Attachment G Cost Schedule~1.xlsx
XLSX spreadsheet 14 KB Posted
- Attached to
- Actuarial Services
- Solicitation number
- 40DHHS-S697
- Issued by
- Churchill County, Nevada
About this file
This document is the Cost Proposal for RFP 40DHHS-S697 for Actuarial Services in the state of Nevada. The vendor must provide cost estimates for various tasks related to rate setting, waiver support, experience monitoring and reporting, risk adjustment, and risk mitigation. These services include capitation rate development, calculations, data book presentations, waiver support, encounter data monitoring, risk scoring, and risk pool management. The vendor must also provide proposed hourly rates for ad hoc analyses. The contract term is not specified.
The total annual cost for the services listed is $0, as the vendor must provide their proposed pricing. The ad hoc hourly rates are provided for various staff levels, including Principal (FSA), Reviewing/Managing Actuary (FSA), Consulting Actuaries (ASA), Actuarial Analyst/Trainee, and Non-Actuarial Support. The state's rating period operates on a calendar year basis, while the state fiscal year is on a July-June cycle. The ad hoc analyses can include items such as legislative fiscal impact requests, demonstration waiver feasibility, Medicaid reform research, and unexpected mid-year rate adjustments.
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Text version
Cost Proposal
| RFP 40DHHS-S697 Actuarial Services | |
| Instructions: Vendor must provide a cost estimate for the services listed below as well as the proposed hourly rates for ad hoc analyses. The list below may change as needed to meet the needs of the agency via the work order process. |
Vendor Name:
| Task Area - Reference Scope of Work for details pertaining to each item. | Annual Cost | ||
| 2.1.1 Rate Setting* | |||
| A. | Methodology - Capitation Rate Development for existing populations | $ - 0 | |
| B. | Calculations including, but not limited to: eligibility and claims processing, Family Planning Services Enhanced FMAP Claiming Identification, Safety Net UPL, Risk Scoring, Health Insurer Provider Fee Impact Analysis, and Medical Loss Ratio Reporting | $ - 0 | |
| C. | Present data book and rate setting methodology and results to the MCOs. | $ - 0 | |
| D. | Dental Capitation Rate Development - currently carved out of medical capitation rates and on an 1115 (d) Prepaid Ambulatory Health Plan (PAHP) Waiver | $ - 0 | |
| E. | Capitation Rate Modifications and Related Other Adjustments including, but not limited to: corrections and adjustments as a result of CMS and/or DHCFP questions or concerns. | $ - 0 | |
| 2.1.2 Waiver Support | |||
| A. | Innovation Program Waivers and Waiver Renewals | $ - 0 | |
| 2.1.3 Experience Monitoring and Reporting | |||
| A. | Encounter Data and Encounter Utilization Monitoring | $ - 0 | |
| 2.1.4 Risk Adjustment | |||
| A. | Risk Scoring Methodology | $ - 0 | |
| B. | Risk Score Calculations | $ - 0 | |
| C. | Risk Adjustment Reconciliations and Capitation Adjustments | $ - 0 | |
| 2.1.5 Risk Mitigation | |||
| A. | Stop-Loss, Maternity Kick Payment (SOBRA), Very Low Birth Weight (VLBW) Risk Pool, Risk Corridor, Specialty Pharmacy | $ - 0 | |
| 2.1.6 Ad Hoc** - services will be paid at the hourly prices identified below in the Proposed Ad Hoc Rates table. | |||
| 2.1.7 General Obligations (H-I) - costs pertaining to this section are assumed to be included in the costs for Sections 2.1.1-2.1.5 listed above. | |||
| Total Annual Cost | - 0 |
| Proposed Ad Hoc Hourly Rates | ||
| Staff Professional Level | Description | Proposed Rate |
| Principal (FSA) | An actuary with highly specialized skills that are in high demand | |
| Reviewing/Managing Actuary (FSA) | An actuary, who is qualified in the applicable practice area, has signature authority in that area of practice who oversees the project. | |
| Consulting Actuaries (all) (ASA) | An actuary who is qualified in the applicable practice area with signature authority in that area of practice. | |
| Actuarial Analyst/Trainee (all) | An individual who is non-credentialed and working under the direction of an actuary who is qualified in the applicable practice area. | |
| Non-Actuarial Support | An individual who is providing administrative support. | |
| *Nevada's rating period and/or premium year operates on a calendar year basis; State Fiscal Year (SFY) operates on a July-June basis. Work performed in CY2019 will consist of working collaboratively with the current Vendor to finalize CY2020 rate building, which will be in progress when the new contract effective date begins. | ||
| **Ad Hoc Analyses can include items such as: Legislative Session Fiscal Impact Requests, Demonstration Waiver Feasibility, Medicaid Reform Research and Analyses, Unexpected Mid-Year Rate Adjustments, HCGP - Program Year 3 Settlement Calculation. |
&"Arial,Regular"&20Attachment G Cost Schedule Proposal
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