NSBU_Medical_Claims_thru_9.30.25.pdf

This medical claims document provides financial data supporting the Request for Proposal 04-26 Agent of Record issued by the Utilities Commission, City of New Smyrna Beach, Florida (NSBU), which serves approximately 180 full-time employees. The file contains detailed medical claims information through September 30, 2025, documenting the organization's current health insurance utilization and associated costs. This claims data serves as critical baseline information for prospective Insurance Agents of Record to understand historical claims experience, cost trends, and employee healthcare utilization patterns. The document establishes the financial foundation necessary for vendors to evaluate the scope of coverage, assess risk, and develop competitive renewal proposals and plan design recommendations.

The medical claims data through September 30, 2025, reflects NSBU's fully insured status with established carrier relationships including Florida Health Care, MetLife, Colonial Life, and MedCom. This historical claims information is essential for prospective agents to conduct market analysis, benchmark costs against industry standards, and identify opportunities for sustainable premium management without reducing current benefit levels. The data directly supports the RFP's primary objective of maintaining affordable rates while preserving existing coverage for group health, dental, vision, basic life and accidental death & dismemberment, long-term disability, and supplemental insurance products. By providing claims experience through mid-2025, NSBU enables responding vendors to make informed assessments regarding the employee population's healthcare needs, demographic distribution spanning ages 22-73, and cost-containment strategies aligned with the organization's financial goals for the one-year initial contract term with potential three-year renewal options.