Attachment A - Vision Ins Questionnaire.xlsx
XLSX spreadsheet 26 KB Posted
- Attached to
- Vision Insurance for District Employees
- Solicitation number
- ITB-13230
- Issued by
- Polk County, Florida
About this file
Attachment A is a Vision Insurance Questionnaire from the St. Johns River Water Management District (SJRWMD) seeking quotes for a fully insured vision insurance plan. The district is requesting electronic responses by 2:00 p.m. on July 18, 2025, with an evaluation and ranking process scheduled for August 4, 2025, and potential oral presentations between August 11-13, 2025. The contract will cover vision insurance for 510 professional, administrative, and technical staff across multiple service centers in northeast and east-central Florida, with an effective date of January 1, 2026. The contract term is anticipated to be two years, from January 1, 2026, through December 31, 2027, with potential annual renewal options.
The estimated annual premiums are approximately $42,000, based on current enrollment of 268 participants across various coverage tiers. The current vision insurance provider is EyeMed Vision Care, with 100% of premiums currently paid by employees and retirees. Respondents must meet specific qualifications, including maintaining an A.M. Best Rating of "A-" or higher, demonstrating at least five years of experience in group vision insurance, and possessing an established network of vision care providers. The district is seeking quotes for two plan options: frames every other calendar year and frames every calendar year, with the evaluation focusing on professional service quality, provider network accessibility, and affordable cost structures. There are no explicit set-aside designations or restrictions for disadvantaged enterprises mentioned in the document.
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Text version
Sheet1
| Vision Insurance Questionnaire and Plan Proposal --- Attachment A |
| Please respond and also use this section to add any additional information that you believe SJRWMD should know about either your company or your service delivery model. If additional space is needed, use additional pages as necessary. |
| Item | ||
| Enter Respondents Firm's Name: | ||
| SECTION I: Organization, Experience and Qualifications | ||
| QUESTION | Firms Response |
| 1.01 | Legal Company Name |
| 1.02 | Year Established/Incorporated |
| 1.03 | Describe your organizational structure (an organization chart may be included under Tab 2). |
| 1.04 | Identify the location(s) where employees will be assigned to provide services described in this Quote Request (provide full address). |
| 1.05 | Identify the location(s) of Respondent's principal office (provide full address). |
| 1.06 | Provide Respondent's website address. |
| 1.07 | Are you authorized to do business in the State of Florida? |
| 1.08 | Indicate your current financial rating. |
(Insurance Carrier must have a minimum A.M. Best Rating of “A-V” for financial strength; documentation of the rating must be included under Tab 1).
1.09 Describe your overall qualifications and capabilities in providing group vision insurance.
(Additional documentation may be submitted under Tab 1)
| 1.10 | How many years of experience does Respondent have in administering vision insurance? (Minimum 5 years required) |
| 1.11 | Describe your experience in providing group vision insurance to public entities and why you are the best choice for award of the Agreement. |
(Additional documentation may be submitted under Tab 2)
| 1.12 | Indicate the approximate number of employers in Florida for which Respondent currently provides vision insurance? (Minimum of three public or private entities with more than 300 full-time employees) Similar projects will be used as references. | |
| 1.13 | Describe the Respondent's practices to maintain compliance across all federal and State of Florida insurance department regulatory requirements for all applicable products and services. | |
| 1.14 | What are the business hours for client services? | |
| SECTION II: Customer Service and Technology Capabilities | ||
| QUESTION | Firms Response |
| 2.01 | Who is the designated insurance agent for the Proposal? |
| 2.02 | How many years of experience does the designated insurance agent have with direct client contact handling similar size accounts? |
| 2.03 | List the key personnel and their individual responsibilities on this assignment. |
(Additional documentation may be submitted under Tab 2)
2.04 Briefly describe the qualifications, including experience, certifications, and licensure of the key personnel / project team.
(Brief resumes not to exceed two pages may be included under Section/Tab 2)
| 2.05 | Will the insurer have a carrier representative available to attend Open Enrollment workshops? |
| 2.06 | Describe the types of information aids that Respondent provides to assist in educating employees regarding the group vision insurance. |
(Sample Benefit Information Aids must be submitted under Tab 2)
| 2.07 | Describe the capabilities of Respondent's internet-based client service portal (if any), including: claim reporting, documenting enrollment, claims status, and loss runs. |
| 2.08 | Describe Respondents electronic enrollment process and procedure, including secure transmittal of the Districts' data. Please list provided preferred file type. |
| 2.09 | Will Respondent allow for self-administration of premiums and enrollment through self-directed uploads? |
| 2.10 | Will Respondent provide an "800 number" to call for Customer support? |
| 2.11 | Will Respondent provide financial and utilization reports to the District on a quarterly basis? Is so, provide a sample report under Tab 2. |
| 2.12 | How is Respondent protecting the personal information of covered employees and claimants? |
| 2.13 | In the event of a data breach that resulted from a non-District error, what efforts would Respondent undertake to cover this risk? |
| 2.14 | Please describe the process for assessing and determining approval for a vision claim. |
(Additional documentation may be submitted under Tab 2)
2.15 Please describe your anticipated service strategy for both employer and employees.
(Additional documentation may be submitted under Tab 2)
| 2.16 | Identify the Customer Service location(s) providing services described in this Quote Request (provide full address). |
| 2.17 | What are the business hours for client services? |
| 2.18 | Describe Respondent's process for resolving complaints from covered employees/claimants. |
(Additional documentation may be submitted under Tab 2)
2.19 Describe Respondent's process for resolving service concerns from the District.
(Additional documentation may be submitted under Tab 2)
2.20 Does the Respondent offer guaranteed levels of service? If so, please describe.
| SECTION III: Plan Design - Cost Containment and Management Strategies | ||
| QUESTION | Firms Response |
3.01 Identify how Respondent is able to meet all the principal areas defined in this Quote Request's Scope & Purpose.
(A written statement may be included under Section 2)
| 3.02 | Is Respondent willing to meet current eligibility timelines for employee coverage (1st day of the month following 30 days of employment)? |
| 3.03 | Respondent must confirm that no employee will lose coverage simply because of a change of carriers/administrators. This applies to all contracts, all plans, etc. |
| 3.04 | Is Respondent agreeable to an "actively-at-work" waiver, where all active employees (as deemed by the District) will be eligible for insurance regardless of whether they are actively-at-work? |
| 3.05 | Is Respondent proposing any deviations from the Policy Requirements set forth in Section V of the Scope & Purpose? |
| 3.06 | Note any additional coverage offerings included in proposed plan. |
| 3.07 | Can a member receive an exam from one provider and materials (frames, lens, or contacts) from another provider? |
| 3.08 | Confirm that your proposal does not require an employer contribution to premiums (voluntary only). |
| 3.09 | Describe any mandatory participation levels for the plan and/or rate. |
| 3.10 | Confirm that you will provide electronic copies of plan materials, including SBCs, SPDs, Certificates of Coverage, and other plan materials. |
| 3.11 | Are ID cards required for members to receive covered services or is there a paperless system? |
| 3.12 | How long does it take for members to receive ID cards after enrollment and/or upon request? |
| 3.13 | Provide an Accessibility Analysis of the in-network providers that includes the number of providers, provider types and distance to providers by zip codes from Exhibit 2 (Vision Enrollments). |
| 3.14 | Describe your approach for a successful implementation by the January 1, 2026, effective date. |
| 3.15 | Do you agree to the notice requirements as described in the solicitation? |
| 3.16 | Is there a rate guarantee and for how long? |
| 3.17 | What is the percentage of commission for the designated insurance agent? |
| 3.18 | Confirm that your proposal does not require a minimum deposit or pre-funding requirement. |
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