CSP019642_Contract_Rev.pdf

Index No.: DAS054

Eff. Date: 07/01/24

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: DISABILITY ADMINISTRATION SERVICES

CONTRACT NUMBER: CSP019642 EFFECTIVE DATES: 07/01/24 TO 06/30/26

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

SRC0000014447 that opened on 12/18/23. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the Department of Administrative Services, State Human Resources Division, Office of Benefits Administration Services as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

https://procure.ohio.gov/

MUTUALLY AGREED TO CLARIFICATIONS / MODIFICATIONS TO THE RFP

1. Clarification response documents titled “1.30.24 State of Ohio Follow Up Final” and “State of Ohio Appendix”.

2. Cost negotiation response titled “2024.02.02 Ohio DAS - Cost Summary Form - Sedgwick revised”.

3. SRC0000014447 Sedgwick Exceptions spreadsheet – final response dated 02/20/24.

4. Revised Supplement A - response dated 02/09/24.

5. Revised Supplement S - response dated 02/15/24.

6. Modification of the staffing plan - Clarification response dated 01/24/24 resulting in a reduction in staffing from ten to six dedicated disability representatives.

7. Final Performance Guarantees:

Performance Guarantees (PG)

The State expects the Contractor to maintain, at a minimum, the following Performance Guarantees throughout the term of the Contract. The State requires a minimum risk of 30% of the total annual administrative fees. Performance Guarantees may be modified on an annual basis, as mutually agreed upon by the State and the Contractor.

PG#

Performance Guarantee Proposed amount of risk (in %)

Enter new claim into claims management system within twenty-four (24) business hours of receipt 95% of the time. 20%

Upload all new documentation to claim file within three (3) days of receipt or creation, 95% of the time. 15%

Determinations to accept, pend, or deny a claim must be made within three (3) business days upon of receipt of all necessary information, 95% of the time.

15%

4 Turn-around time (notification to employee and employing agency) of twenty-four (24) hours following any change in claim status, 95% of the time.

Attendance at all hearings held throughout the state 99% of the time. 20%

95% of claims examiners must receive a score of at least 90% on quarterly internal audits.

The Contractor must agree to renegotiation of Performance Guarantees on an annual basis.

Confirmed

8. *EFFECTIVE 07/01/24

The “Program operation cost Per Employee Per Month (PEPM) based on the eligible employee count as of the 15th of each month” Cost Summary item does not apply prior to the go-live date of 09/01/24.

*Indicates the addition of a mutually agreed upon modification, per amendment 1.

COST SUMMARY

Disability Administration Services

UNSPSC CATEGORY CODE: 85101700

DESCRIPTION

UNIT OF

MEASURE

COST

Program operation cost Per Employee Per Month (PEPM) based on the eligible employee count as of the 15th of each month.

PEPM $2.46

One-time implementation fee Each $25,000.00 Additional customization Hour $85.00 Optional ADAAA accommodation administration Each case $405.00 Pass-through expenses including but not limited to:

Independent medical examination/functional capacity evaluation Vocational evaluations Physician advisory/peer review services Independent physician advisor services for appeals Special investigation unit services

AMT Pass-through

All costs must be in U.S. Dollars.

The State will not be responsible for any costs not identified.

There will be no additional reimbursement for travel or other related expenses.

CONTRACTOR INDEX

CONTRACTOR AND TERMS: CONTRACT NO.: CSP019642

HR00001398 (OHALL) TERMS: Net 30 Days Sedgwick Claims Management Services, Inc.

8125 Sedgwick Way Memphis, TN 38125

PAYMENT ADDRESS:

Sedgwick Service Revenue PO Box 207834 Dallas, TX 75320-7834

CONTRACTOR’S CONTACT: Ms. Claire Hoogland Telephone: 248-227-2167 Fax: 901-415-7406 Email: Claire.Hoogland@sedgwick.com

SUMMARY OF AMENDMENTS

Amendment

Number Effective

Date Description

1 07/01/24 This amendment is issued to include a mutually agreed upon modification to the RFP.

All other prices, terms and conditions remain unchanged.