230000000074.pdf

320 S Walnut Street Lansing, MI 48933 P.O. Box 30026, Lansing, MI 48909

STATE OF MICHIGAN PROCUREMENT

Department Technology, Management and Budget Central Procurement Services

CONTRACT CHANGE NOTICE

CONTRACT SUMMARY

Medicaid Actuarial Services

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

March 1, 2023 February 28, 2026 2 - 1 Year February 28, 2026

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other Yes No

10 W Market Street, STE 1600

Indianapolis IN 46204

Paul Houchens

317-524-3523

Paul.Houchens@milliman.com

CV0066136

MILLIMAN USA INC

C O

N

TR

A C

TO

R

Mary Ostrowski

(517) 249-0438

DTMB

Various Various

OstrowskiM@michigan.gov

C on tr ac t A dm in is tr at or

Pr og ra m

M an ag er

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N/ANET 45

Change Notice Number 7 to

Contract Number 230000000074

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

2 Years February 28, 2028

$17,018,274.00 $31,800,000.00 $48,818,274.00

DESCRIPTION

Please note the Program Manager or Contract Administrator may have changed, and are reflected on this Change Notice.

Effective December 17, 2025, this Contract is exercising two option years and is increased by $31,800,000.00. The revised contract expiration date is February 28, 2028. In addition, this Contract is amended to reflect updated accessibility standards. All prior references to ADA, Accessibility, and/or WCAG 2.0 are replaced and superseded with the following language:

Accessibility Requirements.

The State is required to comply with the Americans with Disabilities Act of 1990 (ADA) and has adopted standards and procedures regarding accessibility requirements for websites, applications, content, and electronic documents. Due to a change in the law, the State is required to comply with specific accessibility standards for websites, applications, content and documents.

Starting 4/24/2026, throughout the Term, all websites, applications, software, content, and electronic documents, including but not limited to mobile applications, text, images, sounds, videos, controls, animations, links, and documents (including files in the following formats: PDF, word processing, presentation, and spreadsheet), created, provided, or made available by the Contractor under this Contract, must comply with WCAG 2.1 Level AA.

All other terms, conditions, specifications, and pricing remain the same. Per contractor and agency agreement, DTMB Central Procurement Services approval, and State Administrative Board approval on December 16, 2025.

AGENCY NAME PHONE EMAIL

LEO Jack Nolish (517)284-0532 NolishJ2@michigan.gov

MDHHS Keith White 517-290-2066 whitek33@Michigan.gov

LEO Sean Egan 517-388-4264 EganS@michigan.gov

Program Managers for

Multi-Agency and Statewide Contracts

CHANGE NOTICE NO. 7 TO CONTRACT NO. 230000000074

STATE OF MICHIGAN

ENTERPRISE PROCUREMENT

Department of Technology, Management, and Budget 320 S. Walnut Street 2nd Floor Lansing, MI 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

CONTRACT SUMMARY

Medicaid Actuarial Services

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

March 1, 2023 February 28, 2026 2 - 1 Year February 28, 2026

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other Yes No

10 W Market Street, STE 1600

Indianapolis IN 46204

Paul Houchens

317-524-3523

Paul.Houchens@milliman.com

CV0066136

MILLIMAN USA INC

C O

N

TR

A C

TO

R

Mary Ostrowski

(517)249-0438

DTMB

Various Various ostrowskim@michigan.gov

C ontract

A dm inistrator Program M anagerSTA

TE

N/AN/A

Change Notice Number 6 to

Contract Number 230000000074

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$16,943,274.00 $75,000.00 $17,018,274.00

DESCRIPTION

Effective June 25, 2025, this Contract is increased by $75,000 for LEO for their Actuarial Analysis services needed regarding future costs associated with Christopher R. Slezak first responder presumed coverage fund (CRFRPC) Statement of Work (SOW), attached below. In addition, the Contract Cover Page and Standard Contract Terms Section 4 is updated to include Jack Nolish as a State Program Manager for this SOW:

Jack Nolish

P.O. Box 30016

Lansing, MI

Email: Nolishj2@michigan.gov

(517) 284-0532

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement approval.

MDHHS Keith White 517-290-2066 whitek33@Michigan.gov

LEO Sean Egan 517-388-4264 EganS@michigan.gov

LEO Jack Nolish (517)284-0532 NolishJ2@michigan.gov

Program Managers for

CHANGE NOTICE NO. 6 TO CONTRACT NO. 230000000074

Statement of Work

Introduction The Christopher R. Slezak first responder presumed coverage fund (“CRSFRPC fund” or “the Fund”) was created by the Michigan state legislature and is administered by the director of the workers' disability compensation agency (“WDCA”). The WDCA is seeking an actuarial services to evaluate the future costs associated with the CRSFRPC fund.

Background The CRSFRPC Fund provides workers' disability compensation benefits to certain first responders as provided in statute, MCL 418.405(2).

In order to qualify for benefits from the Fund, the first responder must meet ONE of the following criteria at the time of filing:

• Be a full time member of a fire department or public fire authority; or

For a diagnosis on or after January 1, 2022:

• Be a former full-time member of a fire department or public fire authority;

• Be a current or former part-time, paid on-call, or volunteer member of a fire department or public fire authority; or

• Be a current or former part-time, paid on-call, volunteer, or full-time forest fire officer or crash rescue officer.

In addition, the first responder must also meet all the following criteria:

1. Must have or have had 60 months or more active service in the department or public fire authority.

2. Been diagnosed with any respiratory tract, bladder, skin, brain, kidney, blood, thyroid, testicular, prostate, lymphatic, ovarian, breast, or non-HPV cervical cancer.

3. If diagnosed with ovarian, breast, or non-HPV cervical cancer, the diagnosis must have been made on or after January 1, 2022.

4. Been exposed to the hazards incidental to fire suppression, rescue, or emergency medical services in the performance of his or her work-related duties with the department or authority.

5. Have applied for and done all things necessary to qualify for any pension benefits to which he or she may be entitled.

The cancers described in the statute are presumed to arise out of and in the course of employment or volunteering for the fire department or public fire authority. The presumption may be rebutted.

The Fund is currently funded with revenues that the state of Michigan receives from internet gaming. Specifically, $2 million annually from the Internet Sport Betting Fund and $2 million annually from the Internet Gaming Fund.

The WDCA has seen an increase to the applications submitted to the Fund as well as an increase in the expenditures associated with the Fund, and is requesting an estimate of:

• The future expenditures associated with applications already approved by the CRSFRPC Fund that are still receiving medical treatment for their cancer diagnosis.

• An estimate of future expenditures for the next five years associated with new applicants approved by the CRSFRPC Fund.

Each of these requests is explained in more detail below.

Project Scope Cancer treatment plans often last longer than one year, so Contractor would expect that the expenditures associated with treatment would increase each year since the Fund is paying for claims that were accepted years ago as well as new claims being accepted.

The Contractor would expect the number of applicants to increase as more current and prior first responders become aware of the benefits the Fund is providing.

The Contractor will design the analysis to provide the WDCA with the tools needed to budget for future CRSFRPC Fund expenditures on a calendar year basis. Part of this will include comparing the actual costs and number of accepted applications to the projected costs and applicants each year. It is the Contractor’s understanding that there is limited historical data available specific to the Fund. As such, the Contractor’s analysis will require the development of various assumptions, some of which are discussed in the Key Assumptions section below, and will likely incorporate other sources of insurance industry and epidemiological data. Due to the numerous uncertainties, the Contractor will derive a range of future cost estimates allowing the WDCA to monitor the actual experience to determine if the actual experience is more in line with low, central or high estimates.

Future Expenditures Associated with Applications Already Approved by the CRSFRPC Fund As of May 2024, 85 claims have been approved by the CRSFRPC Fund with $9.6 million of expenditures since the CRSFRPC Fund was created. As of October 1, 2024 98 applicants have been approved. It is the Contractor’s understanding that many of these claims (89 claims) are still open and the Fund expects to pay for future medical costs, (replacement of lost wages (indemnity), and death benefits. The Contractor will review the historical cost for each claimant and project future medical, indemnity, and death benefits for each claimant in total as well as by calendar year. The Contractor notes that cancer treatment and cost vary by individual circumstance and preference.

The Contractor will not be privileged to personal health information, but rather will use generalized treatment costs by cancer type, length of treatment, employment status (i.e., full-time vs. part-time, paid vs. volunteer, and active vs. retired), and claimant age (if available) to estimate the future cost for the active approved claims.

Future Expenditures Associated with New Applications Projecting future applicants for the CRSFRPC will be based on data that includes historical applicant claims, epidemiological studies containing the frequency of certain cancers by population, and the number of first responders (active paid, active volunteer, or retired) that would be eligible for the Fund if cancer is diagnosed. Using this data, the Contractor will estimate:

• Expected number of applicants to be accepted within the next five calendar years;

• Distribution of cancer type for future applicants; and

• Medical cost, wage replacement, and death benefits for each estimated accepted claimants, both in total and by calendar year.

Communication of Results The Contractor believes a critical part of the Contractor’s role as consultants is to ensure that the State understands the information being presented. The results of the Contractor’s analysis will be communicated in a preliminary draft report. Issuing the report in draft form allows the WDCA the opportunity to comment on the Contractor’s methodology, assumptions, and conclusions. The WDCA’s feedback would be considered, and the results of the Contractor’s analysis will be presented in a final written report.

Key Assumptions The Contractor has identified and described a few key assumptions below to provide additional detail on the approach the Contractor plans to take and explain the purpose of the items in the attached Data Request.

Exposures The future expenditures associated with the Fund are directly proportional to the number of first responders with at least five years of service in Michigan. For the Contractor’s analysis, the Contractor will need the number of first responders in each of these categories: active paid , active volunteer, and retired (both paid and volunteer). Cancer rates vary by age, sex, occupation, and whether the individual smokes. If data is available, the Contractor would like to receive the number of first responders segmented by status of employment (i.e., actively employed or retired), nature of compensation (i.e., paid or volunteer), age (can be grouped in five- or ten-year increments), sex, and smoking habits. If the data is not available, generalized assumptions would need to be made based on publicly available information.

Incidence Rate The incidence rate of cancer varies due to many demographic details, including age, genetics, lifestyle, sex, environmental exposures, occupation, etc. Limited epidemiological studies have been conducted to analyze cancer incidence rates for first responders. However, this data (if available) will likely need to be supplemented with incidence rates of cancer for the general population with adjustments made to account for the working conditions of first responders, under the assumption that first responders are at more risk than other workers for certain types of cancers.

Application / Acceptance Rate Although the legislation presumes certain cancers are work-related for first responders, the Fund can still deny the claim and show that the cancer was not work-related due to other potential contributors like smoking or family history of a particular type of cancer (i.e. a genetic cause). Additionally, a first responder who is diagnosed with cancer may not always file a claim with the Fund. Not filing a claim might be more prevalent for volunteer or retired first responders if they have other insurance providing coverage. Due to the uncertainty of the application / acceptance rate, we would derive a range of indications.

Cost of Medical Care The cost of medical care varies dramatically and is largely determined by the stage of cancer, the types of available treatment, and the length of treatment, amongst other factors. Additionally, cancer treatments continue to develop, and newer / experimental treatments may be more costly. Given the medical cost uncertainty, the Contractor would derive a range of indications by varying the average cost of medical care.

Cost of Indemnity The indemnity (i.e., wage replacement and death benefits) payments that a first responder may receive are also extremely uncertain. Wage replacement benefits support the first responder while they are unable to work due to deteriorating health and/or ongoing cancer treatment. When cancer results in the death of the first responder, additional survivor and burial benefits would need to be reflected. The indemnity benefits vary depending on pay scale, the ability to continue working during treatment for cancer, and the number of dependents, amongst other factors. Given the uncertainty in indemnity benefits, the Contractor would derive a range of indications by varying the average indemnity and death benefits.

Pricing and Timeframe The Contractor’s fees will be charged on a time and expense basis. Time charges will be based upon Contractor’s hourly rates as stated in Schedule B - Pricing of the Contract for the type of assignment and the consultants and staff assigned. Fees are billed monthly per Schedule A, Section 8.1. The Contractor estimates the cost of this analysis to be between $50,000 and $75,000 depending on the available of data from the WDCA and the amount of research and industry information the Contractor would need to gather.

As this is an estimate and the first time the Contractor would do this project, the Contractor agrees to cap Contractor’s charges at $75,000. If the WDCA requests additional work outside the scope of work for this assignment, the Contractor will discuss with the State Program Manager the likely additional charges before proceeding.

The Contractor’s analysis will take approximately four to six weeks to complete from receipt of the necessary information.

Consultants Due to the nature of this project, the Contractor will involve both actuarial and claims consultants on this project. The claims consultants will focus on reviewing and providing future cost estimates for the known active claimants and the actuarial consultants will provide estimates for future applicants yet to apply for coverage from the CRSFRPC Fund.

Lori Julga, FCAS, MAAA, will be the lead consultant and point of contact for this engagement. Lori is a Principal and Consulting Actuary in Contractor’s Milwaukee office and has over 30 years of property & casualty consulting experience. Her area of expertise includes loss reserving and ratemaking analyses for many lines of insurance, including commercial lines (workers’ compensation, general liability, and auto liability).

Lori has assisted numerous self-insured corporate clients, providing expertise in reserving and funding (including stochastic distributional analyses), loss retention studies, allocation calculations, and loss activity monitoring. She has performed reserve analyses and conducted pricing studies of workers’ compensation for self-insureds, group insurance pools, state rating bureaus and insurance companies. Lori is the consulting actuary for the Wisconsin Compensation Rating Bureau and has extensive knowledge of the Wisconsin workers’ compensation market both in terms of reserving and pricing.

Drew Groth, FCAS, MAAA, will be the Project Manager and will lead the day-to-day operations of the project, including managing a team of other actuaries and analysts.

Drew is a Consulting Actuary in the Contractor’s Milwaukee office and has over 10 years of property & casualty consulting experience. Drew has expertise in reserving and predictive modeling for commercial lines, most notably workers’ compensation and APH (asbestos, pollution, and health hazard) liabilities. He has extensive experience utilizing demographic and epidemiological data, such as cancer incidence rates, to project future claim liabilities for asbestos, talc, PFAS (including research into bodily injury related to firefighting professions), glyphosate, and other health hazards. He also assists Lori in managing actuarial assignments for the Wisconsin Compensation Rating Bureau.

Lori and Drew will be assisted by Christine Fleming, J.D., AIC, ACAS, MAAA. Christine is a Principal of the Contractor and leads the Contractor’s Casualty Claims & Underwriting practice. Prior to joining the Contractor 26 years ago, Christine practiced insurance coverage defense law. She specializes in case reserve estimation of commercial casualty claims including WC claims. Christine will be assisted by Stephanie Schmidt, a WC claims specialist. Christine and Stephanie will review a sample of the open currently accepted claims of the CRSFRPC Fund and establish potential future expenditures.

Additional Contractor personnel and experienced analysts will be brought in to assist on the project, as appropriate.

Department of Technology, Management, and Budget 320 S. Walnut Street 2nd Floor Lansing, MI 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

CONTRACT SUMMARY

Medicaid Actuarial Services

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

March 1, 2023 February 28, 2026 2 - 12 Months February 28, 2026

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other Yes No

10 W Market Street, STE 1600

Indianapolis IN 46204

Paul Houchens

317-524-3523

Paul.Houchens@milliman.com

CV0066136

MILLIMAN USA INC

C O

N

TR

A C

TO

R

Mary Ostrowski

(517) 249-0438

DTMB

Various Various ostrowskim@michigan.gov

C ontract

A dm inistrator Program M anagerSTA

TE

N/AN/A

Change Notice Number 5 to

Contract Number 230000000074

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$16,918,274.00 $25,000.00 $16,943,274.00

DESCRIPTION

Effective August 23, 2024, this Contract is increased by $25,000.00 for LEO and their Actuarial Analysis for a Paid Family and Medical Leave (PFML) Insurance Program's additional work, attached below.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement approval.

MDHHS Keith White 517-290-2066 whitek33@Michigan.gov

LEO Sean Egan 517-388-4264 EganS@michigan.gov

Program Managers for

CHANGE NOTICE NO. 5 TO CONTRACT NO. 230000000074

STATEMENT OF WORK (SOW)

Addition to the Actuarial Analysis for a Paid Family and Medical Leave (PFML) Insurance Program (see also Change Notice 2 and 4 of this Contract)

1. SCOPE OF WORK. The Contractor will perform the following services:

A. Analyze the expected costs and contribution requirements for a PFML program in Michigan that features small employer exemptions for employers with fewer than 25 employees.

B. Analyze the expected costs and contribution requirements for a PFML program in Michigan that features small employer exemptions for employers with fewer than 50 employees.

C. Analyze non-pandemic related emergencies related to other non-standard qualifying reasons.

2. DELIVERABLES. The Contractor will deliver the results of our analysis in reports to State that will include detailed documentation of the data, assumptions, and analytical methods.

3. PROJECT COST ESTIMATE AND BUDGET. The estimated cost for providing the services specified in this SOW is $25,000.

Department of Technology, Management, and Budget

525 W. ALLEGAN ST., LANSING, MICHIGAN 48913

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

CONTRACT SUMMARY

Medicaid Actuarial Services

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

March 1, 2023 February 28, 2026 2 Months February 28, 2026

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other Yes No

10 W Market Street, STE 1600

Indianapolis IN 46204

Paul Houchens

317-524-3523

Paul.Houchens@milliman.com

CV0066136

MILLIMAN USA INC

C O

N

TR

A C

TO

R

Mary Ostrowski

517-249-0438

DTMB

Various LEO ostrowskim@michigan.gov

STA

TE

C ontract

A dm inistrator Program M anager

N/AN/A

Change Notice Number 4

Contract Number MA230000000074 to

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$16,878,274.00 $40,000.00 $16,918,274.00

DESCRIPTION

Effective June 1, 2024, this Contract is increased by $40,000 for LEO.

The attached Schedule A - Statement of Work is hereby incorporated into the Contract.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

LEO Keith White 517-290-2066 whitek33@Michigan.gov

LEO Sean Egan EganS@michigan.gov

Program Managers for

CHANGE NOTICE NO. 4 TO CONTRACT NO. MA230000000074

Michigan.gov/MiProcurement

2022-1 1

SCHEDUELE A - OPERATIONAL CONSULTING

SERVICES – TIER-TWO STATEMENT OF WORK

Actuarial Services Tier-two: Actuarial Analysis for Paid Family and Medical Leave Social Insurance Program

BACKGROUND

Original Contract requirements apply for this Section.

SCOPE

Original Contract requirements apply for this Section in addition to the following:

Contract with a qualified third-party actuary with expertise in paid family and medical leave to perform an actuarial analysis for a statewide paid family and medical leave social insurance program. The actuarial study must be completed and shared with the public not later than August 1, 2024. The actuary must compare the costs of at least 2 different paid family and medical leave insurance program models, and must consider at least the following program parameters as they relate to the premiums necessary to maintain solvency:

(a) Use of leave to bond with a new child, recover from one's own serious health condition or care for a seriously ill family member, address needs arising from domestic violence and sexual assault, and address military family needs.

(b) Coverage of self-employed workers, at the option of the worker.

(c) Eligibility for benefits once a worker has earned at least $3,000.00 during a base period.

(d) Use of an inclusive family definition.

(e) A maximum leave duration, not below 12 weeks of job protected leave per year, with at least 1 model providing for a maximum leave duration of at least 15 weeks of job-protected leave per year.

(f) An option to exempt small employers or employers with limited revenues from paying premiums while including their employees.

(g) Understand the cost of allowing employers to provide paid family medical leave benefits through an approved private plan that meets the minimum requirements of the state program.

The actuary must also consider and address the potential effect on premiums of providing workers with leave for bereavement of a covered family member with at least 1 model providing for a maximum of 15 days of bereavement leave per year.

1. REQUIREMENTS

2022-1 2

From Contract Execution through October 31, 2025

1) Develop assumptions for estimating and projecting Michigan PFML costs.

Assumption sources can include, but are not limited to:

a) Claim data from states that have implemented PFML legislation, including California, Connecticut, the District of Columbia, Hawaii, Massachusetts, New Jersey, New York, Rhode Island, and Washington;

b) Relevant assumption data or analysis from states that have approved but not yet implemented PFML legislation, including Colorado, Maryland, and Oregon;

c) Short-term disability rating formulas;

d) Expense data from states that administer PFML benefits;

e) Employment data from the Michigan Labor Market Information office and other relevant sources, such as the American Community Survey, Bureau of Labor Statistics, etc.;

f) Data related to the Family and Medical Leave Act of 1993 from the United States Department of Labor and other relevant departments;

g) Proprietary research on PFML costs and trends; and

h) Other data and approaches as appropriate.

2) Build a model that will be used to compute expected benefit payments.

3) Ensure that the assumptions and modeling methods are flexible for exploring various

PFML program design options. For example, create a toggle so that the effects of private plan opt-outs could be modeled.

4) Estimate other costs related to PFML administration, such as claim management expenses, start-up costs, and reserve requirements. Combine these other costs with the expected benefit payments to estimate total PFML costs in a given year. Then, calculate the required contributions and contribution rates based on these total costs and the assumed taxable wage base. Develop financial projections over a 5-year period to demonstrate how PFML experience in Michigan is expected to emerge over time. The financial projections will include at least the following items:

a) Eligible employees;

b) Taxable Wages;

c) Claims;

d) Benefit Payments, including duration of Benefits;

e) Program Administrative Expenses;

f) Total Expenditure;

g) Contribution Rate;

h) Contributions; and

i) Reserve balance.

5) Create and deliver an accessible final report, PowerPoint presentation, and related modeling workbooks to DEED’s Authorized Representative by October 31, 2023.

6) Provide weekly status updates to discuss progress toward meeting project deliverables and outcomes along with potential shortcomings and possible solutions

2022-1 3 to DEED’s Authorized Representative at dates, times and locations to be determined in writing by mutual consent of both parties.

From November 1, 2024, to June 30, 2025

7) Include allowances for up to five (5) hours of testimony to state legislators and for up to 20 hours of ad hoc consulting to DEED.

8) Contractor will estimate the costs related to the following paid family and medical leave (PFML) qualifying reasons included in the current bill introduced in legislation, and not included in the original scope of work for Contract Change Notice Number 2:

a) Closure of the covered individual's primary workplace by order of a public official because of a public health emergency.

b) To care for a family member of the covered individual who is a child because the family member's school or place of care has been closed by order of a public official or by a school or place of care administrator because of a public health emergency, including, but not limited to, if the school or place of care is closed, but the administrators provide instruction remotely.

c) If a local health department or the covered individual's health care provider determines that the covered individual's or a family member of the covered individual's presence in the community may jeopardize another individual's health because the covered individual or the family member is exposed to a communicable disease, even if the covered individual or family member does not contract the communicable disease.

d) If the President of the United States, governor of this state, or a local official of this state declares an emergency, the inability to work or work remotely during the emergency or an extension of the emergency for any of the following reasons:

i) If the declared emergency is because of a natural disaster or public health crisis, the covered individual has to care for a family member because the family member's usual care professional is unavailable because of the declared emergency.

ii) If the declared emergency is because of a public health crisis related to a communicable disease, any one of the following:

(1) The covered individual has close contact with an individual who tests positive for the communicable disease or with an individual who has 1 or more principal symptoms of the communicable disease.

(2) The covered individual is subject to a personal, 2 local, state, or federal quarantine or isolation order, including, but not limited to, a shelter-in-place or stay-at-home order related to the declared emergency.

(3) The covered individual has a condition or characteristic that might increase the covered individual's susceptibility of contracting, or increase the health risks associated with contracting, the communicable disease, including, but not limited to, age, heart disease, asthma, lung disease, 2022-1 4 diabetes, kidney disease, or a weakened or compromised immune system.

iii) For any other reason related to a declared emergency as provided for in a rule promulgated under this act.

The State reserves the right to change the dates based on need and within the term and conditions of the negotiated contract.

Minimum Requirements:

The successful responder must be a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries (“FSA” and “MAAA”) who has experience directly relevant to PFML analysis.

CENTRAL PROCUREMENT SERVICES

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 3 to

Contract Number 230000000074 whitek33@Michigan.gov

Keith White

Mary Ostrowski paul.houchens@milliman.com

Paul Houchens

Indianapolis, IN 46204

Milliman USA Inc.

CV0066136

317-524-3523

10 W Market Street, , STE 1600

(517) 249-0438

S T

A T

E

P ro g ra m

M a n a g e r

C o n tra ct

A d m in istra to r

C O

N T R A C T O

R

517-290-2066

DTMB

ostrowskim@michigan.gov

$5,378,274.00

March 1, 2023 February 28, 2026

MEDICAID ACTUARIAL SERVICES

February 28, 2026

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

2 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

NET 45

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ N/A

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

N/A

$11,500,000.00 $16,878,274.00

Effective April 9, 2024, This Contract is increased by $11,500,000.00 for MDHHS use.

All other terms, conditions, specifications, and pricing remain the same. Per contractor and agency agreement, DTMB Central Procurement Services approval, and State Administrative Board approval on April 9, 2024.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

N/A

DESCRIPTION

CONTRACT SUMMARY

MDHHS

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 2 to

Contract Number 230000000074

Various

Mary Ostrowski paul.houchens@milliman.com

Paul Houchens

Indianapolis, IN 46204

Milliman USA Inc.

CV0066136

317-524-3523

10 W Market Street, , STE 1600

(517) 855-1376

S T

A T

E

P ro g n a g e r

C o n tra ct

A d m in istra to r

C O

N T R A C T O

R

DTMB

ostrowskim@michigan.gov

$5,292,774.00

March 1, 2023 February 28, 2026

MEDICAID ACTUARIAL SERVICES

February 28, 2026

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

2 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☒ ☐ N/A

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

N/A

$85,500.00 $5,378,274.00

Effective February 14, 2024, the following changes are hereby incoporated into this contract:

1. LEO is hereby added and the value is increased by $85,500.00.

2. The attached Schedule A – Statement of Work and Schedule B – Pricing are hereby incorporated into the Contract.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

N/A

DESCRIPTION

MULTI

2022-1 1

SCHEDUELE A - OPERATIONAL CONSULTING

SERVICES

Actuarial Services: Actuarial Analysis for Paid Family and Medical Leave Social Insurance Program

BACKGROUND

Original Contract requirements apply for this Section.

SCOPE

Original Contract requirements apply for this Section in addition to the following:

Contract with a qualified third-party actuary with expertise in paid family and medical leave to perform an actuarial analysis for a statewide paid family and medical leave social insurance program. The actuarial study must be completed and shared with the public not later than August 1, 2024. The actuary must compare the costs of at least 2 different paid family and medical leave insurance program models, and must consider at least the following program parameters as they relate to the premiums necessary to maintain solvency:

(a) Use of leave to bond with a new child, recover from one's own serious health condition or care for a seriously ill family member, address needs arising from domestic violence and sexual assault, and address military family needs.

(b) Coverage of self-employed workers, at the option of the worker.

(c) Eligibility for benefits once a worker has earned at least $3,000.00 during a base period.

(d) Use of an inclusive family definition.

(e) A maximum leave duration, not below 12 weeks of job protected leave per year, with at least 1 model providing for a maximum leave duration of at least 15 weeks of job-protected leave per year.

(f) An option to exempt small employers or employers with limited revenues from paying premiums while including their employees.

(g) Understand the cost of allowing employers to provide paid family medical leave benefits through an approved private plan that meets the minimum requirements of the state program.

The actuary must also consider and address the potential effect on premiums of providing workers with leave for bereavement of a covered family member with at least 1 model providing for a maximum of 15 days of bereavement leave per year.

1. REQUIREMENTS

2022-1 2

From Contract Execution through October 31, 2025

1) Develop assumptions for estimating and projecting Michigan PFML costs.

Assumption sources can include, but are not limited to:

a) Claim data from states that have implemented PFML legislation, including California, Connecticut, the District of Columbia, Hawaii, Massachusetts, New Jersey, New York, Rhode Island, and Washington;

b) Relevant assumption data or analysis from states that have approved but not yet implemented PFML legislation, including Colorado, Maryland, and Oregon;

c) Short-term disability rating formulas;

d) Expense data from states that administer PFML benefits;

e) Employment data from the Michigan Labor Market Information office and other relevant sources, such as the American Community Survey, Bureau of Labor Statistics, etc.;

f) Data related to the Family and Medical Leave Act of 1993 from the United States Department of Labor and other relevant departments;

g) Proprietary research on PFML costs and trends; and

h) Other data and approaches as appropriate.

2) Build a model that will be used to compute expected benefit payments.

3) Ensure that the assumptions and modeling methods are flexible for exploring various

PFML program design options. For example, create a toggle so that the effects of private plan opt-outs could be modeled.

4) Estimate other costs related to PFML administration, such as claim management expenses, start-up costs, and reserve requirements. Combine these other costs with the expected benefit payments to estimate total PFML costs in a given year. Then, calculate the required contributions and contribution rates based on these total costs and the assumed taxable wage base. Develop financial projections over a 5-year period to demonstrate how PFML experience in Michigan is expected to emerge over time. The financial projections will include at least the following items:

a) Eligible employees;

b) Taxable Wages;

c) Claims;

d) Benefit Payments, including duration of Benefits;

e) Program Administrative Expenses;

f) Total Expenditure;

g) Contribution Rate;

h) Contributions; and

i) Reserve balance.

5) Create and deliver an accessible final report, PowerPoint presentation, and related modeling workbooks to LEO’s Authorized Representative by June 30, 2024.

6) Provide weekly status updates to discuss progress toward meeting project deliverables and outcomes along with potential shortcomings and possible solutions

2022-1 3 to LEO’s Authorized Representative at dates, times and locations to be determined in writing by mutual consent of both parties.

From November 1, 2024 to June 30, 2025

7) Include allowances for up to five (5) hours of testimony to state legislators and for up to 20 hours of ad hoc consulting to LEO.

The State reserves the right to change the dates based on need and within the term and conditions of the negotiated contract.

Minimum Requirements:

The successful responder must be a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries (“FSA” and “MAAA”) who has experience directly relevant to PFML analysis.

2022-1 4

SCHEDULE B – PRICING

Project Fees

Milliman bills its clients on a time and expense basis. Time charges will be based upon the hourly rates for the consultants and staff assigned to the project multiplied by the number of hours worked. Any other expenses would be shown separately on the invoice, such as travel expenses and other out-of- pocket expenses incurred by Milliman (e.g., overnight mail packages or outsourced duplication services).

Expense charges would not include routine telephone, copying, or fax charges.

The following table contains a breakdown of the estimated fees for providing the services outlined above:

Estimated Project Fees Project Task Project Fees

Virtual Planning and Kickoff Meeting $2,000 Data Request and Review $2,000

Research PFML Experience $8,500 Develop Actuarial Assumptions $15,000

Build Model for Projecting PFML Experience $15,000 Estimate Contribution Rates $7,500

Develop Preliminary and Final Reports $7,500 Checking and Peer Review $10,000

One in-person Function in Michigan $3,000 On-Going Consulting Services $15,000

Total $85,500

The fees shown above assume that we will be analyzing up to three different options for the Michigan PFML program. There would be an additional cost of $5,000 for each additional option. The fees for on- going consulting services assume approximately 30 hours of additional consulting following the delivery of the final report. If the on-going services exceed 30 hours, there would be an additional cost of $535 per hour.

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 1 to

Contract Number 230000000074 whitek33@Michigan.gov

Keith White

Mary Ostrowski paul.houchens@milliman.com

Paul Houchens

Indianapolis, IN 46204

Milliman USA Inc.

CV0066136

317-524-3523

10 W Market Street, , STE 1600

(517) 249-0438 S

T A

T E

P ro g n a g e r

C o n tra c t

A d m in is tra to r

C O

N T

R A

C T

O R

517-290-2066

DTMB

ostrowskim@michigan.gov

$5,292,774.00

March 1, 2023 February 28, 2026

MEDICAID ACTUARIAL SERVICES

February 28, 2026

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

2 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ February 28, 2026

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

N/A

$0.00 $5,292,774.00

Effective May 10, 2023, the role of Sr. Healthcare Consultant is added at a rate of $350.00/hr. The follow pricing updates are hereby incorporated into Schedule B

Consultant Hourly Rate Estimated Hours (3 Years) Subtotal Healthcare Consultant $288.00 180 $51,840.00 Sr. Healthcare Consultant $350.00 180 $63,000.00

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

N/A

DESCRIPTION

MDHHS

NOTICE OF CONTRACT

NOTICE OF CONTRACT NO. 230000000074 .

between

THE STATE OF MICHIGAN

and

C O

N

TR

A C

TO

R

Milliman Inc.

ST

A

TE

Pr og an ag er

Keith White DHHS

10 W Market Street, STE 1600 517-290-2066

Indianapolis, IN 46204 Whitek33@michigan.gov

Paul Houchens

C on tra ct

Ad in is tra to r Mary Ostrowski DTMB

317-524-3523 517-249-0438

Paul.houchens@milliman.com ostrowskim@michigan.gov

CV0066136

DESCRIPTION: Medicaid Actuarial Services

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE

INITIAL AVAILABLE

OPTIONS

EXPIRATION DATE BEFORE

CHANGE(S) NOTED BELOW

3/1/2023 2/28/2026 2-1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

Net 45, 1% if paid in 30 Days N/A

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-card ☐ Payment Request (PRC) ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

N/A

MISCELLANEOUS INFORMATION

THIS IS NOT AN ORDER: This Contract agreement is awarded on the basis of the State’s inquiry bearing solicitation number 220000002555. Orders for delivery will be issued directly by the Department through a Delivery Order (DO).

ESTIMATED CONTRACT VALUE AT TIME OF EXECUTION $5,292,774

STATE OF MICHIGAN PROCUREMENT

Department of Technology, Management, and Budget – Central Procurement Services 320 S Walnut St, Lansing MI 48933 P.O. Box 30026, Lansing, Michigan 48933

CONTRACT NO. 230000000074

FOR THE CONTRACTOR:

Company Name

Authorized Agent Signature

Authorized Agent (Print or Type)

Date

FOR THE STATE:

Signature

Name & Title

Agency

Date

STANDARD CONTRACT TERMS

This STANDARD CONTRACT (“Contract”) is agreed to between the State of Michigan (the “State”) and Milliman Inc. (“Contractor”), an Indiana Corporation. This Contract is effective on March 1, 2023 (“Effective Date”), and unless terminated, will expire on February 28, 2026.

This Contract may be renewed for up to three (3) additional one (1) year periods.

Renewal is at the sole discretion of the State and will automatically extend the Term of this Contract. The State will document its exercise of renewal options via Contract Change Notice.

The parties agree as follows:

Duties of Contractor. Contractor must perform the services and provide the deliverables described in Schedule A – Statement of Work (the “Contract Activities”). An obligation to provide delivery of any commodity is considered a service and is a Contract Activity.

Contractor must furnish all labor, equipment, materials, and supplies necessary for the performance of the Contract Activities unless otherwise specified in Schedule A.

Contractor must: (a) perform the Contract Activities in a timely, professional, safe, and workmanlike manner consistent with standards in the trade, profession, or industry; (b) meet or exceed the performance and operational standards, and specifications of the Contract; (c) provide all Contract Activities in good quality, with no material defects; (d) not interfere with the State’s operations; (e) obtain and maintain all necessary licenses, permits or other authorizations necessary for the performance of the Contract; (f) cooperate with the State, including the State’s quality assurance personnel, and any third party to achieve the objectives of the Contract;

(g) return to the State any State-furnished equipment or other resources in the same condition as when provided when no longer required for the Contract; (h) assign to the State any claims resulting from state or federal antitrust violations to the extent that those violations concern materials or services supplied by third parties toward fulfillment of the Contract; (i) comply with all State physical and IT security policies and standards which will be made available upon request; and (j) provide the State priority in performance of the Contract except as mandated by federal disaster response requirements. Any breach under this paragraph is considered a material breach.

Contractor must also be clearly identifiable while on State property by wearing identification issued by the State, and clearly identify themselves whenever making contact with the State.

Notices. All notices and other communications required or permitted under this Contract must be in writing and will be considered given and received: (a) when verified by written receipt if sent by courier; (b) when actually received if sent by mail without verification of receipt; or (c) when verified by automated receipt or electronic logs if sent by facsimile or email.

If to State: If to Contractor:

See Contract Administrator information shown below.

Paul Houchens 10 W Market Street STE 1600 Indianapolis, IN 46204 paul.houchens@milliman.com 317-524-3523

Contract Administrator. The Contract Administrator, or the individual duly authorized 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”):

State: Contractor:

Mary Ostrowski 320 S Walnut St Lansing, MI 48933 Ostrowskim@michigan.gov 517-249-0438

Paul Houchens 10 W Market Street STE 1600 Indianapolis, IN 46204 paul.houchens@milliman.com 317-524-3523

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

State: Contractor:

Keith White 400 South Pine Street Lansing, MI 48933 WhiteK33@michigan.gov 517-290-2066

Paul Houchens 10 W Market Street STE 1600 Indianapolis, IN 46204 paul.houchens@milliman.com 317-524-3523

Performance Guarantee. Contractor must at all times have financial resources sufficient, in the opinion of the State, to ensure performance of the Contract and must provide proof upon request. The State may require a performance bond (as specified in Schedule A – Statement of Work) if, in the opinion of the State, it will ensure performance of the Contract.

Insurance Requirements. See Schedule C.

Reserved Reserved Relationship of the Parties. The relationship between the parties is that of independent contractors. Contractor, its employees, and agents will not be considered employees of the State. No partnership or joint venture relationship is created by virtue of this Contract. Contractor, and not the State, is responsible for the payment of wages, benefits and taxes of Contractor’s employees and any subcontractors. Prior performance does not modify Contractor’s status as an mailto:paul.houchens@milliman.com mailto:Ostrowskim@michigan.gov mailto:paul.houchens@milliman.com mailto:WhiteK33@michigan.gov mailto:paul.houchens@milliman.com independent contractor. Neither party has authority to contract for nor bind the other party in any manner whatsoever.

Intellectual Property Rights. If Schedule A, Statement of Work, requires Contractor to create any intellectual property, Contractor hereby acknowledges that the State is and will be the sole and exclusive owner of all right, title, and interest in the Contract Activities and all associated intellectual property rights, if any. Such Contract Activities are works made for hire as defined in Section 101 of the Copyright Act of 1976. To the extent any Contract Activities and related intellectual property do not qualify as works made for hire under the Copyright Act, Contractor will, and hereby does, immediately on its creation, assign, transfer and otherwise convey to the State, irrevocably and in perpetuity, throughout the universe, all right, title and interest in and to the Contract Activities, including all intellectual property rights therein.

Contract Activities including Software. If Contractor is providing Contract Activities that require the use of Contractor Software, the following terms apply:

a. License Grant by Contractor: Contractor hereby grants to the State, exercisable by and through its Authorized Users, a nonexclusive, royalty-free, irrevocable right and license during the Term and such additional periods, if any, as Contractor is required to provide Contract Activities under this Contract or any Statement of Work, to: (a) access and use the Software, including in operation with other software, hardware, systems, networks and services, for the State’s business purposes, including for processing State Data; (b) generate, print, copy, upload, download, store and otherwise process all GUI, audio, visual, digital and other output, displays and other content as may result from any access to or use of the Software; (c) prepare, reproduce, print, download and use a reasonable number of copies of the Documentation for any use of the Software…