ESMEC HIA Voluntary Benefits RFP 20260129.pdf

Voluntary Benefits

Request for Proposal (RFP):

Eastern Shore of Maryland Educational Consortium Health Insurance Alliance

January 29, 2026

Confidential & Proprietary

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Section A: Overview

I. Introduction

The Eastern Shore of Maryland Educational Consortium (ESMEC) Health Insurance Alliance (HIA) has engaged Bolton to solicit voluntary benefits product proposals. It is anticipated that any new voluntary benefits plans selected will be effective in conjunction with their core benefit plan year of September 1, 2026 and will be enrolled as early as May 2026. For many of the ESMEC entities Bolton currently supports the enrollment of the voluntary benefits utilizing our Decision Support Specialists for Face-to-Face and call center supported enrollment. Enrollment will be managed on their current bswift benefits administration platform, which is maintained by Bolton for all entities.

The ESMEC HIA consists of seven entities:

• Caroline County Public Schools – 990 benefit eligible employees

• Dorchester County Public Schools – 819 benefit eligible employees

• Kent County Public Schools – 333 benefit eligible employees

• Queen Anne’s County Public Schools – 945 benefit eligible employees

• Queen Anne’s County Government – 652 benefit eligible employees

• Somerset County Public Schools – 567 benefit eligible employees

• Talbot County Public Schools – 763 benefit eligible employees

While Bolton currently supports on bswift the core benefits enrollment for all seven ESMEC HIA entities, there are a variety of voluntary offerings in place with numerous carriers across the HIA. Bolton is seeking proposals for the following voluntary products, to be sitused in the State of Maryland, to offer to the seven ESMEC HIA employers:

1. Voluntary Short-Term Disability

2. Voluntary Long-Term Disability

3. Critical Illness

4. Accident Insurance

5. Hospital Indemnity

6. Permanent Life with Long-Term Care / Critical Care Rider

Voluntary benefits will be enrolled in conjunction with the core benefits. They will be on payroll deduction. Bolton will assist with managing the billing and reconciliation process. Each entity will pay for its own enrolled population, with varying billing frequencies among entities, preferably using a self-billing method.

Bolton and the HIA seek to partner with the vendor who can best demonstrate:

• Effective quality customer service

• Consistent, responsive, professional administrative service backed by verifiable performance measurements

• Best in class voluntary products

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Collaboration & Customization

While ESMEC HIA members collaborate to deliver excellent benefits and services for their employees, each entity individually decides which voluntary plans to provide. As a result, although we aim to offer voluntary benefit options that every entity could choose, each entity ultimately has the discretion to adopt any, all, or none of the selected plans.

Further, each entity may want to adjust the final plan design to meet the needs of their unique employee population. Bolton recognizes this could make providing a proposal difficult. To assist, de-identified census data is available via a secure ShareFile site (instructions below) for all entities. Additionally, information is included on four HIA entities' voluntary benefits administered by Bolton. All seven entities currently offer voluntary benefits through various carriers.

The following table provides an outline of the current employee participation in each voluntary benefit plan category as of January 1, 2026:

Bolton is seeking proposals for the plans outlined on the following pages. New standardized plans have been developed to improve current offerings across all entities. While a brief overview of the requested design is listed, the full details for each plan are provided in the required RFP forms (Excel), which must be thoroughly completed. You may suggest additional riders and benefit options by noting your response under Proposed Plan Design for each benefit type within the RFP Forms. However, we kindly request a quote based on the criteria outlined so we can evaluate all submissions fairly.

PLAN TYPE # OF

POLICIES

ANNUAL

PREMIUM

Voluntary Short-Term Disability 563 $177,822

Voluntary Long-Term Disability 661 $205,163

Critical Illness 1,121 $251,861

Accident Insurance 823 $248,855

Hospital Indemnity 527 $173,014

Permanent Life with Long-Term Care / Critical Care Rider 484 $420,000

Total 4,179 $1,476,715

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REQUESTED PLAN DESIGNS

Voluntary Short-Term Disability (STD)

• Benefit Schedule: 60% of predisability earnings

• Maximum Weekly Benefit:

-Option 1 – $1,200 -Option 2 – $1,800 -Option 3 – $3,000

• Minimum Weekly Benefit: $15

• Elimination Period:

-7 days – Option 1 -14 days – Option 2 -30 days – Option 3 (Accidental injuries waive the elimination period)

• Maximum Benefit Duration: 90 days or 180 days

• Sick Leave Coordination: Allows employee to receive up to 100% of predisability earnings when combining disability benefits and sick leave pay

• Guaranteed Issue: Full benefit for all options

• Partial/Residual Disability: Included in all options

• Temporary Recovery Provision: 90 days

• Late Enrollee Rule: No EOI required; however, 60-day benefit waiting period for sickness/pregnancy during first 12 months

• Rate Structure:

- Age-banded rates

- Separate rate tables for 90-day and 180-day maximum duration

- Premium examples required for sample ages/salaries

• Employer Contribution: 0% (fully employee-paid)

Voluntary Long-Term Disability (LTD)

• Benefit Schedule: 60% of predisability earnings

• Maximum Monthly Benefit: Option 1 – $8,000 / Option 2 – $12,500

• Minimum Monthly Benefit: $100

• Benefit Waiting Period: 90 or 180 days

• Maximum Benefit Period: To SSNRA

• Benefit Reductions: Age‑based reduction schedule requested

• Guarantee Issue: Full benefit amount

• Own Occupation Period: 24 months

• Partial/Residual Disability: Included

• Pre‑Existing Condition Limitation: 3/12

• Mental & Nervous Limitation: 24 months

• Substance Abuse Limitation: 24 months

• Musculoskeletal/Connective Tissue Limitation: 24 months

• Return‑to‑Work Incentive: 12 months

• Employee Assistance Program: Includes 3 face‑to‑face visits

• Administrative Services: Taxes/W‑2s prepared by carrier for LTD claimants

• Survivor Benefit: Lump sum equal to 3× LTD monthly benefit

• Reasonable Accommodation Expense: Up to $25,000

• Rates: Age‑banded rates, premium examples required for sample ages/salaries

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Critical Illness

• Employee benefit $10,000–$30,000 in $5,000 increments (or max GI)

• Spouse benefit 100% of employee amount

• Child benefit 50% of employee amount

• Guaranteed Issue for all coverage amounts

• No age-based benefit reduction (child to age 26)

• Health Screening Benefit: $100 per calendar year

• Recurrence Benefit available across conditions

• Pre-existing condition: None

• Treatment-free period: 6 months

• Age-based rates; smoker and non-smoker separate rate tables

• Coverage categories include cancer, cardiovascular, organ failure, infectious disease, childhood conditions, functional loss, neurological, and transplant categories

• Proposed rates required for: Employee and spouse separately (non-smoker / smoker)

• Fully Portable

Accident

• Coverage Type: 24-Hour Coverage

• Organized Sports Benefit: +25% of eligible benefit

• Line of Duty (Police/Fire/EMS): Enhanced benefit requested

• Accident Prevention / Health Screening: $100 per calendar year

• Guaranteed Issue: Included

• Benefit categories include: ER/urgent care, imaging, fractures/dislocations (open & closed), burns, concussion, lacerations, dental injuries, ambulance, therapy services, surgery, hospital admission & confinement, and rehabilitation

• Requested plan design must support two sample accident scenarios (ER visit with fracture;

cut/burn with stitches and follow-up)

• Proposed rates required for: Employee, Employee/Spouse, Employee/Children, and Family

Hospital Indemnity Plan 1

• Hospital Admission: $1,500, 1× per calendar year

• Hospital Confinement: $150/day, up to 15 days

• ICU Admission: $500

• ICU Confinement: $100/day, up to 15 days

• Newborn Nursery: $100/day for 4 days

• Second Opinion Benefit: $50/year

• Pregnancy & Mental Illness: Covered

• Drug/Alcohol Treatment: Not covered

• Observation Stay: $200/year

• Annual Health Screening: $100

• Guaranteed Issue: Included

• Rates required: Employee, Employee/Spouse, Employee/Children, Family

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Plan 2

• Hospital Admission: $1,000, 1× per calendar year

• Hospital Confinement: $100/day, up to 15 days

• ICU Admission: $500

• ICU Confinement: $50/day, up to 15 days

• Newborn Nursery: $50/day for 4 days

• Second Opinion Benefit: $25/year

• Pregnancy & Mental Illness: Covered

• Drug/Alcohol Treatment: Not covered

• Observation Stay: Not covered

• Annual Health Screening: $50

• Guaranteed Issue: Included

• Rates required: Employee Only, Employee/Spouse, Employee/Children, Family

Permanent Life with LTC/Chronic Care

• Employee coverage $10,000–$300,000 in $5,000 increments

• Spouse coverage $10,000–$50,000 in $5,000 increments

• Child term coverage $1,000–$10,000 in $1,000 increments

• Issue Ages: Employee/Spouse 15–80; Child 14 days–26

• Rates: Age‑last‑birthday, unisex, tobacco‑distinct

• Coverage effective first day of month payroll deductions begin

• Guaranteed Issue: Employee $200,000, Spouse $50,000, Child $50,000

• Paid‑Up options: To age 120; optional Paid‑Up at 70

• Re‑enrollment: Existing participants may increase up to GI without evidence of insurability

• Requested riders: Chronic Care or LTC, Restoration of Death Benefit, Waiver of Premium, Accelerated Death Benefit, AD&D, Child Term Rider, other recommended options.

II. Financials

As part of your response please be sure to include any and all financial allowances available to support this enrollment. This should include:

• Implementation, communication, and technology credits – fixed amount to offset the upfront enrollment and communication costs

• Carrier technology offsets (bswift) – fixed PEPM fee or commission override.

• All quotes should note both heap and level commission options – Heaped is preferred if available o Please verify the commissions in MD for each product quoted.

III. Cooperative Purchasing

The ESMEC Health Insurance Alliance reserves the right to extend the terms and conditions of this solicitation to any and all other public agencies as well as any other federal, state, municipal, county, or local governmental agency under the jurisdiction of the United States and its territories. This shall include but not limited to County agencies, City Governments, private schools, parochial schools, non-public schools such as charter schools, special districts, intermediate units, non-profit agencies providing services on behalf of government, and/or state, community and/or private colleges/universities that require these goods, commodities and/or services. This is conditioned upon mutual agreement of all parties pursuant to special requirements, which may be appended thereto. The supplier/contractor agrees to

| 7 notify the issuing body of those entities that wish to use any contract resulting from this bid and will also provide usage information, which may be requested. A copy of the contract pricing and the bid requirements incorporated in this contract may be supplied to requesting agencies.

Each participating jurisdiction or agency shall enter into its own contract and fees with the Awarded Bidder(s) and this contract shall be binding only upon the principals signing such an agreement. Disputes over the execution of any contract shall be the responsibility of the participating jurisdiction or agency that entered into that contract. Disputes must be resolved solely between the participating agency and the Awarded Bidder. The Board does not assume any responsibility other than to obtain pricing for the specifications provided.

IV. Right of Bolton to Reject Proposals

Bolton and the HIA reserves the right to reject all Proposals or to waive, at its discretion, any irregularity, which we deem reasonably correctable or otherwise not warranting rejection of a Proposal.

Recipients of this RFP should note that nothing in this RFP should be construed to imply any obligation whatsoever on the part of Bolton or the HIA. The HIA retains its right, at its sole discretion, to negotiate with one or more of the responding vendors either with or without reference to this RFP; to implement the system(s) using internal staff in whole or in part; and to amend, modify, or waive any aspect or provision of this RFP.

Bolton and the HIA will not be responsible under any circumstances for any costs incurred by respondents in the generation and submission of proposals, site visits, presentations, documentation, or marketing literature. All responses to this RFP and accompanying documentation will become the property of Bolton and the HIA and will not be returned.

Recipients of this document should also understand that Bolton would not be responsible under any circumstances for the disclosure of material submitted by vendor personnel and outside consultants.

All responses will be shared through a wide distribution throughout Bolton and the HIA. To the extent that they wish to minimize the risk of disclosure of such material to unauthorized parties, respondents are advised to label clearly the top of each page of such material with the designation “Proprietary Material”. Vendors should be aware that Bolton shall not sign non-disclosure agreements during the vendor selection process, except in the circumstances surrounding a discussion of unannounced products. Vendors who find this unacceptable should refrain from participating in this competition.

V. Proposing Entities

Bolton is seeking proposals from well-established, financially stable organizations. Bolton seeks to partner with a firm that has their principal services (e.g., customer service operations) owned and/or operated by the bidding entity and the call centers must be in the United States.

The primary voluntary carrier across many of the HIA entities currently provides a dedicated client service manager who is directly available to Bolton and the clients’ benefit teams. The service model provided by any proposing vendor will be extremely important in the proposal process.

Bolton is responsible for managing claims data on behalf of all HIA employers. By responding to this RFP, you acknowledge that both Bolton and the HIA maintain the right to use this claims data to notify enrolled voluntary benefit members about potential opportunities to file benefit or wellness claims.

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VI. Exception Addendum or Suspension

Bolton reserves the right to make exceptions, file proposal addendums and/or suspend this request for proposal. Please confirm that your proposal will be honored should Bolton decide to revise or extend the proposal timeline. Bolton also reserves the right to suspend the request for proposal process due to legitimate business reasons.

Section B: Proposal Process

I. Proposal Timeline

The timeline for the bid process is as follows:

Activity Date

Release request for proposal January 29, 2026 Vendor Deadline to submit questions February 6, 2026

Vendor Proposal deadline February 18, 2026, 4pm ET Summary and recommendations March 6, 2026 Award of business (target date) March 20, 2026

II. Proposal Data & Submission

Census Data De-identified census information is available for your review. Please send a request to Sandy Geho at sgeho@boltonusa.com and with a copy service@boltonusa.com to receive file access.

Proposals must be uploaded to Bolton’s Secure File Sharing site using the following link:

https://boltonpartners.sharefile.com/r-re5e90f1bce67400282da154164d9ddb7

A proposal that is not submitted in complete form to Bolton by 4:00 p.m., Eastern Time on Wednesday, February 18, 2026 may be rejected. However, during the preliminary review stage only, Bolton, in the exercise of its exclusive discretion, may permit the Proposer to correct any error or omission.

All questions should be emailed to Sandy Geho at sgeho@boltonusa.com and copied to service@boltonusa.com. Questions are due no later than February 6, 2026.

III. Notification of Selection

All proposals properly submitted in accordance with this request will be reviewed. Bolton reserves the right to reject any or all proposals at its discretion. The bidder’s compliance with the requirements of this request shall be determined at the sole discretion of Bolton.

Selected and non-selected proposers will be notified in writing at the conclusion of the process. Selection is contingent on satisfactory completion of appropriate agreements, which may be negotiated at Bolton’s sole discretion. Bolton reserves the right to reject all proposals.

mailto:sgeho@boltonusa.com mailto:service@boltonusa.com https://boltonpartners.sharefile.com/r-re5e90f1bce67400282da154164d9ddb7 mailto:sgeho@boltonusa.com mailto:service@boltonusa.com

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Section C: Proposal Requirements and Instructions

I. Proposal Requirements

Your proposal must comply with the following requirements:

• Complete the accompanying Excel Workbook and questions for each benefit.

o Please do not add or delete cells from the workbook.

o Extremely large responses are not encouraged but may be submitted as an attachment to your response.

• Provide full financial cost information to include:

o Current rating agency information for your company.

o State specific commission and override information for each product.

o Rates per product being offered.

o Rate guarantees.

o Available credits for implementation, communication, and technology.

o Performance guarantees.

• Explain all underwriting requirements and limitations by State.

• Executive Summary of proposed offerings.

• Description of customer service support model.

II. Ownership of Proposal

All rights to information developed, disclosed, or provided in a Proposal and its submissions are the property of Bolton, unless the Proposer makes specific reference to data that is considered proprietary.

To the extent that a Proposer claims any copyright, patent, or other intellectual property right in any portion of its RFP, submission of an RFP constitutes the Proposer’s express (a) grant and assignment of a perpetual, transferable (in whole or in part), non-exclusive, royalty free license to Bolton for all such portions, and (b) agreement that Bolton may use any such intellectual property without charge for any lawful purpose in connection with other Bolton projects, including without limitation the creation of derivative works and issuance of sublicenses.