2024_Rosenberg_Worksite_Benefits_Vendor_Response_Workbook.xlsx

XLSX spreadsheet 109 KB Posted Apr 22, 2024

Attached to: Supplemental Insurance
Solicitation number: 2024-23P
Issued by: Fort Bend County, Round Mountain Town, Texas

About this file

Written by GovTribe AI · Jul 3, 2025

This is a vendor response workbook for a Supplemental Insurance solicitation by the City of Rosenberg, Texas, seeking proposals for voluntary worksite benefits. The document outlines a comprehensive request for voluntary insurance products including accident, critical illness, cancer, hospital indemnity, and life insurance offerings. The procurement will be conducted through OpenGov Procurement's eProcurement platform, with vendors required to complete a detailed questionnaire and provide references, organizational information, and specific product details.

The vendor response workbook includes a proposed accident insurance plan with specific rate structures (individual at $9.30, employee + spouse at $16.08, employee + child at $19.81, and employee + family at $24.98) and comprehensive benefit details. Key plan features include no benefit waiting period, lump sum benefits, coverage for dependents up to age 26, portability upon termination, coverage of organized sports, and a 4-day standard claims payment turnaround. The plan offers specific payment examples such as $80,000 for accidental death, $200,000 for common carrier accidental death, and various ambulance and appliance benefits. Vendors are expected to provide detailed information about their administrative capabilities, communication strategies, enrollment options, and technological platforms to support the insurance offerings.

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Vendor Information

	VENDOR NAME HERE
Primary Contact Information
Name
Title
Address
Phone #
Fax #
Email
Secondary Contact Information
Name
Title
Address
Phone #
Fax #
Email
Coverages to be Quoted (Please mark an "x" to all plan types that apply.)
Accident
Critical Illness
Cancer
Hospital Indemnity
ISTD
Universal/Whole Life

General Questionaire

	GENERAL QUESTIONNAIRE
			VENDOR NAME HERE
	Organizational Strength		Response
	1	Provide the name and address of your company.
	2	Is your company publicly traded?
	3	What is your company's A.M. Best rating?
	4	Confirm you are registered with the Secretary of State to do work in the State of Texas.
	References		Response
	5	Please provide three references of current clients and two references of clients you have lost in the past two years.
Ideally, these references would be similar in size to the Client. All fields must be completed.	Current Clients
			1.) Client Name:
			Contact Name:
			Contact Title:
			Phone Number:
			Email Address:
			Years of Service:
			2.) Client Name:
			Contact Name:
			Contact Title:
			Phone Number:
			Email Address:
			Years of Service:
			3.) Client Name:
			Contact Name:
			Contact Title:
			Phone Number:
			Email Address:
			Years of Service:
			Former Clients
			1.) Client Name:
			Contact Name:
			Contact Title:
			Phone Number:
			Email Address:
			Reason for leaving:
			2.) Client Name:
			Contact Name:
			Contact Title:
			Phone Number:
			Email Address:
			Reason for leaving:

Voluntary Prods Questionnaire

VOLUNTARY PRODUCTS QUESTIONNAIRE

***Please include a full proposal along with this completed questionnaire***

Voluntary Products carriers are required to respond to all requests for information contained in this questionnaire. All responses must be provided on a flash drive in Excel format. This questionnaire will be scored; therefore, it is necessary that you provide concise answers. Your responses to the questions should be based on your current proven capabilities. Should there be instances where certain questions are not applicable to your organization or its operations, please so indicate. If you are selected to administer the Client's employee benefit plans, your responses to the questionnaire will be considered part of your contractual responsibilities. You are also requested to return the indicated exhibits as part of your proposal.

Answers should be summarized in short format and not exceed the allotted space within the cell(s) provided. DO NOT add extra rows/columns--work within the allotted space. Additional information in carrier format may be submitted along if a carrier would like to include more detailed information.

		VENDOR NAME HERE
Administration		Response
1	What is the standard turnaround time for new group implementation?
2	Do you provide audits of dependents?	Please Select	Please Select	Yes	No
3	Please confirm you are able to work with the Client's eligibility/Enrollment System: PEC
4	Will your company include Section 125 administration when bundled with Voluntary Products?	Please Select
5	If yes, Will the Section 125 Plan online access to accounts for the employees?	Please Select
Account Management
6	Give the name and title of the person(s) with whom overall responsibility for planning, supervising, and performing the day-to-day administrative services for the Client will be.
7	Will the Client have a dedicated Account Manager?	Please Select
8	If so, where are they located and what are their standard hours?
9	Will they have a back-up contact?	Please Select
Communications and Enrollment
10	What are your E-Services Capabilities?
11	Do you offer pre-printed materials?	Please Select
12	Do you offer benefit booklets?	Please Select
13	What are your enrollment options?
15	Do you guarantee re-enrollments for the length of the contract?	Please Select
16	Will you attend health fairs and annual enrollment on an annual basis?
Billing
17	Do you require a list bill or self bill?
18	Is electronic billing available?	Please Select
Web Tools
19	Do you offer access to employers on product information, etc.?	Please Select
20	Do you offer access to employees on product information, etc.	Please Select
Benefit Admin Platform
21	Confirm you are able to work with PEC.

Accident Proposed-Benefits Proposed Personal Accident Indemnity Plan Design

		Current Vendor	VENDOR NAME HERE
	Accident Rates
1	Individual	$9.30
2	Employee + Spouse	$16.08
3	Employee + Child	$19.81
4	Employee + Family	$24.98
	Accident Product
1	Group/Individual	Group
2	Benefit Waiting Period	None
3	Is the plan based on reimbursement or lump Sum Benefits?	Lump Sum
4	Definition of Dependent	Age 26
5	Participation Requirements	Waived
6	Pre-Existing Conditions Limitations	No Limitations
7	Portable upon Group or Individual Termination	Yes
8	Are organized sports covered?	Yes
9	Standard Turn Around for Claims Payment	4 Days
10	Confirm the plan is for off job coverage	Confirmed
	Payment Examples
1	Accidental Death	$80,000
2	Common Carrier Accidental Death	$200,000
3	Ground Ambulance	$300
4	Air Ambulance	$900
5	Appliance	$375
6	Burns <15% of body	$300
7	Dislocations/ Fractures Rider	$6,000
8	Prosthesis	$1,500
9	Physical, Occupational, or Speech Therapy	$90
10	Laceration	$150
11	Surgery	$3,000
12	Transportation	Up to $750

Cancer Proposed-Benefits Proposed Cancer Plan Design

		Current	Current	VENDOR NAME HERE	VENDOR NAME HERE
		Low Plan	High Plan	Low Plan	High Plan
1	Individual	$10.13	$15.50
2	Employee + Spouse	$15.78	$24.07
3	Employee + Child	$14.44	$22.28
4	Employee + Family	$20.09	$30.84
	Plan Design
1	Hospital and Related Benefits
2	Continuous Hospital Confinement (daily)	$200	$300
3	Private Duty Nursing Services (daily)	$200	$300
4	Extended Care Facility (daily)	$200	$300
5	Hospice Care Center (daily)	$200	$300
6	Hospice Care Team (per visit)	$200	$300
7	Radiation, Chemotherapy, and Healing
8	Radiation/Chemotherapy for Cancer (12 months)	$10,000	$15,000
9	Blood, Plasma, and Platelets (every 12 months)	$10,000	$15,000
10	Medical Imaging (yearly)	$500	$750
11	Hematological Drugs (yearly)	$200	$300
12	Surgery and Related Benefits
13	Surgery	$1,500	$3,000
14	Anesthesia (%of surgery)	25%	25%
15	Ambulatory Surgical Center (daily)	$250	$500
16	Second Opinion	$200	$400
17	Miscellaneous Benefits
18	Inpatient Drugs and Medicine (daily)	$25	$25
20	Physician's Attendance (daily)	$50	$50
21	Ambulance (per confinement)	$100	$100
23	Transportation (per trip or mile)	Coach fare or $0.40	Coach fare or $0.40
24	Outpatient Lodging (daily)	$50	$50
26	Family Member Lodging (daily)	$50	$50
27	Physical or Speech Therapy (daily)	$50	$50
29	New or Experimental Treatment (every 12 months)	$5,000	$5,000
30	Prosthesis	$2,000	$2,000
32	Hair Prosthesis (every 2 years)	$25	$25
33	Nonsurgical External Breast Prosthesis	$50	$50
34	Anti-Nausea Benefits (yearly)	$200	$200
36	Waiver of Premium (Primary insured only)	yes	yes

Crtic Illnes Proposed-Benefit Proposed Critical Illness Plan Design

		Current Vendor	Current Vendor
	Monthly Cost: EXAMPLE RATES $20,000 Benefit with Cancer Rider	Low Option	High Option
1	Individual / Age 30 / Non Tobacco	5.42
2	Individual / Age 50 / Non Tobacco	22.34
3	Spouse/ Age 30 / Non Tobacco	8.54 (Employee +Spouse Rate)
4	Spouse / Age 50 / Non Tobacco	33.95 (Employee + Spouse Rate)
5	Child	25% of employee benefit	25% of employee benefit
6	Maximum age to enroll	Spouse Age 69	Spouse Age 69
	Plan Design
1	Group or Individual Plans?	Group	Group
2	Participation Requirements	None	None
3	Benefit Waiting Period	None	None
4	Maximum Employee Election	10000	20000
5	Minimum Employee Election	10000	20000
6	Increment Amounts	N/A	N/A
7	Guarantee Issue Limits	10000	20000
8	Reduction Schedule	None	None
11	Definition of Dependent	Age 26 and below	Age 26 and below
14	List Critical Illnesses Covered	100% Supplmental Rider

Advanced Alzheimer’s Disease Advanced Parkinson’s Disease Benign Brain Tumor Coma Complete Loss of Hearing Complete Loss of Sight Complete Loss of Speech Occupational HIV Paralysis 100% Supplmental Rider Advanced Alzheimer’s Disease Advanced Parkinson’s Disease Benign Brain Tumor Coma Complete Loss of Hearing Complete Loss of Sight Complete Loss of Speech Occupational HIV Paralysis

15	Pre-Existing Conditions Limitations	No	No
16	Portable upon Group or Individual Termination	Yes	Yes
17	Wellness Benefit amount	$50	$50
18	Reoccurrence benefit	Yes	Yes
	Payment Examples
1	Initial Critical Illness Benefits
2	Heart Attack	$10,000	$20,000
3	Stroke	$10,000	$20,000
4	Coronary Artery Bypass Surgery	$2,500	$5,000
5	Major Organ Transplant	$10,000	$20,000
6	End Stage Renal Failure	$10,000	$20,000
7	Waiver of Premium (employee only)	Yes	Yes
8	Cancer Critical Illness Benefits
9	Invasive Cancer	$10,000	$20,000
10	Carcinoma in Situ	$2,500	$5,000

Hospital Indemnity

Hospital Indemnity Plan
		Current Vendor	VENDOR NAME
	Monthly Rate
1	Employee	$37.18
2	EE +SP	$87.49
3	EE+Ch	$64.35
4	Family	$97.50
	Plan Design	Response	Response
5	Group or Individual Plans?	Group
6	Participation Requirements	None
7	Benefit Waiting Period	None
8	Portable Coverage	Yes
9	Initial Confinement Benefit	$1,000.00
10	Daily Hospital Benefit	$500.00
11	Max Days of Confinement	30 Days
12	Hospital Intensive Care	$500.00
24	Max Days of Confinement	30 Days
25	Pregnancy Waiting Period	No
26	Removal of Pre-exisiting Conditions Limitation	Yes

STD Questionnaire

SHORT TERM DISABILITY QUESTIONNAIRE

Organizational Strength		Response
1	How many clients do you currently have in force for STD on a national level?
2	How many clients do you currently have in force for STD in the state of Texas?
3	How many clients do you currently have in force for STD that are public entities?
Implementation Process		Response
4	What initial information is required from the employer for implementation?
5	Will account manager be available for open enrollment meetings?
6	Standard turnaround time for new group processing? New enrollees?
Financial Review		Response
7	Does your company offer self-bill, electronic billing, or both?	Please Select	Please Select	Self-Bill	Electronic billing	Both
8	Describe your initial and renewal rating methodology for a group of this size. Be sure to address the impact of a deficit at the time of renewal.
Claim Submission and Payment Process		Response
9	Discuss your ability and experience to receive claim notification telephonically.
10	Can you utilize any other method for claim intake (i.e., on-line?)	Please Select	Please Select	Yes	No
11	What are the claim notification and filing requirements?
12	Do you have electronic notification and claims inquiry follow up capabilities for the claimant and/or the employer?	Please Select
13	How do you obtain on-going objective medical information to substantiate continued disability?
14	Describe your method of distributing payments to claimants, including timing.
15	What additional involvement will be required of the employer and how frequently?
Account & Case Management		Response
16	Will the Client have a dedicated Account Manager?	Please Select
17	If so, where are they located and what are their standard hours?
Disability Claim Management		Response
18	Outline the process in place to assure timely, effective claim determinations.
19	What are the qualifications of the claims examiners?
20	How do you communicate clinical status to the Client for employees on disability? How often? In what format?
21	Briefly explain your maternity claims process.
22	Outline your typical appeal process.
23	How does your contract language support early RTW?
24	Discuss the extent of automation and integration in your claims administration system(s) and disability management process system(s).
Reporting Capabilities		Response
25	Please include a copy of your standard reports.
26	How frequently are claim reports produced?
27	Include a sample of each of your standard reports and identify the timing of the reports.
28	Are your standard reports available online?	Please Select
29	Do you have any online capabilities to allow the employer to monitor claim and return-to-work status?	Please Select
30	Is there an additional fee for such online services?

Universal Life

Universal Life
Monthly Cost: EXAMPLE RATES $50,000	Current vendor	VENDOR NAME
Individual / Age 35 / Non-Tobacco	$4.63
Individual / Age 45 / Non-Tobacco	$10.13
Individual / Age 55 / Non-Tobacco	$24.25
Maximum age to enroll	80
Please attach a copy of current rate sheet.	Page 4B of the attached
Product
Whole/UL Product Type	Universal
Minimum Participation	10
Portable Upon Group or Individual Termination	Yes
Waiver of Premium Provision	No
Accelerated Benefit
AD&D Rider
Additional Riders: Please include costs within benefit summaries provided
Long Term Care Rider	Yes
Rider 2
Rider 3
Rider 4
Rider 5
Plan Design
Life Amount for Employees
Maximum Benefit	$250,000
Minimum Benefit	$10,000
Guarantee Issue	$150,000
Increments
Life Amount for Spouse
Maximum Benefit	$150,000
Minimum Benefit	$10,000
Guarantee Issue	$100,000
Increments
Life Amount for Child(ren)
Maximum Benefit	$150,000
Minimum Benefit	$10,000
Guarantee Issue	$50,000
Increments
Comments

File details come from the government source that posted it. Updated Jul 2, 2025.