2. 200000001275 - Schedule A - Statement of Work - Flexible Spending Account.docx

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STATE OF MICHIGAN

Request For Proposal No. 200000001275 Third Party Administration of Flexible Spending Accounts

SCHEDULE A

STATEMENT OF WORK

CONTRACT ACTIVITIES

This schedule identifies the anticipated requirements of any Contract resulting from this RFP. The term “Contractor” in this document refers to a bidder responding to this RFP.

The Contractor must respond to each requirement or question and explain how it will fulfill each requirement. Attach any supplemental information and appropriately reference within your response. DO NOT provide any materials other than those requested within this solicitation.

BACKGROUND

The Michigan Civil Service Commission (MCSC) Employee Benefits Division (Plan Sponsor), requires a third-party administrator for its Health Care and Dependent Care Flexible Spending Account (FSA) plans. The plans are to be administered consistent with Internal Revenue Code (IRC) Section 125. Of approximately 50,000 eligible active State employees, there are currently approximately 12,700 General Purpose Health Care FSA plan enrollments and 1,650 Dependent Care FSA plan enrollments. Effective January 1, 2021, there will be a Limited Purpose Health Care FSA for eligible dental and vision expenses only offered as well. The Health Care FSA plans include carryover and the Dependent Care FSA plan includes a grace period. The MCSC currently handles all activities surrounding the actual enrollment process. Health Care FSA credit cards are provided as an additional payment option to all Health Care FSA participants and are available on request for eligible dependents.

Objectives of this Contract are to:

1. Administer the FSA plans in accordance with applicable IRS and other regulations and ensure that the administration and documentation of the plans comply with any changes in regulations.

2. Maintain a high level of participant satisfaction with the program.

3. Provide quality customer service and account service features, including performance standard guarantees.

4. Provide timely utilization and management reporting as specified in this RFP.

5. Provide expert interpretation of Federal Regulations concerning Flexible Spending Accounts, proactively alert the client of regulation changes or clarifications, and provide expert guidance to the State’s Plan managers upon request.

6. Smoothly transition, if necessary, at the beginning and end of the Contract to another administrator.

7. Fully administer a Health Care FSA credit card offering.

8. Offer an exceptional customer service team dedicated to the State of Michigan.

9. Offer customer service representatives on-line access (e.g., through an electronic claim imaging system or equivalent) to claim processing information through the entire claim payment cycle.

10. Receive and send all correspondence in Health Insurance Portability and Accountability Act (HIPAA) compliant electronic formats, including participant eligibility, payroll deduction, plan experience reporting, and billing. All identifiable data must be compliant with all HIPAA Security Regulations. File formats will be defined by the State.

11. Post all forms needed for the adjudication of claims to the State’s and Contractor’s websites.

12. Receive and track mailed, faxed, and uploaded claim forms and substantiating documentation to Contractor.

13. Offer a web-based participant portal on a Contractor supported website where participants can check claim status, view transaction history, account balances, upload documentation, and general plan provisions.

14. Participant claim rejection notifications must be tracked, retrievable, and must have specific and understandable reasons for rejection and clear follow-up instructions.

15. Contractor must be able to use a State-defined unique participant identifier in all participant specific reporting, correspondence, web access identification, and claim forms.

16. Comply with the State’s Public Act 454 of 2004 (Social Security Number Privacy Act) and Public Act 452 of 2004 (Identify Theft Protection Act) and any State required IT security certifications

SCOPE

This is a Contract for third party administration of the State’s Flexible Spending Account (FSA) plans for the Michigan Civil Service Commission (MCSC).

The Contractor will provide administration, excluding enrollment activities, of the General Purpose and Limited Purpose Health Care FSA and Dependent Care FSA plans, per the terms and specifications in this Contract. This includes, but is not limited to producing customized communications and forms, electronically interfacing with the State’s payroll system with both inbound and outbound data transfers, processing claims received from participants, providing monthly, quarterly and year-end reporting, and providing exceptional customer service for the Plan Sponsor and program participants.

The Contract is to be effective August 1, 2020 through December 31, 2023.

The period of August 1, 2020 through December 31, 2020 will be for implementation and transition for the Contractor; no payment will be made to the Contractor during this period. The Contractor must begin providing all Services, without interruption, on January 1, 2021.

Contractor must provide Services in this Statement of Work at the direction of the State. Contractor and sub-contractor must provide Services and staff and do all necessary or incidental to perform the required Services.

REQUIREMENTS

1. General Requirements A. Administration

1. The Contractor must ensure that the program meets all federal requirements for use of employee pre-tax compensation for payment of qualified Health Care and Dependent Care expenses/services under IRC Section 125 and the latest privacy and security regulations.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must provide administration in accordance with the plan design as outlined in the FSA Plan Booklet.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. The Contractor must proactively alert, and upon request, provide the State with notice of regulation changes and expert guidance and interpretations to IRC Section 125 Federal Regulations concerning FSA plans.

Contractor must check only 1 box below and identify exception(s), if necessary.

4. Account balances for these plans will be funded entirely by employee salary reductions, (e.g., the State will not be contributing to these plans, nor will the State be reimbursing expenses outside the plan parameters). Administrative costs for the plan will be paid by the State. Fees, if any, in association with the administration of the Health Care FSA credit card must be paid by the Contractor.

Contractor must check only 1 box below and identify exception(s), if necessary.

5. The effective date of the Contract will be August 1, 2020, with an expected date of plan year commencement of January 1, 2021. During the initial period, the Contractor must, in coordination with the State, develop and test data interfaces with the State’s Human Resource Management Network (HRMN) system, and develop, in conjunction with the State, customized employee communication materials for the plans.

Contractor must check only 1 box below and identify exception(s), if necessary.

B. Eligibility

1. The Contractor must be able to accept each of the State’s electronic data files sent bi-weekly via FTS, in the file format outlined in Schedules J (Flex Spend Enrollment File Description – ZB607D01), K (FBMC Adjudication File Description – ZB609D01), and L (FSA Deduction Remittance File Description – ZR124), and process change transactions timely, maintain up-to-date information for eligibility certification, proper claim payments and fund deposits without errors such as non-payment or payment of claims due to incorrect interpretation and loading of file data.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must maintain participant information in compliance within the latest HIPAA privacy and security regulations.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. Eligibility information for participants will be transferred by MCSC via File Transfer Service (FTS) (or another method selected by the State) on a bi-weekly basis. The data source for participant information is the HRMN system.

Contractor must check only 1 box below and identify exception(s), if necessary.

4. The Contractor must work with the State in the implementation of this data transfer. The Contractor is responsible for any changes to their systems or processes required to support the receipt and processing of the State’s electronic files at no additional charge to the State.

Contractor must check only 1 box below and identify exception(s), if necessary.

5. The Contractor must, upon verbal or written notification from the Program Manager or designated representatives, complete participant eligibility and/or enrollment updates in real-time.

Contractor must check only 1 box below and identify exception(s), if necessary.

6. The Contractor must use a forced TLS secured connection between the State’s email servers and theirs as an additional layer of protection for all administrative communications concerning individual participants.

Contractor must check only 1 box below and identify exception(s), if necessary.

C. Claim Information

1. The Contractor must offer and administer a credit card for Health Care Spending Account participant reimbursement and allow use at merchants that have an industry standard inventory system (IIAS) that can verify the eligibility of items at checkout.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must offer and administer a direct deposit option for claim reimbursement to participants.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. The Contractor must administer all claims services including eligibility verification, payment, denial, tracking, claim imaging and appeals.

Contractor must check only 1 box below and identify exception(s), if necessary.

4. Contractor must accept claim files from the State’s carriers (e.g., health, prescription, dental, vision) in an agreed upon format and designated frequency for purposes of auto-adjudication.

Contractor must check only 1 box below and identify exception(s), if necessary.

5. The Contractor must utilize a State-defined unique participant identifier (e.g., 6 or 7-digit Employee ID Number) in all participant specific reporting, correspondence, web access identification and claim forms.

Contractor must check only 1 box below and identify exception(s), if necessary.

6. The Contractor must clearly explain and fully detail their substantiation requirements and process related to claims approvals and denials.

Contractor must check only 1 box below and identify exception(s), if necessary.

D. Contractor/State Interface Data collection on behalf of the State program is not to be distributed to any party without the written consent of the State and is not to be used by the Contractor for any purposes without express, written approval by the State. All data identifying specific enrollees or their dependents are highly confidential and are to be treated and secured according to the latest HIPAA privacy and security regulations. Specifically, the State requires that electronic transmission of identifiable data be protected by passwords and an FTS site be used for retrieval.

Contractor must check only 1 box below and identify exception(s), if necessary.

The following are additional Contractor requirements related to the necessary systems interface between the Contractor and the State:

1. The Contractor must accept and accurately use the State’s electronic enrollment files (Schedule J) in the file format outlined by the State and process change transactions to maintain up-to-date information for claim certification and account balances.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must have accessible and experienced information technology professionals to provide timely programming who are capable and authorized to implement system changes and produce reports.

Contractor must check only 1 box below and identify exception(s), if necessary.

E. Financial Arrangements

1. The Contractor must routinely invoice the State for claim payments and report detailed financial data separated by Plans monthly, or on a mutually agreeable timeframe.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must accept fund transfers from the State on a mutually agreeable timeframe, no more frequently than weekly for claims reimbursement and on a monthly basis for administrative fees. The State does not allow account debits.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. The Contractor must immediately notify the State of pending insufficient funds to avert nonsufficient funds for claim payments. The Contractor must honor and pay all claims to participants until the funds are available. The State will make all reasonable efforts to replenish the claims fund account immediately upon notification.

Contractor must check only 1 box below and identify exception(s), if necessary.

F. Participant Services

1. The Contractor must have extended hours, such as 8:00 a.m. to 8:00 p.m. with direct customer service access on business days.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. The Contractor must have a single, front-end, toll-free telephone number with touch-tone routing for participant services, with telecommunications device for the deaf (TDD) capabilities and dedicated phone staff for State participants.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. The Contractor must have a 24-hour, interactive voice response (IVR) system with TDD capabilities and a customizable menu that is mutually agreed upon between State and Contractor Participant must be able to obtain information regarding claim status, account balances and general plan provisions.

Contractor must check only 1 box below and identify exception(s), if necessary.

4. The Contractor must have customer service representatives that have access to a comprehensive, on-line claim tracking through an electronic claim imaging system, or equivalent, to assist State participants with claim inquiries.

Contractor must check only 1 box below and identify exception(s), if necessary.

5. The Contractor must accept all participant forms via hard copy, upload through Contractor’s online portal, smartphone app or facsimile and provide a toll-free facsimile telephone number.

Contractor must check only 1 box below and identify exception(s), if necessary.

6. The Contractors’ customer service representatives must have access to a client specific knowledge-based system.

Contractor must check only 1 box below and identify exception(s), if necessary.

7. The Contractor’s customer service representatives must be trained and have proficiency in State specific aspects of plan design as outlined in the FSA Plan Booklet.

Contractor must check only 1 box below and identify exception(s), if necessary.

8. The Contractor must provide a detailed explanation of their customer service representative monitoring system to ensure quality and accuracy of individual calls.

Contractor must check only 1 box below and identify exception(s), if necessary.

9. The Contractor must provide customized participant communications with all communication subject to the State’s approval.

Contractor must check only 1 box below and identify exception(s), if necessary.

10. The Contractor must generate and mail quarterly participant statements including transactions to date and account balances, and allow participants to opt into paperless options, such as through online portal and smartphone app.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must include a sample participant statement and provide the document name below.

Contractor Response:

11. The Contractor must provide participant web-access with the ability to view account balances, claim status, transaction history, print necessary forms, submit claims online, request health care FSA card and obtain general plan provision information.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must include a screenshot of participant web-access and provide the document name below.

Contractor Response:

12. The Contractor must provide claim eligibility and general plan information to the State for use during annual open enrollment no later than August of that plan year.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must include sample claim eligibility and general plan information and provide the document name below.

Contractor Response:

13. The Contractor must generate and mail a customized welcome letter and a plan enrollment confirmation to each participant that enrolls during the State open enrollment period prior to the start of the plan year. One (1) copy of each appropriate claim form and Health Care FSA credit card transaction substantiation form must be included.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must include samples requested above and provide document names below.

Contractor Response:

14. The Contractor must mail participants clear explanations of rejected claims and required additional documentation within 10 days or via paperless option within 3 days.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must include sample rejected claim explanation and provide document names below.

Contractor Response:

Contractor will offer a secured system for the transfer of any protected health information or other sensitive data. Contractor must comply with all HIPAA Privacy and Security Rule requirements, including entering the Business Associate Agreement for the benefit plans. Contractor must also have access to the conference call and internet-based video-conferencing technology.

Contractor must check only 1 box below and identify exception(s), if necessary.

1.2. Training

The Contractor must provide on-site training, documentation and training materials, covering systems, access, overall product offering, etc. to the State and Call Center depending on State’s need at the time and at no cost to the State.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must provide details of its training. If a separate document is being provided, name of document must be listed below.

Contractor Response:

1.3 Specific Standards

Look and Feel Standard All software items provided by the Contractor must adhere to the State of Michigan Application/Site Standards which can be found at www.michigan.gov/standards.

Mobile Responsiveness The Bidder’s Solution must utilize responsive design practices to ensure the application is accessible via a mobile device. Bidders must provide a list of all mobile devices that are compatible with the Solution. Additionally, Bidder must provide list of features that can be performed via a mobile device.

ADA Compliance The State is required to comply with the Americans with Disabilities Act of 1990 (ADA), and has adopted a formal policy regarding accessibility requirements for websites and software applications. The State is requiring that Bidder’s proposed Solution, where relevant, to level AA of the World Wide Web Consortium (W3C) Web Content Accessibility Guidelines (WCAG) 2.0. Bidder may consider, where relevant, the W3C’s Guidance on Applying WCAG 2.0 to Non-Web Information and Communications Technologies (WCAG2ICT) for non-web software and content. The State may require that Bidder complete a Voluntary Product Accessibility Template for WCAG 2.0 (WCAG 2.0 VPAT) or other comparable document for the proposed Solution. http://www.michigan.gov/documents/dmb/1650.00_209567_7.pdf?20151026134621

Bidder must acknowledge their agreement with this section and provide details for how they will meet the requirements.

Contractor must check only 1 box below and identify exception(s), if necessary.

1.4 User Type and Capacity

Bidder must provide their maximum Number of Concurrent Users limitation. Bidder must be able to meet the expected number of concurrent Users. Bidder must explain how it will be able to support the expected number of concurrent Users. Bidder must also explain whether the Solution can scale up or down without affecting performance.

Bidder must provide details regarding latency response time for (i.e., Generate Page Load, standardized reporting, ad hoc reporting). The Bidder must identify what network connectivity or equipment will the State be required to have to meet the expected latency response time?

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must provide information requested above. If a separate document is being provided, name of document must be listed below.

Contractor Response:

1.5 Access Control and Audit

The Bidder’s solution must integrate with the State’s IT Identity and Access Management (IAM) environment as described in the State of Michigan Digital Strategy (http://www.michigan.gov/dtmb/0,5552,7-150-56345_56351_69611-336646--,00.html), which consist of:

1. MILogin/Michigan Identity, Credential, and Access Management (MICAM)

0. An enterprise single sign-on and identity management solution based on IBM’s Identity and Access Management products including, IBM Security Identity Manager (ISIM), IBM Security Access Manager for Web (ISAM), IBM Tivoli Federated Identity Manager (TFIM), IBM Security Access Manager for Mobile (ISAMM), and IBM DataPower, which enables the State to establish, manage, and authenticate user identities for the State’s Information Technology (IT) systems.

1. MILogin Identity Federation

1. Allows federated single sign-on (SSO) for business partners, as well as citizen-based applications.

1. MILogin Multi Factor Authentication (MFA, based on system data classification requirements)

2. Required for those applications where data classification is Confidential and Restricted as defined by the 1340.00 Michigan Information Technology Information Security standard (i.e. the proposed solution must comply with PHI, PCI, CJIS, IRS, and other standards).

1. MILogin Identity Proofing Services (based on system data classification requirements)

3. A system that verifies individual’s identities before the State allows access to its IT system. This service is based on “life history” or transaction information aggregated from public and proprietary data sources. A leading credit bureau provides this service.

To integrate with the SOM MILogin solution, the Bidder’s solution must support HTTP Headers based SSO, or SAML, or OAuth or OpenID interfaces for the SSO purposes.

Contractor must check only 1 box below and identify exception(s), if necessary.

If Contractor would like to propose an alternate/comparable method for the above requirements it must be provided here. If a separate document is being provided, name of document must be listed below. If no alternative is being provided, write in N/A.

Contractor Response:

1.6 End-User Operating Environment

The SOM environment is X86 VMware, IBM Power VM and Oracle VM, with supporting enterprise storage monitoring and management.

The software must run under commonly used web browsers. At a minimum the software must support Internet Explorer v11 or higher, or Edge, Chrome v71 or higher, Firefox v62 or higher, and Safari v12 or higher for iOS operating systems.

Bidder must support the current and future State standard environment at no additional cost to the State.

Contractor must check only 1 box below and identify exception(s), if necessary.

Bidder must:

· Describe any State system access requirements that are necessary for the Bidder to perform its obligations on a timely basis, including but not limited to, physical or remote access to State networks, servers, or individual workstations.

· Describe if it can comply with the current environment and how it intends to comply with any future changes to the user environment. And if not, describe what end user operating environment its solution supports.

· Describe if it can support the original environment throughout the term of the contract.

· Describe how it communicates changes to its roadmaps.

· Identify any plug-ins necessary for the proposed solution to meet the system requirements of this request.

· Describe how customers collaborate with your organization in the decision-making process for upgrades, maintenance, and change control.

Contractor must provide information requested above. If a separate document is being provided, name of document must be listed below.

Contractor Response:

1.7 Software

Bidder must provide a detailed description of the Solution to be provided under the resulting Contract including, but not limited to, a detailed description of the proposed Software (name, type, version, release number, etc.), its functionality, optional add-on modules, Contractor’s services and the Solution ability to be rapidly configured or scaled as the State’s business or technical demands change. If Bidder is using any open source or third-party products in connection with the proposed Solution the Bidder must identify these separately in its proposal (including identifying any associated cost in Schedule B - Pricing).

For third-party products that are being proposed as part of the overall Solution, Bidder must include any end-user license agreements that will be required to access and use such products.

Bidder must include any end-user license agreements that will be required by the State to access the Solution as Exhibit 2 of Schedule E of the Standard Contract Terms.

Contractor must check only 1 box below and identify exception(s), if necessary.

Contractor must provide information requested above. If a separate document is being provided, name of document must be listed below.

Contractor Response:

1.9 Hosting

Bidder must review the State’s standard Contractor Hosted Software and Services attached as Schedule E. Bidder must note any exceptions to the Service Level Agreements (SLA) by redlining Exhibit 1 to Schedule E.

Bidder must maintain and operate a backup and disaster recovery plan to achieve a Recovery Point Objective (RPO) of 24 hours, and a Recovery Time Objective (RTO) of 24 hours. Bidder must include a copy of its Disaster Recovery Plan as Exhibit 1 Schedule F part of their proposal, which will be treated by the State as confidential information.

Contractor must provide information requested above. If a separate document is being provided, name of document must be listed below.

Contractor Response:

1.10 Products and Services

Bidder must describe additional Solution functionality, products or services that the State specifications do not address but are necessary to implement and support this solution.

Contractor must check only 1 box below and identify exception(s), if necessary.

1.11 SUITE Documentation

In managing its obligation to meet the above milestones and deliverables, the Bidder is required to provide robust project management reporting details such as those in the State Unified Information Technology Environment (SUITE) methodologies, or an equivalent methodology proposed by the Bidder. See also section 4.1 Project Plan and 4.3 Reporting.

Bidder must describe how they will meet the requirements set forth above and note any exceptions for successful implementation and ongoing support of the Solution.

1.12 Secure Web Application Standard

Security Accreditation Contractor is required to complete the State Security Accreditation process for the solution consistent with NIST data classification standards.

Application Scanning

Externally hosted solutions Contractor is required to grant the right to the State to scan either the application code or a deployed version of the solution; or in lieu of the State performing a scan, Contractor will provide the State a vulnerabilities assessment after Contractor has used a State approved application scanning tool. These scans must be completed and provided to the State on a regular basis or at least for each major release.

For COTS or vendor owned applications, Contractor, at its sole expense, must provide resources to complete the scanning and to complete the analysis, remediation and validation of vulnerabilities identified by the scan as required by the State Secure Web Application Standards.

Types of scanning and remediation may include the following types of scans and activities

1. Dynamic Scanning for vulnerabilities, analysis, remediation and validation

1. Static Scanning for vulnerabilities, analysis, remediation and validation

1. Third Party and/or Open Source Scanning for vulnerabilities, analysis, remediation and validation

Infrastructure Scanning Externally hosted solutions A Contractor providing Hosted Services must scan the infrastructure at least once every 30 days and provide the scan’s assessment to the State in a format that can be uploaded by the State and used to track the remediation.

Contractor must check only 1 box below and identify exception(s), if necessary.

2. Acceptance, Inspection and Testing The State will use the following criteria to determine acceptance of the Contract Activities:

Bidder must review Section 3, Hosted Services Testing and Acceptance, of the Schedule E.

Contractor must check only 1 box below and identify exception(s), if necessary.

3. Staffing

3.1. Contractor Representative

The Contractor must appoint a dedicated team of individuals, specifically assigned to State of Michigan accounts, that will respond to State inquiries regarding the Contract Activities, answering questions related to ordering and delivery, etc. (the “Contractor Representative”).

The Contractor must notify the Contract Administrator at least 30 calendar days before removing or assigning any new Contractor Representative.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.2 Contract Administrator

The Contract Administrator for each party is the only person authorized to modify any terms of this Contract, and approve and execute any change under this Contract (each a “Contract Administrator”):

Joy Nakfoor 525 W. Allegan St, 1st Floor NE Lansing, MI 48933 nakfoorj@michigan.gov 517-249-0481 [Name] [Street Address] [City, State, Zip] [Email] [Phone]

Contractor must check only 1 box below and identify exception(s), if necessary.

3.3 Program Manager

The Program Manager for each party will monitor and coordinate the day-to-day activities of the Contract (each a “Program Manager”):

Becky Guyski 400 S. Pine Lansing, MI 48913 guyskir@michigan.gov 517-335-2323 [Name] [Street Address] [City, State, Zip] [Email] [Phone]

Contractor must check only 1 box below and identify exception(s), if necessary.

3.4. Customer Service Toll-Free Number

The Contractor must specify its toll-free number for the State to make contact with the Contractor Representative. The Contractor Representative must be available for calls during the hours of 8 am to 5 pm ET.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.5. Technical Support, Repairs and Maintenance

The Contractor must specify its toll-free number for the State to make contact with the Contractor for technical support, repairs and maintenance. The Contractor must be available for calls and service during the hours of 8 am to 5 pm ET.

When providing technical support, the Call Center must resolve the State’s issue within 24 hours.

Bidder must review the State’s standard Contractor Hosted Software and Services attached as Schedule E.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.7. Key Personnel

A. The Contractor must appoint individuals who will be directly responsible for the day-to-day operations of the Contract (“Key Personnel”). Key Personnel must be specifically assigned to the State account, be knowledgeable on the contractual requirements, and respond to State inquires within 24 hours.

B. The Contractor must identify proposed staff who will be involved with the Contract and those who will be designated as Key Personnel in the table below:

Senior Account Manager (SAM)

Back-up SAM

Implementation Manager

Call Center Support

Claims Processing Support

Technical

Additional Personnel

1. SAM role and responsibilities must include:

a. Serving as the single point of accountability for all projects initiated between the Contractor and the State for management of the Contractor’s Account Team;

b. Authority to make day-to-day decisions regarding service issues;

c. Ability within the Contractor’s organization to obtain the use of Contractor’s resources, both direct and indirect, as necessary;

d. Designating one (1) back-up to the SAM, whose role and responsibilities must include involvement in account management and who is capable of performing the responsibilities of the SAM in the event that the SAM is unavailable. The Contractor’s SAM back-up must be familiar with all specific requirements of this Contract. This back-up role may be filled by another key-staff person.

2. Key Personnel must be made available to the State on a reasonably frequent basis (as determined or scheduled by Plan Sponsor or Program Manager, as designated by the State).

C. The Contractor must provide current detailed chronological resumes for all Key Personnel identified in Section 3.4.D. Qualifications will be measured by education and experience, with particular reference to experience on projects similar to that described in the RFP.

Contractor must provide resumes for all Key Personnel. If separate documentation is being provided, name(s) of document(s) must be listed below.

Contractor Response:

D. The State has the right to recommend and approve in writing the initial assignment, as well as any proposed reassignment or replacement, of any Key Personnel. Before assigning an individual to any Key Personnel position, Contractor will notify the State of the proposed assignment, introduce the individual to the State’s Project Manager, and provide the State with a resume and any other information about the individual reasonably requested by the State. The State reserves the right to interview the individual before granting written approval. In the event the State finds a proposed individual unacceptable, the State will provide a written explanation including reasonable detail outlining the reasons for the rejection. The State may require a 30-calendar day training period for replacement personnel.

E. Contractor will not remove any Key Personnel from their assigned roles on this Contract without the prior written consent of the State. The Contractor’s removal of Key Personnel without the prior written consent of the State is an unauthorized removal (“Unauthorized Removal”). An Unauthorized Removal does not include replacing Key Personnel for reasons beyond the reasonable control of Contractor, including illness, disability, leave of absence, personal emergency circumstances, resignation, or for cause termination of the Key Personnel’s employment. Any Unauthorized Removal may be considered by the State to be a material breach of this Contract, in respect of which the State may elect to terminate this Contract for cause under Termination for Cause in the Standard Terms. It is further acknowledged that an Unauthorized Removal will interfere with the timely and proper completion of this Contract, to the loss and damage of the State, and that it would be impracticable and extremely difficult to fix the actual damage sustained by the State as a result of any Unauthorized Removal. Therefore, Contractor and the State agree that in the case of any Unauthorized Removal in respect of which the State does not elect to exercise its rights under Termination for Cause, Contractor will issue to the State the corresponding credits set forth below (each, an “Unauthorized Removal Credit”):

1. For the Unauthorized Removal of any Key Personnel designated in the applicable Statement of Work, the credit amount will be $25,000.00 per individual if Contractor identifies a replacement approved by the State and assigns the replacement to shadow the Key Personnel who is leaving for a period of at least 30 calendar days before the Key Personnel’s removal.

2. If Contractor fails to assign a replacement to shadow the removed Key Personnel for at least 30 calendar days, in addition to the $25,000.00 credit specified above, Contractor will credit the State $833.33 per calendar day for each day of the 30 calendar-day shadow period that the replacement Key Personnel does not shadow the removed Key Personnel, up to $25,000.00 maximum per individual. The total Unauthorized Removal Credits that may be assessed per Unauthorized Removal and failure to provide 30 calendar days of shadowing will not exceed $50,000.00 per individual.

F. Contractor acknowledges and agrees that each of the Unauthorized Removal Credits assessed above: (i) is a reasonable estimate of and compensation for the anticipated or actual harm to the State that may arise from the Unauthorized Removal, which would be impossible or very difficult to accurately estimate; and (ii) may, at the State’s option, be credited or set off against any fees or other charges payable to Contractor under this Contract.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.8. Organizational Chart

The Contractor must provide an overall organizational chart that details staff members, by name and title, and subcontractors. This chart must also detail each person’s function in regard to this project.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.9. Disclosure of Subcontractors

If the Contractor intends to utilize subcontractors, the Contractor must disclose the following:

The legal business name; address; telephone number; a description of subcontractor’s organization and the services it will provide; and information concerning subcontractor’s ability to provide the Contract Activities.

The relationship of the subcontractor to the Contractor.

Whether the Contractor has a previous working experience with the subcontractor. If yes, provide the details of that previous relationship.

A complete description of the Contract Activities that will be performed or provided by the subcontractor.

Contractor must check only 1 box below and identify exception(s), if necessary.

3.10. Security

The Contractor must review the Data Security requirements set forth in Schedule F – Data Security Requirements. Bidder must note any exceptions to the security requirements by redlining Schedule F – Data Security Requirements.

Contractor must check only 1 box below and identify exception(s), if necessary.

4. Project Management

4.1. Project Plan

The Contractor will carry out this project under the direction and control of the Program Manager. Within 14 calendar days of the Effective Date, the Contractor must submit an implementation plan to the Program Manager for final approval.