SAP

State of South Carolina

Request for Proposal

Amendment 2 Solicitation:

Date Issued:

Procurement Officer:

Phone:

E-Mail Address:

Mailing Address:

5400020469 02/09/2021

NATHAN DAWSON

(803) 737-9931 ndawson@mmo.sc.gov SFAA, Div. of Procurement Services 1201 Main Street, Suite 601 Columbia SC 29201

DESCRIPTION: Workers’ Compensation Insurance Management System

USING GOVERNMENTAL UNIT: SC State Accident Fund

SUBMIT YOUR OFFER ON-LINE AT THE FOLLOWING URL: http://www.procurement.sc.gov

SUBMIT OFFER BY (Opening Date/Time): 03/02/2021 11:00 am (See "Deadline For Submission Of Offer" provision)

QUESTIONS MUST BE RECEIVED BY: 01/14/2020 5:00 pm email questions to ndawson@mmo.sc.gov (See "Questions From Offerors" provision)

NUMBER OF COPIES TO BE SUBMITTED: One (1) on-line submission and One (1) Redacted Copy submitted online, (See “Submitting Redacted Offers” provision Section IV, “Submitting Confidential Information” Section II.A., & “Electronic Copies-Required Media and Format” provision Section II. B.)

Initial here if NO redacted copy is necessary___________

CONFERENCE TYPE: Pre-Proposal Conference DATE & TIME: 01/14/2021 10:00 am

(As appropriate, see "Conferences - Pre-Bid/Proposal" & "Site Visit" provisions) LOCATION: WebEx Online Conference

(email ndawson@mmo.sc.gov before 12:00 noon on 01/13/2021 for call-in instructions)

(See Section IIB “Conference – Pre-Bid/Proposal” clause)

You must submit a signed copy of this form with Your Offer. By signing, You agree to be bound by the terms of the Solicitation. You agree to hold Your Offer open for a minimum of ninety (90) calendar days after the Opening Date. (See "Signing Your Offer" provision.)

NAME OF OFFEROR

(full legal name of business submitting the offer) Any award issued will be issued to, and the contract will be formed with, the entity identified as the Offeror. The entity named as the offeror must be a single and distinct legal entity. Do not use the name of a branch office or a division of a larger entity if the branch or division is not a separate legal entity, i.e., a separate corporation, partnership, sole proprietorship, etc.

AUTHORIZED SIGNATURE

(Person must be authorized to submit binding offer to contract on behalf of Offeror.)

DATE SIGNED

TITLE

(business title of person signing above)

STATE VENDOR NO.

(Register to Obtain S.C. Vendor No. at www.procurement.sc.gov)

PRINTED NAME

(printed name of person signing above)

STATE OF INCORPORATION

(If you are a corporation, identify the state of incorporation.)

OFFEROR'S TYPE OF ENTITY: (Check one) (See "Signing Your Offer" provision.)

___ Sole Proprietorship ___ Partnership ___ Other_____________________________

___ Corporate entity (not tax-exempt) ___ Corporation (tax-exempt) ___ Government entity (federal, state, or local)

COVER PAGE - ON-LINE ONLY (MAR. 2015)

SAP

SAP7

PAGE TWO

(Return Page Two with Your Offer) HOME OFFICE ADDRESS (Address for offeror's home office / principal place of business)

NOTICE ADDRESS (Address to which all procurement and contract related notices should be sent.) (See "Notice" clause)

_________________________________________________ Area Code - Number - Extension Facsimile

E-mail Address

PAYMENT ADDRESS (Address to which payments will be sent.) (See "Payment" clause)

____Payment Address same as Home Office Address ____Payment Address same as Notice Address (check only one) ORDER ADDRESS (Address to which purchase orders will be sent) (See "Purchase Orders and "Contract Documents" clauses)

____Order Address same as Home Office Address ____Order Address same as Notice Address (check only one)

ACKNOWLEDGMENT OF AMENDMENTS

Offerors acknowledges receipt of amendments by indicating amendment number and its date of issue. (See "Amendments to Solicitation" Provision)

DISCOUNT FOR PROMPT PAYMENT

(See "Discount for Prompt Payment" clause)

PREFERENCES - A NOTICE TO VENDORS (SEP. 2009):

**PREFERENCES DO NOT APPLY TO REQUEST FOR PROPOSALS PER

SOUTH CAROLINA PROCUREMENT CODE SECTION [§11-35-1524(E)(5)(b)]**

PREFERENCES - ADDRESS AND PHONE OF IN-STATE OFFICE:

**PREFERENCES DO NOT APPLY TO REQUEST FOR PROPOSALS PER

SOUTH CAROLINA PROCUREMENT CODE SECTION [§11-35-1524(E)(5)(b)]**

PAGE TWO (SEP 2009)

End of PAGE TWO

AMENDMENT #2

Solicitation #5400020469

AMENDMENTS TO SOLICITATION (JAN 2004)

(a) The Solicitation may be amended at any time prior to opening. All actual and prospective Offerors should monitor the following web site for the issuance of Amendments: www.procurement.sc.gov (b) Offerors shall acknowledge receipt of any amendment to this solicitation (1) by signing and returning the amendment, (2) by identifying the amendment number and date in the space provided for this purpose on Page Two, (3) by letter, or (4) by submitting a bid that indicates in some way that the bidder received the amendment. (c) If this solicitation is amended, then all terms and conditions which are not modified remain unchanged. [02-2A005-1]

Highlighted text is added to the original provision. Stricken text is deleted.

As a result of one of the questions received from vendors, a change has been made to Tab 4 of Attachment A (see Question 88 below). As a result of this change, all references in the solicitation to “Attachment A” are replaced with “Amended Attachment A”.

QUESTIONS FROM OFFERORS - AMENDMENT (JUN 2017)

THE SOLICITATION IS AMENDED AS PROVIDED HEREIN. INFORMATION OR CHANGES RESULTING FROM QUESTIONS WILL BE SHOWN IN A QUESTION-AND-ANSWER FORMAT. ALL QUESTIONS RECEIVED HAVE BEEN REPRINTED BELOW. THE “STATE’S RESPONSE” SHOULD BE READ WITHOUT REFERENCE TO THE QUESTIONS. THE QUESTIONS ARE INCLUDED SOLELY TO PROVIDE A CROSS-REFERENCE TO THE POTENTIAL OFFEROR THAT SUBMITTED THE QUESTION. QUESTIONS DO NOT FORM A PART OF THE CONTRACT; THE “STATE’S RESPONSE” DOES. ANY RESTATEMENT OF PART OR ALL OF AN EXISTING PROVISION OF THE SOLICITATION IN AN ANSWER DOES NOT MODIFY THE ORIGINAL PROVISION EXCEPT AS FOLLOWS: UNDERLINED TEXT IS ADDED TO THE ORIGINAL PROVISON. STRICKEN TEXT IS DELETED. [02-2A097-1]

The following questions were received pursuant to the original date and time specified on the front of the solicitation:

INITIAL STATEMENT:

SAF receives approximately 3,500 claims every fiscal year. The Uninsured Employers’ Fund receives approximately 200 workers’ compensation claims every fiscal year. SAF insures approximately 565 state and local governmental entities. These entities renew policies on an annual, semi-annual, or quarterly basis. SAF only writes workers’ compensation coverage for governmental entities in South Carolina. SAF does not write any other lines of business and does not operate in any other states.

1. Question: How many read/write users will be needed for each: Policy, Billing, Claims? Same question for read only users? This can be a combination of both Funds.

State’s Response: Approximately 80-90 internal users will need to have read/write access. We do have external vendors which will need read only access.

2. Question: How many claims do you receive annually across both Funds?

State’s Response: Please see the initial statement above.

3. Question: How many claims will need to be converted to the new platform?

State’s Response: Approximately 170,000 claims.

4. Question: In Attachment A, Tab 1. Policy, Item 1.3.17’s Preference Description states “Ability to support the application of underwriting rules on a per transaction basis.” Does the phrase “application of underwriting rules” refer to rating that follows the underwriting manual, or does it refer to business rules to stop certain users from performing underwriting actions based on rules?

State’s Response: This refers to the process of underwriting policies.

5. Question: In Attachment A, Tab 1. Policy, Item 1.3.24’s Preference Description states “Ability to support the definition of customized page flow sequences to correspond with different writing companies”. What are you looking for with custom page flow sequences? Custom field layouts on screens, customer screen order/navigations in policy back office, or custom screen order/navigation in policy gateway?

State’s Response: This pertains to custom screen order/navigation in policy gateway.

6. Question: In Section IV of the solicitation, Section 1 – Introductory Documents, 1.5 states “Offerors must complete and submit a copy of the Service Provider Security Assessment Questionnaire (Attachment C to this solicitation)” (page 38 of the solicitation). We were not able to find that attachment on the website.

State’s Response: The list of attachments to the solicitation can be found in Section IX. Attachment C begins on page 75 of the solicitation.

7. Question: What is the DWP forecast from 2020 to 2025?

State’s Response: All public financial and claim data is provided in our annual Accountability Report. Please refer to our website for more information.

8. Question: What are the criteria you will be using to rank the software vendors?

State’s Response: The criteria used to evaluate the proposals are outlined on pages 45-46 of the solicitation.

9. Question: Is there a business case to support the replacement of your current PAS system?

State’s Response: No

10. Question: Are there any expectations of when you would like to start and complete the deployment of the proposed solution?

State’s Response: Once the contract becomes effective, SAF would expect the project kickoff to happen immediately. SAF will evaluate the delivery/implementation date proposed by the Contractor once discovery is completed. If SAF determines the date is invalid, adjustments will be made to the schedule, functionality, deliverables to ensure a more realistic delivery date.

11. Question: What are the business drivers/reason for a phased implementation?

State’s Response: By phasing the implementation, SAF will have ample time to test and verify the data from the system being implemented and help identify any breakdown/discrepancies in the new system.

12. Question: In Attachment A, Tab 3. Claims, Item 3.6.7’s Preference Description states “Capability to budget and track legal fees for outside counsel by specific legal entity”. When you refer to “budget…by specific legal entity”, do you mean to set reserves for a specific participant? Or a total reserve for legal expenses?

State’s Response: Set and track and annual legal budget for a specific law firm and aggregation of all contracted firms.

13. Question: Does SAF currently have a Document Composition product in-house for the generation of documents to policyholders, injured workers, etc.?

a. If so, is the State looking to replace this product or is it seeking integration with it?

b. If replacing, is the associated cost to be included as part of the Price Proposal?

State’s Response: Our current system has the ability to generate documents both manually and auto. We are expecting a new product to have the same capabilities.

14. Question: Is Loss Control / Loss Prevention functionality included in the scope of what SAF is looking for in the new WC system?

State’s Response: Not directly. However, SAF is looking for added policyholder portal functionality which may include some aspects of Loss Control.

15. Question: Is Bad Debt Collections Management functionality included in the scope of what SAF is looking for in the new WC system?

State’s Response: No.

16. Question: Is subrogation management functionality included in the scope of what SAF is looking for in the new WC system?

State’s Response: Yes, subrogation case and receipt tracking is a functionality needed in the system.

17. Question: Are there any additional third-party integrations required beyond Hyland OnBase, SCWCC, MMSEA, COBVA?

a. Which medical vendors will be integrated?

b. Which bill review vendors will be integrated?

State’s Response: At this time medical vendors to be integrated will be Compendium Services, Inc., Corvel Corporation, Care IQ, and Corporate Pharmacy Services. Our bill review provider is Planned Administrators Inc. and they utilize Mitchell for their bill review software.

18. Question: For MMSEA integration, does SAF currently report directly to the Federal Government for MMSEA or via a third-party partner (e.g. Mitchell, Franco Signor, ISO, etc.)?

State’s Response: We report directly.

19. Question: Can you please elaborate on the third-party integrations for SCWCC and COBVA (i.e. What is the role of those systems in SAF’s current systems ecosystem)?

State’s Response: We report claims to those two entities per state and federal guidelines.

20. Question: Does SAF cover Workers’ Compensation for any Professional Employer Organizations (PEOs)? If so, can you describe additional details such as how many PEOs, as well as whether they are master policy or MCP’s?

State’s Response: No.

21. Question: Regarding conversion:

21. How many years of data to be migrated? ~10 years

21. Roughly, how many policy transactions will be migrated? 150,500 policy transactions as of 1/21/2021

21. Roughly how many financial transactions will be migrated? 856,705 financial transactions as of 1/21/2021 MEDICAL BILLS – 2,260,642

21. Roughly how many claim transactions will be migrated? 170,752 claims as of 1/21/2021

21. Is data currently in three different systems (Policy, Billing, Claims) or in a single system (a single database)? Are there any other systems that will require a data conversion? Is legal case management in a separate system today? All are in 1 (prod10g, stst3, stst4) – policy, billing, claims, legal.

State’s Response: Total volumes will be adjusted down as SAF is looking to archive past data and keep a rolling 10 years’ worth. These totals are a worst case scenario.

22. Question: For customer specific forms:

22. How many basic forms (A standard non fill-in form, or a form with less than five fields)? 16 forms as of 1/21/2021

22. How many medium complexity forms (A form with 5 - 30 fields with standard sections (with or without overflow) or dynamic functionality)? 197 forms as of 1/21/2021

22. How many complex complexity forms (A form with more than 30 fields, with some programing and multiple instances of overflow or dynamic functionality)? 34 as of 1/21/2021

23. Question: For customer specific reports that are in use today and anticipated to be continued as required in the new system:

a. How many of basic complexity (static formatting, less than 3 sub-entities, and 1 presentation of data (either table or visual))?

b. How many of medium complexity (contains up to 3 sub-entities, combination of 2 presentations (2 tables, 2 charts, 1 chart and 1 table), with 2 different data sets and filters or conditions, as well as conditional formatting applied to no more than 5 fields)?

c. How many of complex complexity (contains more than 3 sub-entities, combination of 3 or more presentations, with more than 2 different data sets and filters or conditions, as well as some coding in SSRS or has more than 5 fields with dynamic formatting)?

State’s Response: After the contract is awarded we will be reviewing our current reports and developing ideas for new reports.

24. Question: Regarding customer specific workflows (if known):

24. How many of basic complexity (A workflow task, emails or assignments based on 1-3 business rules on existing base fields. An example would be assigning the underwriter based on agent/branch assignment or a Loss Control Rep based on Workplace Assignment)?

24. How many of medium complexity (A workflow containing field updates required for automation, or that has task, emails, or assignments based on more than 3 business rules on existing base fields. An example would be claims adjuster assignment rules, when it is looking at premium, claim type, state, jurisdiction, previous claims reported, which increases the amount of datapoints that involve the decision, which increases the level of difficulty)?

24. How many of complex complexity (A string of workflows pointing to data points from various sources. For example, application data along with premium amounts and class codes along with decision based on client specific question or Acord Questions. Workflow which auto decline the quote, or is sent to the underwriter to review. These type of workflows can also include items such as Scoring, or ones that require a specialized query to drill down to the data that needs analysis and building the decisions based on the query output)?

State’s Response: SAF has approximately 149 workflow processes that have one (1) route; 90 with two (2) routes; 18 with three (3) routes. We also have specific routing for New Claim Assignment (38 routes); New Bill Generated (12 routes); Reserve & Payment Authorization (14 routes); Forms (4 routes).

25. Question: Do you have experienced Business Analysts who are knowledgeable about the legacy application, how it’s used, data structures and requirements, and has capacity to support the project, working in conjunction with the chosen vendor?

State’s Response: The SAF project manager assigned to this effort will also play the role of Business Analyst & Data Architect. The PM has a deep background in IT.

26. Question: Do you have an experienced Data Architect who is knowledgeable about their data structures, access methods and requirements, and has capacity to support the project?

State’s Response: The SAF project manager assigned to this effort will also play the role of Business Analyst & Data Architect. The PM has a deep background in IT.

27. Question: Will the demonstration script (Attachment D) only be provided to the top 3 vendors or is available for anyone to review?

State’s Response: The Demonstration Script (Attachment D) can be found on page 77 of the solicitation. Anyone can review it, but only those Offerors invited to demonstrate their proposed solutions will be asked to follow it.

28. Question: The instructions for organizing the Technical Proposal (p. 38 of the solicitation) say, “The Technical Proposal shall be arranged as follows,” then list a variety of other documents in Section 1 – specifically stating that the first 2 pages of the solicitation should be the first 2 pages of the proposal, but then listing our Executive Summary and two questionnaires included as attachments, followed by other material. Is it your intent that these disparate documents be combined into a single electronic document? Or, since this is an electronic submission, is it acceptable to provide the completed solicitation pages & questionnaires as separate files?

State’s Response: You may submit these documents in whichever format you prefer. However, if submitting them as separate documents please be sure and label them clearly.

29. Question: Page 38 of the solicitation cites two security questionnaires (identified as Attachment B and Attachment C, respectively) to be included with the Technical Proposal, but only Attachment B seems to listed/available for downloading from the website. Should we ignore any reference to Attachment C?

State’s Response: Attachment C begins on page 75 of the solicitation.

30. Question: Attachment A, Tab 1. Policy. 1.1 Insurance Product Support

a. How closely does SAF follow the SC NCCI model? Where does SAF deviate? SAF uses NCCI's premium calculation model, classification system and Emod calculation formula.

b. 1.1.1 – What other states does SAF write to / cover? Does SAF file in those states? SAF only has authority to write public entities in SC per SC law. We are not licensed in any states and do not file our rates. We are not under the regulation of NCCI. We are not regulated regarding rates or premiums by the SC Dept. of Insurance, either.

c. 1.1.2 – How many ratings plans does SAF use? We currently use one, but once SAF has procured a new system with this capability, the intent is to transition to two sets of rates, one for our state agencies and one set for non-state agencies.

d. 1.1.3 – How does SAF source class codes and rates? Our actuary sets rates based on a combination of NCCI lost costs and our own insureds' history and we use NCCI class codes.

e. 1.1.4 – What are the forms and endorsements SAF uses for SC and what other forms and endorsements for other states? There are no other states. For SC, we use increased EL limits endorsement. We use ACORD forms for COIs. We use a standard application form. We submit notification of new policies, cancellations and reinstatements to the SC Work Comp Commission.

31. Question: Attachment A, Tab 1. Policy. 1.2 States, Rates, Rules & Forms

a. 1.2.1 – What are the details for each of the rating tiers SAF uses? This is proprietary information and will not be shared.

b. 1.2.2 – What are the other states SAF writes to/provides coverage? Does SAF file in those states? No other states.

c. 1.2.3 – What are the common and unique underwriting rules that SAF uses at the account, policy, product, and coverage level? We follow NCCI standards and need the ability to apply factors that may change accordingly.

d. 1.2.7 – How many standard and company specific SAF forms are used? Can SAF provide samples of all of the unique “company” forms? Standard - applications, COIs, loss runs. Company specific forms include director's letter with renewals, mail audits, aircraft forms and such, but the implementation of a new system may alter our processes and some of our forms.

32. Question: Attachment A, Tab 1. Policy. 1.3 Transactions: General Preferences

a. 1.3.2 – Beyond a standard New Business quote, what other new business transactions are there for SAF? Are there renewal scenarios that are considered New Business? Just standard new business quote.

b. 1.3.3 – Can you elaborate on several coverage renewal transactions that are common for SAF? Policies automatically renew using data from prior policy and payroll from most recent audit. Underwriters review policies prior to renewal.

c. 1.3.4 – What are the conditions that SAF determines DNR? SAF does not deal with conditions of DNR very often but it is evaluated on a case-by-case basis when required.

d. 1.3.16 – Forward looking, how is SAF looking to setup Premium Audit transactions? Are there multiple schedules? Standard premium audit transactions apply.

e. 1.3.21 – What are the current websites that are required to be integrated? What transactions do they support? Do the integrations drive automated transactions? If so, what are the automated transactions? Policyholder Services (Underwriting, Premium audit and Loss Control) currently have little integration with our external website beyond the ability to download a couple of forms. We want to have much greater abilities in this area for our policyholders going forward.

f. 1.3.23 – What is an example of a system-wide underwriting edit for SAF? How often does this typically happen? Is it typically regulatory driven? Because we follow NCCI's guidelines, we may change factors in the premium calculation based on their changes and because our system calculates Emods, NCCI changes in the factors in the calculation are changed accordingly. Changes to these factor typically occur annually.

g. 1.3.24 – How many writing companies are organized within SAF? Currently there is just one, with all policies having the same foundational data. Going forward, we are going to split the state and non-state accounts. This may cause forms and documents to be different for the two different books of business.

h. 1.3.25 – How are SAF policies planned to be sold? Are external or internal "producers" part of the SAF team? If external, how many agencies or independent producers are there? Approximately 150 state agencies are required per state statute to have coverage with SAF. Non-state public entities (school districts, cities, towns, counties, fire depts., etc.) can write with SAF or go to a commercial carrier. We have approximately 400 non-state agencies. These polices are written in-house. SAF doesn't use agents. Although brokers are welcome to bring business to us, we pay no commissions and have no contractual obligation to them. We do, however, track which policies are brokered.

1.3.25 – How many policies are in force today and how many workers are covered? There are approximately 31,000 claimants with approximately 18,000 active claims.

33. Question: Attachment A, Tab 1. Policy. 1.4 Quote

a. 1.4.2 – How common are non-standard term policies at SAF? Because all of our policies currently fall on one of two effective dates (Jan. 1 or July 1), we may write a short-term policy in order to renew to one of those two dates for convenience for our customers at audit and going forward. We don't write policies longer than one year.

b. 1.4.4 – For new quotes to be transferred, does that need to be for the same account or can another account be applied? This is for underwriters to be able to create quote variations for the same policyholder and, if the policyholder accepts a quote, to make it active in the system and to discard the other quotes.

c. 1.4.8 – How often does a quote's effective date need to be manually overwritten? What is the use case at SAF for this scenario? A manual override of a quote does not occur frequently.

d. 1.4.9 – What are the SAF's guidelines on prior and future dated quote effective dates? SAF premium auditors follow NCCI quoting guidelines.

e. 1.4.12 – What is the archiving and purging of quote data at SAF? After a predetermined time, if not accepted, the underwriter closes out an open quote.

f. 1.4.14 – What is the condition for a quote to be marked as "dead" at SAF? Same answer as 1.4.12.

g. 1.4.17 – Is there a standard Quote letter format that can be provided? If there are multiple formats, can the number and samples be provided? We have these but they are manually created. We want this automated in the new system.

h. What class code specific data elements are required for capture and/or rating logic? Payroll, loss history, and loss costs. (Actuary can probably elaborate more on this.)

34. Question: Attachment A, Tab 1. Policy. 1.5 New Business Application

a. 1.5.11 – At SAF, what is the "clearance and registration" process? SAF does not have a clearance and registration process at this time.

b. 1.5.14 – At SAF, is there a standard risk assessment tool / process followed? Can a sample be shared? SAF does not have a standard risk assessment tool at this time.

Note: Please note that SAF usually writes less than 20 new policies each year.

35. Question: Attachment A, Tab 1. Policy. 1.11 Rewrites

a. 1.11.7 – How common is this requirement for SAF? This is not a common requirement. Our current system creates a new policy number for each policy written. We do not cancel and reinstate with a lapse. Going forward we want to look at possibly having the same policy number even if we have to rewrite, but a suffix denoting the policy term.

b. 1.11.8 – At SAF, what is considered "instructions to the billing module?" Is this like a change in a bill plan or premium audit schedule? We have several payment plans and may need to change those on a policy basis.

36. Question: Attachment A, Tab 1. Policy. 1.14 Rating

a. What kinds of ratings are used at SAF and what are the underwriting guidelines to move between ratings when required? SAF follows NCCI standard practices for rating.

b. What scenarios will required automated (straight-thru) processing versus those that are referred to an underwriter? The only deviation from standard rating at this time is the underwriter's decision to include a scheduled credit.

37. Question: Attachment A, Tab 1. Policy. 1.15 Agency Integration

a. What AMS solutions does SAF support today?

State’s Response: Our current claim system is Powercomp.

38. Question: Attachment A, Tab 2. Billing. 2.1 Billing and Invoicing

a. 2.1.11 – What are the minimum deposit requirements?

b. What batch-based document generation requirements exist? Number of forms & timing of batch jobs? Do these documents need to be printed/fulfilled during the batch job?

State’s Response: We do not have minimum deposit requirements. These batch jobs run monthly. On average, 5 documents per policy are generated from this process.

39. Question: Attachment A, Tab 2. Billing. 2.3 Receivables Management

a. 2.3.1 – What is the general ledger system used that the solution will integrate into? How is cash brought into SAF's GL who applies it to policies or accounts?

b. 2.3.2 – How are cash batches received? What current payment methods and payment gateways are used by SAF/ Will new ones be added?

c. 2.3.4 – What are the allocation rules?

d. 2.3.11 – Does SAF use a collection agency today? If so, who is the vendor?

State’s Response: State Accident Fund uses SAGE accounting package. Cash for premium payments are receipted on PHS and come over to the accounting system in an overnight import. Cash balance is then reconciled with SCEIS cash balance. Cash receipts related to claims’ transactions are entered into the accounting system with a monthly journal entry debiting cash and crediting a clearing account. When receipted on CMS the transactions clear the clearing account. CMS also has an import file nightly to bring all transactions into the accounting system.

Currently we process any payments from claims/premium systems as checks. No cash batches are received. The bank cash deposits are all connected to the statewide SCEIS system. Payments are allocated according to the billed premium. The system applies the cash receipt to the outstanding balance on the policy. Balances are all monitored and do not go past due more than 30-60 days.

40. Question: Attachment A, Tab 2. Billing. 2.4 Workflow/Issue Handling

a. 2.4.1 – What are the planned payment plans expected for SAF going forward?

b. 2.4.3 - Can processes be manually triggered that override automated/batch transactions?

c. 2.4.7 – How do policyholders register or authenticate to the website?

d. 2.4.8 – How are NSF check notices received? And are fees associated to the account? What are the allocation rules for payments when there are non-policy fees and the payment is short overall?

e. 2.4.10 – Can you provide examples of the types of tolerance?

f. 2.4.11 – What are the other systems that Billing needs to reconcile with at SAF?

State’s Response: Currently we have monthly, quarterly, semi-annual, and annual premium billing. We can have IT push through transactions should we need them to process before the nightly import.

We receive NSF check notices from the SC State Treasurer’s Office. We do not currently charge fees for NSF checks. Payments are just applied in accordance with the billed premium. Past due balances are monitored and do not go over 30-60 days. We do not charge late fees. We reconcile premium transactions to the general ledger system and premium receipts are also reconciled to SCEIS, which is a state wide system in which the cash deposits are recorded.

41. Question: Attachment A, Tab 2. Billing. 2.6 Other Processes, Integration

a. 2.6.23 – Is there a CRM solution and IVR system in place today? Or, would there be the opportunity to include the Offeror’s CRM?

State’s Response: There is not a current CRM or IVR system in place. SAF is open to Offerors’ suggestions. As experts in this field, Offerors are expected to present their best solution to SAF’s needs, complying with the requirements set out in the RFP. Those solutions will then be evaluated.

42. Question: Attachment A, Tab 3. Claims. 3.3 Investigation

a. 3.3.1 – Is the requirement for the system to automatically generate a work plan for each claim, or for the claim handler to create the work plan?

State’s Response: Preferences are listed in Attachment A. Additionally, the panel will evaluate any features provided in the responses to this RFP.

43. Question: Attachment A, Tab 3. Claims. 3.4 Evaluate

a. 3.4.1 – Please provide additional details about the forecasting requirement. For example, use AI to compare the current claim to similar past claims and make recommendations and predictions to assist claims handling.

b. 3.4.3 – Are there existing in-house or third-party tools you wish to incorporate into the new solution?

c. 3.4.4 – Please provide examples of some different claim review processes for different types of loss.

d. What are the approximate volume of unique reports? Dashboards?

State’s Response: SAF is open to Offerors’ suggestions. As experts in this field, Offerors are expected to present their best solution to SAF’s needs, complying with the requirements set out in the RFP.

44. Question: Attachment A, Tab 3. Claims. 3.10 Medical Management

a. 3.10.4 – Have you identified financial reporting systems that need to be integrated with, and, if so, can you please list them?

State’s Response: State Accident Fund uses SAGE accounting package.

45. Question: Attachment A, Tab 3. Claims. 3.13 Document & Data Management

a. 3.13.1 – Are there batch document generation and distribution requirements, such as having a process generate documents for a number of claims and distribute outside of what a Claim Handler may be doing for any one claim they are adjudicating? Is distribution of a document via email, or could it also be via mail? If via mail, do you have a preferred print service partner or solution?

b. 3.13.2 – Please provide an example of a required document workflow.

State’s Response: SAF is open to Offerors’ suggestions. As experts in this field, Offerors are expected to present their best solution to SAF’s needs, complying with the requirements set out in the RFP.

46. Question: Attachment A, Tab 3. Claims. 3.15 Workflow Management

a. 3.15.3 – Please provide example productivity metrics that are used today.

State’s Response: Our current system does not have this ability.

47. Question: Assuming a phased implementation approach with Claims functionality implemented first, what are the integration capabilities of the current core policy administration system? For example, is there a REST API that provides the ability to query for current coverages for a policyholder?

State’s Response: Windows based client/server system – no rest api.

48. Question: What channels will be used to report new injury claims?

State’s Response: Our medical case management vendors take our first reports directly from our policyholders.

49. Question: What are the scenarios where auto adjudication of claims will be required?

State’s Response: We have no auto adjudication requirements. However, we have an interest in looking at incorporating auto adjudication of claims into our current process.

50. Question: Is there an expectation for CTI/Call center integration to handle calls for claim handlers or other service representatives?

State’s Response: No.

51. Question: The RFP states that SAF currently has two separate programs that handle workers’ compensation-related activities - the SC State Accident Fund and the SC Uninsured Employers Fund. From the claimant and claim handler perspective, how different are these experiences? What is the claim volume per fund?

State’s Response: Please see our initial statement at the beginning of the Questions and Answers portion of this document.

52. Question: What data interfaces are required to support the reporting agency cross-matching requirements?

State’s Response: The vendor should be able to supply any type of file format to support the cross-matching, .CSV, XML, JSON, etc.

53. Question: How many claim handlers are there and how many types and/or levels of specialization determine which claim handler processes a claim?

State’s Response: We have 25-30 claim handlers. For both SAF & UEF we have Adjuster I, Adjuster II, Claims Manager, and Director of Claims as position levels within each team.

54. Question: How many distinct claim review processes are currently utilized?

State’s Response: 3-4

55. Question: How many distinct products will need to be supported by Claims at time of launch?

State’s Response: We have approximately 12-15 interfacing partners that support Claims (i.e., Bill Review, Pharmacy).

56. Question: Attachment A, Tab 4. Technology. 4.1 Mandatory Requirements

a. 4.1.1 – Is Google Chrome a valid browser to be included in the list of supported browsers?

State’s Response: Any claim product that supports Worker’s Comp.

57. Question: Attachment A, Tab 4. Technology. 4.3 Database/Data Management

51. 4.3.1 – Is this a gap?

51. 4.3.2 – Will historical data need to be migrated? If so, what type(s) of data and what are the expected volumes?

State’s Response: Some historical data will need to be migrated. A plan will be derived with the Contractor prior to data migration beginning.

58. Question: Attachment A, Tab 4. Technology. 4.4 Interfaces

a. 4.4.3 – What is the specific version and specifications for interfaces to OnBase that will be required? Will OnBase have credentials for all users or should there be a system user that accesses documents? If a system ID is used, would additional effort be required to build document access audit logs?

b. 4.4.7 – Is there an inventory of all known interfaces/integrations and details on the data specifications? Is a system diagram available?

State’s Response: We currently use OnBase version 18.0.1.51. Each user has their own specific credentials. SAF does not currently have a documented system diagram that shows all of the various interfaces/integrations currently being used. One of the deliverables out of discovery would be this diagram.

59. Question: Attachment A, Tab 4. Technology. 4.5 Security

a. 4.5.5 – What SSO solution is in place or planned to be in place in the future?

State’s Response: We currently use Active Directory but have no SSO configured. It would be preferable if we could use AD (ldap) for this.

60. Question: Can SAF perform 1 or dual awards to the RFP?

State’s Response: Award will be made to one Offeror. Please see Award to One Offeror on page 45.

61. Question: Is SAF open to mitigating risk by using a new SOW for each phase of the implementation rather than one SOW for the full 3-year program as outlined in the RFP?

State’s Response: No.

62. Question: Are there any dates that should govern the program to achieve the intended business value and minimize business risk?

State’s Response: No.

63. Question: What are the primary KPI’s or mechanisms SAF will use to determine success of the program?

State’s Response: The SOW and other agreed upon milestone dates will be used to determine success.

64. Question: What is the time frame from awarded to start/kick off (ramp time)?

State’s Response: Please refer to pages 21, 22, and 23 of the solicitation.

65. Question: Are there limits on the 12-month warranty?

State’s Response: The terms of the 12-month warranty must be in accordance with the warranty provisions described in the RFP, but are provided by the Offeror in their Technical Proposal.

66. Question: Does SAF staff wish to assume full responsibility for each component as completed or upon completion of the full solution?

State’s Response: This will be decided when deliverables are developed.

67. Question: Are resources required to work on-site? Is virtual delivery okay?

State’s Response: There are specific instances where SAF will require the contractor to be on-site.

68. Question: Is Microsoft project required?

State’s Response: MS Project is not required but a justifiable project tracking software must be approved by SAF prior to use. No proprietary software can be used.

69. Question: Deliverables - does SAF provide the templates? Or will deliverables be jointly developed?

State’s Response: SAF would expect a project template to be developed by the Contractor. The SAF Project Manager will help develop and buildout deliverables within the template with the Contractor.

70. Question: In Section III of the solicitation, Section 3.4.1 – Task 1 – Project Management, it states “The Contractor must propose a system development methodology (SDM) that is defined, documented, repeatable and consistent with the Software Engineering Institute (SEI) Level 3 or higher Capability Maturity Model (CMM)” (see page 21). Can you please provide more detail on this request?

State’s Response: The Contractor must follow an industry-wide development lifecycle for the project (SDLC), the contractor can use the waterfall method or Agile framework, but it must be repeatable.

71. Question: The Solicitation refers to a “Hosted Service Provider Security Assessment Questionnaire” that is available online. Can you please provide directions for accessing this document?

State’s Response: The Hosted Service Provider Security Assessment Questionnaire (Attachment B) can be found here: http://webprod.cio.sc.gov/SCSolicitationWeb/contractSearch.do?solicitnumber=5400020469

72. Question: Based on the rest of the IT Change Portfolio, are there any known constraints that should be factored into the implementation approach? Often these are driven by resource constraints.

State’s Response: None at this time.

73. Question: What is the intended collaboration with SAF’s Governance and Architecture teams?

State’s Response: SAF will coordinate weekly meetings with Governance & the Architecture teams until the project is up and running smoothly. These meetings will be scaled back to monthly as dictated by the SAF Director.

74. Question: Is any change management support required?

State’s Response: SAF will develop the Project change management approach and execute Stakeholder engagement, communications, development, and delivery of a workforce transition plan, training design, readiness assessment, and business process re-engineering activities. The Contractor may be asked by SAF to offer assistance or expertise, or review these activities as part of their participation in the project.

75. Question: What planned rollout approaches have been established (aka. pilot releases)?

State’s Response: None at this time.

76. Question: Please provide the following:

a. Annual GWP for SC SAF and by product/coverage if possible

b. Number of internal users by department (e.g., IT, Producers/Sales, UW, Billing, Claims, Other)

c. Business counts for Policies in Force (PIF), Claim Counts, Average Annual # of Claimants

d. Other jurisdictions outside of South Carolina SAF writes business

State’s Response: Please refer to the initial statement at the beginning of the document and any of our publicly provided reports. Some can be found on our website.

77. Question: We use commercially reasonable efforts to make our on-demand services available to our customers 24/7 except for planned downtime (for which we give customers prior notice) and force majeure events. Are availability SLAs negotiable? Will SAF accept an availability SLA of 99.7% or greater?

State’s Response: An SLA of 99.7% or greater per year would be acceptable.

78. Question: We are a service provider and SAF would be one of hundreds of thousands of customers using our service. We can contractually commit to incident response reporting timeframes in a customer contract. One component driving the timeframes is our ability to communicate to a wide customer base in the event of an incident. In a multi-tenant cloud environment, we could be reporting to thousands of customers if there is a security incident impacting multiple customers. We utilize one incident response process for all customers. Utilizing one approach allows for scalability and ease of operations. Additionally, due to the nature of our service, we can only report confirmed breaches, not attempted, suspected, threatened, or foreseeable breaches. As a multitenant environment, an attempted breach against another tenant would not be reported to SAF. In the event of a security breach and if negotiated in the agreement, we can notify SAF's identified points of contact. We cannot notify affected parties because we do not view customer data. We are responsible for maintaining access in terms of performance and availability to the data. The data is owned by the customer. As such, we would like to request the requirements for breach notifications align with our existing reporting requirements that also align with FedRAMP and request that SAF change the breach notification requirement to "within 48 hours of an incident".

State’s Response: SAF agrees that within 48 hours of an incident is an acceptable timeframe to notify SAF of a data breach.

79. Question: Could you please provide a list of both internal and external users? By number of users and job roles?

State’s Response: I think if FedRAMP states notification within 48 hours, then SAF should change the wording.

80. Question: We are not able to agree to a binding contract as a result of responding to this RFP. With a Software as a Service solution, there are many parts of both our Order and Subscription Services Agreement that we need to have in place for our partnership with SAF. We also would be writing a Statement of Work for your implementation upon further discovery of your systems and business processes. For that reason, we are also unable to provide a fixed bid for the implementation work at this time. We can however provide a rough order of magnitude (ROM) implementation number. Please advise if this will require us to withdraw from consideration.

State’s Response: The solicitation requires Offerors to submit fixed pricing in order to be responsive to the RFP. See Fixed Pricing Required on page 48 of the solicitation.

81. Question: What was your 2019 DWP? Where can we get detail similar to an AM Best report? Can you also provide your annual claim volume, broken down by lost time claims and MO? And what are your open case counts? What is your number of annual insurers?

State’s Response: All financial and claim data is provided in our annual Accountability Report. Please refer to our website for more information.

82. Question: Could you please provide clarification around the requirements for this exercise around the Project Administration? We have an implementation methodology and while we can work with our partners, this is a very detailed list of how the project is going to run and be managed.

State’s Response: Offerors are asked to include their “implementation methodology clearly communicated” in their preliminary implementation plan (see Section IV, Instructions for Technical Proposal, Section 4 - Understanding of, and Capability to Perform, the Tasks Required, 4.6 on page 41 of the solicitation). This will be evaluated by the Evaluation Panel in Phase I of the evaluation process (see Section VI, Evaluation Factors – Proposals, beginning on page 45).

83. Question: Section III of the solicitation, Section 3.4.8.3 – Post Implementation Support: Will these conditions be negotiated to include further details and SLAs triggers? 90-day production support? 12-month warranty – Conditions?

State’s Response: The 12-month warranty commences upon SAF acceptance of the final release of the system, which occurs upon successfully completing the performance period.

The terms of the 12-month warranty must be provided at no additional charge to the State and be in accordance with the warranty provisions described in the RFP, but are provided by the Offeror in their Technical Proposal

84. Question: Attachment A, Tab 2. Billing 2.1 Billing and Invoicing

a. 2.1.24 – Can you please provide us with use cases that would lead to uneven installment amounts or irregular installment intervals?

State’s Response: Typically uneven installment amounts come from hardship cases.

85. Question: Attachment A, Tab 2. Billing 2.3 Receivables Management

a. 2.3.5 – Can you please provide us with some context for this requirement or perhaps some examples of “configurable reconciliation edits” that are used in the current system to ensure the policy remains in balance?

State’s Response: The chosen systems needs to have the capability of automatically checking to make sure all billing and payment transactions remain in balance.

86. Question: Is the Fund NCCI compliant and keeping current with circular updates? What version of the NCCI compliant are you on?

State’s Response: We have a NCCI subscription and receive regular updates.

87. Question: Attachment A, Tab 4. Technology 4.2 Architecture

a. 4.2.3 – Where are the “State of South Carolina Division of Technology policies and guidelines” located? Or will they be sent to us?

State’s Response: The State of South Carolina Division of Technology’s policies and guidelines can be found here: https://admin.sc.gov/technology/policies_procedures

88. Question: Attachment A, Tab 4. Technology 4.1 Mandatory Requirements

a. 4.1.2 – “This audit capability must allow for compliance with ORC 1347.15”. This is a requirement for the state of Ohio. Please provide clarification

State’s Response: The reference to ORC 1347.15 has been deleted. Please see the Amended Attachment A.

89. Question: Our solution is Software as a Service (SaaS). A SaaS price includes software, software maintenance, upgrades, fixing of bugs, hosting, etc. The instructions for the Price Proposal do not allow for SaaS pricing.

State’s Response: The instructions for completing the Price Proposal can be found on pages 42 and 70-71 of the solicitation. Offerors should complete and include the table in Section VII starting on page 70. However, if Offerors feel that table does not allow them to adequately address all of the costs associated with their proposed solution, they should include those "additional" costs in some other format.

90. Question: In order to fully respond to Attachment B, we will be providing information of a sensitive nature. To get access to that information, we will require the State to sign a Non-Disclosure Agreement. Will you sign such a document?

State’s Response: The Procurement Officer is statutorily bound not to disclose any information received as part of this RFP. The only other people who will see the submitted proposals are the members of the Evaluation Panel, all of whom must sign an NDA before they are permitted access to the documents.