The City of Henderson

Transcription

1 The City of Henderson P.O. Box 716 Henderson, Kentucky Finance Department Phone: FAX: A. Overview October 19, 2014 Request for Proposal Number Employee Benefits Broker/Consultant The City of Henderson, Kentucky (hereafter referred to as the City ) is seeking the services of a benefit advisory firm to assist in strategically planning, implementing, and communicating a comprehensive employee benefits program which includes, but is not limited to employer sponsored benefits which include health, life and cancer insurance, as well as voluntary benefits such as dental, accident and disability insurance. Approximately 460 employees and their families (approximately 590 dependents) are receiving benefits under the City s plan. B. Background The City is a municipal local government employer, consisting of Police, Fire, Public Works, Parks, Gas, Mass Transit, Administration/Support Services department employees. The City also provides health plan coverage to the City s municipal electric utility and water utility employees. For fiscal year the City has: 313 budgeted benefit eligible employees 5 benefit eligible elected officials 93 budgeted benefit eligible water utility employees 44 budgeted benefit eligible electric utility employees 11 benefit eligible appointed utility board members and electric utility attorney C. Scope of Services Please review that your firm may provide the following scope of services relative to those benefits by acknowledging them in your RFP response. 1. Participate in the development of cost containment and managed care strategy for all employee benefits. This may be with current and any proposed future benefits. 2. Provide on-going consultation and advice on coverage s, including implementation of any recommendations. 3. Review aggregated claims from the standpoint of loss ratio, analysis of claims, expense and other factors, and report the results of such quarterly reviews to the City. 4. At the request of the City, prepare specifications and requests for proposals to be submitted to prospective carriers/providers.

2 5. At the request of the City, analyze proposals received from carriers in terms of premium, retention, policy provisions, administrative services, capacity to handle the risk, and submit such analysis along with recommendation as to the carriers to the City. 6. Consult with the City team when called upon throughout the year on any matters pertaining to the operation of the City s employee benefit program. 7. At the City s request, produce probable cost of actual or hypothetical changes in the employee benefits program. 8. Participate in negotiations with carriers regarding premium renewals and conditions. 9. Review and evaluate periodic reports of claims experience, premiums paid and other statistical reports and report findings on a periodic basis. 10. Participate in the writing of employee benefit insurance contracts in cooperation with the provider, the City attorney, and City leadership team. 11. Provide such other services consistent with devising, adopting, administering or revising plans of employee benefit insurance coverage s for the City. 12. Provide services to evaluate and possibly establish onsite healthcare delivery. D. General Questions 1. List the name, title, mailing address, telephone number, and address of the contact person for this proposal. 2. Provide the history of your benefits advisory firm. 3. Describe the organizational structure of your firm. How many employees are there in your company, specifically relating to the scope of the RFP? Generally, what are their job categories (e.g., management, sales, technical, customer service, etc.)? 4. Who will be working directly with the City on benefits recommendations, administrative issues, questions, or problem solving? Please provide the roles and qualifications of each person. 5. Provide a sample set of your clients. List three references of similar scope to the City who already are utilizing your products and services. 6. Describe knowledge and experience of benefits advisory in the field specifically as it relates to government or other public sectors. Provide specific examples of cost savings achieved with clients. 7. How many clients do you currently represent for employee benefits? 8. Describe the form of professional liability or errors and omissions insurance carried by your company and the amount of coverage. 9. Describe the form of cyberliability/hipaa insurance carried by your company and the amount of coverage. 10. Describe any current activity that may affect the ownership and/or operation of your company. E. Account Management & Communication Services 1. Describe your account services model. 2. What is your process for ensuring customer satisfaction? 3. Do you provide employee communication services for your clients employees? If so, please provide a general description of your capabilities. Please provide a sample of the employee communication materials that you use for other similarly situated clients. 4. Please give examples on how your organization would help with the on-going education and health awareness of the City s employees. 5. How can you assist in facilitating employee meetings and annual open enrollments?

3 6. Please describe your role in the claims appeal process. F. Legislative / Compliance 1. What type of services or applications do you provide to help keep our HR staff informed on issues such as Patient Protection & Affordable Care Act (PPACA), COBRA, HIPAA, or other important employee benefit issues? 2. How do you support your clients in ensuring their employee benefits programs remain compliant with all federal and state laws and regulations? 3. How does your firm assist clients with HIPAA compliance? 4. Describe how your firm maintains client records in a HIPAA secure environment. 5. Do you have in-house legal advisors or outside counsel who provide guidance to you and your clients? 6. Describe the methods you employ to disseminate information about current trends and legislation. Please provide examples. 7. What type of HIPAA training does your staff attend annually? 8. Has your firm had any HIPAA breaches? If so, please describe. G. Data Analysis 1. Do your provide benchmark data for your clients? 2. Does your firm provide financial data and updates for self-funded plans? 3. Does your firm have a means to validate TPA or PBM claims projections? 4. How will your firm help analyze and recommend vendors to the City? 5. Does your firm have experience in integrating and evaluating health and wellness programs with the health plan? 6. For any of the above questions that you answered yes, please provide us a sample report and/or analysis that you have prepared for another client. H. Strategic Planning/Vendor Selection 1. What resources do you have available to help us manage our benefits and outline a benefits strategy consistent with current and future business plans? 2. How will you help us with the competitive marketing and placement of our plans, including development of marketing specifications, identification of market conditions, evaluation of proposals, negotiations, and placement of insurance contracts for annual renewals? 3. Outline your ability to provide expertise and experience in the areas of health benefit plan analysis and design. Explain in detail the types of analyses you have conducted relative to benefits analysis and design. 4. Do you have experience working with wellness programs and integrating those types of programs into an employee health plan? Please describe your experience and successes associated with those types of plans. 5. Do you have experience with onsite healthcare delivery? Please describe. 6. Describe the analysis process of the existing benefit package and reviewing the benefit structure in order to be able to prepare proposals to insurance carriers. 7. Describe the marketing and approach and methodology for soliciting coverage quotations on behalf of the City. 8. Describe the methods/capabilities for analyzing renewal offer from current and prospective carriers.

4 9. Describe your experience in managing partially self-funded health plans. Describe your ability to market stop loss as well as a list of stop loss carriers with whom you have directly placed business. Provide a description of your relationships with third party administrators and PPO networks. Describe your ability to provide insight and advise in the management of prescription drug programs, including your philosophy regarding traditional versus passthrough, transparent pharmacy programs. Provide a list third party administrators and pharmacy benefit managers with whom you are currently working. I. Fees 1. Provide a description and amount of any and all fees/costs/expenses that will be assessed by your firm under this agreement. 2. List any and all circumstances that would result in a change of fees to the City. 3. The City desires to pay the successful respondent a flat annual fee. Please provide a proposed annual fee as well as details on fee guarantees for more than one year. 4. Describe your firm s policy on accepting contingent commissions, or any other sources of income, revenue, consideration, compensation or overrides, in connection with services provided to your clients. 5. Describe your firm s disclosure policy. Provide disclosure of all types of compensation from any source, that you may receive in connection with providing service to the City, including but not limited to interface fees, access fees, administrative or marketing fees, interest income, rebates, bonuses, commissions and contingent commissions. The City reserves the right to select the most beneficial terms. 6. Please provide a sample broker/consulting contract. J. Licensure/Legal 1. Confirm that you hold all appropriate licensure(s) for providing benefit brokerage services in the Commonwealth of Kentucky. Provide a list of any other relevant licenses/certifications held by your organization. 2. What, if any, level of malpractice insurance do you require for each type of professional? 3. Describe how you and your providers keep employee data confidential. Is confidentiality mentioned in the contract? 4. What do you do to insure proper compliance, government filings, and/or legislative changes? K. Specifications 1. Criteria All proposals will be submitted in writing and will specifically address all of the requirements that are listed above. The selected broker/consultant shall be responsible for all items contained in the specifications. Criteria that will be used to determine award of the contract will include but will not be limited to the following: a. Account Management expertise including cost containment; b. Legislative/Compliance expertise for their firm and the ability to provide compliance assistance to the client with respect to federal, state and local laws and regulations; c. Self-funded and/or partially funded health plan experience with public sector employers; d. Strategic planning and experience with onsite healthcare delivery and data analysis;

5 e. The fee for broker/consulting services. Fee quoted must be guaranteed for at least a three-year period following acceptance. f. The qualifications and experience of the broker/consultant and support staff; g. The scope and degree of services provided; h. Thoroughness of the response to the RFP. 2. Consequence for Unsatisfied Requirements Failure to meet specifications as outlined or failure to provide any of the information asked for or addressed in this request in a manner which will permit thorough assessment of a broker/consultant may be grounds to reject any proposal. 3. Contract Term and Effective Date The broker/consultant contract for the City will cover a three-year period and will commence on January 1, 2015 and will end on December 31, The contract will automatically renew for one (1) year term(s) unless either party gives ninety (90) days written notice of their desire not to renew. Multi-year contracts will be considered if offered. The contract may be terminated by either party without cause upon ninety (90) days written notice and with cause upon thirty (30) days written notice. 4. Disclosure The City reserves the right to reject individually or collectively all respondents and accept proposals in full or in part. 5. Contact Information Questions regarding any of the terms above should be directed to: Paul Titzer, Assistant Finance Director, by phone ext Address and Bid Submission Proposals should be sealed, marked Employee Benefits Broker/Consultant and submitted to: Robert Gunter, Finance Director, Henderson Municipal Center, 222 First Street, Henderson, KY Proposals must arrive at the above address no later than 4:00 p.m., local prevailing time, Friday, October 31, 2014, to be considered. Three copies of each proposal should be clearly marked and mailed to the address listed above. Any proposals received after the deadline will be returned unopened. Electronic Proposals will not be accepted. The proposals are being solicited pursuant to KRS 45A.370.