City of Overland Park, Kansas Notice Inviting Proposals for Voluntary Benefits Critical Illness and Vision

Transcription

1 City of Overland Park, Kansas Notice Inviting Proposals for Voluntary Benefits Critical Illness and Vision The City of Overland Park, Kansas is seeking proposals from qualified firms to provide Critical Illness and Vision Benefits Administration. See the following link for more information. Questions concerning this RFP must be submitted by July 5, Responses to questions will be posted on the City s internet site, at least five (5) days prior to the deadline for proposals. All inquiries concerning this RFP are to be directed to the following: Melissa Haskins Mercer Health & Benefits 2405 Grand Boulevard, Suite 900 Kansas City, MO melissa.haskins@mercer.com Proposals are due no later than 5:00 P.M. CT on July 15, Please submit an electronic version of your proposal to Melissa Haskins at melissa.haskins@mercer.com of Mercer Health & Benefits, as well as one hard copy of your proposal to the Mercer address listed below. In addition, an original plus two (2) copies of your proposal must be submitted in printed form to the City at the address listed below in a sealed envelope or box with the following words clearly marked on the outside of the envelope: Request for Proposal: Voluntary Benefits Critical Illness and Vision. The vendor s name and address must be clearly indicated on the envelope or box. There will be no public opening of the proposals. It is the sole responsibility of the vendor to see that their proposal and the appropriate documents are delivered on time. Any proposal received after the scheduled closing time for the receiving of proposals will be returned to the vendor unopened and will not be considered. Mailing Address for Proposals Proposals shall be mailed or delivered to the following addresses: Melissa Haskins Mercer Health & Benefits 2405 Grand Blvd., Suite 900 Kansas City, MO City of Overland Park Attn: City Clerk 8500 Santa Fe Drive Overland Park, KS 66212

2 VOLUNTARY BENEFITS CRITICAL ILLNESS AND VISION REQUEST FOR PROPOSAL CITY OF OVERLAND PARK JUNE 25, 2013

3 REQUEST FOR PROPOSAL CITY OF OVERLAND PARK CONTENTS 1. Introduction Legal/Contract Issues General Questionnaire Appendix A: Census Appendix B: Critical Illness and Vision Plan Design Workbook MERCER i

4 1 Introduction A. Overview Overland Park, Kansas Background The City of Overland Park, Kansas, hereinafter referred to as the City, is located in the Kansas City metropolitan area. It has a population of approximately 177,000, is the second largest City in the State of Kansas and the largest city in Johnson County, Kansas. The City has twelve elected council members and an elected Mayor, which comprise the Governing Body. The Governing Body hires a professional City Manager as the chief administrative official. The City currently employs 809 full-time and part-time employees, including 240 commissioned police officers and 145 fire safety personnel. For additional information regarding the City, please see the City s website at The City is looking to implement and replace various voluntary plans into their benefits portfolio, specifically Critical Illness (CI + Cancer, w/wellness), and Vision (100% Employee Paid) We have included information below as well as attached an employee census file for your use (Appendix A) to develop rates for these two lines of coverage. The City currently contracts with the following vendors: Medical and Prescription Drug Administration (United Healthcare): Two plans are offered, a low deductible PPO and a high deductible PPO with a Health Reimbursement Account (HRA) Dental (MetLife) Basic/supplemental life and basic AD&D (Lincoln Financial) Voluntary short term disability (Lincoln Financial) Cancer (Aflac) - current enrollees in this plan will be considered a closed class. Newly eligible employees will be offered the new critical illness coverage. The City does not currently offer a carved out vision benefit. Preventive eye exams are covered 100 % under the medical plan. Please review the proposed plan designs for critical illness and vision in Appendix B when developing your proposal. Mercer Health & Benefits, LLC will be the broker of record for all products placed. MERCER 1

5 Below is additional information to consider when developing your proposal for the City. 1. # of eligible employees: Description of EE population: Municipality (public works, public safety, city council, etc.) 3. Location(s): Overland Park, KS 4. Mercer office: Kansas City 5. Benefits eligibility: Full-time employees 6. Enrollment method: Active, on-cycle with core benefits 7. Self Service Enroll/Provider: Integrated with client's PeopleSoft system or carrier system 8. Call Center/Provider: Integrated with client's PeopleSoft system or carrier system 9. Enrollment Firm/Provider: None 10. Expected Enrollment date: November Effective Date: 1/1/ Billing Method: Payroll deduction 13. Census File: Attached 14. Critical Illness Plan Design: H.S.A Compliant CI plan with Cancer Benefits, Reoccurrence Benefits, and Wellness Benefit 15. Critical Illness Commission: Graded (First year % / renewals %) 16. Vision Plan Design: See Appendix B: Plan Design Workbook 17. Vision Commission: Graded (Preferred) or Level B. Proposal Process The following describes the anticipated proposal process, including timing, expected proposal format/distribution, how to obtain additional information, and contact information. Please note that the City has engaged Mercer Health & Benefits to manage the RFP process. The City should not be contacted directly. All proposals and related reference information submitted in response to this RFP will become the property of the City and will not be returned. Each entity submitting a proposal, waives any right of confidentiality as to the proposal documents. If an entity submitting a proposal considers certain material in the proposal proprietary information, it shall clearly designate those portions of the proposal it wishes to remain confidential. As a public entity, the City is subject to making records available for public disclosure, to include bids and proposals submitted in a competitive bid process. The City will attempt to maintain the confidentiality of material marked proprietary; however, it cannot guarantee that information will not be made public. MERCER 2

6 Submission of a proposal indicates acceptance by the vendor submitting the proposal of the terms, conditions and specifications contained in this RFP, to include the contract requirements set forth herein. The City will not pay for any information herein requested, nor is it liable for any costs incurred by those submitting proposals. The City reserves the right to select the proposal that will best meet the needs of the City. Proposals that do not meet the stated requirements will be considered in non-compliance and will be disqualified unless the City waives such noncompliance. The City reserves the right to accept or reject any and all proposals, to waive any technicalities or irregularities therein, to award contracts, or to cancel at any time the Request for Proposal (RFP) without awarding a contract. The contents of this RFP and any clarifications distributed or issued by or on behalf of the City shall become part of the contractual obligation of the successful vendor and incorporated by reference into the ensuing contracts as the City deems appropriate. Inquiries All inquiries concerning this RFP are to be directed to the following person: Melissa Haskins Mercer Health & Benefits 2405 Grand Boulevard, Suite 900 Kansas City, MO melissa.haskins@mercer.com Questions concerning this RFP must be submitted by to Melissa Haskins at melissa.haskins@mercer.com at least ten (10) days prior to the deadline for proposals. All responses to questions regarding this RFP will be posted on the City s internet site, at least five (5) days prior to the deadline for submission of proposals. Deadline for Proposals Proposals are due no later than 5:00 P.M. CT on July 15, Please submit an electronic version of your proposal to Melissa Haskins at melissa.haskins@mercer.com of Mercer Health & Benefits, as well as one hard copy of your proposal to the Mercer address listed below. In addition, an original plus two (2) copies of your proposal must be submitted in printed form to the City at the address listed below in a sealed envelope or box with the following words clearly marked on the outside of the envelope: Request for Proposal: Voluntary Benefits Critical MERCER 3

7 Illness and Vison. The vendor s name and address must be clearly indicated on the envelope or box. There will be no public opening of the proposals. It is the sole responsibility of the vendor to see that their proposal and the appropriate documents are delivered on time. Any proposal received after the scheduled closing time for the receiving of proposals will be returned to the vendor unopened and will not be considered. Mailing Address for Proposals Proposals shall be mailed or delivered to the following address: Melissa Haskins Mercer Health & Benefits 2405 Grand Blvd., Suite 900 Kansas City, MO Proposal Requirements City of Overland Park Attn: City Clerk 8500 Santa Fe Drive Overland Park, KS All data included in this RFP and accompanying appendices, as well as census data are confidential information of the City of Overland Park, Kansas. This data and information is provided solely for the exclusive use of vendors in preparing a proposal and may not be shared with any other firm or entity or used for any other purpose. Proposal responses must be signed by a duly authorized officer of the vendor s organization with an effective date of coverage of January 1, All rate/fee proposals require the confirming signature of an officer of your company. All documents must clearly indicate the name of the responding organization, as well as the name, address and telephone number of the primary contact person for this proposal. The original proposal that is submitted by your organization, as well as any follow-up information or correspondence (oral or written) transmitted during the proposal process will be binding. All material submitted during the proposal process becomes the property of the City, for its use and disposition. C. Selection Process and Criteria Proposals will be evaluated by a City staff committee with the assistance of Mercer, utilizing the criteria set forth below. The City staff committee and Mercer will make a recommendation to the MERCER 4

8 City s Finance, Administration & Economic Development Committee, who will in turn make a recommendation to the City s full Governing Body. The proposal submitted will be the primary document upon which the City s selection committee will evaluate each vendor. This document must include the qualifications and relevant experience of those assigned to the project. All proposals will first be screened in determining whether the vendor has previously performed the type of services requested herein and whether the requirements of this RFP are met. After review of the proposals, the selection committee may determine a short list of qualified firms for interviews/presentations. The City reserves the right to accept or reject any and all proposals and all or part of a proposal and may waive informalities, technical defects, and minor irregularities in the proposals received. In reviewing proposals, the criteria and factors considered by the City shall include, but are not limited to the following: A. Scope of Services -- The extent to which the vendor s description of the scope and objectives is sufficiently detailed, logically presented, consistent in terms of the format and content, and demonstrates a clear understanding of objectives as outlined herein. B. Approach -- The extent to which the proposal presents a clearly defined and well thought-out method(s) to achieve each objective and the extent to which the method chosen appears to be an effective, efficient way to accomplish each objective. C. Qualifications -- Prior experience and past performance -- Whether the vendor has a successful record in performing the services associated with the scope of work detailed herein. D. Proposed cost of services E. Value of products or services proposed. F. Quality level of services to be performed and proposed approach to cost control, service level monitoring, and administration. G. Responsiveness to requested proposal format -- The quality of the proposal and the degree to which it conforms to the required format. H. Feedback -- Information from references and others who have had experience with the vendor on similar projects. MERCER 5

9 I. Presentation The quality of the presentation and interviews if this evaluation method is used. J. Acceptance of Contingency Fee Prohibition The City will not engage a vendor that fails to meet the City s standards regarding compensation The City reserves the right to utilize other appropriate selection and evaluation criteria as it deems necessary and appropriate. D. Timetable Task Completion Date Request For Proposal Released June 25, 2013 Written Questions to Mercer July 1, 2013 Response to questions posted on the City s website July 8, 2013 Proposal Due Date July 15, 2013 Review Marketing Results Week of July 22 Conduct Finalist Meetings Week of July 29 Vendor Selection Confirm final enrollment strategy and enrollment dates Week of August 5 Contracting August 2013 Implementation August-November 2013 Enrollment Period November 2013 (Dates TBD) Effective date of coverage January 1, 2014 MERCER 6

10 2 Legal/Contract Issues Below are contract provisions and legal issues that the City considers essential to this proposal. The successful vendor(s) will be required to enter into a contract with the City that will include and/or comply with the provisions set forth below. As to the contract items below, by submitting a proposal the Vendor acknowledges it has read the materials contained in those items and will agree to the contract requirements set forth therein. A. Prohibition Against Contingent Fees Vendor warrants that it has not employed or retained any company or person, other than a bona fide employee working for Vendor, to solicit or secure this Agreement, and that it has not paid or agreed to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage fee, gifts, or any other consideration contingent upon or resulting from the award or making of this Agreement. B. Cash Basis Law The City is obligated only to make payments under this Agreement as may be lawfully made from funds budgeted and appropriated for the purposes as set forth in this Agreement during the City s current budget year. In the event the City does not so budget and appropriate the funds, the parties shall be relieved from all obligations, without penalty, under this Agreement. C. Term of Agreement The initial term of this Agreement shall be from January 1, 2014 to December 31, 2016 with the City s option to extend the Agreement as needed. D. Termination 1. Termination for Convenience. Unless the parties have otherwise agreed, the City may without reason or without cause and solely for the City s convenience terminate this Agreement at any time by providing the Vendor notice in writing at least thirty (30) days prior to the effective date of such termination for convenience. MERCER 7

11 2. If the City terminates for its convenience as herein provided, the City shall compensate Vendor for all services completed to date of its receipt of the termination notice and any additional services requested by the City to complete any necessary work. Compensation shall not include anticipatory profit or consequential damages, neither of which will be allowed. 3. Termination for Cause. Without in any manner limiting the right of the City to terminate this Agreement or declare the Vendor in default thereof for any reason set forth herein, if the work to be done under this Agreement shall be abandoned by Vendor, or if this Agreement shall be assigned by Vendor otherwise than as herein provided; or if the Vendor should be judged as bankrupt; or if a general assignment of its assets should be made for the benefit of its creditors; or if a receiver should be appointed for the Vendor or any of its property; or if at any time the City determines that the performance of the work under this Agreement is being unnecessarily delayed, that the Vendor is violating any of the conditions or covenants of this Agreement, that it is executing the same in bad faith or otherwise not in accordance with the terms of said Agreement; then, in addition to other rights the City may choose to exercise, the City may, at its option, serve written notice upon the Vendor of the City s intention to terminate this Agreement, and, unless within ten (10) days after the serving of such notice upon the Vendor a satisfactory arrangement be made for the continuance thereof, this Agreement shall cease and terminate unless the City otherwise agrees to continue the Agreement. In the event of such termination, the City shall immediately serve notice thereof upon the Vendor and the City may take over the work and prosecute same to completion by contract with another vendor or otherwise and in such event the City may take possession of and utilize in completing the work any and all documents and other materials as may be necessary therefore. When Vendor s services have been so terminated, such termination shall not affect any rights or remedies of the City against vendor then existing or which may later accrue. Similarly, any retention or payment of monies due Vendor shall not release Vendor from liability. If the City terminates for cause or default on the part of Vendor, the City shall compensate Vendor for the reasonable cost of services completed to date of its receipt of the termination notice. Compensation shall not include anticipatory profit or consequential damages, neither of which will be allowed. E. Compliance with Equal Opportunity Laws, Regulations and Rules and Other Law Vendor agrees that: 1. The Vendor shall observe the provisions of the Kansas Act Against Discrimination (K.S.A et seq.) and shall not discriminate against any person in the performance of work under the present Agreement because of race, religion, color, sex, national origin, ancestry or age. MERCER 8

12 2. In all solicitations or advertisements for employees, the Vendor shall include the phrase, "equal opportunity employer," or a similar phrase to be approved by the Kansas Human Rights Commission ("Commission"). 3. If the Vendor fails to comply with the manner in which the Vendor reports to the commission in accordance with the provisions of K.S.A and amendments thereto, the Vendor shall be deemed to have breached the present Agreement and it may be canceled, terminated or suspended, in whole or in part, by the City. 4. If the Vendor is found guilty of a violation of the Kansas Act Against Discrimination under a decision or order of the commission which has become final, the Vendor shall be deemed to have breached the present Agreement and it may be canceled, terminated or suspended, in whole or in part, by the City; and 5. The Vendor shall include the provisions of paragraphs (1) through (4) above in every subcontract or purchase order so that such provisions will be binding upon such subcontractor or vendor. The Vendor further agrees that the Vendor shall abide by the Kansas Age Discrimination In Employment Act (K.S.A et seq.) and the applicable provision of the Americans With Disabilities Act (42 U.S.C et seq.) as well as all other federal, state and local laws, ordinances and regulations applicable to this Project and to furnish any certification required by any federal, state or local laws, ordinances and regulations applicable to this Project and to furnish any certification required by any federal, state or local governmental agency in connection therewith. F. Assignment of Agreement This Agreement shall not be assigned or transferred by the Vendor without the written consent of the City. G. Applicable Law This Agreement is entered into, under and pursuant to, and is to be construed and enforceable in accordance with the laws of the State of Kansas. H. Miscellaneous Legal Issues MERCER 9

13 The City will not agree to indemnify and/or hold harmless the vendor. The City will not agree to resolve disputes through an arbitration process. I. Right to Audit The City reserves the right to audit, including but not limited to a claims audit, either directly or through its authorized agent(s), the voluntary benefits plan administrator s compliance with the terms of the agreement. The City further reserves the right, either directly or through its authorized agent(s), to conduct a chart audit or other appropriate review to assess the quality of any services performed by the voluntary benefits plan administrator or its affiliated health care providers upon reasonable advance notice to the voluntary benefits plan administrator. Upon providing appropriate assurances as to confidentiality and proper use of medical information, the health plan administrator agrees to provide the City or its authorized agent(s) with the medical records maintained by the voluntary benefits plan administrator as well as any data needed to perform audits or other reviews. Any audits will be completed with no additional cost to the City for the services provided or internal costs incurred by you relative to the audit. J. Confidentiality The voluntary benefits plan administrator agrees to maintain the confidentiality of all medical, financial and other patient specific data pertaining to Members, as required by state and federal law. The voluntary benefits administrator agrees that, except as otherwise provided herein, such data will not be released to individuals or entities other than the Member to which the data relate or such Member s authorized representative, except as required by law or as may be required by order of a court having jurisdiction over the Member. The voluntary benefits administrator also agrees that the City has the right to use and disclose all medical, financial and other patient-specific data pertaining to members and the voluntary benefits as defined by law and upon providing appropriate assurances as to compliance with HIPAA and other privacy standards. K. Insurance/Liability To protect the City or any of its affiliates or Members from incurring liability for payment of any fees and costs which are the legal obligation of the voluntary benefits administrator, the voluntary benefits administrator agrees to maintain and demonstrate the maintenance of all of the following protections: MERCER 10

14 i) Insolvency insurance at an amount, which is sufficient, based on relevant industry standards, to cover obligations of providers for services provided to members. ii) Liability insurance at an amount, which is sufficient, based on relevant industry standards, to cover obligations of providers for services provided to members. iii) Contractual arrangements with health care providers affiliated with the voluntary benefits administrator prohibiting such providers from holding any Member liable for the payment of any fees, other than co-pays and deductibles as set forth in the Plan. iv) Other protections for its Members from liability as provided by applicable state or federal laws. L. Member Complaints The voluntary benefits administrator agrees to act promptly in response to complaints received from Members. The voluntary benefits administrator will maintain electronic and written records of all complaints. The records will include, but not be limited to, the date and nature of the complaint filed and the date and manner by which the voluntary benefits administrator responded. The voluntary benefits administrator shall have a grievance and appeal procedures for addressing complaints and shall make such process available when addressing complaints. The City shall have the right to inspect such written records, including transcripts of member telephone calls, during normal business hours by providing advance written notice to the voluntary benefits administrator. M. Hold Harmless/Unauthorized Claims The administrator(s)/carrier(s) will not charge against experience those claim payments not authorized under the benefit plan (except when authorized by the City in writing) if such payments were the result of error, negligence, reckless or willful acts or omissions by the administrator, its agents, officers or employees. The administrator(s)/carrier(s) will reimburse on an immediate basis any overpayments that were the result of error, negligence, reckless or willful acts or omissions by the administrator, its agents, officers or employees. The administrator(s)/carrier(s) will indemnify, hold harmless and save the City, its agents, officers and employees from liability of any kind or nature (including costs, expenses or attorney's fees) for damages suffered by any entity or person as a result of error, negligence, reckless or willful acts or omissions of the administrator, its agents, officers or employees. MERCER 11

15 N. Compliance The selected vendor must be prepared to assist the City with all state and federal compliance issues, including negotiating, in good faith, appropriate Business Associate and similar chainof-trust agreements and contractual provisions ( Agreements ) in order to comply with the HHS final health care privacy and security regulations and, if necessary, any applicable state law. These Agreements may include (i) addenda to the vendor contract to provide the required Business Associate contractual provisions under the HHS privacy and security regulations and (ii) similar Business Associate agreements with any subcontractors (as approved by the City) of the selected vendor and other service vendors to the City and the City s voluntary benefits, as necessary. Vendors must demonstrate their capability and plan for compliance with all federal regulations governing employer-sponsored voluntary benefits. MERCER 12

16 3 General Questionnaire Confirmed Requirement Yes No Explanation 1. The effective date of the contract will be January 1, The first contract year will run from January 1, 2014, through January 1, The vendor agrees to an annual renewable contract with guaranteed rates for a minimum of three years. 3. The original proposal that is submitted to the City of Overland Park by your organization as well as any follow-up information or correspondence (oral or written) transmitted to City of Overland Park during the proposal process will be binding. All material submitted during the proposal process becomes the property of City of Overland Park for their use. 4. Future rate adjustments, following the completion of any rate guarantee period, will be communicated in writing at least 120 days in advance of the effective date and will include a complete description of the methodology used MERCER 13

17 Confirmed Requirement Yes No Explanation 5. The selected vendor shall be required to indemnify and hold the City of Overland Park harmless from all claims liability, losses, and causes of action, which may arise out of the vendor s performance, or non-performance of its obligations under the contract. Further, the vendor selected shall pay all claims and losses of any nature whatsoever in connection therewith, and shall defend all suits in the name of the City of Overland Park when applicable, and shall pay all costs and judgments which may issue therefore except those caused by sole negligence of City of Overland Park officers or employees or agents. The selected vendor agrees to accept claim fiduciary responsibilities including final appeal decisions. 6. Provide quarterly experience reports within 30 days of the close of the reporting period. 7. The selected vendor shall comply with all laws, ordinances, and regulations applicable to the services contemplated herein. By responding to this RFP, you are stating that you are familiar with all federal, state, and local laws, ordinances, code rules, and regulations that may in any way affect the services and products to be provided. 8. The City of Overland Park has the right to terminate the agreement in the event of a change of ownership of the vendor. MERCER 14

18 Confirmed Requirement Yes No Explanation 9. Vendor will be available to attend meetings or teleconferences to discuss the business relationship, upon the client's request. 10. The vendor s designated intake team will be fully trained in both customer service skills and the nuances of the City of Overland Park plans, policies, and programs. Training may be conducted with the City of Overland Park personnel oversight. 11. The vendor will provide sample contract/policy for all requested services. 12. The vendor must be able to perform on-site enrollment meetings. If there is any additional cost, please specify. Organizational Overview Please complete the following: Organization Name: Primary Contact/Representative: Secondary Contact/Representative: Title: Address: Office Telephone: Address: ( ) Mobile: ( ) In a short summary, provide an overview of your organization. Key elements to include: MERCER 15

19 When and Where Organization was formed Key Milestones Total Annual Revenue Number of Employees Primary Lines of Business and Revenue Headquarters and Key Locations Executive Management Provide your most recent financial ratings from the following rating agencies, as well as the date of the rating. Carriers are required to be A rated or better: 1. Standard and Poor s: Moody s: A.M. Best: Fitch: Rating Date of Rating Indicate how long your organization has been operational for the services that you are proposing to City of Overland Park. Response: Which services do you subcontract? Provide brief details of how and by whom these services are provided and your role in managing their delivery. Response: Define the nature of any existing contractual relationships you currently have with City of Overland Park, or City of Overland Park subsidiaries. Give a brief description of these contracts and financial value in terms of premium, where possible. Response: MERCER 16

20 If your organization has been involved in a merger or acquisition within the past three years, specify when the merger took effect, and how you have or will assimilate(ed) operations, account management and claims and clinical systems into your organization. Response: General Strategic Direction How do you differentiate your capabilities from your competitors? Response: Account Management Provide references for three clients (one of which has recently terminated) for which your organization provides services similar to those requested by City of Overland Park. The references should be of similar size as City of Overland Park. For each reference, provide: Client Name Client Address Primary Contact Title Telephone Number Address Number of Employees & Retirees Scope of Services Client #1 Client #2 Terminated Client Please provide the following information for the individuals from your organization who would be primarily responsible for providing account management, ongoing services and network issues, including the dedicated client services representatives, for City of Overland Park: Name Role(s) Location MERCER 17

21 Name Number of Current Accounts Current Account Membership Biography References Client #1 Client #2 Client Name Primary Contact Telephone Number Address Number of Employees & Retirees Scope of Services Implementation For the implementation manager who would be primarily responsible for the City of Overland Park implementation, please provide the following details: Name Years/experience as an implementation manager Location References/Recent Implementations Client #1 Client #2 Client Name Primary Contact Title Telephone Address Number of Employees & Retirees Scope of Services Provide an implementation plan including key dates for a January 1, 2014 effective date. Including your standard transition of care procedures. Response: MERCER 18

22 Claims and Member Service For Member Services, please provide: 2. Proposed Location(s) Proposed Member Service Hours Team Structure: Designated or Dedicated? Special Consumerism Team? Other (please explain) Number of Team Members Number of Accounts/Clients Serviced and Total Members Average and Median Tenure of Team Member Service Lead: Name Number of Accounts/Clients Serviced and Total Members Years/Experience Will the member service location(s) handle all proposed coverages (i.e. critical illness, vision, etc.)? Will the member service team be co-located with any other team members (i.e., claims, clinical, etc.)? How many member service representatives work from home? How many member service representatives are located off-shore? Member Services Indicate in the chart below your member service standards and results for the most recent two years. Standard All Locations Actual 2011 All Locations Actual 2012 Proposed Location Actual 2011 Proposed Location Actual 2012 Average Speed of Answer Abandonment Rate Call Blockage Rate MERCER 19

23 All Locations All Locations Proposed Location Proposed Location Standard Actual 2011 Actual 2012 Actual 2011 Actual 2012 First Call Resolution (% of calls without callbacks within 45 calendar days) Briefly describe the type and capabilities of your call documentation and tracking system. 3. Are all calls recorded? How long are recorded calls archived for? What types of calls do you document in your call tracking system? What percent of all member service inquiries are documented in your call tracking system? What percentage of member service calls is audited? Do claims and customer service staff have access to the same systems or have access to each other s systems? Response: For Claims Processing, please provide: Proposed Location(s) Proposed Claims Processing Hours Team Structure: Designated or Dedicated? Special Consumerism Team? Other (please explain) Number of Team Members Number of Accounts/Clients Serviced and Total Members Average and Median Tenure of Team Claims Processing MERCER 20

24 Claims Processing Lead: Name Number of Accounts/Clients Serviced and Total Members Years/Experience Will the claims service location(s) handle all proposed coverage (i.e., medical, Rx, BH, etc.)? Will the claims processing team be co-located with any other team members (e.g., member services, clinical, etc.)? How many claims processors work from home? Claims Processing How many claims processors are located off-shore? Provide claim statistics for the office that will service the City of Overland Park plan(s) for the most recent two years: Standard All Locations Actual 2011 All Locations Actual 2012 Proposed Location Actual 2011 Proposed Location Actual 2012 Claim Turnaround Time within 14 calendar days (10 business days) Claim Turnaround Time within 30 calendar days (22 business days) Financial (Dollar) Accuracy Payment Incidence Accuracy What is your standard overpayment recovery process for avoidable and unavoidable errors in which you are responsible? Response: MERCER 21

25 Billing Please describe the billing arrangements available to City of Overland Park. Are you willing to customize the billing arrangements? Response: Communications To what extent can open enrollment communication materials be customized with no additional cost? To what extent with an additional cost? 4. Response: 5. Please provide sample written/print communication materials that will aid members in plan usage and understanding the availability and capability of your resources. Response: Web Capabilities Which of the following services are currently available through your website? For those that are not currently available, which will be available by 2014 through your website? Are you currently integrated with PeopleSoft? Are you willing to fund integration costs to embed these programs into the PeopleSoft system for enrollment? Please note if this is a one time or annual contribution. Response: 6. Regarding the online materials and website your organization offers: To what extent will City of Overland Park be able to customize the online materials and website? Would you be willing to waive charges for customizing these online materials for City of Overland Park? MERCER 22

26 To what extent will City of Overland Park be able to customize the online materials and website? Can you support single sign-on from City of Overland Park intranet? Is there a fee for single sign-on? Can this be waived for the City of Overland Park? For single sign-on, can you accommodate use of another employee identifier that is not SSN? Reporting and Data Provide a list and samples of the reports (electronically, in Excel or PDF) included in your standard reporting package available (if any) and the frequency of the reports. 7. Response: MERCER 23

27 APPENDICES Appendix A: Census Information Appendix B: Critical Illness and Vision Plan Design Workbook Please provide rates in the attached workbook, which includes two tabs (Critical Illness (CI) and Vision). MERCER 24

28 Mercer Health & Benefits LLC 2405 Grand Boulevard, Suite 900 Kansas City, MO Services provided by Mercer Health & Benefits LLC. California Insurance License 0E75483