Exhibit_6-_Performance_Guarantee_Standard.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
State Employee Health Benefit Plan Audit Services
Solicitation number
EVT0010856
Issued by
Sedgwick County, Kansas

About this file

This is a Performance Guarantee Standard Reporting Format exhibit for an Account Management contract between the State of Kansas and a vendor covering the State Employees Health Plan (SEHP) for the years 2027, 2028, and 2029. The document establishes performance metrics and reporting requirements across six key performance areas that apply on a quarterly basis throughout the contract term. The vendor must comply with Protected Health Information (PHI) security standards, complete annual audits of self-funded plans by December 31 of the following calendar year, respond to legislative and Health Care Commission information requests within two business days, obtain pre-approval from SEHP for all project aspects with a project timeline as the first deliverable, and maintain service standards for the State's contract management team including 100 percent call and email response rates by 5:00 p.m. on the next business day and resolution of all issues within three business days of receipt.

The contract includes financial accountability provisions requiring vendors to pay any monies owed to the State within thirty calendar days of notification, with vendors having thirty calendar days to document disputes. Failure to remit payments within this timeframe results in liquidated damages of $25 per day until paid, with the SEHP authorized to collect unpaid amounts by deducting funds from the vendor's administrative fees or other contract payments. Any breach in PHI security or unauthorized transmission using non-secure protocols subjects the vendor to penalties in addition to other legal remedies available to the State. All project timelines, methodologies, and implementation activities require SEHP pre-approval, with failure to meet approved timeline goals resulting in liquidated damages.

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Account Mgmt

Exhibit 6- Performance Guarantee Standard Reporting Format EVT0010856
Vendor NameMonth:Quarter:
State of Kansas Report for Performance for 2027, 2028, 2029
Account Management
6.1.01Protected Health InformationJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
If a vendor transmits Personal Health Information (PHI) using non-secure transmission protocols, such as an unencrypted email, or a breach in security results in PHI of State members being released or obtained by others, the carrier will be subject to a penalty. This penalty will apply in addition to any other penalties or requirements of law and provisions of this contract.
6.1.02Annual Vendor AuditsJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
The vendor shall complete the review of each self-funded plan and have the reports sent to the SEHP for review by 12/31 of the following calendar year.
6.1.03Legislative or HCC RequestsJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
The vendor will provide support to the SEHP in responding to information requests made by the Legislature, the Legislative Post Audit Committee, or the Health Care Commission. Responses to these requests are due to the State within two (2) business days of an SEHP request.
6.1.04Approval of Project Timeline and MethodologyJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
All aspects of this project must be pre-approved by the SEHP prior to implementation. A project timeline will be the vendor's first deliverable. Unless the project timeline is modified with the State's approval, failure to meet the timeline goals will result in Liquidated Damages.
6.1.05Service to State of Kansas Contract Management TeamJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
(a) One hundred (100) percent of calls returned by the account service representative by 5:00 p.m. on the next business day.
(b) One hundred (100) percent of emails are responded to by the account service representative by 5:00 p.m. on the next business day.
(c) One hundred (100) percent of issues received by phone call or email are resolved within three (3) business days of receipt.
6.1.06Money Owed to the SEHPJanuaryFebruaryMarchFirst QuarterAprilMayJuneSecond Quarter
Money owed to the State of Kansas shall be paid within thirty (30) calendar days from notification of liquidated damages or monies owed. The vendor has thirty (30) calendar days to document any dispute of amounts owed. Amounts owed that are not received within thirty (30) calendar days will be subject to liquidated damages of $25 per day until paid. After thirty (30) days, the SEHP may collect owed funds by deducting the amounts from the administrative fees or other payments made to the vendor.
6.1.01Protected Health InformationJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
If a vendor transmits Personal Health Information (PHI) using non-secure transmission protocols, such as an unencrypted email, or a breach in security results in PHI of State members being released or obtained by others, the carrier will be subject to a penalty. This penalty will apply in addition to any other penalties or requirements of law and provisions of this contract.
6.1.02Annual Vendor AuditsJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
The vendor shall complete the review of each self-funded plan and have the reports sent to the SEHP for review by 12/31 of the following calendar year.
6.1.03Legislative or HCC RequestsJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
The vendor will provide support to the SEHP in responding to information requests made by the Legislature, the Legislative Post Audit Committee, or the Health Care Commission. Responses to these requests are due to the State within two (2) business days of an SEHP request.
6.1.04Approval of Project Timeline and MethodologyJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
All aspects of this project must be pre-approved by the SEHP prior to implementation. A project timeline will be the vendor's first deliverable. Unless the project timeline is modified with the State's approval, failure to meet the timeline goals will result in Liquidated Damages.
6.1.05Service to State of Kansas Contract Management TeamJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
(a) One hundred (100) percent of calls returned by the account service representative by 5:00 p.m. on the next business day.
(b) One hundred (100) percent of emails are responded to by the account service representative by 5:00 p.m. on the next business day.
(c) One hundred (100) percent of issues received by phone call or email are resolved within three (3) business days of receipt.
6.1.06Money Owed to the SEHPJulyAugustSeptemberThird QuarterOctoberNovemberDecemberFourth Quarter
Money owed to the State of Kansas shall be paid within thirty (30) calendar days from notification of liquidated damages or monies owed. The vendor has thirty (30) calendar days to document any dispute of amounts owed. Amounts owed that are not received within thirty (30) calendar days will be subject to liquidated damages of $25 per day until paid. After thirty (30) days, the SEHP may collect owed funds by deducting the amounts from the administrative fees or other payments made to the vendor.

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