7-02. N267524AN - Questionnaire.pdf

BENEFITS CONSULTING AND ACTUARIAL SERVICES

ITN No. N267524AN

QUESTIONNAIRE

SECTION 1 – FIRM EXPERIENCE & QUALIFICATIONS

1. Firm Overview

• Describe your firm’s background, ownership structure, and organizational structure, including any parent, affiliated, or subsidiary companies.

• Provide the address of your firm’s corporate headquarters and identify the office location(s) that will service the District.

• Is your firm headquartered in Florida? If not, identify the location of your headquarters.

• Identify the office location that will service the District and state staffing levels.

• Describe the services your firm provides and percentage of revenue by service line.

• Provide an organizational chart and describe support structure.

• Describe significant developments within the past three years.

2. Client Base & Experience

• Provide number of consulting, actuarial, and brokerage clients.

• Describe experience with similar public sector clients.

• Provide examples of projects with measurable outcomes.

• Describe experience performing actuarial valuations for similar clients.

3. Assigned Team

• Identify key personnel and provide contact information (name, title, phone, email).

• Describe roles and responsibilities.

• Describe backup and continuity plans.

• State whether consultants or actuaries have other responsibilities.

4. Differentiators

• Describe unique qualifications and resources.

• Describe services not commonly offered by competitors.

• Describe additional relevant experience.

SECTION 2 – TECHNICAL APPROACH

1. Data & Analytics

• Describe claims analysis capabilities.

• Describe data validation processes.

• Confirm inclusion of analytics services in fees.

2. Strategy & Procurement

• Describe approach to providing the requested services

• Describe benefits strategy development.

• Describe procurement support and vendor evaluation.

• Describe marketing and placement approach.

3. Financial & Actuarial

• Describe budgeting and projections.

• Describe actuarial valuation approach.

• Describe funding and trend analysis.

• Describe actuarial assumptions methodology.

4. Compliance

• Describe legislative monitoring and communication.

• Describe HIPAA compliance.

• Describe reporting compliance (112.08).

• Describe legal support resources.

SECTION 3 – GOVERNANCE & RISK

• Describe code of conduct and enforcement.

• Describe review and oversight of consultant recommendations.

• Identify conflicts of interest and management approach.

• Disclose litigation or regulatory actions.

• State whether firm has been censured by any regulatory body.

• Disclose any gifts or compensation provided to District staff within 12 months.

• Describe quality assurance procedures.

• Describe disaster recovery plan.

• Describe insurance coverage including limits, carriers, and structure.

• Identify any services the firm is unable to perform.

SECTION 4 – COST & VALUE

• Provide annual all-inclusive fee.

• Confirm commission structure.

• Describe cost control approach.

• Identify any services excluded from fees.

• Describe additional value-added services.

SECTION 5 – REQUIRED SERVICES MATRIX

Required Services Agree to provide/included

Agree to provide with Deviations

Cannot provide

1. Analyze and evaluate the current employee benefit plans and communicate with stakeholders, as necessary.

2. Review plan documents, summary plan descriptions, and pertinent contract language to ensure accuracy and compliance with appropriate laws and regulations.

3. Assist in developing Requests for Proposals (RFPs), Invitations to Negotiate (ITN), etc.

for employee benefit products as needed, analysis of proposals received, conducting interviews and site visits as necessary and be prepared to defend the recommendations.

4. Attend monthly Insurance Task Force Meetings (and subcommittee meetings) in person.

5. Attend Board meetings (briefing, action, and workshops) in person, as requested.

6. Provide a monthly executive summary of the self-funded health plan in a format that is easy to understand and acceptable to the Insurance Task Force.

Required Services Agree to provide/included

Agree to provide with Deviations

Cannot provide

7. Provide detailed quarterly reports analyzing plan revenues, claims, and administrative expenses in a format that is easy to understand and helpful in decision making to the Insurance Task Force and the Board.

8. Meet with the Assistant Director of Benefits and Wellness, or designee, on a regular basis and be prepared to provide guidance and assistance by telephone or in person, as needed.

9. At the Board’s request, prepare detailed bid specifications and solicit proposals from insurance markets that specialize in group insurance plans as needed. Assist in evaluating bids and bidders, including administration coverage, claim payment procedures, customer service, networks, reserve establishment policies, and financial stability.

Summarize and report results to the Board’s Benefits and Wellness Department and District benefit committees and the School Board as requested.

10. Provide advocacy for the Insurance Task Force when decisions or recommendations are questioned or challenged.

11. Assist the Board in administering all group insurance plans (active and retirees), responding to questions from and providing information to assigned staff, and providing other consulting services during the course of the plan year.

Agree to provide with Deviations

Cannot provide

12. Assist the Board in complying with federal, state, and local laws and regulations related to employee benefits. Provide technical assistance on such matters as COBRA, HIPAA, FMLA, Section 125, GASB, Medicare Part D, Health Care Reform legislation, and other benefit related issues, as necessary.

13. Determine and recommend the most economical funding methods for the benefit programs and strike a balance between cost and comprehensiveness of the programs.

14. Facilitate all benefit negotiations with providers on all issues including premiums, benefit levels, plan design, and special terms and conditions.

Assist in contract development and documentation.

15. Research any new developments in the law and employee benefit programs on an ongoing basis and submit summaries to the District stakeholders for review and discussion.

16. Analyze claims and demographic data and review and benchmark Board benefit programs against national, local, and school district data. Present analysis to District staff as requested.

Agree to provide with Deviations

Cannot provide

17. Identify opportunities to better manage health care costs, including but not limited to disease management, risk assessment, wellness initiatives, carve out programs and other methods to contain costs without compromising service.

18. Assist with billing issues and other vendor problems.

19. Provide a licensed life and health agent/broker in the State of Florida.

20. Provide personnel qualified/certified in the field of employee benefits and/or actuarial services.

21. Provide access to attorney to provide guidance to the District on benefits related issues.

22. Negotiate claims and customer service issues with providers on behalf of the Board.

23. Assist in the completion of annual budget projections.

24. Prepare an annual stewardship report and performance review.

25. Send bulletins to Assistant Director of Benefits and Wellness on hot topics and legislative issues.

26. Provide additional information to assist in the District’s fulfillment of fiduciary duties.