5-2026-13 RFP Employee Benefits Consultant.pdf

2026-13 Employee Benefits Consultant

TOWN OF FAIRFIELD

REQUEST FOR PROPOSAL

The Town of Fairfield (Town) on behalf of its Human Resources Department (HR) is soliciting proposals from qualified firms to provide Employee Benefits Consulting Services for health insurance and other ancillary insurance benefits including Life and Death and Dismemberment, Long-Term Disability, Voluntary Life and Voluntary Long-Term Disability coverage for the Town.

Consulting services shall include, but not be limited to, day-to-day benefit consulting, review and analysis of renewal offers from service providers and/or carriers, budget recommendations, cost containment and other administrative and labor related services. Pricing for services provided to the Town is to be proposed as a flat fee. Should the Town enter into contract for

Employee Benefit Consulting Services, the Town anticipates awarding a three (3) year contract with the option for two (2) additional years at the sole discretion of the Town. The actual terms of any such contract are subject to negotiations. The purpose of this RFP is to determine what services you can provide to the Town and how you would adapt your specific services for the Town’s needs.

BACKGROUND

The employee population of the Town of Fairfield is approximately 600 benefit eligible employees comprised of seven (7) union groups and approximately 40 non-represented employees. The Town at the present time is fully-funded, to provide medical, prescription and dental benefits to approximately 600 employees and retirees based on a monthly average. The current provider for the health and dental insurance benefits is Cigna with an annual July 1st renewal date. The 2025-2026 gross health insurance budget is approximately $13.5 million which includes expected claims, administrative fees, network access fees, individual and aggregate stop-loss and Health Savings Account deductible contributions.

The Town has two (2) health plan options based upon union contract provisions. The Town offers a payment in lieu of health insurance option for employees who may have coverage elsewhere. The foregoing is a summary of existing insurance plans.

Full policy terms are available upon request.

This Employee Benefits Consultant contract is anticipated to become effective January 1, 2026. All employee health benefits have a renewal date of July 1st of each year. In addition, the consultant would be part of a current and upcoming contract negotiations and potential mediation and arbitration as needed.

SCOPE OF WORK

The purpose of this Request for Proposals (RFP) is to solicit proposals from firms qualified to represent the insurance interests of the Town of Fairfield. The selected firm is expected to provide qualified and expert professional services, including but not limited to:

Conduct renewal negotiations or Request for Proposal(s) with the providers/vendors. Prepare complete, accurate and detailed accounting and analysis of all claims cost, administrative fees, stop loss insurance, etc.

Assist the Town with budget planning for employee health care benefits by providing renewal estimates no later than mid-December and final renewal by mid-March. Recommendations to Town of Fairfield Board of

Selectperson’s, administrators, and Finance Director.

Determine annual allocation rates for the various health plans.

Monitor and coordinate services including claims performance, trend analysis, stop-loss threshold, large claims, demographic data, etc. on a regular basis. Analyze and report on utilization trends and costs.

Ensure that fully-funded arrangements with providers/vendors are appropriately managed. Intervene and resolve claims issues with providers/vendors.

Provide consulting advice for all phases of union negotiations relative to health insurance and other ancillary benefits, including attendance at strategy and negotiation meetings, as well as mediation and arbitration if needed.

Ensure accurate follow through on all negotiated contractual agreements.

Assist the Town in establishing a strategic plan for employee health care and other benefits. Provide ongoing analysis and planning of new approaches to employee health care benefits. Take initiative to provide recommendations for cost-containment related to health insurance and other ancillary benefits including plan designs, employee-cost share arrangements, and wellness initiatives. Advise the Town on any current or emerging employee benefit programs.

Assist and provide recommendations for compliance requirements of State and Federal regulations, statutes and mandates, e.g. COBRA, HIPAA, and Healthcare Reform.

Inform the Town of changing legislation and legal decisions affecting employee health benefits. Advise and discuss methods to comply with these changes.

Assure that all health and ancillary insurance documents are current and accurate including medical, prescription and dental plan designs and life insurance and long-term disability insurance policies.

SCOPE OF WORK (continued)

Assist the Town with annual open enrollment process. Development of employee communications and educational programs as needed. Conduct employee information meetings on health benefits, especially as related to new employee benefit programs and/or plan designs.

Provide an annual report including analysis of claims experience and loss exposures, loss control activities, observations on relevant changes in the health care insurance market, and recommendations for cost containment and employee benefit planning.

Provide general problem solving related to employee benefits throughout the year. Prompt responses to questions and requests are an absolute requirement. It is expected that there will be one key representative within the firm to service the accounts. However, there should be other individual(s) within the firm capable of addressing possible concerns.

PROPOSAL EVALUATION

1. Proposals will be evaluated based on the following criteria:

Qualifications and Expertise: Demonstrated knowledge and capabilities, including how the Consultant will adapt their existing services to meet the Town’s requirements.

Relevant Experience and References: Evidence of prior success in providing similar services, with emphasis on the ability to customize approaches for municipal clients; strong recommendations and references.

Claims History, if any: Disclosure of any claims made against the Consultant’s license and explanation of how such matters were addressed or resolved.

Innovation and Value-Added Services: Unique tools, processes, or resources the Consultant can provide beyond the base requirements that would bring added benefit to the Town.

Fees/Cost Reasonableness, transparency, and overall value of proposed fee in relation to the scope of services.

2. After the opening of submissions, one or more Consultants may be asked to provide additional information, to meet with the Town to discuss their proposal, or to address such other issues as deemed important by the Town.

3. The Town’s evaluation team will individually review and rank each Consultant’s submission based on the criteria outlined in the RFP document.

4. The evaluation team may short-list Consultants for interviews and oral presentations in order to clarify qualifications and verify its evaluation. Additional services or significant changes to the submittals during the interview will not be entertained.

5. Based on the responses received, the Town may choose to continue or cancel the RFP process.

6. The Town reserves the right to reject any submission if the Consultant fails to satisfactorily convince the Town that it is properly qualified by experience and expertise, and/or the personnel to carry out the services called for herein.