Attachment_A_-_HCPS__Questionnaire_Pricing.xlsx
XLSX spreadsheet 74 KB Posted
- Attached to
- BENEFITS ADMINISTRATION State and local contract opportunity
- Solicitation number
- 25447-RFP-DST
- Issued by
- Hillsborough County, Florida
About this file
This is a Request for Proposal (RFP) questionnaire and pricing sheet for benefits administration services issued by HCPS (Hillsborough County Public Schools) in Florida. The organization is seeking a comprehensive U.S. benefits administration outsourcing partner to manage health and welfare benefits, employee service delivery, and related compliance functions. The RFP anticipates a July 1, 2026 go-live date for new hires, with Annual Enrollment commencing in fall 2026 and an effective date of January 1, 2027. HCPS currently serves approximately 24,536 active medically enrolled employees, 4,854 non-medically enrolled employees, 646 retirees (471 pre-65 and 175 post-65), and operates with multiple current vendors and carriers. The proposal requirements mandate identification of key assumptions and dependencies, strict adherence to provided forms, vendor assumption of all preparation and submission costs, and electronic signature constituting contractual obligation. HCPS reserves the right to modify estimated requirements, withdraw the RFP, or reject any or all proposals without incurring liability.
Vendors must provide cost-effective and competitive fees with both three-year and five-year contract guarantee options, with pricing to begin in a specified month and continuing through the contract term. The RFP encompasses extensive service requirements including core benefits portal administration, employee service center operations (24,536 PEPM for onshore call center services), carrier and vendor file management (6 eligibility files, 1 HRIS/census file weekly, and 2 payroll files), dependent verification, spending account administration (1,644 FSA participants and 101 DCFSA participants), COBRA services (20 participants), direct bill services (460 LOA/non-COBRA participants), ACA compliance services (4 state mandates), and various optional services such as communications support, decision support tools, and premium payment reconciliation. Implementation fees, coverage conversion file fees, and active enrollment fees are required as one-time charges. The RFP requires vendors to complete detailed questionnaires addressing account management, customer service capabilities, technology platforms, privacy and security certifications (SOC-2, HITRUST, GDPR compliance, PCI-DSS certification, and zero data breaches in the past 36 months), and financial arrangements including bundling discounts, tech credits, and carrier billing services. Commissions and broker fees are explicitly excluded from quoted prices.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 25447-RFP-DST_Benefits_Administration_Intent_to_Award.pdf | ||
| 25447-RFP-DST_Benefits_Administration_Addendum_2_Questions.pdf | ||
| Attachments.zip | ZIP file | |
| SMALL_BUSINESS_ENCOURAGEMENT_PROGRAM9.2.25.pdf | ||
| 25447-RFP-DST_Benefits_Administration_Addendum_1_Due_date_change_and_SBEP.pdf | ||
| 25447-RFP-DST_Benefits_Administration.pdf | ||
| VENDOR_AFFIDAVIT_REGARDING_THE_USE_OF_COERCION_FOR_LABOR_AND_SERVICES.pdf | ||
| STATEMENT_OF_NO_BID.pdf | ||
| Vendor_Registration_Form_07.10.25.pdf | ||
| CONTRACTING_WITH_ENTITIES_OF_FOREIGN_COUNTRIES_OF_CONCERN_PROHIBITED_AFFIDAVIT.pdf |
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Text version
Cover
2025 US Benefit Administration Request for Proposal (RFP)
| HCPS |
| August 2025 |
A-ProposalRqmts HCPS 2025 US Benefit Administration RFP Proposal Requirements
| PROPOSAL REQUIREMENTS | AGREE / DISAGREE | |||
| (as applicable) | RESPONSE DETAILS | |||
| Submission Requirements | Use Drop Down Menu | |||
| 1 | HCPS will rely upon representations made in the vendor's proposal. Vendor must therefore identify key assumptions and dependencies on which it based its proposal. The impact on price, schedule, or functionality of any of the vendor's assumptions must be clearly specified. If no impacts are specified, HCPS will assume there are none. | Agree | ||
| 2 | Response should not be conditional or incomplete or contain any alterations from the forms supplied or other defects or irregularities of any kind. | Disagree | ||
| 3 | Response should be noted in the requested response boxes within this RFP. No responses should refer to a separate attachment unless requested by the RFP to do so. | Agree with Deviation | ||
| 4 | Vendor is responsible for all costs of preparing, submitting and (if requested by HCPS) resubmitting its proposal, and any other prior or subsequent activity associated with the RFP process, including the evaluation of the proposal, vendor presentations, and/or contract negotiations, regardless of whether or not HCPS enters into an agreement with the vendor. | |||
| 5 | Submission of this electronic proposal should be considered an electronic signature of the person authorized to contractually obligate your company to the scope, terms, specification, and pricing contained in your proposal. | |||
| 6 | Any census data or other data provided to you in connection with this RFP contains only estimated requirements for the purpose of this RFP. HCPS reserves the right to modify any estimated requirements prior to signing the agreement with the selected vendor(s). No prospective vendor shall have a claim on HCPS in the event that any estimated requirements are modified for whatever reason. | |||
| 7 | HCPS assumes no obligation regarding confidentiality of all or any portion of a proposal or any other material except that portion that a prospective vendor clearly designates as containing proprietary information by indicating "do not disclose" in the section that contains such proprietary information. In such event, the sole responsibility of HCPS shall be limited to maintaining confidentiality of such information to the same extent that it maintains its own proprietary information. | |||
| 8 | Prior to the due date of this proposal, HCPS may modify this RFP by issuance of one or more addenda or amendments to all prospective vendors to whom HCPS has issued this RFP. | |||
| 9 | HCPS reserves the absolute right to withdraw this RFP by written notice or to reject any or all proposals submitted in response to this RFP. HCPS further reserves the right to accept proposals from and award business to one or more prospective vendors or to decide not to award business to any prospective vendor. HCPS shall not incur any liability whatsoever by reason of such withdrawal, rejection, or acceptance. | |||
| Bidding Requirements and Selection Criteria | ||||
| 1 | Assume a July 2026 go-live date for new hires, fall 2026 for the start of Annual Enrollment. | |||
| 2 | Offer cost effective and competitive fees with three (3) and five (5) year guarantees. | |||
| 3 | Commissions/broker fees are not included in your quote. |
B-General HCPS 2025 US Benefit Administration RFP General Information
| CORE QUESTIONNAIRE | AGREE / DISAGREE | ||
| (as applicable) | RESPONSE DETAILS | ||
| General Questionnaire | Use Drop Down Menu | ||
| 1 | Primary RFP Contact: Name | ||
| 2 | Primary RFP Contact: Phone | ||
| 3 | Primary RFP Contact: Email | ||
| 4 | Full Legal Name of Company | ||
| 5 | Headquarters Address of Company | ||
| 6 | Number of years in business | ||
| 7 | Number of employees employed | ||
| 8 | Publicly traded or Private company | ||
| 9 | Please provide a list of M&A activity associated with your company within the past 5 years, and any not yet finalized but publicly announced. | ||
| 10 | Please provide your Net Promotor Score (NPS) for year to date, and 2024, 2023, 2022 including the following: |
Annual Enrollment NPS:
Overall service NPS:
Implementation NPS:
Feel free to provide alternate scores, as long as you're also providing your NPS.
| 11 | Total number of H&W/Benefit Administration Clients Served |
| 12 | Total number of H&W/Benefit Administration Employees/Participants Served |
| 13 | Number of H&W Clients with < 5,000 Employees |
| 14 | Number of H&W Clients with 5,001 – 10,000 Employees |
| 15 | Number of H&W Clients with 10,001 – 20,000 Employees |
| 16 | Number of H&W Clients with 20,001 – 30,000 Employees |
| 17 | Number of H&W Clients with 30,001+ Employees |
| 18 | Please provide your client retention rate over the last 3 years |
| 19 | Confirm services outsourced including name of outsourced partner and the services the partner provides on your behalf, and describe what access HCPS will have to view these third party platforms. Also include if services by the outsourced partner is performed in the U.S . If not, note the country the services are performed in. |
| Payroll | |
| 1 | Please confirm your ability to accommodate weekly, bi-weekly, and semi-monthly pay periods |
| 2 | Please list any preferred payroll vendors, or enhanced integrations you currently have in place with a payroll vendor |
| 3 | Does your platform have the capability to handle closed loop payroll? If so, please provide an overview of your process, and any differentiators your capabilities have. |
| 4 | Does your closed loop payroll accommodate EE's transferring between pay frequencies to ensure correct deductions? |
| 5 | Please describe how your closed loop payroll process ties into your direct bill process. |
| 6 | Do you have the ability to support frozen annual benefit salaries which are used for medical, life, and disability premium/coverage amounts? |
| Dependent Verification | |
| 1 | Please provide detail on your dependent verification services, process, and client expectations. Does your system accept the uploading of a document? Do you use AI (OCR) technology in this process and if so please describe in detail. |
| Compliance | |
| 1 | Please provide information on any additional compliance support you provide to clients |
| 2 | How do you support distribution of required SPDs/SMM/SAR and/or on demand requests for SPDs/SMMs or SAR by employees? |
| Spending Accounts Administration | |
| 1 | Do you administer spending accounts (FSA, HSA) or commuter benefits, within your benefits platform and if so please describe the infrastructure (home grown, cloud based, etc)? |
| 2 | If so, do you have a dedicated team that administers these accounts and provide detail on the administrative process |
| 3 | Are you able to handle integration with vendor claim files to auto substantiate debit card transactions? |
| 4 | What are the auto substantiation efficiency numbers in your book of business for companies the size of HCPS |
| 5 | Please describe your spending accounts employer portal and what reporting options are offered |
| 6 | Is the funding/reimbursement functionality fully integrated with the debit card transaction platform? |
| 7 | Do you offer the option of customizing notifications that need to be sent to employees? |
| 8 | Please list any preferred spending accounts vendors you currently work with |
| 9 | If you don't have an integrated spending accounts platform, please describe how you support administering spending accounts and how it is integrated within your platform. |
| Retiree Administration | |
| 1 | Please describe your retiree process, from notification, updating status in the system, and file/data transfer process to trigger eligibility and supporting enrollment |
| Voluntary Benefits | |
| 1 | List your preferred voluntary benefit carrier partners and benefits the client will receive because of the partnership (i.e. tech credits) |
| 2 | Do you provide commission offsets or discounts on fees as a result of your partnerships with voluntary benefit carriers? |
| 3 | Please describe any limitations you have in implementing voluntary benefit plans (i.e. stacking, issue age, etc.) |
| Additional Items to be provided separately | |
| 1 | Please provide 2 client references from your current block of business and 2 terminated client references, including clients of similar size, industry and complexity. Provide client name, client contact (email and phone number), employee count, and number of years as a client. For current client references provide one that was implemented within the past 2 years and one that has been a client 5 or more years. |
| 2 | Please provide an executive summary |
| 3 | Please provide team biographies for the dedicated team (both implementation and ongoing account management team members) that will be directly supporting HCPS. Verify you will commit to maintaining the ongoing account management team members for a minimum of two years on the HCPS account after implementation. Will the ongoing account management team be part of the implementation, and if yes indicate who those individuals are. |
C-AcctMgmt HCPS 2025 US Benefit Administration RFP Account Management & Reporting
| CORE QUESTIONNAIRE | AGREE / DISAGREE | ||
| (as applicable) | RESPONSE DETAILS | ||
| Account Management | Use Drop Down Menu | ||
| 1 | Please confirm your organization's approach to account management and describe the roles that will be working with HCPS ongoing and at implementation | ||
| 2 | Please describe what methodology is used when assigning Account Managers (AM) to a client, and when making account management changes (i.e. client size, AM experience, AM capacity, etc.) | ||
| 3 | Confirm that ongoing account team members will be in attendance at finalist meetings and that the account team will be fully engaged during the implementation. | ||
| 4 | Please confirm how handoff is managed between implementation team and account team | ||
| 5 | Please provide the following information for the proposed Executive Sponsor: | ||
| 6 | Name (please identify a resource at this time and do not defer to the finalist stage) | ||
| 7 | Office location (City, State) | ||
| 8 | Number of years with your company | ||
| 9 | Number of accounts and covered members (excluding HCPS) this person serves | ||
| 10 | Percent of time that will be dedicated to HCPS. | ||
| 11 | Please provide the following information for the proposed Account Executive: | ||
| 12 | Name (please identify a resource at this time and do not defer to the finalist stage) | ||
| 13 | Office location (City, State) | ||
| 14 | Number of years with your company | ||
| 15 | Number of accounts and covered members (excluding HCPS) this person serves | ||
| 16 | Percent of time that will be dedicated to HCPS. | ||
| 17 | Please provide the following information for the proposed Account Manager (if known): | ||
| 18 | Name | ||
| 19 | Office location (City, State) | ||
| 20 | Number of years with your company | ||
| 21 | Number of accounts and covered members (excluding HCPS) this person serves | ||
| 22 | Percent of time that will be dedicated to HCPS. | ||
| 23 | Please provide the following information for the proposed Implementation Manager (if known): | ||
| 24 | Name | ||
| 25 | Office location (City, State) | ||
| 26 | Number of years with your company | ||
| 27 | Percent of time that will be dedicated to HCPS. | ||
| 28 | If there are additional resources you would like to name at this time, please do so here. | ||
| 29 | Please confirm turnover of account management teams based on your book of business (please note the timeframe of turnaround statistics) include turnover in the past year, past 3 years and past 5 years. | ||
| 30 | How do the teams with your service delivery model (HCPS service, technology, call center, dependent verification, direct bill, advocacy, spending accounts, etc.) work together, share information, and collaborate? | ||
| 31 | What training and support will you provide to HCPS personnel on your systems, reporting programs, and processes? | ||
| 32 | It is HCPS's expectation that vendor partners align to a pre-determined supplier framework which governs the content and cadence of strategic, reporting, and operational meetings. Please confirm your understanding and ability to accommodate the following: | ||
| 33 | Annual Strategy & Reporting | ||
| 34 | - In-person | ||
| 35 | This review will include an Executive Summary and strategic plan and AE recommendations based on HCPS data | ||
| 36 | - Full reconciliation of AE errors and proposed solutions | ||
| 37 | Operational Calls (based on HCPS's agreed upon call cadence up to weekly calls) | ||
| 38 | - Review and tracking of open operational items | ||
| 39 | - Tracking spreadsheet is created and managed by vendor | ||
| 40 | Please outline the standard reports available and confirm reporting experiences (e.g. are reports pushed or pulled)? | ||
| 41 | Will HCPS and designated consultants have the ability to access and run reports independently? | ||
| 42 | If so, please specify the types of reports HCPS will have access to from your reporting system. | ||
| 43 | Confirm HCPS will have access to real-time reporting | ||
| 44 | Are you willing to customize/develop new reports as required by HCPS? | ||
| 45 | Will you charge an additional fee for providing customization/development of new reports? If yes, please provide. | ||
| 46 | Confirm if you offer an Ad Hoc tool for self-reporting | ||
| 47 | Can the HCPS team set up dashboards to automatically run reports that are needed routinely and at a regular cadence? | ||
| 48 | Please confirm turnaround time for standard and ad hoc reporting | ||
| 49 | Please confirm if there is a secure HCPS portal to share reports, view data, and make changes | ||
| 50 | Does your system allow for HCPS access to participant specific data and information outside of reporting functionality? | ||
| 51 | Can HR administrator access in each location/division be configured to only see the employees and benefits for their location? | ||
| 52 | Please describe the step-by-step approach to issue resolution: discovering accountability, you discover an issue, what happens next and what is involved in getting it resolved? | ||
| 53 | Provide copy of your standard root cause analysis document that would be provided to HCPS. |
| 54 | At what level do you expect HCPS to assist in the review or resolution process? |
| 55 | Describe your process for managing through error reporting related to the eligibility files or the transmission files to the carrier partners. |
| 56 | How involved does HCPS need to be? Does the report auto-generate? |
| 57 | What’s the timing for correcting any errors? Differentiate between system errors vs. non-system errors. Describe when you do regression testing. |
| 57 | Please describe your standard employee case management process. |
What is the standard timing for case resolution? Would HCPS have access to view cases attached to an employee record? Do you have a dedicated employee case management team? What is the process for HCPS notifying your team of employee level issues? Is this tracked in reporting available to HCPS?
| Quality | Use Drop Down Menu | |
| 58 | Do you have a comprehensive, documented quality assurance program? Please describe your program and how you ensure high quality service delivery. | |
| 59 | Describe the quality assurance monitoring systems and/or controls you currently have in place to support benefits administration delivery. | |
| 60 | Please provide details on your audit process and capabilities. Please include details on what processes you audit, the frequency, the end to end process including resolution, root cause analysis when issues are found, and the team that supports this process. Include specifics on your AE audit process. | |
| 61 | What is your standard escalation process when issues need to be escalated past the account management team? Is there a dedicated escalation contact? | |
| 62 | Describe your escalation process for potential errors, process for evaluating root cause, and how you timely address and correct potential errors. How is this managed and reported to HCPS? | |
| 63 | Do you have a standardized method for tracking client satisfaction (i.e. monthly client pulse or scoring) and what is the process when client expectations are not being met? Please describe this in detail as HCPS will require a financial performance guarantee tied to this metric. | |
| 64 | Do you utilize a robust testing process? Please describe your testing process including how you manage and migrate changes in a test to production environment. | |
| 65 | Please describe in detail your Implementation testing process | |
| 66 | Please describe in detail your Annual Enrollment testing process | |
| 67 | Please describe in detail your testing process when system functionality is updated (for both enhancements and fixes and any differences in your approach) | |
| 68 | Does your service model support include regression testing? | |
| 69 | Do you include automated quality control checks and audits in your data and file processes? Please describe. | |
| 70 | Describe your best-practice approach to test plans and user/client acceptance testing. | |
| 71 | Please describe in detail your day-to-day data and file feed process. How is HCPS notified of issues, and what is the standard process for resolution from the vendor and client perspective. Do you have a dedicated team that supports the data and file feeds? Is this team accessible to HCPS if/when they find issues. What is the standard timeline for resolution? | |
| 72 | A smooth implementation is critical. What is your approach to implementation management and describe your ability to provide both quality and partnership from the start of the implementation to the go-live date? | |
| 73 | Provide a full implementation plan, include an implementation timeline, specific to HCPS and their current vendors, demonstrating a July 2026 new hire go-live date, September 2026 AE date and a January 1, 2027 effective date. |
D-CustSvcs HCPS 2025 US Benefit Administration RFP Customer Service
| CORE QUESTIONNAIRE | AGREE / DISAGREE | ||
| (as applicable) | RESPONSE DETAILS | ||
| Customer Service | Use Drop Down Menu | ||
| 1 | Please provide the following for the Customer Service team that will service HCPS. HCPS's expectation is that the customer service model will include high touch concierge-level personalized support that focuses on removing barriers so members can engage effectively with offered programs and services. | ||
| 2 | Centralized or Decentralized | ||
| 3 | Office Location (City & State) - If proposing offshore, please confirm ability for HCPS to select preferred location (if applicable) | ||
| 4 | Number of Representatives in Call Center ; will any representatives be dedicated or semi-dedicated to HCPS | ||
| 5 | During AE: Telephone Hours of Operation - Monday - Friday (include local time or time zone) | ||
| 6 | During AE: Telephone Hours of Operation - Weekends and Holidays (include local time or time zone) | ||
| 7 | Not AE: Telephone Hours of Operation - Monday - Friday (include local time or time zone) | ||
| 8 | Not AE: Telephone Hours of Operation - Weekends and Holidays (include local time or time zone) | ||
| 9 | Ratio of Staff to Members (specify if Book Of Business, Unit, etc.) | ||
| 10 | Average Years of Service (specify if Book Of Business, Unit, etc.) If any representatives are dedicated or semi-dedicated provide their years of service | ||
| 11 | Do you provide a fully domestic U.S. based (Onshore) benefits call center? | ||
| 12 | If so what would be the additional cost? | ||
| 13 | Do you have a central location for this call center or are representatives remotely located across the country | ||
| 14 | What is the turnover rate amongst your call center team? Please provide statistics for 2022, 2023 and 2024 YTD. Can this be broken down by management and phone reps? | ||
| 15 | Are bi-lingual representatives available? | ||
| 16 | If so, which languages are supported by a live customer service representative? | ||
| 17 | Do you have a language line for all other languages not supported by live customer service? | ||
| 18 | Provide the following statistics for the customer service office that will handle the HCPS's account. We are requesting actual 2023 and 2024 YTD results, not your organization's targets/goals. | ||
| 19 | Percent of calls answered within 30 seconds: 2023 and 2024 | ||
| 20 | Average speed to answer (seconds): 2023 and 2024 | ||
| 21 | Call abandonment rate (percentage): 2023 and 2024 | ||
| 22 | First call resolution (percentage): 2023 and 2024 | ||
| 23 | Average length of call (seconds): 2023 and 2024 | ||
| 24 | Percent of incoming calls that are recorded: 2023 and 2024 | ||
| 25 | Percent of outgoing calls that are recorded: 2023 and 2024 | ||
| 26 | Please confirm your willingness to provide recordings and/or detailed summaries of member calls to HCPS upon request. Can HCPS access recorded calls without having to request the recordings? | ||
| 27 | Explain how resources are managed to accommodate higher call volumes for HCPS or any Client. | ||
| 28 | Do you utilize contractors or third parties and what is the process to vet them for security and upskill on training? | ||
| 29 | Do you have written policies/agreements related to management of contractors/third parties? | ||
| 30 | Please describe the communications support available to HCPS included in the proposed fees | ||
| 31 | Please confirm how communications are produced (e.g. dedicated resource provided)? | ||
| 32 | How does HCPS review communications? | ||
| 33 | Are all communications base text or is there opportunity to customize? | ||
| 34 | If it can be customized is it a different process including cost? | ||
| 35 | What does the communication writing and review/process consist of? | ||
| 36 | Is your system capable of push communications to selected groups? | ||
| 37 | How are communications approved before they are released to ensure the selected group is correct? | ||
| 38 | Does your customer service team have access to view the specific communications sent to a participant real time and will participant have access to view all communications sent via the portal as well? | ||
| 39 | Please confirm you are able to create and support printing/fulfillment (as necessary) at no additional cost to HCPS for the following types of communications: | ||
| A | Benefit Guide | ||
| B | Confirmation Statements | ||
| C | Binders for benefits team (including cover and spine) | ||
| D | Banners and Tiles for enrollment site | ||
| E | DOL Marketplace Notice | ||
| F | 5 separate eCards | ||
| G | Leave of Absence Letter | ||
| H | Microsite page content | ||
| I | Poster | ||
| J | Postcards for Actives and Retirees | ||
| K | Retiree Guide | ||
| L | Retiree Letter | ||
| M | Videos for Medical and Rx | ||
| N | Overage Dependent Letter and Form | ||
| 40 | Describe all the ways employees can communicate with you. Text, call, email, live chat, etc. | ||
| 41 | What functionality is available via the portal vs. the app? | ||
| 42 | Provide a sample of the enrollment confirmation employees receive after a successful enrollment. Is there a process to alert employees of incomplete or inaccurate enrollment? | ||
| 43 | Please confirm confirmation statements are included within your proposed fees | ||
| 44 | Please confirm if employees receive an immediate record of elections following enrollment (prior to confirmation statement) | ||
| 45 | Do you have decision support tools available for employees during enrollment, and is this a proprietary engine, and if not what engine is used? Do you use localized and individual claims data? | ||
| 46 | Provide a summary of those tools and samples/screen shots. | ||
| 46 | Do you have specialized representatives to support more complex events (such as retirement, deaths, etc.) separate from your standard general call center representatives? | ||
| 47 | Do you have an internal benefit advocacy team or integration with a third-party advocacy vendor, that HCPS's employees would be able to utilize? Would this team be separate from your standard call center representatives? | ||
| 48 | What is the training criteria for new representatives? | ||
| 49 | What percent of representatives, under 1 year, will be assigned to handle HCPS calls? | ||
| 50 | When a caller threatens a lawsuit or legal action what steps are taken internally and how do you notify the client? | ||
| 51 | Is there a separate group that handles appeals and written inquiries? Describe the operating process for handling appeals and written inquires | ||
| 52 | Do you offer Medicare retirement eligible participants licensed representatives to talk to when deciding if they will stay on the employer's coverage or select one of the Medicare options? If yes, how long have you offered this service and is there any added cost? | ||
| 53 | How do you handle mail or correspondence received by the prior TPA after the implementation? |
E-Technology HCPS 2025 US Benefit Administration RFP Technology
| CORE QUESTIONNAIRE | AGREE / DISAGREE | ||
| (as applicable) | RESPONSE DETAILS | ||
| Technology Capabilities | Use Drop Down Menu | ||
| 1 | Please outline your technology roadmap for the next 3-5 years (including a detailed description of your current and future use of A.I.) | ||
| 2 | What does your Client service delivery portal offer that sets you apart from others in the industry? Please provide specific examples if there are features unique to your platform. | ||
| 3 | Do you have multiple platforms? If so, please list all platforms, the differences between them, and which platform HCPS would be on. | ||
| 4 | Is your portal equipped to support a “self-service” model? | ||
| 5 | Please describe your decision support tools in detail. Is this a proprietary engine, and if not what engine is used? Do you use localized and individual claims data? What vendor do you access your claims data from? | ||
| 6 | What strategies would you use to educate technology-challenged employees on a “self-service” model? | ||
| 7 | Does your organization provide participants with a mobile app? If so, please provide a detailed account of the app’s features and functionality. Finally, please provide a detailed account of your platform functionality on a mobile device. | ||
| 8 | Please confirm which internet browsers your platform supports | ||
| 9 | What is the process and timing for making updates to the portal design and format? | ||
| 10 | What access will HCPS have to make updates to the portal, and if there is a portal designer, will they have direct access to make changes when necessary? | ||
| 11 | Can you segment user experience by user type. Please provide details on how this is done. | ||
| 12 | What makes the participant experience on your delivery portal easy to understand and intuitive from enrollment through the first medical claim? | ||
| 13 | Can a participant save their enrollment, if they get interrupted or does the system time out? If the system does not save partial enrollments what is the time out period? | ||
| 14 | Please provide system reliability statistics and mitigation plans for unknown outages. | ||
| 15 | For appeals can you provide the system access footprint of the participant to know when they went online and what activity, if any, they did. | ||
| 16 | How is the system configured, tested, and monitored? | ||
| 17 | How do you ensure as part of the testing that regression testing is performed? | ||
| 18 | What steps are taken to ensure the change does not break something else in the system? | ||
| 19 | How would HCPS be included in the process and do you provide your findings/results? | ||
| 20 | Please provide an example of integrity checks regularly performed to ensure the data is accurate and the process supporting the correction of any data issues. | ||
| 21 | How are data issues managed and corrections communicated to the Client? | ||
| 22 | Do you also perform mid-year audits and if so, how frequently and what is audited? | ||
| 23 | How do you apply new releases to your product? | ||
| 24 | Is HCPS able to opt in/opt out? | ||
| 25 | What is a standard testing plan for AE changes, plan changes, new company codes, etc. Please provide a complete example of an AE change plan including timelines, business requirements document examples, and testing results, among any other documentation to demonstrate the way AE changes are managed. Describe the Client acceptance testing process and timeline. | ||
| 26 | What is included in your integrations? Are there a limited number included in the base agreement? If so, how many? | ||
| 27 | For integration of master data, are change files the accepted model? | ||
| 28 | How are transactions effective dated? | ||
| 27 | Can there be more than 1 transaction per day? | ||
| 28 | Do you have documentation on how or what security and data protections are in place for HCPS master data that is shared with you? And, are you prepared to share that information and complete HCPS's security assessment/questionnaire? | ||
| 29 | Please provide your best practice for voluntary benefit premium accounting and reconciliation. | ||
| 30 | Describe the capabilities of a system administrator posting documents (SPD, Benefit Highlights) to the website, posting weekly articles, adding links, videos, etc. | ||
| 31 | Describe the process during transition between plan years and how your system handles enrollment for current plan year and annual enrollment. | ||
| 32 | For example, is there a different look to the annual enrollment site, a welcome page, mapping over of enrollment for new hires into new plan year enrollment. | ||
| 33 | How do you communicate dual year elections to the vendor community? | ||
| 34 | Is there a black-out person period to consider during the dual year time frame? | ||
| 35 | How does your system handle evidence of insurability? | ||
| 34 | What type of API or SSO integrations do you have for quick data transfer of EOI information? | ||
| 36 | Does an employee know when amounts are pending? | ||
| 37 | How do they complete the carrier approval process; electronically? | ||
| 38 | How do you transition from pending amounts to approved amounts? | ||
| 39 | Can you accommodate single sign on capabilities? | ||
| 40 | Are there HCPS vendors that you will not or have not accommodated SSO? | ||
| 41 | What is the process to transfer existing processes from current vendor, such as claims/appeals and dependent verification? | ||
| 42 | How are mistakes or missed cases prevented? | ||
| 43 | Describe how you will honor grandfathered coverage amounts for life and/or disability coverages. How will the transition happen from our current partner to your organization? | ||
| 44 | Are the resources on the website and the enrollment site available in Spanish? | ||
| 45 | Can the Client have a customized phone number? | ||
| 46 | What system capabilities are available for the participant to upload documents to the site? | ||
| 47 | What is the billing cycle for COBRA enrollees? Do you accept future dated COBRA elections? | ||
| 48 | Do you have clients that have Single Sign On via their internal website? Describe the authentication process required. | ||
| 49 | What is the billing cycle for LOA participants? How do you reconcile with the client's payroll for refunds. |
F-Privacy and Security HCPS 2025 US Benefit Administration RFP Privacy and Security
| CORE QUESTIONNAIRE | Agree/Disagree | RESPONSE DETAILS | |
| Privacy and Security | Use Drop Down Menu | ||
| 1 | Please confirm that your technology is GDRP Compliant | ||
| 2 | Please confirm your organization has a SOC-2 Certification that has been completed in the past 12 months. | ||
| 3 | Please confirm your organization is HITRUST certified. | ||
| 4 | Please confirm that Personal Information is not stored outside the United States. | ||
| 5 | Please confirm your organization follows a best practice approach on the following activities: | ||
| 5a | Two-factor authentication | ||
| 5b | Access Control Protocols | ||
| 5c | Identity Management | ||
| 5d | Encryption for all aspects of the technology | ||
| 5e | Breach Alerts within the system | ||
| 5f | Maintain firewalls | ||
| 6 | Please confirm documented policies and procedures are in place today to address HIPAA and any other privicy regulations within the US or abroad. | ||
| 7 | Please confirm that quarterly security training programs take place for all colleagues within the organization that touches PHI/PII/PIA data | ||
| 8 | Please confirm that your organization has not had a data breach in the past 36 months. | ||
| 9 | Please confirm that you agree to keep and maintain all Personal Information in strict confidence, using such degree of care as is appropriate to avoid unauthorized access, use, disclosure or Processing of Personal Information and use and disclose Personal Information solely and exclusively for the purposes for which Personal Information pursuant to the terms and conditions of the services provided. | ||
| 10 | Please confirm all personnel that is considered an authorized person who will have access to Personal Information on any mobile device, data center, paper files, severs, back-up system, computer equipment and media storage has been encrypted and will not be transmitted without encryption. | ||
| 11 | Please confirm your organization has disciplinary measures for violations of the Security Program rules in place. | ||
| 12 | Please confirm all subcontractors, secondary service providers and third parties that access, process, or are provided the ability to access Client Data in connection with or behalf of your services, have a risk management program that has been vetted by your organization and that they meet generally accepted industry standards and practices for protection of Personal information. | ||
| 13 | Please confirm you agree to review and assess security measures used by Subcontractors to attest and ensure applicable controls are in place as it pertains to privacy, security and business continuity controls. | ||
| 14 | Please confirm you agree to maintain an appropriate information Governance program to classify and retain Confidential Information and Client Data for a minimum of seven (7) years. | ||
| 15 | Please confirm your Security Program shall restrict Authorized Persons' storage of Confidential Information on personally-owned equipment. | ||
| 16 | Please confirm that Data Privacy and Information Security awareness programs are active for all new and existing personnel, including temporary contractors assigned to perform Services, receive mandatory training at least annually regarding the appropriate protection of Client data. | ||
| 15 | Please confirm background checks on all Authorized Persons who will have access to Confidential Information is part of hiring practice. | ||
| 16 | Please confirm that your organization deploys a data loss prevention tool (DLP Tool) to prevent the unauthorized use of Confidential Information and to enforce security policies and controls. | ||
| 17 | Please confirm that all Confidential Information is encrypted while in transit and at rest in a particular but not limited to Social Security numbers, Protected Health Information and financial account numbers. | ||
| 18 | Please confirm that your organization uses industry-standard encryption methods to protect the Confidential Information transmitted to and from the client. | ||
| 19 | Please confirm that websites hosted by your organization that deliver Confidential Information over the public internet employ SSL with server-gated cryptography for maximum network-layer encryption. | ||
| 20 | Please confirm all mobile media leaving your organizations' custody - including CDs, DVDs, flash drives, tapes and portal hard drives - are encrypted | ||
| 21 | Please confirm your organization has an incident management program, where management and containment of a Data Breach are included as part of the overall mitigation. | ||
| 22 | Please confirm how you assess and manage the security risks associated with any and all use of AI and machine learning in your services. | ||
| 23 | Please confirm how you assess and manage the security risks associated with any and all use of AI and machine learning before integrating them into your environment. | ||
| 24 | Please confirm how you evaluate the security of new and emerging technologies (other than AI) before integrating them into your environment. | ||
| 25 | Please confirm your organization is PCI-DSS certified and can provide a current AoC. | ||
| 26 | Please confirm your organization follows OWASP secure coding best practices, to include regular testing of coders and developers. | ||
| 27 | Please confirm your data handling standard, policy and procedures during offboarding/contract termnation. |
G-Financials HCPS 2025 US Benefit Administration RFP Financials
| CORE QUESTIONNAIRE | AGREE / DISAGREE | ||
| (as applicable) | RESPONSE DETAILS | ||
| Financials | Use Drop Down Menu | ||
| 1 | Based upon all of HCPS's current services and carriers/vendors, would you provide any bundling discounts if selected as the Health and Welfare vendor? If so, please provide which services you would provide bundling discounts for, and provide details on the discount provided. | ||
| 2 | Preferred partners - Cost, timing, partners other than carrier partners | ||
| 3 | Do you offer tech credits? | ||
| 4 | Do you offer carrier billing services? Premium Remittance? | ||
| 5 | Provide the process, the reporting to both HCPS and the vendor partner (if applicable), the timing, the checks/balances to ensure accuracy, and the process for corrections. | ||
| 6 | What resources are you ready to deploy should an outstanding balance be identified by the carrier/vendor? | ||
| 7 | Are you willing to adjust your billing release date to match the carrier billing date? | ||
| 8 | Please explain how change orders are managed, how fee discussions are handled, what is considered in and out of scope of ongoing administration and annual enrollment? | ||
| 9 | Do you differentiate change orders by a defect versus enhancement? | ||
| 10 | What does that look like as it relates to fees? | ||
| 11 | Do all change order implementations follow an iteration schedule? If so, what does that look like? | ||
| 12 | Can the cost of a change order be offset with other revenue (carrier tech credits etc.)? | ||
| 13 | Do you bill HCPS to travel for meetings? |
H-PricingFees
| Ben Admin Partner | |||
| Please outline any contingencies that apply to your proposed pricing. Also include details on future annual expected ECI/CPI increases within the contract if applicable beyond yearly pricing. | Assumed | ||
| Volumes | PEPM | Annual or Flat Pricing per unit | Set-up Fees |
| (if applicable) | Indicate Frequency of Charge | ||
| (Monthly, Annually, One-time, Other) | Notes/Assumptions |
| Contract Length | Please provide pricing for 3 years and note in Col G any deviations in pricing if a 5 year contract were agreed to by HCPS | |||||
| Indicate Month PEPM Billing Begins | ||||||
| Onboarding Fees | ||||||
| Implementation Fee | $ - 0 | $ - 0 | $ - 0 | |||
| Coverage Conversion Files Fees | $ - 0 | $ - 0 | $ - 0 | |||
| Active Enrollment Fees | $ - 0 | $ - 0 | $ - 0 | |||
| Total Onboarding Fees | $ - 0 | |||||
| Ongoing Administration Fees | ||||||
| Core Fees | ||||||
| Benefits Portal Administration - Active Medically Enrolled | 19,682 | $ - 0 | $ - 0 | $ - 0 | ||
| Benefits Portal Administration - Non Medically Enrolled | 4,854 | $ - 0 | $ - 0 | $ - 0 | ||
| Benefits Portal Administration - Non-Benefit Elig | $ - 0 | $ - 0 | $ - 0 | |||
| Benefits Portal Administration - Retirees | 646 | $ - 0 | $ - 0 | $ - 0 | 471 pre-65, 175 post-65 | |
| Employee Service Center (List hours of operation) | ||||||
| Call Center PEPM (please provide 12 hour call center PEPM for fully onshore service) | 24,536 | $ - 0 | $ - 0 | $ - 0 | ||
| Provide Annual Call Center Minute Limit (if applicable) | $ - 0 | $ - 0 | $ - 0 | |||
| Multi-language Support | $ - 0 | $ - 0 | $ - 0 | |||
| Active 2 week OE w/additional 1 week silent period (would be either/or, price both) | $ - 0 | $ - 0 | $ - 0 | |||
| Passive 2 week OE w/additional 1 week silent period (would be either/or, price both) | $ - 0 | $ - 0 | $ - 0 | |||
| Carrier/Vendor Files | ||||||
| # Eligibility Files Included | 6 | $ - 0 | $ - 0 | $ - 0 | ||
| Fees for Additional Eligibility Files | $ - 0 | $ - 0 | $ - 0 | |||
| # HRIS/Census Files included (1x per week) | 1 | $ - 0 | $ - 0 | $ - 0 | ||
| Fees for Additional HRIS/Census Files | $ - 0 | $ - 0 | $ - 0 | |||
| # Payroll Files included/fees for any additional | 2 | $ - 0 | $ - 0 | $ - 0 | ||
| Fees for Additional Payroll Files | $ - 0 | $ - 0 | $ - 0 | |||
| Total Ongoing Administration Fees | ||||||
| Additional/Optional Services | ||||||
| Communication Services | ||||||
| Decision Support Tools (if offered separately from Ongoing Admin) | $ - 0 | $ - 0 | $ - 0 | |||
| Text Messaging | $ - 0 | $ - 0 | $ - 0 | |||
| Customized Communications (During AE Only) | $ - 0 | $ - 0 | $ - 0 | |||
| Public Facing Landing Page | $ - 0 | $ - 0 | $ - 0 | |||
| Website Language Support | $ - 0 | $ - 0 | $ - 0 | |||
| Single Sign-On | ||||||
| # of SSOs Included | $ - 0 | $ - 0 | $ - 0 | |||
| Fees for Additional SSOs | $ - 0 | $ - 0 | $ - 0 | |||
| Billing & Financial Reporting | $ - 0 | $ - 0 | $ - 0 | |||
| ACA Services (FEINs included in standard costs/fees for additional FEINs) | $ - 0 | $ - 0 | $ - 0 | |||
| ACA Employer Mandate Hours tracking (FTE determination) | N/A | $ - 0 | $ - 0 | $ - 0 | ||
| ACA 1094 Filing | $ - 0 | $ - 0 | $ - 0 | |||
| ACA 1095C Fullfillment | $ - 0 | $ - 0 | $ - 0 | |||
| ACA Comprehensive Reporting | $ - 0 | $ - 0 | $ - 0 | |||
| ACA State Mandates | 4 | $ - 0 | $ - 0 | $ - 0 | ||
| COBRA Services (Ben Admin retains 2% fee) | $ - 0 | $ - 0 | $ - 0 | |||
| COBRA Administration | 20 | $ - 0 | $ - 0 | $ - 0 | ||
| COBRA- QE notifications | $ - 0 | $ - 0 | $ - 0 | |||
| COBRA- Direct Bill Services | $ - 0 | $ - 0 | $ - 0 | |||
| COBRA Mid-Year Takeover | $ - 0 | $ - 0 | $ - 0 | |||
| Direct Bill Services (LOA, Non-COBRA) | 460 | $ - 0 | $ - 0 | $ - 0 | ||
| Dependent Verification Services | ||||||
| Dependent Verification (Ongoing) | $ - 0 | $ - 0 | $ - 0 | |||
| Event Verification (Ongoing) | $ - 0 | $ - 0 | $ - 0 | |||
| One-time Audit | $ - 0 | $ - 0 | $ - 0 | |||
| Premium Payments Services/Reconciliation Services | ||||||
| (# carriers included in standard costs/fees for additional carriers) | $ - 0 | $ - 0 | $ - 0 | |||
| Advocacy Services | N/A | $ - 0 | $ - 0 | $ - 0 | ||
| QMSCO Services | $ - 0 | $ - 0 | $ - 0 | |||
| QMCSO Administration (no qualification) | $ - 0 | $ - 0 | $ - 0 | |||
| QMCSO with Qualification | $ - 0 | $ - 0 | $ - 0 | |||
| Spending Account Administration | ||||||
| HSA Administration | N/A | $ - 0 | $ - 0 | $ - 0 | ||
| FSA Administration | 1644 | $ - 0 | $ - 0 | $ - 0 | ||
| DCFSA Administration | 101 | $ - 0 | $ - 0 | $ - 0 | ||
| Limited Purpose FSA Administration | N/A | $ - 0 | $ - 0 | $ - 0 | ||
| Commuter Administration | N/A | $ - 0 | $ - 0 | $ - 0 | ||
| Claims and Appeals Management (Level 1 handled by Ben Admin, level 2 reviewed by client) | $ - 0 | $ - 0 | $ - 0 | |||
| Total Rewards Statements | $ - 0 | $ - 0 | $ - 0 | |||
| Closed Loop Payroll | $ - 0 | $ - 0 | $ - 0 | |||
| Power of Attorney | $ - 0 | $ - 0 | $ - 0 | |||
| Paper Communications | $ - 0 | $ - 0 | $ - 0 | |||
| Implementation Oversight Credit | $ - 0 | $ - 0 | $ - 0 | |||
| Other: | $ - 0 | $ - 0 | $ - 0 | |||
| Total Additional/Optional Services | ERROR:#REF! |
| Total First Year Fee | $ - 0 |
| Total Ongoing Annual Fee | $ - 0 |
Additional Caveats or Assumptions by Ben Admin Partner:
Sheet1
File details come from the government source that posted it. Updated .