RFP 26-24-SD Medical, Dental, Vision, Prescription, and EAP

Agency:	County of Spotsylvania
State:	Virginia
Type of Government:	State & Local
NAICS Category:	423450 - Medical, Dental, and Hospital Equipment and Supplies Merchant Wholesalers
Posted Date:	Feb 6, 2026
Due Date:	Feb 23, 2026
Original Source:	Please Login to View Page
Contact information:	Please Login to View Page
Bid Documents:	Please Login to View Page

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Finance | Procurement Division

8800 Courthouse Road | Spotsylvania, VA 22553

Phone: 540-507-7599

County of Spotsylvania

Request for Proposal (RFP) No. 26-24-SD

Medical, Dental, Vision, Prescription Insurance and EAP Benefits Coverage

January 22, 2026

SOLICITATION CLOSING

Due Date & Time:

February 23, 2026, 2:00 PM

RFP DATA

Questions Deadline: February 6, 2026, 12:00 PM

Procurement Contact: Toni Vaughan, Director of Procurement – TVaughan@Spotsylvania.va.us

Sylvia Dyson, Sr. Procurement Officer – SDyson@Spotsylvania.va.us

All inquiries for information should be directed to the Procurement contacts listed above.

Table of Contents

I. Purpose................................................................................................................................3

II. General Information ..........................................................................................................3

III. Statement of Needs.............................................................................................................4

IV. Offeror’s Instructions ........................................................................................................7

V. Proposal Requirements .....................................................................................................9

VI. Proposal Evaluation Criteria .........................................................................................11

VII. Timeline ............................................................................................................................13

ATTACHMENTS

A – RFP General Terms and Conditions

B – Special RFP Terms and Conditions

C – Contract

D – Offeror Information

E – References

F – Trade Secrets/Proprietary Information Identification

G – Performance Questionnaire

Additional Information Available Upon Written Request

The following documents are available to Offerors upon written request to the Procurement

Officer(s) and will be provided in accordance with the RFP requirements and applicable

confidentiality provisions:

• Current Medical, Dental, and Vision Contract

• Census File

• Utilization Data (incl. Retiree Data pre and post 65)

• Current Premium Contribution Rates

• Benefits Guide

RFP No. 26-24-SD | Page 2 of 13

Purpose

The purpose of this Request for Proposals (herein, “RFP”) is to solicit proposals from highly

qualified sources to establish contract(s) for Medical, Dental, Vision, Prescription Insurance

programs and EAP Services, for all full-time eligible employees, their spouses and dependents,

and retirees in accordance with the enclosed specifications. The current benefits are bundled

through The Anthem Self-Funded. The Spotsylvania County (herein, “County”) are interested in

receiving both bundled and unbundled proposals for the services mentioned prior. Proposals can

be bundled or unbundled. Individual service proposals will also be accepted.

The County is seeking proposals to be rated in different capacities.

a. Proposals including post-65 retirees, and

b. Proposals excluding post-65 retirees.

c. Carriers shall base their proposal on the anticipation of moving to a calendar year basis by the

client. Client is interested in program(s) start dates of October 1, 2026 with calendar year

effective date January 1, 2027.

d. Stop-loss contract currently runs from October 1st through September 30th with accumulators

running on a calendar year. Please prepare a proposal that allows for both stop-loss and

accumulators to be run on a calendar year together. Please provide coverage for stop-loss

starting October 1, 2026. The intent of the RFP is to either have a 15 month contract that runs

from October 1, 2026 through December 31, 2027 then move to the plan to a calendar year;

Or to have a 4th quarter carry over option effective January 1, 2027.

e. For this Proposal, Attachments D, E, F and G are required to be completed and returned with

the RFP Submission. Failure to do so may result in Proposals being rejected.

II. General Information

A. Objectives

1. The primary objective of the Medical, Dental, Vision, and EAP services is to provide

access to the following services to benefit eligible employees and their household

dependents:

a. Provides eligible employees and dependents with quality and affordable plans.

b. Ensure the Medical, Dental, Vision, Prescription and EAP services offer the most

competitive arrangement as measured by benefits, provider discounts, administrative

costs, customer service, and processing accuracy.

c. Maintain flexibility of plan design structure.

d. Maintain current model with reinsurance and pharmacy carved out of medical.

e. Maintain flexible preferred providers.

f. Evaluate self-insured & fully insured proposals. Interested in receiving all options

available.

g. Evaluate High-Deductible Plan and HSA options.

h. Seeking opportunities for carrier investment into a wellness fund to help establish

and support ongoing health management and improve outcomes.

i. Evaluate specialty capabilities (disease management, population health management,

RFP No. 26-24-SD | Page 3 of 13

and wellness programs to ensure “Best in Class” programs are offered).

j. Provide ease of administration for the County.

k. Process eligibility records accurately, efficiently, and timely, and provide accurate

billing on a timely basis.

l. Provide simplified communication resources.

m. Provide timely, responsive customer service to the plan members and to the County.

n. Integrate and coordinate efficiently, timely, and accurately with other related plans

and service providers (i.e., reinsurance carrier, prescription drug plan, wellness,

travel network, Insight Imaging Services, etc.)

o. Provide fees associated with the transfer of medical and pharmacy claims data to

another vendor.

p. Have meaningful financial and service performance guarantees.

q. Maintain a dedicated account management team with highly skilled, qualified, and

experienced personnel.

r. Motivate employees and dependents to make and maintain healthy lifestyle choices

and efficacious, cost-effective healthcare decisions.

2. Products to be offered:

a. Medical Insurance

i. With Stop-Loss Coverage, medical proposals without stop-loss coverage

will not be considered.

b. Dental Insurance

c. Vision Insurance

d. Prescription Insurance

e. EAP Services

3. The County will offer all benefits through payroll deduction.

4. Medical must coordinate with pharmacy and wellness benefits.

B. Background

1. The County currently offers all insurance options through Anthem for Medical, Dental,

Vision and EAP coverage. Plans offered must be compliant with all local, state, and

federal regulations. In addition to meeting all ACA requirements.

a. Approximately 1431 employees are eligible for all health benefit plans.

b. Approximately 1264 Employees are enrolled.

2. The reason out to market is due to the continual increase in pharmacy and medical costs,

and the desire for an outcome-based wellness.

3. All benefits will be effective 10/1/2026.

III. Statement of Needs

The purpose and intent of this RFP is to solicit proposals from qualified sources to establish a

RFP No. 26-24-SD | Page 4 of 13

contract for Medical, Dental, Vision, Prescription Insurance and EAP Benefits for Spotsylvania

County through competitive negotiation. The County is interested in a financially aggressive

option to replace the current benefits being offered. Cost proposals are requested to be quoted net

of commissions. Any Offeror responding to this RFP shall be an insurance carrier or third party

administrator. Proposals will not be accepted from brokers or consultants representing insurance

carriers and/or third party administrators.

A. MEDICAL Proposed Plan Design Specifications

1. The Offeror is requested to submit a proposal for only the following products:

a. All carriers/vendors are to provide either fully insured or self-insured medical

proposals. If self-insured proposals are submitted, please include options with and

without pharmacy and reinsurance carved out.

b. See attached plan design descriptions for full details on current medical and

wellness plans.

i. Current Benefit Offerings include:

1. Three (3) Medical Plans

a. KeyCare 20

b. Keycare 30

c. Anthem High Deductible Health Plan

2. One (1) Dental Plan

a. Dental PPO

3. One (1) Vision Plan

a. Anthem Blue View

c. Please submit proposals for a fully insured and/or self-insured basis for Medical.

i. Option 1: $400k

ii. Option 2: $450k

iii. Option 3: $500k

iv. Option 4: $550k

d. Please submit financial costs that include:

i. Post-65 Retirees

ii. Exclude Post 65-Retirees

e. County is to have flexibility in the desired plan design structure. With a preference

for any benefits being proposed to match the plan structure of current benefits.

f. Details as to how to manage costs, encourage smart and effective utilization,

improve healthy choices, and provide value to Spotsylvania County and its

employees.

g. Provide details of wellness resources, including educational support, employee and

employer communications, engagement/activity-based programs, and outcome-

based programs. Pricing is to be based on estimated utilization, not all eligible

employees, on a per- member per-month basis.

h. Plans must meet all Affordable Care Act and State Mandate requirements.

i. Three-year contract desired – Carrier can receive additional points in the evaluation

if willing to offer future cost guarantees.

j. Accumulators are currently being administered on a calendar year basis. Please offer

RFP No. 26-24-SD | Page 5 of 13

This page summarizes the opportunity, including an overview and a preview of the attached documents.

RFP 26-24-SD Medical, Dental, Vision, Prescription, and EAP

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