44F2C847-DCDE-D822-A4337D82DBDE228F.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 file is a Benefit Program Comparison Variances document for Franklin County Cooperative's RFP 2025-06-09 regarding health insurance and disability/voluntary programs. The document outlines proposed modifications to current employee benefit plans across multiple employee categories, including hourly HMO, new hire hourly HMO, salaried HMO, salaried PPO HDHP, salaried student PPO, and student HMO plans. The RFP requests vendors to identify all deviations from the current scope of work, with a requirement that if awarded, vendors must provide all programs, services, and insurance lines currently offered unless explicitly identified as modifications in the variances document.
The primary identified variances between current and proposed plans include restrictions on preferred specialty drugs (reduced from 34-90 day supplies to limited 30-day supplies with caps on some medications) and significant changes to mental health and substance abuse coverage (proposed plan cannot accommodate current outpatient visit structures with progressive copay tiers or inpatient deductible deferrals, with notation that the group may not achieve Mental Health Parity Compliance under proposed terms). The document emphasizes that medical policy variations are not included in this comparison as medical policies are proprietary and not shared among carriers. Additional variances may emerge during the implementation review process, particularly if current carrier Summary Plan Descriptions were not provided during the proposal phase.
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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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