Hillsborough County benefits committee assigns consensus scores to three health-plan proposals, Cigna tops list

Hillsborough County benefits evaluation committee members reached consensus on scores for three health-plan proposals during a committee meeting; the group recorded Cigna with 100 points, Aetna with 95 and UnitedHealthcare with 89.

Committee members and benefits advisors reviewed each proposer’s technical approach, system capabilities, pricing and experience and applied bonus points for MWBE participation before finalizing scores. The committee’s consensus scoring will be used in the county’s procurement process to compare proposals and inform next steps in selecting a carrier.

The meeting focused on several substantive differences across proposals. A benefits advisor summarized Aetna’s pitch to expand employee medical centers while recommending interim use of existing clinic locations, saying, “Aetna’s proposal on that — that was strong for me.” The group discussed how on-site or local clinics could improve access across the county’s large geography.

Preauthorization lists and prior-authorization practices were a central technical concern. Committee members asked how proposers’ preauthorization lists compare with Hillsborough County’s current rules; the committee cited proposal documents that show Aetna listing 33 services that require prior authorization and UnitedHealthcare listing 48. A committee member recalled past problems when imaging preauthorizations were reintroduced, saying the county previously experienced 7–10 day delays when many imaging orders went through prior authorization, and that the county now allows X-rays without additional steps but maintains step requirements before MRI.

Members also discussed claims-processing speed. Committee members said the team is aiming for roughly 90% auto-adjudication of claims because a higher auto-adjudication rate reduces provider billing confusion and speeds member experience. The committee noted that automatic adjudication can speed approvals and denials but does not guarantee fewer denials overall; a benefits advisor said auto adjudication means claims are evaluated faster, reducing the likelihood that providers will send balance bills while a manual review is pending.

Behavioral-health services and on-site mental-health providers were highlighted as notable features in some proposals. Committee members said Cigna offered a behavioral-health enhancement as a buy-up that could be funded from the county’s benefit “bucket,” and one participant called the ability to deploy an on-site mental-health provider “very important,” noting departments sometimes request immediate access for employees involved in traumatic incidents. The committee recorded that this enhancement was not present or was presented differently in the other two proposals.

Committee members also discussed innovation items: UnitedHealthcare included a tech-enabled, first-dollar co-pay plan intended to steer employees toward lower-cost high-quality providers; advisors called that “innovative” but questioned whether the county’s workforce would widely adopt a tech-first tool. Committee members noted existing clinic networks referenced by proposers (MinuteClinic locations and other local clinics) and that annual wellness visits are offered at no cost under the county’s current design.

On scoring methodology, the committee applied category-level scores (proposal understanding and technical approach; quality of proposed system; pricing and discounts; organization qualifications and experience) and awarded bonus MWBE points where applicable. The committee facilitator read the consensus results into the record: Aetna category totals produced a base score that, with MWBE bonus points, resulted in a total of 95; Cigna’s category scores plus bonus points totaled 100; UnitedHealthcare’s category consensus produced a total of 89. Committee staff asked members to remain briefly after adjournment to sign scoring sheets.

Next steps mentioned during the meeting included recording the consensus scores into the procurement system, printing and signing the scoring sheets and scheduling any follow-up evaluations or clarifications. Committee members noted a follow-up meeting date was on the calendar (an upcoming meeting on the 18th was referenced) to continue procurement work if needed.

Votes at a glance: the committee did not take a roll-call procurement vote but recorded consensus scoring for three proposals: Cigna 100 points, Aetna 95 points, UnitedHealthcare 89 points. The committee recorded the consensus scores for use in the RFP evaluation process and will retain signed scoring sheets as part of the procurement record.

The meeting record shows the committee weighed operational features (clinic access, behavioral-health buy-up, auto adjudication) and scoring categories rather than selecting an award at that session; the committee’s consensus scores will be included in the county’s ongoing procurement evaluation.