26-HR09 Appendix A.PDF

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RFP 26-HR09, Health Insurance and Benefits Broker Appendix A – Proposal Details

The City of Sun Prairie is accepting proposals from qualified consultants and/or brokers to assist with the ongoing management and strategic planning of the City’s employee benefits programs, including the following:

Health insurance Dental insurance Vision insurance Section 125 cafeteria plan administrator Whole Term Life Insurance Pet insurance Employee near-site clinic

Sun Prairie is a rapidly growing community and the largest suburb of Madison, with a population nearing 40,000. The City offers a variety of housing choices, educational opportunities including the Sun Prairie Area School District and three private schools, many community events, and a small-town charm with big city amenities. Sun Prairie is a full-service municipality, with police, fire, EMS, engineering, electric and water utilities, public works, wastewater treatment, building inspection, community development, recreation (including an aquatic center), parks and forestry, a recently expanded public library, and general administrative services (city administrator, assessor, city clerk, finance, city attorney, human resources). The City has approximately 259 FTEs, many part-time and seasonal employees, and a $35M general fund budget.

Employee Demographics The City employees approximately 280 benefit-eligible employees and has approximately 10 retirees enrolled in benefit plans. The City has three collective bargaining units: Wisconsin Professional Police Association Local 20 for police and IAFF Local 311 for both paramedics and firefighters. The City requires an employee to work at least 30 hours a week to be eligible for full-time insurance coverage, and currently pro-rates insurance coverage for part-time employees.

The City’s annual insurance budget is approximately $5,189,524. Current benefit offerings and census information are provided in the chart on the next page:

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Coverage Type Vendor Employer Paid (monthly)

Subscriber Paid (monthly)

Members

Medical/Pharmacy GHC - HMO Full cost less:

$50/month for single $100/month for family *

$50 single $100 family

GHC – PPO

(employees residing outside HMO service area)

$329.34 single $818.45 family per month

Dental Delta $40.29 single $114.83 family

$0 260

Vision EyeMed $0 $6.82 single $16.99 family

FSA EBC $0 Varies 36 EAP Family Service

Madison $0 All

Employees Employee Clinic (self-funded)

SSM $138,000 $0 All FTEs

Life Insurance Securian through WRS

$8119.73 (City covers basic coverage only)

Varies All WRS eligible employees

Income Continuation Insurance

ETF/WRS $0

(Premium Holiday)

$0 288

Supplemental Insurance

AFLAC $0 Varies 12

Pet Insurance Nationwide $0 Varies 14 Whole Life Boston Mutual $0 Varies 5 Deferred Compensation

Mission Square or WDC

$0 Varies 64

HRA MidAmerica $1500 single $3000 family-health Insurance Opt Out (Annual)

$0 52

*police and fire have this amount negotiated into their contracts beginning in 2026 or

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The City is currently fully insured for all benefits unless noted above. Plan design details can be found in the 2026 Benefits Booklet or on the benefits website.

Scope of Services The City is seeking to name a broker of record for the City’s employee benefits programs. The City is committed to being an employer of choice, which includes offering a robust benefits package while containing costs for our taxpayers. The broker selected will be expected to perform a range of benefit program and selection services, including research, implementation, maintenance, communication, and support. The City expects the broker to perform full-service brokerage functions, including but not limited to:

1. Service and Performance. Provide guidance and assistance to city staff with future benefits decisions and represent the City in negotiations with insurance carriers on cost, benefit levels, plan design, administrative fees, special terms and conditions, program alternatives, and plan changes.

2. Benefit Plan/Provider Management. Manage the selection of new insurance providers or renewal agreements in close coordination with city leadership.

3. Plan Performance Analysis and Reporting. Provide medical plan performance review and analysis as follows:

a. Analyze the prior year's data relative to claims, plan enrollment, large claim review, and other essential information.

b. Determine future strategies to control costs and maintain plan effectiveness and market competitiveness.

c. Assist with the medication formulary and negotiate with the City’s pharmacy vendor.

d. Analyze existing benefits package and develop a cost-saving strategy or plan that offers similar options of coverage.

e. Analyze plan utilization through data, including statistical and financial reports, and provide recommendations for improvement or efficiencies.

f. Review municipalities in Dane County and within our WERC comparable communities to ensure the City’s benefits remain competitive.

g. Identify and inform the City of emerging trends in employee benefits and provide appropriate recommendations.

h. Prepare, provide, and present reports as requested, including quarterly cost analysis, forecasting, and trend and experience reports.

i. Provide monthly, quarterly, and annual claim reports for review.

j. Maintain full and accurate records and provide a copy of all project documents, including spreadsheets, assumptions, and calculations, to Human Resources

4. Communication and Problem Solving. Promptly respond to requests from City administration and keep staff informed of current trends, issues, compliance requirements, and training and topics related to benefits and wellness.

5. Compliance. Advise the City on current legislation, court decisions, and other regulatory actions that may impact benefit plans and provide recommended changes when necessary.

https://cityofsunprairie.com/DocumentCenter/View/17322/2026-Sun-Prairie-HR-Benefit-Booklet https://cityofsunprairie.com/955/Benefits

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6. Budget Preparation. Partner with Human Resources and Finance staff in budget preparation for employee benefits, including recommending contribution structures, projecting plan and claim expenses for all benefit expenditures, and recommending cost-saving strategies.

7. Strategy and Renewal. Assist the City with benefit and wellness initiatives and recommend options for renewal coverage or alternate vendors.

8. Wellness Program Evaluation & Implementation. Review effectiveness of current wellness programming, including employee clinic.

9. Open Enrollment. Prepare open enrollment materials and conduct open enrollment meetings in individual and group settings.

10.Voluntary Benefits. Assist the City with evaluation and implementation of other voluntary benefits upon request.

11. Other Services. Please describe any other services you offer, including in-house legal hotlines for benefits questions, coordination of a benefits fair, benefits booklet, and transition in services presentations directly to employees.

Submission Requirements All proposals should include a transmission letter. Additionally, the proposals should be in the order below:

1. Introductory Letter

2. Experience and Qualifications

3. Approach and Methodology

4. Transition Plan

5. Pricing and Fee Proposal

6. Additional Services.

7. Answers to Supplemental Questions.

8. City RFP mandatory forms.

a. W-9

b. Insurance

c. Completed Forms A-G

Staff plan to conduct interviews of all proposers. The evaluation and selection will be based on the written proposal, references, interviews/presentations, and other pertinent factors.

Supplemental Questions

1. The City of Sun Prairie is exploring all options to contain costs. Would you recommend self-insurance for some or all of our benefits packages as an option for cost savings? Why or why not?

2. Employees are concerned about retaining access to University of Wisconsin specialty care providers. Would you suggest plans that maintain this coverage? If

5/5 not, what would you do to transition care to avoid long wait times for our employees to establish with new providers?

3. The City currently has an employer clinic in partnership with the Sun Prairie Area School District. This clinic is with SSM, who was our legacy health provider.

Please evaluate whether this arrangement makes sense with the benefits you would suggest for the city.

4. Disclose all kickback arrangements you receive from vendors.

5. What benefits does the city offer that it should consider sunsetting? What benefits do we not offer that you believe would be appropriate?

6. Please list three comparably sized communities you have recently advised.

7. Please describe the terms of your flat fee arrangement for services.

8. What is your philosophy for managing employee expectations during times of change?

9. How do you minimize the impact to employee morale during benefit changes?