Attachment_A_-_Scope_of_Services_(new).pdf

County of Orange HRS Employee Benefits

RFP # 017-202406-MC

HRA Plan Administration and Investment Services

File Folder No.: 017-2700201

ATTACHMENT A

SCOPE OF SERVICES

(Review this section and submit as Part 5 of the Proposal if there are any proposed changes.

Be sure to note any changes using the “tracked changes” feature in MS Word.

Refer to Section I. C.5)

Initial Plan Communication/Implementation

The Contractor shall perform the services required and provide the logistics necessary to accomplish the following:

A. Plan for the transition of the Plans to the new Administrative and Investment Management

Services Contractor: Within five (5) business days of award of this Contract, the Contractor will present to the County’s Program Manager an updated draft of the implementation/transition plan submitted with Contractor’s proposal. County and Contractor shall meet and mutually agree upon an education strategy. The Contractor shall develop an education plan and communication materials for introducing the new program services for the Plans, including communication of any new investment offerings. The Contractor will be required to provide initial implementation services prior to the Contract Effective Date. The Contractor will not receive any fees under this Contract, other than any agreed upon startup or implementation fees, until the Contract Effective Date.

B. Implement Transition: Within fifteen (15) calendar days of the Contract being approved by the

County Board of Supervisors, the Contractor shall begin transition and start-up of the Plans’ current account balance records to its system. On that date, the Contractor shall also begin the approved transition and start up communication and education program that resulted from the submission of the draft implementation/transition plan required in the paragraph above. The Contractor shall:

1. Provide all requested advice and counsel to the County during the period before the Contract

Effective Date. The Contractor will also prepare a final draft of a detailed implementation/transition plan and project schedule outlining all the steps necessary to set up participant data records, create interfaces with County payroll, and establish enrollment and reconciliation procedures for data and trust/custody/investment accounts.

2. At least thirty (30) calendar days before the Contract Effective Date, Contractor’s customer service telephone line must be staffed with a sufficient number of qualified customer service representatives to answer participant questions about the changes.

3. Communicate changes to Plan participants. Introduce any new investment options, new services, new pricing, the process by which any existing funds will be transferred to comparable investment options, and how participants may select among any new investment options made available under this Contract.

a. The Contractor shall, during the three (3) months before the Contract Effective Date, conduct a full schedule of group meetings to announce the changes to the Plans and assist participants in making any changes necessitated by Contractor’s provision of services. The Contractor must provide educational personnel qualified to provide comprehensive information on the Plans, record keeping and administration, and any changes to the investment lineup and investment mapping agreed to between the Contractor and the County (if applicable). The meetings should also provide an abbreviated explanation of the basics of investing, including investment

RFP # 017-202406-MC

HRA Plan Administration and Investment Services concepts and investment risks and returns and how the Plans’ options fit on the risk/return continuum. During this introductory communication phase, there must be at least 150 group meetings conducted at approximately fifty (50) worksites within the County to maximize the opportunity for all employees to attend. Meetings shall be in-person and virtual, with recorded sessions to be made available for on demand viewing by participants.

b. The Contractor shall also be available to conduct individual meetings to provide more detailed information on any new investment options, the fund mapping process, and assisting participants with selecting appropriate investments using risk profiling and/or similar educational tools. It is expected the Contractor will conduct individual meetings at locations in or near various work locations. Meeting times and locations will be as mutually agreed upon between the Contractor and the County.

c. The Contractor will be responsible for the development, production, and mailing of an announcement letter to all plan participants. The letter is intended to communicate, but may not be limited to, changes in plan services or investments and availability of group meetings explaining the changes. Content of the letter shall be subject to the review and approval by the County.

d. The Contractor shall enhance the visibility of the Plans by marketing the program through a publicity campaign, including education materials, such as, newsletter, business card with County Logo, brochures, magnets, pamphlets and email campaigns for all County DC plan participants. Text must be prepared and printed by Contractor, subject to review and approval by the County. Contractor will utilize its full line of professional materials including posters, business cards, brochures, magnets, information cards, and emails. Contractor shall make materials available for posting on the County’s website upon request. These materials will be customized to fit the County’s needs.

4. Within the first thirty (30) days after approval of the Contract by the County Board of Supervisors, the Contractor will prepare and submit to the County’s Program Manager an educational plan for the initial and ongoing training of County staff. Such training will be delivered to personnel as designated by the County. The training program must give each County staff member the information needed to accurately disseminate information to participants. This training must, at a minimum, include information on:

a. Plan provisions and legal requirements;

b. Plan administration requirements, including the Contractor’s administrative operations;

c. Investment concepts; and

d. Details on the investment offerings provided by the Contractor.

5. Transfer participant account and records to Contractor’s recordkeeping system. By the Contract Effective Date, the Contractor shall have completed conversion of participant account balances to its recordkeeping system. In particular, the Contractor shall be required to do the following:

a. Work with the prior record keeper and any independent auditor retained by the County to verify all existing account records and effect the timely transfer of participant records as of the Contract Effective Date;

b. Take possession of the current participant files (magnetic tape, electronic transmission, etc.)

from the current contractor;

RFP # 017-202406-MC

HRA Plan Administration and Investment Services

c. Establish participant master files and convert all participant accounts to the Contractor’s recordkeeping system;

d. Make the transfer of current investment contracts, participant balances, and conduct any mapping of participant balances into any new investment options as agreed to with the County;

and

e. On the Contract Effective Date, begin to accept participant contributions on a bi-weekly basis according to the County’s twenty-six (26) payroll cycles.

C. Claims Administration

Contractor [or, acting through its third party claims administrator subcontractor], as Claims Administrator, shall provide Claims Administration services for the HRA program. Contractor will ensure that its current or any future subcontractors engaged by Contractor to provide Claims Administration services shall meet all contractual requirements and performance guarantees as provided for in the Contract and all Attachment and Exhibits. Contractor shall monitor its subcontractor’s services and submit reports to the County. County shall also have the ability to review any subcontractor’s performance at County’s sole discretion.

Claims Administration services shall include, but not be limited to, the following:

1. Establishment and maintenance of each Participant’s HRA Account in accordance with The

County of Orange Health Reimbursement Arrangement Plan Document.

2. Adjustment of each Participant’s HRA Account for contributions, earnings, losses and administrative costs. The County will determine the frequency by which HRA Accounts will be adjusted, as can be accommodated by Contractor, provided that adjustments are made no less frequently than annually. Contractor shall make adjustments to each Participant’s HRA Account in accordance with its normal business practices and consistent with reasonable industry standards. Asset and account administration fees will be charged to each Participant’s HRA Account on a quarterly basis, based on the balance in the account on the last day of the previous quarter.

3. Claims Payment

a. Claims Administrator shall pay all Retired Participant, Spouse and Covered Dependent claims that meet the Qualified Medical Expense criteria.

b. County and Claims Administrator shall have discretionary authority to administer and interpret all claims, including the full discretionary authority to determine eligibility for Benefits under the Plan; provided, however, that discretionary authority for final claims determinations shall rest with the County.

c. Benefits under the Plans will only be paid to the extent the claimant Retired Participant, Spouse or Covered Dependent complies, in addition to the other requirements of this Plans, with the claims administration procedures established from time-to-time in writing by County or Contractor. At a minimum such claims administration procedures will require submission by the claimant of a written claim form (signed under penalty of perjury), proof of payment, and sufficient back up materials regarding the claim in order for County or Contractor to substantiate the claim.

d. Approved claims will be paid to the Retired Participant as soon as possible following the

RFP # 017-202406-MC

HRA Plan Administration and Investment Services

County’s or Claims Administrator’s approval. Reimbursement payments under the Plans shall be made directly to the Retired Participant.

4. Claims Review Procedures

a. If the Claims Administrator denies a claim, the Claims Administrator shall provide a written denial notice to the Retired Participant. The notice shall be written in a manner calculated to be understood by the claimant and shall set forth (i) the specific reason(s) for the denial; (ii) specific references to the pertinent Plan or administrative provisions or procedures on which the denial is based; (iii) a description of any additional material or information necessary for the claimant to perfect the claim and an explanation as to why such information is necessary; and (iv) an explanation of the Plan’s claims procedure.

b. After receipt of a written denial notice, the claimant shall have sixty (60) days to appeal the claim denial to the Claims Administrator. The claimant or his duly authorized representative may (i) appeal upon written notice to the Claims Administrator; (ii) review pertinent documents; and (iii) submit issues and comments in writing.

c. A decision by the Claims Administrator will be made no later than sixty (60) days after receipt of an appeal, unless special circumstances (in the opinion of the Claims Administrator) require an extension of time for processing, in which event a decision should be rendered as soon as possible, but in no event later than 120 days after such receipt. The decision of the Claims Administrator shall be written and shall include specific reasons for the decision, written in a manner calculated to be understood by the claimant, with specific references to the pertinent Plan provisions on which the decision is based.

5. Run-Out Claims Processing

a. Claims Administrator shall process and reconcile all claims submitted during any run-out period at the end of the contract term.

D. Account Management

1. Contractor shall:

a. Provide a cohesive, dedicated and responsive account management team that is experienced in services similar to County’s, trained in the County’s plan issues, accessible to the County geographically, focused on proactive and efficient management of the program service and with sufficient capacity and authority to respond to the County’s issues in a timely manner.

b. Provide an Account Manager as the primary point-of-contact for day-to-day communications with the County and have an Account Assistant Manager and back-up plan when the primary person is unavailable.

c. Provide an escalation process to assist in matters that are unable to be resolved at the account team level.

d. Provide the County Program Manager thirty (30) days advance notice of any planned change in Contractor’s primary Account Manager.

e. Provide the County Program Manager the right to interview and agree to the Contractor’s

RFP # 017-202406-MC

HRA Plan Administration and Investment Services intended replacement of the primary Account Manager. The County shall provide written or verbal approval of all proposed replacements.

f. Provide access to an electronic tracking and resolution log of the County issues.

g. Provide documentation of a process for prompt issue resolution in the event of a failure to perform a required service.

h. Attend teleconferences and in person meetings as requested by the County, quarterly and annual program reviews on site as requested at the County to review Plan benefit performance, programs, financial results and servicing of the County’s account, and be available for service questions on any business day that Contractor’s office is open.

2. Each individual of the account management team assigned to the County will have at least two years’ experience in HRA or similarly related services, and will be available to County during normal business hours. In the event the primary account manager is not available, County is to have a back-up contact person with a guaranteed return call guarantee within one business day.

3. Contractor shall administrator the HRA in accordance with IRS regulations.

4. Contractor shall ensure its record keeping is complete and thorough and in compliance with all required rules and regulations. Contractor shall keep accurate records that meet the following minimum requirements:

a. Maintain a consolidated database that shows, at any time, the daily valuation of each Participant's account.

b. Maintain a database listing all statistics related to bi-weekly data transmissions and cash transfers from the County.

c. Maintain a database and supporting records substantiating all Participant contributions and claims payments.

5. Contractor shall maintain daily information associated with a Participant’s account including, but not limited to, investment balances, contributions, transfers, claim reimbursements, earnings, administrative costs, investment elections, current address, beneficiary designation(s), and any other information necessary for the proper administration of a Participant’s account. Regarding the valuation of a Participant’s account, the Contractor will adhere to the following:

a. Amounts will be valued at their net asset value as of the close of each business day, and/or in accordance with any applicable contract with a mutual fund Contractor or in accordance with the fund prospectus.

6. Contractor shall maintain records relating to individual Participants and a database shall be kept, which at a minimum, shall include the following fields for active and inactive Participants:

a. Name

b. Date of Plan entry

c. Date of birth

d. Date of hire

e. Contribution amounts

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HRA Plan Administration and Investment Services

f. Claim activity

g. Bargaining Unit that the Participant works for

h. Home address and telephone number

i. Social security number

j. Personal identification number (PIN)

k. Spouse and Dependent -- Contractor shall be the primary record holder of t h e spouse and dependent designations.

7. Contractor shall develop a system for correcting erroneous contributions or claim payments.

Any errors made by the Contractor shall be corrected, at its expense, so that the value of the Participant’s account is not less than it would have been had the error not occurred.

Contractor shall adjust Participant’s account retroactively if the Participant notifies Contractor within ninety (90) days following the quarterly statement end date. Such system shall provide for prompt repayment or credit of any refunds within fifteen (15) business days following the date on which the reason for such refund or credit is brought to the Contractor’s attention by the County. In the event of an error made by Contractor, and as a direct result, a loss is incurred by the participant (or a gain was not received), Contractor will adjust the account retroactively in accordance with any applicable U.S. Securities and Exchange Commission (SEC) standards and requirements consistent with the Contractor’s error correction policy, unless the Contractor and County mutually agree that an exception to the Contractor’s policy will apply in a given instance. Contractor will correct the transaction and the account will be made 100% whole.

8. Contractor shall issue quarterly Participant statements of accounts. Statements are to be mailed by the Contractor to Participants’ home addresses (or to County location(s) at the direction of the County) no later than the agreed upon date. Statements shall include, but not be limited to, the following information:

a. Participant’s name and address.

b. Beginning and end balances for the quarter.

c. All activity for the quarter including claims payments, transfers, contributions, earnings/losses, and administrative costs all detailed by investment choice.

d. Year-to-date information on contributions and claim reimbursements as well as the totals for a Participant since he/she became eligible.

e. Individual Participant investment performance.

f. Participant fees

g. General Plan-related messages provided or agreed to by the County.

h. Results of all investment options for the quarter, the last year, and the last three (3), five (5), and ten (10) years, if applicable, and compare to the appropriate benchmarks, as agreed upon with the Program Manager.

9. At the request of County, Contractor shall be available to participate in all of County’s open enrollment meetings and health fairs throughout the year up to a maximum of twenty-one (21) meetings per calendar year. Attendance and promotional materials shall be provided by Contractor as part of the base administrative fees and will be provided at no additional charge to the County.

RFP # 017-202406-MC

HRA Plan Administration and Investment Services

10. Contractor shall provide enrollment support specific to the County‘s plan design and will continue to support the County’s electronic file for enrollment of Participants as part of the base administrative fees and are provided at no additional charge to the County.

11. Contractor shall forward the quarterly account management satisfaction surveys/score cards within thirty (30) days of the preceding quarter for evaluation by the County. The survey and scoring methodology shall be mutually agreed upon prior to contract finalization.

12. Contractor shall ensure that it complies with all HIPAA Security, Portability and Privacy requirements. In addition, Contractor shall ensure that any of its subcontractors providing services to the County under the Contract shall comply with all HIPAA Security, Portability and Privacy requirements.

13. Contractor shall cooperate with the Program Manager and other County officials to establish administrative rules for the operation of the Plan, including enrollments, address changes, contributions, transfers, and claim reimbursements. The Contractor will prepare and publish a comprehensive administrative manual that includes the administrative rules described in the first sentence of this paragraph as well as all legal and tax requirements.

14. Contractor shall notify the County within thirty (30) days of purchase, acquisition, and any other change in its ownership or partners or control affecting 10% or greater interest, any acquisition by it of 10% or greater interest in any subsidiary, and any new agreement with, by, or between any affiliates that is relevant to the contract.

15. No services provided, under the Contract, by the Contractor or subcontractors to the County may be provided offshore.

E. Investment Services and Trust Administration

Investment Services

1. Contractor shall provide investment options, as available, to the County for consideration throughout the Term of the Contract or at the County’s request. County shall have the sole discretion to make the final determination of which investment options shall be made available to Participants and may elect to make fund changes at any time throughout the Term of the Contract.

2. Contractor shall offer Participants all investment options authorized by County as stated above.

3. Contractor shall set up all necessary investment accounts and contracts required for the operation of the investment choices to be offered.

4. Contractor shall record all contributions and investment allocations.

5. Contractor shall accept contribution information in a manner compatible with the County’s payroll system(s). County will be submitting contribution data on a twenty-six (26) payroll cycle basis.

6. Contractor shall transfer funds it receives to the appropriate investment service provider on the same day it receives the funds in good order, as long as the funds are received prior to the deadline. Amounts received in good order later in the day will be processed on the next business day.

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HRA Plan Administration and Investment Services

7. Contractor shall compute the amount of transfers between investment options, adjust the amounts allocated to each investment option, and make these transfers on the day instructions are received timely and in good order from the Participant.

8. In the event of a change in investment value, between the time contributions should have been invested and the time it is ultimately invested, if the investment value has increased, and the Contractor caused the suspense item to occur, the Contractor must pay the difference between the initial contribution amount and the price of the investment when it is actually purchased. In the event the investment value has gone down, the entire initial contribution amount will be utilized to purchase the investment at its current price so that there is no gain to the Contractor. The Contractor will maintain and report to the County a monthly suspense account balance reflecting all unpaid and uncleared transactions with corresponding occurrence dates. The Contractor is not responsible for errors made by Participants or the

Trust Administration

9. On behalf of County, Contractor will open and maintain an Internal Revenue Service Code

Section 501(c)(9) or Section 115 trust account, and hold, or instruct the trustee to hold, in such accounts all cash, securities, and certificates of ownership initially deposited plus any additional cash, securities and certificates of ownership that may be received from time to time for the account.

10. Contractor shall keep accurate books and records detailing all investments, receipts (including all investment income), expenses, disbursements and other transitions relating to the account. Contractor shall maintain records of all transactions, including all historical cost basis information, and provide reports required under the Contract and the applicable trust contract based on those records. Such reports shall include all information necessary for the preparation of any applicable government or other required filings.

11. Contractor shall conduct all necessary transactions, including the buying and selling of securities and making deports and withdrawals from investment accounts upon the instructions of authorized parties. As necessary, Contractor shall establish daily interfaces with all investment managers and funds and the record keeper.

12. Contractor shall accrue and pay all authorized Plan expenses in accordance with the applicable Plan document and trust/custody agreement.

13. Contractor shall conduct all necessary activities to register all securities and shareholder accounts and vote all proxies and tender offers received in accordance with the applicable trust agreement.

14. Contractor shall provide County a monthly statement of account of the inventory of all the assets in each account, all activity during the previous month, and the market value of all the assets in the account. Contractor shall also provide such other reports as County may reasonably request, including reports to the County Auditor-Controller or its authorized agents. Contractor shall also provide a monthly summary of transactions, including the payment of benefits and expenses from the Plan.

15. Contractor shall ensure that all custody activities and transactions are in compliance with the provisions of applicable Plan document and trust agreements and do not jeopardize the tax status of the Plan.

16. Contractor shall prepare all report documents necessary to meet trust reporting requirements

RFP # 017-202406-MC

HRA Plan Administration and Investment Services and ACFR requirements in accordance with GASB and Federal/State requirements.

17. Contractor shall provide assistance with preparation and maintenance of trust document.

F. Participant Services

1. Contractor will design and print literature and prepare communications material at no additional cost to the County or Participants, such as brochures, posters, presentations, webinars, and any other materials needed for use in educating eligible employees regarding all aspects of the Plan (including investment education, investment performance, investment selection based on risks and returns, and claims processing information), and, with prior written approval of the County, distribute and present this information in an accurate and clear manner at no additional cost. In each instance, the Contractor shall fully disclose to each employee all of the Plan features and costs. Communications may be delivered electronically based on participant communication preferences.

2. Contractor will create and, after receiving written approval of the County, publish (print and/or electronic) easily understood Plan self-enrollment materials at no additional cost to the County or Participants, which can be used by Participants. Enrollment material must include promotional material, explanatory material (including explanations and notices required by law), and enrollment forms, subject to the County’s approval. The Contractor will act as the County’s agent with regard to the Plan’s enrollment agreements.

3. Contractor must print enough of the materials to ensure that there is an adequate supply of all materials. The Contractor must revise publications when necessary due to changes in investment options, Plan rules/procedures, or other changes. There may also be new forms or communication pieces that must be prepared by the Contractor as the result of federal or state legislation affecting the Plans and the Contractor may also be required to produce additional publications as required by the County.

4. Contractor will be available to assist employees with the completion of enrollment forms or online applications and verify the completeness of such forms, applications or other enrollment documents. Contractor must also be staffed to provide enrollment counseling to employees who wish to discuss Plan participation in person or over the telephone. A supply of self-enrollment packages must also be provided to the County to be made available at various work locations.

5. Contractor will develop literature to communicate Plan changes when they occur, at no additional cost to the County, and upon receipt of advance written approval of the County, distribute the literature to each appropriate County Office with a request that it be distributed to eligible Participants.

6. Contractor will distribute:

a. investment performance information;

b. an investment newsletter; and

c. pertinent articles in each Participant's quarterly Statement of Account at no additional cost. The articles shall include, but are not limited to, updates on the Plan, investment trends, and any applicable legislative updates.

RFP # 017-202406-MC

HRA Plan Administration and Investment Services

7. Materials developed by the Contractor must be submitted to the County for final review and editing and the County must be given at least two (2) weeks for its review. Publications must present an unbiased approach to investment information and educate Participants about all aspects of the Plan, including investment options offered and performance and claim reimbursements. Contractor must provide adequate quantities of materials to keep in different work locations. The Contractor must also respond to Participant’s requests for publications and mail them to the Participant address of record.

8. Contractor must maintain an adequate supply and distribute mutual fund prospectuses to Participants.

9. Contractor shall provide Participant toll-free telephone access to Contractor’s customer service to:

a. receive claim, account and investment option information;

b. conduct transactions related to a Participant’s account; and

c. receive requests for forms, sales literature, prospectuses, and other written information between 8:00 a.m. and 5:00 p.m. Pacific Time. Contractor’s customer service representatives shall be capable of assisting Participants in accessing information about HRA planning, in general, and the County’s Plan, specifically. The customer service representatives will help Participants understand the educational materials the Contractor makes available to help employees make decisions about how to direct their investments given their particular situation.

10. Contractor shall provide Participant toll-free telephone access to a Interactive Voice Response

(IVR) System twenty-four (24) hours a day, seven (7) days a week, excluding scheduled maintenance, in order to: i) receive account and investment option information; ii) conduct transactions regarding a participant’s account; and iii) request written information. Specific information and transactions which will be available via touch-tone telephones on this service shall be as follows:

a. Current total account;

b. Current balances of each investment option selected by a participant;

c. Current interest rates on the stable value investment option;

d. Current net asset values;

e. Current investment allocation information;

f. Ability to transfer balances from one investment option to another;

g. Ability to change the investment allocation of future contributions; and

h. Ability to request fund prospectuses or other informational brochures.

11. Contractor will maintain an adequate number of staff to provide the required information and services directly to County Participants. Contractor shall ensure that people with limited English proficiency and those who are deaf or hearing impaired have access to communication services that enable Participants to utilize the phone lines.

12. Contractor will be required to conduct a reasonable level of group meetings so that all employees at the different locations within the County will have an opportunity to learn about the Plans. The meetings must be held at different locations and at different times of the day to ensure that all interested employees are able to attend. A list of the locations of the various County employment locations, with approximate numbers of eligible employees, will be

RFP # 017-202406-MC

HRA Plan Administration and Investment Services provided by the County. These seminars and meetings will also be provided through web-based recordings. These seminars and meetings will be provided on a monthly basis via live, web-based presentations (e.g., “webinars”) and via electronic-based group meeting technologies such as WEBEX or other technologies available.

13. Contractor shall provide a minimum of two (2) HRA plan specialists dedicated to the County’s Plans to provide ongoing educational seminars, both in-person and virtual, as well as meet with participants on a one-on-one basis.

14. Contractor will record all telephone conversations between service representatives and

Participants, including claims representatives if separate from that standard service representatives. Recordings will be made available to the County upon request.

15. Contractor shall design and maintain a secure, custom website for the Plan (custom URL), available 24/7/365, and distribute information via the Internet. The website must offer the following information and services to Participants:

a. The following specific Participant information services:

Claim status;

Claim denial appeal status and process;

Current account total;

Current balances of each investment option selected by a Participant;

Current performance on all investment option(s);

Current net asset values;

Current investment allocation information;

Transfer of balances from one investment option to another; and

Change the investment allocation of future contributions.

b. Planning for retirement health expenses information and tools, including an interactive planning module that allows Participants to enter their personal financial data and then project a variety of “what if” scenarios, and information about age and income-appropriate portfolio structures;

c. Asset allocation questionnaire that will, based on a Participant’s response to several questions, propose an appropriate allocation of investments.

d. Information regarding all the investment options available in the Plan:

Historical net return information for the last month, the last quarter, calendar year-to-date, the last year, the last three (3) years, the last five (5) years, and the last ten (10) years;

Historical fee information, including management fee information and all other investment expenses;

Volatility information;

Investment style description in layman’s terms;

Profile of fund manager and his/her tenure in the job; and Fund prospectus or informational brochure.

e. Information regarding the Contractor’s procedures for the following:

When are investment election changes made by the record keeper?

When are changes in contribution allocation made by the record keeper?

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HRA Plan Administration and Investment Services

Are there any limits on Participant changes or transfers?

f. Educational Webinars and web-based investment and financial planning tools including, but not limited to, investment information, schedule of seminars, links to specific County documents and local representative contact information.

16. Contractor shall develop and use alternate ID numbers for Participant identification in a format and style approved by County.

17. Contractor shall provide annual Participant-specific satisfaction surveys with a statistically valid sample size that includes Participants that have utilized services from call center Customer Services Representatives and the Internet. County shall be able to customize this survey at no additional charge.

18. During the Term of the Contract, additional collective bargaining units may be added to the Program. In the event this occurs, the Contractor will be required to assist in the implementation, which may include, but not be limited to, group meetings, communication materials etc. These services shall be provided at no additional cost to the County or Participants.

19. Contractor will meet monthly during the first year of the Contract and quarterly thereafter throughout the Contract Term with the County and any officials of any subcontractor that the Contractor or the County may deem necessary to have present who are involved with the Plans, for the purpose of reviewing the Plan’s educational/communication status, resolving any problems, and discussing any relevant issues. The times and locations of the meetings shall be as specified by the County. The County shall have the right to call unscheduled special meetings from time to time as circumstances and needs dictate, and the Contractor is obligated and agrees to be present and prepared to deal with issues appearing in the agenda for such meetings that the County shall supply to the Contractor sufficiently in advance to allow for the assembly of response or presentation materials.

G. Recordkeeping

1. The Contractor will keep accurate records that meet the following minimum requirements:

a. Maintain a consolidated database that shows at any time the daily valuation of each participant's account.

b. Maintain a database listing all statistics related to bi-weekly data transmissions and cash transfers from the County.

c. Maintain a database and supporting records substantiating all participant contributions and claims reimbursements.

d. The Contractor shall maintain Participant and the Plans’ records as follows.

i. Maintain daily information associated with an participant’s account, including but not limited to account balances, investments, contributions, claims paid, earnings, administrative fees, investment elections, current address, beneficiary designation(s), and any other information necessary for the proper administration of a participant’s account. Regarding the valuation of a participant’s account, the Contractor will adhere to the following:

Amounts that are not guaranteed as to principal or interest will be valued at their net asset value as of the close of each business day, and/or in accordance with any

RFP # 017-202406-MC

HRA Plan Administration and Investment Services applicable contract with a mutual fund Contractor or in accordance with the fund prospectus.

Plan assets invested in the stable value option shall be valued at book value, unless otherwise required by generally accepted accounting principles. Interest shall be accounted for on a daily effective method, in accordance with the contract with the County and stable value investment option providers.

ii. Records relating to individual participants will be maintained by the Contractor, and a database shall be kept which, at a minimum, shall include the following fields for all active and inactive participants:

Name Date of Plan entry Date of birth Date of hire Date of rehire, as applicable Contribution amounts Participant’s Bargaining Unit Participant’s Department Code Home address Mailing address Email address (work and personal) Telephone numbers (home, work, mobile) Social security number Employee ID number Employment status (active, leave, etc.)

Benefits eligibility Personal identification number (PIN) Beneficiary(ies) - Contractor shall be the primary record holder of beneficiary designations and conduct re-solicitation of beneficiary designation(s) every three

(3) years.

From time to time during the term of the Contract, the County may conduct an audit of the Plans. The Contractor will reimburse the County, in accordance with the terms outlined in the fee section of this Contract, for an audit of the Plans every two years.

The audit shall be conducted by an independent certified public accounting firm, which firm shall be subject to the approval of the County.

2. Contractor will not modify any operational process during the Term of the Contract without the prior notification of the County, as well as approval by County for any County specific processes.

3. Upon termination of the Contract Term, Contractor shall provide data to succeeding contractor or the County, as directed, including all necessary data and information, except direct deposit information, including but not limited to claims data and patient profiles to ensure an orderly transition, at no additional charge to County. Contractor shall provide up to two files for historical paid claims and open claims, respectively, within 30 days of the termination of the Contract and deliver all records, accounts of operation and claim files to

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HRA Plan Administration and Investment Services

4. Contractor shall accept electronic data transfer and administer membership information in compliance with HIPAA standards for privacy, security and electronic data interchange.

5. Contractor shall provide on-line, unlimited eligibility updating and entry capabilities for authorized County staff. Subject to applicable laws, rules and regulations relating to privacy and confidentiality, Contractor shall provide County’s Benefits Administrator with on-line access to read County’s eligibility information.

6. Contractor shall receive from County, on a biweekly basis, an eligibility file of eligible County

Participants through a Secure File Transfer Protocol (SFTP) feed.

7. Contractor shall notify County or its designee, prior to the eligibility update application, of any material errors or coding problems on the eligibility file that exceeds agreed upon thresholds.

8. Contractor shall notify the County immediately, or as soon as administratively possible, upon identification of system-related problems, programming or data transfer problems. The Contractor shall make every effort necessary to correct such problems within 48 hours, regardless of the time or date, in order to minimize any disruption to Participants.

9. Contractor shall maintain complete records of all claims and payments for a minimum of six years or greater as required by law. At the end of the six-year period, records shall either be transferred to the County or destroyed under the County’s direction, unless further retention is otherwise required by law.

10. Contractor shall provide necessary data files to respond to government requests or respond to class action lawsuits without additional fees for the length of the contract. Such services shall be provided at standard programmer bill rates as defined by the County after the contract has termed.

11. Contractor shall maintain duplicate or back-up computer data files for the Plans in a place of safekeeping. All computer data files of the Plans, as maintained by the Contractor, shall at all times remain the property of the County; notwithstanding the fact that such records may be stored upon or within one (1) or more computer or data retention systems owned, operated, or leased by the Contractor. The County or its representatives shall, at all reasonable times, have access to the records. To the extent that any such records are to be maintained upon a computer system or any other data retention system which is not owned by the Contractor, the Contractor will provide the County with assurances from the owner of such computer facilities, satisfactory to the County, of the continued availability and security of such records at all times.

12. Contractor shall provide the County access to all back-up source materials, reports, books, records, computer programs, and all other information and documentation relating to the Plan, as reasonably required so that the County and/or its designated officers, agents, and accountants, can conduct a financial examination and/or audit of the Plan as requested by the Program Manager. "Access", for the purposes of this paragraph, is defined to include the Contractor's copying records and delivering them to the Program Manager or other electronic delivery agreed to by the Program Manager.

13. Contractor shall provide County support staff on-line access to information on the

Contractor’s recordkeeping system for inquiry and ad-hoc Plan reporting purposes. County staff must be able to obtain Participant account balance information, including the Participant’s recent contributions, claims payments, and other transactions, on an inquiry only

RFP # 017-202406-MC

HRA Plan Administration and Investment Services basis. Staff must also be able to run ad-hoc financial and other data reports for internal use, via easy-to-use report generation. The County will take the necessary steps to enforce password and other security requirements to restrict unauthorized access.

H. Reporting

1. Contractor, itself or by subcontractor, shall collect and report statistics and/or summaries on a monthly, quarterly, and annual basis as specified and as requested by the County. The reports may be standardized reports provided by the Contractor. If any services are subcontracted, reports shall also include subcontractor’s statistics. If the reports do not adequately meet the County requirements, the Contractor shall customize the reports to the County‘s specifications as part of the base administrative fees with no additional cost to the County.

The County’s requirements may change from time to time during the Term of the Contract.

2. Contractor shall provide a financial and program reporting package to County on a monthly basis. These standard reports will include Plan performance and financial information as required by County.

3. Contractor shall provide annual reports to County, as follows:

a. Annual Activity Report: A cumulative Plan year statistical report delivered during the

Contract Term to parties identified by the County within thirty (30) days after the end of each Plan year. If the Contractor fails to deliver the Annual Activity Report within the specified time period, the Contractor will pay the County $500 per day.

b. Annual Financial Statement: The Contractor will provide the County with the Plan’s annual financial statements and information to ensure the County and/or its independent accounting firm is able to audit the Plan in accordance with generally acceptable accounting principles and GASB requirements. The summary financial reports as specified by the County will be provided within fifteen (15) days after the end of the County’s fiscal year. The Plans’ Annual Financial Statements will be provided to the County within forty-five (45) days after the end of each Plan year, in a quantity required by the County. If the Contractor fails to deliver the plans’ fiscal year and annual financial statements within the specified timeframe, the Contractor shall pay the County a $500 per day penalty.

c. Annual Reports to Participants and Management ("Stakeholder's Report"): If requested, the Contractor will work with the Program Manager or his/her designated representative to create an Annual Report to Participants and Management (the “Annual Stakeholder's Report”) that will be produced by the Contractor and delivered to the County within forty-five (45) days after the end of the Plan year. The Stakeholder’s Report will include information from the Annual Activity Report and the Annual Financial Statement as well as a description of the then-current investment options available to Participants and any significant Plan changes that occurred during the Plan year. The Annual Stakeholder's Report will be distributed to Participants and senior management of the County.

d. Contractor's Annual Audit: The Contractor will deliver to the County its annual audit prepared by an independent certified public accountant. Contractor’s annual Audit must be delivered to the County within one hundred and eighty (180) days of the end of Contractor’s fiscal year.

e. Annual SOC 1 and SOC 2 Reports: Contractor will provide the County’s Program Manager with a copy of Contractor’s Statement on Standards for Attestation Engagements

RFP # 017-202406-MC

HRA Plan Administration and Investment Services audit at least annually.

f. Annual Cybersecurity Report: Contractor updates, enhancements and issues associated with cybersecurity protocols and protections. Contractor shall report any data breaches as soon as publicly available following any occurrences, including any impact on the County’s Plans and participants and a remediation plan.

g. Trust Fund Reports: Contractor will provide all necessary reports to meet Trust Fund reporting requirements. The format shall be mutually agreed upon by Contractor and County Program Manager.

h. Annual Affordable Care Act (ACA) Report: Contract will provide all necessary information to meet the County minimal essential coverage reporting of the HRA under

ACA.

4. Contractor shall abide by the following data requirements:

a. Data shall be submitted electronically and by hard copy as requested, according to agreed standards.

b. Data made available electronically shall conform to HIPAA data exchange standards once finalized.

c. The minimum data elements to be provided, where applicable, shall include, but are not limited to, the following: participant’s name, participant’s date of birth, the County identification, claim valuation amounts, denial reason.

5. The Contractor shall provide County with access to a data management/reporting tool, with access provided to the Consultant identified by County. The tool will be provided as part of the base administrative fees with no additional charge to the County.

6. Contractor shall provide four user IDs to access the web-enabled on-line reporting tools as part of the base administrative fees with no additional charge to the County.

7. Contractor shall offer comprehensive onsite or web-based training for the on-line reporting tool as part of the base administrative fees with no additional cost to the County.

I. Deliverables

In addition to the requirement of the Contractor to perform the services and provide the materials listed in the Scope of Services above, the Contractor will also deliver the following to the County’s Program Manager in the manner and on the time schedule shown below in each item:

Within one (1) month of the Contract Effective Date, the Contractor will produce and publish a comprehensive administrative manual that includes the administrative rules established by virtue of the operation of this Contract, as well as all legal and tax requirements.