27-002V Stop Loss Insurance

Schertz-Cibolo-Universal City Independent School District is soliciting proposals under RFP 27-002V for stop loss insurance, with responses limited to insurance companies licensed in Texas and due November 13, 2026 at 2:00 PM local time via Euna Bonfire. Foundation Risk Partners, d/b/a Corporate Synergies, serves as the district's consultant for distribution, evaluation, and negotiations.

Bidders must complete the Proposal Form, as omission results in rejection as non-responsive. Each bidder must certify it is not indebted to the district, not suspended or debarred from federally funded contracts, and has not colluded with other bidders. Bidders must also submit a Felony Conviction Notice, unless publicly held, and a Conflict of Interest Questionnaire (Form CIQ) within seven business days if the vendor has a business relationship with a local governmental officer under Texas Local Government Code Chapter 176.

The coverage is stop loss reinsurance for a self-funded medical plan covering approximately 1,925 employees. Bidders must quote Individual Stop Loss deductible options of $200,000, $250,000, or $300,000 on a 120% corridor, plus Aggregate Stop Loss with maximum annual payment options of $1,000,000 or Unlimited. The plan uses a two-tier network structure (EHN for Tier 1, HealthSmart professional providers for Tier 2), and Sage TPA replaces Aetna as administrator on January 1, 2027. Required reporting includes monthly claims data, HIPAA 834 compliance, and a dedicated reporting contact. Proposals must waive actively-at-work provisions, late entrant penalties, and new laser restrictions at renewal.

Coverage runs January 1, 2027 through December 31, 2027 with one optional one-year renewal and a 24-month paid contract period. The contract carries no minimum guaranteed amount, and the district retains termination rights without penalty. Premiums must be quoted net of commissions, with XL Benefits, the Stop Loss General Agent, receiving standard General Agent Compensation. Payment terms are Net 30. Preliminary renewal rates are due six months before the effective date, and renewal proposals must be released within 120 days of expiration. United Healthcare held stop loss coverage from 2016 through 2024, and HM Life Insurance Company issued the September 1, 2024 through August 31, 2025 policy.

Exhibits include a 2024–25 large claim report listing five claimants above $100,000, with the largest at $350,502, and 24-month pharmacy paid claims totaling $9,286,561.81. The evaluation period runs November 13–16, 2026, with Best and Final Offer requests sent November 16 and BAFO proposals due November 18, 2026. Board approval is tentatively scheduled for December 3, 2026.