Willacy County Seeks Insurance Consultant
Willacy County is not seeking a conventional insurance broker or another plan administrator. It wants an outside expert who can help protect and improve an existing cost-containment model, evaluate claims performance, strengthen direct provider arrangements, and support sound financial decisions.
This RFQ is designed to hire an independent, fee-only health-plan consultant with strong self-funded plan, claims-cost management, reference-based pricing, and public-sector experience.
SUMMARY: Willacy County Employee Health Benefits Program — Insurance Consulting RFQ – Source: Willacy County Request for Qualifications, October 2026
1. Purpose of the RFQ
Willacy County is seeking a qualified, independent insurance consultant to advise the Willacy County Employee Health Benefits (WCEHB) Program on managing and overseeing its self-funded employee health plan. The program covers seven participating public entities.
The consultant will provide strategic advice, financial analysis, and recommendations—not day-to-day plan administration or insurance brokerage services.
2. Key dates and submission requirements
October 28, 2026 — Questions deadline
Written questions must be emailed by 5:00 p.m. Central Time to Libna Sarmiento, Benefits Coordinator, at benefits.coordinator@willacy.gov.
November 4, 2026 — Submission deadline
Three sealed hard copies must be delivered by 12:00 noon Central Time. Electronic, emailed, and faxed submissions will not be accepted.
Delivery address
Hon. Ruben Cavazos, County Treasurer Willacy County, 576 W. Main Ave., Room 143 Raymondville, TX 78580
3. Scope of consulting services
The County wants expertise in:
- Self-funded health plan management and claims oversight.
- Reference-based pricing (RBP), including point-of-service claim adjudication and payment.
- Direct provider contracting, particularly in the Rio Grande Valley.
- Pharmacy benefit management (PBM) strategies.
- Financial forecasting, contribution rates, and reserve management.
- Analysis, recommendations, and written deliverables, generally through quarterly meetings or meetings as needed.
The engagement is designed to complement the County’s existing capabilities rather than replace its plan administrators.
4. Important existing plan characteristics
WCEHB has already developed several distinctive cost-containment strategies:
- A proprietary professional provider network with reimbursement tied to Medicare benchmarks.
- Reference-based pricing for facility claims.
- A point-of-service claim settlement and payment strategy.
- Off-site direct primary care services.
- No use of managed care contracts, with no desire to adopt them.
The RFQ emphasizes that claims drive plan costs and that effective claims management is critical to the program’s continued success.
5. Consultant qualifications
Mandatory requirements (pass/fail):
- Errors and omissions insurance of at least $1 million per claim and $2 million aggregate, unless the County requires different limits.
- Documented experience advising Texas political subdivisions or comparable public employers on self-funded health plans.
- Willingness to accept fee-only compensation without third-party commissions or remuneration.
Preferred qualifications:
- RBP and independent TPA experience.
- Understanding of managed care contracts.
- Direct provider contracting experience in the Rio Grande Valley.
- Financial projections for contributions and reserves.
- Knowledge of market products and trends.
- Documented consulting results supported by quantifiable outcomes.
6. How proposals will be evaluated
Texas public-sector and self-funded plan experience – 30%
RBP, direct contracting and Rio Grande Valley experience – 30%
Plan finances, contributions and reserves – 20%
Documented results and references – 10%
Proposed approach and interview – 10%
Fees are not scored during the qualifications stage. The County will negotiate a fair and reasonable fee with the highest-ranked respondent. If negotiations fail, it may move to the next-ranked candidate.
7. Independence and conflict-of-interest requirements
The consultant must:
- Not serve as the County’s insurance agent, broker, or Broker of Record.
- Receive compensation exclusively from Willacy County.
- Accept no direct or indirect commissions, overrides, contingent compensation, or other third-party remuneration connected to the engagement.
- Disclose relevant ownership interests, appointments, and business relationships with carriers, TPAs, PBMs, providers, and networks.
- Submit the required Conflict of Interest Questionnaire and evidence of E&O insurance.
Material nondisclosure can result in disqualification or termination.
8. Contract terms
- Initial term: One year, subject to appropriation.
- Termination: Either party may terminate for any reason with 30 days’ written notice; the County may also terminate for cause.
- Approval: The Health Insurance Committee recommends a selection, and the Commissioners Court makes the final decision.
- Protests: Written protests must be submitted within five business days after the protester knew or should have known the relevant facts.