, Insurance Consultant Valley Risk Consulting, Inc., 1200 Fresno, Suite C, McAllen, Texas 78501

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The City of Edinburg is accepting proposals for:

RFP# 2025-010 Stop Loss Insurance (Medical & Rx)

Proposals must be submitted electronically to:

https://procurement.opengov.com/portal/cityofedinburg no later than Tuesday, July 15, 2025 @ 03:00 p.m.

Proposals will be accepted until 03:00 p.m. on Tuesday, July 15, 2025. Any proposals received late will not be accepted.

Any questions about this Request for Proposal should be submitted through the procurement portal by 05:00 p.m. Thursday, July 3, 2025.

The proposal will be awarded at a City Commission meeting in August. The city reserves the right to accept or reject any and/or all proposals, waive minor technicalities, or award the proposal to the most responsible offeror who best serves the City's interests.

Please fill out, sign, and submit with your proposal response the enclosed IRS Form, W-9, and Conflict of Interest Questionnaire.

We look forward to hearing from you.

Sincerely, Erica Balli, Director of Human Resources

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Executive Summary Notice Request for Proposals (RFP)

General Information:

1. The purpose of this Executive Notice is to highlight the key requirements of the Request for Proposal

(RFP).

2. The City of Edinburg is requesting proposals from qualified firms to provide Stop Loss Insurance (Medical & Rx). Requested Policy terms: Specific Deductible-$125,000 & Contract Basis-12/12, Aggregate Corridor 125%, Max Liability $1,000,000.

3. Where applicable, all companies submitting proposals must be licensed by the Texas Department of Insurance and be permitted to contract with the State or any of its subdivisions. All insurance carriers must be rated by AM Best Company. Proposers who fall under the guidelines of the Interlocal Cooperation Act, Chapter 791, Title 7, Government Code, will be acceptable.

4. City of Edinburg may award to contract to the bidder who provides goods or services at the best value for the City. In determining the best value for the City, the City may consider:

(1) the purchase prices.

(2) the reputation of the bidder and the bidder's goods or services.

(3) the quality of the bidder's goods or services.

(4) the extent to which the goods or services meet the City's needs.

(5) the bidder's past relationship with the City.

(6) the impact on the ability of the City to comply with laws and rules relating to contracting with historically underutilized businesses and nonprofit organizations employing persons with disabilities.

(7) the total long-term cost to the City to acquire the bidder's goods or services; and

(8) any relevant criteria specifically listed in this request for bids or proposals

5. The contract will be effective as per the Insurance Policy, or after city council approval, whichever occurs later.

The city would prefer a one-year contract with the option to renew for two (2) additional (separate) one (1) year terms, if there are no changes in terms and conditions, insurance agent or underwriting company, and the insurance rates do not increase more than 5% per year.

6. Any questions about this RFP and requests for additional information shall be requested no later than

Thursday, July 3, 2025, 5:00 p.m. via https://procurement.opengov.com/portal/cityofedinburg city will not respond to verbal inquiries. Any form of contact by an offeror or potential offeror regarding this RFP, at any time during the solicitation process from initial advertisement through award, with the Commissioners or any person employed by the City of Edinburg, other than through the communication channels stipulated in the Request for Proposal, or as subsequently instructed by the City of Edinburg through the solicitation process, will constitute grounds for rejection of their Proposal.

7. Public sector employers are not allowed, under current state law, to execute a document containing a Hold Harmless/Indemnification Clause causing the employer to be responsible for other parties’ liability. Therefore, your documents should not contain any such clauses.

8. Since the City of Edinburg is interested in limiting costs associated with the acquisition process, offerors not intending to continue with the RFP are requested to submit a letter requesting they be taken off the mailing list for this solicitation. City of Edinburg reserves the right to reject any or all proposals, waive technicalities, and award the contract in the best interest of the City. Price alone will not be the sole determining criterion in the selection process.

9. Proposers must submit electronically https://procurement.opengov.com/portal/cityofedinburg

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Stop Loss Insurance

(Medical & Rx)

Section 1:

General Information

General Requirements, Instructions, and Conditions

Section 2:

Proposer Questionnaires

Stop Loss Insurance (Medical & Rx)

Section 3:

City Forms

Anti-Collusion Certification W-9 Conflict of Interest

Form 1295 Certificate of Interested Parties Felony Conviction Notice

Section 4:

Benefit Exhibits (Available on Website)

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Section

General Information

(Medical & Rx)

GENERAL REQUIREMENTS AND INSTRUCTIONS

A. Information

1. The information contained in these specifications is confidential and is to be used only in connection with preparing a proposal for the following services or coverages:

Stop Loss Insurance (Medical & Rx)

2. The City of Edinburg reserves the right to accept or reject all or any part of the proposals, waive minor technicalities, and award the proposal to best serve its interest. The City of Edinburg also reserves the right to waive or dispense with any of the formalities contained herein.

3. Proposals are to be submitted based on the specifications contained herein. Alternate proposals will also be considered, provided the alternatives are clearly explained. All deviations from the specifications must be identified and explained.

4. The information contained herein is believed to be accurate and up to date but is not intended to be an express or implied warranty.

5. No mailed or faxed proposals will be accepted.

B. Legal

All parties submitting proposals are expected to comply with federal, state, and local insurance laws and regulations relative to the preparation and submission of insurance proposals. Specifically, the services to be provided are expected to follow the Americans with Disabilities Act (ADA), Family and Medical Leave Act (FMLA), Health Insurance Portability and Accountability Act (HIPAA), insurance laws, and insurance regulations. All proposals that are submitted will be presumed to follow all applicable laws.

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C. Communication and Time Frame

1. Any questions about this RFP and requests for additional information shall be requested no later than Thursday, July 3, 2025, 5:00 p.m. via https://procurement.opengov.com/portal/cityofedinburg Requests from vendors by phone, email, or correspondence to the City of Edinburg or the agency’s consultant to check the status of the proposal will not be permitted.

2. Copies of all correspondence relevant to this assignment will be distributed to all interested participants.

3. The RFP specifications will be available to interested parties no later than 5:00 pm Wednesday, June 25, 2025, on the City of Edinburg’s website:

https://procurement.opengov.com/portal/cityofedinburg

4. The agreement's effective date will be determined by the Commissioners of the City of Edinburg.

D. Proposals

1. Proposals must be clearly explained. All costs, including optional programs, must be clearly stated and summarized. Exceptions to or deviations from the specifications must be explicitly identified.

2. Each party submitting a proposal is asked to screen their designated proposals for correctness and compliance with the specifications. They shall include an inventory list of products submitted, attached to each proposal.

3. The proposal is to be based on duplication of the existing Plan of Benefits. Any deviations must be identified and explained. All proposals will be assumed to have been submitted without any deviations unless clearly noted.

4. The contents of the proposals shall be kept confidential during the process of negotiations. After the insurance agreement is awarded, all proposals will be available for public inspection.

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(Medical & Rx)

E. Disqualification and Rejection of Proposals

Failure to comply with the requirements or the procedures set forth herein, or to satisfy the insurance and servicing criteria as outlined in the specifications, may result in disqualification. It is not intended that exceptions to the specifications will, in and of themselves, result in disqualification.

F. Selection of Vendor

City of Edinburg reserves the right to reject any or all of the proposals, in whole or in part; to waive any informality in any proposal, and to accept the proposal which, in its discretion, is in their best interest of the City. The insurance consulting firm, Valley Risk Consulting, will review Proposals for completeness and compliance with bid specifications. Eligible vendors should be available for questions and answers by telephone or personal appearance at the Consultant’s or City Staff’s request. The Commissioners of the City of Edinburg will make the final award decision.

G. Terms of Agreement

The City of Edinburg is seeking a contract for a primary term to commence upon award by the Commissioners of City of Edinburg for an initial one-year term with the option to renew the agreement for two (2) additional one (1) year terms. The agreement will not commence before October 1, 2025.

The City of Edinburg reserves the right to terminate the agreement at the expiration of the budget period, during the term of the agreement, or at the end of the first anniversary date on sixty (60) days’ notice. The agreement will be for current revenues only, under Local Government Code Section 271.903, to terminate the agreement.

The agreement is to contain a cancellation provision that provides for sixty (60) days’ notice of cancellation (except for non-payment) and sixty (60) days’ notice for non-renewal or material change.

The City of Edinburg reserves the right to terminate the agreement at any time for any or no reason.

Authorized Signature

All proposal forms must be signed by persons who have the legal authority to bind the insurer and administrator to the services that are proposed.

H. Enrollment

The selected Providers will also be responsible for providing enrollment materials before the employee benefit enrollment meetings. The selected provider must provide a plan for non-contact enrollment, such as Virtual Enrollment.

Group Health Insurance

City of Edinburg currently provides medical benefits through a fully funded benefit program. The City’s current group insurance carrier is Blue Cross/Blue Shield of Texas.