Request for Proposals
Seeking proposals for benefit consulting services for the Oregon Essential Workforce Health Care Fund
The Oregon Essential Workforce Health Care Fund (“Fund”) is a newly established Taft-Hartley ERISA Trust that desires to provide self-insured health benefits to employees and dependents of eligible long term care employers. Eligible long term care employers can be a long-term care facility licensed under ORS 441.020, a residential facility as defined in ORS 443.400, or an in-home care agency licensed under ORS 443.315. Non-union employers are eligible to participate. The Fund’s Board of Trustees are jointly appointed by the long term care employers and the Service Employees International Union (SEIU) Local 503. Click here to read/download Trust Agreement.
The Fund goal is to provide quality, affordable health benefits for primarily low-wage workers who are unable to afford their employers’ current plan and are currently or soon to be ineligible for the Oregon Health Plan (Medicaid).
The Oregon Essential Workforce Health Care Fund is requesting proposals from qualified firms to provide benefit consulting services, including:
- Analyze employers’ current health benefits
- Design and implement a new benefit plan for specified employees of participating employers and their dependents in accordance with Trust priorities, including, but not limited to, improvement upon current options, Affordable Care Act (ACA) silver-level actuarial value at minimum, improved affordability of out-of-pocket costs for employees, and others as defined
- Manage the RFP for the Administrative Services Only (ASO) contract for network maintenance, claims processing, rate setting, and plan administration
- Manage the RFP for the preferred provider organization (PPO) contract
- Provide ongoing advice and management education on industry trends and legal and regulatory compliance, market benchmarks, best practices, and act as a resource to management in employee training.
The ideal firm will combine depth of knowledge and breadth of services with a special level of intuition and human insight to identify potential solutions and guide competing interests to common goals.
Frequently Asked Questions
Is the Oregon Essential Workforce Health Care Fund already established?
Is there a Trust Agreement available?
Who will be covered by the Fund?
What is the current breakdown between collectively bargained employees and non-collectively bargained employees in the Fund?
Currently, all employees work for employers in employment covered by a collective bargaining
agreement. The Fund anticipates that some collectively bargained employers will seek to cover their noncollectively bargained employees. In addition, employers without a collective bargaining agreement will have an opportunity to participate once the Fund is operational and the benefit is designed.
We note that it is anticipated that the Fund will not be a MEWA for the first several years of operation
and will remain a Taft-Hartley joint labor management Trust under the Senate Bill 800 exemption from the Oregon MEWA regulations.
Where are these employees currently receiving health benefits?
What is the expected funding?
What is the intended structure of the benefits to be offered?
model where the Fund’s PPO network also handles claims processing, customer service, etc. in a full ASO model with a single PPO vendor network. Our preference is a separate network for prescription drugs.
When are benefits expected to be offered?
delays with the government funding are possible and would necessitate a delay in the start of the
Has the Fund already retained the other Fund professionals?
How many plans designs will be offered?
What request for proposals will need to be conducted by the selected Benefit Consultant?
What other benefits will be offered by the Fund?
vision. Mental health benefits will be part of the medical benefits.
What are the current benefit Plan Years for each of the 4 participating employers?
10/1/2021 to 9/30/2022
11/1/2021 to 10/31/2022
1/1/2022 to 12/31/2022
3/1/2022 to 2/28/2023
Are there any metrics on employee turnover?
Current annual turnover among non-management staff is estimated at 56%.