Knowledgebase-Health Insurance


Information Product

Title:Health Insurance
Summary:
Original Author:White House
Co-Author:
Product Create Date:09/14/2001
Last Reviewed on::05/01/2017
Subject:Personnel
Type:RFP
Original Document:

Reference Documents:

Text of Document: INSURANCE BID NOTICE


Sealed bids for Group Health and Life Insurance will be received by the City of White House, Tennessee until 2:00 P.M. (CST) June 23, 1994 at the White House City Hall, located at 106 College Street, White House, Tennessee, and opened by the Mayor and publicly read. Bids received after the stated time, postmarks notwithstanding, shall be rejected. The insurance to be provided will include Group Health Insurance with optional life insurance coverage. Bid specification packages are available at the City Business office at City Hall, 106 College Street, White House, Tennessee 37188 or by calling 615-672-4350. All bidders are encouraged to attend a pre-bid conference at the City Business Office on June 16, 1994 at 10:00 A.M. (CST).
Bids are to be submitted in accordance with the specifications stipulated in the bid documents on the forms contained in the package and are to be sealed in an opaque envelope and clearly marked "SEALED BIDS FOR GROUP HEALTH INSURANCE". The City reserves the right to accept and\or reject any and\or all bids received.


NOTE:

THIS NOTICE SHALL BE PUBLISHED IN THE LOCAL NEWSPAPER OF GENERAL CIRCULATION IN THE CITY OF WHITE HOUSE THE WEEK OF ___________ ____, 1994.

CITY OF WHITE HOUSE, TENNESSEE
GENERAL BID SPECIFICATIONS AND REQUIREMENTS

1. Coverage shall be effective August 1, 1994 or on a later date requested, in writing, to the bidder by the Mayor. Coverage shall be guaranteed for a minimum of 12 months from the effective date at the same premium rate quoted in the bid. It is the City's intent to renew the coverage after the initial coverage period by negotiation with the bidder. Such renewal process may be conducted annually. The city must be notified forty-five (45) days in advance of anniversary date of any premium increases.

2. If exceptions from coverage are made, exceptions must be clearly stated on each coverage.

3. Envelopes containing the bids shall be sealed and marked "Sealed Bids for Group Health Insurance".

4. The bidder is required to examine carefully the specifications and risks to be covered. It will be assumed that the bidder has made such investigations and is fully informed as to the extent and character of the hazards and requirements of the specifications. No warranty is made or implied as to information contained in these specifications.

5. All bids shall show or conform to the following, in addition to other information required upon the bid form:

A. Name of Proposed Insurance Company.

B. Insurance Company rating as per A.M. Best's Insurance Guide or appropriate financial documents to assure the bidder is a stable, sound and responsible company. Only A OR BETTER rated companies will be considered.

C. Insurance companies must be authorized to do business in the State of Tennessee.

6. All bids shall have an attachment thereto giving a description of services to be supplied as part of the insurance coverage. A brief description of claims or adjustment service shall be included.

7. Cancellation, termination, or expiration of the policy by the insurer or insured shall require sixty (60) days notice.

8. All bidders must agree in writing to furnish the City a quarterly report of all incurred claims.

9. All bidders must agree to furnish a statement of loss experience within fifteen (15) days following the anniversary of the policy including a detailed analysis of pending claims.

10. All policies are to cover any new employees under the same conditions as provided under initial implementation of the coverage.

11. No oral interpretation will be made to any bidder as to the meaning of the bid specifications or any part thereof. Every request for interpretation shall be made in writing to the Finance Director of the City of White House. Any inquiry received seven (7) or more days prior to the date fixed for opening of bids will be given consideration. Every interpretation made to a Bidder will be in the form of an Addendum to the Bid Specifications and, when issued, will be on file in the City Business Office at least three (3) days before Bids are opened. In addition, all Addenda will be mailed to each person holding Bid Specifications, but it shall be the Bidder's responsibility to make inquiry as to the Addenda issued. All such Addenda shall become part of the Bid Specifications and all Bidders shall be bound by such Addenda, whether or not received by the Bidders. Bidders must acknowledge in writing receipt of addendum and include this acknowledgement with his bid.

12. Bids will be received by the Mayor of the City of White House until 2:00 P.M. (CST), June 23, 1994 and opened publicly by the Mayor. Bids received after the above stated time, postmarks notwithstanding, shall be rejected.

13. No bid shall be withdrawn for a period of sixty (60) days subsequent to the opening of the Bids, without consent of the Board of Mayor and Aldermen of White House, Tennessee.

14. Successful bidder shall be required to provide on-site training and question and answer session for all city employees. Also, the successful bidder shall be required to provide a toll free customer service line between 8 a.m. and 5 p.m each work day for city employee access to the insurance provider. User friendly claims forms shall be furnished to the city with detailed instructions that can be provided to employees.

15. The Board of Mayor and Aldermen will make the award as soon as practicable to the (lowest responsible) best bidder, price and other factors considered. The Board of Mayor and Aldermen reserve the right to reject and/or accept any and/or all bids received.


16. For additional information and loss experience, contact Mayor Billy Hobbs, City of White House, P.O. Box 69, White House, Tennessee 37188 or by calling 615-672-4350 (FAX Number 615-672-2939).

17. A pre-bid conference for all persons desiring to bid is scheduled in the City Council Chambers on June 16, 1994 at 10:00 A.M. (CST). All bidders are encouraged to attend.

CITY OF WHITE HOUSE, TENNESSEE
GENERAL INFORMATION

1. Nature of the group to be insured:

The City has approximately 50 employees in the present group working in areas of:

City Hall (Legislative, Administrative, Finance)
Police
Fire
Public Works (Streets, Sanitation, Utilities and Parks)

Approximately 26 employees are under family coverage while approximately 24 employees are under individual coverage.

For more details regarding insured employees and dependents please contact the City Business Office at 615-672-4350.

2. The current carrier is the State of Tennessee Local Government Health Insurance Plan.

3. For financial experience contact the City Business Office or the Tennessee Local Government Health Insurance Program.

PROPOSED PLAN SPECIFICATIONS

1. All Bidders shall use the enclosed bid form.

2. All bids must provide the following:

A. Deductible and waiting period credit.
B. No lost benefits due to transfer of coverage.
C. Immediate maternity benefits for insured.
D. Immediate coverage for presently insured who lose benefits with present carrier.
E. Immediate coverage of transferred COBRA participants.

3. GROUP LIFE INSURANCE:
All bidders shall bid Group Term Life Insurance and Accidental Death and Dismemberment for each employee per $1000 coverage (maximum $10,000 coverage). Upon age 70 limits shall be reduced to $5,000. There will be no life insurance benefits for retirees.


4. GROUP HEALTH INSURANCE:
NOTE: IT IS THE CITY'S INTENT TO SEEK BIDS FOR COVERAGE COMPARABLE TO THE EXISTING STATE OF TENNESSEE LOCAL GOVERNMENT HEALTH INSURANCE PLAN EXCEPT FOR THE REQUIREMENT OF USING TENNESSEE PROVIDER NETWORK SERVICES AS THE SOLE PREFERRED PROVIDER ORGANIZATION.

A. The bidder shall provide coverage for the following:

1. Full-time employees working no less than 30 hours per week.
2. Part-time employees working 1450 hours per year and with at least 45 months previous service.
3. Elected members of the city legislative body (i.e. Mayor and Aldermen).
4. Dependents of covered employees which includes:
a. legally married spouse;
b. unmarried natural or adopted children;
c. stepchildren;
d. grandchildren if employee is legal guardian;
e. any dependent child living in employee's home and dependent upon employee for 51 percent support; and/or
f. any dependent claimed on the employee's federal income tax return.

B. The bidder shall provide for retirees to continue coverage under the group health plan. Coverage for retirees will terminate upon their reaching Medicare eligibility.

C. Following is a brief summary of the benefits the bidder is required to provide. Please refer to the Local Government Group Insurance Program Employee Handbook published by the Tennessee Department of Finance and Administration for a more detailed explanation of the benefits required to be provided by the bidder.

Deductible
Deductible Per Calendar Year
$200 per individual
$500 family maximum


Types of Coverage

After the deductible is met, the Plan shall pay 90% of the usual and customary rate for physician services and 90% of hospital charges provided by a preferred provider organization (PPO).

After the deductible is met, the Plan shall pay 80% for certain non-physician and non-hospital services such as prescription drugs, skilled nursing facilities or ambulance charges.

After the deductible is met, the Plan shall pay 70% of the usual and customary rate for physician services and 70% of hospital charges if provided by a non-preferred provider organization.

After the deductible is met, benefits are reduced to the 50% benefit level, if the utilization management guidelines (i.e. pre-certification) are not met.

If a single participant pays $1,000 out-of-pocket in eligible PPO expenses or $3,000 in eligible non-PPO expenses or a family pays $2,000 out-of-pocket in eligible PPO expenses or $6,000 in eligible non-PPO expenses (including the deductible), the Plan pays 100% of additional eligible expenses for the rest of the calendar year up to the Plan's lifetime maximum amount.

A co-payment of $25 will be required when the plan participant receives care in any hospital emergency room. The co-payment is not applied to the deductible, but is waived if the participant is admitted.

Lifetime maximums shall be as follows:
1. $1,000,000 overall individual maximum.
2. $100,000 individual maximum -- mental health, which includes a $30,000 individual maximum for substance abuse.


CITY OF WHITE HOUSE
GROUP HEALTH AND LIFE INSURANCE
BID FORM


DATE BID SUBMITTED:__________ DATE CITY RECEIVED BID:__________


COVERAGE MONTHLY PREMIUM


I. LIFE INSURANCE

EMPLOYEE COVERAGE PER $1,000

II. HEALTH INSURANCE

EMPLOYEE

FAMILY (employee and dependent)


III. ARE THERE ANY EXCEPTIONS FROM COVERAGE IN ACCORDANCE WITH THE BID SPECIFICATIONS? ______YES ______NO

IF YES, EXCEPTIONS MUST BE CLEARLY STATED BELOW ON EACH COVERAGE. ATTACH ADDITIONAL SHEETS, IF NECESSARY.









This bid is submitted in accordance with the specifications and conditions contained in the Bid Document.

_____________________________
COMPANY

BY:__________________________
AUTHORIZED REPRESENTATIVE

_____________________________
ADDRESS
_____________________________
TELEPHONE
_____________________________
DATE









May 26, 1994

Mayor Billy Hobbs
City of White House
P.O. Box 69
White House, Tennessee 37188


Dear Mayor Hobbs:

Here's the health insurance bid proposal package. As discussed the intent is to provide the City of White House some bids for health coverage for White House employees that provide comparable health coverage without being tied to the Tennessee Provider Network.

Call me if you have any questions or need further assistance. Thank you.


Sincerely,


Randy Williams
Senior Management Consultant

cc: Mike Tallent, MTAS w/ attachments
Pat Hardy, MTAS w/ attachments
MTAS Reading File w/ attachments