2.2 - TPA RFP Revised 2021-05-07.xlsx

XLSX spreadsheet 7 MB Posted

Attached to
Third Party Administrator (TPA) for the Public Employees' Benefits Program (PEBP) State and local contract opportunity
Solicitation number
95PEBP-S1579
Issued by
Churchill County, Nevada

About this file

This document is a Request for Proposal (RFP) issued by the Nevada Public Employees' Benefits Program (PEBP) for Third Party Medical/Dental Claims & Network Administration services. PEBP is seeking a vendor to provide medical and dental claims administration, network management, and related services for its employees and retirees. The RFP outlines mandatory minimum qualifications, including the ability to administer medical and dental claims, provide network access, and meet reporting and compliance requirements. Vendors must submit their proposals by May 14, 2021, and PEBP intends to award a contract with a start date as early as December 1, 2021, though full implementation would not begin until July 1, 2022. The initial contract term is six years, with two optional one-year extensions.

The RFP details specific pricing requirements, including that fees must be firm for the first six years and that vendors cannot include broker fees or commissions. PEBP also requires vendors to comply with Nevada's procurement laws and regulations. While the current Third Party Administrator (TPA) is not named, the RFP indicates that PEBP may want to maintain the existing in-state Aetna Signature Administrators network. Vendors must also have the ability to directly contract with PEBP's ancillary vendors, such as for dental, transparency, and telemedicine services.

View the file

Other files for this state and local contract opportunity

Other files attached to Third Party Administrator (TPA) for the Public Employees' Benefits Program (PEBP), newest first.
File Type Posted
1.5 - Paid Claims Summary 201901-202012.xlsx XLSX spreadsheet
2.1 - Intent to bid.pdf PDF
1.3 - Insurance Schedule.docx DOCX document
95PEBP-S1579 Bid QA.xlsx XLSX spreadsheet
95PEBP-S1579 Presentation Notification~2.pdf PDF
2.3 - References - CONFIDENTIAL.xlsx XLSX spreadsheet
1.6 - Enrollment Summary 202104.xlsx XLSX spreadsheet
1.1 - RFP Information.docx DOCX document
1.2 - Standard Form Contract.docx DOCX document
1.4 - Sample Business Associate Agreement.docx DOCX document
1.7 - Discount Instructions.pdf PDF
95PEBP-S1579 Letter of Intent.pdf PDF
Quote Instructions.pdf PDF
Show all 13

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Listbox

List Box NameValue
ListSentCensusOndiskette
hard copy
email
CD
ListReplaceSuppreplace
supplement
ListYesNoSeeExplainYes
No - See "Explanation"
ListYesExplainYes - See "Explanation"
No
N/A
ListYesNoYes
No
ListYesNoNAYes
No
N/A
ListYesNoNotRequestedYes
No
Not Requested
ListYN_NSeeExpNotReqYes
No
No - See "Explanation"
Not Requested
ListCompletedCompleted
Not Completed
ListCompNotExplainCompleted
Not Completed - See "Explanation"
ListAttachedAttached
Not Attached
ListABCa
b
c
ListYesNotRequestedYes
No
Requested
ListABC_Ga
b
c
d
e
f
g
ListABC_Ha
b
c
d
e
f
g
h
ListYears< 2 years
2 to 5 Years
5 to 10 Years
> 10 Years
ListAccreditationExcellent
Commendable
Accredited
Provisional
Denied
Appealed by Plan
In Process
Revoked
Scheduled
Suspended
Under Review by NCQA
NHP Accreditation
NHP Under Review
NHP Expired
NHP NCQA Discretionary Review
NHP Initial Decision Pending
NHP Future Review Scheduled
ListNameInsureEntityOffered
Not Offered
ListJCAHOAccreditation Not Requested
Accreditation With Commendation
Accreditation Without Type I Recommendations
Accreditation With Type I Recommendations
Provisional Accreditation
Conditional Accreditation
Preliminary Denial of Accreditation
Accreditation Denied
Accreditation Watch
ListTaxStatusFor-Profit
Not-For-Profit
ListModelGroup
IPA
Mixed
Network
Staff
PPO Platform
ListMetNotMetMet
Not Met
ListUnderwritingIndividual Statement of Health
Employer Statement acting as gatekeeper)
Other; specified in "Explanation"
ListProposedRatingCommunity Rating
Group Specific (Adjusted) Community Rating
Community Rating by Class
Community Rating by Age
Experience Rated/Non-Div Eligible (Prospectively-rated)
Experience Rated/Div Eligible (Retrospectively-rated)
ListCommissionsStandard commissions are included in basic premium rates regardless of whether they are paid.
Standard commissions require an increase to basic premium rates.
No commissions available.
ListGeoZip code dispersion
Center of zip code
Geo-coding (employee zip code address)
ListStatesAlabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ListAnnYrEndDays30
60
90
120
180
ListPayFrequencyweekly
bi-weekly
monthly
quarterly
semi-annually
annually
ListPnltyFeeListpremium
administrative fees
ListAdvRenewNoticeDays30
60
90
120
180
ListAccreditationPPOFull
One - Year
Provisional
Denied
Under Review
NCQA Discretionary Review
ListPlanTypeHMO
PPO
POS
HMO/PPO
PPO/POS
HMO/POS
HMO/PPO/POS
Not Applicable
No - See "Explanation"
Not Applicable - See "Explanation"
ListURACAccredited
Not Accredited
ListGuaranteeTypefinancial
service
ListProEnforceproposed
inforce
ListSTDPayFreqweekly
bi-weekly
monthly
quarterly
annually
ListAgreeDisagreeAgree
Disagree
ListRatedRated
Not Rated
See "Explanation"
ListIncluNotIncluNAIncluded
Not Included
N/A - No Additional Costs
ListRateChangeNo Change
Rating Improved
Rating Worsened
Not Rated
ListTeleElecTransFaxMailTelephone
Electronic transmission
Fax and mail
ListIncludedIncluded
Not Included
ListHoursofOperation12:00 AM
12:30 AM
1:00 AM
1:30 AM
2:00 AM
2:30 AM
3:00 AM
3:30 AM
4:00 AM
4:30 AM
5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
3:30 PM
4:00 PM
4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
24 hours / 7 days
Not Open
Other - See Explanation
ListGracePeriod30 days
60 days
90 days
120 days
Other - See Explanation
ListNotedNotNotedNoted
Not Noted
ListContributionsContributory
Non-Contributory
ListBeforeAfterTaxBefore-Tax
After-Tax
Both Before-Tax and After-Tax
ListClassScheduleFlat
Schedule
Formula
ListClassEligibilityActive, FT salaried ee's regularly working min 30 hrs/wk.
Active, FT hourly ee's regularly working min 30 hrs/wk.
Active, FT ee's regularly working min 30 hrs/wk.
Active, FT ee's regularly working min 30 hrs/wk, excluding Class(es) X already covered under this Policy.
Active, FT salaried EE regularly working min 30 hrs/wk who earn more than X per X.
Active, FT hourly ee's regularly working min 30 hrs/wk who earn more than X per X.
Active, PT ee's regularly working min 17.5 hrs/wk.
Other active, PT ee's regularly working min 17.5 hrs/wk, excluding Class(es) X already covered under this Policy.
Other active, FT ee's regularly working min 17.5 hrs/wk, excluding Class(es) X already covered under this Policy.
Active, FT Union ee's regularly working min 30 hrs/wk.
Active, FT Non-Union ee's regularly working min 30 hrs/wk.
ListCompNotComp2Completed - information requested provided
Not completed - no recent or planned activities
Not completed - information available, but not provided
ListClaimsRetentionClaims
Retention
ListStateGovernPay exactly as mandated
May pay more than as mandated for some/all of the states - See "Explanation"
ListStateNotGovernNo interest credited
Interest is credited - See "Explanation"
ListWillingNAExplainWilling
Not Willing
Not Applicable
Not Willing - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListModelDentPPO
DHMO
See "Explanation"
ListYNNAExplainYes
No
Not Applicable
No - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListYNNoExplainYes
No
No - See "Explanation"
ListAgreeNAExplainAgree
Do Not Agree
Not Applicable
Do Not Agree - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListRCInfoHIAA
MDR
Internally Developed
Other
See "Explanation"
ListAttachedNAExplainAttached
Not Attached
Not Applicable
Not Attached - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListNCQAAccreditation Not Requested
Excellent
Full
Commendable
One-year
Accredited
Provisional
Denied
Appealed by Plan
In Process
Revoked
Scheduled
Suspended
Under Review by NCQA
NCQA Discretionary Review
NHP Accreditation
NHP Denial
NHP Under Review
NHP Expired
NHP NCQA Discretionary Review
NHP Initial Decision Pending
NHP Future Review Scheduled
ListProvidedNAExplainProvided
Not Provided
Not Applicable
Not Provided - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListCompletedNAExplainCompleted
Not Completed
Not Applicable
Not Completed - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListClmMailAreaTime24 hours
48 hours
Greater than 48 hours
ListIncludedNAExplainIncluded
Not Included
Not Applicable
Not Included - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListOfferedOffered
Not Offered
ListYNNAYes
No
Not Applicable
ListYNYesExplainYes
No
Yes - See "Explanation"
ListOwnLeaseOwned
Leased
Both
ListEitherHMOPPOHMO
PPO
Either HMO or PPO
Other - See Below
ListYNPlanDesignExplainYes
No - See "PlanDesignExplain" Worksheet
ListHMOEPOPPOPOSHMO/EPO
PPO
POS
HMO/EPO, PPO, POS
Other - See Below
ListSubcontractServChanged in Last 12 Mo's
Planned for Next 12 Mo's
N/A - No Changes
N/A - Not Subcontracted
ListYNNAWebsiteYes
No
Not Applicable - No Website
No - See "Explanation"
ListConfirmedConfirmed
Not Confirmed
Not Applicable
ListProposedRatingCDHCCommunity Rating
Group Specific (Adjusted) Community Rating
Community Rating by Class
Community Rating by Age
Experience Rated/Non-Div Eligible (Prospectively-rated)
Experience Rated/Div Eligible (Retrospectively-rated)
Partially Experience Rated/Non-Div Eligible (Prospectively-rated)
Partially Experience Rated/Div Eligible (Retrospectively-rated)
Other - See "Explanation"
ListProvidedExplainProvided - See "Explanation"
Not Provided
ListNotCompletedExplainCompleted
Not Completed
Not Completed - See "Explanation"
ListNotAttachedExplainAttached
Not Attached
Not Attached - See "Explanation"
ListAttachedExplainAttached
Not Attached
Attached - See "Explanation"
Not Attached - See "Explanation"
ListYPlanDesignExplainNYes - See "PlanDesignExplain" Worksheet
No
ListYNNANoExplainYes
No
No - See "Explanation"
N/A
ListYExplainNNAWebsiteYes - See "Explanation"
No
Not Applicable - No Website
ListLeasedNetworkNot Applicable - No Leased Networks
< 4 Leased Networks - See Data Below
> 4 Leased Networks - See "Explanation"
ListServiceCenter< 2 Service Centers - See Data Below
> 2 Service Centers - See "Explanation"
ListNCQADMProgAccredPatient & Practitioner Accreditation
Patient-Oriented Accreditation
Practitioner-Oriented Accreditation
Accreditation In-Process
Accreditation Not Requested
Accreditation Denied
Other - See "Explanation"
ListNCQADMProgCertProgram Design Certification
Systems Certification
Contact Certification
Certification In-Process
Certification Not Requested
Certification Denied
Other - See "Explanation"
ListJCAHODiseaseCertCertificate of Distinction Awarded
Certification In Process
Certification Not Requested
Certification Denied
Other - See "Explanation"
ListURACDMAccredFull Accreditation
Conditional Accreditation
Provisional Accreditation
Accreditation Not Requested
Accreditation Denied
Accreditation In-Process
Accreditation Voluntarily Withdrawn
Corrective Action
Reaccreditation In-Process
Other - See "Explanation"
ListMinSizeDMProg< 1,000
1,000
2,000
5,000
10,000
Other - See "Explanation"
ListRecommendFreqDaily
Weekly
Monthly
Quarterly
Annually
Other - See "Explanation"
ListStandReportFreqPer Occurrence
Weekly
Monthly
Quarterly
Annually
ListPropFeeLenTime18 months
24 months
36 months
48 months
Other - See "Explanation"
ListMinLeadTime1 month
2 months
3 months
4 months
6 months
Other - See "Explanation"
ListPropRequirementAccept
Refuse
See Modified Language
ListMethDataReceiptDisk
Tape
On-Line File Transfer
Paper
Other
Other - See "Explanation"
ListServOfferedOnlineIncluded in Your Basic Package
Available for an Additional Cost
Neither Included in the Basic Package Nor for an Additional Cost
ListInOutBoundBoth in-bound/out-bound
In-bound only
Out-bound only
ListSubcontractedNAExplainSubcontracted
Not Subcontracted
Not Applicable
Not Subcontracted - See "Explanation"
Not Applicable - See "Explanation"
See "Explanation"
ListAvailabilityOfServiceIncluded in Your Basic Package
Available for an Additional Cost
ListCoreAddServCore Service
Additional Service
ListFrequentlySysWeekly
Bi-Weekly
Monthly
Bi-Monthly
Quarterly
Other
ListFrequentlyRptProdDaily
Weekly
Monthly
Quarterly
Other
ListSTDLTDWCServicesInternal Staff
Subsidiary
Contracted Providers
ListMedClarifPhone
Fax
Other
ListBenPymtDirectly to insured/patient
Assigned to a family member or provider
Both - Directly and Assigned
ListCMInExPerformed internally
External vendor used
ListCommExperCommunity rated/pooled
Experience-rated
ListFullPartialFull
Partial
ListMandatoryVoluntary
Mandatory
Not Applicable
ListOffWksheetOfficer Worksheet Completed and Faxed
Officer Worksheet Not Completed
ListrngpubPrivately-Owned
Publicly-Held
ListLegalEntities1
2
3
4
5
6
Not known at this time
ListYesExemptOfficer Worksheet Completed and Faxed
Officer Worksheet Not Completed
ListCentralizedCentralized
Decentralized
ListClientSupportsupporting only the client
supporting other clients
ListRatedNotRated
Not Financially Rated
ListAMBestNot Financially Rated
A++ (Superior)
A+ (Superior)
A (Excellent)
A- (Excellent)
B++ (Very Good)
B+ (Very Good)
B (Fair)
B- (Fair)
C++ (Marginal)
C+ (Marginal)
C (Weak)
C- (Weak)
D (Poor)
E (Under Regulatory Supervision)
F (In Liquidation)
S (Rating Suspended)
ListAMBestModU (Under Review)
Q (Qualified)
S (Syndicate)
PD (Public Data)
ListStPoorsNot Financially Rated
AAA (Extremely Strong)
AA+ (Very Strong)
AA (Very Strong)
AA- (Very Strong)
A+ (Strong)
A (Strong)
A- (Strong)
BBB+ (Good)
BBB (Good)
BBB- (Good)
BB+ (Marginal)
BB (Marginal)
BB- (Marginal)
B+ (Weak)
B (Weak)
B- (Weak)
CCC+ (Very Weak)
CCC (Very Weak)
CCC- (Very Weak)
CC (Extremely Weak)
R (Under Regulatory Supervision)
ListStPoorsModPI (Rating based on published financial information only)
ListMoodyAaa
Aa
A
Baa
Ba
B
Caa
Ca
C
ListFitchNot Financially Rated
AAA (Exceptionally Strong)
AA+ (Very Strong)
AA (Very Strong)
AA- (Very Strong)
A+ (Strong)
A (Strong)
A- (Strong)
BBB+ (Good)
BBB (Good)
BBB- (Good)
BB+ (Moderately Weak)
BB (Moderately Weak)
BB- (Moderately Weak)
B+ (Weak)
B (Weak)
B- (Weak)
CCC+ (Very Weak)
CCC (Very Weak)
CCC- (Very Weak)
CC (Very Weak)
C (Very Weak)
DDD (Distressed)
DD (Distressed)
D (Distressed)

Submission Checklist

RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - Submission Checklist
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.govConfirm you have emailed to gkdavis@admin.nv.gov
2.1Intent to Bid (due 5/14/2021 @ 2pm)
Submit to NevadaEProConfirm you have submitted in NevadaEPro
2.2This TPA RFP Spreadsheet
2.3References Spreadsheet - CONFIDENTIAL
NAPDNetwork Access and Provider Disruption submission

(see final tab in this spreadsheet for instructions)

Within this WorkbookConfirm 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 ProjectRead only, nothing to return
4.Mandatory Minimum Quals Tab
5.Critical Items Tab
6.Technical Tab
7.Customer Service Tab
8.Financial Tab
9.Performance Guarantees
10.Credits
11.Network Discounts tab (either providing Aon permission to use your semi-annual discount data submission, or you have submitted the data as instructed on this tab)

Vendor Info

RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - 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
Location(s) from which employees shall be assigned for this project
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
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 caseCourtCase 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 caseCourtCase 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 caseCourtCase Number

Status of the litigation

Subcontractor Info

RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - Subcontractor 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.No
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.No
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 caseCourtCase 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 caseCourtCase 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 caseCourtCase 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"

Subcontractor Info (2)

RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - Subcontractor 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.No
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.No
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 caseCourtCase 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 caseCourtCase 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 caseCourtCase 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
Third Party Medical/Dental Claims & Network Administration - Signatures Required
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
Third Party Medical/Dental Claims & Network Administration - Signatures Required
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
RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - Signatures Required
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
Vendor Certifications
Vendor agrees and shall comply with the following:
1. Any and all prices that may be charged under the terms of the contract do not and shall not violate any existing federal, State or municipal laws or regulations concerning discrimination and/or price fixing. The vendor agrees to indemnify, exonerate and hold the State harmless from liability for any such violation now and throughout the term of the contract.
2. All proposed capabilities can be demonstrated by the vendor.
3. The price(s) and amount of this proposal have been arrived at independently and without consultation, communication, agreement or disclosure with or to any other contractor, vendor or potential vendor.
4. All proposal terms, including prices, shall remain in effect for a minimum of 180 days after the proposal due date. In the case of the awarded vendor, all proposal terms, including prices, shall remain in effect throughout the contract negotiation process.
5. No attempt has been made at any time to induce any firm or person to refrain from proposing or to submit a proposal higher than this proposal, or to submit any intentionally high or noncompetitive proposal. All proposals shall be made in good faith and without collusion.
6. All conditions and provisions of this RFP are deemed to be accepted by the vendor and incorporated by reference in the proposal, except such conditions and provisions that the vendor expressly excludes in the proposal. Any exclusion shall be in writing and included in the proposal at the time of submission.
7. Each vendor shall disclose any existing or potential conflict of interest relative to the performance of the contractual services resulting from this RFP. Any such relationship that might be perceived or represented as a conflict shall be disclosed. By submitting a proposal in response to this RFP, vendors affirm that they have not given, nor intend to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant or any employee or representative of same, in connection with this procurement. Any attempt to intentionally or unintentionally conceal or obfuscate a conflict of interest shall automatically result in the disqualification of a vendor’s proposal. An award shall not be made where a conflict of interest exists. The State shall determine whether a conflict of interest exists and whether it may reflect negatively on the State’s selection of a vendor. The State reserves the right to disqualify any vendor on the grounds of actual or apparent conflict of interest.
8. All employees assigned to the project are authorized to work in this country.
9. The company has a written equal opportunity policy that does not discriminate in employment practices with regard to race, color, national origin, physical condition, creed, religion, age, sex, marital status, sexual orientation, developmental disability or disability of another nature.
10. The company has a written policy regarding compliance for maintaining a drug-free workplace.
11. Vendor understands and acknowledges that the representations within their proposal are material and important and shall be relied on by the State in evaluation of the proposal. Any vendor misrepresentations shall be treated as fraudulent concealment from the State of the true facts relating to the proposal.
12. Vendor shall certify that any and all subcontractors comply with Sections 7, 8, 9, and 10, above.
13. The proposal shall be signed by the individual(s) legally authorized to bind the vendor per NRS 333.337.
Company Name
Signature:
Print Name
Date

Terms and Conditions

RFP - Nevada Public Employees' Benefits Program
Third Party Medical/Dental Claims & Network Administration - 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
Third Party Medical/Dental Claims & Network 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.

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated .