ATT 1b_RTM final 01.11.2022.xls

XLS spreadsheet 204 KB Posted

Attached to
Benefits Enrollment and Premium Administration Services for BENEFEDS Program Federal contract opportunity
Solicitation number
24361821R0002
Issued by
Office of Personnel Management

About this file

This federal solicitation requests proposals for benefits enrollment and premium administration services for the BENEFEDS program. Offerors must provide a turnkey system and services to support enrollment, premium administration, call center support, and outreach and communication for the FEDVIP, FSAFEDS, and FLTCIP programs. The government will award an Indefinite Delivery/Indefinite Quantity contract with a 54-month period of performance and task orders issued by the Office of Personnel Management. The anticipated award date is June 30, 2022. A Two-Phase evaluation process will first assess pass/fail criteria before applying confidence ratings. The Phase One submission deadline is included in the solicitation.

View the file

Other files for this federal contract opportunity

Other files attached to Benefits Enrollment and Premium Administration Services for BENEFEDS Program, newest first.
File Type Posted
BENEFEDS QA Amendment 5 3.16.22.pdf PDF
ATT 2_ Quote Schedule 24361821R0002 03.15.2022.xlsx XLSX spreadsheet
ATT 7_SBPCD Template 3.15.22 clean.docx DOCX document
ATT 1_BENEFEDS PWS 3.10.22 Amendment 3.pdf PDF
ATT 2_ Quote Schedule 24361821R0002 03.04.2022.xlsx XLSX spreadsheet
ATT 3_CLAUSES 03.08.2022 Amendment 3.pdf PDF
ATT 5_FORMS -02.25.22 clean.docx DOCX document
SOLICITATION 32591 BENEFEDS 3.10.22 - Amendment 3.pdf PDF
ATT 1a_BENEFEDS Appendices 3.10.22 Amendment 3.pdf PDF
ATT 7_SBPCD Template 3.4.22 clean.docx DOCX document
ATT 7_SBPCD Template 3.4.22 Amendment 3.pdf PDF
BENEFEDS QA Amendment 3_3.10.22.pdf PDF
ATT 5_FORMS -02.25.22 Amendment 3.pdf PDF
ATT 6_PPQ 03.10.22.docx DOCX document
ATT 1_PWS.pdf PDF
ATT 1a_BENEFEDS Appendices 2.3.22.pdf PDF
ATT 5_FORMS -01.13.2022.docx DOCX document
ATT 7_SBPCD Template 08.25.2021.docx DOCX document
ATT 3_CLAUSES 02.16.22.pdf PDF
SOLICITATION 32591 BENEFEDS released 2.16.22.pdf PDF
ATT 9_SB SubK Plan Template 1.19.22.docx DOCX document
ATT 1c_BENEFEDS QASP 10.6.2021.docx DOCX document
ATT 2_ Quote Schedule 24361821R0002 01.13.21.xlsx XLSX spreadsheet
ATT 4_PROVISIONS 02.03.22.pdf PDF
ATT 6_PPQ.docx DOCX document
ATT 8_BENEFEDS FWA Report Template.xls XLS spreadsheet
Show all 26

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Document Overview

Attachment 2
BENEFEDS Solicitation Number OPM XXXX Requirements Traceability Matrix System and Management Requirements / Rules
This document contains the following:

- System Requirements

- System Business Rules Requirements

Note: This document is meant to provide potential offerors with a high-level overview of the potential BENEFEDS system and management requirements / rules. It is not intended to be an exhaustive list of requirements / rules, but rather should be used as a tool by potential offerors to determine how to approach their proposed solution / response to the BENEFEDS RFP.
Date: August 17, 2020

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

&L&P&CBENEFEDS RFP&R&D

System and Business Reqs

Completed by the Offeror
System Req (R) / Business Rule / Req (BR)Rule / Requirement DescriptionProgram(s)Minimum / Future RequirementTurn-keyConfiguredCustom CodeExceptionComments
1-DTDevelopment and Transition
BRThe Contractor's key staff must conduct regular transition meetings with OPM and other key stakeholders. The first transition meeting with OPM and the current Contractor must be held within 14 calendar days from contract award.
BRThe Contractor must provide a solution and implementation plan that facilitates a seamless transition to its services
BRThe Contractor must provide weekly detailed reports on its progress to OPM
BRThe Contractor must submit a development and transition plan that is thorough, detailed and provides specific dates for each step of the process. The project plan and schedule must identify resources, interdependencies, assumptions, what the Contractor expects of OPM and what it expects/needs from the current Contractor to accomplish all tasks identified. The plans must also reflect contract requirements as outlined in the RFP such as security and Section 508 requirements
BRThe Contractor must agree to provide onsite client and project management support at OPM, if requested throughout the transition period and afterwards until such time that OPM and the Contractor mutually agree that onsite support is no longer needed
BRContractor must obtain Authority to Operate (ATO) from the OPM’s Chief Information Officer (CIO) prior to January 1, 2023
BRThe Contractor must contact and work with carriers, payroll providers (including Retirement Services) and OPM to develop and test interfaces
2-EEnrollments
BRThe Contractor must have processes to obtain and validate FEHB enrollment for each enrollee and share that information with carriers on the enrollment fileFEDVIPMinimum
BRThe Contractor must transmit FEHB enrollment information to carriers as soon as possible after the Federal Benefits Open Season, but no later than 7 business days.FEDVIPMinimum
BRThe Contractor must have processes in place to identify, research and resolve enrollment errorsFEDVIPMinimum
BRThe Contractor must have processes in place to research and resolve status changes for an existing enrollment such as retirements, transfers and terminationsFEDVIP, FLTCIPMinimum
BRThe Contractor must manage the transition to survivor annuitant especially related to death in serviceFEDVIP, FLTCIPMinimum
BRThe Contractor must work with EHRI, self service systems, payroll providers and other data sources to research, verify and resolve enrollees with enrollment errors, changes in pay status as well as those who transfer, terminate or retireFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must identify and resolve dual enrollments post-enrollment utilizing methods and information other than dependent SSN matchingFEDVIPMinimum
BRThe Contractor must have processes in place to cancel ineligible enrollments, including notifying enrollee and carrier and refunding premiums (including add-on fees) collectedFEDVIP, FLTCIPMinimum
BRThe Contractor must have processes in place to appropriately screen for and resolve difficult or unusual eligibility questions and issues.FEDVIPMinimum
BRThe Contractor must have processes to track difficult/unusual enrollment issues/problems to a timely resolutionFEDVIPMinimum
BRThe Contractor must issue member IDs that are internal and unique to enable at a minimum, matching/tracking all persons covered under an enrollment on gender, DOB and addressFEDVIPMinimum
BRThe enrollment process must incorporate the ability to authorize personal representatives who may contact BENEFEDS with questions on enrollment or premiums paidFEDVIP, FLTCIPMinimum
BRThe Contractor must develop and maintain a paper enrollment form. It must provide the form to certain enrollees at OPM's discretion.FEDVIPMinimum
RThe system shall process and accept online enrollments, changes in enrollments and disenrollments with self-certification of eligibility regardless of agency or carrier affiliationFEDVIPMinimum
RThe system shall, at a minimum, collect the following data from persons during the enrollment process:

• Enrollee Name

• Active employee/retired

• Date of Birth (DOB) and Gender

• Home Address and Mailing Address, if different

• Phone number(s) and email address(es)

• Employing Agency/Retirement System

• Social Security Number (SSN)

• Eligible dependent name(s), gender, relationship, DOB , address

• Eligible for FEHB and FEHB Enrollment

• Other insurance information, including Medicare and Tricare

• Name of FEDVIP plan(s)

• Number dependent children with different addresses

• Number of dependent children with birthdays within five months of each other

• Information on covered spouse with abilitly to block enrollment of multiple spousesFEDVIPMinimum
RThe system shall support enrollments without an eligibility fileFEDVIPMinimum
RThe system shall allow for the Federal Benefits Open Season enrollmentsFEDVIPMinimum
RThe system shall permit Qualifying Life Event (QLE) enrollments based on regulations and OPM guidanceFEDVIPMinimum
RThe system shall incorporate new legislative and regulatory rules within the timeframe required.FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall perform basic eligibility screening at point of enrollmentFEDVIPMinimum
RThe system shall provide a comprehensive list of employing agencies/annuity systems for enrollees to choose from, as well as offer multiple and/or robust methods for inputting that information, such as (but not limited to) drop-down menu and entering agency name or sub-bureauFEDVIPMinimum
RThe system shall accept belated enrollments (BEO) both retroactively or prospectively, on a benefit-specific basis, or limited by agency or group of enrollees as determined by OPMFEDVIPMinimum
RThe system shall permit a one time opportunity to enroll or change an enrollment during the BEO or QLE, after which that enrollee is “locked out” from any further changesFEDVIPMinimum
RThe system shall permit the continuous opportunity to change enrollment throughout the BEO period, with the last enrollment on file when the BEO ends being the enrollment of recordFEDVIPMinimum
RThe system shall allow an enrollee to enroll and/or list his or her dependents as neededFEDVIPMinimum
RFor a self plus one enrollment, the system shall only permit the enrollee to add one dependent.FEDVIPMinimum
RFor self and family enrollments, the system shall accommodate as many dependents as needed to enroll all eligible family membersFEDVIPMinimum
RThe system shall allow an enrollee to add or edit dependent data as appropriateFEDVIPMinimum
RThe system shall auto-populate the same dependent information for an enrollee who wishes to enroll in both FEDVIP dental and vision plans. Such dependent information must be easy to change if the enrollee wishes to enroll a different dependent.FEDVIPMinimum
RThe system shall track and identify dependents under the age of 22FEDVIPMinimum
RThe system shall track dependents who transfer enrollment from one Federal parent to the other in order to appropriately track waiting periods and maximum benefitsFEDVIPMinimum
RThe system shall automatically change a self plus one enrollment when the dependent reaches age 22 and is no longer eligibleFEDVIPMinimum
RThe system shall track and identify dependents age 22 and over who are incapable of self support, and flag those dependents whose certification has a time limit.FEDVIPMinimum
RThe system shall receive and store documentation supporting eligibility for enrollees and dependents such as for QLEs and certifications for dependents age 22 and older incapable of self-supportFEDVIPMinimum
RThe system shall be able to flag dependents who have been certified as incapable of self support and transmit the information to carriers.FEDVIPMinimum
RThe system shall track and/or relate a survivor to an employee or annuitant who passes awayFEDVIPMinimum
RThe system shall capture and match the SSN for a deceased person upon which the survivor annuitant's eligibility status is based to permit FEDVIP carriers the ability to tie in eligibility, claims and waiting periods from one enrollment to the otherFEDVIPMinimum
RThe system shall transmit information on enrollments, changes to enrollments and terminations to FEDVIP carriers on a daily basis. Contractor must transmit and alert anomolies such as 1) more than three dependents 2) dependents with different addresses 3) dependents with brithdays within five months of each otherFEDVIPMinimum
RThe system shall transmit information on the Federal Benefits Open Season enrollments, changes to enrollments and terminations to FEDVIP carriers in a one-time batch transmittal the day after open season endsFEDVIPMinimum
RThe system shall be the system of record for any program for which it receives and processes enrollment.FEDVIPMinimum
RThe system shall send enrollment feeds to carriers including demographic and dependent information. Contractor must flag anomolies with dependents such as 1) more than three dependents 2) dependents with different addresses 3) dependents with brithdays within five months of each otherFEDVIPMinimum
RThe system shall reconcile enrollment with carriers on at least a monthly basisFEDVIPMinimum
RThe system shall prohibit enrollments outside of a regional plan service areaFEDVIPMinimum
RThe system shall recognize an enrollee's change in his or her dental plan rating area based on a change in address and adjust premium amounts due accordinglyFEDVIPMinimum
RThe system shall pre-populate enrollment screens with known demographic informationFEDVIPMinimum
RThe system shall receive enrollment information feeds from carriersFSAFEDSMinimum
RThe system shall accept any legacy file / file format used in the current version of BENEFEDSFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall identify and resolve invalid enrollmentsFEDVIPMinimum
RThe system shall track and identify enrollees' dependents who are eligible to enroll in their own rightFEDVIPMinimum
RThe system shall include tax and savings calculators that include Federal and state-specific tax rates as well as CSRS and FERS specific effects on such tax savingsFEDVIPFuture
RThe system shall process and accept paper based enrollmentsFEDVIPMinimum
RThe system shall support voluntary eligibility files provided by agenciesFEDVIPFuture
3-CCCall Center
BRThe Contractor must provide domestic and international telephonic accessFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be capable of accepting international calls, receiving voice mail messages during non-call center hours, and assisting the overseas customer as needed, including contacting him or her at a mutually agreed upon timeFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must create appropriate Voice Response Unit (VRU) scripting that can be updated as situations warrant, including for the Federal Benefits Open Season. All scripting must be reviewed and approved by OPMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide Telephone Based-Services to include a toll-free number, Interactive Voice Response (IVR), Teletypewriter (TTY) with live operator help services, the ability to work with relay operators and call back featureFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe BENEFEDS call center shall be available for a minimum of ten hours per day at least Monday through Friday, with expanded hours for the Federal Benefits Open SeasonFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must adequately staff the call center based on demand at all times, especially during the Federal Benefits Open SeasonFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe call center must have expanded work days and hours during open season with extended hours until midnight Eastern Time on the last day of the Federal Benefits Open Season. All calls in the queue at midnight must be serviced.FEDVIPMinimum
BRThe BENEFEDS call center must be open on the Veterans Day holiday (if that holiday falls during the Federal Benefits Open Season) as well as the day after ThanksgivingFEDVIPMinimum
BRThe Contractor must have well-defined minimal qualifications for customer service representativesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must develop a training program for all CSRs and call center staffFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must train all CSRs and call center staffFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must take phone-based enrollments, change enrollments, update demographic information, and refer benefits or claim questions to the appropriate carrierFEDVIPMinimum
BRThe Contractor must make outbound calls to enrollees for various reasons regarding premium/allotment billing errors and/or to inquire about a change in employment status or possible demographic errors during enrollmentFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be capable of making automated calls to enrollees for various reasonsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide an appropriate number of CSRs fluent in Spanish, so that calls can be handled without the need to transfer to an interpreter serviceFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide translation support for languages other than Spanish as necessaryFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must utilize tracking and measurement tools to provide the data necessary to accurately assess staffing needs, staff training and necessary systems enhancementFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide OPM with capability to monitor calls for quality and accuracyFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be capable of randomly surveying both telephonic and online customers to inquire about service, usability, and other issuesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall record 100 percent of all calls and be able to retrieve and review a specific call(er) for at least the current and prior yearFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall employ processes and tools to accurately measure first call resolutionFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system should allow for longer version of Terms and Conditions to be read and register acknowledgement from enrolleesFEDVIPMinimum
RThe call center system shall provide prompts in SpanishFEDVIP, FSAFEDS, FLTCIPMinimum
4-PAPremium Administration
BRThe process must incorporate the ability to authorize personal representatives who may contact BENEFEDS with questions on premiums paidFEDVIP, FSAFEDS, FLTCIPMinimum
BRUpon contract expiration or termination, the Contractor must transfer all current and legacy data to the next Contractor in a format and timeframe that is acceptable to OPM and the successor Contractor.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must develop and maintain working relationships with all participating payroll providers to effect deduction of premiums and allotments from pay and annuityFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have well defined rules and processes for preparing, monitoring and processing direct bills and receiving direct bill paymentsFEDVIP, FLTCIPMinimum
BRThe Contractor must utilize all the file formats, layouts and schedules in place currently and in the future with payroll providers, carriers and OPM.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must submit all bill files to the appropriate payroll provider accurately and timely, by the provider-specific cutoff dateFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have well defined rules, processes and timeframes for managing and resolving enrollees/participants for whom no premium/allotment is received for any reasonFEDVIP, FSAFEDS, FLTCIPMinimum
BRWhere possible, the Contractor must try and resolve bill errors and missed premiums within the same pay cycleFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be alert and prepared to respond to errors by Federal payroll providersFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be able to determine the appropriate employing agency and payroll location for enrollees for whom a premium or allotment payment was not receivedFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must develop and test interfaces with all FLTCIP-only payroll providersFLTCIPMinimum
BRThe Contractor must describe the supporting documentation it will provide to carriersFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must receive and process all bill error files from payroll providers accurately and timelyFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must receive and process all payment files from payroll providers accurately and timelyFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must post payroll payments timelyFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have processes to notify carriers and OPM timely of posted paymentsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have a process to tie funds with funds detail reports to ensure they match before funds are releasedFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must respond timely and accurately to carrier emails regarding premium issuesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have procedures and safeguards in place to protect the integrity of program funds from receipt through reconciliation and disbursement to carriersFEDVIP, FSAFEDS, FLTCIPMinimum
BRIf at a future time payroll providers utilize a unique identifier other than SSN, the Contractor must use such alternate identifierFEDVIP, FSAFEDS, FLTCIPFuture
BRThe Contractor must develop and execute a plan to ensure consistency in file formats by program across payroll providersFEDVIP, FSAFEDS, FLTCIPFuture
BRThe Contractor must work with payroll providers to develop uniform file layouts across providers and programs, improve the data received, etc.FEDVIP, FSAFEDS, FLTCIPFuture
BRThe Contractor must submit pre-tax refunds timely to payroll providers and monitor through disbursement to the enrolleeFEDVIP, FSAFEDS,Minimum
BRThe Contractor must process post-tax refunds timely to the enrolleeFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must submit all account funds transfers timely to payroll providers to assure that W2 information is corrected within the tax yearFEDVIP, FSAFEDSMinimum
BRThe Contractor must be able to reconcile premium at the individual enrollee levelFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must perform regular premium reconciliations with carriers on a frequency agreed to by OPMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must manage the transition from employee to annuitant throughout the period of time that the new annuitant is in interim pay status until his/her final annuity payment is adjudicatedFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must support and manage changes from one payment method to another, such as from direct pay to annuity deduction, or frequency of payment, such as from bi-weekly to monthly or accelerated payments to not accelerated.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must permit FLTCIP enrollees to change their premium payment method at any time, and recalculate the premium amount due if the new premium payment frequency differs from the prior methodFLTCIPMinimum
BRThe Contractor must work to enhance the information obtained from payroll providers such as SF 50 Nature of Action codes, additional errors codes and other information to help determine eligibility for employees who go in and out of pay status as well as whether their bill method needs to changeFEDVIP, FSAFEDS, FLTCIPFuture
BRThe Contractor must employ flexibility for meeting the unique needs of various payroll providersFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be the system of record for any program for which it receives and processes premium or allotment paymentsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall support premium and allotment administration functions for all enrollees regardless of agency or carrier affiliationFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be able to receive an annual premium amount from the FLTCIP carrier and to accurately calculate the amount due based on the enrollee's chosen method of payment, and payroll schedule, if paying via payroll deduction.FLTCIPMinimum
RThe system shall correctly calculate premium/allotment due based on premium information provided by OPM or carrier (depending on program). The calculations must be determined based on each enrollee's pay frequency/scheduleFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall recognize when a premium/allotment payment is missed and recalculate the premium amount due based on OPM-approved recalculation rules for each programFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall recalculate per pay period/pay date premium/allotment amounts due based on employment status changes, such as employed to retired or biweekly pay to monthly payFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall offer an option for accelerated payments for enrollees with certain employment or pay statuses including teachers, seasonal employees, and persons who will enter LWOP during the plan year. The option must be flexible to accommodate program-specific rules on acceleration.FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall request premiums/allotments from payroll providersFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall incorporate new legislative and regulatory rules within the timeframe required.FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall accept any legacy file/file format used in the current version of BENEFEDS.FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall receive payment files from payroll providers by a specific cutoff dateFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall post payroll payments within 2 business days of receiptFEDVIP, FSAFEDS. FLTCIPMinimum
RThe system shall be able to remit funds and supporting documentation on a weekly basis to carriersFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall remit funds and supporting documentation on a weekly basis to OPMFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall identify and resolve instances in which requested deductions were not remitted and communicate promptly with enrollees and payroll providers regardless of whether it is a BENEFEDS error or payroll provider errorFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall request and receive premium directly from enrollees as necessary or appropriate.FEDVIP, FLTCIPMinimum
RThe system shall accept payments from persons other than the enrolleeFEDVIP, FLTCIPMinimum
RThe system shall support the following premium payment methods:

• payroll deductions

• automatic bank withdrawal

• direct bill pay transactionsFEDVIP, FLTCIPMinimum
RThe system shall offer enrollees paying premium via direct bill options for paying such bills, including but not limited to paper checks, and automatic bank withdrawalFEDVIP, FLTCIPMinimum
RThe system shall permit enrollees paying premium via direct bill multiple options for paying such bills, including but not limited to various automated clearinghouse transactions (ACH) and electronic bill payment processes.FEDVIP, FLTCIPFuture
RThe system shall reconcile and report FSAFEDS account funds transfers to the appropriate payroll providerFSAFEDSMinimum
RThe system shall identify whether a regional plan enrollee's move requires a change of planFEDVIPMinimum
RThe system shall identify whether an enrollee's move requires a change in premiumFEDVIPMinimum
RThe system shall adjust premium amounts due, if an enrollee moves to a different rating regionFEDVIPMinimum
RThe system shall deduct retroactive premiums pre or post tax as appropriateFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall refund premiums pre and post-tax in a timely manner as appropriateFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall process approved tax refunds to be mailed within 5 business daysFEDVIP, FSAFEDSMinimum
5-OCOutreach and Communication
BRThe Contractor must communicate important information on enrollment and premium administration issues to enrollees and employing agencies, in consultation with OPM. This may include but is not limited to reminders about the Federal Benefits Open Season, program eligibility and rules, keeping demographic information current, qualifying life events, errors, etc.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must utilize various social media to engage with current and potential enrollees including but not limited to Facebook, Twitter, podcasts, video sharing and blogsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must generate program-specific correspondence to enrollees/participants, including but not limited to the following situations or events:

• Notice of overdue premium

• Unsuccessful ABW attempt

• Termination notification, including dependent turning age 22

• Payroll/allotment/annuity adjustment letters

• Direct Bills

• Default to annuity letters

• Billing error letters

• Premium/allotment amount change notification

• Premium histories

• Premium/enrollment reconciliation

• Reinstatement

• Return mail processing

• Change in planFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must email current enrollees about the following topics and others as needed:

• Program participation (programs they are currently participating in and those they are not)

• Enrollment updates and changes

• Errors or announcements that affect a large number of enrollees

• Federal Benefits Open SeasonFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must communicate in writing to an enrollee whenever there is an adverse decision related to requests for enrollment, belated enrollment, termination, or changes to enrollment related to a QLE. That documentation must be approved by OPM and include clear and concise information on how to request reconsideration or appeal, if permitted.FEDVIPMinimum
BRThe Contractor must utilize various tools to ensure that emails have been received, and if not, to send the correspondence via U.S. mail.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must ensure that all emails to enrollees that include PII are sent via secure emailFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be able to auto-generate emails to all or selected enrolleesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall support requests for plan information and send requests to appropriate carriers for fulfillmentFEDVIP, FSAFEDS, FLTCIPFuture
RThe system shall provide a quick and easy way for enrollees to send suggestions on web site or customer service improvementsFEDVIP, FSAFEDS, FLTCIPMinimum
6.0-SASystem Attributes
6.1-SASystem Interface(s)
BRThe Contractor must manage content in a dynamic fashion and provide a quick/easy way to update style sheetsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall interface with payroll providers for activities such as, but not limited to premium/allotment deductions, pre-validation, and FEHB enrollment for coordination of benefitsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall interface with additional payroll providers as required to support / service active and retired members of the uniformed services, and other eligible groupsFEDVIP, FLTCIPMinimum
RThe system shall interface with EHRI to query and receive enrollee dataFEDVIP, FSAFEDS, FLTCIPFuture
RThe system shall support multiple file formats as required by EHRI - including fixed-width file formatsFEDVIP, FSAFEDS, FLTCIPFuture
RThe system shall push and pull data from EHRIFEDVIP, FSAFEDS, FLTCIPFuture
RThe system shall provide EHRI with voluntary benefit enrollment information so that enrollment information is stored within EHRIFEDVIP, FLTCIPFuture
RThe system shall provide help and Frequently Asked Questions (FAQs)FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall provide help and Frequently Asked Questions (FAQs) with the ability to update quickly, as needed or requested by OPMFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be capable of implementing real time updates to VRU messaging, user interface, and FAQs as needed or requested by OPMFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall interface with the OPM Annuity Look Up tool to query and review enrollee dataFEDVIP, FLTCIPMinimum
RThe system shall provide links to other websites including but not limited to FEDVIP carriers, FLTCIP and FSAFEDS for plan-specific benefit informationFEDVIP, FSAFEDS, FLTCIPMinimum
6.2-SATool Sets
RAt a minimum, the system shall be capable of supporting informatica mappings and workflows as well as Oracle/SQL queriesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall employ tools and techniques for mailing address managementFEDVIP, FSAFEDS, FLTCIPMinimum
6.3-SAUser Interface
BRThe system must utilize best practices to provide a user interface that is visually pleasing, intuitive, easy to navigate, quick and that readily reuses information already gathered to minimize duplicationFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must design and use customer surveys, user groups and other user feedback to gather and drive usability improvementsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have a well-defined process to routinely evaluate, assess and improve site usabilityFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall provide a unique member page ("MyBENEFEDS") that is user ID and password protected, allows users to log in and view:

• enrollment and demographic information

• profile information

• per pay period premium/allotment payments by program for current year

• premium/allotment payment history by program both year to date and per calendar year

• enrollment status for each voluntary benefit (including those voluntary benefits the user is eligible but not enrolled)

• total premiums paid for year-end tax information

• specific terms and conditions agreed to by the enrollee with a date and time stamp ( including telephonic enrollments) for each enrollment that occurs on BENEFEDSFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall allow users to add, update and change certain information on My BENEFEDS in real time, including demographic and profile dataFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall prominently display a link to the Privacy StatementFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall provide a dental and vision plan and premium comparison tool. The dental plan comparison tool must include ADA CDT codesFEDVIPMinimum
RThe system shall be Section 508 compliant (Section 508 of the Rehabilitation Act as amended by the Workforce Investment Act of 1998)FEDVIP, FSAFEDS, FLTCIPMinimum
6.4-SASystem Architecture
BRAs part of its SDLC, the Contractor must establish a configuration control board (CCB) to review and prioritize system changes and enhancements. The CCB must have the following components:

• Charter

• Configuration Management Plan

• Change control approach

• Meeting scheduleFEDVIP, FSAFEDS, FLTCIPMinimum
BROPM must have a seat and voting privileges on the CCBFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide data format information used in exchanging, retrieving and/or disseminating dataFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have a method and plan to support system capacity surges without system failureFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must authenticate a user's personal demographic data either real time or post enrollmentFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must identify the associated security controls for each interfaceFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must keep current with secure file transfer protocols and methods of transmissionFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall accommodate a change in carriers or an addition to the number of carriersFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall include a real-time "read-only" view for carriers to access information on their enrollees onlyFEDVIP, FSAFEDS, FLTCIPMinimum
RThe systems rules engine shall allow for multiple sets of program logicFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be available to users 24/7FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall support multiple secure protocols and clients for file transfers, including but not limited to:

• Connect: Direct FTP+

• FTP Client that supports SSL/Secure Socket Layer

• SFTP (Secure File Transfer Protocol)

• Tumbleweed Secure Transport (FTP Client)

• Secure email that inter-operates with secure email systems of payroll providers, carriers and OPM

• Virtual Private Networks (Checkpoint VPN)FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be IPv6 compliantFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall receive, process, transmit or forward IPv6 packets and be inter-operable with other systems and protocols in both IPv4 and IPv6 modesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be single sign-on enabled by usersFEDVIP, FSAFEDS, FLTCIPFuture
RThe system shall scale to anticipated increases in user volume, as well as occasional usage spikes without degradation to the user's experience, such as delayed page loads, response or down timeFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system's test environments shall mirror the production environment(s) (test environments may have approved reasonable differences to help reduce costs)FEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall support multiple Web 2.0 technologiesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall receive and store carrier rating areas by zip codeFEDVIPMinimum
RThe system shall receive and store regional plan service area zip codesFEDVIPMinimum
RThe system shall receive and store rates for each rating region (as applicable) on a biweekly and monthly basis, with a breakdown by net-to-carrier premium, OPM loading and BENEFEDS loading.FEDVIPMinimum
RThe system shall calculate and store rates for each rating region (as applicable) for pay schedules other than biweekly and monthly, with a breakdown by net-to-carrier premium, OPM loading and BENEFEDS loading.FEDVIPMinimum
RThe system shall receive and store annual premium and allotment amounts per enrolleeFSAFEDS, FLTCIPMinimum
RIn the event of a system failure, all critical applications shall be fully available within four (4) hours and system data shall be available and accessible within 24 hoursFEDVIP, FSAFEDS, FLTCIPMinimum
6.5-SASystem Security
BRThe Contractor must ensure that all BENEFEDS data is available within approved standards as outlined in the QASPFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must develop and maintain a disaster recovery and business continuity plan. The plan must address flexibility for recovery procedures for critical business functions, secure backup site(s) (hot/cold), continuation of services, and protection/accessibility of dataFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must monitor the security of the network and servers, and provide OPM access to appropriate security logsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must ensure that all equipment and data is secured from loss of any typeFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must monitor and manage all servers, infrastructure software, networking equipment, and the application web interfaceFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have a fraud, waste and abuse program that assesses vulnerabilities and detects and eliminates internal/external fraud, waste and abuseFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must accommodate any special security needs of the Intelligence Community, including the provision of staff who can meet enhanced security clearances, undergo OPM security training, and secured space for equipment such as secure phone and secure fax subject to periodic inspectionFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must successfully complete the Certification and Accreditation (C&A) process with an approved provider by the Transfer DateFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must deliver approved or completed Certification and Accreditation Documentation (C&A). The documentation shall include but not be limited to:

• C&A Plan

• System Security Plan

• Risk analysis

• Security Test and Evaluation (ST&E) Plan and Results Report

• IT Contingency Plan

• Continuity of Operations Plan

• Post-Accreditation Action Plan

• Privacy Impact AssessmentFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must maintain its C&A status with an approved provider via ongoing reviewsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall comply with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the associated Privacy and Security regulationsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall comply with the requirements of FISMA and OMB guidance, as amendedFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall comply with both the Federal Enterprise Architecture compliance standards and the Federal Enterprise Architecture Records Management ProfileFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be Public Key Infrastructure (PKI) enabledFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall have secure email capabilities to service enrollees, carriers and OPMFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall have the ability to securely transmit all data and files with PIIFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall have in place safeguards for OPM data as well PII of enrollees, and specifically shall follow NIST guidelines for safeguarding such informationFEDVIP, FSAFEDS, FLTCIPMinimum
7-RReporting
BRThe Contractor must provide to OPM's actuaries a quarterly data file with records for each FEDVIP enrollee. The file must include the following fields:

• Unique ID, which identifies the enrollee and is consistent for a given enrollee from one file to the next (Ideally should match Unique ID from 1st BENEFEDS contract)

• Employment status (S-survivor annuitant, A- annuitant, N- new hire, C- compensationer, F- federal employee)

• Enrollment status/Current coverage status (A-active, I-inactive)

• Internal POI/External POI, which designates payroll location (i.e., NFC) and agency

• Pay frequency (B-biweekly, M-monthly, S-semimonthly, T-every 28 days)

• Accelerated, a yes/no flag showing whether the enrollee accelerated his/her payments

• Accelerated pay period, the number of payments the enrollee chooses to make payments

• Number of dependentsFEDVIPMinimum
BRThe Contractor shall provide ad-hoc reporting at OPM's request.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide reports that summarize performance against QASP metrics within the timeframes specified in the QASPFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide monthly reporting on operations and activitiesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide each carrier daily/weekly updates of enrollment to carriers during the Federal Benefits Open Season to include the carrier's enrollment and total enrollmentsFEDVIPMinimum
RThe system shall generate enhanced reporting during the Federal Benefits Open Season to include, but not be limited to:

• daily call center reporting of number of calls

• average speed of answer

• abandonment rates

• number of customer service representatives available

• number of emails received

• number of emails responded to • • website tracking and usage data, including referral linksFEDVIPMinimum
RThe system shall generate extensive reporting on all elements of enrollment, premium, etc., at varying intervals (weekly, monthly and quarterly) as requested by carriers and agreed to by OPM as well as an annual report to OPM and carriersFEDVIP, FSAFEDS, FLTCIPMinimum
RThe Contractor must provide an annual report detailing any fraud, waste and abuse incidentsFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall be able to provide the ability for carriers and OPM to generate unique or customized reportsFEDVIP, FSAFEDS, FLTCIPFuture
8.0-PMProgram Management
BRThe Contractor must be familiar with applicable laws and regulations related to government systems, privacy, accessibility and benefit programs for which it will perform enrollment and/or premium administration servicesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must deliver an enrollment and/or premium administration system that performs all the components included in the SOO and this RTMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide specific program management support activities to include, but not be limited to:

• development of schedules

• management plans

• risk management approach

• action item tracking and problem resolutionFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor shall continually explore opportunities and methods to leverage currently available FEHB enrollment data to improve and expand coordination of benefits information available to carriers.FEDVIP, FSAFEDSMinimum
BRThe Contractor must be willing and able to meet requirements from payroll providers, EHRI, and other sources in order to continue to be able to exchange files and data.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must notify OPM via email or by phone within two hours of first learning about an incident/error, including a potential error not yet quantified. This notification must take place even if few details are known. The Contractor shall report any breach or potential breach to the OPM Cybersolutions and the Contracting Officer (CO) within 30 minutes of becoming aware of the risk – regardless of the time, or day of the week. An initial written incident report must be provided within twenty four hours, with follow up reports provided at least weekly until the root cause of the incident or error has been identified, and process improvements described and undertaken.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must work with current Contractor to assume seamless ownership of the current BENEFEDS phone numbers, fax numbers, and website addressesFEDVIP, FSAFEDS, FLTCIPMinimum
RThe system shall operate consistent with applicable laws and regulationsFEDVIP, FSAFEDS, FLTCIPMinimum
8.1-PMStaffing Management
BRThe Contractor must provide to this project the leadership staff that has the appropriate education, knowledge and experience to direct all areas of operation.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must indicate its key staff, and provide a detailed job description, resume and indicate the percentage of time that position is dedicated to BENEFEDSFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide a detailed call center staffing plan, including the number/percentage of staff dedicated to OPMFEDVIP, FSAFEDS, FLTCIPMinimum
8.2-PMFinancial Management
BRThe Contractor must account for and maintain each program’s funds (FEDVIP, FLTCIP, etc.) separately, and cannot co-mingle funds with other programs or other Contractor assetsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor's accounting/financial management processes must account for and balance each carrier's funds separatelyFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must release funds to Carriers and OPM on a weekly basis.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must prepare and submit an Annual Accounting Statement to OPM summarizing the financial results of BENEFEDS operations for the previous fiscal year. This statement must be prepared in accordance with the requirements issued annually by OPM and will be due to OPM in accordance with a date established by those requirements.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must have the most recent financial statement for BENEFEDS operations audited by an accounting firm that ascribes to the standards of the American Institute of Certified Public Accountants. The report will be submitted to OPM along with the annual accounting statement.FEDVIP, FSAFEDS, FLTCIPMinimum
BRBased on the results of either the independent audit or a Government audit, the annual accounting statements for BENEFEDS may be adjusted by:

• amounts found not to be properly allocated to a carrier or OPM

• overpayments or underpayments to a carrier or OPM

• amounts found not to constitute properly allocable or allowable travel costsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor’s books and records must support cash and investment balances it reports on for each program in its Annual Accounting StatementFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must employ appropriate short term investment strategies for funds from the time it receives them until disbursement to carriers and OPMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must account for investment income by program and remit any accrued investment income and supporting documentation to OPM on a schedule determined by OPM.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must notify OPM of any proposed change in its cash management procedures involving program funds. Such proposed change is subject to OPM approvalFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must reconcile its accounting statements with premium reports and funds transfers to carriers. Any discrepancies must be resolved to the satisfaction of carriers and OPMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe allowable travel costs chargeable to the contract for a fiscal year will be the actual, necessary, reasonable and allocable amounts incurred with proper justification and accounting support, determined in accordance with Subpart 31.2 of the FAR applicable on October 1 of each year, and the terms of the contractFEDVIP, FSAFEDS, FLTCIPMinimum
8.3-PMOPM and Carrier Relationship Management
BRThe Contractor must support the Federal Benefits Open Season activities as requested by OPMFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must be responsive to all OPM constituencies (subject to OPM's approval), including but not limited to Congress (individual members and committees), retirement organizations, and media organizations that focus on Federal issues.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must respond to Executive or Legislative branch inquiries within required timeframesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must interact with OPM Retirement Operations and/or its contractors to plan and manage the Federal Benefits Open Season activityFEDVIPMinimum
BRThe Contractor must be prepared and responsive to deal with the special needs of older annuitantsFEDVIP, FLTCIPMinimum
BRThe Contractor must accommodate a change in carriers or an addition to the number of carriers for any programFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must give OPM the right to review and approve all Contractor communication prior to use, including emails, letters, and phone scriptsFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must partner with OPM in the planning and preparation for the Federal Benefits Open Season. The Contractor must plan appropriate resources for activities such as evaluating the website, reviewing the enrollment module, and improving the usability of the websiteFEDVIP, FSAFEDSMinimum
BRThe Contractor must accommodate legislative and other mandates within the timeframes specifiedFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must keep OPM regularly apprised of current status on payroll provider issues, concerns, projects, communications, etc.FEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must provide:

• a dedicated email account for OPM to forward inquiries it receives related to BENEFEDS

• a single point of contact who receives these inquiries and provides timely resolutionFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must develop and maintain close working relationships with payroll providers, HR LOB centers, and agency human resource staff as appropriate to ensure smooth processing and develop improvements and enhancements to current policies, procedures and processesFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must host and conduct program specific carrier meetings at least once per year. The FEDVIP carrier meeting must be held in the Washington, D.C. metropolitan area, unless otherwise approved by OPM. For all carrier meetings, the Contractor is responsible for arranging and paying for all meeting logisticsFEDVIPMinimum
BRThe Contractor must meet with OPM onsite up to four times per year as necessaryFEDVIP, FSAFEDS, FLTCIPMinimum
BRThe Contractor must meet with agencies, Agency Benefit Officers (ABOs) and retirement offices/systems as requested by OPMFEDVIP, FSAFEDS, FLTCIPMinimum

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated .