Stop Loss Insurance for Metropolitan Transit Authority of Harris County, Texas

The Metropolitan Transit Authority of Harris County (METRO) is requesting proposals for stop loss insurance coverage effective October 1, 2026, with proposals due June 16, 2026.

METRO seeks medical and prescription drug paid stop loss coverage for a 24-month contract term. The covered population includes approximately 4,789 regular, full-time non-union employees working at least 30 hours per week, plus retirees and dependent children. METRO is simultaneously transitioning its union population to a self-funded medical plan with Cigna for 2026–2027; proposers must submit two separate quote options: one for the non-union population currently under stop loss coverage and one for a combined quote including the newly self-funded union population. Medical and pharmacy administration will remain under contract with Cigna and OptumRx.

Proposers must quote individual stop loss limits at three deductible tiers: $275,000, $300,000, and $325,000. All proposals must include a no-laser option with a 50 percent renewal rate cap, and proposers must confirm that Spec Advance Funding is included with the AAW requirement waived. LASERED members must be identified with adjusted deductibles noted. Pricing must be submitted net of commissions and be firm for 60 days pending board approval. The RFP strictly prohibits renewal language or renewal dates in the final contract. Proposers must provide a corporate office blanket statement confirming whether the employer's plan document will be used for claims determination.

Current carriers are Voya and Cigna. Evaluation is weighted as follows: financial terms and contract strength (35 points), claims management and administration (25 points), client service and support (20 points), qualifications and experience including public sector experience and financial rating (10 points), and implementation and transition support (10 points).