Medical Request for Proposal
| Agency: | City of Seattle |
|---|---|
| State: | Washington |
| Type of Government: | State & Local |
| Posted Date: | Jun 3, 2025 |
| Due Date: | Jul 11, 2025 |
| Solicitation No: | HR0-2025-01 |
| Original Source: | Please Login to View Page |
| Contact information: | Please Login to View Page |
| Bid Documents: | Please Login to View Page |
Description
Project ID: HR0-2025-01
Title: Medical Request for Proposal
Addenda: 0
Release Date: 6/3/2025
Due Date: 7/11/2025
The City of Seattle is seeking Proposals for Medical Request for Proposal , to be submitted through the Procurement Portal at https://procurement.opengov.com/portal/seattle , no later than 5:00 pm on Friday, July 11, 2025 .
City of Seattle is using this request for proposal process as an opportunity to evaluate the marketplace and continue to evolve its health benefit program for its nearly 12,000 benefit eligible employees.
City of Seattle’s benefit strategy is to provide excellent access to high quality providers of health care at a sustainable and affordable price. City of Seattle focuses on the member experience in addition to health care efficiency, cost management and wellness programs to engage members.
Currently, the Aetna PPO plans have pharmacy services carved in with CVS. This proposal is requesting medical services only, to go into effect on January 1, 2027. The City is conducting a separate request for proposal for their Pharmacy Benefit Manager (PBM) as a carved-out solution (concurrently with the medical).
All Proposals must be valid from the proposal due date of July 11, 2025, through the effective date of January 1, 2027.
The City of Seattle is a public municipality providing services to more than 700,000 residents of Seattle, Washington. Services provided include public safety, utilities, park management, transportation, community resources, and city government. The City of Seattle employs and provides benefits for approximately 12,000 employees.
City of Seattle’s benefit administration office is located in Seattle, Washington. All benefit information can be found at this web address: Benefits - Human Resources | seattle.gov
City of Seattle’s plan year is January 1 – December 31. All proposals should assume administrative responsibilities for claims incurred on or after the effective date of January 1, 2027. City of Seattle typically conducts its Annual Benefits Enrollment in October of each year.
Many of the City’s employees are governed by collective bargaining agreements. Any medical plan administrator must be able to administer all of the current plan designs – some of which are grandfathered as defined by the ACA.
The benefit plans included in this RFP are provided to three key populations:
- Most City: Employees have “Most City” coverage if they are not represented by one of the following unions: Local 77 I.B.E.W., SPOG, or Firefighters Local 27. Employees are offered 2 Aetna PPO plans and 2 Kaiser plans . Most City pre-65 retirees are offered 2 Aetna PPO Retiree plans and 2 Kaiser Retiree plans.
- Local 77: Employees who are members of Local 77 I.B.E.W., units 077 (City Light) and 078 (Transportation). Employees are offered 4 Aetna PPO plans and 2 Kaiser plans. Local 77 pre-65 retirees are offered the same retiree plans offered to Most City.
- Seattle Police Officer’s Guild (SPOG): Employees covered by a union contract with Seattle Police Officers Guild. Employees are offered 2 Aetna PPO plans and 2 Kaiser plans. SPOG pre-65 retirees are offered 2 Aetna PPO Retiree plans and 2 Kaiser Retiree plans.
The City of Seattle is soliciting proposals for medical plan administrators for the current self-funded PPO programs administered by Aetna. The Kaiser HMO plans will continue to be offered alongside the PPO options and are not part of the solicitation.
Please provide a proposal for your broad PPO network to ensure minimal member disruption. The City of Seattle is interested in learning about your capabilities in offering alternate networks (high performing, narrow or other) for the future. Please provide information about these networks in your responses on the “Medical Custom Questionnaire Exhibit” document. However, all financial proposals should be based on your broad PPO network.
City of Seattle currently works with an advocacy and care navigation vendor. The City is interested in learning about your capabilities in providing carved-in advocacy and care navigation services. Please provide information about these services in your responses on the "Medical Custom Questionnaire Exhibit" document.
City of Seattle contracts with the following partners. The vendor partner selected from this RFP will be expected to work collaboratively with the existing vendor partners such as those listed below.
|
Plan Name |
Partner |
|
Benefits Administration |
Alight |
|
Data Warehouse |
Merative |
|
Pharmacy |
CVS (subject to PBM RFP results) |
|
Advocacy and Care Navigation |
Accolade |
|
Expert Second Medical Opinion |
Accolade |
|
Dental |
Delta Dental of Washington and DHS |
|
Vision |
VSP |
|
Flexible Spending Account |
Navia |
|
Life |
Securian |
|
Disability |
Hartford |
|
Employee Assistance Program |
ComPsych |
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