Group_Health_Insurance.pdf

RFP- 24 - 004

GROUP HEALTH INSURANCE

City of St. Petersburg

P.O. Box 2842

St. Petersburg, FL 33731

RELEASE DATE: October 9, 2023

DEADLINE FOR QUESTIONS: October 19, 2023

RESPONSE DEADLINE: October 26, 2023, 3:00 pm

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://procurement.opengov.com/portal/stpete

City of St. Petersburg

Group Health Insurance

I. Introduction

II. Solicitation Information

III. Evaluation Criteria

IV. Vendor Questionnaire

V. General Terms

VI. Scope of Services

VII. Special Terms: Service Contract Exceeding $200k

Attachments:

A - Appendix B - Fees Schedule

B - Appendix C- Employee Policy

C - Appendix D - Retiree Policy

D - Appendix E - 2023 Employee Benefits Guide

E - Appendix F - 2023 Retiree Benefits Guide

F - Appendix G - Experience Reports

G - Base Agreement

H - Business Associate Agreement (BAA)

#RFP- 24 - 004

Title: Group Health Insurance

1. Introduction

The City of St. Petersburg (“City”) is soliciting proposals from one or more qualified firms to provide group health insurance.

1.1. Summary

Contractor shall provide administrative services for medical benefits and documentation (such as, but not limited to, Summary Plan descriptions, Plan brochures, member insurance cards and utilization and claims reports) and shall administer the Plan in compliance with the City’s specifications and all applicable laws and regulations. Contractor shall provide an on-site representative, a plan sponsor website with reporting and eligibility functionality, individual internet-based access for members and their dependents, a free mobile app and a toll-free number for member services.

1.2. Background

1. There are approximately 3,065 eligible employees with 2,550 participating in the group health plan. There are also approximately 1,200 retirees covered under the current Plans (not including the

Medicare + Choice Plans noted below). The Group Insurance Plan year begins on April 1. The projected cost of the group health program for the current plan year is approximately $58,000,000.

2. For active employees and retirees, the City currently offers a Preferred Provider Organization (“PPO”) option, an Exclusive Provider Organization (“EPO”) option, a High Deductible Option (“HDP”) with a

Health Reimbursement Account (“HRA”) and a High Deductible Basic Plan (“HDP Basic”). Medicare eligible retirees may choose a supplemental PPO option or one of two Medicare Advantage Plans. The

PPO, EPO, HDP and HRA are currently administered by UnitedHealthcare (“United”), the Medicare

Advantage Plans are provided by Humana. (Note: The City is not soliciting proposals for the Medicare +

Choice Plan coverages as part of this Request for Proposal). A summary of the Benefits is shown in attachments C and D.

3. The City has retained United since 2010 beginning with a fully insured product for the 2010-2011 year, which then became a self-funded arrangement. United is the sole ASO provider for the Group Health

Plans for which the City is soliciting bids. Pharmacy Benefits are currently provided through Optum Rx, a subsidiary of United. The City solicited bids for pharmacy benefit management through a separate

RFP. This solicitation is for ASO medical services only.

4. Since the inception of the contract, United has provided the City with an on-site representative 4.5 day per week. The City anticipates continuing with a sole provider arrangement for both its active and retired employee Group Health Insurance Plans.

5. Those eligible for participation in the Plan include all full-time employees scheduled to regularly work

40 hours per week, temporary employees hired for six months or more scheduled to regularly work 40 hours per week, elected officials, part-time employees who work an average of 30 hours or more per week, former employees and retirees who have elected to stay in the Plan. (“Retiree” shall be defined as an employee who terminates employment after meeting the requirements for service retirement as defined in their respective retirement plan.) Please reference Appendix C for the City Policy.

6. There is currently a 60-day waiting period before coverage begins for new employees.

7. Employees who retire from one of the City’s retirement plans may continue their group health coverage however, if they do not continue coverage at the time of retirement the retiree may not enroll at a later date. Should the City change its administrator as a result of this RFP, the City may allow participating retirees a special enrollment period for the plan year effective April 1, 2024. A copy of the City’s Retiree

Insurance Enrollment Policy is included in Appendix D.

8. The City currently contributes 75% of the premium for group health plan coverage for active employees and their covered dependents. The contribution levels paid by the City and the employee are subject to negotiations between the City and representative Labor Unions.

9. The City currently has a variable rate structure for Retirees who continue coverage into retirement. There are three (3) groups in the variable rate structure. For those in “Group 1” the City contributes 75% of the PPO - Base Option premium cost for retirees and their covered dependents. In

“Group 2” the City has a contribution capped subsidy per level of coverage and in “Group 3” there is no subsidy, and the Retiree pays the full monthly premium. For the City’s capped contribution for retiree’s premiums see Retiree Benefits Guide Appendix F.

10. The City makes no enrollment guarantees. Contractors must offer rates that are guaranteed regardless of enrollment numbers or enrollment mix. Contractors acknowledge that the City has multiple plan designs and that such plan designs may be modified by the City at any time.

11. Contractor must be able to provide access to a robust health care provider network with competitive discounts to the City.

12. The City contracts with Gallagher Benefit Services, Inc. (“Consultant”) to provide consulting services for the Group Health Insurance Plans and other employee benefits programs. The Consultant shall not accept compensation or remuneration from providers of the City’s Group Health Insurance Plan. The

Consultant will provide an evaluation of the quantitative and qualitative aspects of the proposals and assist the City’s evaluation team.

13. Effective July 25, 2013, the City entered into an agreement with Orlando Health, Inc. (Formerly

Bayfront Health St. Petersburg) to provide a primary care health and wellness center solely for employees, retirees and their eligible dependents. Contractor must be able to accept the electronic reporting of zero dollar claims from Orlando Health.

14. The City retains Stop Loss coverage for the group health program through a third-party carrier, Symetra. Contractor must be able to provide electronic reporting to any third party stop loss carrier contracted with the City.

15. The City is not interested in pursuing a reference base pricing program.

1.3. Contact Information

Project Contact:

Victoria Amerson Procurement Analyst Email: victoria.amerson@stpete.org Phone: (727) 551-3387

Procurement Contact:

Victoria Amerson Procurement Analyst mailto:victoria.amerson@stpete.org tel:(727)551-3387

Email: victoria.amerson@stpete.org Phone: (727) 551-3387

Department:

Procurement

Department Head:

Stephanie Swinson Director of Procurement and Supply Management

1.4. Timeline

*Timeline is subject to change

Solicitation Published October 9, 2023 tel:(727)551-3387

Pre-Proposal Meeting (Non-Mandatory) October 12, 2023, 3:00pm

Agenda

Join Zoom Meeting https://zoom.us/j/98331791150

Meeting ID: 983 3179 1150

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Deadline for Questions October 19, 2023, 3:00pm https://zoom.us/j/98331791150 https://zoom.us/j/98331791150 https://zoom.us/u/aDTHrxnL7

Deadline for Submittals October 26, 2023, 3:00pm

Anticipated Recommendation of Award to

City Council

December 7, 2023

2. Solicitation Information

The City of St. Petersburg (“City”) is soliciting proposals from one or more qualified firms to provide group health insurance.

Proposals will be received through the City’s online bidding system no later than 3:00 pm on Thursday, October 26, 2023.

2.1. Submission or Receipt of Proposal

Proposals will be received through the City’s online bidding system no later than 3:00 pm on Thursday, October 26, 2023.

2.2. Standard for Award

The City will award to one vendor whose proposal is determined in writing to be the most advantageous to the City, taking into consideration the price and the evaluation criteria set forth in this solicitation. All awards are contingent on the Vendor meeting the minimum qualifications outlined in this solicitation.

The City reserves the right, at any time, to evaluate more vendors for inclusion on the list of approved vendors. All Vendors must meet the minimum qualifications outlined in this solicitation.

2.3. Selection Process

A. Short-Listing. Where there are multiple responsive proposals to the solicitation, a short-listing of two or more Vendors may be made. Negotiations as outlined in City Code Section 2-209(g) will begin with the selected Vendors on the short-list. If there is only one responsive proposal, negotiations may proceed with a single Vendor.

B. Negotiations. The City may conduct discussions (negotiations) with short-listed Vendors to clarify and understand proposals and to provide responses to post-proposal opening and modifications to the solicitation specifications that are in the best interest of the City and that do not significantly change the scope or purpose of the project for which the solicitation was issued

(“negotiation subjects”). During the negotiation process, short-listed Vendors will be accorded fair and equal treatment with respect to any opportunity for discussion and revision of proposals related to negotiation subjects for the purpose of preparing their best and final offer which may be requested and received by the City prior to the conclusion of the negotiation process. If modifications are made as a result of these discussions, they will be put in writing. Following discussions, the City may set a time and date for the best and final offers from those Offerors with whom discussions were held. Proposals may be reevaluated after receipt of the best and final offers.

C. Award without Discussion. The City may award the Agreement on the basis of initial proposals received, without discussions. Therefore, each initial proposal should contain the Vendor’s best terms in relation to all relevant evaluation criteria.

2.4. Submittal Requirements

1. Submission or Receipt of Proposal https://procurement.opengov.com/portal/stpete/projects/63303

Proposals will be received through the City’s online bidding system no later than: 3:00 p.m. (ET) on

October 26, 2023.

2. Procurement Analyst:

Victoria Amerson, victoria.amerson@stpete.org, 727-551-3387

3. Tentative Schedule

Solicitation Published: October 9, 2023

Deadline for Questions: October 19, 2023 @ 3PM

All questions shall be submitted no later than 3PM, October 19, 2023 to Victoria Amerson, Procurement

Analyst via email at victoria.amerson@stpete.org OR through the online discussion board through the sourcing site.

Deadline for Submittals: October 26, 2023 @ 3PM

Recommendation of Award to City Council: December 7, 2023

*Schedule is subject to change

4. Evaluation Criteria

Qualifications, Experience, & Capacity - 30%

Plan Design/ Differences - 24%

Plan Administration, Services, Guarantee - 25%

Cost or Price - 20%

5. Additional Information

3. Evaluation Criteria

Proposals will be evaluated based solely on the following evaluation criteria:

No. Evaluation Criteria Scoring Method Weight (Points)

1. Qualifications, Experience, & Capacity 0-100 Points 30 (30% of Total)

2. Plan Design/Differences 0-100 Points 25 (25% of Total)

3. Plan Administration, Services, Guarantee 0-100 Points 25 (25% of Total)

4. Cost or Price 0-100 Points 20 (20% of Total)

4. Vendor Questionnaire

4.1. General Information

4.1.1. Is the Vendor registered with the Florida Department of State, Division of

Corporations (Sunbiz) in accordance with Florida Statute §607.1501?* ☐ Yes

☐ No

*Response required

4.1.2. Address for Headquarters location.*

*Response required

4.1.3. Address of office providing service, if different than above.

4.1.4. Contact Information for Contact Person.*

This person must be capable of committing the company to an agreement with the City.

• Name

• Title

• Phone

• Email

*Response required

4.1.5. Description of nature of company’s business.*

*Response required

4.1.6. Year the Company was Founded.*

*Response required

4.1.7. Number of years company has operated under the current name.* *Response required

4.1.8. Number of year company has been in the present business.* *Response required

4.1.9. Company’s bank of record.*

*Response required

4.1.10. Describe any litigation that the vendor has been a party to in the last five years where it was alleged that the offeror breached a contract for similar services with a client/customer and describe any contracts for similar services that the vendor failed to complete for similar services. Describe the facts and status of any such litigation or contract. * Type N/A if not applicable.

*Response required

4.1.11. Identify any government entity that has debarred or otherwise prohibited the vendor from responding to its competitive solicitations within the last five years. Describe the circumstances surrounding such debarment or other prohibition. * Type N/A if not applicable.

*Response required

4.1.12. The vendor acknowledges that it has read, understands and will comply with

Florida Statute §448.095 pertaining to required use of the U.S. Department of

Homeland Security E-Verify system. Should the City terminate the contract with the vendor for violation of §448.095, vendor may not be awarded a contract with the City for at least one year.* ☐ Please confirm

*Response required

4.1.13. The vendor acknowledges that its solicitation response is subject to Public

Records laws (Chapter 119, Florida Statutes).* ☐ Please confirm

*Response required

4.1.14. Will vendor allow other agencies to piggyback the contract if awarded?* ☐ Yes

☐ No

*Response required

4.1.15. The vendor hereby makes all certifications required by Florida Statute

§287.135 related to scrutinized companies.* ☐ Yes

☐ No

*Response required

4.1.16. Is vendor required to provide any disclosures to the City regarding a foreign country of concern pursuant to Florida Statutes §286.101 (3)(a)? * ☐ Yes

☐ No

*Response required

4.1.17. If YES, please provide the disclosure(s) in accordance with the requirements of

Florida Statute §286.101 (3)(a).

4.1.18. The vendor certifies that it takes no exceptions to the terms and conditions of the solicitation.* ☐ Yes

☐ No

4.1.19. If exceptions are taken, specify in space below.

4.1.20. Has the vendor identified any trade secrets or confidential information in its solicitation response?* ☐ Yes

☐ No

*Response required

4.1.21. If yes to the above question, please upload your redacted proposal here.

4.2. Proposal Information

4.2.1. Technical Proposal*

*Response required

4.2.2. Cost Proposal*

*Response required

4.3. Service Contracts

4.3.1. Does vendor employ more than 50 full time employees?*

☐ Yes

☐ No

5. General Terms

5.1. Vendor Registration

Vendor must register online with the City of St. Petersburg via their online sourcing system at https://procurement.opengov.com/signup and subscribe to City's Portal at https://procurement.opengov.com/portal/stpete for solicitation notifications. Prior to an award of an

Agreement resulting from this solicitation, Vendor shall be registered with the Florida Department of

State, Division of Corporations to do business within the State of Florida in accordance with Florida

Statute 607.1501.

5.2. Solicitation Review

Vendors are required to carefully review this solicitation for defects and questionable or objectionable material. Comments concerning defects and questionable or objectionable material must be made in writing to the Procurement Analyst of record for this solicitation and received by the City at least 10 days before the solicitation submission deadline. This will allow issuance of any necessary addendum. A protest based on omission or error, or on the content of the solicitation, will be disallowed if these faults have not been brought to the attention of the City, in writing, at least 10 days before the time set for submission deadline.

5.3. Solicitation Response Preparation

Vendors are expected to examine this solicitation and all related documents. Failure to do so is at the

Vendor’s risk. Each vendor shall furnish the information required by this solicitation. Vendor(s) shall retain a copy of all documents for future reference. All solicitation responses must be submitted with the

Vendor’s legal name and by an officer or employee having the authority to bind the Vendor by his or her signature.

The City will not pay any costs associated with the preparation, submittal, presentation, or evaluation of any solicitation response.

5.4. Questions

All questions must be submitted via City's online sourcing system's Question & Answer feature no later than 3:00 pm on Thursday, October 19, 2023. Questions will be answered via City's online sourcing system no later than NO VALUE on NO VALUE. More complex questions may require a written addendum to the solicitation. Explanations or instructions will not materially alter this solicitation unless they are in writing. Oral explanations or instructions given before the award of an Agreement will not be binding. If necessary, a written addendum to this solicitation will be issued and posted on the City’s online sourcing system at https://procurement.opengov.com/portal/stpete/projects/63303 for download by

Vendors.

5.5. Amendments

Any amendments issued for this solicitation will be posted as an addendum on the City’s online sourcing system at https://procurement.opengov.com/portal/stpete/projects/63303 and notifications will be released to vendors who are following the project by clicking "Follow". Vendors must submit their responses to the most current version of the solicitation as amended, if applicable.

https://procurement.opengov.com/signup https://procurement.opengov.com/portal/stpete

5.6. Submission of Solicitation Responses

Solicitation responses will be received through the City’s online sourcing system. E-mail or in-person submittals will not be considered unless approved before the solicitation submission deadline by the

Procurement and Supply Management Director. Late proposals and modifications will not be considered;

however, solicitation responses may be modified online at any time prior to the submission deadline.

Failure to follow the instructions in this solicitation is cause for rejection of the submittal.

5.7. Mistakes in the Solicitation

Solicitation responses may be modified or withdrawn in the online application portal prior to the time and date set for the solicitation opening. Correction or withdrawal of solicitation responses after the solicitation opening because of an inadvertent non-judgmental mistake in the solicitation requires careful consideration to protect the integrity of the competitive solicitation process and to assure fairness. If the mistake is attributable to an error in judgment, the solicitation response may not be corrected. Solicitation response corrections or withdrawals by reason of non-judgmental mistakes are permissible but only to the extent they are not contrary to the interest of the City or the fair treatment of other vendors.

5.8. Information Designated a Trade Secret and/or Confidential and/or Proprietary

All solicitation responses (including all documentation and materials attached thereto or provided in connection with this solicitation) submitted to the City are subject to Florida’s public records laws (i.e., Chapter 119, Florida Statutes), which requires disclosure of public records, unless exempt, if a public records request is made. Solicitation responses (including all documentation and materials attached thereto or provided in connection with this solicitation (even if in a separate electronic file)) submitted to the City cannot be returned. DO NOT LIST YOUR ENTIRE SOLICITATION RESPONSE AS TRADE

SECRET AND/OR CONFIDENTIAL. The City will not consider solicitation responses if the entire response is labeled a Trade Secret and/or Confidential and/or Proprietary.

If Vendor believes that its solicitation response contains information that is a trade secret (as defined by

Florida law) and/or information that is confidential and/or proprietary and therefore exempt from disclosure, then such information must be submitted in a separate electronic file and comply with the following requirements. In addition to submitting the information in a separate or electronic file, Vendor must include a general description of the information designated as a trade secret and/or confidential and/or proprietary and provide reference to the Florida statute or other law which exempts such designated information from disclosure in the event a public records request.

The City does not warrant or guarantee that information designated by Vendor as a trade secret and/or confidential and/or proprietary is a trade secret and/or confidential and/or proprietary and exempt from disclosure. The City offers no opinion as to whether the reference to the Florida statute or other law by

Vendor is/are correct and/or accurate. Please be aware that the designation of information as a trade secret and/or confidential and/or proprietary may be challenged in court by any person or entity. By designation of information as a trade secret and/or confidential and/or proprietary Vendor agrees to defend and indemnify the City, its employees, agents, and elected and appointed officials (“Indemnified Parties”) against any and all claims, demands, and actions (whether or not a lawsuit is commenced) arising out of or in connection with Vendor's designation of information as a trade secret and/or confidential and/or proprietary and to hold harmless the Indemnified Parties for any award to a plaintiff for damages, costs and attorneys’ fees, and for costs and attorney's fees (including those of the City Attorney’s office) incurred by the City by reason of any claim, demand, or action arising out of or related to the Vendor's designation of information as a trade secret and/or confidential and/or proprietary.

Failure to comply with the requirements above shall be deemed as a waiver by Vendor to claim that any information in its solicitation response is a trade secret and/or confidential and/or proprietary, regardless of whether such information is labeled trade secret and/or confidential and/or proprietary. Vendor acknowledges, understands, and agrees that all information in Vendor's solicitation response (not including information submitted in a separate electronic file and designated trade secret and/or confidential and/or proprietary in accordance with the requirements in this section) will be disclosed, without any notice to Vendor, if a public records request is made for such information, and the City shall not be liable to Vendor for such disclosure.

Vendor acknowledges and understands that Vendor's proposal, including the information submitted in a separate electronic file and designated trade secret and/or confidential and/or proprietary in accordance with the requirements in this section, will be distributed to the evaluation committee members, City staff, and City consultants to allow Vendor's entire solicitation response, including the information submitted in a separate electronic file, to be evaluated and considered for award of the Agreement. The entire contents of the Vendor's solicitation response, including the information submitted in a separate electronic file, may be discussed at meetings that are open to the public, subject to the requirements set forth in

Chapter 286, Florida Statutes.

5.9. Bonds

Vendors will need to furnish a bid bond as indicated in the solicitation, if applicable.

5.10. Cash Discounts

When the City is entitled to a cash discount, the period of computations will commence on the date of delivery, or receipt of a correctly completed invoice, whichever is later. If an adjustment in payment is necessary due to damage, the cash discount period shall commence on the date final approval for payment is authorized. If a discount is part of the Agreement, but the invoice does not reflect the existence of a cash discount, the City is entitled to a cash discount with the period commencing on the date it is determined by the City that a cash discount applies.

5.11. Award

The solicitation will be awarded based on the requirements outlined in the scope, the criteria or factors identified in the solicitation, and the standard for award for the solicitation. The City reserves the right to accept or reject any or all parts of the solicitation response, waive informalities, and request re-solicitations on the services or products outlined in the scope. The City reserves the right to award the

Agreement on a split-order, lump-sum, or individual item basis, or such combination as shall best serve the interest of the City unless otherwise specified.

Pursuant to Florida Statute sec. 287.05701, the City will not request documentation of a Vendor’s social, political, or ideological interests, consider such interests, or give preference to a vendor based on such interests.

5.12. Acceptance Period

Unless otherwise specified in this solicitation, the solicitation response may be held by the City for a period of ninety (90) days after the submission deadline and will continue in full effect and not be subject to withdrawal during that period until an Agreement has been executed with a Vendor. If no Agreement has been executed within the ninety-day period, any solicitation response may be withdrawn or nullified by either the City or the Vendor, or be deemed to be confirmed and extended in time for as long as permitted by the Vendor submitting each solicitation response.

5.13. Right to Reject

Vendors must comply with all the terms of the solicitation, all applicable provisions of the City of St.

Petersburg City Code, and all applicable federal and state laws. The City may reject any solicitation response that does not comply with all material and substantive terms, conditions, and performance requirements of the solicitation.

The City may waive minor informalities that (i) do not affect responsiveness; (ii) are merely matter of form or format; (iii) do not change the relative standing or otherwise prejudice other vendors; (iv) do not change the meaning or scope of the solicitation; (v) are trivial, negligible or immaterial in nature; (v) do not effect a material change in the work; or (vi) do not constitute a substantial exclusion or modification of a requirement or provision in the solicitation.

5.14. Vendor Complaints

All complaints or grievances should be first submitted in writing to the Procurement & Supply

Management Director, by email at Stephanie Swinson@stpete.org or by mail to P.O. Box P. O. Box

2842, St. Petersburg, FL 33731 who will promptly investigate the validity of the complaint and present the findings in writing to the person who submitted the complaint.

5.15. Protest

Any actual or prospective vendor who is aggrieved in connection with the solicitation or award of an

Agreement may protest to the Procurement and Supply Management Director. The protest shall be submitted in writing within 10 days after such aggrieved person knows or should have known of the facts giving rise thereto. The Procurement and Supply Management Director shall have the authority to settle and resolve a protest of an actual or prospective aggrieved vendor concerning the solicitation or award of an Agreement. If the protest is not resolved by mutual agreement, the Procurement and Supply

Management Director shall promptly issue a decision in writing stating the reasons for the action taken and inform the aggrieved person that he or she may make an appeal to the Mayor or designee within five working days.

Vendor’s appeal will be heard by either the Mayor or City Administrator. All complaints, grievances or appeals must be made no later than seven calendar (7) days preceding the date of the City Council meeting approving the Agreement or no later than seven calendar (7) days following the selection of the successful Vendor if the Agreement is not subject to approval by City Council.

5.16. Public Entity Crimes

A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not (i) submit a solicitation response on an Agreement to provide any goods or services to a public entity, (ii) submit a solicitation response on an Agreement with a public entity for the construction or repair of a public building or public work, (iii) submit a solicitation response for leases of real property to a public entity, (iv) be awarded or perform work as a contractor, supplier, subcontractor, or consultant under an Agreement with any public entity, or (v) transact business with any public entity in excess of the threshold amount provided in Section 287.017 for Category Two for a period of 36 months from the date of being placed on the convicted vendor list.

5.17. Nondiscrimination

Vendors for the City of St. Petersburg are required to comply with all applicable laws regarding discrimination in employment, including Pinellas County Code Section 70-53 (a)(1) (prohibiting mailto:Swinson@stpete.org discrimination in employment based on race, color, religion, national origin, gender, sexual orientation, age, marital status, or disability) and all other applicable federal, state and local laws. Vendors are encouraged to provide workplaces free of discrimination in terms of conditions of employment, including benefits.

5.18. Prohibited Communication

Vendors and their employees, agents, contractors, and representatives are prohibited from lobbying City

Council, the Mayor, City staff, selection committee members, and City project consultants relative to this solicitation until the solicitation selection and award processes have been completed. Non-compliance with this provision may result in disqualification from consideration of the award. Notwithstanding the foregoing, this provision shall not prohibit the Vendor from (i) providing public comment in accordance with applicable laws and City policies at public meetings where public comment is permitted, (ii) communicating with the assigned Procurement Analyst, (iii) making a presentation during a selection committee meeting if requested by the selection committee, or (iv) submitting a dispute or complaint in accordance with the requirements set forth in this solicitation.

5.19. Environmentally Preferable Purchasing

It is the policy of the City of St. Petersburg to purchase recycled and environmentally preferable goods.

Environmentally preferable goods are defined as “products or services that have a lesser or reduced effect on human health and the environment when compared with competing products or services that serve the same purpose.” This includes products that contain recycled content, reduced toxicity and pollution, conserve energy, conserve water, prevent waste, and promote sustainability and resiliency initiatives.

This policy does not require the City to specify environmentally preferable products or services when it can be demonstrated that they are not in the best interest of the City compared to products and services that are not as environmentally preferable. Best interests include but are not limited to, service life, life cycle cost, product effectiveness, or compatibility. This policy will be carried out consistent with the

City’s obligations and purpose, and with an overall intent to obtain competitive prices and to provide value to the taxpayer.

5.20. Health In All Policies

Pursuant to Executive Order EO-2018-04, it is the policy of the City to apply the consideration of health, health impacts, and the social determinants of health to the City’s decision-making, including policy development and implementation, budgeting, and the delivery of services and procurement of supplies and construction. Vendors are encouraged to propose services, supplies, and construction that promote health to the greatest extent practicable in their responses to City solicitations. Vendors are further encouraged to provide workplaces that promote the health and well-being of their employees.

5.21. American with Disabilities Act (ADA) Public Notice

In accordance with the requirements of Title II of the Americans with Disabilities Act of 1990, the City of St. Petersburg will not discriminate against qualified individuals with disabilities on the basis of disability in the City’s services, programs, or activities. If Vendor requires an auxiliary aid or service for effective communication, or a modification of policies or procedures to adequately respond to this solicitation. Vendor should contact ADA Coordinator Lendel Bright at (727)-893-7229 or email at lendel.bright@stpete.org as soon as possible but no later than 72 hours before the applicable deadline.

5.22. Background Checks

In the event the solicitation or Agreement requires criminal history checks, Vendor will be responsible for conducting a criminal history check for each employee or subcontractor for which a criminal history check is required.

5.23. Disqualification

The City reserves the right to disqualify Vendors before or after opening, upon evidence of collusion with intent to defraud or other illegal practices on the part of the Vendors.

5.24. Taxes

The City of St. Petersburg is exempt from any taxes imposed by the State and/or Federal Government.

Exemption certificates will be provided upon request.

6. Scope of Services

6.1. Scope of Work

The City of St. Petersburg (“City”) is soliciting proposals from one or more qualified firms to provide group health insurance.

6.2. Contract Term

The initial term of the agreement is five years from date of contract execution, and may, by mutual agreement of the parties, be renewed for a period not to exceed the initial contract term and if, needed, ninety (90) days beyond the expiration date of the current contract period. There will be three one-year renewal options.

6.3. Estimated Annual Expenditure

It is estimated that approximately $58,000,000 may be purchased annually under this solicitation. This is an estimate only and may vary.

6.4. Minimum Qualifications

At a minimum, Vendor must meet the following qualifications:

1. Have been in the business of providing group health care administration as described herein for a minimum of 5 years.

2. Have the ability to obtain the minimum insurance requirements set for in the base agreement.

3. Be a licensed insurance carrier, or administrator (not an agent) per Florida Department of

Insurance regulations.

4. Be free from legal and regulatory matters which might prevent the Vendor from fulfilling the obligations of the Agreement.

5. Exhibit financial stability and company viability sufficient to fulfill the obligations of the

Agreement.

6.5. Vendor Responsibilities

At a minimum, Vendor must provide and meet the following responsibilities:

A. Expectations of Performance

1. Vendor shall provide all labor, materials, supervision, tools, equipment, and vehicles necessary to provide group health Administrative Services Only (“ASO” or “Services”). The

City is seeking the most valuable services at the lowest, long-term net cost to the City and its employees, retirees and dependents (“Members”).

2. Vendor shall provide administrative services for medical benefits and documentation (such as, but not limited to, Summary Plan descriptions, Plan brochures, member insurance cards and utilization and claims reports) and shall administer the Plan in compliance with the City’s specifications and all applicable laws and regulations.

3. Vendor shall provide an on-site representative, a plan sponsor website with reporting and eligibility functionality, individual internet-based access for members and their dependents, a free mobile app and a toll-free number for member services.

4. The City reserves the right to add to or otherwise modify the scope of work at any time prior to the final execution of an Agreement. The term “Agreement” refers to the agreement to be entered into between the City and the Vendor.

B. Materials and Equipment

1. Vendor shall provide a local or toll-free telephonic customer service system accessible by members at a minimum from 7:00 a.m. to 6:00 p.m. Eastern Time, Monday through

Friday. The system shall provide enhancements to accommodate the hearing impaired. Customer Service staff must be capable of answering benefit, claim and network questions. Vendor shall record and maintain information regarding complaints reported by covered members and/or member representatives and provide follow up information regarding issue resolution to the City.

2. Vendor shall ensure that its customer service and claims staff are appropriately trained in the specific technical issues of the City's account. Vendor shall train all staff assigned to the City account in customer service skills and practices. Vendor shall have a quality assurance program in operation for this staff that is monitored on a regular basis and shall provide reports and statistics upon request.

3. Vendor shall provide an Internet accessed, secure website for purposes of obtaining account information for members and Plan management for the City. Vendor shall also provide a mobile app for option for members.

4. Vendor shall provide guidelines for claims processing and have a system to ensure claims are processed timely and accurately.

5. Vendor shall provide an on-site carrier representative to address member issues a minimum of 4 days per week on an ongoing basis during normal business hours of 8:00 a.m. to 5:00 p.m. Monday through Friday. This representative is expected to be available a minimum of four workdays per week, preferably Monday through Thursday and hours to meet one on one with employees, retirees and eligible dependents to resolve concerns and problems and provide assistance in utilizing the Plan without involving the City. The City reserves the right to have the on-site representative replaced at the City’s sole discretion.

6. Vendor shall develop, design, and provide electronic or printed materials including but not limited to, summary plan descriptions, federally mandated communications, informational booklets, network directories and any other appropriate materials describing the Plan and its options, for distribution to members as needed during the term of the Agreement at no additional charge. Literature distributed to members should be in layman’s terms, must be approved by the City and meet any regulatory filing requirements. Such materials are required for the City's annual Open Enrollment as well as the weekly orientation meetings held for newly eligible employees. Vendor shall provide Plan informational materials to the

City within fourteen (14) calendar days of request.

7. Vendor shall also provide the City all documents in either a word processing format

(compatible with Microsoft Office Suite) or PDF format for placement on the City's Intranet web site. Vendor shall, at its expense, mail SPD(s) directly to each member’s home address if requested by the City.

8. Vendor shall participate in the initial enrollment process and annual open enrollment meetings; including making presentations on plan design and coverage at multiple locations, provide general information to employees and retirees and present cost containment explanations and instructions. Vendor shall provide an experienced implementation team to work with the City to effectively implement the Plan within the scheduled timeframe.

C. Schedule

Vendor shall provide comprehensive group health administrative services for the City’s covered members, included but not limited to the following:

1. All ASO medical services for active and retired employees and their eligible dependents.

2. Access to a nationwide health care provider network.

3. A local or toll-free telephone call-in number for member inquiries, that also provides access for hearing- impaired members.

4. An Internet accessed, secure website for purposes of account information and management by the City and members.

5. A free mobile app accessible by members via a secure log on.

6. Customer service representatives qualified to process, research and resolve member inquiries and questions regarding the Plan access and coverage.

7. An on-site representative for a minimum of 4 days per week.

8. Identification cards for each member at no charge to either the City or member.

9. Summary Plan Descriptions, brochures and informational materials, both electronic and printed materials, for the City for distribution to members.

10. Assist the City with the communication of the Plan to employees, and retirees, including conducting initial and annual enrollment meetings to consist of a minimum of ten initial meetings with six to eight meetings each year.

11. Stable contractual relationships with healthcare providers and hospitals.

12. Ability to manage and control costs for members and the City through proven methodologies, including, but not limited to: negotiated discounted fees for services; reimbursement to providers based on per diem or the number of days that a given patient is provided access to a prescribed therapy; or capitation where providers are paid at a set dollar amount determined by a per member per month calculation.

13. Timely and accurate claims processing to be defined as within 10 business days.

14. Annual dollar allowance of a minimum of $50,000 annually, for City sponsored employee wellness programs.

15. Administration of State of Florida dependent coverage in accordance with City’s Policy as defined in Exhibit E.

16. Administration of the City’s Group Health Plans in accordance with federal laws and regulations including the Affordable Care Act.

i. Coordinate ‘zero-dollar” claims with the on-site Health and Wellness Center as referenced in Background.

D. Point of Contact

1. Vendor shall provide a single point of contact (Account Manager) to administer the

Agreement.

2. Account Manager will be readily available during normal business hours to administer the

Agreement. Vendor is responsible for notifying the City with any changes in account manager or contact information. Account Manager’s responsibilities shall include, but are not limited to, overseeing all aspects of implementation, servicing, reporting, and issue resolution.

E. Deliverables of Performance

A. Reports

1. Member Issues – This report shall be submitted to the City in electronic format on a quarterly basis, by the 15th of each month immediately following the end of the quarter, for the previous quarters’ activities. The report shall include the following:

a. Member's issue/ complaint

b. Date Received

c. Staff member assigned

d. Resolution plan or outcome

e. Date of completion once closed

B. Benchmark Report

1. This report shall be submitted to the City in electronic format on a quarterly basis by the 15th day of the new quarter for the previous quarter’s activities. The report shall include statistics that measure Vendor’s claims processing and customer service performance based upon the established benchmarks.

6.6. City's Responsibilities

At a minimum, City shall provide and meet the following responsibilities:

A. City shall provide a point of contact (City Project Manager) to administer the Agreement.

B. City Project Manager shall assist with planning, strategy, and objectives prior to performance of the Work.

C. City Project Manager shall promptly respond to issues and inquiries so as not to hinder the progress, completion, or compensation for the Work.

7. Special Terms: Service Contract Exceeding $200k

7.1. Living Wage

Vendor agrees to be subject to and shall comply with the living wage requirements set forth in St.

Petersburg City Code Chapter 2, Article V, Division 9, as those requirements may be amended from time to time, (collectively, the “Living Wage Requirements”).

7.2. Data Collection

Pursuant to Florida Statute 119.071 Social Security Numbers collected from Vendors are used for identification, verification, and tax reporting purposes.