Appendix_G_Reference_Request_Form.docx
DOCX document 27 KB Posted
- Attached to
- Employee Benefits Consultant Services
- Solicitation number
- 023-DW-0125
- Issued by
- Polk County, Florida
About this file
The document is a Reference Request Form (Appendix G) for the Polk County School Board's Employee Benefits Consultant Services Invitation to Negotiate (ITN) 023-DW-0125. The solicitation seeks a qualified Employee Benefits Insurance Consulting firm to work collaboratively with the district in purchasing insurance products, with services to be compensated on a fee-for-service basis. The reference form is designed to evaluate potential consulting firms across multiple performance dimensions, including communication, responsiveness, reporting accuracy, data management, plan administration flexibility, and overall service quality.
The reference form provides a comprehensive evaluation framework with ratings spanning from unsatisfactory (1) to excellent (6) across 12 key service performance areas. These areas include personnel communication, accessibility, report accuracy, eligibility data management, plan design flexibility, vendor collaboration, account team dedication, open enrollment support, member communication effectiveness, service quality, contractual performance, and overall satisfaction. The form also includes space for additional comments and a recommendation regarding whether the school board would contract with the proposer again, serving as a critical tool for assessing potential consulting firms' capabilities and past performance in employee benefits consulting services.
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| 023-DW-0125_Employee_Benefits_Consultant_Services_Addendum1.pdf | ||
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| Appendix_F_Byrd_Antilobbying_Amendment.docx | DOCX document | |
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Text version
023-DW-0125 Employee Benefits Consultant Services ITN Appendix G, Reference Request Form (Reproduce as necessary) Proposer: Fill in proposer company name and send form to three (3) references with request to complete remaining information and return to you. The completed reference form must be included with proposal submission by deadline in solicitation document, anticipated schedule of events section.
Reference: Complete the reference information requested by the Proposer listed below.
REFERENCE REQUEST
PROPOSER COMPANY NAME:
REFERENCE COMPANY NAME:
REFERENCE COMPANY ADDRESS:
REFERENCE CONTACT PERSON:
| PHONE NUMBER: |
| EMAIL: |
Indicate the date Proposers services began and ended (if applicable):
List the specific services Proposer performs for your company:
SERVICE PERFORMANCE
| EXCELLENT |
| UNSATISFACTORY |
| FACTORS/RATINGS |
| 6 |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Proposer personnel keep an open line of communication about upcoming market changes and compliance issues pertaining to the services provided.
Proposer representatives are accessible, proactive, and provide timely responses to inquiries and benefits related disputes/issues.
Proposer provides accurate, user-friendly reports in a timely manner and provides staff expertise to interpret performance, including recommendations for improvement.
Proposer maintains accurate eligibility data and has established effective procedures to ensure ongoing and timely updates.
Proposer demonstrates flexibility to administer plan design options and customized programs specific to your needs.
Proposer works collaboratively and effectively with you and your benefit vendors and brings forward strategies to improve quality and reduce costs.
A dedicated team is assigned to your account that is knowledgeable, accessible, responsive, and advocates internally on your behalf.
Proposer provides effective support during the annual open enrollment process.
Proposer provides clear, effective communication methods for plan members including digital, telephonic, and written materials.
Members are satisfied with the services of the Proposer with very few service issues and complaints.
Proposer has demonstrated the ability to improve the quality and cost of health plan services performed.
Proposer is accurate and timely in the performance of its contractual obligations.
Invoicing and adjustment concerns are handled promptly.
Questions and inquiries are answered promptly.
Overall satisfaction level with Proposer.
You would contract with this Proposer again and would recommend them to the School Board of Polk County.
Other Comments:
File details come from the government source that posted it. Updated .