023-DW-0125_Employee_Benefits_Consultant_Services_Addendum1.pdf

November 8, 2024

To: All Vendors

From: Denise Whitaker

Competitive Solicitations Managers

Subject: 023-DW-0125, Employee Benefits Consultant Services, Addendum 1

This addendum may provide clarification, interpretation, or additional information to the solicitation document. The written addendum is the official response to questions received by the deadline at www.myvendorlink.com. The addendum shall be posted to the same website where the solicitation is posted.

Q1: Please provide a copy of the current consultant agreement to include detailed scope and compensation.

A1: See attachment Robinson Bush contract FE 05.23.2024

Q2: Please provide the annual amount paid to consultant by the district per year for the prior three (3) years.

A2: see attachment Robinson Bush contract FE 05.23.2024

Q3: Per Section 4, Financial / Plan Performance #3: Is this analysis aggregate or specific claims?

A3: Overall plan performance is looked at on an aggregate basis and expenses broken down by service type (inpatient, outpatient, professional, prescription drug). Large claim activity is also tracked to stop loss. Administrative costs are also reported.

Q4: How often do the Health Strategy Committee and Superintendent Insurance Committees meet?

A4: See ITN, Section 3.3.9

Q5: Per Section 4, Consulting Services #3, is providing an additional staff member a consulting firm responsibility or is this referring to an onsite carrier rep? If consulting firm, is there flexibility with respect to the amount of onsite time each week?

A5: This is a request of the consulting firm. There is flexibility to the amount of time onsite weekly depending upon the work and meetings scheduled.

Q6: Per Section 8.7, is the District willing to negotiate a limit of liability as we have done with all of our school district clients?

A6: The District is willing to negotiate this term.

Q7: In Section 5, Proposal Format, Tab 1, there is item e. Additional Documentation. Can you clarify what is to be included in this section?

A7: See ITN, section 5, Tab 1, e. additional information is where vendor can provide any additional information they wish to provide.

http://www.myvendorlink.com/

Q8: Is it appropriate to include an Appendix section, where we typically attach team bios and additional information not specifically requested in the ITN?

A8: ITN, section 5, tab 2 requests qualifications and experience, additional information can be provided in section 5, tab 1, e.

Q9: Would you prefer the completed Reference Request Forms to be provided under Tab 1 Forms or in Tab 2 Qualifications and Experience. They are included in both Tabs in the ITN.

A9: Reference request form completed and signed should be included in tab 2 qualifications and experience.

Q10: Can you provide a copy of previous workflow analyses or clarify the depth of the analysis beyond typical reporting and vendor management?

A10: As a consultant, the vendor will be expected to look ahead as to strategies and deadlines for projects and participate in leading those initiatives with the BOARD.

Q11: What is the current benefits administration platform? Is there any expectation that the consultant fund the cost of the platform?

A11: Benefitfocus is the current platform. No, the consultant does not fund the platform. However, the consultant provides support as far as benefit administration, payroll, and open enrollment planning within the platform. See ITN section 3.4 Programs and Participation levels

Q12: What is the District`s time frame with respect to the additional primary care centers?

A12: Within the next year, 2025 or early 2026 is the target.

Q13: Disregard the Question concerning Committee meeting frequency. It is in the Service Requirements A13: Acknowledged

Q14: 1. We fear that the RFP as written likely RFP will generate responses from larger Brokers burdened by legacy status quo thinking and solutions and discourage respondents that while smaller, have new and fresh ideas and approaches to benefit plan management. You are requiring: a. Minimum of five (5) years of experience in providing consultation services to both public and private employers of similar size. b. Additionally, the awarded proposer should have school district experience with self-funded health insurance plans and have knowledge and experience in negotiating benefits offered in Central Florida. c. Please provide at least three (3) Florida School District References or (3) most comparable municipal references that Polk County School Board may contact as references. Please complete a Reference Form with the following for each reference including: i. District, key contact person(s); ii. Job title(s) address, phone number, email address for key contacts of the district/municipality. In our experience, most, if not all brokerage houses with these credentials remain mired in the status quo thinking and focus their responses on service capabilities while offering little in the way of strategic thinking about reducing barriers to care and cost at the same time. This section seems to have been written by an entity that chooses to exclude respondents that might bring a fresh approach to POLK COUNTY SCHOOL BOARD. Our view is that anyone dealing with governmental entities such as school systems or municipalities for this long is likely mired in the same thinking you may presently receive. We have 5 ½ very successful years with a Florida school system with 9,100 members. We have been successful by not relying on status quo solutions, but rather by introducing innovative solutions that are dramatically bending the cost curve for our client, resulting in the client coming in under budget for the first time in a decade. All while providing the requisite support for compliance, communications, etc. We replaced a broker that surely will reply to this RFP and improved benefits while saving $52,000,000 over the past 5 years. We do have the requisite 5 years’ experience providing governmental insurance services, but if we cannot satisfy the other criteria mentioned above, are we automatically disqualified? Is there any consideration for the quality of our experience? Or will you continue to seek counsel from only larger organizations? 2. ALTERNATE PROPOSAL QUESTION / SOLE SOURCE JUSTIFICATION QUESTION a. Our Team has created a unique platform and approach to “actively managing” health plan spending for our clients. We believe this qualifies for a “Sole Source” exclusion to standard RFP rules. The standard RFP typically attempts to qualify an advisor based upon size, history, services, etc., but rarely does it seek to understand an advisor’s ability to affect health plan costs. Can this qualify for a “Sole Source” exclusion to standard RFP rules? b. Secondly, would you consider an “alternate proposal” wherein we respond to your RFP questions, but append our response with a separate explanation of our proprietary approach to addressing your health plan’s cost drivers? In other words - can a bidder propose with an alternative approach other than the format provided and not be considered “unresponsive”? Are they allowed? 3. Are “Piggybacks” allowed in lieu of this RFP? 4. Who is the POLK COUNTY

SCHOOL BOARD using for the following: a. Who is the Reinsurance carrier? b. Who is the plan Network partner, and will they go away when you leave Florida Blue TPA? c. Who is the current Broker/Advisor? d. Did your current advisor develop all or part of this RFP? 5. What is the POLK COUNTY SCHOOL BOARD medical plan/other benefits plan year?

6. Often, for a group the size of POLK COUNTY SCHOOL BOARD, the best way to directly control costs is to have available your own health facility. From some of the RFP, it appears POLK COUNTY SCHOOL BOARD has a health center or onsite clinic. Has POLK COUNTY SCHOOL BOARD considered (or would you consider) a Direct Primary Care approach? 7. Does POLK COUNTY SCHOOL BOARD have any current direct contracts/relationships with medical providers in the area? Or are you relying on an “off the shelf” rented network? 8. Your RFP asks for a “fee proposal” and you provided some of the information on the number of covered lives but did not provide a few details about the size of the project. We have some questions concerning the number of employee lives that POLK COUNTY SCHOOL BOARD currently covers: a. Is the total number of POLK COUNTY SCHOOL BOARD benefit eligible employees 11,650 and 305 retirees? b. What is the total number of currently covered employee lives who have elected medical insurance? c. What is the total number of currently covered bellybuttons (all employee lives plus spouse and dependents) who have elected medical insurance? 9. How many years has POLK COUNTY SCHOOL BOARD been working with the current Broker of Record? a. Please briefly describe any deficiency in services or financial results that compel POLK COUNTY SCHOOL BOARD to engage in their RFP process. b. If so, how has this POLK COUNTY SCHOOL BOARD’s current relationship worked out for you? Are your costs lower than they were last year? 2 years ago? c. If there are no such deficiencies, please describe the purpose behind this RFP being issued. 10. Before the current Broker of Record, who did POLK COUNTY SCHOOL BOARD work with and for how many years? 11. Your RFP format doesn’t suggest that this is a flat fee only RFP, and can the broker receive commissions/bonuses from the vendors as long as the Broker submits an annual compensation disclosure agreement.” Of note, “bonuses” are not mentioned in this section. Are bonuses specifically left out? Or did you intend to include them in this section? Is there a licensed Broker in the employ of POLK COUNTY SCHOOL BOARD that might be qualified to receive such remuneration? Do the commissions, etc. relate solely to the medical plan? Or does it include ancillary products and voluntary benefit commissions (that have commissions embedded in the State filed premiums)? What is the annual fee/commissions that POLK COUNTY SCHOOL BOARD is currently paying the current Broker of Record? How does POLK COUNTY SCHOOL BOARD know exactly what the current Broker’s compensation is since governmental entities opt out of ERISA Form 5500 Reporting, and there is so much hidden compensation that would never show up on the Form 5500 even if you were required to file the Form 5500 annually i.e.

per script fee, carrier bonuses, carrier overrides? We are comfortable working on a fee only basis, but in an effort to keep our financial results aligned with better outcomes for the client, we include a “shared savings” component wherein our team receives 10% of the savings over our pre-engagement benchmark. Will POLK COUNTY SCHOOL BOARD entertain such an advisory compensation arrangement that has aligned incentives? Also, as a rule, we do not have preconceived core services or fees. Rather services and fees are built around each individual clients’ needs. Traditionally, fees are negotiated at the time that the final scope of services is developed. Would this approach preclude us from being selected as a finalist? 12. You mentioned that In January of 2025, the School Board of Polk County will transition the third-party administration (TPA) of its Polk County Health Plan away from Florida Blue after twenty-one years. a. Who is that TPA? b. How was this new TPA selected and if through an RFP, when was this done, and the selection made? c.

How long is the current contract with the TPA/medical insurance carrier/ASO assuming you are in a contract with them for 1/1/25, and when does it expire? d. Is the current TPA/medical insurance carrier/ASO to be the TPA regardless of the advisor choice? e. Is the advisor allowed to suggest a different direction for the TPA administrative services? 13. When does POLK COUNTY SCHOOL BOARD expect to evaluate different benefit options in the future, and how soon can they be implemented as we assume you are in contractual relationships with the current vendor partners? 14. The RFP states – “Procurement Services will short-list the selected vendors and invite them to a presentation before the Evaluation Committee, if the committee deems it necessary.“ Based on the past experiences POLK COUNTY SCHOOL BOARD has had with this process, normally will each bidder/finalist have an opportunity to present orally? Is there a chance that POLK COUNTY SCHOOL BOARD will hire a consultant without an oral presentation as the RFP mentions TBD? Please elaborate on the consultant evaluation/selection process. 15. Who will be on the Evaluation/Selection Committee that will perform the evaluation of all proposals and what are their job roles/titles? 16. What role will Unions or collective labor play in general and more specifically in the decision-making process associated with this RFP? As an example, would a Union member be present on the Evaluation/Selection Committee? You do not have “experience with unions” on your qualifications list. We believe such experience is vital to the successful operation of the plan. 17. The RFP didn’t suggest you will show some preference for a “local bidder preference ordinance - Per Chapter 287 of the Florida Statute, Section

287.084 (1)(a), Preference to Florida Business” – will this be taken into account? Like most large account RFPs, your questions seem to be looking for a large size brokerage shop as a virtue in the process. Could you please provide clarity to this seeming contradiction? 18. When you state that the ITN response that we need to have Tab 3 Response to the Statement of Work, are you referencing the Section 4: Deliverables you want us to elaborate on? We didn’t see any Statement of Work questions – please clarify. 19. What is the total medical and Rx spend combined annually for 2021, 2022, and YTD 2023? a. What is the medical ONLY spend annually? b. What is the pharmacy ONLY spend annually? i. What percent of Rx spend is “specialty”? c. Can any claims data be shared with us to review in our response? With your data, respondents can illustrate the impact of their methods. This will allow POLK COUNTY SCHOOL BOARD to review how respondents can impact cost. d. Can you provide the current Benefits Summary for the plan(s)? e. Are the employees “steered” to any entity (hospital, urgent care chain, labs, radiology) to obtain services or prescription from any particular outlet? (even if using financial incentives to do so) f. What is the current sentiment for the committee/board on utilizing local providers versus out of town/state entities? g. What is the current contribution of the plan and the employee? h. For the most recent 4 years what was the increase/decrease in total premiums for the plan? i. For the most recent 4 years what was the increase/decrease in the premiums for plan participants? Per employee per pay cycle will work here. j. Can you provide a copy of the current TPA/insurance carrier ASO Master Services Agreement and the PBM ASO Master Services Agreement and/or any other “direct” to provider contracts? 20. Would it be possible to obtain the following additional health insurance plan reports? : a. Medical paid claims and enrollment counts by month by product (if different plan options were available) and by division/facility if applicable for the last 36 months. b. Aggregate reports for the past 3 years c. Most recent 36 months (24 months if available) of Claim/Trigger Reports / Shock loss information / Catastrophic Claimant Report for claims in excess of $15,000 (if available), including the following: i. Diagnosis ii. Prognosis iii. Relationship (Employee, Spouse or Child) iv. Paid claims 21. Our agency is a founding partner of a multi-State consortium of cutting-edge advisory firms giving us a broad spectrum of knowledge, and access to resources. As long as there is a lead firm, is the POLK COUNTY SCHOOL BOARD open to a multi-advisory firm approach? 22. You have asked us to provide at least three (3) Florida School District References or (3) most comparable municipal references that Polk County School Board may contact as references. Again, we are not inclined to provide this list with all contact information in a manner that will be open to our competitors. Of course, we will be reviewing such a list provided by other respondents and may attempt to engage with some of them. If we don’t satisfy this listing of all clients with whom we have engaged over the past 5 years for the concerns we shared, are we automatically disqualified? 23. What type of benefit technologies does POLK COUNTY SCHOOL BOARD use that POLK COUNTY SCHOOL BOARD may want to keep or would like to review in the future? We are following the protocol listed in the ITN - questions should be submitted via the Vendorlink portal for 023-DW-0125 Employee Benefits Consultant Services ITN for Polk County School Board. Thanks for your attention to these questions.

A14: The Polk County Public Schools is open to ideas that decrease health care costs, improve the health of their employees and result in greater employee retention and satisfaction. We are asking for experience that matches our type of business, which should not limit the creative solutions that may be proposed.

Q15: To confirm the current medical plan in place, is it fully funded or self-funded? · If fully funded, would the District consider a self-funded model if the new model will save money and allow the District greater access to claims data (medical and pharmacy) to assist in analyzing and controlling costs? · Would the District consider another medical carrier if the new carrier can offer the same or improved coverage area with equal or enhanced medical options? · What is the District’s contribution each month to the employee’s medical plan? · Of the 11,650 actives listed on the medical plan, does this number represent only employees or a combination of employees and dependents? · If a combination of employees and dependents, can a specific listing of each be provided? · Same with retirees. · To cover the cost of the clinics, does the District pay on a PEPM or PPPM basis? What the PEPM or PPPM cost for the on-site clinics? · What is the employee participation/usage percentage of the clinics on a monthly basis? · Of the total actives listed for the clinic, does this number represent employees and dependents? · If both, can a list of each be provided as with the medical plans? · Same for retirees.

· Are the clinics used by any other entities (i.e., county or city employees)? · Does the District provide any other direct contributions for each employee other than the cost of employee medical premiums and the clinic costs? · Does the District pay the current TPA a flat fee, commissions, or a combination of the two? If a flat fee, what is the current fee and how is it calculated? · If only a flat fee is currently utilized, would the District consider allowing commissions or a combination fee & commission to save the District money? · Can a copy of the current Broker/TPA contract be provided? · Does the current broker/TPA provide an annual compensation breakdown as required by The Consolidated Appropriations Act (CAA) of 2021? If yes, may a copy be made available? · Does the District have a written and measurable Scope of Work (SOW) reporting system in place to document that the broker/TPA is meeting all items of the SOW and a measurable rating of each item listed? If yes, may a copy be provided? · Does the current broker/TPA provide compliance for Section 125 cafeteria plan reporting as well as for COBRA, FSA, HSA, ACA reporting, etc.? If yes, is the cost included as part of the broker/TPA’s fee or billed separately? · Who is the administrator for retirees, LOA, COBRA, FSA/HSA accounts, ACA, etc.? If administered internally by the District, would the District wish to have any of these items administered by the broker/TPA? · Can a general census be obtained with the following information: employee ID # (not SSN), gender, age (or DOB), DOH, home zip code, plan chosen, tier level (EE, ES, EC, EE&FAM), FT or PT, employment description (i.e. active, COBRA, retiree) and each dependent’s gender, DOB, & zip code, if part of the employee’s plans? If yes, who should be contacted to request? · Does The City allow any parttime employees to receive benefits? If yes, please describe the benefits available. · For COBRA participants, please list benefits allowable under COBRA. · Copy of Pharmacy contract, if available. · Claims data for the most recent 2 years, if available. · If available, the number of employees that have exceeded the out-of-pocket maximum over the past two or three years. · Does the out-of-pocket maximum cause an undue burden on the employee and their family when this occurs? · Who administers the District’s wellness program? · What wellness incentives does the District offer employees? · Does the District have an organized communication campaign established for monthly or quarterly wellness outreach? · What platform does the District use for open enrollment, new hires, and CIS changes? · Who covers the cost of the open enrollment platform and what is the annual cost of the system? · Does the District employ an outside enrollment company to service the 115 locations? · For open enrollment, does the District offer face-to-face, call center, or self-enrollments? Or, a combination of the 3 options? · How long does the District allow for open enrollment and what are the customary dates for open enrollment? · Other than the online Benefits Guide, how does the District communicate the open enrollment messages (e-mail, text, written letters, postcards, etc.)? · The RFP mentions that there is the possibility that the District may experience funding shortages in 2026, which is precipitating the District’s need to re-evaluate the current benefit structure. Is there a calculation available of the expected shortfall (should one occur) that the District is preparing to address? Also, is the shortfall caused by less students and therefore lower FEFP funding, loss of ESSER funds, or other outside impacts on the District’s funding? · What other pain points does the District have related to benefits and/or benefits administration that could be addressed by a broker/TPA that may offer the District economies of scale to lower the District’s overall cost of benefit administration?

A15: The Polk County Public Schools Health Plan is self-funded. The BOARD awarded an RFP in September of 2024.

See 039-MK-0524 Group Health Plan Services at www.myvendorlink.com. The district contribution to medical plan is not relevant to this ITN. ITN, section 3.4 column headings. The clinic costs are not relevant to this ITN. The District does not break out the expense by a PEPM cost.

Q16: 1. We fear that the RFP as written likely RFP will generate responses from larger Brokers burdened by legacy status quo thinking and solutions and discourage respondents that while smaller, have new and fresh ideas and approaches to benefit plan management. You are requiring: a. Minimum of five (5) years of experience in providing consultation services to both public and private employers of similar size. b. Additionally, the awarded proposer should have school district experience with self-funded health insurance plans and have knowledge and experience in negotiating benefits offered in Central Florida. c. Please provide at least three (3) Florida School District References or (3) most comparable municipal references that Polk County School Board may contact as references. Please complete a Reference Form with the following for each reference including: i. District, key contact person(s); ii. Job title(s) address, phone number, email address for key contacts of the district/municipality. In our experience, most, if not all brokerage houses with these credentials remain mired in the status quo thinking and focus their responses on service capabilities while offering little in the way of strategic thinking about reducing barriers to care and cost at the same time. This section seems to have been written by an entity that chooses to exclude respondents that might bring a fresh approach to POLK COUNTY SCHOOL BOARD. Our view is that anyone dealing with governmental entities such as school systems or municipalities for this long is likely mired in the same thinking you may presently receive. We have 5 ½ very successful years with a Florida school system with 9,100 members. We have been successful by not relying on status quo solutions, but rather by introducing innovative solutions that are dramatically bending the cost curve for our client, resulting in the client coming in under budget for the first time in a decade. All while providing the requisite support for compliance, communications, etc. We replaced a broker that surely will reply to this RFP and improved benefits while saving $52,000,000 over the past 5 years. We do have the requisite 5 years’ experience providing governmental insurance services, but if we cannot satisfy the other criteria mentioned above, are we automatically disqualified? Is there any consideration for the quality of our experience? Or will you continue to seek counsel from only larger organizations?

A16: Question and response is duplicate of #14 above

Q17:ALTERNATE PROPOSAL QUESTION / SOLE SOURCE JUSTIFICATION QUESTION a. Our Team has created a unique platform and approach to “actively managing” health plan spending for our clients. We believe this qualifies for a “Sole Source” exclusion to standard RFP rules. The standard RFP typically attempts to qualify an advisor based upon size, history, services, etc., but rarely does it seek to understand an advisor’s ability to affect health plan costs. Can this qualify for a “Sole Source” exclusion to standard RFP rules? b. Secondly, would you consider an “alternate proposal” wherein we respond to your RFP questions, but append our response with a separate explanation of our proprietary approach to addressing your health plan’s cost drivers? In other words - can a bidder propose with an alternative approach other than the format provided and not be considered “unresponsive”? Are they allowed?

A17: Alternate proposal may be provided for consideration in this Invitation to Negotiate under section 5, tab 1-5.

Q18: Are “Piggybacks” allowed in lieu of this RFP?

A18: The District seeks to negotiate with the one or more contractors to provide consultant services for employee benefits awarded under another contract.

Q19: Who is the POLK COUNTY SCHOOL BOARD using for the following: a. Who is the Reinsurance carrier? b. Who is the plan Network partner, and will they go away when you leave Florida Blue TPA? c. Who is the current Broker/Advisor? d. Did your current advisor develop all or part of this RFP?

Q19: a.Symetra is the reinsurance carrier. b) Meritain (Aetna) is the plan TPA as of January 1, 2025 c) Current advisor is Robinson Bush d) The current advisor did not develop this ITN

Q20: What is the POLK COUNTY SCHOOL BOARD medical plan/other benefits plan year?

Q20: Employee Benefits plan year is January-December. See RFP 039-MK-0524 Group Health Plan Services at www.myvendorlink.com

Q21: Often, for a group the size of POLK COUNTY SCHOOL BOARD, the best way to directly control costs is to have available your own health facility. From some of the RFP, it appears POLK COUNTY SCHOOL BOARD has a health center or onsite clinic. Has POLK COUNTY SCHOOL BOARD considered (or would you consider) a Direct Primary Care approach?

A21: Polk County Public Schools would evaluate and consider any approach to reduce costs. See RFP 039-MK-0524 Group Health Plan Services.

Q22: Does POLK COUNTY SCHOOL BOARD have any current direct contracts/relationships with medical providers in the area? Or are you relying on an “off the shelf” rented network?

A22: Currently there are no direct contract relationships with local providers due to limitations of our outgoing TPA. See RFP 039-MK-0524 Group Health Plan Services at www.myvendorlink.com.

Q23: Your RFP asks for a “fee proposal” and you provided some of the information on the number of covered lives but did not provide a few details about the size of the project. We have some questions concerning the number of employees lives that POLK COUNTY SCHOOL BOARD currently covers: a. Is the total number of POLK COUNTY SCHOOL BOARD benefit eligible employees 11,650 and 305 retirees? b. What is the total number of currently covered employee lives who have elected medical insurance? c. What is the total number of currently covered bellybuttons (all employee lives plus spouse and dependents) who have elected medical insurance?

A23: See ITN, section 3.4

Q24: How many years has POLK COUNTY SCHOOL BOARD been working with the current Broker of Record? a.

Please briefly describe any deficiency in services or financial results that compel POLK COUNTY SCHOOL BOARD to engage in their RFP process. b. If so, how has this POLK COUNTY SCHOOL BOARD’s current relationship worked out for you? Are your costs lower than they were last year? 2 years ago? c. If there are no such deficiencies, please describe the purpose behind this RFP being issued.

A24: The ITN contains all relevant information regarding the DISTRICT's intent to negotiate a successful contract.

Q25: Before the current Broker of Record, who did POLK COUNTY SCHOOL BOARD work with and for how many years?

A25: Wittner National Group, length of tenure unknown.

Q26: Your RFP format doesn’t suggest that this is a flat fee only RFP, and can the broker receive commissions/bonuses from the vendors as long as the Broker submits an annual compensation disclosure agreement.” Of note, “bonuses” are not mentioned in this section. Are bonuses specifically left out? Or did you intend to include them in this section? Is there a licensed Broker in the employ of POLK COUNTY SCHOOL BOARD that might be qualified to receive such remuneration? Do the commissions, etc. relate solely to the medical plan? Or does it include ancillary products and voluntary benefit commissions (that have commissions embedded in the State filed premiums)? What is the annual fee/commissions that POLK COUNTY SCHOOL BOARD is currently paying the current Broker of Record? How does POLK COUNTY SCHOOL BOARD know exactly what the current Broker’s compensation is since governmental entities opt out of ERISA Form 5500 Reporting, and there is so much hidden compensation that would never show up on the Form 5500 even if you were required to file the Form 5500 annually i.e. per script fee, carrier bonuses, carrier overrides? We are comfortable working on a fee only basis, but in an effort to keep our financial results aligned with better outcomes for the client, we include a “shared savings” component wherein our team receives 10% of the savings over our pre-engagement benchmark. Will POLK COUNTY SCHOOL BOARD entertain such an advisory compensation arrangement that has aligned incentives? Also, as a rule, we do not have preconceived core services or fees. Rather services and fees are built around each individual clients’ needs. Traditionally, fees are negotiated at the time that the final scope of services is developed. Would this approach preclude us from being selected as a finalist?

A26: Polk County Public Schools has operated under a fee-only basis for the past 21 years. It is plausible the District may entertain other compensation models with those that may be short-listed for further consideration. The current consultant is under a fee-only basis.

Q27: You mentioned that In January of 2025, the School Board of Polk County will transition the third-party administration (TPA) of its Polk County Health Plan away from Florida Blue after twenty-one years. a. Who is that TPA?

b. How was this new TPA selected and if through an RFP, when was this done, and the selection made? c. How long is the current contract with the TPA/medical insurance carrier/ASO assuming you are in a contract with them for 1/1/25, and when does it expire? d. Is the current TPA/medical insurance carrier/ASO to be the TPA regardless of the advisor choice?

e. Is the advisor allowed to suggest a different direction for the TPA administrative services?

A27: The TPA awarded the medical contract was Meritain. This TPA was selected through an RFP beginning in March of 2024. The current contract is for 3 years with two- 1 year options to renew. This is the carrier in place regardless of the advisor chosen. At the conclusion of the contract, other options could be presented for consideration. See 039-MK-0524 Group Health Plan Services

Q28: When does POLK COUNTY SCHOOL BOARD expect to evaluate different benefit options in the future, and how soon can they be implemented as we assume you are in contractual relationships with the current vendor partners?

A28: Other medical options would have to be evaluated, presented before the committee, voted on and negotiated before the expiration of the current agreement. See 039-MK-0524 Group Health Plan Services at www.myvendorlink.com

Q29: The RFP states – “Procurement Services will short-list the selected vendors and invite them to a presentation before the Evaluation Committee, if the committee deems it necessary.“ Based on the past experiences POLK COUNTY SCHOOL BOARD has had with this process, normally will each bidder/finalist have an opportunity to present orally? Is there a chance that POLK COUNTY SCHOOL BOARD will hire a consultant without an oral presentation as the RFP mentions TBD? Please elaborate on the consultant evaluation/selection process.

A29: See ITN, section 6.1

Q30: Who will be on the Evaluation/Selection Committee that will perform the evaluation of all proposals and what are their job roles/titles?

A30: Evaluation committee is comprised of representatives from the DISTRICT and other determined by the DISTRICT, see ITN, section 6.1

Q31: What role will Unions or collective labor play in general and more specifically in the decision-making process associated with this RFP? As an example, would a Union member be present on the Evaluation/Selection Committee?

You do not have “experience with unions” on your qualifications list. We believe such experience is vital to the successful operation of the plan.

A31: See ITN, section 6.1

Q32: The RFP didn’t suggest you will show some preference for a “local bidder preference ordinance - Per Chapter 287 of the Florida Statute, Section 287.084 (1)(a), Preference to Florida Business” – will this be taken into account? Like most large account RFPs, your questions seem to be looking for a large size brokerage shop as a virtue in the process. Could you please provide clarity to this seeming contradiction?

A32: 287.084(1)(a) Florida Statute, applies to purchases of personal property, the district intends to procure professional services as outlined in ITN

Q33: When you state that the ITN response that we need to have Tab 3 Response to the Statement of Work, are you referencing the Section 4: Deliverables you want us to elaborate on? We didn’t see any Statement of Work questions – please clarify.

A33: Response organization tab 3 should include the vendor's response to statement of work that includes how vendor intends to meet expectations in scope of services and deliverables.

Q34: What is the total medical and Rx spend combined annually for 2021, 2022, and YTD 2023? a. What is the medical ONLY spend annually? b. What is the pharmacy ONLY spend annually? i. What percent of Rx spend is “specialty”? c.

Can any claims data be shared with us to review in our response? With your data, respondents can illustrate the impact of their methods. This will allow POLK COUNTY SCHOOL BOARD to review how respondents can impact cost. d. Can you provide the current Benefits Summary for the plan(s)? e. Are the employees “steered” to any entity (hospital, urgent care chain, labs, radiology) to obtain services or prescription from any particular outlet? (even if using financial incentives to do so) f. What is the current sentiment for the committee/board on utilizing local providers versus out of town/state entities? g. What is the current contribution of the plan and the employee? h. For the most recent 4 years what was the increase/decrease in total premiums for the plan? i. For the most recent 4 years what was the increase/decrease in the premiums for plan participants? Per employee per pay cycle will work here. j. Can you provide a copy of the current TPA/insurance carrier ASO Master Services Agreement and the PBM ASO Master Services Agreement and/or any other “direct” to provider contracts?

A34: See RFP 039-MK-0524 Group Health Plan Services at myvendorlink.com

Q35: Would it be possible to obtain the following additional health insurance plan reports? : a. Medical paid claims and enrollment counts by month by product (if different plan options were available) and by division/facility if applicable for the last 36 months. b. Aggregate reports for the past 3 years c. Most recent 36 months (24 months if available) of Claim/Trigger Reports / Shock loss information / Catastrophic Claimant Report for claims in excess of $15,000 (if available), including the following: i. Diagnosis ii. Prognosis iii. Relationship (Employee, Spouse or Child) iv. Paid claims A35: These reports will be available to the successful awarded firm as part of the onboarding process

Q36: Our agency is a founding partner of a multi-State consortium of cutting-edge advisory firms giving us a broad spectrum of knowledge, and access to resources. As long as there is a lead firm, is the POLK COUNTY SCHOOL BOARD open to a multi-advisory firm approach?

A36: See ITN, section 8.9 Joint Proposal

Q37: You have asked us to provide at least three (3) Florida School District References or (3) most comparable municipal references that Polk County School Board may contact as references. Again, we are not inclined to provide this list with all contact information in a manner that will be open to our competitors. Of course, we will be reviewing such a list provided by other respondents and may attempt to engage with some of them. If we don’t satisfy this listing of all clients with whom we have engaged over the past 5 years for the concerns we shared, are we automatically disqualified?

A37: ITN, section 5.3, tab 2 requires vendor to provide at least three Florida School District references. This section is scored in section 6.2 with potential point value 35.

Q38: What type of benefit technologies does POLK COUNTY SCHOOL BOARD use that POLK COUNTY SCHOOL BOARD may want to keep or would like to review in the future?

A38: Benefitfocus is the current platform is used to enroll employees in their employee benefits. The consultant is being asked to provide support as far as benefit administration, payroll, and open enrollment planning within Benefitfocus.

Q39: Question 3.3.10 mentions an employee survey. Can you clarify the role the consultant will play in the survey. Is the role to aid in supplying questions and other advice, or will the consultant be administering the survey and compiling and analyzing results, etc.

A39: The consultant would be asked to help with question design. The District should be able to send survey by using its current system(s).

Q40: Question 3.3.14 discuses the appeals and grievances, etc: a. Please provide the number of appeals the DISTRICT has had in 2023 and YTD 2024. b. The question includes “grievances” as well as “appeals.” Please provide the number of “grievances” the DISTRICT had in 2023 and 2024 and examples of such. c. Who is administering the first and second round of appeals? Is the TPA managing this or another provider, or is the consultant intended to do this this? d. Please provide a workflow of the current appeals process.

A40: The District defers all management of grievances and appeals to the medical management of the health plan. The consultant does get involved in interpreting the SPD or coverage questions with the District, but the care determination is made by the TPA.

Q41: Section 4: Deliverable Financial Plan Performance – Please clarify for question # 9 if the DISTRICT is asking the consultant to house historical claim information that may be used for audits, OR if the DISTRICT is requiring a data warehouse platform to be provided.

A41: Both. The District is just beginning plans to create a data warehouse. Claims data would need to be managed by the consultant for historical and ongoing claims data.

Q42: Is the DISTRICT open to a flat fee vs. hourly fee?

A42: See ITN section 5, tab 4

Q43: As Appendix A requires notarization and the District requires Word submissions, not pdf, we assume an imbedded image of the notary`s signature and seal will be acceptable.

A43: pdf is acceptable format, see ITN section 2.4

Q44: We understand the District`s preference is fee and we are happy to work with you in that way. Our question is whether there is a hard "no commissions under any circumstance" policy in the event commissions made sense for the District. Our approach is transparent and unbiased regardless of the form of compensation.

A44: The DISTRICT has operated under a fee-only basis for the past 21 years. The DISTRICT may entertain other compensation models offered in alternate proposals.

Q45: Could you please help us with these questions in regard to the Benefit Consultant Solicitation?: • Who is the TPA and the PBM • Based on the TPA, what network was chosen to access through the TPA? • Are there any advocacy services provided by TPA or other 3rd party? • Does the 2025 plan design have any incentives to enhance employee engagement?

• PBM questions: o How is the PBM being compensated? o Can PCS control their own formulary? o Can PCS access manufacturer assistance programs or international sourcing through this new PBM? • Can a copy of the scoring for the selection of the TPA/PBM be provided? • We have heard that Jan Bush is retiring, so questions: o Understanding your doing this RFP for consulting services, : ♣ Why is the current contract NOT being renewed? ♣ Were are the top things PCS liked about the current consultant? Where are areas you’d like to see enhanced, more resources, etc.? • • Onsite health center: o How is this going? o Current integration: ♣ What integration does the center have with the BCBSFL program?

o TPA integration: ♣ Have conversations began with the scale of integration with the new TPA? ♣ What type of onsite Rx capabilities is available with the clinic? ♣ Do they/new PBM have 340b capabilities? o Direct contracts ♣ Have any direct contracts with provided been set up for PCS?

A45: See RFP 039-MK-0524 Group Health Plan Services at www.myvendorlink.com. Effective January 1, 2025, TPA is Meritain and PBM is Welldyne. Aetna POS is network. Maternity program for Jan. 1st. No incentive program for engagement yet. The PBM is being compensated on an administration fee basis PMPM only. Yes. Yes.