Benefit Contracts Division
The Benefits Contracts Division is responsible for contract review, monitoring and compliance for vendors of the Texas Employees Group Benefits Program (GBP) and Deferred Compensation (DC) Program, as well as the competitive bid process.
Deferred Compensation Administration
The DC Administration department is responsible for monitoring the Texa$aver TPA, Mutual Fund Vendors, the Investment Advice Service, the Prior 457 Plan, and state and federal legislation. DC staff provide revisions to Chapter 87 Plan rules, recommend changes to ERS’ 401(k) Plan documents, direct fund audit processes, coordinate program communications and work on special projects to meet the diverse and dynamic needs of program participants.
Underwriting Data Analysis & Reporting
The Underwriting Data Analysis & Reporting (UDAR) department of Benefit Contracts gathers data to analyze all product lines. Utilization, claim experience, revenue streams, and plan design are monitored on a consistent basis. UDAR reports to the Director of Benefit Contracts and works closely with outside actuaries for insurance matters. Rates, product offerings, claim experience analysis, and critical industry surveys are completed and reviewed on a monthly basis. Annual rate development is generated and coordinated with ERS’ actuaries.
GBP Contract Compliance and Account Management
The GBP Contract Compliance and Account Management department is responsible for contractual compliance of the medical, pharmaceutical, life, disability, dental, flexible spending account and discount contracts. Account management staff monitors the health and welfare contracts through day-to-day contact with vendors, interpretation of contract requirements, site visits, and through the review of reporting documents to assure contract compliance. The account management department also coordinates audits of GBP contracts by independent auditors and reviews the audit reports for compliance with the contracts.
Proposal Activity Administration
The Proposal Activity Administration department is responsible for the creation, publication, and distribution of divisional requests for: Proposals (RFP), Applications (RFA), Information (RFI) and Qualifications (RFQ). This department evaluates bid responses and provides contracting recommendations to ERS' Executive Office and Board of Trustees. Additionally, this department researches issues that might impact or enhance GBP benefit programs and provides analysis of proposed health and welfare legislation during legislative sessions.
Health & Welfare Administration Services
The Health and Welfare Administration Services department is responsible for the GBP insurance grievance appeal process for the self-funded plans. The services staff reviews the insurance carriers’ justifications and responds to appellants. Additionally, the services staff assists the GBP Contract Compliance and RFP Administration departments in monitoring and developing the GBP Plans.
Federal/State Government Program Management and Class Actions
The Federal/State Government Program Management and Class Actions (FSGPM) department administers the State of Texas Social Security Program for government employers. FSGPM represents the state and acts as a liaison between the Social Security Administration, the Internal Revenue Service, and the government entity to ensure proper coverage for state employees. This department manages the Medicare Secondary Payer program, the Medicare Part D – Retiree Drug Subsidy program, and the Early Retiree Reimbursement Program. In addition, FSGPM manages the prescription drug class action lawsuits for the GBP.