2027 Technical Submittal.docx

RFP 6100062977

Technical Submittal

THIRD-PARTY ADMINISTRATOR FOR FLEXIBLE SPENDING ACCOUNT TECHNICAL SUBMITTAL

Background. The Commonwealth of Pennsylvania offers its Eligible Employees, as defined by Commonwealth of Pennsylvania Section 125 Plan Document (Appendix A, Plan Document), the option to pay medical care expenses and dependent care expenses on a before-tax basis via a new Flexible Spending Account (FSA) plan.

The Commonwealth currently administers and manages a Dependent Care Reimbursement Account (DCAP) for approximately 750 of the 16,000 Commonwealth employees eligible to participate in the DCAP. In Addition, the Commonwealth currently offers a Medical Reimbursement Account (FSA) to approximately 6,600 of the 73,000 Commonwealth employees who are eligible to participate in an FSA. Additionally, the Treasury Department, State Public School Building Authority and Thaddeus Stevens College of Technology are also participating; accounting for approximately 400 additional employees. These numbers are provided as estimates only and are not a guarantee of the number of Participants and/or Eligible Employees. At any time during the Term of the Contract and any subsequent renewals, the number of Eligible Employees and Participants, as defined in Appendix A, Plan Document, located in the Buyer Attachments, may vary.

On behalf of the Commonwealth of Pennsylvania, the Office of Administration, Bureau of Employee Benefits (BEB) is procuring a Third-Party Administrator (TPA) to administer the FSA and DCAP Plan Year 2027 and beyond, including any development, implementation, enrollment, and transfer of any existing participants. Both the FSA and DCAP accounts shall be administered in accordance with Appendix A, Plan Document, located in the Buyer Attachments and applicable sections of the Internal Revenue Code (IRC) of 1986, Section 125. The BEB shall be responsible for Contract and program oversight of the FSA and DCAP.

I. Objective.

A. General. The selected Offeror will be the TPA for both the FSA and DCAP offered to Eligible Employees. The enrollment, administration, and management of the FSA and DCAP shall be provided by the selected Offeror.

B. Specific. The overall goals of the contract resulting from this RFP (Contract) are to:

1. Enhance the available benefits to attract and retain employees;

2. Increase participation in pre-tax savings accounts;

3. Minimize the Commonwealth’s administrative costs and labor;

4. Provide simple and accessible web-based and mobile technology; and

5. Implement a communication strategy that addresses a workforce that is diverse in demographics, education, and technology usage.

Offeror shall acknowledge its understanding of these objectives.

II. Statement of the Project. State in succinct terms your understanding of the project presented, or the service required by this RFP.

Offeror Response

III. Qualifications.

A. Company Overview. Offeror shall provide, at minimum, a five (5) year historical purview of their Company. Offeror shall describe its corporate identity, including name, address, telephone number, website and email address for the legal entity with whom the Contract will be written. In addition, identify the office(s) that will be used to service this program, including the address for each office and the number of years in which the office servicing this program has been administering FSAs and DCAP accounts. Include a corporate organizational chart. The Offeror shall provide similar organizational background information for any subcontractors (exclusive or affiliates). If an Offeror is proposing to use the services or subsidiaries or affiliated firms, the Offeror shall describe the business arrangement with that entity and the scope of the services to be provided by that entity.

Offeror Response

B. Financial Capability. Describe your company’s financial stability and economic capability to perform the Contract requirements. The Commonwealth reserves the right to request additional information to evaluate an Offeror’s financial capability.

Offeror Response

C. Prior Experience. Offeror shall describe their experience in the following:

1. Member services to a client with a minimum of 50,000 eligible employee participants;

2. Work with public sector FSA and DCAP accounts;

3. Work with unionized workforce;

4. Three (3) years of experience as a TPA in the implementation and management of employee funded FSA and DCAP accounts, to include Consolidated Omnibus Budget Reconciliation Act (COBRA) services; and

5. Providing TPA services for multiple FSA and DCAP accounts.

Offeror Response

D. Contract Experience. Offeror shall specify up to three (3) contracts that are similar in size, scope and geographic diversity to that of the Commonwealth, in which their company is presently under contract as the prime contractor to provide TPA services for multiple FSA and DCAP accounts, substantially similar to those described in Appendix A, Plan Document, located in the Buyer Attachments. Offeror shall include the contract duration, contract value, number of Participants, summary of the services offered, and specific types of services (customer service, claims support, appeals processing, enrollment, COBRA, etc.). Offeror should provide any additional experience that they would like considered.

Offeror Response

E. Contract Cancellations, Terminations and Litigations. Offeror shall describe and identify any contract cancellations/terminations/non-renewals within the three (3) years immediately preceding the issuance of this RFP where the number of Eligible Employees was greater than 50,000. Provide details on the customer’s rationale for cancelling or not renewing the contract and the Offeror’s position relevant to the rationale.

Offeror Response

F. Personnel. The Offeror shall complete Appendix B, Personnel Listing and Experience by Position, located in the Buyer Attachments, in its entirety and submit with their technical response. In addition, each description of each role in administering FSAs relative to customer service, claims, account management, etc., and assigned responsibilities for this project shall include specific duties during implementation and the ongoing administration of this project.

1. Key Personnel. Key personnel shall be identified as the primary contacts for each of the business areas identified in this RFP. At a minimum, the Offeror shall designate, as part of its staffing plan, the following Key Personnel.

a. Account Executive. Individual who will serve as the representative of senior management and who will have final authority and accountability in resolution of any issues or disputes. This person should hold the title of Senior Vice President or higher.

b. Account Manager. Individual who will serve as the daily contact for BEB and will manage the implementation and continued oversight of the project. Individual in this position, or their designee, must respond within 24 business hours of initial contact from the Commonwealth. Individual in this position shall be knowledgeable and ready to provide assistance with the website, mobile application and reporting systems. Individual in this position shall have a minimum of two (2) years of professional experience as an Account Manager with the Offeror and working with accounts on a project similar in size and scope of the project identified in this RFP.

c. Implementation Manager. Individual who shall be responsible for overseeing the implementation in accordance with the Contract resulting from this RFP. Implementation Manager will also be responsible for ensuring that all key milestones are accomplished in accordance with the timeline identified in the implementation plan for successful operation of the FSA as well as managing the Implementation Team. Individual in this position shall have a minimum of two (2) of professional experience as an Implementation Manager with the Offeror and working with clients on a project similar in size and scope as identified in this RFP. The Implementation Manager cannot be the Account Manager or Account Representatives.

d. Customer Service Manager(s). Individual(s) who will manage the staff that will be responsible for enrollment, claims resolution, and Participant inquiries. Individual in this position shall have a minimum of three (3) years of professional experience as a Customer Service Manager with the Offeror and working with clients on a project similar in size and scope as identified in this RFP.

e. Information Technology Manager. Individual who will manage the staff that will be responsible for interface file testing, website and mobile application deployment, and BEB administrative access to systems.

f. Accounting Representative(s). Individual(s) who will be responsible for all financial accounting related duties such as, but not limited to, monthly invoicing, credits and account reconciliation for both the individual Participants in the FSA and overall account balance.

Offeror Response

2. Additional Personnel. Individuals, other than key personnel listed above, will provide additional services related to this project including, but not limited to:

a. Account Representative(s). Individual(s) who report to the Account Manager that will be responsible for the resolution of issues/disputes and the daily administration of the account. Account Representatives shall have at least two (2) years of professional experience working with clients on projects of similar size and scope identified in this RFP.

b. Customer Service Supervisory Team. Individuals who report to the Customer Service Manager, and who supervise the day-to-day operations of the Customer Service Center and are able to assist with call and claims reporting as requested by the Commonwealth.

c. Implementation Team. Individual(s) who will report to the Implementation Manager and will be responsible for conducting the day-to-day tasks, as outlined in the Implementation Plan, required during the implementation phase of the project. The implementation team shall also include the Account Manager to ensure Commonwealth requests and policy are followed once we’ve gone live.

d. Open Enrollment Team(s). Individual(s) who will be responsible for managing Open Enrollment meetings and assisting Participants during the Open Enrollment process as outlined in Subsection V.C, Enrollment.

e. Information Technology Team. Individual(s) who will be the day-to-day contacts for interface file testing, website and mobile application deployment, and BEB administrative access to systems.

f. Marketing and Promotions Team. Individual(s) who will be responsible for the development of Commonwealth-specific marketing materials including, but not limited to, how-to guides, videos, posters, e-mails, home mailings, etc.

Offeror Response

3. Subcontractors. Provide a subcontracting plan for all subcontractors, including small diverse business and small business subcontractors, who will be assigned to the project. The selected Offeror is prohibited from subcontracting or outsourcing any part of this project without the express written approval from the Commonwealth. Upon award of the contract resulting from this RFP, subcontractors included in the proposal submission are deemed approved. For each position included in your subcontracting plan provide:

a. Name of subcontractor;

b. Primary contact name and email;

c. Address of subcontractor;

d. Description of services to be performed;

e. Provide the work experience of the subcontractor related to the services the subcontractor will perform;

f. Indicate key personnel of the subcontractor(s) who will be assigned to the subcontracted work, the personnel’s experience related to the work to be conducted by the subcontractor and how long subcontractor personnel have been working in their area of expertise;

g. Resumes (or other similar document) of personnel in Offeror’s subcontractor to include the employees’ names, education and experience in the services outlined in this RFP. The information provided shall also indicate the responsibilities each individual will have in this Project and how long each has been with subcontractor’s company; and

h. Number of employees by job category assigned to this project.

Offeror Response

4. Personnel Vacancies. The selected Offeror shall fill any key and/or subcontractor position vacancies within four (4) weeks of the position being vacated. If a position identified as key becomes vacant, the selected Offeror shall appoint and identify an individual in an acting capacity immediately until the position is filled. BEB has approval authority for all key positions, acting and permanent. Offeror shall acknowledge acceptance of this criteria.

Offeror Response

5. Removal of Personnel. BEB retains the right to order the removal of any selected Offeror and/or subcontractor personnel from this project, or from performing any service under this contract. The Commonwealth will not be responsible for any costs incurred by the selected Offeror and/or its subcontractors in replacing personnel if good cause exists. Offeror shall acknowledge acceptance of this criteria.

Offeror Response

IV. Requirements. Offeror shall acknowledge or describe its ability to meet each requirement listed below and, if applicable, describe any relevant experience and qualifications, which supports the response.

A. Compliance. The selected Offeror shall provide all services in accordance with the policies, procedures and standards of the Commonwealth as well as comply with, and maintain compliance with, all applicable local, state and federal regulations and requirements listed below.

1. Commonwealth of Pennsylvania Section 125 Plan. The Plan Document, located in the Buyer Attachments as Appendix A, Plan Document, provides the eligibility and program requirements. The selected Offeror shall administer the Dependent Care Reimbursement Plan and the Medical Reimbursement Plan that is described in Appendix A, Plan Document. Deviations to Appendix A, Plan Document, will not be considered unless required by the Internal Revenue Code. The Commonwealth reserves the right to unilaterally revise Appendix A, Plan Document, with respect to eligibility of employees and Participants.

2. Changes to Appendix A, Plan Document, Legislation or Collective Bargaining Agreements. Changes to Appendix A, Plan Document, legislation, regulations or collective bargaining agreements that require modifications to the tasks of the Contract are subject to CONTRACT-035.1b Changes (Oct 2013) of Appendix C, Contract Terms and Conditions, located in the Buyer Attachments. The selected Offeror and the Commonwealth will work in good faith to negotiate necessary changes to the Contract.

3. Internal Revenue Code of 1986, Section 125, 26 U.S. Code § 125.

4. Internal Revenue Service (IRS) Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans. Information regarding this document can be found at the following link: IRS Publication 969.

5. Health Insurance Portability and Accountability Act (HIPAA). The selected Offeror shall comply with all federal and state laws related to the use and disclosure of information, including information that constitutes Protected Health Information (PHI) as defined by HIPAA.

The Offeror shall be responsible for presenting to BEB a detailed action plan to ensure compliance with HIPAA regulations and assist BEB in planning, developing, and adhering to HIPAA requirements.

The selected Offeror shall be responsible for assessing its obligations pursuant to HIPAA and will include such assessment in its technical proposal. The selected Offeror will be required to execute a Business Associates Agreement, located in Appendix C, Contract Terms and Conditions of the Buyer Attachments.

6. Non-discrimination Testing (NDT). The selected Offeror shall conduct NDT testing annually in March for both the FSA and DCAP plans in accordance with federal laws and regulations.

Offeror shall acknowledge its understanding and compliance with each of the requirements in Section IV. Requirements. A. Compliance.

B. Information Technology (IT) Requirements.

1. Non-Commonwealth Hosting.

a. The selected Offeror shall meet the hosting requirements outlined in Exhibit B, Requirements for Non-Commonwealth Hosted Applications/Services, located in Appendix C, Contract Terms and Conditions of the Buyer Attachments.

Offeror Response

b. IT Vendor Risk Assessment. The Offeror shall undergo an IT Vendor Risk Assessment review to evaluate the Security and Compliance posture of the offeror. In support of the review, the Offeror should submit the following documents and information. The more information provided will allow for a timely, accurate IT Vendor Risk Assessment.

i. A SOC1 Type II.

ii. All of the following, if available, a SOC2 Type II, ISO 27001 certification, Standard Information Gathering (SIG) questionnaire and other relevant security documentation.

iii. StateRAMP or FedRAMP certificates.

iv. Offeror’s Information Security Policy.

v. Offeror’s penetration testing summary results.

vi. Any other relevant information pertaining to the Offeror’s Security & Compliance programs that would be helpful in evaluating how Offeror manages security for their customers.

Offeror Response

2. Digital Accessibility. The Offeror shall meet Commonwealth accessibility standards as described in Appendix D, Digital Accessibility Requirements Supplier-Built Websites and Applications, including the completion of Appendix F, Policy Driven Adoption for Accessibility Assessment (PDAA Assessment) and an Accessibility Conformance Report (ACR), as required in Appendix D, Digital Accessibility Requirements Supplier-Built Websites and Applications.

Offeror Response

3. Webservices Requirements. To provide the services, data must be exchanged between the Commonwealth and the selected Offeror. The selected Offeror shall meet the following information technology requirements:

a. The selected Offeror shall integrate through a webservice with the Commonwealth’s SAP system, which will be utilized to share data.

b. All data will be exchanged using standard APIs with the Commonwealth’s SAP system. The Commonwealth is modernizing its data management practices and will not build custom integrations to our ERP, nor conduct file data exchanges.

c. The Commonwealth will not provide any data elements that are not already available in the Commonwealth’s SAP system. In addition, there will be no modifications made to the Commonwealth’s SAP system at the request of the selected Offeror, unless required by federal or state law or regulations. The selected Offeror must be able to accommodate webservices and apply transactions in accordance with established API specifications through the webservice, as agreed upon during the requirement discussions with the selected Offeror during implementation. Any changes to the selected Offeror’s system that require a programming change shall not be charged to the Commonwealth or participant and will be the sole responsibility of the selected Offeror.

d. All data exchanged in the integration(s) between the Commonwealth and the selected Offeror shall be encrypted both at rest and in transit. The selected Offeror shall implement appropriate technical and organizational measures and controls to ensure a level of security appropriate to the risk and shall comply with applicable standards. In the event of any conflicts between the Commonwealth and the selected Offeror’s policies/standards, the most comprehensive, restrictive, or effective measures and controls shall prevail. In the absence of any defined appropriate measures and controls, the selected Offeror shall align with security best practices as identified by standards bodies such as the National Institutes of Standards and Technology or SOC2 compliance standards.

e. Successful system end-to-end testing between the selected Offeror and the Commonwealth shall be completed no later than September 1, 2026. All testing shall be conducted in a secure, non-production environment that simulates the production environment. The non-production environment shall be capable of, but not be limited to, testing, quality assurance, user acceptance testing, as well as processing the webservice.

f. The selected Offeror shall be required to utilize webservices for Outbound Deduction Remittance, Inbound Payroll Deduction, and Benefits Eligibility and Activity. The following integrations will be established:

i. Outbound Deduction Remittance Webservice. The Commonwealth will deduct payments on a biweekly basis and these payments will be held in a designated account. The payroll data will be made available to the selected Offeror via the established webservice.

ii. Eligibility and Activity Webservice. The selected Offeror shall accept eligibility and activity information from the Commonwealth via the established webservice. The eligibility data will contain all employees eligible for the program. The activity data will provide the actions that resulted and the reason for changes to the eligibility data. The following are non-exhaustive examples of actions reflected by the activity data:

a) A newly hired employee appearing for the first time on the eligibility data webservice will be reflected on the activity data with a new hire action; or

b) An employee retiring from Commonwealth employment will appear on the activity data webservice with a separation action and will cease to appear on the eligibility data.

iii. Inbound Deductions Interface webservice. The selected Offeror shall send enrollment and deductions data via a web-service to the Commonwealth, which will be used by the Commonwealth to establish and maintain payroll deductions. The inbound data must include all Participants with their current payroll deduction amount. The selected Offeror will be required to send individual or multiple participant data through a specific webservice call as determined by the Commonwealth. The response of the webservice will indicate success or failure of the webservice call. In the event of failures, the Offeror will be required to reattempt the webservice as required by the Commonwealth. The Offeror shall provide a summary report of the overall success and or failures of the webservice to the Commonwealth. The Offeror shall notify the Commonwealth of any Participant-initiated changes no later than the week following the week in which the Participant notified the Offeror. If the payroll deduction is to be canceled, the selected Offeror will send a deduction amount of zero on the inbound webservice deduction data once and then no longer include the Participant on subsequent webservice deduction data.

g. All data at the time of webservice call will be representative of the most recent updates made within the systems. Frequency of the webservice calls for data will be determined during requirements gathering.

h. During the term of this procurement, the Commonwealth anticipates transitioning to a platform that provides for an integrated benefit decision support and enrollment platform. In the event such platform is integrated by the Commonwealth, the selected Offeror shall be required to support the following:

i. Seamless Account Initiation. The webservice or integration that transmits enrollment data from the platform to the selected Offeror shall initiate the account automatically, without requiring any additional steps from the employee.

ii. Real-Time Data Access. The selected Offeror shall be able to expose an API that delivers claims submission and account balance data to the platform.

i. The Treasury Department, State Public School Building Authority and Thaddeus Stevens College of Technology have separate payroll systems; PeopleSoft North American, Sage 100 and Sage Abra, respectively. The selected Offeror must interface with each of these systems, as necessary, in order to establish, maintain, and enter payroll deductions accurately.

j. Please describe your capabilities to utilize APIs for eligibility, enrollment, and payroll interfaces.

Offeror Response

k. Offeror shall include in their technical response the minimum necessary fields needed to process the FSAs.

Offeror Response

4. The Commonwealth anticipates the selected vendor will provide bulk email services for employee outreach and notification related to the benefits provided through this contract. These communications should be coordinated with the Commonwealth, and the vendor may be required to send email campaigns using COPA approved branding, messaging, and contact lists. The vendor shall handle email campaign creation and scheduling, recipient list management, deliverability optimization, performance tracking, and reporting as part of this contract. List management must be in compliance with applicable privacy and consumer laws respecting recipient privacy and allowing for recipient opt-out where applicable.

The technologies used must facilitate the vendor sending bulk emails on behalf of the Commonwealth’s domain (@pa.gov) in a secure and authorized manner that would not degrade the Commonwealth’s online cyber-reputation. Example technologies used to mitigate that risk may include support for Sender Policy Framework, DomainKeys Identified Mail, dedicated sender IP pools, or reputable/capable third-party bulk email distribution services that meet these requirements. The vendor will be required to work with the Commonwealth Office of Information Technology in partnership for implementation.

Offeror Response

C. The selected Offeror shall require that support service calls related to the contract resulting from this RFP be conducted within the United States.

Offeror shall acknowledge its understanding and acceptance of these requirements.

D. The selected Offeror shall not, directly or indirectly, use Participants’ data for solicitation of additional insurance benefits that are not identified in this RFP or on another Commonwealth contract.

Offeror shall acknowledge its understanding and acceptance of this requirement.

E. Disaster Recovery (DR) Plan. The selected Offeror shall provide a comprehensive DR plan for electronic records, equipment, data, files, and all other resources necessary to maintain business operations supported by the solution. The Offeror shall include a copy of its DR Plan with its proposal for evaluation purposes. A finalized DR Plan shall be due within 60 calendar days after the purchase order effective date and must be updated annually. The Offeror shall provide the following information in relation to the DR Plan:

1. How, by whom, and how often its DR plan will be tested.

2. How its DR test plans support compliance with the required system availability.

3. The approach to backing up the infrastructure to provide for continuity of operations.

4. Results of the most recent DR test, including, but not limited to the following:

a. The implementation playbook of how disaster recovery was tested.

b. Measurements against requirements and actual times observed in testing:

· Recovery Point Objective (RPO) in hours.

· Recovery Time Objective (RTO) in hours.

· Work Recover Time (WRT) in hours.

· Maximum Tolerable Downtime (MTD) in hours.

c. A list of all defects found in the disaster recovery process with action items and actual times to resolve each defect found.

Offeror Response

F. Emergency Preparedness. To support the continuity of operations during an emergency, the Commonwealth needs a strategy for maintaining operations for an extended time. One part of this strategy is to ensure that essential contracts that provide critical business services to the Commonwealth have planned for such an emergency and put contingencies in place to provide needed goods and services.

1. The Offeror shall describe how such a crisis will impact its operations.

2. The Offeror shall describe its emergency response continuity of operations plan. Attach a copy of the plan, or at a minimum, summarize how the plan addresses the following aspects of pandemic preparedness:

a. Employee training (describe the organization’s training plan, and how frequently the plan will be shared with employees);

b. Identified essential business functions and key employees (within the organization) necessary to carry them out;

c. Contingency plans for:

i. How the organization will handle staffing issues when a portion of key employees are incapacitated due to illness;

ii. How employees in the organization will carry out the essential functions if contagion control measures prevent them from coming to the primary workplace.

d. How the organization will communicate with staff and suppliers when primary communications systems are overloaded or otherwise fail, including key contacts, chain of communications (including suppliers), etc. and;

e. How and when the emergency plan will be tested, and if the plan will be tested by a third party.

Offeror Response

V. Tasks. Offeror shall describe their technical plan for accomplishing the work using the task descriptions set forth below as a reference point. Modifications of the task descriptions are permitted; however, reasons for changes should be fully explained. A full project plan description is required and not just a restatement of the tasks listed below. The project plan shall provide specific information detailing the overall services related to the administration of the FSA as explained in this RFP.

For each task in this RFP, the Offeror shall specify all associated procedures, timeframes, processes and performance standards. Be specific about any thresholds or events which trigger subsequent actions. Explain how timeframes will be met. State how compliance with the IRC, federal and state statutes and regulations will occur. Explain the tools, templates, or worksheets utilized to accomplish the tasks. When applicable, detail procedures for completing and submitting forms and providing documentation to the Program Manager in BEB, as specified in this RFP. Include diagrams or flow charts to explain processes when needed. Outline, where applicable, oversight and monitoring procedures in place to ensure timely, accurate, and effective accomplishment of tasks. Indicate which, if any, tasks below will be provided through subcontractor(s).

A. Implementation. The selected Offeror shall ensure a seamless implementation of all services by the dates outlined in this RFP and the FSAs shall be available to Participants on January 1, 2027.

1. Implementation Plan. Within seven (7) business days of a fully executed Contract, the selected Offeror shall provide a revised implementation plan, including a detailed project plan and timeline, that addresses the major milestones in order to meet the tasks and requirements identified in this RFP.

The selected Offeror shall meet with the BEB to review potential technical and logistical issues of the proposed implementation plan. Based on the feedback received by the BEB, the selected Offeror shall submit a finalized implementation plan. The selected Offeror and the BEB will jointly agree to a final implementation plan.

Offeror shall provide a draft implementation plan with their response. The draft implementation plan shall assume that Open Enrollment will be the third week of October 2026 and last three weeks. The draft implementation plan shall be detailed enough to ensure implementation is completed in time for uninterrupted services to plan Participants and meets all requirements as specified in the RFP.

Offeror Response

2. Implementation Meetings and Reports. The selected Offeror shall hold weekly meetings with BEB and submit weekly reports during the implementation phase updating BEB on the status of the implementation. Each weekly report must include the following sections:

a. A weekly review of the tasks that were expected to be completed within that period;

b. Tasks that were completed in the respective period;

c. Tasks not completed in the respective period and provide the reason;

d. Details on how the selected Offeror will complete incomplete tasks to meet the required implementation schedule; and

e. An updated list of the tasks that are expected to be completed during the next period;

f. Days projected to complete each remaining task and who is responsible for each task.

Offeror Response

B. Communication. The selected Offeror shall be responsible for providing custom communications materials and notifications to Eligible Employees regarding, but not limited to, FSA/DCAP handbook, website, mobile application, guides for navigating website and mobile application, benefits of participation, outreach events; vendor transfer FAQs; educational webinars, and open enrollment. The selected Offeror shall be responsible for all costs associated with the creation, production, distribution and storage of communication materials as outlined in this RFP.

1. Communication Branding and Approvals. The selected Offeror shall use the Commonwealth logo and program identification on all materials and correspondence sent to applicants and enrollees. Three weeks prior to distribution, the selected Offeror shall submit all draft communication materials for review and approval. The selected Offeror shall review all communications on an annual basis and as required when there are any changes to items identified in Section IV. Requirements. A. Compliance.

Offeror shall acknowledge its understanding and acceptance of this requirement.

2. Program Announcement. Program announcement is the initial set of communications to Participants (addressing transition of benefits) and Eligible Employees (those not currently enrolled in the program.

Offeror Response

3. Initial Open Enrollment. The program’s initial Open Enrollment under this Contract will begin the third week of October 2026 through the first week of November 2026. The Offeror’s communication plan shall identify the communication strategy for Initial Open Enrollment.

Offeror Response

4. Annual Open Enrollment. The Annual Open Enrollment will be the third week of October and continue for three consecutive weeks. The Offeror’s communication plan shall identify the communication strategy for the Annual Open Enrollment and address how the Offeror will incorporate the results of the previous Open Enrollment.

Offeror Response

5. Newly Eligible Employees. The Offeror’s communication plan shall identify the strategy for communicating the availability and benefit of the FSA and DCAP to new Eligible Employees.

Offeror Response

6. Participant Communications. The Offeror’s response shall address individual Participant communications that include but are not limited to requests for documentation (initial and subsequent requests), debit card suspension notices, termination notices, spend down alerts, excess balance alerts, claim status change alerts, payment completion notices, Handbook, website and mobile application updates, etc.

a. Termination Notices. The selected Offeror shall be responsible to develop and issue standard termination notices to individuals whose participation in DCAP shall be terminated. Termination notices shall include, at minimum, the effective date of termination and an explanation/reason for termination. Termination notices shall be issued no later than three (3) business days from receipt of completed Change in Status form or upon separation as reported on the activity file. Offeror shall describe their termination notice distribution process.

Offeror Response

b. Account Balances and Claims. The selected Offeror shall provide samples of all FSA and DCAP related electronic and paper forms related to claims and account balances. At a minimum, the Offeror response shall include and address the following:

i. Claim Submission. FSA and DCAP paper forms, Letter of Medical Necessity.

Offeror Response

ii. Claim Status. For paper forms (non-debit card), the selected Offeror shall describe how Participants can confirm the claim status; including but not limited to:

· Receipt of claim within 24-hours of claim submission;

· Claim approval/denial;

· Reason for denial if denied and

· How to amend the denied claim.

Offeror Response

iii. Claim Payments. Notification to Participants when payments have been processed. Notification shall include, but not be limited to, claim number, date payment issued, who payment was issued to, method of reimbursement (check, direct deposit, etc.), and amount of reimbursement.

Offeror Response

iv. Account Summary Statements. Including but not limited to contributions, deductions/reimbursements, pending transactions, and account balance.

Offeror Response

v. Remaining Balance Notification. Notifications to Participants to submit claims for account balances. A minimum of two (2) notifications must be provided. The Offerors response should include their standard notification process and frequency.

Offeror Response

7. Participant Handbook for FSA and DCAP. The selected Offeror shall provide the Participant Handbook for FSA and DCAP, which must provide information on eligibility, benefit plan design (in accordance with Appendix A, Plan Document, located in the Buyer Attachments, and applicable provisions of IRC Section 125), included and excluded services, and program requirements (i.e. receipts, claim substantiation situations).

Offeror Response

8. Website and Mobile Application Guide. The selected Offeror shall provide a user guide that explains the various functions that are available for Participants. This will include but is not limited to enrollment, claim status, claim submission, claims approved, establishment of ACH transfer, etc. The user guide can be a printable pdf file or embedded into the website.

Offeror Response

C. Carryover Transfer. Appendix A, Plan Document, located in the Buyer Attachments, provides for a Carryover of up to $300. The Offeror will be required to update Participant accounts with the Carryover amounts received from the 2026 Plan Year. The file will be received in April 2027. The Offeror shall describe their plan for transitioning the Carryover amounts from the current vendor. The Offeror’s response should include any requirements, including data elements and method for receiving the information.

Offeror Response

D. Enrollment. The selected Offeror shall conduct, in cooperation with BEB, all Participant enrollment processes (open, new/changes/terminations) for both the FSA and DCAP. Enrollment processes shall be in accordance with Appendix A, Plan Document, located in the Buyer Attachments and IRS regulations as outlined in Subsection IV.A, above.

1. Open Enrollment. The selected Offeror shall be responsible for conducting an annual open enrollment period for Eligible Employees. Open Enrollment period shall begin, no later than, the third Monday of October and last three weeks of each calendar year for services beginning January 1st of the subsequent year. The selected Offeror shall:

a. Process all enrollments made during the open enrollment period;

b. Communicate applicable payroll deductions through webservices as described in Paragraph IV.B.4, Webservices Requirements; and

c. Participate in three onsite events for each open enrollment. The date and location of the events are to be determined by the Commonwealth.

Offeror Response

2. New Enrollment/Changes/Terminations. The selected Offeror shall be responsible for accepting and processing enrollments for new hires and/or completing participation changes for Participants due to qualifying events such as, but not limited to, changes in deduction amounts, Participant termination or removal from the program due to ineligibility, and the transition of active Participants to retired status as appropriate. Offeror shall describe:

a. The process they intend to use to accept enrollments during open enrollment as well as for new hires and/or qualifying events, including, but not limited to, the methods by which an employee may enroll (paper, online, etc.), verifying eligibility of the enrolling employee, and establishing necessary account records for accurate processing; and

b. The process when an employee is on a long-term unpaid leave of absence or other situations where there is insufficient pay to take deductions. Please note that a long-term unpaid leave of absence, is greater than one full pay period and can last up to one year. Response should address pre-scheduled leave and situations where there is no advance notice. Response should address FSA and DCAP separately.

Offeror Response

E. Debit Card. The selected Offeror shall provide a customized preloaded debit card to all FSA Participants for payment of eligible healthcare expenses. The selected Offeror shall issue a customized debit card to newly enrolled FSA Participants no later than December 15th of the FSA Participants’ enrollment year. FSA Participants requiring a new or replacement debit card due to one of the following reasons: new hire, life changing event, lost/stolen/compromised, etc., shall be issued a debit card within 10 business days of written notification to the selected Offeror. The selected Offeror shall provide all debit cards (new, reissued, replacement, etc.) at no additional cost to FSA Participants or the Commonwealth. Offeror shall describe, at a minimum, their process, procedures and timelines for the following:

· Creation of customized preloaded debit card;

· Issuance of debit cards to Participants (open enrollment, new hires, life changing events, etc.);

· Replacement debit cards (wear and tear, name change, etc.);

· Lost/stolen/compromised debit cards;

· Emergency debit card issuance/replacement;

· Email communication to Participants when card enters suspended status or when other global debit card issues arise;

· Card termination (either by selected Offeror or the BEB);

· Card controls and restrictions (i.e. card spending limits, transaction limits, provider restrictions, card activation, etc.); and

· If using a debit card vendor, describe their customer service, and turnaround times for the items listed above.

The BEB reserves the right to eliminate or suspend the use of debit cards throughout the initial term of the Contract and all subsequent renewals.

Offeror Response

F. Training. The selected Offeror shall have a comprehensive training program to meet the needs of the RFP. The selected Offeror is responsible for developing, conducting and managing all the training requirements in this RFP, unless otherwise noted. Training shall include, but not be limited to, the following:

1. Program Overview. The Offeror will be responsible for providing a training plan for the Commonwealth’s benefits staff. The training will be limited to a one (1) day training with a maximum of four (4), 1-hour sessions. Training shall be online using MS Teams, or Zoom. The training curriculum shall consist of, but not be limited to, an overview of the following:

· FSA and DCAP;

· The benefits of using a FSA and DCAP;

· Enrollment process for the FSA and DCAP; and

· Types of care and procedures covered under a FSA and DCAP.

· Overview of federal and state laws and regulations that govern the FSA and DCAP programs.

Offeror shall include a sample training plan in their response for the Program Overview.

2. Administration of the Program. Offeror shall recommend administrative training for the BEB staff. The Offeror’s response shall include the duration of the program, curricula, training materials to be used, number and frequency of sessions, and number and level of instructors. For web-based training programs, provide as part of its proposal a user id and password that can be used during the RFP process and throughout the implementation period to review materials. Additionally, the training shall address, at minimum, the following:

· Client-side website use;

· Reporting Systems; accessing reporting system; running reports, setting reoccurring reports; process to request a specialized report;

· Individual claims statuses;

· Case Management System.

· Reviewing calls

· Reviewing notes

Offeror shall include in their response a sample training plan the Administration of the Program.

G. Customer Service Support for Participants. The Commonwealth is committed to meeting the needs of Eligible Employees, Participants and their Dependents by providing the information and assistance needed for the enrollment and receipt of services related to the FSA and DCAP as well as account information and problem resolution. Support services shall be compliant with all applicable statutes and regulations governing these programs, including, but not limited to IRS Publication 969.

The selected Offeror shall provide and maintain a customer service support center that administers a toll-free customer service help line staffed by a team of customer service representatives to support the needs of Eligible Employees, FSA Participants and their Dependents. The customer service support center shall, at a minimum, be available from Monday through Friday during the normal business hours of 7:30 am ET to 5 pm ET. During Open Enrollment, customer service support, shall, at a minimum, be available from Monday through Friday from 7 am ET to 7 pm ET. The toll-free customer service help line shall include a system that allows potential Participants, Participants and Dependents to easily and efficiently navigate the phone tree to reach the appropriate agent to assist them. The system shall handle large call volumes and include voice messaging that is available during peak call times and non-operational hours when a customer service team member is not available to take the call. The voice messaging feature should be capable of storing voice messages for up to 90 calendar days from the date of messaging. The selected offeror shall be responsible for ensuring that all messages left through the voice messaging are responded to by an appropriate customer service team member within 24 hours. During Open Enrollment, the selected Offeror shall respond to all messages left through the voice messaging within 24 business hours.

The customer service team members shall be trained and proficient in providing information regarding, but not limited, to the following in accordance with applicable documents, statutes, and regulations identified in Section IV. A. Compliance; including Commonwealth-specific requirements in Appendix A, Plan Document.

· General benefits;

· Eligibility;

· Enrollment processes;

· Counseling on the amount to be placed within an FSA or DCAP;

· Counseling on the types of claims/services an FSA or DCAP may be used for;

· Claim submission inquiries;

· Claim status inquiries;

· Submitted documentation review;

· Account balance inquiries;

· Explanation of forfeiture and timing of such forfeiture;

· Explanation of grace period/carry over; and

· Options upon separation from employment.

The selected Offeror shall record 100% of all incoming and outgoing calls related to the Contract resulting from this RFP and provide sufficient notice to persons calling that the call will be recorded and that shall be documented in a manner that provides proof of consent by the person calling in to the support service center. In addition, the selected Offer shall collect data regarding the incoming and outgoing calls that includes logging, tracking and reporting telephone service performance areas, such as call volume, response time, live answer rate, length of time in queue, length of time on hold, and abandonment rate. The selected Offeror shall retain audio recordings of all calls for a minimum of three (3) years as well as provide the BEB with recordings or transcripts, upon request.

Offeror shall describe how they will:

1. Provide support services, identified in this RFP, while maintaining compliance with applicable statutes and regulations governing FSA and DCAP programs. Response shall include, but not be limited to, additional support services such as online-chat capabilities, mobile applications, or other electronic methods that can be provided;

The Offeror shall provide a separate response for each item in this section.

2. Provide and maintain a customer service support center. Description shall include location of customer service support center, hours of operation, and number of customer service team members dedicated to providing the services as described. Additionally, Offeror shall include the support centers call abandon rate, average length of call, average response time, and unscheduled down time for the last four (4) business quarters;

The Offeror shall provide a separate response for each item in this section.

3. Provide a toll-free number. Description phone system and any special facilities (TDD, TTY, etc.) available for the hearing impaired. The Offeror’s response shall include a sample phone system tree and the process for how and when calls are transferred from the phone system to a customer service team member;

The Offeror shall provide a separate response for each item in this section.

4. Process calls received after identified business hours and during peak call times. Include the procedures for overflow of calls to an alternate call center in the Offeror’s response;

The Offeror shall provide a separate response for each item in this section.

5. Increase customer service team members during peak call times, including but not limited to Open Enrollment and February and March for the run-out period. Description shall include what preventive steps are taken to prepare for these time periods, what happens during these time periods when increased staffing is insufficient, extension of call center hours, and the Offerors ability to add additional customer service team members in real time;

The Offeror shall provide a separate response for each item in this section.

6. Train the customer service team members to meet the needs of this RFP and their process for ensuring that the customer service team members remain proficient in meeting the needs of the Participants;

The Offeror shall provide a separate response for each item in this section.

7. Provide Participants with guidance and assistance on payroll deduction, account balance, and claim submission/status inquiries; and

The Offeror shall provide a separate response for each…