Att 3 - Submittal Form F Mandatory Requirements.xlsx
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- Solicitation number
- 2025-0200-0177 / 02-101-25
- Issued by
- Alaska
About this file
This document is a Submittal Form F detailing mandatory requirements for an AlaskaCare state contract opportunity involving claims administration and prescription drug benefit services. The form requires potential offerors to confirm compliance with a series of specific operational, administrative, and service-related conditions across three main categories: General Proposal Conditions, Required Contract Provisions, and Minimum Proposal Qualifications. Respondents must systematically indicate their ability to meet each requirement by selecting "Confirmed" or "Not Confirmed" in a drop-down menu, with the understanding that failure to meet any mandatory requirement may result in proposal rejection.
The contract appears to seek a claims administrator with comprehensive healthcare service capabilities, including maintaining seven years of claims data, providing 24/7 toll-free member support, and demonstrating experience managing prescription drug benefit plans for large-scale clients. Key qualifications include having at least three years of experience serving a minimum of five plan sponsors with 5,000 covered lives each, including one state or public sector client. The offeror must also commit to strict confidentiality protocols, data ownership provisions, and performance guarantees, with an emphasis on responsive customer service and transparent communication with state staff regarding eligibility and claims processing.
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Bid Conditions
Submittal Form F - Mandatory Requirements
| This submittal form outlines AlaskaCare's mandatory requirements. Offeror must specify whether they can comply by selecting "Confirmed" or " Not Confirmed" from the drop-down options. This submittal form must be returned with offeror's proposal. |
| In order to be considered for contract award, the offeror must demonstrate that they satisfy each of the following requirements. An offeror's failure to meet these requirements may cause their proposal to be rejected and determined non-responsive. |
| 1.1 General Proposal Conditions (RFP Sec. 3.04) | ||
| Requirement | Confirmation | |
| 1.1.1 | Offeror must confirm that no commissions shall be included and that all proposal documents must be submitted directly from the offeror without any intermediary. | Select One |
| 1.1.2 | Rights to Claims Data: Offeror must confirm all claims data is the property of the State and must be returned upon request. Offeror confirms and agrees that the data and information provided, which may include protected health information related to the State's participants and beneficiaries, is and shall remain the property of the State. Offeror is not granted any right, title, or interest in any claims data. Offeror may use and disclose claims data solely as necessary to effectuate the purpose of this RFP and shall not use, disclose, decompile, or reverse engineer, any claims data in support of the offeror’s other business activities. Specifically, the offeror shall not de-identify any claims data or aggregate claims data (whether or not de-identified) with data received from the offeror's other clients, customers or data sources. | Select One |
| 1.1.3 | Confidentiality: Offeror must confirm they shall keep all claims data in the strictest confidence, and it is only under adherence to this request that the State is delivering the claims file to prospective offerors. The claims data may be shared only within the offeror’s organization for purposes of preparing your proposal. As such, the claims data may not be copied or reproduced without the State's prior written consent for other purposes and shall not be disclosed to third parties to whom the Plan has not previously consented. | Select One |
| 1.2 Required Contract Provisions (RFP Sec. 1.04 and 3.04) | ||
| Requirement | Confirmation | |
| 1.2.1 | Maintenance and Ownership of Records: Offeror must confirm to maintain all pertinent records for seven years. This is in conjunction with prudent business practices. Awardee shall be charged with the safekeeping of plan experience information and, in the event of contract termination, would be required to cooperate with the State, or their representative, in the orderly transfer of plan experience information to the State or its designated succeeding health plan/carrier. | Select One |
| 1.2.2 | Renewal Notification: Offeror must confirm to provide any rate changes in writing, with full justification, at least 180 days prior to a contract renewal date. The long lead-time is required due to the annual budget pricing, communications, and administration requirements associated with the State's benefit program. | Select One |
| 1.2.3 | Variance Provision: Offeror must confirm any provisions, references, or guidelines relating to re-evaluation of proposed rates due to variation in enrollment in the State have been disclosed in the offeror’s technical proposal. | Select One |
| 1.2.4 | Performance Guarantee: Offeror must confirm as the State's Claims Administrator; the offeror agrees to serve the State and its staff under the terms of a performance agreement executed between the State and awardee. | Select One |
| 1.2.5 | Eligibility Rules: Offeror must agree to the eligibility rules specified in the respective plans' insurance information booklet, links provided in RFP Sec. 2.04, as established by the State for covered parties. | Select One |
| 1.2.6 | Eligibility Questions: Offeror must agree to communicate directly with State staff regarding any uncertain claimant eligibility situation before notifying the claimant directly of ineligible status. | Select One |
| 1.2.7 | Member Inquiries and Requests: Offeror must agree to respond to all inquiries and requests made by AlaskaCare members with a sense of urgency. Phone calls and all correspondence are to be handled by a reasonable number of service personnel who have been trained in customer service and who are familiar with AlaskaCare. | Select One |
| 1.2.8 | Phone Service: Offeror must agree to provide a dedicated toll-free telephone number available 24 hours a day, 7 days a week for all plan members’ exclusive use. | Select One |
| 1.2.9 | System Capacity: Offeror must agree to maintain sufficient system capacity to meet the service specifications outlined in the RFP's Deliverables and Scope of Work. | Select One |
| 1.2.10 | Online Historical Data: Offeror must agree to always maintain at least seven years of the State’s claim and eligibility information, including but not limited to CMS requirements, and to provide data feeds as requested by the State. | Select One |
| 1.2.11 | System Problems - Plan Notification: Offeror must agree to immediately notify the State if their claim system experiences or is scheduled to experience delays or shut down that either: a) exceeds your internal standards in this area, or b) would have an adverse impact on claim payment or customer service. | Select One |
| 1.3 Minimum Proposal Qualifications (RFP Sec. 1.04 and 3.04) | ||
| Requirement | Confirmation | |
| 1.3.1 | Offeror must confirm they are not restricted or prohibited from conducting business in all states where the AlaskaCare members reside or access care. | Select One |
| 1.3.1 | Offeror must confirm they have clearly identified the Account Manager’s experience on Submittal Form B Prior Experience. Offeror’s firm must have experience in the same scope of work as required in this RFP and must include three Client Reference Forms, as provided as an attachment to this RFP, for whom the offeror provides, or has provided, the same services as required in this RFP. | Select One |
| 1.3.2 | Offeror must confirm their firm has at least three years of experience in providing prescription drug benefit plan services under contract to at least five plan sponsors, each with a minimum of 5,000 covered lives, for a minimum duration of three years continuously. At least one of which plans must be a state or public sector client. If expired, the contract must have expired within the previous five years. | Select One |
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