HomeMy WebLinkAboutRFP - 7054 BENEFITS DENTAL-.-
City of
Fort Collins
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ADDENDUM No. 2
7054 Benefits — Dental
SPECIFICATIONS AND CONTRACT DOCUMENTS
Description of RFP: 7054 Benefits — Dental
OPENING DATE: 2:00 P.M. (Our Clock) August 13, 2009
Financial Services
Purchasing Division
215 N. Mason St. 2"' Floor
PO Box 580
Fort Collins, CO 80522
970.221.6775
970.221.6707
fcgov. com/purchasing
To all prospective bidders under the specifications and contract documents described
above, the following changes are hereby made.
Questions and Answers:
1. Can you please provide the Census document in Excel?
Attached as a separate file.
2. Provide the "rolling 12 claim reports", preferably split between the high and
low plans, which show total claims paid by month, and total employee
enrollment by month. This way we can project claim cost the most accurately
by plan design. While the utilization report the City provided is helpful, it will
not be helpful for our claims calculations.
Attached as a separate file.
3. We would like to match benefits as closely as possible, so getting the full
Summary Plan Documents (normally 20-60 pages long) would also be most
helpful, so we can match your current plans as close as possible for items
such as class shifting, frequency limitations, exclusions, etc. The document
provided per Addendum No. 1 appears to be the benefit summary, not the full
SPD.
Attached as two (2) separate files.
4. Please confirm the current dental carrier.
Delta Dental of Colorado
5. Please confirm the proposed plan design.
As defined in RFP Document, Plan Comparison Sheet and SPD.
Section 2.0 Services to Be Provided
In addition to the plan provisions set forth in the attachments, the City has specific requirements
needed to support its day-to-day operations.
2.1 Specific Requirements
• Account Management
The account executive and service representative(s) will deal directly with the City. This
environment requires the account management team to:
➢ Be able to devote the time necessary to the account, including being available for
frequent telephone and on -site consultations with the City. Firms who are not
committed to account service will not receive serious consideration;
➢ Be extremely responsive;
➢ Be comprised of individuals with specialized knowledge of the proposing firm's:
- Claims and Eligibility Systems
- Provider Networks (where applicable)
- Systems Reporting Capabilities
- Claims Adjudication Policies and Procedures
- Administrative Services Contract Wording
- Standard and Non -Standard Banking Arrangements
- Relationships with Third Parties
➢ Be thoroughly familiar with virtually all of the proposing firm's functions that relate
directly or indirectly to the account;
➢ Act on behalf of the City in "cutting through red tape". This facet of account
management cannot be emphasized enough — the account management team
must be able to effectively advance the interests of the City through the firm's
corporate structure.
• Enrollment/Eligibility
The City will provide initial enrollments electronically or on paper. The initial enrollment
and updates will be provided directly to the selected firm by the City.
The selected firm will perform direct eligibility certification to providers and verify
coverage as a part of the claims management and adjudication process. A quarterly
reconciliation between payroll and eligibility will be required of the selected firm.
• Fee Administration
Selected firm will invoice the City. The City may calculate the fees/ premiums payable
on a monthly basis and will submit these fees directly to the selected firm.
0
COBRA Administration
Where applicable, COBRA Administration will be conducted by the chosen firm and
eligibility information will be provided by the City. Supportive services required by the
selected firm will be as follows:
➢ Accept information from the City on COBRA participants
➢ Send COBRA notifications to plan participants at termination
➢ Claims adjudication inquiries
➢ COBRA member service inquiries related to benefits and claims
• Customer Service
The selected firm must have as its primary focus efficient and effective processing of all
inquiries. Satisfactory customer service will include prompt, courteous and accurate
responses to the City and employee inquiries regarding claim submissions, applicable
provider networks, plan design and provisions, etc. A toll free number should be
available for eligibility certification and claim submission inquiries.
• Financial Accounting
On a monthly basis, the selected firm must provide an accounting reconciliation of any
"central bank" accounts utilized.
The selected firm must provide a quarterly written report detailing all administrative
expenses charged outside the Administrative Services Agreement. The selected firm
must present a report detailing and justifying proposed fees for the coming year by
September 1' of the preceding year.
• Right to Audit
The selected firm must agree to allow the City, or its representative, the right to audit all
claims, applicable provider credentialing, financial data and other information relevant to
the City's account.
• Data and Management Information Reporting
The selected firm must provide monthly paid claim summaries and detailed claim
listings, preferably in Excel format or through a secure website. The firm must also
provide its standard reporting package. Ad hoc reports will periodically be requested.
Enrollment, claims and premium/fee information must be accurate and supplied in a
timely manner upon request. Describe online claim reporting and look -up capabilities
that will be available to the City.
7
"No Loss/No Gain" for Covered Employees
It is critical that there will be no loss of coverage for any employees. Therefore it is
required that the proposal waives any "actively at work", "dependent confinement", or
any other rules that would prevent 100% continuity of coverage for any employees or
dependents that are currently covered under the plans.
Section 3.0 Evaluation
The Request for Proposal (RFP) is intended to assess which vendors have the ability to meet
The City's long-term goals and objectives as previously defined. The proposals will be evaluated
per the review and assessment criteria listed below.
3.1 Evaluation and Assessment of Proposal
An evaluation committee shall rank the interested firms based on their written proposals
using the ranking system set forth below. Firms shall be evaluated on the following
criteria:
From 1 to 5, with 1 being a poor rating, 3 an average rating, and 5 an outstanding rating.
Recommended weighing factors for the criteria are listed adjacent to the qualification.
Weighting
Qualification
Standard
Factor
Scope of
Does the proposal show an understanding of the City's
2.0
Proposal
objectives and results desired from the plan(s)? Adherence to
the services requested and described in the RFP.
Do the personnel administering the plan(s) have the needed
Assigned
skills and experience? Are sufficient people of the requisite
2.0
Personnel
skills assigned to the plan(s)? Quality of care and customer
service.
Can the plan(s) be completed in the time frame required? Can
targeted effective date be met? Are other qualified personnel
1.0
Availability
available, if required, to assist meeting the plan(s) schedule? Is
the account management team available to attend meetings as
required by the Project Manager?
Is the firm interested in providing the services requested in this
1.0
Motivation
RFP? Quality of responses to the. RFP's Questionnaire
sections.
Cost /
How competitive are the plan's costs, rate guarantees and
2.0
Financial
where applicable, provider's contracts with area providers?
Effectiveness
Benefit
Experience managing similar plans of this type and scope.
2.0
Management
Thoroughness in selecting providers and managing benefit
plans. Actively seek to provide most appropriate level of
Capability
service?
The City may, at its option, choose the highest ranked firm based on the written proposals or
select up to three of the top rated firms for oral interviews.
Based on results of the written evaluation, the City will select finalists for consideration. Any or
all proposals may be rejected by the City. Finalists may be asked to make formal presentations
of their proposals, as well as to demonstrate their systems and procedures for administering the
City's plans. Site visits may take place at the finalists' home offices and/or the claims and
administrative facility/facilities that would provide service to the City.
3.2 Reference Evaluation (Top -ranked firms)
The Project Manager will check references using the following qualification and standard
criteria. The evaluation rankings will be labeled Outstanding/Satisfactory/Unsatisfactory.
QUALIFICATION
STANDARD
Would you hire this Professional again? Did they show the skills
Overall Performance
required for this project? Did they show flexibility and willingness to
"go the extra mile" to ensure that the employees were given the
appropriate amount and level of service?
Timing
Did the vendor effectively manage the customer's time? Were
requests for information met in a timely manner?
Was the Professional responsive to client needs; did the Professional
Completeness
anticipate problems? Were problems solved quickly and effectively?
Budget
Was the original Scope of Work completed within the project budget?
Did the .Professional possess the appropriate knowledge, skills and
Job Knowledge
abilities, and resources to effectively administer this program? Was
the contract operated smoothly?
Other
What problems (if any) did you encounter with this Professional?
Section 4.0 Proposal Acceptance:
All proposals shall remain subject to initial acceptance 90 days after the day of submittal.
Section 5.0 Agreement:
Firm to provide sample plan agreement for review by the City.
E
Section 6.0 Proposal Process Information and Requirements
6.1 Intent
The intent of this RFP is to confirm key information about specific firms, receive financial
proposals and (where applicable) identify network access compatibilities with the City's
employees. The following describes the anticipated proposal process, including
confidentiality, timing, expected response format and requirements for interaction
regarding questions.
Please note that The City reserves the right to accept or reject any and all
proposals, to waive any technicalities or irregularities therein, to award contracts,
or to withdraw this request for proposal without awarding a contract. Your
response to this RFP and any subsequent correspondence related to this proposal
process will be considered part of the contract, if one is awarded to you. Under no
circumstances are commissions related to the City's benefits payable to anyone in
conjunction with this request.
6.2 Confidentiality
All data included in this RFP, as well as any census data and attachments, are
proprietary to the City. It is for exclusive use in preparing a proposal and must not be
shared with any other firm or used for any other purpose. The use of the City's name in
any way as a potential customer is strictly prohibited.
6.3 Miscellaneous
The City shall not infringe upon any intellectual property right of any firm, but specifically
reserves the right to use any concept or methods contained in this proposal. Any
desired restrictions on the use of information contained in the proposal should be clearly
stated. Responses containing your proprietary data shall be safeguarded with the same
degree of protection as the City's own proprietary data. All such proprietary data
contained in proposal must be clearly identified. Failure to respond due to the
proprietary nature of data in your response may be construed as non -responsive and
could result in disqualification. The City shall not be under any obligation to return any
materials submitted in response to this RFP.
The City's contractual selection of a firm vendor is final. The methodology by which the
proposals are evaluated and vendors are selected is confidential and proprietary to the
City.
The City expects to enter into a written Agreement (the "Agreement") with the chosen
firm ("Chosen Firm") that shall incorporate this RFP into your proposal. The anticipated
terms and conditions of the Agreement are set forth in this RFP; however, the City may
include additional terms and conditions in the Agreement as deemed necessary.
Section 7.0 Proposal Checklist
The following information is requested as part of the proposal process. Please indicate
included attachments by duplicating this checklist and marking the appropriate column
(Yes or No):
10
CHECKLIST OF ITEMS INCLUDED WITH PROPOSAL
Yes No Description of Item
Proposal for Group Dental
Signed Business Associate Agreement
Signed Proposal Compliance Letter
Signed Plan Design Confirmation
Completed and Signed Questionnaire(s)
Dental Network Access Analysis (if applicable)
Copy of your EOB for Dental Services (if applicable)
Proposed Implementation Timeline for the City.
Audited Financial Statements and/or Department of Insurance
filings for the past two years (Only if requested by the City)
Provider "Report Cards" used to provide feedback on clinical
and non -clinical performance measures
Copy of Policy Assuring Member Satisfaction
Samples of all Standard and Optional Reports you are
Proposed to be provided on an account specific basis
Data Specifications for all plans
• In what format can you receive and transmit eligibility data
including additions and deletions?
• Please submit a copy of your file format specifications for
electronic transmissions.
• Do you have any limitations with electronic payroll systems?
Please describe your technology capabilities.
• Describe the security parameters for your systems both for the
employer and the employees (ex: passwords). Do you
require an email address for online access?
Copy of Banking Services Agreement
Copy of Customer Satisfaction Survey
Copy of Administrative Services Agreement or Insurance
Contract that will be in effect January 1, 2010
Signature of Authorized Representative:
11
Section 8.0 Questionnaire
Questionnaire below.
GROUP DENTAL
Summary Description of Plan
The City of Fort Collins offers two dental plans to employees, the Basic Plan and the
Comprehensive Plan. Participation in the Basic Plan allows $1,000 benefit per person each
year, at a lower premium. The Comprehensive Plan allows $2,000 benefit per person each
year, with a slightly higher premium. Orthodontic care is provided through the Comprehensive
Plan only. These plans offer two cleanings/oral exams per year (twice in a 12-month period).
Benefits for restorative services are subject to a $50 deductible on Basic (maximum of $100 per
family) and a $25 deductible on Comprehensive (maximum of $50 per family). All benefits are
paid on a percentage basis. The City provides coverage to eligible employees working 20 or
more hours per week. Benefits are self -funded, and the cost is shared between the City and
employees.
Currently, 130 employees are enrolled for basic coverage; 1,282 are enrolled for comprehensive
coverage. Enrollment distribution between tiers of coverage is:
Level of Coverage
Basic
Comprehensive
Individual
46
411
w/child(ren)
15
131
w/spouse
26
341
w/family
43
399
Total
130
1282
A recent census is included with this RFP as a separate pdf.
12
QUESTIONNAIRE
Group Dental- Administrative Services Only
Do you agree to provide without limitation services to all employees/dependents enrolled
as of December 31, 2009?
2. Will you agree to replicate each of the current plan's provisions? If not, please list the
specific provisions you will not replicate, along with the reason you elect not to replicate
the provision(s). If you do not identify those specific provisions you cannot
replicate and you are selected as the City's dental services provider, you may be
required to make the necessary adjustments in order to achieve replication.
Otherwise, your selection may become void.
3. What is your monthly administrative fee, expressed in terms of dollars per month per
employee?
4. For each geographic area in which you have a network applicable to employee
population, provide the following information:
• Geo-Access, using 2 dental providers in 10 miles; provide a map if available
• Most recent participating provider directory and summary of the number of
participating providers in each of the applicable areas (dentists, specialists, etc.)
Also provide the website where provider information can be found.
5. For each network, describe the specific measures used by your organization to monitor
participating provider access. Provide the most recent corresponding statistics available
for:
• Dentist to member ratios
• Average waiting period for an appointment
6. What percentage of your providers has limited their practice to current patients?
What is your firm's financial rating (e.g., Best & Co., S&P)?
8. Please describe your credentialing procedures.
9. What type of reimbursement/payment method(s) is used to reimburse participating
providers? Please provide a breakdown by method of review.
10. In addition to routine reimbursement and any withholding provisions, can your providers
increase the total reimbursement received from your plan, e.g., by provider incentive
programs? If so, please explain.
11. If provider discounts are used, state the basis of the agreement. Are discounts based on
provider charges or actual cost of service?
12. Is there a formal committee that sets quality assurance policy and review the outcome
on a regular basis?
13. Do you capture all utilization data?
13
14. What claims experience and utilization reports are available? If there is additional cost,
please specify.
15. Describe patient satisfaction surveys that you perform.
16. Do you have an agreement that prohibits providers from billing or collecting from patients
more than the designated coinsurance or co -payment in the plan design?
17. Please describe your method for calculating renewal rates.
18. Do you provide a toll -free number for employees to call with questions on claims, plan
provisions or requests for dentist referrals?
1g. Do you provide a care line that employees can call with questions about proper levels of
care?
20. Will you provide a dedicated representative for the City's Human Resources Department
with telephone and email contact information?
21. Will you perform pre-treatment estimates? If yes, what is your average turnaround time?
22. Will you provide COBRA services?
23. Can your firm certify compliance with HIPAA health information security and privacy
regulations per attached Exhibit A?
24. The City may discontinue offering the Basic Plan effective January 1, 2010. Would you
cover all participants under the Comprehensive Plan?
14
EXHIBIT "A"
HIPAA HEALTH INFORMATION PRIVACY & SECURITY
A. Obligations and Activities of the Business Associate
1. Business Associate agrees to not use or disclose Protected Health Information other than
as permitted or required in the Administrative Services Agreement of which this Appendix is a part or as
required by law.
2. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of
the Protected Health Information other than as provided for by this Appendix.
3. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Appendix.
4. Business Associate agrees to report to the Plan Sponsor (City of Fort Collins, Colorado)
any use or disclosure of the Protected Health Information not provided for by this Appendix of which it
becomes aware.
5. Business Associate agrees to ensure that any agent, including a subcontractor, to whom
it provides Protected Health Information received from, or created or received by Business Associate on
behalf of the Plan Sponsor agrees to the same restrictions and conditions that apply through this
Appendix to Business Associate with respect to such information.
6. Business Associate agrees to make internal practices, books, and records, including
policies and procedures and Protected Health Information, relating to the use and disclosure of Protected
Health Information received from, or created or received by Business Associate on behalf of, the Plan
Sponsor available to the Plan Sponsor, or to the Secretary, in a time and manner or designated by the
Secretary, for purposes of the Secretary determining the Plan Sponsor's compliance with the Privacy
Rule.
7. Business Associate agrees to document such disclosures of Protected Health Information
and information related to such disclosures as would be required for the Plan Sponsor to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in accordance
with 45 CFR § 164.528.
8. Business Associate agrees to provide to the Plan Sponsor or an Individual, in a
reasonable time and manner, information collected in accordance with Section A.7. of this Provision, to
permit Plan Sponsor to respond to a request by an Individual for an accounting of disclosures of
Protected Health Information in accordance with 45 CFR § 164.528.
B. Permitted Uses and Disclosures by Business Associate
1. Except as otherwise limited in this Appendix, Business Associate may use or disclose
Protected Health Information on behalf of, or to provide services to, the Plan Sponsor for the following
purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule if
done by the Plan Sponsor or the minimum necessary policies and procedures of the Plan Sponsor:
performing plan administration functions, obtaining premium bids from insurance companies or other
health plans for providing insurance coverage under or on behalf of the group health plan, or modifying,
amending, or terminating the group health plan.
2. Except as otherwise limited in this Appendix, Business Associate may use Protected
Health Information to provide data aggregation services to the Plan Sponsor as permitted by 42 CFR §
164.504(e)(2)(i)(B).
3. Business Associate may use Protected Health Information to report violations of law to
appropriate Federal and State authorities, consistent with § 164.5020)(1).
15
6. Provide current and previous monthly service fees (per eligible employee).
2004: $3.79
2005: $3.54
2006: $3.72
2007: $3.91
2008: $4.17
2009: $4.17
7. Provide the full Summary Plan Documents (SPD).
Attached as two (2) separate files.
Please contact David Carey, CPPB, Buyer, with any questions regarding this addendum
at (970) 416-2191 or email dcarey(a fcgov.com .
RECEIPT OF THIS ADDENDUM MUST BE ACKNOWLEDGED BY A WRITTEN
STATEMENT ENCLOSED WITH THE BID/QUOTE STATING THAT THIS ADDENDUM
HAS BEEN RECEIVED.
whore renewal is a way of life
C. Obligations of Plan Sponsor
1. Plan Sponsor shall notify Business Associate of any restriction to the use or disclosure of
Protected Health Information that the Plan Sponsor has agreed to in accordance with 45 CFR § 164.522,
to the extent that such restriction may affect Business Associate's use or disclosure of Protected Health
Information.
2. Plan Sponsor shall not request Business Associate to use or disclose Protected Health
Information in any manner that would not be permissible under the Privacy Rule if done by Plan Sponsor.
D. Termination
1. In addition to the termination provisions set forth in the Administrative Services
Agreement of which this Appendix is a part, the following termination provisions are applicable:
a. Upon the Plan Sponsor's knowledge of a material breach by Business Associate
of this Appendix, the Plan Sponsor shall either:
i. Provide an opportunity for Business Associate to cure the breach or end
the violation and terminate the Administrative Services Agreement of which this Appendix is a part if
Business Associate does not cure the breach or end the violation within the time specified by Plan
Sponsor; or
ii. Immediately terminate the Administrative Services Agreement of which
this Appendix is a part if Business Associate has breached a material term of this Appendix and cure is
not possible; or
iii. If neither termination nor cure are feasible, the Plan Sponsor shall report
the violation to the Secretary.
E. Effect of Termination
1. Except as provided in paragraph (2) of this section E, upon termination of the
Administrative Services Agreement of which this Appendix is a part, for any reason, Business Associate
shall return or destroy all Protected Health Information received from the Plan Sponsor, or created or
received by Business Associate on behalf of the Plan Sponsor. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business Associate. Business
Associate shall retain no copies of the Protected Health Information.
2. In the event that Business Associate determines that returning or destroying the
Protected Health Information is infeasible, Business Associate shall provide to the Plan Sponsor
notification of the conditions that make return or destruction infeasible. Upon the Plan Sponsor's
agreement that return or destruction of Protected Health Information is infeasible, Business Associate
shall extend the protections of this Appendix to such Protected Health Information and limit further uses
and disclosures of such Protected Health Information to those purposes that make the return or
destruction infeasible, for so long as Business Associate maintains such Protected Health Information.
Miscellaneous
1. The Parties agree to take such action as is necessary to amend this Appendix from time
to time as is necessary for Plan Sponsor to comply with the requirements of the Privacy Rule and the
Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
2. The respective rights and obligations of Business Associate under Section E of this
Provision shall survive the termination of the Administrative Services Agreement of which this Appendix is
a part.
3. Any ambiguity in this Appendix shall be resolved to permit the Plan Sponsor to comply
with HIPAA.
G. Security Standards
16
1. Business Associate agrees that it will implement policies and procedures to ensure that
its creation, receipt, maintenance, or transmission of electronic protected health information ("ePHI") on
behalf of Plan Sponsor complies with the applicable administrative, physical, and technical safeguards
required to protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164.
2. Business Associate agrees that it will ensure that agents or subcontractors agree to
implement the applicable administrative, physical, and technical safeguards required to protect the
confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164.
Business Associate agrees that it will report security violations to the Plan Sponsor.
H. Definitions
1. "Protected Health Information" shall have the same meaning as the term "protected
health information" in 45 CFR § 164.501, limited to the information created or received by Business
Associate from or on behalf of the Plan Sponsor.
2. "Secretary" shall mean the Secretary of the Department of Health and Human Services
or his designee.
17
City of
Fort Collins
ADDENDUM No. 1
7054 Benefits — Dental
SPECIFICATIONS AND CONTRACT DOCUMENTS
Description of RFP: 7054 Benefits — Dental
OPENING DATE: 2:00 P.M. (Our Clock) August 13, 2009
Financial Services
Purchasing Division
215 N. Mason St. 2"' Floor
PO Box 580
Fort Collins, CO 80522
970.221.6775
970.221.6707
fcgov. com/purchasing
To all prospective bidders under the specifications and contract documents described
above, the following changes are hereby made.
Questions and Answers:
1. Provide Summary of Plan Description (SPD) for the dental plans. These are
needed so that we can ensure that we copy over the benefits as requested.
Attached as a separate file — Comparison of Basic Dental Plan versus
Comprehensive Dental Plan.
2. Can you please provide the RFP document in Word so that we can respond to
the questions?
Attached as a separate file.
3. If additional reports or materials were to be provided, where in the table of
contents can we provide them?
Add as Section X of response.
4. Section IX of the table of contents refers to the Checklist in Section III (see
below). However, Section III refers to the evaluation and assessment of the
proposal. Which checklist is being referred to?
Refers to page 11 of RFP Document - Checklist of Items Included with Proposal.
Also include signed Business Associate Agreement.
5. Please clarify in the required table of contents the difference between Section
IV & IX. See below.
Section IV: Checklist of Items included with Proposal
Section IX: Items Included with Proposal (As indicated on the Checklist
included in Section III. These items should be indexed in the order listed on the
checklist, with a copy of the index included in this section)
The Checklist only should be in Section IV of response.
Checklist items should be included in Section IX of response indexed in order.
Reference to Section III should be changed to Section IV.
6. Provide Dental Claims data for the last 12 months, broken out per month and
per Basic and Comprehensive dental plan. We recognize that the City is
self -funding their dental. However, this will help us generate our
estimated claims pick and help in setting our admin fees.
Attached as four (4) separate Utilization Report files. Two (2) for Basic Plan and
Two (2) for Comprehensive Plan.
7. Provide copy of Disruption Report from in -force carrier. This report should
show claims by provider (name, address and Tax ID number) and dollar
amount. We will use this to run a disruption report and we will also reprice
claims to show any applicable and potential claims dollar savings. This report
will be provided in our final proposal.
Attached as two (2) separate Provider Ranking files.
Please contact David Carey, CPPB, Buyer, with any questions regarding this addendum
at (970) 416-2191 or email dcarey(@fcgov.com .
RECEIPT OF THIS ADDENDUM MUST BE ACKNOWLEDGED BY A WRITTEN
STATEMENT ENCLOSED WITH THE BID/QUOTE STATING THAT THIS ADDENDUM
HAS BEEN RECEIVED.
where renewal is a way of life
City
Financial Services
® of
Purchasing Division
215 N. Mason St. 2nd Floor
F
®r
CuLis
PO Box 580
Fort Collins, CO 80522
970.221.6775
Purchasin 9
970.22
fcgov. com1puom/purchasing
REQUEST FOR PROPOSAL
7054 Benefits - Dental
The City of Fort Collins is seeking proposals from qualified firms for employee Dental (comprehensive and
basic) TPA Services — self -funded with cost shared by employer and employees.
Written proposals, six (6) will be received at the City of Fort Collins' Purchasing Division, 215 North Mason
St., 2nd floor, Fort Collins, Colorado 80524. Proposals will be received before 2:00 p.m. (our clock), August
13, 2009. Proposal No. 7054. If delivered, they are to be sent to: 215 North Mason Street, 2nd Floor, Fort
Collins, Colorado 80524. If mailed, the address is: P.O. Box 580, Fort Collins, 80522=0580.
Questions concerning the scope of the project should be directed to Project Manager Amy Sharkey, Human
Resources Benefits Manager, (970) 416-2721, asharkeyCcDfcgov.com.
Questions regarding proposals submittal or process should be directed to David Carey, CPPB, Buyer, (970)
416-2191, dcarey(a fcgov.com.
A copy of the Proposal may be obtained as follows:
1. Download the Proposal/Bid from the BuySpeed Webpage, www.fcgov.com/eprocurement
2. Come by Purchasing at 215 North Mason St., 2"d floor, Fort Collins, and request a copy of
the Bid.
The City of Fort Collins is subject to public information laws, which permit access to most records and
documents. Proprietary information in your response must be clearly identified and will be protected to the
extent legally permissible. Proposals may not be marked 'Proprietary' in their entirety. Information
considered proprietary is limited to material treated as confidential in the normal conduct of business, trade
secrets, discount information, and individual product or service pricing. Summary price information may
not be designated as proprietary as such information may be carried forward into other public documents.
All provisions of any contract resulting from this request for proposal will be public information.
Sales Prohibited/Conflict of Interest: No officer, employee, or member of City Council, shall have a financial
interest in the sale to the City of any real or personal property, equipment, material, supplies or services
where such officer or employee exercises directly or indirectly any decision -making authority concerning
such sale or any supervisory authority over the services to be rendered. This rule also applies to
subcontracts with the City. Soliciting or accepting any gift, gratuity favor, entertainment, kickback or any
items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is
prohibited.
Collusive or sham proposals: Any proposal deemed to be collusive or a sham proposal will be rejected and
reported to authorities as such. Your authorized signature of this proposal assures that such proposal is
genuine and is not a collusive or sham proposal.
The City of Fort Collins reserves the right to reject any and all proposals and to waive any irregularities or
informalities.
Sincerely,
James B. O'Neill II, CPPO, FNIGP
Director of Purchasing & Risk Management
where renewal is a way of life
Request for Proposal Number 7054 Benefits -Dental
To participate in the RFP process vendors need to sign and return this Business
Associate Agreement.
BUSINESS ASSOCIATE AGREEMENT - SECURITY STANDARDS
This agreement is entered into between
Associate) and the City of Fort Collins.
(Business
Business Associate agrees that it will implement policies and procedures to ensure that
its creation, receipt, maintenance, or transmission of electronic protected health
information ("ePHI") on behalf of the City of Fort Collins complies with the applicable
administrative, physical, and technical safeguards required to protect the confidentiality
and integrity of ePHI under the Security Standards 45 CFR Part 164.
Business Associate agrees that it will ensure that agents or subcontractors agree to
implement the applicable administrative, physical, and technical safeguards required to
protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR
Part 164.
Business Associate agrees that it will report security incidents to the City of Fort Collins,
Security Manager.
By:
PRINT NAME
TITLE
Please return to:
City of Fort Collins
Attn: Purchasing
P.O. Box 580
Ft. Collins, CO 80522-0580
Or fax back to: (970) 221-6707
Date:
Introduction
The City of Fort Collins is seeking proposals from qualified firms for the following employee
benefit plan:
• Dental (comprehensive and basic) TPA Services — self -funded with cost shared by
employer and employees.
Current plan descriptions are available upon request. Included with this RFP are: census data,
claims experience and questionnaires. Answer the respective questionnaire in the format
provided. Rates must be quoted net of broker or other commissions, since the City does not
pay commissions.
The City intends to replicate current plan provisions. Firm's answers must be responsive to the
current plan design and questions posed; otherwise, organization may be deemed non-
responsive and disqualified from consideration. If firm is unable to administer the plans as
written, must specify clearly and specifically where firm's response deviates from current plan
design.
Section 1.0 Proposal Requirements
1.1 General Description
The City provides employee benefits to approximately 1,450 active employees.
Based on the proposals received, The City may select one carrier/administrator for all
plans, or separate carriers/administrators.
The City believes that an essential factor in managing the cost/service/quality balance is
the relationship with each of its business partners. The City will review the selected
vendor as an active partner in assuring employee satisfaction.
1.2 Timetable
The following is a proposed timetable developed for this project. You will be notified of
any significant changes which might occur:
ITEM:
DATE:
Appendices sent to organizations that
have returned Business Associate
Agreements
As agreements are returned to the City of
Fort Collins
Written questions due to the City
JuIV 29, 2009
Written proposals due to the City
August 13, 2009, 2:00 P.M. our clock
Finalist vendors notified
Se tember 3, 2009
Finalists interviews
Se tember 10 and/or 11, 2009
Contract negotiations (completed)
October 12, 2009
Plan effective date
January1, 2010
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1.3 Proposal Submittals
Proposal must clearly indicate the name of the responding organization, as well as the
name, address and telephone number of the primary contact. Proposal must include the
contact name for local service and account management whom the City can call directly.
Proposals due no later than 2:00 p.m. (our clock) on August 13, 2009. Submit six (6)
copies of your proposal to:
If delivered: City of Fort Collins, Purchasing
215 North Mason, 2nd Floor
Fort Collins, Colorado 80524
If mailed: City of Fort Collins, Purchasing
PO Box 580
Fort Collins, CO 80522-0580
Questions regarding this RFP are due to the City no later than July 29, 2009. A written
response to substantive questions will be provided to all proposers.
The City assumes no responsibility for liability for any costs you may incur in responding
to this RFP, including attending meetings, site visits or negotiations.
1.4 Deviations from RFP Specifications
All responses to this RFP must be prepared in accordance with the Proposal
Requirements set forth in Section IV of this RFP. The City reserves the right to refuse
any proposal not prepared according to the Proposal Requirements of Section 1.5
and 1.6.
The City retains the right to directly negotiate the finer points of the proposal that comply
in spirit with this RFP and that satisfy the City's objectives for effective, interactive and
proactive claims and (where applicable) network administration. The City shall not be
bound to accept the proposal with the lowest price. The RFP may be amended or
revoked at any time prior to final execution of an Agreement by the City.
Any deviations from this RFP must be clearly identified and explained in the proposal.
These deviations are to be delineated as instructed in the Proposal Requirements asset
forth in Section 1.5 of this RFP.
It is intended that firm should conform to these specifications as much as possible. Do
not quote alternative plan designs unless absolutely necessary. Quote the requested
financial arrangements only.
Firm will be bound to comply with the provisions set forth in this RFP unless any and all
deviations are explicitly stated in the proposal.
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1.5 Proposal Instructions
Do not deviate from the requested formats. Provide your proposed rates and fees as
specified in this RFP.
The City is seeking an initial premium/administration cost that runs for at least 24 months
(January 1, 2010 — December 31, 2011). Please confirm the time period applicable to
proposed rate/fee guarantees.
Administrative services for dental plan should be quoted for a self -funded plan.
Define specifically what services are included in the fees quoted.
Specify any charges for services that are have not included in the fees quoted above,
including any start-up fees, materials, etc.
Adhere to the instructions in this section when organizing proposal.
1.6 Proposal Requirements
Your response should be organized in the following sections:
Section I: Executive Summary
Section II: Proposal Compliance Letter (Signed by an authorized officer of
your organization signifying firm's proposal is in complete
adherence with the RFP specifications, except as specifically
noted in the appropriate sections)
Section I I I: Business Associate Agreement (Signed by an authorized officer of
your organization)
Section IV: Checklist of Items included with Proposal
Section V: Plan Design Confirmation (Statement indicating your willingness
to replicate current plan provisions or indicating clearly deviations
from current plan design)
Section VI: Questionnaire Responses
Section VII: Performance Guarantees
Section VIII: Financial Exhibits
Section IX: Items Included with Proposal (As indicated on the Checklist
included in Section III. These items should be indexed in the order
listed on the checklist, with a copy of the index included in this
section)
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