9-M6005 Stop Loss Insurance SON-SOW.docx

STATEMENT OF NEEDS/SCOPE OF WORK AND SPECIFICATIONS

A. Provide the following company information:

· Company name, headquarters location, and local service location.

· Number of years in business and number of years providing stop loss insurance.

· AM Best rating.

· Annual stop loss premium volume.

· Name and contact information for the individual authorized to negotiate and sign a contract with the College.

· Name and contact information for the individual(s) assigned to work directly with the College and to respond to questions as they may arise during the life of the policy.

B. Are any of your services performed by employees/partners outside of the United States? If so, briefly describe.

C. The College has requested quotes for the following levels of coverage. Do not provide premium information in this section. Premium details must be provided in Attachment A and separately in your standard proposal documentation.

D. Under what conditions do you typically laser members?

· How frequently do you use laser options?

· Upon review of the College’s data, does your proposal include any lasers? Do not include information here, please note in Attachment A and in your standard proposal documentation.

· Is there a no-new-laser renewal option?

E. Do you offer renewal rate cap options?

F. What are your large claim notification requirements – both thresholds and timing?

G. What information do you typically require prior to reimbursement or payment of a stop loss claim?

H. Do you offer an Advanced Funding arrangement?

· If so, briefly describe.

I. Do you require accounting for or any offset for any prescription drug rebates that the Plan may receive?

· If so, provide a brief summary.

J. Provide the following overview of your renewals in the last 10 years:

· What is your average renewal increase?

· How are renewal rates calculated?

K. The College requests the ability to self-bill premium and provide payment via ACH push in arrears, or within a 60-day grace period. In other words, the College requests the ongoing ability to pay the monthly premium by the end of the month after premium is due. (Example: if premium associated with coverage for August is due on August 1st, the College will self-bill and pay the August premium by the end of September.)

· Will you agree to this method of payment?

· If not, describe your preferred method.

L. Will you agree to provide all contracts, agreements, and plan documents to the College in a MS Word document format for their review and comments? Any changes will be made using the Track Change tool in Word. Please confirm this process is included in the proposed pricing.

M. Will you provide underwriting assistance, including estimated claims impact related to coverage changes, on an ongoing basis?

N. What performance guarantees and/or experience rated refund arrangements are you able and willing to extend to the College?

O. Provide a sample of the policy document(s) that will be implemented with the College. If any provisions of the policy are flexible, please highlight them within the sample policy.

P. Please provide at least three (3) references of customers which have received services similar to those required by the College. Include for each reference, the business name, address, phone number and contact person and a short description of the project and the work performed. The College reserves the right to contact or visit any of the offeror’s current and/or past customers to evaluate the level of performance and customer satisfaction. Information gathered during this process will not be made public. If the offeror is not able to provide the foregoing information, provide a detailed explanation of the reason(s) for such inability.

Technical Evaluation:

(1) Aggregate Factors. The College will review and score the aggregate factors proposed by the offeror based on the overall expected claims experience and by type of contract coverage to determine, in the sole opinion of the College, which will be in the best interest of the College.

(2) Contract Provisions and Coverage. The College will review and score the supplier based on their stated contract provisions and coverage provided in the proposal, ability to meet the requested contract requirements, willingness to mirror the employer's current plan design, level of perceived flexibility, and the availability of underwriting assistance services.

(3) General Administrative Functions and Capabilities. Ability to provide services and administration to the College that, in the sole opinion of the College, will be in the best interest of the College.

(4) Experience, Past Performance, and References.

a. The list of at least 10 Universities, Colleges, and/or private corporations of comparable size to the College, who use services similar to those being requested in this RFP as requested in Section 5 will be reviewed.

b. Upon notification of being a finalist, offerors should be prepared to provide at least five references of customers that have used services similar to those requested by the College as detailed in this RFP. These references may be contacted by the College to discuss their experience with the offeror, including, but not limited to, the implementation process, problem resolution, and overall feeling of the reference regarding the relationship with the offeror.

c. The quality, experience, and performance of the requested functions and services as demonstrated by the responses to the RFP and may be further enhanced through discussions with references provided by finalists

COST PROPOSAL MUST BE SUBMITTED ON THE EXCEL SPREADSHEET ATTACHED!