Title:
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Request Board approval of the following benefits and to authorize the County Manager to execute any related, required documents: Cigna – Prescription Benefits Manger (PBM); Prescription Efficiency/Savings Program – Prescription Care Management (PCM); Reliance Matrix – Dental; SunLife – Supplemental Benefits (Critical Illness/Cancer/Hospital Indemnity/Accident) – SunLife; Pre-Paid Legal – MetLife. Countywide (Christina Brandolini, Human Resources Director)
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Division:
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Human Resources - Employee Benefits
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Authorized By:
Christina Brandolini, Human Resources Director
Contact/Phone Number:
Meloney Koontz/407-665-7225
Background:
Seminole County, along with Alliant (benefits consultant), reviews employee benefit plan offerings annually to ensure quality of service, engagement, efficiency, and fiscal responsibility. Human Resources and Alliant conducted a benefit and wellness work session with the Board on August 12, 2025, during which Alliant presented the results of several request for proposals (RFP’s) conducted on behalf of the County. This included the carrier selection recommendations for each. This agenda item includes the contract awards for prescription benefit manager and additional ancillary benefits for Plan Year 2026. Dental (Exhibit C), Supplemental Benefit Plans (Exhibit D) and Pre-Paid Legal (Exhibit E) are employee paid benefits. Prescription Benefits Manager (Exhibit A) anticipates a savings of $407,000 or 6.3% of pharmacy spend. Prescription Savings/Efficiency Program (Exhibit B) anticipates a savings of $3,914.
Prescription Benefits Manager - (Cigna – Exhibit A)
Manages prescription drug benefits on behalf of the County’s self-insured health benefit plan. These services include negotiating drug pricing and rebates, establishing a formulary, maintaining a pharmacy network, and processing prescription drug claims. Staff is recommending continuing with Cigna, the County’s health benefit administrator, as the prescription benefits manager for the employee health plan, with improved formulary, rebates, and transparency.
Recommend as quoted with Cigna.
Prescription Savings/Efficiency Program – (Prescription Care Management (PCM) – Exhibit B)
Supplemental prescription drug savings program that provides patients an opportunity to maintain clinical outcomes while improving cost efficiency by moving patients, voluntarily, to more effective drugs within the County’s broad prescription formulary. Patient and physician contact and concurrence are required. This benefit is cost neutral.
Recommend as quoted with Prescription Care Management.
Dental (Reliance Matrix– Exhibit C)
Reliance will offer three (3) employee paid plans from which employees may select, including a PPO (low), PPO (mid), and PPO (High) plan. Reliance Matrix has provided a 2-year rate. No fiscal implication to the County, premiums are 100% employee paid.
Recommend as quoted with Reliance Matrix.
Supplemental Benefit Plans Critical Illness/Cancer/Hospital Indemnity/Accident (SunLife – Exhibit D)
Employees have the option to purchase supplemental coverages for critical illness, cancer, hospital indemnity, and/or accidents. The critical illness policy helps protect employees and their families from financial loss upon diagnosis of a covered condition. The cancer plan provides fixed benefits for diagnoses of cancer and for other related expenses or treatments. Hospital Indemnity coverage helps employees with out-of-pocket medical costs incurred with a hospital stay. Accident insurance provides protection for injured employees to help satisfy deductibles, out-of-pocket medical expenses, or pay household bills. These plans have no fiscal implications to the County, premiums for each are 100% employee paid.
Recommend as quoted with SunLife.
Pre-Paid Legal (MetLife – Exhibit E)
Employees can easily access a nationwide network of pre-qualified, experienced attorneys for a variety of legal
support. There is no fiscal implication to the County, premium is 100% employee paid.
Recommend as quoted with MetLife.
Requested Action:
Staff requests Board approval of plans and contracts for each benefit as outlined.