Exhibit_A,_Attachment_A.1_-_Benefit_Administration_Services_Worksheet.docx
DOCX document 59 KB Posted
- Attached to
- Benefit Administrative Services
- Solicitation number
- 26-P-66TF
- Issued by
- Volusia County, Florida
About this file
This document is an Exhibit A Attachment to a Request for Proposals issued by Volusia County, Florida, for benefit administrative services covering the County and Constitutional Officers' employees, retirees, and COBRA participants. The RFP solicits proposals for third-party administration of Medical and Dependent Care Flexible Spending Accounts with debit card functionality, Health Reimbursement Arrangements, COBRA compliance and administration, and retiree billing and premium collection services. The worksheet requires contractors to provide comprehensive information about their firm's history, organizational structure, experience with public entities, personnel assignments, HIPAA and HITECH compliance records, information systems security, and any pending legal or disciplinary actions. Contractors must confirm their ability to deliver specific administrative services including customer service via multiple channels, annual customer service surveys, account management with decision-making authority, employer tracking services, monthly virtual or semi-annual in-person meetings, carrier interface capabilities, and participant education materials with customization options for the County.
The RFP requires contractors to provide detailed responses addressing service delivery capabilities across multiple product lines including FSA non-discrimination testing, debit card processing with funds posted by January 1st of each plan year, secure participant portals and mobile applications, HRA claims adjudication procedures, COBRA notification and premium collection processes, and retiree billing administration. The County has established minimum requirements that waive participation requirements, set-up fees, annual renewal fees, termination fees, premium remittance charges, and initial COBRA notices and open enrollment mailers. The contractor must provide costs based on retention of a 2 percent COBRA administration fee surcharge and charge only one monthly fee per participant regardless of enrollment in both Medical and Dependent Care FSA plans. Contractors must submit sample materials, SAS70/SSAE annual reports, debit card vendor information, claims processing procedures, and detailed descriptions of their operational processes for all requested services through the worksheet format without alterations.
View the file
Other files
Show all 47
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
26-P-66TF Attachment 1 - Benefit Administrative Services Worksheet
GENERAL INFORMATION
Complete all questions in full and return the completed worksheet with the response. Confirm with a “Yes” or “No”. If further clarification is needed provide a brief explanation. Please respond to the questions within the worksheet format – DO NOT ALTER THE WORKSHEET FORMAT. The electronic copies must be Microsoft Word format.
GENERAL INFORMATION
A. Provide the following information about Contractor:
Contractor Name
Service Center Location
Primary Contact for RFP
Contact Person Address
E-mail Address
Telephone
Fax
B. Minimum Requirements
| Requirement |
| Confirm |
1. Confirm minimum participation requirements have been waived.
2. Confirm only one monthly fee shall be charged when a participant enrolls in both the Medical and Dependent Care FSA.
3. Confirm set up fees, annual renewal fees, termination fees shall be waived.
4. Confirm fees for premium remittance to carriers, initial COBRA notice and open enrollment mailers for COBRA and Retiree participants shall be waived.
C. References
Current Clients (Public Groups Preferred) Group Size (EEs)
Product(s) FSA, HRA, COBRA, Retiree,
| Contact Name |
| Contact Title |
| Telephone/ Email Address |
| Years as Client |
D. Background
| Services |
| Response |
1. Provide a brief history of the Contractor and describe the ownership and organizational structure. Please include any recent acquisitions, sales or mergers in the last two (2) years.
2. Has the Contractor experienced any HIPAA or HITECH breaches in the last three (3) years? If yes, please describe.
3. Confirm that the Contractor has information systems in place to perform the services requested including security and back-up procedures. Briefly describe.
4. Briefly describe actions the Contractor is taking to maintain compliance with Federal (including Patient Protection and Affordable Care Act (PPACA)) and State guidelines.
5. Does the Contractor have any pending legal actions, disciplinary actions, restrictions or pending reviews by any client, former client, Federal, or State authorities in the past five (5) years for any actions pertaining to the services proposed herein? If yes, please explain.
| 6. Indicate how long the Contractor has been in the business of FSA, Benefit Continuation Billing Services administration and the experience performing these services for public entities. |
| Product |
| Effective Date |
| 7. |
| Medical FSA |
| 8. |
| Dependent Care FSA |
| 9. |
| Health Reimbursement Arrangement |
| 10. |
| COBRA |
| 11. |
| Retiree Billing Services |
E. List the personnel the Contractor shall assign to administer services proposed.
| Name |
| Location |
| Years with Contractor in current role |
| Current Workload (number of current clients) |
Account Service Rep.
Implementation Manager
Administrative Services
A. Please Confirm the following Services and/or list any Clarifications or Limitations in the Response.
| Service |
| Confirm |
| Clarification/Limitation |
1. Confirm the Contractor shall provide customer service (inbound and outbound) using various methods (email, phone, and web) for all Participants.
2. Confirm the Contractor shall record and maintain information regarding service-related or other complaints reported by covered Participants and/or employee representatives.
3. Confirm the Contractor shall administer, at least annually, customer service surveys and provide summary reports to the County.
4. Confirm the Contractor shall designate an account manager who is able to make decisions and eligibility corrections within internal system as needed.
5. Confirm the Contractor shall provide employer tracking services that include statistical information on FSAs, retiree, COBRA enrollments, transactions and past due premiums.
6. Confirm the Contractor shall be available to meet telephonically/virtually (i.e. Microsoft Teams or other meeting platform) on a monthly basis, in person semi-annually or annually, and as deemed necessary by the County.
7. Confirm the Contractor shall provide an annual account management performance survey to be completed by the County.
8. Confirm the Contractor shall, upon approval from the County, be responsible for coordinating communication and marketing activities related to Services.
9. Confirm the Contractor shall be responsible for all costs of producing, printing, and mailing/distributing adequate quantities of marketing and administrative supplies, as designated by the County. The format and content of all materials used for the County account shall be satisfactory to the County.
10. Confirm the Contractor shall designate an implementation team of the Contractor’s experienced staff to work with the County and/or it’s consultants to effectively implement the program on schedule.
11. Confirm the Contractor shall accept enrollment and eligibility files in the County’s file format from County’s payroll systems at least ninety (90) days prior to effective date.
12. Confirm the Contractor shall interface with the County’s carriers, performing test and initial set up requirements prior to the County’s operational period.
13. Confirm the Contractor shall provide a testing environment to review online services thirty (30) days prior to the effective date of coverage.
B. Please provide a response to the questions below.
| Service |
| Response |
1. Provide sample copies of the FSAs, COBRA, Retiree and education materials, claim forms, explanation of payments/billing statements and claims denial letter. Indicate whether these can be customized for Volusia County.
2. Does the Contractor conduct a SAS70/SSAE annually? Please provide the 2024 report.
FLEXIBLE SPENDNG ACCOUNTS
A. Please Confirm the following Services and/or list any Clarifications or Limitations in the Response.
| Service |
| Confirm |
| Clarification/Limitation |
1. The Contractor shall review the County’s current Section 125 Cafeteria Plan documents, develop recommended changes and maintain the documents, including any federal legislative updates and/or amendments.
2. The Contractor shall administer non-discrimination testing to medical FSA and Dependent Care FSA annually within ninety (90) days prior to start of Plan Year.
3. The Contractor shall administer the County’s initial and ongoing run out and FSA grace period provision.
4. The Contractor shall accept eligibility and enrollment information through an electronic file provided by County on the biweekly basis and/or access to a client portal.
5. The Contractor shall provide data necessary for bi-weekly reconciliation election.
6. The Contractor shall provide the County access to standard County-level reporting, including transactional summaries and monthly report of account activities in downloadable formats, including Microsoft Excel.
7. The Contractor shall provide banking arrangements for FSA accounts. The County will reimburse the Contractor by invoice for the claim payments via Wire/ACH.
8. The Contractor shall provide debit card usage for medical FSA, and Dependent Care FSA.
9. The Contractor shall ensure that debit cards are received by, and funds posted to Participant’s cards, no later than January 1st of each plan year.
10. The Contractor shall provide Participants the ability to self-monitor the balance on their FSA, access information about eligible expenses, filing claims etc. as well as provide balance statements by e-mail or letter to Participants sixty (60) days prior to the Plan Year end.
11. The Contractor shall process FSA reimbursements and distribute to the participants bank account via ACH or check. In no circumstances, shall the Contractor hold the participants reimbursements in a non-qualified account.
12. The Contractor shall develop Participant education materials, including initial and new enrollee welcome letters and updates and revisions as a result of any federal or state mandate changes affecting benefits under employee benefits administrative services, to be reviewed and approved by the County.
13. The Contractor shall provide annual enrollment assistance, including an on-site representative to attend annual enrollment up to five (5) full day meetings.
14. The Contractor shall provide access to claim forms in writable, PDF format for placement on the County’s internal or external websites or provide access to such forms on the Contractor’s web site internet. The County shall have the right to post a link to any such site(s) on the County’s websites
15. The Contractor shall provide a secure portal and / mobile application to allow participants the ability to monitor and submit claims using various technologies.
| Service |
| Response |
1. Indicate the current debit card vendor.
2. Please provide percentage of claims that are automatically adjudicated via debit cards.
3. Please describe the procedure for recovering and reporting debit card funds not substantiated.
4. Describe the process and timeline for handling denied claims appeals.
5. Describe the requirements and options available for initial and ongoing funding of the FSA accounts. Include reference to prefunding of the debit card and medical availability.
6. If claims exceed deposits describe the steps the Contractor shall take to cover claims costs.
7. Describe any ability to interface with medical carrier for claims adjudication.
HRA
A. Please Confirm the following Services and/or list any Clarifications or Limitations in the Response.
| Service |
| Confirm |
| Clarification/Limitation |
1. The Contractor shall review the County’s current HRA document, develop recommended changes and maintain the documents, including any federal legislative updates and/or amendments.
2. The Contractor shall administer the County’s initial and ongoing run out provision.
3. The Contractor shall accept eligibility and enrollment information via email on an as needed basis.
4. The Contractor shall provide the County access to standard County-level reporting, including transactional summaries and monthly report of account activities in downloadable formats, including Microsoft Excel.
5. The Contractor shall develop Participant education materials, including initial and new enrollee welcome letters and updates and revisions as a result of any federal or state mandate changes affecting benefits under employee benefits administrative services, to be reviewed and approved by the County.
6. The Contractor shall provide a secure portal and / mobile application to allow participants the ability to monitor and submit claims using various technologies.
7. The County shall reimburse the Contractor by invoice for the claim payments via Wire/ACH.
| Service |
| Response |
1. Please describe the process your company uses to ensure that only claims eligible for HRA reimbursement, as specified in the plan document, are processed and reimbursed. Include any specific procedures, technologies, or documentation used to verify claim eligibility.
COBRA
A. Please Confirm the following Services and/or list any Clarifications or Limitations in the Response.
| Service |
| Confirm |
| Clarification/Limitation |
1. The Contractor shall provide administrative guidance on COBRA, Federal and State laws.
2. The Contractor shall provide COBRA Participants access to customer service for Participant inquiries.
3. The Contractor shall process COBRA elections within specified timeframes.
4. The Contractor shall send COBRA initial enrollment materials within specified timeframes.
5. The Contractor shall facilitate open enrollment materials to current COBRA Participants.
6. The Contractor shall mail acknowledgement of COBRA participation to new enrollees and COBRA election notice to Participants.
7. The Contractor shall conduct premium calculation, monthly billing to Participants, and management of ongoing premium collection process for COBRA.
8. The Contractor shall provide eligibility and premium reconciliation on the monthly basis.
9. The Contractor shall directly interface with County insurance carriers (dental, FSA, and vision) on COBRA enrollments, terminations, and make premium payments directly to insurance carriers for fully insured products monthly via an eligibility data transfer process.
10. The Contractor shall submit all payments for the County’s self-insured medial plan directly back to the County.
11. The Contractor shall allow for automatic bank account deductions for COBRA premiums.
12. The Contractor shall retain records pursuant to applicable laws.
13. The Contractor shall assume liability for services rendered.
14. The Contractor shall maintain historical enrollment and payment information.
15. The Contractor shall provide the necessary reporting to enable the County to perform employer responsibilities related to ACA enrollment for COBRA Participants.
B. Please provide a response to the questions below.
| Service |
| Response |
1. Describe the notification process for COBRA participants nearing the end of their eligibility period.
2. Indicate the review process used for certifying extended COBRA coverage.
3. Briefly, describe the Contractor’s notification and premium payment process to insurance carriers/contractors.
4. Describe the procedure the Contractor follows when a qualified beneficiary submits a premium payment for more or less than the required amount.
5. Describe the procedure the Contractor follows when a qualified beneficiary submits a delinquent premium payment after the thirty (30) day grace period. How do you document the return of the check? At what point do you send a termination notice to the carriers?
6. Confirm that the Contractor has enclosed sample form/letters you use for COBRA administration under.
7. Confirm that the Contractor shall not charge more than a two percent (2%) surcharge for participants on extended COBRA for disability.
Retiree Billing
A. Please Confirm the following Services and/or list any Clarifications or Limitations in the Response.
| Service |
| Confirm |
| Clarification/Limitation |
1. The Contractor shall collect premiums for retiree plans offerings including the County’s health plan premiums (retirees <65 yrs) and Medicare Supplemental (three (3) plan options) and Employer Group Waiver Part D Pharmacy Plan premiums (retirees ≥65 yrs).
2. The Contractor shall have an established arrangement to allow for coordinate with the Florida Retirement System (FRS), allowing for coordination, including FRS deduction of premium payments and, annual FRS reporting for premiums paid. (FRS deduction is optional.)
3. The Contractor shall maintain historical enrollment and payment information.
4. The Contractor shall directly interface with County carriers on retiree enrollments, termination, and make premium payments directly to insurance carriers on fully insured products on a monthly basis via an eligibility data transfer process.
5. The Contractor shall submit all payments for the County’s self-insured medial plan directly back to the County.
6. The Contractor shall allow for automatic bank account deductions for retiree premiums.
7. The Contractor shall perform eligibility and premium reconciliation on a monthly basis.
8. The Contractor shall administer annual enrollment elections including benefit communications and capturing enrollment changes, paper or electronic enrollment is permissible.
9. The Contractor shall provide the necessary reporting to enable the County to perform employer responsibilities related to ACA enrollment for retiree participants.
IMPLEMENTATION PROCESS
A. Please provide a response to the questions below.
| Service |
| Response |
1. Describe the plan to seamlessly transition FSA, HRA, COBRA, Retiree information from another contractor, INCLUDING IMPLEMENTATION TIMELINES FOR THE COUNTY.
2. Confirm that the Contractor shall provide a testing environment to review online services 30 days prior to start of Plan Year.
3. Describe the termination of service procedures. Include information on what will be provided to the County and the handling of run out and Grace Period claims.
P:\TABATHA\2026 Solicitations\26-P-66TF Benefit Administrative Services (COBRA, FSA & Retiree Billing)\1 SOLICITATION\Exhibit A, Attachment 1 - Worksheet.docx Page 1 of 12
File details come from the government source that posted it. Updated .