ATTACHMENT J - Commonwealth's Response to Vendor Written Questions - RFP 758 2700000012.xlsx
XLSX spreadsheet 63 KB Posted
- Attached to
- HCM ERP System Replacement - Phase 1
- Solicitation number
- RFP 758 2700000012 4
- Issued by
- Elliott County, Kentucky
About this file
This document is the Commonwealth of Kentucky's written response to vendor questions regarding RFP 758 2700000012 for Phase 1 Benefits Administration & Billing Software Solution and Services. The procurement involves the Kentucky Employee Health Plan (KEHP), a multiemployer plan administered by the Commonwealth Personnel Cabinet's Department of Employee Insurance, serving approximately 191,353 participants across 650+ participating employers including state agencies, local school districts, and quasi-governmental organizations. The RFP seeks a new benefits administration and billing platform to replace the incumbent SAP system, which reaches end-of-mainstream maintenance on December 31, 2027, with optional extended maintenance through 2030. The Commonwealth requires implementation to be completed during 2028, with the specific go-live date to be determined based on the selected vendor's recommended project timeline. The RFP process includes a 25% onsite staffing requirement at the cumulative project level during planning, implementation, testing, training, go-live readiness, and post-go-live hypercare phases. Vendors must submit proposals in three parts (technical, cost, and proprietary information) with responses to the Business & Technical Questionnaire provided as Attachment F, and the Commonwealth is considering a phased implementation approach, though a single deployment is preferred.
The procurement involves complex billing and premium administration across multiple employer groups with distinct billing arrangements; the Commonwealth currently processes approximately 900 Non-Commonwealth Paid bills monthly with 150-250 adjustments, 1,500-4,000 batch job adjustments, and extensive reconciliation across 74,575 Federal Employer Identification Numbers. Current financial operations include integration with Tyler Technologies Transaction Payment Engine for payment processing, with members able to pay arrears online and agencies paying through various methods including ACH and checks. The incumbent vendor is SAP, and funding for the procurement has been approved by the Commonwealth, though specific contract value information will not be disclosed. Vendors must meet mandatory requirements including HIPAA compliance, FedRAMP or HITRUST certification for cloud solutions, NIST 800-53 framework familiarity, and robust reporting capabilities. The proposed solution must integrate with the existing SAP HCM system initially and support transition to a future HCM solution, accommodate 35 current integrations across multiple carriers and administrative systems, and support optional services including call center support, dependent verification, and COBRA administration replacement. The contract term is ten years with potential for pricing adjustments based on changes in covered lives, user counts, or purchased modules during the initial term, and the Commonwealth is open to considering commercially reasonable contract redlines and deviations during evaluation and negotiation.
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| Attachment J - Commonwealth's Response to Vendor Written Questions - RFP 758 2700000012 | |||||
| Question number | RFP Section / Requirement Number | Document | Document Page Number | Vendor Questions | Commonwealth Response |
| 1 | General | General | Please confirm whether funding for this procurement has been approved. | Yes, funding is approved. | |
| 2 | General | General | Does the State have an estimated or not-to-exceed total contract value for the initial term and any renewal options? | This information will not be disclosed. | |
| 3 | General | General | Does the State have an estimated annual contract value or anticipated annual spend associated with this procurement? | This information will not be disclosed. | |
| 4 | General | General | Will the State consider vendor-proposed solutions or architectures that differ from the examples described in the RFP, provided all functional and technical requirements are met? | Vendor must submit a proposal that meets the RFP requirements. | |
| 5 | General | General | Please identify the incumbent vendor(s) currently providing services similar to those described in this RFP. | SAP | |
| 6 | General | General | Please provide the expiration date(s) of the incumbent contract(s), if applicable. | 12/31/26; Renewed annually. December 31, end of mainstream maintenance on December 31, 2027. SAP offers optional extended maintenance through the end of 2030. | |
| 7 | General | General | Is the scope described in this RFP substantially similar to the incumbent scope, or does this procurement represent a material change or expansion in services? | This is similar to the incumbent scope. | |
| 8 | General | General | Does the State anticipate conducting a Best and Final Offer (BAFO) phase? | This is not anticipated. | |
| 9 | General | General | Will post-submission discussions be limited to proposal clarifications, or may limited negotiations occur prior to award? | Refer to Section 8, Negotiations. | |
| 10 | General | General | Is there a preference for platform? SAP/Oracle and so on? | There is not a platform preference. | |
| 11 | General | General | Will the list of attendees from the Vendor Conference / Pre-Proposal Meeting be disclosed to participating vendors? | See Attachment K - Vendor Conference Attendees | |
| 12 | General | Attachment A | N/A | Beyond system replacement, what are the Commonwealth's top three business objectives and success metrics for the selected solution during the first two years following implementation? | Agile, supportable, and improved user and participant experience. Ideal solution will address administrative pain points for multi-employer plans, including by facilitating segmentation of different participating employers/member groups, streamlining premium and admin fee billing across multiple client entities, allowing participating employers to run ad-hoc reports of their employees on a self-service model, automate and communicate standardized reporting generated by the Commonwealth, and enhancing and simplifying the Open Enrollment experience. |
| 13 | N/A | RFP | N/A | For pricing and project planning purposes related to ongoing customer support, is the intended support model for the IC/HRGs at each Agency to reach out directly to the SSP for any support needs? Or would the IC/HRGs be contacting the Department of Employee Insurance for any support needs and then the Department of Employee Insurance team would contact the SSP for anything if needed from the SSP? | The primary point of contact depends on the nature of the issue. For technical issues, users would contact the Personnel Cabinet Division of Technology Services (DTS) for support. If internal support cannot address, DTS would escalate to SSP. If the issue concerns security access, the current point of contact is the Plan's Enrollment Branch (EIB) inbox to confirm security status and then EIB enters a ticket to DTS as necessary. If the support need is related to benefits or any benefit determination, the Plan is the primary contact as well. |
| 14 | N/A | N/A | N/A | Are there particular health conditions or cost drivers that your team is prioritizing as part of your benefits strategy, especially as it relates to benefits engagement? | This question is beyond the scope of this RFP. The Plan would expect the Vendor to support any benefits strategy by facilitating transparency with the benefit options and helping members select the benefit options that are best for them. |
| 15 | Overall Structure | N/A | N/A | Please provide a high-level overview of the 650 entities' approach to defining rates and plan eligibility. Is it standardized in any way or varied entity-to-entity? | Rates are the same for all entities that participate with our plan with the exception of the benefits assessment fee. The benefits assessment fee is different for Non-Commonwealth Paid entities (board of education, retirement systems, health dept., etc.) and Commonwealth Paid entities (state agencies). Billing varies slightly for entities regarding health insurance. Most entities are billed with a breakdown by employee and employer rates while a few entities are billed as all employer rates. Optional insurances and flexible spending plans are billed as employee rates. Plan eligibility varies for each entity based off their contract with KEHP. |
| 16 | Overall Structure | N/A | N/A | Do all entities follow the same plan year as the Commonwealth? | Yes; Plan Year is January 1 - December 31 |
| 17 | Overall Structure | N/A | N/A | Would each entity act like their own customer with their own contacts? Or would communications be centralized to the benefits administrator through the Commonwealth? | Centralized to the Commonwealth with respect to vendor interactions. |
| 18 | Overall Structure | N/A | N/A | How often do new customers join the Commonwealth plans? What timeframe does it typically take to onboard new customers? When a new customer joins, are benefits harmonized onto the Commonwealth’s offerings, or are legacy plans/vendors maintained? | It is very rare for large employers (200+ employees) to either enter the plan; often one employer a year or fewer falls into this category. For smaller employers who are eligible to participate in the plan, the plan might onboard between five and 35 employers a year. New employers are typically onboarded from one to four months after signing the participation agreement with the plan. The employer's existing benefits are harmonized with the Plan's benefits, the Plan's benefits nearly always govern going forward. |
| 19 | Overall Structure | N/A | N/A | To confirm data sources, does each entity feed demographic data through the Commonwealth's HRIS or would they send independent data feeds to the benefits administration system? | This varies. Some entities feed directly to the Commonwealth's existing HRIS, while some related entities aggregate their data in their HRIS prior to sending to the Commonwealth's existing Benefits Administration system. |
| 20 | Overall Structure | N/A | N/A | Although individual entities may vary their approach, how many unique benefit eligibility groups are there on average based on differences in eligibility and rate structures (union, non-union, full-time, part-time, executives etc.)? | The Plan limits variation between various participating employers. No participating employer currently has unionized employees. Eligibility is limited to full time employees. Benefit offerings are the same between employees and executives, and in nearly all cases are executives subject to the same premium contribution distribution. |
| 21 | Overall Structure | N/A | N/A | Does the Commonwealth and all the customers of the Commonwealth have a combined logo and design that can be utilized? Is there a desire by some or all of the customers to have different branding? | KEHP Kentucky Employee's Health Plan (KEHP) is the single branding authority for the program. Customers do not have the option to utilize different branding. There are various logos however including Kentucky Employees' Health Plan (KEHP), Department of Employee Insurance (DEI) and LivingWell that are used on various materials and at our clinics. |
| 22 | Overall Structure | N/A | N/A | Are there any unions to consider with benefit impacts, legacy plan offerings, or differing enrollment periods? | There are no unions. |
| 23 | Transactional Counts - Benefits | N/A | N/A | To the extent it is available, please provide transactional counts for the following services: |
- Current COBRA enrollees
- number of COBRA qualifying events in the last year
- Number of FEIN's for ACA purposes
- Number of 1095's produced last year
- Number of participants on a leave of absence
- Number of vendors requiring reconciliation services Answers - Current COBRA enrollees: 225
- number of COBRA qualifying events in the last year: 32,133 last 12 months
- Number of FEIN's for ACA purposes: 74,575 We provide 1095’s for CP, KPPA, and TRS only. However, there is a report with months of coverage available to Quasi an BOE orgs. Plus, we send an “ACA” file to KDE.
- Number of 1095's produced last year: 64,111
- Number of participants on a leave of absence: 259
- Number of vendors requiring reconciliation services: 2 (claims review and payment integrity currently exists for pharmacy and medical claims data vendors) 24 Transactional Counts - Service Center N/A N/A With Service Center services being optional, please provide approximate call volumes from prior year. Internal Customer service Calls: Dental/Vision/Life-1,898 Medical-17,408
| 25 | Integrations | N/A | N/A | RFP materials mention 35 inbound and outbound integrations. Please provide an overview of those integrations and each vendor involved. | This information will be disclosed to the highest ranking vendor upon award. | |
| 26 | Retirees | N/A | N/A | Please describe retiree eligibility and the current administration of retiree plans (pre-65, post-65, potential exchanges, etc). Do plans coordinate with Medicare? | As the plan does not cover retirees aged-65 and older, "coordination" with Medicare is rare. The Plan must consider Medicare status and still treat the new employee as eligible in certain situations, such as if a retiree enrolled in Medicare returns to work and is eligible for coverage under the participating employer as an active employee. The Plan must also respond to coordination inquiries from the Centers of Medicare and Medicaid Services and otherwise engage in normal compliance activities under the Medicare Secondary Payer Act, similar to any other multiemployer plan sponsor. | |
| 27 | General | N/A | N/A | Looking beyond this phased project for The Commonwealth Personnel Cabinet, please share your other strategic initiatives, both short and long-term? | This is not included the scope of this RFP and will not be disclosed. | |
| 28 | General | N/A | N/A | Are there complexities or manual processes that you're hoping to solve for as you consider a new administration partner? | Yes. | |
| 29 | N/A | N/A | N/A | Do you plan to provide seed employer money for the participant that enrolls in a CDH plan along with a Health Savings account? | No. The plan does not currently offer an integrated Health Savings Account for any plan option. The plan does offer Health Reimbursement Arrangements for the Consumer Driven Health plans and those HRAs are funded by the plan. Please see the Benefit Selection Guide for more information. The Plan may seek to provide integrated HSAs in the future. | |
| 30 | N/A | Strategic healthcare navigation question | N/A | Can you share more about how you're leveraging Castlight today? Will that continue to stay in place, or are you open to replacing if the new vendor can support? | Out of scope. The Plan is not making a determination about Castlight's services in conjunction with this RFP. | |
| 31 | N/A | 2026 Benefits Selection Guide | N/A | The 2026 Monthly Premium Contributions refers to "Parent Plus" and "Family Cross-Reference" pricing tiers. Please provide a definition for these terms. | Family cross-reference elections are not included as a future enrollment option as part of this RFP. Family cross-reference refers to both spouses working for a participating employer, or a participating employer and a covered pre-65 retiree, it is a family plan election tier with special pricing. The Parent Plus election refers to coverage of one employee parent plus any dependent children who are eligible for coverage (e.g., under age 26). | |
| 32 | N/A | 2026 Benefits Selection Guide | N/A | With respect to the Waiver Health Reimbursement Arrangement, what is the current process for confirming eligibility based on the employee/employee's dependents having other group health plan coverage (e.g., self attestation, documentation requirements, etc.)? | The Plan currently requires an annual self-attestation. | |
| 33 | N/A | 2027 Tobacco Declaration | N/A | For project planning and implementation timeline purposes, please confirm the preferred go-live date vendors should use when developing their proposed project plan. Based on prior discussions, we understand the anticipated implementation timeframe is in 2028; however, we would appreciate confirmation of the specific date or target timeframe that should be reflected in our response (e.g., mid-year, fall annual enrollment for ongoing services 1/1/2029, etc.). | There is no target date identified. The work plan should drive the recommended implementation date; however, the Commonwealth expects implementation should complete in 2028. | |
| 34 | Attachment A Section 1.1 | Estimated Schedule of Activities | page 1 | Since the response to questions are scheduled until August 17 and the RFP due date is only 2 weeks later, will the Commonwealth consider a 4 week extension to the due date to allow vendors time to appropriately take the responses to the questions into consideration of their proposal. | Refer to Section 1.1. | |
| 35 | RFP Cover Page | RFP | 1 | Our team is actively working on our response to your RFP 758 2700000012 for PHASE I - BENEFITS ADMINISTRATION & BILLING SOFTWARE SOLUTION AND SERVICES and we are very excited about the opportunity to partner with you. To ensure we can provide the most comprehensive, high-quality, and competitive proposal possible; would it be possible to grant a short extension to the submission deadline? We propose moving the deadline from 8/31/2026 to 9/14/2026. We completely understand if the strict procurement timeline does not permit this adjustment, and we appreciate your time and consideration. | Please see response to Question #34. | |
| 36 | 1.1 | Attachment A | Page 3 | Regarding Schedule of Activities. Can the Commonwealth provide a ballpark timeframe of Presentations as well as how much time will be given to prepare. | Considering procurement related activities such as; scoring, demos, negotiation process, these dates cannot be anticipated at this time. | |
| 37 | Submission Checklist | Final_RFP_758_2700000012_1_SO_FORM | pg 3 | In the Submission Checklist section, "Bid Information" is listed; can you advise if this is referencing Final_RFP_758_2700000012_1_SO_FORM? Also, can you advise if Final_RFP_758_2700000012_1_SO_FORM is to be included with the Technical Proposal Content? | Yes and Yes. | |
| 38 | Section 1.1 Schedule of Activities | RFP Addendum #1 | 3 | Given the scope and complexity of this procurement, would the State consider a four (4) week extension to the proposal submission deadline to allow Offerors to submit more complete and competitive responses? | Please see response to Question #34. | |
| 39 | Section 1.1 Schedule of Activities | RFP Addendum #1 | 3 | If an extension is granted, does the State anticipate maintaining the current evaluation and award timeline, or adjusting key milestone dates accordingly? | Please see response to Question #34. | |
| 40 | Section 2 Purpose | RFP Addendum #1 | 4 | Does the State have a preferred solution, platform, or technology stack in mind for this procurement, or is the State open to alternative approaches that meet the requirements? | The Commonwealth does not have a preferred solution, platform or technology stack for this procurement. The state is open to all approaches that meet the requirements and benefit the enterprise and does not introduce undue complexities or risks. | |
| 41 | Section 2.1 Project Goals | RFP Addendum #1 | 5 | You say, "The Commonwealth is looking for a new technology solution that is: Simpler and easier to use, Easier to maintain and support, Aligned with business requirements, Less complex and less costly to operate. What are the specific pain points you are encountering with your existing system that you want the new system to solve? | Complex, challenging to maintain, and costly to operate. Solution should be agile, scalable, and not so costly as well as sustainable and secure. | |
| 42 | Section 2.1 Project Goals | RFP Addendum #1 | 4 | Would you stay on your current platform if it were not for the Dec 2027 sunset provision? | Yes, because it does work. | |
| 43 | 2.2.2 / 3.1.A.1.1 | Attachment A | Page 6 / Page 9 | Please describe any collective bargaining agreements, grandfathered plans, retiree classes, or special populations that require unique eligibility or contribution rules. | The plan does not cover any union employees, so collective bargaining agreements do not apply. Pre-65 retirees participate in different retirement plans, including with the Teacher's Retirement System, the Kentucky Public Pension Authority, the Legislative Retirement Plan, and the Judicial Retirement Plan. Certain benefit options may not be available (are masked) for enrollment for participating retirees of these retirement plans. Premium contribution rules may also be different for these retiree populations (e.g., the retirement system may only cover the premium up to the amount of an employer's contribution to single coverage for one plan option, with the retiree responsible for the balance of that premium). | |
| 44 | 2.2.2 | Attachment A | Page 5 | Does the Commonwealth have plans or considerations to make vendor changes or re-evaluations of incumbents such as condition management solutions, consumer account vendors, and/or others? | This information will not be disclosed. | |
| 45 | 2.2.2 Kentucky Employee's Health Plan (KECP) | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | pg 6 | Please confirm the total number of retirees in each of the following categories: | ||
| • | Pre-65 | |||||
| • | Post-65 | |||||
| • | Life Insurance Only |
Based on the vendor conference, we believe support for post-65 retirees is out of scope; please confirm. Total number of retiree planholders by requested category:
• Pre-65: 39,655
• Post-65: 0 (note that return to work-retirees may be covered as active employees)
• Life Insurance Only: 0 (no retirees 65 and older have a life election managed by the Plan) (Data as of 7/13/2026)
| 46 | 2.2.2 Kentucky Employee's Health Plan (KECP) | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | pg 6 | What (if any) integrations are required with TRS? | TRS currently uses Pathway. Our current way to ingest data from Pathway is in the form of an XML file. | |
| 47 | 2.2.2 Kentucky Employee's Health Plan (KECP) | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | pg 6 | Please confirm if retirees are permitted to pay for benefits via pension deduction or via direct bill only. If both methods are offered, please confirm the number of retirees paying by each method. | Retirees pay by payroll deduction. We can accept individual arrears payments only, not truly a direct bill. | |
| 48 | 2.2.2 Kentucky Employee's Health Plan (KECP) | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | pg 6 | How many unique groups comprise each of the following categories: | ||
| • | State government employees | |||||
| • | Local school district employees | |||||
| • | Employees of certain quasi-governmental organizations |
How many employees are associated with each category?
| Will the proposer interact ongoing with representatives from each of these groups, or will services be coordinated through a centralized Commonwealth? | How many unique groups comprise each of the following categories: |
| • | State government groups/EEs 128:38,757 |
| • | Local school district groups/EEs 180:100,542 |
| • | Employees of certain quasi-governmental groups/EEs 223:11,411 |
Centralized
| 49 | Attachment A | Attachment A | Page 6 | Does each participating employer have their own offerings, or is there a standard set of offerings from KEHP? | The Plan primarily requires standardization across its participating employers. However, some employers have grandfathered offerings that depart from the standard suite of offerings from the Plan. Additionally, some employers may offer additional benefits not managed by the Plan. |
| 50 | Attachment A | Attachment A | Page 6 | How many separate offerings/eligibility groups are there total? | Eligibility falls into two primary groups: 1) full-time active employees of a participating employer, and 2) pre-65 aged retirees of a participating retirement system. |
| 51 | Attachment A | Attachment A | Page 6 | How many variations of rates are there? | The plan currently has 120 rate permutations across employee and employer contributions, factoring in smoking status and completion of a health assessment process that the Plan calls the "LivingWell Promise." |
| 52 | 2.2.2 KEHP | Attachment A | Page 6 | How many carriers will the benefits administrator need to integrate with to provide enrollment data? Please provide carriers. | The Plan currently has only one carrier acting as the third-party Administer -- Anthem of Kentucky. In addition, Anthem currently managers the following fully insured products: Dental and Vision. The plan also sends a variety of files, including but not limited to enrollment files to multiple vendors such as demographic, funding, COBRA, termination files, etc. The new benefits administrator will need the capability to integrate with all carriers/vendors if necessary. Please see KEHP website for additional information about our vendors in general: https://extranet.personnel.ky.gov/pages/healthinsurance.aspx. |
| 53 | N/A | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | pg 7 | Regarding the overall employee count of 191,353, how many of these are state employees versus other organizations? |
| Are there any state employees not eligible for medical? | Of the current planholders (including active Waivers), approximately 21% are state employees, 52% are school board employees, 20% pre-65 retirees, and the rest employees of other organizations. Part-time state employees are not eligible for medical. | |||||
| 54 | Attachment A | Attachment A | Page 7 | How many medical enrolled participants are there? | There are ~143,000 planholders (participants) enrolled in medical coverage. | |
| 55 | Table 1: 2026 KEHP Number of Covered Lives | Attachment A | Page 7 | Is the retiree population included in the 191,353 employee count? If so, what is the split between actives and retirees? If not, how many additional retirees are there? | Yes. See answer to Question #45. | |
| 56 | 2.2.2 | Attachment A | Page 7 | How many retirees are covered within the 191,353 total count? If there are multiple retiree groups, please provide that list, as well as if any of them are over 65. | ~40,000 pre-65 retirees. See answer to Question #45. | |
| 57 | 2.2.2 | Attachment A | Page 7 | Please provide the number of retirees paying via Direct Bill vs Pension. | 100% are paying via a pension adjustment. The retirement system sends the Plan a file with payment amounts by retiree based on their enrollment. The retirement systems work a premium bill in the same manner as a participating employer. For any active return to work retirees, they pay premiums via their employer. | |
| 58 | Attachment A: Section 3.1 | Scope of Work | Page 8 | The Commonwealth is requiring that an SI only partner with one SSP and that one SSP partner with one SI. However, can an SI that is submitting a response also be a subcontractor on additional responses. The Prime SI would still be responsible for the subcontractor. | According to Section 3.1 Scope of Work/Technical Requirements, Systems Integrators (SIs) Requirements, Systems Integrators (SIs) shall not submit proposals independently. The proposal owner is the Software Solution Provider (SSP). The SSP will determine which SI they will choose to include in the proposal response. | |
| 59 | Attachment A: Section 3.1 | Scope of Work | Page 8 | The Commonwealth is requiring only one subcontractor. Does this also apply to third party software and/or services. | The Commonwealth does not require only one subcontractor. Refer to Section 3.1 and Section 3.1.A.2. | |
| 60 | 3.1.A.1.1 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 9 | With respect to 3.1.A.1.1, how does the Commonwealth define each of the following: | ||
| • | Mobility | |||||
| • | Benefits navigation | |||||
| • | Premium billing and reconciliation | Mobility includes but is not limited to mobility by participants between agencies and plan offerings; Benefits navigation includes but is not limited to navigation of all benefit offerings as well as elections during an open enrollment or when making a qualified event/election change; Premium billing and reconciliation includes but is not limited to billing of premiums for plan members, collecting and recording payments and the reconciliation of those bills and payments that include billing adjustments, refunds, write-offs, etc. | ||||
| 61 | 3.1.A.5 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 9 | Please expand on the specific integrations requested with existing ERP and KHRIS. |
| What specific integrations should be assumed for the future state HCM/ERP; expand specifically on the requested integrations with respect to time, absence management, etc. | This is not included the scope of this RFP and will not be disclosed. | |||||
| 62 | 3.1.A.6 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 9 | Please expand on the scenarios in which the proposer would integrate with Tyler Technologies Transaction Payment Engine. Provide a description of the role of each party and a description or other documentation that outlines the expected process flow. | Current ERP integrates to TPE payment system (Payment service provider) through a secure RFC gateway with both systems certificates. Bank details are stored in KHRIS Biller direct portal. When participants pay their bill through ACH in KHRIS portal, KHRIS connects to TPE with all the requested payment details through an RFC request and then TPE interacts with Banks to verify funds and RFC response back to KHRIS with a status message. When payment is successful, KHRIS will be updated with PASS status with all additional details including request ID and marks the open items as cleared in business partner account. When payment status fails, KHRIS updates the payment status as FAIL with all additional details including request ID. Failures mostly happens when TPE system is down of certificates expires. After TPE verifies payment information with financial institutions, they will send us a response through same RFC which will be updated in KHRIS. TPE then sends a report that goes to DEI branch. DEI branch creates a CR for deposit and reconciliation. | |
| 63 | Attachment A Section 3.1.A.6 |
Attachment F BNA-116 RFP Attachment A, Page 9
| Attachment F, BNA-116 | Please provide the expected integration pattern, and any available technical documentation (file specifications, etc.) related to timing, payment statuses, reconciliation files, and responsibilities between the proposed solution and Tyler Technologies Transaction Payment Engine. | See response to Question #62. | ||||
| 64 | 3.1.A.6 | Attachment A | Page 9 | Please describe the current integration and how Tyler Technologies TPE is currently leveraged. What do they currently bill for that is participant-facing? | From Tyler's website: Tyler’s Payments platform is a modern, end-to-end electronic payment processing and transaction management solution that makes it easy for the public sector to accept payments for bills, fees, tickets, and fines. It manages the entire payments life cycle, from billing and presentment, payment capture, fund settlement, and disbursement to flexible merchant hierarchies, reconciliation, and reporting. |
Please see the following webpage for more information: https://www.tylertech.com/products/
Further, Tyler Technologies does not bill participants. The benefits solution will bill participants. Tyler Technologies is a payment enginge that collects and processes payments made to the Commonwealth. Current ERP integrates to TPE payment system (Payment service provider) through a secure RFC gateway with both systems certificates. Bank details are stored in KHRIS Biller direct portal. When participants pay their bill through ACH in KHRIS portal, KHRIS connects to TPE with all the requested payment details through an RFC request and then TPE interacts with Banks to verify funds and RFC response back to KHRIS with a status message. When payment is successful, KHRIS will be updated with PASS status with all additional details including request ID and marks the open items as cleared in business partner account. When payment status fails, KHRIS updates the payment status as FAIL with all additional details including request ID. Failures mostly happens when TPE system is down of certificates expires. After TPE verifies payment information with financial institutions, they will send us a response through same RFC which will be updated in KHRIS. TPE then sends a report that goes to DEI branch. DEI branch creates a CR for deposit and reconciliation.
65 3.1.A.6 Attachment A Page 9 Is the expectation that your new benefits administration vendor manage and collect payments for COBRA, LOA, and Retiree direct billing? Or is Tyler Technologies TPE somehow involved with those processes? Currently, a third-party administrator (HealthEquity) administers COBRA, including collection of payments and remittance of those payments to The Commonwealth in lump sum. The Commonwealth is interested in seeing what solutions are available for a complete replacement of the current COBRA TPA, if such an option is available based on the RFP response.
Tyler Technologies is not involved in COBRA, LOA or retiree direct billing.
| 66 | Attachment A - Sections 3.1.A.2 and Section 9.5 | RFP | Page 9 and 40 | Section 9.5 states "The contractor is permitted to make subcontract(s) with any other party for furnishing any of the work or services herein." Please confirm this means the SSP is permitted to implement and provide ongoing support for the products and services in scope of the RFP using more than 1 subcontractor. | Yes |
| 67 | Attachment A Section 3.1.A.1.1 |
Attachment F BN-100, BN-127 RFP Attachment A, Page 9
| Attachment F, BNA tab | Can the Commonwealth please clarify if the intent with this RFP is to include full COBRA Administration services and replace the Commonwealth's current COBRA TPA? Or is the Commonwealth intending to keep the current COBRA TPA in place and therefore only looking for the SSP to transmit new hire information and COBRA Qualifying Event information to the existing COBRA TPA?" | The Commonwealth is interested in seeing what solutions are available for a complete replacement of the current COBRA TPA, if such an option is available based on the RFP response. | ||||
| 68 | 3.1.A.1.1 | Attachment A | Page 9 | Please provide a detailed summaries of current benefit plans, including medical, dental, vision, life, FSA, and retiree benefit offerings, along with the number of eligibility groups, unique eligibility rules currently maintained. | Please see responses to this Q&A, including questions 18, 20, and 43. Additional information about the Plan is widely available online, including at: https://extranet.personnel.ky.gov/pages/healthinsurance.aspx | |
| 69 | 3.1.A.5 | Attachment A | Page 9 | What HR, payroll, time, and absence management systems will remain in KHRIS during Phase I, and which data exchanges are expected between the proposed solution and those systems? | All will remain in KHRIS during Phase I for the Commonwealth Paid employee population. Exchanges of data for that population will continue with the proposed solution. KEHP benefit only members data will only be in the newly proposed solution with no need to exchange benefit only member data with the current HR ERP, KHRIS. | |
| 70 | 3.1.A.6 | Attachment A | Page 9 | Please provide technical documentation or interface specifications for the Tyler Technologies Transaction Payment Engine (TPE), including supported APIs, file formats, authentication methods, and transaction volumes. | See response to Question #64. | |
| 71 | 3.1.A.1.1 | Attachment A | Page 9 | The RFP references numerous vendor integrations. Can the Commonwealth provide an inventory of all current inbound and outbound integrations, including carriers, wellness vendors, COBRA providers, payroll systems, financial systems, identity providers, and reporting platforms? | This information will be disclosed to the awarded vendor. | |
| 72 | 3.1.A.7 | Attachment A | Page 9 | Please clarify the structure of the 700+ participating employers and 649 billed customers. Are these populations administered centrally or does each employer require separate administration, billing, security, and reporting capabilities? | We bill the agencies for their employees and the agency is responsible for collecting and remitting payment. Each agency requires separate administration, billing, security and reporting capabilities. An entity should not be able to see information for employees in other participating entities. Executive branch agencies are currently handled through payroll administered by the Personnel Cabinet. The Commonwealth is interested in solutions that can streamline and standardize certian processes. | |
| 73 | 3.1.A.7 | Attachment A | Page 9 | Please provide monthly billing volume metrics, including number of invoices, adjustments, refunds, retroactive transactions, and reconciliation exceptions currently processed. | NCP Bills Generated Monthly- 904 give or take if we add a new group or groups drop out (we do not generate bills for CP payroll) |
Refunds- 3- 20 a month (Only NCP, CP is generated through payroll so we do not have those numbers) Adjustments- Range 150-250 depending on the months (During the beginning of the year we have more for Retiree Haz duty adjustments) this does not include KHRIS adjustments that are created by Batch Jobs Batch Job Adjustments- 1500-4000 adj a month, depending on the month. (These are the ones that KHRIS creates) Write-Off’s- Range from 100-200 monthly. Does not include CP members only NCP.
Clarifications- Range 500-1000 depending on month but have had over 5000. Only NCP members for this as well.
Arrears- Range from 250-800 30/60 day letters monthly NCP and CP Discrepancies- Range from 2,000 to over 12,000 lines of reconciliation both NCP and CP.
| 74 | 3.1.A.1.1 | Attachment A | Page 9 | Is COBRA administration currently managed internally or through a third-party administrator? If outsourced, should that relationship continue following implementation? | Currently, a third-party administrator administers COBRA. The Commonwealth is interested in seeing what solutions are available for a complete replacement of the current COBRA TPA, if such an option is available based on the RFP response. |
| 75 | 3.1.A.1.1 | Attachment A | Page 9 | Is ACA administration currently managed internally or through a third-party administrator? Please clarify operational responsibilities expected of the selected vendor. | This is currently handled through a third-party vendor. It is the Commonwealth's desire that this be provided by the new Benefits Administration solution, including federal submission, as well as mandatory states. |
| 76 | 3.1.A.1.2 | Attachment A | Page 9 | Please provide a current inventory of reports, dashboards, compliance reports, financial reports, audit reports, and ad hoc reporting requirements that must be available at go-live. | The Commonwealth will not provide a detailed list of reports. It is the Commonwealth's expectation that the proposed solution will provide robust reporting and dashboard functionality along with data extracts to support the Commonwealth's data warehouse for adhoc reporting needs. |
| 77 | 3.1.A.1.2 | Attachment A | Page 9 | Are vendors required to replicate all existing reports, or will reporting requirements be validated and rationalized during implementation? | Reporting requirements should be validated during the planning state for implementation of the new Benefits Administration solution to include an in-depth review of all standard reporting provided by the solution. |
| 78 | 3.1.A.1.1 | Attachment A | Page 9 | What is the number of 1095 forms produced in the most recent reporting year? | Calendar Year forms for 2025 distributed in 2026: 1095-B: 34,819 and 1095-C 39,183 |
| 79 | 3.1.A.9 | Attachment A | Page 9 | Please provide copies or samples of enrollment affidavits, attestation forms, tobacco-use certifications, LivingWell Promise questionnaires, and waiver forms currently utilized. | Please see KEHP website for forms: https://extranet.personnel.ky.gov/pages/healthinsurance.aspx. |
LivingWell Promise questionnaire is currently provided by Castlight and is provided as Attachment I - KEHP - LivingWell Promise Questionnaire.
| 80 | 3.1.A.12 | Attachment A | Page 10 | The RFP requires 25% onsite staffing. Does the Commonwealth define this requirement at the project level, by individual resource, or by cumulative project effort? | This is 25% at the cumulative project level. See revised Section 3.1.A.12. |
| 81 | 3.1.A.13 | Attachment A | Page 10 | Please define the criteria for Final System Acceptance and release of the 15% retainage associated with deliverable-based payments. | This criteria will be defined by the Commonwealth in collaboration with the Systems Integrator (SI) and aligned upon as part of the Systems Acceptance Checklist Deliverable. |
| 82 | 3.1.A.11 | Attachment A | Page 10 | Please clarify the Commonwealth's expectations for self-configuration. Are vendors expected to provide full configuration access for eligibility, plan setup, rates, communications, workflows, and reporting without vendor involvement? | The Division of Technology Resources (DTS) is 1st line technical support and staff are identified as system admins and will have access to all configurable functionality and perform ongoing config changes post go-live. |
| 83 | Attachment A Section 3.1.A.11 | RFP | Page 10 | For non on-prem / SaaS vendor solutions where the SSP is responsible for performing all system configuration changes on the Commonwealth's behalf, can you please confirm that the Commonwealth team members would not also require the ability to perform system configuration changes within the SSP's platform(s)? | The Commonwealth would also have designated resources with user role access allowing for specified configuration capability. |
| 84 | 3.1.A.12 | Attachment A | Page 10 | Is the 25% requirement for the Implementation Manager or are additional resources also required to be on-site? | Please see response to Question #80. |
| 85 | 3.1.A.11 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 10 | Are there components of implementation and/or ongoing system configuration the Commonwealth is seeking to own versus the proposer providing system configuration services? | Yes. |
| 86 | 3.1.A.12 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 10 | Please confirm if the 25% time delivered on-site requirement is applicable to the implementation phase only or ongoing service delivery as well. | Planning and Implementation Phases, including testing, training, go-live readiness and post go-live hypercare and stability. This is not required for ongoing service delivery. |
| 87 | Section 3.1.A | RFP Addendum #1 | Page 10 | Does the State require any mandatory onsite staffing, or is a remote or hybrid delivery model acceptable? | The RFP requires 25% onsite staffing at a cumulative level. See revised Section 3.1.A.12 for details. |
| 88 | 3.3.1.1 | Attachment A | Page 11 | Is implementation expected to occur as a single deployment or through multiple phases or releases within Phase 1? | The Commonwealth prefers a single deployment; however, this should be discussed and validated as part of the implementation planning. |
| 89 | 3.3.1.4.2 | Attachment A | Page 11 | Please provide the approximate number of active employees, retirees, dependents, beneficiaries, and employer groups that will be converted into the new solution. | See RFP Attachment A, Section 2.2.2 Kentucky Employees Health Plan (KEHP) Table 1: KEHP Number of Covered Lives for current number of enrollees. Please see KEHP website for additional information: https://extranet.personnel.ky.gov/pages/healthinsurance.aspx. |
| 90 | 3.3.1.4.2 | Attachment A | Page 11 | If the SI allows for tracking, maintenance, enrollment, and data transmission to Medicare carriers for Retirees Over age 65, will the Commonwealth consider or require storing this data in the platform, whether in Phase 1 or future Phases? If so, please provide the total count of retirees over 65, as well as spouses covered over the age of 65 and which other coverage is offered to this population. | Out of scope for Phase I. |
| 91 | 3.3.1.4.2 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 11 | Please expand on the current employer group and billing entity data requested for inclusion in the minimum data conversion requirements. | This question is vague. Billing entity data would include but not be limited to employee/employer premium (Health, FSA, HRA & Optional Insurance) amounts, plan names and admin. fees required for agency billing. Agency bills will be to be broken down to the employee level and applied their associated plans. |
| 92 | Attachment A Section 3.3.1.4.2 | RFP | Page 11 | Can the Commonwealth clarify the type of data that is referred to as "billing entity data?" | See response to Question #91. |
| 93 | 3.3.1.4.3 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 12 | Please confirm if the activities included under the heading "Optional/Additional Data Conversion" are optional or required as Attachment E requires affirmative response to section 3.3.1.4 in its entirety. |
| If data conversion is required, please provide further specifics regarding the data to be included in this conversion activity. | The requirement is for the SI to provide a recommended approach to provide additional data beyond the minimum data requirements for the initial active benefit members' data. | |||||
| 94 | 3.3.1.4.3 | Attachment A | Page 12 | Please specify the required historical data retention period and identify which historical records are required for operational, reporting, audit, or compliance purposes. | Data retention is a complex compliance question that cannot be fully answered here. As a guideline, the Vendor can assume that the most common retention period is 10 years. | |
| 95 | 3.3.1.4.4 | Attachment A | Page 12 | Has the Commonwealth completed any data profiling or data quality assessments on KHRIS and related source systems? If yes, can findings be shared? | No data proofing or data quality assessments have been completed. | |
| 96 | 3.3.1.4.6 | Attachment A | Page 12 | The RFP requires multiple conversion cycles. Is the Commonwealth willing to define a maximum number of test conversions included in the fixed-fee implementation scope? | Yes, see Section 3.3.1.4.6 Data Conversion Cycles requesting initial conversion, at least 2-3 additional data conversions in non-production environment prior to final production data conversion. | |
| 97 | Attachment A Section 3.3.1.4.7 | RFP | Page 13 | Can the Commonwealth please specify which Section Reference numbers apply to the mandatory Data Security and Confidentiality requirement in 3.3.1.4.7? | 3.3.1.4.7 Data Security and Confidentiality | |
| 98 | 3.4 | Attachment A | Page 15 | Will the Independent Verification and Validation (IV&V) vendor be selected before implementation begins, and how will IV&V findings impact scope, schedule, and acceptance decisions? | Yes. The Commonwealth—not the IV&V vendor—retains authority over scope, schedule, and acceptance decisions, which aligns with the intent of the RFP; however findings by the IV&V will be reviewed with all parties for consideration. All data conversion activities shall comply with Commonwealth security requirements, including handling of sensitive and highly restricted data. Vendor shall ensure that all data is securely transferred, stored, and processed in accordance with applicable policies and contractual requirements. | |
| 99 | 3.5.1.3 | Attachment A | Page 16 | If call center services are proposed as a value-added service, can the Commonwealth provide estimated annual call volumes, peak open enrollment volumes, and expected service-level requirements? | Internal Customer service Calls: Dental/Vision/Life-1,898 (~190 in Jan, 345 in Oct, otherwise ~130) |
Medical-17,408 (~1800 in Jan, 4000 in Oct, otherwise ~1200)
| 100 | 3.5.1.2 | Attachment A | Page 16 | If dependent verification services are desired in the future, can the Commonwealth provide estimated participant volumes and verification frequencies? | Spousal reverification roughly every 3 years for ~30,000 and Dependent verification on a 7 year cycle of roughly 11,000/year | |
| 101 | 3.5.1.2 | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 16 | Please expand on the call center support requested specific to premium billing operations (e.g., does this represent inquiries from employees/participants paying for coverage via direct bill?) | Call Center support is not being requested for premium billing operations. | |
| 102 | 3.5 Value Added Services | Attachment A | Page 16 | On average, how many dependent verifications occur annually? | Spousal reverification roughly every 3 years for ~30,000 and Dependent verification on a 7 year cycle of roughly 11,000/year | |
| 103 | 3.5 Value Added Services | Attachment A | Page 16 | How many spending accounts are there total: FSA, DCFSA, HRA and HSA? | FSA: ~25,000, DCFSA ~1,500, HRA ~110,000, HSA not offered | |
| 104 | Section 4 Hosting/Data Requirements | RFP Addendum #1 | Page 16 | Are offshore or nearshore resources permitted for any portion of the services, provided all security, data residency, and compliance requirements are met? | Yes | |
| 105 | Attachment A Section 4.1 | RFP | Page 16-17 | For SaaS solutions, can the Commonwealth confirm that hosting the SSP's solution on a COT managed cloud tenant is not a mandatory requirement? | Confirmed | |
| 106 | Attachment A Section 4.1 | RFP | Page 17 | For SaaS solutions, can the Commonwealth confirm that the SSP hosting on an isolated tenant is not mandatory? | Confirmed | |
| 107 | Section 4.8 | Attachment A | Page 18 | Can you expand on why GDPR compliance is required if no processing is occurring within the EU? | If any retiree or COBRA recipient or any other individual interacts with the system in an EU country that individual will have all rights provided by the GDPR. | |
| 108 | 4.13.G | Attachment A | Page 20 | Please provide required Recovery Time Objective (RTO) and Recovery Point Objective (RPO) expectations for the production environment. | The Commonwealth has not established specific Recovery Time Objective (RTO) or Recovery Point Objective (RPO) requirements in this RFP. Vendors should propose industry best practice RTO and RPO targets appropriate for a mission-critical Benefits Administration and Billing solution and describe how those objectives will be achieved and supported within the proposed disaster recovery and business continuity approach. | |
| 109 | Attachment A Section 4.14.A.1 | RFP | Page 21 | For SaaS solutions that are multi-tenant and not an isolated tenant per client, can the Commonwealth confirm data can be co-mingled with another entity? | Section reads Non-ON Prem Solutions No Commonwealth data shall be co-mingled with another entity, without the prior approval of the Commonwealth | |
| 110 | Section 4.19 Security Controls and Personnel Security | RFP Addendum #1 | Page 22 | Are background checks required for all Vendor personnel, or only for personnel with physical or logical access to State systems or data? | This should be scoped at a minimum to staff that have physical or logical access, or hold direct responsibilities for services delivered as part of the contract. As a matter of best practices, all vendor staff should have a background check, but those that have direct interaction with data, infrastructure, and other aspects of service delivery would represent the minimum requirement. It is important to note that this includes all staff that have the potential to access the environment where Commonwealth data exists, not just those with specific job responsibilities to do so. | |
| 111 | 4.2 | Attachment A | Page 23 | Please clarify whether Federal Tax Information (FTI) will be stored, processed, or transmitted by the proposed solution. | Data such as SSN and other PII, FTI, and PHI may be stored. Processing and transmittal would be dependent if the proposed solution has or offers additional functionality the Commonwealth may be interested in such as ACA reporting. | |
| 112 | Section 6.6 Format of Response | Addendum One - ATTACHMENT A - Terms and Conditions - RFP 758 2700000012 | Page 31 | In Attachment A, the instructions state that each of the three parts (technical, cost, and proprietary) should be "submitted on one (1) document". Please confirm that this means we can submit one zip file for the technical proposal that includes all required attachments and other files. | Per Section 6.5 Proposals shall be submitted in three (3) parts: The Technical Proposal, the Cost Proposal, and Proprietary Information. Each part should consist of one document attachment. Do not submit multiple documents as Technical, Cost, or Proprietary. All files should be labeled accordingly. Attachments may not exceed 65,000 KB per document. Documented response to Attachment F, Business & Technical Questionnaire can be provided in multi-part if necessary, and labeled as Part 1 of 3, Part 2 of 3, Part 3 of 3 (for example). | |
| 113 | Section 6.7(A) Transmittal Letter and Deviations | RFP Addendum #1 | Page 32 | Please confirm whether Offerors may submit redlined exceptions to the State’s Standard Terms and Conditions as part of their proposal. | This can be submitted as a deviation. Refer to Section 6.7.A.1 | |
| 114 | Section 6.7(A) Transmittal Letter and Deviations | RFP Addendum #1 | Page 32 | Will commercially reasonable and risk-balanced contract redlines be reviewed and considered during the evaluation and negotiation process? | This can be submitted as a deviation. Refer to Section 6.7.A.1 |
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