ESBD_503812_1775238257030_SBA-26-280 Life and ADD.pdf

THE TEXAS A&M UNIVERSITY SYSTEM

Office of Procurement and Business Services

REQUEST FOR PROPOSAL

RFP NUMBER: RFP-01-SBA-26-280

Group Life and Accidental Death & Dismemberment Insurance

PROPOSAL MUST BE RECEIVED PRIOR TO:

2:00 P.M. Central time on May 4, 2026

EMAIL RFP RESPONSES TO:

soprocurement@tamus.edu

Subject Line: SBA-26-280 – Group Life and Accidental Death & Dismemberment Insurance

NOTE: Proposal responses must be received by The Texas A&M University System Office of Procurement and Business Services before the date and time specified for receipt of proposal in Section 2.3 of this Request for Proposal (“RFP”).

After the due date and time, only the names of respondents may be made public.

REFER INQUIRIES TO:

Jeff Zimmermann, Executive Director Procurement and Business Services | VetHUB Program

The Texas A&M University System soprocurement@tamus.edu

All proposals shall become the property of The Texas A&M University System and the state of Texas upon receipt.

Proposals may be subject to public review after contracts have been executed. Refer to Section 4.10 for more information regarding confidential and proprietary information.

mailto:soprocurement@tamus.edu mailto:Soprocurement@tamus.edu

The Texas A&M University System RFP-01-SBA-26-280 Page 2 of 51

TABLE OF CONTENTS

SECTION 1. INTRODUCTION _________________________________________________________________ 4

1.1 Scope

1.2 Background

1.3 Plan Background

1.4 Enrollment

1.5 Purpose

1.6 Benefits Philosophy

1.7 Priorities/Expectations

1.8 Calendar of Events

1.9 Schedule of Implementation

1.10 Performance Period

SECTION 2. INSTRUCTIONS FOR RESPONDENTS __________________________________________________ 8

2.1 General Information

2.2 Examination of the Request for Proposal

2.3 Submittal Instructions

2.4 Proposal Components

2.5 Inquiries and Interpretations

2.6 Selection Process

SECTION 3. SCOPE OF WORK _______________________________________________________________ 12

3.1 Required Services

3.2 Current Funding

3.3 Reserve Arrangements

3.4 Premium Remittance

3.5 Contract Documents

3.6 Eligibility

3.7 Communications and Enrollment

3.8 Qualifications and Respondents

3.9 Plan Design

3.10 Plan Experience

SECTION 4. PROPOSAL RESPONSE ___________________________________________________________ 20

4.1 Cover Letter

4.2 Company Profile

4.3 Organizational Chart

4.4 Staffing……………………………………………………………………………………………

4.5 Installation Team Staffing

4.6 References

4.7 Certification

4.8 Supplemental AD&D

4.9 Group Life Coverage

4.10 Confidential and Proprietary Information

4.11 IBNR and Reserve Calculations

4.12 Deviations

4.13 Alternative Plan Design

4.14 Supplemental Information

The Texas A&M University System RFP-01-SBA-26-280 Page 3 of 51

4.15 VetHUB Subcontracting Plan

SECTION 5. GENERAL TERMS AND CONDITIONS ________________________________________________ 26

Exhibit A – Execution of Offer

Exhibit B – Non-Collusion Affidavit

Exhibit C – Insurance Requirements

Exhibit D – Questionnaire

Exhibit E – Supplemental Files to RFP Instructions

Attachment: FY26 VetHUB Subcontracting Plan Form

The Texas A&M University System RFP-01-SBA-26-280 Page 4 of 51

SECTION 1 - INTRODUCTION

1.1 Scope

The Texas A&M University System (“A&M System”) is soliciting proposals from qualified vendors licensed to operate in the state of Texas for claims and administration services for its fully-insured group life and group accidental death and dismemberment insurance plans for the upcoming plan year, beginning September 1, 2026. The A&M System desires proposals that represent the best combination of quality and cost.

By submitting responses, each Respondent certifies that it understands this RFP and has full knowledge of the scope, nature, quality, and quantity of the work to be performed, the detailed requirements of the services to be provided, and the conditions under which the services are to be performed. Each Respondent also certifies that it understands that all costs relating to preparing and responding to this RFP will be the sole responsibility of the Respondent.

1.2 Background

A&M System is one of the largest and most impactful higher education systems in the country, with an annual budget of $8.1 billion. Its statewide network includes 12 universities, a comprehensive health science center, eight state agencies, Texas A&M-Fort Worth and Texas A&M-RELLIS. A&M System serves approximately 175,000 students and reaches millions more through service, research and outreach programs each year. With nearly $1.6 billion in annual research expenditures, the A&M System fuels innovation, supports communities and drives Texas’ economy forward.

More information about A&M System and all of its member universities and agencies (“Member” or “Members”) can be found at the A&M System About page.

1.3 Plan Background

A&M System benefit-eligible employees and retirees have the opportunity to elect health plan coverage offered by the A&M System. Upon electing coverage through an A&M System health plan, employees and retirees become automatically covered by a Basic life and AD&D benefit of $7,500, provided through the A&M System’s Group Term Life Insurance plan. The cost for this benefit is paid for by the A&M System.

In addition, the A&M System offers supplemental Life and AD&D coverage to all benefit-eligible employees, retired employees, and dependents on a voluntary, contributory basis.

Respondents may link to the System Benefits Administration website at https://www.tamus.edu/benefits to review details of the current benefit plans offered by the A&M System.

1.4 Enrollment

The A&M System currently has 46,193 benefit-eligible employees and retirees.

Group Accidental Death and Dismemberment (AD&D) Insurance

The AD&D plan currently has 18,066 enrollees.

There is an additional supplemental Excel file named Life and AD&D Census that you must download from the Electronic State Business Daily along with the RFP. The file provides demographic and coverage information for those who are currently enrolled in the Life and AD&D plans. Exhibit E provides further information about the data found on the file.

Group Life Insurance

Current enrollment in the Life plan is as follows: Basic Life – 42,285; Optional Life – 17,420; Spouse Life – http://www.tamus.edu/about/ https://www.tamus.edu/benefits

The Texas A&M University System RFP-01-SBA-26-280 Page 5 of 51

6,764, and Child Life – 5,055.

There was an additional supplemental Excel file named Life and AD&D Census that you must download from the Electronic State Business Daily along with the RFP. The file provides demographic and coverage information for those who are currently enrolled in the Life and AD&D plans. Exhibit E provides further information about the data found in the file.

1.5 Purpose

This RFP provides detailed information about the A&M System and its benefit needs and provides the required format for the vendor’s response. Proposals containing deviations are strongly discouraged. If included, deviations must be identified and described in detail in order to be considered. While a proposal with minor deviations from the RFP will not be disqualified, preference will be given to prospective vendors whose proposals contain the fewest and least significant deviations from the requirements presented herein.

The intent of this RFP is to allow all interested / prospective firms to provide a sufficient amount of data that will enable the A&M System to assess the proposal and qualifications of the Respondent. To this end, each Respondent shall furnish, as a part of the proposal, a complete general description of experience in their respective fields.

By submitting responses, each Respondent certifies that it understands this RFP and has full knowledge of the scope and nature of the opportunity described herein. Each Respondent also certifies that it understands that all costs relating to preparing and responding to this RFP will be the sole responsibility of the Respondent.

Respondent is to independently investigate and verify, at its own discretion, all information acquired from the A&M System or from any other source which is relied on by Respondent in the preparation of its proposal.

1.6 Benefits Philosophy

The A&M System’s benefit programs are viewed as an important part of the total compensation package.

It is expected that the benefits offered will attract new employees, promote the retention of career employees and reward retired employees for their service. Therefore, superior quality and responsiveness to participants’ needs are essential.

The A&M System is committed to providing eligible employees, retired employees and their dependents access to group benefit plans of the highest quality at the lowest possible cost to the A&M System and to its employees. The manner in which the programs are funded demands strict containment of costs in order to maximize benefits for the beneficiaries. Funding for the Basic Life and Basic AD&D plan is derived from the statutory contribution of the State of Texas. The Optional Life and Dependent Life plans, as well as the supplemental AD&D plan, are paid in full by the participants on a payroll deduction or accounts receivable basis.

The A&M System currently maintains its benefit plans on a fully-insured, non-participating basis.

The System Benefits Administration (SBA) staff monitors plan experience, negotiates contracts, maintains official records, and ensures quality, efficiency, and statutory compliance in the benefit plans. SBA also maintains, reports, and analyzes claims and financial data related to the plans. It is the responsibility of each System Member to inform employees and retirees of their insurance eligibility, advise them about options and perform enrollment and counseling functions. These activities are usually performed in the Human Resource and/or Payroll departments of each System Member.

One tool to provide the A&M System administration with a continuous evaluation of benefit plans is the

The Texas A&M University System RFP-01-SBA-26-280 Page 6 of 51

System Employee Benefits Advisory Committee (SEBAC). SEBAC consists of representatives from each System Member, retired employee representatives, and ex-officio members. Meetings are held several times per plan year between September and May to update participants on new developments and provide a forum for public comment. The conclusions of the committee are forwarded as recommendations to the Director for consideration or action.

1.7 Priorities/Expectations

Respondents should note the following priorities and expectations with regard to the possibility of the A&M System establishing a contractual relationship with any Respondent:

(a) Ensuring a Quality Level of Service. This priority encompasses the quality of the level of service that can be provided to all Members in a timely, cost-effective manner. The A&M System is seeking a Respondent that will ensure the provision of such quality in its delivery of service through proven training techniques and established metrics.

(b) Level of Experience and Expertise. Respondent must demonstrate its capabilities in providing the utmost level of experience and expertise to ensure successful implementation and delivery of services as determined by the A&M System.

(c) Delivery Efficiency as it Relates to Total Costs. Respondent must demonstrate its ability to deliver the required services in a cost-effective and timely manner while not sacrificing the quality required by the A&M System.

(d) Financial Stability. Respondent must demonstrate its financial stability and capabilities in providing the required services.

1.8 Calendar of Events

Activity Date

Release of Request for Proposal April 3, 2026

Deadline to Submit Questions April 17, 2026

Release of Addendum (if applicable) April 24, 2026

Responses Due May 4, 2026, by 2:00 p.m. Central Time

Presentation/Interview (if applicable) May 18, 2026

Selection of Respondent May 22, 2026

The A&M System will make every effort to adhere to the above schedule. The schedule, however, is subject to change. This may be in the event that further clarification of responses or terms of contract are in the best interest of the A&M System and/or in the event the A&M System requires more time to assure that the selection of the Respondent is in accordance with its policies, rules and regulations, as well as actual timing needs.

1.9 Schedule of Implementation

Awarded Vendor. These dates are tentative and subject to change based on the needs of the A&M System.

June 2026 Respondent’s first draft of the group policies, riders, group certificates, administrative agreement, and any other legal documentation required to be provided to Benefits Administration staff in electronic format for review and edits.

The Texas A&M University System RFP-01-SBA-26-280 Page 7 of 51

June 2026 Summary Plan Descriptions written and edited by the A&M System and submitted to carriers.

June 10, 2026 Enrollment information materials finalized

July 10 – July 31, 2026 Annual Enrollment period for all A&M System employees and retirees for September 1, 2026 effective date

July 31, 2026 All documents necessary for claim processing and Summary Plan Descriptions available to Benefits Administration staff

August 1, 2026 Administrative agreement, group policy, riders, and any other required legal documentation completed and signed by both parties

September 1, 2026 Effective date of plans

1.10 Performance Period

An initial three-year period of performance under a contract pursuant to this RFP will commence on September 1, 2026. Fees, expense schedules, charges, and management arrangements must be guaranteed for the three-year period through August 31, 2029. Assuming satisfactory performance and terms and fees are mutually agreed upon in writing prior to the expiration of the agreement, an affirmative renewal for up to three years may be allowed. In the event of successive affirmative renewal(s), the maximum period of performance pursuant to this RFP ends August 31, 2032. Any renewal must be agreed to in writing by both parties.

The Texas A&M University System RFP-01-SBA-26-280 Page 8 of 51

SECTION 2 – INSTRUCTIONS FOR RESPONDENTS

2.1 General Information

This RFP outlines the services and proposal requirements in Section 3. Proposals are to be in accordance with the outline and specifications contained herein are to remain in effect a minimum of 180 days from the date of submission and may be subject to further extensions as negotiated. A statement to this effect should be contained in the Respondent's cover letter.

Each proposal shall be prepared simply and economically, providing a straightforward and concise description of the Respondent’s ability to meet the requirements of this RFP. Emphasis shall be on completeness, clarity of content and responsiveness to the offer requirements.

This RFP contains specific requests for information. Respondents are encouraged to examine all sections of this RFP carefully, in that the degree of interrelationship between sections is critical. In responding to this RFP, Respondents are encouraged to provide any additional information they believe relevant.

Clause headings appearing in this RFP have been inserted for convenience and ready reference. They do not purport to define, limit or extend the scope or intent of the respective clauses. Whenever the terms “must", "shall", "will", "is required”, or "are required” are used in the RFP, the subject being referred to is to be a required feature of this RFP and critical to the resulting submittal.

In those cases where mandatory requirements are stated, material failure to meet those requirements could result in disqualification of the Respondent's response. Any deviation or exception from RFP specifications must be clearly identified by the Respondent in its submittal.

Expenses for developing and presenting proposals shall be the entire responsibility of the Respondent and shall not be chargeable to the A&M System. All supporting documentation submitted with this submittal will become the property of the A&M System.

By submitting a proposal, Respondent agrees that Respondent and Respondent’s employees and agents are independent vendors and have no employer-employee relationship with the A&M System. The A&M System shall not be responsible for the Federal Insurance Contribution Act payments, federal or state unemployment taxes, income tax withholding, Workers’ Compensation Insurance payments, or any other insurance payments, nor will the A&M System furnish any medical or retirement benefits or any paid vacation or sick leave.

The A&M System reserves the right to alter the specifications of its benefit programs and subsequently negotiate with the selected Respondent as needed to comply with any required changes.

In the event the selected organization fails to perform any of its duties or obligations as provided by the contract which will include the RFP and the Respondent’s response to the RFP, the A&M System without limiting any other rights or remedies it may have by law, equity or under contract, shall have the right to terminate the contract immediately. The selected organization understands and acknowledges that, notwithstanding any termination of the contract, certain obligations shall survive the termination of the contract.

In addition to and without restricting or waiving any other legal, contractual or equitable remedies otherwise available to the A&M System, the A&M System may terminate the contract without cause by giving the selected organization ninety (90) days written notice.

In the event of a change in condition which may affect the group health plan administrative services for which proposals are solicited, the A&M System will expect a good-faith effort from any Respondent selected, to absorb additional liabilities during the term of the contract without requiring rate increases until the next following renewal date. Such changes in condition include, but are not limited to, the following:

The Texas A&M University System RFP-01-SBA-26-280 Page 9 of 51

• Rules of the Texas Department of Insurance.

• Opinions of the Attorney General of the state of Texas.

• Federal and State statutes, court decisions and regulations from agencies and departments that may affect employment and benefit programs.

2.2 Examination of the Request for Proposal

Before submitting, each Respondent will be held to have examined A&M System requirements outlined in Section 3 and satisfied itself as to the existing conditions under which it will be obligated to perform in accordance with the scope and specifications of this RFP.

No claim for additional compensation will be allowed due to unfamiliarity with the specifications and/or existing conditions. It shall be understood that the Respondent has full knowledge of all the existing and/or revised conditions and accepts them "as is."

2.3 Submittal Instructions

All proposals must be received by the A&M System no later than 2:00:00 p.m. Central Time, May 4, 2026 electronically via email to soprocurement@tamus.edu with the subject line of “SBA-26-280 Group Life and Accidental Death & Dismemberment Insurance”. The sent time indicated within the A&M System email server shall be used for the receipt and acceptance of the response. A file sharing tool may be used to submit the proposal response if large file sizes are an issue. If opting to use a file sharing tool it is recommended to send a test file prior to the due date.

It is each Respondent’s responsibility to ensure that the entire submittal response is received by the A&M System by the deadline stated above regardless of submission method. Late submittals will not be considered under any circumstances.

Submittal File Format: Submission shall be saved as two (2) separate files in Adobe Portable Document Format (PDF) according to the items listed below and named as such: I) “company name – Proposal” and II) “company name – Forms”.

2.4 Proposal Components

The following documents and all requirements from noted sections are to be returned as part of Respondent’s proposal submittal. Failure to include these documents may be basis for response disqualification.

I. Proposal

Cover Letter (Section 4.1)

Table of Contents

Proposal (Section 4.2 – 4.13)

II. Forms

Signed Execution of Offer (Exhibit A)

Non-Collusion Affidavit (Exhibit B) – signed and notarized

Vet-HUB Subcontracting Plan (Section 4.14)

Proposal format: The proposal response shall be presented in the order listed above with sections noted accordingly for easy reference. The Table of Contents shall provide page numbers for each section of the proposal.

mailto:soprocurement@tamus.edu

The Texas A&M University System RFP-01-SBA-26-280 Page 10 of 51

Forms: Additional information regarding the Execution of Offer and Non-Collusion Affidavit.

• Execution of Offer: The signature in the Execution of Offer within the electronic copy shall serve as the official signature of record. Signature can be done electronically with DocuSign, Adobe or another similar tool.

• Non-Collusion Affidavit: The Respondent signature on this document may be done electronically with DocuSign, Adobe or another similar tool. An agreement may not be executed with the awarded Respondent until this document is fully signed and notarized.

The Execution of Offer and Non-collusion Affidavit must be completed, signed, and returned with respondent’s submission. Failure to sign and return these documents may result in the rejection of your proposal submission.

2.5 Inquiries and Interpretations

All technical questions concerning this RFP are to be directed, in writing, to Jeff Zimmermann, Executive Director, Procurement and Business Services to soprocurement@tamus.edu. Respondent may not contact other individuals at the A&M System to discuss any aspect of this RFP, unless expressly authorized by the Procurement Office to do so.

Questions regarding the RFP, including questions for more data or information beyond that included in this RFP and any attachment, should be presented in writing. Deadline for submission of questions is April 17, 2026.

Responses to inquiries which directly affect an interpretation or change to this RFP will be issued in writing by addendum/amendment and posted to the Electronic State Business Daily (ESBD) according to the schedule in Section 1.8. CLICK HERE for the posting to obtain all documents related to this RFP. You may also copy and paste the following link (https://www.txsmartbuy.com/esbd) into your browser and input Agency Number “710” and select “Posted” for the Status.

All such addenda/amendments issued by the A&M System prior to the time that proposals are received shall be considered part of the RFP, and the Respondent shall consider and acknowledge receipt of such within Exhibit A. Addendums issued and not acknowledged by the Respondent shall be considered accepted. Only formal written addenda issued by the A&M System in response to an inquiry shall be binding. Oral and other interpretations or clarification will be without legal effect.

2.6 Selection Process

Proposals submitted in response to this RFP shall be evaluated on the basis of the criteria listed below with the selection being the proposal that the A&M System deems to represent the best value to the A&M System. The list of criteria is not exhaustive and is not listed in order of importance. While the criteria shall provide the basis for an objective evaluation of each proposal, the experience and judgment of the SBA staff and the evaluation committee shall also be important in the selection process.

• Compliance with the requirements listed in the RFP

• Ability to service contracts

• Financial Strength and Stability

• Administrative Capability

• Past experience

• Customer/Member services

• Costs

• Organizational flexibility

• References mailto:soprocurement@tamus.edu https://www.txsmartbuy.com/esbd?agencyNumber=710&page=1&status=1 https://www.txsmartbuy.com/esbd

The Texas A&M University System RFP-01-SBA-26-280 Page 11 of 51

• Finalist presentations

The A&M System is not required to select the lowest priced proposal but will take into consideration other factors such as those enumerated above.

The RFP provides the information necessary to prepare and submit proposals for consideration by the A&M System. All properly submitted proposals will be reviewed, evaluated, scored and/or ranked by the A&M System. The A&M System may compile a final ranking of the Respondents in the order that they provide the overall “best value” to the A&M System based on an evaluation of the responses to the RFP. The A&M System may interview one or more of the top ranked Respondents as part of the evaluation process.

After proposal tabulation and such investigation of Respondents as the A&M System deems appropriate, an award may be made to the Respondent whose proposal it judges to represent the best value to the A&M System. Final determination for award of the contract will be made on the overall best value to the A&M System. The A&M System reserves the right to reject any or all proposals and to not award any Respondent a contract.

The selection of the successful proposal may be made by the A&M System on the basis of the proposals initially submitted, without discussion, clarification, or modification. In the alternative, selection of the successful proposal may be made by the A&M System on the basis of negotiation with any of the Respondents. The A&M System shall not disclose any information derived from the proposals submitted by competing Respondents in conducting such discussions.

All proposals must be complete and convey all of the information requested to be considered responsive.

If a proposal fails to conform to the essential requirements of the RFP, the A&M System alone will determine whether the variance is significant enough to consider the proposal susceptible to being made acceptable, and therefore a candidate for further consideration, or not susceptible and therefore not considered for award.

The A&M System may perform reference checks and seek further information, as needed from all Respondents whose proposals A&M System, at its discretion, considers viable, based on the initial evaluation and scoring. The Respondent’s response to this requirement officially authorizes A&M System to contact these organizations to discuss the services and other considerations which the Respondent has provided to such organizations and authorizes the organizations to provide such information to A&M System and Respondent shall and hereby does release and hold harmless A&M System, the state of Texas, and the organization of any and all liability whatsoever, in connection with providing and receiving all such information. Any negative responses received from reference checks may be grounds for disqualification of the proposal.

The A&M System may cancel this RFP or reject proposals at any time prior to an award and is not required to furnish a statement of the reasons why a particular proposal was not deemed to be the most advantageous. The selection of the successful proposal may be made by the A&M System on the basis of the proposals initially submitted, without discussion, clarification, or modification. In the alternative, selection of the successful proposal may be made by the A&M System on the basis of negotiation with any of the Respondents. The A&M System shall not disclose any information derived from the proposals submitted by competing Respondents in conducting such discussions.

By submitting its proposal in response to this RFP, Respondent accepts the evaluation process and acknowledges and accepts that determination of the “best value” firm will require subjective judgments by the A&M System.

The Texas A&M University System RFP-01-SBA-26-280 Page 12 of 51

SECTION 3 – SCOPE OF WORK

3.1 Required Services

Notwithstanding other sections of this RFP which describe administrative interactions, Respondents are advised of the administrative requirements listed in this section of the RFP. Should a contract be awarded, the selected Respondent will become responsible for these items and services to the A&M System upon the award of any contract. Any cost associated with these items and services must be included in your proposal.

a. Benefit contracts, affirmed by the A&M System as to form and content and approved by the State Board of Insurance in accordance with state and federal statutes, and technical and legal assistance in the administration thereof.

b. Management agreements, in addition to any benefit contracts, which formalize the A&M System’s relationship with any carrier.

c. Communication materials necessary for the proper administration of the plans (including but not limited to claim forms) subject to editing of format, content and final approval by the A&M System.

d. Claim management and processing.

e. Monthly, quarterly, and annual management reports, including but not limited to, enrollment, claims, and case management information as agreed to by the A&M System and the Respondent.

f. Ad hoc reports or analyses as requested by the A&M System which do not represent extraordinary data processing effort by the carrier.

g. Representation at open enrollment meetings across the state during the month of July. (Refer to Section

3.7 of the RFP)

h. Actuarial analysis and reports demonstrating the appropriate premium rates and reserve levels.

i. Assessments of eligibility for Waiver of Premium life insurance cases. We currently have approximately 5 individuals on Premium Waiver for employee basic and optional, spouse, and child life coverage through age 65. The A&M System pays their premiums on an annual basis in the fall following the premium year.

j. Professional underwriting services for the evaluation of late applications which are subject to approval based on medical history.

k. Annual accounting of all financial transactions involving the A&M System including, but not limited to all premiums, claims, reserve changes, interest earnings and retention.

3.2 Current Funding

Funding for the Basic Life and Basic AD&D plan is derived from the statutory contribution of the State of Texas. The Optional Life and Dependent Life plans, as well as the Supplemental AD&D plan, are paid in full by the participants on a payroll deduction or accounts receivable basis. The Life and AD&D plans are all fully insured. The A&M System is committed to providing the highest value of coverage, while minimizing the risk to the individual plans. There are no reserve funds for claims fluctuation.

The plan year, for all coverages, corresponds to the State and the A&M System fiscal year which begins on September 1, and ends on August 31st.

3.3 Reserve Arrangements

Detailed information regarding the Respondent’s methodology for calculating Incurred But Not Reported

The Texas A&M University System RFP-01-SBA-26-280 Page 13 of 51

(IBNR )and pending claim reserves should be provided in Section 4.11 of your response. Reserve calculation formulas are subject to negotiation with the A&M System prior to signing a contract.

3.4 Premium Remittance Process

The A&M System is a self-bill group. We require a 40 -– 50- day premium lag due to the limitations of our payroll system. Premium deductions for a given month do not occur until the first working day of the following month and are then remitted by ACH to the carrier around the 15th of the next month. For example, the premium for the month of September is not deducted from an employee’s pay until October 1 and is remitted in total to the carrier on October 15. Payment to the carrier is made as a lump sum and a detailed remittance advice indicating the participants for whom payment is being made is not available.

However, we will supply summary participation reports each month from which the carrier can estimate premiums and compare to the amount received for reasonableness.

3.5 Contract Documents

According to the schedule stated in Section 1.9, the awarded Respondent will provide a first draft of the group policies, riders, group certificates, administrative agreement, and any other legal documentation required to the appropriate A&M System Benefits Administration point of contact in electronic format (preferably MS WORD) for review and edits. In addition to the standard terms and conditions included in your Administrative Services Agreement, the selected Respondent must also include the required terms and conditions stated in Section 5.

Submission and completion of these documents is not required as part of the RFP response.

3.6 Eligibility

Newly eligible employees have a 31-day enrollment period. Depending upon the date the employee enrolls online or submits an enrollment form, coverage may begin as early as the date of hire, or as late as the first of the month following the 60th day after the hire date.

The A&M System will, in all cases, determine eligibility for coverage and effective dates of coverage in accordance with its rules and procedures. If these rules and procedures differ from those normally utilized by the Respondent, it is understood that the A&M System’s determination will prevail.

Currently, an employee and his/her dependents are eligible for benefits if he/she is one of the following:

a. eligible to participate in the Teacher Retirement System of Texas (TRS) or Optional Retirement Program (ORP), and the employee is either: (1) expected to work at least 20 hours per week and to continue in the employment for a term of at least 4-1/2 months; or (2) appointed for at least 50 percent of a standard full-time appointment.

OR, the employee is employed at least 20 hours a week; and is not permitted to be a member of the Teacher Retirement System of Texas because the individual is solely employed by the system in a position that as a condition of employment requires the individual to be enrolled as a student in the system in graduate-level courses.

b. a retired employee who has met the eligibility requirements for retirement under Texas Insurance Code, Chapter 1601.102

The Texas A&M University System RFP-01-SBA-26-280 Page 14 of 51

Dependents eligible for coverage include:

a. the employee’s/retiree’s spouse

b. the employee’s/retiree’s children younger than age 26, regardless of where they live or whether they are enrolled in school; or disabled dependent children over the age of 26

c. grandchildren claimed on the employee’s/retiree’s income tax

3.7 Communications and Enrollment

The A&M System will conduct an open enrollment period for its eligible employees and retirees from July 10 through July 31, for the plan year beginning the following September 1. Between fifteen and twenty voluntary open enrollment meetings are held across the state and the selected Respondent will be required to have personnel available to make presentations at all meetings, if requested to do so. A supplemental file listed in Exhibit E named Sample Open Enrollment Meeting Calendar contains a copy of the July 2025 open enrollment meeting calendar provided for your reference. SBA will produce a booklet summarizing the benefit plans, and employees will make benefit selections using the A&M System’s enrollment process.

Over 80% of open enrollment benefit selections are done online by employees and retirees.

As new communication materials are developed during the plan year, a request to send these materials to the employees must be submitted in writing to Benefits Administration staff along with copies of the proposed materials.

The A&M System will make personnel available during normal business hours to respond to inquiries regarding the status or eligibility of a participant.

3.8 Qualifications of Respondents

Respondents must be able to demonstrate sufficient financial stature and operational capacity to accommodate the needs of the A&M System. To affirm financial capability, the Respondent must submit all documentation as requested in the Company Profile to be included in the RFP response (see Section 4.2).

All entities responding to this RFP must certify (see Section 4.7) that they are licensed to do business in the state of Texas and permitted to contract with the State or any of its subdivisions.

3.9 Plan Design

Group Accidental Death and Dismemberment Insurance

Your proposal and pricing should be based on the same benefit design that is currently in place. Rates must be for a fully insured plan and guaranteed for the initial three-year term. While highlights of the current plan are provided below, you can view the plan details by linking to the SPD at https://assets.system.tamus.edu/files/benefits/website/SPDs/SPDADD.pdf.

All benefit-eligible employees have the option to enroll in employee-only or family coverage, with coverage amounts based on annual pay as of September 1. Employees with annual pay of $25,000 or less can buy coverage of up to $250,000. Employees with annual pay of more than $25,000 can buy up to 10 times their annual pay in coverage up to a maximum of $800,000. All coverage amounts must be in multiples of $10,000.

Retired employees may choose between retiree-only or family coverage. Retired employees may choose coverage in a multiple of $10,000 up to $200,000 if younger than 70 or up to $60,000 if 70 or older.

Dismemberment benefits, which include loss of limb, eyesight, speech or hearing, are determined using a percentage of the full coverage amount. The percentage is set according to the type and extent of loss.

For employees who choose employee-only coverage, the accidental death benefit paid is the coverage https://assets.system.tamus.edu/files/benefits/website/SPDs/SPDADD.pdf

The Texas A&M University System RFP-01-SBA-26-280 Page 15 of 51 amount purchased. For family coverage, the amount paid for the accidental death of a dependent is based on a percentage of the employee/retiree purchased amount.

With family coverage, the spouse is covered for 50% of the employee’s coverage amount and each eligible child is covered for 10% of the employee’s coverage amount. If the employee does not have a spouse, each eligible child is covered for 15% of the employee’s coverage amount. If the employee has no eligible children, the spouse is covered for 60% of the employee’s coverage amount. The maximum coverage for each child is $25,000.

• Claims Administration

Benefits Administration staff receives notice of claims from participants or beneficiaries, usually through the employee’s local Human Resources Office. The local Human Resources Office then provides the form for the participant or beneficiary to complete. The claimant is advised of required documentation and submits a complete packet of paperwork to the carrier. In addition, Benefits Administration staff submits proof of enrollment and beneficiary designation(s) to the carrier. Any additional information needed by the carrier should be requested directly from the participant or beneficiary.

Once all the required documents have been received, the carrier conducts any necessary investigation and processes payment of benefits and sends the check directly to the beneficiary, and a copy of the payment statement to Benefits Administration staff.

The A&M System expects timely processing of claim payments, and requests that the claim administrator honor assignment of benefits by the beneficiary for the payment of funeral expenses.

Other assignments, irrevocable or collateral, should not be allowed by the terms of this policy.

Group Life Insurance

Your proposal and pricing should be based on the same benefit design that is currently in place. Rates must be for a fully insured plan and guaranteed for the initial three-year term. While highlights of the current plan are provided below, you can view the plan details by linking to the SPD at https://assets.system.tamus.edu/files/benefits/website/SPDs/SPDLife.pdf.

The current plan design has been in place since September 1, 2009 and participants who were enrolled prior to that date were allowed to grandfather existing coverage amounts if they so desired.

Coverage for the A&M System’s life plans must be structured so that no plan participants incur imputed income in accordance with IRC Section 79. For this reason, the Basic Life plan must be a separate policy and the financial accounting for the plan must be separate from the Optional and Dependent Life plans. In addition, our intent is to keep the Optional Life rates below the applicable IRC group term life insurance premium tables.

• Basic Life/Alternate Basic Life and Basic AD&D Insurance (Actives & Retirees)

If a participant has A&M System health coverage: The enrollee is automatically covered by $7,500 in Basic Life insurance and $5,000 in AD&D coverage. Each eligible dependent child is covered by $5,000 in life insurance (enrollment of dependent children for this portion of the coverage is automatic). This coverage is paid for with the employer contribution.

If a participant does not have A&M System health coverage but certifies to other health coverage:

The enrollee may purchase $50,000 in Alternate Basic Life and $5,000 in Basic AD&D coverage. Each eligible dependent child is covered by $5,000 in life insurance. Upon a retiree reaching age 80, Alternate Basic Life coverage is automatically reduced to $30,000. The employer contribution may be used to pay for this coverage. However, the enrollee may not purchase Optional Life coverage if this option is chosen.

https://assets.system.tamus.edu/files/benefits/website/SPDs/SPDLife.pdf

The Texas A&M University System RFP-01-SBA-26-280 Page 16 of 51

• Optional Life Insurance

The A&M System also offers voluntary, contributory Optional Life coverage to all benefit-eligible employees and retired employees. Coverage amounts are as follows:

Active Employees Coverage may be purchased for ½, 1, 2, 3, 4, 5, or 6 times annual salary, up to a maximum of $1,000,000. Evidence of Insurability is required for four times salary or greater.

Retired Employees o If younger than age 70, any multiple of $1,000 up to $100,000 or the amount of coverage in place at time of retirement, whichever is less. Coverage is automatically reduced to $60,000 at age 70 if an amount greater than $60,000 was retained at retirement and to $30,000 at age 80.

o If age 70 or older, any multiple of $1,000 up to $60,000 or the amount of coverage in place at retirement, whichever is less. Coverage is automatically reduced to $30,000 at age 80 if an amount greater than $30,000 was retained at retirement.

Premiums are discounted for non-tobacco users, defined as those who have not used any tobacco product within three months of enrolling in coverage. Employees cannot elect Optional Life Insurance and also be considered a dependent of an A&M System-employed spouse for Dependent Life coverage.

• Dependent Life Insurance

An additional voluntary, contributory coverage is offered to pay benefits to employees and retired employees upon the death of their dependents. Participants may choose to enroll some eligible dependents and not others. The A&M System offers three plan options:

Dependent Life Plan A – (Employee/Retiree must be enrolled in Optional Life Coverage)

Benefit – Spouse – $25,000, $50,000, $75,000, $100,000, $150,000 or $200,000 Premium – Spouse – Optional Life rate based on spouse age (per $1000 of coverage)

Benefit – Child – $10,000 Premium – $0.06 per $1,000 of coverage

Dependent Life Plan B – (Employee/Retiree must be enrolled in Basic Life, Alternate Basic Life, or Optional Life)

Benefit – Spouse and each Child – $5,000 Premium – Flat rate of $1.37 (Spouse - $1.05, Child - $0.32)

Dependents covered under Plan B also have Accidental Death and Dismemberment coverage of $5,000, except that dependents of retired employees must be enrolled in Plan B at the time of the employee’s retirement to be eligible for this benefit.

Dependent Life Plan C – (Employee/Retiree must be enrolled in Alternate Basic Life)

Benefit – Spouse – 50% of employee’s Alternate Basic Life

Benefit – Child – 10% of employee’s Alternate Basic Life

Premium – 50% of employee’s Alternate Basic Life premium; 10% of employee’s Alternate Basic Life premium if no spouse is covered

At retirement, the maximum Dependent Life coverage amount for the participant’s spouse is $50,000.

At age 70, the spouse maximum is $30,000 and at age 80, it is $15,000.

• Evidence of Insurability

All covered persons must be assured continuation of their current level of coverage without needing to

The Texas A&M University System RFP-01-SBA-26-280 Page 17 of 51 prove insurability.

No Evidence of Insurability (E of I) is required for an employee enrolling in Optional Life or Dependent Life coverage at time of employment or within 31 days of initial eligibility with the exception of employees applying for Optional Life coverage of 4, 5 or 6 times salary. E of I is generally required when employees enroll in additional coverage for themselves or dependents beyond the 45th day of initial eligibility. E of I is required when the employee changes from Dependent Life Plan B to Plans A or C. In addition, active employees who have a qualified change in status may enroll in Optional Life coverage of ½ or one times their salary or Alternate Basic Life and enroll a spouse in Dependent Life of $50K without providing E of I.

Retirees must always provide evidence of insurability to increase coverage. Retirees can provide E of I to increase to an amount greater than the amount of coverage held just prior to retirement, with a maximum coverage amount of $100,000 for retirees younger than 70, $60,000 for retirees 70 – 79, and $30,000 for retirees age 80 or older.

• Waiver of Premium Benefit

An employee who becomes totally and permanently disabled is entitled to apply for Waiver of Premium. If approved, the premium is waived for Basic Life coverage and for Optional and Dependent Life coverage if the employee is enrolled in these plans. This benefit may be extended for successive periods of one year each, providing the employee can prove the disability continues to be total and permanent. Life insurance under Waiver of Premium will terminate when the employee can no longer prove total and permanent disability or the date the employee attains age 65. Those reaching age 65 are allowed to revert to retiree coverage levels, if they are eligible, as retirees of the A&M System to retain benefits.

The selected Respondent will be responsible for assessment and determination of eligibility for Waiver of Premium applicants and payment of claims. In addition, the selected Respondent will be responsible for coordinating any necessary ongoing submission of documentation of those on Premium Waiver to prove the disability continues to be total and permanent. If a new carrier is selected, they will be responsible for coordination of the transfer of existing Waiver of Premium claimant information from the current carrier.

There are currently about 5 individuals on Waiver of Premium. There is an Excel file named Life Waiver of Premium which includes a list of the coverage amounts and some demographic information for those on Waiver of Premium that you must download from the Electronic State Business Daily along with the RFP. Exhibit E provides further information about the data found on the files.

An employee applies for Waiver of Premium by requesting forms from their Human Resources Office.

The employee forwards the completed paperwork to the carrier, and Benefits Administration staff verifies enrollment and coverage amount with the carrier. There is no elimination period and an “any occupation” definition is used to establish disability for these plans.

The carrier notifies the employee and the appropriate System Member Human Resources Office of the eligibility determination and contacts the System Benefits Office if Waiver of Premium status is being terminated for any reason other than death or reaching age 65.

Premiums for those on Waiver of Premium are paid by the A&M System. However, the claims are paid and reported by the carrier as they would any other claim. The A&M System will self-bill the premiums and provide premium payment along with detailed backup to the carrier after the close of each plan year.

• Coverage Cost

Generally, the Basic Life and Basic AD&D coverage premiums are paid by the state. The cost of the

The Texas A&M University System RFP-01-SBA-26-280 Page 18 of 51

Optional Life premium is determined by the employee’s age (as of September 1st of each plan year), amount of coverage, and status as a tobacco or non-tobacco user. Coverage amounts and premiums are automatically adjusted each September 1st to reflect age and salary changes.

• Living Access Benefit

The current plan has an Accelerated Death Benefit. If a doctor certifies that a covered individual has less than 24 months to live, they may apply for immediate payment of up to 50% of their total life amount. The beneficiary will receive the remaining benefit after the individual’s death. For those with life coverage of less than $50,000, an Accelerated Death Benefit of up to $25,000, not to exceed the total life benefit may be paid.

• Mid-Year Salary Increases

Most salary increases are effective on September 1st. However, due to promotions or other circumstances that may occur, an employee may receive a salary increase at some time other than September 1st. Premiums are set using the annual salary as of September 1st. If an employee receives an increase at a time other than September 1st, their premium remains unchanged until the next September 1st, but the coverage amount increases upon the effective date of the increase in annual salary.

• Portability

When Optional and/or Dependent Life coverage ends, participants may elect portability of coverage. A spouse and/or dependent children, if covered, may elect portability if they no longer meet the definition of an eligible dependent. Waiver of Premium and the Accelerated Death Benefit are not available once portability becomes effective. Portability coverage may be purchased in any amount up to the amount of coverage lost and is available until age 70.

Current ported participants will remain with the incumbent carrier.

• Conversion Plan

When coverage ends, participants are also allowed to convert the lost coverage to an individual policy.

•…