Copy of T3093 Attachment B.xlsx

This is a Performance Standards and Liquidated Damages attachment for Bid Solicitation 25DPP01075, issued by the State of New Jersey Division of Pensions and Benefits (DPB) for Medicare Advantage Plans serving the State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP). The solicitation establishes performance metrics across six key categories: ID Card Production and Distribution, Claim Administration, Member Services, and Account Management. Bidders must ensure ID cards are produced and mailed within 15 days of eligibility confirmation and received by members at least seven days before the benefit effective date. Claims must be processed within an average of 30 calendar days for 90% of transactions, and member services must maintain an average speed of answer of 30 seconds or less with a first call resolution rate of at least 92% and telephone abandonment rate not exceeding 5%. Additionally, contractors must develop an approved survey mechanism to measure service quality and conduct annual statistically valid member satisfaction surveys targeting an 85% satisfaction rate.

Bidders are required to place a minimum of 2% of their premiums at risk to guarantee performance across these metrics, with the State allocating the total amount at risk annually. The minimum liquidated damage percentages are 0.20% for ID cards, 0.30% for claim administration, 0.30% for each member services metric, 0.30% for account management, and 0.30% for member satisfaction. Bidders are encouraged to propose more stringent performance standards and greater liquidated damage amounts in designated cells, and any fields left blank will result in the minimum amounts being applied. Performance is measured quarterly and assessed annually, with account management and member satisfaction measured and assessed on an annual basis.