6. Attachment E - Reporting and Deliverables.pdf
PDF 94 KB Posted
- Attached to
- RFP No. DMS-2425-312 MAPD
- Solicitation number
- RFP-12976
- Issued by
- Leon County, Florida
About this file
Attachment E is a reporting and deliverables document for Request for Proposal (RFP) No. DMS-24/25-312 issued by the Florida Department of Management Services, Division of State Group Insurance. The document details a comprehensive reporting matrix with 22 different reports that must be submitted at various frequencies: weekly (4 reports), monthly (8 reports), quarterly (9 reports), and annually (6 reports). These reports cover a wide range of requirements including reject records, duplicate records, address errors, subscriber drops, background checks, claims files, performance guarantees, formulary changes, utilization reports, trend analyses, network provider changes, clinical programs, member satisfaction surveys, and annual plan reporting.
The reporting requirements specify precise submission deadlines, with most weekly reports due within 2 business days of file availability, monthly reports due by the 15th of the following month, quarterly reports due within 45 calendar days of quarter-end, and annual reports due by specific dates such as May 1, 2028 for renewal reports or within 45-60 calendar days of year-end. Most reports must be submitted in a department-prescribed format, with some specific requirements like the Enrollee Invoice needing an Excel format with detailed member enrollment and invoicing information. Several reports, such as the Part C and Part D Medicare Membership report, require submission as received from CMS with a data key provided as needed. The document is part of a larger procurement for Medicare Advantage and Prescription Drug plans for Florida state group insurance.
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Text version
RFP No.: DMS-24/25-312 Attachment E: Reporting and Deliverables Page 1 of 3
ATTACHMENT E: REPORTING AND DELIVERABLES
FREQUENCY REPORT
NUMBER REPORT NAME DUE DATE FILE LAYOUT
Weekly 1 Reject Records Report w/in 2 Business
Days starting w/ 1st full day file is available
Department-prescribed format.
2 Duplicate Records Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
3 Address Errors Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
4 System Generated Subscriber Drop Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
Monthly 5 Background
Checks/Persons with Disqualifying Offenses
15th of following month
6 Paid Claims File - to Dept/HIMIS
7 Paid Claims Summary Report
8 Part C and Part D Medicare Membership report (MMR) w/in 15 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
Attachment E: Reporting and Deliverables Page 2 of 3
9 Enrollee Invoice 15th of following month
Excel format, tab 1. Must include enrollment file Member detail matching invoiced amount on subsequent tab(s)
Quarterly
10 Performance Guarantee Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
11 Formulary Changes w/in 45 Calendar Days of quarter end
Department-prescribed format.
12 Key Metric Cost w/in 45 Calendar Days of quarter end
Department-prescribed format.
13 Utilizatin Report w/in 45 Calendar Days of quarter end
14 Trend Analysis Report w/in 45 Calendar end
Department-prescribed format.
15 Network Provider Add / Delete Report w/in 45 Calendar
16 Trend Analysis Report w/in 45 Calendar
17 Clinical Program Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
Annually 18 Renewal Report May 1, 2028, and annually thereafter Department-prescribed format.
19 Participant Member
Satisfaction Survey Report w/in 45 Calendar Days of year end
19 Performance Bond By December 31 of each Plan Year
Attachment E: Reporting and Deliverables Page 3 of 3
20 Insurance Certificates By December 31 of each Plan Year
21 Part C and Part D Model Output Report
(MOR)
w/in 45 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
22 Annual Plan Report within 60 Calendar Days of the end of the Plan reporting year
File details come from the government source that posted it. Updated .