7981 Post-65 Retiree-Rx Coverage Scope of Work7981 Post‐65 Retiree Medical/Prescription Coverage
Scope of Work
The scope of work shall be finalized upon the selection of the Firm. The respondent’s submission shall
have accurately described your understanding of the objectives and scope of the requested products and
services and provided an outline of your process to implement the requirements of the Scope of Work
and Services. It is anticipated that the scope of work will include, at a minimum, the following:
The City of Denton (City) is seeking qualified vendors to provide Post‐65 Retiree Medical/Prescription
Coverage for the City’s post‐65 retirees, and dependents that are eligible for post‐65 medical/prescription
coverage. The City is requesting Medicare Supplement plans only. Medicare Advantage plan proposals
will not be considered. Please match current plan designs as closely as possible. The City is requesting a
one (1) year rate guarantee with four (4) optional annual renewals.
The City offers benefits to all retirees who retire from the City after 20 years of service, or five (5) years of
service, past age 60. Coverage begins the first of the month following the date paperwork is completed
and turned into the Human Resources department. The City also offers benefits to eligible dependents
(legal spouses, declared common‐law spouses, unmarried children up to 26 years of age, children of any
age if mentally or physically incapacitated and dependent on the employee for financial support, and
dependent grandchildren that qualify as defined by the IRS or Federal Income tax return).
Retirees are covered if the retiree qualified for regular retirement benefits, or disability retirement
benefits, as defined by the Texas Municipal Retirement System or the City’s Fire Pension Fund. Retirees
must elect coverage at the time of retirement. A retiree can drop coverage at any time, but once dropped,
this member will not be able to re‐enroll in retiree coverage. Members can add a dependent during a
qualifying life event with proof of event. The qualifying life event must be loss of coverage for the spouse.
The City currently offers post‐65 retirees a Medicare Supplement plan, including prescription coverage,
with the medical coverage provided by United American, and the prescription coverage provided by
Humana. The Post‐65 Medicare/Prescription Coverage services providing customer service for both the
medical and prescription coverage. A brief summary of benefits (in electronic format) of the current
medical and prescription drug has been provided as an attachment. Several current members are enrolled
in Part F and are grandfathered into this plan.
Current Plan Design
Current Rates
Full Rate
United American Medical Rate $191.00
Humana RX Rate $180.05
Total Rate* $371.05
*Enrolled members must enroll in both medical and prescription for the full rate of $371.05. Members
cannot enroll in just medical or just prescription separately.
Employee/Employer Split
Background
The City of Denton (City) is requesting your proposal to provide Post‐65 Retiree Medical/Prescription
Coverage for post‐65 retirees and spouses enrolled in the City’s self‐funded dual option medical plan at
time of retirement. The City is requesting Medicare Supplement plans only. Medicare Advantage plan
proposals will not be considered. The City is requesting a one (1) year rate guarantee with four (4)
optional annual renewals. Additionally, the City extends medical benefits to our retirees, and their eligible
dependents, if the retiree elects to maintain coverage at the time of separation.
The City of Denton has a work force of approximately 1,534 employees. The City has had an effective
safety and risk management program since 1970, an active Wellness Program since 1990, an insured
employee assistance program (EAP) since 1998 and became self‐funded for the employee health plan in
2008. Additionally, the City has an Employee Insurance Committee (EIC) representing all departments,
providing education and feedback as well as recommendations to City Management and City Council. The
City has an active Wellness Committee and has developed a wellness incentive program that began in
2011.
The City has approximately 1,506 full time employees with approximately 1,392 employees covered under
the City’s health plans. Additionally, approximately 115 pre‐65 retirees, including surviving spouses, are
covered under the active medical plans. In total, the City’s active medical plans have approximately 3,800
covered lives. The City’s Medicare Supplement coverage, has approximately 201 retirees, including
spouses, covered on the Medicare Supplement plan. In total, there are 266 retirees covered on a City
medical plan.
The City’s benefit plan year is January 1 through December 31.
Philosophy
The City wants to provide high quality, cost effective medical care with a focus on wellness and prevention
to our eligible retirees, and dependents (“members”) that participate in the City’s Medicare Supplement
plan.
**Please include a list of key personnel and their resumes as well.**
Please note, failure to provide references at the time of submittal could result in disqualification.