DRAFT_SOW_-_NFIP_Standard_Operations.pdf

National Flood Insurance Program

Standard Operation Services

Draft Statement of Work (SOW)

Award Date: TBD

Table of Contents

Contents Purpose

Background

Scope of Work

Period of Performance

Place of Performance

Government Furnished Equipment (GFE)

Deliverables - Appendix A: Deliverable Table

Performance Objectives and Requirements

Task 1.0 - Program and Project Management

Task 2.0 - Communications to NFIP Policyholders

Task 3.0 - Records Management

Task 4.0 – Provide Subject Matter Expertise (SME) in Meetings

Task 5.0 – Provide Accounting and Financial Management Support and Control

Task 6.0 – Provide Statistical and Financial Reporting

Task 6.1 - Write Your Own (WYO) and NFIP Direct Operating Reports

Task 7.0 Provide Actuarial Analysis and Subject Matter Expert Support

Task 8.0 Support Underwriting Activities

Task 8.1 Support Policy Appeals

Task 8.2 Provide Special Rating and Submit for Rate Support

Task 9.0 Support Claims Activities

Task 9.1 Provide Adjusting Services

Task 9.2 Perform Claims Reinspections

Task 9.3 Flood Adjuster Registration Management

Task 9.4 Increased Cost of Compliance (ICC) and Subrogation Reporting

Task 9.5 Special Claims Projects and Analyses

Task 10 Support Claims Appeals Activities

Task 11.0 Audit and Litigation Support

Task 12.0 Provide FEMA Regional, Field, and Disaster Support Services

Task 12.1 Establish, Maintain, and Manage a Letter of Credit (LOC)

Task 12.2 Flood Response Offices (FRO)

Task 12.3 Support Creation of Severe Flooding Tracking

Task 13.0 Forms, Manuals, and Publications

Task 14.0 Support Industry Management and Oversight Activities

Task 15.0 Provide Correspondence Support

Task 16.0 Ad-Hoc Reporting Assistance

Task 17.0 Policy Analysis and Program Enhancements

Task 18.0 Transition-In

Task 19.0 Transition Out

SECTION H: Special Clauses

Clauses Incorporated by Reference

Purpose The purpose of this SOW is to obtain world-class standard operation contract support for the NFIP services that meet the objectives described herein in a manner that aligns with FEMA’s Strategic Plan, FIMA’s guiding principles and values and the Federal Insurance Directorate’s (FID) Strategy.

Background FEMA’s mission is to help people before, during, and after disasters. FEMA accomplishes this mission through the development and execution of the FEMA Strategic Plan.

FEMA’s Strategic Goals are:

• Build a Culture of Preparedness

• Ready the Nation for Catastrophic Disasters

• Reduce the Complexity of FEMA

FEMA focuses on building and developing a culture of preparedness across the country and unifying all levels of community and government into an integrated approach to emergency management. As part of FEMA, the Federal Insurance and Mitigation Administration (FIMA) concentrates on increasing the capabilities necessary to reduce loss of life and property by lessening the impact of disasters. FIMA has developed guiding principles that drive decision making.

FIMA’s guiding principles are:

• Emphasize integration and collaboration

• Strive for innovation where needed

• Improve the customer experience

• Improve organizational health

FIMA manages the National Flood Insurance Program (NFIP). Congress created the NFIP through passage of the National Flood Insurance Act (NFIA) of 1968, and over the last 50 years, Congress has updated and added new requirements through various other legislation. Through passage of these acts, Congress authorized FEMA to institute regulations that govern the NFIP and the delivery of flood insurance to policyholders in eligible communities using Title 44 Code of Federal Regulations (44 C.F.R.)

parts 59 through 62. To emphasize the importance of the information, FEMA incorporated the entirety of the Standard Flood Insurance Policy (SFIP) into 44 C.F.R. FEMA also issues further guidance to external partners to aid in the issuance of policies and adjusting of claims, such as the Flood Insurance Manual (FIM), the National Flood Insurance Claims Manual, and various FEMA Bulletins.

Under FIMA, the Federal Insurance Directorate’s (FID) mission is to provide customer focused flood insurance to help survivors and their communities effectively recover from flood events.

FEMA administers the Write Your Own (WYO) program, which enables participating private insurance companies to sell and service the flood insurance product as fiscal agents of the federal government, and offers policies directly for sale through its NFIP Direct. There are approximately 5.1 million NFIP policies in force, with over $1.3 trillion of coverage in force. These policies are sold and serviced through approximately 60 private insurance companies participating in the WYO program, all of whom must report every transaction to the NFIP.

The WYO companies are the primary vehicle for selling, delivering and servicing flood insurance policies, and they are responsible for over 80% of NFIP policies in force. The WYO companies have been invaluable in the NFIP’s effort to increase the flood insurance policy base, increase the geographic distribution of policyholders, improve service to policyholders as well as insurance agents, and enhance the NFIP's ability to settle claims promptly and fairly in post-catastrophe environments.

FEMA is procuring contracts to support the NFIP. NFIP contracts will support the direct sale and servicing of NFIP policies; marketing and communications; operations, maintenance, and development for NFIP technology; standard business operations (the scope of this SOW); and program management.

Universal objectives, assumptions, and constraints applicable to all contracts are provided below.

Scope of Work FEMA requires a contractor, hereinafter referred to as “Contractor,” to provide standard operations support – including insurance subject matter expertise, financial management, and standard operations.

The Contractor is a source of information and support for the WYO insurance companies and the NFIP Direct contractor as they work to provide the information required by the NFIP. The Contractor will also engage in support activities that include tracking, collecting, disseminating, maintaining, and updating information on the NFIP and the WYO companies.

The Contractor must also establish catastrophe and coordination field offices in the event of large scale or severe flooding. These offices are set up to expedite claims and coordinate WYO activities. Also, through coordination with the communications contractor, the Contractor will support NFIP outreach efforts.

The work that the Contractor will perform will be UNCLASSIFIED. It should be noted that a substantial amount of data is considered Personally Identifiable Information (PII) and must be treated as such.

Overarching Assumptions and Constraints

• All activities align with DHS/FEMA strategic goals and constraints. Outreach activities are coordinated, integrated, and consistent with NFIP messaging throughout the program including appropriate advisory focus groups.

• Data security and privacy issues are a major focus of the federal government's information technology efforts. All program activities must be compliant with the Government Information Security Reform Act, OMB policies, and FEMA and the Department of Homeland Security requirements.

• The solution must include a transition plan describing how continuity of services will be maintained (e.g., ongoing marketing and sales efforts, program management, etc.)

Universal Objectives

The NFIP is growing. As we close the nation’s insurance gap and work to double the number of structures covered by flood insurance by 2022, our support services must scale to meet the workload expected to deliver world-class operations, inclusive of day-to-day as well as response and recovery activities.

The NFIP must make it easier to sign up and maintain flood insurance. From forms, to rating, to the claims process, the NFIP must continue to evolve how it delivers the program to help close the insurance gap. All providers must contribute to improving the customer experience.

FEMA must reduce the complexity of the NFIP and increase the program’s transparency. Leveraging process changes, improved communications, and new technology, FEMA must ensure that homeowners have insight, education, and confidence in the entire insurance lifecycle.

To ready the nation for catastrophic disaster, FEMA must build and sustain mutually beneficial partnerships and coalitions with public and private organizations, extending the reach of the NFIP’s mission.

The NFIP must plan for and implement changes stemming from the reauthorization and other legislative and regulatory changes.

Universal Assumptions and Constraints

• All activities will align to DHS/FEMA/FIMA/FID strategies and intents.

• Pivot will become the NFIP’s System of Record (SOR) prior to contract award.

• FEMA is updating policy forms, and while some will be finalized, not all will be completely in place at the time of contract award.

• Updated rates will be implemented in a phased approach, with initial new rates going into effect on

October 1, 2020.

• The NFIP will continue to operate according to the current authorization and regulations but must ensure flexibility for changes.

• The NFIP will embrace data and fraud analytics to drive better operations through improved oversight, speed, quality, and customer service.

• The NFIP will leverage data analytics and behavioral science to better inform decisions and improve the program’s marketing approach.

• The NFIP will embrace industry-standard customer experience models (online sales, mobile claims through smartphone applications, agents at the contact center, etc).

• The NFIP will strengthen and expand partnerships—including through incentives.

• Outreach activities are coordinated, integrated, and consistent with NFIP messaging.

• Data security and privacy issues are major focus of the federal Government’s information technology efforts. All program activities must be compliant with the Government Information Security Reform Act, OMB policies, DHS, and FEMA requirements.

• Solutions must include transition plans detailing how continuity of services will be maintained (e.g., operations of IT systems in various states of health and development, ongoing marketing and sales efforts, program management, etc.)

Period of Performance The period of performance shall be twelve (12) months, with four (4) twelve (12) month option periods.

Place of Performance

Contract objectives shall be performed primarily at the contractor’s site within the National Capital Region (NCR). Given the nature of disaster response services, some staff will not be located in the NCR. FEMA requires support throughout the normal business day (8:00AM to 6:00PM EST) and potentially around the clock during disaster events.

The Contractor shall provide 1-2 on-site staff members at FEMA Headquarters to facilitate issues, respond to inquiries, and other general coordination support at the direction of the COR.

The Contractor shall provide workspace for 2-3 FEMA employees to monitor the monthly financial close-out and other processes as required for oversight of the financial statements/reports.

Government Furnished Equipment (GFE) The awardee shall furnish all personnel, facilities, equipment, software, material, supplies, and services, except as may be expressly set forth in this SOW as furnished by the Government. To ensure the highest level of protection, all GFE must be imaged by and maintained with a DHS/FEMA certified image. The awardee shall be responsible for operating and storing all GFE in a secure manner and in accordance with current rules and regulations. Additionally, the awardee shall designate a single point of contact (POC) for FEMA to work through when assigning or issuing GFE. This individual will be responsible for tracking the whereabouts of all issued GFE.

The Contractor shall prepare and deliver at least annually or upon request by the Contracting Officer (CO)/Contracting Officer’s Representative (COR) a detailed list of all GFE.

The Contractor shall provide a daily courier drop off and pick up at Federal Insurance and Mitigation Administration (FIMA) Headquarters. The courier shall meet all Federal, DHS, and FEMA security badging and clearance requirements to facilitate services.

Deliverables - Appendix A: Deliverable Table All formal deliverables under this contract are listed in APPENDIX A: Deliverable Table and shall be delivered to FEMA on the designated dates provided. Should any designated dates coincide with a non-business day, the associated deliverable will be due on the next available business day unless otherwise directed by the COR.

The Contractor shall e-mail deliverables to the COR, Alternate COR and the distribution list (as approved by the COR) by the due date according to the chart. The Contractor shall also upload the deliverables onto a SharePoint or similar site, as provided by the COR. The due dates of the deliverables are subjected to change. The COR will communicate the changes to the Contractor with advanced notice.

The COR then has twenty (20) business days to review each deliverable and request corrections and/or adjustments from the Contractor before the document is accepted by FEMA.

Performance Objectives and Requirements

Task 1.0 - Program and Project Management The Contractor shall develop and implement a comprehensive Program Management Plan (PMP) for this SOW. The PMP must include, but is not limited to, cost, schedule, quality, risk, delivery, and performance management. The Contractor shall provide ad hoc reports or responses to the Contracting Officer (CO)/Contracting Officer’s Representative (COR) on contract related items (i.e. Entrance on Duty staff status, invoicing inquiries, project risks and issues, etc.)

Quality Control is the monitoring and oversight performed by the Contractor to ensure that work is accomplished in accordance with the terms of the contract. FEMA performs Quality Assurance to verify that the Contractor is performing the work required by the contract. The Contractor shall provide services in accordance with the terms of this contract. Elements in the Quality Control Plan shall include, but are not limited to:

• A program of internal audit, analysis and reporting.

• An internal quality control, inspections, and feedback system to facilitate internal and external monitoring and auditing.

• Plans to collaborate with other NFIP contractors to develop an effective system to analyze data quality, to capture and report trends and to initiate action in response to these trends.

• Procedures to ensure compliance with Federal and NFIP regulations.

Task 2.0 - Communications to NFIP Policyholders The Contractor shall send with each new policy and additionally at each annual renewal, the property’s loss history information, as required by the Flood Insurance Reform Act (FIRA), Section 202 (a)(4), the Claims Handbook, as required by FIRA, Section 204, the acknowledgment, as required by FIRA, Section 203, and a cover letter that references these enclosures. The Contractor shall also include the true flood risk determination of property regardless of the premium being charged, as required by Homeowners Flood Insurance Affordability Act of 2014 (HFIAA) Section 28. The contractor shall be required to send additional information to policy holders as directed by statute. The current volume is approximately 6,000,000 mailings per year.

The Contractor shall implement and maintain electronic record-keeping procedures for the acknowledgement letter to show proof of mailing and receipt or lack of receipt of a policyholder’s signed acknowledgement.

Task 3.0 - Records Management The Contractor shall maintain WYO and NFIP Direct data and information in accordance with FEMA Manual 5400.2 Records Management Files Maintenance and Records Disposition. The Contractor shall develop FEMA-approved Standard Operating Procedures (SOP) for such activities, and shall, as appropriate, recommend changes to the SOP and to FEMA Records Disposition Schedule. The media used for record keeping must follow the Federal Records Act, National Archives and Records Administration regulations, and guidance provided by the FEMA Records Officer.

The Contractor shall maintain documents detailed below and make the copies available to FEMA personnel upon request. The documents must be scanned within thirty (30) days of receipt and retained according to applicable FEMA Records Disposition Schedules.

• 1316 documents

• Coastal Barrier Resources Act documents

• Policy Appeal documents

• Claims Appeal documents

• FIRA acknowledgments

• FIRA mailings

• Severe Repetitive Loss and Repetitive Loss documents

• Underwriting documents

• Claims Documents

• Others upon request of the Government.

Task 4.0 – Provide Subject Matter Expertise (SME) in Meetings The Contractor shall participate and assist in non-training and non-media activities, with the approval of the COR. These activities can include meetings with groups (e.g. agents, lenders, Government officials, and citizens); independent claims adjustment organizations, WYO companies, etc. The Contractor shall, having been provided reasonable notice, participate in meetings, conferences, conventions, and trade shows, including those that may include WYO companies, FEMA contractors, NFIP stakeholders or combinations thereof. The Contractor shall prepare and supply materials, including agenda items, to facilitate communication of NFIP information to these audiences. The contractor shall provide SME support of executive level meetings, audits, briefings and conferences for each of the areas outlined within this SOW. The Contractor shall seek approval for participation from the COR.

Task 5.0 – Provide Accounting and Financial Management Support and Control The Contractor shall perform all accounting and financial control functions described below to ensure the financial integrity of the program. FEMA is responsible for both maintaining accurate financial records and reporting relevant financial information to DHS.

The Contractor shall be responsible for the financial research, interpretation, reporting and analysis of the WYO Financial Control Plan. The contractor shall support the requirements of the Chief Financial Officers Act of 1990, the financial controls of OMB Bulletin #1-09, and the preparation of consolidated financial statements and reports.

The Contractor shall provide, in accordance with Generally Accepted Accounting Principles (GAAP), cash receipts and disbursements and perform a monthly reconciliation of all receipts and disbursements.

The Contractor shall provide adequate generally accepted internal controls for cash receipts and disbursements and establish internal control to safeguard Government funds and interest.

The Contractor shall maintain an automated general ledger (G/L) on an accrual basis in conformance with GAAP. Conversely, the Contractor shall exchange financial information via an automated interface with the FEMA accounting system and Integrated Financial Management Information System (IFMIS) – or its successor - that requires U.S. Government Standard General Ledger accounts format as documented in the Treasury Financial Manual.

The Contractor shall perform the reconciliation of G/L accounts and adjustment of entries monthly. The Contractor shall, monthly, reconcile G/L accounts to supporting records (Transaction Record Reporting and Processing (TRRP) Plan submissions, adjustments, financial reconciliation, etc.) to validate accruals of income and expenses.

The Contractor shall maintain a detailed audit trail of all transactions, consistent with GAAP accounting methods. The audit data shall be sufficient in detail to facilitate the reconstruction of financial activity if compromise or malfunction occurs or is suspected. All manual G/L entries shall be separately verified and fully tracked.

The Contractor shall make available online within two (2) business days after request by FEMA any financial reporting pertaining to current or historical reporting periods as may be required to meet FEMA reporting requirements. Financial records shall be maintained in accordance with FEMA Records Disposition Schedule. The media used for record keeping shall be in compliance with the Federal Records Act, National Archives and Records Administration regulations and guidance provided by the FEMA Records Officer.

The Contractor shall perform all accounting and financial control functions utilizing the prescribed System of Record (SOR). There is a summary of the required documents in the Deliverables Chart in Appendix A.

The Contractor shall process checks received for deposit. Additionally, the checks should be stored in a safe, with access being limited to the Accounting Director and one other person on the accounting staff. The Contractor shall maintain a check log and have security features to prevent any unauthorized use of checks. The check log must contain the following information: date of issue, who issued the check, who the check was issued to, who the check was given to, the check number, and the date check was given. The acceptor of the check should sign for it in the log; the log shall be made available to FEMA when requested.

The Contractor shall process deposits received at their facility and deposit them in a restricted Treasury General Account (TGA) in an authorized bank within one (1) business day. The Contractor shall set up this restricted bank account within forty-five (45) calendar days of award.

Task 6.0 – Provide Statistical and Financial Reporting

The Contractor shall provide accounting and financial management support to respond to the needs of FEMA, the WYO companies, other contractor staff, auditors, and other stakeholders in the operation of the WYO Program. Such support shall include the sustainment of automated systems for the communication, recording, and transfer of financial data; reviewing materials for program consistency;

and if required, development and providing technical assistance to the WYO companies and the NFIP Direct.

The Contractor shall supply suitably trained and experienced financial personnel needed to prepare, edit, and analyze financial reports and statements. A minimum of two (2) licensed Certified Public Accountants must be provided.

Reporting requirements shall be periodically reviewed to ensure completeness and to maximize the timeliness and efficiency of data collection and reporting. Technical reports, designs identifying source data and calculations performed within reports shall be delivered to the COR when scheduled or requested.

Task 6.1 - Write Your Own (WYO) and NFIP Direct Operating Reports The Contractor shall provide operating reports on WYO financial and statistical performance as described below. These reports and related analyses are used by FEMA and the WYO Standards Committee to monitor WYO activity and adherence to relevant performance measures.

The Contractor shall accumulate, consolidate, and reconcile the financial data to the statistical data submitted by the WYO companies and the NFIP Direct contractor in accordance with the TRRP Plan, its successors, and Appendix A: Deliverable Table.

Reporting includes:

• Posting financial data to the NFIP General Ledger system for each WYO Company and the NFIP Direct contractor.

• Producing monthly and annually consolidated reports on Letter of Credit draw-downs as reported by the WYO companies and the NFIP Direct contractor.

• Producing monthly and annually separate financial statements for the WYO Program and NFIP Direct contractor and consolidated financial statements in a format specified by FEMA.

• Reviewing the monthly financial and statistical reports for completeness, reasonableness, and resolve any discrepancies for each of the WYO companies, and the NFIP Direct contractor.

The Contractor shall provide support to FEMA and to the WYO Standards Committee, including such reports and analyses as necessary for FEMA to exercise appropriate oversight of WYO companies and the NFIP Direct contractor performance under the Financial Control Plan.

Task 7.0 Provide Actuarial Analysis and Subject Matter Expert Support The Contractor shall provide expert actuarial support to perform reviews and analyses in support of FEMA’s policy, financial, and rate setting responsibilities.

The Contractor shall supply suitably trained and experienced actuarial personnel needed to assess and analyze business environments within which financial decisions concerning insurance and investments are made including the application of mathematical concepts and other techniques to the various areas of actuarial practice with a particular focus on flood insurance and reinsurance placement. The Contractor shall, at a minimum, retain the services of either an Associate (ACAS) or Fellow (FCAS) of the Casualty Actuarial Society (CAS) who is qualified to issue a Statement of Actuarial Opinion (SAO) regarding loss and loss expense reserves.

The Contractor must support FEMA actuarial activities, including but not limited to answering specific actuarial questions, supporting FEMA policy analyses, performing ad-hoc analyses in support of the planning and evaluation of the NFIP (including mitigation, risk assessment, and risk transfer activities), supporting annual rate reviews and development of appropriate rate and rule revisions, and revisions to actuarial statistical plans.

The Contractor shall provide catastrophic modeling support, including the design and review of models in support of various NFIP activities. This support must be provided by personnel with modeling experience in the property/casualty insurance industry. The Contractor must have experience using R and SQL software, as well as at least two of the following modeling vendors: AIR, RMS, Katrisk, and CoreLogic.

The Contractor will inform FEMA of industry evolution and best practices for catastrophic modeling, and assist with reviewing new and updated catastrophe model releases and providing assessments to FEMA.

Task 8.0 Support Underwriting Activities The Contractor shall provide underwriting subject matter expertise and support (utilizing staff with a minimum of three (3) years of experience underwriting flood insurance) to FEMA, the WYO companies, the NFIP Direct, and policyholders, helping ensure that each policy is correctly written and rated.

The Contractor shall receive, resolve, and track underwriting inquiries and coverage problems referred by FEMA, policy holders, agents, WYO companies, State Insurance Departments, and others. For underwriting files where there is a question of coverage involving policy interpretation, the Contractor shall promptly refer them to FEMA through the COR. The Contractor has three (3) business days from the date of receipt to respond to a WYO company or NFIP Direct contractor inquiry or forward it to

FEMA. The Contractor has three (3) business days from receiving FEMA’s response to an inquiry to send it to the WYO Company or NFIP Direct contractor.

The Contractor shall also provide the following support:

• Provide technical assistance to WYO companies and the NFIP Direct contractor with applying the proper rules and regulations of the NFIP to their policies.

• Support analysis, development, implementation, and communication of the requirements for NFIP rate and rule changes.

• Gather rating and payment information, calculate refunds, perform quality control, and process prior term premium refunds, including HFIAA Section 28 provisions, when applicable

• Respond to NFIP inquiries from a WYO, NFIP Direct, or other NFIP stakeholders.

• Provide underwriting technical expertise in Operational Reviews. Review NFIP policies for accurate rating and processing to ensure valid documentation and policy information was obtained by the WYO or NFIP Direct.

• Coordinate Coastal Barrier Resource Act (CBRA) eligibility with the U.S. Fish and Wildlife Service and the WYO or NFIP Direct.

• Provide insight into the status of ongoing and completed inquiries and tasks.

Task 8.1 Support Policy Appeals

• Support the collection and submission of data to substantiate policy appeals, including but not limited to designations of 1316, Coastal Barrier Resource Area, repetitive loss, severe repetitive loss, property address waivers, floodproofing, special rating, preferred risk policy eligibility, leased federal properties, and prior term refunds.

• Review and recommend approval or denial of the policy appeal.

• Coordinate with other FEMA contractors to ensure that the policy appeals are fully adjudicated in a timely manner.

• Implement any adjustments or corrective actions as a result of FEMA’s adjudication of the policy appeal.

Task 8.2 Provide Special Rating and Submit for Rate Support The Contractor shall provide support for Special Rating and the Submit for Rate process based on FEMA guidance. The Contractor shall obtain and validate underwriting policy files from WYO companies and the NFIP Direct contractor. All necessary documentation must be verified for accuracy and completeness prior to submittal to FEMA for review. The Contractor shall review and verify that inquiries on new and existing policies are correctly rated. The Contractor shall follow up on pending new and existing policies and request additional information if needed.

Task 9.0 Support Claims Activities The Contractor shall provide support for claims processing to FEMA, the WYO companies, and the NFIP Direct contractor. The support is required to ensure the proper collection of accurate claims information for all claims submitted. This entails providing general adjusters, managing adjuster certifications, performing reinspections as necessary, support claims operational reviews, maintain appropriate logs, and perform special projects and analyses as requested.

Flood Insurance Claims Knowledge: The Contractor shall provide experienced flood insurance claims personnel to respond to and support FEMA, the WYO companies, the NFIP Direct contractor and other stakeholders in the implementation of the NFIP claims program. The Contractor shall provide personnel with two different levels of claims experience. One level shall have, at minimum, one (1) year of experience in flood insurance claims; the other level shall have, at a minimum, three (3) years of experience in commercial insurance claims.

Collection of Claims Information: The Contractor shall be the focal point for the collection of information about coverage issues, policy interpretation, severity questions, and all other claims matters. If the issue is critical or time sensitive, the issue shall be referred to FEMA through the COR within 24 hours of determination of such. Otherwise, the Contractor shall process all claims information and subsequently notify FEMA of issues encountered and all actions taken by the Contractor.

Task 9.1 Provide Adjusting Services The Contractor shall provide an in-house staff of no less than ten (10) General Adjusters with NFIP flood insurance claims experience and have the capability to increase the numbers of General Adjusters needed to service any flood event. The NFIP General Adjusters are required to be claims professionals, have correct authorization with an active Flood Control Numbers (FCN), have appropriate NFIP flood insurance claims experience to expertly address difficult technical claims issues with policyholders and their representatives, and have the computer and software skills necessary to perform the duties. The Contractor shall provide General Adjusters with two (2) different types and levels of experience: some shall have a minimum of five (5) years of experience in residential flood claims estimating, and some shall have a minimum of five (5) years of experience in commercial estimating. The NFIP General Adjusters must demonstrate excellent customer service skills and written and verbal communication skills. NFIP General Adjusters may be required to travel extensively in the USA, and the U.S. Territories, to conduct damage assessments, adjuster briefings, and workshops to staff catastrophe offices in flooded areas, to conduct re-inspections, and other assigned duties.

Task 9.2 Perform Claims Reinspections The Contractor shall plan, implement and manage the NFIP Claims Reinspection process. There are four

(4) types of re-inspections: Congressional, FEMA Appeals, Special Assists, and Random Claims Quality Check (RCQC).

The Contractor shall have an NFIP authorized General Adjusters make on-site property re-inspections.

The General Adjusters shall record and report their findings on the reinspection form, which must be completed in full and signed by both the WYO company representative and the NFIP General Adjuster indicating agreement with the findings.

The Contractor shall analyze and summarize the results of the re-inspections, including identifying trends, overpayments and underpayments, etc. and provide a quarterly report on reinspection activities to FEMA.

FEMA must approve the format of these reports.

The Contractor shall maintain a detailed database of the re-inspections and the associated findings, including overpayments and underpayments, and provide feedback to FEMA, the WYO companies, and the NFIP Direct contractor through the COR on claims matters arising from re-inspections, including repeated issues and trends.

If not yet automated by Pivot, the Contractor shall collect Adjuster Preliminary Damage Assessment (APDA) forms via email and enter necessary data into the SOR for reports used by community and FEMA officials for floodplain management activities.

The Contractor shall plan, implement, and manage the NFIP Random Claims Quality Checks (RCQC) process.

Task 9.3 Flood Adjuster Registration Management The Contractor shall obtain information regarding adjusters seeking NFIP registration or annual reregistration from the NFIP training contractor. The Contractor shall track the adjuster’s training, distribute adjuster authorization documentation with FCN cards, and maintain historical records. The Contractor must maintain a list of active adjusting companies (AC) and training plans from any AC authorized to provide NFIP Adjuster Training. FEMA expects all registered adjusters to reregister every three years to ensure that information in the database is current for every registered adjuster.

Task 9.4 Increased Cost of Compliance (ICC) and Subrogation Reporting.

The Contractor shall maintain a log of all claims reported where the policyholder consents to the assignment of the ICC claim payment. The Contractor shall obtain a copy of the Assignment of Increased Cost of Compliance and supporting documentation to be disseminated to the appropriate WYO carrier or the NFIP Direct contractor. In addition, the contractor will maintain database of all Cause of Loss and Subrogation Reporting forms submitted by WYOs and the NFIP Direct.

Task 9.5 Special Claims Projects and Analyses As requested by the COR, the Contract shall support special claims projects and ad-hoc analyses. The projects may involve an in-depth review of claims files and field surveys of specifically identified areas (e.g. condominiums, ICC, repetitive loss, subrogation, CBRA, etc.)

Task 10 Support Claims Appeals Activities The Contractor shall provide two teams of claims specialists to support the processing of claims appeals.

One team will support the triage/ insurer response/ examiner determination queues in Pivot. This team should be comprised of experienced flood insurance adjusters and examiners, with no less than 5 years of experience. The other team will write appeals decision memos in the editorial review queue within Pivot.

This team should be comprised of technical writers or non-practicing attorneys capable of writing well using the IRAC (issue – rule – analysis – conclusion) format.

The Contractor shall effectively transition from supporting the prompt requesting and uploading of claim files and synopses from the WYOs and NFIP Direct (prior to these entities having access to the Pivot Appeals application) to facilitating the review of these files (following these entities gaining access to the Pivot Appeals application). The contractor will support the training of WYOs and NFIP Direct upon their receiving access to the Pivot Appeals application.

The Contractor shall facilitate the reinspection of claims where needed for appeals, the scheduling of calls with policyholders who request a post-decision meeting and support the maintenance of the FEMA Appeals email inboxes, including logging and responding to status requests from policyholders when appropriate. The Contractor will help develop and maintain a repository of completed decision memos, with metadata/tags for ease of reference and ability to quickly recall through a search. The Contractor will also monitor and report if any policyholders with active appeals file a lawsuit regarding their claim.

The Contractor shall support the design and implementation of a claim appeals web portal for policyholders that enables policyholders to Directly enter their appeals into Pivot and learn in real-time whether their appeal meets the eligibility requirements (e.g., within 60 days of denial; copy of denial letter included, etc.) The development of any portal or application will be completed by the FEMA Information Technology contractor. No IT development will occur in this contract.

Claims Appeal claim file and synopsis requests to WYOs and the NFIP Direct must be complete within one business day of receipt and assignment in Pivot. A final draft decision memo must be delivered to FEMA within 21 calendar days after assignment in the Editorial Review queue.

Task 11.0 Audit and Litigation Support The Contractor shall furnish all pertinent files, records, documentation, procedures, data, and any other information which is in its possession that may be required by any governmental organization and requested of FEMA. FEMA will initiate all relevant requests of the Contractor. Similarly, files, records, reports, data, other information, and assistance shall be furnished to the FEMA Office of Chief Counsel (OCC) for initiation or defense of litigation, or in connection with any other action or proceeding. The Contractor shall furnish these materials within three (3) business days of the request.

The Contractor shall provide support to the FEMA OCC and the DHS Office of the Inspector General (OIG). Such support shall consist of claim review and litigation discovery assistance, appearing as witnesses for hearings, proceedings, or depositions, investigatory assistance, retention of expert witnesses or retention of outside counsel. No employee, agent, or outside counsel retained by the Contractor shall act or represent themselves to others as legal counsel for FEMA or the NFIP.

The Contractor shall support all FEMA Directed audits in all functional areas including the annual external fiscal year audit that covers select aspects of the business processes described in this SOW which typically requires Contractor support throughout a nine (9) month period from March through November of each calendar year.

The Contractor shall support the implementation of, and annual support for, FEMA’s Financial Statement Audit, Improper Payments Elimination and Recovery Information Act of 2002 (IPERIA) audit, and WYO Financial Control Plan activities.

The Contractor shall establish internal audit activities for underwriting and claims analyses to assure the integrity of WYO underwriting and claims data and reporting.

Task 12.0 Provide FEMA Regional, Field, and Disaster Support Services The Contractor shall provide support for each of the ten (10) FEMA Regional Offices to support FEMA Regional Flood Insurance Liaisons by providing Subject Matter Expertise (SME) for outreach activities, assisting with community and policyholder issues, and responding to flood events at the direction of the COR. The contractor may be required to sit within one of the Regional Offices or FEMA Joint Field Offices (JFOs) with COR approval. A monthly report which summarizes the monthly activities of the regional personnel is included in the APPENDIX A: Deliverable Table.

The Contractor will assist stakeholders (policyholders, insurance agents, community officials, realtors, condominiums associations) with flood insurance issues and questions. Research and address inquiries as required by the FEMA Regional and HQ staff.

The Contractor will attend various trainings and conferences conducted by FEMA and others to understand the latest trends and efforts to support flood insurance activities, including marketing and communication contractor webinars to understand resources and materials available.

Task 12.1 Establish, Maintain, and Manage a Letter of Credit (LOC) The contractor will be granted access to a Letter of Credit (LOC) for approved activities. The Contractor shall provide a detailed expenditure report, and a daily status report for all Letter of Credit (LOC) expenses and activities when requested by the government and at the end of each month. All expenditures must be approved by the COR.

The Contractor shall request and provide justification and supporting documentation to the COR for LOC increases as necessary. The cover letter must include a certification statement validating the authenticity of the request by the contractor.

Letter of Credit activities may include but are not limited to:

• Claim losses, Allocated Loss Adjustment Expenses (ALAEs) and Special Allocated Loss Adjustment

Expenses (SALAEs), Increased Cost of Compliance (ICC), Premium and Prior-Term Refunds, HFIAA Refunds, Overpayment Refunds.

• Flood Response Office (FRO) operating and disaster Expenses

• NFIP Printing Materials

• Special Travel Expenses

• Postage, Freight, and Delivery

All costs for postage, private express delivery, and freight shall be paid directly out of the LOC. The Contractor shall establish and maintain internal controls to assure the security and accounting for all postage, private express delivery, freight, and delivery expenses of the program. The Contractor shall manage postage and express delivery activities to minimize costs to FEMA.

The Contractor shall report monthly on the nature of postal and express delivery expenditures, any unusual or unanticipated expenses, measures being taken, and progress being made to reduce the costs.

The Contractor shall make best efforts to reduce postage, freight, and delivery costs by, for example, preparing mailing lists annually, using the most economic classes of mail, and using all applicable US Postal Service discounts.

Task 12.2 Flood Response Offices (FRO) The Contractor shall provide support in establishing and maintaining Flood Response Offices as described below. At any time, FEMA may, at its option and upon notice to the Contractor in accordance with the provisions of this section, require the Contractor to activate and operate one or more FROs for any duration.

FEMA shall provide the Contractor written, electronic, or telephonic notice of exercise of this option. In the event notice is given by telephone, written or electronic confirmation shall be provided. Such notice shall specify the time at which the period of Flood Disaster Response (FDR) is to commence, which shall not be less than twenty four (24) hours subsequent to the receipt of such notice by the Contractor, and not before the FRO team can safely and reasonably arrive at the location where the FRO will be established and maintained for the anticipated duration of the FDR period. FEMA shall provide the Contractor written, electronic, or verbal notice within a reasonable period of time (in the event notice is given by telephone, written or electronic confirmation shall be provided) of termination of the period of FDR.

In the event of a large scale or multiple flooding events, the Contractor shall provide qualified, NFIP certified adjusters to augment the existing General Adjusters. The Contractor shall submit a plan to provide additional qualified and authorized adjusters with an active Flood Control Number (FCN) to the COR for approval prior to May 1st each year.

The Contractor shall request pre-approval from the COR for all FRO expenses, including but not limited to supplies and services. FEMA shall reimburse the Contractor for reimbursable supplies and services are those items specified in the contract as reimbursable, or otherwise pre-approved by the COR/CO.

The Contractor shall provide adequate office space for each FRO, subject to approval from the COR. The Contractor shall inform the affected FEMA region(s) of the location of each FRO that is established.

Task 12.3 Support Creation of Severe Flooding Tracking The Contractor shall advise FEMA that a Flood Event Designation Number (EDN), formerly known as Flood Insurance Claim Office (FICO) number, is required to track all ensuing claims of severe flooding events. At the direction of FEMA, the Contractor shall disseminate a claims bulletin to the WYO Principal Coordinators and the NFIP Direct contractor advising of the EDN(s), affected states, and the dates of loss.

Task 13.0 Forms, Manuals, and Publications The Contractor will support the development and maintenance of operating forms, manuals, and other required publications, including bilingual materials, in accordance with all applicable Government regulations. Development and changes to the forms shall be coordinated with FEMA.

The Contractor shall develop and supply descriptive, paper-based materials and program information. The contractor shall ensure that artifacts have no spelling, grammatical, or punctuation errors and are precise, concise, and reflect agency values, clear writing and exemplary professionalism. Peer reviews and proofreading are required to ensure consistent and accurate information. Some materials developed require significant concurrence from many program offices within FEMA and may require multiple revisions. Timelines for delivery should include extra time to accommodate significant FEMA and other reviews and allow for the Contractor to ensure 508 compliance.

The Contractor shall maintain Microsoft Office Specialist (MOS) Expert certifications, Microsoft Publisher certification, Adobe Certified Expert (ACE) certifications, or equivalents. The contractor shall provide editing support, including a write-editor and a line editor to ensure that the products meet government standards of writing in plain English language.

Publication and Document Support includes;

• Create manuals, technical bulletins, and other materials as designated or required, and review material for accuracy and consistency.

• Develop text, tables, and graphics for the periodic revisions of the Flood Insurance Manual and Claims Manual and other insurance guidance documents.

• Identify trends and issues and propose strategies to address them in program documentation.

• The Contractor shall develop and maintain Standard Operating Procedures (SOPs) for all business processes covered by this SOW and provide to FEMA for review and approval. Initial SOPs are due within 30 days of transition.

• Translate complex technical material into simple, clear explanations or instructions.

• Provide all finished materials to FEMA for review before sending to printer through the

Government Printing Office (GPO) print process. All printing shall be done through the GPO unless otherwise directed by FEMA.

• Ensure all materials sent to GPO are fully compliant with all FEMA, DHS and GPO rules and regulations.

Task 14.0 Support Industry Management and Oversight Activities In addition to the financial and statistical activities detailed above the Contractor shall provide technical expertise in supporting WYO oversight including, but not limited to, tracking the statuses of WYOs, name changes, onboarding, off boarding, etc.)

The Contractor shall also provide general administrative and logistical support. Support may include working with the NFIP on preparing WYO Arrangement Packages and preparing and reviewing reports on WYO company compliance with FEMA requirements.

Task 15.0 Provide Correspondence Support The Contractor shall provide support for the correspondence that is required to meet stakeholder needs.

This support consists of establishing documented procedures for handling all correspondence, fielding the originating requests, creating appropriate responses for the request and maintaining logs of all correspondence activity.

The Contractor shall respond to technical claims and underwriting inquiries and review the grammar and technical content of the draft responses prior to forwarding them to FEMA. The Contractor shall use FEMA-approved templates as guides.

The Contractor shall draft responses with no spelling, grammatical, or punctuation errors and are precise, concise and reflect agency values, clear writing and exemplary customer service.

The Contractor shall implement, document, and maintain detailed procedures for handling of all NFIP related correspondence, and demonstrate complete control over all incoming and outgoing correspondence, how the Contractor will perform quality assurance, and deliver timely performance of all correspondence tasks.

The Contractor shall utilize an automated system for the control, analysis, and reporting of all correspondence received that ensures accurate and efficient data capture processing during the life cycle of the claim correspondence, e.g. notifications of incoming correspondence, notification of all activity, track correspondence status, etc.

The Contractor shall provide reports on the nature of correspondence, sources (e.g. White House, Congress, State Officials, agents, insureds, etc.) trends, (e.g. geographic and programmatic) and timeliness of problem resolution and responses. The Contractor shall have the ability to upload and electronically deliver to FEMA complete files that are too large to send via email. The Contractor should be prepared to accommodate correspondence procedural changes due to significant disasters, changes to internal FEMA correspondence processes, or other issues.

Correspondence Support…