44F2A935-093F-1234-3F0F06EFB73CE154.xlsx
XLSX spreadsheet 34 KB Posted
- Attached to
- Voluntary Programs: Short and Long Term Disability, Legal Plan, Identity Theft, and Pet Insurance
- Solicitation number
- RFP #2025-06-09
- Issued by
- Franklin County, Ohio
About this file
This is a benefits plan comparison document for Franklin County Cooperative's 2025-06-09 Request for Proposal (RFP) detailing variances between current and proposed health insurance and voluntary benefit programs. The RFP addresses multiple employee groups across different plan types, including Hourly HMO, New Hire Hourly HMO, Salaried HMO, Salaried PPO HDHP, Salaried Student PPO, and Student HMO plans. The document serves as a structured template for bidders to identify and document all deviations from the County's current plan design. If awarded the contract, the successful bidder must provide all programs, services, and administration currently offered by the incumbent carrier unless explicitly listed as a deviation in this document. The RFP encompasses health insurance benefits, short-term disability (STD), long-term disability (LTD), legal services, pet insurance, and newly added ID Theft insurance.
Identified benefit variances in the Hourly HMO plans include reductions in preferred specialty drug supplies (from 34-90 day supplies to maximum 30 days with 15-unit limits on some drugs) and the proposed carrier's inability to accommodate current mental health and substance abuse coverage structures, potentially creating Mental Health Parity Compliance issues. Specifically, the proposed plan cannot maintain the current outpatient visit structure (visits 1-20 at 100% with $20 copay for visits 21+) or inpatient deductible waiver for visits 1-45. In voluntary programs, legal services benefits are being reduced from four sessions to three sessions under the proposed plan. The document indicates that medical policy variations are excluded from this comparison as they are proprietary information not shared among carriers. Additional variances may emerge during the implementation review process, and this analysis is contingent upon the availability of current carrier Summary Plan Descriptions provided during the proposal process.
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Text version
Hourly HMO
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
| 1 | Preferred Specialty Drugs | Allow 34 day supply some 60 - 90 day supply | Limited to 30 day supply, with 15 limit max on some specialty drugs |
| 2 | Mental Health & Substance Abuse Outpatient Services | Visits 1-20 process at 100%, Visits 21 and greater apply $20 copay | Cannot accommodate. Based on Payment Policy and group may not be Mental Health Parity Compliant. |
| 3 | Mental Health & Substance Abuse Inpatient Services | Deductible does not apply for first 1-45 visits, Ded & Coin applies visits 46 and greater | Cannot accommodate. Based on Payment Policy and group may not be Mental Health Parity Compliant. |
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Plan Deviations
| Franklin County Cooperative - RFP 2025-06-09 Disability and Voluntary Programs RFP |
| Plan Deviations |
| Please note any deviations from the County’s current plan design. All plan deviations must be identified and confirmed. If awarded the contract, bidder will be required to provide all programs, services and administration that currently are provided by the incumbent unless identified in the following plan deviations document. |
This document is intended to identify all plan deviations for:
-STD
-LTD
-Legal Services -Pet Insurance Please note that ID Theft insurance would be newly added and therefore no deviations are required to be listed below.
Benefit/Policy Type Benefit/Policy Specification Current Plan Proposed Plan Deviation
| Sample | Legal Services | ____ Benefit limit | 4 session limit | 3 session limit |
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New Hire Hourly HMO
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
| 1 | Preferred Specialty Drugs | Allow 34 day supply some 60 - 90 day supply | Limited to 30 day supply, with 15 limit max on some specialty drugs |
| 2 | Mental Health & Substance Abuse Outpatient Services | Visits 1-20 process at 100%, Visits 21 and greater apply $20 copay | Cannot accommodate. Based on Payment Policy and group may not be Mental Health Parity Compliant. |
| 3 | Mental Health & Substance Abuse Inpatient Services | Deductible does not apply for first 1-45 visits, Ded & Coin applies visits 46 and greater | Cannot accommodate. Based on Payment Policy and group may not be Mental Health Parity Compliant. |
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Salaried HMO
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
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Salaried PPO HDHP
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
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Salaried Student PPO
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
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Student HMO
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
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Sheet7
| BENEFIT PROGRAM COMPARISON VARIANCES |
| RFP Request |
| Following is an outline of the variances/alternatives between the current and proposed benefit programs for - |
| GROUP NAME |
Please note: Additional variances may become evident during the implementation review process. If the current carrier documents (Summary Plan Descriptions) were not provided during the proposal process, this document may not encompass all benefit variances.
Benefit Current Plan Proposed Plan Client Decision
Medical Policy variations are not included in the scope of this document. Medical Policy information is proprietary, not shared among carriers and it is not included in this aspect of benefit administration comparisons.
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