ESBD_360338_1716477852919_RFP 2024-P11 Employee Group Health, Dental and Employee Assistance Plans.pdf

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 1 of 45

SOLICITATION, OFFER

AND AWARD

Hays County Purchasing Office

712 S. Stagecoach Trail, Suite 1012 San Marcos, Texas 78666

Solicitation No.:

RFP 2024-P11 Employee Group Health, Dental, and

Employee Assistance Plans Date Issued: May 23, 2024

SOLICITATION

Vendors must submit proposals as listed: One (1) original and one (1) digital copy on a thumb drive at the Hays County Purchasing Office at the address shown above or Electronically through BidNet Direct and one (1) hard copy at the Hays County Purchasing Office at the address shown above until:

10:00 a.m. local time June 17, 2024.

Proposals received after the time and date set for submission will be returned unopened.

For information please email:

purchasing@co.hays.tx.us

Questions concerning this RFP must be received in writing no later than 5:00 on June 4, 2024.

Phone No.: (512) 393-2267

OFFER (Must be fully completed by Respondent)

In compliance with the above, the undersigned offers and agrees to furnish all items or services awarded at the prices stipulated for each item delivered at the designated point(s) and within the time specified herein. Award shall include all solicitation documents and attachments.

MANUALLY SIGN ALL COPIES SUBMITTED. SIGNATURE IS MANDATORY.

Respondent Respondent’s Authorized Representative Entity Name:

Mailing Address:

Name:

Title:

Email Address:

Phone No.:

Signature: Date:

Name, Email Address and Phone No. of person authorized to conduct negotiations on behalf of Respondent:

NOTICE OF AWARD (To be completed by County) Funding Source: Awarded as to item(s): Contract Amount:

Vendor: Term of Contract:

This contract issued pursuant to award made by Commissioners Court on:

Date: Agenda Item:

Important: Award notice may be made on this form or by other Authorized official written notice.

Hays County Judge

Date

Hays County Clerk Date mailto:purchasing@co.hays.tx.us

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Table of Contents

Solicitation, Offer and Award I. RFP Submittal Checklist II. Summary III. Specifications

A. Introduction B. Background C. Scope of Work D. Qualifications E. Proposal Requirements F. Evaluation Criteria G. Submittal Requirements H. Award of Contract I. Warranty of Performance

IV. General Terms and Conditions for Solicitations V. Vendor Reference Form VI. Certificate of Interested Parties VII. Conflict of Interest Questionnaire VIII. Code of Ethics IX. HUB Practices X. House Bill 89 Verification XI. Iran, Sudan, and Foreign Terrorist Organization Certification (TGC 2252) XII. Israel Boycott Certification Form (TGC 271.002) XIII. Prohibition of Energy Company Boycott Certification Form (TGC 2274) XIV. Debarment and Licensing Certification XV. Vendor/Bidder’s Affirmation XVI. Federal Affirmation and Solicitation Acceptance XVII. Related Party Disclosure Form

Attachments:

Attachment A: Response Form Attachment B: Hays County Census (April 2024) Attachment C: Summary Plan Descriptions Attachment D: Claims Enrollment Aggregate Report 2021-2024 Attachment E: Deer Oaks EAP Utilization Attachment F: Hays County SBCs 2022-2024 Attachment G: Hays County Structure Attachment H: March 2024 Invoice with Counts Attachment I: Additional Supporting Claims and Enrollment Information Attachment J: Dental PPO and DHMO disruption Information Attachment K: Medical Disruption File Attachment L: Rx Usage for Disruption and Pricing April 2023-March 2024 Attachment M: PY 2024 Retiree Rates Attachment N: PY 2024 Funded Insurance Rates Attachment P: 2024 Medical Renewal Attachment Q: 2024 Dental Renewal

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I. RFP Submittal Checklist

This checklist is provided for the Vendor’s convenience and identifies documents that MUST be submitted for the bid/proposal/SOQ to be considered responsive, as well as the required forms requested by Hays County.

A COMPLETE SOLICITATION RESPONSE PACKAGE INCLUDES:

The following forms MUST be returned for the bid/proposal/SOQ to be considered responsive:

____ 1. Proposal, and Solicitation, Offer and Award Form completed and signed

____ 2. Attachment A: Response Forms

____ 3. Vendor Reference Form

Required Forms by Hays County: (all forms completed and signed)

____ 1. Conflict of Interest Questionnaire

____ 2. Code of Ethics

____ 3. HUB Practices

____ 4. House Bill 89 Verification

____ 5. Iran, Sudan, and Foreign Terrorist Organization Certification (TGC 2252)

____ 6. Israel Boycott Certification (TGC 2271.002)

____ 7. Prohibition of Energy Company Boycott Certification (TGC 2274)

____ 8. Debarment & Licensing Certification

____ 9. Vendor/Bidder’s Affirmation

____ 10. Federal Affirmations and Solicitation Acceptance

____ 11. Related Party Disclosure Form

____ 12. System for Award Management (www.SAM.gov) Entity Registration Page

____ 13. Any addenda applicable to this solicitation

Hays County will accept bids/proposals/SOQ, by the stated due date by one of the following methods:

____ 1. Electronic Submission of Proposals through BidNet Direct and one (1) hard copy delivered, within 24 hours of due date, in a sealed envelope with the Solicitation Number and Vendor’s name on the outermost envelope addressed to: Hays County Purchasing, 712 S Stagecoach Trail, Suite 1012, San Marcos, TX 78666

OR

____ 2. One (1) original proposal and one (1) digital copy on a thumb drive in a sealed envelope with the Solicitation Number and Vendor’s Name on the outermost envelope, addressed to:

Hays County Purchasing, 712 S Stagecoach Trail, Suite 1012, San Marcos, TX 78666 http://www.sam.gov/

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II. Summary

1. Type of Solicitation: Request for Proposal (RFP)

2. Solicitation Number: RFP 2024-P11

Employee Group Health, Dental, and Employee Assistance Plans

3. Issuing Office: Hays County Purchasing Office 712 S. Stagecoach Trial, Suite 1012 San Marcos, TX 78666

4. Responses to Solicitation: Sealed proposals marked with Solicitation Number and Vendor Name on the outermost envelope Manual: One (1) Original and one (1) digital copy on a thumb drive, or

Electronic: Proposals can be submitted through BidNet Direct and one (1) hard copy is required to be received within 24 hours of due date.

5. Deadline for Responses: In issuing office no later than:

June 17, 2024; 10:00 a.m. Central Time (CT)

6. Initial Contract Term: Three (3) Years: August 2024-August 2027

7. Optional Contract Terms: Two (2), two (2) year renewals

8. Designated Contact: Hays County Purchasing Email: purchasing@co.hays.tx.us

9. Questions & Answers: Questions regarding this solicitation must be made in writing and submitted to the designated contact above no later than June 4, 2024;

5:00 p.m. CT. Telephone inquiries will not be accepted. Questions may be submitted by email to the address above. Answers to questions will be provided in the form of an addendum posted after the question deadline on the CivicPlus, BidNet Direct, and ESBD websites for the benefit of all potential respondents. The County reserves the right to contact the person submitting a question to clarify the question received, if necessary. Each clarification, supplement, or addenda to this IFB, if any, will be posted on the CivicPlus, BidNet Direct and ESBD websites. All potential or actual respondents are responsible for monitoring the websites for such materials. Respondents are deemed to have notice of, and are required to comply with, any such material posted in accordance with this paragraph. Respondents should not rely upon any other sources of written or oral responses to inquiries.

10. Addenda Any interpretations, corrections or changes to this RFP and specifications will be made by addenda. Sole issuing authority of addenda shall be vested in the Hays County Purchasing Office. It is the Vendor’s mailto:purchasing@co.hays.tx.us

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 5 of 45 responsibility to acknowledge receipt of all addenda with proposal submission.

11. Contact with County Staff: Upon issuance of this solicitation, employees and representatives of

Hays County, other than the Purchasing Office staff identified as the Designated Contact above, will not discuss the contents of this solicitation with any Vendor or its representatives. Failure of a Vendor or any of its representatives to observe this restriction may result in disqualification of any related offer. This restriction does not preclude discussions between affected parties for the purpose of conducting business unrelated to this procurement.

Anticipated Schedule of Events May 23, 2024 Issuance of RFP June 4, 2024 Deadline for Submission of Questions (5:00 PM CT) June 17, 2024 Deadline for Submission of Proposals (10:00 AM CT)

Late proposals will not be accepted.

July 2024 Anticipated contract award date

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III. Specifications A. Introduction

Hays County (County) is seeking proposals from qualified companies to provide Employee Health, Dental and Employee Assistance Plans. The County is looking for a comprehensive package to include Medical, Pharmacy, Dental, and Employee Wellness/Assistance Plan. The County is fully committed to implementing the chosen plans effective January 1, 2025, with open enrollment starting October 1, 2024. It is our intent to evaluate any combination of plan designs, networks, and services, as well as value added services, and is looking to partner with insurance companies who can help us to achieve competitive long term and stable financial success whilst offering a very robust benefits package. This does not include banking for the Health Savings Account.

The primary objectives of the Hays County Benefits Plan is to:

• Attract, retain and motivate quality employees with a competitive total compensation package,

• Ensure employees easy access to quality care and services,

• Increase the overall emphasis on wellness and preventive behaviors,

• Maintain employee satisfaction by offering them a choice of benefit plans and services,

• Provide long-term cost control,

• Minimize administration costs, and

• Strive toward a long-term partnership with a responsive and progressive benefits plan provider.

The County will award a contract for Employee Health, Dental and Employee Assistance Plans or will award two separate contracts, one for Health and Dental Plans and one for Employee Assistance Plans:

depending on the best option for Hays County Employees.

The following attachments are part of this solicitation and can be downloaded from any of the three websites where the solicitation is posted.

Attachment A: Response Form Attachment B: Hays County Census (April 2024) Attachment C: Summary Plan Descriptions Attachment D: Claims Enrollment Aggregate Report 2021-2024 Attachment E: Deer Oaks EAP Utilization Attachment F: Hays County SBCs 2022-2024 Attachment G: Hays County Structure Attachment H: March 2024 Invoice with Counts Attachment I: Additional Supporting Claims and Enrollment Information Attachment J: Dental PPO and DHMO Disruption Information Attachment K: Medical Disruption File Attachment L: Rx Usage for Disruption and Pricing April 2023-March 2024 Attachment M: PY 2024 Retiree Rates Attachment N: PY 2024 Funded Insurance Rates Attachment O: Stop Loss Amendment (2024) Attachment P: 2024 Medical Renewal Attachment Q: 2024 Dental Renewal

B. Background Our employees consist of officials who are elected by the citizens and employees who are recruited and hired. Jobs include law enforcement, road and bridge, administrative, accounting, maintenance, RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 7 of 45 attorneys and judicial. The Couty provides coverage for full time active employees, and to retirees who are eligible for retirement through Texas County & District retirement System (TCDRS) as provided in the Texas Local Government Code Chapter 175 and meet the County’s qualifications for coverage as a retiree, as well as Consolidated Omnibus Budget Reconciliation Act (“COBRA”) participants.

• The county employs approximately 1,037 active full-time employees in total, and we have about 956 enrolled in Medical, and 983 in Dental, and another 137 retirees enrolled in Medical, and 148 enrolled in Dental.

• Retirees are eligible for medical, dental and vision plans; and may also enroll spouses and dependents if they are covered on the employee’s plan at the time of retirement.

• Currently, the County offers active employees, retirees, and COBRA three plan designs, which consist of two Preferred Provider Organization (“PPO”) plans and one High Deductible Health Plan – Health Savings Account (“HDHP-HAS”) plan.

• Retirees over the age of 65 are also offered a Medicare Advantage Plan.

• The Hays County Appraisal District is included in the Hays County Coverage.

• The Medical plans and Pharmacy plans are self-insured with both specific of $200,000 and aggregate stop loss at 125%.

• The Dental PPO plan is self-insured and the DHMO is insured. The Usual and Customary level for the Dental PPO is the 90th percentile.

C. Scope of Work All respondents MUST review and return the documents in Attachment A: Response Forms and provide the following information.

The requested services include the following:

• Medical claims administration

• Dental plan administration

• Cobra and Retiree Administration

• Pharmacy Benefit Management

• Insured Dental HMO

• Employee Assistance Plan Services, including DOT Substance Abuse Evaluations

• Stop Loss insurance, consisting of both specific and aggregate coverage

• Serve as the plan fiduciary to make final, binding decisions, including initial and final appeals

• Management reporting, including Ad hoc and expanded online reports

• Assistance with compliance reporting, including RxDc, ACA, Medicare Part D and Consolidated

Appropriations Act/No Surprises Act, and links to machine readable files

• Availability of broad provider and pharmacy access for employees and retirees; and recruitment of highly utilized providers

• Member Advocacy and Support Services by a dedicated team of professional

• A wellness allowance of a minimum of $35,000 annually

• Administration of external of appeals

• Out of network fee negotiation

• Specialty Disease Management programs for diabetes, hypertension, musculoskeletal, and other chronic conditions

• Case management services, including nurse and care support/navigation and Centers of

Excellence for transplants, cancer, kidney and heart

• Claims auditing and fraud review

• Management of Coordination of Benefits and Subrogation

• Healthy Pregnancy Program

• Onsite biometric screenings

• 24/7 Nurseline and Telehealth services

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Health & Dental Plans:

• All fees/premiums are quoted NET of commissions; no commissioners or fees are to be paid to any entity.

• Confirm your quote includes the following disruption reports specific to the networks and formulary quoted, with a summary report (by count and dollar) and the detail by provider/medication/pharmacy: Medical, Dental PPO, DHMO, Medications (tiering and exclusions), and Pharmacies.

• Preliminary renewal rates, factors, fees pharmacy pricing (discounts, rebates) and all other pricing (stop loss premiums and factors, other fees not in rate guarantee) must be submitted five months prior to the effective date.

• Awarded vendor will be responsible for producing the Summary Plan Description (SPD). The client reserves the right to review/revise the SPD prior to final printing.

• Awarded vendor agrees to provide an SPD draft within 60 days of the effective date.

• Awarded vendor agrees to provide all communication materials in electronic (pdf) format.

• Awarded vendor agrees to provide Summary of Benefits and Coverage (SBC) within 30 business days after notification of final plan designs.

• Awarded vendor agrees to provide all standard reports to the client and its actuary consultant.

• Claims experience must be provided at least monthly, including each renewal.

• Awarded vendor is in compliance with all HIPAA Privacy, Electronic Data Interface (EDI) and

Security Regulations and will use HIPAA 834 (ASC X12N 834) for the file transmission layout.

• Awarded vendor has reviewed and accepts the Plan’s eligibility provisions.

• Awarded contract, including the PBM agreement, must require no more than a 90-day notice of termination. Awarded contract cannot prohibit the group from terminating coverage at any time. There must be no penalties for late notification or for termination off anniversary.

• If the County wishes to carve-out the pharmacy benefit, TPA agrees to take real time/daily feeds from the pharmacy vendor and will mine/integrate the data into the medical management program.

• Awarded vendor agrees to provide a designated reporting contact for the client and its broker/consultant. The contact will be responsible for running ad hoc reports for the client and/or its consultant’s discretion, at no additional cost to the client.

• Awarded vendor’s organization has online capabilities in the following areas:

Provider selection – tools that will help members select reputable and effective providers Quality comparison – tools that will help members compare quality outcomes of providers and facilities Price comparison – tools that will allow members to compare the price for services of various hospitals, providers, lab and x-ray facilities, etc.

Wellness information and tools (i.e. BMI calculator, health risk assessments)

• The current medical and dental administration fees include runout administration. Submitted quotes must include medical and dental administration fees include runout administration.

• Awarded vendor agrees to pay 100% of pharmacy rebates through both the medical plan and pharmacy plan to the County. This will consist of a monthly PEPM credit to the administration fees with an annual reconciliation within 120 days following the end of the plan year to return any remaining portion of rebates attributable to Hays County.

• Submitted proposals must include minimum guaranteed pharmacy discounts for retail and mail order, brand, generic, specialty, and the dispensing fees are quoted as well. Your quote should include performance guarantees for achieving the minimum discounts quoted.

• All rebates earned during the contract period are payable to the County. Any rebates earned which are paid after the contract terminates will be paid to the County.

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• Audit Requirements: Client retains access to 100% of all claims data including all data fields necessary to perform a 100% analysis of claims paid by plan for the applicable period, including but not limited to all claim’s payment fields, provider name, provider billing address, and all provider contact information including phone number. The carrier will remove any restrictions that may restrict client access to service including selection of a third-party audit vendor.

Willingness to provide a copy of the administrators written audit policy.

Employee Assistance Plans:

In consideration for the “per employee per month” fee described in Attachment A: Proposal Forms

(4. Pricing Dent EAP Cobra Ret), Company agrees to provide to Employer’s employees and their dependents, and anyone residing in their household (collectively, “participants”) all the services described in this Agreement, and in Company’s proposal to Employer, including, but not limited to, the services described below.

• Eligibility: All employees, dependents, and household members with the exception of minors are eligible to access the EAP starting on day one of the contract regardless of whether they are or are not covered under other mental health service plans. Eligibility is based on the attestation of the member. Employees and retirees who terminate their employment for any reason will have continued access to the EAP for six (6) months post-employment. Employer Group will verify the numbers of employees eligible for the EAP benefit by the 10th day of each month and adjust the reimbursement to Company accordingly. Company will contact Employer Group if there appears to be significant access of the EAP benefit by anyone who is not eligible.

• Intake (Telephonic Triage): This service will be immediately available during regular business hours and in emergency situations via the 24-hour, 7 days a week emergency on-call system.

Basic demographic information will be gathered. Client needs will be assessed. Those in crisis will be connected to a counselor.

• Initial Diagnostic Assessment: Following the intake, a Face-to-Face or Telephonic consultation appointment is offered. During the assessment the counselor will gather information regarding the presenting problem in order to create a diagnosis and develop a treatment plan for short-term counseling. This session counts as one of the EAP visits included in the plan. Telephonic Assessments in lieu of face-to-face assessments will only be conducted at the request of the participant.

• Assignment/Appointments with Provider – The Company will assist with finding an available provider and setting the appointment. Depending on the criticality of the situation: Critical appointment contact made within 6 hours, Traumatic – appointment contact made within 1-2 days. Routine – appointment contact within 5 days.

• Short-Term Therapeutic Counseling: Company will offer up to six (6) visits for short-term EAP counseling benefit per participant, per issue, per calendar year (including the initial appointment). The Company will be fully responsible for the clinical care provided to participants. The specific number of sessions and treatment plans will be determined by the Company’s counselor and will be based on clinical presentation, need, and suitability for a short-term counseling model of treatment.

Minor coverage: A minor may contact the EAP directly or a parent/guardian may do so on their behalf. The Company cannot assess a minor telephonically and cannot refer to EAP service without parental or legal guardian involvement and written consent.

Minors accessing the service directly, without parental involvement, will be checked for safety, offered in-the-moment support and, where appropriate, referred to other Agencies. Upon receiving parental consent, children ages 8-13 are eligible for family counseling; children ages 14-17 are eligible for individual counseling; and children under age 8 must be referred out of the EAP.

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Telephonic counseling can be made available in lieu of face-to-face counseling only at the request of the participant. In addition, a confidential chat session via e-Connect can also be available in lieu of face to face at the request of the participant.

If a participant possesses clinical symptomatology that requires longer-term and/or a different psychotherapeutic approach to treatment, the Company will coordinate with the employer’s medical benefit plan to either make a referral to another provider and/or provide these services under the umbrella of the employee’s medical benefit.

• Range of Counseling Types: Counseling may include individual, family, and/or marital interventions for issues suitable for a short-term counseling approach. Common presenting problems include, but not limited to stress, family problems, marital problems, sadness/grief, worrying, parent/child problems, work-related difficulties, interpersonal problems with co-workers and supervisors, anger management problems, drug or alcohol use, workplace violence, single parenting problems, legal and financial difficulties, coping with medical problems, and crisis counseling.

• Case Management & Follow-Ups: Company shall attempt to follow-up with all participants accessing services to ensure their satisfaction. Additionally, Company shall conduct comprehensive case management and follow-up for any participants referred to the EAP on a mandatory basis due to a job performance concern, work-place violence, sexual harassment, or suspicion of substance abuse or other employer group policy violation or concern.

• Referrals: For cases requiring medical or longer term/more intensive behavioral health intervention, referrals will be made by the Company to the employer’s Medical Plan when indicated, or to another qualified professional that is within the financial means of the participant if the participant is not covered by the major medical plan. Low cost and free community referrals are also available to EAP participants.

• Referrals for Psychological Testing/Fitness-For-Duty Evaluations (FFDs) and DOT/SAP Evaluations: The Company provides expert telephonic consultation dealing with decisions regarding the need for a Fitness-for-Duty (FFD) Evaluation and can assist in recommending a FFD facilitator and coordinating a referral to the provider. However, the employer is solely responsible to decide whether to refer an employee for a Fitness-for-Duty Evaluation.

The employer is responsible for working directly with the FFD provider, as well as paying for the Fitness-for-Duty Evaluation directly. With regard to DOT/SAP evaluations, the Company will coordinate, and case manage DOT/SAP Evaluations at a fee for service.

• Education & Prevention: The Company offers Supervisor and Employee Wellness Training via webinars and in person.

An extensive array of education and prevention seminars are available to employees and supervisors dealing with a wide variety of topics including wellness, stress management, coping with change, motivating employees, recognizing substance abuse, other personal or work-related concerns.

Monthly electronic newsletters for employees and supervisors are designed by the Company for distribution by the employer to provide additional educational and preventative tips and activities.

Additionally, unlimited training seminars are available to download via the Company’s website at no additional fee.

Excluding orientation, 6 Onsite Employee/Supervisor Training Seminars/Webinars that may be used at the Employer Groups discretion for training/orientation, employee orientations, wellness /brown bag seminars, and health fair/open enrollments.

• Work/Life Services: Company will assist participants with balancing personal and work life concerns, coping with maternity/paternity and return to work, time management, childcare/eldercare services, and other work/life issues such as assistance with referrals for adoptions, relocations, college planning, and adjusting to retirement.

• I.D. Recovery: Company will provide participants with I.D Recovery which offers a thirty (30) minute consultation with an Identity Recover Professional that will aid in the recovery process

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 11 of 45 by assessing the situation, creating and implementing an action plan. Company will provide participants credit score monitoring through Credit Karma which will provide secure credit scores, reports and monitoring and financial tools.

• Employer Group Services: Company will provide assistance to the Employer Group as needed.

These services include immediate response to any employees coping with a trauma or critical incident in the workplace within 24 hours of the request of Hays County or at a time and place of Hays County’s choosing. Unlimited hours of on-site debriefing sessions (2 hour minimum per event) are included. Contract includes unlimited Account Management services and telephonic management consultations by assigned Company Account Manager.

• Online Services: Company will maintain comprehensive online services available 24/7 to employees and their family members seeking tools, tips, articles, videos, and resources to help cope with improving overall wellbeing, balancing personal and work-related issues. Health and Wellness topics, on-line Library and over one hundred (100) legal forms are available through the website. Trainings regarding Orientation to the EAP benefit as well as access to the work-life services and legal/financial services are available online as well.

• Legal and Financial Services: Company shall offer legal and financial counseling and resources to employees and their family members, a free (up to 30 minute) initial assessment and a 25% reduction on legal counseling rates with an in-person attorney following any retainer. Free unlimited telephonic financial counseling and education. Online legal and financial resources will also be available. In addition, Company shall offer a legally binding simple state-specific will at no cost through a step by step online “interview process.”

• Confidentiality: Issues of confidentiality will be handled with the utmost sensitivity and protect the employee’s rights to privacy. The Company is fully HIPAA compliant. Where appropriate, consent forms will be obtained to provide written authorization to exchange information with any Employer Group benefits director or supervisor.

• Utilization Reports: The Company will provide confidential Utilization Review Reports to the Employer Group on a quarterly basis. The reports may include: the number of EAP participants seeking assistance, the reasons for accessing the EAP, basic demographics for the EAP participants, in-services, participant survey results and community referrals. These reports will be provided quarterly to the Employer Group.

• Implementation and Program Promotion: The Company will provide Initial Promotional Materials including an electronic introductory letter to the employees on the new EAP provider, as well as 10 Employee Orientation and # of Supervisor orientation). The Company will provide promotional information for employees and supervisor orientation.

• Initial Promotional Materials: Company will provide monthly ongoing electronic promotional materials (e.g. flyers, e-mail articles, newsletters) as needed throughout the duration of the contract term as well as links/ CD-ROM containing additional flyers and posters that may be used as needed. Company will complete a Comprehensive Needs Assessment to ensure Program is customized and tailored to meet Employer Group’s expectations.

• Access: Employees and participants may contact the EAP via the toll-free access number to Employer Group’s employees and their dependents 24 hours a day, seven days a week, throughout the term of this Agreement. Routine appointments are offered generally within three (3) business days, urgent appointments within 48 hours, and emergency appointments are arranged same day. Company offers a nationwide network of affiliate providers in multiple locations shall make every effort to participant’s specific request for an appointment time or location. Bilingual counseling services are also available.

• Company Representative: The Company will assign a primary representative at the discretion of the County. The Hays County Human Resources Director, Shari Miller, shall be the primary representative of Company for the purposes of this Agreement (the "Company Representative").

Primary representative’s address, telephone and fax numbers and 24 hour emergency contact information will be provided to the County.(The Company may also assign additional Account Management Specialists to the team handling the account at the Company’s discretion or as

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 12 of 45 needed. Employer Group may contact the Company Representative (or designated assistant) directly regarding any questions, problems, or concerns Employer Group may have which are related to this Agreement. Company may change the person designated as the Company Representative by prior notice to the Employer Group; provided, however, that Company shall appoint a replacement Company Representative at any time within thirty days after the receipt of a request from the Employer Group.

D. Qualifications Hays County is seeking to contract with a competent Insurance Company and Employee Assistance firm that has had experience in providing the services included in the Scope of Work to organizations.

Specifically, it is seeking those persons or firms with the following qualifications:

• Proven expertise and competence to deliver services.

• Proactive use of technology to better serve Hays County employees.

• Resources to quickly respond to employee request for assistance

• At least five years of experience delivering the services requested in the RFP.

• Demonstrated experience in successfully working with government agencies and counties in

Texas of a similar size and scope as Hays County.

• Individuals assigned to the RFP have the necessary experience, education, and understanding to provide the scope of work.

• Prefer Texas Based company with local office and representatives.

REFERENCES: Hays County requires respondent to supply with the statement of qualifications, a list of at least three (3) references where like services have been supplied by their company. Include name of company, address, telephone number and name of representative.

RESPONSIBILTY: A prospective respondent must affirmatively demonstrate respondent’s responsibility.

A prospective respondent must meet the following requirements:

• Have adequate financial resources, or the above ability to obtain such resources as required

• Be able to comply with required or proposed delivery schedule

• Have a satisfactory record of performance

• Be otherwise qualified and eligible to receive an award

TIME OF PERFORMANCE: It is imperative that the prospective respondent respond to County requests in a timely manner and comply with required or proposed delivery schedules. Please describe how you intend to respond to and track County requests.

SYSTEM FOR AWARD MANAGEMENT: Respondent and its Principals may not be debarred or suspended nor otherwise have an exclusion record created in the System for Award Management (SAM) website.

Include verification that the company as well as the company's principals are not listed (are not debarred) through the System for Award Management (www.SAM.gov). Enclose a printout of the Entity Registration page that shows your firm is in active status and is not expired.

E. Proposal Requirements All proposals shall demonstrate the organizations’ experience in providing the required services for other entities similar in size. For the County representatives to accurately evaluate whether the organization meets the “Minimum Qualifications” and the “Scope of Work”, all proposals shall include the following.

The disruption reports (Medical, dental PPO, DHMO, Prescriptions, and Pharmacies) must be provided in an Excel format.

Proposals shall not exceed thirty (30) pages (15 sheets front and back) in length, but not including:

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• Letter of Transmittal signed by the individual authorized to negotiate for and contractually bind the company.

• Table of Contents

• Appendix materials (any required forms, see RFP Submittal Checklist, and addenda from Hays

County)

• Front and rear covers

Items that count towards the 30-page limit

• Profile/Experience of the Organization Organization information shall include: Organization legal name of the Bidder, principal place of business, number of years in business, and description of company organization including identification of number of staff dedicated to the project.

Experience of the Organization and prior work performance.

List of any criminal charges, civil lawsuits, or dispute resolutions to which the

Organization is a part in the past five (5) years and the nature of the issue. Indicating if and how it was resolved.

Key Personnel o Provide resumes of all employees who may be assigned to provide services if your organization is selected.

o Provide an organizational chart containing the names, telephone numbers and email address of the prime providers and any sub-providers that would be proposed for the team and their contract responsibilities by work category.

• Quality of Service Describe the quality of service provided in order to perform the Scope of Work activities.

Provide a description of your proposed approach/strategy to provide and perform the objectives, specific elements, and tasks associated with services.

• Reporting & Systems

Provide a detailed plan which describes your general reporting capabilities, frequency, level of detail, online employer tools, EOI tracking, and claim status.

• Vendor Integration Please provide your proposed transition plan to a new provider. Please include proposed timeline schedule, from date of County award to complete delivery and implementation of all system components, to include but not limited to all hardware, software, and County staff training.

• Network Access/Strength Provide details abouts your Network Access.

• Proposed Fees The proposal must include all pricing forms.

The lowest/best price will not be used as the sole basis for entering into this contract; rather, an award will be made to the company providing the best value, cost and other factors considered.

Sheet size is limited to 8½” x 11” sheets only, using 12-point font. Appendix materials (related project graphics, resumes, etc.) are not included in the 30-page limit but should be conservative in their inclusion. The organizational chart is included in the 30-page limit and it is permissible to use an 11” x “17” sheet (one-sided) and a font smaller than 12-point for the organizational chart, provided text is clearly legible. It is permissible to use a font smaller than 12-point for graphics, provided text is clearly legible.

The proposal must be submitted with a continuous binding (e.g. – spiral, GBC, etc.) along the left edge;

no other binding will be accepted. While the County does not desire tab dividers in the proposals, if

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 14 of 45 included they would not count towards the 30-page limit. Required forms (see Section I. RFP Submittal Checklist) do not count towards the 30-page limit.

F. Evaluation Criteria The Evaluating Committee will evaluate each respondent’s proposal based on a comprehensive set of criteria. Proposals received shall be evaluated and ranked by the County according to the following criteria: (Maximum Point Total 100)

1. Vendor Integration 10 points

2. Reporting & Systems 15 points

3. Projected Quality of Service 20 points

4. Proposed Cost 25 points

5. Network Access/Strength 30 points

Interview (optional) Ranking At the County’s discretion, submitting entities may be requested by the Evaluating Committee to conduct interviews as part of the evaluation process, prior to making recommendations to Commissioners Court regarding award.

It is the practice of Hays County to encourage local participation and to promote and encourage contracting and subcontracting opportunities for locally owned businesses and labor in all contracts.

The County of Hays does not discriminate on the basis of race, color, national origin, sex, religion, age and disability in employment or the provision of services. Hays County is an Affirmative Action/Equal Opportunity Employer and strives to attain goals for Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701u), as amended. Section 3 Residents and Business Concerns, Minority Business Enterprises, Small Business Enterprises and Women Business Enterprises are encouraged to submit proposals.

G. Submittal Requirements The Company must deliver their proposal to the Hays County Purchasing Department by one of the following methods by the specified deadline:

Mailed or Dropped off Proposals:

• One (1) original proposal with required forms manually signed by the respondent with original signatures

• One (1) digital copy of the full proposal with all required forms on a thumb drive

Electronic Proposals:

• Upload proposal with required forms manually signed by the respondent. (through BidNet

Direct)

• One (1) original proposal with required forms manually signed by the respondent, delivered to the Hays County Purchasing Office. The electronic proposal must be submitted by the due date and time, the hard copy must be delivered to the purchasing office within 24 hours of the due date and time.

LATE SUBMITTALS WILL NOT BE ACCEPTED.

ALTERING PROPOSALS: Any interlineations, alteration, or erasure made before receiving time must be initialed by the signer of the proposal, guaranteeing authenticity.

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WITHDRAWING OF PROPOSAL: A proposal may be withdrawn at any time prior to the official opening.

After the official opening, proposals may not be amended, altered or withdrawn without the recommendation of the County Purchasing Manager and the approval of Commissioners Court.

ADDENDA: Any interpretations, corrections or changes to this RFP and specifications will be made by addenda. Sole issuing authority of addenda shall be vested in Hays County Purchasing Manager. It is the Respondent’s responsibility to acknowledge receipt of all addenda with proposal submission.

FORMS: All proposals must be submitted on the forms provided in this solicitation document. Changes to solicitation forms made by bidders shall disqualify the proposal.

REPONDENT’S ACCEPTANCE: by submitting a response to this RFP, the respondent certifies that is has fully read and understands the terms, conditions and statements of this Request for Qualifications and has knowledge of the scope of the quality of services to be furnished and intends to adhere to the provisions described herein.

H. Award of Contract BASIS OF AWARD: The County reserves the right to award a contract for named project to an organization on the basis of “best value”. Best value will be determined based on cost, experience, qualifications, references, proposed methodology/technical proposal, and overall responsiveness, clarity, and organization of the solicitation response.

COMPANY AGREES, if this proposal is accepted, to furnish any and all services upon which prices are offered, at the price(s) and upon the terms and conditions contained in the specifications. The period for acceptance of the proposal will be one hundred twenty (120) calendar days.

The awarded company expressly warrants that all services specified in the RFP will be performed with care and diligence and in accordance with all specifications of the RFP. The awarded company agrees to correct any deficiencies in its performance of services upon notification by the County and without additional expense to the County.

ACCEPT OR REJECT: It is understood that Hays County reserves the right to accept or reject any and all submittals as it shall deem to be in the best interest of Hays County. The prospective entities are fully responsible for all costs incurred in the preparation and/or presentation of the RFP submittals. All received RFP submittals will become the property of the County. The RFP does not commit the County to award a contract, issue a purchase order, or pay any costs incurred in the preparation of a submission in response to this RFP. Proposals may be held for one hundred twenty (120) calendar days after opening without taking action.

COMMISSIONERS COURT APPROVAL REQUIRED: The Hays County Commissioners Court must approve the contractors selected to provide the services requested in this RFP. The County reserves the right to authorize contract negotiations to begin without further discussion with contractors submitting a response. Therefore, each proposal should be submitted as completely and accurately as possible. The County reserves the right to request additional data, oral discussions, or presentations in support of the written proposal. If the proposal is accepted and approved by Commissioners Court, this document shall be made part of the contract.

Respondent’s Obligation Regarding Evaluation

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a. SUBMISSION OF INFORMATION. Submitters are cautioned that it is each contractor and or individual’s sole responsibility to submit information related to the evaluation categories, and the County is under no obligation to solicit such information if it is not included with the proposal. Failure of a contractor or individual to submit such information may cause an adverse impact on the evaluation of the specific proposal.

b. SUBMITTER REVIEW OF RFP. Submitters are responsible for examining and being familiar with all specifications, terms, conditions, provisions, and instructions of the RFP and their responses.

Failure to do so will be at the contractor and/or individual’s risk and will not be a determinative factor when awarding the contract for services.

ORAL NON-BINDING: Any non-written representations, explanations, or instructions given by County staff or County agents are not binding and do not form a part of, or alter in any way, the RFP, a written agreement pertinent to the RFP, or the awarding of the contract.

RESERVATIONS BY COUNTY: The Commissioners Court has the right to accept, reject, or cancel any and all submissions. In addition, the County expressly reserves the following:

1. waive any defect, irregularity, or informality in any submission or RFP procedure;

2. extend the RFP closing time and date;

3. reissue this RFP in a different form or context;

4. procure any item by other allowable means;

5. revise and modify, at any time before the RFP submittal due date, the factors and/or weights of factors the County will consider in evaluating RFP submittals and to otherwise revise or expand its evaluation methodology as set forth herein;

6. investigate the qualifications of any contractor under consideration and require confirmation of information furnished by a contractor;

7. require additional information from a contractor concerning contents of its RFP submittal and/or require additional evidence of qualifications;

8. waive minor deviations from specifications, conditions, terms, or provisions of the RFP, if it is determined that waiver of the minor deviations improves or enhances the County’s business interests under the RFP;

9. extend any contract when most advantageous to the County, as set forth in this RFP.

10. appoint an evaluation committee to review RFP submittals or responses, make recommendations and seek the assistance of outside technical experts in RFP submittal evaluation;

11. hold interviews and conduct discussions and correspondence with one or more of the contractors responding to this RFP to seek an improved understanding and evaluation of the responses to this RFP.

12. disclose information contained in an RFP submittal to the public as required under the Texas Public Information Act; AND/OR

13. exercise any other right reserved or afforded to Hays County under this RFP. The County reserves the right to modify the process, in its sole discretion, to address applicable law and/or the best interest of the County.

The County shall not, under any circumstances, be bound by or be liable for any obligations with respect to any construction project until such time (if at all) a contract has been awarded and all approvals obtained in form and substance satisfactory to the County have been executed and authorized by the County, and then only to the extent of such agreements.

I. Warranty of Performance The successful respondent expressly warrants that all services specified in the RFP will be performed with care and diligence and in accordance with all specifications of the RFP. The successful bidder agrees

RFP 2024-P11 Employee Group Health, Dental, and Employee Assistance Plans Page 17 of 45 to correct any deficiencies in performance of services upon notification by the County and without additional expense to the County.

CONTINUING NON-PERFORMANCE of the bidder, in terms of specifications, shall be basis for the termination of the contract by the County. The County shall not pay for merchandise/services that are unsatisfactory. Failure to perform any provision will constitute a default of contract, in which case, corrective action shall take place within ten (10) days from the date of written notice citing the nature of breach. Failure to take corrective action or to provide a satisfactory written reply excusing such failure within the prescribed ten (10) days will authorize the County to terminate this agreement by written notice.

COMPLIANCE WITH LAWS: The successful Respondents shall comply with all applicable federal, state and local laws and regulations pertaining to the practice of the profession and the execution of the duties under the solicitation. Any contract executed as a result of this RFP shall be governed by the laws of the State of Texas.

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IV. General Terms and Conditions for Solicitations Applicable To: Request for Proposals (RFP)

1. GENERAL DEFINITIONS:

a. "Auditor" means the Hays County Auditor or his/her designee.

b. "Commissioners Court" means Hays County Commissioners Court.

c. “Contract” means the contract awarded pursuant to the RFP.

d. “Contractor” means a person or firm receiving an award of contract from Commissioners Court.

e. "County" means Hays County, Texas, a political subdivision of the State of Texas.

f. "County Building" means any County owned buildings and does not include buildings leased by County.

g. "Is doing business" and "has done business" mean:

i. Paying or receiving in any calendar year any money or other valuable thing which is worth more than $250 in the aggregate in exchange for personal services or for purchase of any property or property interest, either real or personal, either legal or equitable; or

ii. Loaning or receiving a loan of money; or goods or otherwise creating or having in existence any legal…