HomeMy WebLinkAboutRFP - 7053 BENEFITS - LIFE AND DISABILITYFinancial Services
City of
Purchasing Division
215 N. Mason St. 2nd Floor
Box 580
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Fort Collins, CO 80522
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970.221.61775
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970.221.6707
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fcgov. com/purchasing
ADDENDUM No. 2
7063 Benefits — Insurance — Life and Disability
SPECIFICATIONS AND CONTRACT DOCUMENTS
Description of RFP: 7053 Benefits — Insurance — Life and Disability
OPENING DATE: 2:00 P.M. (Our Clock) August 13, 2009
To all prospective bidders under the specifications and contract documents described
above, the following changes are hereby made.
QUESTIONS AND ANSWERS:
1. Can you provide Claims information?
STD Claims info was included in RFP. Three (3) files attached for LTD and Life.
2. Can we get copies of the current contracts and/or booklets for the Basic
Life/AD&D, Supplemental Life/AD&D and LTD coverages?
SPD's attached as three (3) separate files.
3. Can we get a copy of the final SPD for the self funded STD plan?
SPD attached as a separate file.
4. For the Basic and Supplemental Life/AD&D, can we get the past 3 years (or
more if possible) of paid premium and claims? Can we also get the current
listing of waiver of premium claims?
Attached as two (2) separate files.
5. For the LTD, can we get the past 3 years (or more if possible) of paid
premium and claims? Can we also get the current open claim listing with
gender, date of birth, and reserves?
Attached as separate files.
6. Do the City employees on the plan participate in a PERS/STERS plan? If so,
will you please supply a booklet?
No.
Section 2.0 Services to Be Provided
In addition to the plan provisions set forth in the attachments, the City has specific vendor
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. Proposers who are not
committed to serious account service will not receive serious consideration;
➢ Be extremely responsive;
➢ Be comprised of individuals with specialized knowledge of the proposing company'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 company'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 vendor'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 vendor(s) by the City.
The selected vendor(s) 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 vendor(s).
Fee Administration
Basic and Supplemental Life/AD&D and Long Term Disability - fee/premium statements
will be self -billed by the City. The City will calculate the fees/ premiums payable on a
monthly basis and will submit these fees directly to the selected vendor(s).
Voluntary Life/AD&D will invoice the City. The City may calculate the fee/premiums
payable on a monthly basis and will submit these fees directly to the selected vendor(s).
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Customer Service
The selected vendor(s) 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 vendor(s) must provide an accounting reconciliation of
any "central bank" accounts utilized.
The selected vendor(s) must provide a quarterly written report detailing all administrative
expenses charged outside the Administrative Services Agreement. The selected
vendor(s) must present a report detailing and justifying proposed fees for the coming year
by September 1 sc of the preceding year.
• Right to Audit
The selected vendor(s) 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 vendor(s) must provide monthly paid claim summaries and detailed claim
listings, preferably in Excel format or through a secure website. The vendor(s) 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. Please describe your online claim reporting and look -up
capabilities that will be available to the City.
"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 your 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.
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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
Does the proposal show an understanding of the City's
2.0
Scope of 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 skills and experience? Are sufficient people of
2.0
Assigned Personnel
the requisite 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 available, if required, to
1.0
Availability
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
1.0
Motivation
requested in this RFP? Quality of responses to the
RFP's Questionnaire sections.
How competitive are the plan's costs, rate guarantees
2.0
Cost Financial
and where applicable, provider's contracts with area
Effectiveness
providers?
Experience managing similar plans of this type and
2.0
Benefit Management
scope. Thoroughness in selecting providers and
Capability
managing benefit plans. Actively seek to provide most
appropriate level of 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
Overall Performance
Would you hire this Professional again? Did
they show the skills 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?
Timetable
Did the vendor effectively manage the
customer's time? Were requests for
information met in a timely manner?
Completeness
Was the Professional responsive to client
needs; did the Professional anticipate
problems? Were problems solved quickly and
effectively?
Budget
Was the original Scope of Work completed
within the project budget?
Job Knowledge
Did the Professional possess the appropriate
knowledge, skills and 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:
Proposer to provide sample plan agreement for review by the City.
Section 6.0 Proposal Process Information and Requirements
61 Intent
The intent of this RFP is to confirm key information about specific proposers, receive financial
proposals and (where applicable) identify network access compatibilities with the City's
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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 your 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 vendor, 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 your
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 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 vendor
("Chosen Vendor") 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 your
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 Life Insurance, AD&D and Supplemental Life
Proposal for Voluntary Group Life and AD&D
Proposal for Group Long Term Disability
Proposal for Advise -to -Pay Short Term Disability
Signed Business Associate Agreement
Signed Proposal Compliance Letter
Signed Plan Design Confirmation
Completed and Signed Questionnaire(s)
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 your Policy Assuring Member Satisfaction
Samples of all Standard and Optional Reports you are proposing
to provide 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 your Banking Services Agreement
Copy of your Customer Satisfaction Survey
Copy of your Administrative Services Agreement or Insurance
Contract that will be in effect January 1, 2010
Signature of Authorized Representative:
11
Section 8.0 Questionnaires
Questionnaires for each plan appear below. Please respond to each plan for which you wish to
be considered.
Group Long Term Disability (LTD)
Summary Description of Plan
The City's fully -insured Group LTD Plan covers classified and non -classified employees who
work 20 or more hours per week. Uniformed police and fire employees are not eligible to
participate in this plan, but rather have separate coverage. The City pays 100% of premiums
and participation is mandatory for eligible employees. For approved LTD claims, benefits are
paid at 66 2/3% of their monthly earnings in the event that they become disabled and are not
able to work. The maximum benefit available is $7,500 per month, and the minimum benefit
available is $1.00, or 10% of your gross monthly benefit, whichever is greater.
The plan provides for a 24-month own occupation disability, after which benefits are continued if
the claimant cannot work at any job for which he/she is reasonably qualified on the basis of
education, training and experience.. LTD benefits are payable after you have been continuously
totally or partially disabled for 90 days. This is considered the "elimination period". The benefit
period is dependent upon your age when you become disabled.
The current LTD provider, makes the determination of eligibility based on information provided
by the employee, their physician and the City. To determine eligibility, the vendor must receive
proof that you are totally or partially disabled due to an injury or sickness and that you are under
regular, continuing care of a physician.
LTD benefits are subject to reduction by other types of income. Other types of income that
could offset a disability benefit would be workers' compensation, retirement distributions, social
security disability, vacation payout at separation, or any kind of earned income.
The current vendor provides for a life insurance waiver for employees applying for LTD. This
means that whatever life insurance coverage the employee may have with the current vendor,
the premium for that life insurance may be waived. Whether or not the employee is approved
for LTD, employee may be eligible for the life insurance waiver. When an LTD claim is filed, the
waiver of premium is also automatically applied for. The waiver of premium will only be
considered if the applicant is under the age of 60.
Approximately 1,100 employees are enrolled for LTD coverage. The current volume of
coverage is approximately $5,345,301 in monthly earnings. The current carrier has served the
City since January 1, 1997, and has paid $2,361,422.93 in total claims. The total disabled life
reserve is $901,970.
Please answer completely the following questions.
A recent census is included with this RFP as a separate pdf.
12
QUESTIONNAIRE
Group Long Term Disability
1. Will you agree to cover without limitation all employees 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 group LTD vendor, you may be required to make the
necessary adjustments in order to achieve replication. Otherwise, your selection may
become void.
3. What is your fully insured premium rate for this coverage? Please express your premium
rate in terms of cents per $100 of base monthly salary. Premiums must be net of any
commissions or broker fees. If you are selected for multiple plans, will you offer discounted
premiums?
4. Include samples of claim payment reports, e.g., premiums vs. claims, etc.
5. Is there a toll -free number for employees to call with questions on plan provisions or claim
status? What is the average call waiting time?
6. What are the payment options available to.employees (check, direct depost, etc.)?
7. What is the average length of time an employee waits for an inquiry to be answered fully?
8. What performance guarantees will you provide?
9. Specify clearly any conditions and circumstances that would be excluded from coverage.
10. Would there be an assigned claims examiner for all City claims or would each event/claim
be assigned to someone from a team of examiners?
11. Will you provide a dedicated Representative for the City's Human Resources Department
with telephone and email contact information?
12. Can your firm certify compliance with HIPAA health information security and privacy
regulations per attached Exhibit A?
13
Advise -to -Pay Short Term Disability (STD)
Summary Description of Plan
Short Term Disability is a benefit that is intended to provide eligible employees with up to 90
days of paid time off at 70% of base pay for certain short term disabilities arising from non -
occupational illnesses or injuries per calendar year. The elimination period is the first
consecutive 14 calendar days of short term disability leave and is unpaid unless the employee
elects to use available sick leave, vacation leave, award time, accrued but unused holiday time,
and/or compensatory time (compensatory time cannot be used during FMLA leave) during the
elimination period. Any short term disability leave following the elimination period will be paid by
the City at 70% of the employee's regular base pay. An employee's STD Bank is used to make
the employee's salary "whole" by making up the difference in pay between 70% pay (STD-70%
Pay) and the employee's full salary.
• An eligible employee may take available but unused short term disability leave when he
or she is disabled and unable to perform his or her job due to a non -occupational
personal illness, injury, or other medical condition. Related to this benefit, the term
"disabled" means that the employee is unable to perform one or more of the essential
functions of his or her job with the City and the employee is not able to work modified
duty.
• An eligible employee shall not use short term disability leave if the employee is
temporarily able to perform one or more of the essential functions of the job and is
placed on modified duty (if available).
• If an employee is provided with partial day/week modified duty, it does not disqualify the
employee from using partial day or partial week short term disability. Short term
disability would apply to all hours not worked during the partial/reduced schedule.
• An eligible employee shall not be permitted to use short term disability leave if the
employee is on an unpaid leave of absence for 30 continuous calendar days.
Employees in classified and unclassified management positions are eligible to use short term
disability leave. All other employment categories are ineligible for this leave. Additionally, this
policy is not applicable to Police Services employees in the Bargaining Unit who are subject to
the collective bargaining agreement.
Number of Advise -to -Pay Claims:
2007 = 37
2008 = 34
14
QUESTIONNAIRE
Advise -to -Pay Short Term Disability
1. Will you agree to cover without limitation all employees 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 group STD vendor, you may be required to make the
necessary adjustments in order to achieve replication. Otherwise, your selection may
become void.
3. What is your self insured premium rate for this coverage? Please express your premium
rate in terms of per employee per month dollar amount. Premiums must be net of any
commissions or broker fees. If you are selected for multiple plans, will you offer discounted
premiums?
4. Include samples of advise -to -pay reports.
5. Is there a toll -free number for employees to call with questions on plan provisions or claim
status? What is the average call waiting time?
6. What is the average length of time an employee waits for an inquiry to be answered fully?
7. What performance guarantees will you provide?
8. Specify clearly any conditions and circumstances that would be excluded from coverage.
9. Would there be an assigned claims examiner for all City claims or would each event/claim
be assigned to someone from a team of examiners?
10. Will you provide a dedicated Representative for the City's Human Resources Department
with telephone and email contact information?
11. Can your firm certify compliance with HIPAA health information security and privacy
regulations per attached Exhibit A?
15
7. For Life, provide Paid Premium separated for basic and supp (3-5 most recent
years) Individual paid claim separate for basic and supp (3-5 most recent
years) Waiver claims separated for basic and supp (3-5 most recent years)
Attached as separate files.
8. For LTD, provide Paid Premium (3-5 most recent years) Paid Claims (3-5
most recent years) Incurral Exhibit (looking for IBNR and Reserves) Open
and Closed Claim listing
Attached as separate files.
9. For the STD Advice to Pay (ATP) we were provided with a basic plan outline
and the number of claims for 2007 & 2008. We can provide a quote with this
info, we would like to have covered lives for 2007 & 2008 in order to calculate
accurate incidence numbers.
Attached as two (2) separate files.
10. For LTD, please provide a current incurral exhibit on a constant premium
basis (4+ years would be optimal).
Attached as separate files.
11. For LTD, please provide constant premium, paid claims, and reserves by
incurral period.
Attached as separate files.
12. For LTD, please provide an open claim listing - Including the following: date
of disability, gender, date of birth, gross monthly benefit, offset information,
and diagnosis.
Attached as separate files.
13. Please provide a closed claims listing - date of disability, term date, and total
benefits paid.
Attached as separate files.
14. For Life, provide 5 years of Premium, Lives, Volumes by coverage for all life
lines
Attached as separate files.
15. For Life, provide, 5 years of paid claims (shown by individual line of
coverage).
Attached as separate files.
Group Life Insurance, AD&D and Supplemental Life
Summary Description of Plan
The City's fully insured Group Life/Accidental Death & Dismemberment (AD&D)/Supplemental
Life Insurance Plan covers classified and non -classified employees who work 20 or more hours
per week. Uniformed police and fire employees are eligible to participate in this plan. Basic
coverage is mandatory for each eligible employee, and is 100% paid by the City. No retiree life
insurance is available, except through individual conversion. Waiver of premium is required.
Eligible employees may elect basic coverage in the amount of one -times annual base salary.
Basic AD&D coverage is equal to the basic life amount. We currently offer an election of base
coverage in the amount of $10,000. We would eliminate this option in 2010 and all eligible
employees would be covered at one-time annual base salary. Employees may also elect
additional life and AD&D coverage in amounts of one-, two- or three -times base annual salary.
Spousal coverage is available in $10,000 (offered without evidence of insurability) and then
increments of $25,000 up to $100,000. Dependent child coverage is available in amounts of
$5,000 or $10,000.
The guaranteed Basic Maximum Benefit is $125,000. The guaranteed issue amount for Basic
and Optional Life is $125,000. The combined maximum benefit is $500,000. Benefits reduce
by 30% at age 65; 50% at age 70; 70% at age 75; and 80% at age 80.
A recent census is included with this RFP as a separate pdf.
16
The following table indicates the coverage amounts in effect and the number of enrolled
persons (effective June 2009):
n toverage
ployee Life $10,000
1-x salary
Employee AD&D `.
I-x salary
Add'I 2-x
Add'I3-x .
�- Upto $1.25,000
73 727,0
1417 86,895.1
73
727,
14z17
86,895,
148 " s ; . ,.
9",828;
66
8,239
17,242,
-- -- 1 - - - -
- - 125,
>ptional Employee
1-xsalary
210
13,494,401
ife
2-x salary
93
11,760,001
3-x salary
125
22,211,001
Up -to $125,000
1
125,001
>ptional "Spousal
$ 10;000 **
138
1;380,001
ife
$ 25,,000
51
�1,275,001
50,000
41 .
2,050,0D
$.75,000
19..
1.,4251001
$100,000
12
1.200.001
Optional Children) $ 5,000 24• 120,000
Life $10,000 291 2.910.000�
*This level of coverage would no longer be offered. Selected vendor(s) agreement to coverage
all eligible employees at 1-x salary.
**This level of coverage is only available to new hires.
17
QUESTIONNAIRE
Group Life Insurance, AD&D and Supplemental Life
1. Do you agree to cover without limitation 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 group life vendor, you may be required to make the
necessary adjustments in order to achieve replication. Otherwise, your selection may
become void.
3. What is your fully insured premium rate for this coverage? Please express your premium
quote in terms of cents per covered $1,000 of base annual salary. Premiums must be net of
any commissions or broker fees. If you are selected for multiple plans, will you offer
discounted premiums?
4. What would be the fully insured premium rate if the guaranteed Basic Maximum Benefit and
Optional Life is $150,000 rather than $125,000?
5. Include samples of claim payment reports, e.g., premiums vs. claims, etc.
6. What is the average length of time required to resolve fully an employee inquiry?
7. What performance guarantees will you provide?
8. Specify any situations that would result in a claim denial.
9. Will you provide a dedicated Representative for the City's Human Resources Department
with telephone and email contact information?
10. Can your firm certify compliance with HIPAA health information security and privacy
regulations per attached Exhibit A?
IN
Group Voluntary Life + ADa,D
Summary Description of Plan
pw6 AW
Ina ion to basic and supplemental life insurance, employees may elect additional voluntary
life insurance coverage. This coverage is fully -insured and 100% employee paid. Applications
are subject to medical evidence. Smoker and non-smoker rates are in effect. Coverage is
available in $10,000 increments up to $300,000. Benefits must be portable and offered at the
same monthly rate as if the employee were still employed by the City. A guaranteed issue
amount on employees of $30,000 and spouse $10,000 if elect coverage during the new hire
enrollment period. The following coverage amounts are in effect.
luntary fife -. Employee:
luntary Life — Spousal:
luntary Life — Children:
)luntary AD&D Er
luntary AD.&D — R
Volume_
.$'68,875,0
$ 32,64.0,0
$ 4525,0
$ 8:260. o
Volume # of Partici
'ortability Voluntary Life -`Employee '$ 12;260,000. 82
'ortability Voluntary Life .Spousal $, 6,360,000`` 49
'ortability Voluntary Life —Children. $ 130'.000 .. 26
A recent census of active participants is included with this RFP as a separate pdf.
19
QUESTIONNAIRE
Group Voluntary Life
1. Do you agree to cover without limitation all employees/dependents enrolled on 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 voluntary life vendor, you may be required to make the
necessary adjustments in order to achieve replication. Otherwise, your selection may
become void.
3. What is your fully insured premium rate for this coverage? See rate sheet (included) as an
example for quoting premium rates. Premiums must be net of any commissions or broker
fees. If you are selected for multiple plans, will you offer discounted premiums?
4. Include samples of claim payment reports, e.g., premiums vs. claims, etc.
5. Do you agree to offer the portability provision? If not, why?
6. Will you offer group voluntary life insurance coverage and at rate that replicates coverage
for those former employees and dependents listed on page 19 of RFP document as
Portability Voluntary Life participants?
7. Will you provide a dedicated Representative for the City's Human Resources Department
with telephone and email contact information?
8. Can your firm certify compliance with HIPAA health information security and privacy
regulations per attached Exhibit A?
20
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).
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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.
F. 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.
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G. Security Standards
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.
3. 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.
23
16. For Life, provide 5 years of rate history for all lines of coverage
Attached as separate files.
17. For Life, provide a listing of any individuals that are not actively -at -work
and their current coverage amounts
Attached as separate files.
Please contact David Carey, CPPB, Bu yer, with any questions regarding this
addendum at (970) 416-2191 or email dcarey(a)fcgov.com .
RECEIPT OF THIS A DDENDUM MUST BE ACK NOWLEDGED B Y A WRIT TEN
STATEMENT ENCL OSED WIT H THE B ID/QUOTE STATIN G THAT T HIS
ADDENDUM HAS BEEN RECEIVED.
where renewal is a way of life
F6rt of
` Purchasing
Financial Services
Purchasing Division
215 N. Mason St. 2nd Floor
PO Box 580
Fort Collins, CO 80522
970.221.6775
970.221.6707
fcgov.com/Purchasing
ADDENDUM No. 1
7053 Benefits — Insurance — Life and Disability
SPECIFICATIONS AND CONTRACT DOCUMENTS
Description of RFP: 7053 Benefits — Insurance — Life and Disability
OPENING DATE: 2:00 P.M. (Our Clock) August 13, 2009
To all prospective bidders under the specifications and contract documents described
above, the following changes are hereby made.
Questions and Answers:
1. Can you provide census in Excel format with service area and department
columns?
Attached as a separate file.
2. Can you provide copies of all current benefit booklets (SPD's)?
Attached as four (4) separate files.
3. Do City employees participate in PERA or Social Security?
Social Security.
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
N. Mason St. 2"d Floor
F6rt
Collins
Box 580
Fo215
Fort Collins, CO 80522
�Pu
970.221.6775
rc h a s i n g
970.22, .6707
fcgov.com/purchasing
REQUEST FOR PROPOSAL
7053 Benefits — Insurance — Life and Disability
The City of Fort Collins is seeking proposals from qualified firms for certain employee benefit plans including
Group Life, Accidental Death & Dismemberment (AD&D), Short Term Disability and Long Term Disability
Insurance.
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. 7053. If delivered, they are to be sent to 215 North Mason Street, 2"d 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,
Compensation, Benefits and HRIS Manager, (970) 416-2721, asharkey@fcgov.com.
Questions regarding bid submittal or process should be directed to David M. Carey, CPPB, Buyer,
(970)416-2191, dcarey@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 7053 Benefits — Insurance — Life and Disability
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
and the City of Fort Collins.
(Business Associate)
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.
in
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:
2
Introduction
The City of Fort Collins is seeking proposals from qualified firms for the following employee
benefit plans:
• Basic Group Life and AD&D — fully insured and completely employer paid
• Supplemental Group Life and AD&D — fully insured and completely employee paid
• Voluntary Group Life and AD&D — fully insured, portable and completely employee paid
• Group Long Term Disability — fully insured and completely employer paid
• Short Term Disability Advise -to -Pay — self insured and completely employer paid
Single as well as multiple plan providers are encouraged to respond. Proposals may be on one
or multiple plans.
Current plan descriptions are available upon request. Included with this RFP are: census data,
claims experience and questionnaires. For each plan in your response, please 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. Your answers must be responsive to the
current plan design and questions posed; otherwise, your organization may be deemed non-
responsive and disqualified from consideration. If you are unable to administer the plans as
written, you must specify clearly and specifically where your 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(s) 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
July 29, 2009
Written proposals due to the City
Au ust 13, 2009, 2:00 P.M. our clock
Finalist vendors notified
Se tember 3, 2009
Finalists interviews
September 10 and/or 11, 2009
Contract negotiations (completed)
October 12, 2009
Plan effective date
January 1, 2010
3
1.3 Proposal Submittals
Your proposal must clearly indicate the name of the responding organization, as well as the
name, address and telephone number of the primary contact at your organization for this
proposal. Your 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 your 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 your proposal. These
deviations are to be delineated as instructed in the Proposal Requirements as set forth in
Section 1.5 of this RFP.
It is intended that you should conform to these specifications as much as possible. Do not
quote alternative plan designs unless absolutely necessary. Please quote the requested
financial arrangements only.
Your company will be bound to comply with the provisions set forth in this RFP unless any and
all deviations are explicitly stated in your proposal.
4
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 your
proposed rate/fee guarantees.
Quote all life and long term disability coverage on a fully insured non -participating basis. Quote
short term disability advise to pay on a per employee per month basis.
Define specifically what services are included in the fees your company has quoted.
Specify any charges for services that your company has not included in the fees quoted above,
including any start-up fees, materials, etc.
Adhere to the instructions in this section when organizing your 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 your proposal's complete adherence with the RFP specifications,
except as specifically noted in the appropriate sections)
Section III: 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) .
5