17-A3 - Cobra Questionnaire.xlsx
XLSX spreadsheet 85 KB Posted
- Attached to
- Ancillary Insurance Benefits
- Solicitation number
- RFP 2026-018
- Issued by
- Johnson County, Texas
About this file
This is a COBRA Questionnaire assessment document related to the State of Texas's Ancillary Insurance Benefits contract opportunity, which encompasses Life, Disability, Employee Assistance Program (EAP), Health Savings Account (HSA)/Flexible Spending Accounts (FSA)/Health Reimbursement Arrangement (HRA), COBRA administration, and voluntary worksite products. The questionnaire is designed to evaluate potential vendors' capabilities and experience in administering COBRA benefits, a critical component of the overall ancillary insurance benefits program. The document appears to serve as a pre-qualification or evaluation tool to assess vendor readiness to provide comprehensive COBRA administration services to the state, including compliance with federal COBRA requirements and management of employee continuation coverage benefits.
The questionnaire format suggests this is part of a structured procurement process to identify qualified vendors capable of handling the administrative complexities of COBRA compliance and employee benefit continuation. As part of the broader ancillary insurance benefits solicitation, vendors responding to this questionnaire would need to demonstrate competency in COBRA administration alongside their offerings in other benefit categories. This evaluation mechanism helps the State of Texas ensure that selected contractors possess the necessary expertise, systems infrastructure, and operational capacity to manage COBRA obligations effectively while maintaining compliance with federal regulations and serving the state's employee population.
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Text version
Front Cover
Request for Proposal-COBRA Administration
City of Burleson
| Prepared by: |
| Lockton Companies |
| Effective: |
| 1/1/27 |
| 2100 Ross Avenue, Suite 1200 |
| Dallas, Texas 75201 |
| www.lockton.com |
Introduction COBRA Administration Introduction
| Background |
| The City of Burleson has requested Lockton Companies to complete an evaluation of its COBRA vendor. |
| At this time, we are requesting your assistance in providing a proposal for administration consistent with the current structure. |
| Current Program |
| The current Cobra vendor for the City of Burleson is FloresHR. |
| Effective Date |
| January 1, 2027 |
| Commission Level |
| Net commissions |
| Service |
| Rates |
| Rate Validation/Check |
| Network Accessibility |
| Claims Service |
| New Client/Prospect |
| Renewal Review |
| Other |
| Flat fee |
| Capitated fee (per employee per month) |
| Flat percentage of premium |
| Graded percentage of premium |
| Member-based sliding schedule |
| Net of commission |
| Other |
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Vendor Information
| Vendor Name |
| Vendor Contact Name |
| Vendor Contact Phone Number |
| Vendor Contact Email |
Current Program COBRA Administration: Current Program
| COBRA Administration Services | |
| Current COBRA Administrator: | FloresHR |
| Approx Number of Current Benefit Eligible Employees: | 433 |
| Approx Number of Employees Currently Under the Medical Plan: | 385 |
| COBRA Eligible Benefit Plans | Medical: UHC |
Dental: UHC Vision: UHC
| Average Terminations Per Month | 5 (benefit-eligible) |
| Average New Hires Per Month | 6 (benefit-eligible) |
| Admin Fee | $0.49 - includes QE and initial notices |
Minimum of $50 per month
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Financial Analysis COBRA Administration Financial Analysis
| Vendor Name | ||
| One Time Fees | ||
| Implementation Fee | ||
| Takeover Fees (# COBRA participants) | ||
| One Time Fees - Annual Total | $0 | |
| Ongoing Fees | ||
| Annual Fee | ||
| Monthly Service Fee - PEPM Fee (# enrolled & # eligible) | ||
| Monthly Service Fee - Per COBRA Beneficiary | ||
| Ongoing Fees - Annual Total | $0 | |
| Additional Fees | ||
| Initial Notifications (existing & new hire) | ||
| Qualifying Event Notices | ||
| Carrier Notifications - reinstatement/termination | ||
| HIPAA Certificates | ||
| Online Services | ||
| Real-time & Monthly Reporting | ||
| Past Due Notices to Continuants | ||
| Retro COBRA Initial Rights Notices | ||
| Per Carrier Eligibility File Fee | ||
| Per Carrier Premium Remittance Fee | ||
| Does your firm retain the 2% administration charge | ||
| Monthly Minimum Fee | ||
| Post-COBRA HIPPA Certificates of Coverage on outside COBRA members (per certificate) | ||
| HIPPA Privacy Notices (per notice) | ||
| Medicare-D Notifications | ||
| Direct (Retiree) Billing Services | ||
| Direct (Retiree) Billing (per continuant per month) | ||
| Past Due Notices to Continuants (per notice, upon request) | ||
| Open Enrollment Services | ||
| Open Enrollment Service (per person): |
Includes packaging and distribution of all related benefit materials and/or informational documents as designated by and provided by the client
*There is a $100 minimum for Open Enrollment Services
| Rate Guarantee | ||
| Current Vendor COBRA Admin Fee | $0.49 PEPM |
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Questionnaire COBRA Administration Questionnaire
| Organization | [Insert Vendor Name] | |
| v | How long has your business been in existence? | |
| v | How long has your business been administering COBRA? | |
| v | Provide the location of your business. | |
| v | What is the company's ownership: parent/subsidiary/affiliate relationships. Is the company public or privately held? | |
| v | Is the company public or privately held? | |
| v | Please provide a 3-year history of the number of employers your organization has provided COBRA administration services. | |
| v | What is the average size of your clients? What is the largest? The smallest? | |
| v | Provide three current client references similar in size and industry. Include contact name, title and phone number. | |
| v | What has been your client retention percentage for each of the past three years? | |
| v | Has your organization been acquired or merged with any other organization in the past 12 months? | |
| v | Do you anticipate merging or buying another carrier vendor in the next 12 months? | |
| Customer Service/Member Service | ||
| v | Will you provide information regarding Lockton Marketplace for the public exchange in your Qualified Event Notices? |
(Reference link: www.locktonmarketplace.com/dunning)
| v | Will you provide a dedicated account manager for City of Burleson ? | |
| v | Will member and client calls be handled by this individual or by your general customer service department? | |
| v | Does your organization have service offices in Texas? | |
| v | If not, from which location will you service this account? | |
| v | What types of standard reports do you provide the client? | |
| v | How can members communicate with customer service? | |
| v | Is a toll-free number available? | |
| v | Is an automated voice mail system available for routine questions? | |
| v | Can a member also contact customer service over the internet? | |
| v | Do you provide COBRA participants access to online access to your site? | |
| v | What are your customer service hours of operation? | |
| v | What languages does your customer support team currently offer for participant assistance across all service channels (phone, chat, email, and secure messaging)? | |
| v | Describe the member website capabilities (what can members do after logging in). | |
| v | How quickly is transaction information updated on member accounts in the website/mobile app (how current is the data) | |
| v | Do you offer a mobile app? | |
| v | Describe your employer portal functionality. | |
| v | How often is data refreshed in the employer portal? | |
| v | What implementation and training support is provided for employer portal users? | |
| Implementation | ||
| v | Describe your implementation process. | |
| v | What is the lead time for implementation of COBRA administration? (Please provide a tentative timeline.) | |
| v | Are you willing to work with the incumbent administrator to transfer data electronically? | |
| v | Provided a detail description of your implementation process, with takeover procedures. | |
| Financial | ||
| v | Please describe the banking options for the City to submit payment for COBRA Administration. (Example, Check and/or ACH) | |
| v | Please confirm if rates/costs on Financial sheet are guaranteed for a minimum of five years. | |
| HIPAA Compliance | ||
| v | When was your last HIPAA Audit? | |
| v | Name of outside consultant that provided the audit? | |
| v | Do you have any instances of self-reported HIPAA violations? | |
| v | Last SOC1 audit? | |
| Carrier Notification | ||
| v | Describe options in which you notify carriers? Electronic or Paper | |
| v | How often will you notify carriers? Weekly, Monthly | |
| v | Describe the controls in place to ensure COBRA elections and terminations processed correctly? | |
| Premium Collection | ||
| Do you manage direct billing to participants? | ||
| v | Outline payment options COBRA participants have when submitting premium. (Example, Check or Credit Card) | |
| v | How are the premiums collected remitted back to the client? (Example, Check or ACH) | |
| v | How often are the premiums remitted to client? (Example: Weekly, Bi-weekly, Monthly) | |
| v | Outline your premium collection reporting available to client. | |
| How are terminations for non-payment processed? | ||
| How frequently are employer remittance reports provided? | ||
| Event Processing | ||
| v | Outline the various options in which you can received COBRA events. (Example, eligibility file, paper, fax, phone call, excel file) | |
| v | What is the turn around time to process events? (Example, Daily, Weekly, Bi-weekly, Monthly) | |
| v | What is the process of sending out communications to the members including documenting proof of providing required communications/notifications? | |
| Annual Enrollment | ||
| v | Please describe your process for handling Annual Enrollment for COBRA current participants and those in waiting period. | |
| Cyber Security | ||
| v | Outline your Cyber Security processes and practices to protect your networks, computers and programs from an attack. | |
| v | Do you have Cyber Security Insurance? If yes, who is the insurance though? |
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Back Cover
| OUR MISSION |
| To be the worldwide value and service leader in insurance brokerage, risk management, employee benefits, and retirement services |
| OUR GOAL |
| To be the best place to do business and to work |
lockton.com
© 2023 Lockton, Inc. All rights reserved.
Template COBRA Administration Questionnaire Comparison
| Organization | Carrier 1 | Carrier 2 | ||
| v | Identify and describe your relevant experience with administering COBRA services similar to this plan in both size and design. | |||
| v | Provide three current client references similar in size (based on funded lives) and industry. Include contact name, title and phone number. | |||
| v | Provide three prior client references similar in size (based on funded lives) and industry. Include contact name, title, and phone number. | |||
| Implementation | ||||
| v | Describe your process for implementation of the benefit plan including: | |||
| v | Timeline required by your company. | |||
| v | ID card design and welcome package options including time needed for approval by City of Burleson . | |||
| v | Claim form design and approval from City of Burleson . | |||
| v | Participant material production, review, approval, and distribution process. | |||
| v | Implementation and open enrollment communication strategy. | |||
| v | Assuming a business award date of (date), please include a copy of your detailed transition plan/timeline that includes completion dates for each specific task. List any start-up fees. | |||
| v | Please provide an implementation guarantee that includes having ID cards in employees hands and loading/testing of all benefits accurately on or before the effective date of the new plan. Include 'drop dead' dates for receiving all information and the fees you will place at risk for non-performance. |
| v | What type of cost and performance guarantees are you willing to provide for the following areas, along with the amount you will be putting at risk: | |
| v | Implementation | |
| v | Delivery of Cards | |
| v | Delivery of Contract/SPD | |
| v | Account Management | |
| v | Claims Processing | |
| v | Customer Service | |
| v | Reporting | |
| v | Are your fees (rates) guaranteed for more than one year? If not, are you willing to provide a guarantee of two or three years? | |
| v | Do you provide introductory letters to member homes? | |
| v | If so, please provide a copy of your standard new member communications materials. | |
| v | Are you willing to work with the incumbent vendor to transfer data electronically through out the implementation phase? | |
| v | Open enrollment meetings each year will be held at each of the [Client]'s facilities . The carrier representative will need to be available to attend those meetings. There could be as many as 30 different enrollment meetings the first year of implementation. | |
| v | Please provide if you will allow enrolled members to change or drop coverage during an annual open enrollment period. | |
| v | What is the minimum amount of time you believe is necessary to implement City of Burleson 's plans in an efficient and effective manner? | |
| v | Please describe the banking options for bill payment that are available to this client. | |
| v | Do you offer an integrated program (one system, one member, service number, etc.)? | |
| v | Can you provide COBRA Administration services policy review and recommendations to employees? | |
| v | What specific information, not already provided in this RFP, do you need in order to be able to implement properly? | |
| Communication | ||
| v | Do you provide the following at no additional cost? | |
| v | Enrollment kits, posters, brochures | |
| v | Monthly employee articles | |
| v | Monthly payroll stuffers | |
| v | Wallet cards | |
| v | Ongoing employee orientations | |
| v | Participate in health fairs and/or organizational events | |
| v | Monthly HR e-mailer | |
| v | Member access to a Web site for educational tools | |
| v | Can your Web site be customized by client? | |
| Financial | ||
| v | What is your minimum participation requirement, if any? | |
| v | Please list your typical set-up fees. | |
| v | Is this rate flexible or is a set rate depending on client size, bundling products, etc? | |
| v | Do you offer the optional services listed below? If yes, please indicate applicable fees/rates. | |
| v | COBRA Initial Rights Notification | |
| v | HIPAA Initial Rights Notification | |
| v | Post COBRA HIPAA Certificates of Coverage | |
| v | Past Due Notices to Continuants | |
| v | Retro COBRA Initial Rights Notice | |
| v | Carrier Communication and Premium Remittance | |
| v | Are they included in your Ongoing Fees/Administration pricing or are they separate charges? | |
| v | Who retains the 2 percent administration fee? | |
| Do these ongoing fees vary by client size? | ||
| v | Set-up fees | |
| v | Monthly administration fees | |
| v | Annual renewal fees | |
| v | Qualifying event services (per QE) | |
| v | Is your administration fee inclusive of certain services or is "a la carte" pricing available? | |
| v | Do your costs vary by size of the client? If yes, please explain. | |
| v | Are there any other services not listed above that are included in the Admin Fee? | |
| v | What are standard commissions? | |
| v | From the time you have received data necessary to issue contract, how many days does it take to actually issue/deliver contract? | |
| v | What is your standard premium grace period? | |
| v | Please provide us with a copy of your Business Associate Agreement. Will you endorse the clients BAA? | |
| v | Will you agree to provide Schedule A or C information to the client (for filing Form 5500) within 120 days following the end of the plan year? | |
| Customer Service/Member Service | ||
| v | Describe your standards and procedures for maintaining contact with the employer and employee. Provide timing of these contacts. | |
| v | Does your organization have service offices in [City/State]? If not, from which location will you service City of Burleson 's account? | |
| v | Do these offices have previous experience in City of Burleson 's type of business? If yes, please specify which and what size employee groups. If not, what will you do to become familiar with the claims experience and nuances of City of Burleson 's business? | |
| v | Will you guarantee that all incoming calls form City of Burleson will be returned the same day they are placed? | |
| v | Do you provide dedicated customer service teams to handle member questions/issues or do service center call agents handle claim issues? | |
| v | The bidder will provide a description of their resources for effective and timely customer service. This will include current customer service staffing levels, dedicated staff commitments, customer service representative (CSR) training (initial and ongoing), systems for CSR call reporting and tracking, CSR performance management and other related activities. | |
| v | Specify the documentation procedures for inquiries to the customer service department. | |
| v | What percentage of inquiries are documented? | |
| v | Are inquiries updated immediately? | |
| v | Please answer the following regarding your customer service reporting capabilities. | |
| v | Will you provide client-specific reports? | |
| v | Will you provide issue-specific reports? | |
| v | How frequently will customer service reports be provided to City of Burleson ? | |
| Account Management | ||
| v | What is the current number of clients serviced by the account manager/account executive that would be assigned to City of Burleson ? | |
| v | Do you provide a dedicated account manager? | |
| v | What was the turnover rates of your account managers for the last three years, respectively? | |
| v | Will you provide support to the Client to manage client eligibility and other administrative tasks? Can the Client update in real time on-line? | |
| v | How will you help the Client monitor plan performance? | |
| v | How frequently do you provide status updates to your clients? What information is documented and provided at these meeting? | |
| v | How often will your account manager review the quality and effectiveness of the program with the client? | |
| Claims | ||
| v | Do you have an audit process that monitors the accuracy of claims paid? If yes, how often do audits occur and what are the results? | |
| v | Describe the accuracy standards of your claims processing facility. What were your results for last year? | |
| v | What percentage of claims are automatically adjudicated? | |
| v | What is your claim rejection rate and how do you resolve claims that reject from the claims system? | |
| v | What percentage of your claims can be submitted electronically? What percentage of you claims are submitted electronically? | |
| v | How many claims does your organization process annually? | |
| v | What is the average tenure of your claims staff? | |
| v | Over the last three years, what percentage of claims were for services from a network provider? | |
| v | What is your average claims backlog? | |
| v | Detail how you handle employees and dependents residing or traveling outside of established service areas. What provisions does the program have for emergency care provided outside of the plan's service area or after normal working hours? | |
| v | Please describe your process for paying claims for members traveling outside of the United States. | |
| v | Are claim forms ever required of members? If so, in what instances? | |
| v | What extended benefits are available for work in progress after contract termination? | |
| v | How do you investigate for potential subrogation or other third party liability claims? | |
| v | What are your goals and results for claim turnaround time? | |
| v | Describe the qualifications of the consultants who review claims. What is your method of assuring standardization of consultant review decisions? | |
| v | Describe any outsourced clinical review processes | |
| v | What prompts a claim to be referred to clinical review? | |
| v | Do you have the capability to feed the client's Flexible Spending Account (FSA) vendor claims data to be used for substantiation of claims under the FSA program? | |
| v | Is it available for this client? | |
| v | If so, is there an additional cost for this service? | |
| v | What claims reporting will be provided to monitor claims dollars paid in-network, dollars paid by participant tier, total savings attributable to network discounts, dollars not covered, etc? Provide samples of claims reports considered ‘Standard’ and those considered ‘Custom’ (additional cost). | |
| v | Please provide your claim service center statistics for turn-around-time, pay dollar accuracy, average speed of answer, percentage of paid claims paid accuracy, etc. Are you willing to provide service level guarantees, placing fees at risk? | |
| Reporting | ||
| v | Describe what reporting is available to the Client and how frequently (monthly, quarterly, annually)? | |
| v | Can the Client generate these reports? Is this reporting capability available on-line at no additional charge? | |
| v | Do you offer ad hoc or special-request reporting? Are these also available on-line? Are there additional fees for the standard reporting package and/or ad hoc reports? If so, explain costs. | |
| v | Are there additional costs associated with any of these reports? | |
| v | Does your reporting indicate the following: | |
| v | Total Identified Members | |
| v | Total Participating Members | |
| v | Total Members who declined participation | |
| v | Are customized reports available through your organization's web site? |
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