RFP No. 2130386 - Employee Health Benefits Plan

The City of Miami has issued Request for Proposals (RFP No. 2130386) for a comprehensive Employee Health Benefits Plan to be implemented on January 1, 2026. The procurement seeks an Administrative Services Only (ASO) provider to manage a self-insured health plan covering approximately 1,889 full-time employees, 154 retirees under 65, and 195 retirees over 65, totaling around 4,391 members. The scope encompasses multiple benefit components including self-funded medical and pharmacy services, an Employee Assistance Program, an onsite health clinic, fully insured dental HMO and PPO plans, comprehensive vision coverage, Healthcare and Dependent Care Flexible Spending Accounts, and COBRA administration. Key objectives include enhancing healthcare access, improving health outcomes, ensuring cost-effective administration, and implementing innovative solutions to meet evolving population healthcare needs. The RFP is due on November 3, 2025, with a voluntary pre-proposal conference scheduled for October 8, 2025, via Microsoft Teams. Evaluation criteria will likely include network adequacy, claims administration capabilities, member services, compliance mechanisms, performance guarantees, and administrative fee structures.

The RFP includes provisions supporting local business participation, such as a Living Wage Ordinance requiring contractors to pay employees a minimum wage of $15.00 per hour without health benefits or $13.19 per hour with health benefits. While no specific set-aside designations for disadvantaged enterprises are explicitly detailed, the current incumbent is CIGNA, which has been providing comprehensive healthcare services across medical, dental, vision, prescription, and auxiliary benefits. The current stop-loss insurance covers specific losses up to $350,000 with an aggregate corridor set at 120%. The plan is funded through combined City and employee contributions, with administrative service fees and stop-loss insurance playing critical roles in the overall cost structure. While precise award values are not specified, the extensive documentation suggests an annual healthcare spend approaching $50 million, with administrative service fees and stop-loss insurance contributing additional costs. The contract includes provisions for a five-year initial term with options for two additional three-year renewal periods, indicating a potential long-term partnership opportunity for the selected vendor.