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Agenda 09/26/2017 Item #16E20
09/26/2017 EXECUTIVE SUMMARY Recommendation to approve Amendment #4 to Agreement #11-5729 to Allegiance Benefit Plan Management, Inc. for the award of Group Health Third Party Administration Services; award an Agreement (#17-7209) for Managed Care Services to Naples Physician Hospital Organization, known as Community Health Partners, Inc., and authorize the Chair to execute the Amendment and Agreement. OBJECTIVE: To professionally administer the Collier County Group Health Plan through the selection of Group Health Third Party Administration and Managed Care service vendors. CONSIDERATIONS: The Board of County Commissioners sponsors a comprehensive group insurance program for its employees and their eligible dependents. The program includes a partially self -funded group health and dental insurance plan also known as the “Plan.” To administer the Plan, the County employs the services of a Group Health Third Party Administration company to adjudicate claims and perform Plan administration services. In addition, the vendor provides HIPAA and COBRA administration services, flexible spending account services, dependent care reimbursement account services, health reimbursement account services and access to wrap preferred provider networks outside Collier County, as needed. These services are known as the “Core” services. Since 2012, the County has utilized Allegiance Benefit Plan Management, Inc., for these services and the current Board approved agreement #11-5729 will expire on December 31, 2017. In addition to these Core services, the County employs the services of a Managed Care company to provide local network access, pre-certification, utilization review, concurrent stay and disease management services to the Plan. The Naples Physician Hospital Organization, known as Community Health Partners (hereafter, CHP), established the only local, standalone nonprofit physician/hospital preferred provider network in the mid 1990’s to assist employers and insurance carriers in the administration of their health plans. The network consists of over 800 providers. The current Board approved agreement #12-5854 with CHP will expire on December 31, 2017. Since similar services may also be acquired through Group Health Third Party Administration Services firms, it was decided t hat Managed Care services would also be solicited to assure that these services remain competitive. Traditionally, a joint solicitation through the local Collier County Healthcare Consortium (the CCHCC) has been used to secure these services. The Consortium consists of the County, the Sheriff’s Office, the District Schools and the NCH Healthcare System and encompasses 25,000 covered lives. The mission of the group is to work together to address healthcare financing issues common to each employer; engage in joint purchasing where possible; and to adopt common administrative processes designed to reduce overhead and improve efficiency. The County, the District Schools and the NCH Healthcare System agreed to pursue a joint solicitation utilizing the Purchasi ng Department of the District School Board. Willis Towers Watson, Inc., who serves as the benefits and actuarial consultant to the Consortium prepared the Request for Proposal (RFP) and provided technical support to the process. The RFP was released on March 21, 2017 by the Purchasing Department of the Collier County District Schools. Proposals were received on April 13, 2017. Four firms submitted proposals, however, one firm submitted a proposal applicable only to NCH. Willis Towers Watson prepared an analysis of the remaining three proposals and presented the information for consideration. The three remaining firms were Allegiance, HealthScope and Blue Cross/Blue Shield. The Board’s selection committee met on June 22, 2017 and ranked the proposals. Of the three firms, the 16.E.20 Packet Pg. 2434 09/26/2017 committee declared Blue Cross/Blue Shield as non-responsive due to their failure to adequately respond to the requirements of the RFP. The committee then ranked the two remaining firms as follows: (1) Allegiance Benefit Plan Management, Inc., and (2) HealthScope. The unanimous consensus of the committee was to recommend the award for Group Health Third Party Administration to Allegiance Benefit Plan Management, Inc. The Selection Committee also completed a review of the Managed Care portion of the proposals. The committee determined that the CHP program remains competitive in terms of both price and service capabilities. The committee recommends that the attached agreement with CHP be approved concurrent with the award to Allegiance. In addition, staff recommends an amendment to the existing Agreement #11-5729 with Allegiance rather than drafting a new Agreement. The core services under the existing Agreement remain essentially unchanged and the existing language is sufficient to reflect the scope of services sought under the RFP. The primary changes resulting from this RFP are limited to the contract term of the Agreement and fees to be charged. Therefore, an amendment is sufficient to reflect the results of this award and promote the continuity of the existing relationship. FISCAL IMPACT: The estimated annual fees for calendar year 2018 to be paid to Allegiance Benefit Plan Management, Inc. are $696,332 based upon current enrollment. The estimated annual fees for calendar year 2018 to be paid to Community Health Partners, Inc. are $101,844 based upon current enrollment. Funds are available under Fund 517, Group Health and Life, for this purchase. The attached agreements contain an initial contract term of three years with the o ption to renew for two additional one year periods. Services will commence on January 1, 2018. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval. -SRT RECOMMENDATION: To approve Amendment #4 to Agreement #11-5729 to Allegiance Benefit Plan Management, Inc. for the award of Group Health Third Party Administration Services. To award an Agreement (#17-7209) for Managed Care Services to Naples Physician Hospital Organization, known as Community Health Partners, Inc., and authorizes the Chair to execute the Amendment and Agreement. PREPARED BY: Jeff Walker, CPCU, ARM, Director, Risk Management ATTACHMENT(S) 1. 17.100 TPA Services RFP WTW 3-15-2017 (DOCX) 2. 11-5729 Allegiance_Amendment 4_CAO (PDF) 3. 2018 Managed Care Network Agreement_rev 2_VendSign (PDF) 4. Appendix IV CCPS 17-100 Final Rank (PDF) 5. CCG TPA RFP Analysis For Board August 3 2017 (PDF) 6. Appendix I Florida Blue Description for Scoring Committee 2017-6-19 (PDF) 7. CCG Appendix II Cost summary - FINAL 08 03 17 (PDF) 8. CCPS 17-100 NORA (2) (PDF) 16.E.20 Packet Pg. 2435 09/26/2017 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.20 Doc ID: 3733 Item Summary: Recommendation to approve Amendment #4 to Agreement #11-5729 to Allegiance Benefit Plan Management, Inc. for the award of Group Health Third Party Administration Services; award an Agreement (#17-7209) for Managed Care Services to Naples Physician Hospital Organization, known as Community Health Partners, Inc., and authorize the Chair to execute the Amendment and Agreement. Meeting Date: 09/26/2017 Prepared by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 08/31/2017 2:56 PM Submitted by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 08/31/2017 2:56 PM Approved By: Review: Procurement Services Opal Vann Level 1 Purchasing Gatekeeper Completed 08/31/2017 4:37 PM Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 09/01/2017 11:54 AM Procurement Services Sandra Herrera Additional Reviewer Completed 09/05/2017 4:25 PM Procurement Services Ted Coyman Additional Reviewer Completed 09/06/2017 3:11 PM Procurement Services Swainson Hall Additional Reviewer Completed 09/08/2017 11:27 PM Procurement Services Len Price Additional Reviewer Skipped 09/15/2017 2:50 PM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 09/15/2017 3:00 PM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/18/2017 7:40 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 09/18/2017 10:05 AM Office of Management and Budget Laura Wells Additional Reviewer Completed 09/18/2017 10:35 AM County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 09/19/2017 2:37 PM Board of County Commissioners MaryJo Brock Meeting Pending 09/26/2017 9:00 AM 16.E.20 Packet Pg. 2436 REQUEST FOR PROPOSAL RFP Number and Title: #17-100 Medical/Dental Claims & Flexible Spending Account Administration Posting Date: March 20, 2017 RFP Due Date & Time: 4:00 PM, Thursday, April 13, 2017 RFPs received after this time and date will not be accepted Florida Tax Exempt #85-8012621827C-2 A 188126 (Federal) FEID 59-6000557 Individuals covered by the Americans with Disabilities Act of 1990 in need of accommodations to attend public openings or meetings sponsored by the School District shall contact the Purchasing Department at (239) 377-0047, at least five (5) business days prior to the scheduled opening or meeting. Proposer Acknowledgement This acknowledgement MUST be completed, signed and returned with RFP. Failure to do so will be cause for rejection of RFP. Company Name: Phone #: Fax #: Street Address: City: State: Zip Code: E-Mail Address: Website (optional): I certify that this bid is made without prior understanding, agreement or connections with any corporation, firm or person submitting a bid for the same materials, supplies or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all conditions of this bid and certify that I am authorized to sign this bid for the bidder. In submitting a bid to Collier County Public Schools (CCPS) the bidder offers and agrees that if the bid is accepted, the bidder will convey, sell, assign or transfer to CCPS all rights, title, and interest in and to all causes of action it may now or hereafter acquire under the Anti-trust laws of the United States and the State of Florida for price fixing relating to the particular commodities or services purchased or acquired by CCPS. At CCPS’s discretion, such assignment shall be made and become effective at the time CCPS tenders final payment to the bidder. X Authorized Signature (Manual) Date Typed / Printed Name Title NO BID: I hereby submit this as a “NO BID” for the reasons checked below: 1. Specifications were unclear or restrictive 6. We do not offer the product or service requested 2. Our schedule will not permit us to respond 7. Cannot supply at this time. 3. Could not meet specifications 8. Cannot meet delivery schedule 4. Terms & Conditions were unclear or restrictive 9. Other/Remarks: 5. Could not meet Insurance requirements All PROPOSALS shall be submitted in a sealed envelope / package and clearly labeled as follows: “SEALED RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration 4:00PM, DAY, MARCH, 2017” BIDDER NAME BIDDER ADDRESS, CITY, STATE, ZIP CODE BIDDER PHONE # BIDDER E-MAIL ADDRESS 16.E.20.a Packet Pg. 2437 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 2 Section 1 - General Conditions & Instructions ***PLEASE READ CAREFULLY*** Failure to meet the following instructions may be cause for rejection of proposal. CONE OF SILENCE DURING COMPETITIVE SELECTION PROCESS A cone of silence is hereby established for all competitive selection processes including Invitations to Bids (RFP), Request for Quotes (RFQ), Request for Proposals (RFP), Request for Qualifications (RFQu), and Invitations to Negotiate (ITN) for the provision of goods and services. The cone of silen ce is designed to protect the integrity of the procurement process by shielding it from undue influences prior to the recommendation of contract award. This cone of silence shall be imposed on these procurements after advertisement of same. See Attached Bo ard Policy 6324. 1.1 Definitions For the purpose of this Request for Proposal (RFP) and evaluation to responses the following shall apply: written matter shall prevail over typed matter; numbers spelled in word form shall prevail over Arabic numerals (“one” over “1”). The word “shall” is always mandatory and not merely directory. Furthermore, the following words and phrases shall have these meanings: a. “CCPS” or “District” shall mean Collier County Public Schools or The School District of Collier County, FL. b. “Bidder/Proposer” shall mean any person, firm or corporation who submits a response pursuant to this RFP. c. “Contractor” shall mean the successful bidder, whether a corporation, partnership, individual or any combination thereof, and its, their or his successors, personal representatives, executors, administrators, and assignees. 1.2 Convicted Vendor List Proposers shall be aware of the provision of paragraph (2)(a) of Section 287.133, Florida Statutes which reads as follows: “A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime, may not submit a bid on a contract to provide any goods or services with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list.” 1.3 RFP Submissions a. Proposals not conforming to the instructions provided herein will be subject to disqualification at the sole option of CCPS. b. The proposer, by submitting a proposal represents that: i. It has read and understands the RFP in its entirety and that any Proposal submitted is made in accordance therewith; ii. It possesses the capabilities, resources and personnel necessary to provide efficient and successful service to the District iii. It has made all investigations and examinations necessary to ascertain site and/or local conditions and requirements affecting the performance of the contract. If bidder receives an award, failure to have made any necessary investigation/examination will in no way relieve the bidder from its obligations to comply with this RFP, nor will it be a basis for any claim for additional compensation or relief. c. All proposals shall be submitted in a sealed envelope / package and clearly labeled PER THIS RFP. d. Any proposal received after the stated time and date, will be rejected and may be returned unopened to the proposer(s). e. All proposals shall be typed or written in ink and utilize attached forms where applicable. All spaces requesting information shall be completed. f. RFP shall contain a manual signature in the space(s) provided of an officer/representative authorized to legally bind the proposer of any and all conditions and provisions herein. All signatures and initials must be in ink. The use of erasable ink or pencil is not permitted. g. One (1) manually signed original, with all proper documentation of the RFP/documentation must be submitted. (Please note that it is not necessary to return every page of this RFP with the proposal; return only the pages that require information or signatures and all necessary back-up documents). h. Thirty (30) electronic copies of proposal and documentation shall be submitted. Electronic copies shall be on thirty (30) separate Flash Drives. Please note the RFP # and name of bidder (if possible) on drive. If confidential materials are submitted, bidder may submit a 2nd drive with confidential material and label with RFP #, name of bidder and “CONFIDENTIAL”. i. RFPs may be hand delivered to the Business Office, Purchasing Department, Attn: David Nara, Director of Purchasing, 5775 Osceola Trail, Naples, Fl 34109, forwarded by United States Mail, or other delivery service available. CCPS disclaims any responsibility for proposals forwarded by the U.S. Mail or other delivery service and received beyond the proposal-opening deadline. j. Neither CCPS nor its representatives shall be liable for any expenses incurred in connection with preparation of a response to this RFP. Bidder(s) should prepare RFP’s simply and economically, providing a straightforward and concise description of its ability to meet the requirements of the RFP. k. The use of correction fluid or erasures to correct line item bid prices and/or quantities are not acceptable. Corrections must be by strikethrough (strikethrough) of the incorrect figure(s), writing in of correct figure(s) and initialing of the correction(s) by the originator. Correction fluid of erasure corrected bids will be considered non-responsive for the corrected items only. 1.4 RFP Opening and Analysis a. RFPs will be publicly opened in the Purchasing Department, read aloud and recorded at the time and date indicated within 16.E.20.a Packet Pg. 2438 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 3 RFP. Bidder(s) may, but are not required to attend. CCPS will not announce prices or release other materials pursuant to 119.07 Florida Statutes, only the names of the responding firm(s) and their locations will be read. b. RFPs will be analyzed, tabulated, and recommendations for award, which the Superintendent intends to make to the School Board or the Purchasing Department intends to make for projects less than $50,000, will be posted by tabulation sheet at the School District of Collier County, Dr. Martin Luther King, Jr. Administrative Center, Purchasing Department, 5775 Osceola Trail, Naples, Florida 34109-09919, as well as on-line at CCPS’s website: www.collierschools.com/purchasing and at www.demandstar.com. Notification to all bidder(s) will be made by fax or e-mail. Date and time stamp from the Purchasing Department’s fax machine or date and time of e- mail posting, will constitute the time of notification. c. Proposers who feel they will be adversely affected by the recommendation(s) may protest under provisions of Board Policy 6320-Bid Protest attached hereto. Failure to file a protest within the time prescribed in Florida Statutes 120.57(3) will constitute a waiver of proceedings under Chapter 120, Florida Statute. 1.5 Interpretation and/or Modifications to the RFP / Inquiries / Addenda a. It is incumbent upon each bidder to carefully examine all specifications, terms and conditions contained within the RFP and to fully understand all items hereto. b. No interpretation of the meaning or contents of the RFP, no correction of any actual or apparent error, ambiguity, and inconsistency therein, shall be made to any proposer orally. Every request for interpretation or any questions regarding the RFP, whether technical, procedural or otherwise, shall be made in writing, addressed to the respective Purchasing Department employee below. Requests may be submitted by facsimile, electronic mail, USPS or other regular mail delivery service as follows: District Contact: David Nara, Director of Purchasing Street Address: PURCHASING DEPARTMENT 5775 Osceola Trail, Naples, FL 34109 Facsimile Number: (239) 377-0047 Electronic Mail: purchasing@collierschools.com c. All requests, questions and inquiries shall be received at least seven (7) business days, unless otherwise stated within this RFP, prior to the due date. d. Any and all written inquiries received will be compiled and official responses will be developed by appropriate CCPS employees. The compilation of written questions and their official responses will be issued solely by the Purchasing Department in the form of an e-mail, memorandum or an Addendum (if necessary) and posted on CCPS’s website: www.collierschools.com/purchasing and on www.demandstar.com. Bidder should ensure that all addenda and amendments to the RFP have been received prior to submitting its response. e. It is the responsibility of the bidder(s) to make sure they have all addenda associated with this RFP. Addenda will be posted on CCPS’s website: www.collierschools.com/purchasing and on www.demandstar.com, and may be e-mailed, faxed and/or made available upon request. CCPS is not responsible to e-mail or mail addenda directly to potential bidders. Any and all addenda issued shall be acknowledged by signature and returned with RFP, unless otherwise instructed on the Addenda. Failure to acknowledge addenda may result in rejection of bid. f. Only interpretations, supplemental instructions, and corrections so given in writing by the Purchasing Department representative shall be binding. Proposer(s) and Prospective Contractor(s) are advised that no other source is authorized to give interpretations, supplemental instructions, corrections, or information concerning, explaining, or interpreting the RFP. Any verbal interpretation/modification will not be considered part of this RFP and therefore, CCPS will not be held accountable. The issuance of a written addendum is the only official method by which interpretation, clarification or additional information can be given. g. Additional information acquired by any other means shall not be utilized in the configuration of any vendor’s proposal and shall not be considered in the evaluation of proposals submitted and shall be considered inadmissible in proposal dispute proceedings. Proposers may be disqualified who solicit or receive (even if unsolicited) additional information regarding this RFP by any other means than the process described herein. h. No addendum will be issued later than three (3) calendar days prior to the due date, except an addendum withdrawing the RFP or one that includes postponement of the date for receipt of bids. 1.6 Joint Proposal a. In the event multiple proposers submit a joint proposal in response to the RFP, a single proposer shall be identified as the Prime Vendor. If offering a joint proposal, Prime Vendor must include the name and address of all parties of the joint proposal. Prime Vendor shall provide all bonding and insurance requirements, execute any Contract, complete the REQUIRED SIGNATURE PAGE shown herein, and have overall and complete accountability to resolve any dispute arising within this contract. Only a single contract with one proposer shall be acceptable. Prime Vendor responsibilities shall include, but not be limited to, performing of overall contract administration, preside over other proposers participating or present at District meetings, oversee preparation of reports and presentations, and file any notice of protest and final protest as described herei n. Prime Vendor shall also prepare and present a consolidated invoice(s) for services performed. b. CCPS shall issue only one check for each consolidated invoice to the Prime Vendor for services performed. Prime Vendor shall remain responsible for performing services associated with response to this RFP. 1.7 Award a. The School Board or Purchasing Department reserves the right to award the contract(s) to the bidder(s) that it deems to offer the lowest responsive and responsible proposal(s), as defined by this RFP. The Board and/or Purchasing Department are therefore not bound to accept a proposal on the basis of lowest price. Award will be made to the lowest responsive, responsible proposer whose bid represents the best overall value to CCPS when considering all evaluation factors and that meet or exceed the minimum requirements of this RFP. 16.E.20.a Packet Pg. 2439 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 4 b. The School Board or Purchasing Department will award contract(s) based on experience, qualifications of firm, qualifications of staff, quality of work and pricing, as well as bidder’s ability to meet or exceed the minimum requirements of this RFP. c. Proposals will be evaluated and given points according to how well it meets the specifications and requirem ents of the RFP. The proposal with the highest number of evaluation points will be ranked first. The Evaluation Committee reserves the right to negotiate further terms and conditions, with the highest ranked proposer. If the Evaluation Committee cannot r each a mutually beneficial agreement with the first selected proposer, the Committee reserves the right to enter into negotiations with the next highest ranked proposer and continue this process until an agreement is reached. d. During the evaluation and review of bid(s), CCPS may consider any information or evidence which comes to its attention. This information may be utilized in determining the bidder’s capability to fully perform the services of this RFP and/or the bidder’s level of integrity and reliability that is required to assure satisfactory performance of any and all award or contracts produced from this RFP. e. In order to be considered for selection, bidder shall submit a complete response to the RFP and provide all documentation necessary to fully demonstrate the bidder’s capabilities and qualifications. Proposal shall provide adequate detail for a clear understanding of the bidder’s RFP and intentions. The standardization shall facilitate evaluation of the comparative merits of the proposals submitted. Failure to comply with the required organization and structure outlined in the RFP or provide documentation as required, may result in a proposal being deemed non-responsive. f. CCPS reserves the right to award contract to a single contractor for all items and services herein, however, nothing will prevent CCPS from making multiple awards and/or to deem all proposals responsive and assign work to multiple or any contractor deemed responsive or with the highest rated proposals. g. This RFP does not commit the School Board to make an award nor shall CCPS be responsible for any cost or expense incurred by any contractor prior to the execution of a purchase order or contract agreement. h. The obligations of CCPS under an award of this RFP are subject to the availability of funds lawfully appropriated for its purpose. All purchases are contingent upon available funding. i. Any and all award(s) made as a result of this RFP shall conform to applicable School Board Policies, State Board Rules, and State of Florida Statutes. j. CCPS reserves the right to award only a portion of the items and/or services specified, if it is deemed to be in its best interest. 1.8 RFP Withdrawal Any proposal may be withdrawn prior to the date and time the proposals are due. Any proposal not withdrawn will constitute an irrevocable offer, for a period of one hundred eighty (180) days, to provide CCPS with the services specified in the proposal, subject to Board approval of a contract mutually agreeable to both parties. Proposer agrees to good faith negotiations on a contract document and pricing if necessary. 1.9 RFP Rejection a. CCPS reserves the right to reject any and all proposals, in whole or in part, and to waive any and all proposal irregularities, formalities and/or technicalities. Furthermore, CCPS reserves the right to re-advertise for other proposals or to bid separately any projects deemed to be in the best interest of CCPS. b. CCPS reserves the right to reject non-conforming proposals. c. CCPS reserves the right, prior to approval, to cancel the RFP or portions thereof, without penalty. 1.10 Unreasonable Bid CCPS is not bound to accept any bid, quote or proposal it may receive under this RFP. In addition, CCPS will reject submittals which are considered to have been priced unreasonably low and will determine the vendor to be Non-Responsive. Unreasonable low pricing shall be at the determination of CCPS. 1.11 Misrepresentation All information submitted and representations made by the proposer are material and important and will be taken into account by CCPS when awarding the RFP. Any misstatement or omission (a “Misrepresentation”) shall be treated as a fraudulent concealment of the true facts relating to submission of the solicitation. A misrepresentation shall be a basis to reject or disqualify the proposer from this RFP, and any re-solicitation pertaining to this subject matter (regardless of whether the re-solicitation resulted from Respondent’s misrepresentation), and shall be punishable under law, including, but not limited to, Chapter 817, F.S. 1.12 Content of RFP/Bidder Response The contents of this RFP, all terms, conditions, specifications, and requirements included herein and the accepted and awarded response thereto will be incorporated into an agreement to purchase and become legally binding. Any terms, conditions, specifications, and/or requirements specific to the item or service requested herein shall supersede the requirements of the “GENERAL CONDITIONS & INSTRUCTIONS.” 1.13 Non-Exclusive Contract Any contract award(s) resulting from this RFP shall not be construed as an exclusive means for CCPS to acquire services, equipment, supplies or maintenance as outlined in this RFP. CCPS reserves the right, during the term of this contract, to issue separate formal and/or informal competitive solicitations for the acquisition of these services or commodities. Furthermore, CCPS reserves the right to enter into purchase agreements for these commodities/services based on awards made by the State of Florida, other governmental entities, other CCPS awards or contracts available through national purchasing alliances. 1.14 Pricing a. All pricing submitted will be firm for the duration of the contract, unless otherwise stated or negotiated with this RFP. b. Pricing shall be based on FOB Collier County, Florida and will include all packaging, handling, shipping charges, and delivery to any point within Collier County, Florida to a secure area or inside delivery. 16.E.20.a Packet Pg. 2440 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 5 c. CCPS is exempt and does not pay Federal Excise and State of Florida Sales taxes. Certificate of exemption available upon request. d. Any discrepancy or error in bid pricing, the unit price will govern. All calculation errors will be recomputed by the Purchasing Department. 1.15 Order Placement, Purchase Orders and Procurement Cards Award does not constitute any order(s). After approval of an award has been made of this RFP, CCPS will place orders utilizing one of the following procedures: a. CCPS issued purchase orders (blanket or normal): Purchase orders will be either a blanket purchase order to cover a specific period of time and dollar amount for multiple purchases against it, or will be for specific items. b. Procurement Card: Sites or departments may place orders utilizing a CCPS issued procurement card. Only authorized staff will be allowed to submit orders via the procurement card. c. School/Site based internal account purchase order: A specific site or school will issue a purchase order through the site’s bookkeeper and will be processed at the school level. Please note that schools may vary in their ordering and payment procedure. Contractor(s) shall not provide any items or services, on any CCPS initiated order without one of the above ordering methods. It will be the responsibility of the Contractor to fully understand the order and how and when to process according to how the order is placed. Failure to allow orders placed by any of the above methods may be cause for rejection of bid and/or termination of contract. 1.16 Invoicing & Payment a. The contractor will be required to submit invoices as it supplies/services CCPS. All invoices and correspondences shall be legibly written, typed, or computer generated and dated. b. All invoices shall reference a valid/current purchase order number. Failure to provide a current purchase order will be cause for delay in payment or non-payment. c. Invoices and statements shall be mailed directly to: Collier County Public Schools Accounts Payable Department 5775 Osceola Trail Naples, Florida 34109 d. Invoices shall reference an incident or work order number when applicable. e. The contractor shall issue separate invoices for each purchase order number unless special instructions are given. Partial payment shall not be made unless specified. f. Payment will be made within thirty (30) days after acceptance of the invoice. g. Invoices which do not reference valid purchase order numbers or which are erroneous (incorrect pricing, additional fees, incorrect purchase order) may be returned to Contractor for resolution. Payment will not be made until all discrepancies are corrected and approved. h. All invoices will be itemized to reflect all rates or discounts per this RFP. Lump sum invoices will not be accepted. Failure to provide itemized invoices will be cause for delay in payment or non-payment. 1.17 Conflict of Interest The award hereunder is subject to the provisions of Chapter 112 Florida Statutes. Bidder shall complete Exhibit A – “Conflict of Interest Statement” attached hereto and submit with bid. Failure to provide shall be grounds for rejection of proposal. 1.18 Unauthorized/Illegal Aliens CCPS shall consider the employment by any Contractor of unauthorized/illegal aliens in violation of Section 274A of the Immigration and Nationality Act. Such violation shall be cause for immediate termination of contract (s). Furthermore, bidder shall complete the attached Exhibit B - “Contractor’s Affidavit Concerning Illegal Aliens” and submit with proposal. Failure to complete this affidavit will be cause for rejection of RFP. 1.19 Debarment All contractors receiving individual awards, using federal funds, and all subcontractors; certify that the organization and its principals are not debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency from doing business with the Federal Government. Bidder shall complete the attached Exhibit C - “Debarment Form” and submit with its proposal. Failure to complete will be cause for rejection of bid. Instructions are also attached. 1.20 Drug-Free Workplace Certification CCPS supports and encourages initiatives to keep the workplace of Florida’s suppliers and contractor’s drug free. In cases where identical tie bids are received, preference shall be given to a proposal received from a vendor that certifies it has implemented a drug-free workforce program. If applicable, bidder shall sign and submit Exhibit D - “Drug-Free Workplace Certification”, attached hereto, to certify that the respondent has a drug-free workplace program. 1.21 Funding Out/ Termination / Cancellation a. Florida Laws prohibit Public Employers from creating obligations in anticipation of budgeted revenues from one fiscal year to another without year-to-year extension provisions in the agreements. b. It is necessary that fiscal funding out provisions be included in all proposals in which the terms are for periods longer than one (1) year. c. Therefore, the following funding out provisions is an integral part of this proposal and must be agreed to by all respondents: CCPS may, during the contract period, terminate or discontinue the services covered in this proposal at the end of CCPS’s then current fiscal year upon ninety (90) days prior written notice to the successful respondent. Such written notice will state: i. That the lack of appropriated funds is the reason for termination, and ii. “This written notification will thereafter release CCPS of all further obligations in any way related to the services covered herein.” iii. The Funding Out statement must be included as part of any agreement. No agreement will be considered that does not include this provision for “funding out.” 16.E.20.a Packet Pg. 2441 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 6 1.22 Termination of Contract a. In the event the successful contractor violates any of the provisions of the contract, CCPS may serve written notice upon such bidder of its intention to terminate the contract. Such notice is to state the reasons for intention to terminate the contract, and, unless ten (10) days after serving such notice upon the bidder, such violation(s) cease and satisfactory arrangements for correction are made, the contract shall, upon expiration of said ten (10) days, cease and terminate, but the liability of such bidder and his surety for any and all such violation(s) shall not be affected by any such termination. CCPS may immediately terminate contract for any blatant violations or continual non-performance/violation. b. CCPS reserves the right to terminate any contract resulting from this RFP, with or without cause, at any time , upon giving thirty (30) days prior written notice to the awarded contractor(s). If said contract should be terminated for convenience as provided herein, CCPS will be relieved of all obligations under said contract. CCPS will only be required to pay to the contractor(s) that amount of the contract actually performed to the date of termination. c. Repeated instance of failure to perform may result in cancellation of the contract and removal of the Contractor from consideration on other CCPS contracts for a duration of the contract period or for three (3) years, whichever is longer, at the discretion of the Director of Purchasing. d. In the event the Contractor wishes to terminate the contract, it must submit its request in writing to the Purchasing Department. Request must give a 120-day notice of cancellation and should list any reasons why contract is being terminated. Failure to give proper notice may result in the withholding of monies owed or reduction of monies owed for any expense incurred from failure to submit proper notification of cancellation. e. Upon cancellation hereunder, CCPS may pursue any and all legal remedies as provided herein and by law. 1.23 Public Records a. Pursuant to subsection 119.071(1)(b) Florida Statutes, 2013 “sealed bids, proposals or replies received by the District pursuant to a competitive solicitation are exempt from the Public Records Act (Chapter 119) and Section 24(a), Article 1 of the Florida Constitution until such time as the District provides notice of an intended decision or until thirty (30) days after opening the bids, proposals, or final replies, whichever is earlier.” b. All bid documents or other materials submitted by the Bidder in response to this RFP will be open for inspection, upon request, by any person and in accordance with Chapter 119, Florida Statutes. Only trade secrets as defined in Section 812.081, Florida Statute shall be exempt from disclosure. c. CCPS has the right to use any or all documents, submittals, ideas presented in any response to this RFP. Selection or rejection of any submittal does not affect this right. d. If CCPS rejects or cancels RFP and intends to reissue, then all bids, proposals or replies submitted, will remain exempt from public records, and may be returned unopened. e. Per Florida Law, Contractor shall also maintain any and all records, and must: i. Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service; ii. Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law; iii. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; iv. Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the contractor upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. If the Contractor has questions regarding the applicability of Chapter 119, Florida Statutes, to the Contractor’s duty to provide public records relating to this contract, contact Ms. Donna Woods, Coordinator, Technology Department woodsdo@collierschools.com (239) 377-0457. 1.24 Disputes In case of any doubt or difference of opinion as to the items to be furnished hereunder, the decision of CCPS shall be final and binding on both parties. 1.25 Governing Laws and Venue a. In the event that the awarded proposer(s) should breach this contract the CCPS reserves the right to seek remedies in law and/or in equity. b. All legal proceedings brought in connection with this Contract shall only be brought in a state or federal court located in the State of Florida. Venue in state court shall be in Collier County, Florida. Venue in federal court shall be in the United States District Court. Each party hereby agrees to submit to the personal jurisdiction of these courts for any lawsuits filed there against such party arising under or in connection with this Contract. In the event that a legal proceeding is brought for the enforcement of any term of the contract, or any right arising therefrom, the parties expressly waive their respective rights to have such action tried by jury trial and hereby consent to the use of non-jury trial for the adjudication of such suit. 16.E.20.a Packet Pg. 2442 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 7 c. All questions concerning the validity, operation, interpretation, construction and enforcement of any terms, covenants or conditions of this Contract shall in all respects be governed by and determined in accordance with the laws of the State of Florida without giving effect to the choice of law principles thereof and unless otherwise preempted by federal law. 1.26 Warranty a. Proposer agrees that, unless otherwise specified, the product and/or service furnished as a result of this RFP and award thereto, shall be covered by the most favorable commercial warranty the Proposer gives to any customer for comparable quantities of such products and/or services and that the right and remedies provided herein are in addition to and do not limit any rights afforded to CCPS by any other provision of the RFP. b. Contractor warrants to that all materials and equipment furnished under this contract will be NEW unless otherwise specified, and that all work will be of good quality, free from faults and defects and in conformance with the RFP. All work not conforming to these requirements, including substitutions not properly approved and authorized, may be considered unacceptable. If required by CCPS, Contractor shall furnish satisfactory evidence of the kind and quality of materials and equipment used to meet the requirements of the proposal. c. During the warranty period, the Contractor must repair and/or replace any faulty item without cost to CCPS, with the understanding that all replacements shall carry the same warranty as the original equipment. The Contractor shall make any such repairs and/or replacements immediately upon discovery or receiving notice from CCPS staff. The Contractor further warrants that the item(s) and or services provided are fit, and otherwise conforming, for the purpose(s) intended by CCPS. 1.27 Hold Harmless & Indemnification Agreement Contractor shall indemnify, save harmless and defend CCPS, its appointed officials, its employees, agents, volunteers and others working on behalf of CCPS, from and against any and all claims, losses, costs, attorney’s fees, damages, or injury including death and/or property loss, expense claims or demands arising out of or caused or alleged to have been caused in any manner by a defect in any equipment or materials supplied under this Contract or by the performance of any work under this Contract, including all suits or actions of every kind or description brought against CCPS, either individually or jointly with Contractor for or on account of any damage or injury to any person or persons or property, caused or occasioned or alleged to have been caused by, or on account of, the performance of any work pursuant to or in connection with this Contract, or through any negligence or alleged negligence in safeguarding the work area, or through any act, omission or fault or alleged act, omission or fault or alleged act, omission or fault of the Contractor, its employees, Sub-contractors or agents or others under the Contractor’s Contract. 1.28 Protection of Property The contractor shall at all times guard CCPS property against damage or loss to property. The contractor shall replace any loss; repair any damage to CCPS property, attainable to the contractor or its associate(s). CCPS may withhold payment or make such deductions, as it might deem necessary to insure reimbursement for loss or damage to property through negligence of the Contractor. 1.29 Safety Standards a. All contractors performing services for CCPS are required and shall comply with all OSHA, State and County Safety and Occupational Health Standards and any other applicable rules and regulations. The bidder warrants that the products/services supplied to or performed for CCPS shall conform in all respects to the standards set forth in the Occupational Safety and Health Act, as amended. Failure to comply with this condition will be cause for termination of contract. b. Contractors shall insure the safety of its employees, building occupants, and the environment throughout the course of the contract for any and all CCPS projects. c. Contractors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site, and insure its employees have received safety equipment training, to include individual health protection measures, and manufacturer’s product and safety data sheets (SDS) as required for the work by the U.S. Occupational Safety and Health Administration, and as described by this specification. d. The Contractor shall be responsible for instructing and training their employees in all safety measures e. Contractor shall determine the need for and provide its personnel with any and all protective or safety items required for the safe performance of work. Protective clothing, equipment, and devices shall, at a minimum, conform to U.S. Occupational Safety and Health Administration (OSHA) standards for the products being used. Failure to comply will be grounds for termination of contract. f. All equipment used by the Contractor shall be maintained in safe operating condition at all times, and be free from defects or wear that may in any way constitute a hazard to any person or persons on CCPS property 1.30 Discrimination An entity or affiliate who has been placed on the discriminatory vendor list may not submit a proposal on a contract to provide goods or services to a public entity, may not submit a proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit proposals on leases of real property to a public entity, may not award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity. 1.31 Bullying & Harassment Vendor, contractor and all affiliates agree to abide by provisions of Board Policy 5517.01 for non-tolerance of bullying and harassment of all students and employees. 1.32 Smoke and Tobacco Free Environment Pursuant to School Board Policy No. 1215, 3215, 4215, 5512 and 7434, all of CCPS facilities are declared smoke and tobacco free. The smoking of any substance, or the use of any tobacco product, to include, but not be limited to, cigars, cigarettes, pipes, chewing tobacco, snuff or any other matter or substance that contains tobacco, is strictly prohibited on any CCPS site, which includes all interior and exterior spaces within the property boundaries. Violations of this policy will result in the removal of said violator 16.E.20.a Packet Pg. 2443 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 8 from the property. Repeated violations may result in the termination of contract. 1.33 Possession of Weapons & Other Destructive Devices a. Possession of weapons and other destructive devices will not be tolerated on any CCPS property (except authorized law enforcement personnel, or persons pre-approved by the Superintendent). The term "weapon" and/or "destructive device" means any object which, in the manner in which it is used, is intended to be used, or is represented, is capable of inflicting death, serious bodily injury, or property damage, as well as endangering the health and safety of persons. Weapons and destructive devices include, but are not limited to, firearms, guns of any type, bombs, explosive, explosive devices, poison gas, knives, razors, clubs, electric weapons, metallic knuckles, martial arts weapons, ammunition, or any other category of weapon and/or destructive device as set forth in F.S. 790.001. b. CCPS prohibits anyone from keeping any weapon or firearm in a private vehicle on school property, even if weapon/firearm stays in the vehicle, is securely encased and is not readily accessible for immediate use, except as authorized in support of school-sanctioned and supported activities including, but not limited to, property leased, owned, or contracted for by CCPS, a school-sponsored event, or in a CCPS vehicle c. If any employee of an independent contractor or sub- contractor is found to have brought a firearm on CCPS property, said employee will be terminated from the project by the independent contractor or sub-contractor. If the subcontractor fails to terminate said employee, the sub- contractor's agreement with the independent contractor for the project shall be terminated. If the independent contractor fails to terminate said employee or fails to terminate the agreement with the sub-contractor who fails to terminate said employee, the independent contractor's agreement with CCPS shall be terminated. 1.34 Force Majeure The contractor(s) shall not be held responsible for failure to perform the duties and responsibilities imposed by the contract due to legal strikes, fires, riots rebellions and acts of nature beyond the control of the contractor(s), unless otherwise specified. 1.35 Other Agencies Contractor(s) may permit any school board, community college, state university, municipality or other governmental entity, to include Public Charter Schools to participate in the awarded contract under the same prices, terms and conditions. It is understood that each entity will issue its own purchase order to the Contractor(s). 1.36 Additional Information a. CCPS reserves the right to request any additional information, after the RFP opening, to further clarify or explain any information submitted with the proposal. b. CCPS reserves the right to allow for the clarification of questionable entries and the correction of obvious mistakes. 1.37 Additional Terms CCPS reserves the right to reject offers or bids containing alternative terms or conditions, or additional terms and conditions contradictory to those requested in the RFP. ***CCPS reserves the right to reject any and/or all proposals, in whole or in part, and to waive any and all formalities, technicalities, or other as may be deemed to be in the best interest of CCPS.*** 16.E.20.a Packet Pg. 2444 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 9 Section 2 – Proposal Information & Requirements 2.1 Purpose The purpose of this Request for Proposal (RFP) is to solicit competitive sealed proposals for Medical/Dental Claims and Flexible Spending Account Administration Management Services for use by Collier County Health Care Consortium (CCHCC) members. Any specifications listed herein are the minimum required performance specifications for this RFP. They are not intended to limit competition nor specify any particular respondent but to ensure that CCHCC receives quality services. 2.2 Background A. Collier County Health Care Consortium (CCHCC) is comprised of the following four major Collier County employers. Collier County Government (CCG) Collier County Public Schools (CCPS) Collier County Sheriff’s Office (CCSO) NCH Healthcare System, Inc. (NCH) Since 2001, these four employers have shared information and ideas and collaborated to understand the factors driving health and health care cost. These employers work together, dedicating their time, resources and expertise to understand and act on the factors that have continued to make it difficult to finance health care benefits for employees. Although this gro up is informal, it is dedicated to health and health care, as evidenced through regularly scheduled meetings throughout the year, mutual respect and the use of solid metrics to monitor progress towards its goals. These employers believe, by working in par tnership with providers, they can make a difference and help keep private health insurance affordable. The CCHCC employers have approximately 8,300 employees covered under various medical plan options and services associated with the operation of medical p lans. B. The following summarizes the core values guiding the group’s collaborative efforts: The cost of providing health care benefits continues to escalate at a rate exceeding the general growth of the economy. This continued escalation in the cost of providing quality and affordable health care benefits impacts the organizations’ ability to efficiently serve their "customers.” It also impacts their employees' ability to raise their standard of living since they participate financially in the increases. Finally, health and health care plays an important role in how the community is viewed as a place to live, raise a family and operate a business. The group believes health care cost is determined by more than just how large a discount can be negotiated off of the cost per unit of service provided. Rather, health care cost is determined by a complex interaction where multiple stakeholders have the ability to impact the cost, type and volume of services provided. Typically, cost is seen as a simple function of price per unit time’s volume: Price per unit x Volume = Cost In health care "Total Cost" is a more complex function where multiple stakehol ders have influence over the total cost of healthcare, as they are able to influence the number of services provided, type of services provided, cost of the services provided and, whether those services influence the health status of a covered member. 16.E.20.a Packet Pg. 2445 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 10 Price per unit x multiple volumes adjusted for Outcome = Total Cost Volume1 = Determined by physician practice and billing patterns Volume2 = Determined by patient preferences and expectations Volume3 = Determined by patient health status and lifestyle Volume4 = Determined by payer Volume5 = Does the patient understand and comply with proposed treatment? Outcome = Benefit to the patient as determined by: a. Efficacy: Which treatment produces the best result for the patient? b. Effectiveness: Does the treatment result in superior outcomes when applied in the delivery system? c. Appropriateness: Is the treatment used appropriate at the right time in the right place? d. Execution: How well does the provider perform the procedure? e. Patient Compliance: Does the patient understand and comply with the treatment plan? C. CCHCC employers believe affordable health insurance and improving the health of the population is attainable provided plan sponsors, employees, vendors and providers recognize the following: No one party alone is responsible for the current situation; providers, employers, employees and patients have all shared equally in creating the problem. Hence they all share equally in the solution. Data must be used on a regular basis to identify opportunities to improve cost, utilization and outcomes. Strategies are then developed and implemented to address those opportunities. Finally, data is used to measure results and adjust strategies where appropriate. A detailed organizational picture of the aggregate health status of employees and their dependents is vital to developing effective strategies to prevent and treat disease. However, this cannot be done at the risk of jeopardizing the privacy of members’ health and health related records. Individual information must be protected and kept confidential. Poor health impacts not only the cost of health benefits, but also productivity and the quality of life of our employees and their dependents. Better quality leads to lower cost. By focusing on quality we can keep h eath care affordable-- everything the group advocates focuses on the right care at the right time and in the right place. The group’s ability to work effectively together for over 15 years is grounded in one core principle that has guided the interaction of the employers throughout the years. That is each employer maintains the ability to make individual decisions regarding the design of its benefit programs, the strategies they deploy and the vendors they choose to work with. Although this has led to the use of different vendors and approaches, the group has always demonstrated a laser focus on cost and quality. D. Following is a summary of where the employer groups diverge in approach: The CCG, CCPS and CCSO are public employers serving all of the communi ty. For this reason, all employers want as inclusive a network as possible and that provider network access is delivered under a direct contract that is facilitated via a messenger model coordinated by Community Health Partners. Provider 16.E.20.a Packet Pg. 2446 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 11 payment under this direct contract is a percentage of Medicare’s RBRVS schedule for physicians and either DRGs or discounts off billed charges for the local hospitals in Collier County. As is the case with any inclusive network, the CCG, CCPS and CCSO also believe utilization review, and case management should be provided locally. To support this goal, these organizations have contracted with the local Physician Hospital Organization - Community Health Partners (CHP) to provide traditional precertification review, case management and disease management services. CHP also coordinates health screening via Quest (CCPS)/Midland (CCG) and provides health support services via an onsite dedicated nurse advocate/coaches for both organizations. NCH is a provider as well as an employer and, as such, wishes to drive as much care as it can to its facilities and allied providers. Their network access and care management is provided via Florida Blue which supports an overall design that drives as much of the care as possible to be provided domestically. To understand cost drivers and to manage health and pharmacy claims data, the group collectively uses Verscend’s Health Sightlines Medical Intelligence system. Verscend is also used by CHP in conjunction with the McKesson system to support contracting, utilization management, wellness and population health efforts. In 2009, with the exception of the CCSO, these organizations evaluated numerous plan design alternatives to drive age and gender appropriate screenings, health awareness and support activities to maintain and improve health. They eventually arrived at what they referred to as a “Behavioral Based Health Plans.” Under the Behavioral Based Health Plan model, a significant paradigm shift occurs. Instead of implementing a choice of plans where employees pay more to get better coverage or greater access to providers, a single plan is offered under which members can qualify for lower cost share at point of service by participating in a variety of activities. These activities are designed to ensure age and gender appropriate screening occur, that members experience improved health awareness and the appropriate processes are in place to help people maintain their health and address chronic disease or serious medical conditions. These activities apply to employees and spouses. Dependents are not included. The frequency of screening and activities varies from employer to employer. However, the following are the core activities that are consistent across the CCG, CCPS and NCH: Completion of a confidential health history questionnaire (with the exception of CCPS) Complete defined metabolic panel Weight, height and blood pressure recorded Meet with health advocate and select a primary care physician if they do not have level of ben efits Complete age and gender appropriate screening (i.e., Pap test, colonoscopy, etc.) Actively engage with health advocates and case managers as requested Actively participate in a disease management program if eligible The CCG and NCH also offer a program that allows participants to earn deposits to a Health Reimbursement Account (as allowed by IRS revenue ruling 2002-41) by completing a variety of health education and activity programs that each of these employer’s offers By focusing on its core values and the core areas, collectively, the group has maintained flat per member per month cost for the last six (6) years without a material cost transfer to employees via larger deductibles, coinsurance and copays. 2.3 Scope of Services A. Over the past sixteen (16) years, the Collier County Government (CCG), Collier County Public Schools (CCPS), Collier County Sheriff’s Office (CCSO) and NCH Healthcare System, Inc. (NCH) have undertaken 16.E.20.a Packet Pg. 2447 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 12 periodic joint vendor evaluation processes. The purpose of these joint evaluati on processes is not to force any of the employers to select the same vendor. However, the employers have realized the following benefits as a result of the joint vendor evaluation process: Continually evaluate whether a material benefit would be realized through the use of a single vendor from either a service or economic perspective or both Leverage the synergies of a group selection and evaluation process to broaden the discussion and perception of the service capabilities of various vendors and how they may best meet the unique needs of each employer Realize the efficiencies of joint versus individual processes The group also believes this approach is more efficient for vendors replying to the RFP as they reply to one set of questions and, if selected as a finalist, make one group presentation versus responding to three separate RFPs and potentially making up to three finalist presentations. The CCG, CCPS and NCH agreements with their current administrators expire at the end of 2017. These three employers are interested in obtaining quotations for claims payment and administrative services for their medical plans. The CCG and CCPS are interested in obtaining quotations for claims payment and administrative services for their dental plan as well. Services sought for each employer are as follows: Each group’s contract expires at the end of 2017 and each group is seeking a unique separate scope of services as summarized below: B. Scope of services sought by CCG Medical and dental claims payment, COBRA, Health Care Spending (FSA-Section 125), Dependent Care Spending (DSA-Section 129) and Health Reimbursement Accounts (HRA-IRS revenue ruling 202-41). In addition, the CCG wishes to assess the scope and financial effectiveness of your provider network both inside and outside of Collier County. The CCG currently utilizes CHP for UR, CM, and DM. They fully anticipate continuing to utilize CHP for these services. However, the CCG would like a quote for these services. If for any reason during the duration of the contract period with the selected vendor CHP would be unable to provide these services, the CCG would have the option to retain the firm selected to provide these services. C. Scope of services sought by CCPS Medical and dental claims payment, COBRA, Health Care Spending (FSA-Section 125) and Dependent Care Spending (DSA-Section 129). Although the CCPS does not currently offer a Health Reimbursement Accounts (HRA-IRS revenue ruling 202-41), it may do so in the future and is interested in exploring the cost and your capabilities of providing the service. In addition, the CCPS wishes to assess the scope and financial effectiveness of your provider network both inside and outside of Collier County. The Florida State Retirement System mandates, CCPS offer retirees the option to stay on the medical plan by paying the active rate on a monthly basis. The current TPA bills, collects premiums and remits retiree premium payments for about 120 retirees. Your quote assumes you will provide this service. CPS is also interested in a quote that provides EAP services, as well as any programs you have that will support their current wellness program. The CCPS currently utilizes CHP for UR, CM and DM. They fully anticipate continuing to utilize CHP for these services. However, the CCPS would like a quote for these services. If for any reason during the duration of the contract period with the selected vendor CHP would be unable to provide these services, the CCPS would have the option to retain the firm selected to provide these ser vices. 16.E.20.a Packet Pg. 2448 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 13 D. Scope of services sought by NCH Medical claims payment, utilization review, case management, disease management, pharmacy benefit management services, COBRA, Health Care Spending (FSA -Section 125), Dependent Care Spending (DSA- Section 129) and Health Reimbursement Accounts (HRA-IRS revenue ruling 202-41). NCH also wishes to evaluate the scope and financial terms of your network both inside and outside of Collier County. They may also elect to utilize the same physician network that is utilized by the CCG and CCPS. Florida Blue, via WebMD, currently provides services relative to NCH’s wellness and population health pr ogram. NCH is interested in assessing your ability to either directly or via a relationship with a preferred vendor provide these services. Florida Blue/New Directions currently provides an Employee Assistance Program (EAP) to NCH employees. NCH is interested in assessing your ability to provide EAP services either directly or via a relationship with a preferred vendor. E. Summary of scope of services sought by all three employers With respect to the above services respondents are also advised of the followin g requirements that are consistent among the three employers: On-site customer service representative Access to a robust website providing employees access to detailed information about the plans, claims payments, ID care requests, etc. Provide monthly claims payment extracts in the required formats to Verscend, CHP and Willis Towers Watson Access to ad hoc financial reporting systems and processes Provide necessary financial reporting and banking service support As is the case currently, each employer will have the opportunity to choose the TPA it determines best serves its needs. As a result, proposers are to base its pricing on the assumption that each employer may purchase the scope of services noted above from the vendor individually. However, if proposer offers a volume discount if two or all three of the employers noted above purchase services from the same vendor under a contract from this RFP, then Proposer shall outline how volume discounts and award from multiple employers will affect its quoted terms. An overview of key aspects of each employer and their plans is provided in the table below. Those services highlighted in green are included in this RFP. Those that are not are not included in this RFP. Employer Abbr Avg EEs on Medical Total Participants Current TPA PBM Lab On-Site Representative Plan Collier County Government CCG 2,080 4,550 Allegiance Benefit Plan Administrator s EnvisionRx Midland Yes Behavioral Based Collier County Public Schools CCPS 5,025 6,954 Allegiance Benefit Plan Administrator s EnvisionRx Quest Yes Behavioral Based NCH Healthcare System NCH 2,614 5,313 Florida Blue Prime Therapeutics Health Designs Yes Behavioral Based 9,719 16,817 16.E.20.a Packet Pg. 2449 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 14 Employer PBM Medical Admin Dental Admin FSA Admin COBRA Admin EAP HRA Network Collier Co Network outside Collier Co UR, CM, DM CCG EnvisionRx Allegiance Allegiance Allegiance Allegiance Aetna N/A CHP Cigna CHP CCPS EnvisionRx Allegiance Insured/ MetLife Allegiance Allegiance Humana N/A CHP Cigna CHP NCH Prime Therapeutics Florida Blue Insured/ Cigna Florida Blue/ Health Equity Allegiance Florida Blue/ New Directions Florida Blue/ Health Equity Florida Blue Florida Blue Florida Blue Complete details of the applicable plans that each employer offers are provided in Appendices 6-9. F. Additional Summary Information The CCSO is currently under contract with Meritain and EnvisionRx through 2018 and will not be participating in this RFP process. As noted earlier, the CCG and CCPS collectively use CHP to provide network, utilization review, case management and disease management programs. Proposer shall demonstrate the willingness and ability to work closely with CHP on an ongoing basis. CCPS uses its own propriety enrollment platform to handle enrollment. The CCG uses SAP as its enrollment platform, and NCH uses currently uses Kronos via their payroll system for enrollment. Vendors must be willing to share data and work with these systems or to work with a vendor of the employer’s choice. Experience working with these and other current commercial online enrollment vendors will be viewed positively. In formulating your responses, the CCHCC employers want proposer to go beyond the typical answers. Please ensure that proposal focuses on the specific expectations noted in this RFP. The CCHCC employers seek concise, fact-based statements about what makes proposer’s organization different and how proposer will change and adapt to address the issues raised in this document. PLEASE NOTE: The unique health plan benefit design for each employer along with separate contacts and reporting shall be maintained. G. Additional Requested Information The representatives of each employer’s selection team are seeking information that addresses the following areas: 1) Implementation and Transition 2) Control over Administration 3) Provider Network 4) Communication 5) Technology 6) Service to Providers 7) General Service Issues 8) Data Availability 9) Service to Employees 10) General Requirements 11) Value Added Services and Transparency 16.E.20.a Packet Pg. 2450 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 15 For each of these areas there is an outline of key issues, services, attributes or questions identified by the employers as important to them. When preparing responses to each question, where applicable, proposer shall outline the following: State if proposer has had experience with the issue, service, attribute or question; If proposer has had experience to the issue, service, attribute or question, then it shall state how it responded to said item; or, If proposer has had no experience with the issue, service, attribute or question, then it shall state how it has changed or how it would change its organization and process to respond to this need? 2.4 Time Schedule CCHCC employers intend to use the following time schedule, which will result in selection of a proposer(s) for an implementation date of January 1, 2018. Notification of any changes to the time schedule will be posted on CCPS’s website: www.collierschools.com and/or www.demandstar.com and may be made to available to proposer (s) by e-mail or fax upon request . Response to inquiries regarding the status of a proposal will not be made prior to the posting of award recommendation. 2.5 Lobbying The RFP process is being overseen by the CCPS Purchasing Department. As outlined, a formal selection process is being followed. Vendors are not permitted to lobby, contact, etc… with any member of the administration, employees, employee organizations or Board members regarding this RFP. All questions are to be directed to the CCPS Purchasing Department as noted below. The CCHCC employers may, at its option, hold a bidder’s conference to further answer questions to this RFP. Any responses to questions will be shared with all prospective bidders. Any vendor who discusses this RFP with administration, employees, employee organizations or Board members, unless expressly authorized in writing, the respective entity will be disqualified from consideration. All questions, comments, etc… during the RFP process shall be directed as instructed pursuant to this RFP. Date Event March 20, 2017 RFP Posted and advertised. April 6, 201 7 All written questions and inquiries are due by 10:00AM. April 13, 2017 Proposals due no later than 4:00PM. April 13 –21, 2017 Proposal(s) analysis and evaluation. April 20, 2017 Proposals will be reviewed to narrow down applicants for possible presentations and interviews. Vendors will be notified of their proposal acceptance and schedule (if necessary) for presentations & interviews. Proposers should be ready and available to present within a one week notice. April 20-21, 2017 Possible interviews from short -listed proposers April 21 – May 1, 2017 Discussion of contracted terms May 31, 2017 (or earlier) Notice of Recommended Selection June 13, 2017 Presentation to CCPS School Board for approval July 1, 2017 Program Implementation begins January 1, 2018 Program Becomes Effective 16.E.20.a Packet Pg. 2451 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 16 2.6 Disclosure of Proposal Content All material submitted becomes the property of the CCHCC and may be returned only at the CCHCC’s option. The CCHCC has the right to use any or all ideas presented in any reply to this RFP. Selection or rejection of any Bid Submittal does not affect this right. All information contained in this Request for Proposal is confidential and proprietary to the extent permitted under Florida Public Records Law. This informatio n must be used solely for the purpose of responding to the CCHCC employers Request for Proposal. If confidential materials and/or trade secrets as defined by applicable public records laws are being submitted proposer may segregate any such materials on a separate drive, plainly labeled “Confidential Materials.” 2.7 Required Signatures Each person signing any document pertaining to the RFP, attachments and/or subsequent contract, warrants that they are duly authorized to do so and to bind the respective party. 2.8 Proposal Evaluation Process The RFP is part of a competitive procurement process, which shall determine the proposal that shall serve in the best interest of each CCHCC employer. Each CCHCC employer participating in this process has identified a project selection team comprised of representatives appointed from each member organization. These teams, with the technical support and guidance of Willis Towers Watson, will be responsibl e for providing the necessary evaluations of potential vendors responding to this RFP. The analysis and selection will adhere to the following steps: 1. The CCG and CCPS representatives of the evaluation team will review and score the written responses to the RFP according to a predetermined scoring method outlined below. NCH will score responses independently. CCG TPA and Network Scoring Category Points Score Potential Score Qualitative Assessment 1) Implementation and Transition 10 1 to 5 10 to 50 2) Control over Administration 10 1 to 5 10 to 50 3) Provider Network 10 1 to 5 10 to 50 4) Communication 10 1 to 5 10 to 50 5) Technology 10 1 to 5 10 to 50 6) Service to Providers 10 1 to 5 10 to 50 7) General Service Issues 10 1 to 5 10 to 50 8) Data Availability 10 1 to 5 10 to 50 9) Service to Employees 10 1 to 5 10 to 50 10) General Requirements 5 1 to 5 5 to 25 11) Value Added Services and Transparency 5 1 to 5 5 to 25 Total 100 to 500 Quantitative Assessment 1) Administrative Cost 30 See RFP for Calc 2) Contract Term 10 3) Network Terms 60 Total 100 100 to 400 16.E.20.a Packet Pg. 2452 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 17 CCG TPA and Network Scoring Category Points Score Potential Score Total Score to Select Finalists 200 to 900 Finalist Interviews Selected finalists can add up to 200 points to final score Addressing Questions Asked Versus Selling 10 1 to 5 10 to 50 Fit with Organizational Culture 10 1 to 5 10 to 50 Understands CCHCC Objectives 10 1 to 5 10 to 50 Will work well with CHP 10 1 to 5 10 to 50 Score 40 to 200 Grand Total Potential Score 240 to 1100 CCPS TPA and Network Scoring Category Points Score Potential Score Qualitative Assessment 1) Implementation and Transition 10 1 to 5 10 to 50 2) Control over Administration 10 1 to 5 10 to 50 3) Provider Network 10 1 to 5 10 to 50 4) Communication 10 1 to 5 10 to 50 5) Technology 10 1 to 5 10 to 50 6) Service to Providers 10 1 to 5 10 to 50 7) General Service Issues 5 1 to 5 10 to 50 8) Data Availability 10 1 to 5 10 to 50 9) Service to Employees 15 1 to 5 10 to 50 10) General Requirements 5 1 to 5 5 to 25 11) Value Added Services and Transparency 5 1 to 5 5 to 25 Total 100 to 500 Quantitative Assessment 1) Administrative Cost 30 See RFP for Calc 2) Contract Term 10 3) Network Terms 60 Total 100 100 to 400 Total Score to Select Finalists 200 to 900 Finalist Interviews Selected finalists can add up to 200 points to final score Addressing Questions Asked Versus Selling 10 1 to 5 10 to 50 Fit with Organizational Culture 10 1 to 5 10 to 50 Understands CCHCC Objectives 10 1 to 5 10 to 50 Will work well with CHP 10 1 to 5 10 to 50 Score 40 to 200 Grand Total Potential Score 240 to 1100 2. Willis Towers Watson will perform an evaluation of the financial terms and provide a summarization of the qualitative aspects of the RFP. 16.E.20.a Packet Pg. 2453 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 18 3. The financial terms of proposer responses will be evaluated by a process where the lowest vendor overall financially will receive the highest possible score. Scores for the remaining vendors will be determined utilizing the following formula: Score = (number responding x [lowest cost] / vendor cost) 4. Based on a composite evaluation of the financial terms and the project team’s evaluation of the written responses to this RFP, two or more finalists may be selected. 5. Finalists will be expected to travel to Naples, Florida to be interviewed. Additionally, representatives of the CCHCC may want to tour the TPA’s operations. During these tours, finalists will be subjected to a consistent set of predetermined questions. Each representative of the evaluation team wi ll independently score responses to these questions. 6. A final recommendation and selection will be based on the weighted scores of the evaluation team with respect to the following: Scores regarding written responses to the proposal Scores regarding financial response Scores regarding finalist interviews This RFP process and the terms proposers provide are to be based on the assumption of each of the entities that make up the CCHCC participating in this process will be contracting individually with your organization. Any and all entities reserve the right independently or collectively to not contract with the respondent. The CCHCC employers reserve the right to modify their final section process, to modify the factors for consideration and make their selection in the manner they choose. If the respondent believes there is any reasons why it would be advantageous for the organizations to contract with you selectively either from a qualitative or quantitative perspective, then is shall outline those reasons in its response. Please note that all RFP factors are considered during the evaluation process and not solely based upon price. Any award shall be made to the Firm whose proposal is determine d to be the most advantageous to each entity, taking into consideration all evaluation factors set forth in the RFP. For CCPS award, t he Purchasing Department will prepare and submit an agenda item to the Superintendent of Schools, Collier County, Florida. The Superintendent will recommend to the School Board, the award or rejection of any and/or all proposal(s). The School Board will award or reject any or all proposal(s). 2.9 Oral Presentations / Interviews a. CCHCC may require selected (short listed) Proposers to give oral presentations to the selection committee or any members therein, in support of their Proposals or to exhibit or otherwise demonstrate the information contained therein. Estimated dates are provided in the RFP Time Schedule. All Proposers should be prepared to attend and present in the event they are selected in the initial ranking process. Any and all expenses involved in making any presentation(s) will be at the expense of the Proposer. b. Please have appropriate staff hold April 20-21 for finalist interviews c. CCHCC reserves the right to interview any or all proposers and to require a formal presentation with proposer before recommendation of award. 16.E.20.a Packet Pg. 2454 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 19 d. Recommended/Awarded Proposer may be requested to attend the School Board meeting in which the RFP award is being presented, in the event any School Board Member may have questions or concerns on the item. 2.10 Inspection of Organization a. CCHCC reserves the right before recommendation of an award to inspect the facilities and organization; or to take any other action necessary to determine the legitimacy of the bidder’s submittal and its ability to perform all services under this RFP at or above a satisfactory level. CCHCC further reserves the right to reject proposals where investigation and evaluation or other evidence submitted indicates an inability of the bidder to meet any requirements or to perform the services of this RFP. The ability or inability to meet all requirements and service CCHCC under this RFP will be at the discretion of CCHCC. b. Contractor shall at all times during the Contract remain responsive and responsible. Contractor must be prepared, if requested, to present evidence of experience, ability, and financial standing, as well as a statement as to its capacity to perform the services under this RFP. If it is determined that the conditions of the solicitation documents are not complied with, or that the services to be furnished do not meet the specified requirements, or that the qualifications, financial standing, or sufficient capacity to perform are not satisfactory, or that performance is untimely, CCHCC may reject the response or terminate the Contract. c. Bidder may be disqualified from receiving awards if anyone in its employment, has previously failed to perform satisfactorily in connection with public bidding or contracts. d. This section shall not mean or imply that it is obligatory upon CCHCC to make an investigation either before or after award of the Contractor, but should it elect to do so, contractor is not relieved from fulfilling any and all Contract requirements or documents. 2.11 Contract & Term a. The contents of this RFP and all provisions of the awarded bidder’s submittal shall be considered a contract and become legally binding. A separate contract document, other than the purchase order, may not be issued. b. The proposer shall not enter into sub -contracts, or assign, transfer, convey, sublet, or otherwise dispose of the ensuing contract, or any or all of its right, title or interest herein, or its power to execute such contract to any person, company, or corpo ration. c. All financial terms shall be for a period from January 1, 2018 through December 31, 2020. Contract may be renewed annually on expiration date of original contract. This renewal may be accomplished for up to two (2) additional years*. Renewals will be for a one (1) year period, from January 1 to December 31. All renewals are contingent upon satisfactory performance by the Contractor and the availability of funds. Actions taken under this provision will be at the option of CCPS. * Fee guarantees that extend to 2021 and 2022 will be viewed favorably. d. The Purchasing Department will, if considering renewal, request a letter of intent to renew or an addendum to the existing contract from the Contractor prior to the end of the current contract period. If needed, the contract will be extended ninety (90) days at the current pricing beyond the contract expiration date. Contractor will be notified when the recommendation has been acted upon by the Board. e. In the event the resulting agreement is terminated, not renewed or naturally expires, the Contractor agrees that CCPS may provide written notice to the Contractor retaining the services for a month -to- month basis on the same terms and conditions set forth in the agreement. Such month -to-month services 16.E.20.a Packet Pg. 2455 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 20 shall continue until CCPS has established a new agreement. In any event, these services will not be required to continue for a period of time exceeding six (6) months. f. The proposer will be prohibited from publishing or releasing any information related to the requested services without the prior written permission of CCPS. All reports and other documents resulting from the ensuing contract will remain the sole property of CCPS. 2.12 Deviations All proposals must clearly and with specific detail, note all deviations to the exact requirements imposed upon the respondent by the Specifications. Such deviations must be clearly stated otherwise CCHCC will consider the subject proposals as being made in strict compliance with said Specifications to respondents; the respondent being held therefore accountable and responsible. Respondents are hereby advised that CCHCC will only consider proposals that meet the exact requirements imposed by the Specifications; except, however, said proposals may not be subject to such rejection where, at the sole discretion of CCHCC, the stated deviation is considered to be equal or better than the imposed requirement and where said deviation does not destroy the competitive character of the RFP process by affecting the amount of the proposal such that an advantage or benefit is gained to the detriment of the other respondents. 2.13 Post-Proposal Discussions with Respondents It is CCHCC’s intent to award a contract(s) to the respondent(s) deemed most advantageous to CCHCC in accordance with the evaluation criteria specified elsewhere in this RFP. CCHCC reserves the right however, to conduct post-closing discussions with any respondent who has a realistic possibility of contract award including, but, not limited to: request for additional information, compet itive negotiations and best and final offers. CCHCC reserves the right, before awarding the contract, to require proposer(s) to submit further evidence of qualifications or any other information CCPS staff may deem necessary for further clarification or c larification of items submitted. 2.14 Local Conditions Proposer(s) should be familiar with any local conditions, which may, in any manner, effect the services required, to include climate, indigenous pests, common pests in the area, common issues in school si tes, etc… The proposer(s) is/are required to carefully examine the RFP terms and to become thoroughly familiar with any and all conditions and requirements that may in any manner effect the work to be performed under the contract. No additional allowance will be made due to lack of knowledge of these conditions. 2.15 Collusion The CCHCC reserves the right to disqualify bids upon evidence of collusion with intent to defraud, or other illegal practices to include circumventing or manipulating the bid process in a manner that conflicts with applicable law, upon the part of the Bidder(s), Bidder’s employees or agents, the CCHCC’s Professional Consultant(s), or Consultant’s agents, or any CCHCC employee(s) who may, or may not, be involved in the development of bid specifications and/or firm bid schedules. Multiple bids from an individual, partnership, corporation, association (formal or informal) or firm under the same or different names shall not be considered. Reasonable grounds for believing that a Bidder has interest in multiple proposals for the same work shall be cause for rejection of all proposals in which such Bidder is believed to have an interest in. Any and/or all proposals shall be rejected if there is any reason to believe that collusion exists among one or more of the Bidders, the CCHCC’s Professional Consultant(s) or CCHCC’s employees. Contractors involved in developing a bid specification or Contractors with knowledge of bid specifications prior to a bid advertisement shall be disqualified from participating in the applicable bid process. 2.16 Minor Irregularities CCHCC reserves the right to waive minor irregularities in proposals, providing such action is in the best interest of CCHCC. Minor irregularities are defined as those that have no adverse effe ct on CCHCC’s best interests, and 16.E.20.a Packet Pg. 2456 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 21 will not affect the outcome of the selection process by giving the respondent an advantage or benefit not enjoyed by other respondents. 2.17 Litigation Respondents shall submit details of all litigation, arbitration or other claims, whether pending or resolved in the last five years, with the exception of immaterial claims which are defined herein as claims with a possible value of less than $25,000.00 or which have been resolved for less than $25,000.00. Notwithstanding the foregoing, all litigation, arbitration or other claims, of any amount, asserted by or against a state, city, county, town, school district, political subdivision of a state, special district or any other governmental entity shall be disclosed. Please indicate for each case the year, name of parties, case of litigation, matter in dispute, disputed amount and whether the award was for or against the Respondent. 16.E.20.a Packet Pg. 2457 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 22 Section 3 – Contractor & Contract Requirements 3.1 Contractor Materials Upon selection of a vendor, it is expected that contracts, necessary administrative forms, administrative manual, employee communications, deductible transfer data and other materials will be prepared as quickly and reasonably as possible. The chosen administrator will be expected to bear the cost of installation of appropriate administrative systems, contract preparation, billing, network enhancements, related administrative manuals, enrollment forms and communication with employees and providers. 3.2 Audit Contractor shall agree to allow CCHCC employers individually or as a group the right to audit the financial and non-financial records of the medical claims administrator and its agents as they relate to the administration of their programs whenever deemed appropriate. Such audits may be performed by CCHCC employers’ personnel or outside auditors selected by the CCHCC employers. Proposer quoted fees are to assume that the proposer’s firm will absorb the costs of preparing for and supporting an annual medical and clinical management audit conducted by a third party. In addition, proposer fees should reflect that its firm will absorb the cost of, and facilitate, a third party pre- implementation audit for each of the employers that choose to purchase services from proposer’s firm. 3.3 Claims Record Retention/Transfer The claims administrator will be required to maintain all pertinent claim records for seven (7) years from the date of each claim payment. In the event of termination, the TPA must agree to transfer to the CCHCC employers (or another party as designated by the CCHCC) within thirty (30) days notification, all required data and records necessary to administer the plans. This data would include, but not be limited to, the following: List of covered employees and dependents Preauthorization information for specific medicines Records or hard copy of claims transaction data as designated by the CCHCC employers No fees required to retrieve data less than two years old. 3.4 Contractor Employee Requirements a. Contractor shall be responsible to CCPS for the acts and omissions of its employees, sub-contractors and their agents and employees, and other persons performing any of the work under a contract with the awarded Contractor(s) of this RFP. b. **The Contractor shall strictly prohibit interaction between its employee(s), suppliers or anyone involved in any manner with projects under this RFP and the student population.** c. Conduct: Contractor employees will be expected to conduct themselves in an orderly fashion and adhere to the School Board’s policies for conduct and behavior. Contractor employees will refrain from using foul, abusive or profane language on CCPS property. The Contractor shall prohibit its employees from disturbing CCPS property that is not within the employee’s scope of responsibility. d. School Regulations: Contractor shall require its employees to comply with the instructions pertaining to conduct and School Board regulations, issued by duly appointed officials, such as the Principal, Facility Manager, etc. CCPS Administration and/or the Principal of any site where work is being performed or his/her designee, at their discretion, may require that the contractor im mediately remove any employee from working on CCPS premises for violating any School Board policies, general misconduct or terms of this agreement. 16.E.20.a Packet Pg. 2458 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 23 e. Dress Code: Employees of the Contractor shall be required to dress in accordance with CCPS’s dress policy and must wear proper attire and company uniform at all times while on CCPS property. The Contractor shall require employees to be dressed in their uniform attire when reporting to work and/or arriving at any CCPS site and remain in work attire for the duration of services. All uniforms shall clearly identify the employee as a Contractor employee and have company name and/or logo on shirt. f. Break Areas and Restrooms: Lunch and Break areas are restricted to the contractor vehicle parking area or off campus. Rest room facilities are restricted to those areas designated by the site Principal or Facility Manager. g. CCPS reserves the right to require a change in service of any contractor employee if the conduct by the Contractor’s personnel, in the opinion of CCPS, is unprofessional. 3.5 Background & Identification Badges a. Bidder shall adhere to all CCPS & State requirements pertaining to fingerprinting and badging . Bidder shall review and complete Exhibit JLA attached hereto and submit with its bid. b. Pursuant to School Board Policy 8475, all contractual personnel of Collier County Public Schools shall be subject to a criminal background check. This includes any and all sub-contractor employees. c. After award of bid, contractors’ and sub-contractors’ employees may need to be screened pursuant to CCPS policy 1121.01. The fee schedule and other important information pertaining to fingerprinting can be obtained on our website at http://www.collierschools.com/hr under the heading “Fingerprinting & ID Badges”. Failure to comply will result in the immediate termination of contract and removal from the bid list for a period of three (3) years. d. Contractor employees are required to wear, at all times on any site, State issued identification badges per CCPS policies and the Jessica Lunsford Act. Employees will not be allowed on any CCPS site without proper badges. Failure to meet this requirement will result in the immediate removal of any employee without a badge from any site. Continued non-compliance with this clause may result in the termination of contract(s). Please note that Contractor(s) must submit all COI’s, licenses etc… before badges can be issued. e. Contractor may be required to submit a list of badged employees to CCPS within thirty (30) days after commencement of contract. Any changes during the course of the contract must be updated and submitted immediately. f. ***Contractor employees using badges from another, terminated or retired employee is strictly PROHIBITED and will be cause for immediate termination of contract***. g. Contractor must immediately return any and all badges of terminated or retired employees to CCPS. Failure to do so may be cause for termination of contract. h. Please note fingerprinting and badging procedures are subject to change without notification. It will be the Contractor’s responsibility to insure they meet all State and CCPS requirements. 3.6 Contractor Vehicles Contractor vehicles shall be clearly labeled with contractor name and logo, unless otherwise approved by CCPS, and shall meet all Federal, State and local statutes and regulations. 16.E.20.a Packet Pg. 2459 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 24 3.7 Insurance Requirements Contractor shall maintain the following insurance requirements, and must submit proof of or statement of compliance with RFP as to such: Professional liability insuring against vendor’s errors or omissions in the performance of the services outlined in the RFP in an amount of not less than $2,000,000 each occurrence and in the aggregate. For NCH medical malpractice in the amount of $1,000,000 per occurrence; $3,000,000 with aggregate Excess coverage to $5,000,000. Workers Compensation insurance and employers’ liability insurance with a limit of not less than $1,000,000. Commercial general liability insurance with limits of not less than $1,000,000 per occurrence and $5,000,000 in the aggregate. Crime coverage against theft or other misappropriation of funds by whatever means for the vendor, its directors, officers, partners, shareholders, emp loyees or agents. Such coverage to include "client property" (which would be property of the client, i.e. the vendor's employee steals a client laptop, camera, or other client property while onsite). Coverage limits of no less than $1,000,000. Cyber risk network security insurance of no less than $2,000,000. Confirmation that coverage for sexual abuse and molestation is not excluded from the policy covering the health care professionals rendering service and any employees of the TPA that perform services at the site of the client. Auto Liability, inclusive of non-owned automobile liability should be requested for at least $1,000,000. In addition to the insurance requirements noted above, the vendor must certify that it has policies and procedures in place and fully intends to: Act in full compliance with all HIPAA regulations, all local, state and federal regulations and laws and insurance to cover civil acts that arise from a violation. The successful contractor(s) agrees that they shall comply with all local, state, and federal law statutes, rules and regulations including, but not limited to, the Rehabilitation Act of 1973 and the Americans with Disabilities Act. In the event that any claims should arise with regards to this contract for a violation o f any such local, state, or federal law, statutes, rules, or regulations, the provider will indemnify and hold CCG, CCPS and NCH harmless for any damages, including court costs or attorney fees, which might be incurred. In addition to the above general insurance requirements, CCPS has its own separate minimum requirements that must be met as follows: a. Certificate of Insurance Certificates of Insurance (COI), as outlined herein, shall be furnished to CCPS upon receipt of approval of the award of the contract. Certificate of Insurance shall provide a minimum of a thirty (30) day notice of cancellation to CCPS and shall name Collier County Public Schools as an additional insured as follows: The District School Board of Collier County, FL 5775 Osceola Trail Naples, Florida 34109. All certificates shall list the RFP # and title and be submitted to Ms. Tiffany Daniel, Purchasing Department either via e-mail (purchasing@collierschools.com) or facsimile ((239) 377-0074). Failure to provide a COI shall be cause for termination of contract. b. Duration of Insurance Policies 16.E.20.a Packet Pg. 2460 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 25 All insurance policies herein specified shall be in force for the term of the contract and contain a Rider that the insurance policies cannot be cancelled without a thirty (30) day prior written notice to the parties insured. c. Insurance Policy Review Insurance policies may be submitted for review to the School Board's attorney and/or the Purchasing Department. Said policies shall be in form and content satisfactory to the CCPS’s said representatives. Said policies shall also name CCPS as an additional insured party where specified herein. d. Worker’s Compensation Contractor(s) must comply with FSS 440, Workers’ Compensation and Employees’ Liability Insurance with minimum statutory limits. e. Comprehensive General Liability Successful bidder shall procure and maintain, for the life of this contract/agreement, Comprehensive General Liability Insurance. This policy shall provide coverage for death, bodily injury, personal injury products and completed operations liability and property damage that could arise directly or indirectly from the performance of this agreement. It must be an occurrence form policy. The minimum limits of coverage shall be $1,000,000 per occurrence, combined, Single Limit for Bodily Injury Liability and Property Damage Liability. f. Business Automobile Liability Successful bidder shall procure and maintain, for the life of the contract/agreement, Business Automobile Liability Insurance. The minimum limits of coverage shall be $1,000,000 per occurrence, combined Single Limit for Bodily Injury Liability and Property Damage Liability. This coverage shall be an “Any Auto” or “Comprehensive Form” policy. The insurance must be an occurrence form policy. 3.8 Right to Require Performance The failure of CCHCC at any time to require performance by the contractor of any provision herein shall in no way affect the right of CCHCC thereafter to enforce same, nor shall waiver by CCHCC of any breach of any provision herein be taken or held to be a waiver of any succeeding breach of such provision or as a waiver of any provision itself. Furthermore, indulgence by CCHCC on any non-compliance by the contractor does not constitute a waiver of any rights under this RFP. 3.9 Compliance with Laws & Regulations The respondent/contractor shall be responsible to know and to apply all applicable federal and state laws, all local laws, ordinances, rules, regulations, and all orders and decrees of bodies or tribunals having jurisdiction or authority which in any manner affect the work, or which in any way affect the conduct of the work. Respondent shall always observe and comply with all such laws, or dinances, rules, regulations, orders and decrees. Respondent shall protect and indemnify CCHCC and all its officers, agents, servants, or employees against any claim or liability arising from or based on the violation of any such law, ordinance, rule, regu lation, order, or decree caused or committed by respondent, its representatives, subcontractors, sub -consultants, professional associates, agents, servants or employees. Additionally, respondent shall obtain and maintain at its own expense all licenses and permits to conduct business pursuant to this contract from the Federal Government, State of Florida, Collier County or municipalities when legally required and maintain same in full force and effect during the term of the contract. NO STATEMENT WITHIN THIS DOCUMENT SHALL NEGATE COMPLIANCE WITH ANY APPLICABLE GOVERNING REGULATION. 3.10 Changes in Scope of Work/Services a. CCHCC may order changes in the work consisting of additions, deletions, or other revisions within the general scope of the contract. No claims may be made by the respondent that the scope of the project or 16.E.20.a Packet Pg. 2461 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 26 of the respondent’s services have been changed, requiring changes to the amount of compensation to the respondent or other adjustments to the contract, unless such changes or adjustments have b een made by written amendment to the contract signed by CCHCC Representative, CCPS Director of Purchasing or designee, and the respondent. b. If the respondent believes that any particular work is not within the scope of services of the contract, is a material change or will otherwise require more compensation to the respondent, the respondent must immediately notify CCHCC’s Representative in writing of this belief. If CCHCC’s Representative believes that the particular work is within the scope of the contrac t as written, the respondent will be ordered to and shall continue with the work as changed and at the cost stated for the work within the scope. The respondent must assert its right to an adjustment under this clause within thirty (30) days from the date of receipt of the written order. c. CCHCC reserves the right to negotiate with the awarded respondent(s) without completing the competitive RFP process for materials, products, and/or services similar in nature to those specified within this RFP for which requirements were not known when the RFP was released. 3.11 Modifications due to Public Welfare or Change in Law CCHCC shall have the power to make changes in the contract as the result of changes in law and/or rules of CCHCC to impose new rules and regulations on the respondent under the contract relative to the scope and methods of providing services as shall from time-to-time be necessary and desirable for the public welfare. CCHCC shall give the respondent notice of any proposed change and an opportunity to be heard concerning those matters. The scope and method of providing services as referenced herein shall als o be liberally construed to include, but is not limited to the manner, procedures, operations and obligations, financial or otherwise, of the respondent. In the event any future change in Federal, State or County law or rules of CCHCC materially alters the obligations of the respondent, or the benefits to CCHCC, then the contract shall be amended consistent therewith. Should these amendments materially alter the obligations of the respondent, then the respondent or CCHCC shall be entitled to an adjustment in the rates and charges established under the contract. Nothing contained in the contract shall require any party to perform any act or function contrary to law. CCHCC and respondent agree to enter into good faith negotiations regarding modifications to t he contract which may be required in order to implement changes in the interest of the public welfare or due to change in law. When such modifications are made to the contract, CCHCC and the respondent shall negotiate in good faith, a reasonable and appropriate adjustment for any changes in services or other obligations required of the respondent directly and demonstrably due to any modification in the contract under this clause. 3.12 Advertising The successful respondent shall not publicly disseminate any information concerning the Contract without prior written approval from the CCHCC, including, but not limited to mentioning the Contract in a press release or other promotional material, identifying any of the employers, employers’ individual departments, any employer personnel, as a reference, or otherwise linking any of the employers’ name and either a description of the Contract or the name of any employer, its departments, or employees, in any material published, either in print or electronically, to any entity that is not a party to the Contract, except potential or actual authorized subcontractors, distributors, dealers, resellers, or service representatives. 3.13 Security and Confidentiality The successful respondent shall comply fully with all security procedures of the employer in performance of the Contract. The successful respondent or its agents, distributors, resellers, subcontractors, officers or employees in the course of performing Contract work, including, but not limited to, security procedures, business operations information, or commercial proprietary information in the possession of any of the employers. The successful respondent shall not be required to keep confidential informat ion or material that is publicly available through no fault of the successful respondent, material that the successful respondent developed independently without relying on employer’s confidential information or material that is otherwise 16.E.20.a Packet Pg. 2462 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 27 obtainable under State law as a public record. To insure confidentiality, the successful respondent shall take appropriate steps as to its personnel, agents and subcontractors. The warranties of this paragraph shall survive the Contract. 3.14 Suspension of Work CCHCC’s Authorized Representative or its designee may in its sole discretion suspend any or all activities under the Contract, at any time, when in the best interest of CCHCC or the individual employer to do so. CCHCC’s Authorized Representative or designee shall provide the successful respondent written notice outlining the particulars of suspension, including the length of time the contract shall be suspended (i.e.: 90 days). Examples of the reason for suspension include, but are not limited to; budgetary constraints, d eclaration of emergency or other such circumstances. After receiving a suspension notice, the successful respondent shall comply with the notice and shall not accept any purchase orders during the specified time of suspension. Within ninety days (90), or any longer period agreed to by the successful respondent, CCHCC’s Authorized Representative or designee shall either (1) issue a notice authorizing resumption of work, at which time activity shall resume, or (2) terminate the Contract. Suspension of work shall not entitle the Vendor/Respondent to any additional compensation. 3.15 Literature Upon request, the Respondent shall furnish literature reasonably related to the Services offered, for example, user manuals, price schedules, catalogs, descriptive brochures, etc. 16.E.20.a Packet Pg. 2463 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 28 Section 4 – Special Terms & Conditions 4.1 Statement of Compliance In preparing proposal, Firm shall complete and submit Appendix 1 – Statement of Compliance. 4.2 Willis Towers Watson Remuneration – NET of Commission Proposals should be NET of commission and clearly stated as such. Proposer shall delete all commissions from its quoted premium rates or administrative fees. Quoted rates must include all costs. Clearly indicate whether your rates remain the same whether commission is paid to Willis Towers Watson or not. 4.3 Verscend, McKesson, Deerwalk and Willis Towers Watson Data Requirements Through a master agreement with CHP and Willis Towers Watson the CCHCC employers have access to a medical and pharmacy claim data aggregator known as Verscend. This is an Internet -based data analysis tool that enables the CHP, the CCHCC employers and Willis Towers Watson to identify potential high -cost claims and areas of high utilization through the use of data -driven, fact-based research, and develop targeted intervention programs. The system consolidates claim information at the diagnosis and procedur e code levels and delivers a series of online interactive reports via a secure web application. Vendors must agree to provide all data at their expense on a monthly basis in the format provided. Community Health Partners utilizes McKesson to support certa in cost management programs and processes. There are also unique data requirements that support the advocacy program. These data requirements are included in Appendix 4; see the Excel document “17.100 TPA SERVICES Appendix 4 Required Data Elements.” Proposer shall refer to this attachment and confirm its ability to meet all data requirements as indicated and submit with its proposal. Any deviations must be clearly noted as such. 4.4 Questionnaire Proposer shall submit questionnaire. Please refer to the Excel document “17.100 TPA Services Appendix 2 Questionnaire” and complete in full without re-formatting. 4.5 Financial Proposal Proposer shall submit financial proposal as outlined in the Excel document “17.100 TPA SERVICES Appendix 3 Financial-Cost Proposal” and shall complete in full without re-formatting to reflect the financial terms of its proposal. 4.6 Proprietary Network Repricing & Disruption Analysis Proposer shall provide the requirements in the PDF document “17.100 TPA SERVICES Appendix 5 Network Repricing and Disruption Analysis Instructions and Questions,” which are necessary to obtain the claim files for network disruption and repricing. Proposer will then complete the network repricing and disruption analysis and questions also outlined in Appendix 5. 4.7 Attachments All RFPs shall be submitted with any and all documentation. Proposer must complete any and all appendices, exhibit, etc… and submit with its response. List of attachments are as follows: Appendix 1 – Signed Statement of Compliance Appendix 2 – “17.100 TPA SERVICES Appendix 2 Questionnaire”- without reformatting Appendix 3 – “17.100 TPA SERVICES Appendix 3 Financial-Cost Proposal” – without reformatting 16.E.20.a Packet Pg. 2464 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 29 Appendix 4 – “17.100 TPA SERVICES Appendix 4 Required Data Elements” – without reformatting Appendix 5 – “17.100 TPA SERVICES Appendix 5 Network Repricing and Disruption Analysis Instructions and Questions” Appendix 6 – “17.100 TPA SERVICES Appendix 6 CCPS SPD” Appendix 7 – “17.100 TPA SERVICES Appendix 7 CCG MED SPD” Appendix 8 – “17.100 TPA SERVICES Appendix 8 CCG DENT SPD” Appendix 9 – “17.100 TPA SERVICES Appendix 9 NCH MED-Wellness SPD” Appendix 10 – “17.100 TPA SERVICES Appendix 10 CCPS Monthly Claims and Enrollment” Appendix 11 – “17.100 TPA SERVICES Appendix 11 CCG Monthly Claims and Enrollment” Appendix 12 – “17.100 TPA SERVICES Appendix 12 NCH Monthly Claims and Enrollment” Exhibit A - Conflict of Interest Statement Exhibit B – Affidavit Concerning Illegal Aliens Exhibit C – Debarment Form Exhibit D – Drug Free Workplace Certification Exhibit JLA – Jessica Lunsford Act Statement Protest Policy 6320 Cone of Silence Policy 6324 16.E.20.a Packet Pg. 2465 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 30 APPENDIX 1 - Statement of Compliance In preparing proposal, Firm must adhere to the specifications outlined in this Request for Proposal document. In addition, it must respond to the questionnaire fully and completely yet concisely. Respondents are advised that each and every question in this RFP must be completely ans wered or your response will be considered nonresponsive and may be excluded from further consideration. In addition, the responses to this RFP will be incorporated by reference into the contract with the CCHCC employers. In the event that proposal deviate s from the requested specifications or proposer is unable to complete portions of the questionnaire for any reason, proposer is requested to clearly identify such deviations and omissions in its submission. It is understood that this response will be incor porated into the final agreement by reference. Proposer shall acknowledge: We have further reviewed and agree to the data reporting requirements outlined in within this RFP. These requirements are nonnegotiable and are a requirement of the contact. Further, the CCHCC employers are committed to meeting all state and federal laws and regulations providing for equal employment opportunity. The CCHCC employers will decline to contract with any firm that has not evidenced its own commitment as an equal opportunity employer. The respondent agrees to provide such evidence to the CCHCC employers upon request. We acknowledge receipt of this RFP and agree to the requirements and our responses except as listed below. Signature Date Printed Name Title Exceptions: 16.E.20.a Packet Pg. 2466 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 31 APPENDIX 2 – Questionnaire SEE ATTACHED EXCEL SPREADSHEET TITLED – “17.100 TPA SERVICES Appendix 2 Questionnaire” Proposer shall not re-format or alter spreadsheet. APPENDIX 3 – Financial-Cost Proposal SEE ATTACHED EXCEL SPREADSHEET TITLED – “17.100 TPA SERVICES Appendix 3 Financial-Cost Proposal” Proposer shall not re-format or alter spreadsheet. Please note there are 3 worksheets under this file as follows: Worksheet #1 – TPA Worksheet CCG (Collier County Government) Worksheet #2 – TPA Worksheet CCPS (Collier County Public Schools) Worksheet #3 – TPA Worksheet NCHHS (NCH Healthcare Systems) APPENDIX 4 – Verscend, McKesson, Deerwalk and Willis Towers Watson Data Requirement SEE ATTACHED EXCEL DOCUMENT TITLED – “17.100 TPA SERVICES Appendix 4 Required Data Elements” APPENDIX 5 – Proprietary Network Pricing and Disruption Analysis SEE ATTACHED PDF DOCUMENT TITLED – “17.100 TPA SERVICES Appendix 5 Network Repricing and Disruption Analysis Instructions and Questions” APPENDIX 6-9 – Summary Plan Description (SPD) SEE THE ATTACHED PDF DOCUMENTS TITLED: APPENDIX 6: “17.100 TPA SERVICES Appendix 6 CCPS SPD” APPENDIX 7: “17.100 TPA SERVICES Appendix 7 CCG MED SPD” APPENDIX 8: “17.100 TPA SERVICES Appendix 8 CCG DENT SPD” APPENDIX 9: “17.100 TPA SERVICES Appendix 9 NCH MED-Wellness SPD APPENDIX 10-12 – Monthly Claims and Enrollment and Large Claims Listing SEE THE ATTACHED EXCEL DOCUMENTS TITLED: APPENDIX 10: “17.100 TPA SERVICES Appendix 10 CCPS Monthly Claims and Enrollment” APPENDIX 11: “17.100 TPA SERVICES Appendix 11 CCG Monthly Claims and Enrollment” APPENDIX 12: “17.100 TPA SERVICES Appendix 12 NCH Monthly Claims and Enrollment” 16.E.20.a Packet Pg. 2467 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 32 Exhibit A - Conflict of Interest Statement Bidder shall complete Exhibit A – “Conflict of Interest Statement” attached hereto and submit with bid. I hereby certify that: I, , am the (Printed name) (Title) and the duly authorized representative of the firm of (Name of Firm) whose address is and that I possess the legal authority to make this affidavit on behalf of myself and the firm for which I am actin g. I do hereby disclose: I. The name(s) of any company owner, officer, director, employee or agent who is an employee of Collier County Public Schools1 and/or is an employee of Collier County Public Schools1 and owns, directly or indirectly, an interest of five percent (5%) or more of the bidding company. AND/OR II. The name of any company owner, officer, director, employee or agent who has a spouse or child that is an employee of Collier County Public Schools1. AND/OR III. Any other company owner, officer, director, employee or agent, not listed above, of the firm who has any conflicts of interest, real or apparent, due to ownership, other clients, contracts, or interests associated with this project. 1 – Please include the Collier County Public School department/site when listing a CCPS employee. The above information is true and correct to the best of my knowledge. Signature Date Printed Name Organization Name State of: County of: Subscribed and sworn to before me this day of , in the year by who is personally known to me or has produced as identification. NOTARY PUBLIC, signature PRINTED NAME Commission#: (Seal) Commission expires: 16.E.20.a Packet Pg. 2468 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 33 Exhibit B - Affidavit Concerning Illegal Aliens The undersigned deposes and states that complies with the provisions of (Organization Name) Section 274A of the Immigration and Nationality Act; that substantiates (Organization Name) that all employees providing services or involved in any way on projects funded directly by or assisted in whole or part by state & grant funds or federal stimulus dollars can legally work in the United States and compli es with the provisions of federal and state laws, and will maintain such throughout the life of this contract. Any misrepresentation or any employment of persons not authorized to work in the United States constitutes a material breach and shall be cause for the imposition of monetary penalties up to five percent (5%) of the contract price, per violation, and immediate termination of the contract for all awarded sites. Signature Date Printed Name Organization Name Title Address, City & State State of: County of: Subscribed and sworn to before me this day of , in the year by who is personally known to me or has produced as identification. NOTARY PUBLIC, signature PRINTED NAME Commission#: (Seal) Commission expires: 16.E.20.a Packet Pg. 2469 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 34 Exhibit C - Debarment Form CERTIFICATION REGARDING, DEBARMENT, SUSPENSION INELIGIBILITY AND VOLUNTARY EXCLUSION - LOWER TIER COVERED TRANSACTIONS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 34 C.F.R. Part 85, Section 85.510, Participants responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160 - 19211). ***** BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON NEXT PAGE ***** 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in thi s certification, such prospective participant shall attach an explanation to this proposal. Date: Organization Name: Names & Titles of Authorized Representative(s): Signature Printed Name & Title Signature Printed Name & Title Signature Printed Name & Title State of: County of: Subscribed and sworn to before me this day of , in the year by who is personally known to me or has produced as identification. NOTARY PUBLIC, signature PRINTED NAME Commission#: (Seal) Commission expires: 16.E.20.a Packet Pg. 2470 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 35 Exhibit C - Debarment Form Instructions 1. By signing and submitting this form, the prospective lower tier participant is providing the certification set out herein in accordance with these instructions. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms ”covered transaction”, “debarred”, “suspended”, “ineligible”, “lower tier covered transaction”, “participant”, “person”, “primary covered transaction”, “principal”, “proposal”, “voluntarily exclude”, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. 5. The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this form that it will include this Exhibit without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a perspective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant ma y, but is not required to, check the Non-procurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a cove red transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction may pursue available remedies, including suspension and/or debarment. 16.E.20.a Packet Pg. 2471 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 36 Exhibit D - Drug Free Workplace Certification Preference shall be given to businesses with drug-free workplace programs. Whenever two or more responses, which are equal with respect to price, quality and service, are received by the state or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie responses will be followed if none of the tied vendors have a drug-free workplace program. In order to have a drug-free workplace program, a business shall: a. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. b. Inform employees about the dangers of drug abuse in the workplace, the business’s policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. c. Give each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in subsection (a). d. In the statement specified in subsection (a), notify the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. e. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee’s community, by any employee who is convicted. f. Make a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above drug-free workplace requirements. Signature Date Printed Name Organization Name Title Address, City & State 16.E.20.a Packet Pg. 2472 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 37 Exhibit JLA - Jessica Lunsford Act Statement / Vendor & Contractor Responsibilities Each Vendor and Contractor of Collier County Public Schools shall comply with the following after they have received notification of their award, however, this statement must be completed and returned with RFP. Please note that procedures and policies may change without notification . 1. All personnel will be required to obtain badges through the State of Florida. Badging assistance may be provided by the CCPS Human Resources (HR) Department. 2. Badges will only be issued to vendors with contracts, purchase orders or direct permission from an authorized CCPS Department. All vendors requesting badges must submit all insurances, proof of contract etc… to the Legal Department prior to the issuance of any badge. 3. Provide HR with a list of individuals that will be assigned to this contract, along with their home address, phone number, date of birth and driver’s license number (forms are available through the HR Department). 4. There is a fingerprinting and State badge fee, which can be viewed at the link below. This badge must be worn in plain sight when vendor/contractor employees are on school grounds. 5. Contractor with current issued State badges, commencing work with CCPS, shall complete necessary paperwork and submit to CCPS Human Resource Department. 6. Vendor shall notify CCPS when any individual has left their company or been terminated. 7. Use of an individual’s badge by another individual is a terminable offense. All individuals MUST be properly badged. 8. It will be the responsibility of the contractor to insure they meet any and all badging requirements. *Please note fingerprinting and badging procedures are subject to change without notification . It will be the Contractor’s responsibility for any modification or change to any of the fingerprinting or badging requirements and to insure they meet all State and CCPS requirements. Vendors can do this by monitoring the CCPS’s web site, http://www.collierschools.com/hr for updates and changes in procedure. I acknowledge that I’ve read, understand and will comply with the Vendor/Contractor Responsibilities as listed above. Signature Date Printed Name Organization Name Title Address, City & State *All pricing subject to change without notification. 16.E.20.a Packet Pg. 2473 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 38 Protest Policy School Board of Collier County Bylaws & Policies 6320 - PURCHASING Bid Protest A. A bidder, who wishes to file a bid protest, must file such notice and follow procedures prescribed by F.S. 120.57(3), for resolution. For bids solicited by the purchasing department or the facilities department, the notice must be filed with the purchasing department. B. Any person who files an action protesting a decision or intended decision pertaining to a bid pursuant to F.S. 120.57(3)(b), shall post at the time of filing the formal written protest, a bond payable to the Board in an amount equal to $25,000 or two percent (2%) of the lowest accepted bid, whichever is greater, for projects valued over $500,000 and five percent (5%) of the lowest accepted bid for all other projects. The bond shall be conditioned upon the payment of all costs which may be adj udged against the protester in the administrative hearing in which the action is brought and in any subsequent appellate court proceeding. If, after completion of the administrative hearing process and any appellate court proceedings, the District prevails, it shall recover all costs and charges, which shall be included in the final order or judgment, including charges made by the Division of Administrative Hearings, but excluding attorney's fees. If the protester prevails, s/he shall recover from the District all costs and charges which shall be included in the final order of judgment, excluding attorney's fees. C. Failure to file a notice of intent to protest, or failure to file a formal written protest within the time prescribed in section F.S. 120.57(3), shall constitute a waiver of proceedings under F.S. Chapter 120. 16.E.20.a Packet Pg. 2474 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 39 Cone of Silence Policy School Board of Collier County 6324 – CONE OF SILENCE DURING COMPETITIVE SELECTION PROCESS A cone of silence is hereby established for all competitive selection processes including Invitations for Bids (IFB), Request for Proposals (RFP), Request for Qualifications (RFQ), and Invitations to Negotiate (ITN) for the provision of goods and services. The cone of silence is designed to protect the integrity of the procurement process by shielding it from undue influences prior to the recommendation of contract award. This cone of silence shall be imposed on these procurements after advertisement of same. The cone of silence prohibits any communication regarding a particular IFB, RFP, RFQ, or ITN between: A. a potential vendor, service provider, bidder, lobbyist, consultant or any employee of one of these entities and the staff of the District, including school principals; and/or B. a potential vendor, service provider, bidder, lobbyist, consultant or any employee of one of these entities and any one (1) or more of the School Board members or member ‐elects. The cone of silence prohibits a potential vendor, service provider, bidder, lobbyist, or consulta nt from actively soliciting the community to lobby on their behalf with staff of the District, or any one (1) or more of the Board members or member‐elects. Unless specifically provided otherwise in the applicable IFB, RFP, RFQ or ITN the cone of silence does not apply to the following: A. Communications between a potential vendor, service provider, bidder, lobbyist, or consultant and the District's purchasing department. B. Communications between a potential vendor, service provider, bidder, lobbyist, or cons ultant and the District's facilities department, when said communication pertains to competitive acquisitions administered by that department (e.g., Architect/Engineer (A/E) selection, capital projects). C. Communications between a potential vendor, service provider, bidder, lobbyist, or consultant and the District's staff attorney or Board attorney. D. Communications at duly noticed pre‐bid meetings and site visits prior to bid opening or post bid ‐opening meetings and site visits, which are administered by either the purchasing department or the facilities department, prior to issuance of a written recommendation of contract award. The cone of silence commences after the advertisement of the IFB, RFP, RFQ or ITN. Competitive procurements are advertised on the purchasing department's bid posting web page or in the newspaper of general circulation. The cone of silence terminates at the time the Board acts on a written recommendation from the purchasing department or facilities department regarding contract award; provided, however, that communications are permitted when the Board receives public comment at the meeting when the recommendation is presented. The purchasing department and facilities department shall ensure that all solicitations include provisi ons describing the requirements and prohibitions of the cone of silence, including how a potential vendor, service provider, bidder, lobbyist, or consultant may communicate with District personnel. 16.E.20.a Packet Pg. 2475 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) COLLIER COUNTY PUBLIC SCHOOLS #17-100 Medical/Dental Claims & Flexible Spending Account Administration Page 40 Any person, whether employed by the District or not, who knowingly violates a provision of this policy shall be prohibited from serving on a District competitive selection committee. Violation of this policy by a particular bidder, proposer, respondent, and/or representative may, at the discretion of the District, result in rejection of said bidder, proposer, respondent, and/or representative's bid, proposal, or offer and may render any contract award to said bidder, proposer, or respondent voidable. In addition to any other penalty provided by law, violation of this policy by a District employee may subject said employee to disciplinary action up to and including dismissal from service. Adopted 9/8/14 © Neola 2012 END OF RFP 16.E.20.a Packet Pg. 2476 Attachment: 17.100 TPA Services RFP WTW 3-15-2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2477Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2478Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2479Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2480Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2481Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2482Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2483Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2484Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2485Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2486Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2487Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2488Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.bPacket Pg. 2489Attachment: 11-5729 Allegiance_Amendment 4_CAO (3733 : Recommendation to award Collier County Public Schools RFP 17-100) 16.E.20.c Packet Pg. 2490 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2491 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2492 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2493 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2494 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2495 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2496 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2497 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2498 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2499 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2500 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2501 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2502 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2503 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2504 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2505 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2506 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP 16.E.20.c Packet Pg. 2507 Attachment: 2018 Managed Care Network Agreement_rev 2_VendSign (3733 : Recommendation to award Collier County Public Schools RFP RPS #: CCPS 17-100 Title: Medical/Dental Claims & Flexible Spending Account Administration Name of Firm Jeff Walker Sonja Sweet Mariana St. Surin Total Selection Committee Final Rank Allegiance 545 540 532.5 1617.5 1.0000 Health Scope 460 468 466 1394 2.0000 Procurement Professional Brenda Brilhart, Procurement Strategist 6/22/17 Step 1: Upon direction by the Procurement professional, the individual selection committee member should provide their ranking of the proposals (from highest being number one (1) to lowest. Step 2: The procurement professional will review the mathematically calculated final rank and discuss the rank order and determine if consensus is reached. Page 1 of 1 16.E.20.d Packet Pg. 2508 Attachment: Appendix IV CCPS 17-100 Final Rank (3733 : Recommendation to award Collier County Collier County Government TPA RFP Analysis August 3, 2017 1 of 6 Collier County Government Decisions, Background, Financial Summary and Observations Concerning Responses to RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration Executive Summary Willis Towers W atson prepared this document to outline the process the Collier County Government (CCG) used to obtain quotes, evaluate them, and make the recommendation to retain Allegiance Benefit Plan Administrators, Inc. (Allegiance) to provide: •Administrative services relative to the health, dental, and flexible spending account plans •Access to a preferred provider network outside Collier County As part of the process, the CCG is also recommending that Community Health Partners (CHP)be retained to continue providing utilization review, case/disease management, and network management services in Collier County Attached to this document are the following: 1 Appendix I -A summary of the reasons why the response received from Florida Blue could not be included in the financial analysis prepared for the selection committee 2 Appendix II -A summary analysis (Appendix II) of the financial terms offered by the vendors who responded to the RFP 3 Appendix III -The responses that Allegiance and HealthSCOPE provided to the questions raised in the RFP (note: The responses that each of the vendors provided are on file with Risk Management and the Purchasing Department 4 Appendix IV -The scores assigned to each response by the selection committee Background Collier County Health Care Consortium (CCHCC) is comprised of the following four major Collier County employers: •Collier County Government (CCG) •Collier County Public Schools (CCPS) •Collier County Sheriff’s Office (CCSO) •NCH Healthcare System,Inc. (NCH) Since 2001, these four employers have shared information, ideas and collaborated to address the factors driving health and health care cost within their community. Although this group is informal, it is dedicated to health and health care, as evidenced by regularly scheduled meetings throughout the year and the use of solid metrics to monitor progress towards its goals. The CCG, CCPS, and NCH agreements with their current administrators will all expire at the end of 2017. Although each entity mentioned above retains independent rights with respect to the selection of an administrator for their medical plans, these three members of the CCHCC agreed to combine their efforts and release a joint RFP for TPA services. Historically they have found it beneficial to issue a joint RFP for the following reasons: 16.E.20.e Packet Pg. 2509 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Collier County Government TPA RFP Analysis August 3, 2017 2 of 6 1 Allowing interested administrators to respond to a single RFP 2 The benefit of working together regarding this selection process leads to enhanced outputs since one entity may see something or have ideas another may not 3 For the public employers to continually assess if there is a benefit to using a single administrator 4 A continuation of the partnership of sharing ideas and processes designed to reduce growing cost trends with respect to the provision of health benefits to employees For this process, W illis Towers Watson’s role in the process was that of consultant in the following specific services, as applicable: •Assistance in developing the RFP; •Gathering the necessary information vendors would need to provide a competitive quotation; •Working with the purchasing Department of the CCPS to answer questions during the process; •Analysis of the financial terms provided; •Guidance in the overall evaluation of the responses; •Coordination of finalist interviews if appropriate; and Negotiation of final terms and implementation support will be provided as appropriate. To conform to public procurement requirements for CCG and CCPS, the process was coordinated and overseen by David Nara, the Purchasing Director at CCPS. Since NCH is not a public entity and not bound by public entity requirements, a similar analysis process was provided. The Collier County Sherriff’s office contract with its current administrator was not expiring and, therefore, they did not to participate in the RFP process. RFP Process Willis Towers W atson worked with the CCHCC as a group and individually to develop a request for proposal that accurately reflected the unique scope of services that each organization required. The RFP was reviewed and approved by the purchasing department at the CCPS, and posted publically via DemandStar on March 20, 2017. Responses were due by April 13. David Nara Director of the CCPS’ Purchasing Department provided the following summar y concerning interest in RFP. •110 vendors notified •19 vendors downloaded the RFP from the CCPS’s website Formal responses were received from the following organizations: •Allegiance Benefit Plan Administrators (Provided proposals for CCG, CCPS and NCH) •Florida Blue (Provided proposals for CCG, CCPS and NCH) •HealthSCOPE (Provided proposals for CCG, CCPS and NCH) •UMR (Provided a proposal for NCH) 16.E.20.e Packet Pg. 2510 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Collier County Government TPA RFP Analysis August 3, 2017 3 of 6 Due to the unique nature and complexities of the health plan, there are only a limited number of vendors who are able to provide the scope of services sought by the CCG. Decisions to respond are also influenced by the extent to which a respondent believes they can offer competitive terms. Evaluation Process Each CCHCC employer participating in this RFP process identified a selection committee comprised of representatives appointed from each member organization. These committees, with the technical support and guidance of W illis Towers Watson, were responsible for providing the necessary evaluations of potential vendors responding to this RFP. The CCG Board selection committee will review and score the written responses to the RFP according to the predetermined scoring method outlined on the following page. The scoring criteria were set prior to the posting of the RFP. Assigned CCG TPA and Network Scoring Weights Category Points Score Potential Score Qualitative Assessment 1) Implementation and Transition 10 1 to 5 10 to 50 2) Control over Administration 10 1 to 5 10 to 50 3) Provider Network 10 1 to 5 10 to 50 4) Communication 10 1 to 5 10 to 50 5) Technology 10 1 to 5 10 to 50 6) Service to Providers 10 1 to 5 10 to 50 7) General Service Issues 10 1 to 5 10 to 50 8) Data Availability 10 1 to 5 10 to 50 9) Service to Employees 10 1 to 5 10 to 50 10) General Requirements 5 1 to 5 5 to 25 11) Value Added Services and Transparency 5 1 to 5 5 to 25 Total 100 to 500 Quantitative Assessment 1) Administrative Cost 30 1 to 4 2) Contract Term 10 1 to 4 3) Network Terms 60 1 to 4 Total 100 100 to 400 Total Score to Select Finalists 200 to 900 Finalist Interviews if conducted Selected finalists can add up to 200 points to final score Addressing Questions Asked Versus Selling 10 1 to 5 10 to 50 Fit with Organizational Culture 10 1 to 5 10 to 50 Understands CCHCC Objectives 10 1 to 5 10 to 50 Will work well with CHP 10 1 to 5 10 to 50 Score 40 to 200 Grand Total Potential Score 240 to 1100 16.E.20.e Packet Pg. 2511 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Collier County Government TPA RFP Analysis August 3, 2017 4 of 6 The Board selection committee was made up of the following individuals: •Jeff W alker CPCU, ARM –Director of Risk Management •Sonja Sweet –Group Insurance Manager •Mariana St. Surin –Benefits Analyst To support the decision process, Willis Towers Watson: 1 Completed an evaluation of the financial terms 2 Provided a high level assessment of the qualitative aspects of the responses 3 Assisted the selection committee with questions concerning the responses and the analysis Scoring The Board’s selection committee met on June 22, 2017 and ranked the proposals. Of the three firms, the Board selection committee declared Florida Blue’s proposal as non-responsive due to their failure to adequately respond to the requirements of the RFP. Attached to this report is Appendix I which contains the details concerning why it was not possible to evaluate the Florida Blue response in accordance with what was requested in the RFP. The committee then ranked the two remaining firms, Allegiance and HealthSCOPE. The unanimous consensus of the committee was to recommend the award for Group Health Third Part y Administration to Allegiance Benefit Plan Management, Inc. There were four primary factors driving this recommendation: 1.Allegiance’s cost for the scope of services requested was lower over the proposed five-year term than HealthSCOPE 2.Based on the analysis of the claims files provided to each respondent, CIGNA offered higher discounts than Aetna portrayed via their analysis of the same claim files 3.An assessment of the qualitative aspects of the responses did not suggest a material improvement in overall service would be realized through HealthSCOPE. The Selection Committee also completed a review of the Managed Care portion of the proposals. The committee determined that the CHP program remains competitive in terms of both price and service capabilities. The committee recommends that the agreement with Naples Physician Hospital Organization, known as Community Health Partners, be extended concurrent with the Allegiance contract. The scores assigned by the selection committee are attached as Appendix IV. Willis Tow ers Watson Observations and Analysis As previously noted, during this process Willis Towers Watson provided support to the Board selection committee by creating a comparison of the financial terms, network discounts reported by the respondents, and qualitative aspects of the written response. Quantitative Summary Assessment: •Allegiance’s fixed fees for medical claims administration, health reimbursement accounts (HRA), flexible spending accounts (FSA), COBRA, dental administration and provider network access for services provided outside of Collier County were slightly higher than HealthSCOPES for the initial three-year term with a total cost of $2,107,811 versus $2,098,067. However, if the CCG elects the 16.E.20.e Packet Pg. 2512 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Collier County Government TPA RFP Analysis August 3, 2017 5 of 6 five-year term offered Allegiance was lowest with an estimated cost of $3,538,105 versus $3,603,434. See Appendix II. •Each firm responding to the RFP was provided a detailed claims file for all claims paid in 2016. Using this file each respondent was asked to indicate: •If the claim would have been in network as of April 1st of 2017 •What the average discount would be for in-network claims The network discounts reported by CIGNA (the parent company of Allegiance) were greater than what was reported via HealthSCOPE through their agreement with Aetna’s national network (58.0% versus 52.9%). The claims file was de-identified and did not include any data concerning the patient. See Appendix II. •Under the current arrangement with Community Health Partners, (CHP), the annual cost of managing the Collier County provider network, utilization review (UR) case management (CM), and disease management services (DM) will be $101,844 in 2017. CHP’s proposed fees for these services remain unchanged in 2018, increase to $103,831 in 2019 and $105,818 in 2020. These fees are not guaranteed past 2020, but shown as the same in 2021 and 2022 for illustrative purposes in Appendix II. As shown below, these costs are less than what was offered by Allegiance or HealthSCOPE and include management of the provider network in Collier County. •Over the initial three-year term, the proposed cost of UR, CM and DM services was lower for Allegiance, $511,704 versus $656,521 for HealthSCOPE annually. If the CCG elects the five year term offered Allegiance was lowest with an estimated cost of $859,464 versus $1,127,748, See Appendix II. Qualitative Summary Assessment The RFP contained questions designed to elicit information from the vendors to help the selection committee assess whether there are material differences in how each of the vendors responding approach the core business of processing claims and providing service to employees. Allegiance and HealthSCOPE on the basis that CHP would provide utilization review and health management services as well as the local provider network, both responded affirmatively to all questions in the request for proposal regarding their ability to administer the CCG Health Plan. In reviewing responses to the individual questions, there was no single question or area where there was a significant difference between the responses provided by Allegiance and HealthSCOPE Successful execution of the administrative processes is no less important than the platform structure itself. One cannot glean from an RFP response whether a firm will deliver on its promises. That insight will come from experiences. As the incumbent, the CCG is familiar with Allegiance’s plan administration effectiveness. As stated during the scoring process. Allegiance has been a cooperative partner who has shown significant diligence with respect to working with all stakeholders and administering the plan, according to the intent of the CCG. If the selection committee had elected to proceed with interviewing finalists, attention could have been given to carefully designing interview questions that focus on whether each organization’s culture, philosophy, and approach to conducting business is consistent with that of the CCG. However, Allegiance’s known commitment to partnership and good service has exceeded expectations. Based on these specific components, it was deemed to be unnecessary to pursue further evaluations of a relationship with HealthSCOPE, which had a slightly higher cost structure and whose service delivery culture and philosophy, while referenceable, was not a known quantity to the County. 16.E.20.e Packet Pg. 2513 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Collier County Government TPA RFP Analysis August 3, 2017 6 of 6 Community Health Partners In addition to the core services sought via the RFP, the County employs the services of a Managed Care company to provide local network access, precertification, utilization review, concurrent sta y,and disease management services to the Plan. The Naples Physician Hospital Organization, known as Community Health Partners (CHP), established the only local, standalone non-profit physician/hospital preferred provider network in the mid 1990’s to assist employers and insurance carriers in the administration of their health plans. They assist the Collier County Government, Collier County Sheriff’s Office, and Collier Count y Public Schools in providing a local Collier County-based network containing over 800 professionals and both of the local hospitals. The current agreement with CHP will expire on December 31, 2017. Since similar services may also be acquired through Group Health Third Party Administration Services firms, it was decided that Managed Care services would also be solicited to assure that these services remain competitive. The RFP also sought information from responding firms concerning their ability to provide utilization review, case management, and disease management services. These services have been provided to the CCG for over 15 years. The RFP sought terms for alternate sources to provide these services for the following reasons: 1 To incorporate into the agreement the ability to have the TPA replace CHP and provide these services, in the event CHP was no longer able to do so. 2 To check whether the overall cost structure CHP was offering for the period January 1, 2018 through December 31, 2021 was competitive. 3 As noted above, the fees offered by CHP were below the quotes provided by Allegiance and HealthSCOPE and include management of the provider network in Collier County. As noted earlier, the fees offered by CHP were less than the quotes provided by Allegiance and HealthSCOPE and include management of the provider network in Collier County. However,the fees offered by CHP were only guaranteed for three years. Additional Comments Following are additional comments relative to the selection process: ·The initial proposal from Allegiance included an allowance for members of the Risk Management department to visit their headquarters. Due to concerns over whether it would be appropriate to accept this, the selection committee directed W illis Towers Watson to request a reduction in the quoted administrative fees equal to the value of the allowance. This resulted in a $.10 reduction in the fees over the term of the contract. Willis Towers Watson reviewed this adjustment and confirmed it will be equal to or exceed the amount of the allowance. Appendix II reflects this adjustment and replaces the previous appendix utilized in the scoring process. ·Both vendors offered additional services beyond the scope requested. These items were not taken into account by the selection committee nor are they included in Appendix II. 16.E.20.e Packet Pg. 2514 Attachment: CCG TPA RFP Analysis For Board August 3 2017 (3733 : Recommendation to award Collier County Public Schools RFP 17-100) Appendix I June 19, 2017 1 May 8, 2017 Willis Towers Watson Confidential Appendix I Following is a summary of two areas where Florida Blues response to RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration did not provide the specific data requested.The lack of data prevented Willis Towers Watson from completing a level playing field analysis to the responses that were provided by Allegiance Benefit Plan Administrators (Allegiance) and Health SCOPE Benefits (HealthSCOPE). Summary Florida Blue did not follow the instructions concerning the information requested regarding network discounts and disruption and pricing for the scope of services requested . First, Florida Blue did not provide requested information regarding network discounts and disruption. They chose instead to infer that the results they have achieved for NCH would be applicable to the Collier County Government (CCG) and Collier County Public Schools (CCPS). Second, the scope services sought via the RFP indicated the CCG and CCPS wished to continue to utilize Community Health Partners (CHP) to provide certain services with respect to network and utilization management. Florida Blue did not break out pricing for the service components currently provided by CHP,choosing to only provide an all-encompassing global fee for claims administration,network and utilization management services. Following are the details of what was requested, the responses provided by Florida Blue and additional comments where appropriate. Network Discounts and Disruption The RFP requested the following with respect to the network: These employers are interested in obtaining a better understanding of your network pricing terms, scope of network and your approach to provider contracting. Also there is an interest in assessing how your network compares to the current messenger model that is in operation. To facilitate this understanding, please: 1.Reprice each client separately (there is no need to combine them) 2.Provide your allowed amount for each claim using provider contract terms in effect as of 2/1/2017. 3.Indicate for each claim whether it is in or out of your network . 4.Indicate for each claim whether you would consider that claim to have occurred in Collier County, Lee County,Florida or outside Florida. 5.For NCH only, indicate whether the service was provided by an NCH provider. WTW observations: prior to issuing the RFP,WTW provided a year of de-identified detailed claims data from both Allegiance and Florida Blue. This data was provided via a secure means to vendors that met 16.E.20.f Packet Pg. 2515 Attachment: Appendix I Florida Blue Description for Scoring Committee 2017-6-19 (3733 : Recommendation to award Collier County Public Appendix I June 19, 2017 2 May 8, 2017 Willis Towers Watson Confidential the requirements outlined in the RFP. With the exception of any information related to the patient,this data provided extensive information on the claim level including the following data elements: ·NPI national provider number ·Provider tax identification number ·Provider name ·Data of service ·Description of service provided ·Diagnosis ·Place of service ·Charged amount ·Indication of whether the provider was in or out of network A detailed response to this request is crucial to assessing the extent to which another firms netwo rk covers the current provider utilization of each of these clients,as well as providing a high level understanding of how the discounts compare . For example, a network offering a 70% discount might appear very appealing from a financial perspective however, if that network only contains 30% of the providers the employees currently utilize ,selecting it could produce several unfavorable outcomes for the plan sponsor among which are: 1.Employee dissatisfaction due to disruption of relationships with providers 2.Potential disruption to continuity of care 3.Increased utilization of non-network providers 4.As non-network provider utilization increases, this leads to higher out of pocket cost to the employee and depending on how non-network providers are reimbursed,potential increased cost to the employer Florida Blue Response to network discounts and disruption questions: We are unable to complete the network disruption for CCG and CCPS due to the lack of complete information to accurately reflect our vast network. However, we are the #1 and most dominant health solutions company in the area, state, and country. Disruption results are based on the data elements received in the file that is provided to us. We would need the exact provider name (first and last), including the state, zip code and 9-digit TAX ID number. Below are a few recommendations to assist you in submitting a comprehensive provider file. ·Remove duplicate providers -duplicate names can distort the results. ·Include the provider office address not the billing address -provider billing addresses produce low results. ·Remove hyphens and extra spaces -inconsistent name segments produce low results. ·List the full name of the provider -last name only or last name and first initial result in an inaccurate match. ·Remove dentists, ancillary providers, and groups -these data elements produce low results. 16.E.20.f Packet Pg. 2516 Attachment: Appendix I Florida Blue Description for Scoring Committee 2017-6-19 (3733 : Recommendation to award Collier County Public Appendix I June 19, 2017 3 May 8, 2017 Willis Towers Watson Confidential As the incumbent for NCH Healthcare System, Inc., there will be no disruption with their network. Naples Community Healthcare System has 99.8% in network utilization. Repricing Exercise We are currently achieving 61.5% network savings through our provider contracts for Naples Community Healthcare System. When we repriced Allegiance/Cigna claims back in 2013 they were generating around a 41% network discount. We are only providing total aggregate network discount as our response to the re-pricing exercise which is 61.5% for all claims. We have also provided Value Quest market reports, located in Appendix C, and analysis performed by Milliman which is an independent consulting firm and they reflect the significant network discount advantage the Blues have over the other major carriers. We are also including o ur Southwest Florida Collier/Lee county average discounts. We are willing to discuss and negotiate a network discount guarantee if selected as a finalist Other respondent replies to Network discounts and disruption questions There were three responses in addition to the Florida Blues. They were provided by the following firms: 1.Allegiance Benefit Plan Administrators 2.HealthSCOPE Benefits 3.UMR (only provided terms for NCH) Each of these firms was able to provide,on an aggregate basis,the information requested in the network and disruption section of RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration. WTW was unable to complete a similar analysis of the Florida Blue response as it did not provide the information requested noted above. Pricing for scope of services requested RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration outlined the following scope of services requested for the CCG and CCPS: B.Scope of services sought by CCG Medical and dental claims payment, COBRA, Health Care Spending (FSA -Section 125), Dependent Care Spending (DSA-Section 129) and Health Reimbursement Accounts (HRA-IRS revenue ruling 202-41). In addition, the CCG wishes to assess the scope an d financial effectiveness of your provider network both inside and outside of Collier County. The CCG currently utilizes CHP for UR, CM, and DM. They fully anticipate continuing to utilize CHP for these services. However, the CCG would like a quote for t hese services. If for any reason during the duration of the contract period with the selected vendor CHP would be unable to 16.E.20.f Packet Pg. 2517 Attachment: Appendix I Florida Blue Description for Scoring Committee 2017-6-19 (3733 : Recommendation to award Collier County Public Appendix I June 19, 2017 4 May 8, 2017 Willis Towers Watson Confidential provide these services, the CCG would have the option to retain the firm selected to provide these services. C.Scope of services sought by CCPS Medical and dental claims payment, COBRA, Health Care Spending (FSA -Section 125) and Dependent Care Spending (DSA-Section 129). Although the CCPS does not currently offer a Health Reimbursement Accounts (HRA-IRS revenue ruling 202-41), it may do so in the future and is interested in exploring the cost and your capabilities of providing the service. In addition, the CCPS wishes to assess the scope and financial effectiveness of your provider network both inside and outside of Collier County. T he Florida State Retirement System mandates, CCPS offer retirees the option to stay on the medical plan by paying the active rate on a monthly basis. The current TPA bills, collects premiums and remits retiree premium payments for about 120 retirees. Your quote assumes you will provide this service. CPS is also interested in a quote that provides EAP services, as well as any programs you have that will support their current wellness program. The CCPS currently utilizes CHP for UR, CM and DM. They fully a nticipate continuing to utilize CHP for these services. However, the CCPS would like a quote for these services. If for any reason during the duration of the contract period with the selected vendor CHP would be unable to provide these services, the CCPS would have the option to retain the firm selected to provide these services. The response from Florida Blue did not include a separate quotation for the services currently provided by CHP. Instead,they chose to provide a single fee that included both cl aims administration as well as the services currently provided by CHP. In addition, Florida Blue chose not to complete the pricing schedule that was included in RFP #17-100 Medical/Dental Claims & Flexible Spending Account Administration and used its own format. Both HealthSCOPE and Allegiance provided the completed the pricing schedule that broke out the cost of the services provided by CHP from the cost of core administrative services. Since the Florida Blue response did not provide a breakout of the services currently provided by CHP,WTW was not able to complete a comparison similar to what is prepared for Allegiance and Health Source. 16.E.20.f Packet Pg. 2518 Attachment: Appendix I Florida Blue Description for Scoring Committee 2017-6-19 (3733 : Recommendation to award Collier County Public Appendix II Collier County Government TPA Services Enrollees 2017 2018 2019 2020 2021 2022 2018 2019 2020 2021 2022 Admin Fee 2,070 $16.94 $17.26 $17.26 $17.70 $17.70 $17.70 $14.90 $14.90 $14.90 $15.65 $16.43 HRA 761 $4.00 $4.00 $4.00 $4.10 $4.10 $4.10 $3.50 $3.50 $3.50 $3.68 $3.86 FSA 495 $5.00 $5.00 $5.00 $5.15 $5.15 $5.15 $3.75 $3.75 $3.75 $3.94 $4.13 COBRA 2,070 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1.00 $1.00 $1.00 $1.05 $1.10 Dental 1,962 $2.75 $2.75 $2.75 $2.85 $2.85 $2.85 $3.24 $3.24 $3.24 $3.40 $3.57 Wrap Network Access Fee *2,070 $5.50 $5.50 $5.50 $5.65 $5.65 $5.65 $7.00 $7.00 $7.00 $7.35 $7.72 Annual Admin, HRA, FSA, COBRA Fees $487,018 $494,966 $494,966 $507,700 $507,700 $507,700 $449,193 $449,193 $449,193 $471,653 $495,227 Annual Dental TOTAL $64,746 $64,746 $64,746 $67,100 $67,100 $67,100 $76,283 $76,283 $76,283 $80,097 $84,052 Annual Wrap Access TOTAL $136,620 $136,620 $136,620 $140,346 $140,346 $140,346 $173,880 $173,880 $173,880 $182,574 $191,765 Annual TOTAL $688,384 $696,332 $696,332 $715,147 $715,147 $715,147 $699,356 $699,356 $699,356 $734,323 $771,044 * fees to access provider network outside Collier County $2,107,811 $3,538,105 $2,098,067 $3,603,434 Collier Network Access Fee 2,070 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 $1.50 CHP UR / CM 2,070 $2.60 $2.60 $2.68 $2.76 $2.76 $2.76 $2.60 $2.68 $2.76 $2.76 $2.76 Annual TOTAL $101,844 $101,844 $103,831 $105,818 $105,818 $105,818 $101,844 $103,831 $105,818 $105,818 $105,818 GRAND TOTAL $790,228 $798,176 $800,164 $820,965 $820,965 $820,965 $801,200 $803,187 $805,174 $840,142 $876,862 Utilization Review / Case Management / Disease Management Proposal non-CHP UR 2,070 n/a $1.65 $1.65 $1.70 $1.70 $1.70 $1.81 $1.81 $1.81 $1.90 $2.00 non-CHP CM 2,070 n/a $2.40 $2.40 $2.45 $2.45 $2.45 $3.00 $3.00 $3.00 $3.15 $3.31 non-CHP DM 2,070 n/a $2.75 $2.75 $2.85 $2.85 $2.85 $4.00 $4.00 $4.00 $4.20 $4.41 Annual TOTAL n/a $168,912 $168,912 $173,880 $173,880 $173,880 $218,840 $218,840 $218,840 $229,782 $241,445 $511,704 $859,464 $656,521 $1,127,748 Discounts from Repricing Only Network 2016 Claims 58.0%52.9% Discounts from Repricing All 2016 Claims 55.9%50.1% 2016 Claims Paid Outside of Collier County - per Allegiance $5,626,938 NOTE: Reflects adjustment for removal of travel allowance Community Health Partners Current Allegiance Proposed Allegiance Proposed HealthSCOPE Proposed Allegiance Proposed HealthSCOPE Community Health Partners Community Health Partners 8/3/2017 16.E.20.g Packet Pg. 2519 Attachment: CCG Appendix II Cost summary - FINAL 08 03 17 (3733 : Recommendation to award Collier Notice of Recommended Award Solicitation: CCPS 17-100 Title: Medical/Dental Claims & Flexible Spending Administration Due Date and Time: 4/13/2017 4:00 PM Selection Committee Date and Time: 6/19/2017 1:00 PM Respondents: Company Name City County State Final Ranking Responsive/Responsible Allegiance Benefit Plan Management, Inc. Missoula Missoula MT 1 Yes/Yes HealthSCOPE Benefits Little Rock Pulaski AZ 2 Yes/Yes Blue Cross Blue Shield Jacksonville Duval FL Non-Responsive No/Yes Utilized Local Vendor Preference: Yes No Recommended Vendor(s) For Award: Allegiance Benefit Plan Management, Inc. 16.E.20.h Packet Pg. 2520 Attachment: CCPS 17-100 NORA (2) (3733 : Recommendation to award Collier County Public Schools RFP 17-100)