44F2C847-DCDE-D822-A4337D82DBDE228F.xlsx
XLSX spreadsheet 34 KB Posted
- Solicitation number
- RFP 2026-03-03
- Issued by
- Franklin County, Ohio
About this file
This file is a Benefit Program Comparison Variances document for Franklin County Cooperative's RFP 2025-06-09 regarding health insurance benefits for hourly and salaried employee groups. The document outlines proposed changes to current health benefit plans across multiple employee categories, including hourly HMO, new hire hourly HMO, salaried HMO, salaried PPO HDHP, salaried student PPO, student HMO, disability and voluntary programs, and additional unspecified benefit programs. The RFP requests vendors to identify all variances and deviations from the county's current scope of work, with the requirement that any awarded vendor must provide all programs and services currently provided unless explicitly identified as a deviation in this document.
The identified variances between current and proposed plans reveal significant differences in specialty drug supply limits and mental health coverage. Specifically, the proposed plan restricts preferred specialty drugs to a 30-day supply with a 15-day maximum limit on some drugs, compared to the current plan's allowance of 34-day supplies and some 60-90 day supplies. Most critically, the proposed plan cannot accommodate the current mental health and substance abuse benefits structure for both outpatient services (visits 1-20 at 100%, visits 21+ with $20 copay) and inpatient services (deductible waived for visits 1-45, deductible and coinsurance applied thereafter), with the vendor noting potential non-compliance with Mental Health Parity requirements. The document emphasizes that medical policy variations are excluded from this scope, as such information is proprietary and not shared among carriers. Additional variances may emerge during implementation review if current carrier Summary Plan Descriptions were not 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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Scope of Work Deviations
| Franklin County Cooperative - RFP 2025-06-09 Disability and Voluntary Programs RFP |
| Scope of Work Deviations |
| Please note any deviations from the County’s current Scope of Work. |
All deviations from the Scope of Work must be identified and confirmed. If awarded the contract, vendor will be required to provide all programs, services and insurance lines that currently are provided unless identified in the following plan deviations document.
Current Scope of Work Element Proposed Scope of Work Modification
| Sample | e.g. Produce electronic W-2s at the agency level at no cost | e.g. Can only provide W-2s at an agency level for an additional cost |
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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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