Exhibit_D_-_VolunCritIllnessRFP_22-05BenMatrix-MUSTCOMPLETE.xlsx
XLSX spreadsheet 121 KB Posted
- Attached to
- RFP 25-05 Voluntary Critical Illness Plan (USI)
- Solicitation number
- 0000036102
- Issued by
- San Bernardino County, San Bernardino City, California
About this file
This document is a Benefit Matrix for a Critical Illness Request for Proposal (RFP #25-05) issued by the Superior Court of California, County of San Bernardino. The RFP seeks a group critical illness insurance plan for court employees, with coverage options for employees, spouses, and children. Eligible employees must work a minimum of 40 hours per pay period in a regular position, with a 14-day waiting period for coverage. Benefit amounts range from $10,000 to $30,000 for employees, $5,000 to $15,000 for spouses, and 50% of the employee amount for children, with a guaranteed issue amount of $30,000 for employees and $15,000 for spouses.
The proposed critical illness plan includes comprehensive coverage for various conditions such as cancer, heart attack, stroke, major organ failure, and specific child critical illnesses. The plan offers portability, multiple payouts for additional occurrences, and a $50 annual wellness/health screening benefit. Enrollment methods include onsite meetings, electronic and printed materials, and support from The Standard insurance provider. The plan requires a minimum participation of 10 members, with potential for waiver under an Enrollment Best Practice Agreement. Ongoing guaranteed issue allows late entrants to apply during annual enrollment periods, and the plan is designed to be price-competitive with individual purchasing options.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment_5_-_Good_Standing_Form.docx | DOCX document | |
| Exhibit_C2_-_SCCCSB_Voluntary_Critical_Illness_Certificate.pdf | ||
| Attachment_3_-_Acceptance_of_Terms-Conditions-Benefits.docx | DOCX document | |
| Exhibit_C1_-_Voluntary_Critical_Illness_Benefit_Summary.pdf | ||
| Exhibit_C3_-_July_2025_Premium_Statement.pdf | ||
| Attachment_6_-_Darfur_Contracting_Act_Certification.docx | DOCX document | |
| Attachment_8_-_Unruh_CRA_and_CA_FEHA_Certification.docx | DOCX document | |
| Attachment_1_-_Administrative_Rules.docx | DOCX document | |
| Exhibit_A_-USIMarketingLetterRFP25-05VolCriticalIllness.pdf | ||
| RFP_25-05_Voluntary_Critical_Illness_Plan.docx | DOCX document | |
| Exhibit_B_-_Payment_Provisions.docx | DOCX document | |
| Attachment_4_-_General_Certifications_Form.docx | DOCX document | |
| Exhibit_E_-_2025_Benefit_Fair_Locations.xlsx | XLSX spreadsheet | |
| Attachment_7A_-_Bidder_Declaration.docx | DOCX document | |
| Attachment_7B_-_DVBE_Declaration.docx | DOCX document | |
| Attachment_2_-_General_Terms-Conditions-Benefits.docx | DOCX document |
Show all 16
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READ FIRST
| Superior Court of California, County of San Bernardino |
| Critical Illness RFP #25-05 |
| Important note to bidding carriers: In addition to completing the Court's RFP documents, you must also complete the following tabs of this workbook and provide the supporting benefit summaries with each plan. |
| Use drop down menu in column B and note any responses in column C | Critical Illness |
| Remember to have your Compliance contact review the Court's mandatory terms & conditions | |
| NOTE: The Court's Teamsters group offers Critical Illness through Colonial. These members will be eligible for the Court's Critical Illness plan as well. |
Critical Illness
| Superior Court of California, County of San Bernardino |
| Critical Illness Benefit Matrix |
Critical Illness Benefit Provisions Requested Parameters Proposed Vendor to Confirm
| (Use drop down menu) | Proposed Vendor to note details and/or deviations | |
| Product Type | Group - Critical Illness | |
| Plan offered should be robust and price-competitive compared to if purchased individually. | ||
| Post-Tax Payroll Deduction & Frequency | Yes, bi weekly (26) frequency | |
| Eligibility | Employee in a regular position with a minimum of 40 hours worked per pay period. | |
| Waiting Period | 1st day after 14 days as a member & employee must be scheduled and paid for 40 hrs./pay period. | |
| Status Change Effective | Eligibility waiting period begins the date of the status change. | |
| Benefit Amounts (include increments) | Employee: $10K to $30K in $10K increments |
Spouse: $5K to $15K in $5K increments
| Child(ren): 50% of the Employee Amount | Will Match | |||
| Issue Ages; Spouse Rate Basis | Issue -age; uni-tobacco; 16 - 64; spouse rate based upon spouse's age | Not applicable, not included, or cannot match | ||
| Guaranteed Issue Amount Format | Employee: $30,000 |
Spouse: $15,000 Child: 50% of the Employee Amount Dependent Coverage Spouse: $5k to $15K in $5K increments - cannot exceed 50% of EE amount.
Child(ren): 50% of the Employee Amount
| Pre-existing condition? | None |
| Portability | Yes |
| Cancer | 100% of Coverage |
| Non-invasive Cancer (carcinoma in situ) | 25% of Coverage |
| Heart Attack | 100% of Coverage |
| Coronary Artery Bypass Surgery | With recommendation for Bypass Surgery: |
25% of Coverage
| Severe Stroke | 100% of Coverage |
| Major Organ Failure - Transplant | 100% of Coverage |
| Cerebral Palsy | Covered as Child Critical Illness: 100% of Coverage |
| Downs Syndrome | Covered as Child Critical Illness: 100% of Coverage |
| Coma | 100% of Coverage |
| Blindness | 100% of Coverage |
| Additional Covered Conditions | 100% of Coverage - End Stage Renal Failure, Paralysis of 2 or more limbs, and Occupational Hepatitis |
| Covered Child Critical Illnesses | Anal Atresia, Anencephaly, Biliary Atresia, Cerebral Palsy, Cleft Lip or Cleft Palate, Club Foot, Coarctation of the Aorta, Cystic Fibrosis, Diaphragmatic Hernia, Down's Syndrome, Gastroschisis, Hirschsprung's Disease, Hypoplastic Left Heart Syndrome, Infantile Hypertrophic Pyloric Stenosis, Muscular Dystrophy, Omphalocele, Patent Ductus Arteriosis, Spina Bifida Cystica with Myelomeningocele, Tetralogy of Fallot, Transposition of the Great Arteries. |
| Multiple Payouts | Additional occurrence included with a 90-day separation of diagnosis. No maximum benefit. |
| Reoccurrence | Member and dependent(s) need to have been continuously insured between the initial and subsequent diagnosis and have served a 12-month treatment free period during that continuous insurance. 100% of Coverage |
| Guaranteed Issue | Employee: $30,000 |
Spouse: $15,000 Child(ren): 50% of Employee Applies to New Hire, w/in 31 days of a Family status change and during annual enrollment.
| Benefit Reduction | No benefit reduction schedule |
| Wellness/Health Screening Benefit | $50 per year per insured. No waiting periods. |
| Minimum Participation Requirement | 10 members (20% waived with Enrollment Best Practice Agreement) |
| Other | Ongoing Guaranteed Issue - Late entrants can apply on a GI basis at any future annual enrollment. |
Annual Open Enrollment - employees and spouses can enroll during the annual enrollment period - also applies if members wish to increase coverage up to the maximum.
Methods of Communication The Standard can support your efforts to enroll employees in contributory coverage. We can provide a custom enrollment strategy that fits the needs of your employees. This strategy may include electronic versions of the following materials. They will be included in the quoted rate:
• Custom enrollment forms
• Custom coverage highlights
• Employee coverage booklets
• Video-based, online decision support tool
• Posters, postcards and emails Court requires printed summaries and soft copy.
Methods of Enrollment The Standard can also provide onsite enrollers who are familiar with your plan. Onsite meetings are usually available for locations with at least 50 eligible employees. The enrollers are professional. They are noncommissioned. They will:
• Provide information to employees
• Answer questions regarding eligibility and costs
• Support onsite, online enrollment and medical history submission
• Provide promotional items and door prizes This is merely a summary of benefits for comparison purposes. Please refer to the carrier's proposal for details.
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