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Submission Checklist
| | RFP - Nevada Public Employees' Benefits Program |
| | Telemedicine - Offeror Information |
| | We are providing this sheet as a helpful tool to ensure you have completed all items required for submission with this RFP. The Intent to Bid is non-binding. |
| Please pay attention to the purple boxes at the top of each tab. They contain important information and helpful tips related to this RFP. | complete all gray boxes | |
| | (fill in Offeror name here) |
| Email to gkdavis@admin.nv.gov | | Confirm you have emailed to gkdavis@admin.nv.gov |
| 2.1 | Intent to Bid (due 8/13/2021 @ 2pm) | |
| Submit to NevadaEPro | | Confirm you have submitted in NevadaEPro |
| 2.2 | This RFP Spreadsheet | |
| 2.3 | References Spreadsheet - CONFIDENTIAL | |
| Within this Workbook | | Confirm you have completed these tabs, and then submit to NevadaEPro |
| 1.a. | Vendor Information Tab | |
| 1.b. | Subcontractor Tab (if applicable) | |
| 2. | Signatures Required Tab | |
(either print, sign, scan and upload as separate pdf - or insert photo of signature)
| | 3. | Terms and Conditions |
| Please read all three sections: Procurement and Proposal, Contract, and Project | Read only, nothing to return | | |
| | 4. | Mandatory Minimum Quals Tab |
| | 5. | Technical Tab |
| | 6. | Customer Service Tab |
| | 7. | Financial Tab |
Vendor Info
| RFP - Nevada Public Employees' Benefits Program | |
| Telemedicine - Offeror Information | |
| complete all gray boxes |
| (fill in Offeror name here) |
| 1.0 - Company Name and Contact Information | |
| Company Name | |
| Company Street Address | |
| City, State, Zip Code | |
| Telephone Number | |
| Toll Free Number | |
| Web Address: | |
| Dun and Bradstreet Number | |
| Federal Tax Identification Number | |
| Please include the last two years and current year interim Profit and Loss statements for your company. | Embed here, if unable to embed a hyperlink, send as a separate attachment clearly labeled "Organization'sName_00_ProfitLossStmts-CONFIDENTIAL" |
| 2.0 - Contact Person for Questions/Contract Negotiations |
| Name |
| Title |
| Address |
| City, State, Zip Code |
| Telephone Number |
| Email Address |
| 3.0 - Vendor Information |
| 3.1 - Company Profile |
| Ownership (sole proprietorship, partnership, etc.) |
| State of Incorporation |
| Date of Incorporation |
| # of years in business |
| List of Top Officers |
| Location of company headquarters, to include City and State |
| Location(s) of the office that shall provide the services described in this RFP |
| Number of employees within Nevada with the expertise to support the requirements identified in this RFP |
| Number of employees nationally with the expertise to support the requirements identified in this RFP |
| How many health plans and TPAs do you work with? Provide listing of health plans and TPAs. |
| Identify any known and significant changes in ownership, business operations, technologies, partnerships or staffing in the next 24 months that would impact services requested in this RFP or the level of service provided to PEBP. (Limit response to 10 sentences or less). |
| Is your company owned by another company or by a common controlling shareholder of interest? If so, describe these affiliate relationships. (Limit your response to 10 sentences or less). |
| Describe company background/history and why Offeror is qualified to provide the services described in this RFP. (Limit response to 15 sentences). |
| List any mergers, acquisitions, spin-off's or significant organizational changes in past 2 years. |
| 3.2 - Vendor Licensing |
| Please be advised: Pursuant to NRS 80.010, a corporation organized pursuant to the laws of another state shall register with the State of Nevada, Secretary of State’s Office as a foreign corporation before a contract can be executed between the State of Nevada and the awarded vendor, unless specifically exempted by NRS 80.015. |
| The selected vendor, prior to doing business in the State of Nevada, shall be appropriately licensed by the State of Nevada, Secretary of State’s Office pursuant to NRS 76. Information regarding the Nevada Business License can be located at http://nvsos.gov. |
| Nevada Business License Number |
| Legal Entity Name |
| Is the Legal Entity Name the same name as vendor is Doing Business As (DBA)? Yes/No, if no, please explain. |
| 3.3 - State of Nevada Experience |
| Has the vendor ever been engaged under contract by any State of Nevada agency? |
| If yes, complete the following tables for each contract being identified. (If additional spaces are required, please submit as separate attachment). |
| State Agency Name |
| State Agency Contact Name |
| Date Services were Performed |
| Type of Duties Performed |
| Total Dollar Value of the Contract |
| State Agency Name |
| State Agency Contact Name |
| Date Services were Performed |
| Type of Duties Performed |
| Total Dollar Value of the Contract |
| State Agency Name |
| State Agency Contact Name |
| Date Services were Performed |
| Type of Duties Performed |
| Total Dollar Value of the Contract |
| 3.4 - Vendor Current or Former Employee |
| Are you now or have you been within the last two (2) years an employee of the State of Nevada, or any of its agencies, departments, or divisions? Yes/No. If yes, please explain when the employee is planning to render services; i.e., while on annual leave, compensatory time, or on their own time. |
| If you employ (a) any person who is a current employee of an agency of the State of Nevada, or (b) any person who has been an employee of an agency of the State of Nevada within the past two (2) years, and if such person shall be performing or producing the services which you shall be contracted to provide under this contract, you shall disclose the identity of each such person in your response to this RFP, and specify the services that each person shall be expected to perform. |
| 3.5 - Prior or Ongoing Contractual Issues |
| Disclosure of any significant prior or ongoing contract failures, contract breaches, civil or criminal litigation in which the vendor has been alleged to be liable or held liable in a matter involving a contract with the State of Nevada or any other governmental entity. |
Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed.
| Does any of the above apply to your company? | | |
| If Yes, please provide information in the table(s) below (for each issue being identified). If you require more space, please duplicate this table and attach separately. | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
| Status of the litigation | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
| Status of the litigation | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
Status of the litigation
Subcontractor Info
| RFP - Nevada Public Employees' Benefits Program | |
| Telemedicine - Offeror Information | |
| Subcontractors are defined as a third party, not directly employed by the contractor, who shall provide services identified in this RFP. This does not include third parties who provide support or incidental services to the contractor. | complete all gray boxes |
| (fill in Offeror name here) |
| 1.0 - Subcontractor Definition | |
| Does this proposal include the use of subcontractors? Yes/No. | |
| If Yes, vendor shall: | |
Identify specific subcontractors and the specific requirements of this RFP for which each proposed subcontractor shall perform services.
If any tasks are to be completed by subcontractor(s), vendor shall describe:
A. How the work of any subcontractor(s) shall be supervised;
B. Channels of communication shall be maintained;
C. Compliance with contracts terms and conditions will be assured; and D. Your previous experience with subcontractor(s) Vendor shall not allow any subcontractor to commence work until all insurance required of the subcontractor is provided to the vendor.
Vendor shall notify the using agency of the intended use of any subcontractors not identified within their original proposal and provide the information originally requested in this tab of the RFP response.
| 2.1 - Subcontractor Company Profile |
| Vendors shall provide an overall company profile for all proposed subcontractors in the following table. |
Table may be duplicated for additional proposed subcontractors, if needed and attached separately.
| Subcontractor Company Name | | |
| Ownership (sole proprietorship, partnership, etc.) | | |
| State of Incorporation | | |
| Date of Incorporation | | |
| # of years in business | | |
| List of Top Officers | | |
| Location of company headquarters, to include City and State | | |
| Location(s) of the office that shall provide the services described in this RFP | | |
| Number of employees within Nevada with the expertise to support the requirements identified in this RFP | | |
| Number of employees nationally with the expertise to support the requirements identified in this RFP | | |
| Location(s) from which employees shall be assigned for this project | | |
| Subcontractor Company Name | | |
| Ownership (sole proprietorship, partnership, etc.) | | |
| State of Incorporation | | |
| Date of Incorporation | | |
| # of years in business | | |
| List of Top Officers | | |
| Location of company headquarters, to include City and State | | |
| Location(s) of the office that shall provide the services described in this RFP | | |
| Number of employees within Nevada with the expertise to support the requirements identified in this RFP | | |
| Number of employees nationally with the expertise to support the requirements identified in this RFP | | |
| Location(s) from which employees shall be assigned for this project | | |
| 2.2 - Subcontractor Licensing | | |
| Please be advised: Pursuant to NRS 80.010, a corporation organized pursuant to the laws of another state shall register with the State of Nevada, Secretary of State’s Office as a foreign corporation before a contract can be executed between the State of Nevada and the awarded vendor, unless specifically exempted by NRS 80.015. | | |
| The selected vendor, prior to doing business in the State of Nevada, shall be appropriately licensed by the State of Nevada, Secretary of State’s Office pursuant to NRS 76. Information regarding the Nevada Business License can be located at http://nvsos.gov. | | |
| Nevada Business License Number | | |
| Legal Entity Name | | |
| Is the Legal Entity Name the same name as vendor is Doing Business As (DBA)? Yes/No, if no, please explain. | | |
| Nevada Business License Number | | |
| Legal Entity Name | | |
| Is the Legal Entity Name the same name as vendor is Doing Business As (DBA)? Yes/No, if no, please explain. | | |
| 2.3 - Subcontractor State of Nevada Experience | | |
| Has the vendor ever been engaged under contract by any State of Nevada agency? | | |
| If yes, complete the following tables for each contract being identified. (If additional spaces are required, please submit as separate attachment). | | |
| State Agency Name | | |
| State Agency Contact Name | | |
| Date Services were Performed | | |
| Type of Duties Performed | | |
| Total Dollar Value of the Contract | | |
| State Agency Name | | |
| State Agency Contact Name | | |
| Date Services were Performed | | |
| Type of Duties Performed | | |
| Total Dollar Value of the Contract | | |
| State Agency Name | | |
| State Agency Contact Name | | |
| Date Services were Performed | | |
| Type of Duties Performed | | |
| Total Dollar Value of the Contract | | |
| State Agency Name | | |
| State Agency Contact Name | | |
| Date Services were Performed | | |
| Type of Duties Performed | | |
| Total Dollar Value of the Contract | | |
| State Agency Name | | |
| State Agency Contact Name | | |
| Date Services were Performed | | |
| Type of Duties Performed | | |
| Total Dollar Value of the Contract | | |
| 2.4 -Subcontractor Current or Former Employee | | |
| Are you now or have you been within the last two (2) years an employee of the State of Nevada, or any of its agencies, departments, or divisions? Yes/No. If yes, please explain when the employee is planning to render services; i.e., while on annual leave, compensatory time, or on their own time. | | |
| If you employ (a) any person who is a current employee of an agency of the State of Nevada, or (b) any person who has been an employee of an agency of the State of Nevada within the past two (2) years, and if such person shall be performing or producing the services which you shall be contracted to provide under this contract, you shall disclose the identity of each such person in your response to this RFP, and specify the services that each person shall be expected to perform. | | |
| 2.5 - Subcontractor Prior or Ongoing Contractual Issues | | |
| Disclosure of any significant prior or ongoing contract failures, contract breaches, civil or criminal litigation in which the vendor has been alleged to be liable or held liable in a matter involving a contract with the State of Nevada or any other governmental entity. | | |
| Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed. | | |
| Does any of the above apply to your company? | | |
| If Yes, please provide information in the table(s) below (for each issue being identified). If you require more space, please duplicate this table and attach separately. | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
| Status of the litigation | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
| Status of the litigation | | |
| Date of alleged contract failure or breach | | |
| Parties involved | | |
| Description of the contract failure, contract breach, or litigation, including the products or services involved | | |
| Amount in controversy | | |
| Resolution or current status of the dispute | | |
| If the matter has resulted in a court case | Court | Case Number |
| Status of the litigation | |
| 2.6 - Subcontractor Company Background | |
| For first subcontractor - Company background/history and why vendor is qualified to provide the services described in this RFP. Limit response to no more than two (2) pages. | Embed response here, or attach, naming the file "OrganizationName_SubName_1_history" |
| For first subcontractor - Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed. | Embed response here, or attach, naming the file "OrganizationName_SubName_1_claim_litigation" |
| For second subcontractor - Company background/history and why vendor is qualified to provide the services described in this RFP. Limit response to no more than two (2) pages. | Embed response here, or attach, naming the file "OrganizationName_SubName_2_history" |
| For second subcontractor - Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed. | Embed response here, or attach, naming the file "OrganizationName_SubName_2_claim_litigation" |
Signatures required
| RFP - Nevada Public Employees' Benefits Program | | |
| Telemedicine - Offeror Information | | |
| PEBP requires that you either print this page, sign each section, scan, and then submit as a pdf. Or insert electronic signatures on this tab and save. | | complete all gray boxes |
| | sign all signature boxes |
| (fill in Offeror name here) | |
| Verification of Vendor Info tab | | |
| Name of Individual Authorized to bind the Organization | | |
| Name: | | |
| Title: | | |
| Signature of Individual Authorized to bind the vendor | | |
| Signature: | | |
| Date | | |
| RFP - Nevada Public Employees' Benefits Program | |
| Telemedicine - Offeror Information | |
| PEBP requires that you either print this page, sign each section, scan, and then submit as a pdf. Or insert electronic signatures on this tab and save. | complete all gray boxes |
| sign all signature boxes |
| Confidentiality and Certification of Indemnification |
| Submitted proposals, which are marked “confidential” in their entirety, or those in which a significant portion of the submitted proposal is marked “confidential” shall not be accepted by the State of Nevada. Pursuant to NRS 333.333, only specific parts of the proposal may be labeled a “trade secret” as defined in NRS 600A.030(5). Network Discount information is deemed to be a trade secret. All proposals are confidential until the contract is awarded; at which time, both successful and unsuccessful vendors’ technical and cost proposals become public information. |
In accordance with the submittal instructions of this RFP, vendors are requested to submit confidential Reference information in one separate file marked “References - CONFIDENTIAL”. Discount data that is used by Aon will also be automatically treated as Confidential.
The State shall not be responsible for any information contained within the proposal. If vendors do not comply with the labeling and submission requirements, proposals shall be released as submitted. In the event a governing board acts as the final authority, there may be public discussion regarding the submitted proposals that shall be in an open meeting format, the proposals shall remain confidential.
By signing below, I understand it is my responsibility as the vendor to act in protection of the labeled information and agree to defend and indemnify the State of Nevada for honoring such designation. I duly realize failure to so act shall constitute a complete waiver, and all submitted information shall become public information; additionally, failure to label any information that is released by the State shall constitute a complete waiver of any and all claims for damages caused by the release of the information.
| Company Name |
| Signature: |
| Print Name |
| Date |
Terms and Conditions
| RFP - Nevada Public Employees' Benefits Program |
| Telemedicine - Procurement and Proposal Terms and Conditions |
| PEBP requests that you read this page in it's entirety. |
| Procurement and Proposal Term and Conditions | |
| 1. | This procurement is being conducted in accordance with NRS Chapter 333 and NAC Chapter 333. |
| 2. | The State reserves the right to alter, amend, or modify any provisions of this RFP, or to withdraw this RFP, at any time prior to the award of a contract pursuant hereto, if it is in the best interest of the State to do so. |
| 3. | The State reserves the right to waive informalities and minor irregularities in proposals received. |
| 4. | The State will post all official communication regarding this RFP at https://NevadaEPro.com. |
| 5. | Any changes, amendments, or clarifications will be issued in the form of written responses to vendor questions, amendments, or addendum published on the NevadaEPro website entry for this RFP. |
| 6. | Vendors should check the NevadaEPro website frequently for notification of matters affecting the RFP prior to submitting a proposal. |
| 7. | Vendors failure to periodically check for updates does not release vendors from any additional requirements or information that may have been posted on the NevadaEPro website. |
| 8. | Pursuant to NRS 333.350, the State reserves the right to reject any or all proposals received prior to contract award. |
| 9. | Pursuant to NRS 333.350, the State reserves the right to limit the Scope of Work prior to award, if deemed in the best interest of the State. |
| 10. | Pursuant to NRS 333.335, the State shall not be obligated to accept the lowest priced proposal, however, shall make an award in the best interest of the State of Nevada after all factors have been evaluated. |
| 11. | Proposals which appear unrealistic in the terms of technical commitments, lack of technical competence, or are indicative of failure to comprehend the complexity and risk of the project, may be rejected. |
12. Proposals from employees of the State of Nevada shall be considered in as much as they do not conflict with the State Administrative Manual (SAM), NRS Chapter 281 and NRS Chapter 284.
| 13. | Proposals may be modified or withdrawn by written notice received prior to the proposal opening time. |
| 14. | Withdrawals received after the proposal opening time shall not be considered except as authorized by NRS 333.350(3). |
| 15. | Prices offered by vendors in their proposals are an irrevocable offer for the term of the contract and any contract extensions. |
| 16. | The awarded vendor agrees to provide the purchased services at the costs, rates and fees as set forth in their proposal in response to this RFP. |
| 17. | No other costs, rates or fees shall be payable to the awarded vendor for implementation of their proposal. |
18. The State is not liable for any costs incurred by vendors prior to entering a formal contract.
| 19. | Costs of developing the proposal or any other such expenses incurred by the vendor in responding to the RFP, are entirely the responsibility of the vendor, and shall not be reimbursed in any manner by the State. |
| 20. | Proposals submitted per proposal submission requirements become the property of the State, selection or rejection does not affect this right. |
| 21. | An unsuccessful vendor may file an appeal in strict compliance with NRS 333.370 and NAC Chapter 333. |
| 22. | NRS 333.290 grants a preference to materials and supplies that can be supplied from a ‘charitable, reformatory or penal institution of the State’ that produces such goods or services through the labor of inmates. |
| 23. | The Administrator reserves the right to secure these goods, materials or supplies from any such eligible institution, if they can be secured of equal quality and at prices not higher than those of the lowest acceptable bid received in response to this solicitation. |
| 24. | In addition, NRS 333.410 grants a preference to commodities or services that institutions of the State are prepared to supply through the labor of inmates. |
| 25. | The Administrator shall apply the preferences stated in NRS 333.290 and 333.410 to the extent applicable. |
| 26. | Pursuant to NRS 333.338, the State of Nevada cannot enter a contract with a company unless that company agrees for the duration of the contract not to engage in a boycott of Israel. |
| 27. | By submitting a proposal or bid, vendor agrees that if it is awarded a contract it will not engage in a boycott of Israel as defined in NRS 333.338(3)(a). |
| RFP - Nevada Public Employees' Benefits Program | |
| HSA/HRA Administration - Contract Terms and Conditions | |
| PEBP requests that you read this page in it's entirety. | |
| Contract Term and Conditions | |
| 1. | General |
| a. | Vendors shall review the terms and conditions of the standard contract (refer to the Standard Contract Form Attachment) used by the State for all services of independent contractors. |
| b. | The State expects the contract form to be signed as is. |
| c. | It is not necessary for vendors to complete the contract form with their proposal. |
| 2. | Sole Point of Contact |
| a. | The awarded vendor shall be the sole point of contract responsibility. |
| b. | The State shall look solely to the awarded vendor for the performance of all contractual obligations which may result from an award based on this RFP, and the awarded vendor shall not be relieved for the non-performance of any or all subcontractors. |
| 3. | Insurance Coverages |
| a. | Vendors shall review and provide if awarded a contract the insurance requirements as specified in the Insurance Schedule Attachment. |
| b. | The awarded vendor shall maintain, for the duration of the contract, insurance coverages as set forth in the fully executed contract. |
| c. | Work on the contract shall not begin until after the awarded vendor has submitted acceptable evidence of the required insurance coverages. |
| d. | Failure to maintain any required insurance coverage or acceptable alternative method of insurance shall be deemed a breach of contract. |
| 4. | Taxes |
| a. | The State shall not be liable for Federal, State, or Local excise taxes per NRS 372.325. |
| 5. | Final Contract Terms |
| a. | The State reserves the right to negotiate final contract terms with any vendor selected per NAC 333.170. |
| b. | The contract between the parties shall consist of the RFP together with any modifications thereto, and the awarded vendor’s proposal, together with any modifications and clarifications thereto that are submitted at the request of the State during the evaluation and negotiation process. |
| c. | In the event of any conflict or contradiction between or among these documents, the documents shall control in the following order of precedence: |
i. The final executed contract;
ii. Any modifications, and clarifications to the awarded vendor’s proposal;
iii. The RFP and RFP Amendments, if applicable; and
iv. The awarded vendor’s proposal
| d. | Specific exceptions to this general rule may be noted in the final executed contract. |
| e. | The State shall not indemnify vendor from any liability or damages, including but not limited to attorney’s fees and costs, arising under any contract resulting from this RFP. |
| 6. | Third Party Beneficiaries |
| a. | Local governments as defined in NRS 354.474 and State agencies are intended third party beneficiaries of any contract resulting from this RFP and may join or use any contract resulting from this RFP subject to Nevada law. |
| b. | The State is not liable for the obligations of any local government which joins or uses any contract resulting from this RFP. |
| 7. | Federal Contracts |
| a. | Any person who requests or receives a Federal contract, grant, loan or cooperative agreement shall file with the using agency a certification that the person making the declaration has not made, and shall not make, any payment prohibited by subsection (a) of 31 U.S.C. 1352. |
| 8. | Discrimination |
| a. | Pursuant to NRS Chapter 613 in connection with the performance of work under this contract, the contractor agrees not to unlawfully discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex, sexual orientation or age, including, without limitation, with regard to employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including, without limitation apprenticeship. |
| b. | The contractor further agrees to insert this provision in all subcontracts, hereunder, except subcontracts for standard commercial supplies or raw materials. |
| 9. | Payment |
| a. | Upon review and acceptance by the State, payments for invoices are normally made within 45 – 60 days of receipt, providing all required information, documents and/or attachments have been received. |
| b. | Pursuant to NRS 227.185 and NRS 333.450, the State shall pay claims for supplies, materials, equipment and services purchased under the provisions of this RFP electronically, unless determined by the State Controller that the electronic payment would cause the payee to suffer undue hardship or extreme inconvenience. |
| 10. | Billing |
| a. | The State does not issue payment prior to receipt of goods or services. |
| b. | The vendor shall bill the State as outlined in the approved contract and/or payment schedule. |
| 11. | Timeliness of Billing |
| a. | The State is on a fiscal year calendar from July 1 to June 30. |
| b. | All billings for dates of service prior to July 1 shall be submitted to the State no later than the first Friday in August of the same year. |
| c. | A billing submitted after the first Friday in August that forces the State to process the billing as a stale claim pursuant to NRS 353.097, shall subject the contractor to an administrative fee not to exceed $100.00. |
| d. | This is the estimate of the additional costs to the State for processing the billing as a stale claim and this amount shall be deducted from the stale claims’ payment due the contractor. |
| RFP - Nevada Public Employees' Benefits Program |
| HSA/HRA Administration - Project Terms and Conditions |
| PEBP requests that you read this page in it's entirety. |
| Project Term and Conditions | |
| 1. | Award of Related Contracts |
| a. | The State may undertake or award supplemental contracts for work related to this project or any portion thereof. |
| b. | The contractor shall be bound to cooperate fully with such other contractors and the State in all cases. |
| c. | All subcontractors shall be required to abide by this provision as a condition of the contract between the subcontractor and the prime contractor. |
| 2. | Products and/or Alternatives |
| a. | The vendor shall not propose an alternative that would require the State to acquire hardware or software or change processes in order to function properly on the vendor’s system unless vendor included a clear description of such proposed alternatives and clearly mark any descriptive material to show the proposed alternative. |
| b. | An acceptable alternative is one the State considers satisfactory in meeting the requirements of this RFP. |
| c. | The State, at its sole discretion, shall determine if the proposed alternative meets the intent of the original RFP requirement. |
| 3. | State Owned Property |
| a. | The awarded vendor shall be responsible for the proper custody and care of any State-owned property furnished by the State for use in connection with the performance of the contract and shall reimburse the State for any loss or damage. |
| 4. | Inspection/Acceptance of Work |
| a. | It is expressly understood and agreed all work done by the contractor shall be subject to inspection and acceptance by the State. |
| b. | Any progress inspections and approval by the State of any item of work shall not forfeit the right of the State to require the correction of any faulty workmanship or material at any time during the course of the work and warranty period thereafter, although previously approved by oversight. |
| c. | Nothing contained herein shall relieve the contractor of the responsibility for proper installation and maintenance of the work, materials and equipment required under the terms of the contract until all work has been completed and accepted by the State. |
| 5. | Travel - If travel is required, the following processes shall be followed: |
| a. | All travel shall be approved in writing in advance by the Public Employees’ Benefits Program Executive Officer or his/her Designee. |
| b. | Requests for reimbursement of travel expenses shall be submitted on the State Claim for Travel Expense Form with original receipts for all expenses. |
| c. | The travel expense form, with original signatures, shall be submitted with the vendor’s invoice. |
| d. | Vendor shall be reimbursed travel expenses and per diem at the rates allowed for State employees at the time travel occurs. |
| e. | The State is not responsible for payment of any premium, deductible or assessments on insurance policies purchased by vendor for a rental vehicle. |
| 6. | Completion of Work |
| a. | Prior to completion of all work, the contractor shall remove from the premises all equipment and materials belonging to the contractor. |
| b. | Upon completion of the work, the contractor shall leave the site in a clean and neat condition satisfactory to the State. |
| 7. | Right to Publish |
| a. | All requests for the publication or release of any information pertaining to this RFP and any subsequent contract shall be in writing and sent to the Executive Officer or designee. |
| b. | No announcement concerning the award of a contract due to this RFP can be made without prior written approval of the Executive Officer or designee. |
| c. | As a result of the selection of the contractor to supply the requested services, the State is neither endorsing nor suggesting the contractor is the best or only solution. |
| d. | The contractor shall not use, in its external advertising, marketing programs, or other promotional efforts, any data, pictures or other representation of any State facility, except with the specific advance written authorization of the Executive Officer or designee. |
| e. | Throughout the term of the contract, the contractor shall secure the written approval of the State per Section 1.8.2 prior to the release of any information pertaining to work or activities covered by the contract. |
| 8. | Protection of Sensitive Information |
| a. | Confidential personal data shall be encrypted. |
| b. | Any electronic transmission of personal information shall comply with NRS 603A.215 (2 & 3). |
| c. | Sensitive data shall be encrypted in all newly developed applications. |
Mandatory Min Quals
| RFP - Nevada Public Employees' Benefits Program | |
| Telemedicine - Mandatory Minimum Qualifications | |
| Confirm your compliance with these items. Please be aware, your inability to comply with any one of these items would disqualify you from bidding on this RFP. | complete all gray boxes |
| | (fill in Offeror name here) |
| Mandatory Minimum Qualifications | | |
| 1 | Ability to offer Telemedicine services? | |
| 2 | Currently provide services to a minimum of two large employer groups, i.e., clients of 5,000 employees or more. | |
| 3 | The Offeror must guarantee PEBP that staff members who work on PEBP’s account have appropriate skill levels and qualifications. | |
| 4 | In addition to all standard services, the administration must include, but is not limited to the following services. Confirm your ability to comply with these requirements: | |
| a. | Administration materials (e.g. website, phone service, forms, etc.). | |
| b. | Plan management, performance and periodic reports. | |
| c. | Account management and training for PEBP’s staff. | |
| d. | Direct phone line for PEBP’s benefits staff. | |
| e. | Communication materials. | |
| f. | Customer service representatives. | |
| g. | Financial and process audits. | |
| 5 | Offeror must accept enrollment/eligibility data into secure site from PEBP’s outside online benefit administration system (Benefitfocus). The Offeror must be able to read and track all data elements provided on the file. This must be a system-supported (not manual) function. | |
PEBP may transition to a new benefit administration system during the term of this contract. The awarded Contractor will not charge PEBP to transition to a new system.
| 6 | The initial term for the Telemedicine Services Vendor will begin as soon as possible after contract award. Preferably as soon as on March 1, 2022. Awarded Offeror(s) will not be paid for integration/implementation work. Awarded Offeror(s) will not be eligible to receive payment until July 1, 2022. |
| 7 | Offeror shall accept a payment in a manner determined by PEBP. All payments are made a minimum of one month in arrears without interest or late payment penalty. Premiums due the first of the month will be paid by PEBP no later than the 15th of the following month (e.g. July premium paid by August 15). PEBP will create a monthly invoice using the monthly headcount report generated by the PEBP eligibility system each month. |
Offeror shall pay claims from PEBP owned controlled disbursement bank accounts. PEBP will fund the accounts daily for the checks/EFT that has been presented for the previous business day.
| 8 | Offeror agrees that PEBP reserves the right to determine eligibility. |
| 9 | Offeror must be properly authorized, licensed and registered to conduct business in the State of Nevada for the services being offered through this RFP. |
| 10 | Offeror must assume responsibility for administering PEBP’s obligations in accordance with all applicable state and federal laws, regulations, and IRS requirements. |
| 11 | Offeror must hold each and every one of its subcontractors, independent contractors and subsidiaries to the same standards to which the Contractor is being held. |
| 12 | A local office is not required for this RFP. However, Offeror must be easily accessible from 8:00am to 5:00pm PT by email and toll-free telephone number. |
| 13 | Offeror must have reporting capabilities, allowing PEBP to gather, sort and analyze utilization information for auditing and forecasting needs. Offeror must work with PEBP to develop an appropriate reporting package in electronic format to facilitate analysis. |
| 14 | If the relationship is terminated, confirm you have the ability to provide PEBP with a detailed report of the status of each participant, in order to transition these participants to another health plan. |
| 15 | If requested, Offeror agrees to attend and participate in PEBP Board meetings (which are held on a bi-monthly basis - locations in both Carson City and Las Vegas, virtual attendance may also be acceptable). Also if requested, the Offeror agrees to attend an annual strategy session (typically held in Northern Nevada). |
| 16 | Confirm you agree to comply with PEBP's required contract terms as seen in the Standard Contract Form Attachment 1.2 or if you are not able to comply, please confirm that you have attached a redline. |
| 17 | Confirm you agree to comply with PEBP's required contract terms on Indemnification: "To the fullest extent permitted by law Contractor shall indemnify, hold harmless and defend, not excluding the State's right to participate, the State from and against all liability, claims, actions, damages, losses, and expenses, including without limitation, reasonable attorneys' fees and costs, arising out of any alleged negligent or willing acts or omissions of Contractor, its officers, employees and agents." |
| 18 | Confirm you have read and agree to comply with Procurement and Proposal Terms and Conditions, Contract Terms and Conditions, and Project Terms and Conditions as outlined on the previous tab labeled Terms and Conditions. |
| 19 | Confirm you are able to comply with PEBPs Insurance Requirements as detailed in Attachment 1.3, or if you are unable to do so please confirm that you have attached a redline of Insurance Requirements. |
| 20 | Confirm you are able to comply with PEBPs IT requirement that their data be encrypted in transit and in rest. |
| 21 | Confirm you are able to comply with PEBPs IT requirement that state data assets must be maintained stateside and data will not be held offshore (this includes offshore assets that have access to PEBP data including customer service centers, claims processing, mail handling facilities, software development centers, data storage, or debt collection services). |
Technical
| RFP - Nevada Public Employees' Benefits Program |
| Telemedicine - Technical |
| Unless a response allows a longer "Embed here" response, all answers must fit within the cell provided. Concise answers are appreciated. | | |
| | OFFEROR NAME |
| 1.0 - Company Overview | | |
| 1.1 | What is your company's financial backing (Public, Private, Venture Capital, Other-Specify)? | |
| 1.2 | Do you currently provide your solution to any other states for their employees and dependents? If yes, please provide names. | |
| 1.3 | Do you currently provide your solution to any other public entities for their employees and dependents? If yes, please provide names. | |
| 1.4 | Does your company offer services beyond general consult telemedicine visits (e.g. virtual urgent care)? If yes, please list the virtual care services that are included in this proposal (i.e. 2nd medical opinion, behavioral health, dermatology, virtual primary care, nutrition, wellness, smoking cessation, etc.). | |
| 1.5 | Please attach a document that lists all of the additional services available at no additional cost and separately provide a list of services that are considered optional buy up solutions. | Embed your attachment here labeled "YourOrganization'sName_01_Services" |
| 1.6 | What are your hours of operation for each service included in this proposal? | |
| 1.7 | How many members have access to your Telemedicine services? Break out the number between direct client relationships and number of members through health plans. | |
| 1.8 | Are any of the virtual care services identified above provided via a third-party relationship/partner? If so, please describe. | |
| 1.9 | Are you able to provide the services above in all 50 states? Please confirm the specific services you are able to perform in these states. | |
| 1.10 | Does your organization have a Supplier DE&I Program? | |
| 2.0 - Clinical Services | | |
| 2.1 | For telemedicine, how many physicians are 1099 providers? | |
| 2.2 | For telemedicine, how many physicians are W2 providers? | |
| 2.3 | Number of member lives currently covered by your system. | |
| 2.4 | In less than 1 page, describe your provider network: (1) number of employees / staff providers, (2) number of contracted providers, (3) provider screening and recruiting, (4) training, (5) credentialing, (6) licensing, (7) provider relations program | Embed your attachment here labeled "YourOrganization'sName_02_Network" |
| 2.5 | Are clinicians able to write prescriptions and have them sent automatically to a pharmacy convenient to the patient? Specify the type of prescriptions and how many states this is available (specifically if Nevada is or is not included). | |
| 2.6 | Do you support asynchronous care? | |
| 2.7 | How many prescriptions were issued with video consults in the 2020 calendar year? | |
| 2.8 | How many consults were reported via video in the 2019 and 2020 calendar years? Please report each year separately. | |
| 2.9 | Describe the process for clinicians to share detailed patient records with the patient's personal physician. | |
| 2.10 | Can clinicians conduct follow-up calls or emails after consultation? Describe method of follow up and frequency. | |
| 2.11 | Can patients select clinicians based on needs and preferences? Specify if patients are able to choose a clinician based on specialty, gender, language, practice proximity, and network status. | |
| 2.12 | Do you track customer satisfaction of the provider and service quality? | |
| 2.13 | What clinical quality monitoring do you have in place for services offered? | |
| 2.14 | Outline and describe the features and functionality that support PCMH and ACO methods of care: (1) real-time provider to provider consultations, (2) asynchronous provider collaboration, (3) secure messaging, (4) patient health history visibility, (5) patient activity summary, (6) clinical insights such as gaps in care, interventions and alerts. | |
| 2.15 | What type of behavioral health services do you offer? | |
| 2.16 | Are services available for all ages including pediatrics? | |
| 2.17 | Do BH services include counseling? | |
| 2.18 | Please describe your staffing levels for behavioral health services. | |
| 2.19 | Is chronic condition management included in your Telemedicine proposal? If so, please describe your approach to chronic condition management and how your service improves care adherence, closes gaps in care and lowers overall burden of chronic conditions. | |
| 2.20 | Please describe your referral process including information shown to members, sources of data and approach to cost and quality transparency for provider referrals. | |
| 3.0 - Reporting/Technology | | |
| 3.1 | What are the technical requirements for patients and providers to use your services? Include software downloads, hardware and any third party software. | |
| 3.2 | Please describe your systems integration support for single sign on, web services, portlets/webparts. | |
| 3.3 | Describe your recommended connectivity for employers, health plans, and providers. | |
| 3.4 | Describe your capabilities regarding the downloading of member-specific clinical data sets to a health plan and to providers (include frequency). | |
| 3.5 | What is the capacity for the number of users? What is the highest level of simultaneous users successfully handled? | |
| 3.6 | What are the hours of system availability? What hours are maintenance and support available? | |
| 3.7 | Do you require a data feed from PEBP's plan administration? | |
| 3.8 | What reports are available at employer level? Please embed a sample. | Embed your attachment here labeled "YourOrganization'sName_03_Reports" |
| 3.9 | What engagement statistics are tracked and reportable? | |
| 3.10 | Will PEBP have access to custom reporting? | |
| 3.11 | Are you able to integrate health assessment data from a third party? | |
| 3.12 | Do you have the ability to receive data from multiple health plans and vendors? | |
| 3.13 | Are you willing and able to integrate data with a third party (data warehouse company, wellness vendor, lab data, medical, pharmacy vendor, etc.) at no additional fee? | |
| 4.0 - Structural and Policy Level Program Aspects | |
| The following outlines the structural and policy level aspects that we look to achieve through this program. Address the following questions pertaining to this topic in questions below. | |
| 4.1 | Identify any other services that your organization currently provides (advocacy, navigation, second opinion, etc.). |
| 4.2 | Identify the types of services you provide (behavioral, pediatric, chronic, etc.). |
| 4.3 | Identify the types of delivery model you provide and indicate if each is offered to PEBP via this bid. (Telephonic, web video, mobile photo, mobile video, remote monitoring, delayed specialist video consult (asynchronous), etc.) |
| 4.4 | Will you assign a dedicated account team for PEBP? If not, please describe your account management structure. |
| 4.5 | Please confirm that you have an escalation process where your firm responds to inquiries within 24 hours and provides a resolution within 48 hours. |
| 4.6 | What’s your strategy in working with ACOs and PCMH where payment methodology may either inhibit or foster telehealth services? |
| 4.7 | How will you coordinate with ACOs in managing overall population health and integrate with a medical carrier? |
| 5.0 - Innovation | | |
| 5.1 | What innovations do you foresee in your industry and/or organization and how will you incorporate those into PEBP's contract as the market evolves? | Embed your attachment here labeled "YourOrganization'sName_04_Innovation" |
| 6.0 - Performance Guarantees | | |
| Description | Do you agree to (Yes/No): |
| 6.1 | ROI Guarantee of 1.5 savings to $1 of fees in all years of the agreement. Please confirm agreement | |
| 6.2 | Meet PEBP's key dates for implementation (15%) | |
| 6.3 | 95% access to behavioral health professional within 5 days (15%) | |
| 6.4 | 95% of scheduled appointment times are met (15%) | |
| 6.5 | Patients are called back within 30 minutes of intake (10%) | |
| 6.6 | Achieve participation target (10%) | |
| 6.7 | Achieve claims savings target (10%) | |
| 6.8 | >=90% patient satisfaction (15%) | |
| 6.9 | Monthly reporting provided to PEBP (10%) | |
Customer Service
| RFP - Nevada Public Employees' Benefits Program |
| Telemedicine - Customer Service Questionnaire |
| Unless a response allows a longer "Embed here" response, all answers must fit within the cell provided. Concise answers are appreciated. | | |
| | OFFEROR NAME |
| 1.0 - Member Experience | | |
| 1.1 | How do patients access your services? | |
| 1.2 | Do you support scheduled visits? | |
| 1.3 | What health information will be available to a provider during a live visit? | |
| 1.4 | What options are provided to patients for follow-up care? | |
| 1.5 | How do you drive utilization to teleservices? | |
| 1.6 | Do you track customer satisfaction at the client level? If so, describe. | |
| 1.7 | How many members were reported as registered for telemedicine services in 2019 and 2020? Please report each year separately. | |
| 1.8 | How many consults were reported via phone in 2019 and 2020 calendar years? Please report each year separately. | |
| 1.9 | Is there a minimum age requirement for patients for each of the services included in this proposal? | |
| 1.10 | Describe how you handle calls from individuals calling from one of the states where you have no providers or law prevents you from providing telephonic or online care. | |
| 1.11 | What are the hours of service available to patients? | |
| 1.12 | How is overuse or inappropriate use addressed? | |
| 1.13 | Please describe the services available to Members including such capabilities as: finding doctors, making appointments, message PCP and care team, access to electronic health record, accessing information on benefits and programs, etc. | |
| 1.14 | Please describe any digital health tools available. | |
| 1.15 | If virtual primary care is being proposed for PEBP, can a member see the same primary care provider on a subsequent virtual visit? If so, for how many days after the initial visit? | |
| 1.16 | Please describe your Artificial Intelligence (AI) capabilities for improving member experience. How long has this been place? | |
| 2.0 - Employer Customization | |
| 2.1 | Can the Mobile App be white-labeled for PEBP? |
| 2.2 | Can a member payment differential be implemented? |
| 2.3 | Do you have any type of benefit plan design that you cannot administer (e.g. $0 copay plan for Virtual PCP)? |
| 2.4 | Will PEBP and employees/dependents have access to a call center 24/7? Is set-up and custom scripting available? |
| 2.5 | Is a dedicated phone number available to PEBP's employees/dependents to register and/or schedule appointments for telehealth services, etc.? |
| 2.6 | Will call center personnel register patients, schedule appointments for telehealth services, provide quality assurance and troubleshoot customer service issues? |
| 2.7 | Do you offer texting capabilities? If so, describe. |
| 3.0 - Implementation | | |
| 3.1 | Briefly describe your onboarding process. | |
| 3.2 | How long does it take to implement the system once the paperwork is finalized? | |
| 3.3 | Are there any medical or pharmacy carriers which you have attempted to share data with but have been unable to secure a relationship? | |
| 3.4 | Please provide a proposed project implementation plan specific to PEBP. | Embed your attachment here labeled "YourOrganization'sName_05_Implementation" |
| 3.5 | Please describe your online implementation methodology specific to PEBP. | |
| 3.6 | What account management and technical support is available to PEBP and its employees? | |
| 3.7 | If granted the business, please confirm that an implementation allowance of $50,000 will be given to PEBP. | |
| 3.8 | What is the client support structure once implementation is concluded (dedicated account manager, designated account mgr. or team, client service line, etc.)? | |
| 4.0 - Member Communication/Education | |
| 4.1 | Describe what member communications or education materials are provided to the client for email, mail, and benefit fairs. |
| 4.2 | Do you offer turnkey marketing and communications materials for Employers and Employees that are general and customizable? Please provide a few examples (feel free to attach samples labeled - "YourOrganizationsName_06_Marketing"). |
| 4.3 | Please describe your navigation approach for members including member education and integration with PEBP's existing vendors and programs. |
| 4.4 | Please describe your level and types of support to address Social Determinants of Health. |
This is the start of the file's text. The full file is on GovTribe.