Denton Ionwave #9161 Addendum 1

City of Denton solicitation for specific and aggregate stop-loss insurance

The City of Denton is seeking stop-loss insurance for its self-funded employee health and prescription plans. - Buyer: City of Denton, Purchasing; Denton, Texas. - Requested coverage: Specific (individual) and aggregate stop-loss insurance for eligible employees, retirees, and dependents. Proposals should cover medical and prescription plans on a 24/12 or paid contract basis. - Specific deductible options: $185,000, $200,000, $225,000, and $250,000; no aggregating specific deductible is requested. - No fixed quantities or part numbers are specified. - Vendors and plan administrators mentioned: UnitedHealthcare is the current stop-loss carrier, and SunLife is the former stop-loss carrier. Surest administers medical claims for the referenced self-insured plan, while OptumRx administers outpatient prescription benefits. These are references to existing coverage or administration, not stated selections for the new stop-loss contract. - Notable coverage requirements: The City seeks continuity of benefits for currently covered employees and dependents, including waivers of applicable pre-existing-condition, actively-at-work, and non-confinement provisions for initial enrollment. It prefers coverage without lasers or run-in limitations, but will consider risk provisions and enhancements such as no-new-laser renewals and second-year rate caps. - Referenced plan details: The Surest plan has no deductible, in-network copayments, and annual in-network out-of-pocket maximums of $6,500 per individual and $13,000 per family. OptumRx prescription copayments vary by tier and retail, mail-order, or specialty channel; out-of-network medical coverage is generally limited or unavailable.

Description

The City of Denton is requesting proposals for specific and aggregate stop loss insurance for its medical and prescription plan. The coverage is for employees, retirees, and dependents covered under the City's self-insured health plan, with proposals based on a January 1, 2027 effective date. Proposals should address the requested coverage options and deductibles, and include pricing and required proposal documents. Submissions are accepted through IONWAVE or by hard copy; questions must be submitted through IONWAVE.

View original listing