For employer groups with over 50 full-time permanent employees under Vermont law (30 or more hours per week in a typical workweek), a medical insurance proposal is obtained from each carrier; there are no published rates. The employer in the large-group category may also be large enough to consider the partially self-insured option. In either case some basic information needs to be compiled in order for BDS to obtain accurate quotes from medical carriers and/or reinsurance markets. A minimum lead-time of at least two, and preferably 3, months prior to the group’s anniversary date is recommended to ensure time to assemble the RFP, receive quotes from carriers, prepare the BDS proposal, decide on the best plan for your group, to impliment the selected coverage and enroll participants.

Information most Vermont carriers and reinsurers require to produce a medical quote include:

1. Current census in an Electronic Format (if dual plans are offered, indicate plan selected for each employee). Contact BDS for the information that should be included with your census.
2. If there have been significant changes in enrollment over the past two years, please provide enrollment totals by month or quarter.
3. Current medical premiums for plan year and dollar amount or percentage of employer contribution (if your company has different classes of employees, please indicate):
   

   	Current Premium	$	or % of Employer Contribution
   Single	$	$	or %
   Two-Person	$	$	or %
   Family	$	$	or %

4. New Hire/Rehire Probationary or Waiting Period policy.
5. Current Plan Design or Schedule of Benefits (a one-page summary should be sufficient)
   
6. Specifications for Proposed Plan Design and Other Aspects of Proposed Quote if different from in-force plan(s)
   
7. If Self-Funded, working and COBRA rates that incorporate Administration Fees, Network Access Fees, Stop Loss Premiums and Projected Claims.

   	For Active Employees	COBRA Rates
   Single	$	$
   Two-Person	$	$
   Parent/Child	$	$
   Family	$	$

8. Claims Experience for 2-plus years by month, if available. (If aggregate claims include health and other benefit [i.e. dental, vision], please supply a break down of claims experience by type.)
9. High Risk Claims. Please list any potentially high-risk claimants (employees or dependents) giving information requested below. A high risk individual is one with actual or projected claims generally exceeding $20,000, but is dependent on the group size.

   AGE	GENDER	DATE	DIAGNOSIS	TREATMENT/PROGNOSIS	EST. COST
   ___	_____	_____	______________	_______________________	$ _______
   ___	_____	_____	______________	_______________________	$ _______

10. Current Funding Mechanism. Please indicate if current plan is (circle one):
    • fully insured
    • partially self-insured: Specific Stop-Loss Breakpoint: $ _________
    Aggregate Stop-Loss Breakpt: $ _________
    • high deductible with employer-paid supplemental health plan (SHIP)
    • fully insured with contingent rating.