CMU-16-2556 Documented Quote Benefits Insurance Broker Documented Quote Issue Date October 25, 2016 Written Inquiries Due October 31, 2016, 11:00 a.m. Response to Written Inquiries November 3, 2016 Proposal Submission Deadline November 9, 2016, 11:00 a.m. Oral Presentations (if necessary) To Be Determined (If Necessary) Notice of Award November 16, 2016 (estimated) Contract Issued Within 30 days (estimated) ADMINISTRATIVE INFORMATION During the solicitation process all communication shall be with the point of contact for this solicitation. All written inquiries shall be made to Suzanne Ellinwood at sellinwo@coloradomesa.edu. The University is requesting that all proposals are submitted electronically to the point of contact prior to the proposal submission deadline. Work awarded to the successful contractor as a result of this solicitation will be via a University contract; a sample contract is posted with this solicitation. BACKGROUND, OVERVIEW AND GOALS Colorado Mesa University is a four-year institution of higher education located in Grand Junction, Colorado, with an enrollment in excess of 10,000 students The University is seeking to engage a broker to provide advisory services related to Colorado Mesa University s Benefit Plans for the approximate 700 benefit eligible faculty and administrative staff, and their dependents. The Colorado Mesa University Benefit Plan consists of medical, dental, vision, life / AD&D, long term and short disability and a number of voluntary plans, including but not limited to supplemental life, cancer and accident insurance. The University is seeking to engage the broker as a strategic partner in ensuring the University is providing a comprehensive and competitive benefit package. The University anticipates the primary focus by the Broker in year 2017 to be an in-depth analysis and marketing of the health insurance plan to be effective January 1, 2018. In subsequent years, the broker will be responsible for analysis of the health plan, including renewal negotiations. The University secured a three-year rate guarantee with our Dental, Life and Disability products effective January 1, 2017. Based on the satisfaction with these carriers and the overall market, there may not be an immediate need to negotiate or market these products. However, the University would ask that the broker continue to analyze these products to ensure the Universities satisfaction with the carriers. In addition, the University would expect an ongoing analysis of all voluntary plans offered to our employees, providing recommendations as the broker sees fit or as requested by CMU. Eligibility A. Employees must be employed as a 0.75 Full Time Equivalent (FTE) assignment for the full fiscal year in order to be considered benefits-eligible. Benefits begin on the first of the month following their date of employment. However, if the employee begins employment on the first of the month, their benefits will begin the same day. B. Dependent(s) include only: 1. an employee s spouse:
a. The spouse of an employee pursuant to a marriage recognized by the federal tax law, if such spouse is not divorced or legally separated from employee, and who has presented marriage certification. b. Common Law Spouse means an adult who is at least 18 years of age; with whom the employee cohabitates; and who represent themselves to the community as married to each other; and there is no legal impediment to the marriage; and who, with the employee spouse, has completed an Affidavit of Common Law Marriage c. Current Domestic Partner means an adult who is at least 18 years of age; and who is the same gender as the employee; and with whom the employee has shared an exclusive, committed relationship with that same person for at least one year prior to claim of tuition benefit with the intent for the relationship to last indefinitely; who is not related to the employee by blood to a degree that would prohibit marriage; and who, with the employee partner, has completed an Affidavit of Domestic Partnership. d. Current Partner in a Civil Union means an adult, regardless of the gender of either party, at least 18 years of age who is not a partner in another civil union; who is not married to another person; who is not under guardianship, unless the partner under guardianship has the written consent of his or her guardian; and neither partner is a relative of the other, whether the relationship is by the half or the whole blood; and who has obtained a license and certificate of the civil union and presented a certified copy to the University. 2. The dependent child of the employee: a. An employee s child under the age of 26, including a natural child, stepchild, child under court-ordered guardianship, adopted child, foster child, and child of a civil union or domestic partner. A child is considered adopted if he is in the legal custody of the Employee under an interim court order of adoption, whether or not a final adoption order is ever issued. C. Retiree health insurance coverage is also offered as gap coverage. A retiree means a participant in the University s health benefit plan who satisfied all of the following requirements: (1) terminates employment with the University due to retirement prior to age 65, (2) was covered by the University s health benefit plan immediately prior to retirement and upon termination of employment elects to continue coverage under the University s health benefit plan pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA); exhausts such COBRA coverage and timely elects to continue coverage under the University s health benefit plan as a retiree. Retiree coverage is effective until the employee become eligible for benefits under Medicare. There are currently 3 retirees participating in the University s plans. Overview & Goals The intent of this Request for Proposal and resulting contract is to obtain a qualified licensed health benefits broker to provide a number of ongoing services. The brokers task will be to identify and negotiate on behalf of the University with carriers to ensure competitive pricing and appropriate plan design. The broker will also be required to provide an analysis of current offerings, plan design and tier structure. In addition, the University will rely on the brokers expertise to provide comprehensive monthly, quarterly and annual financial and plan analysis reporting. For CY16, the University is currently providing medical coverage through Rocky Mountain Health Plans; dental coverage through Delta Dental; life, AD&D, long term disability and short term disability through SunLife; along with a number of voluntary coverages through a number of vendors. For more information about the University s benefit plans refer to CMU s
Human Resources department website at: http://www.coloradomesa.edu/humanresources/faculty-staff/benefits.html. STATEMENT OF WORK With this solicitation the University will select an insurance broker licensed in the State of Colorado to submit proposals outlining their qualifications to provide access to group supplemental health insurance products and services for the University. The broker s primary service will be to identify and negotiate with various carriers to arrange the best and most economical health benefit package that will provide the University s current plan designs at a lower cost or enhanced plan designs at the same cost. For plan year CY2018, the Colorado Mesa University will require a full market analysis and recommendation for the medical plan benefit. The University may be interested in additional services beyond the primary service. The questions and requirement in section B below give some indication of what some of those services might be, however, some are also expected to be included in the primary service please indicate which are included in the primary service and which are extra. Information and answers will be used to assess and determine the level of expertise your firm can provide. Please provide a full range of services that your firm offers in support of health and supplemental health plan administration. Include cost and fee structure for those services. A. Fee Structure 1. Provide an itemized schedule of all fees and commissions for the primary scope of service (B.1 below). If you are proposing a flat fee retainer, please state the total number of hours and hourly rate your proposal is based on. Please list what services will be included. If your fees are based on commissions, please state the commission percentage and the overall amounts of compensation you expect to receive from all commissions (all lines of coverage). Disclose any over-ride commission structures you have with carriers that are received based on volume incentives. 2. Itemize any fees for additional services (B.2 below) beyond the fee associated with the primary scope of service. 3. Itemize any out of pocket/reimbursable expenses for services provided, beyond those identified in 1 and 2 above. B. Services 1. Primary Scope of Service a. Describe the process you will follow to represent the University in negotiations with providers related to premiums, service, benefit levels, plan design, special terms and conditions, annual renewal, reporting capabilities, etc. Include what you view are the responsibilities of the University and your expectations of support in achieving the expected outcome. b. Provide a timeline and key targets dates relating to the process for a medical plan renewal of January 1, 2017. In addition, provide performance measures the University could use in evaluating your services on an annual basis. Note: In addition to B.1 please respond to which of the following services you can provide and indicate which are included as a standard practice in providing the primary service requested and additional fees, if any, beyond those assessed for B.1. 2. Additional Services a. Annual review and report of employee benefits programs for quality and adequacy of benefits provided, cost effectiveness, competitiveness, and plan administration and recommendations concerning changes in terms, conditions and limits. b. Website capability to support on-line enrollment, changes, and employee educational module to assist employees in self-management of benefits.
c. Review of and resolution of issues concerning insurance policies, certificates of insurance and other documents related to employee benefits programs. d. Monthly claims experience reports and special studies and reports as requested by the University. e. Annual summaries of financial status of insurers. f. Assisting in the development of long-range goals and strategies for the University s employee benefits programs. g. Monitoring of ongoing contracts, including provider plan administration, tracking of performance standards, provider compliance with contracts and incurred claims. h. Semi-annual estimates of renewal rates and cost trends and assistance to University staff in preparation of budget figures. i. Information, consultation, and recommendations on employee benefit issues, trends and existing, proposed, or new legislation including but not limited to COBRA, HIPAA, Medicare, FMLA, CFRA, ADA, ACA and IRS rules. j. Identification and analysis of cost containment and efficiency measures such as employer partnerships, electronic benefits administration, etc. k. Attendance at and assistance with meetings with the Board of Trustees, University staff, special committees and the general employee population. l. Assistance with the design and delivery of employee health benefits brochures and information, including participation at the annual Benefits Fair. m. Assistance with resolving issues that arise during the year regarding employee benefits contract administration with service provision. n. Review of and assistance with resolving disputes regarding coverage, billing questions and service delivery. C. Describe the Firm 1. Describe your organization, the year it was founded, its ownership structure, its primary focus, its greatest strengths, its affiliations with other companies, and whether there are any anticipated ownership changes. 2. Describe the broker services and other related services you provide to other companies. 3. What is the total size of your broker staff, support staff and other staff? 4. What size client represents your target market? Identify any client you serve that is similar to Colorado Mesa University in size and benefit type. 5. List the personnel you would expect to assign to this relationship and their responsibilities relative to the University. Please provide brief biographical information on each individual including position in
the company, education, training, years of experience in the employee benefit/insurance field, and number of current clients. Resumes are not required, but may be provided in an appendix to the proposal. 6. For personnel you would assign to this relationship, list references of three public clients for whom they have provided broker services. Indicate contact name, address and telephone number. Indicate length of time they have provided services to the client and a brief synopsis of the extent of those services. 7. Describe how personnel s performance is evaluated and compensation determined. 8. How do you ensure the longevity of the team assigned to this relationship? What has been your professional/non-professional staff turnover in the last 5 years? 9. Describe the experience of your firm, particularly with governmental entities and universities. Note your role in providing such services. Specifically, describe your experience in working with the following: Fully insured Medical Plans Pharmacy Benefit Manager (PBM) Compliance Issues Wellness Programs Web-based Self-Management Programs Health Savings Accounts Flexible Spending Plans Healthcare Reform (ACA) 10. Describe your experience in providing services and working with the following: Fully Insured Dental Plans Basic Life and AD&D Benefits Supplement Life and AD&D Benefits Disability products Vision Plans Supplemental products such as critical care, cancer insurance, long term care, etc. Other voluntary and supplemental programs 11. Describe your experience in other program areas not currently offered by the University. 12. Describe your organization s resources and database of information that you feel will be advantageous to servicing our account. 13. Does your organization subcontract any services to other firms? If so, be specific and list the firm, what services they will be providing and dollar value of the subcontracted services. 14. Describe how you inform your clients of law changes and other benefit related developments.
15. Describe some of the recent innovative programs you ve helped design which have addressed your client s specific needs. (Client names are not necessary) 16. Describe how you and your company distinguish yourself from your competition. 17. Describe seminars or programs that your company offered to your clients in 2016. What do you plan to offer for 2017? 18. Please describe potential conflicts of interest in relation to this endeavor. 19. Please describe potential or pending litigation that could adversely affect the services offered by your company to the University. D. Describe the processes, analysis and methods used in providing broker services to CMU 1. Describe the process you would use to prepare bid information, including bid documents, bid summaries and recommendations. 2. Describe strategies and processes in detail that will be used to accomplish the University s goal of providing comprehensive health plans at the most cost-beneficial basis. 3. Describe your capabilities and methods of evaluating an insurance company s service, stability and solvency. 4. Describe the type of resources available that would be used to provide the University with excellent customer service in managing its health care programs throughout the year. Enclose samples of reports or other documentation that would demonstrate your expertise. 5. Describe the methods you would use to verify that the insurance carrier continues to meet the objectives they were selected to meet. 6. Describe how you measure carrier performance and the criteria you use to determine when an insurance carrier needs to be terminated. 7. Describe your company s relationship, if any, with the University s current carriers. 8. Describe your philosophy and process for conducting proper due diligence when conducting an insurance carrier search. 9. Does your company maintain a database of insurance carriers? If so, please indicate how many carriers are in your database, how often the database is reviewed and updated, and under what circumstance would you add or remove a carrier from the database? 10. Describe the knowledge, experience and advantage your company would have with carriers throughout the U.S.; in Colorado; specific to the Western Slope. 11. Specifically describe the services you would provide as the broker that are not already addressed through previous questions above.
OFFEROR S RESPONSE FORMAT Section 3, Statement of Work, outlines the information required to determine the quality of the products being offered. Please address all items and provide responses where required in the order presented as outlines in Section 3. Initiate each response by restating the item or section reference number. Those proposals, which do not follow this format, may be disqualified. Evaluation Criteria Evaluation Process An evaluation team will judge the merits of each proposal received in accordance with the requirements outlined in Section 3. The recommendations of this committee will be forwarded to the Purchasing Manager for approval. Failure of the Offeror to provide any information requested in the RFP may result in disqualification of the proposal and shall be the responsibility of the bidding individual or firm. The sole objective of the evaluation committee will be to recommend the Offeror whose proposal is most responsive to Colorado Mesa University s needs within the available resources. The specifications within the documented quote represent the minimum performance necessary for response. Evaluation Criteria The focal point of the evaluation process will be on the following criteria: Criteria Weight Price Response 30% Technical Response - Plan Implementation - Customer Service - Annual plan review & market analysis - Timely delivery & performance - Employee Resources / Education - Insurance markets represented - Compliance knowledge and resources - Qualifications & Experience (Company) - Vendor Reputation - Experience with Universities / Government - Vendor availability - Company resource s - Qualifications & Experience of Team assigned to CMU - Experience with Universities / Government - Reputation in supporting client - Longevity of the team - Combined knowledge providing benefit expertise 30% 25% 15% While a numerical rating system may be used to assist the evaluation committee in selecting the competitive range (if necessary) and making the award decision, the award decision
ultimately is a business judgment that will reflect an integrated assessment of the relative merits of the proposals using the factors and any relative weights if established. Basis of Award The technical factors will be assessed based on the soundness of the Offeror s approach and understanding of the requirements. The experience and/or demonstrated capabilities factor will be assessed by considering the extent to which the qualifications, experience, and past performance are likely to foster successful, on-time performance. Assessments include a judgment concerning the potential risk of unsuccessful or untimely performance and the anticipated amount of University involvement necessary to ensure timely, successful performance. The selection is ultimately a business judgment that will reflect an integrated assessment of the relative merits of proposals using the factors identified above. The University reserves the right to reject any (or all) proposal(s) that pose in the judgment of the University, unacceptable risks of unsuccessful or untimely performance, unacceptable University resource requirements, or costs exceeding the budget constraints. Failure of the Offeror to provide any information requested in the quote may result in disqualification of the proposal and shall be the responsibility of the Offeror