RFP,_TUHSD_00188,_Life,_STD,_COBRA,_FSA,_HSA_RFP_Background_and_SOW_2027(6007309.2).pdf

6007309v2/00188.001 1

BACKGROUND

Nestled in the Greater Phoenix area, the Tempe Union High School District is located in Tempe, Arizona and services approximately 11,000 students in six comprehensive high schools. The District encompasses 162 square miles and serves the City of Tempe, the Town of Guadalupe, the Gila River Indian Community, the Ahwatukee Foothills areas of Phoenix and parts of Chandler.

For purposes of determining final rates, all proposals should be submitted net of commissions. Segal is compensated through a consulting fee.

It is required that pre-existing condition limitations be waived for initially enrolled employees and their eligible dependents. It is the intention of the Client that, should a change in carriers be implemented, no employees or dependents will suffer a loss of benefits by virtue of the change in carriers.

The District shall require a master contract reflecting the elimination of the active-at-work restrictions or deferred effective date for employees and dependents eligible on the effective date of the contract.

ELIGIBILITY

The following provides a summary of the categories of employees and dependents eligible for benefits.

You are eligible to elect employee benefits if you are:

An active hourly employee regularly scheduled to work a minimum of 30 hours of service per week Benefits are effective the 1st of the month after 30 days in a benefit eligible position.

Legal dependents include:

lawful spouse; and children up to age 26.

PROJECT SCOPE

It is the intention of the District to continue to offer the current plan designs for the July 1, 2027 through June 30, 2032 plan year for:

Basic Life and Accidental Death and Dismemberment (AD&D) Voluntary Life and AD&D Short-Term Disability (STD) Flexible Spending Account (FSA) Administration Health Spending Account (HSA) Administration COBRA Administration

The following components should be included in your response to this section of the RFP:

1. ACCOUNT MANAGEMENT

• Provide a designated Account Manager and Account Management Team

2. CUSTOMER SERVICE

• Provide a designated call and claim unit with toll free telephone access.

• Provide customer service to answer inquiries on claims, eligibility, provider network, services, coverage, or other inquiries from participants Monday through Friday from 8:00 AM to 6:00 PM (AZ time)

• Provide prompt response to all telephone inquiries from plan participants and providers of service

6007309v2/00188.001 2

3. OPEN ENROLLMENT SUPPORT

• Attend four (4) days of Annual Open Enrollment Meetings in Tempe, Arizona during normal business hours.

4. COMMUNICATION/EDUCATION SUPPORT

• Provide bilingual communication/educational materials

5. BASIC AND VOLUNTARY LIFE AND AD&D/SHORT-TERM DISABILITY

• Provide claims forms

• Receive claims and process payments of benefits in accordance with the plan designs for all claims incurred

• Correspond with participants if additional information is necessary to complete the processing of claims

• Determine benefits payable under the Plan, pursuant to the terms and conditions of the District’s Benefit Plans

• Coordinate benefits payable under the Plan and with other benefit plans, if applicable

• Provide notice to the Participants regarding the reason(s) for denial of benefits (which are denied) and provide for the review of such denied claims

• Provide W2 and 1099 forms, if needed

• Administer a Fraud and Abuse Detection Program (as applicable)

• Enrollment, premiums, volume by coverage annual reporting

• Detailed paid claims and premium waivers by coverage (Basic, Voluntary, etc.) reporting annually

• Utilization Report/consultative analytics

6. FLEXIBLE SPENDING ACCOUNT/HEALTH SPENDING ACCOUNT ADMINISTRATION

• Provide a Summary Plan Document to the District to modify and distribute in accordance to legal requirements.

• Provide enrolled participants with a welcome kit to be received by mail, which contains the debit card (if elected and available) and other plan materials.

• The offeror shall host a 24/7 accessible participant website to help participants manage their account online where they can, among other activities:

.a. access their account balance, distribution history, and transaction activities;

b. review, enter and pay claims;

c. update their email preferences; and

d. download account servicing (e.g., distribution request) forms.

6007309v2/00188.001 3

• The offeror shall provide a 24/7, toll-free, Member Services access number to participants.

• Offeror shall make available monthly statements to participants to view and download from the offeror’s website or the participants may elect to receive paper statements in the mail.

• The offeror shall make available a directed payment mechanism on the website whereby participants can direct their funds to be paid to one or more service providers.

• The offeror shall make available paper claims forms whereby participants may request distribution of their funds by completing the claim form.

• For adjudicated claims files received from the District's health plans(s), the offeror shall populate participant's accounts with the claim data so that participants may pay the adjudicated claims directly from the account.

• The offeror shall make information available to help participants save and spend their account balances. This may include SRPMIC specific educational programs and e-mail based messaging (based on having email address).

• Provide investment options for the participant to invest their HSA account balance if they so choose.

• Provide online reporting to the District that includes a summary roll-up of account transactions, eligibility, claims details, and funding reports.

• Perform an annual employer non-discrimination test where applicable.

• Determine benefits payable under the Plan, pursuant to the terms and conditions of the District’s Plan Document

• Receive claims and process payments of benefits in accordance with the plan designs for all claims incurred (as applicable)

• Correspond with participants and providers if additional information is necessary to complete the processing of claims

7. COBRA ADMINISTRATION

COBRA Administration should include the following services:

a. Initial COBRA Notice

b. Election Notice/Enrollment Applications

c. Coupon mailing/billing statement

d. Premium collection and tracking/ACH premium deductions

e. COBRA termination letters, including early termination

f. Mailing of rate change letters

g. Updating of system for new plan year’s rates

h. Vendor eligibility reporting (electronic reports to the carriers with copies to the County)

i. Distribution of unavailability of COBRA coverage

j. Monthly reporting

8. ELIGIBILITY/ENROLLMENT ADMINISTRATION/NOTICES

• Administer eligibility based on the District’s eligibility criteria

• Provide enrollment materials

6007309v2/00188.001 4

• Lag Report

10. SECURED INTERNET ACCESS

• Access to Enrollment/Eligibility Administration Portal for Employer

• Access to participant website to help participants manage their account online

• Employer and/or Designated Consultant access to Claims Data Reporting Portal

BASIC LIFE AND AD&D AND VOLUNTARY LIFE AND AD&D

The Basic Life and AD&D AND Voluntary Life and AD&D coverage has been underwritten by Voya since July 1, 2017. The District pays 100 percent of the cost of the Basic Life and AD&D coverage and the Voluntary Life and AD&D is 100% Employee paid. For more information, see the policy provided in Attachment B1. Shown below is a five-year rate history of the Life plan (enrollment and experience is available in Attachment B2).

Basic Life and AD&D – Rate History

07/01/2022- 06/30/2025 07/01/2025-06/30/2027

Basic Life (per $1,000) $0.118 $0.148

Basic AD&D (per $1,000) $0.012 $0.012

Voluntary Employee/Spouse Life – Rate History 7/1/2022-6/30/2027

Age Band Employee (per $1,000) Spouse (per $1,000)

20-24 $0.050 $0.037

25-29 $0.050 $0.037

30-34 $0.060 $0.040

35-39 $0.070 $0.050

40-44 $0.080 $0.076

45-49 $0.120 $0.133

50-54 $0.180 $0.246

55-59 $0.330 $0.441

60-64 $0.510 $0.989

65-69 $0.984 $1.809

70-74 $1.600 $3.228

6007309v2/00188.001 5

Voluntary Child Life– Rate History

Voluntary Child Life (per unit) $0.146 $0.146

Voluntary AD&D– Rate History

Voluntary AD&D (per $1,000) $0.015 $0.015

6007309v2/00188.001 6

SHORT-TERM DISABILITY

The Client’s short-term disability coverage is self-funded with claims being administered by Sun Life since July 1, 2009. The District pays 100 percent of the cost of the STD coverage. For more information, see the policy provided in Attachment B3. Shown below is a five-year rate history of the STD administration fee (experience is available in Attachment B4).

Short-Term Disability – Rate History

07/01/2022- 06/30/2024 07/01/2024- 06/30/2025 07/01/2025-06/30/2027

STD Administration Fee

(PEPM) $0.23

$0.40 $0.65

COBRA ADMINISTRATION

P&A Group provides the District’s COBRA administration. The turnover rate at the District of 16.3% and the District has had 356 new hires/qualifying events during the past 24 months. Shown below is a five-year rate history.

COBRA – Rate History 07/01/2022- 06/30/2027

Initial Notices (per notice) $10.00

Qualifying Event (per notification) $20.00

FLEXIBLE SPENDING ACCOUNT ADMINISTRATION

The Client is requesting proposals to administer a Flexible Spending Account (FSA) plan that allows employees to pay for unreimbursed medical expenses and dependent care expenses on a pre-tax basis.

P&A Group has administered this program since July 1, 2015.

Shown below is a five-year rate history (utilization information is available in Attachment B5 and flex document in Attachment B6).

FSA – Rate History 07/01/2022- 06/30/2027

FSA/DCAP Administration Fee (PPPM) $3.00

HEALTH SAVINGS ACCOUNT ADMINISTRATION

The District is exploring the option of adding a third medical plan offering effective July 1, 2027. This plan would be a qualified high-deductible plan (HDHP). The District is requesting proposal for Health Savings Account Administration to accompany the potential new HDHP plan. Details of the new plan design are currently being explored and are not finalized. Aetna\CVS is the District’s Medical/Rx carrier, but these

6007309v2/00188.001 7 services are currently out to bid and therefore a new carrier may be in place effective July 1, 2027 depending on the results of the bid.

For the purpose of this bid, the District wants you to match the current plan designs as closely as possible.

If your plan designs preclude you from matching the existing schedule of benefits, quote a plan that best matches the current plans and note the deviations on the appropriate form.

Please contact Khin Han at khan@segalco.com with a carbon copy (cc) to Rachel Calisi at rcalisi@segalco.com for the Census not contained in this document.

Since some of this information contains confidential data, you will be required to have a current (within last 5 years) executed Confidentiality Agreement or bid-related NDA on file with Segal to receive the census document which will be sent to you via secure email service. If you do not have a current executed Confidentiality Agreement or NDA on file with Segal, you will be sent the necessary form for completion and submission before the data will be released.