ATTACHMENT F - Business & Technical Questionnaire - RFP 758 2700000012.xlsx
XLSX spreadsheet 90 KB Posted
- Attached to
- HCM ERP System Replacement - Phase 1
- Solicitation number
- RFP 758 2700000012 3
- Issued by
- Elliott County, Kentucky
About this file
This is a Business & Technical Questionnaire (Attachment F) for RFP 758 2700000012 issued by the Commonwealth of Kentucky's Department of Employee Insurance (DEI) as part of the HCM ERP System Replacement - Phase 1 initiative. The questionnaire serves as the primary evaluation tool for vendor responses regarding the proposed benefits administration and billing software solution, along with associated optional services. The RFP seeks a comprehensive solution to replace legacy systems and support the Kentucky Employee Health Plan (KEHP), which covers state agencies, boards of education, health departments, quasi-governmental entities, and retirement systems. The questionnaire is organized into multiple sections including Benefits Administration (BN), Benefits Accounting (BNA), General Technical (GT), Artificial Intelligence (AI), Systems Integrator services (SI), and optional service offerings for Spending Account Administration, Dependent Eligibility Verification, Call Center Support, and Low Code/No Code capabilities.
The questionnaire contains 206 primary specifications across the core sections, with the majority designated as "Highly Desired" priority requirements. Vendors must respond using standardized definitions: Standard Functionality (SF) for out-of-the-box capabilities, Development Tools (DT) for customizations using delivered toolsets, Future Release (FR) for planned functionality with announced dates, and Does Not Provide (DNP) for unavailable features. Vendors must identify whether responses are provided by the Software Solution Provider (SSP), Systems Integrator (SI), or both, and provide detailed comments supporting their degree-of-fit selections. The specifications encompass eligibility management, enrollment administration, benefits accounting and billing, payment processing, reporting and analytics, workflow management, security controls, integrations with existing state systems (SAP HCM, CGI Finance, ADP, PeopleSoft, Munis), compliance capabilities including ACA reporting, and technical infrastructure requirements including mobile access, data encryption, and multi-factor authentication. Optional service offerings address specialized needs such as health savings account administration, dependent eligibility verification, call center support with defined service levels, and low-code/no-code development platforms to enable Commonwealth staff to build custom applications post-implementation.
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Instructions Attachment F - Business & Technical Questionnaire
| VENDOR - BUSINESS & TECHNICAL QUESTIONNAIRE |
| Instructions: |
In Attachment F (the Business & Technical Questionnaire) the Commonwealth prefers that the vendor responds to each question within this attachment reqarding the requested specifications.
b) Vendor(s) indicate in the column marked “Identify Which Vendor Is Responding” whether the answer to each specification was produced by the SSP, the SI, or both the SSP and SI.
c) For each specification, Vendor(s) respond in the column marked “Degree of Fit,” selecting one of the response options provided and described below.
| This table of definitions will be utilized by the vendor(s) to provide a response to the questions provided in the Business & Technical Questionnaire. | |
| Vendor Questionnaire Response Definitions | |
| Responses | Response Definition |
| SF - Standard (Configurable) Functionality | The proposed software provides the requested functionality without screen, code, or design changes, or any combination thereof. The product can satisfy the specification “out-of-the-box” without any modification to the vendor’s standard baseline software offering. The software may require configuration using supplied configuration options or tools. The Vendor should only use “SF” if the baseline software as delivered in the current release meets the specification “as-is” or through software configuration with minimal effort. |
| In the case of a report, query, or integrations related specification, the Vendor should only use “SF” if there is no development effort associated with meeting the specification (e.g., a standard delivered report). If the user would need to design a query or report to satisfy the specification, that item would be classified as “DT”. | |
| If the product that provides this functionality is a third-party solution, not a component of the proposed ERP software, Vendors should state the name of the third-party software in the “Comments” field associated with the specification and select “Specialty Solution” in the “Solution” column. If there is a cost associated with this third-party solution, that cost must be reflected in the Cost Proposal. | |
| DT - Development Tools | The desired feature or functionality is not available as part of the standard proposed software functionality, but customizations can be made to the standard software utilizing a delivered “development toolset” to satisfy the designated specification and does not require modifications to the system source code. Examples of customizations done using delivered tools might include adding new data fields, changing a field length, creating a query, creating an interface/integration, writing a custom report or modifying a view or screen. |
| A brief explanation is required to support any proposed development. Explanations should be provided in the “Comments” section of the specification’s response, including the name of tool or toolset that is recommended. Development tools can be sourced by the ERP vendor or a viable third-party vendor. The vendor providing, licensing, or providing the development tool service should be clearly described in the “Comments” column. | |
| If the product that provides this functionality is a third-party solution, not a component of the proposed ERP software, Vendors should state the name of the third-party software in the “Comments” field associated with the specification and select “Specialty Solution” in the Solution column. If there is a cost or fee associated with acquiring or licensing this third-party solution, that cost or fee must be reflected in the Cost Proposal. | |
| FR - Provided in Future Release | A future release of the proposed software will provide the requested functionality without screen, code, or design changes. The Vendor should only use “FR” if the future release of the base or third-party software will fully meet the specification and the release date has been publicly announced by the software vendor. |
| A brief identifier/description of the software component, including referenced release, and the expected release date should be included in the “Comments” field associated with the specification. | |
| If this is planned functionality, Vendor should provide the approximate timing of the release. | |
| DNP - Does not Provide | The desired feature or functionality is not available as part of the standard (base or third-party) software functionality, or requires modifications to the system source code, or is a future release item without a scheduled release date. Without modifying the system, the functionality as described would most likely be met by a process workaround or by interfacing to an existing legacy application. |
| If selecting this option, the Vendor should add a comment in the response proposing a workaround or other method/process that could satisfy this need for the Commonwealth. |
Dictionary
| Dictionary of Terms for RFP | |
| Term | Definition |
| 101 KAR 2:102 | https://apps.legislature.ky.gov/law/kar/titles/101/002/102/ |
| 18a.205 | https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50811 |
| 18a.225 | https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=55802 |
| Agency | Entity to which benefit offerings are available to eligible employees; offerings may differ by agency and/or individual eligibility |
| ASO | Administrative Services Only |
| BAF | Benefits Admin Fee |
| BL | Billing Liasson |
| BN | Benefits Administration |
| BNA | Benefits Accounting |
| BOE | Board of Education |
| CA | Cost Allocation |
| COBRA EE | COBRA Employee |
| CoKY | Commonwealth Paid / Commonwealth of Kentucky Paid State Employees |
| COT | Commonwealth Office of Technology |
| CR | Cash Receipt |
| CGI | Commonwealth of Kentucky's Finance System (CGI) |
| DEI | Department of Employee Insurance |
| DHRA | Department of Human Resources Administration |
| DIA | Division of Insurance Administration |
| DTS | Division of Technology Services |
| Dual Employees | Employees who are concurrently, regularly employed with different agencies (e.g. school board and state company) and who meet the benefit eligibility requirements for both employers. |
| EE | Employee |
| EIB | Enrollment Information Branch |
| eMARS | Commonwealth of Kentucky's Finance System (CGI) |
| Employee/Participant | A person employed by or a retiree of an entity participating with KEHP and eligible to apply for coverage under KEHP |
| Entity | Agency for whom benefit offerings are provided to eligible individuals for participation |
| EOI | Evidence of Insurability |
| EOM | End-of-Month |
| ER | Employer |
| ERP | Enterprise Resource Planning |
| Evidence of Insurability (EOI) | Medical history/health condition of the employee and/or dependent in order to qualify for certain life insurance coverage outside of Open Enrollment or a valid QE - See SOH |
| FMB | Financial Management Branch |
| Forced Waiver | When DEI or the solution places someone on a waiver without HRA funds because they are ineligible for other plan types. |
| Group | Group can be used interchangeably with the word agency or entity. |
| HCM | Human Capital Management |
| IC | Insurance Coordinator |
| KPPA | Kentucky Public Pensions Authority (also Kentucky Retirement System (KRS) and County Employee Retirement System (CERS)) |
| LivingWell Promise | A promise from Planholder(s) who elect KEHP plans to take the Health Assessment during the time period allotted. |
| M, HD, D, O | Mandatory, Highly Desired, Desired, Optional |
| MSB | Member Services Branch |
| NMSO/NMSN | National Medical Support Order / National Medical Support Notice is a legal document that ensures children receive health care coverage as part of a child support order. |
| Non-CoKY | Non-Commonwealth Paid; paid by an entity other than the commonwealth |
| OIB | Optional Insurance Branch |
| Optional (Benefits) | Life, Dental, and/or Vision |
| PBB | Premium Billing Branch |
| Plan Codes | A code tied to each plan type and specific plan option |
| Planholder | Legal owner of a benefit policy |
| Plan Types | Benefit or product type such as Health, Dental, Vision, FSA, etc. |
| Quasi-governmental agency | A public entity or entity partially-funded with public funds that is KEHP-eligible under KRS Chapter 18A but not otherwise included as another eligible entity type (e.g., an entity not a state agency, retirement system, etc.). |
| QE (QLE) | Qualifying Event (Qualifying Life Event) - A specific situation or occurrence that enables a Planholder to enroll or terminate coverage outside the designated enrollment period for self and/or eligible Dependents, as a result of that person becoming eligible for or losing eligibility for coverage under this Plan or another plan. Events must adhere to Cafeteria 125 rules and HIPAA special enrollment rights. |
| RTW | Return to Work Retiree - A Retiree who resumes active employment with any employer participating in KEHP. |
| Statement of Health (SOH) | Health questionnaire used by life insurance carrier for Evidence of Insurability (EOI) to be reviewed my carrier's medical review board - see EOI |
| Supplemental | Additional life insurance without employer (ER) contribution |
| Term for Non-Pay | Termination of Benefit(s) for Planholder non-payment |
| TRS | Teachers' Retirement System Kentucky (also referred to as KTRS) |
| Wage Type | A wage type is a specific category or code used to identify and classify different kinds of employee payments or deductions in a payroll system. |
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=55802https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50811https://apps.legislature.ky.gov/law/kar/titles/101/002/102/
BN
| Attachment F | Benefits | ||||||
| Specification # | Category | Subcategory | Question | Priority (Highly Desired or Desired) | (Vendor Response) Identify Which Vendor Is Responding | (Vendor Response) | |
| Degree of Fit | (Vendor Response) | ||||||
| Solution | (Vendor Response) |
Comments BN-100 Benefits Eligibility Describe how the proposed solution would maintain and store eligibility for:
- Active Subscribers, including Retirees
- Dependents, including disabled dependents
- Employees on leave of absence (Military Leave vs other leave types) If leave other leaves > than 13 months automate termination of benefits
- COBRA participant
| - Aging out dependents, ACA Eligible, Court-Ordered Dependents, NMSO (Differentiated), Elected School Board Officials, Board Members, See eligibility in KRS 18A.225, KRS 18A.205. Note: New Business Entities can join at anytime of the year and 1st Day Benefit Coverage or various waiting periods across multiple products and/or groups. | Highly Desired | ||||
| BN-101 | Benefits | Eligibility | Describe how the proposed solution will provide a secure, integrated, intuitive web-based eligibility and enrollment platform for fully and self-insured benefits. | Highly Desired | |
| BN-102 | Benefits | Eligibility | Describe the proposed solution's capabilities to configure eligibility rules based on defined criteria (e.g., transfer or new hire, employee termination, Forced Waiver term for non-pay, all qualifying events, dual employment, hazardous duty, retiree, retiree return-to-work, etc.). | Highly Desired | |
| BN-103 | Benefits | Eligibility | Describe how the proposed solution provides the capability for employees to initiate a qualifying event change including a status change (e.g. position change). | Highly Desired | |
| BN-104 | Benefits | Eligibility | Describe how the proposed solution will track and maintain qualifying events (QEs) as outlined by general statutes and Internal Revenue Code Section 125 for cafeteria plans as part of the enrollment workflow which includes varying the enrollment window based on the enrollment event (e.g., initial enrollment, Retirement, Separation, and type of benefit offering). | Highly Desired | |
| BN-105 | Benefits | Eligibility | Describe how the proposed solution supports the document upload process for qualifying events, including any employee self-service or employer upload functionality. | Highly Desired | |
| BN-106 | Benefits | Dependents and Beneficiaries | Describe the proposed solution's ability to support Dependent Eligibility Verification and provide capablity for users to attach the necessary supporting documentation and track the verification documents to show it has met the necessary requirements for coverage. | Highly Desired | |
| BN-107 | Benefits | Dependents and Beneficiaries | Describe the proposed solution's ability to cancel dependents based on business rules, such as dependent reaching the maximum age limit for coverage or other criteria that would make them ineligible. | Highly Desired | |
| BN-108 | Benefits | Dependents and Beneficiaries | Describe how the proposed solution provides the capability to capture and maintain Beneficiary information (life insurance vs. other benefits) via employee or employer self-service. | Highly Desired | |
| BN-109 | Benefits | Dependents and Beneficiaries | Describe the proposed solution's capability to manage Custodian information for an eligible dependent or beneficiary should the custodian be someone other than the planholder/participant (e.g., capture, maintain, etc.). (example, NMSO) | Highly Desired | |
| BN-110 | Benefits | Benefits Enrollment | Describe how the proposed solution will display applicable premium rates for a planholder's plan as well as modeling premium rates for plan changes such as adding a dependent. | Highly Desired | |
| BN-111 | Benefits | Benefits Enrollment | Describe how the proposed solution provides the capability for Insurance Coordinators (ICs) to initiate, approve, and maintain their planholder enrollment. | Highly Desired | |
| BN-112 | Benefits | Benefits Enrollment | Describe how the proposed solution will recognize the need for EOI (Evidence of Insurability) and incorporate an EOI questionnaire (Statement of Health/SOH) or link. | Highly Desired | |
| BN-113 | Benefits | Benefits Enrollment | Describe the proposed solution's system audit measures for example real-time name and address comparison to USPS mail database or other identity verification databases during data entry. If entry appears invalid, a message should prompt the user to recheck and reverify the name and address. | Highly Desired | |
| BN-114 | Benefits | Benefits Enrollment | Describe how the proposed solution will update the enrollment effective date and rates appropriately upon Evidence of Insurability (EOI) confirmation or denial based on Plan rules. | Highly Desired | |
| BN-115 | Benefits | Benefits Enrollment | Describe how the proposed solution will track and maintain enrollments, increases or decreases of coverage of Basic, Optional, and Dependent coverage of Group Term Life. | Highly Desired | |
| BN-116 | Benefits | Benefits Enrollment | Describe how the proposed solution will prevent duplicate enrollments for all benefits at the planholder and dependent level, with the option for an override for dual coverage for health plans. | Highly Desired | |
| BN-117 | Benefits | Benefits Enrollment | Describe how the proposed solution will support automated emails and mailings via the system for notifications associated to new hire enrollments, summaries of coverage, rejected or approved workflow and status updates. | Highly Desired | |
| BN-118 | Benefits | Benefits Enrollment | Describe the proposed solution's unique identifier capabilities for benefits within the system. (e.g., add, create, store, trace, and report). | Highly Desired | |
| BN-119 | Benefits | Benefits Enrollment | Describe the proposed solution's capability to allow a transferring employee to elect other new coverage options that were not offered at a previous group for enrollees. | Highly Desired | |
| BN-120 | Benefits | Integrations | Describe how the proposed solution will collect, store, extract, and send benefits data via Electronic Data Interchange (EDI) with various vendors. | Highly Desired | |
| BN-121 | Benefits | Integrations | Describe the proposed solution's capability to integrate with Agency HR/Payroll (Munis, PeopleSoft, ADP, etc.) to support hires, terms, enrollment changes, and benefit deductions. Please provide a list of all Payroll/HR/other benefit system integrations available. | Highly Desired | |
| BN-122 | Benefits | Inquiry and Reporting | Describe how the proposed solution will provide online access to current participant information based on user-defined requirements. | Highly Desired | |
| BN-123 | Benefits | Inquiry and Reporting | Describe the proposed solution's capability to create an annual premiums report by plan and plan type with breakdowns for EE and ER contributions. | Highly Desired | |
| BN-124 | Benefits | Inquiry and Reporting | Describe how the proposed solution will produce and deliver customized and standard reports that provide information on detailed and summary levels of user-defined data regarding plans, participants, coverages, etc. for internal and external entities. | Highly Desired | |
| BN-125 | Benefits | Benefits Administration | Describe how the proposed solution allows for varying effective and termination date selection. (For example, death being immediate or End- of-Month (EOM)). | Highly Desired | |
| BN-126 | Benefits | Benefits Administration | Describe how the proposed system will provide the capability to pend the EOI (for both participant and spouse) until it is confirmed by the vendor via report, file, or automated transmission. | Highly Desired | |
| BN-127 | Benefits | Benefits Administration | Describe how the proposed solution manages transfers. (e.g., between groups, active to active, or active to COBRA). Eligibility may vary (e.g., 1st day benefits for new hires). | Highly Desired | |
| BN-128 | Benefits | Benefits Administration | Describe how the proposed solution administers automated and timely notification of portability and/or conversion options and eligibility criteria to maintain life insurance coverage after separating employment, ensuring compliance with regulatory deadlines and specifically outlining procedures, responsibilities, forms provision with a link to contact support of current TPA/provider. | Highly Desired | |
| BN-129 | Benefits | Benefits Administration | Describe the proposed solution's capability to publish and host videos. (e.g., script, studio design, providing video development specialists, standalone web page for hosting, and updating, including, but not limited to, the ability to submit videos to be hosted on external websites such as YouTube). | Desired | |
| BN-130 | Benefits | Benefits Administration | Describe how the proposed solution manages and administers off-cycle special enrollments (e.g., by periods, by group, by product, etc.). | Desired | |
| BN-131 | Benefits | Benefits Administration | Describe the ability to *sync* or *true-up* snapshot data from proposed solution and a vendor system such as enrollment or election data. | Highly Desired | |
| BN-132 | Benefits | Benefits Administration | Describe how the proposed solution will provide the capability to receive and process audit file feedback from vendors (benefit vendors will send back items that don't match post-audit and the enrollment vendor will research and update if necessary). | Highly Desired | |
| BN-133 | Benefits | Benefits Administration | Describe how the proposed solution will calculate and display rates based on all of the following, including but not limited to: |
- Enrollment Tier
- Planholder only
- Planholder/spouse
- Planholder /child(ren)
- Employee/family
- Benefit Type (Health, Life, Dental, Vision, etc.). - Coverage Period
- Employment status Surcharge/Discount (e.g., Tobacco Status, Living Well Promise, etc.)
| - Evidence of Insurability (EOI) approval/disapproval | Highly Desired | ||||
| BN-134 | Benefits | Benefits Administration | Describe the proposed solution's capability to track current dependents/beneficiary information (including multiple beneficiaries per benefit type) visible to the planholder, ICs and plan administrator. | Highly Desired | |
| BN-135 | Benefits | Benefits Administration | Describe the proposed solution's capability to apply retroactive changes to enrollments and communicate retroactive changes to vendors. | Highly Desired | |
| BN-136 | Benefits | Benefits Administration | Describe to what extent the proposed solution provide flexibility to allow and to restrict retroactive changes? | Highly Desired | |
| BN-137 | Benefits | Benefits Administration | Describe the proposed solution's capability to calculate premium cost or contribution amounts for both planholder and employer based on costs for each benefit plan type (e.g., by plan or agency). | Highly Desired | |
| BN-138 | Benefits | Benefits Administration | Describe the proposed solution's capabilities to transfer enrollee(s) to a new agency individually or by agency. | Highly Desired | |
| BN-139 | Benefits | Benefits Administration | Describe how the proposed solution transfers an "agency" (multiple planholders) to a new legal entity (combine or split). | Highly Desired | |
| BN-140 | Benefits | Benefits Administration | Describe how the proposed solution supports adding new agencies and/or moving agencies who no longer wish to participate to inactive status, including cataloging and reporting features. | Highly Desired | |
| BN-141 | Benefits | Benefits Administration | Describe how the proposed solution will automatically generate notifications to planholders due to future age-out event. | Highly Desired | |
| BN-142 | Benefits | Benefits Administration | Describe how the proposed solution would track and report perpetual and plan year HRA contributions made by KEHP. | Highly Desired | |
| BN-143 | Benefits | Benefits Administration | Describe how the proposed solution will allow for tracking and reporting of "groups" to distinguish variances between options and or eligibility rules. Groups would include: state agencies, BOEs, Health Departments, quasis, and retirement (multiple subtypes). | Highly Desired | |
| BN-144 | Benefits | Benefits Administration | Describe what information the proposed solution will need to receive from the Commonwealth to provide eligibility, enrollment, administration, billing and ongoing support for the KEHP benefit programs, along with providing the necessary solution to reconcile billings to the both the individual and the agency. | Highly Desired | |
| BN-145 | Benefits | Open Enrollment | Describe how the proposed solution will provide an online enrollment portal to support participant access from a desktop. | Highly Desired | |
| BN-146 | Benefits | Open Enrollment | Describe how the proposed solution will provide an online enrollment portal to support participant access from a tablet. | Highly Desired | |
| BN-147 | Benefits | Open Enrollment | Describe how the proposed solution will provide an online enrollment portal to support participant access from a mobile device, both iOS and Android. | Highly Desired | |
| BN-148 | Benefits | Open Enrollment | Describe how the proposed solution will provide a step-by-step guided enrollment process. | Highly Desired | |
| BN-149 | Benefits | Open Enrollment | Describe how the proposed solution would handle an active enrollment versus a passive enrollment. | Highly Desired | |
| BN-150 | Benefits | Open Enrollment | Describe how the proposed solution will provide and present Plan comparisons. | Highly Desired | |
| BN-151 | Benefits | Open Enrollment | Describe how the proposed solution will provide cost visibility of the various benefit options to include the participant cost, employer cost, and total cost. | Highly Desired | |
| BN-152 | Benefits | Open Enrollment | Describe how the proposed solution will facilitate updates to dependents during open enrollment. | Highly Desired | |
| BN-153 | Benefits | Open Enrollment | Describe how the proposed solution will facilitate beneficiary management for the enrollment in life insurance products on an ongoing basis, including during OE. | Highly Desired | |
| BN-154 | Benefits | Open Enrollment | Describe how the proposed solution will accurately determine the participant's eligibility for each coverage offering, to include: retiree eligibility, life/dental/vision/FSA option, or ACA requirements; all of which may vary by employer. | Highly Desired | |
| BN-155 | Benefits | Open Enrollment | Describe how the proposed solution will accurately determine spouse/dependent eligibility based on such items as dual eligibility or dependents aging out prior to plan year. | Highly Desired | |
| BN-156 | Benefits | Open Enrollment | Describe how the proposed solution will allow the Commonwealth to establish/set up an open enrollment in the system. | Highly Desired | |
| BN-157 | Benefits | Open Enrollment | Describe how the proposed solution will allow for configuration of validation rules for various elections. | Highly Desired | |
| BN-158 | Benefits | Open Enrollment | Describe how the proposed solution facilitates the Evidence of Insurability (EOI) workflow. | Highly Desired | |
| BN-159 | Benefits | Open Enrollment | Describe how the proposed solution supports acknowledgements and actions/elections as part of the open enrollment process. This should include time/date stamp, tracking, and reporting. | Highly Desired | |
| BN-160 | Benefits | Open Enrollment | Describe how the proposed solution will support automated emails and system notifications associated to open enrollment. | Highly Desired | |
| BN-161 | Benefits | Open Enrollment | Describe how the proposed solution will support reminders for open enrollment deadlines. | Highly Desired | |
| BN-162 | Benefits | Open Enrollment | Describe how the proposed solution will provide confirmation statements to participants (downloadable, email, etc.). | Highly Desired | |
| BN-163 | Benefits | Open Enrollment | Describe how the proposed solution may support broadcast announcements or video messaging including push notifications. | Highly Desired | |
| BN-164 | Benefits | Open Enrollment | Describe how the proposed support model will efficiently and effectively provide customer support during the open enrollment window and ongoing. | Highly Desired | |
| BN-165 | Benefits | Open Enrollment | Describe how the proposed solution will provide view/access and/or override capabilities to designated Department of Employee Insurance staff with audit trail. | Highly Desired | |
| BN-166 | Benefits | Open Enrollment | Describe how the proposed solution provides enrollment participation dashboards by entity, groups, overall. | Highly Desired | |
| BN-167 | Benefits | Audit | Describe how the proposed solution provides an Audit Log of benefit elections for open enrollment and throughout the year for new hire enrollment and for benefit changes. | Highly Desired | |
| BN-168 | Benefits | ACA Reporting | Describe how the proposed solution will support ACA tracking, forms distribution (via online and USPS depending on planholder election, along with compliance reporting responsibility for all entities using the Commonwealth Employer Identification Number (EIN), even if the participants are not paid by the Commonwealth's payroll system. | Highly Desired | |
| BN-169 | Benefits | ACA Reporting | Describe how the proposed solution will provide ACA forms and reporting to all non-state agencies participating in KEHP health plans, including 1095 forms and related employee counts and required reporting. | Highly Desired | |
| BN-170 | Benefits | ACA Reporting | Describe how the proposed solution will provide the option to have ACA forms made available to all participants and all forms available to the agency should the agency wish to print and mail. | Highly Desired | |
| BN-171 | Benefits | Integrations | Describe how the proposed solution manages error handling for rejected interfaces? Rejected data elements? | Highly Desired | |
| BN-172 | Benefits | Workflow | Describe how the proposed solution supports the configuration of the required workflow process including approvals and rejections. | Highly Desired | |
| BN-173 | Benefits | Support | Describe how the Vendor will provide the Commonwealth Department of Employee Insurance with a dedicated, customer support team (onshore/near-shore) to address service-related (non-technical) issues. | Highly Desired | |
| BN-174 | Benefits | Compliance | Describe how the Vendor will cooperate with the Commonwealth / Department of Employee Insurance in analyzing the impact of proposed legislation on the operation of the Contract as it relates to identification of solution change requests, operational impacts, reporting and/or compliance to include potential cost impacts. Responses requested within 3 business days to allow for appropriate turnaround to legislature. | Highly Desired |
Values
| SF |
| DT |
| FR |
| DNP |
| SSP |
| SI |
| Both |
BNA
| Attachment F | Benefits Accounting | ||||||
| Specification # | Category | Subcategory | Question | Priority (Highly Desired or Desired) | (Vendor Response) Identify Which Vendor Is Responding | (Vendor Response) | |
| Degree of Fit | (Vendor Response) | ||||||
| Solution | (Vendor Response) |
Comments
| BNA-100 | Benefits Accounting | Billing | Describe how the proposed solution will provide flexibility in frequency and/or timing when generating monthly premium bills with the capability of segmenting and customizing at the group level. For example, March bills may be generated the week before March begins or March bills may be generated at the beginning of March for March premiums. Premiums are current pay and will be due in March regardless of billing cycle or payroll cycle dates. | Highly Desired |
| BNA-101 | Benefits Accounting | Billing | Describe how the proposed solution will provide flexibility for split billing, where portions are billed to one entity for payment while another entity pays for the rest. (e.g., Kentucky Department of Education (KDE) pays Admin Fees, Basic Life and Employer portion of health insurance, while each school board pays FSAs, Employee portion of health insurance and all optional benefits.) | |
| Highly Desired | ||||
| BNA-102 | Benefits Accounting | Billing | Describe how the proposed solution will support flexible billing dates for any benefit. | Highly Desired |
| BNA-103 | Benefits Accounting | Billing | Describe how the proposed solution's capabilities can refresh and/or regenerate monthly bills throughout the month to ensure enrollment changes are accurately reflected in a timely manner. For example, if March bills are generated on February 28, and an enrollment change is entered on March 8 which effects the March bill, the March bill may be refreshed to ensure the bill reflects the updated, correct amount(s). Also need capability to regenerate the bill if necessary or desired. | Highly Desired |
| BNA-104 | Benefits Accounting | Billing | Describe how the proposed solution can support benefits like Dependent Care FSAs with submission of premiums to the vendors upon payroll receipt. | Highly Desired |
| BNA-105 | Benefits Accounting | Billing | Describe how the proposed solution provides for detailed billing for agencies to include, but not limited to, listing of participants with cost and plan information for each line item, along with capability for the billing contact to be able to adjust the individual line items (e.g., Health, Life Basic and Optional, Dental, Vision, Health Savings Account (HSA), Health Reimbursement Account (HRA), etc.) | Highly Desired |
| BNA-106 | Benefits Accounting | Billing | Describe how the proposed solution will provide notification to Agency contact when the bill is ready to be processed. | Highly Desired |
| BNA-107 | Benefits Accounting | Billing | Describe how the proposed solution will provide notification to DEI when the bill has been processed. | Highly Desired |
| BNA-108 | Benefits Accounting | Billing | Describe how the proposed solution allows for integration with Agencies to automate the submission of remittance files for premium postings. | Highly Desired |
| BNA-109 | Benefits Accounting | Billing | Describe how the proposed solution will have the flexibility to bill different benefits admin fees (BAF) for different plans and agencies. | Highly Desired |
| BNA-110 | Benefits Accounting | Billing | Describe the proposed solution's capability to handle missed insurance premiums (e.g., creating an arrearage for missing premium, setup payment plans options, or one time payments for arrearage). | Highly Desired |
| BNA-111 | Benefits Accounting | Billing | Describe how the proposed solution will allow multiple users to be working on and paying separate portions of the bill at the same time? Ex: Company A participates with Health, Life, Vision & Dental plans. The company has two employees who deal with benefits, and they split duties by plan type. Employee 1 works on Health and Vision, while Employee 2 works on Life and Dental. Will the system allow them both to be working on bills, simultaneously, or is it limited to allow one person at a time? | Desired |
| BNA-112 | Benefits Accounting | Billing | Describe how the proposed solution will allow the agency to make a payment that is less or more than the overall total bill for the agency? | Desired |
| BNA-113 | Benefits Accounting | Overdue Premiums | Describe how the proposed solution will automatically generate and distribute arrearage correspondence when an account reaches 30 days past due. If the arrears remain unpaid at 60 days, the system will issue a termination notice. The 30 and 60 day termination notice will be printed and mailed to the plan holder, and an electronic notification will be sent to the appropriate agencies. | Highly Desired |
| BNA-114 | Benefits Accounting | Overdue Premiums | How can the system allow for reinstatement at the benefit level (regulated by security level) as needed for those employees termed for non-payment? | |
| Highly Desired | ||||
| BNA-115 | Benefits Accounting | Overdue Premiums | Describe how the proposed solution will provide the capability to continue to bill Benefits Admin Fees (BAF) to agencies for members, that have a plan(s) terminated for non-payment. (Note: with termination of a plan coverage, i.e., benefits, plan is terminated, and employee is moved to “Waiver”. Admin fee must still be charged because of other benefits (i.e., BASIC Life).) | Highly Desired |
| BNA-116 | Benefits Accounting | Member Payments | Describe how the proposed solution will integrate to Tyler Technologies Transaction Payment Engine "TPE" to provide the necessary billing and payment information to facilitate bill payment and processing to be reconciled with benefits billing and accounting in the proposed solution. | Highly Desired |
| BNA-117 | Benefits Accounting | Member Payments | Describe how the proposed solution will provide flexibility with the member payment process, which should be flexible to enable payments for any of their plans, for a specific billing period or for a number of plans across an extended period of bills for arrearages only. | Highly Desired |
| BNA-118 | Benefits Accounting | Member Payments | Describe how the proposed solution will provide confirmation of payment via email to the "payer" and proof of payment information should be maintained in the system for DEI staff to utilize when needed. DEI use of this information will include generating reports, and reconciling payments received within the system to payments posted in the state accounting system and deposited in the state bank account. | Highly Desired |
| BNA-119 | Benefits Accounting | Member Payments | Describe how the proposed solution will display and allow updates by designated user access roles to the Member's account and payment history overview. | Highly Desired |
| BNA-120 | Benefits Accounting | Member Payments | Describe how the proposed solution will provide the agency contacts notification of the member's payment. | Highly Desired |
| BNA-121 | Benefits Accounting | Agency Payments | Describe how the proposed solution will allow for designated Agency users to log into payment solution and make payment for monthly billing. Please list payment options. | Highly Desired |
| BNA-122 | Benefits Accounting | Agency Payments | Describe how the proposed Billing solution logs will track payment-related details including, but not limited to, the payment date, payment amount, plan type, description of what payment covers and method of payment. Please list additional data captured in log. | Highly Desired |
| BNA-123 | Benefits Accounting | Agency Payments | Describe how the proposed solution will provide the capability and/or support for the following items demonstrating flexibility in supporting Agency payment processes to allow: |
| i. | Payments using various banks and bank accounts | ||||
| ii. | Advance payments to cover upcoming months | ||||
| iii. | Future dated payments | ||||
| iv. | Over payments | ||||
| v. | Partial payments | ||||
| vi. | Varying payrolls | ||||
| vii. | Payments (Overpayment) for members who are not yet active & enrolled | ||||
| viii. | Notes from agency to DEI for specific adjustments (i.e., Member termed employment, money no longer due; Qualifying Event, additional money due, etc.). | Highly Desired | |||
| BNA-124 | Benefits Accounting | Agency Payments | Describe how the proposed solution will provide Agency account and payment history overview, along with drill-down capabilities, including, but not limited to, members, benefit elections, coverage plans, bill dates, due dates, coverage level, etc. | Highly Desired | |
| BNA-125 | Benefits Accounting | Agency Payments | Describe how the proposed solution will support the requirement that Employee or Agency payments which need to be passed on to vendors may not be sent to vendors until the money has been posted to the state accounting system (eMARS) and is deposited in the state bank account. Note: A “promise of payment” at the time the bill is worked and paid is not sufficient in itself. |
| Payments received must be processed, deposited to state bank account and reconciled before the monies are utilized to transfer to third-party provider. Payment received, not bill worked. DEI does not prefer to clear receivable on employee account until the money is posted in the state’s bank account by agency. | Desired | ||||
| BNA-126 | Benefits Accounting | Payment Processing: Clearing | Describe how the proposed solution will automatically apply payments to charges pending against the oldest due date first. | Highly Desired | |
| BNA-127 | Benefits Accounting | Payment Processing: Moving Money | Describe how the proposed solution will support the need to move payments within a member's record to allow member-paid funds to be applied appropriately to various plans as necessary. | Highly Desired | |
| BNA-128 | Benefits Accounting | Payment Processing: Adjustments/Write-Offs | Describe how the proposed solution will allow for manual billing corrections/adjustments as well as processing write-offs for outstanding balances (debits and credits) as needed. | Highly Desired | |
| BNA-129 | Benefits Accounting | Payment Processing: Refunds | Describe how the proposed solution will trigger refunds through state accounting system to agencies and employees and log it (if integrated) or can allow for refunds, reporting of refunds, and store refund information (if unable to integrate). | Highly Desired | |
| BNA-130 | Benefits Accounting | Reports | Describe how the proposed solution will support provide for Standard and Non-Standard Reports & Dashboards, including but not limited to the following: |
i. Standard billing, payment and reconciliation reporting is necessary for DEI to ensure proper oversight, administration, and audit of accounts. Also describe any existing dashboards that are provided.
| ii. | DEI desires additional specialized reports which further help us to administer financials. | |||
| Highly Desired | ||||
| BNA-131 | Benefits Accounting | Reports | Describe how the proposed solution will provide detailed and summary reporting for Reconciliation for members and for agencies to include, but not be limited to, the following: |
i. Expected vs Received and outstanding differences
ii. Billing Liaisons would like to be able to run a report to see how much they have paid YTD for their employees.
| iii. | Any outstanding balance over 60 days | Highly Desired | ||
| BNA-132 | Benefits Accounting | Reports | Describe how the proposed solution will provide Management level reporting around: |
i. Agency level and member level account reports
ii. Arrears reporting – high-level and detailed
| iii. | Termination for non-payment |
| iv. | Small balances (outstanding debit or credit under $6) |
v. Write-offs
| vi.Outstanding agency bills | Highly Desired | |||
| BNA-133 | Benefits Accounting | Reports | Describe how the proposed solution will provide reporting reflective of the business needs of the designated user access roles as identified necessary by the commonwealth. Examples include but are not limited to the following: |
i. Internal Users
| 1. | DEI Staff |
| 2. | Management – branch, director, budget level staff, others |
3. Division of Technology Staff
| ii. | External Users | |||
| 1. | Agency Insurance Coordinators (ICs) and Billing Liaisons (BLs) | |||
| 2. | Agency management and/or budget level staff | |||
| 3. | DEI staff will require additional reports, both standard and ad hoc, to ensure proper oversight and administration of accounts | |||
| Highly Desired | ||||
| BNA-134 | Benefits Accounting | Reports | Describe how the proposed solution will allow for the automated scheduling of designated reports and the ability to execute reports on demand as necessary. |
| Many reports should be scheduled to run at specific times of the month. However, DEI desires the ability for internal and external users to run reports off-cycle, when needed. | Highly Desired | ||||
| BNA-135 | Benefits Accounting | Reports | Describe the proposed solution's capability for provide reporting for financial statements. | Highly Desired | |
| BNA-136 | Benefits Accounting | Reports | Describe how the financial reporting capabilities of the proposed solution including, but not limited to, reports for audit and data necessary for the Commonwealth's Annual Comprehensive Financial Report (ACFR). Examples include reports for premiums paid and membership counts for life, dental, and vision. | Highly Desired | |
| BNA-137 | Benefits Accounting | Financials - Integration | Describe how the proposed solution integrates with other third-party accounting programs, which accounting programs it currently integrates with, and how it would accommodate integration with non-standard programs such as eMARS, the Commonwealth of Kentucky’s financial accounting system. | Highly Desired | |
| BNA-138 | Benefits Accounting | Financials - Integration | Describe how the proposed solution enables and/or complies with soft and hard financial closes associated to established accounting periods. | Highly Desired | |
| BNA-139 | Benefits Accounting | Sibrodummy and Clarifications | Describe how the proposed solution can accept premium payments for employees who are not enrolled in a plan. Specifically, would this be a "kickout" or how would DEI be notified, are there dummy accounts for individuals or agencies? (Currently a sibrodummy is what SAP uses so the system can accept premium payments for EE's who are not yet enrolled in a plan). | Highly Desired |
General Technical
| Attachment F | General and Technical | ||||||
| Specification # | Category | Subcategory | Question | Priority (Highly Desired or Desired) | (Vendor Response) Identify Which Vendor Is Responding | (Vendor Response) | |
| Degree of Fit | (Vendor Response) | ||||||
| Solution | (Vendor Response) |
Comments
| GT-100 | Technical | Alerts/Notifications | Describe how the proposed solution will provide the capability to generate alerts and notifications (e.g., system, email, SMS) for any transaction based on user-defined criteria. Commonwealth desires utilization of GovDelivery; communication APIs, and SMS capability within the solution (native) and separately with APIs to third-party communication providers. | Highly Desired |
| GT101 | Technical | Alerts/Notifications | Describe how the proposed solution will provide the capability to allow broadcast messages to be tailored to agency or user roles/responsibilities, etc. based on designated administrator or authorized user roles. | Highly Desired |
| GT-102 | Technical | Alerts/Notifications | Describe how the proposed solution will provide the agency contacts notification of the member's payment. Add to other specifications to cover across the board. Notification may be provided by way of notification (i.e., email, or a flag/attribute on member’s account, report, etc.) | Highly Desired |
| GT-103 | Technical | Integrations | Describe how the proposed solution will provide integration management capability through industry-standard protocol to interface to a 3rd parties, including APIs. | Highly Desired |
| GT-104 | Technical | Integrations | Describe how the proposed solution will provide the capability to integrate with Microsoft Outlook, Teams, etc. and other packages to leverage capabilities. | Highly Desired |
| GT-105 | Technical | Integrations | Describe how the proposed solution will allow for the integration to OnBase for document storage and retrieval. | Highly Desired |
| GT-106 | Technical | Application | Describe how the proposed solution will provide the capability to integrate with other state systems (SAP HCM, CGI Finance, Cornerstone Learning Management System, SAP Enterprise Business Intelligence (EBI) Data Warehouse solution, etc.) utilized, and describe what other HCM ERP or Vendor providers that you have "out of the box" integrations and/or APIs with to ensure multiple options are available, as the Commonwealth will be replacing SAP HCM in Phase II of this initiative. | Highly Desired |
| GT-107 | Technical | Application | Describe how the proposed solution will provide the capability to autofill solution-based forms and letters with data/values stored in the solution. | Highly Desired |
| GT-108 | Technical | Application | Describe how the proposed solution will provide the capability to default values for a field based on user-defined business rules. (e.g., 1st Day Benefits Coverage for New Hires for CoKY agencies). | Highly Desired |
| GT-109 | Technical | Application | Describe how the proposed solution will provide the capability to enter a description for all transactions types. | Highly Desired |
| GT-110 | Technical | Application | Describe how the proposed solution will provide the capability to use alphanumeric characters for documents (e.g., journal entry) and other references (e.g., vendor, customer). | Highly Desired |
| GT-111 | Technical | Application | Describe how the proposed solution will provide the capability to extract data and export in common formats (including, but not limited to, PDF, Excel, Text, and CSV). | Highly Desired |
| GT-112 | Technical | Application | Describe how the proposed solution will provide the capability to have multiple browser windows open. | Highly Desired |
| GT-113 | Technical | Application | Describe how the proposed solution will provide the capability to import/export data to and from all supported software and platforms, such as Microsoft Office. | Highly Desired |
| GT-114 | Technical | Data Encryption | Describe how the proposed solution will provide the capability to support industry standard protocols to encrypt data transfer. | Highly Desired |
| GT-115 | Technical | Electronic Signatures | Describe how the proposed solution will provide the capability to capture electronic signatures. | Highly Desired |
| GT-116 | Technical | Security | Describe how the proposed solution will provide for multiple administrator roles, each with differing permissions. | Highly Desired |
| GT-117 | Technical | Security | Describe how the proposed solution ensures a user is automatically logged out after a designated period of inactivity period as defined by the system administrator. | Highly Desired |
| GT-118 | Technical | Mass Changes | Describe how the proposed solution allows for mass changes to occur for defined groups of transactions and/or data. | Highly Desired |
| GT-119 | Technical | Multi-factor Authentication | Describe how the proposed solution will support programmatic provisioning of users for multifactor authentication from the Client's Administration system. | Highly Desired |
| GT-120 | Technical | Personal Data | Describe how the proposed solution will provide the capability to designate gender choices other than Male/Female. | Desired |
| GT-121 | Technical | Personal Data | Describe how the proposed solution will provide for the planholder (optionally) to provide ethnicity for benefits purposes (Social Determents of Health for Race/Ethnicity Data) to be captured and reported separately from the ethnicity provided by the HR solution. | Highly Desired |
| GT-122 | Technical | Personal Data | Describe how the proposed solution will allow for a user to input and maintain foreign addresses. | Highly Desired |
| GT-123 | Technical | Personal Data | Describe how the proposed solution will provide the capability to maintain a history of participant name changes and other biographical data with proper audits. | Highly Desired |
| GT-124 | Technical | Records Retention | Describe how the proposed solution will provide the capability to maintain records within the solution based on user-defined time periods and in accordance with the State’s records and retention schedules. | Highly Desired |
| GT-125 | Technical | Forms/Letters & Reporting | Describe how the proposed solution will provide the capability to create user-defined documents and notifications, including, but not limited to, form letters (e.g., arrears, term for non-payment), business forms, reports, etc. | Highly Desired |
| GT-126 | Technical | Reporting | Describe how the proposed solution will be accessible and available for 24-hours/7 days a week access (excluding scheduled maintenance windows) including reporting and business intelligence capabilities. | Highly Desired |
| GT-127 | Technical | Reporting | Describe how the proposed solution will provide a reporting solution that conforms to a documented set of standards and includes the appropriate tools, methodologies, and provision of training such that business reporting and analysis functions can be operated, expanded, modified or enhanced over time. | Highly Desired |
| GT-128 | Technical | Reporting | Describe how the proposed solution will provide the capability to save an ad hoc query/report for later execution without impacting any base query that was used as a starting point. (Note: The authorized user should be prompted to provide a descriptive name for the saved ad hoc query/reports.) | Highly Desired |
| GT-129 | Technical | Reporting | Describe how the proposed solution will provide the capability to customize reports at designated user levels. | Highly Desired |
| GT-130 | Technical | Reporting | Describe how the proposed solution will provide the capability to define or modify the sort order of a report. | Highly Desired |
| GT-131 | Technical | Reporting | Describe how the proposed solution will provide the capability to delete shared reports from their personal reports list without deleting the shared report from another user's personal report list. | Highly Desired |
| GT-132 | Technical | Reporting | Describe how the proposed solution will provide the capability to designate report publisher to unpublish reports to individual users or groups of users based on designated user access roles. | Highly Desired |
| GT-133 | Technical | Reporting | Describe how the proposed solution will provide the capability to develop ad hoc reports that can also be shared with other users or published for broader usage. | Highly Desired |
| GT-134 | Technical | Reporting | Describe how the proposed solution will provide the capability to export a query and report results in spreadsheet format (.xls or .xlsx) with options to output data only. | Highly Desired |
| GT-135 | Technical | Reporting | Describe how the proposed solution will provide the capability to layer reports with drill down functionality to access detailed data from higher level report results. | Highly Desired |
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