COUNTY OF MARIN. May 30, Copyright 2014 by The Segal Group, Inc. All rights reserved.

Transcription

1 COUNTY OF MARIN Request for Proposal for Flexible Spending Account (FSA), Health Reimbursement Account (HRA), Health Savings Account (HSA), and COBRA Administration May 30, 2014 Copyright 2014 by The Segal Group, Inc. All rights reserved.

2 Ta b l e o f C o n t e n t s Request for Proposal for Flexible Spending Account (FSA), Health Reimbursement Account (HRA), Health Savings Account (HSA), and COBRA Administration May 30, 2014 Section I: Introduction & Overview... 1 Objective... 1 Scope of Services... 1 Background... 3 Selection Criteria... 3 Timetable... 3 Section II: Terms and Conditions... 5 Section III: Vendor Questionnaire... 7 A. Company History and Financial Profile... 7 B. Organizational Experience and References... 8 C. FSA Administration D. HSA/HRA Administration E. Debit Cards F. COBRA Administration G. Computer Systems and Support H. HIPAA I. Reporting Capabilities J. Work Plan/Technical Approach Section IV: Proposed Fees Appendix A: Letter of Intent Appendix B: Summary Plan Description Appendix C: Enrollment & Transaction Volumes Appendix D: Sample Agreement i

3 Section I: Introduction & Overview On behalf of The County of Marin ( County ), The Segal Company ( Segal ) invites your organization to submit a proposal to provide Flexible Spending Account ( FSA ), and COBRA administration services for the County. Proposals are also requested for the administration of a Health Savings Account ( HSA ) or Health Reimbursement Account ( HRA ) should the County decide to add such programs. The anticipated effective date of services for any contract resulting from this RFP process would be October 1, 2014 (or, as soon as possible). All bidders must follow the instructions pertaining to the bid specifications as described throughout the document, and must complete all questions and tables. For more information about specific plan provisions and benefits provided by the County, please see Appendix B for plan descriptions and other documents. Objective The County wants to evaluate the current TPA marketplace for FSA (Health, Dependent Care and Transit), HRA, HSA, and COBRA administration services and select a TPA that is best in class and competitive in terms of services, technology, size, and fees. The County is also interested in evaluating the cost and benefits of offering a debit card for direct payment of eligible expenses from a participant s account without having to submit a claim form for reimbursement. To that effect, the County is seeking a TPA that not only can provide the administrative services outlined in this RFP, but can also demonstrate best in class attributes through proactive, innovative, and creative solutions, as well as technology, and operational efficiency. Scope of Services The selected vendor will be responsible for: 1. FSA Administration (Health, Dependent Care and Transit) Discrimination testing Communication materials Attendance at initial transition meetings and possibly at the first open enrollment meeting under the new vendor s enrollment procedures Handling of open enrollment information packages Process participant requests for reimbursement according to plan and IRS rules Online web tools for enrollment, submission of expense documentation and account balances Fax and IVR capabilities Periodic employee statements Daily transit claim reimbursements via check or direct deposit Provide debit card(s) and manage all debit card transactions for participants eligible to withdraw expenses for reimbursement Promptly credit contributions to participant accounts and update account balances within 48 hours of receipt of transmittal; 1

4 2. COBRA Administration Initial COBRA Notice Election Notice/Enrollment Applications Coupon mailing/billing statement Premium collection and tracking/ach premium deductions COBRA termination letters, including early termination Mailing of rate change letters Updating of system for new plan year s rates Vendor eligibility reporting (electronic) Distribution of unavailability of COBRA coverage Monthly reporting Self-pay premium administration for participants on leave 3. HSA/HRA Administration (potential new program) Process participant requests for reimbursement according to plan and IRS rules, preferably with an on-line submission system; Provide on-line portal for the County and participants to view all transactions and balances; Create, print, and stock all necessary forms to carry out plan operations; Provide weekly transition status calls with the County during plan implementation. Conduct meetings at the County as requested Establish any custodial trust agreements necessary for the financial transactions; Provide debit card(s) and manage all debit card transactions for participants eligible to withdraw expenses for reimbursement; Provide claims procedures information to enrolled participants when they retire or terminate and are eligible to submit expenses for reimbursement; Promptly credit contributions to participant accounts and update account balances within 48 hours of receipt of transmittal;4. General Administration Provide the County with the information in its custody for use in preparing all returns and reports that are required by the Internal Revenue Service, the Department of Labor and any other federal, state, or county agencies. The selected vendor shall assist in the preparation of such returns and reports whenever called upon to do so the County Provide employee communications material in ready-to-print format such as benefit booklets, newsletters or similar informational materials, web-access to interactive information, new participant letters and informational packets, etc. Stay current on legal and regulatory changes affecting any of the plans administered by your company, and advise the County of any regulatory, legal, or procedural changes Handle the intake and review of all customer service inquiries and appeals Maintain records of contributions, interest income, benefit payments and other administrative fee deductions, and resulting account balances of County participants and report the same to the County in a format and frequency acceptable to the County 2

5 Maintain participant information including all necessary data elements to ensure proper plan administration Maintain a bilingual call center fully-staffed with representatives Background The County has approximately 1,990 active employees who are eligible for benefits. FSA Administration Employees currently fill out an enrollment form either as a new employee or during annual open enrollment. Information is entered into the HR payroll system. It is anticipated that during the lifetime of the contract with the FSA administrator the County will institute online employee selfservice for benefits elections. Employees are reimbursed on their bi-weekly paycheck, or by direct payment from the administrator. Employees must submit receipts by end of the pay period. Selection Criteria The successful proposer must meet the following criteria: 1. Provide all requested FSA and COBRA administration services on a bundled basis (including HRA or HSA if adopted); 2. Offer competitive administrative fees with long-term guarantees; 3. Demonstrate excellence in all the requested administration services; 4. Emphasize consistently high levels of quality client and employee service; 5. HIPAA Compliance: All bidder services must be in compliance with the HIPAA EDI, Privacy and Security rules as well as the HITECH and Safe Harbor provisions; 6. Have the experience and ability to interface, coordinate and manage relationships with freestanding and contracted vendors as well as plan advisors; and 7. Provide ad-hoc data reporting as needed to support the administrative functions of the County. Timetable The following is the proposed timetable for the competitive bidding process: TASK TARGET DATE* RFP Issue Date May 30, 2014 Letter of Intent Submittal June 6, 2014 Vendor Proposal Due June 27, 2014 Finalist Presentations (Tentative) Week of July 21, 2014 Vendor Selection/Notification (Tentative) July 28, 2014 Implementation August September 2014 Effective Date October 1,

6 * Please note that the timetable reflects target dates that are subject to change. 4

7 Section II: Terms and Conditions The successful proposer must agree to indemnify and hold harmless the County for any liability arising from errors and omissions in delivering services on behalf of the County. During the bidding process, and unless otherwise directed by the Segal Consultant identified in this RFP, vendors shall direct all communications involving the RFP, whether oral or written, solely to the Segal Consultant and to no other employee or agent of the County. Non-authorized contact with the County s staff regarding this RFP may be grounds for disqualification. Please confirm your willingness to agree to the following terms and conditions: 1. Proposers must base their proposals on the benefits, statistics and demographics summarized herein. 2. Proposals must conform to the formats provided in these specifications. 3. Responses to the questions and completed exhibits must be provided together in one section of your proposal and must be separate from any informational material. 4. For your convenience, we are transmitting the RFP document electronically so that you may insert your answers directly below each question and return the completed RFP in the same manner. 5. Any cost incurred by a bidder in preparing or submitting proposals is the bidder s sole responsibility. 6. Exceptions Any deviations or exceptions to terms, conditions or other requirements in any part of these specifications must be clearly and separately stated. Otherwise, it will be considered that all items offered are in full compliance with the specifications, and the successful proposer will be responsible for compliance. The County will consider such exceptions as part of the evaluation process. 7. Reference to Other Proposals Only information received in response to these specifications will be evaluated. Reference to information previously submitted will not be considered. 8. Evaluation of Proposals All qualified proposals will be evaluated according to completeness, content, ability of the proposer, its staff and price. The award will be made to the proposer whose overall arrangement is deemed to be in the best interests of the County. 9. Time for Acceptance of Proposal The bidder agrees to be bound by its proposal for a period of at least 120 days, during which time the County and/or Segal may request clarification or correction of the proposal for the purpose of evaluation. Amendments or clarifications shall not affect the remainder of the proposal, but only the portion so amended or clarified. 10. Confidentiality The successful proposer will be requested to sign a statement of confidentiality to ensure the proposer s capability of maintaining all employee information in strict confidence. 11. County s Standard Contract The purpose of the attached Sample Agreement (Appendix D) is to indicate the type of contract contemplated and to set forth some of the general provisions the County anticipates including in the final contract. In submitting a proposal, the Proposer will be deemed to have agreed to each clause unless the proposal identifies an objection, sets forth the basis for the objection, and provides substitute language to make the clause acceptable to the 5

8 Proposer. Such objections and substitute language must be submitted no later than the deadline for the proposal. The County may or not agree with proposed language changes to the standard agreement. 12. HIPAA Business Associate Agreements: The successful proposer will be requested to sign a Business Associate Agreement to ensure the proposer s compliance with the HIPAA EDI, Privacy and Security rules, as it pertains to the County s Protected Health Information, as well as HITECH. 13. Right to Audit The successful proposer will be required to allow the County the full right to audit and provide all data elements requested by the County s auditor. 14. Bidder s Representation The person signing the proposal must be an officer of the firm authorized to bind the firm to a contract in the event of an award. 15. Plan Rules The bidder agrees to accept any specified eligibility or benefit rules established by the County. Any proposed modifications to the specified eligibility or benefit rules must be clearly pointed out in the appropriate section of the proposal. 16. Transfer of Records In the event of contract termination, the administrator agrees to transfer to the County (or to a successor administrator) within 30 days of termination notice all data and employee records necessary for the continued administration of the plans. The administrator must agree to continue operations until the transfer of data has been completed. 17. All record documents and data shall be the property of the County and not the administrator. 18. All questions should be directed to Joanna Yip at jyip@segalco.com. No questions should be directed to any County employee. 19. Letter of Intent All proposers must respond in writing or submit a notification letter (Appendix A) as to whether or not they will be submitting a proposal by June 6, Please your notification to Joanna Yip at jyip@segalco.com. You will receive an notification confirming the receipt of your Letter of Intent. 20. Proposal Submission: Electronic Copy Please submit an electronic version of your complete proposal to Joanna Yip at Segal via at jyip@segalco.com. The completed RFP questionnaire should be returned in a Microsoft Word format (no PDFs, please). 21. Proposal Submission: Paper Copy In addition, the following hard copies of your complete proposal and any collateral materials should be sent to each of the following: Mr. Scott Hadley (4 Copies) Employee Benefits Supervisor County of Marin Department of Human Resources 3501 Civic Center Drive, Suite 415 San Rafael, CA Robert Mitchell (2 Copies) 330 North Brand Boulevard Suite 1100 Glendale, CA Due Date Electronic Responses must be received before 5:00 PM Pacific Time on June 27, Hardcopies may be shipped for overnight delivery the following business day. 6

9 Section III: Vendor Questionnaire Instructions Provide an answer to each question and do not leave blank or unanswered questions. Answer the question as directly as possible and incorporate all information within the questionnaire section. Please avoid referring to attachments or collateral materials in lieu of answers. Do not include promotional materials. The bidder will be held accountable for accuracy/validity of all answers. Please remember, RFP responses will become part of the contract between the winning bidder and the County. A. Company History and Financial Profile 1. Where is your company located and how long has it been operational? 2. Is your company a division or subsidiary of a parent firm? If yes, please indicate the name of the parent firm. 3. Include a statement of your company's history, management, business objectives, and financial structure, including ownership and general financial condition. 4. Do you plan to sub-contract any portion of the services required to another firm? If Yes, answer the following: Which of the services do you plan to sub-contract and to which company? Do you use sub-contractors operating outside the United States? If so, please describe if any administrative functions such as data entry, computer programming or customer service/call center will be sub-contracted to these entities. 5. Are you licensed to do business in the State of California? What other states are you licensed in? In addition, the contract will be issued in accordance with the laws of California. Please confirm whether your organization will agree to comply with this requirement. 6. Provide the latest annual report or other financial reports (including audited financial statements) that indicate the financial position of your organization. If your company is privately held, list owners with 5 percent or more of equity. 7. Has your company been a party to any litigation or arbitration within the past ten years? If yes, please explain. 8. Has your company, its affiliates, or any of its staff, principals, or owners ever been subject to a governmental investigation? Please describe. 9. Please describe any type of external audits performed of your operations including but not limited to SAS-70 or SSAE-16 and the frequency of these audits. Please include a copy of your most recent SAS-70 or SSAE-16 (or other external audit). 10. What fidelity and surety insurance or bond coverage do you carry to protect your clients? Specifically describe the type and amount of the fidelity bond insuring your employees that 7

10 would protect the County in the event of a loss. Do you agree to furnish certificate of coverage for all such policies for review by legal counsel if requested? 11. Has your firm or any client administered by your firm ever sustained a fidelity loss or claim? If yes, please provide details. 12. Indicate your firm s liability insurance limit with regard to errors, omission, negligence, etc. Please include deductible and annual limit (per occurrence and aggregate) information and name of insurer. 13. Designate the individual(s) with the following responsibilities. Include the name, title, address, phone number and address of each individual, along with a brief description of his/her qualifications and experience. The individual(s) representing your company during the proposal process. The individual(s), who will be assigned to the overall ongoing management. The individual(s) responsible for day-to-day service Response B. Organizational Experience and References 1. Please list the number of years your company has provided the following services: Health FSA Administration Dependent Care FSA Administration Transit FSA Administration HRA Administration HSA Administration COBRA Administration 2. What percentage of your organization s total revenue is represented by the administration of FSAs? HRAs? HSAs? COBRA? 3. How many clients are you currently administering? How many additional clients are expected during the next 6 months? 4. Of your company's current clients, what three would be viewed as peer groups for the services requested by the County? Include the following information: Client name Principal location Number of covered participants Client contact including name, title, and phone number Services provided please be specific 8

11 Effective date of contract 5. Has any client terminated the administration services of your firm? If so, please provide the names along with the reason for each termination. May they be contacted? 6. Provide a reference list of current and former public sector clients, including contact name and telephone number. If you do not have public sector clients please provide references (including contact name and telephone number) of at least three private sector clients. 7. Has your firm ever been subject to a legal action brought by a client or former client in the last five years? If so, please explain the nature and current status of the action(s). 8. Describe how your company keeps its staff apprised of legislative updates both federal and state. Indicate the scope of your company's technical research ability, including staff and access to legal resources. 9. Provide a brief overview of the administration office you would propose for the the County. What is the location and hours of operation of the office that would provide day-to-day account service? How long has it been operational? What types of services does it provide? 10. Describe the staffing of the proposed administration office. How many employees work in that location? What was the turnover rate for customer service and account management staff in the last 12 months? 24 months? What was your total turnover? (Express as a percentage of total staff members.) What is the average number of years of experience of these employees? 11. Indicate how many full time and part time individuals (by position type and level) would be dedicated or assigned to the County s account. Will dedicated employees have shared duties with other accounts? What percentage of time would be dedicated to the County? Please include customer service and programming staff specifically, in your response. Who will be assigned as the account executive on the account? Please provide his/her professional biography with your response. 12. Describe the supervision function. Who would be responsible for daily ongoing administrative issues? How would account service for the County be coordinated? If your firm is selected, do you anticipate hiring additional staff? If so, how many and in what category? 13. What is the average hold time before a participant is able to reach a customer service representative? 14. Please describe what online services are available for reviewing account balances and transactions. Please describe your current Internet capabilities as they relate to customer service including what features are available, what information can be accessed by the County benefits staff/plan Administrator, what information can be accessed by the County employees, and what information can be updated using the Internet. 15. What are your performance guarantees? Describe your guarantees and associated financial penalties. 16. Will a toll-free number be available to participants to handle eligibility inquiries or other service issues? Please specify whether the numbers will be dedicated to the County or shared (Check only one). Yes, at no extra charge Yes, at a charge of $ (Please include this fee in Table 1) 9

12 No 17. Will a toll-free fax number be available to participants for submitting claims and documentation? Please specify whether the numbers will be dedicated to the County or shared (Check only one). Yes, at no extra charge Yes, at a charge of $ (Please include this fee in Table 1) No 18. What hours will the telephone lines be staffed by actual customer service representatives? (Please do not include hours the telephone line will be staffed by an answering service. Include weekend hours, if applicable.) 19. Indicate the ways in which your organization is able to accommodate special needs of enrollees (check all that apply): No special accommodations Have a TDD (Telecommunications Device for the Deaf) or other voice hearing impaired capability for the We accommodate non-english speaking enrollees by contracting with an independent translation company We maintain customer service staff with the ability to translate Spanish We maintain customer service staff with the ability to translate the following languages: C. FSA Administration 1. Please describe your ability to provide FSA administration services as outlined in this RFP. 2. Will you provide seminars and other educational activities upon request from the County to promote this program? 3. The County requires that the following services (on next page) be provided in administering the FSA program. If your proposal does not include all of these services, or includes other additional services, please describe in detail. Also, please indicate the cost of each service in the Financial Section. Service Will your organization perform the following services? Indicate Y or N Yes Communication to plan members Web-based on-line tool for enrollment information & inquiries Web-based on-line access to employee accounts Onsite enrollment meetings Processing of requests for reimbursement, including eligibility No Explain the way in which you will provide each of these services 10

13 verification Service Will your organization perform the following services? Indicate Y or N Yes No Explain the way in which you will provide each of these services Ongoing record keeping of accounts Issuance of reimbursement drafts and pertinent documentation Employee notification of account balances near year-end Periodic accounting and statistical reports (include examples) Nondiscrimination testing to ensure Plan is in compliance with IRS Code Section 125 on an annual basis. Is there an additional cost for the annual testing? Banking arrangement for financing the FSA program Debit cards (Include Brand) Employee statement mailings - How frequently will you mail statements? For transit benefit, allow payroll deduction changes on a month-tomonth basis 4. Describe the information that will be required from the employee to submit a valid claim for FSA benefits reimbursement, i.e., do they need a copy of the EOB from the health carrier confirming their out of pocket, etc. 5. How often would reimbursements be made to participants? Vendor Response Health care reimbursement account? Dependent care reimbursement account? Transit account? Can the schedule be different for different benefits? Yes No Do you require an initial deposit? Yes No If so, how much? 6. Indicate how contributions, accounting and reimbursements are tracked. 7. Does your system calculate salary reduction and payroll deduction amounts? Can it provide this information for our payroll department? 11

14 8. Can your system accommodate changes to an employee s election during the plan year due to: Employee status changes Family status changes Changes in eligibility Other; please detail: 9. How does your system check for duplicate expenses and verify plan maximums? 10. Describe your method for ensuring that benefit terminations are adequately and timely handled. How does the system track termination dates? Describe how you would handle a retroactive termination regarding claims reimbursement and enrollment. 11. If requested by the County, can you administer FSA during the COBRA extension period? 12. What safeguards exist against an ineligible plan member attempting to gain reimbursement under the program? 13. Can your system flag certain recurring expenses that have already been substantiated? (i.e., will you require substantiation of a recurring eligible expense each time the expense is submitted or only the first time the expense is submitted?) 14. Does the system maintain covered dependent and beneficiary information? 15. Can your system administer multiple plan years concurrently and allow dual records during the first months of a new plan year? Can your system automatically enroll eligible employees who elect to continue to participate? 16. How are deposits to participants accounts entered to the system? On-line? From participants elections? Payroll extract? 17. How do you handle overpayments and underpayments? 18. How will forfeitures be handled for year-end accounting? 19. How are requests that exceed a participant s account balance handled? 20. Can EOB messages be customized? 21. Will the system allow employees to submit reimbursement requests for eligible expenses incurred during the prior year, for a period of no more than 90 days after the end of the plan year? 22. Describe the way in which the banking arrangement works. Include the timing of the call for funds, any deposit amount required in the account, its term (weekly, monthly), how it is determined and any interest earned on the deposit or on amounts held in the account until checks are cashed. 23. Do you offer ACH or direct deposit of reimbursements? If yes, does an additional fee apply? (Please include fee in Table 1) 24. Provide samples of communication materials to be distributed by the vendor to all members including but not limited to: Procedures for obtaining reimbursement 12

15 Procedures for appealing an adverse reimbursement determination Claim forms Claim substantiation when using debit card D. HSA/HRA Administration 1. Indicate any special or extraordinary charges that you anticipate. 2. Are communication materials to members ordinarily included in your fee quotation? 3. Please submit a work plan outlining your ability and approach to providing the HSA and HRA administration services outlined in this RFP. 4. What company do you use to serve as your custodial bank? 5. What entity is the named Trustee on that account? 6. Will the funds for the County be segregated or pooled? 7. Can your firm charge all administrative fees, including banking fees to the participant account? 8. How often are these charges made? 9. Describe in detail the investment funds that you can make available to participants. 10. Do you have investment funds that are categorized by the amount of risk? 11. Are there opportunities for the County to recommend additional funds? 12. Do you have a default investment option for the immediate deposit of contributions should a participant not elect a particular investment option for contributions? 13. What alternative arrangement can you recommend that would inure interest to the accounts? 14. Describe in detail the process for the transfer of funds when requests are made for reimbursement or upon the establishment of a debit card for reimbursement. 15. Does the process vary should a debit card be issued from the normal method or reimbursement? 16. The County requests the following services be provided in administering the HRA program. Please complete the following table. Service Communication to plan members including telephone service Web-based on-line tool for enrollment information & inquiries Will your organization perform the following services? Indicate Yes Web-based on-line access to employee No Explain the way in which you will provide each of these services 13

16 accounts Service Processing of requests for reimbursement, including eligibility verification including EFT and automatic payment of premiums Ongoing record keeping of accounts including quarterly statements Issuance of reimbursement drafts and pertinent documentation and EFT Employee notification of year-end account balances Periodic accounting and statistical reports (include examples) for the County Banking arrangement for holding trust deposits to the HRA program Reconciliation, audit detail for the County Auditor Selection of Multiple Investment Options for participants Will your organization perform the following services? Indicate Yes No Explain the way in which you will provide each of these services If your proposal would not include all of these services, or would include other additional services, please describe in detail. You may refer in each of the answers above to exhibits, which are illustrative samples of the documents referenced in your answers. 17. Please describe your claim reimbursement process. 18. Are there provisions for online submission of claims? 19. Are there additional investment fees associated with any investment options? If yes, please describe these charges. E. Debit Cards 1. Describe your debit card services and type of benefits handled (e.g., FSA, HRA, HSA, Dependent Care, Transit, etc.). Do you provide a proprietary card or do you use an outside vendor? 2. With what other companies do you contract in order to provide debit card services (e.g. bank, credit card company, etc.). Describe the services provided by your company and those contracted to other companies, and the contractual arrangements. 3. Please describe your recommended procedure for "stacking" the Health Care and Dependent Care FSA accounts. Describe alternative arrangements that you can support. 4. Describe how you pay claims during the 90-day grace period for FSAs. 5. Describe when paper substantiation must be submitted by an individual and any substantiation that the individual is requested to retain for tax purposes. 14

17 6. How do you assure that every claim, both electronic and paper, is properly substantiated in accordance with IRS guidelines? 7. Describe which automatic electronic substantiation methods you use: Copayments Recurring claims Real-time substantiation Inventory Information Approval System (IIAS) 8. Are you in compliance with IRS Notice ? If not, please describe your compliance program. What types of claims cannot be administered via your debit card? 9. Provide a list of items that you consider qualified medical expenses that are payable by your program using an electronic substantiation method. 10. Can your card program be used to pay for over-the-counter medication? If so, please provide a sample list of payable medications. 11. Describe your procedures and policies that prevent abuse of the debit card (e.g. use by the employee to purchase items that are not qualified medical expenses). 12. Confirm that all fees associated with the debit cards are included in the base FSAadministration fees. 13. Describe the banking arrangements necessary to implement your debit card program. Include information about when money transfers would be required and how often. 14. Must all participants use the debit card or can only certain individuals elect the debit card option? 15. When you offer a debit card, do you require that all reimbursements be administered via this debit card or will you accept hard copy claim submissions by those participants who forget to use their card? F. COBRA Administration 1. Please describe your ability to provide COBRA administration services as outlined in this RFP. Please confirm that you are able to provide the following: Initial COBRA Notice Election Notice/Enrollment Applications Coupon mailing/billing statement Premium collection and tracking/ach premium deductions COBRA termination letters, including early terminations Mailing of rate change letters Updating of system for new plan year s rates Vendor eligibility reporting (electronic) Monthly reporting by Plan Type by location 15

18 2. Are you able to send eligibility files to the County s medical, dental, and vision plan administrators directly? Are you able to issue file feeds in the standard HIPAA 834 format? 3. The County administers benefits for active employees on a bi-weekly schedule. Can you prorate the first monthly COBRA premium to account for just the days remaining in the first month? 4. Is your system capable to administer COBRA subsidy payments? Either from the County or required by regulations.? 5. Please describe in detail.what kinds of reports are available on COBRA administration, claims and overall costs to the plan? Is there an extra charge for such services? If so, please explain the level of and basis for the charge. 6. Do you have the ability to customize reports? Do you charge for customization and If, what is the basis for determining cost? 7. Do you have the ability to access and/or query data through your website? 8. Will the County have the ability to add participants online directly into your system, for emergency cases only? If so, how will your system handle the participant that was manually entered when it s included in the file transfer data? 9. Do members have the option to pay monthly bills online and/or via credit card? 10. Do you enroll new COBRA participants directly? 11. Do you provide COBRA letters to the new COBRA members? 12. Can you receive an electronic file with terminations for initiating the COBRA notification process? 13. Do you automatically terminate members for non-payment? 14. Do you send out delinquent letters? What is your timing? 15. On the current month reports, can you include payments from members that were supposed to be made the month prior? 16. If a member makes a payment for the current month and the two months following, will the payment be reflected on the report as each month paid goes by? G. Computer Systems and Support 1. Please describe your FSA (medical, dependent care and transit), HRA, and HSA, and administration systems (hardware, platform, software, etc.). Describe how you would track and capture employer contributions, eligibility information, benefit payments, account balances, etc. Please be specific. 2. Please describe your COBRA administration systems (hardware, platform, software, etc.). Describe how you would track terminations, qualifying events, allowable COBRA periods, plan choices and the associated premium amounts, etc. Please be specific. 3. Please indicate what components of the computer application were (a) developed in-house, (b) purchased, or (c) licensed. If software is purchased or licensed, please indicate from whom. 16

19 Function Developed In-House Purchased Licensed Year of Last Major Modification Name of Software Vendor Enrollment/Recordkeeping FSA Administration HRA Administration HSA Administration COBRA Administration Imaging/Scanning Workflow Customer Service Other: 4. Please confirm that your system can store alternate participant ID numbers in addition to social security numbers (SSN), and that your system can perform search, sort and reporting functions using alternate participant IDs in lieu of SSN. 5. Do you have a policy that addresses the handling of client s data should the client wish to select another service provider? If yes, describe. 6. Describe your disaster recovery program and business continuity/contingency plans. 7. With regard to your computer systems, please describe your record retention and destruction policy, including how long records are retained. 8. Describe the security controls you have with regard to your website and the transfer of data. H. HIPAA 1. Considering the nature of the services to be provided to the County, would you consider your regulatory status under HIPAA to be the plan's Business Associate as defined under the recently published final rules modifying HIPAA Privacy and Security? Please include with your proposal a copy of your HIPAA Business Associate Agreement, if any. If you would not consider yourself the plan's HIPAA Business Associate, or have no standard HIPAA Business Associate Agreement, please explain. 2. Describe the process used by your company to comply with HIPAA Privacy and Security requirements. Have you conducted a HIPAA security risk assessment and if so, when was it conducted? 3. Is your staff trained on all Privacy and Security requirements? Please describe your training program and enforcement policy. 4. Does your system presently meet requirements in the regulations issued pursuant to the HIPAA HITECH Security standards? If not, have you identified areas in which your system does not meet the proposed standards and what is your timetable for bringing your system into compliance? 17

20 5. Does your system produce sufficient audit trails to satisfy the HIPAA Privacy and Security regulations? 6. Are all electronic transmissions of PHI, including eligibility files, authorizations, reports, etc., encrypted or sent via secure means? 7. Which encryption methods do you support for s and file attachments? Are your database servers (data at rest) encrypted? Please describe. I. Reporting Capabilities 1. Describe what type of standard reports are available to clients. What information and reports are available via on-line access? 2. Please include samples of the following material for each of the programs you are proposing to administer: Communication material Enrollment and any other forms Management reports Reimbursement draft 3. Would you provide ad-hoc data reports at the County s request? If so, please describe your adhoc data reporting capabilities. Would there be additional fees for these reports? If so, please describe and include all additional fees in Tables 1 and 3 of the Financial Section. J. WORK PLAN/TECHNICAL APPROACH 1. Explain as succinctly as possible how your firm would accomplish the work and satisfy the the County s service objectives as described in this RFP. Include a project plan with dates, timelines, and the responsible party. 2. Describe information, documents, staff assistance, facilities or other resources you would require from the County to complete your work. Identify any other critical assumptions upon which your work plan is based. 3. Do you have a special team assigned to handle the transition of new clients? Who would be in your the County Team if you are the selected proposer? Please include the titles and credentials of this team if applicable. 4. Are all implementation costs included in your basic fees? If no, please identify all additional charges and include in Tables 1 and 3 of the Financial Section. 5. Please confirm that you will be able to successfully implement and take over the County s program effective October 1, Please provide a description of the following topics as they relate to the implementation of your proposed services: The strategy and approach to implementation 18

21 The proposed implementation schedule (with estimated dates) including all milestones such as critical events, tasks and task dependencies, and the County required tasks to successfully implement the administration services related as outlined herein Your approach to the management of the project including status meeting, status reporting, and issue resolution The qualifications and experience of the proposed Project Manager Your approach to project communications and outreach Your proposed data migration strategy Your approach to risk and issue management, scope control, and quality assurance 19

22 Section IV: Proposed Fees Monthly fees should include all administration services outlined in this request for proposal. If you are proposing fees on a bundled/flat monthly basis, which may differ from the suggested breakdown, ensure that all services are accounted for and indicate Included in the appropriate fee box. List in Table 3 any services that you would not provide or that are not included in your fees. Please be advised that if your quotes are not firm or final you must clearly indicate it in your proposal and explain exactly what information will be needed in order for the quote to become final. In providing fee estimates please keep in mind the following: 1. Please complete the fee tables that are at the end of this section. Include all assumptions used to develop the fees. In preparing the tables, please keep in mind the following: If you are quoting on a per-capita basis, please use the headcounts provided and show all calculations; Any set-up fees to transfer records to your recordkeeping system should be listed separately; and Any special fees or charges of any kind for services or supplies that will not be covered by your proposed per-capita fee must be disclosed in your proposal. Please describe any services or supplies you will not cover. 2. Please confirm that: All fees are guaranteed for 36 months from contract inception. Fees are guaranteed for 12 months upon renewal after the initial contract expiration (at the County s option), and fee increases shall occur no more frequently than once every 12 months in the absence of benefit revisions. Confirmed Not Confirmed All future rate adjustments will be communicated at least 90 days in advance of the effective date Confirmed Not Confirmed The County s fees are payable at the end of the 30-day grace period Confirmed Not Confirmed Fees should include the cost of routine printing and mailing Confirmed Not Confirmed 3. Detail your reconciliation responsibilities and procedures. The County will require that all reconciliations be performed by the selected vendor. 4. Describe how you handle the banking arrangement for clients that are fully outsourced, what type of accounts you would propose for the County, and your strategy for eliminating or minimizing banking fees. 20

23 5. Confirm that you agree to perform the following functions in the event of cancellation: Guarantee a post-termination administrative fee of no more than your last month s monthly fee Confirmed Not Confirmed Transfer all records to the County or the successor administrator within 30 days of termination in a form that is acceptable to the recipient Confirmed Not Confirmed 6. Detail any rights reserved by your firm to call any additional funds. 7. In the event of termination, would you transfer the administrative records to the County or any carrier/ TPA who replaced you at no charge? 21

24 Table 1 Summary of Fees SERVICE MONTHLY FEE Year 1 Year 2 Year 3 1. FSA Administration Health Care Dependent Care Transit Expenses 2. Debit Cards Initial Card Additional Card Duplicate Card 3. COBRA Administration Initial Notification Monthly Per Capita Per Item Charges (List items) 4. Other Administrative Fees: Discrimination Testing Communication Materials 800 Number (Specify shared or dedicated) Postage Printing of Forms Travel 5. Other Fees (Specify) 6. Total Monthly Fees 7. Total Annual Fees Table 2 First Year Set Up Fees Service Set-Up Fees (Year 1 Only) 1. Initial Set-Up Charge 2. Development of Communication Materials (e.g., transition announcement letters, etc.) 3. Other (Specify) Total Set-Up Fees 22

25 Table 3 Fees and Services List of all services that are included in fees (Please specify all services as this list will be included in a contract agreement should your firm be selected). Any special fees, charges or expenses of any kind not included in the base administrative fees. List of optional services not included in fees, along with associated fees. 23

26 Table 4 Additional Fees and Services HSA/HRA Administration (if adopted by the County) SERVICE MONTHLY FEE YEAR 1 YEAR 2 YEAR 3 HSA Administration HRA Administration Debit Cards Initial Card Additional Card Duplicate Card Other Administrative Fees: Discrimination Testing Communication Materials 800 Number (Specify shared or dedicated) Postage Printing of Forms Travel Implementation Fees (including any start-up costs) List of all services that are included in fees (Please specify all services as this list will be included in a contract agreement should your firm be selected) List of optional services not included in fees, along with associated fees 24

27 Appendix A: Letter of Intent For FSA (medical, dependent care, transit), HRA, HSA, & COBRA Administration Services for County of Marin Please this form by Friday, June 6, 2014 to the following individual: Joanna Yip Name of Bidder: We confirm the receipt of your RFP and will take the following action [check only one box]: We intend to bid all services We decline to bid (please provide reason) Signature: Name (Print): Telephone #: Fax #: Date: Intent to Bid Forms must be received by June 6,

28 Appendix B: Summary Plan Description Please refer to the County s website for more information: 26

29 Appendix C: Enrollment & Transaction Volumes The following provides approximate enrollment counts and processing volumes: Number of Active Employees Eligible to Participate Note: Employee counts are based on the first pay period in January of each year , , , , , ,990 Total Contributions per FSA Account Type Year Medical Dependent Care Transit 2009 $314, $245, $8, $373, $286, $10, $366, $271, $8, $436, $335, $4, $478, $360, $3, Medical FSA Participants Dependent Care FSA Participants Transit Expense FSA Participants

30 COBRA Participants as of February 2014 Medical 4 Dental 23 Vision 8 28

31 Appendix D: Sample Agreement On separate attachment. 29