230000003226 Questions Answers.pdf
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- Attached to
- HMO Services for MPSERS
- Solicitation number
- RFP - 171 - 230000003226
- Issued by
- Ingham County, Lansing City, Michigan
About this file
This document is a Questions and Answers (Q&A) addendum to a Request for Proposal (RFP) issued by the Michigan Office of Retirement Services (ORS) for HMO health coverage, including medical and prescription drug services, for the Medicare-Eligible Members and non-Medicare Eligible Members of the Michigan Public School Employees' Retirement System (MPSERS). The resulting contract will have a one-year term with four one-year renewal options. The RFP seeks fully-insured HMO offerings to provide coverage for retirees, beneficiaries, COBRA participants, and dependents. The Q&A addresses various questions related to the claims data, service area requirements, key personnel, invoicing, and deliverables. A revised census data file has also been provided.
The Q&A clarifies that the medical claims data does not include IBNR amounts, the prescription drug claims data does not include rebates, and the Medicare prescription drug claims data does not include Part D subsidies for one of the HMOs. The State requires a current Medicare Advantage service area map as proof of service area approval. The State will consider all bidders who meet the evaluation criteria, and there may be multiple contract awards. The RFP also provides details on invoicing requirements, which must be met by all bidders, including incumbent providers.
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Michigan.gov/MiProcurement
BIDDER QUESTIONS & ANSWERS
Version 2021-2
Request for Proposal No. 230000003226 HMO Services for MPSERS
Bidders who submitted questions for the above Solicitation by the deadline have answers below.
Q # Document and Section
Page
Bidder Question Answer
1 Schedule H, Paid Claims
Tab and
Are the Medical Paid $'s in columns D and G inclusive of IBNR? If not, what is the paid through date?
The medical claims are not inclusive of IBNR amounts. The paid-through date is 3/31/2023.
2 Schedule H, Paid Claims
Tab and
Are the Prescription Drug Paid $'s in columns E and F inclusive of Rebates? If not, can Rebate $'s be provided?
The prescription claims information is not inclusive of rebates. Rebate information is not available to the State under fully-insured arrangements.
3 Schedule H, Paid Claims
Tab and
Are the Prescription Drug Paid $'s in columns E and F on the Medicare Claims tab inclusive of part D subsidies (LICS, Reinsurance and Coverage Gap)? If not, can the Part D subsidy $'s be provided?
HMO 1: YES
HMO 2: NO; Part D subsidy information (LICS, Reinsurance and Coverage Gap) is not currently available to the State for HMO 2.
4 Schedule A, 1.1.2 22 What evidence does the State require as proof of service area approved by DIFS?
A current Medicare Advantage service area map is sufficient. If the non-Medicare service area differs from the Medicare Advantage service area, Bidder must provide a statement explaining the difference(s).
5 Proposal Instructions; 4.6 Key Personnel; 4.6.5.2
63 Can the SAM on a State of Michigan contract also be assigned as the backup SAM on another State of Michigan Contract?
Yes.
6 Proposal Instructions; 4.6 Key Personnel; 4.6.5.2
63 Can the backup SAM on a State of Michigan contract also be assigned as the SAM on another State of Michigan Contract?
Yes.
7 Proposal Instructions; 4.6 Key Personnel; 4.6.5.2
63 Can we leave the name as TBD for the SAM until one is assigned?
No.
8 Proposal Instructions;
Disclosure of Subcontractors 4.9
66 Are you asking only for the Contractor HMO organization chart or also provide an overall organizational chart or charts for all lines of business?
The overall organizational chart for all lines of business. The overall chart can be high-level, however, specific to the HMO organization, must represent/identify all personnel, with any proposed Key Personnel and Subcontractors for this contract bolded with individuals’ names and titles.
9 Proposal Instructions; 7 Evaluation Process.
6 Does this item confirm that there will be only one contract award winner or will the contract be awarded to any bidder who meets or exceeds the criteria in Question 7, Evaluation Process?
The State intends to consider for award all Bidder(s) evaluated as “Passing” per the terms in Proposal Instructions, Section 7 Evaluation Process.
10 Schedule M HMO Census Data
Colu mn F, Medic are Statu s
What does MEDI, NMED, and MDIN represent? MEDI = Medicare Eligible NMED = Non-Medicare Eligible MDIN was an error. See Schedule M HMO Census Data REVISED.
11 Proposal Instructions, Section 4.9
67 What is considered a deliverable? Deliverables are the “Contract Activities” described in the Statement of Work. See Contract Terms, Section 1. Duties of Contractor.
12 Proposal Instructions;
Invoicing and Payment 8.1
81 82 Current Invoice does not contain (d) Any associated State Delivery Order (DO) number (State’s term for Purchase Order) or (H) Prompt Payment Discount identifier. However, any Prompt Payment Discount would be applied as a standalone invoice adjustment.
Is the information on the current invoicing sufficient to comply with the RFP requirements?
Incumbents, regardless of current arrangement, are not exempt from this requirement. Sample invoice must meet requirements stated in Schedule A, Section
8.1. If Bidder cannot meet this requirement, Bidder must state the exception(s) in the response box.
13 Proposal Instructions;
Invoicing and Payment 8.1
82 Late Enrollment Penalty (LEP) will continue to be invoiced back to the customer using the current billing arrangement. Is the information on the current invoicing sufficient to comply with the RFP requirements?
Incumbents, regardless of current arrangement, are not exempt from this requirement. Sample invoice must meet requirements stated in Schedule A, Section
8.1. If Bidder cannot meet this requirement, Bidder must state the exception(s) in the response box.
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