ATTACHMENT_D.5_SAMPLE_TASK_ORDER_FOUR.docx

Analysis of the Impact of ACA on Mid-Sized Group Health Plans

1. Background

In March 2010, the Affordable Care Act (ACA) was signed into law, substantially altering the market for health insurance in the United States. Beginning in 2014, individuals will largely be required to have insurance and employers with more than 50 full-time equivalent employees will be required to offer health insurance, or be subject to penalties. This, coupled with Medicaid expansion in certain states and the existence of both public and private health exchanges, will substantially change how and from where people get insurance coverage. Because of the employer requirements of the ACA and the fact that historically the majority of the insured population are covered by employer-sponsored health plans, the Department of Labor and specifically EBSA are interested in how the ACA will impact group health plans.

Much of the initial focus on the impact of the ACA on employers has been on small employers, who may not be required to offer insurance, may receive subsidies if they do offer insurance and will largely be able to offer insurance through state exchanges beginning in 2014. “Mega employers” (those with 5,000 or more employees) generally self-insure and are expected to continue offering health insurance outside the market. However, little attention has been paid to “mid-size” employers – those with between 100 and 5,000 employees – who will face the full impact of the changes in the health insurance marketplace.

EBSA is particularly interested in how mid-sized employers respond to the changes in health insurance laws. Specifically how it will impact their decision to offer insurance, the type of insurance they offer, where the purchase insurance, how they fund insurance, and how much they will contribute to their employees’ plan. EBSA seeks proposals for an analysis of existing data to address the research questions outlined below.

2. Research Questions

Research questions to be addressed through this study include, but are not necessarily limited to, the following:

· How did mid-sized plans offer health insurance prior to the ACA?

· What share offered health insurance and what influenced the decision not to for those not offering?

· How does this vary by industry, region and workforce?

· How many plans did employers offer? How generous were these plans? What were employee take-up rates?

· How many plans chose to self-insure? How often was stop-loss insurance used to mitigate risk?

· Mid-size employers who do not offer health insurance to their employees may be subject to penalties.

· At what point is the penalty (and the impact of attracting better workers) cheaper than offering insurance?

· What share of their employees may be eligible for Medicaid under the new rules?

· Are mid-sized plans turning to private exchanges and what are the incentives to do so?

· Will mid-sized plans not previously self-insured consider that option? Are stop-loss insurers offering more attractive attachment points marketed to mid-sized employers in anticipation of these plans switching their funding method?

· How will offers, types of insurance, funding, and cost-sharing of insurance change for mid-sized employers in light of the ACA?

3. Tasks

EBSA seeks a 12-month research study contract that will utilize pre-existing data; data collection costs should not be included in any price proposals. In their proposal, offerors should describe in substantive detail how they would accomplish each of the tasks outlined below. All work done under this task order shall be performed under the general guidance of EBSA and is subject to EBSA approval. The contractor shall furnish the necessary personnel, materials, services, facilities, and otherwise do all things necessary or incident to conducting the study. The following sections describe the anticipated tasks required for conducting the study.

Task 1. Initial Project Meeting and Summary of Available Data

Within two weeks of the task order contract award, the contractor shall meet with the Contracting Officer’s Representative (COR) and other relevant staff from EBSA to clarify the project objectives, scope of work, deliverables, requirements, and any questions the contractor may have regarding the project. The contractor shall be prepared to discuss any issues pertinent to work plan development and present possible approaches to the data analysis.

Within a week following the initial meeting, the contractor shall submit a memorandum to the COR summarizing the meeting and any conclusions or decisions that resulted.

Deliverables:

1. Briefing: Initial Project Meeting, due two weeks after date of award

Task 2. Prepare Project Work Plan, The contractor shall prepare a work plan for the project detailing the intended approach with attention to conceptual, methodological, and practical issues. The plan shall include, at a minimum: a detailed discussion of the research questions; the analytic methods to be used to answer each of the questions; and a detailed presentation of the timeline and specific steps to be taken to perform the study. The work plan shall be based on the research questions presented in this statement of work as well as other questions agreed upon and decisions made at the initial project meeting under Task 1.

A draft work plan shall be submitted to the COR no later than six weeks from the contract award. A final work plan shall be submitted no later than two weeks after receiving final comments on the draft work plan from the COR.

Task 3. Conduct Literature Review

The contractor shall conduct a review of the existing literature related to the mid-sized insurance market and the ACA. Published and unpublished sources will be perused to describe the mid-sized market prior to passage of the ACA – how it compared to the large and small markets and detail which rules in the ACA will directly apply and impact mid-sized plans. Peer-reviewed journals and trade magazines are examples of published sources and government documents and in-house reports are examples of unpublished sources.

A draft literature review must be submitted to the COR no later than 10 weeks from the contract award. A final literature review shall be submitted no later than two weeks after the contractor has received comments from EBSA on the draft literature review.

Task 4. Memorandum

The contractor shall conduct an analysis of either initial health plan data collected from 2014 or if not available at the time of the contract, run simulations on existing health plan data to predict how insurance offerings, funding and type of insurance and other questions outlined above will change for mid-sized employers post-ACA implementation. The contractor shall them submit a draft report which describes the background, methodology, findings and conclusions of the analysis performed. The draft report shall include the following sections at a minimum:

· Abstract – a brief summary of the aim, methods, and findings of the study, no more than one-third (⅓) of a page

· Executive summary – concise summary of the report, capable of serving as a stand-alone document, that synthesizes the key findings and main themes of the study

· Introduction – background, overview

· Literature and Policy context – description of the related literature and policy issues

· Methodology – analytical methods, techniques, limitations

· Findings – comprehensive overview of what was learned through the study; conclusions to be drawn from the findings

· Discussion – what was learned as a result of the this study and the policy implications

· Appendix – additional technical information as appropriate

The contractor shall submit a draft report to the COR for review and approval by week 35. The contractor shall prepare a final report that reflects the COR’s and other reviewers’ input, including feedback provided during the briefing described below. The final report will be due two weeks after final comments on the draft report from the COR.

The contractor’s project director, and other key staff as appropriate, shall brief EBSA officials, in Washington, DC, on the study’s approach and findings by week 38. Materials and hand-outs to be used for the briefings shall be submitted to the COR for approval three business days prior to the briefing. Upon incorporating comments from the COR and approval by the COR, the contractor shall make copies of the materials and handouts for the briefing.

Task 5. Monthly Progress Reports and Ongoing Communication

The contractor shall prepare brief monthly memoranda, to be conveyed to the COR via e-mail, documenting the progress of the project. These reports shall summarize for each month the specific work done to accomplish tasks, problems encountered, work anticipated in the coming month, the proportion of project money and labor hours expended each month, and any budgetary or substantive issues requiring the COR’s action. The cost data in the monthly progress reports shall include expenditures for the reporting period and to date by task and project total, and the proportion of funds and labor hours expended in relation to project totals.

In addition to these written monthly reports, the contractor shall communicate by phone and e-mail with the COR as needed and in accordance with agreements made at the initial meeting for the project.

4. PAYMENT TYPE AND PERIOD OF PERFORMANCE

EBSA proposes a firm-fixed price, non-severable 12-month study, with progress payments and a period of performance of 09/30/2013 through 09/29/2014.

5. CONTRACTOR-FURNISHED PERSONNEL

Except for those items or services specifically stated as government furnished, the contractor must furnish all supplies, equipment and personnel needed to perform this contract according to all its terms.

Key Personnel

The Contractor shall designate persons as key personnel and essential for the successful completion of all work assigned under this contract. EBSA anticipates that the successful completion of this project will require the services of people who will provide, individually or in combination, the following expertise and specialties:

Project Director Expert in managing projects, with a minimum of ten years of experience and a Ph.D. in a relevant field. Or an equivalent combination of education and relevant experience (i.e. minimum 14 years of experience with a Master’s or other graduate degree).

Task Leader Expert in managing projects, with a minimum of five years of experience and a Ph.D. in a relevant field. Or an equivalent combination of education and relevant experience (i.e. minimum 9 years of experience with a Master’s or other graduate degree).

Health Economist Expert in health economics, with a minimum of five years of experience and a Ph.D. in a relevant field. Or an equivalent combination of education and relevant experience (i.e. minimum 9 years of experience with a Master’s or other graduate degree).

Statistician Expert in statistics with a minimum of ten years of experience, a graduate degree in statistics and at least 10 years of post-graduate experience in this field, including sampling theory, estimation of variance from complex survey designs, and implementation of random sample.

6. DELIVERABLES

6.1 Products, Tasks, Services and the Standards for Success

The contractor must provide all personnel, equipment, tools, materials, supervision, and other items and services necessary to perform the data analyses described in Task 3 and/or Task 4. The contractor must provide the deliverables and perform the services listed below to the standards that are included below:

Monthly Progress Reports

a. Must include:

(1) specific work done to accomplish tasks during the previous month,

(2) specific milestones and deliverables due in the past month (specifying whether they were met and, if not, the revised completion date),

(3) problems encountered during the previous month,

(4) work anticipated in the coming month,

(5) a list of deliverables invoiced in the previous month, and

(6) any budgetary or substantive issues requiring the COR’s action

b. The monthly reports shall be submitted in MS Word.

c. The first such report will be due on November 15, 2013 and subsequent reports will be due on the 15th of each month for the duration of the performance period.

· Detailed study design plan

· Timeline linking tasks and deliverables to specific dates

· Strategies for accomplishing research goals

· Detailed list of information or assistance needed from DOL

· A listing of research questions to be addressed and a mapping of each research questions to the deliverable that will address the question

b. Draft must be provided within 6 weeks of the performance period start date in MS Word.

c. Must set forth a realistic timetable of tasks leading to implementation of the study.

d. Must be agreed to by the COR for work to continue.

· Detailed description of current market for mid-sized health plans

· Descriptions of those ACA rules which will directly impact mid-sized health plans and how

b. Must be written in proper “business English” without grammatical or typographical.

c. Must be submitted to EBSA electronically in MS Word and according to schedule above.

· Abstract

· Executive Summary

· Introduction

· Literature and Policy Context

· Methodology

· Findings

· Discussion

· Appendix

b. Must be written in proper “business English” without grammatical or typographical errors and be sufficiently descriptive for the analysis to be understood by a non-technical audience.

c. Must accurately describe the statistical significance of estimates.

d. Must accurately describe the applicable regulatory conditions, if relevant.

e. Statements and conclusions must be supported by evidence well-founded and unbiased.

f. Must be submitted to COR electronically in MS Word and according to schedule above.

b. This task supports the submission of a Work Plan and schedule

b. Analysis must be free of errors.

c. Report uses appropriate statistical techniques to identify confidence intervals and/or conduct hypothesis testing for the main estimates, if applicable.

b. Conducted by contractor’s project director, and other key staff as appropriate.

b. Conducted by contractor’s project director, and other key staff as appropriate.

c. Materials and hand-outs submitted to the COR for approval three business days prior to the briefing.

d. Hard copies of the briefing slides and other materials provided at briefing.

This project does not require OMB Paperwork Reduction Act (PRA) clearance for data collections.

1.2 Summary Memo

2 weeks after award 1 week after Initial Meeting

2.2 Final work plan

6 weeks after award 2 weeks after final comments from the COR

3.2 Final Lit Review

10 weeks after award 2 weeks after final comments from the COR

4.2 Briefing

4.3 Final Report

35 weeks after award 38 weeks after award 2 weeks after final comments from the COR

All deliverables will be formatted in Word or the format determined by EBSA, submitted electronically to the COR as attachments to e-mail, and subject to approval by the COR. The contractor shall provide hard copies of briefing slides and other materials for the briefing. The due dates above may be adjusted in the Work Plan upon mutual agreement between EBSA and the Contractor.

7. DOL DATA RIGHTS AND RESTRICTIONS ON CONTRACTOR’S USE OF DATA

Except for particular Task Orders issued under the contract, which may specify different DOL license requirements, the FAR 52.227-17 Rights in Data – Special Works will govern DOL’s rights of use in deliverables, including data sets, under this contract. Essentially, the Contractor grants to DOL, and others acting on its behalf, a paid-up, nonexclusive, irrevocable, worldwide license to copy, distribute, prepare derivative works, and perform and display publicly, by or on behalf of the Government, all deliverables, including those first-produced and those not first-produced by the contractor under the contract, except as otherwise agreed upon between the Contractor and Contracting Officer, or as otherwise provided for by this FAR clause.

This Sample Task Orders will fall into the category of Type A studies. The following specific restrictions will apply to the Contractor’s use of certain deliverables and related data/information:

· For Type A studies, such as academic research, the Contractor will not release, distribute, or publish such deliverable/s, nor authorize others to do so, until expiration or termination of the applicable Task Order, unless prior written permission of the Contracting Officer is given to do so during the period of performance. In addition, the Contractor agrees to notify the Contracting Officer at least two weeks before releasing, distributing or publishing such deliverables.

During the period of performance, the Contractor agrees to notify the Contracting Officer of publications it creates for public access (e.g. articles in academic journals, news release, website articles) that are based on the work it performs under this contract.

Some information and data provided by DOL to the Contractor for its performance of the contract may contain confidential information that, due to requirements of the Privacy Act of 1974 and/or other federal laws, will be prohibited from being disclosed or used by the Contractor outside the terms of the contract. DOL shall clearly mark such information and/or data prior to providing it to the Contractor and may require that Contractor execute a Nondisclosure Agreement in connection with such information.

The FAR 52.227-16 Additional Data Requirements shall govern situations in which DOL may require the delivery of additional data produced or used in performance of this contract. Essentially, the Contracting Officer may, at any time during contract performance or within a period of 3 years after acceptance of all items to be delivered under this contract, order any data first produced or specifically used in the performance of this contract. DOL’s rights in such data shall be governed by the Rights in Data – Special Works, as discussed in the first paragraph, above.