Attachment_A_Disability_RFP_Questionnairev3.xlsx
XLSX spreadsheet 20 KB Posted
- Attached to
- Short- and Long-Term Disability
- Solicitation number
- 2024-335
- Issued by
- Collin County, Texas
About this file
This document is a Disability Request for Proposal (RFP) Questionnaire for Collin County, Texas, detailing comprehensive requirements for a Short- and Long-Term Disability insurance and administration contract. The county is seeking a vendor to provide group benefits administration for its disability programs, with a contract effective date of January 1, 2025. The questionnaire covers a wide range of operational, administrative, claims processing, reporting, and service requirements that potential offerors must address, including detailed specifications for disability claim handling, benefit calculations, coverage conditions, communication protocols, and technological capabilities.
The questionnaire outlines specific financial and administrative terms, including a 67% scheduled monthly benefit for long-term disability, a 26-week maximum benefit period for short-term disability, and a 180-day elimination period for long-term disability. Key administrative requirements include monthly reporting, providing a robust online administrative platform, offering customer service between 8:00 am and 7:00 pm CST, and agreeing to Collin County's self-billing process and 60-day payment grace period. The county requires comprehensive compliance with HIPAA standards, data protection measures, and the ability to provide detailed claims and performance reports. Vendors must also agree to continued claims administration for ongoing claims even after the contract period ends.
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Disability RFP
| Attachment A - Disability Questionnaire |
| Offeror Name: |
RFP responders are required to respond to all requests for information contained in this questionnaire. Your responses to the questions should be based on your current proven capabilities. Should there be instances where certain questions are not applicable to your organization or its operations, please indicate this by selecting "N/A". All "No" or "N/A" answers recorded in this questionnaire require additional information. Additional information to accompany those answers MUST be detailed in the Exceptions section (7.0) of your response. If no exceptions are listed in the Exceptions section, it is understood that the Offeror has agreed to all requests as listed in the RFP even if discrepancies are listed in other sections. The Offeror will be held strictly responsible for all items contained in the specific requirements.
If you are selected to administer this plan, your responses to the questionnaire will be considered part of your contractual responsibilities.
| Answer by placing an "X" in the appropriate response column. DO NOT add extra rows/columns. | ||||
| General Requirements | Yes | No | N/A | |
| 1 | Will the Offeror administer the plan as outlined in Collin County's existing benefits documentation? Describe any deviations to the plan in Section 8.2 - Exceptions. | |||
| 2 | The Offeror agrees that if they are selected to administer the County's plan, their responses to the |
questionnaire will be considered part of their contractual responsibilities?
| 3 | The Offeror agrees to list and clearly detail any coverage or service that will not be provided as requested in writing in section 8.2 Exception? It is imperative that any exclusions, limitations, or any other exceptions be clearly outlined and detailed. |
| 4 | The Offeror agrees if no exceptions or alternate responses are listed in Section 8.2 - Exceptions, it is understood that the Offeror has agreed to all requests as listed in the RFP even if discrepancies are listed in other parts of the response? The Offeror will be held strictly responsible for all items contained in the specific requirements. |
| 5 | The Offeror agrees to comply with federal, state, and local laws and regulations applicable to the plan design, services, and payments for services which are being proposed at no additional cost? Proposals submitted will be presumed to be in compliance with all applicable laws. |
| 6 | The Offeror agrees to make system adjustments as necessary to comply with current and future legislation at no |
additional cost?
| 7 | The Offeror agrees to indemnify, hold, and save the County, their agents, officers and employees harmless from liability of any nature or kind, including costs, expenses, and attorney's fees, for harm suffered by Collin County or any person as a result of the negligent, reckless, or willful acts of omissions by the Offeror's organization, its officers, agents or employees? |
| 8 | The Offeror agrees not to give away or sell employee data, even "de-identified" data, with or without employee consent? If no, must specify what data is being sold/given away in Section 8.0. |
| 9 | The Offeror agrees to be fully responsible for preparation and dissemination of any information to be sent to the IRS such as 1099 forms and provide copies of information filed with the IRS to the County if requested? |
| 10 | The Offeror agrees if penalties are assessed because of incorrect or late filings to the IRS by the Offeror, they will be responsible for any such assessments and will hold the County harmless? |
| 11 | The Offeror agrees to offer Collin County the right to audit claim processing service, records, and other relevant activity associated with its plan participants? |
| 12 | The results from audit requests will help measure performance guarantees. The Offeror agrees to accept these findings? |
| 13 | The Offeror acknowledges that they comply with HIPAA standards, have security measures, and have cyber insurance to protect Collin County and the data maintained in their electronic systems? |
| 14 | The Offeror's current systems that have access to Collin County insured's confidential health data have an automatic logoff capability? |
| 15 | If the Offeror's current systems that have access to Collin County insured's confidential health data have an automatic logoff capability, is it required? |
| 16 | Does the Offeror support multi-factor authentication for the County to access confidential health data? |
| 17 | Is multi-factor authentication to access confidential health data required? |
| 18 | Will Collin County administrators in the Offeror's system have the ability to download and store confidential health data? |
| 19 | Will the Offeror communicate Collin County insured's confidential health information in secured e-mail? |
| 20 | The Offeror agrees that in order to prevent loss of coverage for a participant because of a transfer of insurance carriers, coverage will be provided for participants who are not actively at work due to sickness or injury as long as the prior group insurance policy insured them and the cost of their insurance under the prior group insurance policy has been paid or will be paid within the currently established 60-day grace period? |
| 21 | The Offeror agrees to be responsible for all claims incurred on or after the effective date of 01/01/2025, and within the contract period? This includes claims which occurred during the contract period but are filed after the contract has ended. |
| 22 | Collin County reserves the right to add or reduce any and all services provided. If such an addition or reduction occurs, The Offeror agrees that this change will not negatively affect the prices of any of the remaining services provided? |
| 23 | The Offeror agrees to notify the County at least one hundred and twenty (120) days prior to any change to the policy or condition that effects services? |
| 24 | The Offeror agrees any claims that are not paid in accordance with the plan due to an error or negligence by the Offeror shall not be charged to Collin County? In the event of overpayment, the Offeror shall be responsible for all collections, plan reimbursement expenses, legal expenses, and any penalties or late fees charged to Collin County or the member, resulting from the error or negligence. |
| 25 | The Offeror agrees to be responsible for preparing and updating necessary administrative documents including a SPD at no additional cost? These documents shall include a detailed administrative manual including procedural information on all agreed upon plan administration and claims procedures. |
| 26 | The Offeror agrees to submit the administrative manual to Collin County within sixty (60) days after the contract becomes effective? Subsequent changes should be submitted within thirty (30) days of change. |
| 27 | The Offeror agrees to provide SPD booklets and certificates of coverage at no additional cost in printed and electronic format? SPDs can be made electronically available to the employer and be mailed to an employee only upon request. |
| 28 | The Offeror agrees that any written communications regarding plan administration issues sent to Collin County will be mailed within two (2) days of the day listed on the letter? |
| 29 | The Offeror agrees to make changes to their forms as requested by Collin County? |
| 30 | The Offeror agrees not to send written materials to employees without the review and approval by Collin County unless a prior written release has been received? |
| 31 | The Offeror agrees to be responsible for receiving and evaluating claims? |
| 32 | Does the Offeror require a long-term disability claimant to apply for Social Security Disability benefits due to their illness or injury? |
| 33 | The Offeror agrees to pay short-term disability claims at least two (2) times per month? |
| 34 | The Offeror agrees to pay long-term disability claims at least one (1) time per month? |
| 35 | The Offeror agrees to notify the County before payment is made to an employee? |
| 36 | The Offeror agrees to notify the County each time the approval dates of a claim change? |
| 37 | The Offeror agrees to coordinate benefit payment dates with Collin County prior to issuing payment to the claimant? |
| 38 | If benefits are denied, the Offeror agrees to provide both the County and the employee a written letter indicating the exact reason for the denial as well as the appeal process and timeframes? |
| 40 | Does a disability claim submission automatically generate a claim for waiver of premium? If not, describe in detail the process for generating a claim for waiver of premium in Section 8.2- Exceptions. |
| 41 | The Offeror agrees not to limit coverage for mental health or any specific medical condition? If not, detail the specific medical conditions and limits in Section 8.2- Exceptions. |
| 42 | The Offeror agrees that all covered employees shall not lose or gain benefits as a result of a change in insurance carriers? This is commonly referred to as "No loss/No gain". |
| 43 | The Offeror agrees to provide coverage for employees at work on a full-time basis, either at Collin County's place of business or any other place Collin County may require them to go? |
| 44 | The Offeror agrees to provide coverage for employees in a paid status (such as PTO, CTO, jury duty, administrative leave, or compensatory time)? |
| 45 | The Offeror agrees to provide coverage for employees on an unpaid absence of one year or less in which the individual remains employed? |
| 46 | The Offeror agrees to provide coverage for employees on family and medical leave? |
| 47 | The Offeror agrees to provide coverage for employees on workers' compensation leave? |
| 48 | The Offeror agrees to provide coverage for employees who have exhausted their family and medical leave entitlement but are still receiving compensation from Collin County? |
| 49 | The Offeror agrees to provide coverage for employees on military leave immediately upon their return without a waiting period? |
| 50 | For an employee on short-term disability at the time the Offeror assumes the contract, the Offeror agrees to cover the insured on long-term disability once they become eligible? |
| 51 | The Offeror agrees to provide coverage for future new hires and rehires after satisfaction of the County's chosen waiting period? |
| 52 | The Offeror agrees to provide coverage for future qualifying participants after satisfaction of the County's chosen waiting period? Continuous employment in a regular position with Collin County (such as a part-time employee) counts towards the waiting period. |
| 53 | If coverage is denied due to an unintentional error or omission on the part of Collin County, the Offeror agrees to still provide coverage if coverage would have been provided had the unintentional error or omission not occurred? |
| 54 | The Offeror agrees the elimination period for short-term disability due to injury or illness will be 14 calendar days with benefit payments beginning on the 15th day? |
| 55 | Collin County treats maternity/pregnancy like other medical conditions. The elimination period begins on the day of delivery unless there are medical complications and a physician's statement indicating the medical necessity for absence is submitted in which case, the elimination period begins on the first day the employee is medically unable to work. The Offeror agrees to administer the plan accordingly? |
| 56 | The Offeror agrees the maximum benefit period for short-term disability claims will be 26 weeks including the elimination period? |
| 57 | The Offeror agrees the elimination period for long-term disability will be the first 180 calendar days of a period of disability? |
| 58 | The Offeror agrees to be responsible for the complete calculation of payable benefits? |
| 59 | The Offeror agrees a claimant's pre-disability weekly earnings will be based on the employee's base pay? |
| 60 | The Offeror agrees bonuses will not be included in the pre-disability weekly earnings? |
| 61 | The Offeror agrees overtime pay will not be included in the pre-disability weekly earnings? |
| 62 | The Offeror agrees shift differential will not be included in the pre-disability weekly earnings? |
| 63 | The Offeror agrees any other extra compensation will not be included in the pre-disability weekly earnings? |
| 64 | The Offeror agrees the scheduled monthly benefit for long-term disability will be 67% of pre-disability earnings? |
| 65 | The Offeror agrees to continue to use the County's current long-term disability maximum benefit duration schedule as outlined in Section 2.2 of this RFP? |
| 66 | County employees participate in the Texas County and District Retirement System as well as contribute to Social Security Insurance. It continues to be our intent that neither short-term nor long-term disability benefits will be offset by any payments received by the participant from the County’s retirement plan (similar to a private sector 401k). The plan is currently being administered this way. The Offeror agrees to administer the plan accordingly? |
| 67 | With our current policy, BlueCross BlueShield prepares, draws, and mails the checks to the employee. The Offeror agrees to be responsible for the preparation, drawing, and mailing of the checks? |
| 68 | Does the Offeror administer any mandatory vocational or physical rehabilitation programs? If so, describe them in Attachment B - #1.3. |
| 69 | Do Does the Offeror administer any voluntary vocational or physical rehabilitation programs? If so, describe them in Attachment B - #1.3. |
| 70 | Does the Offeror offer an Employee Assistance Program (EAP)? |
| 71 | Most out-of-network charges are not covered by our plan. The Offeror agrees the EAP will coordinate with physicians/counselors within our medical provider's network (currently UnitedHealthcare)? |
| 72 | Is access to the EAP limited to disability plan participants? |
| 73 | Is access to the EAP extended to dependents? |
| 74 | Are there any available reporting functions for the employer regarding the EAP, e.g., number of calls per month, number of referrals, aggregate issues addressed, average length of time on a call, customer satisfaction surveys, etc. based solely on Collin County data? If so, please provide an example of the reports in Attachment B - #4.5. |
| 75 | Will the Offeror provide statistics on average claim processing time and accuracy based only on our organization? |
| 76 | The Offeror agrees to provide Collin County with statistical reporting information on both short-term and long-term disability claims separately? |
| 77 | The Offeror agrees to provide the following reports on at least a monthly basis: |
| A) Claims Status | |
| B) Most Recent Checks Issued (including claimant's name and one other unique identifier such as date of birth) | |
| C) Claims to Pay | |
| D) Claims in Non-Payment Status | |
| E) Payment Detail (including claimant's name and one other unique identifier such as date of birth) | |
| 78 | Are there reports available that identify overpayments? |
| 79 | The Offeror agrees to, at any time during the contract/agreement, supply necessary ad hoc reports including current and historical data (as determined by Collin County), such as participant reports, experience reports, and claims paid reports at no cost to Collin County? Provision of such data will be provided according to the specifics requested by Collin County and shall be provided within ten (10) business days of the request. |
| 80 | Should the nature of additional ad hoc reports warrant compensation beyond the bounds of this contract, The Offeror agrees the report shall be provided at a cost mutually agreeable between the County and the Offeror? It is the Offeror’s responsibility to clearly communicate the cost of providing the requested report prior to producing the report. If the report is produced and the cost was not approved in writing prior to creation, Collin County will not be responsible for the cost of producing the report. |
| 81 | The Offeror agrees to provide a robust, turn-key administrative website that Collin County can access to perform tasks such as: |
| Submit claims | |
| Check claims status that includes insured's name, claim number, date of disability, and approved through date | |
| Paid claim summaries including status of return to work efforts | |
| Submit paperwork for insured such as employer statement | |
| Update insured's return to work status | |
| Billing information | |
| 82 | The Offeror agrees to provide County employees training that is necessary to run reports through the employer website? This also includes any other training related to the provider's services that might be requested by the plan administrator. Any costs associated with training must be clearly listed in Attachment C - Pricing Information. |
| 83 | Can claimants submit claims information via the internet? |
| 84 | The Offeror agrees that Collin County may have a new account manager assigned to the account at any time, for any reason? |
| 85 | The Offeror agrees to provide a toll free number to Collin County administration and our employees to be used for claims or other service issues? |
| 86 | Will the County have a dedicated claims analyst that the Human Resources department can contact with questions and issues with claims? If not, indicate what is required to have a dedicated claims analyst in Section 8.2 - Exceptions. |
| 87 | The Offeror agrees to respond to telephone calls and e-mail communications from the Collin County Human Resources department within one (1) business day? |
| 88 | Will the Offeror provide County employees access to a customer service representative at a minimum of between 8:00 am and 7:00 pm central standard time Monday through Saturday? If representatives are not available between these hours, please provide information on their availability in Section 7 - Exceptions. |
| 89 | The Offeror agrees should an employee need to leave a message for customer service, a customer service representative will return the call to the employee within four (4) business hours? |
| 90 | Collin County self-bills based upon eligible employee count. The Offeror agrees to accept Collin County’s self-billing each month and that any billing-related documents will be provided to Collin County in electronic format? |
| 91 | Collin County has a standard process for payment of all Offerors which requires a 60-day payment grace period from due date of payment. The Offeror agrees to the 60-day grace period? |
| 92 | The Offeror agrees that payment may be made by either wire or check? |
| 93 | The Offeror agrees to notify Collin County of any billing/payment issues within one hundred twenty (120) days from the date the check was submitted to the Offeror and that notice will be made in writing? |
| 94 | The Offeror agrees any billing/payment issues presented to the County after the one hundred twenty (120) day date will not be owed? |
| 95 | The Offeror agrees annual renewal rates will be provided to the County a minimum of one hundred and twenty (120) days prior to each renewal? |
| 96 | The Offeror agrees that changes in premium may only be instituted on a policy anniversary date? |
| 97 | The Offeror agrees when the contract period ends they will be responsible for administering any ongoing short-term and long-term disability claims through to completion of each claim? |
| 98 | The Offeror agrees a notice of cancellation due to error, omission, or payment issue will include a detailed explanation and at least twenty (20) days for Collin County to remedy the situation? |
| 99 | The Offeror agrees that Collin County reserves the right to cancel the contract at any time for any reason and that if the contract is cancelled by Collin County, services will terminate after a 30-day termination notice has been provided by Collin County? |
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