ESBD_379720_1730745131589_REVISED - Exhibit B - Response Template_ RFP 2510-006.xlsx
XLSX spreadsheet 40 KB Posted
- Solicitation number
- 2510-006
- Issued by
- Travis County, Austin City, Texas
About this file
This document is a Request for Proposals (RFP) issued by the Travis County Healthcare District d/b/a Central Health for life, short-term disability, and long-term disability employee benefits coverage. Central Health is seeking qualified vendors to provide basic life & AD&D, voluntary life & AD&D, employer paid short-term disability, voluntary short-term disability, and employer paid long-term disability insurance coverage for approximately 1,900 employees. The RFP allows for a one-time open enrollment for all employees with no underwriting up to the guarantee issue amount, and Central Health is seeking to bundle the life and disability coverages with the same vendor. The initial contract term is two years, with optional four one-year renewal periods.
The RFP does not mention any set-aside designations or restrictions on the types of organizations that can respond. There are no listed incumbent vendors or current contractors, and no specific details on existing infrastructure or technology that requires integration. The RFP does not provide any information on possible award values or budget ranges, though the historical claims data and premium information suggests this is a significant employee benefits contract for the Travis County Healthcare District.
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Text version
All vendors must respond RFP 2510-006 - Supplier Response Template
| General Questionnaire Template | |
| RFP Instructions - Complete the information requested in the light yellow shaded cells and submit this form electronically with additional required documentation to XXXX | |
| RFP # | XXXX |
| RFP Title | Employee Benefits - Basic and Voluntary Life Insurance & AD&D, Voluntary & Employer Paid Short-Term Disability, Long-Term Disability |
| RFP Submission Requirements | |
| Business Information | |
| Business Name | |
| Federal Tax ID | |
| Address 1 | |
| Address 2 | |
| City | |
| State | |
| Zip | |
| Contact Name | |
| Contact Title: | |
| Contact Phone # | |
| Contact Fax #: | |
| Contact email: | |
| Business Website: | |
| Name/Title of individual authorized to contractually commit company | |
| Name/Title | |
| Products and/or service provided by business: | |
| Number of years in business: | |
| Duns #: | |
| Type of business entity (Corporation/LLC/LP/LLP/Other) | |
| In what state & year did your business organize in your current structure? | |
| Is business or parent publicly traded? | |
| Full legal name of parent or holding company, if any: | |
| Within the last 24 months, has your firm been acquired? With the last 24 months, has your firm acquired another organizations which increased gross revenues by 15% or more? If yes, please provide details on the other party involved, the services proviced, and the stage of integration. | |
| Products and/or service provided by business: | |
| Ability to Perform/Provide | |
| Business Performance | |
| Last Year's Revenue | |
| Last Year's Profit | |
| Gross Profit Margin | |
| Return On Equity | |
| Debt To Equity Ratio | |
| EBITDA | |
| Current A.M. Best Rating | |
| Current Standard and Poor's Rating | |
| Current Moody's rating | |
| General Company Information | |
| Please provide a brief summary of your organization (including number of years providing life and disability insurance). | |
| Provide an overview of your company’s account management function and service model proposed for Travis County Healthcare District. | |
| How long have you been doing business in the state of Texas? | |
| How many contracts and how many covered lives does your disability plan have in Texas? | |
| Do you conduct educational and/or feedback forums for Benefit Managers of your major accounts? If yes, please give frequency and a list of past topics. | |
| References: Provide references (names, address and telephone numbers) for three (3) clients who are currently using your services. At least one reference should currently use a benefit plan similar to the Option being strongly considered by Travis County Healthcare District. Please indicate which specific services/programs they use. | |
| Reference 1 | |
| Organizations Name | |
| Contact Names | |
| Telephone numbers | |
| Type of services provided | |
| How long have you served this client | |
| Reference 2 | |
| Organizations Name | |
| Contact Names | |
| Telephone numbers | |
| Type of services provided | |
| How long have you served this client | |
| Reference 3 | |
| Organizations Name | |
| Contact Names | |
| Telephone numbers | |
| Type of services provided | |
| How long have you served this client | |
| Quality | |
| Travis County Healthcare District may request an audit of your compliance with the guaranteed pricing terms, based on a 100% sampling of all claims paid over a particular time period. Will Travis County Healthcare District have complete audit rights, including the right to select the auditor of its choice? | |
| Describe your approach to quality assurance. | |
| What criteria do you measure in evaluating quality of care? | |
| What are the staffing levels for member services? | |
| What is the turnover percentage in member services for the last 24 months? | |
| Describe the specific grievance resolution system you have implemented to respond to disputes for plan members. | |
| Services | |
| Claims Administration | |
| Provide samples of: claims forms/instructions with envelopes | Submit as an Attachment |
| Describe the organization, methods, and procedures your claims office would use to respond to routine claims inquiries from the Travis County Healthcare District employees. During what hours would you be accepting such inquiries? Provide the toll-free number. | |
| What customer service office will be responsible for this account? Will you provide a toll-free 800 number? Are any charges associated with this number? List the days and hours of operation. | |
| Please indicate whether or not you satisfy all applicable provisions of HIPAA regarding rules on electronic transactions, also known as the Electronic Data Interchange (EDI) Standards, from Department of Health and Human Services regulations (15 CFR Parts 160 and 162). | |
| Does your company accept monthly eligibility feeds in order to act as the administrator of the plan so that Travis County Healthcare District involvement in claims processing is minimized? | |
| Enrollment and Communication - only include if you'd like a disability carrier representative onsite for open enrollment meetings | |
| Respondents must agree to have a representative present at the approximately X enrollment meetings held in January/February of each year in Austin, Texas. | |
| Provide resumes of the key individuals who will manage the Travis County Healthcare District account. Include experience, education and time with your company | Submit as an Attachment |
Page &P of &N &D
Confirmations and General RFP 2510-006 - Supplier Response Template
| Central Health RFP Template Instructions & Assumptions | |
| RFP Instructions - Complete the information requested in the light yellow shaded cells for all tabs: Confirmations and General, Basic and Voluntary Life, AD&D, STD & LTD, Pricing and Underwriting, and Rate History. Submit this form electronically with additional required documentation. | |
| RFP # | 2510-006 |
| RFP Title | Employee Benefits - Basic Life & AD&D, Voluntary Life & AD&D, Employer Paid Short-Term Disability, Voluntary Short-Term Disability, Employer Paid Long-Term Disability |
| RFP Submission Requirements | |
| Business Name | |
| Confirmations and General Questions | |
| Effective Date of Coverage: Respondents must be able to provide required coverage and services by March 1, 2025. | |
| Licensure: Respondents must have all applicable licenses required by Texas. | |
| Premium Rate Guarantees: Proposals’ premium rates must be guaranteed for a minimum period of three years with option for extending the contract for two additional years. | |
| Renewals: Renewals must be submitted to Travis County Healthcare District 180 days prior to the contract renewal date. | |
| Contract Termination: Respondent’s contract termination provision can occur only at third year renewal. Travis County Healthcare District can terminate coverage at any time. | |
| No Loss No Gain: Insured coverage must be offered on a no loss/no gain basis for all covered participants. | |
| Transition Management: Respondents agree, should they be selected, they will proactively manage the transition of coverage from the subsequent carrier. | |
| Administration: Respondents must agree to comply with existing administration of Travis County Healthcare District. Any modifications needed to accommodate Travis County Healthcare District’s data will be done at the vendor’s own expense. | |
| Confirm that your company agrees to self-billing for Life & AD&D, STD and LTD. - please confirm if you would like to have self-billing or list billing. | |
| The insurer must provide the Travis County Healthcare District with an adequate volume of applications, certificate booklets, and claim forms for distribution to Travis County Healthcare District members, in addition electronic versions are required. | |
| Describe the process for supporting the benefits team with administration questions or employee issues on an ongoing basis. | |
| Do you have the ability to receive Electronic Data Interchange (EDI) eligibility files from all payroll & benefit management vendors? Specifically UKG Ready? | |
| Compliance | |
| Do you have an internal compliance team? If yes, please describe its staff and years of experience. | |
| How do you update your system and staff on new legislation or regulations? | |
| Reporting | |
| Describe your reporting capabilities. Include copies of any standard reports. | |
| How are reports received? | |
| Performance Standards | |
| Average customer service hold times: | |
| Average customer service e-mail response time: | |
| Average call speed to answer time: | |
| Account manager turn around time for inquiries received: | |
| Average claim processing time for electronic and paper submissions: | |
| Claim payment accuracy rate: |
Basic and Voluntary Life RFP 2510-006 - Supplier Response Template
| Travis County Healthcare District RFP Template Instructions & Assumptions | |
| RFP Instructions - Complete the information requested in the light yellow shaded cells and submit this form electronically with additional required documentation. | |
| RFP # | 2510-006 |
| RFP Title | Employee Benefits - Basic Life & AD&D, Voluntary Life & AD&D, Employer Paid Short-Term Disability, Voluntary Short-Term Disability, Employer Paid Long-Term Disability |
| RFP Submission Requirements | |
| Business Name | |
| Basic Life and Voluntary Life Questionnaire | |
| Who will be the company’s primary liaison with Travis County Healthcare District and where is this person based? Identify any other members of the client management team, along with their roles. Providee as attachments the bios/resumes of the team members’ experience and qualifications. Where will they be based? | |
| What customer service office will be responsible for this account? Will you provide a toll-free 800 number? Are any charges associated with this number? List the days and hours of operation. | |
| Will you agree to provide draft certificate language within 60 days of contract award? | |
| Describe how the claim processing and customer service functions are handled. Are both functions handled by the same person? | |
| What kinds of employee communication materials will you provide to Travis County Healthcare District and participants? Can these materials be customized? Provide samples of these materials including a sample certificate, claim form and any other sample employee communications in the appendix of your proposal. | |
| Are you able to underwrite the basic and supplemental plans described in the current Standard Certificate of Coverage and Amendments? If your proposal deviates in any way from the current plans, you must specify the coverage differences in the response to this question. This includes differences in contract terminology, ancillary benefits, age reduction schedules, coverage during FMLA, waiver provisions, etc. Unless specified in this section, your proposal will be assumed to duplicate the existing coverages and terms. | |
| Do you agree to match the current employee benefits as listed below: |
Basic Life (Plan One)
Class 1 (Full-time employees working 30 hour per week or more) - One times your Annual Earnings, rounded to the next higher multiple of $1,000, if not already a multiple of $1,000. The maximum amount is $350,000.
Class 2 (Part-time employees working 20 hours per week or more) - One times your Annual Earnings, rounded to the next higher multiple of $1,000, if not already a multiple of $1,000. The maximum amount is $350,000.
Voluntary Life (Plan Two)
$25,000 to $750,000 in $25,000 increments, not to exceed 10x basic annual earnings; Guaranteed Issue: $350,000 Confirm your agreement that if an employee is covered under the Voluntary Life (Plan Two) Insurance that the following dependent life options are available on a voluntary basis:
Spouse: $5,000 to $250,000 in increments of $5,000, not to exceed 50% of the employees voluntary life benefit; Guaranteed Issue: $50,000; spouses rates based on spouse age Child (from live birth to age 26): $10,000 not to exceed 100% of the employees voluntary life benefit; Guaranteed Issue: $10,000
| Do you agree that no form of underwriting is required for both Basic and Voluntary Life provided coverage is elected within 31 days for first becoming eligible? |
| Please list EOI requirement for employees and dependents electing coverage outside of their first time eligible enrollment? Explain the process for obtaining the EOI application. Is there an electronic option? |
| Confirm that benefit increases resulting from salary increases are not subject to Evidence of Insurability. |
| Would you agree to a one-time open enrollment for coverage to be effective March 1, 2025? If yes, explain any conditions that would apply. |
| Do you agree to waive the Evidence of Insurability requirements for Voluntary Life Coverage in the event of the following family status changes: |
1. Marriage, divorce or legal separation.
2. The birth of your Child.
3. The adoption of a Child by you.
4. The death of your Spouse and/or Child.
5. The commencement or termination of your Spouse's employment.
6. A change in employment from full-time to part-time by you, your Spouse.
This applies to both voluntary employee and voluntary dependent coverage.
| Describe any online access capabilities for employees and spouses to complete Evidence of Insurability requirements. Include in your description whether automatic approvals are given, the information required for both the short and long form, and the average turnaround time for long forms. |
| Are credit reports considered in the determination for EOI requests? |
| Describe the repatriation benefit included in the Basic Life and Voluntary Life coverages |
| Does the repatriation benefit also apply to dependent life? |
| Do you agree to the definition of eligible employees includes active employees of Travis County Healthcare District regularly working 20 or more hours per week? |
| List the age reduction schedule that applies to your quote. |
| Confirm your quote includes Waiver of Premium. |
| Confirm your quote include Accelerated Benefits and describe the coverage availability and terminal definition. |
| Confirm agreement to allow employees 60 days to elect portability of coverage. |
| Describe the portability feature in your contract, including the following: (1) whether this applies to Basic Coverage only, Voluntary Coverage, or both Basic and Voluntary Coverage; (2) Whether spouse and child coverage is eligible for port; (3) the minimum and maximum port benefit available for the employee, spouse, and child. |
| Is the coverage portable at the same rates as in effect while employed? If not, please provide rating structure for ported policies. |
| Confirm the earnings definition is the earnings in effect on the last day of active work. |
| Confirm that your Basic Life proposal provides guarantee issue. |
| Confirm that your Voluntary Life proposal provides guarantee issue. |
| Describe the actively at work provision that applies for new hires or individuals approved for an increase in insurance. |
| Describe the "actively at work" definition that applies to dependent spouses and children. |
| Does your contract duplicate the Own Occupation definition requirement under the Premium Waiver provision contained in the Standard Contract? |
| Will you agree that termination of the master contract cannot eliminate your liability for an employee whose disability (waiver of premium) occurred prior to termination of the master contract? |
| Are the quoted rates guaranteed at a minimum through March 1, 2028? Are you willing to guarantee rates for a longer period? If so, for how long and under what terms? |
| Please provide your current turnaround time for claims payment for Life claims. |
| Does your policy contain a suicide exclusion? If so, what are the terms? |
| List any lifestyle exclusions that apply to your policy, such as calf roping, skydiving, piloting aircraft, etc. |
| Does your company put any restrictions on the participation level for the supplemental life program? Describe any limitations. |
| Identify the conversion options available to insured participants. What is the charge to the policyholder? |
| Do your quoted rates include a provision for early payment of life proceeds upon proof of terminal illness? If yes, please explain. |
| Provide a list of the exclusions that will apply to your Basic and Supplemental coverages. |
| Confirm agreement to the following definition: |
Dependent Child means an Insured’s unmarried child, from the moment of birth to age 26. A child, for eligibility purposes, includes an Insured’s: 1) natural child; 2) stepchild; 3) adopted child (a child is considered adopted from the moment the Insured is party in a suit to adopt the child); or 4) grandchild who is dependent on the Insured for federal income tax purposes at the time application for coverage of the child is made.
Insurance will continue for any child who reaches age 26 who is (1) unable to engage in any substantial gainful activity because of a mental or physical handicap and (2) is chiefly dependent on the insured for support and maintenance.
If the Insured has elected coverage for a Dependent child, any newly born child of the Insured will be covered from the moment of birth for 31 days. Coverage may be continued beyond this time period if the Insured notifies the carrier within 31 days of the child’s birth and pays any required premium
| Do you offer a contingent rate renewal that will extend rates beyond the initial guarantee period if the loss ratio for the Employee Basic and Voluntary Coverage is below a specified percentage? If yes, please describe, including defining how the loss ratio is determined. |
| Up to what age does portability apply? |
| To elect port coverage, what requirements apply. |
| Up to what age does waiver of premium apply? |
| What is your definition of total disability as it applies to waiver of premium? |
| Under your contract, must the individual elect conversion or portability during the premium waiver waiting period? Describe how coverage is maintained during the premium waiver waiting period. |
AD&D
RFP 2510-006 - Supplier Response Template
| Travis County Healthcare District RFP Template Instructions & Assumptions | |
| RFP Instructions - Complete the information requested in the light yellow shaded cells and submit this form electronically with additional required documentation. | |
| RFP # | 2510-006 |
| RFP Title | Employee Benefits - Basic Life & AD&D, Voluntary Life & AD&D, Employer Paid Short-Term Disability, Voluntary Short-Term Disability, Employer Paid Long-Term Disability |
| RFP Submission Requirements | |
| Business Name | |
| General Questions for Basic and Voluntary AD&D |
| Do you agree to cover employees working 20 hours or more per week? |
| Do you agree to match the current basic life benefit of Class 1 & 2 of one times basic annual earnings to a maximum of $350,000? |
| What is your time period for a loss? |
| Confirm agreement to the following definition: |
Dependent Child means an Insured’s unmarried child, from the moment of birth to age 26. A child, for eligibility purposes, includes an Insured’s: 1) natural child; 2) stepchild; 3) adopted child (a child is considered adopted from the moment the Insured is party in a suit to adopt the child); or 4) grandchild who is dependent on the Insured for federal income tax purposes at the time application for coverage of the child is made.
Insurance will continue for any child who reaches age 26 who is (1) unable to engage in any substantial gainful activity because of a mental or physical handicap and (2) is chiefly dependent on the insured for support and maintenance.
If the Insured has elected coverage for a Dependent child, any newly born child of the Insured will be covered from the moment of birth for 31 days. Coverage may be continued beyond this time period if the Insured notifies the carrier within 31 days of the child’s birth and pays any required premium
| Confirm that both your basic AD&D and voluntary AD&D policies do not include an exclusion for accidents or deaths resulting from the insured's intoxification. |
| Basic AD&D Questions |
| Indicate the continuation period and benefit coverage for the following Situations: |
For Layoffs For Family Medical Leave for the employee Continuation of coverage for dependents during the employee's Family Medical Leave For Leave of Absence
| Do you agree to duplicate the principal sum benefits for the Basic Employer Paid Coverage as follows: One times basic annual earnings to a maximum of $350,000. If no, specify the amounts quoted. |
| Do you agree to the following Benefit Schedule? |
Loss of life - 100% of the Principal Sum Loss of both hands or both feet - 100% of the Principal Sum Loss of sight of both eyes- 100% of the Principal Sum Loss of one hand and sight of one eye- 100% of the Principal Sum Loss of one foot and sight of one eye- 100% of the Principal Sum Quadriplegia- 100% of the Principal Sum Paraplegia- 50% of the Principal Sum Hemiplegia - 50% of the Principal Sum Loss of one hand - 50% of the Principal Sum Loss of one foot - 50% of the Principal Sum Loss of sight of one eye - 50% of the Principal Sum Loss of speech - 25% of the Principal Sum Loss of hearing- 25% of the Principal Sum Loss of Thumb and Index Finger of the Same Hand - 25% of the Principal Sum
| What is your Exposure and Disappearance coverage? |
| What is your coma benefit? |
| What is your Felonious Assault and Violent Crime Benefits? |
| What is your Seatbelt and Airbag benefit? |
| What is your emergency medical benefit and please provide the definition? |
| What is your emergency medical evacuation benefit? |
| What is your repatriation of remains benefit? |
| Describe the conversion option offered, including the situations for which it is available and the amount of coverage offered. |
| List all exclusions appicable to Basic AD&D. |
| Voluntary AD&D |
| Indicate the continuation period and coverage for dependents in the event of death of the insured. |
| Describe the conversion option offered, including the situations for which it is available and the amount of coverage offered. |
| Have you agreed to match the current benefits? If no, describe any deviations. The current benefits are listed below. |
Principal Sum: Units of $25,000; Maximum Benefit: $750,000, Minimum Benefit: $25,000 Spouse Principal Sum: Units of $5,000; Maximum Benefit: $250,000, Minimum Benefit: $5,000; Not to exceed 50% of the employee's supplimental AD&D Dependent Child Principal Sum: $10,000 not to exceed 100% of the employee's supplimental AD&D Time Period for Loss: 365 days Do you agree to the following Benefit Schedule?
Loss of life - 100% of the Principal Sum Loss of both hands or both feet - 100% of the Principal Sum Loss of sight of both eyes- 100% of the Principal Sum Loss of one hand and sight of one eye- 100% of the Principal Sum Loss of one foot and sight of one eye- 100% of the Principal Sum Quadriplegia- 100% of the Principal Sum Paraplegia- 50% of the Principal Sum Hemiplegia - 50% of the Principal Sum Loss of one hand - 50% of the Principal Sum Loss of one foot - 50% of the Principal Sum Loss of sight of one eye - 50% of the Principal Sum Loss of speech - 25% of the Principal Sum Loss of hearing- 25% of the Principal Sum Loss of Thumb and Index Finger of the Same Hand - 25% of the Principal Sum
| What is your bereavement and trauma counseling benefit? |
| What is your Child Care Center Benefit? |
| What is your coma benefit? |
| What is your common accident benefit? |
| What is your emergency medical benefit and please provide the definition? |
| What is your Home Alteration and Vehicle Modification Benefit |
| What is your Felonious Assault and Violent Crime Benefits? |
| What is your Seatbelt and Airbag benefit? |
| Do you offer a dependent child dismemberment benefit if the child sustains a covered loss from a covered accident. If yes, please specify. |
| What is your emergency medical evacuation benefit? |
| What is your repatriation of remains benefit? |
| Describe the conversion option offered, including the situations for which it is available and the amount of coverage offered. |
| Do you offer a special education benefit? If yes, describe the following: Definition of a qualifying child, time periods for filing claims, covered expenses, the number of annual payments, and the maximum benefit offered. |
| What is your spouse retraining benefit? |
| List all exclusions applicable to Voluntary AD&D. |
STD & LTD
RFP 2510-006 - Supplier Response Template
| Travis County Healthcare District RFP Template Instructions & Assumptions | |
| RFP Instructions - Complete the information requested in the light yellow shaded cells and submit this form electronically with additional required documentation. | |
| RFP # | 2510-006 |
| RFP Title | Employee Benefits - Basic Life & AD&D, Voluntary Life & AD&D, Employer Paid Short-Term Disability, Voluntary Short-Term Disability, Employer Paid Long-Term Disability |
| RFP Submission Requirements | |
| Business Name | |
| Short-Term and Long-Term Disability Questionnaire | |
| Confirm your company will provide draft Certificate language within 60 days of contract award. | |
| Confirm the following reports are available online: |
a. Claims submission
b. Claims status reports Does your standard LTD contract, contain any cost containment features, if so please explain in detail? Examples of Cost Containment Features:
a. Self-reported illness limitations
b. Specific illness limitations other than mental nervous/substance abuse
c. Musculoskeletal/Connective Tissue, chronic fatigue, etc.
d. Prudent person Pre-existing condition exclusion
e. Substance Abuse Limitations
| Are discounts applied to these limitations? |
| If your contract contains wording regarding “Gainful Occupation”, please define. |
| If your contract contains wording regarding “Maximum Capacity, please define? |
| If your contract includes a 40 hour work week limitation, please define? |
| Does your contract include rehabilitation benefits? Are are they mandatory or voluntary? |
| Please explain the repercussions of the mandatory program. Is there a discount applied to the rate? |
| Describe the availability of staff to be onsite at Travis County Healthcare District facilities for purposes of addressing return to work situations with Travis County Healthcare District management and disability claimants.. |
| Does your contract offset benefits for the following items? If yes, describe for each item how the offset is applied any flexibility permitted. |
A. No Fault Motor Vehicle B. Subrogation C. Third Party Settlements D. Individual Disability policies E. Formal/Informal Salary continuation or PTO programs
| Please describe the partial disability formula included in your quote? |
| Describe your work incentive benefit feature. |
| Describe the formula used for CPI indexing of benefit payments. |
| Indicate if your voluntary STD proposal matches the following: |
a. Weekly benefits of 60% of the first $5,000 of weekly predisability earnings, reduced by deductible income
b. Maximum weekly benefit of $3,000 (current benefit is $1,400)
c. Minimum monthly benefit of the greater of $10 or 10% of the STD benefit before reductions
d. 14 day elimination period
e. 24 week duration Indicate if your employer paid STD proposal matches the following:
a. Weekly benefits of 60% of the first $3,000 of weekly predisability earnings, reduced by deductible income
b. Maximum weekly benefit of $3,000 (current benefit is $1,400)
c. Minimum monthly benefit of the greater of $10 or 10% of the STD benefit before reductions
d. 14 day elimination period
e. 24 week duration Indicate if your LTD proposal matches the following:
a. Monthly benefits of 60% of the first $16,666.67 of monthly predisability earnings, reduced by deductible income
b. Maximum monthly benefit of $10,000 (current benefit is $6,000)
c. Minimum monthly benefit of the greater of $100 or 10% of the LTD benefit before reductions
d. 180 day elimination period
e. Own Occupation timeframe: 24 months, thereafter any occupation
| Provide the exact definition of disability during the Own Occupation period that will be used in your contract with Travis County Healthcare District |
| Indicate the definition of Any Occupation that will be used in your contract. |
| Confirm that your return to work earnings threshhold during both the Own Occupation is 80% of predisability earnings and Any Occupation period is 60% of predisability earnings. (Benefits will be paid if earnings are less than 80% of predisability earnings.) |
| Indicate the deductible income sources that will be included in your Travis County Healthcare District contract. |
| Describe your Maximum Benefit Period, inclicating the number of months applicable. |
| What is your age reduction schedule? |
| Does your contract contain a childcare benefit. If so, describe the benefits and trigger features. |
| Does your contract contain a spouse disability benefit? If yes, describe. |
| Describe your reasonable accommodation benefit. |
| Does your proposal include waiver of premium while LTD benefits are payable? |
| If an EAP benefit feature is included, describe the program, including number of covered consultations and whether the program is face to face, telephonic or both. Please include premium amount. Premium must be able to be separated for COBRA purposes. |
| Describe the rehabilitation program included. Is participation mandatory or voluntary? If mandatory, what happens if an employee fails to comply? |
| Describe your takeover provision feature that will ensure no loss or gain in coverage. |
| Does your contract contain any “Long Term Care” benefits or features? If yes, describe how this works and any additional cost for this program. |
| Please explain how your “own occupation” definition of disability works. |
| Does the elimination period go against the “own occupation” period? |
| Provide your definition of pre-disability earnings |
| Is an earnings loss and occupation loss required to satisfy the elimination period or begin paying benefits? Please explain: |
| What is the timeframe for temporary recovery during the elimination period and during the benefit payment period for which a new Elimination period is not required. |
| Are there any other features or limitation not mentioned above that are include in your standard contract, if so please explain in detail? |
| What is your pre-existing condition definition? |
| Do you offer a benefit for pre-existing conditions for a limited time frame? If so, what is the time frame and additional cost? |
| If you provide a quote to us and you are quoting limitations or features not outlined above as a standard feature, do you highlight this in your quote? Please explain: |
| What deviations from the current plan are included in your proposal? |
| Do you issue W-2's for STD and/or LTD? |
| Do you provide FICA Match for STD and/or LTD? |
| What is the participation requirement on voluntary STD? |
| Do you allow a true open enrollment each year for voluntary STD? |
| Does your STD contract include an organ donor benefit? |
| Will you grandfather everyone currently enrolled in STD? |
| Do you agree to the definition of eligible employees includes active employees of Travis County Healthcare District regularly working 20 or more hours per week? |
| Claims Administration |
| Where will your organization process the Travis County Healthcare District claims? What would be the size and makeup of the staff that would be assigned to processing their claims? (A single claim office is desired). |
| If claims are processed at more than one location, describe the methods and procedures you will use to ensure that claims are processed consistently by each of these offices. |
| Provide an organizational chart which displays the major departments and groups located at the claim office(s) identified in Question 1. What are the hours of operation (CST) for these offices? |
| Confirm your company has an online claims filing system for both STD and LTD. |
| Please provide samples of your claims forms/instructions with envelopes and administrative manuals. |
| What involvement is required by the companies benefit team in order for you to process a claim? Is there an option for no employer involvement with filing and processing a claim, by gathering all required information through EDI feed. |
| What is the avaerage turnaround time for Claim processing? |
| STD and LTD Questions- Quality of Care / Customer Service |
| Describe your approach to quality assurance. |
| What criteria do you measure in evaluating quality of care? |
| What are the staffing levels for member services? What is the turnover percentage in member services for the last 24 months? |
| Describe the specific grievance resolution system you have implemented to respond to disputes for plan members. |
| Describe the process for supporting the benefits team with administration questions or employee issues on an ongoing basis. |
| Staffing |
| Describe the organizations, methods and procedures your claims office would use to respond to claim inquiries. During what hours would you be accepting such inquiries? Is there a toll free number? Do you provide internet accessibility? |
| Describe your hiring and training practices with respect to claims examiners, and processors. Describe any audit and quality controls that you have established for claims examiners. |
| Describe the processing procedures for disability claims – both short term and long term from receipt of claim to time first check is issued. |
| Provide a complete explanation of your rehabilitation support activity for long term disability claimants. |
| Describe in full the services offered to LTD claimants in support of obtaining eligible Social Security Disability payments. |
| What is your SSDI approval rate? |
| Reporting |
| Travis County Healthcare District needs online access to Short Term and Long-Term Disability claims. Describe in full your capabilities in this area. |
Pricing and Underwriting
| RFP 2510-006 - Supplier Response Template | |||||
| Pricing Worksheet for Proposals | |||||
| RFP # | |||||
| RFP Title | Employee Benefits - Basic and Voluntary Life Insurance & AD&D, Voluntary & Employer Paid Short-Term Disability, Long-Term Disability | ||||
| Business Name | |||||
| Pricing Worksheet | |||||
| Instructions - Complete the information requested in the light yellow shaded cells and submit this form with additional required documentation | |||||
| Covered Volume | Monthly Premium Rate | Rate Basis | Monthly Premium | Initial Rate Guarantee Period | |
| Short-Term Disability | Per $10 of weekly benefit | ||||
| Long-Term Disability | Per $100 of covered monthly earnings | ||||
| Basic Life | Per $1,000 | ||||
| Basic AD&D | Per $1,000 | ||||
| Voluntary AD&D | |||||
| Employee only | Per $1,000 | ||||
| Employee and Family | Per $1,000 |
| Describe the conditions for which the rates could change during the initial rate guarantee period. |
| Do you offer a contingent rate renewal that will extend rates beyond the initial guarantee period if the loss ratio for the coverage is below a specified percentage? If yes, please describe, including defining how the loss ratio is determined. |
| Describe the renewal underwriting formulas that will apply after the initial rate guarantee period. |
| Indicate any performance guarantees proposed for claims payment turnaround time, accuracy, EOI processing, Social Security Disability approval rates, or other standards. |
| Will your rate change if multiple lines of coverage are awarded? If so, how much per line? |
| Do you offer any implementation or technology credits? If so, how much per line? |
| Do you have API connectivity with UKG Ready? |
Rate History
| 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | |
| Short-Term Disability | 0.328 | 0.328 | 0.328 | 0.344 | 0.344 | 0.452 | 0.452 | 0.443 |
| Long-Term Disability | 0.315 | 0.315 | 0.315 | 0.315 | 0.315 | 0.461 | 0.511 | 0.586 |
| Class 1: Basic Life Insurance | 0.04 | 0.04 | 0.04 | 0.04 | 0.04 | 0.04 | 0.04 | 0.04 |
| Class 1: AD&D Insurance | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 |
| Class 2: Basic Life Insurance | 0.11 | 0.11 | 0.11 | 0.11 | 0.11 | 0.11 | 0.04 | 0.04 |
| Class 2: AD&D Insurance | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 |
| Voluntary Life Insurance | ||||||||
| Under 25 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 |
| 25-29 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 | 0.076 |
| 30-34 | 0.090 | 0.090 | 0.090 | 0.090 | 0.090 | 0.090 | 0.090 | 0.090 |
| 35-39 | 0.106 | 0.106 | 0.106 | 0.106 | 0.106 | 0.106 | 0.106 | 0.106 |
| 40-44 | 0.136 | 0.136 | 0.136 | 0.136 | 0.136 | 0.136 | 0.136 | 0.136 |
| 45-49 | 0.196 | 0.196 | 0.196 | 0.196 | 0.196 | 0.196 | 0.196 | 0.196 |
| 50-54 | 0.288 | 0.288 | 0.288 | 0.288 | 0.288 | 0.288 | 0.288 | 0.288 |
| 55-59 | 0.438 | 0.438 | 0.438 | 0.438 | 0.438 | 0.438 | 0.438 | 0.438 |
| 60-64 | 0.724 | 0.724 | 0.724 | 0.724 | 0.724 | 0.724 | 0.724 | 0.724 |
| 65-69 | 1.178 | 1.178 | 1.178 | 1.178 | 1.178 | 1.178 | 1.178 | 1.178 |
| 70-74 | 1.996 | 1.996 | 1.996 | 1.996 | 1.996 | 1.996 | 1.270 | 1.270 |
| 75 and above | 1.996 | 1.996 | 1.996 | 1.996 | 1.996 | 1.996 | 2.060 | 2.060 |
| Monthly Child Rate | 0.200 | 0.200 | 0.200 | 0.200 | 0.200 | 0.200 | 0.200 | 0.200 |
| Voluntary AD&D Insurance | ||||||||
| Employee Only | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 | 0.015 |
| Employee & Family | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 |
File details come from the government source that posted it. Updated .