ESBD_398544_1740433034017_Cobra Questionnaire - UPDATED.xlsx

XLSX spreadsheet 84 KB Posted Feb 24, 2025

Attached to: COBRA and Flexible Spending Accounts Administration
Solicitation number: RFP2025-018
Issued by: Texas

About this file

Written by GovTribe AI · Feb 24, 2025

This is a COBRA Administration questionnaire and RFP document issued by the City of Waco with support from Lockton Companies. The City is seeking proposals for COBRA administration services with an effective date of October 1, 2025. The current program covers 1,603 benefit-eligible employees with 1,496 currently enrolled in the medical plan. The scope includes administration of COBRA for multiple benefit plans including medical (UMR), dental (Delta Dental), vision (Superior Vision), and FSA (Navia). The City experiences approximately 4-8 terminations and 4-8 new hires per month.

The current COBRA administrator is Navia, which charges a $0.50 per employee per month (PEPM) administrative fee. The RFP requires vendors to detail their fee structure including one-time implementation fees, ongoing PEPM fees, additional fees for services like initial notifications, qualifying event notices, carrier notifications, and various other administrative services. Vendors must also specify if they retain the 2% COBRA administration charge and provide details about their customer service capabilities, implementation process, premium collection methods, carrier notification procedures, and cyber security measures. The City requires proposals to be submitted through their online procurement platform, Bonfire.

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Other files

File	Type	Posted
ESBD_398544_1740432992173_RFP 2025-018 Zoom Information.pdf	PDF	Feb 24, 2025
ESBD_398544_1740432969120_RFP 2025-018 Proposal Package (ESBD Posting).pdf	PDF	Feb 24, 2025
ESBD_398544_1740433017834_City of Waco FSA Elections.xlsx	XLSX spreadsheet	Feb 24, 2025
ESBD_398544_1740433049968_FSA Questoinnaire - UPDATED.xlsx	XLSX spreadsheet	Feb 24, 2025

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Front Cover

Request for Proposal-COBRA Administration

City of Waco

Prepared by:

Lockton Companies

2100 Ross Avenue, Suite 1200

Dallas, Texas 75201

www.lockton.com

Introduction COBRA Administration Introduction

Background

The City of Waco has requested Lockton Companies to complete an evaluation of its COBRA vendor.

At this time, we are requesting your assistance in providing a proposal for administration consistent with the current structure.

Current Program

The current Cobra vendor for the City of Waco is Navia.

Effective Date

October 1, 2025

Proposals should be uploaded via the City's online procurement site, Bonfire. Go ONLINE to enroll in Bonfire and pull down the RFP specifications and documents.

Lockton Team - Dunning Series

Morgan Young

Kristy Hinojosa

Michael Plumer

Commission Level

Net commissions

Service

Rates

Rate Validation/Check

Network Accessibility

Claims Service

New Client/Prospect

Renewal Review

Other

Flat fee

Capitated fee (per employee per month)

Flat percentage of premium

Graded percentage of premium

Member-based sliding schedule

Net of commission

Other

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Vendor Information

Vendor Name

Vendor Contact Name

Vendor Contact Phone Number

Vendor Contact Email

Current Program COBRA Administration: Current Program

COBRA Administration Services
Current COBRA Administrator:	Navia
Number of Current Benefit Eligible Employees:	1,603
Number of Employees Currently Under the Medical Plan:	1,496
COBRA Eligible Benefit Plans	Medical: UMR

Dental: Delta Dental Vision: Superior Vision FSA: Navia

Average Terminations Per Month	4-8
Average New Hires Per Month	4-8
Admin Fee	$0.50 PEPM

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Financial Analysis COBRA Administration Financial Analysis

		Vendor Name
One Time Fees
	Implementation Fee
	Takeover Fees (# COBRA participants)
One Time Fees - Annual Total		$0
Ongoing Fees
	Annual Fee
	Monthly Service Fee - PEPM Fee (# enrolled & # eligible)
	Monthly Service Fee - Per COBRA Beneficiary
Ongoing Fees - Annual Total		$0
Additional Fees
	Initial Notifications (existing & new hire)
	Qualifying Event Notices
	Carrier Notifications - reinstatement/termination
	HIPAA Certificates
	Online Services
	Real-time & Monthly Reporting
	Past Due Notices to Continuants
	Retro COBRA Initial Rights Notices
	Per Carrier Eligibility File Fee
	Per Carrier Premium Remittance Fee
	Does your firm retain the 2% administration charge
	Monthly Minimum Fee
	Post-COBRA HIPPA Certificates of Coverage on outside COBRA members (per certificate)
	HIPPA Privacy Notices (per notice)
	Medicare-D Notifications
Direct (Retiree) Billing Services
	Direct (Retiree) Billing (per continuant per month)
	Past Due Notices to Continuants (per notice, upon request)
Open Enrollment Services
	Open Enrollment Service (per person):

Includes packaging and distribution of all related benefit materials and/or informational documents as designated by and provided by the client

*There is a $100 minimum for Open Enrollment Services

Rate Guarantee
	Current Vendor COBRA Admin Fee	$0.50 PEPM

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Questionnaire COBRA Administration Questionnaire

	Organization			[Insert Vendor Name]
	v	How long has your business been in existence?
	v	How long has your business been administering COBRA?
	v	Provide the location of your business.
	v	What is the company's ownership: parent/subsidiary/affiliate relationships. Is the company public or privately held?
	v	Is the company public or privately held?
	v	Please provide a 3-year history of the number of employers your organization has provided COBRA administration services.
	v	What is the average size of your clients? What is the largest? The smallest?
	v	Provide three current client references similar in size and industry. Include contact name, title and phone number.
	v	What has been your client retention percentage for each of the past three years?
	v	Has your organization been acquired or merged with any other organization in the past 12 months?		Please Select
	v	Do you anticipate merging or buying another carrier vendor in the next 12 months?		Please Select
	Customer Service/Member Service
	v	Will you provide information regarding Lockton Marketplace for the public exchange in your Qualified Event Notices?
(Reference link: www.locktonmarketplace.com/dunning)		Please Select
	v	Will you provide a dedicated account manager for City of Waco?		Please Select
		v	Will member and client calls be handled by this individual or by your general customer service department?	Please Select
	v	Does your organization have service offices in Texas?		Please Select
		v	If not, from which location will you service this account?
	v	What types of standard reports do you provide the client?
	v	How can members communicate with customer service?
		v	Is a toll-free number available?	Please Select
		v	Is an automated voice mail system available for routine questions?	Please Select
		v	Can a member also contact customer service over the internet?	Please Select
		v	Do you provide COBRA participants access to online access to your site?	Please Select
	v	How can members communicate with customer service?
	Implementation
	v		Describe your implementation process.
	v		What is the lead time for implementation of COBRA administration? (Please provide a tentative timeline.)
	v		Are you willing to work with the incumbent administrator to transfer data electronically?	Please Select
	v		Provided a detail description of your implementation process, with takeover procedures.
	Financial
	v	Please describe the banking options for the City to submit payment for COBRA Administration. (Example, Check and/or ACH)
	v	Please confirm if rates/costs on Financial sheet are guaranteed for a minimum of five years. If longer, please indicate.
	HIPAA Compliance
	v	When was your last HIPAA Audit?
	v	Name of outside consultant that provided the audit?
	v	Do you have any instances of self-reported HIPAA violations?		Please Select
	v	Last SOC1 audit?
	Carrier Notification
	v	Describe options in which you notify carriers? Electronic or Paper		Please Select
	v	How often will you notify carriers? Weekly, Monthly
	v	Describe the controls in place to ensure COBRA elections and terminations processed correctly?
	Premium Collection
	v	Outline payment options COBRA participants have when submitting premium. (Example, Check or Credit Card)
	v	How are the premiums collected remitted back to the client? (Example, Check or ACH)
	v	How often are the premiums remitted to client? (Example: Weekly, Bi-weekly, Monthly)
	v	Outline your premium collection reporting available to client.
	Event Processing
	v	Outline the various options in which you can received COBRA events. (Example, eligibility file, paper, fax, phone call, excel file)
	v	What is the turn around time to process events? (Example, Daily, Weekly, Bi-weekly, Monthly)
	v	Can you integrate data with the City of Waco's BenAdmin system, Munis (Tyler Technologies)?
	v	What is the process of sending out communications to the members?
	Annual Enrollment
	v	Please describe your process for handling Annual Enrollment for COBRA current participants and those in waiting period.
	Cyber Security
	v	Outline your Cyber Security processes and practices to protect your networks, computers and programs from an attack.
	v	Do you have Cyber Security Insurance? If yes, who is the insurance though?

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Back Cover

OUR MISSION

To be the worldwide value and service leader in insurance brokerage, risk management, employee benefits, and retirement services

OUR GOAL

To be the best place to do business and to work

lockton.com

Template COBRA Administration Questionnaire Comparison

Organization			Carrier 1	Carrier 2
v	Identify and describe your relevant experience with administering COBRA services similar to this plan in both size and design.
v	Provide three current client references similar in size (based on funded lives) and industry. Include contact name, title and phone number.
v	Provide three prior client references similar in size (based on funded lives) and industry. Include contact name, title, and phone number.
Implementation
v	Describe your process for implementation of the benefit plan including:
	v	Timeline required by your company.
	v	ID card design and welcome package options including time needed for approval by City of Waco.
	v	Claim form design and approval from City of Waco.
	v	Participant material production, review, approval, and distribution process.
	v	Implementation and open enrollment communication strategy.
	v	Assuming a business award date of (date), please include a copy of your detailed transition plan/timeline that includes completion dates for each specific task. List any start-up fees.
v	Please provide an implementation guarantee that includes having ID cards in employees hands and loading/testing of all benefits accurately on or before the effective date of the new plan. Include 'drop dead' dates for receiving all information and the fees you will place at risk for non-performance.

v	What type of cost and performance guarantees are you willing to provide for the following areas, along with the amount you will be putting at risk:
	v	Implementation
	v	Delivery of Cards
	v	Delivery of Contract/SPD
	v	Account Management
	v	Claims Processing
	v	Customer Service
	v	Reporting
v	Are your fees (rates) guaranteed for more than one year? If not, are you willing to provide a guarantee of two or three years?
v	Do you provide introductory letters to member homes?
	v	If so, please provide a copy of your standard new member communications materials.
v	Are you willing to work with the incumbent vendor to transfer data electronically through out the implementation phase?
v	Open enrollment meetings each year will be held at each of the [Client]'s facilities . The carrier representative will need to be available to attend those meetings. There could be as many as 30 different enrollment meetings the first year of implementation.
v	Please provide if you will allow enrolled members to change or drop coverage during an annual open enrollment period.
v	What is the minimum amount of time you believe is necessary to implement City of Waco's plans in an efficient and effective manner?
v	Please describe the banking options for bill payment that are available to this client.
v	Do you offer an integrated program (one system, one member, service number, etc.)?
v	Can you provide COBRA Administration services policy review and recommendations to employees?
v	What specific information, not already provided in this RFP, do you need in order to be able to implement properly?
Communication
v	Do you provide the following at no additional cost?
	v	Enrollment kits, posters, brochures
	v	Monthly employee articles
	v	Monthly payroll stuffers
	v	Wallet cards
	v	Ongoing employee orientations
	v	Participate in health fairs and/or organizational events
	v	Monthly HR e-mailer
	v	Member access to a Web site for educational tools
	v	Can your Web site be customized by client?
Financial
v	What is your minimum participation requirement, if any?
v	Please list your typical set-up fees.
	v	Is this rate flexible or is a set rate depending on client size, bundling products, etc?
v	Do you offer the optional services listed below? If yes, please indicate applicable fees/rates.
	v	COBRA Initial Rights Notification
	v	HIPAA Initial Rights Notification
	v	Post COBRA HIPAA Certificates of Coverage
	v	Past Due Notices to Continuants
	v	Retro COBRA Initial Rights Notice
	v	Carrier Communication and Premium Remittance
v	Are they included in your Ongoing Fees/Administration pricing or are they separate charges?
v	Who retains the 2 percent administration fee?
	Do these ongoing fees vary by client size?
	v	Set-up fees
	v	Monthly administration fees
	v	Annual renewal fees
	v	Qualifying event services (per QE)
v	Is your administration fee inclusive of certain services or is "a la carte" pricing available?
v	Do your costs vary by size of the client? If yes, please explain.
v	Are there any other services not listed above that are included in the Admin Fee?
v	What are standard commissions?
v	From the time you have received data necessary to issue contract, how many days does it take to actually issue/deliver contract?
v	What is your standard premium grace period?
v	Please provide us with a copy of your Business Associate Agreement. Will you endorse the clients BAA?
v	Will you agree to provide Schedule A or C information to the client (for filing Form 5500) within 120 days following the end of the plan year?
Customer Service/Member Service
v	Describe your standards and procedures for maintaining contact with the employer and employee. Provide timing of these contacts.
v	Does your organization have service offices in [City/State]? If not, from which location will you service City of Waco's account?
v	Do these offices have previous experience in City of Waco's type of business? If yes, please specify which and what size employee groups. If not, what will you do to become familiar with the claims experience and nuances of City of Waco's business?
v	Will you guarantee that all incoming calls form City of Waco will be returned the same day they are placed?
v	Do you provide dedicated customer service teams to handle member questions/issues or do service center call agents handle claim issues?
v	The bidder will provide a description of their resources for effective and timely customer service. This will include current customer service staffing levels, dedicated staff commitments, customer service representative (CSR) training (initial and ongoing), systems for CSR call reporting and tracking, CSR performance management and other related activities.
v	Specify the documentation procedures for inquiries to the customer service department.
	v	What percentage of inquiries are documented?
	v	Are inquiries updated immediately?
v	Please answer the following regarding your customer service reporting capabilities.
	v	Will you provide client-specific reports?
	v	Will you provide issue-specific reports?
	v	How frequently will customer service reports be provided to City of Waco?
Account Management
v	What is the current number of clients serviced by the account manager/account executive that would be assigned to City of Waco?
v	Do you provide a dedicated account manager?
v	What was the turnover rates of your account managers for the last three years, respectively?
v	Will you provide support to the Client to manage client eligibility and other administrative tasks? Can the Client update in real time on-line?
v	How will you help the Client monitor plan performance?
v	How frequently do you provide status updates to your clients? What information is documented and provided at these meeting?
v	How often will your account manager review the quality and effectiveness of the program with the client?
Claims
v	Do you have an audit process that monitors the accuracy of claims paid? If yes, how often do audits occur and what are the results?
v	Describe the accuracy standards of your claims processing facility. What were your results for last year?
v	What percentage of claims are automatically adjudicated?
v	What is your claim rejection rate and how do you resolve claims that reject from the claims system?
v	What percentage of your claims can be submitted electronically? What percentage of you claims are submitted electronically?
v	How many claims does your organization process annually?
v	What is the average tenure of your claims staff?
v	Over the last three years, what percentage of claims were for services from a network provider?
v	What is your average claims backlog?
v	Detail how you handle employees and dependents residing or traveling outside of established service areas. What provisions does the program have for emergency care provided outside of the plan's service area or after normal working hours?
v	Please describe your process for paying claims for members traveling outside of the United States.
v	Are claim forms ever required of members? If so, in what instances?
v	What extended benefits are available for work in progress after contract termination?
v	How do you investigate for potential subrogation or other third party liability claims?
v	What are your goals and results for claim turnaround time?
v	Describe the qualifications of the consultants who review claims. What is your method of assuring standardization of consultant review decisions?
	v	Describe any outsourced clinical review processes
v	What prompts a claim to be referred to clinical review?
v	Do you have the capability to feed the client's Flexible Spending Account (FSA) vendor claims data to be used for substantiation of claims under the FSA program?
	v	Is it available for this client?
	v	If so, is there an additional cost for this service?
v	What claims reporting will be provided to monitor claims dollars paid in-network, dollars paid by participant tier, total savings attributable to network discounts, dollars not covered, etc? Provide samples of claims reports considered ‘Standard’ and those considered ‘Custom’ (additional cost).
v	Please provide your claim service center statistics for turn-around-time, pay dollar accuracy, average speed of answer, percentage of paid claims paid accuracy, etc. Are you willing to provide service level guarantees, placing fees at risk?
Reporting
v	Describe what reporting is available to the Client and how frequently (monthly, quarterly, annually)?
	v	Can the Client generate these reports? Is this reporting capability available on-line at no additional charge?
	v	Do you offer ad hoc or special-request reporting? Are these also available on-line? Are there additional fees for the standard reporting package and/or ad hoc reports? If so, explain costs.
v	Are there additional costs associated with any of these reports?
v	Does your reporting indicate the following:
	v	Total Identified Members
	v	Total Participating Members
	v	Total Members who declined participation
v	Are customized reports available through your organization's web site?

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File details come from the government source that posted it. Updated Feb 24, 2025.