RFP Checklist

When requesting a self-funded proposal, please provide the following (in electronic format, if possible):

• Name and location of the employer

• Industry/SIC # of the employer

• Current census (Excel format preferred). For each employee, provide:

  • Sex

  • DOB

  • Family status (single, 2-party, family)

  • Plan choice (if more than one plan is offered)

  • Benefits enrolled in (if employee can pick and choose benefits cafeteria-style)

  • ZIP code (if multiple employee locations)

• COBRA participants

• Current plan designs. Please note if any significant benefit changes were made in the last 24 months.

• Proposed plan designs

• Current and renewal rates

• Experience (minimum 2 years, if available). Include:

  • Employee counts by month

  • Claims by month, broken out by benefit (i.e., medical, prescription, dental, vision)

• Large claim information for each year of experience provided, including:

  • Diagnosis

  • Prognosis

  • Was the patient an employee or dependent?

• Specific stop-loss deductible requested

• Aggregate coverage requested

• Contract term requested