Bid Document - Complete.pdf

REQUEST FOR PROPOSALS

Issued By

COUNTY OF TAZEWELL

OFFICE OF THE COUNTY FINANCE DIRECTOR

MINDY L. DARCY, CPA

TAZEWELL COUNTY FINANCE DIRECTOR /

ASSISTANT COUNTY ADMINISTRATOR

11 S. 4TH STREET, SUITE #120

PEKIN, ILLINOIS 61554

PHONE (309) 477-2237 FAX (309) 477-3095

Sealed bids will be received at the Office of the

County Finance Director, Suite #120 Tazewell County

Pekin, Illinois 61554

Third-Party Administrative Services for Medical Plan

Project # 2023-E-01

SUBMITTED BY:

RETURN THIS COPY Mindy L. Darcy, CPA

ATTACHED TO YOUR BID Tazewell County Finance Director/

Assistant County Administrator

We hereby submit our proposal for the Tazewell County Third-Party Administrative

Services for Medical Plan, Project #2023-E-01.

______________________________________, herein called “bidder,”

Company Name acknowledges receipt of the following documents, which are incorporated herein by reference and together with this proposal, are herein called “contract documents.”

A. Request for Proposals

B. General Instructions to Bidders

C. Bid Form (in RFP Specifications)

D. RFP Specifications

E. Non-Collusion and Certification of Eligibility Affidavit

F. Agreement for County of Tazewell (Sample)

Signature & Title

Date

REQUEST FOR PROPOSALS

TAZEWELL COUNTY

Project #2023-E-01

Tazewell County is inviting sealed Request for Proposals from interested and qualified

Third-Party Administrator (TPA) firms to provide claims/administrative services for our self-funded employee medical plan.

Copies of the Request for Proposals documents may be obtained from the Tazewell

County Finance Office, beginning Monday, October 2, 2023, at 11 S. 4th Street, Suite

#120, McKenzie Building, Pekin, Illinois, 61554. A link to the Request for Proposals documents via BidNet Direct is at tazewell-il.gov. Please follow all Instructions to

Bidders.

Proposals will be received in the Tazewell County Finance Office, 11 S. 4th Street, Suite

#120, Pekin, Illinois, 61554 no later than 3:30 p.m. CST, Monday, October 16, 2023.

Proposals will be publicly opened in the Tazewell County Finance Office located at 11

S. 4th Street, Suite 120, Pekin, IL immediately following the close of receipts.

Questions regarding this Request for Proposals may be directed to Mindy L. Darcy, Tazewell County Finance Director / Assistant County Administrator at mdarcy@tazewell-il.gov, or (309)477-2237 through October 6, 2023.

Mindy L. Darcy, CPA

Tazewell County Finance Director /

Assistant County Administrator mailto:mdarcy@tazewell-il.gov

GENERAL INSTRUCTIONS TO BIDDERS

1. All instructions contained herein are applicable.

2. Bid Proposal Form:

Separate duplicate copies of the proposal form as provided, are to be submitted by the bidder for that purpose as set forth below.

3. Preparation of Bid:

A. Bids shall be submitted in duplicate on forms which will be furnished by the Tazewell

County Finance Director’s Office.

B. All spaces provided for on the form shall be either typewritten or written in ink. Where both written words and numerical figures are given, the written words will apply in the event of a conflict.

4. Questions and Inquires:

Questions or inquires concerning the specifications, terms, and conditions of the requested bid should be directed to the County Finance Director or designee as named in the detailed specifications. If the nature and volume of inquires indicate a substantial defect in the aforesaid specifications, terms and conditions, the County will either issue an addenda, schedule an additional pre-bid conference, extend the time for submission of bids, or reject all bids and reissue corrected or appropriately modified specifications, terms, and conditions. All such addenda shall become a part of the specifications as if originally submitted. However, in no case will changes, additions, or deletions be made without receipt of either an addenda or change order from Mindy

L. Darcy, Tazewell County Finance Director.

Submission of Bids:

A. Bids will be received at the time and place set forth in the invitation to bid.

B. Envelopes containing bids shall be sealed; mailed or delivered, and addressed as follows:

Mindy L. Darcy, CPA

Tazewell County Finance Director /

Assistant County Administrator

11 S. 4th Street, Suite #120

Pekin, Illinois 61554

5. Contract to be Awarded/Terms and Conditions:

The following general contract terms and conditions are included in these instructions to inform vendors of general terms and conditions to which the County will require the successful vendor to agree. Successful vendor hereafter referred to as “Contractor”.

A. Assignment of Contractual Rights:

It is agreed that the Contractor shall not assign, transfer, convey, or otherwise dispose of the Contract or its right, title or interest in the Contract or any part thereof, without previous written consent of County and the sureties.

* County includes all offices of the County unless an individual officer is exercising independent contractual authority. Contact the County Administrator at (309) 477-2272 if this is an issue.

B. Contract Management:

The Contractor shall appoint an individual person as an Agent who shall be available for discussions; when requested, concerning the fulfillment of the Contract. The County will deliver official documents addressed to the Contractor to the Agent of the Contractor.

The Agent shall be available at the time of Contract award. The name, address and telephone number of the person to be designated as Agent shall be included in the

Proposal.

C. Meetings:

After the award of the Contract, technical, scheduling and status meetings may be held.

These meetings will be for the purpose of, but not limited to:

- Establishment of project schedule

- Establishing functional details of the construction or equipment

- Delivery, installation and maintenance of equipment or hardware

The Contractor shall provide the services of his technical staff and Agent for these meetings.

D. Progress Reports:

The Contractor is required to submit monthly reports on the status of the project so that the County is kept fully informed of progress. The information required will be specified at the meetings with the Contractor.

E. Notice and Service Thereof:

Any notice to Contractor from the County relative to any part of this Contract shall be considered delivered, and the service thereof completed, when said notice is posted by

U.S. mail to the said Contractor at his last given address or delivered in person to

Contractor’s Agent.

F. Conflict of Interest

A Contractor filing a proposal thereby certifies that no officer, agent or employee of the

County who has a pecuniary interest in this proposal has participated in the contract negotiations on the part of the County, that the proposal is made in good faith without fraud, collusion, or connection of any kind with any other Contractor for the same

Request for Proposals, and that the Contractor is competing solely in its own behalf without connection with, or obligation to, any undisclosed person or firm.

G. Compliance With Laws:

The bidder shall at all times observe and comply with all laws, ordinances and regulations of the federal, state, local, and County governments, which may in any manner affect the preparation of proposals or the performance of the contract.

H. Equal Employment Opportunity

In the event of the Contractor's noncompliance with any provision of this Equal Opportunity clause, the Illinois Fair Employment Practices Act, or the Fair Employment Practices

Commission's Rules and Regulations for Public Contracts, the Contractor may be declared not responsible and therefore ineligible for future contracts with the State of Illinois or any of its political subdivisions or municipal corporations, and the contract may be canceled or voided in whole or in part, and such other sanctions or penalties may be imposed or remedies invoked as provided by statute or regulation.

During the performance of this contract, the Contractor agrees as follows:

(a) That he shall not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, handicap, national origin or ancestry; and further that he will examine all job classifications to determine if minorities or women are under-utilized and shall take appropriate affirmative action to rectify any such under-utilization.

(b) That, if he hires additional employees in order to perform this contract or any portion hereof, he shall determine the availability (in accordance with the Fair Employment Practices

Commission's Rules and Regulations for Public Contracts) of minorities and women in the area(s) from which he may reasonably recruit, and he shall hire employees for each applicable job classification in such manner that minorities and women are not under-utilized.

(c) That, in all solicitations or advertisements for employees placed by him or on his behalf, he shall state that all applicants will be afforded equal opportunity without discrimination based on race, color, religion, sex, handicap, national origin or ancestry.

(d) That he shall send to each labor organization or representative of workers with which he has or is bound by a collective bargaining or other agreement or understanding, a notice advising such labor organization or representative of the Contractor's obligations under the

Illinois Fair Employment Practices Act and the Fair Employment Practices Commission's

Rules and Regulations for Public Contracts. If any such labor organization or representative fails or refuses to cooperate with the Contractor in his efforts to comply, the Contractor shall promptly so notify the Illinois Fair Employment Practices Commission and the contracting agency and shall recruit employees from other sources when necessary to fulfill his obligations there under.

(e) That he shall submit reports as required by the Fair Employment Practices

Commission's Rules and Regulations for Public Contracts, furnish all relevant information as may from time to time be requested by the Commission or the contracting agency, and in all respects comply with the Illinois Fair Employment Practices Act and the Commission's Rules and Regulations for Public Contracts.

(f) That he shall permit access to all relevant books, records, accounts and work sites by personnel of the Fair Employment Practices Commission and the contracting agency for purposes of investigation to ascertain compliance with the Illinois Fair Employment Practices

Act and the Commission's Rules and Regulations.

(g) That he shall include verbatim or by reference the provisions of paragraphs a through g of this clause in every performance subcontract as defined in Section 2.10(b) of the

Commission's Rules and Regulations for Public Contracts so that such provisions will be binding upon every such subcontractor; and that he shall also include the provisions of paragraphs a, e, f, and g in every supply subcontract as defined in Section 2.10(a) of the

Commission's Rules and Regulations for Public Contracts so that such provisions will be binding upon every such subcontractor. In the same manner as with other provisions of this contract, the Contractor shall be liable for compliance with applicable provisions of this clause by all subcontractors; and further he shall promptly notify the Fair Employment Practices

Commission and the contracting agency in the event any subcontractor fails or refuses to comply therewith. In addition, no Contractor shall utilize any subcontractor declared by the

Commission to be not responsible and therefore ineligible for contracts or subcontracts with the State of Illinois or any of its political subdivisions or municipal corporations.

With respect to the two types of subcontractors referred to under paragraph (g) of the Equal

Employment Opportunity Clause Above, following is an excerpt of Section 2 of the FEPC's

Rules and Regulations for Public Contracts:

Section 2.10: The term "Subcontract" means any agreement, arrangement of understanding, written or otherwise, between a Contractor and any person (in which the parties do not stand in the relationship of an employer and an employee):

(h) For the furnishing of supplies or services or for the use of real or personal property, including lease arrangements, which, in whole or in part, is utilized in the performance of any one or more contract; or

(i) Under which any portion of the Contractor's obligation under any one or more contracts is performed, undertaken or assumed; or

(j) For bid specifications for construction or services.

I. Liability and Insurance:

The County does not assume any liability for acts or omissions of Contractor and such liability rests solely with Contractor.

Contractor’s Insurance – The Contractor and all subcontractors shall secure and maintain such insurance policies as will protect him self from claims for bodily injuries, death or property damage which may arise from operations under this Contract whether such operations be by himself or anyone employed by him directly or indirectly. The following insurance policies are required:

- Statutory Worker’s Compensation

- Comprehensive General Liability

Combined Single Limit $ 1,000,000.00

Property Damage $ 1,000,000.00

- Automobile Public Liability and Property Damage

Combined Single Limit $ 1,000,000.00

Property Damage $ 1,000,000.00

Insurance Inclusions – The comprehensive general liability insurance shall include independent contractor’s protective liability, products and completed operations broad form property damage coverage. The completed operations and products liability shall be maintained for two years after final payment.

Contractual Liability – The insurance required above shall include contractual liability insurance coverage for the Contractor’s obligations under Section N below entitled, “Hold Harmless and Indemnification Agreement”.

Certificates of Insurance – Certificates of insurance acceptable to the County indicating insurance required by the Contract is in force shall be filed with the County prior to approval of the Contract by the County. These certificates shall contain a provision that coverage afforded under the policies will not be canceled until at least thirty (30) days prior written notice has been given to the County.

J. Hold Harmless and Indemnification Agreement:

The Contractor shall save and hold harmless and indemnify the County and the citizens of Tazewell County against any and all liability, claims and costs of whatever kind and nature for injury to or death of any person or persons and for loss or damage to any property occurring in connection with or in any way incident to or arising out of the use, service, operation or performance of work under the terms of this contract, resulting from the negligent acts or omissions of Contractor, or any employee, agent or subcontractor.

Contractor is not responsible for consequential damages.

K. Limited Distribution or Use of Certain Data and Information:

Performance of this contract may require the Contractor to have access to and use of data and information which may be considered proprietary to a County agency or County contractor, or which may otherwise be of such a nature that its dissemination or use, other than in performance of this contract, would be adverse to the interest of the County or others.

Contractor agrees that contractor personnel will not divulge or release data or information developed or obtained in connection with their performance of the resulting contract, unless made public by the County, except to authorized County personnel or upon written approval of the Tazewell County Administrator.

Except as may be otherwise agreed to with a data owner, the Contractor agrees not to use, disclose or reproduce proprietary data, other than as required in performance of this contract; provided, however, that nothing herein shall be construed as precluding the use of any data independently acquired by the Contractor without such limitation.

All proprietary information and all copies thereof shall be returned to the County upon completion of the work for which it was obtained or developed.

L. Inspection of Materials:

The County shall have a right to inspect any materials or equipment to be used in carrying out this Contract. The Contractor shall be responsible for the contracted quality and standards of all materials, equipment, components or completed work finished under this Contract up to the time of final acceptance by the County. Materials, equipment, components, or completed work not complying therewith may be rejected by the County and shall be replaced by the Contractor at no cost to the County. Any materials, equipment or components so rejected shall be removed within a reasonable time from the premises of the County at the entire expense of the Contractor.

M. Responsibility for County Property:

The Contractor assumes full responsibility for and shall indemnify the County for any and all loss or damage of whatsoever kind and nature to any and all County property

(and/or property belonging to other County agencies within Tazewell County), including any equipment, supplies, accessories, or parts furnished, while in Contractor’s custody and care for storage, repairs, or services to be performed under the terms of the resultant contract, resulting from the negligent acts or omissions of Contractor or any employee, agent or representative of Contractor or subcontractor.

The Contractor shall do nothing to prejudice the County’s right to recover against third parties for any loss, destruction of, or damage to County property (and/or property belonging to other County agencies within Tazewell County), and upon the request of the contracting officer shall, at the Contractor’s expense furnish to the County all reasonable assistance and cooperation, including assistance in the prosecution of suit and the execution of instruments of assignment in favor of the County in obtaining recovery.

N. Right to Audit:

Contractor agrees that the County or its representatives shall have the right to examine any of Contractor’s records, which directly relate to this contract.

O. Default

(a) The County may, subject to the provisions of paragraph (c) below, by written notice of default to the Contractor, terminate the whole or any part of this contract in any one of the following circumstances:

(i) if the Contractor fails to make delivery of materials or to perform services within the time specified herein or any extension thereof, or

(ii) if the Contractor fails to perform any of the other performances of this Contract, or so fails to make progress as to endanger performances of this contract in accordance with its terms, and in either of these two circumstances does not cure such failures within a period of ten days, or such other period as the Purchasing Agent may authorize in writing, after receipt of notice from the Purchasing Agent.

(b) In the event the County terminates this contract in whole or in part as provided for in paragraph

(a) of this clause, the County may procure, upon such terms and in such manner as the

Purchasing Agent may deem appropriate, materials or services similar to those so terminated, and the Contractor shall be liable to the County for any excess costs for such similar supplies or services. The County may deduct these costs from any unpaid balance due the Contractor or may collect against any bond or surety in effect.

(c) The Contractor shall not be liable for any excess of costs if acceptable evidence has been submitted that failure to perform was due to causes beyond the control of and without the fault or negligence of the Contractor.

P. Taxes:

The County is exempt from all State and City sales tax and will provide documentation, if required.

Q. Change Orders:

While the Contract is in effect, if unforeseen conditions require a change or major variations from the original plans, a Change Order will cover such work. The Change

Order is to set forth in complete detail the nature of the change and reasons therefore.

Whether it is an addition or reduction with respect to the original Contract price is to be covered in detail as well as any extension or reduction of the completion date.

6. Examination of Site: (when applicable)-

Each bidder shall visit the site of the proposed work and fully acquaint himself with conditions as they exist, so that he may fully understand the facilities, difficulties and restrictions that may and can affect the work and cost thereof. Bidders shall also thoroughly examine and be familiar with the specifications as set forth for this project.

7. Withdrawal of Bids:

Any bidder may withdraw his proposal at any time prior to the time and date set for the termination of bidding in writing. No bidder may withdraw his proposal for a period of thirty (30) days after the time and date set for the termination of bidding.

8. Award of Contract:

A. An award will be made to the lowest qualified bid that complies with the terms and conditions of the specifications provided that it is in the best interest of the County to accept the proposal. Awards will be made on a per item basis unless otherwise stated.

The quality of the articles to be supplied, their conformity with specifications, their suitability to the requirements of the County and the delivery terms will be taken into consideration in making the award.

B. Award of a contract as a result of this invitation is dependent upon the availability of funds from which payments will be made.

C. Professional service selection will be awarded within the guidelines of the Local

Government Professionals Service Act (50ILCS 510/0.01).

9. Rejection of Bids:

The County of Tazewell reserves the right to reject any or all bids when such rejection is in the best interest of the County.

Unless called for, substitute or alternative bids shall not be considered.

10. Acceptance of Bids:

The right is reserved, as the interest of the County may require, rejecting any or all bids and to waive any nonmaterial informality or irregularity in the bids received. The County will accept one of the proposals or reject all proposals within ninety (90) calendar days from the bid opening date.

11. Prices:

Unit prices shall be shown for each unit on which there is a bid and shall include all packing, crating, freight and shipping charges and cost of unloading supplies at destination unless otherwise stated in the bid proposal. Unit prices shall not include any local, state or federal taxes. In case of a mistake in extension of price, unit shall govern. All prices must be typewritten or written in ink.

No erasures are permitted. Mistakes must be crossed out and corrections typewritten in ink adjacent thereto and initialed in ink by the party signing the bid or his authorized representative.

12. Discounts:

Cash discounts for payment within fifteen (15) days or more will be considered in awarding the bid. Discounts of less than fifteen (15) days will not be considered in the bid evaluation. Where the net bid is equal to a bid with the cash discount deducted, the award shall be made to the net bid. Discounts will be figured from the date of delivery and acceptance of the articles, or in the case of incorrect invoice, from the date of receipt of corrected invoice.

13. Price Reduction:

If at any time after the date of the bid or offer the Contractor makes a general price reduction in the comparable price of any item covered by the Contract to customers generally, an equivalent price reduction based on similar quantities and/or considerations shall apply to the Contract for the duration of the contract period (or until the price is further reduced). Such price reduction shall be effective at the same time and in the same manner as the reduction in the price to customers generally. For the purpose of this provision, a “general price reduction” shall mean any horizontal reduction in the price of an article or service offered (1) to Contractor’s customers generally, or (2) in the Contractor’s price schedule for the class of customers, i.e. wholesalers, jobbers, retailers, etc., which was used as the basis for bidding on this Contract. An occasional sale at a lower price, or sale of distressed merchandise at a lower price, would not be considered a “general price reduction” under this provision. The Contractor shall invoice the County at such reduced prices, indicating on the invoice that the reduction is pursuant to the Price Reduction provision of the contract documents. The contractor shall, within ten days of any general price reduction, notify the Purchasing Agent of such reduction by letter. Failure to do so may result in termination of the

Contract.

14. Patents:

The successful bidder agrees to protect, defend, and save the County harmless against any demand for payment for the use of any patented material process, article, or device that may enter into the manufacture, construction or form a part of the work covered by the contract.

15. Guarantees and Warranties:

All guarantees and warranties required shall be furnished by the Contractor and shall be delivered to the

Purchasing Agent before final voucher on the Contract is issued.

16. Cancellation:

The County reserves the right to cancel the whole or any part of the contract, if the Contractor fails to perform any of the provisions in the contract or fails to make delivery within the time stated.

The Contractor will not be liable to perform if situations arise by reason of strikes, acts of God or the public enemy, act of the County, fires or floods.

17. Signatures:

Each bid must be signed by the bidder with his usual signature. Bids by partnerships must be signed with the partnership name by one of the members of the partnership, or by an authorized representative, followed by the signature and title of the person signing. Bids by corporations must be signed with the name of the corporation, followed by the signature and title of person authorized to bind it in the matter. All signatures must be in ink.

18. Special Conditions:

Where special conditions are written in the specifications, these conditions shall take precedence over any conditions listed under the “Instructions to Bidders”.

19. Permits and Licenses:

The Contractor shall obtain, at his own expense, all permits and licenses that may be required to complete the contract.

20. Prices Specified:

The Contractor agrees to furnish the material or services according to the County’s plans, specifications and conditions and at prices specified hereon.

21. Samples:

Samples of items; when required, must be submitted within the time specified and at no expense to the County; and if not destroyed in testing, they will be returned at the bidders request and expense. Samples: which are not requested for return, within thirty (30) days, will become the property of the County.

22. Bid Envelope Identification:

Bidders are requested to indicate in the lower left hand corner of their envelope the item being bid, bid number and date the bid is due.

23. Prevailing Wages:

The Contractor and all subcontractors shall comply with 820 ILCS 130/1, et. seq., concerning general prevailing rate of hourly wages. A copy of the County ordinance dealing with prevailing wages is available at the office of the Tazewell County Clerk for examination.

24. Taxes:

The County is exempt, by law, from paying State and City Retailer’s Occupation Tax, State

Service Occupation Tax, State Use Tax and Federal Excise Tax. The County will execute tax exemption certificates whenever required. The unit prices should be exclusive of all taxes. In the event unit price includes taxes, the bidder must show the amount of tax included in the unit price

25. Investigation:

Bidders shall make all investigations necessary to thoroughly inform themselves regarding the supplies and/or service to be furnished in accordance with the bid proposal. No plea of ignorance by the Contractor, of conditions that exist or that may hereafter exist as a result of failure or omission on the part of the bidder to make the necessary examinations and investigations, will be accepted as a basis for varying the requirements of the County or the compensation to the bidder.

26. Non-Collusion Affidavit:

Whenever the Affidavit of Non-Collusion form is attached to the specifications, the bidder must properly execute it or the bid will not be considered for acceptance.

27. Bid-Rigging or Bid Rotating:

The signed form certifies that the bidder is not barred from bidding on this bid as a result of a conviction for the violation of State of Illinois laws prohibiting bid rigging or bid-rotating per

Public Act 85-1295, Section 33E-3 and 33E-4.

Project 2023-E-01

Tazewell County

REQUEST FOR PROPOSAL (RFP) TO PROVIDE THIRD-PARTY

ADMINISTRATIVE (TPA) SERVICES FOR MEDICAL PLAN OF

TAZEWELL COUNTY, ILLINOIS

NOTICE IS HEREBY GIVEN that Request for Proposals (RFP) are invited by Tazewell County, Illinois for specifications to provide Employee Medical Plan Claims/Administrative Services in strict accordance with the specifications.

Tazewell County is seeking proposals from qualified Third Party Administrator (TPA) firms to provide claims/administrative services for its self-funded employee medical plan which cover approximately 320 active & retired employees as well as their dependents in strict accordance with the specifications.

Proposal forms and specifications are available on the County’s website at https://www.tazewell-il.gov/Finance/FinanceBids.html and must be delivered to the Finance

Director, 11 South Fourth Street, Suite 120, Pekin, Illinois 61554, up to but not later than, Monday, October 16, 2023, at 3:30 PM CST.

The County reserves the right to reject any and/or all proposals received.

Information on Bid Process/Clarification/Questions

Mindy Darcy, Finance Director

309-477-2237 mdarcy@tazewell-il.gov

Sealed proposal shall be marked “Proposal for Health TPA Services" and indicate project name and proposal opening date. The sealed proposals should include one (1) original and two (2) copies.

The submission should also include an electronic copy.

DISCLAIMER: The County does not assume any liability of responsibility for errors/omissions in any document or email transmitted electronically.

1.0 TIMELINE OF BIDDING PROPOSAL PROCESS

RFP Posted and Disseminated October 2

Bidder Questions Due October 6

Responses to Bidder Questions October 10

Written Proposals Due October 16

Finalist Interviews (if necessary) October 19-20 (tentatively)

Selection October 25

1.1 CONSEQUENCE OF SUBMISSION OF PROPOSAL

A. The County shall not be obligated to respond to any proposal submitted nor be legally bound in any manner by the submission of a proposal.

B. Acceptance by the County of a proposal obligates the proponent to enter into an agreement with the County.

C. An agreement shall not be binding or valid against the County unless or until it is executed by the County and the proponent.

D. Statistical information contained in these documents is for informational purposes only. The

County shall not be responsible for the accuracy of said data. County reserves the right to increase or decrease the project scope.

1.2 ACCEPTANCE OR REJECTION OF PROPOSAL

The County reserves the right to select the successful proposal and negotiate an agreement as to the scope of services, the schedule for performance and duration of the services with proponent(s) whose proposal(s) is/are most responsive to the needs of the County. Further, the

County reserves the right to reject any and all proposals, or alternate proposals, or waive any informality or irregularity in the proposal as is in the County’s best interest.

The County reserves the right to reject any and all proposals, or portions thereof, received in response to the Request or to negotiate separately with any source whatsoever, in any manner necessary, to serve the best interests of the County. Additionally, the County may, for any reason, decide not to award an agreement(s) as a result of this Request.

TAZEWELL COUNTY, ILLINOIS

The determination of acceptance and rejection are entirely arbitrary, and left to the final decision of the office of the County.

Non-acceptance of any proposal shall not imply that the proposal was deficient. Rather, non-acceptance of any proposal will mean that another proposal was deemed to be more advantageous to the County or that the County decided not to award an agreement as a result of this Request.

1.3 RIGHT TO CHANGE OR AMEND REQUEST

The County reserves the right to change the terms and conditions of this Request.

The County will notify potential proponent(s) of any material changes by posting an addendum on Bidnet Direct, which is accessible on the County’s website at https://www.tazewell-il.gov/Finance/FinanceBids.html as well as by email to those registered for the bid in Bidnet

Direct.

No one is authorized to amend any of the Request requirements in any respect, by an oral statement, or to make any representation or interpretation in conflict with their provisions. If necessary, supplementary information and/or clarifications/questions/answers will be issued in an addendum. Failure of any proponent to not have received such information and/or clarifications/questions/answers shall not relieve such proponent from any obligation under his/her proposal as submitted.

1.4 CANCELLATION

The County reserves the right to rescind award of the contract at any time before execution of the contract by both parties if rescission is deemed to be in County’s best interest. In no event shall

County have any liability for the rescission of award. The proponent assumes the sole risk and responsibility for all expenses connected with the preparation of its proposal.

1.5 EXAMINATION OF PROPOSAL MATERIALS

The submission of a proposal shall be deemed a representation and warranty by the proponent that it has investigated all aspects of the Request, that it is aware of the applicable facts pertaining to the Request process and its procedures and requirements, and that it has read and understands the Request. No request for modification of the provisions of the proposal shall be considered after its submission on the grounds the proponent was not fully informed as to any fact or condition. The County disclaims any responsibility for this information which may subsequently be determined to be incomplete or inaccurate.

TAZEWELL COUNTY, ILLINOIS

1.6 DISQUALIFICATION

Any of the following may be considered cause to disqualify a proponent without further consideration:

A. Evidence of collusion among proponents;

B. Any attempt to improperly influence any member of the evaluation panel;

C. Any attempt to communicate in any manner with a County elected official during the

RFP/bid process will, and shall be, just cause for disqualification/rejection of proponent’s proposal/bidder’s bid submittal and considered non-responsive.

D. A proponent's default in any operation of a professional services agreement which resulted in termination of that agreement; and/or

E. Existence of any lawsuit, unresolved contractual claim, or dispute between proponent and the City.

1.7 CONDITIONS TO BE ACCEPTED IF ANY WORK IS SUBCONTRACTED

A. The proponent assumes full responsibility, including insurance and bonding requirements, for the quality and quantity of all work performed.

B. If proponent's supplier(s) and/or subcontractor's involvement requires the use of a licensed, patented, or proprietary process, the proponent of the process is responsible for assuring that the subcontractor, supplier, and/or operator have been properly authorized to use the process or for providing another process which is comparable to that which is required prior to submission of a proposal.

1.8 INSURANCE REQUIREMENTS

Proponent, at proponent's sole cost and expense and for the full-term of the resultant agreement or any extension, shall obtain and maintain at least all of the insurance requirements listed in

Exhibit A.

All policies, endorsements, and certificates shall be subject to approval by the City Administrator of Tazewell County as to form and content. These requirements are subject to amendment or waiver if so approved in writing by the County Administrator. Proponent agrees to provide

County with a copy of said policies, certificates, and/or endorsements.

All coverage shall be provided by a carrier authorized to transact business in the State of Illinois and shall be primary.

TAZEWELL COUNTY, ILLINOIS

1.9 TERM

The proposed agreement will be for an initial three (3) year term. The term may be extended for additional, successive one (1) year periods upon mutual agreement.

1.10 UNCONDITIONAL TERMINATION FOR CONVENIENCE

The County may terminate the resultant agreement for convenience by providing sixty (60) calendar day advance notice and the County will not be charged termination fees unless otherwise stated in writing.

1.11 AWARDING OF CONTRACT

Upon conclusion of the Request process, a contract may be awarded for the County of Tazewell, Illinois.

The County reserves the right to select the successful proponent and to negotiate terms of a contract with the proponent(s) whose proposal(s) is/are most responsive to the needs of the

County. Further, the County reserves the right to reject any and all proposals, or alternate proposals, or waive any informality in the proposal as is in the County’s best interest.

2.0 BACKGROUND

The County of Tazewell, Illinois is located in central Illinois with a population of approximately

130,000 people. Its center of governance is located in Pekin, Illinois. The County’s governing body is the Tazewell County Board. The County of Tazewell is a legal subdivision of the State of Illinois. The services and functions of Tazewell County Government are limited to those that are specifically authorized by State law.

The County is self-insured for medical and ancillary claims, and currently has a contract with

IPMG Employee Benefit Services. The County maintains a reinsurance contract with a

$125,000 specific deductible and which is subject to lasers.

The County’s Director of Human Resources is directly responsible for the day-to-day operation of the employee health and ancillary plans, including the pharmacy benefit manager (PBM).

The County is finishing the second year of an exclusive five-year contract with Carle Health Plus

(Methodist), formerly UnityPoint Network for PPO network services.

The County partially self-funds and will be administrating four (4) plans in our next plan year:

Traditional PPO Plan, Mid-Level PPO Plan, Qualified HDHP Plan, and a Medical

Reimbursement Plan. These plans are non-grandfathered and the HDHP will qualify as an HSA.

TAZEWELL COUNTY, ILLINOIS

2.1. SCOPE OF SERVICES

The scope of claims/administrative services for the County’s self-insured medical plan would include, but would not be limited to, the automated processing and payment of medical and prescription drug claims (in accordance with plan documents and contracted PPO network reimbursement fee schedule), utilization review, case management, stop loss reporting, third-party recovery, and coordinating medical review.

A. Plan Documents.

Maintain a master file of plan documents, summary plan descriptions, plan booklets, benefit provisions, claims administration policies and guidelines, changes in plan benefits, and any other material needed to properly administer claims in accordance with the provisions of the plan applicable state and federal law.

B. Eligibility.

Maintain eligibility information to verify eligibility for benefits for plan participants and dependents. Eligibility to be transmitted electronically and/or manually by the County or its designee. The administrator will be required to maintain name physical address, email address, and phone number files by employee and dependent. The administrator will also monitor and track the eligibility status of dependent children over the age of 19 though the age of 26.

C. Forms.

Design, print, deliver, and periodically update all forms and form letters used in connection with claims processing at administrator’s expense. The County reserves the right to approve and disapprove all forms and form letters. The forms required include, but are not limited to:

1. Explanation of Benefit

2. Third-party liability inquires

3. Coordination-of-Benefits inquiries

4. Student Eligibility Letters

5. Identification Cards

6. Subrogation Letters

7. Open Enrollment Notifications

8. COBRA Notifications

9. Medical Necessity Letters

TAZEWELL COUNTY, ILLINOIS

D. Claims Processing.

1. Install historical data including, but not limited to, deductibles and lifetime maximums, from previous administrator. Maintain accurate claims records/files, which contain all pertinent claims, bills, correspondence, deductibles, benefits accumulated and maximums, coordination of benefits information, etc. Provide adequate security of patient information.

2. Review and examine claims (bills, invoices, and statements) submitted by plan participants or received from physicians, hospitals, pharmacies, labs, and any other eligible providers who have rendered care to eligible employees and their dependents. Procure any missing information immediately, by personal contact, telephone, or correspondence.

3. Determine reasonableness of charges and monitor the qualify, quantity, and utilization of professional, medical, and hospital care rendered, referring medical claims for “medical review” when necessary.

4. Process all appropriate claims as determined by the provisions of the plan documents and plan administrative policies/guidelines, utilizing the fee/reimbursement schedules established and provided by the City’s contracted PPO network. For claims incurred outside of Illinois, determine and pay reasonable and customary charges for that geographical area via utilization of a previously established wrap network. There is no wrap network at this time.

5. Obtain timely updates of fee schedules and conversion factors. Accurate claims processing in a timely manner, according to performance standards.

6. Prepare/issue checks and itemized Explanation of Benefits forms to plan participants and providers.

7. Pend or deny claims not eligible for payment and issue related correspondence. Advise plan participants, dependents, or beneficiaries whose claims have been denied of the specific reasons for such denial, and the procedure for a review of the denial. Advise plan participants regarding the pending of a claim, the reasons for such action and the actions necessary to release the claim.

8. Follow the records retention policy established/approved by the County.

E. Customer Service.

1. Provide prompt telephone response with accurate benefit information to participants and providers.

2. Provide professional, courteous, and timely responses to telephone, written, in person inquiries and complaints from all sources. Such inquiries may include eligibility information, TAZEWELL COUNTY, ILLINOIS claims payment, benefit provisions, and related questions, from parties with authorized access to information such as plan participants, providers, legal counsel, the County, etc.

3. Furnish a toll-free telephone number for incoming customer service calls.

4. Provide assistance when requested with respect to special inquiries from the County which could arise involving claims processing for payment of claims.

5. Survey plan participants annually on their satisfaction with the service and provide results to the City.

6. Make use of technology, both online and via smartphone, for employee customer service and claim inquiries.

7. Attend Committee, Board, and Employee meetings, open enrollment meetings, and health fairs as necessary.

8. Provide necessary assistance with notifications, reporting, filings, etc required by federal and state laws such as HIPAA, ERISA, HRCA, etc.

F. Prescription Drug Program.

Coordinate processing and payment of prescription drug claims utilizing an electronic claims processing pharmacy system/network selected and/or approved by the County.

G. Case Management.

Provide the services of a registered nurse/case manager (or a contracted case management agency) approved by the County, for chronic or catastrophic injuries/illnesses. Services should include making arrangements for necessary home health care/special equipment rentals, and coordination of patient care needs with physician, family and patient. Provide timely Case

Management reports to the County.

H. Utilization Review Services.

Provide hospital pre-admission certification; hospital concurrent utilization review; hospital length of stay monitoring; discharge planning services; preauthorization when requested by providers and plan participants, etc.

TAZEWELL COUNTY, ILLINOIS

I. Medical Review.

Coordinate with the County’s contracted PPO network to utilize their peer medical review services/committee or provide a medical review system, utilizing medical professionals, acceptable to the County.

J. Coordination of Benefits.

Provide coordination of benefits in accordance with plan documents and federal/state law. Apply standard, non-duplication of benefits.

Follow the requirements of federal law concerning coordination of benefits with Medicare, Medicaid, etc. Track and utilize credit reserve for eligible plan participants.

K. Stop Loss.

Work with the County’s Stop Loss reinsurance carrier, reporting large claims in a timely manner, in accordance with policy requirements, ensuring reimbursement to the County for claims exceeding the Stop Loss deductible each policy year. Provide stop loss documentation/reports to the County’s Benefit Section on a monthly basis.

L. Subrogation – Third Party Liability.

Pursue liens in favor of the County for sums of money recovered by the plan participant in connection with any illness, injury, disease, or other condition for which a third party may be liable to the extent of the benefit payments made by the plans.

M. Overpayments.

Collect all overpayments or other incorrect payments. Any outstanding overpayments/incorrect payments should be reported to the County on a quarterly basis.

N. Management Reports

Provide reports/information pertaining to the program which may be required by us, our auditor, actuary, legal counsel, or consultant and assist with the preparation and filling of any reports required by law. This will include, but is not limited to:

1. Provide monthly reports by the tenth (10) day of the month.

2. Register/report of claim payments and other claim data for each payment cycle.

3. Number of claims by line of coverage (hospital, surgery, physician charges, prescription drugs, etc.)

4. Dollar amount claimed.

5. Number of claims.

TAZEWELL COUNTY, ILLINOIS

6. Total allowable charges.

7. Deductibles taken.

8. Amount paid by line of coverage.

All reports must be provided on a monthly and year-to-date basis by line of coverage each month. This information is to be prepared separately, by plan and group.

Claims history will include dates received, date pended, additional information requested, additional information received, date processed, date paid, and/or date denied. Special reports including:

1. Case Management.

2. Lag Studies.

3. Coordination of benefits savings Stop Loss and high-dollar claims.

4. Quarterly subrogation.

O. Internal Controls.

1. Apply industry standard internal claim control systems/procedures necessary for the effective implementation of the plan.

2. Audit all hospital claims where payment exceeds $25,000.

3. Administrator must agree to maintain the security and confidentiality of all medical, financial, and patient information, guaranteeing HIPAA requirements are met in all areas of operation.

P. Financial Services.

1. Follow the banking requirements of the County, such as establishing, maintaining, and reconciling an interest-bearing, checking account with appropriate deposit and transfer procedures for the payment of claims; or make other claims payment arrangements, which are acceptable to the County. The claims administrator will maintain check registers and will provide a weekly check register to the County.

2. Accumulate data, prepare, and mail 1099 forms for all providers of service who are paid during the calendar year, as required by the Internal Revenue Code.

3. Provide any required federal or state financial or tax reports.

4. Provide appropriate information and documentation to the County’s Auditor when requested.

Q. Administrative Expenses.

The selected administrator will be expected to bear the cost of:

1. Installing any necessary administrative systems.

2. Installing historical data, including lifetime maximums and deductibles

TAZEWELL COUNTY, ILLINOIS

3. from the previous administrator.

4. Transferring records and systems to the succeeding Administrator at the termination of the contract.

5. Administrative fees should cover the cost of administrator’s staff, all office space, supplies, forms, medical plan identification cards, standard management reports, telephone expenses, postage, computer hardware/software and other equipment/supplies necessary for claims handling.

R. Client Communication.

1. Attend quarterly client meetings with County staff. Administrator’s travel expenses in connection with client meeting or other matters relating to claims processing shall be paid by the administrator.

2. Notify the County of all claim back logs on a regular and timely basis.

3. Provide prompt updates on legal and regulatory changes that could affect the plan.

4. Obtain opinion/response from legal counsel (administrator’s in-house or outside counsel) when necessary.

5. Promptly notify the County of any pending egregious claims and/or claims action and litigation.

6. Provide assistance, such as cost calculations for benefit changes, benefit adequacy studies, etc., when requested for proposed plan design changes.

7. Matters of significance must be called to the County’s attention at the earliest appropriate time (i.e. claims processing back logs, system problems, large overpayments, etc).

3.0. PROPOSAL GUIDELINES, CONTENT AND FORMAT

The County will utilize a qualifications-based selection process in obtaining these services. In order for the County to properly evaluate the Proponents ’qualification to perform this work, the proposals shall include, as a minimum, the following information:

A. Evidence of the…