9-Attachment A Sample Plan Design Modeling.pdf

This file is a sample plan design modeling document illustrating actuarial scenarios for a generic public-sector employer benefits program. The document demonstrates how a benefits consultant would evaluate various plan-design alternatives, estimate relative changes in plan value, and project annual financial impacts using synthetic data. The scenarios presented include modifications to traditional health plan structures such as increasing individual and family deductibles (estimated savings of $980,000 with a 1.2% plan value reduction), adjusting out-of-pocket maximums ($720,000 savings at 0.9% reduction), modifying coinsurance percentages ($465,000 savings at 0.6% reduction), and revising copay structures for primary care, specialist, emergency department, and pharmacy services. Additional scenarios address high-deductible plan modifications, including reduced employer Health Savings Account contributions (estimated $1,250,000 impact) and increased out-of-pocket maximums ($560,000 savings at 1.4% reduction).

The modeling document emphasizes that all values are illustrative and based on synthetic data with assumptions held constant for network, utilization, and enrollment distribution where applicable. The document notes that financial impacts represent estimated reductions in plan-paid claims or employer contributions, with plan value changes reflecting estimated shifts in actuarial value. Critical consultant support requirements include documenting assumptions, identifying interactions among scenarios, distinguishing modeled savings from guaranteed results, and performing separate modeling for combined scenario changes, as impacts are not necessarily additive. This sample modeling directly supports Hillsborough County's five-year Benefits Consulting and Actuarial Services contract opportunity in Florida, valued at $1,208,376.34, which seeks competitive sealed proposals for comprehensive employee benefits consulting services.