Fully Insured Medical Insurance Service

Saint Paul, Minnesota seeks a vendor to provide fully insured medical insurance covering active, COBRA, leave, disabled, and pre-65 populations.

Be authorized to transact business in the State of Minnesota
Submit a competitive financial proposal including a 2-year rate guarantee and a Minimum Loss Ratio Guarantee
Provide client-specific program experience data including: Monthly Membership Report, Model Output Report, Monthly allowable claims, paid claims and enrollments, Provider/facility utilization data covering 100% of claims, and Prescription drug utilization data covering 100% of claims
Offer a plan design comparable to the current offering
Include a broad open-access network for all members
Ensure adequate network access for medical providers/facilities and retail pharmacies
Minimize disruption to members as measured by Provider Match and Prescription Drug Match
Commit to timely enrollment processing and issue resolution
Provide experienced implementation resources and comprehensive transition resources
Offer an implementation credit or other alternatives to support transition
Provide high performing customer service dedicated to serving members
Offer value-add benefits for members
Be willing to participate in employee informational sessions
Provide a streamlined enrollment process
Offer experienced, dedicated account management
Be willing to present to the Evaluation and Labor Management Committee as a finalist
Provide positive public-sector references and implementation references of a similar size
Be willing to comply with requested negotiation items
Guarantee all fees for the period of January 1, 2027, to December 31, 2028
Provide notification of contract termination by the Vendor at least 90 calendar days in advance, with cause
Provide a renewal notice at least 180 days prior to each contract anniversary date
Accept ongoing manual enrollments from the Client
Transfer all required data and records to the Client within 30 days of notice of termination, subject to confidentiality
Not terminate services due to Client contract violation without notifying the Client and providing at least 60 days to remedy
Refrain from issuing external communications material mentioning the Client's benefit plans without written approval
Prepare and file all legal documents necessary to comply with state/federal requirements at no charge
Monitor federal and state legislation affecting benefits and report timely on mandated plan changes
Provide any contract amendments to the Client within 60 days of a written request
Provide a thirty-five (35) day grace period for invoice payments
Accept two standard ANSI weekly electronic eligibility files for Active participants
Accept weekly manual eligibility for Pre-65 Retirees
Reconcile monthly eligibility updates for COBRA and Leave of Absence
Grant the client online access to all eligibility and claims information, including edit access for eligibility
Accept manual enrollments for all participants at no additional costs
Allow a ninety (90) day calendar period for retroactive adjustment to coverage and recalculation of premiums
Carry a fiduciary bond as required by ERISA for fiduciary arrangements
Accept liability for claim processor negligence or fraud
Provide reasonable assistance for preparation of Summary Plan Descriptions (SPDs)
Conduct statistically credible member satisfaction surveys at least annually
Provide details on the Pharmacy Benefit Manager (PBM)
Specify the number of retail pharmacies in the network within the 7-county metro area
Explain any major chains excluded from the pharmacy network
Provide the name of the proposed formulary and any alternate formularies with estimated savings
Complete the annual Gag Clause Prohibition attestation on behalf of the District
Produce and provide Form 1095 B / 1095 C on behalf of the District
Complete a full submission of required Prescription Drug Cost (RxDC) reporting to CMS on behalf of the District
Provide Medicare Part D creditable/non-creditable notices to applicable members
Attend the annual health and benefits fair at the beginning of open enrollment
Support District new hire meetings (held at least monthly) by presenting medical benefit options
Provide a sample Explanation of Benefits (EOB) with explanations for each section
Indicate available online tools for members (Web/Mobile App): General medical plan coverage information, Chat with customer service, View secure messages, Ability to download forms, Ability to view ID cards, Ability to print/request additional or replacement ID cards, Ability to look up the status of a claim, Ability to track deductibles/out-of-pockets/maximums, Ability to obtain provider cost information, Ability to obtain provider quality information, Ability to view Explanations of Benefits, Ability to run reports to analyze medical spending
Specify mobile app availability (iTunes, Google Play) and any additional features
Provide a test user ID/password to explore the website as a member and employer
Describe employee-facing tools and resources for decision-making during open enrollment 2026
Indicate willingness to support employee and pre-65 retiree meetings for significant benefit changes without additional cost

$40,000,000 – $50,000,000

RFP Distribution Date: March 2, 2026

Proposers Submit Intent to Bid to Aon: March 9, 2026

Mandatory Bidders Call: March 12, 2026

Vendor Questions Due via GetAll: March 18, 2026

Response to Vendor Questions via GetAll: March 20, 2026

Proposals Due via GetAll: March 27, 2026

Notification of Finalists via Email: May 8, 2026

Finalist Meetings: Week of May 18, 2026

Notification of Vendor Selection: June 23, 2026

Implementation Begins: Mid July, 2026

Effective Date: January 1, 2027

Saint Paul Public Schools

Organization overview and procurement intelligence available on paid plans.

A government authority in Saint Paul, Minnesota is seeking a vendor to provide fully insured medical insurance services. The coverage must address active employees as well as those under COBRA, those on leave, disabled individuals, and pre-65 retirees. The requirement is for medical insurance offered strictly on a fully insured basis.

A mandatory pre-bid meeting will be held on March 12, 2026 to review project requirements. Vendors must submit any questions about the solicitation no later than March 18, 2026.

Fully Insured Medical Insurance Service

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