Stop Loss Coverage for Self-Funded Health Plan

Background
The City of Sarasota is seeking proposals for Stop Loss Coverage for its Self-Funded Health Plan. The City has a strong commitment to health and wellness, providing incentives for covered members, including employees, retirees, and spouses. The self-insured health plan is administered by BCBS of SC with pharmacy benefits managed by RxBenefits/CareMark. Approximately 720 employees and 145 retirees are enrolled in the health plan, with Medicare-eligible retirees excluded from Stop Loss coverage.

Work Details
The proposal requests Stop Loss Coverage on a 24/12 contract basis, covering both medical and prescription drug expenses. The options include:
- Individual Specific Loss (ISL) coverage at $250,000 and $275,000 levels.
- Aggregate coverage with a 125% corridor.
Proposers must submit firm proposals that will be evaluated based on proposed rates, terms & conditions, and responses to a questionnaire. Current rates are $59.21 per employee per month (PEPM) for Individual Stop Loss and $3.26 PEPM for Aggregate Stop Loss.

Period of Performance
The effective date for the Stop Loss Coverage is January 1, 2025.

Place of Performance
The services will be performed in Sarasota, Florida.