ESBD_557641_1790989763118_RFP No. 26-1398 Health and WellnessMedicalRxDental.pdf

Request for Proposals Competitive Sealed Proposals for Healthcare Insurance Services

Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services

RFP NO. 26-1398

RFP Due Date: 10:00 AM Central Time, October 6, 2026

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TABLE OF CONTENTS

Proposal Title: Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA

Insurance Services RFP No.: 26-1398

TITLE PAGE

Request for Proposal Cover Page ................................................................................. RFP – 1 of 11

Supplier Diversity Purchasing Policy ......................................................................... RFP – 2 of 11

General Instructions to Respondents................................................................... RFP – 2 - 3 of 11

Submittal Schedule .................................................................................................. RFP – 4 of 11

Request for Proposal ...................................................................................... RFP – 5 - 10 of 11

Acknowledgment of Request for Bids and Receipt of Addenda ....................... RFP – 11 of 11

W-9 Form ................................................................................................................................... W9 – 1 – 6

Conflicts of Interest Questionnaire [CIQ] form .............................................................. CIQ – 1 to 2

Non-Collusion Affidavit Form..................................................................................................... NCA – 1

Example Response to Litigation History Question (Tab A (6)) ....................................... EXR – 1

APPENDIX A: Current Plan Summaries .............................................................. APP:A – 1 – 8

APPENDIX B: RFP Cost Sheet Instructions (Refer to Attachment 1) .................... APP:B – 1 – 1

APPENDIX C: BRA Facility Locations ................................................................... APP:C – 1 – 1

Attachments below are incorporated by reference into this Request for Proposal and Contract Documents:

Attachment 1 BRA RFP Submission Forms.xlsx 7 tabs

Attachment 2 BCBS-TX Medical HMO Certificate of Coverage 170 pages

Attachment 3 BCBS-TX Medical HSA Certificate of Coverage 126 pages

Attachment 4 BCBS-TX Medical PPO Certificate of Coverage 129 pages

Attachment 5 BCBS-TX Dental BASE Certificate of Coverage 52 pages

Attachment 6 BCBS-TX Dental BUY-UP Certificate of Coverage 52 pages

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services Page 1 of 11

Request for Proposals September 9, 2026 RFP No. 26-1398

Dear Prospective Respondent:

Competitive Sealed Proposals will be received by the be received by the Purchasing Agent or other designee of the Brazos River Authority no later than 10:00 AM, October 6, 2026 for Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services. All qualified firms including service-disabled veterans are encouraged to submit proposals in response to this request.

Proposals must be submitted and received no later than the due date and time specified. Any Proposal received later than the specified time, shall not be considered. The BRA is NOT responsible for ensuring the delivery of Proposals.

Refer to Section 14. Delivery of Proposal Submittals for instructions on submitting a response to this solicitation.

Proposal must be clearly identified as follows on the outside of the sealed physical submission. The BRA shall not be responsible for submissions that are not properly identified. Proper identification of Respondent’s proposal is the sole responsibility of the Respondent and failure to do so may result in the submission not being included in the proposal opening:

PROPOSAL: Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services

RFP NO: 26-1398

RFP DUE DATE: 10:00 AM, October 6, 2026

The BRA shall have the right to accept or reject any or all Proposals, or any part thereof, and to waive any technicalities in the interest of the BRA.

BRA will evaluate all relevant COVID-19, health, safety and business factors on all solicitations to determine when to initiate a notice to proceed on all projects, delivery of goods and/or services or procurement of construction related services to best attempt to balance BRA needs and to protect the health and safety of BRA employees, the employees of respondents and the public at large.

Sincerely, Allison Sheeler, CTCD, CTCM Purchasing Agent

4600 Cobbs Drive • Waco, Texas 76710 254.761.3153

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services Page 2 of 11

SUPPLIER DIVERSITY PURCHASING POLICY

The Brazos River Authority (BRA) will ensure that purchases of equipment, materials, supplies, and/or services conform with Texas Procurement law as applicable to the BRA, are cost effective, and contribute to the competitiveness of the BRA and its customers.

Procurement activities will be conducted in an open and fair manner with equal opportunity provided to all qualified parties. The BRA will provide equal contracting opportunities as provided by all applicable State and Federal laws to service-disabled veterans.

GENERAL INSTRUCTIONS TO RESPONDENTS

The Work consists of the furnishing of all labor, materials, services, equipment, and appliances required for the delivery and the supplying of products and/or services as described herein and in the contract documents.

1. PROPOSAL SUBMISSION: Proposals must be received no later than the Proposal opening date and time specified above. All Proposals received after closing time will not be considered.

A. To be considered as eligible, a Respondent shall have complied with all legal requirements to permit them to operate in the State of Texas.

B. Proposals must be submitted electronically, mailed or hand delivered to be considered.

2. WITHDRAWAL OF PROPOSALS: No Proposal may be withdrawn for a period of ninety (90) days after Proposal opening, except by: 1) mutual consent of the BRA and Respondent; or 2) a previously submitted Proposals may be withdrawn upon written request received from Respondent prior to time established for receipt of Proposals.

3. SIGNATURE ON PROPOSALS: To be valid, Proposals must be signed by an authorized person. By such signature, Respondent agrees to strictly abide by the terms, conditions, and Scope of Services embodied in this Request for Proposal.

4. EXAMINATION OF PROPOSAL DOCUMENTS: Before submitting a Proposal, all Respondents shall examine the complete Proposal documents, including Proposal Notice, Instruction to Respondent, and Scope of Services, all of which are part of the Proposal documents.

5. ADDENDA: Unless otherwise stated in the Proposal, answers to all questions, inquiries, and request for additional information will be issued in the form of Addenda. During the Proposal period, prospective Respondent may be advised by Addenda of additions, deletions from, or changes in the requirements of the Proposal documents. The BRA will not be responsible for the authenticity or correctness of oral interpretations of the Proposal documents or for information obtained in any other manner than through the media of Addenda. Receipt of each Addendum shall be acknowledged by the Respondent.

Any questions concerning this Proposal should be submitted on https://www.bidnetdirect.com/texas/brazosriverauthority no later than five (5) days prior to the opening of the Proposal. This is to allow the BRA sufficient time to respond to inquiries and provide information to all interested Respondents by Addendum. Unless otherwise stated in the Proposal, Addenda will be posted on https://www.bidnetdirect.com/texas/brazosriverauthority.

Respondent is responsible for checking https://www.bidnetdirect.com/texas/brazosriverauthority for updates and Addenda until the time at which the submission is due. Failure to respond to all requirements, including those Addenda, shall be grounds for rejection of your Proposal.

6. TAXATION: The BRA is exempt under the Texas Sales Tax and Use Tax Laws, and the Respondent shall not include such taxes in the Proposal.

7. QUALIFICATION OF RESPONDENTS: The BRA reserves the right to reject any Proposal if the evidence submitted by, or investigation of, such Respondent fails to satisfy the BRA that such

Respondent is properly qualified to carry out the obligations of the contract and to complete the Services contemplated herein.

Conditional Proposals will not be accepted.

8. CONSIDERATION OF PROPOSALS: Unless stated otherwise in the Advertisement or Request for Proposal, the properly identified Proposals received on time will be opened publicly and only the names of the Respondent will be read aloud. Respondents are invited to be present.

9. COMPLIANCE WITH SCOPE OF SERVICES AND RIGHT OF

SELECTION: The Respondent shall abide by and comply with the true intent of the scope of services and not take advantage of any unintentional error or omission.

10. DEVIATION FROM SCOPE OF SERVICES: All deviations from the scope of services must be noted in detail by the Respondent, in writing, at the time of submittal of the formal Proposal. The absence of a written list of deviations at the time of submittal of the Proposal will be considered acceptance of the Scope of Services as written.

Any deviations from the Scope of Services as written not previously submitted, as required by the above, will be grounds for rejection of the material and/or item when delivered.

In case of ambiguity or lack of clarity, the BRA reserves the right to consider the most advantageous Proposal or reject the Proposal.

11. REPRESENTATIONS: By execution and submission of this Proposal, the Respondent hereby represents and warrants to the BRA that Respondent has read and understands the Proposal Documents and this Proposal is made in accordance with the Proposal Documents.

12. INDEMNIFICATION: THE RESPONDENT SHALL COMPLY

WITH THE REQUIREMENTS OF ALL APPLICABLE LAWS, RULES,

AND REGULATIONS AND SHALL EXONERATE, INDEMNIFY AND

HOLD HARMLESS THE BRA FROM ANY AND ALL LIABILITY OR

DAMAGES RESULTING FROM FAILURE TO DO SO.

IN ADDITION, THE RESPONDENT AGREES TO INDEMNIFY,

KEEP, SAVE AND HOLD THE BRA HARMLESS FROM ANY AND

ALL ACTIONS, LIABILITIES, DAMAGES, JUDGMENTS, COSTS

AND EXPENSES INCLUDING REASONABLE ATTORNEY’S FEES,

IN CASE AN ACTION IS FILED OR DOES IN ANY WAY ACCRUE

AGAINST THE BRA, ITS OFFICIALS, OFFICERS, AND

EMPLOYEES IN CONSEQUENCE OF THE AWARDED CONTRACT

FOR ANY NEGLIGENT ACT OR OMISSION OF THE RESPONDENT

IN THE PROVISION OF SERVICES UNDER THE AWARDED

CONTRACT, OR THAT MAY RESULT FROM THE CARELESSNESS

OR LACK OF SKILL OF THE RESPONDENT OR THE

RESPONDENT’S OFFICERS, AGENT, CONTRACTORS, ASSIGNS

OR EMPLOYEES. IN THE EVENT A JUDGMENT IS RECOVERED

AGAINST THE BRA FOR ANY SUCH LIABILITY, COSTS OR

EXPENSES, SUCH JUDGMENT SHALL BE CONCLUSIVE

AGAINST THE RESPONDENT.

IT IS SPECIFICALLY UNDERSTOOD AND AGREED BY THE

RESPONDENT THAT SUCH INDEMNITY IS INDEMNITY BY THE

RESPONDENT TO INDEMNIFY AND PROTECT THE BRA FROM

LIABILITY, CLAIMS, SUITS, LOSSES, DAMAGES OR CAUSES OF

ACTION DUE TO THE RESPONDENT’S NEGLIGENCE, ERROR OR

OMISSION.

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13. CRITERIA FOR AWARD: The BRA will select the most highly qualified Respondent on the basis of demonstrated competence and qualifications and then attempt to negotiate with that Respondent a contract at a fair and reasonable price. If a satisfactory contract cannot be negotiated with the most highly qualified Respondent, the BRA will select the next most highly qualified Respondent and attempt to negotiate a contract with that Respondent at a fair and reasonable price. The BRA also reserves the right to end negotiations, reject all proposals, or cancel and re-advertise the solicitation if it is determined to be most advantageous to the BRA. REFER TO SECTION 5

“SELECTION PROCESS.”

14. TERMINATION: The awarded contract may be terminated at any time by the BRA, in BRA’s sole discretion, for any cause or for convenience without penalty or liability. Upon receipt of such notice, the supplier shall immediately discontinue all services and actions.

The BRA shall pay the Respondent promptly the accrued and unpaid amounts due for services to the date of termination, to the extent the services are approved by the BRA.

15. CHANGE OF CONTRACT PRICE: The agreed upon contract price shall not be exceeded without the prior written consent of the BRA and may only be modified by a written amendment to the contract executed by both BRA and Respondent.

16. PAYMENT: Unless otherwise specified, payment for services and/or product will be processed within thirty (30) days from invoice date and acceptance of Services and/or product. Invoices presented for payment must be submitted in accordance with instructions contained on the purchase order including reference to purchase order number and submittal to the correct address for processing. Unit price on invoice shall be in two (2) decimal places only, i.e., $ .XX.

The BRA has set a goal to have as much paperwork submitted electronically. Respondents are asked to submit invoices electronically to the following Accounts Payable email address:

accounts. payable@brazos.org. Respondents who use the electronic service should not mail the original invoice.

17. CONFIDENTIALITY OF DOCUMENTS: The BRA is subject to the Texas Public Information Act (PIA). Any information submitted to the BRA by a Respondent shall be considered non-confidential and available to the public, except as follows:

In the event a Respondent considers a specific portion of their Proposal to be confidential and subject to an exception to disclosure under the PIA, such portion must be clearly identified and marked "CONFIDENTIAL". Do not mark an entire Proposal confidential, as this is not in conformance with the PIA and is not acceptable. Only the specific portion or portions of the Proposal that the Respondent considers to be confidential pursuant to the PIA should be marked. IF

AN ENTIRE PROPOSAL IS MARKED CONFIDENTIAL, THE BRA

WILL NOT TREAT ANY PORTION OF THE PROPOSAL AS

CONFIDENTIAL AND THE PROPOSAL MAY BE REJECTED AS

NON-CONFORMING. The BRA will honor notations of confidentiality made in accordance with this paragraph and decline to release such information initially. However, final determination of whether a particular portion of a Proposal may in fact be withheld pursuant to the PIA will be made by the Texas Attorney General or a court of competent jurisdiction.

In the event a public information request is received for a portion of a Proposal that has been marked confidential, the BRA shall ask the affected Respondent if the information may be released. If the release is agreed to, the BRA shall release the information.

If the release is denied, the matter shall be referred to the Texas Attorney General's Office in accordance with the process set forth in the PIA. The Respondent shall be fully and solely responsible for submitting arguments and evidence within the statutory timeframes to the Texas Attorney General’s Office regarding its claim of confidentiality. The BRA will NOT submit arguments on behalf of the Respondent.

The Texas Attorney General's office shall rule on the matter. In the event that it is determined by opinion or order of the Texas Attorney General or a court of competent jurisdiction that such information may not be withheld, then such information will be made available to the requester. If it is determined that the information may be withheld, BRA will withhold the information from the requestor.

Pricing information contained in Proposals or contracts is not considered confidential under the PIA and will be disclosed without making a request to the Texas Attorney General.

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services Page 4 of 11

REQUEST FOR PROPOSALS

HEALTH AND WELLNESS MEDICAL/RX, DENTAL,

FSA, HRA AND COBRA INSURANCE SERVICES

SUBMITTAL SCHEDULE

Requests for Proposals are posted on the BidNet Direct website at https://www.bidnetdirect.com/texas/brazosriverauthority and prospective Respondents should visit the site for potential updates to Proposal requirements.

Wednesday, September 9, 2026 RFP is available to download at https://www.bidnetdirect.com/texas/brazosriverauthority

4:00 PM, Friday, September 18, Last date and time to ask questions or request additional information. Please submit your questions at https://www.bidnetdirect.com/texas/brazosriverauthority

4:00 PM, Tuesday, September 22, Post response to questions received as of the deadline or as soon thereafter, as an Addendum on https://www.bidnetdirect.com/texas/brazosriverauthority

10:00 AM, Tuesday, October 6, Proposals are due.

11:00 AM, Tuesday, October 6, Proposals will be opened virtually at the link below……………………………..

https://youtube.com/live/hrhyseCwyZk?feature=share

Local Time Prevailing.

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services Page 5 of 11

1. General The BRA requests responses to Proposal for services to provide fully-insured Medical/Rx, Dental, FSA, HRA and COBRA insurance coverage. BRA’s current Medical and Rx provider is Blue Cross Blue Shield of Texas (BCBSTX) with a December 31, 2026 contract end date. BRA’s current Dental provider is BCBSTX, and FSA, HRA and COBRA are all with Flores & Associates.

Number of Active Full-Time Employees: 277 Number of COBRA: 2 Eligibility of New Hires: 1st of month following 60 days from date of hire.

Medical Geo Access

General: 2 in 10 mile radius Specialist: 2 in 10 mile radius Hospital: 1 in 10 mile radius

Dental Geo Access General: 2 in 10 mile radius Specialist: 2 in 10 mile radius

The BRA is requesting that Proposers submit pricing based on the current deductible and aggregate limits. All coverages are to be quoted NET of Commissions. New coverage effective date will be January 1, 2027.

Refer to APPENDIX A for Current Plan Summaries.

Refer to APPENDIX B for Requested Plan Options – Excel Submission Forms.

Refer to APPENDIX C for BRA Facility Address Locations and Map.

2. Scope of Services Offeror must provide a comparable network within the coverage areas to qualify as a responsive proposer. Proposals shall be based on the requested plan(s) of benefits.

A. Proposals shall be based upon the census provided in the RFP.

B. The BRA is exempt from paying applicable State premium taxes per Chapter 222 of the Texas Insurance Code. All applicable state premium taxes must be excluded from the BRA’s rates.

C. All participants enrolled in the Employee Benefits Plan as of 12/31/2026 are to receive immediate coverage under the new plan. All health services incurred on or after January 1, 2027 for currently enrolled participants are to be eligible expenses. The BRA's enrollment records are to be the basis for "take-over."

D. Credit is to be given for accumulated deductible and coinsurance.

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3. Base Proposal Proposal price to include all labor, materials, tools, equipment and incidentals necessary to satisfactorily design, fabricate, manufacture, furnish, deliver components and complete assemblies.

4. Information Required in the RFP Submittal - Tab Format The BRA specifically requests succinct submittals tailored to the general and discipline-specific scope of services summarized above. All submittals become the property of the BRA. Each Bid submittal shall include the information requested below.

FAILURE TO SUBMIT ANY OF THE REQUESTED INFORMATION MAY BE GROUNDS

FOR REJECTION OF PROPOSAL OR DELAY ISSUANCE OF A PURCHASE

ORDER/CONTRACT.

Tab A: Include the following:

(1) Date your company was established and a brief history; number of employees; provide number and location of offices.

(2) Provide name, title and office location of person who will be the principal contact for the BRA and the billing location if different.

(3) Describe the types of organizations that your company typically serves and general nature of the work as it relates to this RFP.

(4) A list and description of similar services completed within the last five years under your current company name or any other company name similar in nature to this solicitation.

PROVIDE FIVE (5) TEXAS GOVERNMENTAL CLIENT REFERENCES. This should include the name, the location, a brief description of Scope of Services, and a contact name and telephone number of a reference for each client. List litigation that your company has been a party to in the last five (5) years, under your current company name or any other company name. Include only litigation that involves business units in your company that are proposed for performing services under this RFP.

(5) List all such litigation involving owners and/or general contractors. To be fully responsive, provide the level of detail in the attached example, as well as a name and phone number to contact an authorized representative of your company in the event that the BRA needs to clarify your response. Failure to be fully responsive will be sufficient grounds for the BRA to disqualify your company.

(6) Have you ever defaulted, failed to complete a contract or had a contract terminated by the other party? If so, where and why? Provide name and telephone number of the other party.

(7) Please provide the contact information including the email address of the person responsible for providing proof of insurance.

Tab B: Include the following completed and signed forms. Failure to submit the required forms will result in rejection of the proposal as non-responsive.

(1) Complete and submit ALL Excel forms listed in APPENDIX B.

(2) Complete and submit the attached Request for Proposals – Proposal Form

(3) Complete and submit the attached W-9 form, or if foreign entity submit the appropriate tax document information.

(4) Complete and submit the attached Conflicts of Interest Questionnaire [CIQ] form.

(5) Complete and submit the Non-Collusion Affidavit form.

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(6) Medical/Rx Certificate(s)

(7) Medical/Rx Provider Disruption

(8) Dental Certificate(s)

(9) Dental Provider Disruption

(10) Rx Disruption

5. Selection Process Proposals will be evaluated and scored based upon the factors listed below. Criteria is listed in general order of importance, from generally more important to generally less important, and the BRA shall select the provider whose services will provide the best value for the BRA while maintaining a comparable level of service to the BRA’s current plan at a reasonable price:

Cost

a. Fixed Costs: includes insurance costs and administrative costs

b. Ability to reduce claims expense

25 %

Network Statistics 15%

Financial Stability

a. Insurance Company, AM Best Rating

15%

Communication

a. Educational material for employees

b. Summary Plan Description capabilities

c. Administrative kits for locations

d. Bilingual capability

10%

Claims Processing

a. Turnaround time excluding medical review of claims

b. Pended claims procedures

c. Statistical accuracy

d. General service procedures

e. Willingness to contractually establish performance criteria

10%

Claims Management Reports

a. Frequency and format of claims reports are the utmost importance.

10%

Integrated Systems / Technology Initiative Integrated systems linked to database are integral to the provider selection. The following components make up the whole of an integrated system:

a. Eligibility

b. Utilization review / Disease Management Programs

c. Claims function

d. Claims payments

e. Internet based enrollment/eligibility

10%

References 5%

All proposals will be evaluated by HUB International, a contracted insurance broker for the BRA.

Respondents to this RFP may be required to submit additional information, which HUB

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services Page 8 of 11

International may deem necessary to further evaluate the proposer’s qualifications. HUB International will evaluate each proposal in accordance with the evaluation criteria included in the Request for Proposal. HUB International will arrive at a short list of the top respondents and these short-listed respondents may be scheduled for a structured oral presentation and interview. Such presentations will be at no cost to the BRA or HUB International. At the end of the oral presentation and interview, the evaluation of the short-listed respondents will be completed. The oral interview may be recorded and/or videotaped.

6. RFP Inquiries All communication related to this RFP shall only be directed to the Purchasing Agent via https://www.bidnetdirect.com/texas/brazosriverauthority The Purchasing Agent will direct any inquiries to the appropriate BRA staff, a response will be issued and if warranted, an Addendum will be posted on the BidNet Direct site. Failure to adhere to this restriction during the advertising, evaluation, and selection phases will result in the rejection of a Respondent’s Proposal.

EXCEPTION to RFP Inquiries: RFP attachments containing Protected Health Information (PHI): Respondents are to submit written requests via email to BRA’s broker, HUB International, to obtain the following attachments which are a part of this RFP:

1. Claims Experience

2. Employee Census

3. Medical/Rx and Dental Top Providers for Disruption

Email requests to Caysi Mitchell at caysi.mitchell@hubinternational.com. Document access will be provided through a secured online system. State and federal statutes pertaining to PHI and HIPAA apply to Respondents.

7. Respondent’s Past Performance BRA will consider Respondent’s past performance and may conduct reference checks with other entities regarding past performance. BRA may examine Respondent’s performance including, but not limited to: the Vendor Performance Tracking System, notices of termination, cure notices, assessments of liquidated damages, litigation, audit reports, repeated negative performance, records of repeated non-responsiveness to performance issues, and non-renewals of contracts.

Such sources of Respondent performance may include any governmental entity, whether an agency or political subdivision of the State of Texas, another state, or the Federal government.

Further, BRA may initiate such examinations of Respondent performance based upon media reports. Any such investigations shall be at the sole discretion of BRA, and any negative findings, as determined by BRA, may result in non-award to Respondent.

8. Conflict of Interest Pursuant to Chapter 176 of the Local Government Code, any person or agent of a person who contracts or seeks to contract for the sale or purchase of property, goods, or services with a local government entity (i.e., Brazos River Authority) must disclose in the Conflicts of Interest Questionnaire Form ("CIQ") the person's affiliation or business relationship that might cause a conflict of interest with the local government entity. By law, the CIQ must be filed with the BRA Records Management Officer no later than seven (7) days after the date the person begins contract discussions or negotiations with the BRA, or submits an application or response to a Request for Proposals, correspondence, or another writing related to a potential agreement with the BRA. Updated Questionnaires must be filed in conformance with Chapter 176.

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A copy of the CIQ is attached. If you have any questions about compliance, please consult your own legal counsel. Compliance is the individual responsibility of each person or agent of a person who is subject to the filing requirement. An offense under Chapter 176 carries a penalty up to a Class A misdemeanor. For your convenience, the current BRA Board of Directors can be found here: https://brazos.org/about-us/about-the-bra/board-of-directors.

9. Disclosure of Interested Parties Pursuant to Section 2252.908 of the Government Code, the selected Firm in contracts for the sale or purchase of property, goods, or services with a local government entity (i.e., BRA) anticipated to have a value of at least $250,000/$500,000 must submit a Disclosure of Interested Parties Form to the local government entity that discloses all persons at the Selected Firm who have a controlling interest in the selected Firm or who actively participated in facilitating the contract or negotiating the terms of the contract.

The requirements of Section 2252.908 of the Government Code are subject to change, and if you have any questions about compliance, please consult your own legal counsel.

https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm

10. Term of Agreement The term of this Contract shall be for a period of one (1) year, commencing on the Effective Date, and may be renewed by subsequent agreement of the parties for up to four (4) additional one

(1) year periods, for a total potential term of five (5) years.

If it is the Respondent's intent to increase rates at the renewal date, the BRA must be notified of the maximum increase for each renewal period and the basis for calculating the increase. The BRA must be notified of renewal rates 120 days prior to the effective date of the rate change.

11. Contract The executed contract between BRA and the selected Respondent shall be a BRA standard form contract for Professional Services. Contract terms are not subject to modification and Respondent will be expected to execute the contract in substantially the form provided.

Respondent should not base a proposal on an expectation that BRA will modify its contract terms.

The BRA reserves the right to award contract(s) without any negotiations and reserves the right to not make awards. The BRA reserves the right to conduct studies and other investigations as necessary to evaluate any submittal. Submission of a proposal confers no legal right upon any Respondent.

The decision of BRA, or its designee with regard to the above, shall be administratively final.

BRA, in its sole discretion, may waive administrative deficiencies and/or minor technicalities in submittals received.

12. Insurance Requirements The Respondent shall, at Respondent’s sole expense, maintain insurance coverage as determined acceptable to the BRA. The Respondent must obtain the following minimum insurance requirements and provide proof to the BRA prior to entering into a contract:

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Health and Wellness/Medical/Dental/Rx Administration:

TDI license in good standing in Texas AM Best rating, minimum A- Statutory reserve/solvency confirmation, evidenced by the AM Best rating HIPAA compliance certification / Business Associate Agreement

FSA and HRA Administration:

CGL: $1M/$2M

Professional Liability (E&O): $1,000,000 per claim/$3,000,000 aggregate Cyber Liability: $3,000,000 per claim Fidelity/Crime Bond: 10 percent of estimated annual plan funding, with a $500,000 minimum.

Employer's Liability/WC: statutory

COBRA Administration

CGL: $1M/$2M

Professional Liability (E&O): $1,000,000 per claim/$3,000,000 aggregate Cyber Liability: $3M Fidelity Bond: 10 percent of estimated annual plan funding.

Vendor to name BRA as an indemnified party for any statutory penalties arising from their administrative error.

13. Recycled and Recyclable Products The BRA encourages the use of recycled products and products that may be recycled or reused.

14. Delivery of Proposal Submittals Proposals may be submitted in one of the following manners:

Electronic Transmission. Electronic Transmission. Electronic submittals will be received on the following platform. BidNet Direct requires you to register at no charge.

https://www.bidnetdirect.com/texas/brazosriverauthority

Drop Box Submission Prior to Proposal Submission Deadline: Hand delivery of one sealed, clearly identified original signed paper copy submission may be received up to the proposal submission deadline contained in the solicitation at the Brazos River Authority Waco Central Office, 4600 Cobbs Dr. Waco, Texas 76710, utilizing the secure drop box located at the entrance of the office building. The BRA shall not be responsible for submissions that are not properly identified. Proper identification of Respondent’s proposal is the sole responsibility of the Respondent and failure to do so may result in the submission not being included in the proposal opening.

Mail-In Delivery: Mailed by commercial carrier, overnight or express mail, one sealed clearly identified original signed paper copy submission may be accepted by the Purchasing Agent or other designee up to the proposal submission deadline contained in the solicitation at the Brazos River Authority Waco Central Office, 4600 Cobbs Drive, Waco, Tx. 76710. The BRA shall not be responsible for submissions that are not properly identified. Proper identification of Respondent’s proposal is the sole responsibility of the Respondent and failure to do so may result in the submission not being included in the proposal opening.

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REQUEST FOR PROPOSALS – PROPOSAL FORM

ACKNOWLEDGMENT OF REQUEST FOR PROPOSALS AND RECEIPT OF ADDENDA

RESPONDENT MUST ACKNOWLEDGE RECEIPT OF THIS REQUEST FOR PROPOSALS

AND ADDENDA BY SIGNING BELOW AND SUBMITTING THIS ACKNOWLEDGEMENT

WITH YOUR PROPOSAL. FAILURE TO SIGN THIS ACKNOWLEDGEMENT WILL

DISQUALIFY THE PROPOSAL AS NON-RESPONSIVE. SIGNATURE MAY BE DIGITAL,

ELECTRONIC OR HANDWRITTEN.

This acknowledgement shall become part of your response and the subsequent contract documents if applicable.

ACKNOWLEDGMENT OF REQUEST FOR PROPOSALS:

Respondent hereby acknowledges that it has received and read the Request for Proposals and all Addenda, and that this Proposal is made in accordance with the provisions thereof.

Respondent acknowledges that this Proposal meets or exceeds all terms, requirements, conditions, and/or specifications set forth in the Request for Proposal and Addenda, and exceptions or deviations from such terms, requirements, conditions, and/or specifications, if any, have been clearly and conspicuously identified as such in the Proposal.

Does your company have ten (10) or more full-time employees? Check one box only.

YES NO

Name of Firm (Respondent)

Signature – Authorized Representative

Printed Name

Date

E-mail Address

Telephone Number

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 1 of 8

APPENDIX A

Note: This is a brief summary and not intended to be a contract. Any discrepancy between the benefits stated herein and the contract, the contract controls.

CURRENT MEDICAL PPO PLAN DESIGN

MEDICAL BENEFITS BCBSTX - PPO

Deductible

In-Network $1,600 Ind. / $3,200 Fam.

Non-Network $2,250 Ind. / $4,500 Fam.

Out Of Pocket Max Deductible Included In-Network $4,000 Ind. / $8,000 Fam.

Non-Network No Max

Coinsurance

In-Network 80% Non-Network 60%

Lifetime Max Unlimited Emergency Room

In-Network Ded. / 20% Non-Network Ded. / 20%

Maternity Included Physician Office Visit

In-Network $30 Copay Non-Network Ded./ 40%

Specialist Office Visit

In-Network $30 Copay Non-Network Ded./ 40%

Preventive Care

In-Network Covered 100% Non-Network Ded./ 40%

Urgent Care

In-Network $50 Copay Non-Network Ded./ 40%

In-Patient Hospital Per Admission In-Network Ded./ 20% Non-Network Ded./ 40%

Out-Patient Per Admission In-Network Ded./ 20% Non-Network Ded./ 40%

Prescriptions Rx Out of Pocket Maximum ($1,000 Ind./ $2,000 Family)

Network Retail Pharmacy $5/$35/$60 Mail Order $5/$35/$60 Specialty Drugs $150

Note: This is a brief summary and not intended to be a contract.

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 2 of 8

CURRENT MEDICAL HSA PLAN DESIGN

MEDICAL BENEFITS BCBSTX – HSA

Deductible

In-Network $3,500 Ind. / $7,000 Fam.

Non-Network $4,000 Ind./ $8,000 Fam.

Out Of Pocket Max Deductible Included In-Network $5,400 Ind. / $10,800 Fam.

Non-Network No Max

Coinsurance

In-Network 80% Non-Network 60%

Lifetime Max Unlimited Emergency Room

In-Network Ded. / 20% Non-Network Ded. / 20%

Maternity Included

Physician Office Visit

In-Network Ded. / 20% Non-Network Ded. / 40%

Specialist Office Visit

In-Network Ded. / 20% Non-Network Ded. / 40%

Preventive Care

In-Network Covered 100% Non-Network Ded./ 40%

Urgent Care

In-Network Ded. / 20% Non-Network Ded. / 40%

In-Patient Hospital Per Admission In-Network Ded. / 20% Non-Network Ded. / 40%

Out-Patient Per Admission In-Network Ded. / 20% Non-Network Ded. / 40%

Prescriptions Deductible, then:

Network Retail Pharmacy $5/$35/$60 Mail Order $5/$35/$60

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 3 of 8

CURRENT MEDICAL HMO PLAN DESIGN

MEDICAL BENEFITS BCBSTX – HMO

Deductible

In-Network $1,600 Ind. / $3,200 Fam.

Non-Network n/a

Out Of Pocket Max Deductible Included

In-Network $4,000 Ind. / $8,000 Fam.

Non-Network n/a

Coinsurance

In-Network 80% Non-Network n/a

Lifetime Max Unlimited

Emergency Room

In-Network Ded. / 20%

Non-Network Ded. / 20%

Physician Office Visit

In-Network $30 Copay

Non-Network n/a

Specialist Office Visit

In-Network $30 Copay Non-Network n/a

Preventive Care

In-Network Covered 100%

Non-Network n/a

Urgent Care

In-Network $50 Copay

Non-Network n/a

In-Patient Hospital Per Admission

In-Network Ded./ 20% Non-Network n/a

Out-Patient Per Admission

In-Network Ded./ 20%

Non-Network n/a

Prescriptions Rx Out of Pocket Maximum ($1,000 Ind./ $2,000 Family)

Network Retail Pharmacy $5/$35/$60

Mail Order $5/$35/$60

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 4 of 8

CURRENT DENTAL PLAN DESIGN - BASE

DENTAL BENEFITS BCBSTX

Type I – Preventive Services 100%

Waiting Period None

Oral Examinations 2 per year

X-rays

- Bite Wings Frequency 2 per year

- Full Mouth Frequency 1 per 36 months

Cleanings 2 per year

Topical Fluoride Treatment 2 per year, to age 16

Sealants 1 per 36 months, to age 16

Space Maintainers 1 per year, to age 16

Type II – Basic Services 80%

Waiting Period None

Fillings Type II

Root Canal Treatment Type II

Root Planning Type II

Extractions Type II

Periodontics Type II

Perio Maintenance Type II

General Anesthesia Type II

Type III – Major Services 50%

Waiting Period None

Inlays and Onlays/Crowns Type III

Removable / Fixed Bridge-Work Type III

Partial or Complete Dentures Type III

Denture Relines / Rebases Type III

Implants Type III

Type IV - Orthodontia 70%

Waiting Period None

Orthodontia Lifetime Maximum $2,000

Orthodontia Eligibility Child Only (Age 19)

Calendar Year Deductible Type II, III

Individual $50

Family $150

Dental Annual Maximum $2,000

UCR Out of Network Percentile 90th

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 5 of 8

CURRENT DENTAL PLAN DESIGN – BUY UP

DENTAL BENEFITS BCBSTX

Type I – Preventive Services 100%

Waiting Period None

Oral Examinations 2 per year

X-rays

- Bite Wings Frequency 2 per year

- Full Mouth Frequency 1 per 36 months

Cleanings 2 per year

Topical Fluoride Treatment 2 per year, to age 16

Sealants 1 per 36 months, to age 16

Space Maintainers 1 per year, to age 16

Type II – Basic Services 80%

Waiting Period None

Fillings Type II

Root Canal Treatment Type II

Root Planning Type II

Extractions Type II

Periodontics Type II

Perio Maintenance Type II

General Anesthesia Type II

Type III – Major Services 50%

Waiting Period None

Inlays and Onlays/Crowns Type III

Removable / Fixed Bridge-Work Type III

Partial or Complete Dentures Type III

Denture Relines / Rebases Type III

Implants Type III

Type IV - Orthodontia 70%

Waiting Period None

Orthodontia Lifetime Maximum $3,000

Orthodontia Eligibility Child Only (Age 19)

Calendar Year Deductible Type II, III

Individual $50

Family $150

Dental Annual Maximum $3,000

UCR Out of Network Percentile 90th

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 6 of 8

RATE AND CONTRIBUTION SUMMARY

MEDICAL RATES

Medical - PPO

BCBSTX

BCBSTX

BCBSTX

BCBSTX

BCBSTX

Employee Only $1,016.64 $1,006.77 $891.27 $778.64 $756.25

Employee + Spouse $2,033.25 $2,013.52 $1,782.52 $1,557.25 $1,512.48

Employee + Child(ren) $1,880.76 $1,862.51 $1,648.83 $1,440.45 $1,399.04

Employee + Family $2,948.18 $2,919.57 $2,584.63 $2,258.00 $2,193.09

Medical - HSA

BCBSTX

BCBSTX

BCBSTX

BCBSTX

BCBSTX

Employee Only $842.56 $834.38 $738.66 $649.34 $630.67

Employee + Spouse $1,685.11 $1,668.75 $1,477.31 $1,298.67 $1,261.34

Employee + Child(ren) $1,558.76 $1,543.63 $1,366.54 $1,201.29 $1,166.75

Employee + Family $2,443.43 $2,419.72 $2,142.12 $1,883.08 $1,828.94

Medical – HMO

BCBSTX

2025 (NEW)

Employee Only $943.70 $934.54

Employee + Spouse $1,887.39 $1,869.07

Employee + Child(ren) $1,745.84 $1,728.89

Employee + Family $2,736.68 $2,710.12

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 7 of 8

RATE AND CONTRIBUTION SUMMARY

DENTAL RATES

Dental

BCBSTX

Equitable

Equitable

2023-2022

Employee Only $31.37 $28.34 $26.12 $24.88

Employee + Spouse $68.88 $62.22 $57.35 $54.62

Employee + Child(ren) $72.93 $65.88 $60.72 $57.83

Employee + Family $109.77 $99.16 $91.39 $87.04

Dental – Buy Up

BCBSTX

BCBSTX

2025 (NEW)

Employee Only $34.82 $31.45

Employee + Spouse $76.45 $69.09

Employee + Child(ren) $80.94 $73.12

Employee + Family $121.84 $110.06

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX A: 8 of 8

Monthly Medical and Dental Contributions

Medical Costs Per Month PPO HMO HDHP/HSA/HRA

Employee Only $25.00 $10.00 $0

Employee & Spouse $518.75 $468.34 $387.99

Employee & Children $282.85 $249.36 $191.43

Employee & Family $748.63 $681.72 $579.27

Dental Costs Per Month Base Buy-Up

Employee Only $0 $3.12

Employee & Spouse $33.88 $40.72

Employee & Children $37.54 $44.78

Employee & Family $70.82 $81.72

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX B: 1 of 1

APPENDIX B

The excel submission file “BRA RFP Submission Forms.xlsx” must be completed and submitted with proposal in order to be considered.

DOWNLOAD the excel submission file “BRA RFP Submission Forms.xlsx”

(ATTACHMENT 1) from the Attached Documents list on the BidNet Direct portal.

Please note there are SEVEN (7) worksheet tabs in the Excel file:

Tab 1: Medical

Tab 2: Dental

Tab 3: MedicalRx Network SF

Tab 4: Dental Network SF

Tab 5: FSA

Tab 6: HRA

Tab 7: COBRA

ALL TABS FOR QUOTED LINES MUST BE COMPLETED AND SUBMITTED.

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services APPENDIX C: 1 of 1

HEALTH AND WELLNESS MEDICAL/RX, DENTAL,

FSA, HRA AND COBRA INSURANCE SERVICES

RFP NO. 26-1398

APPENDIX C

BRAZOS RIVER AUTHORITY FACILITY LOCATIONS

BRA - Central Office 4600 Cobbs Drive PO Box 7555 Waco, TX 76714-7555

BRA - Temple/Belton 2405 East Sixth Avenue Belton, TX 76513

BRA - Doshier Farm 2515 E. Avenue H Temple, TX 76501

BRA - East Williamson County 201 County Road 496 Taylor, TX 76574

BRA - Hutto Central

350 CR 199

Hutto, TX 78634

BRA - Hutto South

10700 FM 1660

Hutto, TX 78634

BRA - Lake Limestone 20226 Sterling Robertson Dam Rd. Thornton, TX 76687

BRA - Lake Granbury 4552 Mambrino Hwy.

Granbury, TX 76048

BRA - Possum Kingdom Lake 301 Observation Point Road Graford, TX 76449

BRA - Clute/Richwood 1411 Mockingbird Lane Clute, TX 77531

BRA - Sugar Land South 4802 Scenic River Drive Sugar Land, Texas 77479

BRA - Sugar Land North 16450 Southwest Freeway Sugar Land, Texas 77498

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services ATTACHMENTS

ATTACHMENT 1

DOWNLOAD the excel submission file “BRA RFP Submission Forms.xlsx” from the Attached Documents list on the BidNet Direct portal.

RFP No. 26-1398 Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services ATTACHMENTS

ATTACHMENT 2

BCBS-TX Medical HMO Certificate of Coverage

170 pages

Your Health Care Benefits Program

Blue EssentialsSM Plan

For Employees of Brazos River Authority

Group # 401012 4010120003.0126

Effective January 1, 2026

BlueCross BlueShield of Texas

Blue Cross and Blue Shield of Texas, a Division of Health Care Services Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the

Blue Cross and Blue Shield Association

TX-LG-HMO-CC-COC-26 1

BLUE CROSS AND BLUE SHIELD OF TEXAS

a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent License of the Blue Cross and Blue Shield Association (herein called “BCBSTX” or “HMO”)

1001 East Lookout Drive Richardson, Texas 75082

1-877-299-2377 www.bcbstx.com

EVIDENCE OF COVERAGE

INTRODUCTION

NOTICE TO CONSUMER

This Consumer Choice of Benefits - Health Maintenance Organization (HMO) health care plan, either in whole, or in part, excludes or limits certain state mandated benefits normally required under Texas law.

This health care plan may provide a more affordable health care plan for you; however, it may provide you with fewer health care plan benefits than those normally afforded as state mandated health care benefits under Texas law. Please consult with your insurance agent to determine which state mandated health care benefits are excluded under this Certificate of Coverage.

This is your Evidence of Coverage (“Certificate”). Please read the information in this Certificate carefully so you will have a full understanding of your health care benefits. It explains your covered services and how you obtain them while you are a member, and coverage is valid. This Certificate is part of the group agreement between the group and Blue Cross and Blue Shield of Texas (“BCBSTX”)(“HMO”). It is governed by applicable federal and state law and determines the terms and conditions of your coverage.

This Certificate applies only to your HMO coverage. It does not limit your ability to receive health care services that are not covered services. No participating provider or other provider, institution, facility, or agency is an agent or employee of the HMO.

Please note: Except as shown under the GENERAL PROVISIONS: COBRA Continuation Coverage section, coverage is not provided for any services received before coverage starts or after coverage ends.

The defined terms throughout this Certificate are in bold font and defined in the GLOSSARY or applicable section.

The terms “member”, “you”, “your”, “participant” and “subscriber” are used in this Certificate in reference to the employee.

This Certificate is not a Medicare supplement policy or a Workers’ Compensation insurance policy. If you are eligible for Medicare, please review the Guide to Health Insurance for people with Medicare available from BCBSTX.

http://www.bcbstx.com/

TX-LG-HMO-CC-COC-26 2

Have a complaint or need help?

If you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help.

Even if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation To get information or file a complaint with your insurance company or HMO:

Call: Blue Cross and Blue Shield of Texas Toll-Free: 1-877-299-2377 Email: BCBSTXComplaints@bcbstx.com Mail: P. O. Box 660044, Dallas, TX 75266-0044

The Texas Department of Insurance To get help with an insurance question or file a complaint with the state:

Call with a question: 1-800-252-3439 File a complaint: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: Consumer Protection, MC: CO-CP, Texas Department of Insurance, P.O. Box 12030, Austin, TX 78711-2030

¿Tiene una queja o necesita ayuda?

Si tiene un problema con una reclamación o con su prima de seguro, llame primero a su compañía de seguros o HMO. Si no puede resolver el problema, es posible que el Departamento de Seguros de Texas (Texas Department of Insurance, por su nombre en inglés) pueda ayudar.

Aun si usted presenta una queja ante el Departamento de Seguros de Texas, también debe presentar una queja a través del proceso de quejas o de apelaciones de su compañía de seguros o HMO. Si no lo hace, podría perder su derecho para apelar.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation Para obtener información o para presentar una queja ante su compañía de seguros o HMO:

Llame a: Blue Cross and Blue Shield of Texas Teléfono gratuito: 1-877-299-2377 Correo electrónico: BCBSTXComplaints@bcbstx.com

Dirección postal: P. O. Box 660044, Dallas, TX 75266-0044

El Departamento de Seguros de Texas Para obtener ayuda con una pregunta relacionada con los seguros o para presentar una queja ante el estado:

Llame con sus preguntas al: 1-800-252-3439 Presente una queja en: www.tdi.texas.gov Correo electrónico: ConsumerProtection@tdi.texas.gov Dirección postal: Consumer Protection, MC: CO-CP, Texas Department of Insurance, P.O. Box 12030, Austin, TX 78711-2030 mailto:tion@tdi.texas.gov http://www.tdi.texas.gov/ mailto:ConsumerProtection@tdi.texas.gov

TX-LG-HMO-CC-COC-26 3

TABLE OF CONTENTS

INTRODUCTION

QUICK REFERENCE

CUSTOMER SERVICE

SCHEDULE OF COPAYMENT AND BENEFIT LIMITS

GLOSSARY………………………………………

WHO GETS BENEFITS

UTILIZATION MANAGEMENT

HOW THE PLAN WORKS

COVERED SERVICES

PREVENTIVE CARE

MEDICAL LIMITATIONS AND EXCLUSIONS

PHARMACY BENEFITS

CLAIM FILING AND APPEALS PROCEDURES

GENERAL PROVISIONS

TX-LG-HMO-CC-COC-26 4

QUICK REFERENCE

W h e r e t o F i n d t h e A n s w e r

Provider Directory www.bcbstx.com

Prescription Drug List www.bcbstx.com

Prior Authorization List www.bcbstx.com

Preventive Services https://www.bcbstx.com/provider/clinical/clinical-resources/preventive-care o Customer Service o Prior Authorization o Inpatient Admissions o Appeals o Claim Forms o Prescription Drug o Mail-Order Services o Pharmacy Locator

Please see CUSTOMER SERVICE section in this benefit booklet for contact information such as websites and mailing addresses where available.

Definitions Please see GLOSSARY section.

Defined terms are in bold in your booklet.

Your…