Attachment_C_-_Specific_Stop_Loss_Cost_Proposal-RETURN_WITH_BID.xlsx

This is a Specific Stop Loss Insurance Cost Proposal form for the City of Tucson, Arizona, requiring vendors to provide pricing for stop loss coverage effective July 1, 2026. The City seeks to insure 4,508 covered employees and retirees under a self-funded plan that will transition to Blue Cross Blue Shield of Arizona as its medical TPA and network provider, with OptumRx serving as the pharmacy benefit manager. The coverage applies to both medical and prescription drug benefits, with vendors required to submit proposals using the provided Excel workbook format without altering pre-labeled rows, columns, or text. Vendors must provide pricing for four specific deductible options ranging from $1,100,000 to $1,500,000 on either an incurred or paid contract basis, with detailed pricing exhibits permitted as attachments.

Vendors must quote composite premium rates (PEPM) with corresponding monthly and annual cost totals for each deductible option and may optionally provide pricing for gene therapy coverage. All proposals must include rate guarantees for a minimum of 12 months, confirmation that rates are net of commissions, and assurance that quoted rates are firm unless enrollment changes exceed 15 percent. Vendors must also commit to providing preliminary renewal notifications at least 120 days prior to contract anniversary and firm renewals 60 to 90 days before anniversary with rate change justification and underwriting caveats. Multi-year rates and rate caps will be viewed more favorably in the evaluation process. The City's current self-funded plan generated approximately $43.5 million in paid medical and prescription drug claims over the most recent 12-month period through March 2026. Failure to complete the proposal form in its entirety may result in a non-responsive submission determination.