UNMH Stop Loss Insurance Coverage

The University of New Mexico Hospital (UNMH) is seeking a qualified insurance carrier to provide stop‑loss coverage for its self‑funded employee health plan. The award will cover the 2026 plan year and transition to a proprietary network on January 1 2027, requiring the carrier to handle both medical and pharmacy claims, meet specific deductible options, and provide timely reimbursement and reporting. The contract emphasizes a high A.M. Best rating, a dedicated account manager, and the ability to offer multi‑year rate guarantees with “no‑new‑laser” provisions. • Provide individual stop‑loss coverage with deductible options of $525k, $550k, $600k, and $1 M. • Interface with UNMH’s claims administrator (Community Care Partners) and process both PPO and HDHP plans. • Submit a firm cost proposal (PEPM or composite rate) and meet technical criteria such as rate caps, no‑laser contracts, and a firm renewal for plan year 2028.