Metrocare_Services_Medical_Contributions_2026.pdf

This is a medical contributions pricing document for Metrocare Services in Texas related to an Individual Coverage Health Reimbursement Arrangement (ICHRA) administrator procurement. The document outlines 2026 tier-based monthly rates for two medical plan options: HDHP (High Deductible Health Plan) and EPO (Exclusive Provider Organization). Four tier levels are specified for each plan—EO (Employee Only), ES (Employee + Spouse), EC (Employee + Child), and EF (Employee + Family)—with corresponding monthly rates, employer contributions, and employee contributions.

The pricing structure demonstrates a 50% cost-sharing arrangement between employer and employee for all tiers and plan types. HDHP rates range from $433.33 monthly for Employee Only to $1,307.34 for Employee + Family, while EPO rates are substantially higher, ranging from $1,161.34 to $6,178.50 monthly across the same tier structure. Each tier specifies identical employer and employee contribution percentages, with contributions split equally at the midpoint of the total monthly rate. This pricing framework will likely serve as the baseline for evaluating vendor proposals for comprehensive ICHRA administration services, including plan design, implementation, compliance management, and employee support services.