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 services contract, seeking a medical insurance provider or third-party administrator to manage a robust health benefits program for municipal employees. The procurement targets a five-year contract beginning January 1, 2027, with potential two additional three-year renewal periods, covering approximately 1,889 full-time employees, 154 retirees under 65, and 195 retirees over 65. The comprehensive health benefits package includes self-funded medical and pharmacy services, an Employee Assistance Program (EAP), an onsite health clinic, fully insured dental HMO and PPO plans, comprehensive vision coverage, and Flexible Spending Accounts for healthcare and dependent care. Key objectives include enhancing member experience, promoting wellness, increasing generic drug utilization, minimizing care gaps, and effectively managing critical diseases. The RFP requires a voluntary pre-proposal conference on October 8, 2025, at 11:00 AM via MS Teams, with proposals due by November 3, 2025, at 5:00 PM. Potential vendors must demonstrate innovative health plan designs, advanced technology integration, multi-lingual customer service, and comprehensive administrative services across medical, pharmacy, dental, vision, EAP, and COBRA benefits.

The RFP does not explicitly indicate specific set-aside designations for disadvantaged enterprises, though the Local Office Certification Form suggests a preference for local businesses with a staffed office within Miami's corporate limits for at least twelve consecutive months. The current incumbent for these services is CIGNA, which has been providing comprehensive healthcare administration and insurance services across multiple benefit categories, including medical, dental, vision, prescription drug, and employee assistance programs. The existing infrastructure involves a self-insured health plan with stop-loss insurance covering specific losses up to $350,000 and an aggregate corridor set at 120%. While precise award values are not definitively stated, the historical claims data suggests an annual healthcare spending range between $41 million and $49 million, with administrative service fees around $980,000 annually. The city's health benefits plan covers approximately 5,600-5,700 subscribers and 11,200-11,300 total members monthly, indicating a substantial and complex healthcare services procurement opportunity with significant financial implications.