3._EDD_ICMS_EXHIBIT_A_-_STATEMENT_OF_WORK.pdf

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EXHIBIT A: STATEMENT OF WORK

1. BACKGROUND AND PURPOSE

1.1. BACKGROUND

The Employment Development Department (EDD) plays a vital role in fostering the state's economic growth and prosperity by collaboratively delivering innovative services tailored to meet the evolving needs of employers, workers, and job seekers. We serve as a nexus connecting employers with qualified job seekers, while administering essential programs such as Unemployment Insurance (UI), Disability Insurance (DI), and Paid Family Leave (PFL). Additionally, we oversee employment and training initiatives under the federal Workforce Innovation and Opportunity Act, furthering workforce development efforts.

Operating across ten (10) branches and 160 locations statewide, EDD boasts a workforce exceeding 10,000 employees. Key branches, including the Unemployment Insurance Branch (UIB) and Disability Insurance Branch (DIB), manage multi-billion-dollar benefit programs like UI and State Disability Insurance (SDI), providing critical financial stability to workers and communities alike. The Tax Branch plays a pivotal role, collecting over $100 billion in taxes annually and processing more than 130 million documents across various programs.

Currently, the benefit systems operate on three independent, non-integrated platforms, relying on an aging mainframe legacy system alongside external sub-systems and components. The Information Technology Branch (ITB) oversees the maintenance of these systems, which include the UI Online System, SDI Online System, and associated programs such as Voluntary Plan (VP), Non-Industrial Disability Insurance (NDI), Non-Industrial Disability Insurance - Family Care Leave (NDI-FCL), and Disability Insurance Elective Coverage (DIEC), among others. Additionally, the ITB supports the Tax Branch's Accounting and Compliance Enterprise System (ACES), which interfaces with these benefit systems. Notably, ACES features an integrated mechanism for managing benefit overpayment collections, addressing instances where individuals are overpaid on their UI, DI, or PFL claims.

Moving forward, the EDD seeks to modernize its claims processing capabilities through the implementation of the Integrated Claims Management System (ICMS) solution. This ICMS transformative endeavor, led by the EDDNext Modernization and Innovation Branch (EDDNext), aims to consolidate and streamline EDD claims management processes, enhancing efficiency, accessibility, multilingual functionality and overall service delivery for both claimants and employees.

1.2. PURPOSE

The purpose of the ICMS project is to revolutionize the EDD approach to claims processing by implementing a cohesive, customer-centric solution. This initiative aims to:

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• Elevate customer service standards through enhanced access and self-service capabilities.

• Improve adaptability to regulatory requirements and responsiveness to changing demands.

• Strengthen fraud mitigation measures to safeguard integrity.

• Facilitate informed decision-making in claims management.

• Streamline and optimize all claims-related processes, thereby enhancing the employee experience.

The ICMS solution will integrate program functionalities (UI, SDI, PFL), and encompass functionalities including intake, eligibility, payments, collections, and appeals. The integrated solution will also include inherent benefit overpayment collections functionality, migrated from ACES. EDD expects to benefit from automated workflow management, integrated claimant information management, and centralized business rules administration. The overarching goal is to boost efficiency, effectiveness, agility, and sustainability across the claims management spectrum. Emphasis is placed on fostering equitable access and self-service options for claimants, alongside delivering substantial enhancements to employee satisfaction.

2. DESCRIPTION OF NEW SYSTEM OR SERVICE

EDD envisions a significant shift with the implementation of the ICMS solution, which is integral to overcoming current digital limitations and achieving the vision and desired business outcomes. The conceptual architecture model (Figure 2.0A, ICMS Solution Architecture) outlines the framework for this solution.

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Figure 2.0A, ICMS Solution Architecture

Target Infrastructure:

EDD aims to transition from legacy systems to a modern, scalable cloud-based infrastructure. The solution shall align with EDD's cloud standards and security architecture, which shall ensure compliance with FedRAMP moderate requirements (see SECTION 7. STATE DATA CENTER OR CONTRACTOR HOSTED FACILITY ENVIRONMENT and SECTION 18. SECURITY). It shall also possess advanced integration capabilities to interact with modern solutions and scale according to fluctuating customer demands.

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Figure 2.0B Target Infrastructure

ICMS:

The ICMS solution must encompass robust claims management functionality, serving as the central hub for various processes. This includes managing claims processing (including UI, DI, NDI, NDI-FCL, VP, PFL, and Benefit Overpayment Collections (BOC)) from intake to completion, handling exceptions, and managing benefit overpayments and collections. Additionally, it must integrate with enterprise-level document and content management solutions.

Figure 2.0C ICMS

Integrated Data Management:

Supported by integrated data management components, the core solution must include shared services, a data management platform, business intelligence, and fraud and decision analytics. This ensures efficient data processing and utilization across the organization. It is envisioned the integrated data management components will include shared services (business rule processing, case management, exception processing), integrated data management platform (master data management and governance), business intelligence, as well as, fraud and decision analytics. Additionally, the integrated

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data management functionality encompasses integration services (ETL, API-based platforms), data processing (DP engines, Machine Learning frameworks, and big data computing), and data catalogs.

Upon contract award, the Contractor will be provided access to the ICMS repository for additional details of the Data Management Plan.

Figure 2.0D Integrated Data Managment

Contact Services and Channels:

Integration with existing customer channels and contact center services is essential. This includes various communication approaches such as voice, mail, email, online forms, mobile apps, web, and AI chat, the latter of which shall adhere to the State's GenAI policy (as applicable), functionalities. Secure data transmission and interoperability with existing and emerging EDD solutions are crucial for seamless interactions. Leveraging and integrating with EDD's established ID proofing service, Socure, is also crucial for ensuring secure, low-friction interactions between customers and the system, along with effective management of customer contacts across communication pathways.

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Figure 2.0F Customer Channels and

Contact Center

EDD Employee Access:

The employee portal within the ICMS solution plays a pivotal role in optimizing operations and enhancing employee productivity. It shall offer a seamless and user-friendly experience, accessible across various devices to accommodate diverse work environments. The portal shall provide access to domain-specific workflows and work items tailored to different program areas, aligning with specific job roles and responsibilities. Leveraging EDD's Single Sign-On (SSO) mechanism simplifies authentication processes, enhancing security and user experience by eliminating the need for repeated logins. Interactive dashboards, customizable views, and intuitive navigation menus contribute to a clear and simple user experience, ensuring easy access to relevant information and tools for efficient task management.

The employee portal shall integrate and optimize the operations, providing functionality for access by all EDD users (SECTION 2.7. INTEGRATION WITH EDD SYSTEMS).

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Figure 2.0G EDD Employee

Access

UX and Automation:

A focus on delivering exceptional user experiences (business outcome) and customer journeys is paramount. The solution shall overcome current digital limitations by incorporating adaptable automation and self-service options to streamline processes, enhance user satisfaction, and improve overall efficiency. EDD places significant emphasis on delivering an exceptional user experience (UX)/customer experience (CX) journeys for its customers as a critical factor of the ICMS project solution.

2.1. VISION, STRATEGIC OBJECTIVES, AND KEY BUSINESS PRINCIPLES

EDDNext Vision:

The vision of EDDnext is to deliver an efficient workforce insurance programs and services that provide exceptional claimant experiences and empower the Department to make informed and effective decisions while maintaining Federal and State compliance.

ICMS Vision:

Upon implementation of the new ICMS solution, EDD's UI, SDI, PFL, and benefit overpayments and collections and appeals functions and services achieve unmatched efficiency and user satisfaction, State of California Employment Development Department

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empowered by data-driven insights, timely decision-making, with clear and transparent state and federal regulations, while significantly reducing fraud.

Figure 2.1A Business Outcomes

Strategic Business outcomes (see Figure 2.1A):

The following strategic business outcomes represent EDD's commitment to delivering exceptional value and fostering sustainable growth.

1. Consistent customer experience that Empowers Customers by improving Equitable Access and Self-Service options,

2. Enhanced Fraud Mitigation with Improved security

3. Integrated Systems (w/ modern technology)

4. Transformed Business Performance

Targets:

EDD has identified the following key target areas to measure improvements that ultimately lead to achieving the business outcomes associated with the ICMS solution.

1. A consistent customer experience that improves equitable access and self-service options:

Implement customer journey mapping, personalized service enhancements, and initiatives to reduce average resolution time for customer issues, aiming for a 15% increase in Net Promoter Score (NPS) over the next three consecutive fiscal years.

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2. Increased fraud mitigation efforts through advanced fraud detection technologies, employee training on fraud prevention, and regular audits in high-risk areas, aiming for a 70% reduction in undetected fraudulent activities annually over three years.

3. Reduced Average Claim Processing Time (ACPT) by standardizing processes, improving communication channels, and implementing integrated claims management tools for each program area by 20% compared to respective baselines within two fiscal years, achieving or exceeding federal guidelines. Upon contract award the Contractor will be provided access to the ICMS repository for additional details.

4. Enhanced self-service capabilities that allow claimants to successfully submit, monitor and complete the claims process, increasing the Self-Service Claim Completion Rate (SSCCR) by 25% annually over three years.

Key Business Principles

These key business principles serve as the cornerstone of EDD's strategic approach to effectively address challenges, drive innovation, and optimize EDD processes:

Key Business Principle #1: Enterprise Business and System Interoperability takes precedence over individual program performance.

This principle enforces a focus on integration and collaboration among different business units and systems across EDD. The emphasis on interoperability ensures that the organization values a cohesive and interconnected approach to its systems and operations, aiming for seamless communication and functionality between various claims processing steps.

Key Business Principle #2: Rapid, Iterative, and Continuous Improvement

This principle promotes a commitment to consistent, dynamic, and iterative improvements. EDD values the ability to adapt quickly and continuously refine its processes to achieve business outcomes. The emphasis is on agility, innovation, and the pursuit of excellence through ongoing, iterative enhancements rather than infrequent, large-scale changes.

Key Business Principle #3: Improved Data Quality for Data-Driven Business

This principle establishes the importance of data in the organization's decision-making and operational performance. The emphasis on improved data quality is a commitment to accuracy and reliability in information. “Data-driven business" ensures that data insights, analytics, and performance are available for enterprise governance.

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Figure 2.1B Digital Transformation

To achieve the business outcomes, EDD has identified 6 digital limitations that must be overcome by the ICMS solution:

1. Lack of Self-Service - Online self-service options, integrated solutions, and mobile-friendly applications are not feasible with the current system's environment. Modernization will allow for customer self-service enhancements (e.g., mobile access, multiple languages, phone system integration, 24x7 accessibility) that will ultimately allow EDD the ability to connect with and provide services to customers in the ways they expect and desire.

2. Lack of Automation - The lack of automated capabilities in the current state is a frequently voiced concern throughout the program improvement sessions, which is consistent with the evaluation of the requirements. Automation of tasks can free up staff time for more value-added, impactful services, as well as allow for better oversight and governance.

3. Lack of Integration - The current technical infrastructure consists of many aged, disparate systems that utilize different technology platforms with highly constrained abilities to interact and share using modern and flexible technologies. Improving integration across lines of business, as well as across department boundaries, allows for an integrated claims system that supports DI, PFL, Benefits overpayments, collections, and appeals functions.

4. Limited Data Availability - Due to the limitations of current legacy systems, such as the limited

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ability to add or expand data fields, optimal use of information has been largely curtailed, which limits efficiency, effectiveness, quality, transparency, compliance, and operational excellence.

Improvements in this area will allow for the implementation of desired legislative changes, as well as increased service and oversight.

5. Lack of Workforce Options - The existing processes, security, systems, and technologies have grown increasingly difficult to support, based on a declining workforce interest in aging solutions.

EDD needs to modernize the required skill sets to open new opportunities to retain internal and recruit external workforce.

6. Increasing Security Threats - The existing systems were not designed with integrated security in mind, nor are they capable of managing user access consistently and appropriately. Improving security using newer technology provides the ability to better manage the complexity and threats associated with today’s challenging cybersecurity environment, and greatly enhances fraud detection.

2.2. Description of Services

This section outlines the array of services tailored to address fundamental aspects of the ICMS solution.

I. Vision and Strategy-Related Services

The Contractor is expected to understand and align with EDD's vision for the optimization of its business, technology, and organizational culture. This involves re-imaging business and technology architectures to improve integration and efficiency. Additionally, The Contractor shall establish a strategic roadmap that enumerates and defines major activities that will realize EDD's vision, goals, and objectives. For more details, refer to SECTION 2.1. VISION, STRATEGIC OBJECTIVES, AND KEY BUSINESS PRINCIPLES.

II. Technology Optimization Related Services

The Contractor must deliver technology optimization services without disrupting EDD's current operations.

The solution shall align with EDD's Target Conceptual and Future State Technical Architecture as described in SECTION 2.5. FUTURE STATE TECHNICAL ARCHITECTURE . Moreover, the Contractor must address EDD's Personas and User Stories, per SECTION 14.1.67. DEL67NN MONTHLY SPRINT STATUS REPORTS, and leverage the Hybrid Agile Framework SECTION 2.9. EDD’S HYBRID AGILE FRAMEWORK to blueprint and roadmap improvements that meet requirements (See SECTION 6.

SOLUTION REQUIREMENTS). Upon contract award, the Contractor will be provided access to the ICMS repository for additional details of the EDD's Personas and User Stories. The solution must enable EDD to adapt to changing business rules and adopt strategic technologies in the future as outlined in EXHIBIT C: Functional/Non-Functional Requirements.

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III. Business Optimization Related Services

Contractor services will facilitate business optimization without disrupting current operations, moving current functionality to new processes and the solution. The solution must align with EDD's existing Business Architecture and address Personas, User Stories, and any gaps through the Hybrid Agile Framework. Additionally, the solution must position EDD to quickly respond to legislative changes, implement new programs, and serve new customers.

IV. Organizational Optimization Related Services

Contractor leadership and staff will integrate seamlessly with EDD and EDD third-party Contractors to deliver organizational optimization services related to the ICMS solution (e.g., OCM, BPR, Training, etc.).

V. Integration Optimization Related Services

The Contractor is responsible for delivering integration optimization services to ensure full integration of the ICMS solution with EDD's internal and external data sources. This includes training EDD staff to maintain and implement new connections, interfaces, integrations, and data sources.

VI. Data Optimization Related Services

The Contractor will deliver data optimization services for the ICMS solution. This involves identifying and validating critical business and operational data impacted by the project, as well as planning, designing, and managing all aspects of data migration, conversion, translation, and preparation to ensure data integrity and security.

2.3. IMPLEMENTATION MILESTONES/PHASES

The ICMS Implementation Timeline places a strong emphasis on a flexible schedule framework. We have grouped the the project into 5 Milestone for the Contractors work efforts, and these will be connected to the overall project timeline and deliverables-based contract. Functional program (UI, DI, PFL) releases have been identified within Milestones 2, 3, and 4.These Functional Reelase milestones contain 7 phases: e The Milestones and Phases are below::

• Milestone 1 – Project Initiation/onboarding

• Milestone 2, 3, & 4

• Phase 1 – Discovery, analysis, verification of full requirements, design and Documentation.

• Phase 2 – Environment specifications, setup, base application installed as applicable

• Phase 3 – Sprints executed as Application Configured as needed, interfaces, forms, reports designed and implementation with EDD User testing for each sprint

• Phase 4 – Contractor System Integration Testing (SIT) commences as Entry Criteria are

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met and approved by EDD.

• Phase 5 – EDD User Acceptance testing commences (UAT) as all Entry Criteria are met and approved by EDD. High Quality Data is converted, validated, loaded for UAT

• Phase 6 – All Users configured, ICMS Major Release II deployment completed, Warranty then M&O started

• Milestone 5 - M&O -

For a detailed schedule of when each deliverable is expected from the Contractor, please refer to

SECTION 14. CONTRACTOR DELIVERABLES.

2.4. ICMS SOLUTION ALIGNMENT WITH EDDNEXT STRATEGIC OBJECTIVES

The following table displays each Business Objective mapped to the EDD strategic objectives it corresponds to. These ICMS Business Objectives help EDD to ensure that the ICMS requirements align with EDD’s strategic goals.

Table 2.4A Performance Measures and ICMS Objectives

OBJ REF EDDNEXT STRATEGIC OBJECTIVE ICMS BUSINESS OBJECTIVE

1.1 Enhanced customer-centric design:

Ensure equity by optimizing service channel design in multiple languages across channels such as mobile, social media, self-service websites, live chat, emailed and mailed notices.

Objective: Enhanced customer-centric design - Ensure equity by optimizing service channel design in multiple-languages across channels such as mobile, social-media, self-service websites, live chat, emailed and mailed notices.

1. Metric 3.1: Number of supported languages by EDDNext systems across channels (e.g., mobile, social-media, self-service websites, live chat, emailed and mailed notices).

◦ Baseline: 2 supported languages: English and Spanish across channels (e.g., mobile, social-media, self-service websites, live chat, emailed and mailed notices).

◦ Target Result: By the end of the project, EDDNext systems will

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OBJ REF EDDNEXT STRATEGIC OBJECTIVE ICMS BUSINESS OBJECTIVE

support 8 languages including English and Spanish across channels (e.g., mobile, social-media, self-service websites, live chat, emailed and mailed notices).

2. Metric 3.2: The percentage of claims that were processed timely based on their targets and relative to fraud levels.

UI metric is first payment promptness.

◦ Baseline:

◦ UI: 76% 14 days / 88% 21 days in 2019 (784,695 claims).

◦ UI: 62% 14 days / 79% 21 days in 2020 (4,709,534 claims).

◦ UI: 36% 14 days / 48% 21 days in 2021 (1,217,611 claims).

◦ DI: 95% 14 days in 2019

(616,285 claims).

◦ DI: 95% 14 days in 2020

(598,729 claims).

◦ DI: 93% 14 days in 2021

(640,707 claims).

◦ PFL: 88% 14 days in 2019

(242,345 claims).

◦ PFL: 87% 14 days in 2020

(245,177 claims).

◦ PFL: 85% 14 days in 2021

(268,416 claims).

◦ Target Result: 18 months after project implementation, target:

UI: >=87% of all 1st payments made within 14/21 days after the week ending date of the first compensable week in the benefit year. DI and PFL: 86%

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first payment promptness in 14 calendar days.

3. Metric 3.3: Percent of claims paid within one week of first certification received.

◦ Baseline: 81% UI claims paid within one week of first certification received.

Target Result: By the end of the project, target 90% of UI claims are paid within one week.

2.1 Increase self-service opportunities:

Simplifying the claim's intake process by expanding self-service functionality across all programs.

Objective: Increase self-service opportunities - Simplify the claim's intake process by expanding self-service functionality across all benefit programs.

1. Metric 1.1: The proportion of claims that are filed through the online portal vs. all other means (e.g., phone, in person etc.)

◦ Baseline: UI: 77% online, 23% other means (16% paper, 7% telephone claim filing).

DI: 74% online, 26% other means (2021). PFL: 0% online, 100% other means.

◦ Target Result: By the end of the project, target the proportion of claims filed through online portal vs other means as:

• UI: 95%

• DI: 85% online.

• PFL: 85% online.

2. Metric 1.2: The number of unique self-service actions available to claimants, employers, and medical providers.

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◦ Baseline: Current number of existing self-service actions available to claimants, employers, and medical providers.

◦ Target Result: By the end of the project, increase of 5 self-service actions by the end of project. Examples:

• Claimant profile/ preferences update.

• Claimant view transaction history.

• Claimant view DI/PFL claim status.

• Claimant view electronic notices.

• Claimant/Employer/ Physician document upload.

• Claimant/Employer/ Physician embedded help.

◦ The current system does not have any of the above self-service actions.

3. Metric 1.3: Ratio of phone calls entering the Customer Support Center (CSC) to unique callers within one year of going live.

◦ Baseline: Peak ratio: UI Call Center 14.9 calls for every unique caller week of 2/6/2021.

Current ratio: UI Call Center 2.7 calls for every unique caller

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week of 3/19/2022.

◦ Target Result: By the end of the project, peak ratio: Less than

5.0 calls for every unique caller.

Normal operations ratio: 1.5 call for every unique caller.

4. Metric 1.4: Percent of errors in initial claims determinations found through Field Office Basic Evaluation System (FOBES) check.

◦ Baseline:

• UI: 9.5% error rate

(2,470 claims reviewed in 2019)

• DI: 2.1% error rate in initial claims (501 initial claims examined from Q1 2019 to Q1 2020).

• PFL: 0% error rate in initial claims (114 initial claims examined from Q1 2019 to Q1 2020).

◦ COVID:

• DI: 8.4% error rate in initial claims (1,327 initial claims examined from Q2 2020 to Q3 2021).

• PFL: No FOBES conducted.

• UI: No FOBES conducted.

◦ Target Result: 18 months after project implementation, the

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percent of errors in initial claims determinations found through Field Office Basic Evaluation System (FOBES) check will be reduced to:

• UI: 5%.

• DI: TBD*.

• PFL: TBD*

◦ DI and PFL are unable to provide the target rate for the CSC metrics at this time. The DI Branch just added a new command center in late February of this year and the new command center is in the beginning stages of establishing their KPIs. The KPIs need to be set before targets. Project team will revisit target results in Stage

5. Metric 1.5: The average wait time for a caller before speaking to a representative.

◦ Baseline:

• UI: 9 minutes (in Contact

11/2021-12/2021)

• DI: 21.3 minutes (01/

2019 - 02/2020).

• PFL: 23.7 minutes (01/

2019 - 02/2020).

• Tax: 7 minutes (2019 and 2020).

◦ Covid:

• UI: 45 minutes (in

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Contact 08/2020 - 10/ 2021).

• DI: 26.9 minutes (03/ 2020 - 12/2021).

• PFL: 32.4 minutes (03/ 2020 - 12/2021).

• Tax: 21 minutes (2020).

◦ Target Result: 18 months after project implementation, the average wait time for a caller before speaking to a representative UI: 10-15 min.Tax: 10 min. DI: TBD*. PFL:

TBD*

◦ DI and PFL are unable to provide the target rate for the CSC metrics at this time. The DI Branch just added a new command center in late February of this year and the new command center is in the beginning stages of establishing their KPIs. The KPIs need to be set before targets. Project team will revisit target results in Stage 4.

6. Metric 1.6: The number of abandoned calls while a customer was waiting on hold to connect with a human agent (Abandon Rate).

◦ Baseline:

• UI: 9% (in Contact 11/

2020-12/2020, 226K abandoned calls).

• DI: 11.7% (01/2019 - 02/

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2020, 486K abandoned calls).

• PFL: 12.5% (01/2019 -

02/2020, 90K abandoned calls).

• Tax: 3% (6,427 abandoned in 2021).

◦ Covid:

• UI: 18% (in Contact 08/

2020 - 10/2021, 3.2M abandoned calls).

• DI: 12.2% (03/2020 - 12/

2021, 271K abandoned calls).

• PFL: 13.7% (03/2020 -

12/2021, 51K abandoned calls).

• Tax: 8.5% (21,918 abandoned calls in 2019).

◦ Target Result: 18 months after project implementation, the number of abandoned calls while a customer was waiting on hold to connect with a human agent (Abandon Rate) will reduce to: UI: 5-8%. DI: TBD*.

PFL: TBD*

◦ DI and PFL are unable to provide the target rate for the CSC metrics at this time. The DI Branch just added a new command center in late February of this year and the new command center is in the

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beginning stages of establishing their KPIs. The KPIs need to be set before targets. Project team will revisit target results in Stage

3.1

Mitigate fraud - Protect claimant identity, reduce fraudulent activities, and reduce this costly risk to the state by enhancing technology-driven security.

Objective: Mitigate fraud - Protect claimant identity, reduce fraudulent activities, and reduce this costly risk to the state by enhancing technology-driven security.

1. Metric 2.1: Number of multi-factor authentication options available for claimant to authenticate their access to online systems for Unemployment, Disability, and Paid Family Leave programs by the end of the project.

• Baseline: Current Unemployment, Disability, and Paid Family Leave online systems use security questions in addition to login password to authenticate user access which does not constitute multi-factor authentication (MFA).

• Target Result: By the end of the project, implement one or more multi-factor authentication option for claimants to access EDD benefit system (Unemployment, Disability, and Paid Family Leave).

4.1

Improved consistent integrated program delivery - Extending data analytics to deliver more useful claims processing information and enhanced employee training.

Objective: Improved consistent and integrated program delivery - Enhance standardization in user experience. Enhance data analytics to expand dashboards, provide daily reporting on claims processing and backlog, and assist in fraud analysis. Enhance standardization in user

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experience. Enhance training modules.

1. Metric 4.1: Customer satisfaction results from an equitably distributed survey (ex. SARS unit) on claimant, employer (future state), and/or medical (future state) experience with their online portals, particularly focused on effectiveness and intuitiveness of the portals.

2. Baseline: UI: 60% of respondents who used UI Online/Mobile rated the online methods very easy for finding their claim or payment status. DI: 64% of respondents whose goal was to “Access SDI Online” achieved their goal.

3. Target Result: 18 months after project implementation:

• UI: 80% of respondents rate UI Online or UI Online mobile as very easy to find claim status.

• DI: >90% of respondents whose goal it is to "Access SDI Online" are able to meet their goal.

• PFL: New functionality.

• Employer/Medical Provider:

New functionality.

5.1 Greater adaptability for faster

program changes - Eliminate the siloed systems in place of an integrated, interoperable, modular framework that enables rapid program changes, can scale to meet the demand of unusual spikes in claim submissions, and seamlessly implement U.S. Department of Labor

Objective: Greater adaptability for faster program changes - Eliminate the siloed systems in place of an integrated, interoperable, modular framework that enables rapid program changes, can scale to meet the demand of unusual spikes in claim submissions, and seamlessly implement U.S. Department of Labor (DOL) and California government modifications.

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(DOL) and California government modifications.

1. Metric 5.1: Number of configurable and interoperable components available in the data and system integration platform that are shared across programs.

• Baseline: No configurable and interoperable components are shared across programs.

• Target Result: By the end of the project, the expected result is that claimants have one login/ profile for all EDD services and can see their benefits history and outstanding items for all programs on their claimant portal.

2. Metric 5.2: Benefit systems performance and stress tests results from simulating peak user demand (i.e., peak COVID numbers) to include number of system crashes, total downtime, and number of users negatively impacted.

• Baseline: Peak COVID demand ~500,000 UI claims per day.

Does not count claimants that were unable to file due to issues. Peak COVID Baseline:

1,064,826 UI claims filed week of 03/21/2020. Does not count claimants that were unable to file due to technical issues.

Source. >500,000 claims a day.

• Target Result: 18 months after project implementation, all benefits systems pass stress

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tests at simulated peak claims filed +25% (625,000) with no crashes or recorded system downtime during performance testing.

Table 2.4B Performance Measures

EDDNEXT STRATEGIC OBJECTIVES Aligned with outcomes

EDDNext Strategic Objective

Outcome

Enhanced customer-centric design - Ensure equity by optimizing service channel design in multiple-languages across channels such as mobile, social-media, self-service websites, live chat, emailed and mailed notices.

Design and optimize multi-language service channels for EDDNext, supporting 8 languages and ensuring prompt payment targets for UI, DI, and PFL claims across various communication platforms.

Improved consistent integrated program delivery - Extending data analytics to deliver more useful claims processing information and enhanced employee training.

Improved Data-Driven Decisions Making - Enrich data analytics and interactive dashboard reporting to provide data metrics for data transparency, as well as providing sustainable operation efficiency measures for internal and external users. Higher quality data that business users can rely on to interpret and support data-driven decision-making across the enterprise.

Enhanced Oversight and Data Governance: Enhance data governance to provide hands-on observation, audit, and correction in key areas of quality, policy, and data stewardship. Define policies for data management, access, usage, security, and quality, ensuring the right people have access to appropriate data based on their role.

Enhanced Data Management Services - Enhance shared service for

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EDDNext Strategic Objective

Outcome hosting structured, semi-structured, and unstructured data, as well as common services for collecting and governing the data. Structured data is generally tabular data with relationships kept in a database. Semi-structured includes data such as csv, json and xml files. Unstructured data can include pdf, tiff, bmp, wav, mp4, and other formats where the query of key/value pairs requires the file be processed and key/value pairs created.

Unstructured data is generally in a format meant to be directly consumed by humans such as through word, pdf reader, or video playback.

Improved Enterprise Content Management (ECM) - Develop an enterprise content management solution that provides long-term care, organizing, and shared tools for information embedded in content (generally semi-structured and unstructured data.) Content in ECM generally has a specific audience such as evidence in image format to be used by a worker on a claim, or a pdf to be mailed, or a report to be distributed to management.

Enterprise content management allows for the EDD internal workflow, indexing, search, versioning, alerting, and transformation of the content.

This is the primary storage and access for content, while in Integrated Contact Center – Forms / Paper / Mail / Scanning, content may be consumed or distributed to and from clients and other external partners.

Greater adaptability for faster program changes

- Eliminate the siloed systems in place of an integrated, interoperable, modular framework that enables rapid program changes, can scale to meet the demand of unusual spikes in claim submissions, and seamlessly implement U.S. Department of Labor (DOL) and California government modifications

Improved Enterprise Integration Services – Develop reliable middleware that allows EDD solutions to securely access and be securely accessible from partner services anywhere. Within EDD solutions, the integration services will provide uniformity to remove integration complexity and to govern service usage. For partners, the integration services will provide and consume the breadth of interfaces that partners require.

More Accurate Reporting to Regulatory and Auditing Agencies: Establish strong data governance to meet Department of Labor (DOL), California Legislature, and Labor and Workforce Development Agency (LWDA) reporting requirements in a timely and accurate manner. Implement a data governance framework that vigorously ensures data quality will allow EDD to be confident in meeting external reporting requirements.

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EDDNext Strategic Objective

Outcome

Increase self-service opportunities - Simplifying the claims intake process by expanding self-service functionality across all programs.

Reduced Staff Workload: Decrease staff workload by allowing data users to quickly understand where to locate data and how to interpret it.

Inaccurate, poorly documented, or duplicated data leads to time wasted for EDD staff. The result of a strong data governance program reduces errors in databases, giving EDD branches a solid foundation to work from and saving vprecious time that would otherwise be used to correct existing data. Time saved is taxpayer dollars saved.

Mitigate fraud - Protect claimant identity, reduce fraudulent activities, and reduce this costly risk to the state by enhancing technology-driven security.

Enhanced Identity Components - Develop components that manage and verify user and system identity, roles, and authorization across EDD IT infrastructure. While within any business component, roles and attributes may be mapped to specific granular permissions, the access to the component and the verification of the identity shall reside within a shared service. This is to provide robust audit, single sign-on, single revocation of access, and other access controls in a uniform and governed manner.

Secured Customer Data: Establish the appropriate roles and permissions for accessing data. With various data types, such as, claimant, employer, and medical documentation, EDD has an obligation to ensure that data utilized across programs is treated in accordance with internal policy and any applicable external regulations.

2.5. FUTURE STATE TECHNICAL ARCHITECTURE

The ICMS High-Level Technical Architecture is depicted below which:

• Provides the overview of the solution functionality in scope for this Agreement.

• Identifies the technical functionality needed to support business processes.

• Identifies solution interactions to support business processes.

To enhance program performance through digital transformation, EDD is requiring a modular, cloud-first, enterprise class, digital architecture to achieve the single ICMS that must support all EDD programs. The proposed architecture, environment and applications need to empower EDD programs and services to achieve unprecedented efficiency and user satisfaction, driven by automation, data-driven insights, timely decision-making, and compliance with federal and state regulations, while significantly reducing fraud.

EDD requires a digital solution that overcomes the limitations of our current processes, information access, and technologies to help us achieve our program performance targets. The legacy Benefits application portfolio comprises a disparate set of non-integrated applications operating on various

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technologies, housing mission-critical information with varying levels of accessibility, security, and integrity. The current architecture limits our ability to improve outdated processes, access disparate datasets, primarily due to systems that have become increasingly cumbersome to maintain, update, and upgrade. These limitations pose significant challenges in adapting to regulatory changes, managing caseload increases, and combating fraudulent activities. Moreover, our current forms, processes, and reports require excessive manual effort and activities to maintain our required accuracy.

EDD is taking a holistic and strategic approach to modernizing and improving the benefits system, requiring a solution that significantly reduces the dependency on, or even decommission, legacy technologies, systems, and applications. As stated above, our core focus is on providing a fit for purpose claims and case management system that directly achieves our business outcomes and removes our digital limitations. See +SECTION 2.4. ICMS Alignment with Objectives.

To achieve these goals, EDD requires a complete revamp of the digital assets. We seek to move away from digital diversity, customized applications, and convoluted manual processes, instead leveraging low-code/no-code and/or Commercial-off-the-Shelf (COTS) technology, built for purpose platforms, as well as automation and AI-driven solutions that improve efficiency and commonality between applications. The new platform must utilize common elements and modules where appropriate, with a focus on the ICMS and the supporting data management capabilities. The ICMS must serve as a unified claims management system handling all EDD claims, while the DIH must facilitate the movement of data within the new platform and between legacy data sources, ensuring efficiency and scalability.

The solution description must clearly detail the nuances, approach, and benefits of the technical architecture proposed. Below we have included a proposed Target Technical Reference Model that describes our understanding and desired architecture. The ICMS technical architecture is guided by and the solution shall be based on the following digital principles:

1. Business Outcome Alignment: Ensure the proposed technical solution closely aligns with the business outcomes and effectively addresses digital limitations. (Reference: Section [Reference Number] of the project documentation)

2. Scalability: Achieve scalability to accommodate fluctuations in service demands, such as economic downturns or pandemics, while meeting evolving customer experience. Upon contract award, the Contractor will be provided access to the ICMS repository for additional details to desired capacity.

3. Adaptability: Exhibit increasing flexibility to rapidly accommodate regulatory and policy changes within defined timeframes. Upon contract award, the Contractor will be provided access to the ICMS repository for additional details for information on regulation cycles, response timeframes, and policy adjustments.

4. Interoperability and Integration: Achieve seamless integration with existing systems, applications, and third-party services while adhering to industry standards and protocols. Upon

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contract award, the Contractor will be provided access to the ICMS repository for additional details.

5. Security and Compliance: Ensure robust security measures, including encryption, access controls, and compliance with relevant regulatory requirements such as HIPAA. Upon contract award, the Contractor will be provided access to the ICMS repository for additional details for specific security protocols and standards.

6. Reliability and Resilience: Demonstrate reliability and resilience, including uptime guarantees, disaster recovery capabilities, and fault tolerance mechanisms. Upon contract award, the Contractor will be provided access to the ICMS repository for additional details to detailed downtime and availability metrics.

7. Usability and User Experience: Measure, manage, and monitor the effectiveness and satisfaction of the customer journey, focusing on factors such as accessibility, ease of navigation, and intuitiveness of features.

8. Total Cost of Ownership (TCO): Consider the total cost of ownership associated with the proposed technical environment, encompassing implementation costs, ongoing maintenance expenses, and potential hidden costs. (Reference Earned Value and expected return on investment)

9. Contractor Support and Service Level Agreements (SLAs): Ensure that the proposed technology solution meets the required SLAs for response times, resolution procedures, and escalation processes as outlined SECTION 35. SERVICE LEVEL AGREEMENTS (SLAS).

2.6. EXISTING TECHNOLOGY STACK

The technology stack used as part of the existing benefit systems within EDD is provided in ATTACHMENT 21: Existing Technology Stack. EDD is open to proposed alternatives as part of the ICMS solution.

2.7. INTEGRATION WITH EDD SYSTEMS

The ICMS solution will integrate with all the new and existing interfaces established within EDD. The internal and external interfaces include, but are not limited to, the following:

• Identity, Credential and Access Management (ICAM): Identity and access management manage and verify user and system identity, roles, and authorization.

• Document Management System (DMS): Improve document scanning and optical character recognition (OCR) capabilities.

• myEDD Portal: Portal leveraged by claimants from all programs, employers, and medical providers as part of the claims management process.

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• Accounting and Compliance Enterprise System (ACES): Core system that the EDD Tax Branch leverages for daily operations.

• Integrated Contact Center (ICC): Includes interactive voice response (IVR), automated call distribution (ACD), screen pop, and customer relationship management (CRM).

• Existing Internal and External systems and Partners supporting claims management. Refer to +SECTION 6.1.9. System Context Mode where the existing interfaces have been provided. These interfaces will be reviewed and updated during the Design / Discovery phase of this project.

• New Systems and Interfaces as identified during the Milestone 01 – Initiation phase to support claims management.

The image below describes the integrations that have been identified so far for the ICMS solution.

Upon contract award the Contractor will be provided access to the ICMS repository for additional details of all integration points.

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Figure 2.7 ICMS Integrations

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2.8. ICMS CONCEPTUAL ARCHITECTURE

A high-level architecture context was developed (image below) to depict the ICMS solution among other evolving solutions at EDD. The high-level solution components as part of the ICMS solution are listed below:

• Data Management Capabilities serve as the enterprise data integration platform that will need to integrate with several investments in modern technology and capabilities that EDD has implemented or will be implementing.

• ICMS will be implemented to manage all aspects of claims processing, payment, over-payment recovery, and claimant communications.

Figure 2.8 ICMS Conceptual Architecture

2.9. EDD’S HYBRID AGILE FRAMEWORK

Throughout the term of the contract, the Contractor will be required to work collaboratively with EDD and third-party Contractor employees. As the EDDNext transformation involves various modernization initiatives, EDD has established a Transformation Office to manage and oversee the various initiatives across the EDDNext enterprise. The Transformation Office resources will provide services including Project Management, Enterprise Architecture (business and technical), Organizational Change

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Management, Quality Assurance, and Independent Verification & Validation. It is critical to the success of the EDDNext program that the Contractor integrate their implementation methodology with the EDDNext Transformation Office processes and guidelines.

The Contractor's implementation approach and methodology will be required to align with EDD’s Hybrid Agile Framework (HAF). The HAF is aimed at tailoring several agile methodologies to the EDD’s needs and includes phases, sub-phases, roles, responsibilities, documentation, and templates that are not part of a typical agile effort, hence the “Hybrid” designation.

The EDD’s HAF is an approach in which the solution for a business problem or opportunity can evolve over the life of the project yet project initiation and planning documentation such as approved Requirements, Product Roadmap, the Project Charter, Roles Accountability Matrix, and the Project Management Plan are more waterfall in nature and solidify initial project or phase scope and control methodologies. The EDD understands that the ICMS design, development and implementation will take several years. The HAF methodology is designed to allow for changes and flexibility in a fast-moving technology landscape, so the EDD will provide Californians with products and services that are modern, relevant and user-centric when they are implemented. HAF is a way of implementing using several core principles and Prototyping.:

• Iterative development

• User-centered design

• Iterative planning

• Flexible scope management

• Team ownership

• Continuous improvement of processes

The EDD has developed a comprehensive HAF Reference Guide, HAF Processes, Artifacts and Templates. The EDD understands that there are several widely accepted Hybrid Agile methodologies such as Scaled Agile Framework (SAFe) and…