OFFICE OF PROCUREMENT AND CONTRACTING 301 Largo Road, Largo Maryland

Transcription

1 OFFICE OF PROCUREMENT AND CONTRACTING 301 Largo Road, Largo Maryland REQUEST FOR PROPOSAL #18-01 NEW HEALTH CARE PLAN MEDICAL, PRESCRIPTION DRUG, DENTAL & VISION Addendum No. 2 Issued: Monday, October 23, 2017 Addendum No. 2 is hereby issued by PGCC Web posting. Except as modified below, the Request for Proposal (RFP) remains unchanged. Please make note of the following changes/clarifications to this solicitation: 1. Attachment A - List of Clarifications 2. Attachment B - Responses to Questions received 3. Attachment C - Bidder s Proposal Form 4. Attachment D - MBE Participation Provisions & MBE Utilization Affidavit The Bidder must acknowledge the respective Addendum with their proposal. End of Addendum No. 2

2 ATTACHMENT A Addendum No. 2

3 Clarifications to Request for Proposal No Clarification #1: The Bid due date for RFP is November 13, Clarification #2: Clarification #3: Clarification #4: Clarification #5: Clarification #6: Clarification #7: In order to receive the Health bid documents, vendors must complete and submit the Non-Disclosure Form via to The form title Instructions & Regulations for Bidding was erroneously included within this RFP and is hereby removed. Each Bidder should submit one original (clearly labeled Original), three hard copies and a Flash Disk copy of their proposal response to the RFP. Each response to the RFP should include a completed Bidder s Proposal Form (see attached) as well as the bidder s actual cost for services as it retains to this bid s specifications. Please ensure that the Excel document that provides history of claims experience are completed in its entirety and submitted with the proposal. Failure to do so may result in missing data from your response to the RFP. The MBE Participation Provisions & MBE Utilization Affidavit mentioned within the RFP is attached, and should be completed along with the MBE Schedule. Both forms must be completed with the bidder s proposal response.

4 ATTACHMENT B Addendum No. 2

5 Responses to Questions received 1. Please clarify the due date for the response for the vision portion of the RFP, is it 10/30 at 10:00 am or 11/13 at 10:00 am? The due for RFP #18-01 is November 13, 2017 at 10:00am. 2. Will the college consider a hearing carve out program as part of the bidding process? Not at this time 3. Does PGCC participate in the State Pension Program? Yes 4. Is a bid, performance or payment bond required for this procurement? No 5. Can you confirm you want a total of four copies as indicated in section 2.12 (page 7 of the PDF), rather than 2 copies as indicated in Section 2.g (page 20 of the PDF)? Each Bidder should submit one original (labeled), 3 hard copies and a Flash Disk copy in Response to RFP. 6. Section 1. General Information 1.1 letter E (page 3 of the PDF) indicates that a label was provided with the bid to include on our RFP response, but we can t find the label. Should we just create our own, or can you provide? Each Bidders should create their own labels according to section 2.12 Proposal Submission Deliverables 7. Can we provide our response to all three of the products (Medical, Dental, Vision) in the same hard copy binder, assuming we spilt the sections out by product? If so, do we only need to fill out the Bidder s Proposal Form and Bid Proposal Affidavit once, to cover all three?

6 Yes, Bidders can response to all three of the products, however if the plans are three separate plans, then each binder should be separated. 8. Can you confirm that sample packages are no applicable to this RFP, since it is for a service contract (Letter k, page 21 of the PDF)? This requirement was listed in the form Titled INSTRUCTIONS AND REGULATIONS FOR BIDDING and it is no longer made a part of this RFP. 9. What is the reason for the marketing? (Service, Billing, Support, Price) The purpose for marketing the RFP is to obtain a new Contract as the current Contract is expiring. The College is seeking a new Contract for its employees. 10. Will you need an actual proposal from current provider or will a renewal letter suffice as that is what we typically provide during the renewal cycle. Additionally, will we need to complete the Questionnaire, plan design summaries, etc.? The Current provider for the College s health and medical contract should submit an actual proposal response. A renewal letter will not suffice. Yes, the Questionnaire should be completed. 11. Please confirm the correct mailing address for hard copies. Page 1 notes Prince George s Community College 301 Largo Road Kent Hall, RM. 262 Largo, Maryland However, page 7 notes Karen Kelly, Procurement Coordinator Office of Procurement & Contracting Kent Hall, Room 264 Prince George's Community College 301 Largo Road Largo, Maryland The correct mailing address for response to RFP is as follows: Karen Kelly, Procurement Coordinator Office of Procurement & Contracting Kent Hall, Room 264, Prince Georges Community College, 301 Largo Road, Largo, MD In our review of the RFP, the following requirement was outlined. The Bidder is required to demonstrate an effort to retain a minimum of 25% minority firms of the subcontractors or vendors anticipated to be retained by the Bidder for the College s project. Bidders are to note in the submission under this category as to what MBE participation level they will commit and how this commitment will be achieved giving that all trade packages are completely bid. This will be very difficult to obtain. We typically see a much smaller % or $ amount and like to get your feedback on this?

7 We highly encourage that each bidder demonstrate an effort to meet the 25% minority business goal as part of their proposal. Bidders must indicate their MBE percentage on the MBE form include within the RFP. 13. Please clarify the MBE participation goal as a percentage of total contract dollars. The MBE participation goal of 25% will be calculated against the total Proposal costs. 14. Page 2 of the RFP refers to attachment e) MBE Participation Provisions and attachment f) MBE Utilization Affidavit, please provide these documents. See attachment in Addendum 15. Please confirm if the MBE Participation Schedule (pp of the solicitation document) is the only MBE document required with submission; if not, please provide required forms (i.e., utilization affidavit). The MBE Participation Schedule and the MBE Affidavit are both required forms for the bid response. 16. Please clarify if the 25% participation goal is for each product, including ancillary lines (vision, dental)? The 25% participation goal should be reflected against the total bid costs. 17. Please confirm the current MBE firms being used by the incumbent and please confirm that it is the intention of the college that all MBE s have an applicability to the contract being bid. Yes, it is the intent that all MBEs submitted as part of the Bidder s Proposal response be applicable to the contract. 18. The preparation of bids section states Bids shall be submitted on the form entitled Bidders Proposal. Can you confirm that this is the Excel spreadsheet titled PGCC Vision RFP xlsx. I did not find any other forms titled Bidders Proposal. The Bidder s Proposal attached, should be included as part of the bidder s response. The Excel Spreadsheet should also be included as part of the proposal response to bidder responding to the vision portion 19. The Proposal Submission Deliverables section states they require one (1) original and three (3) printed proposals (and one electronic copy), however under Instructions for Preparation for Bids (section- g) it states The original and one copy of each bid shall be placed in an envelope.can you please confirm if they would like 1 or 3 printed copies to accompany the original. Please refer to the following: Clarifications section of the Addendum Responses to Question 11

8 20. Has the current carrier gone through negotiations on the renewal? No, our current carrier is also invited to participate in this Request for Proposal 21. Is there going to be a finalist meeting? There may be a meeting with shortlisted Bidders 22. Under Regulations, Section 3c states Where required, successful bidder must furnish a performance and payment bond as indicated on the bold documents. Please confirm if they require a payment bond for voluntary vision. See response to Question Why is the group out to bid? Is there a big renewal increase? Are there service issues? The current Contract is expiring and the college is seeking a new Contract for its employees. 24. In the RFP Questionnaire, question 1 asks for confirmation that the quotes should be guaranteed for 24 months. The original RFP asks for a 36 month guarantee. Please confirm the desired rate-guarantee duration. Medical Admin: 3 years Dental: 24 months Vision fully insured: 3 years or more 25. As we recently received the files, can there be an extension provided for questions? Unfortunately, the Prince George s Community College will not extend the due date for RFP # Regarding the rates, should the rates contain commission or be net of commission? Commission should only be included if replacing the Kaiser plan as that is the only plan with commissions on the Health, Dental and Vision RFP. 27. Please provide the current carrier booklet (SPD) for the coverages that we are being asked to quote for both plans. Booklets have been posted to links and are available for download. Upon submission of the Non-Disclosure form ed to kkelly14380@pgcc.edu, document will be available for download. 28. Can you please provide a copy of the full dental booklet with procedures and frequencies?

9 Booklets have been posted to links and are available for download. Upon submission of the Non-Disclosure form ed to document will be available for download. 29. Can you please provide a copy of the current vision plan? The certificate that was provided does not included the plan design. Plan Summary has been posted to link and is available for download. Upon submission of the Non-Disclosure form ed to kkelly14380@pgcc.edu, document will be available for download. 30. Please provide confirmation of the rate guarantees requested for each product (Medical, Rx, Dental and Vision). Medical Admin: 3 years Dental: 2 years Vision fully insured: 3 years or more 31. It appears from the RFP spreadsheet that both plans are MAC for OON. Can we confirm for both plans, how the out-of-network claims reimbursed? Negotiated fee schedule or R&C? If R&C, which percentile? Out-of-network claims are reimbursed based on the negotiated network fee schedule for both plans 32. Please clarify discrepancies in enrollment counts for all lines of business listed throughout the different worksheets of each bid. For instance, on both medical and vision census files, the counts are far greater than on the geo charts. Specifically, the medical zip code pivot table shows 1,259 zip codes, but the chart shows 1,131. Similarly, the vision shows 754 on the template, but the census shows 854 (after removing the waivers/nas). Portion of Medical RFP that shows employee contribution only illustrates active enrollment as labeled. Geo Access only requests that you run based on all enrolled retirees and all eligible employees. The discrepancy is that there are retirees on census who are not currently covered that we excluded from Geo Access request. Vision Geo Access should be the same as medical all active eligible and covered retirees. The discrepancy is that the Geo only shows active employees. 33. Please clarify if you are requesting both fully insured and ASO quotes for medical and vision products, or only for the dental products. Currently, Medical is predominately self-funded through CareFirst, with a portion of the medical population insured through a fully insured HMO with Kaiser Permanente. We only expect fully insured rates if offering a Staff Model HMO

10 (like Kaiser Permanente) or Medicare Advantage plans. Dental- Prefer self-funded quotes but will accept fully insured if you are unable to offer self-funded. Vision is currently fully insured and we are requesting fully insured quotes. 34. Could PGCC please confirm their expected rate guarantee period? In the Vision RFP (Excel document), Contract Period and Renewal Options section on the Cover tab asks for a 3-year rate guarantee while the Proposal Requirements tab asks us to confirm a 4- year rate guarantee. The College would require at least a 3-year rate guarantee. Longer rate guarantees will be accepted. 35. There seems to be a discrepancy in the formula on the Medical Rx claims enrollment history tab. Under Column J, Total Med & Rx seems to be adding Column F + Column I, rather than Column E + Column I. Please confirm or advise. The correct formula is Should Column E+ Column I. This has been adjusted and reposted to the medical link. Claims broken out by class are also available. 36. In the Traditional Indemnity Plan, do CareFirst network providers ( in-network providers ) accept an allowed amount (fee schedule amount) as payment in full for each service, or are members who obtain services by in-network providers balanced billed to the submitted amount? CareFirst Traditional Indemnity Network providers do no balance bill members 37. Is the Maximum Allowed Charge ( MAC ) in the Traditional Indemnity Plan the same MAC fee as the Preferred PPO plan by procedure (i.e. are the underlying fee schedules the same between the Indemnity and the Preferred plans)? MAC is the in-network allowable charge for Traditional Indemnity Plan. 38. Does the incumbent carrier define MAC as the same fee an in-network preferred provider would accept as full payment for a service, or is the MAC set at some other percentile of UCR? If the MAC is different, what percentile of UCR is it? MAC is the in-network allowable charge for in-network PPO Plan. 39. The instructions page states that requested funding is self-insured. However in the RFP Questionnaire, question 2 asks for confirmation that the quotes are on a fully insured and self-funded basis. Please specify if the College would like rates for both fully-insured and self-insured or only self-insured. Self-funded quotes are preferred. The College will accept Fully insured Proposals. 40. Are those opting out of coverage receive any additional money as an incentive to opt-out (besides the employee s contribution)?

11 No 41. Since 2013, has there been any changes to the dental plans? If so, please specify date and type of change. No changes 42. How long has the College been with CareFirst for Dental Insurance Coverage. 13+ years 43. Please provide ASO rate history. Upon submission of the Non-Disclosure form ed to document will be available for download. 44. Please provide proposed 2018 renewal rates, if available. The renewal rates are not available. Incumbent carriers are quoting as part of RFP process 45. Please provide any renewal packages with rate developments and network usage reports available from prior years. Renewal packages with rate development will not be provided. Claims files indicate whether claim was processed in-network or out-of-network. 46. Over the last 12 months, what percentage of total submitted charges were from innetwork PPO dentists? 83.9% 47. Over the last 12 months, what percent of the in-network submitted charges were discounted due to participating dentist fee allowances? The percentage of in-network charges discounted was 39% for the 12- month period ending 6/30/2017; 90% of total paid claims were paid innetwork. 48. Over the last 12 months, what percent of the out-of-network (non-participating) submitted charges were disallowed due to the out-of-network (non-participating) reimbursement cap? The percentage of out-of-network charges discounted was 32.6% for the 12-month period ending 6/30/ Can you confirm you would like us to provide you with a Medicare Advantage Quote, since you included a copy of the Kaiser Medicare Group Plan with the proposal?

12 Yes, but not required. 50. In the Carrier TPA Questionnaire Tab of the Medical Workbook, you ask us to respond Y/D/N but some of the items actually require an answer instead (Example: how long to you actively maintain claim history on-line? ). Should we just include our response to these types of questions in the Deviation column? Yes, but it is not required. 51. Please provide the plan design for the Over 65 Medicare CareFirst members? CareFirst over 65 plans are Medicare complimentary, where PGCC will provide benefits described in booklets after Medicare pays as primary. 52. What are the plans being offered to the Post 65 retirees (we just see the Kaiser plan design)? Can you provide the benefit summaries for these plans. CareFirst over 65 plans are Medicare complimentary, where PGCC will provide benefits described in booklets after Medicare pays as primary. 53. For the plans being offered to the Post 65, what is the coordination method (how does it coordinate with Medicare?) Please see the below: For the Medicare eligible retirees, please confirm the current coordination of benefits methodology with Medicare that is used; COB (coordination of benefits, retiree comes out whole), MOB (maintenance of benefits, also called Carve-out and Non-duplication) or Government Exclusion (also called Medicare exclusion) basis: COB Coordination of benefits/ retiree comes out whole - Calculates what the plan would have paid as sole provider and adds what Medicare pays. If the total is more than 100% of the bill, the plan pays only enough to total 100%. The retiree often pays no deductible or coinsurance. MOB - maintenance of benefits or also called Carve-out and Non-duplication - Calculates the plan s payment as if there were no Medicare coverage, applies the deductibles, coinsurance and other plan limits and pays the remaining amount minus what Medicare pays. Government Exclusion (also called Medicare exclusion) - Determines the total expenses covered under the plan, reduces them by Medicare benefits and then applies the deductibles, coinsurance and other plan limits. PGCC s plan is MOB. Can you provide claims for the Post 65 population? Medical and Rx Claims by class posted under links for download. Upon submission of the Non-Disclosure form ed to kkelly14380@pgcc.edu, document will be available for download. Can you provide a census for the Post 65 population How many retirees are there excluding the Kaiser population?

13 Included in the census provided columns are labeled for active vs. retiree. 54. Can you confirm you only require a self-funded quote on the Dental PPO Plans? Confirmed 55. Can you provide both dental plan enrollment and dental plan experience split out by the existing plans? Dental Enrollment July 15 thru Jul 17 posted under links for download Dental claims July 14 thru July 17 posted under links for download Upon submission of the Non-Disclosure form ed to kkelly14380@pgcc.edu, document will be available for download. 56. You provided a document called MD DHMO Plan 2 SIG wadult Dental DME - Prince Geo which indicates DHMO on the top. However, it appears to be a Medical HMO Plan, and the Dental Response document only seems to be asking for Dental PPO/Indemnity Plans. Can you confirm we do not need to price for a DHMO? If we do, can you provide the requested DHMO plan? MD DHMO Plan 2 Sig w/ Adult Dental DME Prince GEO is the Kaiser medical plan No pricing is needed for a DHMO. 57. Please confirm the make-up of the proposed retail pharmacy network. Confirm if there are any excluded pharmacies, and if so, please provide a listing. The CVS National Network has over 68K pharmacies. All major chains and most independent pharmacies are included in the network. If a pharmacy is not in the network it is usually because they don't process claims electronically, they chose not to be in the network or they were terminated for violation, which would be very rare. No major retail chains are excluded from the network. 58. Please describe the proposed formulary noted as formulary 2 and its composition. Are there excluded drugs? If so, please provide exclusions. Formulary 2 Drug Removals posted under links for download. 59. Who is the current claim fiduciary? Prince George s Community College 60. What are the current programs/services the group has today? (i.e. Disease Management, Maternity Management, etc.)

14 PGCC uses CareFirst s full breathe of Total Care and Cost Improvement Programs including: i. Hospital Transition of Care Program ii. Complex Case Management Program iii. Chronic Care Coordination Program iv. Home Based Services Program v. Enhanced Monitoring Program vi. Comprehensive Medication Review vii. Community Based Program viii. Pharmacy Coordination Program ix. Expert Consult Program x. Urgent Care and Convenience Access Program xi. Transplant and Centers of Distinction Program xii. Substance Abuse and Behavioral Health 61. What programs/services are to be included in the quote? Please include all programs you believe would help PGCC and you manage claims expense. List fees separately. 62. Are we to include any allowances in the Medical quote? Only those specifically requested within the RFP (i.e. Wellness Fund) 63. Please provide large claim data (dollar amounts, diagnosis, prognosis) to match the most recent 12 months of experience data. Large claims Data August 16 through July 17 has been posted to the link and is available for download. Note CareFirst does not provide prognosis information. 64. Are dollars over the ISL level included in the claims experience? Yes 65. Please confirm you would like to see a medical self-funded admin fee, as well as 3T premium equivalent rates. Correct 66. Why are there only POS claims for July 2017? Beginning July 1, 2017, PGCC changed the network of its PPO plan (BluePreferred) to a BlueChoice Advantage network plan. 67. In reference to the plan change history: do the plan designs provided reflect benefits post the 7/1/17 changes? Yes. If so, please the plan designs prior to the changes. Changes made are listed on plan changes tab.

15 68. Please confirm that the Fully Insured piece refers to the Kaiser Medicare enrollees only No, the Fully insured Kaiser is for active and retired employees. 69. The incumbent has ITS fees that go through the claim wire. Please identify the ITS fees that are included in the current CareFirst claims experience so competing vendors are not overstating their claims projections. Updated claim experience file separating out the ITS Fees has been posted to links and are available for download. Upon completion and submission of the Non-Disclosure form ed to document will be available for download. 70. For vendors with capitation charges that routinely go through the claims wire, please specifically outline where you will be capturing those expenses as they can be quite substantial. All vendors should disclose capitated services under fixed fee section of RFP and include the PEPM/PMPM charge.

16 ATTACHMENT C Addendum No. 2

17 BIDDER S PROPOSAL FORM RFP #18-02 PROVIDE HEALTH CARE PLAN (MEDICAL, PRESCRIPTION DRUG, DENTAL & VISION FOR PRINCE GEORGE S COMMUNITY COLLEGE NAME OF BIDDER: TO: Board of Trustees of Prince George s Community College The undersigned, having carefully examined the Invitation for Bid, Specifications, Bidder s Proposal, Bid Proposal Affidavit and Mandatory Procurement Contract Provisions hereby offer to furnish the service called for in accordance with the said documents for the sums stated. The undersigned acknowledges receipt of any addenda. Addendum # Addendum # Addendum # SIGNATURE PRINT NAME FIRM TITLE PHONE NUMBER ADDRESS

18 ATTACHMENT D Addendum No. 2

19 Prince George's Community College MBE Participation Schedule Prime Contractor (Firm Name, Address, Phone) Project Description Project Number Total Contract Amount $ ***List Information For Each Certified MBE Subcontractor On This Project*** A. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract B. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract C. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed Project Commitment Date MBE Federal ID Number: Project Completion Date Agreed Dollar Amount Percentage Of Total Contract THIS FORM PREPARED BY: (Contractor signature is required) Date: (PGCC OFFICIAL USE ONLY) _ APPROVED: YES NO DATE SIGNATURE - OFFICE OF PROCUREMENT & CONTRACTING USE CONTINUATION PAGE AS NEEDED SUMMARY TOTAL MBE PARTICIPATION: $ TOTAL AFRICAN-AMERICAN MBE PARTICIPATION: $ TOTAL WOMAN-OWNED MBE PARTICIPATION: $ % % % MBE Classification: Hispanics, Asian, American Indians, Women, African American, Physical or Mentally Disabled SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL

20 Prince George's Community College MBE Participation Schedule Page 2 List Information For Each Certified MBE Subcontractor On This Project D. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract E. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract F. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract G. Minority Firm Name, Address, Phone MBE Classification: MBE Certification Number: Work To Be Performed MBE Federal ID Number: Project Commitment Date Project Completion Date Agreed Dollar Amount Percentage Of Total Contract SUMMARY SUB-TOTAL MBE PARTICIPATION: $ SUB-TOTAL AFRICAN-AMERICAN MBE PARTICIPATION: $ SUB-TOTAL WOMAN-OWNED MBE PARTICIPATION: $ % % % MBE Classification: Hispanics, Asian, American Indians, Women, African American, Physical or Mentally Disabled SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL

21 BOARD OF TRUSTEES OF PRINCE GEORGE S COMMUNITY COLLEGE MINORITY BUSINESS ENTERPRISE UTILIZATION AFFIDAVIT I hereby declare and affirm that I am the (Title) and the duly authorized representative of (Name of Bidder) I further declare and affirm that the Bidder acknowledges the Minority Business Enterprise participation goal of not less than 25 percent of the total contract amount, and commits to make a good faith effort to achieve the goal. I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THE FOREGOING DOCUMENT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF, AND THAT I AM AUTHORIZED, ON BEHALF OF THE ABOVE BIDDER, TO MAKE THIS AFFIDAVIT. (Date) (Affiant s Signature) Print or type name