HUD-MWRD_(FY25-26).pdf

This is a specific stop loss insurance procurement document for the City of Tucson, Arizona's self-funded health plan covering 4,508 employees and retirees. The City is seeking stop loss insurance coverage for both medical and prescription drug claims with an effective date of July 1, 2026. The coverage will apply to the City's transition to Blue Cross Blue Shield of Arizona as its medical TPA and network provider, with OptumRx serving as the PBM partner. Stop loss insurance will provide protection against high-cost individual and aggregate claims under the self-funded plan structure.

The City's plan generated approximately $43.5 million in paid medical and prescription drug claims over the most recent 12-month period through March 2026. The current self-funded arrangement through Cigna has been in place since July 1, 2019, with the City having maintained an insured contract with Cigna from 2007 until the transition to self-funding. The stop loss insurance will cover both medical and prescription drug expenses, protecting the City against catastrophic claim costs while maintaining control over plan administration through its new arrangement with Blue Cross Blue Shield of Arizona and OptumRx.