Medical Benefits Administrative Services, PMB, Dental Benefits & Stop-Loss

The Town and Public Schools of Vernon, Connecticut, administered by Acrisure, LLC, is soliciting proposals for Administrative Services Organization (ASO) services covering medical benefits, behavioral health care, pharmacy benefit management (PBM), dental benefits, and stop-loss insurance for a self-funded employee health plan. Respondents may submit proposals for a comprehensive package of all services or individual carve-out options for specific components, with Vernon retaining the right to select either a single plan administrator for all products or separate administrators for different benefit components. The procurement covers approximately 230 eligible town employees and 640 eligible board of education employees, with an effective date of July 1, 2026, and a contract period of 36 months (July 1, 2026, through June 30, 2029) with options for up to two additional one-year renewal periods. Key requirements include multi-year administrative fee guarantees, provider discount guarantees, aggressive performance guarantees across all service areas, and fully transparent, pass-through pricing for pharmacy services with all discounts, fees, and rebates guaranteed for the contract term. Vendors must demonstrate financial stability through recent financial reports and independent auditor reports, possess Connecticut licensing requirements, carry specified insurance coverage with the Town named as additional insured, achieve a minimum 90 percent provider network match, integrate medical and prescription drug claims data from current vendors, and ensure all current participants are covered immediately upon the effective date without evidence of insurability or pre-existing condition exclusions. The proposal submission deadline is January 27, 2026, at 10:00 a.m., with six hard copies and one electronic copy required to be submitted in a sealed envelope to John W. Kleinhans, Town Administrator, 14 Park Place, Vernon, Connecticut 06066. Questions must be submitted by January 13, 2026, at 3:30 p.m. to Nichole Greco, Project Coordinator, at ngreco@vernon-ct.gov, with responses posted by January 15, 2026. Finalist meetings are scheduled for the week of February 23, 2026, with vendor selection anticipated for the week of March 9, 2026, and an implementation/transfer phase running from February 20 through June 30, 2026.

Minority-owned businesses (MBEs), women-owned businesses (WBEs), and small businesses (SBEs) are encouraged to apply, with the Town requiring active MBE certification at the time of bid submission or pending status with the Department of Administrative Services (DAS) with finalization prior to contract award. The current incumbents are Cigna for medical coverage and Anthem for dental coverage; bidders must integrate with existing medical and prescription drug claims data from these current vendors and must mirror current plan designs as outlined in collective bargaining agreements without proposing alternative plan designs. The plan demonstrates a cumulative loss ratio of 87.2 percent for Vernon Public Schools and 110.7 percent for the Town of Vernon through November 2025, with a combined net fund balance for both entities of $1,334,009 as of November 2025, providing insight into the financial scope and claims experience of the self-funded plan. Bidders will have access to detailed dental claims data, prescription drug detail files, updated large claims reports covering July through November 2025, and monthly claims data through November 2025 to inform their proposals. The RFP does not specify a total contract value or estimated award amount in the available solicitation documents. All selected vendors must comply with municipal, state, and federal affirmative action and equal employment opportunity requirements, and Vernon reserves the right to reject any or all proposals and to negotiate with any submitting companies.