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