5-Attachment B - Questions for Vendors.docx

USHE Consolidated Health & Welfare Benefits | Questions for Potential Vendors Utah System of Higher Education Request for Statement of Qualifications Broker and Consulting Services for a Consolidated Health and Welfare Benefits Program Attachment B: Questions for Potential Vendors Solicitation Number: 07072026 Issued: 7/7/2026

Vendor Name

Primary Contact

Contact Email

Contact Phone

Date Submitted

Instructions to Vendors Vendors shall provide a complete answer to each of the questions herein. Responses should be concise and specific to the engagement described in Attachment A - RFQ Information & Scope of Work. Responses should be organized using numbering in this document and submitted in the text boxes provided. Vendors may include attached documentation if such documentation is responsive to a question beyond what can be reasonably captured in a free text field (e.g. reference resumes, sample quantitative analysis, etc.).

This solicitation is being conducted under Utah Code Title 63G, Chapter 6a, Part 15. Vendors shall not include any fee, cost, hourly rate, commission rate, or other pricing information in their response. Inclusion of pricing information may result in the submission being deemed non-responsive. Fees will be negotiated with the highest-ranked firm following the qualifications evaluation.

Vendors should review Attachment A - RFQ Information & Scope of Work, and the USHE Feasibility Study for Consolidation of Benefits dated June 10, 2025 (provided for reference) before preparing their response.

Questions for Potential Vendors Section A (20% Weight) 1.a Firm Overview and Authority to Contract Provide an overview of your firm, including legal name, headquarters location, ownership structure, year founded, total number of employees, and total number of employees dedicated to health and welfare benefits consulting and brokerage work.

Identify all states in which your firm is licensed as an insurance broker, consultant, or producer, including specifically your firm’s licensure status in the State of Utah.

Confirm that your firm is authorized to enter into a contract with the Board and that there are no pending mergers, acquisitions, regulatory actions, or other matters that would materially affect your firm’s ability to perform the engagement described in Attachment A.

[Response]

1.b Work History and Comparable Engagements Describe your firm’s experience designing, procuring, and implementing consolidated health and welfare benefits programs of comparable scope and complexity to the engagement described in Attachment A.

Provide at least three (3) detailed case studies of comparable engagements. For each case study, describe: (a) the client and the size of the covered population; (b) the scope of consolidation (including whether the engagement involved multiple previously independent risk pools, geographic dispersion, or multiple participating employers); (c) the duration of the engagement; (d) the results achieved, with specific reference to cost outcomes, member satisfaction, and operational outcomes where measurable; and (e) any material complications encountered and how they were resolved.

Specifically identify any of your firm’s experience with: (i) multi-employer or consortium benefit programs; (ii) higher education clients; (iii) state or public-sector clients in Utah or in comparable jurisdictions; (iv) engagements involving the consolidation of previously independent risk pools; and (v) engagements involving an academic medical center as both an employer and a provider organization.

[Response]

1.c References Provide at least four (4) client references for engagements similar in scope to the engagement described in Attachment A. For each reference, include client name, address, contact name, contact title, contact phone, contact email, and a brief description of services performed and reference time frame. At least two (2) of the references must be public-sector clients, higher education clients, or multi-employer or consortium clients. By providing references, the Vendor authorizes the Board to contact references at any time before, during, or after the procurement process for the purpose of evaluating the Vendor's qualifications, performance, and ability to provide the required services. The Vendor further authorizes its references to disclose relevant information in response to such inquiries.

[Response]

Section B (20% Weight)

2. Approach to Strategic Design and Disaggregated Analysis Describe how your firm would approach the strategic design work described in Section 6.2 of Attachment A, including claims data analysis, network adequacy analysis, plan portfolio recommendations, rating methodology recommendations, and governance recommendations.

Specifically describe how your firm would deliver the separate benefit consolidation analysis described in Section 6.3 of Attachment A. Explain how you would structure the analysis so that the Board can make an informed decision on a fully consolidated benefit program or with a partially consolidated benefit program. If you would consider a phased approach, outline how this would be structured. Identify any frameworks, models, or tools your firm uses to evaluate component-level and integrated-program cost, disruption, and operational implications.

[Response]

Section C (20% Weight) 3.a Approach to Downstream Vendor Procurement Describe how your firm would approach the downstream vendor procurement work described in Section 6.4 of Attachment A. Identify the categories of downstream vendors with which your firm has direct experience procuring and contracting for clients (e.g. third party administrators, networks, pharmacy benefit managers, stop-loss carriers, ancillary carriers, wellness vendors, care management vendors, etc.).

Describe your firm’s pharmacy benefit manager evaluation methodology, including approaches to pricing transparency, rebate audit, and contract terms.

Describe your firm’s approach to stop-loss and reinsurance procurement and to evaluating self-insured economies of scale at the scale contemplated in Attachment A.

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3.b Approach to Implementation and Member Transition Describe how your firm would manage implementation of the consolidated program for an effective date of July 1, 2027, including project management methodology, governance interfaces, and risk management. Provide an illustrative high-level implementation work plan or timeline based on your typical approach.

Describe your firm’s approach to managing member transition, including communications strategy, transition of active care episodes, accumulator and prior-authorization continuity, and coordination with member-institution human resources and benefits staff.

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3.c Approach to Ongoing Account Management and Renewals Describe your firm’s ongoing account management model for a client of the size and complexity of the proposed consolidated USHE program. Identify the cadence and content of routine and ad-hoc reporting your firm would provide to USHE governance, the structure and frequency of governance meetings, and your firm’s approach to annual strategic review and market benchmarking.

[Response]

3.d Approach to Scope of Work, Timeline, and Resource Commitment Review the RFQ Information & Scope of Work in Attachment A, including the deliverables and timeline in 6.10. Confirm that your firm can commit the resources required to achieve the scope objectives within the timeframe described, supporting a July 1, 2027, effective date.

If your firm proposes any modifications to the scope, sequencing, or timeline, describe the proposed modifications and the rationale.

Identify any exceptions your firm would propose to the State of Utah’s standard terms and conditions (provided as a separate attachment to this solicitation). Identification of exceptions in your response will not necessarily render the response non-responsive, but unresolved exceptions may affect final negotiation.

[Response]

Section D (15% Weight)

4. Key Personnel and Team Composition Identify the key personnel proposed for the USHE engagement. At a minimum, identify the engagement lead, analytical lead, pharmacy benefit specialist, stop-loss and reinsurance specialist, network strategy lead, and implementation lead. For each individual, provide: (a) a resume; (b) the percentage of professional time the individual will be dedicated to the USHE engagement; (c) the individual’s years of experience in the relevant role; and (d) any specialized credentials.

Identify whether the firm proposes to use any subcontractors. For any proposed subcontractor, identify the firm’s name, the work to be performed, the rationale for using the subcontractor, and your firm’s approach to oversight and quality control of subcontractor work.

Describe your firm’s succession plan in the event a key individual departs or is otherwise unavailable to complete the engagement.

[Response]

Section E (10% Weight)

5. Compensation, Transparency, and Conflicts of Interest Disclose all current and recent (within the past three years) engagements and material business relationships between your firm and any of the following: USHE member institutions; the Public Employees’ Health Program (PEHP); Regence BlueCross BlueShield of Utah; SelectHealth; Intermountain Health; University of Utah Health (including University of Utah Health Plans); MountainStar Healthcare; CommonSpirit Health; and any other entity reasonably expected to be a participant in or affected by the consolidated USHE program.

For each disclosed relationship, describe the nature of the relationship, the compensation or other consideration received, how the relationship may affect your firm’s work for USHE, and any procedural safeguards your firm would commit to in connection with downstream vendor selection (for example, independent fairness review, recusal protocols, or third-party validation).

Describe your firm’s standard compensation transparency practices, including disclosure of base broker commissions, override commissions, contingent commissions, bonuses, incentive payments, supplemental compensation, marketing allowances, and any other consideration received from downstream vendors. Confirm whether your firm is willing to provide annual certification of all compensation received from USHE and from any downstream vendor in connection with USHE business.

If your firm has ownership, affiliation, or material business relationships with one or more potential downstream vendors, describe how those relationships may benefit USHE (for example, favorable unit cost arrangements, integrated service offerings, technology access) and how your firm will ensure competitive procurement of downstream vendors notwithstanding the relationship.

[Response]

Section F (10% Weight) 6.a Troubleshooting, Communication, and Issue Escalation Describe how your firm communicates and operates when an engagement encounters difficulty (for example, vendor service failures, material claims experience deterioration, member or member-institution dissatisfaction, regulatory developments, or implementation delays). Provide a specific example from a comparable engagement in which a significant issue arose, including how the issue was identified, how it was communicated to the client, what corrective action was taken, and what the outcome was.

Describe your firm’s issue escalation protocol, including the roles and authority of the engagement lead and the firm’s senior leadership in dispute resolution and material decisions.

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6.b Coordination with Board-Retained Advisors Describe your firm’s experience coordinating with client-retained independent advisors (including actuarial, legal, and procurement advisors) on engagements of comparable scope. Describe how your firm shares work product, models, and downstream vendor materials with such advisors, and how your firm participates in joint working sessions and reviews.

[Response]

Section G (5% Weight) 7.a Data Management, Security, and Privacy Describe your firm’s analytical environment, including platforms used for claims analytics, modeling, plan design, and reporting. Identify whether the analytical work would be performed using your firm’s proprietary tools, third-party tools, or a combination.

Describe your firm’s data security program, including HIPAA compliance program, SOC 2 or equivalent attestation status, encryption practices, access controls, and incident response procedures. Identify the location of any data centers or cloud regions in which USHE data would be stored or processed.

Confirm your firm’s willingness to execute a Business Associate Agreement and a Data Use Agreement in forms acceptable to USHE prior to receiving any USHE data containing protected health information.

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7.b Sample Work Product Provide examples of work product from comparable engagements, sanitized or redacted as necessary to protect client confidentiality. At a minimum, please provide: (a) a sample strategic design or program structure recommendation; (b) a sample financial reporting deliverable for a client of comparable size; (c) a sample pharmacy benefit manager evaluation or contract review; and (d) a sample disruption or member-impact analysis. If sample work product cannot be provided, state why it cannot be provided then describe the materials in detail.

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