Stop Loss Reinsurance for Partially Self-Funded Medical and Prescription Health Plans

The City of San Angelo Human Resources Department is seeking Stop Loss Reinsurance proposals for its partially self-funded Medical and Prescription Health Plans. The procurement involves obtaining a one-year contract with two potential renewal options, effective January 1, 2026, covering 820 full-time employees, 157 pre-65 retirees, and one COBRA participant. Current medical plans are administered by Aetna, with prescription services managed by CVS, and the city is soliciting proposals for stop loss coverage with specific deductible options of $200,000, $225,000, and $250,000, maintaining a 125% aggregate corridor. Proposals are due on November 4, 2025, by 2:30 PM CST, with vendor evaluation based on a comprehensive scoring methodology: 50% cost, 30% financial stability, 10% claims processing, and 10% past performance. Proposers must submit detailed pricing documentation, complete a stop loss questionnaire, and provide various exhibits including conflict of interest forms and verification documents.

The procurement opportunity appears open to all qualified insurance vendors, with no specific set-aside designations explicitly mentioned. The City of San Angelo has incorporated multiple compliance requirements, including local preference considerations, debarment and suspension certifications, and verification of non-discriminatory practices. Vendors must comply with Texas state legislative requirements, including provisions related to contracts with foreign organizations, boycott restrictions, and anti-discrimination standards. While specific budget ranges are not definitively stated, the solicitation suggests the potential contract value will depend on the selected deductible level and the city's population coverage. Proposers must demonstrate financial stability, robust claims processing capabilities, and a track record of effective stop loss insurance management to be considered for the contract.