26-HR09 QA FORM.PDF
PDF 403 KB Posted
- Attached to
- HEALTH INSURANCE AND BENEFIT BROKER
- Solicitation number
- 26-HR09
- Issued by
- Dane County, Wisconsin
About this file
This is a Questions and Answers document for RFP 26-HR09, issued by the City of Sun Prairie, Wisconsin, to procure comprehensive health insurance and benefits broker services for the period January 1, 2027, through December 31, 2030, with options for two additional one-year renewal periods. The City seeks a qualified broker to provide full-service benefits consulting and management services for approximately 280 benefit-eligible employees and 10 retirees, including health insurance, dental insurance, vision insurance, Section 125 cafeteria plan administration, whole term life insurance, pet insurance, and employee near-site clinic oversight. Key deliverables include benefit plan and provider management, plan performance analysis and reporting, cost containment strategies, compliance advisory, budget preparation, renewal strategy assistance, wellness program evaluation, open enrollment support, voluntary benefits management, and recommendations for benefit modifications. The proposal submission deadline is March 31, 2026, at 2:00 PM CST, with a question deadline of March 20, 2026, and posted answers by March 27, 2026. Open enrollment is scheduled for October 12 through November 1, 2026, and the selected broker should begin work in June 2026 to support the 2027 renewal cycle.
The City currently maintains fully insured benefits programs with GHC for medical coverage (HMO and PPO plans with monthly premiums ranging from $796.68 to $2,769.92), Delta for dental, EyeMed for vision, and various providers for supplemental benefits, with an annual insurance budget of approximately $5,189,524. The incumbent broker, USI, currently provides health insurance brokerage services on a commission basis and is eligible to respond to this RFP. The City strongly prefers a fee-based compensation model and will dock points for proposals that lack transparency regarding commissions. Key concerns include self-funding feasibility, plan design flexibility within Act 10 constraints, and the City's desire to explore cost-saving opportunities through comprehensive benefit program evaluation. The City has experienced an 82 percent loss ratio on its medical plan in 2026 and utilizes an SSM Health near-site clinic partnership with 26 percent unique patient utilization in 2024 and 21 percent in 2025, with a three-year contract projected at $145,307 for July 2026, increasing to $152,575 and $160,200 in subsequent years.
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Other files
| File | Type | Posted |
|---|---|---|
| 26-HR09 RFP Form B.PDF | ||
| City of Sun Prairie 2026 Renewal Folder.pdf | ||
| 26-HR09 RFP Form D.PDF | ||
| 26-HR09 RFP.PDF | ||
| 26-HR09 RFP Form F.PDF | ||
| 26-HR09 Draft Contract.PDF | ||
| 26-HR09 Appendix A.PDF | ||
| 26-HR09 RFP Form E.PDF | ||
| 26-HR09 RFP Form C.PDF | ||
| City of Sun Prairie 2025 Renewal Folder.pdf | ||
| 26-HR09 RFP Form A.PDF | ||
| 26-HR09 RFP Form G.PDF | ||
| Census Data.xlsx | XLSX spreadsheet |
Show all 13
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Text version
RFP 26-HR09, Health Insurance and Benefits Broker Appendix A – Proposal Details
Questions and Answers
1. How long has the city been with GHC? 3 years
a. Last three renewals, what were the results?
See documents titled “City of Sun Prairie 2025 Large Group Renewal” and “City of Sun Prairie 2026 Large Group Renewal”
b. List plan design changes made past 3 years?
No plan design changes were made. The only change was to implement employee premium contributions of $50/$100 month for non-unionized employees.
2. Has a self-funded feasibility study been performed? No, this is something we are looking for our next broker to evaluate and conduct for us.
3. Percent of employees using the SSM clinic? 26% unique patient utilization in 2024; and 21% unique patient utilization in 2025
a. Do you receive reports categorically itemizing services utilized? Yes
4. Briefly describe open enrollment process
a. Timing. October 12, 2026- November 1, 2026
b. Format. Through Tyler MUNIS ESS portal
c. Materials. Benefits booklet, OE presentation, video of OE presentation to post on intranet site.
d. Venue. City Hall. Would be open to adding off site meetings for large departments (Utilities, Police, Fire)
5. Any employee incentives? Only those available through GHC wellness portal.
a. Wellness. See above.
b. Preventative care. Free preventative care is provided by the Employee Wellness Clinic but employees are not incentivized to go.
c. Other
6. Any employee sub-committees? No.
7. Is the City currently working with a benefits broker or consultant? Yes, USI.
8. If so, what services does the incumbent provide today, and is the incumbent eligible to respond to this RFP? Broker for Health Insurance only. They are eligible to apply.
9. Are there any current CBA provisions (WPPA Local 20 or IAFF Local 311) that restrict plan design changes, carrier selection, or contribution structures? The City complies with Act 10 so plan design and carrier selection are not subjects of bargaining. The current contribution structures are in the contracts, which are available online at https://cityofsunprairie.com/385/Human-Resources.
10.Are any CBAs currently in negotiations or set to expire during the contract term? Yes, see the link to the contracts above.
11. Are there any reopener clauses related to healthcare benefits? No.
12.Can the City share utilization data, annual cost, and performance metrics for the SSM Health near-site clinic partnership with the Sun Prairie Area School District?
For July 2025 to June 2026:
The next contract would likely be another 3 years with a 5% increase each year.
July 2026: $145,307 July 2027: $152,575 July 2028 $160,200
13.What percentage of employees utilize the clinic annually? 26% unique patient utilization in 2024; and 21% unique patient utilization in 2025.
https://cityofsunprairie.com/385/Human-Resources https://cityofsunprairie.com/385/Human-Resources
14. Is the school district’s participation guaranteed through the contract term, or subject to renewal? Subject to renewal.
15.Will the City make available 3–5 years of medical and pharmacy claims data, including large claimant reporting and enrollment trends? The City has made the information in our possession available as part of the Renewal Folders and the Census Data.
16.Will de-identified claims data be provided in a format suitable for actuarial modeling?
No, not as a part of this initial RFP process.
17.Does the City currently maintain any stop-loss relationships? No.
18.What are the City’s primary concerns regarding self-funding (e.g., risk tolerance, volatility, governance)? Dane County health insurance market structure tied to a specific provider and volatility in pricing.
19.Does the City have a preferred pricing structure (annual fee, PEPM, or other)? Annual fee is preferred, but City is open to all cost-effective models.
20.Should proposals assume a fully transparent, commission-offset model, or is the City open to hybrid compensation structures? The City strongly prefers a fee-based model but will consider all fully transparent commission-offset models. Proposals that are not transparent regarding commissions will be docked points.
21.What is the expected timeline for onboarding the selected broker? Beginning in June.
22.Should the selected firm begin work upon contract execution in 2026 to support the 2027 renewal cycle? Yes.
23.What level of involvement is expected during the transition period? Moderate involvement in the transition period.
24.Beyond the published scoring criteria, are there specific capabilities, service models, or differentiators that will most influence the City’s final selection? City policy requires that we follow the scoring process set forth in the RFP.
25.What challenges or gaps is the City seeking to address through this RFP process? The RFP was requested by an elected official who desires the City to explore self-funding to save money.
26.What would success look like in the first 12–24 months of the engagement? A comprehensive benefit program focusing on all the City’s benefits that is affordable for employees and employer and meets the changing needs of the workforce.
27.Can you share the anticipated timeline, format (virtual or in-person), and structure of proposer interviews? To be determined based on responses after initial evaluation by the scoring committee.
28.What is the current cost structure for benefits? Commission-based health insurance through broker; Dental/Vision and all other benefits are currently contracted directly.
29.Do any of the current benefit plans have commissions built into them? Health Insurance.
30.What are the loss ratios for the:
a. Medical plan. 82% in 2026
b. Dental plan. This was requested from Delta Dental but has not been provided at the time of this response. If information is provided, it will be posted.
c. Income continuation plan. N/A
31.Who is the current payroll provider for the City of Sun Prairie? Tyler MUNIS
32.What technology or platform are you using for benefit administration / enrollment? Tyler
MUNIS ESS
33.What is utilization of the mybenefits2go advocacy app? The City does not have data on this.
34.Can the City provide a Current Monthly Invoice for the Medical Plan? (Otherwise, please provide total premium for each medical plan-Employer + Employee share)
Family Single GHC HMO (monthly) $2051.47 $796.68 GHC PPO (monthly) $2769.92 $1076.02
35.Can the City provide an employee enrollment census (member census preferred, if available) that indicates which plan an employee/member is enrolled in, including those opting out, DOB, Gender, Zip Code and tier (single or family)
Census is attached.
Opt out numbers are as follows: 31 family; 13 single; and 9 part-time prorated benefited employees.
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