Stop Loss Insurance

Austin Independent School District (AISD) is soliciting proposals for Stop Loss Insurance through Request for Proposals (RFP) 26RFP020, seeking qualified firms to provide comprehensive stop loss coverage for its self-insured medical benefit program. The procurement covers stop loss insurance for the district's medical and prescription benefits, with vendors required to propose coverage for three individual stop loss levels: $1,000,000, $850,000, and $750,000. The district currently offers one High-Deductible Health Plan (HDHP) and one Health Maintenance Organization (HMO) plan, and is transitioning to three Blue Cross Blue Shield plans for 2026. Proposals are due on October 28, 2025, at 2:00 pm CST, with a virtual bid opening conducted via Google Meet and a tentative board review/approval scheduled for December 18, 2025. Vendors must provide detailed pricing options on a per employee per month (PEPM) basis, address specific contract provisions, and offer comprehensive claims experience and reporting capabilities. Key evaluation criteria include pricing, coverage levels, contract flexibility, and alignment with district requirements.

The procurement does not specify explicit set-aside designations or restrictions for disadvantaged enterprises. The current stop loss insurance is provided by Aetna Life Insurance Company, with a total enrollment of 8,988 participants and an existing Individual Stop Loss (ISL) coverage amount of $1,000,000 per participant. The existing contract has a Composite PEPM rate of $8.39, resulting in an estimated annual ISL policy period premium of $904,912, which represents a 14.8% increase from the previous year. The district requires vendors to propose all fees and premiums net of broker/agent commissions, with pricing to remain firm for the initial one-year contract term and potential renewals for up to four additional one-year periods. Price adjustments at renewal will be limited to a maximum of 5% per period, subject to AISD's approval and substantiation of cost increases. The district's existing infrastructure includes medical plans administered by Blue Cross Blue Shield, with detailed claims history and enrollment data available for vendor review.