Avondale Elementary School District #44

Transcription

1 Avondale Elementary School District #44 ADDENDUM NO. 1 Request for proposal solicitation # December 18, 2015 This Addendum No. 1 is hereby made a part of the contract documents and shall be included with all proposals. Offeror shall acknowledge receipt of this Addendum No. 1 by including this page with all proposals, signing and dating the following statement: Addendum No. 1 acknowledged by: Firm: Representative: Representative Signature Date: Request for Proposal due date remains the same Tuesday, January 6, 2016 at 2:00pm Local Time. Request for additional information and/or questions from vendors are as follows. Information provided is what is currently available to Avondale Elementary School District. Addendum 1 Page 1 of 8

2 Avondale Elementary School District #44 REQUEST FOR ADDITIONAL INFORMATION AND/OR QUESTIONS BY VENDORS Medical Insurance/HSA Administration: Q1: On page 28 under Experience Information a Large Claim list has not been supplied for 7/1/ /30/2016. We would like to request the large claims for the current policy period 7/1/2015 6/30/2016. If a large claim report is not available, can you please indicate which claimants listed in the 7/1/2014-6/30/2015 large claims report are still active and the claims incurred for those members since 7/1/2015. A1: We have embedded an updated large claims report for the 07/01/ /30/2015 period and provided the most recent large claim report for the current period. LARGE_CLAIM_ to 0615.pdf LARGE_CLAIM_ to 1215.pdf Q2: On page 29, there is a statement that the group is considering eliminating the copay gold plan and making the value gold as their high plan and H.S.A. plan as their low plan. Please quote a $750 and $1,000 deductible plan as an option. For these options, is the intent to increase the deductible on the Value Copay plan from $500 to $750 or $1,000 and leave the other benefit levels as is (i.e., Copay s coinsurance, etc.)? If not, please clarify what benefits you would like quoted. Would you like the Out of Pocket maximum increased as well? A2: Please see below: Quote benefits that match the Value Gold Copay Plan using a $500/$1,500 deductible in-network with coinsurance at 75% in-network and the Out of pocket maximum at $5,000/$10,000 in-network. For out of network benefits, coinsurance percentage should equal 50%. Please match the value gold plan as closely as possible for the out of network benefits. Quote benefits that match the HDHP $1,300 using a $1,300/$2,600 deductible in-network with coinsurance at 80% in-network and Out of pocket maximum of $6,000/$12,000 in-network. For the out of network benefits, coinsurance percentage should equal 50%. Please match the HDHP as closely as possible for the out of network benefits. For the $750 plan design, please quote a deductible of $750/$1,500 in-network; $1,500/$3,000 for out of network. Please use a coinsurance percentage of 75% in-network and 50% out of network. For the out of pocket maximum please us $6,000/$12,000 in-network and $12,000/$24,000 for out of network. Please quote physician office visits at $40/$50 for PCP/specialist. Rx copays at $25/$40/$100 for generic, preferred brand and specialty drugs. For the $1,000 plan design, please quote a deductible of $1,000/$2,000 in-network; $2,000/$4,000 for out of network. Please use a coinsurance percentage of 80% in-network and 50% out of network. For the out of pocket maximum please us $6,000/$12,000 in-network and $12,000/$24,000 for out of network. Please quote physician office visits at $30/$40 for PCP/specialist. Rx copays at $25/$40/$100 for generic, preferred brand and specialty drugs. Q3: Please provide retiree claim experience for 7/1/13 6/30/14. Addendum 1 Page 2 of 8

3 A3: Monthly claim experience prior to 7/1/14 is not available within the ASBAIT Trust because it was consolidated within a retiree pool. This information is not broken out by District for reporting purposes. Beginning 7/1/14, separate claims data has been provided by ASBAIT and is included in the claim experience reports provided. Q4: Please provide claims experience from 11/1/13 1/31/14. It doesn t look correct on the active piece. Please have the correct claims sent over for both Medical and Rx or advise if we re incorrect. A4: Please see the revised embedded claims experience below: med exp report revised 1207.p Q5: Please provide current membership (including retirees) to make sure we re quoting the correct average contract size and estimating claims accurately. A5: We have included below an eligibility summary report by plan. ELIGIBILITY SUMMARY REPORT 1 Q6: Please confirm if the Silver plan Employee +Spouse rate and Employee +Child(ren) rates should be flipped. The Employee +Spouse rate is lower than the Employee +Child(ren) rate and it s usually the other way around. The other three plans have the Employee +Child(ren) rate lower than the Employee +Spouse rate so it looks it looks a little odd. A6: We have confirmed that the Retiree Classic Silver rates for the 7/1/2015 6/30/2016 plan year are as follows: Employee + Spouse is $1, and Employee + Child(ren) is the $1, Q6: ERISA Status: Can you please advise if the District is ERISA or Non-ERISA? A6: The District is not subject to ERISA. Q7: Renewal Rates: Will the renewal rates from ASBAIT be made available? A7: No, ASBAIT must submit a bid to the RFP and that serves as their renewal. Q8: Large Claims: Can you please provide a large claims report on a rolling 12-month paid basis? Also can you please make sure that the report contains the plan that the claimant was enrolled in at the time of the occurrence? A8: For the current plan year, there are no large claims at this time. Exhibit below is the large claims for the period of to as of Please note that A01 = Copay Gold Cobra; D02 = Classic Silver Retiree; E01 = Value Gold; and J01 = HDHP. Addendum 1 Page 3 of 8

4 Larg e Claims as of 12 Q9: Claim Experience Membership: Can you please provide member counts by month by plan? This is different from the provided employee counts. This information enables us to determine what the average contract size was during the experience period. If this is not available, can you please provide at a minimum what the current average contract size is? A9: Please refer to response to question 5 above. Q10: Out of Network Percentile: Can you please advise what the current R&C percentile or % of Medicare Reimbursement is on the Out of Network benefits for each of the current medical plans? A10: The Medicare Reimbursement is 80%. 11: Classic Silver Retiree Only SPD: Can you please provide a copy of the Summary Plan Description Document for the Classic Silver Retiree Only PPO Plan. The one provided in the RFP only shows the Copay Gold and Value Gold plans. A11: Please see the embedded document below: Retiree SPD.pdf Q12: Pharmacy Formulary: Can you please provide a copy of the current pharmacy formulary? A12: Please see the embedded document below: Catamaran Advantag e 3 Column Q13: Pharmacy Clinical Programs: Can you please provide a list of the current pharmacy clinical programs in place today (i.e. step therapy, prior authorizations, quantity limits, etc.)? A13: The current clinical program includes quantity limits, step therapy, compound drug management, specialty drug management, mandatory mail order for maintenance drugs to receive 3 month supply at 2 month copay. Q14: References/Performance Evaluation Survey: Would it be acceptable to the District if we provided a list of references requested and submit the Survey form upon selection as a finalist? We value the privacy of our current and former clients and we feel that asking them to complete this Survey form at this stage of the process would be too burdensome. A14: Part of the evaluation and scoring process is based on references we recommend you follow the RFP. Employee Assistance Program: Q1: Regarding the submission requirement on pag3 23 and page 25. In reference to the 3 rd bullet, is the 3 rd bullet simply referencing the same original actual proposal as the 1 st bullet? If not, please clarify. A1: Yes. To clarify, you will submit one original proposal and two copies. Each of these proposals (total of 3) should include an exact copy of your proposal in MS Office format. For example, the questionnaire is a word Addendum 1 Page 4 of 8

5 document, you must include this in your electronic copy in a word document, not a pdf. If the document is an excel document, you must include this as an electronic copy in the excel format, not a pdf Q2: In reference to page 25, in Tab 1, we will include the Certified Proposal Response forms (questionnaire and evaluation attached on page 30 in #7). We are responding for EAP only. Would you like the additional forms Submission Document, page 41 and Reference Evaluation on page 42, placed in Tab 1 or Tab 2? A2: These forms may be placed in Tab 1. Q3: In reference to page 25, Tab 5, do you want a page stating that an electronic copy is included? A3: This is optional, however, the actual electronic copy must be placed in Tab 5. Basic Life/AD&D Voluntary Life Dependent Life: Q1: Can you please provide an updated census with clarified class descriptions? Currently, the policy defines classes as the following: Class 1 Administrators working a minimum of 30 hours per week; Class 2 All other full time employees working a minimum of 30 hours per week; and Class 3 Part-time employees working a minimum of 15 hours per week. Currently, the census lists classes as: Administrators, Classified, Certified, and PPACA Variable hour employees. There is no reference to full time or part time status. A1: Please see the following clarification on classes for the life products: Class 1 All employees listed as Administration. Class 2 All other employees working 30 hours or more per week. Employees identified as Certified, Classified, or PPACA are in this Class. For the PPACA employees, they are included on the census (a total of three employees). Class 3 All part time employees working 15 hours or more per week. We have embedded the part-time employee census below that is in addition to the original census that was provided at the time the RFP was released. 15 Part Time Employee De-identif Q2: The plan design shows Class 3 with a Flat $10,000 benefit, but on the census there are only 3 employees with a Life benefit of $10,000 and their salaries are showing as $10,000. Is there anyone on the census who should be in Class 3, Flat $10,000 life benefit? If so, can you please identify? A2: Yes, there are part-time employees for Class 3 that were not included in the original census. The three employees with a life benefit included on the original census are PPACA variable hour employees. These individuals are eligible for the Flat $10,000 benefit. Q3: There are retirees on the medical census, but not on the life census. We want to confirm that the basic life does not include retiree coverage. A3: After reviewing the certificate booklet which was provided in the original RFP, page B clearly states that coverage terminates at retirement. Addendum 1 Page 5 of 8

6 Q4: The plan shows Class 3 with a Flat $10,000 benefit, but on the census there are only three employees with a Life benefit of $10,000 and salaries of $10,000. Is there anyone on the census that should be in class 3, Flat $10,000 life benefit amount? If so, can you clarify who they are? A4: Yes, there are part-time employees for Class 3 that were not included in the original census. Please refer to answer 1 for the embedded part-time census document. The three employees with a life benefit included on the original census are PPACA variable hour employees. These individuals are eligible for the Flat $10,000 benefit. Supplemental Worksite Individual Insurance: Q1: What type of worksite products would you like to see quoted? How would enrollment take place? Do they have any worksite products in place now? A1: We have included a worksite evaluation. Please include quotes for each of the following products if offered: accident, cancer, and critical illness. These benefits are currently offered by Aflac. Q2: The RFP asks for worksite benefit, but does not provide products or plan designs. Does the group currently have worksite benefits inforce? If so, can you provide worksite benefits or certificates, a recent bill and rates? If not, what products and plan designs would they like to see? A2: We included a worksite evaluation in the RFP for you to complete on the products you are offering. Please provide quotes for accident, cancer and critical illness. Please see the embedded document below for additional information: Avondale School District -Aflac plans.p Q3: What is your current method of enrollment of your core benefits? Paper or electronic? If electronic, what is the name of your enrollment system that is utilized? A3: Electronic, BenefitsCONNECT is the enrollment system utilized by the district. Q4: Will you allow face to face meetings with your employees to explain the enrollment of voluntary benefits? Will these be required or voluntary meetings since it would be a new offering? A4: At this time, it has not been determined if the District would allow face to face meetings. Q5: How many classifications do you currently have with your existing basic and voluntary life coverage? Does the benefit amount vary by these classes? A5: There are three classes and the benefits doe vary between classes as outlined in the RFP and its embedded documents. Q6: Do you currently offer any type of short term disability coverage for your employees? Is this group or individual coverage? What is the elimination and benefit periods if such coverage is currently inforce? A6: The District offers Voluntary Short Term Disability on a group platform. However, this benefit is not currently being bid at this time. Q7: What will your medical deductible and co-insurance be for the next year? Is your medical plan a high deductible health plan? A7: Please note that within the RFP document, the benefit summaries for the current and past medical plans have been included. It has not been determined what plans will be offered next year. Addendum 1 Page 6 of 8

7 Q8: Would you welcome a company that could enroll and communicate all of your benefits to your employees at no cost? A8: It has not been the practice of the district to have one on one enrollments and we do not see that position changing at this time. General Questions: Q1: If we are the incumbent carrier, must we respond to the bid or can we submit the renewal? A1: You must respond to the bid, your response will act as your renewal. Q2: Regarding the submission requirement on pag3 23 and page 25. In reference to the 3 rd bullet, is the 3 rd bullet simply referencing the same original actual proposal as the 1 st bullet? If not, please clarify A2: Yes. To clarify, you will submit one original proposal and two copies. Each of these proposals (total of 3) will include an exact copy of your proposal in MS Office format. For example, the questionnaire is a word document, you must include this in your electronic copy in a word document, not a pdf. If the document is an excel document, you must include this as an electronic copy in the excel format, not a pdf. Q3: Can we submit our proposal on a CD instead of a flash drive. A3: You must submit your proposal as outlined in the RFP on a flash drive. Q4: On the Excel Benefits summary document, instructions say to also provide a cd or disk; however, RFP instructions ask for a flash drive. Please clarify the electronic media required for the Excel Benefits summary document. A4: Please submit documents on a flash drive only. Q5: Which Tab should contain any signed addendums? A5: Please include acknowledgement of signed addendums in Tab 2. Q6: Many of our sample communication pieces and timelines are in pdf form. Can we includes those pieces in pdf format? A6: Yes, you may include these items as a pdf file. Evaluations and questionnaires need to be in the format of Excel and Microsoft Word. Q7: For file combination/printing purposes, we normally do combine files into adobe acrobat. To complete this submission with all forms, samples, documents, etc., we anticipate having files. Would it be acceptable to submit the complete package in an electronic pdf, and then in non-pdf files also attach 1) standard proposal document with letter, 2) certified proposal document: Questionnaire, and 3) certified proposal document: benefit summary? A7: Yes, you may pdf the complete package. However, for the questionnaire(s), evaluations, you must provide them in their original format (see answer 6 above). Q8: Is it sufficient to include all electronic versions on one type of media example, 3 flash drives for all electronic submissions. Addendum 1 Page 7 of 8

8 A8: As noted above in Answer 3 above, you must submit your proposal using a flash drive along with the hard copies as outlined in the RFP. Q9: In reference to page 25, in Tab 1, we will include the Certified Proposal Response forms (questionnaire and evaluation attached on page 30 in #7). We are responding for EAP only. Would you like the additional forms Submission Document, page 41 and Reference Evaluation on page 42, placed in Tab 1 or Tab 2? A9: These forms may be placed in Tab 2. Q10: In reference to page 25, Tab 5, do you want a page stating that an electronic copy is included? A10: This is optional, however, the actual electronic copy must be placed in Tab 5. Q11: Will you send out the embedded attachments? A11: If you have a specific reason why you cannot access the embedded documents, please let us know and we will see how best to get the documents to you. However, we do not plan to provide the documents separately as you should be able to access through Microsoft Word. Q12: On page 27 it requests sample documents as stated in proposal information and requirements. Which sample documents are being requested? There are none requested on pages 25 & 26 under the title: proposal information and requirements. A12: Please provide communication pieces, sample contracts, and any other material that you feel is valuable to the District and should be considered in the review of your proposal. Q13: Is it necessary to provide an original W-9 form? Or would a scanned form dated 11/9/15 suffice? A13: It is necessary to provide an original W-9 form. Addendum 1 Page 8 of 8