Laredo. Tel: Fax: * * * * * * * * * * * * * * * * * * * * * * Page 1 LAREDO DELIVERED MUST BE. respondent.

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1 Laredo Independent School District Purchasing Department 1702 Houston Street, Rm. 101 Laredo, Texas Tel: Fax: Request for Proposal LAREDO INDEPENDENT SCHOOL DISTRICTT invites you to submit proposal for: REFERENCE NUMBER: MUST BE DELIVERED BY: MUST BE DELIVERED OR HAND CARRIED TO: RFP # Health Insurance Date: June 6, 2:30 p.m. CST (Note: Timely physical delivery is at the risk of the respondent.) LAREDO INDEPENDENT SCHOOL DISTRICT PROCUREMENT DEPARTMENTT 1702 HOUSTON STREET, RM. 101 LAREDO, TEXAS ESTIMATED CONTRACT PERIOD: September 1, 2012 thru August 31, 2013, with an option to renew for a second and third year DISTRICTT BUYER IN CHARGE OF PROPOSAL: All questions regarding this proposal should be in writing to and ivelarde@laredoisd.org by 12:00 p..m. May 24, Answers to questions will be posted on District website at: PROCUREMENT DIRECTOR: Gustavo Alcantar * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Timeline: Vendor Submission: Required Forms: General Conditions: Scope of Work District Profile & RFP Response Questionnaire: Plan Exhibits & Claims History Page 2 Page 3 Pages 4-12 Pages Pages Pages Page RFP# HEALTHH Page 1

2 REQUEST FOR PROPOSALS Laredo Independent School District will accept sealed proposals on Request for Proposal Health Insurance No Health Insurance as per attached specifications. Please address proposal to Laredo Independent School District Procurement Department to 1702 Houston Street Room #101, Laredo, Texas Mark envelope on the outside: RFP Health Insurance. Proposals will be received until 2:30 p.m., June 6, 2012 at the Procurement Department, Room #101. All proposals will be stamped, with time and date received, at the time of delivery to the Procurement Department. Proposals will be considered late if turned in after the required deadline. Proposals will not be accepted and tabulated unless the vendor identification portion of the proposal form is completely filled in and is manually signed by authorized representative of the company. Proposals are tentatively scheduled to be presented to the Board of Trustees at the July 19, 2012 Regular Board meeting. The Board of Trustees of Laredo Independent School District, reserves the right to accept or reject any or all proposals and to waive any formalities and/or irregularities. Timeline: a) 1 st Advertisement:. May 5, 2012 b) 2 nd Advertisement:. May 6, 2012 c) Distribute Bid Specifications:. May 7, 2012 d) Last date for questions from vendors May 24, 2012 e) Deadline to Submit Proposal:.. June 6, 2012 at 2:30 P.M f) Opening/Reading:. June 6, 2012 at 3:00 P.M. g) Evaluation of Proposal Response: June 7, June 11, 2012 h) Vendor Interviews June 13, June 14, 2012 I) Approximate Recommendation /Award of Bid: July 19, 2012 *The Vendors Response must consist of a three ring binder with tabs with the following information. RFP# Page 2 HEALTH

3 Tab I- Vendor should submit: 1. A Sample Contract or letter of Understanding that the District and Vendor will execute if an award is made. Bear in mind that the contract will be subject to negotiations 2. Pricing sheet a. Pricing sheet on page 27 which details a fully insured program. Be advised that the District will accept proposals with or without an agent. b. Questionnaire for fully insured plan beginning on page 28. Vendors should address each question in detail It should be noted that the District is currently offering all employees an Early Notification Incentive program for separation of employment. Through this program, several employees will leave the District prior to July 1, 2012 and will no longer be insured by the District. Once proposals are received by the District, qualified vendors may be asked to re-price their plan excluding employees that leave the District through the Incentive Program. c. Optional Submission - Proposer Questionnaire for the Self Funded Program (pages 31-58) d. Optional Submission - A brief summary of Pricing for Self Funded Program. The vendor should provide a premium summary for all options listed in their self funded plan. Please note that items 1 (c) and (d) are optional, failure to submit these items will not disqualify a vendor s proposal. 3. Brief biography of company. Limit 2 pages 4. AM Best rating or equivalent; (or latest audited financial statements with independent auditor opinion) carriers, affiliates. 6. Certificate of authority to sell insurance in Texas; 7. A narrative that details the extent to which the vendors proposal (s) are comparable to the basic health coverage plan provided to state employees via the Employees Retirement System of Texas (ERS) and your compliance with the health care reform. At a minimum this narrative should indicate the differences in premiums benefits, deductibles and co-pays between the vendors proposal(s) as compared to TRS Active Care; Limit 3 pages 8. Insurance certificates meeting specifications of this RFP as detailed on page 15 of this proposal. 9. Provide a CD listing all medical providers, specialists, hospitals, pharmacies etc. (a) A list of in-network providers that are available under our current plan is provided on the District website at : Vendors should review this list and on a one or two page document detail which medical providers would need to be added to their network so employees will not have to change physicians or have a break in service. Tab II All required forms listed on pages (4-12) of this proposal. RFP# Page 3 HEALTH

4 LAREDO INDEPENDENT SCHOOL DISTRICT C/O Mr. Gustavo Alcantar, Director of Procurement 1702 Houston Street, Laredo, Texas Required Document Specification Form If this form is not entirely completed, proposer may be disqualified. Note: Vendor will be evaluated on criteria specified under General Condition number 8 in accordance with TEC (b). Please complete the questions below and the specifications included herewith. If a question is not applicable, please indicate N/A. DELIVERY INFORMATION Item(s) will be begin delivered within days after the purchase order/contract is received. COMPANY INFORMATION Company has been in business years Doing business in Laredo and/or Texas years Number of Employees: Company Employer Identification Number (EIN): Historically Underutilized Business, if applicable (type): ACKWLEDGMENT OF RECEIPT OF ADDENDUM (If applicable) Addendum No.: Date: Addendum No.: Date: I, as an authorized representative for the organization named below, certify that the information provided in the Scope of Work/Specifications has been reviewed by me and the information furnished is true and correct to the best of my knowledge. I acknowledge that I will abide by the General Conditions as specified within this invitation to bid and understand that these conditions become a part of any and all contracts that may be issued along with the Notice of Award. Signature of Authorized Representative Date Print Name and Title Organization Name RFP# Page 4 HEALTH

5 LAREDO INDEPENDENT SCHOOL DISTRICT CHECKLIST C/O Mr. Gustavo Alcantar, Director of Procurement 1702 Houston Street, Laredo, Texas Proposers are encouraged to complete and return this checklist and the required documents as a part of their response submittal. Failure to return any of the required documents may subject your proposal to disqualification. Indicate your responses under column Proposer Use Only. RFP # Vendor: Item/Description 1. Are one (1) original and four (4) copies of the proposal submitted? 2. Have all envelopes containing proposals and (4) copies been properly referenced and labeled with RFP Health Insurance. 3. Is proposal submitted timely in accordance with General Condition requirements? Tab 1 4 Has a sample contract been submitted? 5. Has a coverage summary page been included? 6 Has a brief biography of your company been included? 7. Has documentation detailing A.M. Best rating or equivalent been provided? 8. Have you included the company s Certificate of authority to sell insurance in Texas? 9 Have financial statements been included? 10 Has a narrative indicating how the enclosed proposal(s) are comparable to ERS plans and compliant with the health care reform? Tab 2 (Pages 4-12) 11 Is the Specification Form completed and signed 12. Is the Specification Form completed and signed 13. Is the Felony Conviction Notification completed and signed? 14. Is the Conflict of Interest Questionnaire completed and signed? 15. Is the W-9 Form completed and signed? 16. Are the Vendor Certification Forms completed and submitted? Applicable only if awarded the contract and must be provided prior to work beginning. 17 If awarded the contract, will the Certificate of Insurance reflect Laredo ISD as an additional insured and the proper limits secured for all categories and can you provide copy of same? 18 If awarded the contract, will the Certificate of Insurance reflect Laredo ISD as an additional insured and the proper limits secured for all categories and can you provide copy of same? For Laredo ISD Procurement Department Use Only Proposer Use Only Laredo ISD Use Only Yes No n/a Yes No n/a Reference No: RFP # Vendor: The purpose of this preliminary evaluation is to determine whether this proposal will proceed to the next step for consideration. Buyer must review and evaluate all submitted documents and complete the column For Laredo ISD Use Only on the table shown above. If answers to all required items are answered Yes, then proceed for consideration. If any one required item is answered No, then the proposal will be Declined. The appropriate will be disclosed below. [ ] YES. Proceed for consideration. Buyer Initials: Date: [ ]. Decline for consideration. Buyer Initials: Date: Reason(s) for decline: [ ] Missed timeline (Date and time received: ) [ ] Missing documentation as listed: [ ] Other *: * Procurement Director: Date: RFP# Page 5 HEALTH

6 Required Document LAREDO INDEPENDENT SCHOOL DISTRICT Felony Conviction Notification Texas Education Agency Code, Section , Notification of Criminal History, Subsection (a), states "a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony." Subsection (b) states "a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract." This notice is not required of a PUBLICLY-HELD CORPORATION. I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the information furnished is true to the best of my knowledge. Vendor s Name: Authorized Representative of Company (please print): Please check off one box and sign the form in the appropriate space(s): A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. Signature of Company Official: Date B. My firm is not owned nor operated by anyone who has been convicted of a felony. Signature of Company Official: Date C. My firm is owned and operated by the following individual(s) who has/have been convicted of a felony: Name of Felon(s): Details of Conviction(s): Signature of Company Official: Date RFP# Page 6 HEALTH

7 LAREDO INDEPENDENT SCHOOL DISTRICT CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80 th Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section (a-a) with a local governmental entity and the person meets requirements under Section (a). OFFICE USE ONLY Date received By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7 th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offence if the person knowingly violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. 1] Name of person & business doing business with local governmental entity. 2) Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated questionnaire with the appropriate filing authority not later than the 7 th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3) Name of local government officer with whom filer has employment or business relationship. Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section (1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, for the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction o the local government officer named in this section AND the taxable income is not received from the local government entity? Yes No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each employment or business relationship with the local government officer named in this section. 4) Signature of person doing business with the government entity Date RFP# Page 7 HEALTH

8 Required Document Form W-9 (Rev. January 2005) Department of the Treasury Internal Revenue Service Name (as shown on your income tax return) Request for Taxpayer Identification Number and Certification Give form to the requester. Do T send to the IRS. Print of type See Specific Instructions on page 2 Business name, if different from above. Individual/ Exempt from backup Check appropriate box: Sole proprietor Corporation Partnership Other Address (number, street, and apt. or suite no.) Requester s name and address (optional) City, state and ZIP code List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I Instructions on Page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Part II Under penalties of perjury, I certify that: Certification Social security number Or Employer identification number 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien). Certification Instructions.-You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See the instructions on page 4.) Sign Signature of Here U.S. person Date For further instructions on completing this form please visit the Internal Revenue Service Website at: RFP# Page 8 HEALTH

9 LAREDO INDEPENDENT SCHOOL DISTRICT Vendor Certification Forms CERTIFICATION OF COMPLAINCE REGARDING TEXAS FAMILY CODE Required Document (pg. 1 of 2) As per Section of the Texas Family Code, added by S.B. 84, Acts, 73 rd Legislature, R.S. (1993), all bidders must complete and submit with the bid the following affidavit: I, the undersigned vendor, do hereby acknowledge that sole proprietor, partner, majority shareholder of a corporation, or an owner of 10% or more of another business entity is 30 days or more delinquent in paying child support under a court order or a written repayment agreement. I understand that under this doe, a sole proprietorship, partnership, corporation or other entity in which a sole proprietor, partner, majority shareholder or a corporation, or an owner of 10% or more of another entity is 30 days or more delinquent in paying child support under a court order or a written repayment agreement is T eligible to bid or receive a state contract. CERTIFICATION OF COMPLIANCE REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7CFR Part 3017, Section , Participants responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages ). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. APPLICABLE TO GRANTS, SUBGRANTS, COOPERATIVE AGREEMENTS, AND CONTRACTS EXCEEDING $100,000 IN FEDERAL FUNDS. Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The undersigned certifies, to the best of his/her knowledge and belief, that: 1. No Federal appropriated funds have been paid or will be paid or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, disclosure Form to Report Lobbying, in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all sub-recipients shall certify and disclose accordingly. RFP# Page 9 HEALTH

10 LAREDO INDEPENDENT SCHOOL DISTRICT Vendor Certification Forms - Continued CERTIFICATION OF COMPLIANCE WITH EPA REGULATIONS APPLICABLE TO GRANTS, SUBGRANTS, COOPERATIVE AGREEMENTS, AND CONTRACTS EXCEEDING $100,000 IN FEDERAL FUNDS I, the vendor, am in compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970, as amended (42 U.S.C. 1857(h)), Section 508 of the Clean Water Act, as amended (33 U.S.C. 1368), Executive Order and Environmental Protection Agency Regulation, 40 CFR Part 15 as required under OMB Circular A-102, Attachment O, Paragraph 14(l) regarding reporting violations to the grantor agency and to the United States Environment Protection Agency Assistant Administrator for the Enforcement. CERTIFICATION OF COMPLIANCE WITH THE DAVIS-BACON WAGE DETERMINATION ISSUED BY THE U.S. DEPARTMENT OF LABOR I, the vendor, am in compliance with all applicable requirements issued by the U.S. Department of Labor. The Wage and Hour Division of the U.S. Department of Labor determines prevailing wage rates to be paid on federally funded or assisted construction projects. See U.S. Department of Labor site for prevailing wages for Webb County at CERTIFICATION OF COMPLIANCE WITH THE BUY AMERICA PROVISIONS I, the vendor, am in compliance with all applicable provisions of the Buy America Act. Purchases made in accordance with the Buy America Provision must still follow the applicable procurement rules calling for free and open competition. The Proposer agrees to comply with all laws, rules, regulations and ordinances of the Federal Government, the State of Texas, the County of Webb, and the City of Laredo. It is further acknowledged that Proposer certifies compliance with all provisions, laws, acts, regulations, etc. as noted above. Organization Name Address, City, State, and Zip Code Phone Fax Printed Name Title of Authorized Representative Address Signature Date Required Document (pg. 2 of 2) RFP# Page 10 HEALTH

11 Required Document (pg. 1 of 2) Laredo Independent School District Certification of Criminal History Record Information SB 9, passed during the 80 Ih Legislative Session, requires that all Texas public school districts receive certification from any entity with which it contracts to provide services that it has obtained a criminal history background check on all employees hired before January 1, 2008 who (1) have continuing duties related to contracted services; and (2) have direct contact with students. The required criminal history record information can be obtained from either of the following: A law enforcement or criminal justice agency A private entity that is a consumer reporting agency governed by the Fair Credit Reporting Act (15 U.S.C. Section 1681 et seq.) Although state law provides guidance as to which employees must have a criminal background check, there is no specific definition or description as to what equals an employee who (1) has continuing duties related to contracted services; and (2) has direct contact with students. The law states that the Commissioner of Education may adopt rules necessary to implement this requirement; however, at this time none have been adopted. Therefore, all entities and individuals who contract with the District to perform services, must complete the attached LISD Form Certification of Criminal History Record Information, that includes an information sheet related to the services to be performed and the duties related to those services that employees will be performing and the type of contact that those employees might have with students. Employees who are hired by an entity that contracts with a school district after January 1, 2008 must submit to national criminal history record information review which may include fingerprints and photographs before serving in the capacity described. At any time, a school district administrator, including a campus principal or designee, may request copies of the actual criminal background check or national criminal history record The school district may not allow any employee of the entity or an individual to serve at the district if information is obtained through this review that the employee has been convicted of one of the following: (1) A Title 5 felony offense (2) An offense requiring the individual to register as a sex offender (3) An offense under the laws of another state or federal law that is equivalent to a Title 5 felony in the state of Texas or that would require registration in the Texas sex offender databank. information review which may include fingerprints and photographs from the entity or individual who has contracted with the school district or may obtain from any law enforcement or criminal justice agency all criminal history record information that relates to an individual described above. RFP# Page 11 HEALTH

12 Laredo Independent school District Certification of Criminal History Record Information Please complete this form and attach it to your proposal packet response Required Document (pg. 2 of 2) Section 1 Vendor: Name Address / City / State / Zip Code RFP / CSP / RFCO / Bid Number: Answer Y for Yes or N for No: Will employees, including yourself, have continuing duties related to the proposal named above? Until it receives further guidance, the District considers "continuing duties" to mean repetitive work duties rather than a one time appearance or engagement. Will those employees, including yourself, have direct contact with students? Until it receives further guidance, the District considers "direct contact" to mean services that may be performed independently from school district staff involvement. Direct contact can include chance contact such as performing routine inspections or maintenance; contact with groups of students during organized activities; or more obvious examples such as tutoring or therapy. If either question is answered "no", vendor should complete section 2 of this form. If answer to both questions is "yes", vendor should complete section 3 of this form. Section 2 I agree and understand employees of the company or individuals, including myself, who have not received the required criminal background check because the above description does not apply to them/myself will be considered visitors when on school campus and must follow school district and campus policies related to visitors on school campuses. Signature of Vendor Print Name Date Section 3 I,, certify that all employees, including myself, of the company that I own, operate, or manage, or myself as an independent contractor who have continuing duties related to the service to be performed on a Laredo Independent School District Campus and who also have direct contact with students have undergone the required criminal history background check or national criminal history record information review which may include fingerprints and photographs and that no prohibited contact as described herein was revealed. Signature of Vendor Print Name Date Health Insurance RFP# Page 12

13 General Conditions 1. SUBMISSION, MODIFICATION, AND WITHDRAWAL OF RFP a. Submission - All proposals, whether delivered by hand, mail, or overnight service must be delivered (in sealed envelopes/packages) endorsed with RFP Health Insurance no later than June 6, 2012, at 2:30 p.m. central time at the District s Procurement Department located at 1702 Houston Street, Room 101, Laredo, Texas Responses sent by overnight mail shall have proposal number and name written on the delivery ticket. Proposal must be signed by an authorized agent of the vendor that has authority to bind the vendor contractually. Please submit one (1) original and four (4) copies. Proposals may not be faxed or ed. b. Modification - No response may be changed, amended, or modified, after the same has been submitted or filed in response to this solicitation, except for obvious errors in extension. These modifications must be made by written or electronic notice in accordance with original submission terms. c. Withdrawal/Resubmission - A proposal may be withdrawn and resubmitted by written notice received by the District s Procurement Department prior to the exact hour and date specified on the proposal. A proposal may also be withdrawn in person by a vendor or an authorized representative, provided his/her identity is made known and he/she signs a receipt for the proposal, but only if the withdrawal is made prior to the exact hour and date set for the receipt of proposals. Resubmissions may be done in accordance with the original submission terms in paragraph (A) above. 2. LATE PROPOSAL All bids delivered will be stamped with the date and time as proof they were received. For the purposes of this proposal the official time will be kept by the DYMO date time stamped located at the LISD Procurement Department. If a proposal is received after the stated date and time, it will be considered late and will not be opened. These proposals will be considered late and returned unopened. If a return address is not provided on the envelope, a late bid will be opened for identification purposes only and returned to the address provided within. 3. AWARD DATE It is anticipated that a recommendation for this bid will be submitted at the July 2012 Board meeting. 4. OPENING OF PROPOSAL Proposals will be publicly opened at the Procurement Department at 3:00 p.m. CST at the Procurement Department, 1702 Houston Laredo, Texas. The District will only read proposer s names at the RFP opening. 5. APPLICABILITY These conditions are applicable and form a part of the contract document and are part of the terms and conditions of each purchase order (standard purchase terms and conditions) issued as a result of this proposal. The selected proposer will receive a Notice of Award with a contract that must be signed by the awarded proposer in accordance with specified timelines. If proposer has their own contract they are to provide a copy of that contract for evaluation and determination by the District legal counsel. Any deviations to these general conditions and/or specifications shall be conspicuously noted in writing by the Proposer and shall be included with the proposal. 6. DETERMINING AWARD/Evaluation of Proposal The DISTRICT may evaluate the proposal based on criteria as provided in the Texas Education Code (b). a. the purchase price; Health Insurance RFP# Page 13

14 b. the reputation of the vendor and of the vendor s goods or services; c. the quality of the vendor s goods or services; d. the extent to which the goods or services meet the district s needs e. the vendor s past relationship with the district; f. the impact on the ability of the district to comply with laws and rules relating to historically underutilized businesses; g. the total long-term cost to the district to acquire the vendor s goods or services; and h. any other relevant factor(s) specifically listed in the request for bids or proposal (i.e. delivery terms, safety records, certifications/licenses). If specific criteria are stated in the Bid specifications, those criteria will supersede the general criteria identified in this section of the General Conditions. Consideration may also be given to any additional information and comments if they increase the benefits to the DISTRICT. The Proposer must provide relevant information for the items above that will enable the District to evaluate the Proposer for each category. 7. RESPONDENT S ACCEPTANCE OF EVALUATION METHODOLGY Submission of a proposal indicates respondent s acceptance of the evaluation criteria and respondent s recognition that some subjective judgments must be made by the DISTRICT during the evaluations. 8. QUALIFICATION OF PROPOSER The DISTRICT may make investigations deemed necessary to determine the qualifications and / or ability of the bidder to perform in accordance with the bid terms and conditions specified herein. The bidder shall furnish to the DISTRICT all such information as the DISTRICT may request. The DISTRICT reserves the right to reject any bid if the bidder fails to satisfy the DISTRICT that such bidder is properly qualified to carry out the obligations of the contract. 9. DISQUALIFICATION OF PROPOSER Reasons that shall disqualify Proposers shall be disqualified and their responses not considered for any of the following reasons: a. Failure to submit proposal by required date and time b. Failure to submit prices in accordance with All or Some / All or None criteria as specified in #4, above. c. Failure to abide by Non-Collusion Statement as specified in # 32, below. d. Any pertinent information coming to the attention of the District resulting in material legal matters. 10. DISQUALIFICATION OF PROPOSER - Reasons that may disqualify Proposers may be disqualified and their responses not considered for any of the following reasons: a. The bidder being interested in any litigation against the Board. b. The bidder being in arrears on any existing contract or having defaulted on a previous contract. c. Failure to demonstrate competency as revealed by any required financial statement, experience or equipment questionnaire, or omission or falsification of required proposal submittals on this or prior procurements, etc. d. Failure to demonstrate financial ability to fund the projects on an interim basis as revealed by a financial statement, financial records, bank references, etc. e. Current or uncompleted work, which, in the judgment of the District, will prevent or hinder the timely completion of additional work, if awarded. f. Other information or circumstances which establish reasonable grounds for belief that the bidder or proposer is not a responsible bidder or responsible proposer. Health Insurance RFP# Page 14

15 11. MODIFICATION OR WITHDRAWAL BY SUCCESSFUL PROPOSER Modifications or withdrawal of a bid by the successful bidder will be accepted only if the change is in the best interest of the DISTRICT and executed in writing. 12. REQUIREMENTS The contractor must provide a certificate of coverage to the District prior to being awarded the contract. Proposer may be disqualified for not providing this required document. A copy of a certificate of insurance, a certificate of authority to self-insure issued by the Texas Department of Insurance (TDI), or a coverage agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project is required for the duration of the project. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. The following are the types of coverage and acceptable limits that shall be maintained: a. Worker s Compensation Insurance - documentation of insurance will be required prior to the work beginning. If applicable, the contractor shall procure and maintain during the life of this agreement Worker s Compensation Insurance in accordance with the Workers Compensation Act of the State of Texas and forwarded as evidence to the Laredo Independent School District that it is in force. b. Comprehensive General Liability in the following minimum amounts: i. General Aggregate $2,000,000 ii. Products-Comp/Ops Aggregate $2,000,000 iii. Personal & Advertising Injury $2,000,000 iv. Each Occurrence $2,000,000 The Comprehensive General Liability Insurance must include liability coverage for bodily injury, personal injury (including employment related suits), independent contractor, blanket contractual, product, fire, medical expense, and complete operations After a contract is awarded LAREDO I.S.D. must be added as an additional insured on the Comprehensive General Liability. c. Comprehensive Automobile Liability Insurance in the following minimum amounts: i. Bodily Injury: $100,000 per person ii. Bodily Injury: $300,000 per accident iii. Property Damage: $100,000 per accident d. Professional Liability The agent and or proposer must have an errors and omissions policy with a minimum limit of $2,000,000. The policy must be in place during the life of the contract. Health Insurance RFP# Page 15

16 13. F.O.B DESTINATION Bids/proposals must be submitted on a F.O.B. Destination basis with freight prepaid. Freight is to be assumed by the bidder. No additional charges will be accepted. Possessions of goods will not pass to the DISTRICT until received at the DISTRICT S receiving dock. 14. DELIVERY Delivery personnel must provide a current, valid company picture identification card when making deliveries to the District. Deliveries required in this proposal shall be freight prepaid F.O.B. destination and bid price shall include all freight and delivery charges. No delivery, no sale. 15. DISTRICT RESERVES THE RIGHT OF THE FOLLOWING: a. RIGHT OF AWARD - The DISTRICT reserves the right to award as is in its best interest and May therefore chose items from different vendors. The DISTRICT may negotiate with the top three proposers. A written Notice of Award letter will be sent to the awarded vendor(s). The District may either enter into a contract with the vendor(s) or the award letter followed by a purchase order to the success full bidder(s) may result in a binding contract without further action by either party. b. RIGHT TO REJECT PROPOSALS - The DISTRICT reserves the right to reject any or all proposals and waive informalities and minor irregularities in the proposals it receives and award the proposal that best serves its interest. The District, in its sole discretion, will determine whether an irregularity is minor. c. RIGHT TO HOLD PROPOSALS - The DISTRICT reserves the right to hold proposals for 60 days before awarding the contract. d. RIGHT TO EXTEND AWARDED CONTRACT The DISTRICT and the vendor may mutually agree to extend the contract on a monthly basis, or other agreed upon period, if needed. e. RIGHT TO AMEND RFP - The DISTRICT reserves the right to amend the RFP prior to bid opening date. The DISTRICT may also consider and accept an alternate proposal as provided herein when most advantageous to the DISTRICT. f. RIGHT OF NEGOTIATIONS The DISTRICT reserves the right to conduct discussions and negotiate final scope and price. 16. AVAILABILITY OF FUNDS All awards are subject to approval upon availability of funds. In the event funds do not become available, the contract may be terminated with a written notice. 17. CERTIFICATION OF PAYMENT Payment by the DISTRICT will be made in accordance with the terms of the contract. 18. UNIFORM COMMERCIAL CODE All contracts and agreements between vendor and the District shall strictly adhere to the statutes as set forth in the Uniform Commercial Does as last amended by the American Law Institute and the National Conference of Commissioners on Uniform State Law. 19. FELONY CONVICTION TIFICATION A person or business entity that enters into a contract with the DISTRICT shall notify the DISTRICT if the person or an owner or operator of the business entity has been convicted of a felony. Such notice shall include a general description of the conduct resulting in the conviction. Failure to provide such information may result in termination of the contract. Vendors shall complete and submit the Felony Conviction Notification included with this packet in the Required Forms. Health Insurance RFP# Page 16

17 20. CONFLICT OF INTEREST No member or spouse of the board, president, superintendent, business manager or any other person holding any position or employment under said board, shall be directly or indirectly interested in an purchase, sale, business, work or contract, the expense, price or consideration of which is paid from school funds of said district, nor shall any such officer or employee purchase any warrants or claims against said board of district, or any interest herein, or become surety for any person or persons having a contract or any kind of business with said board, for the performance of which security may be required. Anyone violating this provision shall be removed from office, or be discharged from services by the majority of the board. No member of said board shall vote upon any question in which such member has an interest, distinct and apart from that of the citizens at large, and any member shall disclose such interest and refrain from voting. All interested parties shall comply with Board Policy BBFA (LEGAL) Conflict of Interest Disclosures and if applicable (for members of the Board and Superintendent), complete and submit Exhibit found at BBFA (EXHIBIT) also please refer to The Texas Ethics Commission website at for more information. Additionally, an employee interested in responding to this proposal shall disclose to his or her immediate supervisor a personal financial interest, a business interest, or any other obligation or relationship that in any way creates a potential conflict of interest with the proper discharge of assigned duties and responsibilities or that creates a potential conflict of interest with the best interest of the District, Board Policy DBD (LOCAL). 21. GENERAL ETHICAL STANDARDS Gifts & Gratuities - It is a breach of ethics to offer, give or agree to give any employee or former employee of a school district, or for any employee or former employee of a school district to solicit, demand, accept or agree to accept from another person, a gratuity or an offer of employment in connection with any decision, approval, disapproval, recommendation, preparation of any part of a program requirement or purchase request, influencing the content of any specification or procurement standard, rendering of advice, investigation, auditing, or in any other advisory capacity in any proceeding or application, request for ruling, determination, claim or controversy, or other particular matter pertaining to any program requirement or a contract or subcontract, or to any solicitation or proposal therefore pending before this government. Acceptance of gratuities may be construed as a criminal offense. 22. N COLLUSION STATEMENT The proposer affirms that he/she is duly authorized to execute a contract, that this company, corporation, firm, partnership or individual has not prepared this proposal in collusion with any other Proposer, and that the contents of this proposal as to prices, terms or conditions of said proposal have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business prior to the official opening of this proposal. The proposer also affirms that they have not given; offered to give, do not intend to give at any time hereinafter any economic opportunity, future employment, gift, loan, gratuity, specified discount, trip, favor, or service to a private service in connection with this contract. Proposer further affirms that after the opening of this proposal, proposer (or any representative of proposer s company) will not discuss the contents of this proposal with any person affiliated with LAREDO ISD, other than the Procurement Director or its Designee, prior to the awarding of this bid/proposal. Failure to observe this procedure will cause the proposal to be rejected. 23. INDEMNIFICATION PROVISION Health Insurance RFP# Page 17

18 To the extent allowed by law, the written contract executed between the successful respondent and LISD will contain an indemnification provision in which the successful respondent agrees to indemnify and hold harmless LISD from any and all loss, expense, cost or liability arising from any claim or cause of action for loss or damage rising from or relating to respondent s performance of services or goods made the subject of this bid. LISD does not agree to indemnify the successful respondent. 24. VENUE It is understood and agreed by both the successful bidder and the DISTRICT that venue for any litigation from this contract shall lie in Webb County, Texas. 25. PROPOSAL INTERPRETATION No interpretation to the meaning of the Invitation to Bid or other documents will be given orally. Every request will be in writing, addressed to the Procurement Director, and must be received at least five days prior to the date fixed for the opening of the bids. Any and all such interpretations and supplemental instructions will be in the form of written addenda to the Invitation to Bid, which if issued, shall be mailed to all known prospective bidders. Failure of any bidder to receive any such addenda or interpretations shall not relieve such bidder from any obligation under his bid as submitted. All addenda so issued shall become part of the contract document. 26. RIGHT TO AUDIT CLAUSE The District upon written notice shall have the right to audit all documents relating to all projects. Records subject to audit shall include, but not limited to records which may have a bearing on matters of interest to the District in connection with the Vendor s work for the District and shall be open to inspection and subject to audit and/or reproduction by the District s agents or its authorized representative to the extent necessary to adequately permit evaluation and verification of (a) Vendor s compliance with contract requirements (b) compliance with District procurement policies and procedures (c) compliance with provisions for computing billings to the District and (d) any other matters related to the contract between the District and the Vendor. Additionally, in accordance with TEC (c) the state auditor may audit purchases of goods or services by the District. 27. ARBITRATION CLAUSE To the extent allowed by law, the written contract executed between the successful respondent and LISD will contain an indemnification provision in which the successful respondent agrees to indemnify and hold harmless LISD from any and all loss, expense, cost or liability arising from any claim or cause of action for loss or damage arising from or relating to respondent s performance of service or goods made the subject of this bid. LISD does not agree to indemnify the successful respondent. There will be no agreement for binding arbitration in any written contract between LISD and Respondent relating to a dispute involving the services, products or goods made the subject of the bid. 28. DEFINITION The words bids, competitive sealed proposals, quotes and their derivatives may be used interchangeably in these terms and conditions. These terms and conditions are applicable on all bids, request for proposals, quotes, competitive sealed proposals, etc. to which they are attached. 29. LIMITATION OF LIABILITY REMEDIES OR DAMAGES LISD will not contractually agree to limit in any manner either Respondent s potential liability or LISD s potential remedies or damages relating to or arising from any potential dispute between the parties or relating to the services, products or goods made the subject of this proposal. Health Insurance RFP# Page 18

19 30. COMMUNICATION Company s submitting proposals shall not discuss this RFP with employees of LISD, members of the Board of Trustees, or LISD s Benefit Consultant. Communication includes but is not limited to unsolicited literature, , faxes or phone calls related to any aspect of the RFP. The District will utilize the Insurance Consulting Services of Valley Risk Consulting. However, requests for information must be in writing and must be faxed or ed by May 24, 2012 to: Gustavo Alcantar, Director of Procurement (956) galcantar@laredoisd.org Failure to abide by this requirement may result in automatic disqualification of the agent/company representative and/or the company at the discretion of the District. It is the policy of the Laredo Independent School District not to discriminate on the basis of race, color, national origin, gender, limited English proficiency, or handicapping condition in its programs. Health Insurance RFP# Page 19

20 Scope of Work Health Insurance RFP# Page 20

21 Introduction Scope of Work Laredo Independent School District ( District ) is seeking Health Insurance plan proposals from qualified carriers to underwrite the district sponsored and provided health insurance coverage. The Health Insurance Program is to include all of the minimum required levels of health insurance benefits coverage, as currently in place or other acceptable alternate plans, for all its TRS qualified/eligible employees and their dependents. The health insurance provider must submit evidence of liability to insure and service the group without undue requirements of the district and/or its employees & dependents. Under the new plan, all insured covered by the current plans are to receive immediate coverage. Continuity of coverage shall be on a no loss, no gain basis, including allowance of fair credit for all or part of the deductibles and/or co-insurance, and lifetime maximum benefits, which have been satisfied prior to the new coverage policy period. Currently, the District provides coverage thru Aetna insurance company. The District offers Four (4) health plans (Basic, Low, High, and State Comparable) which in turn each contain a 4 tier option (Employee Only, Employee & Spouse, Employee & Child (ren), Employee & Family) within each plan. The district contributes $265 for each eligible employee, applicable to any of the options offered. The employees of the District are responsible for the amount of premiums beyond the $265 district contribution. Approximately 2,934 of the 3,650 eligible full-time employees are currently enrolled in the Aetna Health Insurance program. There are also seven (7) COBRA participants enrolled as well. The total health insurance enrollment is 2,941. Health Insurance RFP# Page 21

22 RFP Proposal Assumptions 1. Laredo ISD is Non Grandfathered under the Patient Protection Affordable Care Act (PPACA). Therefore, the proposal shall include a rate cap on all covered services and supplies effective 9/1/2012 thru the end of the plan year 2013 must be included in the submitted price. 2. Proposal should include a second year renewal option with a maximum cap per plan and a third year option. 3. Proposal must include a summary page (see attachment) identifying all cost associated with this RFP. The summary should include, coverage plan offered and cost for each plan. Alternate proposals should be clearly identified. 4. Self Funded proposals will be considered but must include Preferred Provider Organization Network (PPO), Pharmacy Benefit Manager (PBM) and Specific and Aggregate Stop Loss Insurance. 5. Specific and Aggregate Stop Loss insurance with ISL amounts no greater than $200,000, other optional deductible amounts will be considered. Aggregate insurance must be included. 6. Proposal must duplicate current coverage and/or provide options that may result in savings in a premium. 7. Proposal must include continuity of coverage, provision 8. Currently the District s contribution towards premiums is currently $265 per qualified employee. 9. Effective date is 9/1/12 on a no loss, no gain basis with allowance of credit for satisfied portions of deductibles or co-insurance & lifetime maximum benefits. 10. Services shall include monthly routine, customized reports on request. Including availability of staff and materials (ID cards, benefit booklets, enrollment/change forms, etc.) necessary to conduct the appropriate normal operations i.e. initial enrollments, employee orientations, etc. 11. Services shall include local service office and/or carrier representative. 12. The Education Code states that the executive director of Teacher Retirement System of Texas (TRS) shall certify whether a district s coverage is comparable to the basic health coverage provided under the Texas Employees Uniform Group Insurance Benefits Act... All proposals submitted must include a comparable plan and/or disclose to what extent such plans submitted are comparable to the basic health coverage plan provided to state employees administered by the Employees Retirement System of Texas (ERS). If unavailable, please provide an explanation. 13. Carrier must comply with all of the requirements and conditions as set forth in the RFP in its entirety. 14. Complete and provide, for each proposal, the appropriate proposal response forms, procurement required forms and all other information. 15. Provide proof of being licensed by the State of Texas. 16. Provide documentation of financial stability via A.M. Best (or equivalent) rating 17. If applicable, provide documentation, via certificates of insurance, of coverage for Workers Compensation insurance (statutory limits), Errors & Omissions, General Liability, and/or Professional Liability insurance with minimum limits of $2,000,000 and effective dates on or before and during the time services will be in effect. When/where applicable, the district needs to be named as additional insured and the insurance coverage(s) need to be maintained up to date and in effect during the complete term(s) of the service agreement. 18. Submit as part of the proposal a complete copy of a contract and/or any forms requiring authorization by LISD to which LISD will be a party to, if the district accepts the proposal. 19. Preferred terms must include a cancellation notice clause of minimum 90 days written notice to the District of cancellation, non-renewal, and/or material change of contract language by the carrier. The 90 day clause must be included on the endorsement. 20. The district is requesting a premium payment method of twelve (12) monthly payments. If not applicable or feasible, please indicate method of acceptable payment options. 21. The awarded vendor shall provide insurance coverage binder before or on the date coverage goes into effect. The awarded vendor shall also provide the actual insurance policies to the District before or within 30 days of inception of coverage. 22. The District reserves the right to reject any and/or all proposals in order to allow selection of the proposal which provides the best value to the District and to negotiate separately in a professional manner necessary to serve in the best interest of the District. Health Insurance RFP# Page 22

23 23. This RFP request does not commit or obligate the District to pay for any costs associated with the preparation or the response submission for this proposal or to contract for any or all services. 24. Carrier agrees to submit renewal rates at least 180 days prior from the expiration date the rates must be firm and not subject to change. Rates shall incorporate any legislative change and shall be noted on the proposal. 25. Carrier must comply with All Federal and State Laws, including the Patient Protection Affordable Care Act (PPACA). 26. The district welcomes direct quotes from all vendors. Health Insurance RFP# Page 23

24 District Profile Health Insurance RFP# Page 24

25 District Profile 1. Laredo Independent School District 2. Address: 1702 Houston, Laredo, TX Telephone: (956) Type of Business: Public Schools Educational Entity 5. Superintendent: Dr. A. Marcus Nelson 6. School Board of Trustees: 7 Elected Officials (Single Member Districts) 7. Tax ID#: Number of Schools: 30 (5 HS, 1 Alt. Sch., 4 MS, 20 ES) 9. UIL Classification: 29-5a and 31-4a 10. Accreditation: Texas Education Agency 11. Total Estimated Student Enrollment: 26, Total Estimated Employees: 4,062 (3,984 FT & 78 PT) 13. Total Estimated Employee Health Insurance Participants: 3,301 (Est. Eligible 3,984) 14. District Summary Financial Data: Year Total Revenue Total Expenditure Surplus/Deficit $215,942,967 $219,252,429 ($3,309,462) $216,635,369 $217,405,137 ($769,768) $206,635,369 $207,092,768 ($1,077,617) 15. Health Insurance Enrollment, Premium & Paid Claim History (As of March 2012): Year Carrier Claims Paid Premiums Paid Loss Ratio 9/1/07-8/31/08 Blue Cross $ 12,145,861 $14,461,559 84% 9/1/08-8/31/09 Blue Cross $ 12,644,621 $ 14,453,951 87% 9/1/09-8/31/10 Blue Cross $ 14,010,882 $ 15,213,894 92% 9/1/10-8/31/11 Blue Cross $ 13,677,278 $ 16,032,901 86% 9/1/11-8/31/12 Aetna $ 9,990,076 $ 8,683, % Total: $62,468,718 $ 68,845,548 92% Health Insurance RFP# Page 25

26 Response Forms (Required): Proposal Premium Quote Questionnaires Health Insurance RFP# Page 26

27 Proposal Premium Summary with Duplication of Benefits and Services: Premium Quote for: Duplication of Services Fully Insured Plan Comparable/ Equivalent Fully Insured Plan Note: Please attach complete Schedule of Benefits for each proposal. 1. Proposal Plan Name: 2. Vendor/Agent Name; Address CSZ Telephone # & Address 3. Insurance Carrier Name: Address CSZ Telephone # & Address 4. A.M. Best (or equivalent) Financial Strength/Size Rating: 5. Proposed Premium Rates: A. Basic Plan (New) (70/30) Current Rates Est. # Insured Proposed Rates Est. Annual Premiums 1. Emp. Only $ Emp. & Spouse $ Emp. & Children $ Emp. & Family $ Sub-total 18 B. Low Plan (70/30) 1. Emp. Only $ , Emp. & Spouse $ Emp. & Children $ Emp. & Family $ Sub-total 2,031 C. High Plan (80/20) 1. Emp. Only $ Emp. & Spouse $ Emp. & Children $ Emp. & Family $1, Sub-total 889 D. State Comparable (90/10) 1. Emp. Only $ Emp. & Spouse $ 1, Emp. & Children $ 1, Emp. & Family $ 1, Sub-total 3 E. Grand Total 2,941 F Other fee(s) Print Name and Title of Authorized Representative Authorized Representative Signature Date Health Insurance RFP# Page 27

28 Proposal Premium Summary without Duplication of Benefits and Services: Premium Quote for: Duplication of Services Fully Insured Plan Comparable/ Equivalent Fully Insured Plan Note: Please attach complete Schedule of Benefits for each proposal. 1. Proposal Plan Name: 2. Vendor/Agent Name; Address CSZ Telephone # & Address 3. Insurance Carrier Name: Address CSZ Telephone # & Address 4. A.M. Best (or equivalent) Financial Strength/Size Rating: 5. Proposed Premium Rates: A. Basic Plan (New) (70/30) Current Rates Est. # Insured Proposed Rates Est. Annual Premiums 1. Emp. Only $ Emp. & Spouse $ Emp. & Children $ Emp. & Family $ Sub-total 18 B. Low Plan (70/30) 1. Emp. Only $ , Emp. & Spouse $ Emp. & Children $ Emp. & Family $ Sub-total 2,031 C. High Plan (80/20) 1. Emp. Only $ Emp. & Spouse $ Emp. & Children $ Emp. & Family $1, Sub-total 889 D. State Comparable (90/10) 1. Emp. Only $ Emp. & Spouse $ 1, Emp. & Children $ 1, Emp. & Family $ 1, Sub-total 3 E. Grand Total 2,941 F Other Fee(s) Print Name and Title of Authorized Representative Authorized Representative Signature Date Health Insurance RFP# Page 28

29 Questionnaire Fully Insured Plan Answers to the questions included in this section should be detailed enough to satisfactorily explain your company's position on each particular item on which a question is based. The questions should be answered in the numerical order below. It is your responsibility to respond to these questions in such a way that the Health Insurance Advisory Committee (HIAC) and the benefits office will have a full and complete understanding of your intent. In many instances, the answers to these questions will be the basis for interpretation of various aspects of the agreement between the LISD and the Carrier selected to underwrite the program. It is important that you carefully define any key words or phrases used in answering these questions. General Questions 1. Please provide an organizational chart identifying the personnel who will be responsible for the administration and management of the Program. Provide the name, address, telephone number and e- mail addresses of all representatives that will be servicing the account for the District. 2. Are agent and insurance company licensed and authorized to do business in Texas? 3. Please describe your Errors & Omissions, General Liability, and/or Professional Liability insurance and include carrier name, amount of coverage limits, and policy dates information. 4. Provide as reference the names of at least five (5) organizations that your company has previously or currently provides group health insurance services benefits. 5. Enumerate and describe each deviation between your proposal and the RFP in its entirety. You must specifically identify each deviation for it to be considered. References to your contract will not be considered as satisfactory identification of a deviation. LISD will interpret your proposal to match the specifications except for deviations specifically noted and described in appropriate response form to this item. 6. Describe the provisions for the continuation of coverage for employees and retirees who, (a) become disabled, (b) retire, (c) terminate employment, or (d) become entitled to Medicare. Are the actively-atwork and disabled provisions waived for the effective date of the contract? 7. Describe the continuation of coverage provisions applicable to dependents that would otherwise loose coverage as a result of (a) age (b) employee death (c) employee loss of employment (d) divorce, (e) school status. 8. Describe the coordination of benefits provision included in your contract. What information will be requested and stored on a spouse's employment, other coverage, etc. for coordination of benefits purposes? 9. Describe evidence of insurability, pre-existing condition, waiting periods, actively at work and/or any other provision which might serve to limit or restrict coverage under your proposal. Health Insurance RFP# Page 29

30 10. Provide sample copies of listings for local, state, and national names and locations of hospitals, physicians, labs, pharmacies and any other health care providers included in the network. How many of the following medical providers are in the local (Webb County) network? a. Hospitals Laboratories Gen/Family Practice b. Pediatricians OB/GYN Endocrinologists c. Chiropractors Psychiatrists Dermatologists d. Pharmacies Other Specialists (Describe): e. Total: 11. Describe the complete in-network and out-of-network medical benefits provisions and exclusions, including: a. When a network physician refers patient to a non-network provider; b. Coverage for injectables by network physician; c. Lab and X-rays performed in or out of office of a network physician; d. Must insured select a primary care physician? 12. Please indicate the following impatient information for each of your PPO hospitals in Webb County for the previous twelve months (without naming the hospitals): DRG 774/774- Vag delivery 194- Simple Pneumonia/Pleurisy 392- Gastro Disorders 177/178- Respiratory Infections Septicemia/Sepsis 638/639- diabetes 683- Renal Failure 291/292/293- Heart Failure 470- Major Joint Replacement 330- Major Bowel Procedures 440- Pancreatic Disorders 419- Laparoscopic Cholecystectomy 190/191/192- COPD # of Services Billed Charges PPO Allowed Amount 13. Are all outpatient surgical and diagnostic procedures for your Webb County PPO hospitals reimbursed on a fixed fee, case rate or per visit basis? Please describe any procedures or services provided on a percentage of billed charges, if any. 14. Has your company renegotiated any of your Webb County PPO Network hospital contracts within the previous twelve months? If yes, what provisions were modified? Did reimbursements to the hospital increase or decrease as a result of the re-negotiation and by what percentage? Please elaborate on the modifications (if any). Health Insurance RFP# Page 30

31 15. If selected, are you willing to negotiate/renegotiate contractual provisions/reimbursement terms with your Webb County PPO network Hospitals, if requested by Laredo ISD? 16. What are your average Webb County PPO hospital discounts, expressed as a ratio of PPO allowed amount/billed charges? Are you willing to reprice sample hospital claims for your PPO network hospitals, if requested by Laredo ISD, in order to validate these discount percentages? 17. Describe the prescription drug benefits provisions including: co-pays for generics, brand and formulary drugs and specialty drug co-pays. Please describe the following; a) Drug step therapy programs. b) Clinical review process c) Diabetic supplies or education programs d) 90 day retail or mail order programs e) Pharmaceutical rebates 18. How long are your rates guaranteed? Are you willing to provide a rate guarantee beyond 12 months? If your proposed rates are not guaranteed, describe the methodology used in developing current and future renewal rates. 19. How many enrollment opportunities available? Describe enrollment procedures for each, including initial enrollment to meet effective term of 9/1/12 and available necessary staff. 20. Will your company accept enrollment forms from our present carrier? If not, please provide a sample of your enrollment form. 21. What communication assistance do you provide to explain the changes to our employees? 22. How soon after enrollment will you provide the plan document and booklet drafts for new plans and amendments to existing benefits? Please confirm that additional costs associated with these items are included in the proposed rates. 23. Please submit samples of standard reports that will be provided to the district? How often will these reports be provided? How soon after the close of the reporting period will the district receive these reports? Please confirm that any charges for these reports are included in the proposed rates. Do the monthly reports include? a. Monthly and year to date paid claims by type of plan (low, high, state comparable); b. Monthly and year to date paid claims by type of benefit; c. Monthly and year to date paid claims by service provider; d. Monthly and year to date number of insured employees and dependents; e. Monthly and year to date individual paid claims in excess of $25,000 with detailed data containing ID code, date of birth, gender, relationship to employee, date of event, diagnosis, prognosis, monthly benefits paid by month of service, etc.; 24. Describe the reporting capabilities. Provide current samples of utilization and cost containment reports available. How often are these reports prepared? Health Insurance RFP# Page 31

32 25. Does you proposal include disease management programs? If so, please describe the services available including, nurse line, physician referral, etc. 26. Upon termination of the contract, what is the procedure for submitting incurred but not paid claims? 27. Please confirm that there will be a toll-free number available for the members to contact the claims office? Is this line available 24 hours a day? If not, what are the days and hours? Do you have telephone standards? What are the standards? What is the average time on hold? What is the abandonment rate? Health Insurance RFP# Page 32

33 Section 2 Proposer Questionnaire (Self-Funded Program) ASO Claims Administration 1. Describe the business entity submitting the proposal: a. Name of Business Entity: b. Current Business Address: c. Mailing Address: d. Contact Person: e. Telephone Number: f. Type of Business Entity: Corporation General Partnership Sole Proprietorship Registered Limited Liability Partnership Limited Liability Company g. Please provide jurisdiction for corporation or partnership charter: h. Please provide date corporation or partnership chartered: i. Is the business entity licensed by the State of Texas as a Third Party Administrator? Yes No j. Will you agree to provide a resume for each key employee in your organization upon request? Yes No 2. Pending Lawsuits/Claims: a. Has the business entity been a defendant in any lawsuit in any state or federal court during the preceding five (5) years? Yes No If yes, identify each lawsuit by party, case number, court, subject matter, and disposition: Health Insurance RFP# Page 33

34 b. Does the business entity have any claims filed against it which is unresolved and presently pending before any State of Texas Administrative agency? Yes No If yes, please provide a full description of the matter: 3. Financial Information: a. Has the business entity filed a voluntary or involuntary petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years? Yes No If yes, provide the name of the court and the case number(s): b. Has any owner, member, or partner of the business entity filed a petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years? Yes No If yes, provide the name of the court and the case number(s): c. Audited financial statement for the preceding fiscal year included with response? 4. Describe Claim Administration experience: a. Number of Clients: b. Number of Covered Employees: c. Other: 5. Provide five (5) Texas client references: Yes No Name of Client Contact Person Telephone Number Number of Employees Health Insurance RFP# Page 34

35 6. Describe what quality assurance procedures you currently have in place to ensure accuracy of payments, eligibility, check draft security, appropriateness of treatment versus diagnosis, medical necessity, adherence to reasonable and customary allowances, coordination of benefits 7. Administration Contract: a. Will you allow District to modify your standard Administration Contract? Yes No b. Will you agree to process 98% of all submitted claims within fifteen (15) business days at a minimum of 98% overall accuracy and/or other mutually agreed upon performance guarantees? Yes No c. Will you agree that a failure to uphold the standards in (b) and/or other mutually agreed upon performance guarantees may result in a penalty to be deducted from the administration fee? d. What is your customer service accuracy? Yes No e. Will you agree to allow third party to conduct an on-site claims audit? Yes No f. Will you agree to hold the District harmless if any of your staff is found to be negligent in the administration of benefits in the Plan? Yes No g. Is a specimen copy of your administration contract included with your response? Yes No Health Insurance RFP# Page 35

36 8. Claim Payment Services a. Location of office where actual settlement of claims will be made? b. Will a specific analyst be assigned to this account? Yes No c. Will a claims analyst be available for on site claims handling on a scheduled basis? Yes No e. Is a toll-free telephone number available for checking status of claim? Yes No f. What is the average time on hold? g. What is the abandonment rate? h. What is average talk time? i. Can insured or District s Insurance Department speak directly to claim examiner for questions related to payment of claim? Yes No k. What is normal processing time? l. Describe process of appeal for contested claim. m. Do you screen for unbundling of provider charges? Yes No n. Do you pay for printing costs of checks and explanation of benefits? Yes No o. Is sample EOB and check included with your response? Yes No p. Please describe banking arrangements necessary to reimburse claims that are paid. q. Describe basis and procedure for determining Reasonable and Customary. r. When was the last Third Party Claim Audit? Health Insurance RFP# Page 36

37 s. Describe procedure used for subrogation investigation and recovery. t. Describe procedures used for preexisting condition investigation: 9. Other Services (List additional costs, if any): a. Ex. Large Case Management, Disease Management, Continuation of Coverage, Actuarial Services, Plan Design and Consultation Services: b. Describe experience in coordinating with Preferred Provider organizations (include repricing capabilities): c. Do you have a repricing agreement for Out of Network Benefits? Yes No d. Do you provide access to transplant network(s) (centers of excellence) through Administrative Services Agreement? Yes No 10. Are On-Line Services available and included in the cost? Please describe (Ex. Claims Status, Enrollment, Provider Directory, Reports): Yes No e. Are enrollment and education meetings and monthly on site claims assistance included? Yes No f. Will all materials necessary to effectively communicate and administer the program be prepared and printed by proposer at proposer s expense? (Ex: ID Cards, Employee Benefit Book, Claim Forms, Schedule of Benefits, EOB s, Certificates of Credible Coverage) Yes No Health Insurance RFP# Page 37

38 g. Will employee ID cards, Employee Benefit Book and other related materials be mailed to the employee s home at the proposer s expense? Yes No h. Do you provide all required HIPPA notices to members including Certificates of Creditable Coverage? Yes No Are there additional costs associated with this service? Yes No i. Do you provide COBRA administration? Please describe which aspects of COBRA you will and will not administer. Yes No Are there additional costs associated with this service? Yes No 10. Please state any variations to the Request for Proposal or other qualifications for your proposal: 11. For what period of time are quoted rates guaranteed? Is a longer rate guarantee available? Yes No Health Insurance RFP# Page 38

39 ASO Claims Administration Signature Page Company Name Authorized Signature Address Type Signatory s Name and Title Telephone Number Agent Name Fax Number Address Health Insurance RFP# Page 39

40 Section 2 Proposer Questionnaire PPO Network Services 1. Describe the business entity submitting the proposal: a. Name of Firm: b. Address: c. Contact Person: d. Telephone Number: Fax Number: e. Year Founded: 2. Describe PPO Network experience: a. Number of Clients: b. Number of Texas Clients: c. Number of Employees Covered: d. Number of Network Providers: e. Other: 3. Provide five (5) Texas client references: Name of Client Contact Person Telephone Number Number of Employees Health Insurance RFP# Page 40

41 4. Insurance coverage: The business entity must provide satisfactory evidence of existing insurance coverage in the amount of $2,000, for Errors and Omissions or other fiduciary liability. If the business entity is selected to provide services it must provide evidence that such coverage will be in effect for the duration of the agreement. (Include Copy of Insurance Certificate) 5. Provider Network: a. Name of network: b. Approximately how many insured are enrolled in the network? Webb County Texas United States c. How long has the network been operational in Webb County? d. How many of each of the following medical providers is in your Webb County network? Do not count any physician more than once, due to multiple locations or specialties. Hospitals Laboratory General/Family Practice Pediatrician OB/GYN Endocrinologist Chiropractors Psychiatrists Dermatologists Other Specialists Total e. Describe network access outside of the Webb County area for Specialty care not available in local area: Other Texas providers: f. The District desires to have access to a Transplant Network(s). Please provide details related to access to the network(s) and specific information on the contract rates and facilities to be used for transplants. g. Provide disruption analyses or % disruption expected. Supporting documentation for % disruption will be required. Health Insurance RFP# Page 41

42 6. Preferred Provider Services: a. Are the physicians in your network required to accept assignment of benefits? Yes No b. How do you prevent physicians in your network from balance billing? c. Are you willing to provide current Provider Network information for providers currently under contract upon request: Yes No d. Describe procedure for notifying District of change in providers: e. What criteria are used for selecting providers? f. Describe provider discount structure and average savings generated by the provider discounts in this geographic area? How can your savings be documented? g. Describe provider reprising procedures: h. Will you be willing to provide sample reports upon request? i. How often are Provider Directories updated? j. Is Provider information on the Internet? k. Describe claims cost management procedures: Yes Yes No No l. Describe provider reprising procedures: m. Are out of network claims negotiated? n. Do you have a reprising agreement for Out of Network Benefits? Yes No Health Insurance RFP# Page 42

43 7. Will you be prepared to re-price sample claim upon request for the PPO network evaluation? Yes No 8. Please indicate the following impatient information for each of your PPO hospitals in Webb County for the previous twelve months (without naming the hospitals): DRG 774/774- Vag delivery 194- Simple Pneumonia/Pleurisy 392- Gastro Disorders 177/178- Respiratory Infections Septicemia/Sepsis 638/639- diabetes 683- Renal Failure 291/292/293- Heart Failure 470- Major Joint Replacement 330- Major Bowel Procedures 440- Pancreatic Disorders 419- Laparoscopic Cholecystectomy 190/191/192- COPD # of Services Billed Charges PPO Allowed Amount 9. Are all outpatient surgical and diagnostic procedures for your Webb County PPO hospitals reimbursed on a fixed fee, case rate or per visit basis? Please describe any procedures or services provided on a percentage of billed charges, if any. 10. What is the contractual stop/loss limit for hospital claims at each of your PPO hospitals in Webb County? Please specify (without naming the hospitals) Hospital #1 Hospital #2 Hospital #3 11. Do claims which are greater than the stop/loss limit revert to a first dollar or second dollar discount? Please specify for each of your PPO hospitals. Hospital #1 Hospital #2 Hospital #3 Health Insurance RFP# Page 43

44 12. Please specify the reimbursement provisions for your Webb County PPO hospitals for paid claims above the stop loss dollar threshold, indicating whether they a percentage of billed charges or a fixed dollar per diem amount. Hospital #1 Hospital #2 Hospital #3 13. Has your company renegotiated any of your Webb County PPO Network hospital contracts within the previous twelve months? If yes, what provisions were modified? Did reimbursements to the hospital increase or decrease as a result of the re-negotiation and by what percentage? Please elaborate on the modifications (if any). 14. If selected, are you willing to negotiate/renegotiate contractual provisions/reimbursement terms with your Webb County PPO network Hospitals, if requested by Laredo ISD? 15. What are your average Webb County PPO hospital discounts, expressed as a ratio of PPO allowed amount/billed charges? Are you willing to reprice sample hospital claims for your PPO network hospitals, if requested by Laredo ISD, in order to validate these discount percentages? 16. Please state any variations to the Request for Proposal Assumptions or other qualifications for your proposal: 17. For what period of time are quoted rates guaranteed? 18. Is a longer rate guarantee available? If so, please describe: Yes No Health Insurance RFP# Page 44

45 PPO Network Services Signature Page Company Name Authorized Signature Address Type Signatory s Name and Title Telephone Number Agent Name Fax Number Address Health Insurance RFP# Page 45

46 Section 2 Proposer Questionnaire Pharmacy Benefit Management 1. Describe organization submitting proposal: a. Name of Firm: b. Address: c. Contact Person: d. Telephone Number: e. Year Founded: 2. Audited financial statement for the preceding fiscal year included with response? 3. Describe Prescription Drug experience: a. Number of Texas Political Subdivision Clients: b. Name of primary network: c. Other: 4. Provide five (5) Texas client references: Yes No Name of Client Contact Person Telephone Number Number of Employees 5. Describe Pharmacy network: a. Will you be willing to provide list of pharmacists currently in pharmacy network in Webb County upon request? Yes No Health Insurance RFP# Page 46

47 b. Describe relationship with pharmacists including degree of automation and reimbursement procedures: c. The District is soliciting Transparent Modeling only. Is your proposal transparent? If your answer is no, discontinue answering questionnaire. 6. Services a. Will your proposal provide real time software free of charge? Yes No a. Will you provide a copy of the current Maximum Allowable Cost (MAC) pricing? Yes No b. What is the percentage of the MAC expressed as a percentage of the available generics? c. Will there be a price differential (spread) between the amount paid to the pharmacy providers and the amount billed to the District? Yes No d. Will your contract allow for third party audits of the Districts cost and expenses? Yes No 7. Prescription Drug Costs Attach complete fee schedule including dispensing and AWP drug cost per 30 day supply. Include administration fees, or any other fees associate with this proposal. 8. For what period of time are quoted rates guaranteed? 9. What is the length of time in which MAC pricing are guaranteed? 10. Is there a MAC pricing guarantee? Yes No 11. Are they any administration fees? If so, what are the costs and will there be a second year renewal? Yes No 12. Will you provide member ID cards Yes No 13. Other a. Describe Wire Transfer Payment procedures: Health Insurance RFP# Page 47

48 b. Does you proposal include 100% prescription rebates with no sharing? Please explain rebate program. 14. Please state any variations to the Request for Proposal Assumptions or other qualifications for your quote: Health Insurance RFP# Page 48

49 Pharmacy Benefit Management Signature Page Company Name Authorized Signature Address Type Signatory s Name and Title Telephone Number Agent Name Fax Number Address Health Insurance RFP# Page 49

50 Section 2 Proposer Questionnaire Individual Stop Loss Insurance (ISL)/Aggregate Stop Loss Insurance (ASL) 1 Describe the business entity submitting the proposal: a Insurance Company Name: b Address: c Contact Person: d Telephone Number: e Year founded (Insurance Company): f What percentage of overall business is Health related? g Managing Underwriter s Name: h Year founded (Managing Underwriter) I Number of Years for representing insurance company: 2 Describe Financial Stability of Insurance Company: a Financial Rating Service A.M. Best Standard & Poors Moody s Current Rating Prior Year Rating Prior Two (2) Years Rating b Is Insurance Company authorized to do business in Texas? Yes No 3 Provide five (5) Texas client references Name of Client Contact Person Telephone Number Number of Employees PLEASE ANSWER QUSESTIONS 4 THROUGH 7, IF STOP LOSS IS BEING SUBMITTED BY MANAGING UNDERWRITING GROUP OR OTHER BUSINESS ENTIRY ACTING AS AN AGENT OR REPRESENTATIVE FOR ANY COMPANY. Health Insurance RFP# Page 50

51 4. Describe the business entity submitting proposal: a Name of Business Entity: b Current Business Address: c Mailing Address: d Contact Person: e Telephone Number f Type of Business Entity: Corporation General Partnership Sole Proprietorship Registered Limited Liability Partnership Limited Liability Company g Do you handle claims In-House : Yes No H Are there additional carriers accepting levels of risk Yes No h Please provide date corporation or partnership chartered: 5 Pending Lawsuits/Claims: a Has the business entity been a defendant in any lawsuit in any state or federal court during the preceding five (5) years? Yes No If yes, identify each lawsuit by party, case number, court, subject matter, and disposition b Does the business entity have any claims filed against it which is unresolved and presently pending before any State of Texas Administrative agency? Yes No If yes, please provide a full description of the matter: 6 Financial Information: a Has the business entity filed a voluntary or involuntary petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years? Yes No If yes, please describe: b Has any owner, member, or partner of the business entity filed a petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years? Yes No If yes, please describe: c Audited financial statement for the preceding fiscal year included with response? Yes No 7 Insurance coverage Health Insurance RFP# Page 51

52 The business entity must provide satisfactory evidence of existing insurance coverage in the amount of $2,000, for Errors and Omissions or other fiduciary liability. If the business entity is selected to provide services it must provide evidence that such coverage will be in effect for the duration of the agreement. (Include Copy of Insurance Certificate) 9 ISL and ASL claim payment: a Where will claims be paid? b What is the definition of paid claim to be eligible for reimbursement? (Are Cost-containment investigation expenses, PPO percentage of discount costs, higher deductible amounts (lasers), pharmacy dispensing fees, prescription rebates, etc eligible for reimbursement) c Can the District s Insurance Department speak directly to claim examiner for questions related to payment of claim? Yes No d What is the normal processing time for ISL claim? e What is normal processing time for ASL claim? f If the District has negotiated with providers, with these discounts be accepted in lieu of doing a hospital audit? Yes No g Describe documentation needed for ISL claim reimbursement: h What is the maximum time you allow for submission of Stop Loss payments by a TPA? i Do you provide/require access to transplant networks(s)-centers of excellence direct or through TPA? Yes No j Do quoted rates include advance funding for: Specific Claims? Yes No If no, additional cost to provide Aggregate Claims? Yes No If no, additional cost to provide 10 Underwriting a How recent must claims experience be in order to provide final terms Health Insurance RFP# Page 52

53 b Will any claimants be excluded or assigned a higher deductible? Yes No If so, Please describe: c Will renewal rates be provided to District 90 days prior to renewal date? Yes No d What trend factors have you used in your proposal? Insurance Utilization Inflation Total e Is you experience rating set by formula? Please explain. Yes No f Does your Stop Loss insurance contract have any exclusions or limitations that are more restrictive than those used in the District s booklet? Yes No g Does your Stop Loss contract have any limits for any of the following: Transplants Yes No Substance Abuse Yes No Mental Nervous Conditions Yes No AIDS Yes No Other Yes No h Are the active-at-work and disabled dependent provisions waived for the effective date of the contract? Yes No 11 Is the quote based on the services of a particular claim administrator or provided network? Yes No 12 Do you require your TPA to provide Error s & Omissions coverage? At what limits? Yes No 13 Do you provide override commissions for higher levels of production to the TPA being proposed? Yes No 14 Do you reserve the right to unilaterally terminate a group for poor experience? Yes No 15 Are there any additional surcharges or taxes not disclosed in this proposal? Please explain. 16 For what period of time are quoted rates guaranteed? Yes No Is a longer rate guarantee available? Yes No Health Insurance RFP# Page 53

54 17 Are quoted rates net of commission? Yes No 18 Please state any variations to the Request for Proposal or other qualifications for your quote: Company Name Address Authorized Signature Type Signatory s Name and Title Telephone Number Agent Name Fax Number Address Health Insurance RFP# Page 54

55 `Section 2 Proposer Questionnaire Utilization Review Services 1 Describe organization submitting proposal: a b c d e Name of Firm: Address: Contact Person: Telephone Number: Year Founded: 2 Audited financial statement for the preceding fiscal year included with response? 3 Describe Utilization Review experience: Yes No a b c Number of Clients: Number of Insured Employees: Other: 4 Provide five (5) Texas client references Name of Client Contact Person Telephone Number Number of Employees 5 Insurance coverage: The business entity must provide satisfactory evidence of existing insurance coverage in the amount of $2,000,000 for Errors and Omissions or other fiduciary liability. If the business entity is selected to provide services it must provide evidence that such coverage will be in effect for the duration of the agreement. (Include Copy of Insurance Certificate) Health Insurance RFP# Page 55

56 6 Utilization Review Services: a Do you provide toll-free telephone access? Yes No b Is 24-hour service provided? Yes No 7 Describe the following services a Hospital Pre-Certification b Concurrent/Continued Stay Review c Claim Pay or Notification: 8 Describe Pre-Certification Procedures: a Employee Notification: b Employer Notification: c Claim Pay or Notification: 9 Does employee receive written confirmation for Hospital Pre-Certification? Yes No 10 Reports If yes, Please provide sample. a Will you be willing to provide sample reports provided to employers upon request? Yes No b How often are reports provided? c May employer request special reports? Yes No Is there an additional charge for this service? Yes No Health Insurance RFP# Page 56

57 11 Please state any variations to the Request for Proposal Assumptions or other qualifications for your quote: 12 For what period of time are quoted rates guaranteed? Company Name Address Authorized Signature Type Signatory s Name and Title Telephone Number Agent Name Fax Number Address Health Insurance RFP# Page 57

58 Attachment Current Group Health Insurance Policy with: Summary of Benefits Basic Plan Summary of Benefits Low Plan Summary of Benefits High Plan Summary of Benefits State Comparable Plan Health Insurance RFP# Page 58

59 Health Insurance RFP# Page 59

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90 Aetna, Inc. Products & Services Health Insurance RFP# Page 90

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92 Attachment Large Claims History by Plan Large Claims Paid Over $50,000 Large Claims Paid Over $25,000 COBRA Health Insurance Census Full Time Employees by Age, Birth date and Gender Health Enrollment Census by Plan Exhausted Leave Census by Plan Health Insurance RFP# Page 92

93 Health Insurance RFP# Page 93