OHI_RFP_Q-A_06-25-14.xls

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Attached to
Other Health Insurance Federal contract opportunity
Solicitation number
HT0011-14-R-0021
Issued by
Defense Health Agency

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Updated Questions and Answers. See attached document for more information.

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Master Sheet

RFP SectionQuestionGovernment ResponseCategoryRpt?Change ?
1N/ADue to the significant size and scope of this OHI contract, would the government consider using a NAICS code with a $19M or higher threshold?The selected NAICS code represents the work to be performed, not any dollar threshold.
2N/AWhat is the process for documenting insurance policies that could not be identified or were validated to be termed, etc. in DEERS? (i.e. If the contractor identifies insurance for 7% of the patient records, how do we document the remaining 93% indicating that insurance could not be located?)Offerors are welcome to recommend a solution based on industry standard/best practice.
3CLINS 2002, 3002, and 4002Should the following CLINS 2002, 3002 and 4002 read 0-20k instead of 0-100k?No, the CLIN information as shown in the RFP is accurate
4CLINSIn regards to the volume bands, if 125K policies are discovered in a given month will the government pay the first 100K discovered at one price and then the balance (in this case 25K) at another rate? Or, will all policies be invoiced at the same rate (in this example, the rate associated with the second volume band 101K to 150K)?when the maximum band on a particular CLIN is reached, the vendor shall utilize the next CLIN for the next higher volume/band
51.4 ScopeThe Government will provide the Contractor access to data from DEERS in the form of an extract file. Please specify the frequency (weekly, monthly, etc.) the government will be providing this extract file.Timely update of the DEERS OHI data respository is desired. Offerors are welcome to recommend a solution based on industry standard/best practice, but at least a monthly check is expected.
61.4 ScopeWhat is the data format that the OHI data file will be given to contractor?The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
71.4 ScopePlease identify the patient demographic fields that will be made available to the contractor in the data extract file.The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
81.6.1 Quality Control“The Contractor shall develop and implement procedures to identify retrospective billing opportunities from OHI files and initiate recovery.” Is this within the scope of this OHI contract? If so, what are the expectations of initiating recovery?POD - Recommend this requirement be dropped. See amendment 0002
91.6.15 Contractor TravelThe government is requesting pricing for travel CLINS 1014, 2014, 3014, and 4014. If travel is authorized on an as needed basis, what is the approximate frequency, number of participants, location, and duration of the travel?$5K per year for a total of $25K
105.5 Specific TasksAre all newly identified and validated policies uploaded via DMDC OHI web service, rather than DEERS? If so, how will we get access to the DMDC web serviceThe Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
115.5 Specific TasksWhat is the data format that the DMDC OHI web service requires for loading into DEERS?The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
125.5 Specific TasksWhat are acceptable methods of secure data transfer of the OHI data from Contractor to DoD and vice versa?The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
135.5 Specific TasksIs B2B connectivity to DEERS or DMDC OHI web service required to complete this contract? If yes, will the government support and sponsor the B2B connection?Yes B2B connectivity will be required and supported/sponsored by the Government.
14Technical Exhibit 4Are billable Medicare Supplement policies to be identified, validated and returned to the government?No
15Contract Terms and ConditionsWill the government confirm personnel working on this contract are subject to wage determination rates under the Service Contract Act?No, personnel working on this contract are not subject to service contract act. See amendment 0001
16Instructions to OfferorsUnder Proposal Submission Address on page 93, submit signed and dated offers to the following email addresses. On page 94, it states Offerors must submit hard copies of proposal. Will the government confirm the method of submission? If hardcopy and CD-ROM are requested please provide the mailing address it should be submitted to.Electronic submission only. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14. see amendment 0001
17Section C; 1.4The RFP states: "Only OHI data that was not previously identified by the Government will be considered as “new OHI discovery.”
Please provide clarification as to what data will be provided for validation of existing OHI. Part 3, 3.5 states that "The Government will provide patient data files in an electronic format identifying Uniformed Services beneficiaries that do not currently have any OHI documented in DEERS so the Contractor can perform the tasks required by this contract." But there is not a mention of OHI records that require updating.The Government will provide two types of data: 1) Records with no current OHI information recorded in DEERS and 2) Placeholder records in DEERS where existence of OHI has been confirmed through the Coordination of Benefits process, but the billing information is missing.
18Section C; 1.5Please provide the estimated start date for the contract.estimated July 2014
19Section C; 1.6The RFP states: "The contractor shall develop and implement procedures to identify retrospective billing opportunities from OHI files and initiate recovery. The Contractor shall compile a before and after report of findings and statistics of cost avoidance."
This statement does not seem consistent with the intent of the scope. Is the contractor expected to perform billing recovery effort? Or just find OHI?Statement will be removed. A formal RFP and amendment reflecting updates will be posted by 25 Jun 14. See amendment 0002
20Section C; 1.6.5The RFP states: "The government will award a firm fixed price contract single task order using Government-Wide Acquisition Contract (GWAC)."
Please provide the name of the GWAC to be used for this task order.This is an administrative error. The Government will award a firm fixed priced contract single award using Full and Open procedures. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
21Section C; 1.6.9.3.8.3.1The RFP states: "1.6.9.3.8.3.1 Upon request, DHA will provide the Contractor with the notice of privacy practices that DHA produces in accordance with the DoD HIPAA Issuances and the corresponding 45 CFR 164.520."
Please provide an overview of these practices in order for the contractor to fully understand the scope of work for consideration as we price the proposal.A formal RFP and amendment reflecting updates (citing the DHA website) will be posted by 25 Jun 14. See amendment 0002
22Section C; 1.6.19.2Please provide more information on the mechansim of delivery of OHI data to the Government. For example, will data be submitted by secure FTP via a system to system interface? We understand that Part 5 item 5.5 mentions that data should be provided in a manner that can be consumed by DMDC Other Health Insurance web service; however, we are not clear as to the mechanism the data files must be provided to DMDC.The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
235. Specific TasksSection 5.1 requires that OHI identification begins within 30 days of contract award. Please consider making this 60 days to align with the transition in period. It may take up to 60 days to complete the security and privacy provisions for data handling.RFP will updated to allow 60 days. A formal RFP and amendment reflecting updates will be posted by 25 Jun 14. See amendment 0002
245. Specific TasksSection 5.2 requires that OHI submission to DEERS must begin with 60 calendar days. Please consider revising this to 90 calendar days given the 60 day transition in period.Section 5.2 will remain at 60 days. Government will coordinate the 1st file.
25Part 6, Other Terms and ConditionsPlease confirm that CAC cards will not be required to perform the scope of work of the contractor.PWS para 6.1 addresses this. "The contractor shall ensure all employees accessing the DEERS database or the B2B Gateway must have and use a DoD issued CAC."
265. Specific TasksSection 5.1 requires that OHI identification begins within 30 days of contract award. When will the existing patient data files in an electronic format identifying Uniformed Services beneficiaries that do not currently have any OHI documented in DEERS be provided to the Contractor?At contract award
27Part 3, 3.5How frequently will the Government provide updated patient data files?Timely update of the DEERS OHI data respository is desired. Offerors are welcome to recommend a solution based on industry standard/best practice, but at least a monthly check is expected.
28Part 1, 1.5Is it accurate that vendors will continue to be responsible for the full performance of the contract during the 60 days Transition Out period in Option Year IV?yes
29Section L; Quality Control PlanThe RFP requires the "[a]ppointment of an official who shall be responsible for the operation of the quality control system/department and for investigating and ascertaining the causes of deficiencies." Will the Government please define the intent or meaning of "an official"?The contractor shall have the knowledge to be able to appoint an official within the company to overlook and be in charge of the Quality Control Plan
30Section L; Past PerformanceUnder References, the RFP states that "Offerors must provide at least five (5), primary past performance contract references from the past 3 years, from RFP issue date, as it relates to the requirements of this solicitation." Under Process, the RFP states that "[c]ompletion of the three primary references is a four-step process." Please confirm that the Government is only requiring three primary references, with the option to include three additional references.It is only a three step process. 5 primary references; A formal RFP and amendment reflecting updates will be posted by 23 Jun 14. at least five references are required. See amendment 0001
31Section M; Evaluation Factor 1 - Technical Approach; Subfactor 1.1The RFP references PWS Part 5 for sub factor 1.1: Prior Experience. Please clarify if that is the correct reference.Prior Experience is located in Part 1 of the PWS, paragraph 1.6. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
32Section C, 1.6, Prior Experience and 1.6 General InformationPlease confirm that 1.6, General Information, and all related subsections should be 1.7.A formal RFP and amendment reflecting updates will be posted by 23 Jun 14. The subsection are correctly stated in amendment 0001.
33Section M; Evaluation Factor 1 - Technical ApproachThe RFP states: "This factor includes two subfactors, which are equal in importance. Each subfactor will be rated for Technical Merit and Technical Risk. Subfactor ratings will be combined to determine the overall Technical Approach rating." These two subfactors are identified as Sub Factor 1.1: Prior Experience (PWS Part 5) and Sub Factor 1.2: HIPAA and Clearing Warehouses (PWS Para 1.6.9.3.1). Please clarify which subfactor addresses the technical approach to address requirements of 1.6, General Information (and all subsequent subsections, with the exception of 1.6.9.3.1).The appropriate references for the Factors and Sub Factors are provided in Section M, page 101
34Section M; Evaluation Factor 3: Past Performance (PWS Para 1.6)Evaluation Factor 3 seems to address the information required of Section 4: Past Performance (within Section L), which relates to the past perfomance contract references. As such, please confirm if this evaluation factor is related to PWS Para 1.6. If so, is it the Government's intent to have the projects detailed in "Prior Experience" (PWS Para 1.6) to be the same as the primary past performance contract references?A formal RFP and amendment reflecting updates will be posted by 25 Jun 14. See evaluation factor 3 under 52.212-2
35Section L; Volume III - PriceThe RFP mentions that award will be under a GWAC and that discounts on established pricing should be applied. Please define “adequate documentation” from the following RFP requirement:
The proposed fixed unit prices for discovery and validation CLINs shall be adequately documented in order for the Contracting Officer to make the determination that the prices/costs are fair and reasonable. Offerors are encouraged to provide discounts on their established pricingAll Reference to GWAC will be deleted. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
36Section B; Estimated Workload Data; Appropriate VolumesPer the instructions to offerors on page 93 of the RFP, we understand that offerors shall price the appropriate columes to faciliate independent evaluation by the government. The B-Tables have pre-defined quantities and associated units of measure along with the estimated workload data identified below each item number. Please confirm offerors are to price the quantities and units of measure for evaluation purposes and that the estimated workload data provided in the b-tables is strictly for information purposes.The quantities are Estimated, the vendor shall provide a price per OHI Discovery and a price per Validation for existing OHI
37Non-US CitizensN/A
38Volume III - PriceThe RFP states offerors are encouraged to provide discounts on their established pricing. Which contract vehicle is this procurement under?This is a FAR 15 Acquisition, Full and Open, and is not solicited against any existing contract. However, the vendor is encouraged to discount their prices.
39Section L, Page 98Section J, Attachment 26 Past Performance Questionnaires template was not provided. Will the Government be providing the template?A formal RFP and amendment will be reflecting updates will be posted by 23 Jun 14.
40Section L, Page 93 Section L, Page 94Proposal Submission Address: Submit signed and dated offers to the following email addresses : marcellus.jernigan@dha.mil &Millie.mitchell@dha.mil is in conflict with the statement below. Offerors must submit hard copies of proposals, as well as an electronic submission. The proposal shall be divided into separate volumes and provided with the number of copies specified below. Each hard-copy volume must be in a separate three-ring binder with the Offeror’s name, solicitation number, and volume number on the spine of the binder. If applicable, each page of the proposal shall be marked with the restrictive legend per FAR 52.215-1(e). Please clarify proposal submission instructions.A formal RFP and amendment reflecting updates will be posted by 25 Jun 14. Only accepting electronic submissions. See amendment 0001 and 0002.
41Section L, Page 98Offerors must provide at least five (5), primary past performance contract references from the past 3 years, from RFP issue date, as it relates to the requirements of this solicitation. The Offeror may submit up to three additional references beyond these three primary references. The three primary references must include completed Performance Questionnaires (Section J, Attachment 26), as directed below.
Please clarify the number of primary past performance contract references 3 or 5?5 references; A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
42MissingNo Section A included with the solicitation. Will the government be providing a Section A?Yes, A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
43Technical Exhibit, page 62Technical Exhibit, page 62. “required data for Other health Insurance, Policy Coverage and health Insurance Carrier”. Question: Will the Government provide the vendor the ability to update the DEERS Database via API or Interfaces or will the Vendor be required to assist the Government in creating a process to update the DEERS database with the Insurance result files?The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS.
44MissingWill the Government provide labor category positions and descriptions?No, The vendor shall propose this
45MissingWill the Government provide the IGE estimate of the Level of Effort?No, a workload estimate was provided
46Section J Attachment 26We are unable to locate this document. Please confirm if an amendment will be issued to provide this required questionnaire document. We appreciate your time.A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
47Some types of plans held by beneficiaries, such as supplemental insurance plans, Medicare, pharmacy loyalty programs, etc., can be confused as being OHI when in fact they are not OHI, which may lead to a number of false positives. Is the contractor required to ensure such programs are not flagged as OHI? It is recommended that the requirements be clarified in an upcoming amendment to the solicitation so that all offerors may accurately prepare their offerings.Yes.
48In situations where the contractor has evidence that a beneficiary does indeed have OHI, but the contractor also has a verbal or written statement from the beneficiary claiming they do not have OHI, is the contractor required to rely on the word of the beneficiary or the evidence of OHI that may be contrary to the beneficiary’s word? It is recommended that the requirements be clarified in an upcoming amendment to the solicitation so that all offerors may accurately prepare their offeringsOHI is verified with insurer
Will DHA provide Technical Exhibit 5? This exhibit was not included in the solicitation.Will be re-numbered. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section B, pages 2-27; 1.6.16 Other Direct Costs, pages 44- 45The price schedule in Section B includes a line for ODC estimates; however, Section 1.6.16 on page 45 states “none” under Other Direct Costs. Should offerors include ODC estimates in their price quotes?A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section L, Proposal Preparation Instructions, page 94Are offerors required to submit hard copies and electronic copies? The solicitation only provides an email address for submitting offers. Follow-up Question a.: If hard copies are required, what quantity, and to which address should they be sent?Electronic submission only; A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section L, Proposal Preparation Instructions, page 95“All pages of the proposal shall be numbered, using a uniform paragraph numbering system.” Question: Is DHA requiring each paragraph to be numbered?Yes, paragraphs should be numbered; A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section L, Content, Section 4 Past Performance, page 98Question: How many primary past performance references are required: 3 or 5? Follow-up Question a.: The solicitation states Past Performance is a 4-step process, but only 3 steps are labeled. What is Step 4? Follow-up Question b.: Will DHA provide the Past Performance Questionnaire? It is missing from the solicitation.3-step; yes we will provide questionnaire; A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section M, Subfactor 2.2, Quality Control Plan, page 102“In addition, the evaluation will consider the degree to which the plan includes initiatives and self‐reviews to ensure that services are provided on a timely basis, that network healthcare providers meet contract requirements, that records are properly maintained, that Government databases are updated quickly and accurately, and the level of care remains high.” Question: Please confirm the applicability of this section to the Identification and Validation of OHI PWS. Is the OHI contractor responsible for managing network healthcare providers and providing a high level of care?This section refers to a Quality Control Plan that the vendor is required to manage, not managing network healthcare providers.
Section M, Factor 3 Past Performance, page 103“Relevant past performance is considered to be federal, state, and local government or commercial contracts/work performed or being performed that were/are similar in nature to the current acquisition.” Question: Will federal government experience be rated higher than commercial experience? Follow-Up Question a.: Will DHA evaluate the number of insurance identifications and accuracy of results produced by each offeror? Follow-up Question b.: Will DHA require the disclosure of subcontracting arrangements when a vendor used another company as a subcontractor for OHI past performance?Past Performance will be rated equally No, federal government experience will not be rated higher than commercial experience, Qa. Will be rated in accordance with evaluation criteria; Qb. No, however some details may require disclosure during contract administration.
Section M, Factor 4, PriceQuestion: The cost of returning OHI policies is significantly small as compared to the amount of dollars recovered, therefore making it increasingly more important to select a firm that can maximize the number of OHI Discovery policies identified. Given this paradigm, how will DHA evaluate best value? Follow-up Question a.: Will DHA take into account prior experience as a predictor of future performance and evaluate OHI results of firms and price to identify overall ROI/value to DHA or use some other methodology?The vendor shall prepare and submit the Technical and Price Proposal as outlined in the RFP
Section L - Instructions, Conditions and Notices to BiddersGiven the number of outstanding issues it will be difficult to respond with a fully compliant response in the time allotted from the Government. To ensure time to craft the best solution possible will the Government consider providing a due date extension?Yes.

1 week extension is adequate.

1.4 Scope, page 27“…as well as validate and update existing OHI information stored in the OHI repository in the Defense Enrollment Eligibility Reporting System (DEERS) database.” Question: Ongoing monitoring of existing OHI information (re-validation) is a best practice of successful OHI programs. It is unclear whether re-validation (separate from the Validation of Existing OHI Placeholder Policies workload) is included in the PWS. Does DHA intend to include re-validation and updating existing information as part of the PWS?
Follow-Up Question a.: If re-validation is included in the scope, please provide offerors with corresponding CLINs in Section B and estimated workload data in Technical Exhibit 3.The Government will provide two types of data: 1) Records with no current OHI information recorded in DEERS and 2) Placeholder records in DEERS where existence of OHI has been confirmed through the Coordination of Benefits process, but the billing information is missing

DHA did not intend to include re-valiation of any other OHI data. Revalidation will not be a separate task; the government will determine which records to revalidate and the revalidation schedule.

1.6.1 Quality Control, page 28“The contractor shall develop and implement procedures to identify retrospective billing opportunities from OHI files and initiate recovery.” Question: Is the contractor responsible for initiating recovery? This task is not identified elsewhere in the PWS.Subject paragraph will be removed from the RFP. A formal RFP and amendment reflecting updates will be posted by 23 Jun 14.
Section 1.6.13“The Contractor agrees that it has a contractual obligation to mitigate the consequences of the loss of Key Personnel and shall promptly secure any necessary replacements in accordance with this PWS section. Failure to replace a Key Person pursuant to this clause and without a break in performance of the labor category at issue shall be considered a condition endangering contract performance and may provide grounds for default termination.” Question: This statement seems to be contradictory with your requirement that this is a Firm Fixed Price Contract, please clarify.The obligation to mitigate the loss of Key Personnel has no relation or impact on the Government's intend to award a FFP contract.
Technical Exhibit 3, page 60Question: What data elements will be provided for the OHI Placeholder workload? (e.g., member name and OHI=yes; member name, insurance carrier, and policy number?) Follow-Up Question a.: Is the OHI placeholder workload intended to be included in the validation CLINs in the pricing schedule? Follow-Up Question b.: For pricing purposes, will the validation unit price be applied to every placeholder the contractor processes, or only for validated placeholders with active OHI policies?The Government will provide initial data specifications at contract award. The Government initially may provide data extracts and at a later point provide access to a web service for the contractor to directly update OHI information into DEERS

a. Yes

b. Only for validated placeholders with active OHI policies.

1.1 RFP page 27, Description of Services/IntroductionThe contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, other items, and non-personal services necessary to perform other health insurance identification and validation support services as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract. Question: Does the Government anticipate the PM working on-site and if so will space be provided for the PM to perform their duties?The PM does not need to be on-site.
Section 4: Past Performance, Page 97,Offerors must provide at least five (5), primary past performance contract references from the past 3 years, from RFP issue date, as it relates to the requirements of this solicitation. The Offeror may submit up to three additional references beyond these three primary references. The three primary references must include completed Performance Questionnaires (Section J, Attachment 26), as directed below. The information shall address any contractual issues that arose and the corrective actions taken. Past performance history not specifically related to providing any of the services in this solicitation will not be considered relevant information for the purpose of determining the performance confidence rating. Question: Does the Government anticipate a write up for each Past Performance example provided and if so, will the write ups be part of the 10 page allotment for Volume 2 (two)? Follow-Up Question a.: Are three (3) or five (5) references example considered primary references?Duplicate question:; 5 references

Tilley, Birgit, CIV, DHA:

need to check the PWS to ensure it's clear Tilley, Birgit, CIV, DHA:

verify in PWS Tilley, Birgit, CIV, DHA:

customer

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