RFP #16-BA121 HMO, PPO, and HSA/CDS Medical Programs Addendum 1 - Vendor Questions

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1 RFP #16-BA121 HMO, PPO, and HSA/CDS Medical Programs Addendum 1 - Vendor Questions Q1: Will notification be sent when addenda are released? A1: Notification will be sent to all Vendors who provided questions when the addendum has been posted on the District Purchasing website. Q2: Which census should be used for the Geo-Access report? Page 16 of the RFP mentions a SBCC Census, but only an Active Census and a Retiree Census seem to be present. A2: The Active Census and Retiree Census combined make up the SBCC Census. Q3: On the Hospital Networks tab in the proposal response form, please clarify what Geographic Area # 1 (Cell 10) is requesting. A3: Geographic Area #1 is Clay County Q4: On Line 181 of the Questionnaire the question reads as follows: Is the HSA debit card the same as the FSA debit card? (i.e. If at Open Enrollment, a former HCFSA participant elects the HSA plan, will their existing HCFSA card be loaded with their new HSA elections?) What does HCFSA stand for? A4: HCFSA is Health Care Flexible Spending Account. The District is looking to determine whether an employee will receive a new debit card for the HSA at Open Enrollment if they had a debit card while participating in the prior year s Flexible Spending Account. Also please indicate whether your vendor uses the same debit card for FSA and HSA services (i.e. a stacked card). Q5: Are you able to send the questionnaire in a Word document? A5: No. Vendors must complete the Questionnaire in Excel format, as specified in the RFP. Q6: How many employees are currently enrolled in FSA? A6: There are a total of 706 participants. 43 are in Dependent Care FSA, 542 participate in Health Care FSA, and 121 contribute to an HSA. Q7: Is there a ProShare Agreement or ability to retain a percentage of a surplus from positive claim experience currently in place? If so, How much has been received in previous years and what is expected at end of contract year? A7: The District entered a ProShare Agreement beginning in 10/1/2013 for plan years 2013 and The ProShare surplus will be calculated in January. Currently the District is not expecting a surplus payment. Q8: Will the contribution strategy for each plan stay the same for ? If no, will it increase or decrease per each plan? A8: The contribution strategy is subject to collective bargaining, it is unknown at this time if the contribution strategy will change for Q9: May we have the Large Claims information for each benefit plan in place currently? A9: The plan is indicated on the HCC report. Vendors may use the following key for mapping the claimant by plan:

2 PPO HMO H.S.A Single H.S.A Family C01 C02 R05 R06 R01 R02 R07 R Q10: Can you provide a description of the current incentive based wellness program in place today as well as who funds the incentives? A10: The incentives are funded through the Wellness budget. The wellness program (Better You For Blue) provides free biometric screenings, health coach, smoking cessation and weight management programs, and educational programs. The wellness program includes a points-based incentive program for participating in certain wellness activities across the District. The points program is accessed through the member website and points can be accumulated up to $25 in value. Aggregate reports have been made available to the District, however the impact of the current program has not been measurable. Vendors are encouraged to provide details on how their wellness capabilities can directly improve the wellbeing of the employees. Q11: May we have NDC codes listed for formulary disruption? A11: Yes, see the addendum attachment Top Rx with NDC Q12: May we have the full Tax ID numbers of providers/facilities to complete a Network disruption report? A12: We are not permitted to release the entire Tax ID number onto this public website for privacy purposes. Q13: Does the Office who signs have to be a corporate office or can our Florida Health Plan CEO sign? A13: Any corporate representative who has authority to execute the terms of the submitted proposal may sign the RFP (i.e. CEO, CFO etc.). Q14: What is the contribution strategy for the H.S.A.? How much is funded? A14: The District does not contribute to the Employees Health Savings Account. Q15: What is included in the administration of the FSA? Debit Cards, reporting, etc. A15: Debit card, online tools for participants to substantiate claims via claim feeds from medical, dental, and vision carrier, reimbursement processing, plan sponsor utilization reporting quarterly or as requested. Q16: Is a current incentive based Wellness program in place? A16: Yes. Employees are eligible for onsite biometric screenings and financial incentives associated with participating in various wellness activities.

3 Q17: The RFP states the proposal is to be returned to the School Board, will Aon also need a copy? A17: No all submissions should be delivered to the SBCC Purchasing Department only. Q18: If there is a need to provide clarification to the TERMS AND CONDITIONS section of the insurance_rfp_16-ba-121 PDF file should a clarification/deviation word document be created and added to the table of contents with the Attachment A Supplements? A18: Deviations from the Attachment A Questionnaire and worksheets should be identified within the Excel Explanations tab. Please submit additional clarifications related to the SBCC Terms and Conditions on a separate document (Word is acceptable) and add to the Table of Contents Attachment A Supplements. Q19: For the required forms there was not a placeholder in the Attachment A Supplements for them, should they be included there or as a separate item in the response? A19: Please attach Required Forms and Attachment A Supplements as separate attachments within your complete response. Q20: Can you provide a listing of your preventable drugs covered at 100%. Please confirm what plans this list applies too as well. A20: The list of no-cost prescription drugs differs by Plan. The HMO and PPO members have access to the attached Addendum No Cost Drugs_HMO and PPO. The HSA participants access the attached Addendum No Cost Drugs_HSA only Q21: There is not a spot a placeholder in Attachment A for the Vendor Acknowledgement Form. Is that to be returned with the other requested forms? A21: Yes, please return the Vendor Acknowledgement Form behind the Title Page. Q22: Please confirm that a non-officer individual with the authority to bind a contract is sufficient to sign all applicable signature documents required for this RFP submission. A22: Confirmed. Q23: Please confirm that in order to minimize printing, we can provide large attachments and requested samples and brochures on CD-ROM. A23: No, please provide all attachments on flash drives. Q24: Please confirm if we can provide 12 CD-ROMs instead of 12 flash drives. A24: No. Please provide 12 flash drives. Q25: Please provide the top 10 hospitals currently being utilized with dollar amounts spent. A25: This information is reflected in the Provider Disruption tab. Q26: Please provide the top 25 providers currently being utilized with dollar amounts spent. A26: This information is reflected in the Provider Disruption tab.

4 Q27: Please provide information concerning current wellness programs, services and incentives, as well as how they are being funded and what measurements are in place to track efficacy. A27: The incentives are funded through the Wellness budget. The wellness program (Better You For Blue) provides free biometric screenings, health coach, smoking cessation and weight management programs, and educational programs. The wellness program includes a pointsbased incentive program for participating in certain wellness activities across the District. The points program is accessed through the member website and points can be accumulated up to $25 in value. Aggregate reports have been made available to the District, however the impact of the current program has not been measurable. Vendors are encouraged to provide details on how their wellness capabilities can directly improve the wellbeing of the employees. Q28: Please confirm if page numbering can restart within each tab of the proposal. A28: Confirmed. This is acceptable. Q29: Please confirm if Attachment A should be printed in only the original or all of the hard copies as well. A29: Please include the printed Attachment A in all copies. Vendors responses within the Attachment A Excel file constitute the complete response. Q30: Please provide Tax Identification Numbers for the Provider Disruption reports in Attachment A. A30: We are not permitted to release the entire Tax ID number onto this public website for privacy purposes. Q31: Page 1 of the RFP: SEALED RFP: All RFP sheets, requested documents, and this form shall be executed and submitted in a sealed envelope. (Do not include more than one RFP per envelope.) Please confirm if this is referring to including more than 1 binder in an envelope or more than 1 type of RFP with a separate RFP #. We want to be sure it is acceptable to provide all 6 binders in 1 box for delivery. A31: Yes, it is acceptable to place all 6 binders in one box for delivery. Q32: Please provide NDCs (National Drug Codes) for the top 100 drugs listed in Rx Top 100 Utilization and Rx Top 100 Spend tabs? We will need this information in order to be able to complete the tier analysis/formulary disruption. A32: See the addendum attachment Top Rx with NDC. Q33: Are we providing a Post 65 Medicare Advantage proposal for the Post 65 retirees? (Currently Post 65 retirees are covered under the active plan). If yes, please specify if MA, or MAPD. Also specify required benefits. A33: No. Q34: How many FSA participants does the School Board of Clay County have today? A34: There are a total of 706 participants. 43 are in Dependent Care FSA, 542 participate in Health Care FSA, and 121 contribute to an HSA. Q35: (FSA) Are they using a debit card? A35: Yes

5 Q36: Can you provide a sample of all reporting that is currently being received on the FSA and advise the frequency? A36: The Insurance Department has access to online reports and can pull them as needed. Sample reports are not included in this Addendum. Proposers should address their capabilities in this function. Q37: Do they want a COBRA and Direct Bill proposal quote as well? If yes, please confirm the additional questions related to those products below: a) How many current and pending COBRA participants are there today? b) Who handles COBRA administration today? c) What is the average number of initial COBRA notices per month?. d) What is the average number of COBRA Qualifying Event Notices per month? e) How many Direct Bill participants (retirees) are there? A37: No, the SBCC is not requesting COBRA or Direct bill services. Q38: Please describe the specific role/function of the dedicated on-site resource, currently provided by Florida Blue, which vendors are to replace. A38: Provide support for employee questions, coordinate wellness events, answer calls, attend meetings, provide support during all pre-employment meetings, and provide overall plan support to the District, as directed by the Insurance Department. The onsite representative will be expected to lean the jobs and responsibilities of the Insurance Department and be willing to assist the Department in fulfilling daily functions. Q39: Are claims over the pooling point included in the experience? What is the current pooling point? A39: Yes. Currently the plans have a $295,000 Pooling Level. Q40: Please provide more information on all claimants over $50k on the large claim report, such as diagnosis and prognosis and identify which plan each claimant is on. If possible please provide case notes. A40: Prognosis is not available. The plan is indicated on the HCC report. Vendors may use the key from Question 9 for mapping the claimant by plan. Q41: Please confirm what type of programs you currently have in place (Disease Management, Maternity Management, Online Health Records, etc)? A41: The current program includes Disease Management, Health Risk Assessment, biometric screenings, Care Coordination, Transition of Care, Centers of Excellence, nearsite Health Management Centers, online Health Record. Q42: Please provide claims experience broken out by actives, pre-65 retirees and post-65 retirees by plan for the most recent 12 month period if available. Also provide large claims broken out by actives, pre-65 retirees and post 65 retirees with prognosis and diagnosis for the same time period. A42: The structure of the medical plan prevents a breakout of pre and post 65 individuals. Individuals noted with an R01 or R02 in the Division code are retirees, but not necessarily over 65.

6 Q43: Please indicate if any benefit plan changes were made at the most recent renewal. If changes were made, please detail the benefit changes or provide benefit summaries for the previous plan year. A43: No changes were made to the HMO Plan or PPO Plan from the 2014/2015 plan year to the 2015/2016 plan year. The HSA was introduced for the first time beginning 10/1/2015. Q44: In the census there are some subscribers that are labelled as having 2 employees work for the County. In an example where there is an employee and spouse both working for county, is the vendor billing 2 employee single rates, or 1 employee spouse rate? A44: Employees who are married to another SBCC will elect Employee + Spouse coverage and will receive two District Subsidies for their election. The District s benefit administration system maintains the primary employee who will have contributions withheld from their pay. Q45: With regard to the out-of-pocket maximum, on or after January 1, 2015 plans will have two options to maintain compliance with Health Care Reform. Is it your intent to: a. Integrate medical and pharmacy OOP maximum that does not exceed the statutory limit? And expect Aetna to maintain an integrated OOP maximum for those plans? Or, b. Non-integrate medical and pharmacy OOP maximums that collectively do not exceed the statutory limit and offer plans that contain separate medical and pharmacy OOP maximums? A45: Medical and Rx costs should be integrated to accumulate toward the OOPM. The 2016 HSA Medical Plan must be proposed as an ACA compliant plan with required plan changes in this benefit feature. Q46: Page 18 #4 Respond clearly and concisely to all questions in the questionnaire section without referring to additional materials If the response is more than space allowed, can we add supplemental document and if so, how should we name it and refer reader to additional document. A46: If space is limited, broad explanations can be provided in the space provided and additional explanations should be provided on the Explanations Tab. Vendors are permitted to attach additional details, titled and referenced by name. Any and all deviations to plan design or medical program should be clearly highlighted in the Excel document. The District wished to avoid searching through additional materials to discover a plan discrepancy. Q47: Please provide the password to unprotect the excel disruption tabs 12 and 13 in Attachment A. A47: We have attached an updated, unlocked disruption report Provider Disruption_Unlocked. Vendors must not modify the report in any way with their submission.

Avondale Elementary School District #44

Avondale Elementary School District #44 ADDENDUM NO. 1 Request for proposal solicitation # 16-001 December 18, 2015 This Addendum No. 1 is hereby made a part of the contract documents and shall be included