Georgetown Ionwave #202703

Georgetown seeks medical and prescription-drug stop-loss insurance

The City of Georgetown is seeking stop-loss insurance proposals for its self-funded employee medical and prescription-drug plans. - Buyer: City of Georgetown Purchasing Department, Georgetown, Texas. - Coverage requested: Specific and aggregate medical/RX stop-loss coverage for the 2027 plan year, serving approximately 1,000 full-time employees. - Required pricing scenarios: Specific deductibles of $150,000, $200,000, and $250,000; each scenario must include a 125% aggregate corridor and a $1,000,000 aggregate maximum. An optional 24/12 basis may also be quoted for the $150,000 deductible. - Key coverage terms: Quote on a broad run-in/Paid-12 basis with no material coverage gap; no claimant-specific lasers, exclusions, or deductibles in the required 2027 scenarios; 100% reimbursement after the applicable specific deductible or aggregate attachment point; unlimited maximum specific benefit per covered person; Aggregate Accommodation; and specific advance reimbursement/funding, with fees disclosed. - Renewal protections: No New Laser protection and a renewal rate cap of no more than 50% for the subsequent renewal. Proposals should explain claims administration, reimbursement, prescription-drug offsets, specialty therapies, exclusions and limitations, reporting, and independent dispute resolution. - Named organizations: UnitedHealthcare (UHC), including UnitedHealthcare Insurance Company, is identified as the incumbent medical/RX administrator and stop-loss carrier; bidders must coordinate with UHC. Alliant Insurance Services is identified as the City's benefits broker/consultant, not as a proposer. The listed invited suppliers are 1st Pass Healthcare Solutions, LLC; A6 Scientific Corp.; AAllen.us, LLC; Adila Hilal; AEB; Aetna; Aetna/CVS; AFFION PUBLIC; Aflac; Aflac Benefits Solutions; Aflac1; Alamo HR, LLC; Alight Solutions; and All About People. These invitations do not indicate selection or award. - Reference information: A prior UHC policy amendment describes 2026 specific and aggregate coverage, including a $150,000 specific deductible, 100% reimbursement, unlimited specific benefit, and $1,000,000 annual aggregate maximum. A separate pricing comparison lists UHC individual stop-loss premium of $2,990,657.28; this is historical/reference information, not an award or proposed contract price. - Contract structure: The draft agreement describes an initial three-year term with two optional one-year renewals. No product hardware is requested.

Description

The City of Georgetown is requesting proposals for specific and aggregate Medical/RX stop loss insurance for its self-funded medical and prescription drug plans. The coverage is for the 2027 plan year, and proposals must meet the RFP requirements, include the required Stop Loss Questionnaire, and be submitted electronically through the City E-bid system. Respondents must maintain proper licensing and comply with applicable federal, state, and local laws. The City will evaluate responsive proposals using criteria that include price, coverage and underwriting terms, claims administration and service, financial stability and experience, and past performance.

View original listing