25523-RFP-DST_Stop_Loss_Insurance_RFP_Questionnaire.xlsx
XLSX spreadsheet 46 KB Posted
- Attached to
- Stop Loss Insurance State and local contract opportunity
- Solicitation number
- 25523-RFP-DST
- Issued by
- Hillsborough County, Florida
About this file
This is a Stop Loss Insurance Request for Proposal (RFP) questionnaire issued by the School Board of Hillsborough County, Florida, a public school district headquartered in Tampa with approximately 24,328 eligible employees. HCPS is seeking Stop Loss insurance coverage effective January 1, 2026, to support its transition from fully insured coverage under Aetna to a self-funded model. The RFP covers approximately 19,121 enrollees as of August 2025, comprising 18,601 active employees, 44 COBRA participants, and 476 pre- and post-65 retirees and surviving spouses, with 78.5% currently enrolled in Medical/Rx coverage. Initial Illustrative Individual Stop Loss (ISL) proposals were due October 20, 2025, based on claims data through July 2025, with Best and Final/Firm proposals due October 27, 2025, following receipt of additional data through August and September 2025. The RFP was released September 19, 2025, with questions due September 26, 2025.
Vendors are required to submit net quotes (excluding commissions) with proposed specific deductible options of $1,000,000, $1,250,000, or $1,500,000 on a 24/12 contract basis, with unlimited annual and lifetime maximum reimbursement for Medical and Rx benefits. HCPS currently receives services from Aetna as both the medical/Rx carrier and Third Party Administrator/ASO carrier; the organization is moving to Aetna as the self-funded TPA effective January 1, 2026. Vendors must confirm compliance with specified plan provisions including plan mirroring, clinical trial coverage, actively at work waivers, No New Laser guarantees with rate caps, terminal liability coverage, and the inclusion of COBRA/LOA enrollees and pre- and post-65 retirees. Aon Consulting, Inc. serves as the broker of record. Comprehensive claims data, census information, benefit plan summaries, formularies, large claim reporting (claims exceeding $100,000), transplant information, and monthly enrollment and paid claims data for 2023 through 2025 were provided to vendors to support underwriting and proposal development.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 25523_Addendum_3_Questions.pdf | ||
| HCPS_COBRA_as_of_08.01.2025_updated.xlsx | XLSX spreadsheet | |
| 25523_Addendum_1_Data_Update_Aug.pdf | ||
| Data_Included_Aug_2025.zip | ZIP file | |
| 25523-RFP-DST_Stop_Loss_Insurance.pdf | ||
| Data_Included.zip | ZIP file | |
| CONTRACTING_WITH_ENTITIES_OF_FOREIGN_COUNTRIES_OF_CONCERN_PROHIBITED_AFFIDAVIT.pdf | ||
| STATEMENT_OF_NO_BID.pdf | ||
| Vendor_Registration_Form_07.10.25.pdf |
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Read Me First-Client Info
| The School Board of Hillsborough County, Florida |
| Stop Loss RFP |
| Client Overview and RFP Request |
| The School Board of Hillsborough County, headquartered in Tampa, FL, 33601 and referred to throughout this document as HCPS is requesting quotes for Stop Loss effective on January 1, 2026. The total number of eligible employees is approximately 24,328, of which 78.5% currently are enrolled in Medical/Rx coverage. Enrollment as of August 2025 includes 18,601 active employees, 44 COBRA participants, and 476 pre-65/post-65 retirees and surviving spouses for total enrollment of 19,121. |
HCPS is currently fully insured through Aetna through 12/31/25, but will be moving to Self Funded under Aetna effective 1/1/26.
HCPS is initially requesting Illustrative ISL-only Stop Loss proposals using data through 07/2025 and will look to firm up quotes using data through 08/2025 and 09/2025, once available. After receiving additional data releases, Best and Final/Firm proposals will be due to Erika James at erika.james@hcps.net.
| Client Information | |||
| Client Name | The School Board of Hillsborough County, FL | ||
| Client Address, City, State, and ZIP Code | 2920 N 40th St, Tampa FL 33605 | ||
| Where is the group sitused | |||
| (legal jurisdiction)? | Florida | ||
| Size of Client | 24,328 | ||
| Industry Description | Public School District | ||
| Compensation | |||
| Aon Consulting, Inc. is the broker of record for HCPS. Please provide quotes net of commissions (no commissions included). | |||
| Medical Eligibility | |||
| New employees must elect or waive coverage within 30 days of hire and shall be insured after the first of the month following 60 days not to exceed 90 days. |
Enrollment elections may not be changed until the next open enrollment period, unless there is an IRS-qualified change in status.
| Groups | Description |
| Benefit-Eligible Permanent employees | Eligible after first of the month following 60 days of employment. HCPS provides coverage to all employees meeting 30 hours per week for ACA. |
| Dependent | Spouse, as defined by Florida Law Children to age 26 (as required by the Healthcare and Education Affordability act of 2010) - biological, legal guardian, step or legally adopted |
| Special Provisions Regarding Dependents | A child born to a dependent child is covered for a minimum of 18 months or as long as that dependent child remains eligible for coverage as a dependent. |
Coverage for children age 26-30 is provided is they meet the following criteria:
-unmarried with no dependent children -resident of the state for Florida and a student, AND -no medical insurance as a named subscriber, insured enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan; or not be entitled to benefits under Title XVII of the Social Security Act Retirees All retirees are eligible to continue coverage on the medical plans. Total rates/plans for retirees are the same as Actives. Alternatively. they can choose to enroll in one of the Medicare plans under Humana. Eligible Surviving spouses may continue coverage.
| ACTIVITY | DATE |
| RFP Released | 9/19/25 |
| Questions Due | 9/26/25 |
| Initial/Illustrative Proposals Due | 10/20/25 |
| Best and Final/Firm Proposals Due | 10/27/25 |
Temple University Health System Stop Loss RFP 2023 Client Information &P 4/24/2023
Vendor Information
| The School Board of Hillsborough County, Florida |
| Stop Loss RFP |
| General Information | Answer Format | Response | Explanation |
| Proposer Brand Name | text | ||
| Parent Co. Legal Entity Name | text | ||
| d/b/a (Name in Marketplace) | text | ||
| Year Established/Incorporated | Month Day, Year | ||
| NAIC Code | numeric | ||
| Industry Classification | text | ||
| FEIN (Federal Employer Identification Number) | text | ||
| Tax Status | text | ||
| Public or Privately-Held | drop down box |
Public/Privately-Held
| Ownership/Controlling Interest Structure | text |
| List the number and percentage of employers of similar size to HCPS that your organization currently contracts with directly for Stop Loss. | text |
| Are you authorized to do business in the State of Florida? | drop down box |
Yes/No
| Home Office Location | text |
| Address Line #1 | text |
| Address Line #2 | text |
| City | text |
| State | text |
| Zip | text |
| Web Address | text |
| General Information | |
| A.M. Best: Rating Status | |
| Financial Rating | text |
| Date | text |
| Standard & Poor's: Rating Status | |
| Financial Rating | text |
| Date | text |
Vendor Information &P 4/24/2023
Stop Loss_Plan_Provisions
| The School Board of Hillsborough County, Florida |
| Stop Loss RFP |
| Common Provisions | Inforce Plan | Marketing Request | Quoted Plan | Vendor K:T | |
| General Information | |||||
| Current Plan | |||||
| Will the medical plan be self-funded in 1/1/2026? | Yes | ||||
| Will this be a new Stop Loss implementation? | Yes | ||||
| Total Number of Employees Covered under Stop Loss | |||||
| Actives (including Cobra and Disabled) | Single: | 17521 | |||
| Family: | 1600 | ||||
| Retirees Under 65 Covered Under Stop Loss? | Yes | ||||
| Retirees Under 65 | Single: | 312 | |||
| Retirees Under 65 | Family: | 76 | |||
| Retirees Over 65 Covered Under Stop Loss? | Yes | ||||
| Retirees Over 65 | Single: | 81 | |||
| Retirees Over 65 | Family: | 7 | |||
| Stop Loss Carrier History | |||||
| Current Year (incumbent) | N/A | ||||
| Prior Year 1 | N/A | ||||
| Prior Year 2 | N/A | ||||
| Third Party Administrator (TPA)/ASO Carrier History | |||||
| Current Year (incumbent) | Medical | Aetna | |||
| Rx | Aetna | ||||
| Prior Year 1 | Medical | Aetna | |||
| Rx | Aetna | ||||
| Prior Year 2 | Medical | Humana | |||
| Rx | Humana | ||||
| PPO Network Provider | |||||
| Current | Aetna | ||||
| Proposed | Aetna | ||||
| Specific Stop Loss | |||||
| Specific Deductible Level | |||||
| Specific Stop Loss Deductible | N/A | $1,000,000 | |||
| Alternate Deductible | N/A | $1,250,000 | |||
| Alternate Deductible | N/A | $1,500,000 |
| Specific Contract basis | |||
| Specific Contract basis (i.e. 12/12, 24/12) | N/A | 24/12 | |
| Is there an Aggregating Specific? | N/A | No | No |
| Aggregating Specific | N/A | N/A | N/A |
| Advance Funding/Special Cash Flow Assistance Included | [Select] | Yes | [Select] |
| Specific Maximum Reimbursement | |||
| Specific Annual Maximum Reimbursement - Annual | N/A | Unlimited | |
| Specific Lifetime Maximum Reimbursement - Lifetime | N/A | Unlimited | |
| Benefits covered under the Specific, e.g. Medical & Rx | |||
| Benefits covered under the Specific | N/A | Medical, Rx | |
| Terminal Liability | |||
| Terminal Liability | N/A | Yes | [Select] |
| Transplants Carved Out? | |||
| Transplants Carved-Out? | N/A | No | [Select] |
| Actively At Work - Dependent Non-confinement | |||
| Is the policy 'actively at work' provision waived? | N/A | Yes | [Select] |
| Actively at Work is Waived (assumed "yes"upon acceptance of disclosure unless stated otherwise) | N/A | Yes | [Select] |
| No New Laser Product | |||
| Does your offer include a No New Laser product guarantee? | N/A | Yes | [Select] |
| If yes, does it include a rate cap? | N/A | Yes | [Select] |
| If yes, what is your 2nd year rate cap? | N/A | Quote lowest possible | |
| Aggregate Stop Loss | |||
| Aggregate Coverage | |||
| Is there Aggregate Stop Loss Coverage? | N/A | No | No |
Stop Loss_1_Provisions_1 &P 4/24/2023
Questionnaire
| The School Board of Hillsborough County, Florida |
| Assumptions and Conditions: Stop Loss |
| No. | Question | 0 |
| Confirmation Statements | ||
| 1 | Stop Loss quote complies with the quote request parameters outlined in this document without exceptions. | Select |
| 2 | Stop loss covers the eligibility as described in the plan of benefits without exceptions | [Yes/No], [Enter comments] |
| 3 | Proposal is subject to a signed disclosure statement | Select |
| 4 | By submitting your responses to this questionnaire, you represent that you have submitted a complete quote, inclusive of all material information, terms and conditions without reference to any additional or external materials, even if such materials are provided through the Procurement website. You will not change or alter your responses or the terms or conditions of this quote, except by written modification to this questionnaire with notice to HCPS. You acknowledge and understand that the information contained herein will be directly presented to HCPS, and that HCPS may rely upon this information in selecting the quote and coverage. | Select |
| 5 | Carrier will accept the large claims information provided with the RFP for disclosure purposes | Select |
| Contact Information | ||
| 6 | Provide the contact name and email address of the individual that can answer questions on your proposal. | [Name, email address] |
| Data Requirements | ||
| 7 | Confirm whether proposal is Firm with all underwriting complete (including Medical review), or Illustrative | Select |
| 8 | Date Firm Through | [Date] |
| 9 | If Not Firm, provide information needed to firm. | [Enter Comment] |
| 10 | Indicate and list all items needed to issue the stop loss policy. | [Enter Comment] |
| Plan Provisions | ||
| 11 | All Actively at Work, Disabled and Dependent non-confinement provisions will be waived upon disclosure of individuals | Select |
| 12 | Stop loss covers all claims that are covered by the medical plan (and Rx plan) at 100% of the paid amount, as long as the claim is eligible to be paid under the plan document (i.e. Plan Mirroring) | [Yes/No], [Enter comments] |
| 13 | Stop loss coverage includes clinical trials | Select |
| 13A | Clinical Trials Comments | [Enter Comment] |
| 14 | Please describe your payment turnaround timing standards | [Enter Comment] |
| 15 | Participation Requirements | [Yes/No], [provide %] |
| 15A | Participation Requirements Comments | [Enter Comment] |
| 15B | Proposal is subject to change if enrollments vary by a certain % | [Yes/No], [provide %] |
| 16 | Exceptions Listing | [Enter Comment] |
| 17 | Proposal includes COBRA/LOA enrollees | Select |
| 17A | If so, maximum % of COBRA/LOA allowed of total enrollment | [Enter %] |
| 18 | Proposal includes Pre-65 Retirees | Select |
| 18A | If so, maximum % of Pre-65 retirees allowed of total enrollment | [Enter %] |
| 19 | Proposal includes Post-65 Retirees | Select |
| 19A | If so, maximum % of Post-65 retirees allowed of total enrollment | [Enter %] |
| Interface Fees | ||
| 20 | Are you a preferred vendor with this client's medical incumbent? | Select |
| 20A | If yes, is the interface fee waived? | Select |
| 20B | If no, identify other ways you can offset the interface fees. | [Enter Comment] |
| Additional Comments | ||
| 21 | Additional Comments on any previous Stop Loss Sections | [Enter Comment] |
Stop Loss Financials_Spec
| The School Board of Hillsborough County, Florida | Carriers - complete cells shaded this color (totals will auto-populate) |
| Financial Summary: Specific Deductible |
| Lives | 0 | 0 | 0 | |
| Proposed | Proposed | Proposed | ||
| Specific Deductible PEPM | $1,000,000 | $1,250,000 | $1,500,000 | |
| EE | 17,521 | |||
| Family | 1,600 | |||
| Composite | 19,121 | $0.00 | $0.00 | $0.00 |
| Annual Premium | N/A | N/A | N/A | |
| Additional Liability | ||||
| Interface Fees | ||||
| Lasers (include details in Lasers tab) | ||||
| Total Cost | ||||
| Total Overall Cost ($) | N/A | N/A | N/A | |
| Total Annual Cost + Liabilities | FALSE | FALSE | FALSE | |
| Provisions | ||||
| No New Laser Provision | ||||
| Renewal Rate Cap (%) | ||||
| Full Exclusion Lasers | ||||
| Run-in Limits Specific |
Lasers
| The School Board of Hillsborough County, Florida |
| Stop Loss RFP |
| 0 | ||||
| Claimant # | Laser Type | Laser Amount | Diagnosis | Comments |
Data Included
| The School Board of Hillsborough County, Florida | |||
| Stop Loss RFP | |||
| Data Included | Comments | Attachments | |
| Census including Active, Retirees, Surviving Spouse, LOA | See Zip File |
Password protected: sdhc13009 COBRA Census See Zip File Password protected: sdhc13009
| 2025 Benefit Plan Summary (SBC/SPD) | See Zip File | |
| 2025 Rx Formulary | See Zip File | |
| 2026 Benefit Plan Summary (SBC Only) | Full re-design of medical plans for 2026; SPD still in development | See Zip File |
| 2026 Rx Formulary | See Zip File | |
| Large Medical/Rx Claim Reporting | ||
| LARGE CLAIM REPORTING: |
Medical & Rx Carrier Large claims >$100k including diagnosis for the paid periods
DATA POINTS INCLUDED:
1. Unique Claimant Identifier or 2 other identifiers.
2. Paid claim amount, separate for medical and Rx
3. Specific Diagnosis Description
| 4. Heading with paid period as well as coverages (medical only or medical and Rx). | 1/1/2025-12/31/2025 | See Zip File | ||
| 1/1/24-12/31/2024 | See Zip File | |||
| 1/1/2023-12/31/2023 | See Zip File | |||
| Transplant List | ||||
| Number of transplants by condition. | 1/1/2025-12/31/2025 | See Zip File | ||
| 1/1/24-12/31/2024 | See Zip File | |||
| Monthly Paid Claims | ||||
| Monthly Paid Claims | 1/1/2025-12/31/2025 | See Zip File | ||
| 1/1/24-12/31/2024 | See Zip File | |||
| 1/1/2023-12/31/2023 | See Zip File | |||
| Monthly Paid Claims | ||||
| Monthly Employee Enrollment, Includes: |
Active (Suffix 001) COBRA (Suffix 101)
| Retiree (Suffix 201) | 1/1/2025-12/31/2025 | See Zip File | |||
| 1/1/24-12/31/2024 | See Zip File | ||||
| 1/1/2023-12/31/2023 | See Zip File | ||||
| TRUE |
File details come from the government source that posted it. Updated .