Appendix_7.21_RFP_31786-00186%20Scorecard.xlsx
XLSX spreadsheet 17 KB Posted
- Solicitation number
- RFP 31786-00186
- Issued by
- Davidson County, Tennessee
About this file
This is an SLA Quarterly Scorecard document for a state and local contract opportunity (RFP 31786-00186) that establishes performance measurement standards for a contractor providing member services and claims administration. The contract requires the contractor to meet ten key performance indicators across call center operations, member enrollment and satisfaction, claims processing, and reporting functions. Specific requirements include maintaining an 85% first call resolution rate, mailing welcome kits to 95% of new members within ten business days, achieving an 85% member satisfaction rating in year one and 90% in subsequent years, processing enrollment files within two business days, resolving enrollment discrepancies within two business days, submitting required reports on time, maintaining average call answer speeds of 30 seconds or less, and achieving 98% claims payment accuracy, 97% claims processing accuracy, and 98% claims processing turnaround within 21 days. Performance is measured quarterly for most metrics and annually for member satisfaction and claims accuracy measures.
The scorecard establishes a payment structure tied directly to contractor performance, with quarterly base payments of $30,000 for Q1 and $50,000 for Q2-Q4, subject to reduction based on quarterly performance scores. A quarterly score of 95% or greater results in no payment reduction, while scores of 74.9% or below result in a $50,000 withhold. Each KPI has maximum available points of 10, with specific performance bands determining points earned; for example, a first call resolution rate of 85% or greater earns full 10 points, while rates of 83-84.9% earn 6 points, 80-82.9% earn 2 points, and below 80% earn zero points. The 2025 quarterly results shown indicate Q1 and Q2 performance at 83.33% and 16.67% respectively, with Q3 and Q4 showing minimal achievement. Total available points per quarter range from 60 points in Q1-Q3 to 100 points in Q4, reflecting the inclusion of annual metrics in the final quarter.
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Text version
SLA Quarterly Scorecard
| Contract Requirements | Measurement Frequency | Calculation Notes | KPI | KPI Name | KPI Description | KPI Performance Requirement | KPI Contractor Performance | Score if Met | 2025 Q1 Contractor Performance | Available Points | 2025 Q1 Contractor Score | 2025 Q2 Contractor Performance | Available Points | 2025 Q2 Contractor Score | 2025 Q3 Contractor Performance | Available Points | 2025 Q3 Contractor Score | 2025 Q4 Contractor Performance | Available Points | 2025 Q4 Contractor Score | |
| A.4.c.: The Contractor’s call center shall maintain a monthly average First Call Resolution rate of | |||||||||||||||||||||
| eighty-five (85%) or greater. | QUARTERLY - Monthly average (the exact months of the quarter being reported) | The average of the three monthly averages should be used. Round to the nearest tenth. | 1 | First Call Resolution | The Contractor’s call center shall maintain a monthly average First Call Resolution rate of eighty-five percent (85%) or greater as required in Contract Section A.4.c | 85% | 85% or greater |
83% -84.9% 80% - 82.9% Less than 80% 10
| 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 0 | |||
| A.6.b: As a new Member(s) joins the Program, they shall be mailed a welcome kit no later than ten (10) Business Days from the date initial enrollment was passed to the Contractor on the enrollment file. At least ninety-five percent (95%) of ongoing welcome kits shall be mailed within ten (10) Business Days of new Member enrollment record being received. | QUARTERLY - average (the exact months of the quarter being reported). | Round to the nearest tenth. | 2 | Mailing of ongoing welcome kit | Ninety-five percent (95%) of ongoing welcome kits shall be mailed within ten (10) Business Days of new Subscriber enrollment record being received as required in Contract Section A.6.b. | 95% | 95% or greater |
93% -94.9% Less than 93% 10
| 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 0 | |||
| A.9.k.: The Contractor shall perform, following review and approval by the State, Member satisfaction surveys no less than annually. The survey instrument shall be developed by the Contractor and approved by the State In Writing. The survey shall be conducted at a time mutually agreed upon by the State and the Contractor and shall involve a statistically valid random sample of State Members. The Contractor shall guarantee a statistically valid response rate consistent with the sample size. The Contractor shall obtain an overall Member satisfaction rating equal to or greater than eighty-five percent (85%) in the first year and ninety percent (90%) in all subsequent year(s) within the Term. Based upon the results of the survey, the Contractor and the State shall jointly develop an action plan to correct problems or deficiencies identified through this activity. | ANNUAL - annual measurement (enter into Nth quarter results column based upon when survey results were tallied). Key "N/A" into the other quarter result cells. | Round to the nearest tenth. | 3 | Member Satisfaction Survey | The level of overall Member satisfaction, as measured annually through the Member satisfaction survey, shall be equal to or greater than eighty-five percent (85%) in the first year of the Contract, and shall be equal to or greater than ninety percent (90%) in all subsequent year(s) within the contract term as required in Contract Section A.9.k. | 90% (in years 2-5 of contract) | 90% or greater |
88-89.9% 86-87.9% Less than 86% 10
| 0 | 0 | 0 | 0 | 10 | 0 | ||||||
| A.11.h.(2).: The Contractor shall electronically process the State’s electronically retrieved enrollment full population file within two (2) Business Days of receipt of the weekly file. | QUARTERLY - average (the exact months of the quarter being reported). | Round to the nearest tenth. | 4 | Enrollment Posting | One hundred percent (100%) of electronically retrieved enrollment files processed within two (2) Business Days of receipt of the weekly file as required in Contract Section A.11.h.(2). | 100% | 100% |
98.0-99.9% 96.0-97.9% Less than 96% 10
| 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 0 | |||
| A.11.h.(4).: The Contractor shall resolve all enrollment discrepancies identified by the Contractor for internal correction within two (2) Business Days of identification. The Contractor shall process all error corrections received from the State within two (2) Business Days of receipt of the correction information. | QUARTERLY - average (the exact months of the quarter being reported). | Round to the nearest tenth. | 5 | Enrollment Discrepancies | Resolve 100% of enrollment discrepancies as identified by the Contractor for internal correction within two (2) business days of identification and within two (2) Business Days of receiving corrected information from the State as required in Contract Section A.11.h.(4). | 100% | 100% |
98.0-99.9% 96.0-97.9% Less than 96% 10
| 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 0 | |||
| A.13.a: The Contractor shall submit reports to the State electronically, in the format specified by the State (e.g. Excel instead of PDF), and shall be of the type and at the frequency indicated in Contract Attachment D. The State reserves the right to modify reporting requirements as deemed necessary to monitor the Program. The State will provide the Contractor with at least ninety (90) days’ notice prior to implementation of a report modification. | QUARTERLY - percentage on time during the quarter being reported | Round to the nearest tenth. | 6 | Reporting | The Contractor shall distribute to the State all reports required in the Contract within the time frame and in the format specified in the Contract as required in Contract Section A.13.a | 100% | 100% |
98.0-99.9% 96.0-97.9% Less than 96% 10
| 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 0 | |||
| A.4.c.(1): The Contractor’s call center shall maintain a monthly Average Speed Of Answer rate of thirty (30) seconds or less. | QUARTERLY - Monthly average (the exact months of the quarter being reported). | The average of the three monthly averages should be used. Round to the nearest tenth. | 7 | Average Speed of Answer | The Contractor’s call center shall maintain a monthly Average Speed of Answer rate of thirty (30) seconds or less as required in Contract Section A.4.c.(1). | 100% | 30 Sec. or less Avg. |
31-35 Sec, Avg.
36-40 Sec Avg.
Greater than 40 Sec Avg. 10
| 0 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 0 | |||
| A.9.p.: The Contractor shall maintain an annual average rate of ninety-eight percent (98%) or higher for Claims Payment Accuracy, ninety-seven percent (97%) or higher for Claims Processing Accuracy, and ninety-eight percent (98%) or higher within twenty-one (21) days for Claims Processing Turnaround. | ANNUAL - annual calculation (enter into 4th quarter results column). In this row, N/A will display in cells where results should not be entered. | Round to the nearest tenth. | 8 | Claims Payment Accuracy | The Contractor shall maintain an annual average rate of ninety-eight percent (98%) or higher for Claims Payment Accuracy as required in Contract Section A.9.p. | 98% or greater | 98% |
97%-97.9% 96.0-96.9% Less than 96% 10
| 0 | N/A | N/A | N/A | 10 | 0 | |||||
| A.9.p.: The Contractor shall maintain an annual average rate of ninety-eight percent (98%) or higher for Claims Payment Accuracy, ninety-seven percent (97%) or higher for Claims Processing Accuracy, and ninety-eight percent (98%) or higher within twenty-one (21) days for Claims Processing Turnaround. | ANNUAL - annual calculation (enter into 4th quarter results column). In this row, N/A will display in cells where results should not be entered. | Round to the nearest tenth. | 9 | Claims Processing Accuracy | The Contractor shall maintain an annual average rate of ninety-seven percent (97%) or higher for Claims Processing Accuracy as required in Contract Section A.9.p. | 97% or greater | 97% |
96%-96.9% 95.0-95.9% Less than 95% 10
| 0 | N/A | N/A | N/A | 10 | 0 | |||||
| A.9.p.: The Contractor shall maintain an annual average rate of ninety-eight percent (98%) or higher for Claims Payment Accuracy, ninety-seven percent (97%) or higher for Claims Processing Accuracy, and ninety-eight percent (98%) or higher within twenty-one (21) days for Claims Processing Turnaround. | ANNUAL - annual calculation (enter into 4th quarter results column). In this row, N/A will display in cells where results should not be entered. | Round to the nearest tenth. | 10 | Claims Processing Turnaround | The Contractor shall maintain an annual average rate of ninety-eight percent (98%) or higher within twentyone (21) days for Claims Processing Turnaround as required in Contract Section A.9.p. | 98% or greater | 98% |
97%-97.9% 96.0-97.9% Less than 96% 10
| 0 | N/A | N/A | N/A | 10 | 0 | ||||
| Total Quarterly Points Available | 60 | 60 | 60 | 100 | |||||
| Total Quarterly Points Achieved | 10 | 10 | 10 | 0 | |||||
| Quarterly Score | 83.33% | 16.67% | 16.67% | 0.00% | |||||
| Payment Amount Due | $ 30,000.00 | $ 50,000.00 | $ 50,000.00 | $ 50,000.00 |
| Quarterly Score At Risk Performance Payment | |
| >=95% | $0.00 |
| 90.1-94.9% | $10,000.00 |
| 85-90% | $20,000.00 |
| 80-84.9% | $30,000.00 |
| 75-79.9% | $40,000.00 |
| 74.9% or below | $50,000.00 |
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