County of Sonoma. Request for Proposal (RFP) Health Reimbursement Arrangement (HRA) Administration Services. October 16, 2012

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County of Sonoma Request for Proposal (RFP) Health Reimbursement Arrangement (HRA) Administration Services October 16, 2012 Tom Morrison Senior Vice President (818) 956-6777 tmorrison@segalco.com The Segal Company 330 North Brand Boulevard, Suite 1100 Glendale, California 91203-2337 www.segalco.com

Section TABLE OF CONTENTS Page I. INTRODUCTION A. Timetable... 3 B. Objective... 3 C. Background... 5 D. Process... 8 II. III. IV. INFORMATION REQUEST A. QUESTIONNAIRE... 10 B. Cost / Pricing Proposal Sheet... 14 CONTRACT REQUIREMENTS A. Sample Agreement... 25 B. Term... 25 EXHIBITS A. Intent to Bid Form B. Plan Document C. Sample Contract D. Current Plan Statistics/Information i 5215964v2/10520.001

I. INTRODUCTION On behalf of the County of Sonoma ( County ), The Segal Company ( Segal ) is seeking proposals from your company with respect to Health Reimbursement Arrangement ( HRA ) administrative services. The current administrator of the program is FBMC/WageWorks Benefits Management. The County will be seeking bids from HRA administrators that can display experience and proven success at administering the proposed HRA program. The effective date for the potential takeover would be determined with input from the successful bidder during the RFP process based on the earliest possible date that a successful transition could be accomplished, but no later than January 1, 2013 for the receipt of on-going contributions. The transfer of existing assets may occur at a later time, depending upon the ability of the current custodial trust bank, Wilmington Trust, to liquidate the current investments, or transfer these over to a new custodial bank. Of critical importance to the County and the Eligible Participants are the following requirements. The County will prioritize the importance of these issues based upon the response of the bidders that express interest in the County contract. Your company s responses should emphasize your abilities in these areas: Ability to administer the plan as stipulated in the plan document Prompt credit of transferred amounts from the County to the Individual Accounts Ability of participants to view on-line account balances which are promptly updated to reflect deposits The administrative simplicity of operating the plan Single point-of-contract for resolving member issues with deposits and withdrawals Ability of the selected administrator to assist and effectuate a prompt transfer of existing accounts from the present administrator to your company Electronic submission of requests for reimbursement Debit card access to account balances for accounts eligible for reimbursement The customer satisfaction of existing customers of your firm and the longevity of the relationship with your company 2

A. TIMETABLE Release of RFP October 16, 2012 Submission of Intent to Bid Form October 23, 2012 Submission of Questions Submission of Proposal Until RFP Submission Deadline November 8, 2012 (4PM) PDST (See Section D) B. OBJECTIVE Through this Request for Proposals (RFP), the County is seeking proposals from HRA vendors with demonstrated experience in the administration of interest bearing individual HRA accounts, and providing investment management services to assume the responsibilities from the current HRA Administrator, FBMC/WageWorks. Scope of Services 1. The selected vendor shall provide HRA administration and investment services as follows: Administer HRA Plan according to plan rules (Exhibit B, Plan Document); Maintain participant information including all necessary data elements to ensure proper plan administration; Provide claims procedures information to enrolled participants when they retire or terminate and are eligible to submit expenses for reimbursement; Promptly credit contributions to participant accounts and update account balances within 48 hours of receipt of transmittal; Provide on-line portal for the County and participants to view all transactions and balances; Process participant requests for reimbursement according to plan and IRS rules, preferably with an on-line submission system; Maintain records of the County s contributions, interest income, benefit payments and other administrative fee deductions, and resulting account balances of County participants and report the same to the County in a format and frequency acceptable to the County; Prepare participating employees quarterly and year end reports of the contributions made by the County and the benefits paid to, or on behalf of participating employees under the plan. Reports may be made available electronically; Maintain records of all transactions under the Agreement during the term of the Agreement and subsequent periods in compliance with applicable Local, State and Federal requirements; 3

Provide debit card(s) and manage all debit card transactions for participants eligible to withdraw expenses for reimbursement; Provide online access to account balance information via a secure Internet portal both to plan participants and the County; Create, print, and stock all necessary forms to carry out plan operations; Establish any custodial trust agreements necessary for the financial transactions; Include in the monthly administrative fees, all expenses; Stay current on legal and regulatory changes affecting HRA plans and debit cards, and conduct internal audits of operations to assure compliance with policies and procedures; Conduct meetings at the County at least two times per year; Manage the transition from the current administrator (WageWorks/FBMC), record keeper (Accu-Record) and custodial trustee (Wilmington Trust Bank); and Provide weekly transition status calls with the County during plan implementation. 2. The selected vendor shall provide the County with the information in its custody for use in preparing all returns and reports that are required by the Internal Revenue Service, the Department of Labor and any other federal or state agency. The selected vendor shall assist in the preparation of such returns and reports whenever called upon to do so by the County. 3. The selected vendor shall provide the following additional services: Provide employee communications material in ready-to-print format such as benefit booklets, newsletters or similar informational materials, webaccess to interactive information, new participant letters and informational packets, etc.; Stay current on legal and regulatory changes affecting HRA plans and advise the County of any regulatory, legal, or procedural change; and Handle the intake and review of all customer service inquiries and appeals. 3. Charges are to be stated on a per participant account per month basis. If you are unable to quote fees except based upon assets or account balances although your quotation will be accepted, this basis is not the preferred method. 4. Should you require alternative payment methods, please provide a detailed description of your proposed fee structure in the Cost Section (Section II, B) of this RFP. 4

C. BACKGROUND The County of Sonoma is the employer to over 4,000 employees in a wide variety of professions including law enforcement, social work, health and mental health care, building inspection, road maintenance, parks, general administration, etc. County employees work within twenty-eight departments or agencies of the County. Current HRA Plan - Overview The County established its current HRA Plan as of January 1, 2009. The Plan is intended to qualify as an employer-provided medical reimbursement plan under Code sections 105 and 106 and regulations issued thereunder in the form of a health reimbursement arrangement in accordance with Internal Revenue Service Notice 2002-45. In addition, the assets of this Plan shall be held in a trust established under Code section 115 and shall be an irrevocable trust under applicable law of the State of California. The Trust Fund established under this Plan and the assets thereunder will not be used for, or diverted to, purposes other than the exclusive benefit of Participants. Eligibility: All regular full-time and certain part-time employees of the County with an original hire date of January 1, 2009, or after are eligible to participate. Only Eligible Employees who meet all of the following requirements are eligible to participate in the Plan and have employer contributions made to an HRA Account: a. Have completed two (2) full years of consecutive regular service with the County (defined as 52 consecutive pay periods in pay status, excluding overtime) as an Eligible Employee; and b. Are contributing members of (or members who have contributions made on their behalf to) the Sonoma County Employees Retirement Association for the duration of the period described in subsection a. above. c. NOTE: Further expansion of the HRA program is explained later in this RFP. Contributions: Once an Eligible Employee has met eligibility requirements, the County shall make an initial contribution, as described in subsection a. below, and an on-going contribution, as described in subsection b. below, to the Eligible Employee s HRA Account. All Employer contributions made shall be paid to the Trustee for deposit into the Trust Fund in accordance with the terms of that document. Eligible Employees are immediately 100% vested in the contributions made to their HRA Accounts. a. As of the first pay date following the date an Eligible Employee has met eligibility requirements, the Employer shall make a one-time, lump sum contribution equal to $2,400 for full-time employees. The lump sum contribution for part-time Eligible Employees shall be pro-rated. The eligibility period for a full time employee is two years from the date of employment, pro-rata for less than full time employees. 5

b. For each pay period after the initial contribution is made, the County shall contribute $0.58 per hour the Eligible Employee is in pay status to a maximum of 80 hours per biweekly period (excluding overtime hours), including for periods of qualified leave with pay. Please refer to the Plan Document for additional Plan rules and details. Special Participation Rule: County employees who were eligible to retire and receive a monthly benefit from the Sonoma County Employees Retirement Association (including reduced and unreduced retirement benefits) and who actually terminated employment with the County from July 1, 2009 until September 1, 2009 received an retirement incentive and were eligible to participate in the Plan only for purposes of receiving a one-time employer contribution of approximately $25,000 to $30,000 made to an HRA Account. The deposits were immediately vested and available for HRA expense submission. Current Participation: Active Participates (Retirees) 50 Inactive Participates (Active Employees) 321 Current HRA funding/investment amount as of 12/31/2011 is contained in an attachment to this RFP New Hire Projection: o Current employee population: approximately 3,400 actives o 7% Annual Turnover o Projected Annual New Hires: 238 Plan Information/Statistics: Refer to Exhibit D Termination of Participation: A Participant will cease to be a Participant in this Plan upon the earliest of: a. The date the Eligible Employee s or former Eligible Employee s HRA Account is depleted; or b. The date the Eligible Employee or former Eligible Employee dies without a surviving Spouse or Dependents; or c. The date of termination of this Plan with respect to future contributions only. Future HRA Plan - Overview (In addition to the current plan) The County is in the process of negotiating with its represented employees the establishment of an HRA for active employees, to be effective April 1, 2013. This would apply also to all nonrepresented employees. Because these details are current under negotiation, the amount of the monthly contribution is not available for public disclosure, however, the estimated contribution 6

is from 2 3.5% of covered salary. These contributions would immediately be available to active employees to reimburse employee premiums or miscellaneous expenses allowed under sections 105 and 106 of the IRC. Amounts could also be deferred to future periods during or after employment. Amounts would be vested upon deposit by the County. These accounts will NOT be notional, but the County will make contributions on a 26 pay period cycle. Plan amendments will be drafted upon the completion of negotiations. Whereas the current retiree HRA plan balances may only be accessed by individuals postemployment with the County and meeting certain requirements (see Plan Document), this additional plan would be available for participant withdrawals while they are actively working for the County. The Plan is also intended to qualify as an employer-provided medical reimbursement plan under Code sections 105 and 106 and regulations issued thereunder in the form of a health reimbursement arrangement in accordance with Internal Revenue Service Notice 2002-45. In addition, the assets of this Plan shall be held in a trust established under Code section 115 and shall be an irrevocable trust under applicable law of the State of California. The Trust Fund established under this Plan and the assets thereunder will not be used for, or diverted to, purposes other than the exclusive benefit of Participants. Eligibility: It is anticipated that all eligible full and part-time employees of the County will be eligible to participate subject to the terms stipulated in the Memorandum of Understanding with the bargaining units representing employees. Contributions: For all Eligible Employees, the County shall make HRA contributions based upon what is negotiated with each individual bargaining unit (tbd). All Employer contributions made shall be paid to the Trustee for deposit into the Trust Fund in accordance with the terms of that document. Eligible Employees are immediately 100% vested in the contributions made to their HRA Accounts under this expanded Active Employee HRA plan. Please refer to the Plan Document for additional Plan rules and details. Projected Additional Participation: Anticipated number of eligible participants as of 12/31/2013: o All Active Full and Part-Time Eligible Employees: 3,400 Termination of Participation: A Participant will cease to be a Participant in this Plan upon the earliest of: a. the date the Eligible Employee s or former Eligible Employee s HRA Account is depleted; or b. the date the Eligible Employee or former Eligible Employee dies without a surviving Spouse or Dependents; or 7

c. The date of termination of this Plan with respect to future contributions, only. High Line Corporation s HRMS and Payroll solution INTERFACE WITH COUNTY The selected HRA vendor shall provide turn-key services and perform all necessary administrative and investment functions as requested in this RFP. The County will interact with the selected vendor and provide appropriate support, as follows: Provide specifications for the County HRMS systems (High Line Corporation s HRMS and Payroll solution). Determine eligibility and provide enrollment information to selected vendor. Transmit contribution information to selected vendor, at the end of each pay period. Perform contribution money transfers to selected vendor. Provide sufficient information for County Auditor-Controller, Treasurer, Tax- Collector to create adequate audit trail of deposits and transfers. D. PROCESS 1. Questions All questions should be directed to Tom Morrison or Robert Mitchell at The Segal Company at 818-956-6700 or by e-mail to TMorrison@Segalco.com or RMitchell@Segalco.com Inquiries are not to be directed to any individuals affiliated with or employed by the County. 2. Response Submittal a. RFP responders should submit the requested information in electronic format by November 8, 2012 4PM (Pacific Standard Time) i. Electronic copies to: TMorrison@Segalco.com; and RMitchell@Segalco.com ii. Three hard copies should be mailed to: Thomas Morrison c/o The Segal Company 8

330 North Brand Blvd., Suite 1100 Glendale, CA 91203 Hard copies may be received after the deadline. Electronic copies must be submitted by the deadline. 9

II. INFORMATION REQUEST A. QUESTIONNAIRE Provide an answer to each question and do not leave blank or unanswered questions. Answer the question as directly as possible and incorporate all information within the questionnaire section. Please avoid referring to attachments or collateral materials in lieu of answers. Do not include promotional materials. Clearly identify and label all supplemental attachments and collateral materials with the corresponding questionnaire section and question number. Submit your response electronically, using Microsoft Word or other compatible software in a writable format (no PDFs, please). Company History and Financial Profile 1. The firm name, mailing address, telephone number, and the name of the primary contact person and e-mail address. 2. Where is your company located and how long has it been operational? 3. Identify and include roles of all subcontractors you plan to utilize to fulfill the requirements of this RFP. What company will provide custodial banking, trust services. 4. Are you licensed to do business in the State of California? What other states are you licensed in? Organizational Experience and References 5. Describe your company s experience administering HRA benefits for public sector entities. 6. What percentage of your organization s total revenue is represented by the administration of HRAs? 7. Of your company's current clients, what three would be viewed as peer groups for the services requested by the County? Include the following information: a) Client name b) Principal location c) Number of covered participants d) Client contact including name, title and phone number e) Services provided please be specific f) Effective date of contract g) Verify whether or not the County (or Segal) may contact the client 10

8. List any clients that terminated the administration services of your firm. Include a contact and verify whether or not the County (or Segal) may contact the former client. HRA Administration 9. Please note any exceptions you wish to make to your ability to administer the plan as stipulated in the Plan Document. 10. If there are exceptions, what are your suggested modifications? 11. Do you agree to accept the Plan Document, as attached, as the administrative document for the plan? 12. Will you agree to the Terms of the Trust document, attached? 13. Will you illustrate your estimated, monthly fees for administering the two types of accounts: a) Active employees receiving contributions, but not eligible to request reimbursement for expenses b) Terminated or retired employees eligible to receive reimbursement for medical expenses and no longer receiving contributions 14. Indicate any special or extraordinary charges that you anticipate. 15. Are communication materials to members ordinarily included in your fee quotation? 16. Please submit a work plan outlining your ability and approach to providing the HRA administration services outlined in this RFP. 17. Provide a detail plan for transitioning account balances from the current administrator, FBMC and its custodial Trust Bank, Wilmington Trust, to your administration and trust account. The amount in each investment fund is included with the plan experience. 18. What company do you use to serve as your custodial bank? 19. What entity is the named Trustee on that account? 20. Will the funds for the County be segregated or pooled? 21. Can your firm charge all administrative fees, including banking fees to the participant account? 22. How often are these charges made? 11

23. Describe in detail the investment funds that you can make available to participants. 24. Do you have investment funds that are categorized by the amount of risk? 25. Are there opportunities for the County to recommend additional funds? 26. Do you have a default investment option for the immediate deposit of contributions should a participant not elect a particular investment option for contributions? 27. What alternative arrangement can you recommend that would inure interest to the accounts? 28. Describe in detail the process for the transfer of funds when requests are made for reimbursement or upon the establishment of a debit card for reimbursement. 29. Does the process vary should a debit card be issued from the normal method or reimbursement? 30. The County requests the following services be provided in administering the HRA program. Please complete the following table. Service Communication to plan members including telephone service Web-based on-line tool for enrollment information & inquiries Web-based on-line access to employee accounts Processing of requests for reimbursement, including eligibility verification including EFT and automatic payment of premiums Ongoing record keeping of accounts including quarterly statements Issuance of reimbursement drafts and pertinent documentation and EFT Yes Will your organization perform the following services? Indicate Employee notification of year-end No Explain the way in which you will provide each of these services 12

Service account balances Periodic accounting and statistical reports (include examples) for the County Banking arrangement for holding trust deposits to the HRA program Reconciliation, audit detail for the County Auditor Selection of Multiple Investment Options for participants Yes Will your organization perform the following services? Indicate No Explain the way in which you will provide each of these services If your proposal would not include all of these services, or would include other additional services, please describe in detail. You may refer in each of the answers above to exhibits, which are illustrative samples of the documents referenced in your answers. 31. Please describe your claim reimbursement process. 32. Are there provisions for online submission of claims? 33. Describe in detail if investment options are available to be selected by participants. 34. Provide a description of each of these options. 35. What are the historical returns for these options on a 1 year, 5 year and YTD basis? 36. Are there additional investment fees associated with any of these funds? If yes, please describe these charges Debit Cards 37. Do you provide debit card reimbursement capability? What is the additional cost to the participant for these services? 38. Describe your debit card services. Do you provide a proprietary card or do you use an outside vendor? 39. Describe which automatic electronic substantiation methods you use in detail: Copayments 13

HIPAA Recurring claims Real-time substantiation Inventory Information Approval System (IIAS) 40. Does your system presently meet requirements in the regulations issued pursuant to the HIPAA Security standards? B. COST This section should disclose all charges to be assessed by the County for the required services. All proposals must include a proposed fee schedule of hourly time charges for each class of personnel you would assign. If your fee schedule is calculated differently (for example, a per employee or flat rate fee), please describe and include the number of personnel provided at the scheduled rate(s). Proposals must detail any items in addition to personnel costs that will be charged to the County, such as travel costs and office expenses. Please also provide hourly time charges for additional services not included within the scope of routine services outlined in this RFP. Additional services would be undertaken only at the written request of the County. Describe any special services and/or benefits offered at no cost to the County. 1. Please confirm that: a. All fees are guaranteed for 36 months from contract inception. b. All future rate adjustments will be communicated at least 60 days in advance of the effective date. c. Your fees include printing of benefit statements, enrollment forms, benefits applications, and all other routine supplies and materials. Fees should include printing and mailing costs. 2. Detail your billing reconciliation responsibilities and procedures. The County will require that all reconciliations be performed by the successful vendor. 3. Confirm that you agree to perform the following functions in the event of cancellation: a. Guarantee a reduced or discounted post-termination administrative fee. b. Transfer all records to the Trustees or the successor administrator within 30 days of termination in a form that is acceptable to the recipient. Also, detail any rights reserved by your firm to call any additional funds. 14

TABLE 1A SUMMARY OF FEES EXISTING RETIREE HRA PLAN NOTE: ALL FEES ARE TO PAID FROM PARTICIPANT ACCOUNTS SERVICE 1 MONTHLY FEE 2 1. HRA Administration and Investment Services (must be all inclusive) Year 1 Year 2 Year 3 2. Debit Cards: Initial Card: $ Add l Card: $ Dup Card: $ 3. Other Administrative Fees: Communication Materials Custodial Bank Fees Transfer and other investment costs 1 Monthly fees should include all administration services outlined in this request for proposal as well as the fees associated with the Custodial Trust Bank and transfer costs. If you are proposing fees on a bundled basis, which may differ from the suggested breakdown above, please ensure that all services are accounted for and indicate Included in the appropriate fee box. Please list in Table 3 any services that you would not provide or that are not included in your fees. 2 For capitated quotes, please specify which participant population the fee should apply to (i.e., actives, retirees, per account, etc.). 15

SERVICE 1 MONTHLY FEE 2 4. Other Fees 800 Number (Specify shared or dedicated) Postage Printing of Forms Other (Specify) 5. Total Monthly Fees 6. Total Annual Fees Year 1 Year 2 Year 3 16

TABLE 2A FIRST YEAR SET UP FEES, IF ANY SERVICE SET-UP FEES (Year 1 Only) 1. Initial Set-up Charge including transfer of funds and records from current administrator 2. Development of Communication Materials (e.g., transition announcement letters, etc.) 3. Other (Specify) Total Set-up Fees 17

TABLE 3A FEES AND SERVICES List of services included in fees Any special fees, charges or expenses of any kind not included in fees List of services not included in fees, along with associated fees must be all inclusive 18

TABLE 1B SUMMARY OF FEES EXPANDED HRA PLAN INCLUDING ACTIVES NOTE: ALL FEES ARE TO PAID FROM PARTICIPANT ACCOUNTS SERVICE 3 MONTHLY FEE 4 1. HRA Administration and Investment Services (must be all inclusive) Year 1 Year 2 Year 3 2. Debit Cards: Initial Card: $ Add l Card: $ Dup Card: $ 3. Other Administrative Fees: Communication Materials Custodial Bank Fees Transfer and other investment costs 3 Monthly fees should include all administration services outlined in this request for proposal as well as the fees associated with the Custodial Trust Bank and transfer costs. If you are proposing fees on a bundled basis, which may differ from the suggested breakdown above, please ensure that all services are accounted for and indicate Included in the appropriate fee box. Please list in Table 3 any services that you would not provide or that are not included in your fees. 4 For capitated quotes, please specify which participant population the fee should apply to (i.e., actives, retirees, per account, etc.). 19

SERVICE 3 MONTHLY FEE 4 4. Other Fees 800 Number (Specify shared or dedicated) Postage Printing of Forms Other (Specify) 5. Total Monthly Fees 6. Total Annual Fees Year 1 Year 2 Year 3 20

TABLE 2B FIRST YEAR SET UP FEES, IF ANY EXPANDED HRA PLAN INCLUDING ACTIVES SERVICE SET-UP FEES (Year 1 Only) 1. Initial Set-up Charge including transfer of funds and records from current administrator 2. Development of Communication Materials (e.g., transition announcement letters, etc.) 3. Other (Specify) Total Set-up Fees 21

TABLE 3B FEES AND SERVICES EXPANDED HRA PLAN INCLUDING ACTIVES List of services included in fees Any special fees, charges or expenses of any kind not included in fees List of services not included in fees, along with associated fees must be all inclusive 22

D. GENERAL INFORMATION 1. Rights and Regulations The County of Sonoma reserves the right to accept any proposal and to negotiate agreements with any Contractor. The successful Contractor(s) will be required to comply with all applicable equal opportunity laws and regulations. The County of Sonoma reserves the right to reject any or all proposals, or to waive any defect or irregularity in a proposal. The County further reserves the right to award the agreement to the Contractor(s) that, in the County s judgment, best serves the needs of the County. All proposers submit their proposals to the County with the understanding that the recommended selection of the review committee is final and subject only to review and final approval by the Human Resources Director or Board of Supervisors. Upon submission, all proposals shall be treated as confidential documents until the selection process is completed. Once the selections are made, all proposals shall be deemed public record. In the event a proposer desires to claim portions of its proposal proprietary and exempt from disclosure, it is incumbent upon the proposer to clearly identify those portions with the word Confidential printed on the top right hand corner of the page. The County will consider a proposer s request for exemptions from disclosure; however, the County will make a decision based upon applicable laws. An assertion by a proposer that the entire proposal, or large portions, is exempt from disclosure cannot be honored, as required by law. 2. Pre-contractual Expenses The County shall not be liable for any pre-contractual expenses incurred by the proposer or selected Contractor(s). The County shall be held harmless and free from any and all liability, claims, or expenses whatsoever incurred by, or on behalf of, any person or organization responding to this RFP. 3. Alternatives Proposers may not take exception or make alterations to any requirement of this RFP. Alternatives must be submitted as separate proposals and so noted on the cover of the proposal. The County reserves the right to consider such alternative proposals, and to award an agreement based thereon if it is determined to be in the County s best interest and such proposal satisfies all minimum qualifications specified in this RFP. Proposers must indicate in the cover letter that the proposal offers an alternative to this RFP. 23 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

4. Lobbying/Ex-Parte Communication Any party submitting a proposal or a party representing a proposer shall not influence or attempt to influence any member of the selection committee, any member of the Board of Supervisors, or any employee of the County of Sonoma, regarding acceptance of a proposal. Any party attempting to influence the RFP process through ex-parte contact may be subject to rejection of their proposal. 5. Duration All proposals will remain in effect and legally binding for at least 120 days, during which time the County and/or The Segal Company may request clarification or correction of the proposal for the purpose of evaluation. Amendments or clarifications shall not affect the remainder of the proposal, but only the portion so amended or clarified. 24 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

III. CONTRACT REQUIREMENTS A. SAMPLE AGREEMENT Attached is a sample template of the agreement (Attachment C) that will be used. Proposers shall be willing to provide the required insurance and accept the terms of the Agreement. With few exceptions, the general terms will not be negotiated. Proposers must include in their proposals a statement as to their willingness to sign an agreement with the existing contractual language. Statements must include specifics as to any contractual language or insurance requirements the proposer wishes to change. Please note that any exceptions or changes to the Agreement may constitute grounds to reject the proposal. Please note that if you submit a proposal that does not address exceptions to the agreement, you are accepting all terms and conditions contained therein. The Contractor must sign the agreement within forty (40) working days of notice of intent to award an agreement from the County or the County reserves the right to cancel the notification of intent to award an agreement and to begin negotiations with another proposer. The Contractor is required to provide proof of insurance and appropriate additional insured endorsement prior to commencing any work for the County. B. TERM Term of the agreement(s) with selected Contractors will be January 1, 2013 to December 31, 2015, with an option to renew the contract for two consecutive one-year terms, upon the mutual consent of both parties. 25 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

EXHIBIT A INTENT TO BID For HRA Administration Services for: The County of Sonoma Please complete this page and fax or email a scanned image to: Mr. Tom Morrison or Robert Mitchell The Segal Company Fax number: (818) 956-6790 Tmorrison@SegalCo.com or Rmitchell@SegalCo.com I have read the Request for Information, and my organization understands its contents. We confirm the receipt of your request for information and would intend to bid if we received a formal Request For Proposal (RFP) from the County [check only one box]: We intend to bid: We decline to bid - Please provide reason: Today s Date: Company Name: Signature: Name (Print): Title: Telephone: E-mail Address: Date: Intent to Bid Forms should be sent by October 23, 2012. Submission of an Intent to Bid Form is not a requirement to submit a response. A submission of an Intent to Bid Form is not binding on the proposing company. 26 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

PLAN DOCUMENT EXHIBIT B Current Plan - Plan Document: Sonoma HRA Plan Document.pdf Current Plan - Plan Amendment: Sonoma HRA Plan Amendment.pdf 27 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

SAMPLE AGREEMENT EXHIBIT C Exhibit C-1 - County of Sonoma - Sample A Exhibit C-2 - County of Sonoma - Sample A 28 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.

CURRENT PLAN STATISTICS/INFORMATION EXHIBIT D Account balance at Wilmington as of 12/31/11 - $586,659.52 Current number of inactive HRA participants (active employees) 321 Current number of active HRA participants (retirees) - 50 29 Copyright 2012 by The Segal Group, Inc., the parent of The Segal Company. All rights reserved.