Keenan & Associates
City of La Quinta
March 23, 2021
Karyn Goodsite
Assistant Vice President
4204 Riverwalk Pkwy Suite 400
Riverside, CA 92505
951.255.1272
kgoodsite@keenan.com
Employee Benefits Broker/Consultant Services
0
City of La Quinta Response to Request For Proposal
March 23, 2021 Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
TABLE OF CONTENTS
1. COVER LETTER .......................................................................................................... 1
FIRMS BACKGROUND, QUALIFICATIONS, AND EXPERIENCE: ....................................... 3
2. REFERENCES OF CALIFORNIA GOVERNMENT AGENCIES ....................................... 19
3. COST OUTLINE ......................................................................................................... 20
4. LIST OF COMPLEMENTARY SERVICES ..................................................................... 22
5. STAFFING AND PROJECT ORGANIZATION ............................................................... 23
6. SUBCONTRACTING SERVICES ................................................................................... 28
7. DISCLOSURES ............................................................................................................ 29
8. EXPLANATION OF METHODOLOGY .......................................................................... 30
9. ACKNOWLEDGMENT OF INSURANCE REQUIREMENTS ............................................ 42
10. NON-COLLUSION AFFIDAVIT ................................................................................... 44
11. ACKNOWLEDGEMENT OF ADDENDA ........................................................................ 46
APPENDICES ...................................................................................................................... 48
APPENDIX 1 – SAMPLE ANNUAL REPORT .................................................................. 49
APPENDIX 2 – SAMPLE BENEFITS ENROLLMENT GUIDE (5 PAGES)............................ 96
1
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
1. COVER LETTER
March 23, 2021
City of La Quinta
Attn: Human Resources Division
78495 Calle Tampico
La Quinta, California 92253
Re: RFP – Employee Benefits Broker/Consultant Services
Dear Selection Committee:
Keenan is pleased to present our proposal to Employee Benefits Broker/Consultant
Services to the City of La Quinta. Keenan has specialized in the needs of California
public agencies and schools since our inception in 1972.
Our philosophy is based on a consultative approach. Rather than just placing your
coverage with carriers and vendors, our goal is to establish a partnership where we can
serve as an extension of your human resources division. In this role, we regularly
reevaluate your existing programs to identify alternative options that can provide
greater value to both the City and your employee benefits program participants.
Ultimately, Keenan's role in this partnership is to alleviate as much workload from your
team so that your human resources staff can focus on your primary organizational and
mission-critical goals. This effort includes identifying efficiencies that can be obtained
in your benefits program for both administration, as well as ease of use for your
employees. As such, we serve as proactive advocates, identifying where potential
problems may arise so that they can be addressed before they impact your budget or
program.
Furthermore, our consulting services are designed to understand the entire life cycle of
the public sector employee, from their initial hire through post-employment benefit
needs. With Keenan, you will not only receive the best products, the greatest selection
of options, and the most dedicated customer service the industry can provide, but you
will gain a partner who truly cares about you and the needs of your employees.
Thank you for the opportunity to submit a proposal for your consideration, including
pricing for the targeted scope of services included in the RFP.
As the Municipalities Practice Leader of Keenan & Associates, I am fully authorized
to bind Keenan & Associates to the following proposal.
2
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
We look forward to this opportunity to serve you and the employees of the City of La
Quinta. Should you have any questions regarding this proposal, please do not hesitate
to contact Karyn Goodsite at 951.255.1272 or via e-mail at kgoodsite@keenan.com.
Sincerely,
Laurie LoFranco
Senior Vice President, Municipalities Practice Leader
3
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
FIRMS BACKGROUND, QUALIFICATIONS, AND EXPERIENCE:
(a) Number of years in business
Keenan was established 49 ago in 1972.
(b) Taxpayer identification number
Keenan's Federal Tax ID Number is 95-2798626.
(c) Firm ownership and, if incorporated, list the state in which the firm is included and
the date of incorporation
Keenan was founded and incorporated in California on December 2, 1972. Keenan is
privately-held and became part of the AssuredPartners family of companies in March
of 2017. AssuredPartners was founded in 2011 and is headquartered and incorporated
in Florida.
(d) If the firm is a subsidiary of a parent company, identify the parent company
AssuredPartners is Keenan's parent company.
(e) Resumes of the Project Manager and key personnel who will be responsible for
performance if any agreement results from this RFP
The following key personnel will support the City of La Quinta's benefits programs:
Day-to-Day Service Team
• Karyn Goodsite - Account Executive
• Yvette Fields - Senior Account Manager
• Laurie LoFranco - Practice Leader, Municipality Benefits
Extended Support Team (As-Needed)
• Jovita Juanillo - Senior Vice President, Underwriting & Actuarial
• Christine Hough - Vice President, Underwriting & Actuarial
• Ralph Gowen - Vice President, Client Technology
• Robin Rager - Director of Health Management
• Amy B. Donovan - Vice President, Legislative & Regulatory Affairs
Bios for these Key Personnel are included in Section 5 of this proposal.
(f) Applicable certifications and licenses
All personnel assigned to support the City of La Quinta have the appropriate insurance
licenses. Keenan's California Department of Insurance license number is 0451271.
4
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
(g) Discuss your firm's resources and activities as they relate to knowledge and
understanding of municipalities
Keenan is unique in that it was founded and remains dedicated to serving California
public agencies' unique needs. Furthermore, our consulting services are designed to
understand the complete life cycle of the public sector employee, from their initial hire
through post-employment benefit needs. With Keenan, you will not only receive the
best products, the greatest selection of options, and the most dedicated customer service
the industry can provide, but you will gain a partner who truly cares about you and the
needs of your employees. Keenan currently provides brokerage and consulting services
to more than 1,100 California public agencies and schools, including more than 150
municipalities.
(h) Describe your firm's resources and services provided. Include both the services
outlined in this request, as well as additional services that you would like to
recommend and/or provide
Keenan's mission is to protect our clients' financial assets by constantly anticipating
change and redirecting solutions to ensure that their benefits programs provide their
employees, retirees, and their families with high-value benefits, within a sustainable
philosophy.
• Value and Position in the Marketplace – Keenan is one of the largest regional
consultants/brokers, and our parent company, AssuredPartners, is one of the
largest nationally. As part of the AssuredPartners family of companies, we have
a significant block of business with virtually all carriers and the single largest
block of public agency business in California. Our market share affords us
significant leverage with these carriers.
5
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Benefits Underwriting and Actuarial Services Department – Our Benefits
Underwriting and Actuarial team is highly experienced in the use of carrier and
administrator data for the purpose of analyzing utilization and determining
actionable targets for improvement of utilization metrics. We review the
existing reporting identify gaps that are not being provided and make
recommendations for obtaining any additional data needed to produce a
complete picture of our client's experience.
• Proactive Advocates – We are proactive advocates for our clients, working on
behalf of you and your employees, as well as their dependents, on all topics and
issues. As a resource for the City of La Quinta, we are an extension of your
benefits department, providing both expert guidance and valuable support to all
parties. With our market leverage, combined with our internal subject matter
experts' expertise, we are uniquely positioned to intervene efficiently and
effectively for the City of La Quinta on all benefits issues.
• Legislative and Regulatory Updates & Review Summary Plan and
Evidence of Coverage Documents – Keenan's legal department provides our
clients with comprehensive communications and training on legislative and
regulatory issues that impact their benefit plans and participants. We regularly
issue written briefings to all our clients, and provide an annual summary of key
compliance considerations in advance of renewal. Additionally, our
professional contract specialist and service team are ready to assist the City of
La Quinta in reviewing the insurance provisions in your SPDs and EOCs. We
review to make sure that the provisions you applied and contracted for are
correctly included and that compliance disclosures have been incorporated in
the documents.
• Open Enrollment and Communications
Support – Keenan's Service Team is highly
experienced in assisting with the full range of open
enrollment and employee communications
capabilities. From coordination of open enrollment
events, design of materials, and implementation of
online systems for enrollment and
communications, Keenan will deliver
comprehensive enrollment support customized to
the City of La Quinta's needs. Additionally, we
will review and recommend enhancements for
employee and retiree communications for both the
types of communications and the methodology for
communicating with the different employee
groups.
6
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Provide Comprehensive Wellness Program Consulting – Keenan has a team
of subject matter experts that specifically focus on analyzing, crafting, and
implementing wellness programs for California public agency clients. Our
educated professionals will provide the City of La Quinta with valuable analysis
and recommendations regarding your wellness program. Keenan's Wellness
Program Specialists have practical knowledge and experiences in advocating
for clients and will work in the City of La Quinta's best interest in dealing with
health plans and health management service vendors. The specialist provides
data monitoring and analytic expertise.
• Administrative Tools and Resources – Keenan has an impressive number of
specifically designed resources to support California municipalities for
administrative support, including proprietary Keenan-owned technologies. Our
suite of services includes BenefitBridge, Health Care Reform consulting and
services, COBRA Administration, Enrollment and Communications support,
and Section 125 support.
While many firms have some public sector clients, Keenan's clients are California
public agencies. Our entire history has been dedicated to developing innovative
solutions that address the benefit issues for public agencies. Furthermore, our
consulting services are designed around an understanding of the full life-cycle of the
public sector employee, from their initial hire through post-employment benefit needs.
Additionally, as a privately-held firm, we are able to focus on the long-term needs of
our clients. Our competitors, as publicly-traded firms, have to be concerned with Wall
Street or venture capital ownership that forces them into short-term planning. Keenan's
focus is on being part of your community; being main street and providing the solutions
that our clients need for long-term strategic goals.
If one of our clients simply views us as a vendor, we have failed to realize our mission
and core philosophies. Our clients should recognize us as a proactive partner and an
extension of their own human resources and benefits personnel.
With our focus on providing solutions to California public entities, we have developed
a unique perspective of how intertwined our interests are. All our associates are
ultimately consumers of our public sector clients' services. Just as significantly, we are
all directly impacted by our clients' budget concerns as consumers and community
members. Therefore, we approach every project and every client-need with the explicit
knowledge that we are obligated to
provide a high-value solution for these agencies, mindful of budgetary concerns.
7
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
UNIQUE PROGRAMS DESIGNED FOR OUR CLIENTS
As a proven leader in California public sector consulting, Keenan's database of public
employers is unmatched in California. We have developed several proprietary
programs designed to meet the unique needs of the public sector. While not all of our
innovative solutions fit every client's specific requirements, we work closely to identify
the appropriate services to ensure the best quality of service at a competitive price.
Our unique and proprietary services include:
• BenefitBridge – A more robust, proprietary Web-based technology solution for
employee benefits administration, eligibility, enrollment, billing, reporting, and
employee communications.
• Individual and Family Plan – A solution that greatly assists Part Time
employees as well as employees with dependents over age 26 is Keenan's
Individual and Family Plan Division. Using KeenanDirect.com and/or our
licensed, certified customer service staff, individuals can check their subsidy
eligibility and sign up for insurance with any carrier in or out of Covered
California.
• KeenanWell – A comprehensive health management program incorporating
wellness and disease management, including online tracking, personal health
strategies and coaches, and engaging site-based programs, if desired.
• Keenan Pharmacy Purchasing Coalition (KPPC) – An innovative pharmacy
program that delivers cost savings and the most advanced prescription
management capabilities. In just four years, KPPC has grown to more than
275,000 members and has saved over $55 million for participating plans.
(i). Describe your firm's resources or methods to provide education on best practices,
trends, or hot topics
Keenan's Legal Department maintains dedicated personnel who regularly track both
pending and newly enacted legislation to provide updates to our clients promptly. These
are issued to clients through briefings, blog posts, webinars, and regular service team
meetings with the City.
EDUCATION OF KEENAN SERVICE TEAM
Ongoing education and information dissemination to Keenan Sales and Service Teams
is provided through:
• Monthly Sales/Service Team Meetings – Each month, all Keenan
Municipality Sales and Service teams in the state meet to discuss specific
8
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
activities occurring at each client. This forum allows each group to share how
client issues were addressed, solutions that were implemented, and what
methods have proven to be best practices. By facilitating monthly dialogue
internally at Keenan, we avoid "reinventing the wheel" regularly. But similarly,
this facilitates a collaborative approach across all teams for solutions that can
positively impact all clients.
• Annual Service Team Meetings – Annually, all Keenan Service teams in the
state meet to discuss major benefits issues, new products that are being rolled
out to improve client programs and savings, and major changes tracked in the
industry, and other related items. Similar to the monthly meetings, these allow
for collaborative solutions to be developed for our clients.
• Internal Webinars and Seminars – Outside of monthly and annual meetings,
all Keenan Service team members participate in internal webinars and training
on various topics, as they become relevant. For example, suppose major
changes to voluntary benefits programs are being impacted by new legislation.
In that case, Keenan subject matter experts provide an internal webinar on the
subject to educate our employees on what information needs to be
communicated to clients, and what resources (i.e., written information) can be
provided to help our clients understand the issue being addressed.
DISSEMINATION OF CRITICAL/RELEVANT INFORMATION TO CLIENTS
Information is disseminated to our clients in a number of ways. Your assigned Service
Team will communicate relevant information to you. This communication includes:
• Webinars – Keenan conducts webinars and
training throughout each year for our clients
on major benefits program issues. Keenan
Service Team members will make you
aware of upcoming webinars, as well as
previously recorded webinars, that may be
of importance to you and your overall
benefits program.
• Client Briefings – Client Briefings are
issued multiple times throughout the year,
whenever legislative or regulatory
information needs to be communicated.
Your Service Team will forward these
briefings to you, and be available to discuss
the issues covered with you.
9
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Keenan Blog – Keenan maintains a blog that includes weekly posts on a variety
of insurance-related topics. Anyone can subscribe to the blog; however, your
Service Team will also alert you of blog posts that may be specifically relevant
to you.
• Keenan Benefits Survey – For more than
40 years, we have been conducting benefit
surveys for California public agencies.
Having the largest single block of California
public agency clients has afforded us a
significant amount of data with which we
have been able to analyze that data to
identify trends, major cost drivers and areas
for potential savings through plan design
and program structure. Annually, we publish
the results of our benefits survey and present
these findings to our clients. Over the years,
many agencies have found this report to be
a valuable reference tool in reviewing their
benefits programs and exploring program
alternatives.
• Keenan's Website and Other Internet Resources – All of the resources
mentioned above are also archived and easily accessible on Keenan's website.
Additionally, Keenan posts articles and presentations from other resources on
our Facebook, LinkedIn, and Twitter feeds.
(j) Describe your firm's legal research capabilities and how you communicate legislative
updates to your clients
All of Keenan's service team personnel are trained on current
legislative issues and potential changes to legislation and
regulations, including those listed above. As critical
legislation is enacted, Keenan will provide the City of La
Quinta with comprehensive resources to ensure you receive
the information needed to keep abreast of the changes in
state and federal laws, statutes, and regulations. Our
services include access to webinars, trainings and manuals,
based on the type of issues being covered.
Keenan's Legal/Compliance Department maintains
dedicated personnel who regularly track both pending and
newly enacted legislation in order to provide updates to our
clients in a timely manner. Communication of legislative
issues is provided by Briefings, webinars and onsite
10
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
meetings. Our website features a section specifically devoted to California public
agencies. Webinars can be viewed and downloaded at:
http://www.keenan.com/resources/webinars/
Additionally, Keenan is a member of the Council of Insurance Agents and Brokers
(CIAB) Legal Counsel Working Group and is represented by Amy Donovan at the
CIAB's meetings in Washington D.C. where she meets regularly with federal
lawmakers, lobbyists and thought leaders to discuss national trends in health and
liability insurance issues.
Keenan regularly distributes Compliance Advisories designed to inform clients of news
and legislation that may impact them. During the past three years, Keenan has
conducted many client seminars and educational programs, provided at no cost to our
clients. Topics include:
• Health Benefit Webinars and Trainings: Keenan conducts webinars and
trainings throughout each year for our clients that cover topics including: health
care reform; HIPAA; FMLA; CFRA, COBRA; and, pending legislation.
• GASB Retiree Health Liability Lunch & Learns: An introduction to the
requirements for accounting for and reporting future benefit liabilities and
strategic solutions for funding and investment (conducted in numerous local
community groupings throughout the state).
• Collaboration with our Benefit Underwriting & Actuarial Department:
Our legislative team works with our actuaries and underwriters to assess the
cost impact of legislative changes to retiree benefit programs to proactively
inform clients of potential increases in future costs.
• Affordable Care Act Lunch & Learns: Keenan presents training and legal
updates throughout California on the latest regulatory changes and legislation
under the Affordable Care Act. Information is presented in layman 's terms with
concrete examples of how to make legal changes applicable to each agency's
needs.
• Conference Speakers: Keenan is a frequent conference speaker on various
topics related to benefits, legal issues and financial related savings products.
Our Health Care Reform Consulting Services provide our customers direction and
strategic planning to prepare for and implement the Affordable Care Act (ACA).
Recognizing the significant impact Health Care Reform (HCR) would have on our
clients, Keenan committed resources early on to providing consulting and education
services around HCR for our clients. Starting in 2010 when the ACA was signed into
law, we began conducting extensive and continuing internal training dedicated to the
11
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
ACA to prepare our field teams to work with our customers. We have a full-time
attorney and research team specializing in employee and retiree benefits and the
provisions of the ACA. As regulations are released, we developed numerous consulting
tools used to educate clients and analyze the benefit plan and workforce characteristics
that will affect critical decisions. These capabilities combine to give our clients
approaches and solutions that individually fit their objectives and philosophy.
We developed an online resource (www.keenan.com/hcr) available to all our public
agency clients and the public as a whole to educate and disseminate information about
the ACA. Each week the Web site is updated with the latest developments about HCR.
We have hosted more than a dozen HCR webinars for our clients and prospects to keep
them informed of the major provisions and action items. These informative
presentations are available for on-demand viewing from our Web site at:
http://www.keenan.com/resources/webinars
Furthermore, Keenan has assembled a multidisciplinary task force from every involved
area of our organization to address the economic, legal, regulatory, technical, and
employee relations aspects of the ACA and coordinate communications internally and
externally. Finally, Keenan has contracted with best-of-breed specialty vendors to
provide the necessary supplemental ACA resources to comprehensively address data
gathering, decision making and recordkeeping for employers while delivering a cost-
effective solution.
Keenan can also provide additional solutions related to ACA compliance.
Both HIPAA and COBRA compliance (as well as education on other relevant
compliance needs) are supported by Keenan's legal and service teams.
Other examples of our approach in this area, which have been provided to our clients
as the legislation was enacted, are:
• COBRA administration manual specifically designed for public entities
• HIPAA overview and compliance services
• The ongoing monitoring of Section 125 regulations and how they affect
members plans
• Development of retiree liability regulations and compliance with Governmental
Accounting Standards Board (GASB) requirements
• AB88 – Mental Health Parity
• Medicare Modernization Act
Keenan, however, is not a law firm and therefore does not give legal advice to our
clients. We always recommend that our clients consult their own legal counsel to ensure
compliance with all federal and state regulations.
12
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Keenan provides an array of educational, training, communication and support services
to our clients. Our structure is built so that our staff is exposed to ongoing, consistent
statewide training to bring the most up-to-date information to the City of La Quinta
staff and management.
(k) Describe your renewal process and timeliness
Keenan's renewal and negotiation timeline is customized based on the specific
characteristics of each client. In general, we follow the following steps:
• Comprehensive look at current plan experience and utilization trends, using
appropriate benchmarking tools to identify potential areas of change and
targeted utilization management.
• Preliminary renewal (where available) in advance so our Benefits Underwriting
and Actuarial Department can analyze and determine the appropriateness of the
rate position, reserves and other expense factors in the preliminary renewal.
• Conducting underwriting analyses to drill down on the plan design and key cost
drivers.
• Evaluate alternatives in the market: Keenan utilizes BenefitPoint, an automated
platform for conducting the RFP process and communicating with the carriers
and health plans to facilitate timely and accurate quotes and benefit options.
• Final negotiations are completed and presented to you far enough in advance
for retiree communication, payroll and billing requirements to be completed.
(l) Resources your firm offers to assist with the administration of a benefits program
(i.e., online benefits enrollment and management, COBRA administration, and
flexible spending account administration)
Keenan has a proprietary online benefits administration, eligibility, and enrollment
system called BenefitBridge. As with any of our solutions, we do not approach this as
a one-size-fits-all product. We evaluate our clients' needs and the capabilities of both
our system as well as other systems provided by vendors in the marketplace and
ultimately make a recommendation to our clients on what we believe would meet the
specific needs.
Following are some details on our BenefitBridge platform.
The BenefitBridge employee benefits portal
provides administrative automation and on-
demand information for our clients' employee
benefits needs in a Web-based, total technology solution. Through a single online
13
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
portal, BenefitBridge integrates benefits enrollment, eligibility, participant
communications, and employee self-service tools to maximize benefit plans and
resources' effectiveness. The BenefitBridge platform has the ability to
automatically send eligibility data to CalPERS, unlike other systems in the
marketplace.
Saves Time. Saves Money.
Your benefits department has too much work for too few employees. BenefitBridge
saves your HR department from making entries in multiple systems and faxing or e-
mailing eligibility information to a variety of carriers. The BenefitBridge single-point-
of-entry system enables you to enter the information once and transmit it to multiple
carriers – reducing the amount of time spent entering data and reducing the possibility
of data errors.
Adds Value to Your Benefits Program
With BenefitBridge, employees have access to their benefits information 24/7 from any
computer with internet access. The system provides tools to educate users about the
benefits and perform a side by side comparison of benefit plans enabling them to make
informed choices. BenefitBridge also provides access to a health and wellness library,
which includes information regarding life events ranging from new babies to new
houses.
Since BenefitBridge is a Web-based system there is no technology investment required
for implementation. If the City is interested in BenefitBridge we are happy to
provide a demonstration of the system as well as discuss program costs.
Following are the key features and functionality of BenefitBridge as it relates to both
Employee self-serve features as well as Employer features.
Employee Features Include
• Online enrollment in benefit plans for new
hires, open enrollment and life events
• Identifying which plans they are currently
enrolled in and which of their dependents are
covered in those plans
• Viewing and comparing plan designs within
a plan year and between plan years
• Use of an online encyclopedia covering a
wealth of health and wellness topics
14
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Reviewing guidelines for handling life events and their impacts on an
employee's benefits
• The ability to download any form or document pertaining to their benefits, to
perform cost comparisons between plans, to print a copy of their selected
benefits.
The many self-service features of BenefitBridge will help to free-up your benefits
administration staff to handle other functions as employees shift to self-service for
selected benefit changes.
Employer Features Include
Using the integrated online interface, the Human Resources Administrator will be able
to:
• Manage employee demographic and
employment information
• Manage employee's dependent information
• Make enrollment changes including adds,
waivers, terminations and changes –
terminations with PERS is not handled in the
system.
• Provide a system of record for all eligibility
data regardless of carrier, greatly simplifying
customer service
• Review employee entered enrollment records
• Automatic transmittal of all eligibility data with the
exception of retroactive enrollment changes
• Automatic creation of Carrier Billing Reports, greatly simplifying carrier
billing reconciliation and enabling self-billing for plans in some situations (e.g.,
volume based bills for voluntary life insurance).
• Manage overage dependents
• Identify personnel requiring Cobra notification
• Produce benefits summaries for employees which include the employer
contribution towards the employee's benefits
15
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Provide a large number of management reports for ad hoc data analysis
including census, enrollment, payroll, dependent, and retiree data.
AVAILABLE REPORTING FROM BENEFITBRIDGE
Workflow Reports
• Dependent Age Changes
• Benefit Terminations
• Age-Rated Premium Changes
• Retiree Age Changes
• COBRA Qualifying Events
• COBRA Scheduled
Termination
• Benefit Additions
• Benefit Summary Batch Report
• Retiree Scheduled Termination
Status Reports
• Employees with Coverage
• Census - Carrier Based
• Over-Age Dependents
• Enrolled Subscriber by Plan
• Open Enrollment
• Employees without Coverage
• Census – Status Based
• Carrier Enrollment Census
• Summary Count
• New Hires
Billing Reports
• Carrier Billing
• Payroll Deductions by Carrier
• Payroll Deductions by Employee Classification
• Payroll Deductions Discrepancy Report
(m) Describe your firm's capabilities concerning communication. Include ongoing
employee communication/open enrollment and web-based communications.
Public agency workforces are diverse and include personalities that differ in how they
wish to seek out and absorb benefits information. Comprised of Millennials, Generation
X, Baby Boomers, etc, these employees all have different preferences as to how they
want to receive information. Additionally, these diverse groups have different desires
16
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
when it comes to how much information they want on their program options. Some
want to know what time it is (i.e., just the bottom line), while others want to know how
the clock works (i.e., they want to know every detail of a specific benefit).
The general overview of our strategy in developing a communication/engagement
strategy begins with the evaluation of your current communication activities:
• Identify Client Needs - Working with the City of La Quinta, Keenan would
identify items such as:
− Most frequently asked questions of your human resources staff by
employees
− Utilization of specific benefits; under-utilization of any specific benefits
− Benefits personnel self-identified needs
• Evaluation of Current Communication Resources - Such as benefits
enrollment platforms, webinar usage, e-mail communication tools, etc. as well
as other relevant components of the in-place communication strategy.
• Clarity and Comprehensiveness of Current Printed Materials and/or
Electronic Documents - An evaluation of items such as open enrollment
guides, benefits fair communications, post card reminders, etc.
In order to implement an efficient communications strategy, Keenan uses the
information gathered in the evaluation phase combined with the knowledge of the types
of learners as identified at the beginning of this answer. Keenan looks to a multi-
medium approach to ensure that each eligible employee can obtain the information they
need in order to make a decision. These mediums can include:
• Traditional printed material, mailed or delivered to the employee
• Mobile-friendly documents that can be easily reviewed from smart phones or
tablets
• Web-based flyers, briefings, and other informative materials regarding benefits
programs and issues
• Videos and webinars that explain benefits and/or enrollment processes
These are just some of the examples of the innovative approach that Keenan has
included in a communication strategy. Ultimately Keenan discusses recommended
strategies with our clients, in order to provide the most cost-efficient and effective
strategy.
Examples
While each client requires a different approach, following are some components that
have been implemented.
17
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
A client with multiple locations was looking to increase participation in Keenan's
CompleteCare program. CompleteCare encourages employees to enroll in an
alternative group medical plan through their spouse with the opportunity to get up to
100% of their out-of-pocket expenses, copays, and deductibles reimbursed. By
transferring medical plan costs to the spouse's employer, premium savings are
immediately realized and risk is reduced for the employer. It also gives employees
another cost-effective benefit option with more coverage to choose from.
In the first year the program was offered, organic enrollment, with no enhanced
communications strategy, was approximately 2%. Since there was a significant
potential benefit to both the client and to the employees opting into the program,
Keenan was tasked with implementing a comprehensive communications strategy to
educate eligible employees on this benefit, and increase the participation.
Keenan implemented a multi-medium approach that included:
• Onsite presentations at multiple locations.
• E-mail communication campaign through a resource called Airbo, which sends
short-form communication tiles (50-150 or so words and graphics). This
communication strategy allowed the recipient to interact with "tiles" to request
additional information and tracked open rates that allowed for re-targeting of
potentially interested parties.
• Recorded webinars, similar to onsite presentations that could be hosted on the
client's intranet and used for onboarding of new employees.
The communication strategy resulted in a 50% increase in the number of employees
opting into the program. In dollar terms, the client had realized a savings of $1.03
million in premium in year-one of the program, and in year-two of the program the
savings was $1.56 million, attributed to the increase in opting into the benefit.
Compared to clients with similar demographics that did not run a communication
strategy, but rather relied on basic open enrollment communications, enrollment has
stayed consistent year-over-year.
This communication strategy can be used with any program (wellness, health fairs,
open enrollment) that requires employee communications.
(n) Describe your firm's transition plan indicating how you will assume the current
vendor's services in a smooth and orderly manner.
A custom transition plan would be presented to the City during the contract signing
phase. Keenan has extensive experience facilitating transitions from other brokers,
without impacting our clients. Following are the initial transition meetings and
activities from a client requiring the immediate marketing of their plans.
18
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Date Details Responsible Party
START Kick off meeting / Analysis phase begins. Keenan/ City
Week 1
Request data on benefit plans Keenan
Weekly Status Call Keenan/ City
Contact Current Vendor’s to begin discussions for
transition from City Keenan
Evaluate employee demographics & needs Keenan
Assemble requested data City
Week 2 Weekly Status Call Keenan/ City
Review of all plan benefit components Keenan
Week 3
Weekly Status Call Keenan/ City
Develop proposed plan designs Keenan
Discuss communication strategy & branding Keenan
Monthly Meeting – Discuss benefits consortium Keenan/ City
Week 4 Refine Plan Design for RFPs & Renewals Keenan/ City
Assessment of proposed plan design City
Week 5 Issue RFPs & Renewal Requests Keenan
Weekly Status Call Keenan/ City
(o) Submit a sample of annual and periodic reports you provide similar clients.
Keenan has included a sample annual report in Appendix 1.
19
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
2. REFERENCES OF CALIFORNIA GOVERNMENT AGENCIES
Please only include California government agencies your firm has provided similar
services to within the past three (3) years. (a) Client name, client project manager,
telephone number, and e-mail address (b) Services provided (c) Start date, and end date
(d) Staff assigned to each project by the firm (e) Number of years firm has provided
employee benefits broker/consultant services to municipalities (f) Include the number of
employees for each agency.
Following are client references for the City’s review:
Client Name: Coachella Valley Water District
Point of Contact: Bill Walters, Human Resources Administrator
Phone: 760.398.2651
E-Mail: bwalters@cvwd.org
Services Provided: Employee Benefits Consultant/Broker
Length of Service: January 1, 2015 to Present
Number of Employees: 547 employees
Client Name: City of Indian Wells
Point of Contact: Peter Castro, Deputy City Manager
Kevin McCarthy, Finance Director
Phone: 760.346.2489
E-Mail: pcastro@cityofindianwells.org
kmccarthy@cityofindianwells.org
Services Provided: Employee Benefits Consultant/Broker
Length of Service: January 1, 2021 to Present
Number of Employees: 31 employees
Client Name: City of Desert Hot Springs
Point of Contact: Pamela Meuse, Human Resources Manager
Phone: 760.329.6411, ext. 401
E-Mail: pmeuse@cidyofdhs.org
Services Provided: Employee Benefits Consultant / Broker
Length of Service: July 1, 2015 to Present
Number of Employees: 86 Employees
20
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
3. COST OUTLINE
Proposal shall include a detailed fee schedule for the services requested by this RFP.
As compensation for its provision of the Benefits Services, Keenan shall receive
commissions from insurance carriers and/or other vendors for the placement of
insurance coverage. The City of La Quinta shall have no responsibility for the payment
of any such commission to Keenan.
If elected to install, Keenan's BenefitBridge Administration System is optional at the
cost of $20,000 per year. BenefitBridge has a one-time implementation fee of $7,500.
Describe your method of compensation for your services.
As compensation for its provision of the Benefits Services, Keenan shall receive
commissions from insurance carriers and/or other vendors to place insurance coverage.
The City of La Quinta shall have no responsibility for the payment of any such
commission to Keenan.
Does your company accept any carrier "overrides"?
It is a long-standing practice in the insurance industry for insurers to establish
additional compensation programs for brokers based on factors that are not specific to
a particular client or placement of coverage. These arrangements are typically referred
to as overrides, contingencies or indirect compensation (collectively, "Other
Compensation"). Keenan may from time to time enter into arrangements for Other
Compensation based upon: (i) technology investment and services provided by
Keenan, (ii) assistance with developing, marketing and/or distributing products offered
by insurance carriers and product vendors, (iii) specialized expertise in niche markets
that may assist insurers to properly assess market risks and to develop products, (iv)
efficiencies that may be achieved through the collective administration of larger groups
of business, and (v) aggregate volume, persistency or new business development.
Keenan believes and seeks written assurances from insurers that any such Other
Compensation does not adversely impact the pricing and coverage terms that Keenan
is able to obtain for its clients.
If on a commission basis, would your company be taking any form of compensation
beyond the commission built into our premium rates?
Our compensation as your benefits consultant/broker would be based on commission
from the carriers only. We would not charge any additional fee for the benefits/broker
services.
21
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
If selected, what are your disclosing compensation methods to the City and the frequency
of that disclosure?
Keenan will provide annual disclosure of compensation or upon request.
22
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
4. LIST OF COMPLEMENTARY SERVICES
List of complementary services offered by proposer along with corresponding prices.
Think HR Human Resource Information System - no cost.
Ongoing training and assistance with state and federal legislative compliance. Ongoing
training for HR current staff and future new staff. Virtual Open Enrollment support.
Benefit Guide customized to the City’s benefit programs.
23
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
5. STAFFING AND PROJECT ORGANIZATION
The following key personnel will support the City of La Quinta's benefits programs:
Day-to-Day Service Team
• Karyn Goodsite - Account Executive
• Yvette Fields - Senior Account Manager
• Laurie LoFranco - Practice Leader, Municipalities Benefits
Extended Support Team (As-Needed)
• Jovita Juanillo - Senior Vice President, Underwriting & Actuarial
• Christine Hough - Vice President, Underwriting & Actuarial
• Ralph Gowen - Vice President, Client Technology
• Robin Rager - Director of Health Management
• Amy B. Donovan - Vice President, Legislative & Regulatory Affairs
Day-to-Day Service Team Bios
Karyn Goodsite - Account Executive
Karyn Goodsite is an Account Executive responsible for providing benefits consulting
and overall strategic planning for the employee benefit programs. Karyn will be your
primary point of contact.
Prior to joining Keenan & Associates, Karyn worked with employee benefits in various
corporate industries, including marketing, advertising and law.
Since joining Keenan in August 1995, Karyn has worked with many Southern
California large public sector clients on plan design analysis, funding methodology,
implementation of self-funded and fully-insured medical programs, including specialty
carve-outs, carrier consolidations/replacements, and project managed implementation
of online eligibility and self-serve enrollment tools. Karyn also has a solid
understanding of the collective bargaining environment and has extensive experience
working with benefits insurance committees to achieve established goals through
effective collaboration with district management and bargaining group representatives.
Karyn is the lead administrator for the California Purchasing Health Care Coalition, the
lead consultant for the Controlling Insurance Costs In California Schools Trust, and a
Board Member for the Inland Empire Public Management Association – HR. Karyn
possesses Life & Disability and Long Term Care agent licenses.
24
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Yvette Fields - Senior Account Manager
Yvette joined Keenan & Associates in 2007. She came to us with a wealth of experience
and knowledge, including more than 15 years of expertise in employee benefits from
Aetna and Custom Employee Benefits. She is responsible for the management and
service of new and existing plans for public sector clientele in Riverside County. In
addition, she serves as the liaison managing the installation of our BenefitBridge
product with key clients.
Yvette possesses a Life & Disability agent license and is currently pursuing her
Certified Employee Benefits professional designation from the International
Foundation of Employee Benefit Professionals and the Wharton School of the
University of Pennsylvania.
Laurie LoFranco - Practice Leader, Municipalities Benefits
Laurie LoFranco is a Senior Vice President and Municipalities Practice Leader. She
has more than 24 years experience in human resources and employee benefits. Laurie
joined Keenan & Associates in 2008 after spending the previous 12 years at the City of
Corona, most recently serving as their Human Resources Director. Laurie served on
the Board of Directors for the California Personnel Employee Labor Relations
Association (CALPELRA) and is currently serving on the Board of Directors for the
Inland Empire Chapter of IPMA. Laurie holds an Executive Level Human Resources
Certification from IPMA and holds a California State Insurance License in Accident,
Health and Life Insurance. Laurie graduated from the College of Notre Dame with a
Degree in Human Services and holds a Masters Degree in Public Administration from
California State University, San Bernardino.
Extended Support Team Bios
Jovita Juanillo – Senior Vice President, Underwriting & Actuarial
Jovita Juanillo, Senior Vice President of our Benefits Underwriting and Actuarial
Services Department, is responsible for managing various Keenan purchasing coalition
programs and Joint Powers Authority plans, including Keenan's Dental and Vision
Coalition programs, and Stop Loss/Excess Risk Coalition Program. Prior to joining
Keenan & Associates, Jovita was the Director of Pricing Analytics for Ultralink, an
employee benefits consulting firm. She was the chief employee benefits negotiator for
Fortune 100 employer clients such as American Airlines, Union Pacific, Lucent
Technologies, Avaya, Reed Elsevier, Dow Chemicals, Owens Corning, Eaton,
Ingersoll-Rand, and others. Jovita began her health care career in 1983 as an
underwriter for CIGNA HMO and Indemnity products. She has held various senior
underwriting roles at CIGNA, Blue Cross of California (WellPoint), and CareAmerica
(now Blue Shield). She also served as the Director of Underwriting for United
Healthcare's Pacific Region and was involved in three start-up insurance operations in
California and Nevada.
25
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Christine Hough – Vice President, Underwriting & Actuarial
Christine Hough, a Vice President in the Torrance office, has more than 20 years of
consulting experience in the employee benefits field. She supports the Account
Executives at Keenan in the design and analysis of all lines of insurance coverage that
includes medical, dental, life/AD&D, and LTD.
Prior to joining Keenan, Christine was with Mercer Human Resource Consulting and
Towers Perrin HR Services where she provided actuarial valuation and consulting
services. Her clients included leading companies in the aerospace/defense, energy,
motion pictures, banking, engineering/construction, and automotive industries.
Christine is a Fellow of the Society of Actuaries and a member of the American
Academy of Actuaries. She has a Bachelor of Science degree in Computer Science and
Engineering and a Master of Science degree in Electrical Engineering from California
State University, Long Beach.
Ralph Gowen – Vice President, Client Technology
Ralph L. Gowen, Vice President of Field Services, has more than 30 years of
technology and management consulting experience including software solutions
directly supporting the employee benefits industry. He has held various senior
management positions throughout his career within the technology/consulting industry.
Ralph's responsibilities at Keenan include the overall Product Management of
technology solutions supporting the Employee Benefits practices such as
BenefitBridge. In that capacity, Ralph guides the overall direction of the products
including software development, marketing, and sales support, vendor management,
and coordinates with the Keenan implementation and service teams ensuring the
product remains best of class and is tailored to meet the explicit and unique
requirements of Keenan's clientele.
In September 1999, Ralph joined a technology startup called BenefitPoint, Inc. in San
Francisco, CA. as Vice President of Service. BenefitPoint, Inc. created an e-
infrastructure platform using the Internet to create a common ASP platform upon which
many of the nation's leading insurance carriers and brokers are able to negotiate and
purchase group insurance benefits. In this capacity, Ralph was responsible for creating
and managing the service infrastructure of BenefitPoint, Inc. Ralph led the
development of the web-based training materials, the implementation of BenefitPoint
at hundreds of brokerage and carrier offices throughout the country, and the creation of
the customer service tools and procedures to support BenefitPoint.
Ralph is an experienced technology and management consulting professional having
previously served as the Vice President of Professional Services for Avinon, Inc., a
web services software startup, and having consulted independently and as a
Director/Practice Leader of Cambridge Management Consulting. Ralph's area of focus
has been the management and technology surrounding Customer Relationship
26
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Management and e-commerce. He has consulted with leading companies in many
industries including Kaiser, Bank of America, Apple Computer, Hewlett Packard,
Cisco, First Data Corporation, Chevron, the United States Navy, and Southwest Bell.
He earned a Master of Business Administration degree in Finance from California State
University, Hayward in 1994 and graduated in 1983 with a Bachelor of Arts degree in
Mathematics from the University of California, Berkeley.
Robin Rager – Director of Health Management
Robin Rager, Vice President of Health Management, joined Keenan in 2010. Robin has
been involved in the field of health promotion for nearly 24 years, both as a consultant
and as a college professor. His consulting and academic activities have focused on
individual and population health assessment, and the design and evaluation of effective
health promotion and disease management programs in a variety of populations and
settings - ranging from health care systems to railroad workers to military personnel to
migrant farmworkers.
Robin supports both Public Agency and HealthCare current and prospective customers
He also holds a Ph.D. in Health Education, has taught at two universities over a 15 year
period, authoring numerous articles on wellness.
Prior to joining Keenan, Robin was the owner of Optimum Health Management, which
provided health management services to businesses and health care organizations,
including needs assessment, program design, marketing, online and onsite health
promotion services, and program evaluation. His research and development projects
have included a variety of workforce studies related to the impact of health risk
reduction and disease management interventions (e.g., smoking cessation, weight
management, diabetes management, sleep/fatigue and alertness, depression/anxiety
management, injury prevention, health-related impairment in worker productivity),
nutritional supplement product efficacy; the design of online health risk assessment
instruments; the design of health care claims analysis systems; and the development
and management of a risk-rated employee wellness incentive program.
During his two decades in academia, Robin was a health education professor at Penn
State University and Texas Woman's University and served as the Director of PSU's
Center for Worksite Health Enhancement. He has been honored as a Fellow of the
Association for Worksite Health Promotion (FAWHP), served as chair of the American
Public Health Association's Worksite Health Promotion Committee, and participated
in the development of the Healthy People 2010 Objectives for the Nation as a member
of the Worksite Health Promotion Work Group.
27
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Amy B. Donovan – Vice President, Legislative & Regulatory Affairs
Amy Donovan is Vice President of Legislative & Regulatory Affairs and is Keenan &
Associates' primary source for legislative and regulatory research, analysis, and
advocacy. Amy authors the firm's Briefings and position papers on emerging
legislation, regulation, and litigation and works with stakeholders at a state and national
level to advocate on issues that impact the firm and its clients. As a member of the
Council of Insurance Agents and Brokers (CIAB) Legal Counsel Working Group, she
meets regularly with federal lawmakers, lobbyists, and thought leaders to discuss
national trends in health and liability insurance issues. She brings that knowledge to
bear in addressing Keenan clients throughout California on such topics as the ACA,
Family and Medical Leave Act, Section 125 Cafeteria Plans. She has been with the
firm since 2006.
Prior to working at Keenan, Amy worked for 11 years as a civil litigator and litigation
manager in New Jersey. Among her areas of expertise are employment discrimination
and employee benefits. Through her volunteer work with the New Jersey Junior
Leagues, Amy also advocated for legislation impacting children's health and safety.
Amy graduated from Smith College with a Bachelor of Arts in American Studies and
received her Juris Doctorate from Seton Hall University School of Law, where she
handled federal disability appeals as a volunteer and worked as a research assistant for
then-Congressman Charles E. Schumer of New York. She is admitted to the bar in both
California and New Jersey.
28
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
6. SUBCONTRACTING SERVICES
Subcontracting any portion(s) of the Scope of Services is not preferable; however, if a
proposer can demonstrate to the City's satisfaction that is in the best interest of the
project to permit a portion of the service(s) to be subcontracted by the proposer, it may
be considered. Provide details on the role of any subcontractor that will be used.
Assignment is prohibited.
Keenan does not anticipate subcontracting any of the services described in this RFP
response.
29
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
7. DISCLOSURES
Disclosure of any alleged significant prior or ongoing agreement failure, any civil or
criminal litigation or investigation pending, which involved the proposer or in which the
proposer has been judged guilty or liable within the last five (5) years. If there is no
information to disclose, the proposer must affirmatively state there is no negative history.
There are no significant prior investigations, litigation, or settlements against Keenan.
30
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
8. EXPLANATION OF METHODOLOGY
The RFP responses will be evaluated based upon the following: Understanding of SOW;
Approach; Experience; Creativity and Innovation; Overall Presentation
We have addressed our abilities previously in this response. Following is a final
overview of our methodologies related to the overall project.
Our mission is to protect our clients, their employees and their critical financial assets
by constantly anticipating change and redirecting solutions to benefit the health of their
programs. As a uniquely integrated organization, our propriety programs maximize
efficiencies, improve communication and focus on reducing your total cost. Following
are the key characteristics that will benefit the City of La Quinta.
Our philosophy has always been that solving the needs of our customers and directly
supporting our communities is good for our business. We continually present
informational workshops and seminars on topics relevant to our customers and provide
scholarships for administrators to further their education and advancement. Because of
our specialized expertise in claims services and technology, we can help you offer
higher quality, efficiency and cost effectiveness in your benefit programs.
If you simply view us as a vendor, then we have failed in realizing our mission and
core philosophies. Our clients recognize us as a proactive partner and an extension
of their own human resources and benefits personnel.
31
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
OVERALL METHODOLOGY
Your dedicated Keenan team will work with the City to establish a strategic work plan
and successfully complete each requirement and need as described in the City's RFP.
If appointed as your insurance broker, we believe our priority is to further our
understanding of the City's benefits needs in relation to your overall culture and
employee concerns. This enables our team to evaluate and recommend the most
innovative and best-fitting coverage. Our approach in developing this understanding is
different with each client. In general, we follow a four-phase action plan, illustrated in
the following exhibit.
32
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Using all of the information identified in Phases I through IV of our four phase action
plan, a two-year strategy will be developed. This plan will be more of a "work in
progress" as budgetary and collective bargaining conditions change. Using our
knowledge of the California public sector marketplace, our annual surveys of public
sector benefit programs and trend forecasts, changes in the existing programs will be
recommended and adjusted to meet the City's projected budgets. Consideration will
also be given to the following:
• Projections in State and Federal funds
• Future staffing requirements
• Expected retirements and resulting liabilities
• Emerging technologies
ACTUARIAL TOOLS AND RENEWAL DATA ANALYSIS
Carrier renewals and rates are validated and benchmarked using Keenan's proprietary
actuarial tool as developed and calibrated by Milliman USA. Milliman USA started in
1947 and is one of the premier actuarial firms in the United States. Our unique Keenan-
Milliman actuarial model allows us to perform in-depth and high accuracy pricing
analysis on behalf of our clients by determining the value of over 100 variations of
benefit plan designs, assessing cost enrollment/migration impact, providing fully-
insured vs. self-insured cost-analysis, identifying the cost of carved-out benefits, and
validating the claim cost factors utilized by carriers in their renewal rate development.
We will provide meaningful and practical analysis of your contracts, plan designs and
any available claims data. At renewal, the "surprise factor" will be minimized
significantly by thorough, regular evaluation and action plans based on that evaluation.
Utilizing our data analysis, we will seek to negotiate more favorable costs and
contractual terms for the City and proactively manage utilization patterns, thereby
lowering participant and benefit plan expenses where possible. We will work with the
City and Benefits Committee to establish a Needs Assessment and Work Plan. The
outcome of this work will result in recommendations of both traditional and "state of
the art" programs that will best serve the City's needs. If it is determined that it would
be beneficial to the City to evaluate alternatives in the market, Keenan utilizes
BenefitPoint to facilitate timely and accurate quotes and benefit options.
The information and evaluations of the vendor, gathered through this process, are then
used to enter into the final negotiations on the upcoming renewal. Our expertise in
underwriting and premium evaluation allows us to work with carrier underwriters on
their own level and to negotiate favorable rates and conditions for our clients from a
position of strength. Final negotiations are completed, and a final renewal is obtained
far enough in advance for benefit communication, payroll and billing requirements to
be completed. Final rates are also checked by the Service Representative and formally
documented for your records and ours.
33
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
As a proven leader in California public sector consulting, Keenan has more experience
with a wide variety of medical plan designs than any other broker or consultant in the
state. Our database of public employers is unmatched in California, and we know the
impact of potential plan changes based on actual experience. In addition to our
extensive experience with virtually every type of managed care program and every
funding variation (e.g., self-funded, flex funded, experience rated, minimum premium,
fully insured) available, we have developed a number of proprietary programs designed
to meet the unique needs of the public sector.
PROACTIVE ADVOCATES
We will serve as proactive advocates on behalf of the City, your employees and retirees,
as well as their dependents, on all topics and issues. As a resource for the City, we are
an extension of your benefits department, providing both proactive guidance and
valuable support to all parties. We will also work with the carriers and health plans to
help you resolve billing and eligibility problems and serve as your liaison on all
administrative details with carriers.
ANALYSIS SUPPORT FOR YOUR PROGRAM
Keenan's Benefits Underwriting and Actuarial Department is comprised of more than
15 subject matter experts related to analysis, actuarial support and plan design for
benefit plans. This department provides high-level analysis of benefit programs and
their performance; reviews data trends and works with the primary service team to
provide alternative plan design options; and, supports the primary service team with
stop loss quotes, marketing plans to carriers, actuarial support and other technical
services.
Overall, the Benefits Underwriting and Actuarial Department provides underwriting
and actuarial work including, but not limited to, renewal analysis, reserve estimates,
plan change pricing and claim utilization analysis. This department also monitors
industry trends and provides Federal and State legislative updates on a regular basis.
Members of our Benefits Underwriting and Actuarial Department will be available to
participate as necessary to help with the presentation of any technical data or
information. The primary services of this department include:
• Underwriting
− Trend Analysis
− Renewals (existing business)
− Funding Rate Development (new business)
− Renewal Audits (fully insured plans)
− Rate Negotiations
− Benefit & Rate Comparisons (new and existing clients)
− Premium and Rate Validations
34
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Select Product Marketing
− Private Label Pool Products / off-the-shelf
− Stop Loss Programs
• Financial and Experience Reporting
− Loss Ratio Reports
− Premium & Claims Reports
− Utilization Reports
− IBNR Reporting
− Industry Trend Reporting
− Client Presentations
• Private Label Program Maintenance
− Annual Pool Renewals
− Annual Renewal Binder
− Pool Marketing
• Technical Consulting
− Prospective Group Funding Calculations
− Pricing Calculations for Plan Changes
− Rate Stabilization Reviews
− General consulting services for all benefit plans
Keenan's proposed benefit program changes are strongly supported by data derived
from our client's specific historical health plan experience, Keenan's own Book of
Business experience, and Industry-Leading Actuarial Tools which allow for objective
discussions with bargaining units about anticipated plan changes. Our financial
analysis involves a comprehensive approach:
• Plan Design – We are able to project renewal rates based on more than 100
variations of plan design, through the use of our proprietary actuarial tool
developed with Milliman USA. This allows us to evaluate fully-insured vs. self-
funded options, as well as innovative plan designs that can be crafted for your
unique needs.
• Review of Health Plan Data – We review multiple years of your health plan's
standard reporting package to give us a more accurate view of our client's
current plan utilization and cost drivers over the years. We use this as a starting
point because we believe that an in-depth understanding of our client's
experience is essential in determining the most precise and cost-effective
benefit change recommendations. It also minimizes unintended consequences
and benefit adjustments after changes have been implemented in their benefit
coverage.
35
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Mede/Analytics – Keenan Public Agency Data Initiative – Keenan is piloting
a study uniquely with Kaiser, to provide our clients with expanded analysis and
reporting of Kaiser claims data. This is a first of its kind initiative being piloted
by Kaiser and they selected Keenan as their partner. It will enable Kaiser's
performance to be benchmarked on an "apples to apples" basis with other
Health Plans such as Anthem's. Mede/Analytics is a third-party data warehouse
technology company with expertise in creating reports that assist customers in
developing informed decisions from complicated data. Keenan is engaged in
this pilot with the goal of using Kaiser's current PUR underwriting and
experience reports, that currently only benchmark against Kaiser's book of
business, to expand benchmarking to Kaiser and non-Kaiser plans as well.
• Self-funding – Self-funding is an essential mechanism to controlling long term
healthcare costs. When self-funding plans are in place we analyze stop-loss
coverage to determine opportunities for maximum cost savings. Keenan
manages self-funded medical plans for more than 10,000 employees throughout
California and self-funded dental plans for more than 30,000 employees. We
are very experienced with TPA services, pricing, network discounts, and other
aspects essential to administering an efficient and properly funded self-funded
plan.
• Stop Loss Program Design – We assess the current benefit coverage including
specific and aggregate pooling amounts appropriate for your group's risk
tolerance. This involves a review of the current stop loss program design, at
least 36 months of stop loss experience, and the severity and frequency of
claims at various pooling levels. Some of the stop loss questions we help our
client answer are as follows:
− What benefit program changes can we implement to reduce stop loss risks?
− How do we minimize large claims?
− What specific deductible level is appropriate for my group?
− Can we save money through aggregate stop loss protection?
− What aspects of my stop loss policy should be focused on to comply with
Health Care Reform?
• Stop Loss Pricing – We validate a carrier's stop loss underwriting to determine
if our client's risk was appropriately priced and use Keenan's public entity stop
loss book of business experience to benchmark stop loss premium costs. In
addition, we review the desirability of our client to self-insure some of their
stop loss liability and arrange for reinsurers to provide a range of pricing factors
for self-funding or minimum premium stop loss programs.
• Stop Loss Contracts – We evaluate the viability of proposed contracts and
validate if all terms and features negotiated with the carrier are expressed in the
contract. We review the contract language for removal of lasering at renewal,
36
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
adequate claim re-submission deadline; reasonable requirements for
experimental treatments and trials, inclusion of off-label drugs, reasonable
reporting requirements, and other contract language that can help reduce our
client's stop loss risk. We also review the carrier's financial stability rating,
efficiency in evaluating a claim, and speed in payment of stop claims
reimbursements.
MARKETING OF PLANS
We have significant experience in designing public sector benefit programs. Our
standard process begins by collaborating with clients to understand their financial and
benefit objectives. Once the objectives are defined, we work with the client to
determine a customized scoring aligned with their objectives. This is important as we
understand that every client is different, and priorities may change. We articulate what
is most important for our clients in the RFP, not simply using a standard RFP template.
Once the objectives of the RFP and the scoring systems are developed, we start our
electronic questionnaire process for creating the proposal and prepare the client's
benefit program data for the RFP. A sample RFP questionnaire with RFP timeline is
attached, however, we believe that every client is different, and we customize the
questionnaire according to our client's specific needs and objectives. The number of
questions range from 25 to over 200 depending on the type of RFP and our clients'
need.
We routinely require at least 3-4 weeks turnaround time for formal RFPs. Responses
must be received in the stated requirements and formats and also incorporate Q&A time
and in-person provider presentations.
Keenan then provides a summarized version of the responses to the questionnaire
which is analyzed by our account management and underwriters and reviewed in-depth
with the client, so they can provide feedback. A proposed rating of each provider is
presented to the client, but that rating can be revised or changed by the client after the
in-person provider presentations have been concluded. Our consulting team and the
client will then finalize the scoring and select the winning provider by the results of the
overall scores.
Once a vendor is selected, we then ensure that financial and service guarantees are in
place. A significant amount of financial risk is attached to a first year's program
implementation and standard guarantees on subsequent years.
Following are the key issues that Keenan considers when preparing for the marketing
of benefit programs.
• Your philosophical objective
• The collective bargaining environment
• Financial objectives including enhanced investment opportunities
37
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Assessment of results generated by existing programs
• Projection of plan design change claim and cost impact
• Measurement of results versus objectives
• Identification of areas of benefit utilization where savings may be generated
• Comparison with other programs throughout the state
Following is an overview of the steps and responsible personnel for the marketing of
benefit plans.
• Creation of RFP
• RFP creation in collaboration with the City by:
• Account Service Team
• Support from Benefits Underwriting Actuarial Department (BUAD)
• BenefitPoint used to release RFP
− The Account Service Team enters the RFP into the BenefitPoint, an online
system that releases the RFP to the carriers in the marketplace that have
been targeted
− Aggregates responses to the RFP
− Allows for review of criteria included for other RFPs released by Keenan
for benefits clients
• Evaluation of Responses
− Performed by:
Account Service Team
BUAD
38
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
ANALYZE EXISTING COVERAGES AND DEVELOP COST-SAVINGS RECOMMENDATIONS
As identified above, we continuously analyze existing coverages to ensure that the City
of La Quinta receives the best value and that all cost-savings measures are being
explored, presented and implemented where appropriate.
Our overall consulting philosophy is to ensure our clients receive best-value, and this
includes:
• Identifying costs versus services received
• Evaluation of costs and benefit changes if a particular measure is not
implemented
• Providing the City of La Quinta with options that include highlights of benefits
gained and costs incurred versus coverage issues and cost implications
Additionally, Keenan has been an industry leader in the establishment and management
of Joint Powers Authority (JPA) programs. Our experience with innovative solutions
has assisted our clients with realizing cost-effective solutions for their benefits
programs.
MONITORING EXPERIENCE TRENDS
Keenan consistently monitors and reviews carrier reporting on your claims experience
(if available). The importance of appropriate, accurate, and timely analysis cannot be
overstated. In addition to our professional staff in the Torrance office, our Benefits
Underwriting and Actuarial Services Department constantly monitors and reports on
all relevant financial aspects of each benefit plan. This department provides
underwriting and actuarial work including, but not limited to, renewal analysis, reserve
estimates, plan change pricing and claim utilization analysis.
Keenan is committed to monitoring vendor performance on an ongoing basis. We keep
the City of La Quinta informed of the insurance carriers' and health care service plans'
performance by:
• Performing quarterly reviews of plan administrators to assure compliance with
contract performance guarantees
• Developing annual report formats for each of the vendors based on the
organization's needs
• Developing and implementing Quality of Care benchmarks and report cards for
benefit plans and distributing results to plan participants
• Providing revised annual financial projections quarterly for the benefits
program (both calendar year and fiscal year projections) based on current
enrollment levels and cost trends, comparing financial projections to approved
budgets and advising the City with respect to potential corrective measures to
balance the budget, if necessary
39
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Analyzing financial experience with respect to risk sharing cost targets
• Monitoring health vendors' AM Best and Standard & Poor's and other financial
and claim paying capabilities ratings
• Preparing annual summary reviews of health vendors' performance for the
contract
Carrier renewals and rates are also validated and benchmarked using Keenan's
proprietary actuarial tool as developed and calibrated by Milliman USA. Milliman
USA started in 1947 and is one of the premier actuarial firms in the United States. Our
unique Keenan-Milliman actuarial model allows us to perform in-depth and high
accuracy pricing analysis on behalf of our clients by determining the value of
approximately 100+ variation of benefit plan designs, assessing cost
enrollment/migration impact, providing fully insured vs. self-funded cost-analysis,
identifying the cost of carve-out benefits, and validating the claim cost factors utilized
by carriers in their renewal rate development.
Our staff has the background in all types of large claims, occurrences, total cost of a
diagnosis, and what project cost would be depending on what stage of the treatment an
individual is in. Access to statistics based on diagnosis and the low and high cost based
on region through our data warehouse enables us to produce credible projections and
negotiate with Stop Loss vendors and carriers to reduce premium cost and laser
amounts. An understanding of not only medical claims and cost, but general insurance
practices as well are requisite.
The effectiveness of any cost containment initiatives (e.g., critical care, maternity,
condition management, wellness) depends primarily on the vendor selection. The
Keenan staff assists by thoroughly researching and interviewing potential vendors via
an exhaustive RFI process, to identify both best-of-breed and best cost. Once a cost
containment program is implemented, ongoing management reports are analyzed and
reviewed with clients on a regular basis to help determine program effectiveness and
possibly show where plan design could be modified to enhance medical and/or
prescription benefits to improve cost outcomes.
NEGOTIATIONS WITH CARRIERS
This is the area which underscores the value of our niche. Because Keenan
represents the largest aggregate premium block with insurance carriers conducting
business with public agencies in California, we bring a corresponding leverage to the
negotiations process. Further, our Benefits Underwriting and Actuarial Services
Department performs the renewal underwriting audit of all carrier renewals and is
closely involved in all renewal negotiations.
Carrier renewals and rates are validated and benchmarked using Keenan's proprietary
actuarial tool as developed and calibrated by Milliman USA. Milliman USA started in
1947 and is one of the premier actuarial firms in the United States. Our unique Keenan-
40
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Milliman actuarial model allows us to perform in-depth and high accuracy pricing
analysis on behalf of our clients by determining the value of about 100+ variation of
benefit plan designs, assessing cost enrollment/migration impact, providing fully-
insured vs. self-insured cost-analysis, identifying the cost of carved-out benefits, and
validating the claim cost factors utilized by carriers in their renewal rate development.
Once a carrier renewal evaluation is completed and submitted to the carrier for
additional review, meetings are immediately scheduled with senior-level management
to negotiate the rates.
Our Benefits Underwriting and Actuarial Services Department supports the Account
Team in evaluating and negotiating renewal rates and benefits during annual renewals.
A Technical Underwriter with a minimum of 10 years of insurance
underwriting/actuarial consulting experience is assigned to review a carrier's renewal
and act as a lead-in rate negotiations. A standard renewal audit is performed by the
assigned underwriter which includes utilizing Keenan's state-of-the-art proprietary
actuarial tools. An actuary may also be involved in the renewal negotiations depending
on the complexity of the renewal underwriting. The underwriter/actuary will then
prepare a thorough renewal underwriting audit report which will be submitted to the
carrier for review. The report summarizes the main points and justification for a
reduced renewal rating including a re-calculation of the carrier's renewal rates. An in-
person or telephonic rate negotiation call is scheduled to discuss our renewal audit and
to inform the carrier of our expected renewal action. The carrier is given a deadline to
provide the expected renewal increase or rates.
EMPLOYEE COMMUNICATION
We have provided communication services for employee benefit plans since our
inception in 1972. In order to support the specific communication needs of our clients,
Keenan maintains a Marketing Department that is staffed with communication experts
in a variety of disciplines.
Keenan's award-winning Marketing Department assists with the development and
delivery of communication materials. This includes communication pieces that are both
electronic and hard copy for benefit enrollment guides, health fair announcements,
employee education meetings and other related communications activities.
In order to facilitate an efficient communication strategy, Keenan looks to a multi-
media approach to ensure that each eligible employee can obtain the information they
need in order to make a decision. Media selections include:
• Traditional printed material, mailed or delivered to the employee
• Mobile-friendly documents that can be easily reviewed from smart phones or
tablets
41
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
• Web-based flyers, briefings, and other informative materials regarding benefits
programs and issues
• Videos and webinars that explain benefits and/or enrollment processes
These are just some of the examples of the innovative approaches that Keenan has
included in a communication strategy. Ultimately Keenan discusses recommended
strategies with our clients in order to provide the most cost-efficient and effective
strategy.
Please see Appendix 2 for the first five pages of a sample Employee Benefits Guide.
42
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
9. ACKNOWLEDGMENT OF INSURANCE REQUIREMENTS
Proposals must include a written statement that, if selected, the proposer will provide the
minimum insurance coverage and indemnification noted in Exhibits E and F,
respectively, of the City's Agreement for Contract Services included as Attachment 2.
Please see Keenan’s completed Attachment 2, immediately following.
Page 12 of 14
ATTACHMENT 2
INSURANCE REQUIREMENTS ACKNOWLEDGEMENT
Must be executed by proposer and submitted with the proposal
I, ________________________________________ (name) hereby acknowledge and
confirm that __________________________________ (name of company) has reviewed
the City’s indemnification and minimum insurance requirements as listed in Exhibits E and
F of the City’s Agreement for Contract Services (Attachment 1); and declare that insurance
certificates and endorsements verifying compliance will be provided if an agreement is
awarded.
I am _________________________________ of ______________________________,
(Title) (Company)
Commercial General Liability (at least as broad as ISO CG 0001)
$1,000,000 (per occurrence); $2,000,000 (general aggregate)
Must include the following endorsements:
General Liability Additional Insured
General Liability Primary and Noncontributory
Commercial Auto Liability (at least as broad as ISO CA 0001)
$1,000,000 (per accident)
Personal Auto Declaration Page if applicable
Errors and Omissions Liability $1,000,000 (per claim and aggregate)
Worker's Compensation (per statutory requirements)
Must include the following endorsements:
Worker's Compensation Waiver of Subrogation; or
Declaration Regarding California Workers’ Compensation if applicable
Cyber Liability
$1,000,000 (per occurrence)
$2,000,000 (general aggregate)
Laurie LoFranco
Keenan & Associates
Municipalities Practice Leader Keenan & Associates
44
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
10. NON-COLLUSION AFFIDAVIT
Proposals must include an executed Non-Collusion Affidavit, included as Attachment 3,
executed by an official authorized to bind the firm.
Please see Keenan’s completed Attachment 3, immediately following.
Page 13 of 14
ATTACHMENT 3
NON-COLLUSION AFFIDAVIT FORM
Must be executed by proposer and submitted with the proposal
I, ________________________________________ (name) hereby declare as follows:
I am _________________________________ of ______________________________,
(Title) (Company)
the party making the foregoing proposal, that the proposal is not made in the interest of,
or on behalf of, any undisclosed person, partnership, company, association, organization,
or corporation; that the proposal is genuine and not collusive or sham; that the proposer
has not directly or indirectly induced or solicited any other proposer to put in a false or
sham proposal, and has not directly or indirectly colluded, conspired, connived, or agreed
with any proposer or anyone else to put in a sham proposal, or that anyone shall refrain
from proposing; that the proposer has not in any manner, directly or indirectly, sought by
agreement, communication, or conference with anyone to fix the proposal price of the
proposer or any other proposer, or to fix any overhead, profit, or cost element of the
proposal price, or of that of any other proposer, or to secure any advantage against the
public body awarding the agreement of anyone interested in the proposed agreement;
that all statements contained in the proposal are true; and, further, that the proposer has
not, directly or indirectly, submitted his or her proposal price or any breakdown thereof,
or the contents thereof, or divulged information or data relative hereto, or paid, and will
not pay, any fee to any corporation, partnership, company, association, organization,
proposal depository, or to any member or agent thereof to effectuate a collusive or sham
proposal.
I declare under penalty of perjury under the laws of the State of California that the
foregoing is true and correct.
Proposer Signature: __________________________________________________
Proposer Name: __________________________________________________
Proposer Title: __________________________________________________
Company Name: __________________________________________________
Address: __________________________________________________
Laurie LoFranco
Municipalities Practice Leader Keenan & Associates
Laurie LoFranco
Municipalities Practice Leader
Keenan & Associates
2355 Crenshaw Blvd., Suite 200, Torrance CA 90501
46
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
11. ACKNOWLEDGEMENT OF ADDENDA
If any addendum/addenda are issued, the proposer shall initial the Acknowledgement of
Addenda, included as Attachment 4.
Please see Keenan’s completed Attachment 4, immediately following.
Page 14 of 14
ATTACHMENT 4
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA
Must be executed by proposer and submitted with the proposal.
If no addenda has been issued, mark "N/A" under Addendum No. indicating
Not Applicable and sign
ADDENDUM NO. SIGNATURE INDICATING RECEIPT
No. 1 Q&A
48
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
APPENDICES
Appendix 1 – Sample Annual Report
Appendix 2 – Sample Benefits Enrollment Guide (5 pages)
49
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Appendix 1 – Sample Annual Report
License No. 0451271 License No. 0451271 Innovative Solutions. Enduring Principles.
[Client]
Stewardship Report and Strategic Planning
Respectfully Submitted by:
Laurie LoFranco, Practice Leader
[Service Consultant], Service Consultant
March 7, 2019
License No. 0451271 Innovative Solutions. Enduring Principles.
2
Agenda
•Your Keenan Benefits Team
•Stewardship Report 2018 Highlights
–Keenan’s Role
–Marketing and Final Renewal Summary
•Utilization
•Highlights of Keenan Services
•Health Plan Trends
•Strategic Planning for 2019/2020
•Compensation Disclosure
•Value-Added Services
–Legislative Updates / Webinars / Keenan Blog
3
Marketing
Training
Technology
Keenan
Financial
Services
Corporate
Technical Resources
Jovita Juanillo
Underwriting/Actuarial
Name
Service Consultant
[Client Name]
Laurie LoFranco
Practice Leader
Legislative
Updates
Your Keenan Benefits Team
Name
Senior Service/Marketing
Coordinator
3
Robin Rager
Director, Health
Management
2
Stewardship Report
2018 / 1st Quarter 2019
Highlights
License No. 0451271 Innovative Solutions. Enduring Principles.
5
Keenan’s Role
•Renewal Negotiations
•Marketing
•Implementation of New Plans
–Review of Plan Documents
•Open Enrollment Planning and Preparation
–Benefit Guide
–Employee Communication Materials
–Health Fairs
–Flu Shots
•Carrier Administrative Meetings and Liaison
•Wellness Program
•Employee Advocate
License No. 0451271 Innovative Solutions. Enduring Principles.
6
2019 Medical Renewal Overview
•Kaiser Initial/Final +5.24%
•Blue Shield (rate cap)
TRIO ACO HMO Plan +6.88%
Access+ HMO Plan +9.88%
PPO Plan +9.88%
PPO HDHP +9.88%
(Includes Wellness Fund of $25,000)
•Kaiser & Blue Shield Renewal Combined
–Final +6.73%
License No. 0451271 Innovative Solutions. Enduring Principles.
7
2019 Medical Plan Enrollment Comparison
2014
(SD County)2015 2016 2017 2018 Carrier Change 2018 2019 # Change
2018 to 2019
Kaiser HMO 634 648 637 632 Kaiser HMO 502 481 -21
Kaiser HDHP 16 24 30 30 Kaiser HDHP 32 34 2
Sharp HMO 273 301 318 282 Blue Shield HMO 203 183 -20
Sharp HMO HDHP n/a n/a 25 20 Blue Shield Trio HMO 220 252 32
Sharp PPO HDHP 15 10 7 6 Blue Shield PPO HDHP 1 1 0
Sharp NationCare PPO 68 32 23 20 Blue Shield PPO 7 6 -1
Total Medical 1006 1015 1040 990 Total Medical 965 957 -8
Medical Waivers 238 235 236 243 Medical Waivers 220 235 15
Total Medical and Waivers 1244 1250 1276 1,233 1,185 1,192 7
% Change
2018 to 2019
Kaiser 52%54%52%54%Kaiser HMO 45%43%-9%
Sharp HMO 22%24%27%24%Blue Shield HMO 36%36%12%
Sharp PPO HDHP 7%3%2%2%Blue Shield PPO 1%1%-1%
Total Medical 81%81%82%80%Total Medical 81%80%1%
Medical Waivers 19%19%18%20%Medical Waivers 19%20%-1%
Total Medical and Waivers 100%100%100%100%100%100%
% Of Total Enrollment
License No. 0451271 Innovative Solutions. Enduring Principles.
8
2019 Dental PPO & Dental HMO Renewal
and Marketing Overview
•United Concordia Renewal
–Initial Renewal, Rate Pass for Dental PPO and Dental HMO
–Negotiated Renewal, Dental PPO -4.75% & Dental HMO -4.75%, or
Dental PPO -2.50% & Dental HMO -2.50% 2 year rate guarantee
•[Client] decision to move to Cigna
–Dental PPO -10.79% adding adult/child orthodontia (50% to $2,000),
3 year rate guarantee.
–Dental HMO –No change in rates, 2 year rate guarantee with a rate cap in
the 3rd year of 6%
–Approximate savings of $51,656
2019 Carrier Change from
United Concordia to Cigna 2018 2019 # Change
2018 to 2019
Dental HMO Plan 408 396 -12
Dental PPO Plan 501 547 46
Total Dental 909 943 34
License No. 0451271 Innovative Solutions. Enduring Principles.
9
2019 Vision Renewal and Marketing
Overview
•VSP
–Initial Renewal was a rate pass
–Final Negotiated Renewal -6%
•2 year rate guarantee (1/1/2019-12/31/2020)
•Approximate savings of $8,191 or $16,382 over a 2 year period
[Client]
Vision Marketing Overview
Effective -January 1, 2019
Carrier Contact Email Phone Number RFP Sent RFP Received Proposal
Received Reason Not Presented
Cigna Matthew Overby matthew.overby@cigna.c
om (714) 390-4447 05/16/18 05/21/18 05/30/18
EyeMed Jake Indich jake.indich@eyemed.com(310) 913-9375 05/16/18 05/22/18 05/30/18
MES Karen Carnakis kcarnakis@MESVision.co
m (909) 948-6861 05/16/18 05/17/18 05/30/18
MetLife Jonathan "JP"
Eveleth jeveleth@metlife.com 213-797-3442 05/16/18 05/17/18 05/30/18
Principal
Financial Amy Nielsen Nielsen.Amy@principal.c
om (949) 310-8116 05/16/18 05/17/18 06/05/18 Not competitive
VSP Jason Watkins Jason.Watkins@vsp.com (916) 858-5775 5/16/2018
Renewal
Received
5/11/18
Incumbent-Initial rate pass, Final
negotiated -6%
License No. 0451271 Innovative Solutions. Enduring Principles.
10
•Medical -Blue Shield & Kaiser
•Changed Dental from United Concordia to Cigna
•Vision remained with VSP with a 6% decrease to rates
•HSA Administrator remained with Optum
•Multi-year contracts
–Basic Life/AD&D and Long Term Disability –3 Years (ending
December, 2020)
–EAP–3 Years (ending December, 2020)
–ASI FSA Administrator –No change
•Total Estimated Savings $59,656 or $119,312 over a 2
year period
2019 Final Renewal Summary
Utilization
License No. 0451271 Innovative Solutions. Enduring Principles.
12
Utilization –Blue Shield (received 3/6/19)
This is HMO and Trio combined and Blue Shield will use the combined experience for the renewal.
There are only 14 subs on the PPO so they don’t release experience.
License No. 0451271 Innovative Solutions. Enduring Principles.
13
Utilization –VSP (received 3/6/19)
Highlights of
Keenan Services
License No. 0451271 Innovative Solutions. Enduring Principles.
15
2018 Educational and Administrative
Meetings
•Renewal/Marketing Meeting
•Implemented a Comprehensive Wellness
Program
•Medicare Workshop
–Planning started in January 2019 for February 22nd
–Keenan provided, agenda, presentation, facilitation of
speakers, collected presentations
License No. 0451271 Innovative Solutions. Enduring Principles.
16
2018 Employee Communications
•Branding
–Collaboration with
Keenan’s graphic
designer
–Uniform branding for
all employee marketing
pieces
•Flu Shot Flyer
•Calendar Event Flyer
•Flyer Template
–Easily manipulated for
future events
License No. 0451271 Innovative Solutions. Enduring Principles.
17
2018 Annual Enrollment
Benefit Guide
-Timeline challenges
-Comprehensive
•Open enrollment
•Plan changes
•Plan comparisons
•Medical overview (Am I an
HMO, PPO or HDHP type
of person?)
•Premiums and Flex
Credits
•Important Notices
•Contacts
•And more….
License No. 0451271 Innovative Solutions. Enduring Principles.
18
2018 Annual Enrollment (continued)
•Flu Shots (6 locations) included High Dose
•Health Dimensions Health Fairs (2)
–Keenan invested in two health fairs and partnered in planning/executing
the events
•Benefit Expos (4)
–Keenan scheduled all vendors and represented those that could not
attend
•Carrier Materials
•Carrier Plan Documents Request, Review, and Distribution
–October: Benefit Summaries/SBC’s for Intranet
–December/January/February: EOC’s/Policies
•Assistance with carrier EDI Feeds
License No. 0451271 Innovative Solutions. Enduring Principles.
19
2018 Wellness Program Framework
San Diego Superior Court 2018 Proposed Program Framework
Program Components Details Timeframe Participation Incentive
Survey • Employees Wellness Program Interest
Survey (online)
February 2018 • No incentive provided
Wellness Challenge • Health Enhancement Systems (HES)
offers a variety of fun online wellness
challenges.
March-May
2018 • Participants who successfully reach
certain milestones during the challenge
will qualify for a drawing.
Onsite Fitness Classes • Strive Fitness offers the following onsite
fitness classes: Yoga, Zumba, Functional
Fitness and Boot Camp.
April-June
2018 • No incentive provided
Quarterly Onsite
Wellness Workshops • Quarterly onsite wellness workshops
provided by carriers, vendors, and local
wellness organizations
March-December
2018 • Participants who attend a workshop
will qualify for a drawing.
Finding Balance - Stress
Management Program • Kaiser’s 8-week stress management
challenge email campaign
July-August
2018 • Participants who complete the end-of-
program survey will qualify for a
drawing.
Health Fair/Flu Shots • 2018 Health Fair/Flu Shots September-October
2018 • Food and refreshments provided at
Health Fair for attendees.
Wellness Challenge • Health Enhancement Systems (HES)
offers a variety of fun online wellness
challenges.
September-October
2018 • Participants who successfully reach
certain milestones during the challenge
will qualify for a drawing.
Maintain Don’t Gain -
Weight Management
Program
• Kaiser’s 8-week holiday weight
management challenge email campaign
November-December
2018 • Participants who complete the end-of-
challenge survey will qualify for a
drawing.
Carrier Online Wellness
Resources • Personal health and wellness portal
• Healthy lifestyle program modules
• Health/fitness tools, trackers, planners
• Health information materials and library
Ongoing
Carrier 24-Hour Nurse
Line • Toll-free 24/7 telephonic health
consultation
Ongoing
Participation numbers for this year’s activities are as follows: Onsite Fitness Classes: 5-19 participants, Feel Like a Million Challenge: 176 participants
License No. 0451271 Innovative Solutions. Enduring Principles.
20
2019 Wellness Program Framework
San Diego Superior Court 2019 Proposed Program Framework
Program Components Details Timeframe Participation Incentive
Onsite Fitness Classes • Strive Fitness offers the following onsite
fitness classes: Yoga, Zumba, Functional
Fitness, Stretching, Stress Mgmt.
Mindfulness and Boot Camp.
January-March
2019 • No incentive provided, free onsite
fitness classes are the incentive.
Quarterly Onsite
Wellness Workshops • Quarterly onsite wellness workshops
provided by carriers, vendors, and local
wellness organizations
January-December
2019 • Participants who attend a workshop
will qualify for a drawing.
Wellness Challenge • Health Enhancement Systems (HES) offers
a variety of fun online 6-week wellness
challenges.
February-March
2019 • Participants who successfully reach
certain milestones during the challenge
will qualify for a drawing.
Wellness Challenge • Rest and Revive - Kaiser’s 8-week sleep
promotion challenge email campaign
May-June
2019 • Participants who complete the end-of-
program survey will qualify for a
drawing.
Health Fair/Expo/Flu
Shots • SDSC coordinates Health Fair’s at two
locations. Flu shot clinics administered at
all locations.
September-October
2019 • Food and refreshments provided at
Health Fair for attendees. No incentive
provided.
Wellness Challenge • Health Enhancement Systems (HES) offers
a variety of fun online 6-week wellness
challenges.
October-November
2019 • Participants who successfully reach
certain milestones during the challenge
will qualify for a drawing.
Carrier Online Wellness
Resources • Personal health and wellness portal
• Healthy lifestyle program modules
• Health/fitness tools, trackers, planners
• Health information materials and library
Ongoing
Carrier 24-Hour Nurse
Line • Toll-free 24/7 telephonic health
consultation
Ongoing
License No. 0451271 Innovative Solutions. Enduring Principles.
21
Macro Issues Facing Health
Insurance and Municipalities
And
Medical Carrier Market Trends
License No. 0451271 Innovative Solutions. Enduring Principles.
22
The Current California Fiscal Landscape
•Good News:
–Unemployment is at an historic low of 4.1%
–$21 billion budget surplus
–Newsom proposed budget increases Rainy Day Reserve to $15.3
billion, pays down a total of $4.1 billion state pension liabilities,
$415 million for emergency preparedness and response, $1.5
billion for affordable housing
•Bad News and Uncertainties:
–Employer-provided health insurance premiums have risen 20%
since 2013; 55% since 2008
–$12.4 billion in losses due to 2018 wildfires
–Unfunded OPEB liability of $187 billion
–Affordable housing crisis
–Risks of recession, trade war, stock market volatility
License No. 0451271 Innovative Solutions. Enduring Principles.
23
Health Care Trends –Medical and Rx 1/28/19
Access To
Care
•Average Covered California premium increase for 2019 will be 8.7% for people who get
no subsidies. For people who get subsidies, the average premium increase is closer to
4%.1
•CA uninsured rate fell to 7.2% in 2017, a 60% decrease since 2014 rate of 17.2%.2
Cost of
Care
•National health expenditures avg. annual growth rate forecast 2017-2026 of 5.5% vs
nominal GDP growth of 4.5% 3
•Insured population forecast to fall from 91% in 2017 to 89.3% in 2026 3
•The average annual premiums for employer-sponsored health insurance in 2018 are
$6,896 for single coverage and $19,616 for family coverage. The average premium for
family coverage has increased 20% since 2013 and 55% since 2008.4
Healthcare
Reform
•Repeal of the ACA’s Individual Mandate penalty effective January 1, 2019. The Employer
Mandate and all employer reporting requirements remain in effect.
•Appeal filed in controversial case –Texas v. Azar –after lower court declared entire ACA
invalid. The law remains in effect while the case makes it way through the courts.
•With Democrats now in the majority in the U.S. House of Representatives, expect to hear
more discussion about “Medicare for All” type plans. Legislation unlikely to move forward
under current Administration.
References:
1.Covered California 10/18/18 Board meeting minutes
2.Covered California 9/13/18 news release
3.CMS National Health Expenditure Data NHE Forecast Summary, NHE Projections 2017-2026 www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports
4.Kaiser Family Foundation, 2018 Employer Health Benefit Survey, October 3, 2018
License No. 0451271 Innovative Solutions. Enduring Principles.
24
Market Trends
Trends are applicable for North and South except where noted.
* Kaiser Trends are not updated quarterly. They are set Annually.
Note: PacifiCare/UHC has decided not to participate in our trend report.. If their position changes we will add them to the report.
.
Insurance Trends Report
1st Quarter 2019
CARRIER Vision
Health Net
Capitation Non-Capitated Hospital Professional Overall PPO Dental Net
5.52%8.60%9.80%7.13%8.70%4.5%4.5%
Blue Shield
North South North South North South PPO DHMO
North South North South
12.1%12.8%12.4%12.8%
North South
4.2%4.6%
North South North South North South PPO DHMO
6.08%6.29%6.32%6.51%6.08%6.29%5.0%4.0%
Premier PPO
5.0%5.0%
VSP *3.0%
MES *4.0%
8.9%13.2%9.5%
3.8%
11.2%
Delta Dental
Rx-HMO
9.9%8.35%
10.20%9.20%
CARRIER TREND
HMO PPO DentalPOS
2.4%4.2%
7.8%7.8%9.4%
6.75%
Schools HealthCare
9.20%8.40%6.80%10.20%
Cigna 7.9%
Prescription Drugs
4.0%
Kaiser *
Express Scripts
North North
Sutter Health Plus *
Prescription Drugs
Anthem
8.4%
Aetna
Rx-PPO Rx-HMO
2.5%
2.5%
3.0%
North
5.0%
South
5.0%
Rx-PPO
9.9%
12.0%
2019/2020 Strategic Planning
License No. 0451271 Innovative Solutions. Enduring Principles.
26
Strategic Planning 2019/2020
•Marketing
–Medical?
•Renewals –Due Date?
–Blue Shield (will receive by 6/1)
–Kaiser (will receive by 6/1)
•Wellness
–Wellness Program ($25,000 wellness fund)
•Voluntary Products
–Voluntary Short-Term Disability, Critical Illness, ID Theft
–Long Term Care
License No. 0451271 Innovative Solutions. Enduring Principles.
27
Strategic Planning 2019/2020 (continued)
•Any new challenges surface?
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
License No. 0451271 Innovative Solutions. Enduring Principles.
28
2020 Renewal Timeline -Ideal
•All renewals (Medical) due June 1, 2019
–Marketing decisions
–Finalize all plans by August 1, 2019
•Based on desired annual enrollment
–October 7–October 25, 2019
•Benefit Guide
–September 21: Final Benefit Guide to [Client]
–September 1 –20: Development with minimum changes
–August 15 –September 20: Development with many changes
–August 1: Finalize all plans
2018 Compensation
Disclosure
License No. 0451271 Innovative Solutions. Enduring Principles.
30
2018 Keenan Consulting Fee Accounting
Medical Medical
Effective Kaiser Blue Shield Total per Month
Month Pol#232167 Pol#W0065140
Jan-18 7,632.85 6,534.21 14,167.06
Feb-18 7,542.67 6,545.73 14,088.40
Mar-18 7,470.74 6,371.77 13,842.51
Apr-18 7,384.71 6,418.24 13,802.95
May-18 7,357.65 6,368.97 13,726.62
Jun-18 7,360.94 6,325.86 13,686.80
Jul-18 7,405.13 6,455.20 13,860.33
Aug-18 7,337.57 6,403.81 13,741.38
Sep-18 7,265.28 6,420.44 13,685.72
Oct-18 7,306.67 6,387.31 13,693.98
Nov-18 7,316.37 6,536.41 13,852.78
Dec-18 7,084.10 6,477.45 13,561.55
Total 88,464.68 77,245.40 165,710.08
165,710.08 2018 YTD Commissions
(161,000.00) 2018 Annual Cap
4,710.08 2018 Excess Cap
2018 Superior Court of California, San Diego County
As of 02/05/19
License No. 0451271 Innovative Solutions. Enduring Principles.
31
Keenan & Associates Compensation Disclosure Statement
Keenan & Associates’ mission has been to provide high-quality, innovative products and services to meet the insurance
and risk management needs of our clients for many years. Keenan embraces industry efforts for transparency and
believes it is important that clients are provided with information that may be relevant to their choice of insurance products
and services, such as (i)the terms of coverage and services that are offered, (ii) the cost of such insurance and services,
(iii)the reported financial viability of insurers, and (iv) compensation that may be directly or indirectly paid to Keenan in
connection with the products or services that are presented and ultimately selected. The following paragraphs provide
additional information concerning the services that are offered by Keenan and the manner in which Keenan may be
compensated for such services. Clients that have questions regarding any of these items or that desire additional
information are encouraged to contact their Keenan account representative to discuss in more detail.
Consulting and Brokerage Services
Commission Compensation –Keenan offers consulting and brokerage services to assist clients in reviewing their
insurance needs and available insurance options. When Keenan is asked to obtain proposals for insurance and/or excess
insurance coverage, Keenan obtains quotations from appropriate insurers with coverage for the types of risks involved. A
summary of the insurance markets that were approached and the quotations received will be presented to the client.
Keenan is typically compensated for its brokerage services through commissions paid by the insurers, the cost of which is
usually included in the cost of the insurance coverage obtained. In some cases, Keenan may be requested to obtain
insurance quotes “net of commission,” in which case Keenan will enter into an agreement with the client to provide
insurance brokerage services for a fee that is paid by the client.
Other Contingent Compensation –It is a long-standing practice in the insurance industry for insurers to establish
additional compensation programs for brokers based on factors that are not specific to a particular client or placement of
coverage. These arrangements are typically referred to as overrides, contingencies, supplemental compensation or
indirect compensation (collectively, “Other Compensation”). Keenan may from time to time enter into arrangements with
insurers for Other Compensation based upon: (i)technology investment and services provided by Keenan, (ii)assistance
with developing, marketing and/or distributing products offered by insurance carriers and product vendors, (iii)specialized
expertise in niche markets that may assist insurers to properly assess market risks and to develop products,
(iv)efficiencies that may be achieved through the collective administration of larger groups of business, and (v)aggregate
volume, persistency or new business development. Such compensation does not impact our recommendations and
Keenan believes, and seeks written assurances from insurers, that any such Other Compensation does not adversely
impact the pricing and coverage terms that Keenan is able to obtain for its clients.
License No. 0451271 Innovative Solutions. Enduring Principles.
32
Keenan & Associates –Compensation Disclosure Statement (continued)
Other Services
BenefitBridge Platform Hosting and Services –BenefitBridge is Keenan’s proprietary online employee benefits eligibility
and billing system that provides clients with a web-based, technology solution for employee benefits administration,
eligibility, enrollment, billing reporting and employee communications. The significant investment that Keenan has made to
develop and support the implementation of BenefitBridge has created efficiencies and improved accuracy for clients and
participating insurers. These participating insurers pay a fee to Keenan based upon the use of the BenefitBridge platform,
which fee is separate from commission compensation that may be paid and does not impact the cost of insurance that
Keenan is able to obtain for participating clients.
Joint Powers Authority Administration –Keenan also assists public agencies in developing joint powers authorities
(JPA’s) or other purchasing coalitions to aggregate their insurance needs and reduce costs. In connection with such
programs, Keenan provides numerous types of services, including administration, consulting, underwriting, claims
administration, safety inspections, eligibility assessments, financial processing and reporting. Keenan is compensated for
these types of services pursuant to separate written agreements with the JPA or group.
Reinsurance Services –Keenan also assists JPA’s that issue a memorandum of coverage to obtain reinsurance for all or
parts of the covered risks. Keenan’s services include reinsurance marketing, intermediary services, financial processing,
reporting and claims handling with respect to risks that have been ceded to reinsurers. Keenan is typically compensated
for such services pursuant to a fee agreement or through the payment of ceding commissions.
Additional Services –Keenan may provide consulting services to clients that do not involve the purchase of insurance
coverage or products. Examples of such services include: benefits analysis, dependant audit verification, leave of absence
management, safety inspections, claims administration, and financial processing. Keenan provides these services for a
fee that is paid by the client.
License No. 0451271 Innovative Solutions. Enduring Principles.
33
Keenan Value-Added
Solutions and Services
License No. 0451271 Innovative Solutions. Enduring Principles.
34
Legislation
License No. 0451271 Innovative Solutions. Enduring Principles.
35
2018 Legislation
License No. 0451271 Innovative Solutions. Enduring Principles.
36
2017/2018 Legislation (continued)
•Health Care Reform: Texas Federal Court Invalidates ACA but Appeal is Expected to
Follow
December 17, 2018
•Health Care Reform: IRS Extends Reporting Deadline & Good Faith Relief Once Again
December 3, 2018
•2019 Benefit Limits for Health & Welfare Plans
November 22, 2018
•California Legislative Summary 2017-2018 End of Session
November 2, 2018
•Health Care Reform: Updated Benefit Limits for 2019 Plan Years
May 24, 2018
•Health Care Reform: Cadillac Tax and Other ACA Taxes Delayed Under 2018 Spending
Bill
January 24, 2018
License No. 0451271 Innovative Solutions. Enduring Principles.
37
Webinars
License No. 0451271 Innovative Solutions. Enduring Principles.
38
2017/2018 Webinars
License No. 0451271 Innovative Solutions. Enduring Principles.
39
Keenan Blog
License No. 0451271 Innovative Solutions. Enduring Principles.
40
KeenanDirect
License No. 0451271 Innovative Solutions. Enduring Principles.
41
KeenanWell
License No. 0451271 Innovative Solutions. Enduring Principles.
42
Time
•2 VTO Days Per Year
•Company-Wide Service Day
•Company-sponsored VTO Projects
Talent
•Right Start Mentoring Program focused
on middle school kids
Product
•Abuse Prevention Center
•Online Mandated Reporter Training
•School Safety Center
Dollars
•Donated more than $300K to support
local causes in 2018
•Engaged tradeshow attendees in
“Impact Projects” helping local charities
Corporate Social Responsibility
License No. 0451271 Innovative Solutions. Enduring Principles.
43
September 2018
Compliance Letter
License No. 0451271 Innovative Solutions. Enduring Principles.
44
2017-2018 End of Session
Legislative Summary
License No. 0451271 Innovative Solutions. Enduring Principles.
45
November 2018 Briefing
with 2019 Benefit Limits
License No. 0451271 Innovative Solutions. Enduring Principles.
46
THANK YOU!
We truly appreciate your business and look forward
to working with you and your employees for many
years to come.
We believe in forming a mutually beneficial
partnership and welcome your constructive
comments on how we may serve you better
96
City of La Quinta Response to
March 23, 2021 RFP - Employee Benefits Broker/Consultant Services
CA License No. 0451271 Innovative Solutions. Enduring Principles.
Appendix 2 – Sample Benefits Enrollment Guide (5 pages)
BenefitsEmployee
2019 Guide
CLIENT LOGO
iFooter Name CLIENT
2019
Employee
Benefits Guide
If you (and/or your dependents) have Medicare or you will become eligible for Medicare in the
next 12 months, a Federal law gives you more choices about your prescription drug coverage.
Please see page 27 for more details.
The information in this brochure is a general outline of the benefits offered under [Client’s] benefits program. Specific details and plan limitations
are provided in the Summary Plan Descriptions (SPD), which is based on the official Plan Documents that may include policies, contracts and plan
procedures. The SPD and Plan Documents contain all the specific provisions of the plans. In the event that the information in this brochure differs
from the Plan Documents, the Plan Documents will prevail.
1. General Information
1. Introduction
3. Core Benefits
3. About Your Coverage
5. Dental
7. Vision
8. Other Benefits
8. Basic Life & AD&D
9. Supplemental / Optional / Voluntary Life
10. Supplemental / Optional / Voluntary AD&D
11. Short Term Disability
12. Long Term Disability
13. Voluntary Short Term Disability
14. Voluntary Long Term Disability
15. Rates
16. Employee Assistance Program
17. Flexible Spending Accounts
19. Trustmark Voluntary Insurance
21. Employee Benefits Web Site
22. Miscellaneous
22. Important Notices
32. Contact Information
1Footer Name CLIENT
Introduction
[Client] employees receive excellent compensation packages. Benefits include employer-paid health and dental coverage, life
insurance, paid vacation, holiday and sick leave, and contributions to retirement plans. In addition, [Client] offers education
achievement incentives, professional training, workshops, and advancement opportunities.
Annual Enrollment for Current Employees
Health insurance is one of the most critical benefits offered
by [Client]. A major illness or injury could be financially
devastating without adequate insurance. Even the cost of
treatment of minor conditions can be prohibitive. With this
in mind, our benefit program is designed exclusively to
meet the health care needs of you and your family.
Depending on where you live, your personal preference
regarding physician choice and type of health care
environment you prefer, you may choose the plan that is
most suitable for you and your family members.
The benefit elections you make during open enrollment will stay in effect from October 1, 2016 through September 30, 2017 if
you remain eligible for benefits. However, after open enrollment ends, you can make plan changes ONLY if you have a qualified
status change. Please refer to “Making Mid Year Changes to Your Benefits” within this booklet.
[Client] is fortunate to
be able to pay for the benefits for you and your
family members. Choosing the right plan is a
very personal thing.
Use this booklet to find one that’s Right for your
lifestyle, Right for your needs, Right for your
peace of mind.
Footer Name CLIENT2
Introduction (continued)
What’s New for 2018-2019
What is Happening with Health Insurance?
You may have heard in the news or seen advertising about
the Affordable Care Act (ACA) and Covered California (also
known as the Health Insurance Exchange or Marketplace).
Many people are still unaware of the huge changes taking
place in our health care system, the decisions they will need
to make and the impact on their personal health care costs.
Under the ACA, most people were required to have health
insurance coverage by January 1, 2014, or they will have to
pay a tax penalty. You may already be enrolled in or may
be eligible for health coverage through [Client]. We will be
offering our eligible employees health coverage during
our regular enrollment period again this year. Please visit
[Client]’s intranet site for additional information.
Qualifying Events
In accordance with the provisions of [Client]’s Flexible
Benefits Plan, changes outside of the open enrollment
period can only be made for one of the following reasons:
• Changes due to “a change in the Participant’s family
status.” (Section 5.5) Changes must be made within
30 days of the change in family status. Failure to
make changes within 30 days of the change in family
status will require that the employee wait for the
next open enrollment period.
• Changes due to a “significant change in the cost of
coverage of the benefits previously elected by the
Participant.” (Section 5.6)
• Employees may request to drop coverage through
the Agency’s health plan in order to become
covered under a spouse’s health plan outside of
the Agency’s open enrollment period, ONLY IF
the spouse has just become eligible for coverage.
The spouse’s employer must provide proof that
their employee has just become eligible for this
coverage. Otherwise, the employee must wait until
the next open enrollment period.
Changes are not permitted outside of the open enrollment
period except as provided under “Qualifying Events”. Said
changes of an election outside of the open enrollment
period must be consistent with the change in status.
Employees are responsible for informing the Benefits
Department of any changes in dependent status within
30 days of said change. Failure to do so will result in no
coverage for your eligible dependents(s) / spouse.
Do You Need to Do Anything?
The answer is “no” unless you want to:
• Change your plan election
• Add or delete coverage for an eligible dependent
See “Making Mid-Year Changes to Your Benefits” on the
next page for more information. Keep in mind that after the
Open Enrollment period, you cannot change your benefit
elections during the year unless you have a qualifying life
event.
Stay tuned to [Client] communication pieces
related to ACA updates and information for
employees.
Drop Dependent
The effective date used when you drop a
dependent will be the first of the month
following the date of notification to the Agency.
3Footer Name CLIENT
If you and your spouse are both covered as employees
under the Agency’s plans, each employee may enroll as a
subscriber and each may enroll your dependents.
When Are You Covered?
If an employee is hired between the 1st – 15th of the
month, coverage becomes effective the first day of the
month following date of hire. If an employee is hired the
16th of the month or after, coverage becomes effective the
first of the month following 30 days of employment. Your
family members are covered:
• For all existing family members, on the date you
are covered;
• For a new spouse and step child, the first day of the
month after the date your spouse and step child
become a family member(s) due to marriage;
• The date a child becomes your family member due
to birth, adoption, or legal guardianship.
Making Mid-Year Changes to Your
Benefits
The benefit elections you make during open enrollment will
stay in effect from October 1, 2018 through September 30,
2019 if you remain eligible for benefits. Each year, during
open enrollment, you have the opportunity to change your
coverage elections for the following plan year. However,
after open enrollment ends, you can make plan changes
ONLY if you have a qualified status change. Qualified status
changes include:
• Marriage or registration of a domestic partner
• Divorce or legal separation from a spouse
• Birth, adoption, placement for adoption, or legal
guardianship of a child
• Death of a spouse / domestic partner or a child
• Child’s loss of eligibility due to age
• You or your spouse has a change in employment
status that results in gaining or losing eligibility for
benefits coverage
• Full-time / part-time employment status change
resulting in an insurance eligibility change
• Commencement of or return from an unpaid leave
of absence
• Change for an individual eligible for Medicare or
Medicaid
• QMED
• CHIP
Over-Age Dependents
Health care reform legislation has mandated that group
health plans offer coverage to dependent children until
they attain age 26.
About Your Coverage
Important Notice About Dependent Eligibility
• You are an employee and meet the eligibility requirements.
• If you do not add newly eligible family members to your health plan within the 30-day period of eligibility, you
will have to wait until the next open enrollment period before you can enroll them.
• Your former spouse / domestic partner, parents, parents-in-law, other relatives, and children over age 26, are
not eligible for coverage under your health care plans.
• They must be your natural, step, or adopted children (children for whom you may be a legal guardian for are
also eligible).