Medical/Rx

The Hillsborough County Public Schools is seeking a proposal for medical benefits, including behavioral health and pharmacy, for its active employees, under age 65 retirees, Medicare-eligible retirees, and COBRA participants, effective on January 1, 2027. The total number of eligible employees is approximately 24,328. The school district is looking for a self-funded option with various structures for respondents to choose from, with the goal of claims cost mitigation. Some key points to consider: • The school district is currently fully insured through Aetna but will be moving to a self-funded plan effective January 1, 2026. • The district is introducing three new medical plans in 2026. • Respondents have the option to propose different structures, including self-funded ASO or TPA options with Rx carved in or out. • The proposal should help the district achieve its goals of claims cost mitigation.