Insurance Benefit Consultant FY 2026-2027

The City of Edinburg, Texas is soliciting proposals for an Insurance Benefit Consultant to review group medical, group ancillary, and group voluntary benefit plans for approximately 1,200 full-time employees, 60 part-time employees, and 110 retirees, with proposals due August 4, 2026 at 3:00 p.m. and questions due July 24, 2026 at 3:00 p.m.

The consultant will serve as an advisor for fully funded medical plans (providing analysis and quarterly reporting) or as a financial advisor for self-insured plans, and will provide vendor sourcing for third-party administrators, pharmacy benefits managers, and stop-loss carriers as needed. Core deliverables include RFP preparation, competitive benefit program review, provider contract negotiation, plan design assistance, quarterly utilization reviews, premium funding projections during budget cycles, claims audits, municipal plan comparisons, and medical inflation analysis. The consultant will act as the City's representative to insurance vendors and provide periodic reports to City Council.

The total compensation is capped at $45,000 over the contract term, payable in four quarterly installments. The contract runs for one year from the effective date with automatic renewal on each anniversary, terminable by either party with 30 days' written notice (or immediately by the City for breach). Special services such as 1095C and 1094C reporting are considered upon City approval.

The consultant must maintain comprehensive general liability ($250,000 per person / $500,000 per occurrence), automobile liability ($100,000 per person / $500,000 per occurrence), and professional liability ($1,000,000 per claim and aggregate) with the City named as additional insured. The consultant is classified as an independent contractor. All work products become exclusive City property. A Business Associate Agreement establishing HIPAA compliance is required.

Evaluation is weighted 40% qualifications and experience, 20% rates and fees, 10% each on the consultant questionnaire and project design/methodology, and 10% on company operational information and references. Respondents must submit firm qualifications, organizational charts, staff resumes, three governmental references, audited financial statements, work plans, and compliance disclosures including conflict of interest, litigation history, and statutory verifications. Proposals will be publicly opened August 4 at 3:00 p.m. at City Hall. The City reserves the right to award one, more than one, or no contract and holds proposals for 90 days without taking action.