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HomeMy WebLinkAboutRFP - 7671 BENEFITS - LIFE, DISABILITY & FAMILY MEDICAL LEAVE ADMINISTRATION7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 1 of 29 REQUEST FOR PROPOSAL 7671 Benefits - Life, Disability, and Family Medical Leave Administration The City of Fort Collins is seeking proposals from qualified firms for employee benefit plans including Group Life, Accidental Death & Dismemberment (AD&D), Short Term Disability and Long Term Disability Insurance, and Family Medical Leave Administration. Proposals submission via email is preferred. Proposals shall be submitted in Microsoft Word or PDF format and e-mailed to: purchasing@fcgov.com. If electing to submit hard copy proposals instead, five (5) copies 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 3:00 p.m. (our clock), August 1, 2014 and referenced as Proposal No. 7671. 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. The City encourages all disadvantaged business enterprises to submit proposals in response to all Requests for Proposals and will not be discriminated against on the grounds of race, color, national origin. Questions concerning the scope of the project should be directed to the Project Manager, Amy Sharkey at (970) 416-2721 or asharkey@fcgov.com. Questions regarding bid submittal or process should be directed to Jill Wilson, Buyer at (970) 221-6216 or jwilson@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 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. 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 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 2 of 29 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, Gerry S. Paul Director of Purchasing & Risk Management 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 3 of 29 Vendors need to sign and return this Letter of Confidentiality to Jill Wilson, Buyer at jwilson@fcgov.com in order to obtain Census Data. Letter of Confidentiality RE: Census Data File for 7671 Benefits - Life, Disability, and Family Medical Leave Administration To the Signer, The City of Fort Collins is providing you with certain confidential information regarding the above-named subject to assist you in preparing a proposal to the City. In consideration of the City providing you with such information, to set forth a clear understanding of the mutual rights and obligations, and intending to be legally bound, the parties agree as follows: 1. You agree to maintain in confidence all information which we provide to you relating to the Census Data File (“Information”). 2. The Information will be used solely for the purpose of preparing a proposal in response to RFP 7671. The Information will not be used for your own or another's benefit, or for our detriment. 3. You will not reproduce, duplicate or make additional copies of the Information in any manner, without our written permission. 4. The Information will be disclosed solely to your employees who are directly responsible for evaluating the Information on a need-to-know basis. You will inform them of the obligations of this Letter of Confidentiality and obtain their written commitment to maintain the Information confidentially. You agree to take reasonable measures to restrain such employees from prohibited or unauthorized disclosures or use of the Information. In any event, you will be liable and responsible for any breach of this Letter of Confidentiality by you or any of your employees. WHEREFORE, the parties acknowledge that they have read and understand this Agreement and voluntarily accept the duties and obligations set forth herein. Recipient of Confidential Information: ______________________________ Name ______________________________ Title ______________________________ Signature _____________________ Date 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 4 of 29 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  Group Long Term Disability – fully insured and completely employer paid  Short Term Disability Advice-to-Pay – self-insured and completely employer paid o Short Term Disability – Advice to Pay Option o Short Term Disability – Advice to Pay Hybrid Option o Short Term Disability – Full Insured Option  Family Medical Leave Administration 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. Attached and incorporated in this Request for Proposal (RFP) are: Letter of Confidentiality to obtain census data, Exhibit “A”- Claims Experience, Exhibit “B”- Renewal Experience Summary, Exhibit “C”- Renewal Analysis, Proposal Checklist as listed under Section 7 and Questionnaires as listed under Section 8. 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 clearly specify 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: 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 5 of 29 Item: Date: Written questions due to the City July 22, 2014 Written proposals due to the City August 1, 2014 Finalist vendors notified August 18, 2014 Finalists interviews Week of September 1, 2014 Contract negotiations (completed) October 15, 2014 Plan effective date January 1, 2015 1.3 Proposal Submittals Your proposal must clearly indicate the name of the responding organization, as well as the name, address, telephone number and email of the primary contact at your organization for this proposal. Your proposal must include the contact name for local service and account management with whom the City can call directly. Questions regarding this RFP are due to The City no later than July 22, 2014. A written addendum to address 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 1.6 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. 1.5 Proposal Instructions Do not deviate from the requested formats. Provide your proposed rates and fees as specified in this RFP. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 6 of 29 The City is seeking an initial premium/administration cost that runs for at least 24 months (January 1, 2015 – December 31, 2016). Please confirm the time period applicable to your proposed rate/fee guarantees. 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: Checklist of Items included with Proposal, attached and incorporated herein by this reference Section IV: Plan Design Confirmation (Statement indicating your willingness to replicate current plan provisions or clearly indicating deviations from current plan design) Section V: Questionnaire Responses, attached and incorporated herein by this reference Section VI: Performance Guarantees Section VII: Financial Exhibits Section VIII: 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) 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 consideration; 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 7 of 29  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).  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 shall 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 1st of the preceding year. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 8 of 29  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”, and/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 Factor Qualification Standard 2.0 Scope of Proposal Does the proposal show an understanding of the City’s objectives and results desired from the plan(s)? Adherence to the services requested and described in the RFP? 2.0 Assigned Personnel Do the personnel administering the plan(s) have the needed skills and experience? Are sufficient people of the requisite skills assigned to the plan(s)? Quality of care and customer service are key. 1.0 Availability 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 assist meeting the plan(s) schedule? Is the account management team available to attend meetings as required by the Project Manager? 1.0 Motivation Is the firm interested in providing the services requested in this RFP? Quality of responses to the RFP’s Questionnaire sections. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 9 of 29 Weighting Factor Qualification Standard 2.0 Cost / Financial Effectiveness How competitive are the plan’s costs, rate guarantees and where applicable, provider’s contracts with area providers? 2.0 Benefit Management Capability Experience managing similar plans of this type and scope. Thoroughness in selecting providers and 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? 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 10 of 29 Section 4.0 Proposal Acceptance All proposals shall remain subject to initial acceptance ninety (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 6.1 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 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. Under no circumstances are commissions related to the City’s benefits programs 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 confidential and 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 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 as per EXHIBIT “D“, attached herein and incorporated by this reference; however, the City may include additional terms and conditions in the Agreement as deemed necessary. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 11 of 29 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”): CHECKLIST OF ITEMS INCLUDED WITH PROPOSAL Yes No Description of Item _____ _____ Proposal for Group Life Insurance, AD&D and Supplemental Life _____ _____ Proposal for Group Long Term Disability _____ _____ Proposal for All Short Term Disability Options _____ _____ Proposal for Family Medical Leave Administration _____ _____ 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 _____ _____ 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, 2015 Signature of Authorized Representative: ____________________________________________ 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 12 of 29 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. 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 $100, or 10% of your gross monthly benefit, whichever is greater. Uniformed police and fire department employees are eligible to participate in this plan after they are no longer eligible for FPPA benefits; which is after 25 years of service and age 55. Uniform police and fire employee benefits are paid at 60% or their monthly earnings. 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 the employee has been continuously totally or partially disabled for 90 days. This is considered the “elimination period”. The benefit period is dependent upon the age in which the employee became 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 an individual is totally or partially disabled due to an injury or sickness and that they 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 a 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 1,153 employees are enrolled for LTD coverage. The current volume of coverage is approximately $5,973,181 in monthly earnings. The current carrier has served the City since January 1, 2010. Please answer completely the following questions. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 13 of 29 QUESTIONNAIRE Group Long Term Disability 1. Will you agree to cover, without limitation, all employees enrolled as of December 31, 2014? 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 null and 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 deposit, 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. Does your plan provide any other services to assist the employee with returning to their own occupancy or to potentially obtain another job? 13. If an employee becomes permanently disabled, do you provide any services to assist with their application for Social Security Disability benefits? 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 14 of 29 Short Term Disability (STD) Options 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 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 work schedule. Employees in classified and unclassified management positions are eligible to use short term disability leave. All other employment categories are ineligible for this leave. Number of Advise-to-Pay Claims: 2012 = 76 2013 = 64 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 15 of 29 QUESTIONNAIRE Short Term Disability Options 1. Will you agree to cover, without limitation, all employees enrolled as of December 31, 2014? 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 null and void. 3. What is your premium rate for this coverage (give rates for all options)? 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. Please provide plan coverage and provisions for each option, as mentioned on Page 3 (Introduction). 5. Include samples of reports. 6. 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? 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 you provide claims management for current STD claimants during the runout period? 13. Please describe the employee claim filing and intake process. 14. Do you allow for single claim filing for STD, LTD, FML, waiver of premium, etc.? 15. Who pays for additional costs/fees for obtaining medical records? 16. Please confirm that you have an effective, documented process in place for notifying the Employer of Waiver of Premium in a timely manner when the employee becomes disabled. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 16 of 29 Family Medical Leave (FML) Administration 1. What is your rate for this administration? Please express your rate in terms of a per employee/per month fee. Premiums must be net of any commissions or broker fees; if you are selected for multiple plans, will you offer discounted premiums? 2. 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? 3. What is the average length of time an employee waits for an inquiry to be answered fully? 4. What performance guarantees will you provide? 5. 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? 6. Will you provide a dedicated Representative for the City’s Human Resources Department with telephone and email contact information? 7. What is your implementation time line for leave administration? 8. Please outline your file specs for feeds and provide the frequency of feeds. 9. Is FML outsourced or provided in house? 10. Is there a single employer reporting system or portal for FML and STD? 11. How long has your organization been providing leave administration services? 12. Do you allow for a single point of intake for FML, STD, LTD claim filing? 13. Do you have the ability to coordinate all types of leaves- FML, STD, ADA, employer leave of absence, etc.? 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 17 of 29 Group Life Insurance, AD&D and Supplemental Life Summary Description of Plan The City’s fully insured Group Life/Accidental Death & Dismemberment (AD&D) and Supplemental Life Insurance Plan covers classified and non-classified employees who work 20 or more hours per week. Uniformed police and fire department 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 are covered one-time (1X) their annual base salary. Employees may also elect additional life and AD&D coverage in amounts of one, two or three times their 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 Maximum Benefit is $100,000. The combined maximum benefit is $500,000. Benefits reduce by 30% at age 65; 50% at age 70; 70% at age 75; and 80% at age 80. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 18 of 29 The following table indicates the coverage amounts in effect and the number of enrolled persons (effective July 10, 2014): Plan Coverage # Enrolled Volume ($) Employee Life 1-x salary 1542 102,267,000 Employee AD&D 1-x salary 1542 102,267,000 Add’l 1-x 132 9,493,000 Add’l 2-x 67 8,798,000 Add’l 3-x 119 24,767,000 $100,000 150 15,000,000 Optional Employee 1-x salary 183 12,674,000 Life 2-x salary 102 13,554,000 3-x salary 179 36,570,000 $100,000 207 20,700,000 Optional Spousal $ 10,000 ** 234 2,340,000 Life $ 25,000 43 1,075,000 $ 50,000 62 3,100,000 $ 75,000 33 2,475,000 $100,000 29 2,290,000 Optional Child(ren) $ 5,000 38 190,000 Life $10,000 320 320,000 **This level of coverage is only available to new hires. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 19 of 29 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, 2014? 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 Life is $125,000 rather than $100,000? 5. Include samples of claim payment reports, e.g., premiums vs. claims, etc. 6. What is the average length of time required to fully resolve 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. Are the life insurance policies you are offering the City portable and/or convertible? If so, how are the rates determined? EXPERIENCE PRESENTATION FOR: "Cigna" is a registered service mark and the "Tree of Life" logo and “GO YOU” are service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. © 2014 Cigna. Some content provided under license. City of Fort Collins Experience As Of: 5/23/2014 Claims Reported on an Incurred Basis Period Description Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Start Date 1/1/2010 1/1/2011 1/1/2012 1/1/2013 Total End Date 12/31/2010 12/31/2011 12/31/2012 12/31/2013 FALSE # of Months 12 12 12 12 48 Constant Premium 287,680 286,711 306,507 328,860 1,209,758 Paid Claims 127,008 308,163 163,089 171,796 770,056 Reserves - 290,287 80,085 398,398 768,770 IBNR - - - 18,980 18,980 Net Incurred Claims 127,008 598,792 245,664 586,342 1,557,806 Loss Ratio 44.1 % 208.8 % 80.1 % 178.3 % 128.8 % Open/Pending Claims - 3 2 5 10 Closed Claims 8 5 11 7 31 Total Claims 8 8 13 12 41 City of Fort Collins Long Term Disability LK 0962251 As Of 5/23/2014 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 2 of 10 Created: 1:57 PM - 6/9/2014 All Claims Age Gender Date of Disability Coverage Status Benefit 68 M 11/25/2013 CC 3,006 59 F 10/31/2013 AC 3,660 43 F 10/29/2013 CC 4,352 39 F 10/20/2013 AC 3,056 60 M 8/27/2013 AC 3,595 66 M 7/3/2013 CC 2,984 68 F 5/5/2013 CC 2,568 63 F 4/22/2013 AC 3,034 60 M 2/28/2013 AC 4,280 61 M 1/30/2013 CC 3,614 52 F 1/23/2013 CC 2,759 55 F 1/5/2013 CC 2,355 57 F 11/2/2012 AC 2,739 58 M 10/23/2012 CC 2,811 66 F 10/10/2012 CC 2,530 58 M 10/1/2012 CC 2,607 58 F 9/20/2012 CC 2,944 51 F 9/6/2012 CC 2,219 59 F 9/4/2012 CC 4,649 62 M 8/15/2012 CC 4,114 60 M 6/12/2012 CC 3,746 51 F 5/18/2012 CC 2,423 65 F 4/26/2012 CC 5,205 62 F 2/27/2012 CC 2,119 62 F 2/27/2012 CC 2,119 61 M 1/2/2012 AC 3,111 65 M 12/16/2011 CC 2,756 48 M 12/12/2011 CC 3,335 63 M 12/1/2011 AC 4,617 69 M 8/31/2011 CC 1,992 64 F 8/29/2011 CC 1,888 64 F 8/29/2011 CC 3,415 63 M 8/11/2011 AC 3,967 33 M 6/22/2011 CC 2,907 41 F 3/8/2011 AC 4,244 56 M 12/15/2010 CC 1,343 City of Fort Collins Long Term Disability LK 0962251 As Of 5/23/2014 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 3 of 10 Created: 1:57 PM - 6/9/2014 Age Gender Date of Disability Coverage Status Benefit 56 M 12/15/2010 CC 3,335 32 M 9/22/2010 CC 4,575 61 F 8/17/2010 CC 2,996 66 F 8/2/2010 CC 2,530 61 F 7/2/2010 CC 2,119 51 F 5/18/2010 CC 2,577 49 F 3/1/2010 CC 2,778 44 M 2/19/2010 CC 2,158 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 4 of 10 Created: 1:57 PM - 6/9/2014 Claims Reported on a Paid Basis Period Description Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Start Date 1/1/2010 1/1/2011 1/1/2012 1/1/2013 1/1/2014 Total End Date 12/31/2010 12/31/2011 12/31/2012 12/31/2013 5/23/2014 FALSE # of Months 12 12 12 12 5 53 Constant Premium 129,313 130,194 135,705 143,903 60,697 599,813 Paid Claims 173,054 160,724 188,008 - - 521,786 Outstanding Reserves - - - - - - Waiver Reserves - 41,693 8,116 6,974 - 56,783 IBNR - - - - 18,624 18,624 Net Incurred Claims 189,086 202,932 196,941 8,009 225 597,193 Loss Ratio 146.2 % 155.9 % 145.1 % 5.6 % 0.4 % 99.6 % Total Claims 3 3 3 - - 9 City of Fort Collins Basic Life FLX0963106 As Of 5/23/2014 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 5 of 10 Created: 1:58 PM - 6/9/2014 Claims Reported on a Paid Basis Birth Date Gender Date of Incurral Coverage Status Total Paid Benefit Paid Date Outstanding Reserve Waiver Reserve Coverage Code 12/9/1973 F 10/20/2013 AC 5/23/2014 6,974 093 9/20/1955 F 11/2/2012 AC 5/23/2014 8,116 093 5/6/1949 F 10/1/2012 CC 39,000 10/8/2012 010 6/11/1965 M 8/11/2012 CC 2 8/17/2012 170 6/11/1965 M 8/11/2012 CC 81,000 8/17/2012 010 8/15/1951 M 7/14/2012 CC 68,000 8/6/2012 010 8/15/1951 M 7/14/2012 CC 6 8/6/2012 170 7/29/1948 M 10/20/2011 CC 5 11/16/2011 170 7/29/1948 M 10/20/2011 CC 47,000 11/16/2011 010 5/8/1969 F 3/8/2011 AC 5/23/2014 41,693 093 3/5/1944 M 2/16/2011 CC 42,700 3/22/2011 010 3/5/1944 M 2/16/2011 CC 7 3/22/2011 170 4/18/1955 M 12/21/2010 CC 12 2/23/2011 170 4/18/1955 M 12/21/2010 CC 71,000 2/23/2011 010 10/5/1953 M 9/17/2010 CC 22 11/18/2010 170 10/5/1953 M 9/17/2010 CC 65,000 11/18/2010 010 4/24/1969 M 7/4/2010 CC 10 8/16/2010 170 4/24/1969 M 7/4/2010 CC 40,000 8/16/2010 010 10/23/1954 M 1/8/2010 CC 23 2/26/2010 170 10/23/1954 M 1/8/2010 CC 68,000 2/26/2010 010 020 Voluntary Employee Life 030 Dependent Life 093 Waiver of Premium 094 Terminal Illness 170 Interest City of Fort Collins Basic Life FLX0963106 As Of 5/23/2014 Coverage Code Table 010 Basic Life Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 6 of 10 Created: 1:58 PM - 6/9/2014 Claims Reported on a Paid Basis Period Description Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Start Date 1/1/2010 1/1/2011 1/1/2012 1/1/2013 1/1/2014 Total End Date 12/31/2010 12/31/2011 12/31/2012 12/31/2013 5/23/2014 FALSE # of Months 12 12 12 12 5 53 Constant Premium 141,279 143,315 153,542 168,741 76,782 683,659 Paid Claims 183,051 165,022 68,006 - - 416,078 Outstanding Reserves - - - - - - Waiver Reserves - 124,539 10,144 12,681 - 147,364 IBNR - - - - 16,648 16,648 Net Incurred Claims 195,518 290,056 79,160 14,046 1,309 580,090 Loss Ratio 138.4 % 202.4 % 51.6 % 8.3 % 1.7 % 84.9 % Total Claims 2 2 1 - - 5 City of Fort Collins Voluntary Life - Employee FLX0963106 As Of 5/23/2014 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 7 of 10 Created: 1:58 PM - 6/9/2014 Claims Reported on a Paid Basis Birth Date Gender Date of Incurral Coverage Status Total Paid Benefit Paid Date Outstanding Reserve Waiver Reserve Coverage Code 12/9/1973 F 10/20/2013 AC 5/23/2014 12,681 093 9/20/1955 F 11/2/2012 AC 5/23/2014 10,144 093 8/15/1951 M 7/14/2012 CC 68,000 8/6/2012 020 8/15/1951 M 7/14/2012 CC 6 8/6/2012 170 7/29/1948 M 10/20/2011 CC 11 11/16/2011 170 7/29/1948 M 10/20/2011 CC 94,000 11/16/2011 020 5/8/1969 F 3/8/2011 AC 5/23/2014 124,539 093 4/18/1955 M 12/21/2010 CC 12 2/23/2011 170 4/18/1955 M 12/21/2010 CC 71,000 5/26/2011 020 10/5/1953 M 9/17/2010 CC 22 11/18/2010 170 10/5/1953 M 9/17/2010 CC 65,000 11/18/2010 020 4/24/1969 M 7/4/2010 CC 29 8/16/2010 170 4/24/1969 M 7/4/2010 CC 118,000 8/16/2010 020 020 Voluntary Employee Life 030 Dependent Life 093 Waiver of Premium 094 Terminal Illness 170 Interest City of Fort Collins Voluntary Life - Employee FLX0963106 As Of 5/23/2014 Coverage Code Table 010 Basic Life Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 8 of 10 Created: 1:58 PM - 6/9/2014 Claims Reported on a Paid Basis Period Description Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Fully Revealed Start Date 1/1/2010 1/1/2011 1/1/2012 1/1/2013 1/1/2014 Total End Date 12/31/2010 12/31/2011 12/31/2012 12/31/2013 5/23/2014 FALSE # of Months 12 12 12 12 5 53 Constant Premium 30,585 30,610 32,128 35,248 15,721 144,291 Paid Claims 7,001 17,003 10,000 20,005 - 54,009 Outstanding Reserves - - - - - - Waiver Reserves - - 20,289 - - 20,289 IBNR - - - - 3,160 3,160 Net Incurred Claims 9,499 17,068 30,434 20,263 194 77,458 Loss Ratio 31.1 % 55.8 % 94.7 % 57.5 % 1.2 % 53.7 % Total Claims 1 2 1 2 - 6 City of Fort Collins Voluntary Life - Dependent FLX0963106 As Of 5/23/2014 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 9 of 10 Created: 1:58 PM - 6/9/2014 Claims Reported on a Paid Basis Birth Date Gender Date of Incurral Coverage Status Total Paid Benefit Paid Date Outstanding Reserve Waiver Reserve Coverage Code 9/20/1973 F 4/10/2013 CC 3 7/9/2013 170 9/20/1973 F 4/10/2013 CC 10,000 7/9/2013 030 5/26/1988 M 3/15/2013 CC 10,000 5/14/2013 030 5/26/1988 M 3/15/2013 CC 2 5/14/2013 170 11/19/1950 M 11/13/2012 CC 10,000 12/7/2012 030 9/20/1955 F 11/2/2012 AC 5/23/2014 20,289 093 10/24/1941 M 11/11/2011 CC 7,000 12/9/2011 030 3/15/1958 F 7/14/2011 CC 3 9/27/2011 170 3/15/1958 F 7/14/2011 CC 10,000 9/27/2011 030 10/31/1941 M 5/9/2010 CC 1 6/1/2010 170 10/31/1941 M 5/9/2010 CC 7,000 6/1/2010 030 020 Voluntary Employee Life 030 Dependent Life 093 Waiver of Premium 094 Terminal Illness 170 Interest City of Fort Collins Voluntary Life - Dependent FLX0963106 As Of 5/23/2014 Coverage Code Table 010 Basic Life Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2014 Cigna Corporation) 10 of 10 Created: 1:58 PM - 6/9/2014 City of Fort Collins Summary of Experience Reports Product Time Period Constant Premium Incurred Claims Incurred Loss Ratio Combined Basic and Voluntary Life 01/2010 – 05/2014 $1,427,763 $1,216,309 85.2% LTD 01/2010 – 12/2013 $1,209,758 $1,538,826 127.20 Total $2,637,521 $2,755,135 105.5% Long Term Disability: 1. I have removed the Incurred but Not Reported (IBNR) from the Incurred Loss Ratio. 2. Incurred Claims includes $770,056 of paid claims and $768,770 of reserves 3. Currently 10 open LTD claims and 2 pending LTD claims. 4. Claim incidence has increased over last two years: 2010 – 8 claims, 2011 – 8 claims, 2012 – 13 claims, 2013 – 12 claims; 2014 – 2 pending claims. *Incurred claims on life exhibit include the following: 1. $991,873 of paid Life and voluntary Life claims and $224,436 of approved Waiver of Premium reserves for the basic and voluntary Life 2. Incurred claims exclude IBNR. 3. Voluntary Life is the primary driver of the life premium. City of Fort Collins Renewal Analysis 1/1/2015 Product Long Term Disability Basic Life Voluntary Life Advice to Pay STD Inforce Rate Annual Premium 0.462/$100 cp $302,162 .12/$1000 $134,689 Age-Banded $255,399 $1.27 PEPM $20,391 Case Rate Annual Premium 0.579/$100 cp $378,684 .184/$1000 $206,524 Renewal Rate Annual Premium Annual Increase 0.525/$100 cp $343,366 +$41,204 .12/$1000 $134,689 0 Match Inforce $255,399 0 $1.27 PEPM $20,391 0  The renewal reflects an overall increase of 5.8% in annual premium (LTD, Life and ASO).  The renewal rates for all lines will be guaranteed for 24 months to 1/1/2017. Long Term Disability  The current LTD rate of $0.462 has been in effect since the last renewal on 1/1/2013. Prior rate history: Effective 1/12010 = .365%; effective 1/1/2012 - .42%.  LTD is 26.5% credible.  It is running at 127.2% loss ratio  Average age of the group is 49, 57% male.  66 2/3% benefit on Class 1 is impacting the manual rate √ All paid claims have been in Class 1. Life Insurance  Combined basic and voluntary Life is running at 85.2% loss ratio. Experience is 38.4% credible.  Loss ratio is being driven by first 3 years of experience. Experience has improved over the last two years.  Voluntary Life has great participation at 43% which is helping with the improved experience.  Good demographics and growth over the last 2 years. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 20 of 29 EXHIBIT D SERVICES AGREEMENT (For informational purposes, do not fill in or submit with proposal) THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and , hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of ( ) page and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. 2. The Work Schedule. [Optional] The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule attached hereto as Exhibit " ", consisting of ( ) page , and incorporated herein by this reference. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within ( ) days following execution of this Agreement. Services shall be completed no later than . Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 4. Contract Period. [Option 1] This Agreement shall commence upon the date of execution shown on the signature page of this Agreement and shall continue in full force and effect for one (1) year, unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for an additional period of one (1) year at the rates provided with written notice to the Service Provider mailed no later than ninety (90) days prior to contract end. 5. Contract Period. [Option 2] This Agreement shall commence , 200 , and shall continue in full force and effect until , 200 , unless sooner terminated as herein 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 21 of 29 provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed ( ) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. The Denver Boulder Greeley CPIU published by the Colorado State Planning and Budget Office will be used as a guide. Written notice of renewal shall be provided to the Service Provider and mailed no later than ninety (90) days prior to contract end. 6. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City of such condition within fifteen (15) days from the onset of such condition. 7. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Service Provider: City: Copy to: Attn: City of Fort Collins Attn: PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of early termination by the City, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement. Such payment shall be the Service Provider's sole right and remedy for such termination. 8. Contract Sum. The City shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, per the attached Exhibit " ", consisting of ( ) page , and incorporated herein by this reference. Service Provider shall submit invoices to the City monthly. Payment will be made for all undisputed charges via Automatic Clearing House (“ACH”) direct account-to- account electronic deposit within thirty (30) days of receipt of an invoice. The Service 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 22 of 29 Provider herein agrees to execute the applicable direct deposit authorization form. 9. City Representative. The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City Representative. 10. Independent Service Provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 11. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City, nor will it obligate the City to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City to the same extent as the work of the Service Provider. 12. Personal Services. It is understood that the City enters into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City. 13. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 23 of 29 14. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City-furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City. 15. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof. 16. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 17. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 24 of 29 18. Indemnity/Insurance. a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit , consisting of one (1) page, attached hereto and incorporated herein by this reference. The Service Provider before commencing services hereunder, shall deliver to the City's Director of Purchasing and Risk Management, P. O. Box 580 Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 19. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 20. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 21. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 25 of 29 Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 26 of 29 consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 22. Red Flags Rules. Service Provider must implement reasonable policies and procedures to detect, prevent and mitigate the risk of identity theft in compliance with the Identity Theft Red Flags Rules found at 16 Code of Federal Regulations part 681. Further, Service Provider must take appropriate steps to mitigate identity theft if it occurs with one or more of the City’s covered accounts and must as expeditiously as possible notify the City in writing of significant breeches of security or Red Flags to the Utilities or the Privacy Committee. 23. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit “ “ - Confidentiality, consisting of one (1) page, attached hereto and incorporated herein by this reference. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 27 of 29 CITY OF FORT COLLINS, COLORADO a municipal corporation By:_______________________________ Gerry Paul Director of Purchasing and Risk Management Date:_____________________________ ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: ________________________________ Assistant City Attorney By:_______________________________ __________________________________ PRINT NAME __________________________________ TITLE Date:_____________________________ 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 28 of 29 EXHIBIT INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: "The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins." In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Service Provider's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement: 1. Workers' Compensation insurance with statutory limits as required by Colorado law. 2. Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee. B. Commercial General & Vehicle Liability. The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. 7671 Benefits - Life, Disability, and Family Medical Leave Administration Page 29 of 29 EXHIBIT CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City, or the City so requests for any reason, the Service Provider shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law.