ESBD_525520_1781037653184_RFP 2606-001 Exhibit A-2 Questionnaire.xlsx
XLSX spreadsheet 18 KB Posted
- Attached to
- HR Benefits - Hospital Indemnity Insurance
- Solicitation number
- 2606-001
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Request for Proposal (RFP) questionnaire for hospital indemnity insurance coverage issued by Central Health in Texas. The organization is seeking proposals for a new line of hospital indemnity coverage to be implemented by January 1, 2027, with an initial enrollment period beginning in October. The contract will cover approximately 2,300 active team members on a 100% team member contribution basis with no commissions paid to carriers. The proposal must be structured as a one-year term with the right to extend for additional years up to a total of four years at the district's discretion. Carriers must commit to annual renewal delivery by April 1, provided all necessary data is submitted and approved, and must provide 120 days written notice for contract termination.
Bidders must submit multi-year rate guarantees (with three years preferred) and confirm agreement to 60-day payment terms and waiver of all "actively at work" provisions. Initial enrollment is guaranteed issue with no evidence of insurability required for all team members regardless of medical history. The carrier must accept electronic eligibility file feeds on a weekly basis at no cost, confirm compatibility with the UKG benefits administration vendor without requiring a deduction file, and offer summary/self-billing as a payment option. Carriers should specify credits, funds, or subsidies provided for technology and communication costs associated with open enrollment, file feed setup, and product development. Proposals must include detailed implementation plans with assigned accountability and anticipated completion timelines, claims processes and documentation requirements, online portal capabilities for policy management, and benchmarking data or insights comparing plan design and costs against similar organizations in the marketplace.
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Text version
General
| Requirements | Confirm / Not Confirmed | Additional Remarks |
| The System finalizes their budget in June. Will you be able to deliver the renewal annually by April 1, provided all necessary data is submitted and approved? | ||
| Company must provide 120 days written contract termination notification. | ||
| If subcontractors are used, the proposal must include the subcontractor's name and identification of functions to be performed | ||
| Proposals must be for a one year term, with the right to extend the contract additional years (up to a total of 4 years) at the discretion of the district. Please indicate if you are providing multi-year rate guarantees (three years is preferred). | ||
| Confirm you agree to 60-day payment terms. | ||
| All "actively at work" provisions must be waived. | ||
| Questions/Requests | Confirmed / Not Confirmed | Additional Remarks |
| Name of firm (legal name and d.b.a., if any) | ||
| Financial rating for each proposed entity and provide source | ||
| Provide an overview of the account management team to be assigned to Central Health, including a description of their responsibilities. | ||
| Indicate the hours of operation (CST) for the Customer Service office that will service this account. | ||
| Detail your open enrollment support (i.e. promotional materials, onsite and virtual presentations). | ||
| Please provide an implementation plan/timeline of the services proposed assigning accountability and indicating the anticipated time frame for completion for timely implementation by January 1, 2027. Please note that open enrollment starts in October of each year. | ||
| Central Health will require the carrier to take an electronic eligibility file feed on a weekly basis. Please confirm you can accept an electronic file and any cost associated are waived. The benefits administration vendor is UKG. | ||
| Please confirm that you do not require a deduction file. | ||
| How does your firm measure its performance in areas such as implementation, customer service responsiveness, and claim accuracy? | ||
| Would your firm be willing to guarantee Central Health's satisfaction regarding these subjective areas on a “pass/fail” basis? If so, how much of the fees/premiums would your firm be willing to attach to each area of service? | ||
| Confirm that you offer summary/self billing as a payment form. |
Hospital Indemnity
| General Information | ||
| Carrier History | N/A New line of coverage | |
| Contributions | 100% team member Paid | |
| Commissions | None | |
| General / Claims / Service | Confirmed / Not Confirmed | Additional Remarks |
| Please confirm that you offer a true annual open enrollment each year with no waiting periods for team members who have previously waived coverage on the plan. | ||
| Please provide a copy of your hospital indemnity contract. | ||
| Please outline your standard claims process and the supporting documentation that must be submitted by the insured. | ||
| Please outline your standard claims process and the supporting documentation that must be submitted by the insured. | ||
| Confirm you provide an online portal for policy management (manage claims, review coverage, beneficiaries, etc.) If not, please explain how members manage their policy and claims. | ||
| Is submitting a wellness claim different than submitting an incident claim? If so, how is it different (including timing)? | ||
| How many days does a participant have to file of claim from the date of event? | ||
| Please outline how long team members on unpaid LOA can be on leave before you would consider them termed. | ||
| Confirm you will issue certificates based on group employer situs and NOT on team member's state of residence. If disagree, please outline if this impacts all states or only specific states. | ||
| Confirm the plan(s) exclude elective surgeries. If confirmed, please provide clarification as to what would qualify as an “elective” surgery and be excluded vs. what types of known surgeries may be covered. If not confirmed, please explain. | ||
| Confirm that a child may be added within 30 days of birth | ||
| Confirm that if a child is admitted to the hospital within 30 days after birth, the team member can add them to the plan if it is within the 30 days. | ||
| Please confirm that their "Hospital Stay" benefit includes maternity/ delivery and that there is no "pre-existing condition" waiting period for pregnancy if enrolled during the initial rollout. | ||
| Will you be able to auto-adjudicate the claim or do "medical integration" so that a team member doesn't have to manually file a claim? | ||
| How do the plan(s) standardly cover hospitalizations due to Mental and Nervous Disorders? If an insured is admitted as an inpatient to the hospital resulting from a mental/nervous disorder, will you cover this admission and resulting confinement similar any other hospital admission/confinement? If standardly excluded, do you have the flexibility to waive this exclusion? | ||
| Reporting Requirements | Confirmed / Not Confirmed | Additional Remarks |
| Please provide an example of your claims reports. | ||
| Please confirm you will setup the eligiblity file feeds with UKG. | ||
| Do you provide access to ulitization data through online portals or reporting tools? What level of detail is available? | ||
| Implementation Plan and Schedule | Confirmed / Not Confirmed | Additional Remarks |
| Provide an overview of your Implementation Plan that includes step-by-step your approach to ensure a smooth rollout. | ||
| What are the anticipated timelines and any related fees? | ||
| Will there be an assigned Implementation Manager? | ||
| Identify any other key contacts responsible for implementation. | ||
| Underwriting and Renewal Process | Confirmed / Not Confirmed | Additional Remarks |
| Describe your renewal process including the timeline for renewal offers. | ||
| Describe your data requirements for renewal underwriting, and the methodology used to determine renewal rates. | ||
| What is your capability of providing benchmarking data or insights to Central Health, comparing their dental plan design, performance, and costs against similar organizations in the marketplace? | ||
| Please include a sample benchmark report. | ||
| Quoting Options | Confirmed / Not Confirmed | Additional Remarks |
| Please provide a multi-year quote with the following options: |
1. Please quote a dual option high/ low Hospital Indemnity plans as new coverage.
| Please confirm your proposal is net commissions. |
| Please confirm that Initial enrollment is Guarantee Issue with no Evidence of Insurability required for all 2,300 active team members, regardless of medical history. |
| Please complete Exhibit B: Pricing Sheet, with a complete list of all fees/premiums. |
| Please specify how much your company is willing to provide in credits/funds/subsidies for the following |
| Technology / Communication |
| Costs associated with open enrollment updates, new product builds, file feed set ups, etc. |
| Other |
| Please outline any other credits/funds/subsidies included in your proposal. |
File details come from the government source that posted it. Updated .