26PP-129 Post 65 Retiree Insurance Plans

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
Attachment A - Scope of Work/Specifications
New Castle County is seeing sealed priced proposals for Post 65 Retiree Insurance Plans.
Background
New Castle County offers two Fully-Insured Medicare Advantage plans to Post-65 retirees and
their spouses. Both plans include prescription drug coverage. The County is seeking bids on behalf
of all Post-65 retiree participants at this time.
The County's objectives of this RFP are:
* Review Alternatives to the current fully insured Medicare Advantage plans for
Medical/Rx
* Reduce New Castle County's costs
* Minimize disruption to Post-65 Retirees
* Minimize administrative burden on HR
Important Note:
Please review the requests and information contained within and please provide responses to all
sections indicated within the RFP instructions.
Section 1 - Introduction
1. Required Response: Your response must address all requested information as outlined in #'s
3 and 4 below.
2. Coverages Marketed:
* Fully-Insured Medical and Prescription Drug coverage for Post-65 Retirees
Will consider Medicare Advantage or Medicgap plans
Must provide at least two options: Base and Buy-up
Provide at least one plan matching the current Base Plan
3. Attachments & Corresponding Appendix
* New Castle Medical Benefit Summaries - Appendix A - Please email Mischelle Lindsay at
mischelle.lindsay@usi.com, for the benefit summaries
September 28, 2025 Bid# 26PP-129 Page 1 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
Current Census -In order to obtain the current Census, bidder must complete and return
the Non-Disclosure Agreement and email to Robin Allen (robin.allen@newcastlede.gov),
the completed form will be reviewed and provided to USI who will provide Census to the
bidder.
4. Please fill-out, sign and return the following pages from this document:
* Takeover Issues
* One electronic copy emailed to USI at mischelle.lindsay@usi.com
Section 2 - Client Background Information
1. Client Information
* Name of Company: New Castle County, Delaware
* Headquarters: New Castle County, Delaware
* Multi-Locations: None
* Contract Situs State: Delaware
* Nature of Business: County Government
* Waiting Period: Not Applicable
* Domestic Partners: Not Covered
* Retirees: Retirees over 65 are covered
* Number of Active Members enrolled: 590
2. Current Plan Information
* Plan Renewal Date: January 1, 2023
* Funding Type: Fully-Insured
* Current Medical/Rx Carrier: Not provided
* Current Plans:
- Choice of two plans: Core and Buy-up with Telemedicine Option
* Plan Changes: Please list all deviations
* Current & Requested Broker Commissions: None
3. Marketing Objectives and Selection
3.1. Objectives: The County's objectives in seeking to obtain more competitive insurance
rates and obtain enhanced benefits. The county is required by the Union to shop all
coverage lines every three years.
September 28, 2025 Bid# 26PP-129 Page 2 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
3.2. Marketing Instructions:
* Bidders should provide fully insured medical and prescription drug benefits
* In addition to matching the current benefits, feel free to provide any suggestions or
creative product changes that your firm feels would benefit the County's
employees.
* The county will consider both Medicare Advantage and Medigap plans
Section 3 - RFP Instructions
1. Effective Date: 1/1/2027
2. Broker Commissions: Net of commissions
3. Requested Plans
3.1. Please match the current plan designs as closely as possible.
3.2. Any deviations from the current benefits MUST BE noted in the "Plan Deviations" file,
Appendix D. If there are no deviations, then please confirm this in Appendix D.
4. Requested Coverage
4.1. Fully-Insured Medical and Prescription Drug
5. Required RFP Responses:
* Sections 4 through 9 must be completed and returned
5. Open Enrollment: On-Site assistance is required when requested
6. Employee Web Service: Web-based employee self-service including: claims history, claim
form download, ID card print out, eligibility certification, online network directories,
communication materials and the ability to email custom service inquiries.
7. Delivery Method
See Page 1 of the RFP for delivery method.
Additionally, one electronic copy emailed to USI at mischelle.lindsay@usi.com
September 28, 2025 Bid# 26PP-129 Page 3 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
Section 4 - Deviations
1. Complete the Deviations chart, Appendix D
2. If there are no plan deviations, you may confirm here:
Are there no plan deviations? Yes No
Section 5 - Capabilities
1. Provide a brief history of your organization. Please include statistics such as:
1.1. How long you have provided Medicare Solutions to other clients
1.2. The number of Medicare eligible retirees you currently serve
1.3. The distribution by state for the Medicare eligible retirees served
2. Provide the organization's most recent satisfaction survey results.
3. Please provide the organization's financial rating of at least two agencies.
4. Please provide the organization's CMS Star rating over the past five years.
5. Please provide a copy of the organization's most current annual report.
6. A number of City retirees live outside of Delaware. Confirm that your solution will provide
access in all states where City retirees reside.
7. Describe the unique advantages of your organization's solution vs. other types of
8. solutions.
9. Please provide an organization chart of the professionals who will manage and
10. service the County relationship and account. Please include a brief biography for each of
these individuals.
11. Describe how your organization will conduct the full enrollment and communication process
during the open enrollment period and throughout the plan year. Provide details around
the communication services that will be provided.
12. Please provide a listing of any and all services that are subcontracted, including a description
of the function(s) being performed by the subcontractor(s) and the nature of the
relationship of each subcontractor to your organization.
13. Please describe support services your company provides to Medicare eligible retirees
14. throughout the year, including
14.1.1. Medicare retirement plan education (Parts A, B, C and D)
14.1.2. Medicare enrollment services
14.1.3. Telephonic support services
September 28, 2025 Bid# 26PP-129 Page 4 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
14.1.4. Financial planning and decision support resources available to Medicare retirees
Section 5 - Capabilities
15. Please provide the average premium increases for Medicare Advantage Plans over the last 3
calendar years.
16. Please provide a list of governments that have utilized the services offered by your
organization.
18. Please run, in a separate attachment, a GEO Access report using the current census (all
participants) based upon the criteria listed above in Section 5.3.2.
GEO Access Notes
- Run a separate GEO for each network used
- Important: Do NOT include secondary or "wrap network" providers in the GEO
Access for the primary network
19. Please complete the chart below as a supplement to the GEO Access reports provided.
Network Name Access to PCP Access to Access to Hospital
(2 in 10) Specialists (2 in 10) Facilities (1 in 15)
Section 6 - Customer Service
1. General
* Telephone Hours of Operation?
* After Hours Voicemail Availability?
* Email Inquiries?
2. Service Team
September 28, 2025 Bid# 26PP-129 Page 5 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
* Account Manager's Experience?
* Dedicated Claims Examiner?
* Dedicated Customer Service?
3. Eligibility Maintenance
* Internet Access/Real Time Adds and Terminations? Yes No
* Electronic File? Yes No
* What format of electronic files? Yes No
* Paper/Fax? Yes No
4. Online Tools
Product/Service Included Additional Cost
in Base
Admin
Fees?
Online Member Access to Claim Status N/A
Online Claims status look up (for HR) N/A
Online ID card request Yes No
Online Management Reports Yes No
Section 7 - Client Specific Questions
This section is designed for you to answer specific questions regarding the employee benefits
you are proposing. Please respond to this questions and provide a complete schedule of
benefits for the proposed plans. Thank you in advance for your cooperation and assistance.
1. Vendor Information: Please provide the legal name and NAIC code of your company
* Response:
2. Participation Requirements: Are there any participation requirements?
* Response:
September 28, 2025 Bid# 26PP-129 Page 6 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
3. Contribution Requirements: What is the employer contribution requirement?
* Response:
4. Renewal Timing: For this client, we are requesting renewals to be provided no later than
120 days prior to the effective date. Please confirm if you will be able to comply with this
request.
* Response:
5. Renewal Calculations: Confirm how renewals will be calculated for a group of this size.
* Response:
6. Account Management: Confirm there will be a dedicated account management team
assigned to New Castle County and provide their titles and names. Titles and names may be
provided if you are named a finalist (if not available currently).
* Response:
7. Customer Service
List customer service center hours.
* Response:
8. Claims Office: Out of which office location will claims be paid?
* Response:
9. Implementation: Please describe your implementation process and include a timeline.
* Response:
10. Enrollment Support: Please describe the type of enrollment support offered with this
proposal.
* Response:
11. Pre-Enrollment Hotline: Will you offer a pre-enrollment hotline or access to customer
service during open enrollment and prior to the effective date?
* Response:
12. On-Site Enrollment Meeting Support: Please confirm your willingness to attend on-site
enrollment meetings and any requirements for your attendance on-site.
* Response:
September 28, 2025 Bid# 26PP-129 Page 7 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
13. Timely Entrants and Late Entrants: Please identify any waiting periods for timely or late
entrants.
* Response:
14. ID Cards: 1. Do you provide printed ID cards? 2. Can you add New Castle County's logo at no
additional charge? 3. How long does it typically take for ID cards to be issued? 4. Confirm
that social security numbers will not be utilized on the ID cards. 5. Do you use a third party
to distribute ID cards? If so, please name the vendor.
* Response 1:
* Response 2:
* Response 3:
* Response 4:
* Response 5:
15. Enrollment and Eligibility Data: 1. Please confirm your ability to accept enrollment and
eligibility data in an electronic form at no additional charge. 2. What format do you accept?
* Response 1:
* Response 2:
16. Billing: 1. Can you provide bills in both electronic and paper format? 2. Are all bills provided
in one document separately by lines of coverage or plan type? 3. Can bills be ran by
multiple codes, including locations, department, etc.?
* Response 1:
* Response 2:
* Response 3:
17. Grace Period: What is the grace period for premium and/or fee remittance?
* Response:
18. Retroactivity: What are our retroactivity rules for additions, cancellations and
terminations?
* Response:
19. Takeover: Please describe how you handle service process upon a takeover.
* Response:
September 28, 2025 Bid# 26PP-129 Page 8 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
20. References: Please provide references for three existing similarly sitused customers and for
three customers recently lost.
* Current Client 1:
* Current Client 2:
* Current Client 3:
* Lost Client 1:
* Lost Client 2:
* Lost Client 3:
Section 8 - Fee Proposal
1. Please provide a schedule of benefits for each proposed product, to include:
1.1. Premiums broken-out by services
1.2. Employee locations if offering geographically based plans
1.3. Any fee guarantees and length of guarantee
Section 9 - Takeover Issues
An authorized representative of your Company must sign this Exhibit on the last page. Any
exceptions to these requirements must be stated on the last page of this Exhibit in addition to
the standard wording in your proposal (attach additional pages as necessary). It is very important
that we be notified of any exceptions to these requirements so that we can address these
concerns prior to awarding the business.
1. "No loss/no gain" to apply for all retirees and spouses currently covered under the plan.
This means that an employee or participant will not be penalized or lose benefits already
attained for having switched insurance carriers, nor will they gain any additional
benefits/provisions for which they have not yet satisfied the requirements or are not yet
eligible.
2. All benefits will apply to all retirees and their spouses under who are covered under the
current carrier.
3. No evidence of insurability required for those currently enrolled.
September 28, 2025 Bid# 26PP-129 Page 9 of 10

New Castle County
Purchasing Division
87 Reads Way
New Castle, DE 19720
(302) 395-5250
Bid# 26PP-129
Post-65 Retiree Insurance Plans
Carrier accepts the above terms and conditions for Medical/Rx coverage:
(__) with exceptions noted below and on following pages.
(__) without exceptions.
By:
Signature Date
Title
For:
Vendor/Carrier Name
Section 9 - Takeover Issues - Exceptions
List any exceptions to the form above within:
NOTE: PLEASE COMPLETE THE NON-DISCLOSURE AGREEMENT AND RETURN TO ROBIN ALLEN
(robin.allen@newcastlede.gov) in order to receive the Census Information.
September 28, 2025 Bid# 26PP-129 Page 10 of 10