UPDATED_Section_L_-_T2017_-_01.29.16.pdf

SECTION L

INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

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L.1. SOLICITATION PROVISIONS

Federal Acquisition Regulation (FAR) 52.252-1 Solicitation Provisions Incorporated by Reference. (Feb 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer (CO) will make their full text available. The Offeror is cautioned that the listed provisions may include blocks that must be completed by the Offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the Offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this address:

http://farsite.hill.af.mil

(End of Provision)

FAR 52.204-6 Data Universal Numbering System (DUNS) Number. (Jul 2013)

FAR 52.204-7 System for Award Management. (Jul 2013)

FAR 52.211-14 Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use. (Apr 2008)

Any contract awarded as a result of this solicitation will be [ ] DX rated order; [X ] DO rated order certified for national defense, emergency preparedness, and energy program use under the Defense Priorities and Allocations System (DPAS) (15 CFR 700), and the Contractor will be required to follow all of the requirements of this regulation.

FAR 52.215-1 Instructions to Offerors - Competitive Acquisition. (Jan 2004)

FAR 52.215-16 Facilities Capital Cost of Money. (Jun 2003)

FAR 52.215-20 Requirements for Certified Cost or Pricing Data and Data Other than Certified Cost or Pricing. (Oct 2010) Alternate III (Oct 1997). AND Alternate IV (Oct 2010).

(a) Submission of certified cost or pricing data is not required.

(b) Provide information described below: Submit the proposal cost schedules and supporting information identified in the paragraphs under L.8.

(c) Submit the “information other than cost or pricing data” portion of the proposal via the following electronic media: As identified in paragraphs under L.8.

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FAR 52.215-22 Limitations on Pass-Through Charges-Identification of Subcontract Effort.

(Oct 2009)

FAR 52.216-1 Type of Contract. (Apr 1984)

The Government contemplates award of a contract consisting primarily of cost-plus fixed-fee types, with fixed-price elements, cost reimbursable elements and performance incentive fees included resulting from this solicitation.

FAR 52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation. (Feb 1999)

FAR 52.222-46 Evaluation of Compensation for Professional Employees. (Feb 1993)

FAR 52.233-2 Service of Protest. (Sep 2006)

(a) Protests, as defined in section 33.101 of the FAR, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the CO by obtaining written and dated acknowledgment of receipt from the CO, address in Block 7 of the Standard Form 33.

(b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO.

AGENCY LEVEL PROTESTS (APRIL 14, 2014)

An interested party filing a protest with Defense Health Agency (DHA) has the option of requesting review by either the Contracting Officer (CO) or an independent review Official (IRO), who is a DHA official at a level above the CO. Alternately, an interested party may request IRO review as an appeal of the CO’s protest decision.

Where applicable, an interested party must clearly state in the protest that IRO review is requested, and must specify the nature of the independent review sought – whether as an alternative to CO review or as an appeal of the CO’s decision.

Regardless of which review is requested, all protests must be complete and submitted to the CO within the timeframes specified in FAR Subpart 33.1.

(End of requirements language)

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FAR 52.252-5 Authorized Deviations in Provisions. (Apr 1984) The use in this solicitation of any FAR (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of “(DEVIATION)” after the date of the provision.

DFARS 252.225-7003 Report of Intended Performance Outside the United States and Canada--Submission with Offer. (OCT 20105)

L.2. GENERAL INSTRUCTIONS

L.2.1. The Government will conduct a full and open competition after exclusion of sources in this solicitation to foster an adequate number of viable Contractors to reduce any risk to the stability of the administration of the TRICARE program, and to ensure the continuous availability of healthcare services for TRICARE beneficiaries. Therefore, the Government will award two contracts for managed care support services to two different prime Contractors under this solicitation. There will be one TRICARE Region (i.e., geographical area for contract performance) per contract award. The selection of two different prime Contractors will occur even if a potential Contractor submits proposals for more than one contract region and each of the proposals is evaluated as the best value for the Government for the contract region of submission. In such a situation, the Government will select the awardees in accordance with Section M.2.1.1.

L.2.2. Offeror. The Government will, subject to FAR 9.604 Limitations, recognize the integrity and validity of Contractor team arrangements provided the arrangements are identified and company relationships are fully disclosed in an offer. For purposes of exclusion of sources under this solicitation, a company or business entity identified in an offer as a potential prime Contractor shall be considered to include the named company or business entity, its parent or subsidiary, or a company or business entity directly related to the company or business entity through common (regardless of the percentage) ownership, control, or management (whether by a parent company or otherwise). Under this solicitation, no company or business entity may be awarded more than one contract as a prime Contractor. In addition, if a contract is awarded to a prime Contractor in which a company or business entity has formed a business arrangement (e.g., partnership, joint venture, LLC) to act as a prime Contractor, any Offeror which includes that company or business entity in a business arrangement to act as a potential prime Contractor, shall be excluded from award of the other one contract under this solicitation. A company or business entity may be awarded a contract as a prime Contractor in one TRICARE Region and serve as a subcontractor to a prime Contractor in the other region.

L.2.3. Offerors are cautioned to follow the instructions provided in this section carefully to assure the Government receives consistent information in a form that will facilitate proposal evaluation. Proposals that take exception to inclusion of specific requirements in the resultant

HT9402-15-R-0002 Page L-4 of L-31 Amendment 000009 contract shall not be considered. Offerors may propose on one or both regions. Offerors shall submit only one offer per region, and alternative offers will not be accepted or evaluated by the Government. Although Offerors may propose separately on both regions, an Offeror will only be awarded a single region. Proposals with conditional pricing for the award of both regions will not be considered. All proposal material shall be labeled clearly identifying the region for which the proposal applies.

L.2.4. This section provides general guidance for preparing proposals as well as specific instructions on the format and content of the proposal. In addition to the offer, the Offeror’s proposal must include all data and information requested in this solicitation and must be submitted in accordance with these instructions. The offer shall be compliant with the requirements as stated in the solicitation and applicable attachments. Non-conformance with the instructions provided in the solicitation and this section may result in an unfavorable proposal evaluation or rejection of the proposal. The proposal shall be clear, concise, and shall include sufficient detail for effective evaluation and for substantiating the validity of stated claims.

Attachment L-1, Sections L, M, and C Cross Reference Table is provided to assist Offerors.

L.2.5. The Offeror’s final proposal revisions (FPR) should contain the Offeror’s best terms from a price or cost and technical standpoint. The Government intends to make award without obtaining further revisions. This request for information serves to clarify certain aspects of proposals (e.g. the relevance of an Offeror’s past performance information and adverse past performance information to which the Offeror has not previously had an opportunity to respond) or to resolve minor or clerical errors. This exchange shall not be used to cure weaknesses or material omissions of the offer, or materially alter the technical or cost information in the proposal. Under no circumstances will the Offeror revise its offer in response to clarification questions; any such revision will not be considered.

L.2.6. Reserved.

L.2.7. The proposal shall not simply rephrase or restate the Government's requirements, but rather shall provide convincing rationale to address how the Offeror intends to meet these requirements. Offerors shall assume that the Government has no prior knowledge of their facilities, capabilities, and experience. The Government will base its evaluation on the information presented, plus any additional past performance information obtained by the Government from other sources.

L.2.8. Offerors shall submit their anticipated organizational structure at least fifteen (15) calendar days prior to the initial proposal due date. The organizational structure must include the prime Contractor and first tier subcontractors. The organizational structure shall include addresses and telephone numbers. In the case of a joint venture or other business structure, a clear description of the organizational relationships must be disclosed. This organizational structure is to be emailed to the following: Mr. Roger J. McAughan at

HT9402-15-R-0002 Page L-5 of L-31 Amendment 000009 roger.j.mcaughan.civ@mail.mil and to Mr. William H. Coffenberry at william.h.coffenberry.civ@mail.mil.

L.2.9. ORGANIZATIONAL CONFLICTS OF INTEREST

L.2.9.1. The Offeror's attention is directed to FAR, Subpart 9.5, "Organizational and Consultant Conflicts of Interest."

L.2.9.2. It is the position of the Defense Health Agency (DHA) that the following companies, due to the nature of their performance with DHA, have an actual or potential organizational conflict of interest, which must be avoided, neutralized, or mitigated: A-Team Solutions, LLC; Architecture, Engineering, Consulting, Operations and Management (AECOM); Axiom Resource Management Inc.; Booz Allen Hamilton; Cherokee Information Services Inc; Compliance Automation Inc.;

Concept Plus, LLC; E.R. Williams Inc.; Information Technology Solutions & Consulting, LLC (ITSC); Intellidyne, LLC; Kennell and Associates Inc.; Keystone Peer Review Organization, Inc.

(KePRO); Kforce Government Solutions, Inc. (KGS); Lockheed-Martin; ThinkQ; Ernst & Young Global Limited; Ernest and Young; Developing Global Trust with International Interests LLC;

SofTec Solutions, Inc; and Stratitia. The actual or potential OCI extends to subsidiaries, parents, and affiliates of these companies. Due to the dynamic nature of DHA contract requirements, offerors are advised that the above list of companies may not include every company having an actual or potential organizational conflict of interest. Offerors shall determine if an actual or potential conflict of interest exists with any company or entity to include any parent company, affiliate, business partner, subcontractor, or consultant used in support of its effort related to responding to this Solicitation or performing the resultant contract.

L.2.9.3. The Offeror shall represent in writing within Volume 1 the proposal that, to the best of the Offeror's knowledge, there are no relevant facts or circumstances concerning any past, present, or potential contracts or financial interest relating to the work to be performed, which could give rise to an organizational conflict of interest, as described in FAR, Subpart 9.5. In the event an actual or potential organizational conflict of interest exist, the Offeror shall submit a mitigation plan to the CO as soon as possible, but no later than 15 calendar days prior to the proposal due date, that effectively demonstrates how the Offeror will mitigate any actual or potential organizational conflict of interest while supporting this contract and any other DHA contract. The Offeror shall also provide the CO, no later than 15 calendar days prior to the proposal due date, with information of previous or ongoing work that is in any way associated with this solicitation. Any organizational conflicts of interest found after proposal submittals shall be disclosed to the CO immediately. Failure to disclose a conflict of interest timely may result in an offeror being determined ineligible for contract award.

L.2.9.4. The CO will review all mitigation plans to determine whether award to the Offeror is consistent with FAR, Subpart 9.5. If the CO determines that no conflict would arise or that the mitigation plan adequately protects the interest of the Government, the Offeror will be eligible for award. If the CO determines that the organizational conflict of interest has not been eliminated, avoided, or adequately mitigated, remedial actions will be considered, including mailto:roger.j.mcaughan.civ@mail.mil mailto:charles.l.hargett.civ@mail.mil

HT9402-15-R-0002 Page L-6 of L-31 Amendment 000009 elimination from the solicitation process, termination of related contract efforts already awarded, or negotiation of the mitigation plan.

L.2.9.5. The above restrictions shall be included in all subcontracts, teaming arrangements, and other agreements calling for performance of work which is subject to the organizational conflict of interest restrictions identified in these provisions.

L.2.9.6. The Offeror acknowledges the full force and effect of these provisions. The Government reserves the right, in case of a breach, misrepresentation or nondisclosure, to terminate the resultant contract, disqualify the Offeror from subsequent related contractual efforts, or pursue any remedy permitted by law, regulation or the terms and conditions of this solicitation.

L.2.10. Use of Former Department of Defense (DoD)/DHA/TMA Employees and Uniformed Service Members in Proposal Preparation.

The involvement of a former DoD, DHA and TRICARE Management Activity (TMA) employee/member in an Offeror’s proposal preparation may give rise to an unfair competitive advantage or the appearance thereof, if the former DoD/DHA/TMA employee/ member acquired non-public, competitively-useful information in his or her former position. Such knowledge includes proprietary information of competitor’s performance on past or current contracts with similar requirements or source selection sensitive information pertaining to this procurement.

Consequently, the Offeror must notify the CO prior to the involvement in the proposal preparation by a former DoD/DHA/TMA employee/member reasonably expected to have had access to such information. Based on the notification, the CO will make a determination whether involvement of the former DoD/DHA/TMA employee/member in proposal preparation could create an unfair competitive advantage or appearance thereof. The CO will further determine whether any mitigation measures taken or proposed by the Offeror are adequate to alleviate this concern. Failure to comply with these procedures may result in the Offeror’s disqualification for award.

L.2.11. Offerors shall submit proposals to the CO at the address indicated below. The proposals are to be in electronic and hard copy format in accordance with L.4. Hardcopies and DVD/CD- ROMs shall be submitted to:

Contracting Officer TRICARE 2017 Managed Care Support Contract Operations Division – Aurora (COD-A) 16401 East Centretech Parkway, Aurora, CO 80011-9066

Each DVD/CD and/or volume shall be marked as follows:

OFFEROR’s COMPANY NAME, e.g., XYZ Corporation

HT9402-15-R-0002

TRICARE 2017 Managed Care Support, Region Volume Number DVD/CD number (e.g., 1 of 3)

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Identify if the data is protected by the Privacy Act, HIPAA or both as appropriate Date the DVD/CD was created Software and version used

L.3. INFORMATION

L.3.1. The CO and contract specialist (CS) are the sole points of contact for this procurement.

Questions regarding the solicitation or other concerns are to be submitted in accordance with L.3.7.

L.3.2. Summary level data on eligible beneficiaries, direct care workload, purchased care costs, electronic and paper claims quantities, administrative support services workload volumes, and other categories are available at no cost to all interested parties in attachments to Section L.

Offerors should refer to Attachment L-2, List of Data Available to Offerors.

L.3.3. Detail level data on purchased care costs, direct care workload, eligible beneficiaries, and pharmacy workload may be ordered by potential Offerors for a processing fee of $2,500.00 that will include the original data set and updated data sets, if any, for the acquisition. Offerors should refer to Attachment L-3, Summary Level Data, and also refer to Attachment L-2, List of Data Available to Offerors.

L.3.4. Current TRICARE manuals referenced in Section C are included as an attachment to the RFP located on the Federal Business Opportunities website posting. Offerors may access previous versions of the TRICARE Manuals through the DHA website at http://manuals.tricare.osd.mil/. Offerors are reminded that only the manuals referenced in Section C of the RFP are applicable to this effort.

L.3.5. The remarks, explanations, and answers provided by Government representatives whether orally, or in writing, shall not change or qualify any of the terms or conditions of the solicitation.

The solicitation can only be changed by a formal written amendment issued by the CO.

L.3.6. Non-Government Advisors: Non-Government Advisors: The expertise of Non- Government advisors may be required to support evaluation of technical proposals. The Government plans to use the following Non-Government advisors during proposal evaluations:

Axiom Resource Management Inc.; Kennell and Associates Inc.; and CD Stacey and Associates, Inc. If an additional Non-Government advisor(s) is used, DHA will immediately provide the name(s) by correspondence to the Offerors. These advisors will have broad and comprehensive knowledge of the civilian healthcare industry and managed healthcare in particular, and will apply their expert knowledge of civilian healthcare industry practices and standards to assist the Government in evaluation of proposals. Non-Government advisors are subject to the limitations http://manuals.tricare.osd.mil/

HT9402-15-R-0002 Page L-8 of L-31 Amendment 000009 of FAR 7.503 and FAR Part 37.2; and shall not determine ratings or rankings of Offerors’ proposals or perform any inherently Governmental function.

Upon review of the above limitations and after the identity of the Non-Government advisor(s) is provided, any Offeror having concerns/issues regarding these Non-Government advisors having access to its proposal information should notify the CO of said objection or obtain a written agreement between the Non-Government advisor and the Offeror in accordance with FAR 9.505- 4(b), and submit to the CO within seven (7) working days at time of notification. If no agreement or objection to the proposed Non-Government advisors is submitted within the seven (7) working days, the Offeror will be deemed to have consented to the limited access described above.

Note that Cherokee Information Services Inc. and Information Technology Solutions & Consulting, LLC (ITSC) will be performing administrative functions in support of this procurement; however, the administrative support contractor personnel will not have access to offerors’ proposals.

L.3.6.1. The Release of Proposal Information to Non-Government Advisors: The release of proposal information to non-Government advisors will be subject to the controls of DHA.

L.3.6.2. Prohibitions: Non-Government advisors are prohibited from proposal rating, ranking, or recommending the selection of a source. They are not normally allowed to participate in discussions with Offerors, but may attend if requested by the chairperson(s). Non-Government advisors are not normally allowed to participate in Government decision-making meetings (Source Selection Evaluation Board (SSEB) sessions or SSA briefings), unless invited by the chairperson(s) to be present during a particular portion to provide specific technical information.

L.3.6.3. Access to Proprietary Information: Non-Government advisors that have access to proprietary information in performing their roles for the Government must agree to protect the information from unauthorized use or disclosure for as long as it remains proprietary and refrain from using the information for any purpose other than that for which it was furnished. All non- Government advisors are required to sign a Non-Disclosure Statement, DHA Form 821. The CO shall retain the signed agreements in the contract file.

L.3.6.4. Organizational Conflict Of Interest (OCI): OCI clauses are included in the contracts under which non-Governmental technical advisors are performing services for the Government.

The OCI clauses require the companies and individual non-Government advisors to protect Offeror proprietary data and Government source selection information and prohibit the companies from otherwise participating as an Offeror, a subcontractor as a consultant to an Offeror/subcontractor in relation to this acquisition participation.

L.3.7. Solicitation Questions

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Questions regarding this solicitation shall be submitted using Attachment L-10 Excel Spreadsheet titled “Offeror Questions.” The Government will answer all questions prior to the deadline for proposal submittal provided those questions are received by 2:00PM Mountain Daylight Time, 22 January 2016.

Written questions must be submitted by email to:

Defense Health Agency – COD-AB ATTN: Roger J. McAughan Telephone: 303-676-3602

Email: roger.j.mcaughan.civ@mail.mil

Alternate POC: William H. Coffenberry Telephone: 303-676-3764 Email: william.h.coffenberry.civ@mail.mil

Government responses to questions pertaining to the solicitation will be provided to all potential Offerors in accordance with FAR 15.201(f). The Government reserves the right not to respond to any questions received concerning this solicitation after the question receipt date and time above. Accordingly, Offerors are encouraged to carefully review all solicitation requirements and submit questions to the Government early in the proposal cycle. It is not anticipated that the closing date for receipt of proposals will be extended.

The Government will post the answers to questions on the solicitation at www.fbo.gov .

L.4. PROPOSAL PREPARATION

L.4.1. An Offeror is required to provide separate proposals volumes I-V for each region it chooses to submit an offer. The overall proposal shall consist of five (5) physically separated and detachable parts/volumes, individually titled as indicated below. Offerors are required to submit separate proposals for each region if proposing more than one region. The Offeror shall provide one original paper copy of all volumes (clearly marked “ORIGINAL” on the binder cover and on the first page), plus the number of copies as follows:

PART/VOLUME

NAME

NO. OF COPIES

Paper/Electronic http://www.fbo.gov/

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Volume I Executed Offer, to include:

• SF 33

• Completed Schedule B

• Completed Section K Certs & Reps

• Completed copy of paragraph G.3.4 (Points of Contact)

• Completed copy of paragraph H.2.3.1.1 (Guaranteed Network Provider Discounts)

• Completed copy of paragraph H.4.3 (Performance Guarantees)

• OCI representation statement (L.2.9.3)

• Subcontracting Plan (L.5.2)

5/3

Volume II Technical to include

• Written Technical Proposal (see L.6.1.)

• Offered elements exceeding minimum standards/requirements

35/3

Volume III Past Performance (see L.7.) 12/3

Volume IV Price/Cost (see L.8.)

• Completion of H.2.3.1.1

Volume V Financial Data (see L.9.) to include Guarantee Agreement for Corporate Guarantor

L.4.2. Electronic Copies: Proposals shall not be submitted via any web-based means (e.g., e-mail transmission). The electronic portion of the proposal shall be submitted on DVD/CD-ROMs compatible with Microsoft Office 2010 applications. For Section B Portable Document Format (PDF) is an acceptable format. In addition, each DVD/CD must be made “final.” “Final” is a recording option that renders the DVD/CD totally used so no other data tracks can be added. Do not use compressed file formats. Use separate files to permit rapid location of all portions, including exhibits, annexes, and attachments, if any. A separate DVD/CD is required for each Volume identified above. A directory shall also be placed on the CD/DVD, if it contains more than one file. Each DVD/CD and/or volume shall be marked as follows:

OFFEROR’s COMPANY NAME, e.g., XYZ Corporation

HT9402-15-R-0002

TRICARE 2017 Managed Care Support, Region Volume Number DVD/CD number (e.g., 1 of 3) Identify if the data is protected by the Privacy Act, HIPAA or both as appropriate

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Date the DVD/CD was created Software and version used

L.4.3. Paper Copies: Each paper volume must correspond to a directory on the DVD/CD. Paper copies shall be separated by Volume, each in a three-ring binder and identified with the region proposed, Offeror’s name, volume number and title, proposal date and solicitation number. A separate binder is required for each Volume. All paper copy proposal narrative material shall be submitted on white paper with one inch (1") margins on all sides. Volumes II (Technical) and III (Past Performance) of the proposal shall be double-spaced. The font for both DVD/CD and paper submissions shall be Times New Roman, not smaller than 12 points; however, smaller fonts are permitted on illustrations, organization charts, supporting data exhibits, report listings or labels on process flows if those areas of the proposal cannot accommodate 12 point font. Elaborate brochures or documentation, binding, detailed artwork, or other embellishments shall not be submitted. Footnotes on text pages shall also be in 12 point font. Proposals shall be printed double-sided only with non-duplicative, sequential page numbers at the bottom of each printed page; however, pages may be printed single-sided for Volume IV, Price/Cost only. In instances where the paper copy differs from the electronic copy, the original paper volume prevails.

L.4.4. Specific Instructions for the Price/Cost Proposal: The electronic price/cost proposal shall duplicate the hardcopy version. Do not use compressed file formats. Submitted files shall contain all formulae, calculations, and worksheet/workbook links used to compute the proposed amounts. The cell formulae, calculations, and links shall not be hidden. Print image files or those Excel files/ Excel worksheets containing only “values” are not acceptable. There is no page limit for the price/cost proposal Volume IV or for the financial viability/statements; however, brief but concise explanations, summaries, and worksheets are advised and appreciated.

L.4.5. Page Limitations: Page limitations shall be treated as maximums. If exceeded, the excess pages will not be considered in the evaluation of the proposal and will be destroyed without review. The following table contains all page limit requirements. If there is a requirement for information to be submitted in the proposal, but it is not included in the following table, then a page limitation is not applicable.

Reference and Description Page Limit Organization Chart 3

Written Technical Proposal 250

List of Offered Elements Exceeding Minimum Standards/Requirements

Past Performance Narrative 30

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Summary Description of Largest Clients (see L.7.4.)

3 pages per client

Resumes for Key Personnel (if applicable, see L.7.11.)

1 page per resume

The Offeror’s Quality Management/Quality Improvement Program Plan (QM/QIP Plan) and the Integrated Master Plan (IMP) and Integrated Master Schedule (IMS) do not count towards the technical proposal page limitations; however, information in the QM/QIP Plan and IMP/IMS will only be considered under their respective evaluation subcriteria (M.7.6.2 and M.7.7)

L.4.6. Proposals will be reviewed for completeness and compliance with the solicitation and preparation instructions. If an Offeror (1) fails or refuses to assent to any of the terms and conditions of the RFP, (2) proposes additional terms and conditions of this RFP (beyond the List of Offered elements exceeding minimum standards/requirements permitted in L.6.1.), or (3) fails to submit any of the information required by this RFP, then DHA may consider the offer to be materially non-compliant, which could make the offer ineligible for contract award. Offerors shall not include price information anywhere in the proposal package other than in the Price/Cost volume, and prices in completed Section B. All pages of each proposal shall be appropriately numbered and identified with the solicitation number.

L.4.7. For the final proposal revision (FPR), offerors shall additionally provide the following:

For Volumes I (Executed Offer), III (Past Performance), IV (Price/Cost), and V (Financial Data), a list of any changes made from the initial offer to the FPR. The list of changes should be included in the front of the binder and does not count toward any page limitations. For the Price Evaluation Template, in lieu of a list of changes, the Offeror may indicate changes via red bold font within the template. For Volume II (Technical), in addition to the 35 clean copies, provide 25 hardcopies with all changes (additions and deletions) tracked. A “clean copy” is a proposal volume with all changes incorporated and not identified via track changes or other methodology showing edits made. The page limitation for the written technical proposal, set forth in Section L.4.5, applies to the clean copy only.

L.4.8. Additional Instructions for the IMS and IMP: The IMP must be submitted in both electronic and paper copy. Offerors must submit the IMS in electronic copy, but offerors need not submit the IMS in paper copy. With respect to the IMP, offerors shall submit the required track changes version referenced in L.4.7. With respect to the IMS, offerors shall submit one version only, a Microsoft Project version with additions and changes in a red bold font. Any deletions shall be indicated by the bracketed term “[Deleted],” and deleted text should not appear.

L.5. VOLUME I, EXECUTED PROPOSAL

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L.5.1. Volume 1 shall contain the signed original of all documents requiring signature of the Offeror. Use of reproductions of the signed original is authorized in the copies. Offerors shall commit in writing to fulfilling the terms and conditions of the contract. All certifications and representations, to include Section K, required by the solicitation shall be completed and provided in Volume 1. The provision in Section K, FAR 52.204-8, Annual Representations and Certifications, must be completed and submitted with the proposal. An online Representations and Certifications Application is available at https://www.sam.gov .

L.5.2. Offerors designated as large businesses shall include in Volume I a subcontracting plan as required by FAR 19.702, FAR 19.704, FAR 52.219-8 Utilization of Small Business Concerns, FAR 52.219-9 Small Business Subcontracting Plan, and DFARS 252.219-7003, Small Business Subcontracting Plan (DoD Contracts). Please note that network providers are not considered subcontractors of the prime Contractor, and therefore healthcare services provided by network providers may not be counted in the subcontract plan. Additionally, Offerors are advised in accordance with 10 U.S. Code 2410d, Contractors may use the services and/or products of the AbilityOne program (National Industry for the Blind/National Industry for the Severely Handicapped) in meeting their small business subcontracting goals. The 11 elements of FAR

19.704 are required to be included in offeror’s subcontracting plan and are shown below:

(1) Separate percentage goals for using small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns as subcontractors;

(2) A statement of the total dollars planned to be subcontracted and a statement of the total dollars planned to be subcontracted to small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(3) A description of the principal types of supplies and services to be subcontracted and an identification of the types planned for subcontracting to small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(4) A description of the method used to develop the subcontracting goals;

(5) A description of the method used to identify potential sources for solicitation purposes;

(6) A statement as to whether or not the offeror included indirect costs in establishing subcontracting goals, and a description of the method used to determine the proportionate https://www.sam.gov/

HT9402-15-R-0002 Page L-14 of L-31 Amendment 000009 share of indirect costs to be incurred with small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(7) The name of an individual employed by the offeror who will administer the offeror’s subcontracting program, and a description of the duties of the individual;

(8) A description of the efforts the offeror will make to ensure that small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns have an equitable opportunity to compete for subcontracts;

(9) Assurances that the offeror will include the clause at 52.219-8, Utilization of Small Business Concerns (see 19.708(a)), in all subcontracts that offer further subcontracting opportunities, and that the offeror will require all subcontractors (except small business concerns) that receive subcontracts in excess of $650,000 ($1.5 million for construction) to adopt a plan that complies with the requirements of the clause at 52.219-9, Small Business Subcontracting Plan (see 19.708(b));

(10) Assurances that the offeror will—

(i) Cooperate in any studies or surveys as may be required:

(ii) Submit periodic reports so that the Government can determine the extent of compliance by the offeror with the subcontracting plan;

(iii) Small business subcontracting reports shall be submitted in accordance with FAR 52.219-9, “Small Business Subcontracting Plan (Deviation 2013-O0014) (Aug 2013) – Alternate II (Oct 2001)", whereby "The consolidated SSR shall be submitted annually for the twelve month period ending September 30. The report is due 30 days after the close of the reporting period."

(iv) Ensure that its subcontractors with subcontracting plans agree to submit the ISR and/or the SSR using the eSRS;

(v) Provide its prime contract number and its DUNS number, and the e-mail address of the offeror’s official responsible for acknowledging receipt of or rejecting the ISRs to all first-tier subcontractors with subcontracting plans so they can enter this information into the eSRS when submitting their ISRs; and

(vi) Require that each subcontractor with a subcontracting plan provide the prime contract number, its own DUNS number, and the e-mail address of the http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_215.htm#P1280_218529 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/19.htm#P805_174054 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_215.htm#P1314_223741 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/19.htm#P805_174054

HT9402-15-R-0002 Page L-15 of L-31 Amendment 000009 subcontractor’s official responsible for acknowledging receipt of or rejecting the ISRs, to its subcontractors with subcontracting plans.

(11) A description of the types of records that will be maintained concerning procedures adopted to comply with the requirements and goals in the plan, including establishing source lists; and a description of the offeror’s efforts to locate small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns and to award subcontracts to them.

L.5.3. Offerors must complete, sign, and date the offer at Blocks 12 through 18 of the Standard Form 33. Source selection procedures including the evaluation of offers received in response to the solicitation are projected to require up to 270 days to complete. As a result of this, the Government requires that the Minimum Acceptance Period identified in Item 12 of the Standard Form 33 be a minimum of 270 days. The Contractor’s information for paragraph G.3.4, Contractor Points of Contact personnel, shall be included in this Volume.

L.5.4. Offerors must acknowledge receipt of the amendments when submitting the offer and include the acknowledgements in this volume.

L.5.5. Offerors shall submit a completed original Section B in Volume I. Offerors are required to complete Section B, Supplies or Services and Prices/Costs. Offers submitted in response to this solicitation shall be in terms of U.S. dollars. Offerors are instructed to price the appropriate contract line items and sub-line items in Section B.

L.6. VOLUME II, TECHNICAL PROPOSAL

L.6.1. Written Technical Proposal Submission: The Offeror shall submit a written technical proposal which effectively demonstrates the Offeror’s understanding of the requirements, and provides a successful technical solution for the prospective contract. The written technical proposal shall also include a separate list of those elements of the offer that exceed the Government’s minimum requirements including performance standards that exceed the minimum standard or additionally offered performance standards (“enhancements”). The separate list shall have a clear cross reference to where each offered element is located in the technical proposal. The technical proposal shall clearly describe each element offered and demonstrate how the Offeror will meet the higher standards or exceed minimum requirements and why it is in the best interest of the Government. An enhancement may be incorporated into the contract, if the Government also determines that it exceeds requirements/standards and finds it to be in the best interests of the Government. Accordingly, for each enhancement, within the separate list described above, the Offeror shall include adequate language that may be incorporated into the contract as an enforceable provision. The Government, at its sole discretion, may incorporate some, none or all proposed enhancements.

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L.6.1.2. The proposal shall not reflect a marketing or sales presentation. Unnecessarily elaborate proposals beyond those sufficient to present a complete and effective response to this solicitation are not desired. The proposal should illustrate the Offeror’s capability, and clearly demonstrate the organization and methodology that will satisfy the solicitation requirements. The proposal should clearly describe the technical solution and overall approach to the solicitation requirements and address all of the subfactors identified in Section L which will be evaluated against the criteria specified within Section M of this solicitation. The proposal may have information on the Offeror’s experience (for this purpose, experience refers to what an Offeror has done, not how well it was accomplished) in performing proposed processes and procedures.

This information may be considered in the evaluation of specific technical approaches and related technical proposal risk. However, any such information in the technical proposal will not be considered for purposes of the overall past performance rating as described in Section M.8.

The price/cost proposal, past performance information, and financial information shall not be addressed in the technical proposal volume, and no part of the technical proposal shall incorporate by reference portions of other volumes of the proposal.

L.6.1.3. Offerors shall include a table of contents with their Technical Proposal. The Table may be single spaced, and does not count toward the page limitations.

L.6.2. Technical/Management

L.6.2.1. Subfactor 1 - Network Management:

L.6.2.1.1. The Offeror’s proposal will include its approach for developing and maintaining an accredited, stable, high-quality network that supplements services provided by the MTF within access to care standards as defined in 32 Code of Federal Regulations (CFR) 199. The Offeror will provide its network sizing model, including the number of providers, types of providers, consideration of MTF capacity/capability and beneficiary population and approach to address network shortages. The Offeror’s proposal will include examples of how its network sizing model will be applied to PSAs surrounding the following locations as a representative sample of the contract requirements:

• Colorado Springs eMSM (West Region)

• Ft. Bliss (West Region)

• Camp Pendleton (West Region)

• Tidewater eMSM (East Region)

• Ft. Hood (East Region)

• Dover (East Region)

The Offeror’s technical proposal shall not address any proposed network discounts. Network discounts will be addressed only in the price proposal.

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L.6.2.1.2. The Offeror will describe how it will ensure access to care if MTF capabilities and capacities change, including its approach for responding to such changes on short notice. The Offeror will describe how it will stay informed of potential changes, and how activities will be coordinated with the Regional Director and/or the MTF Commander.

L.6.2.1.3. The Offeror will describe its methodology for directing beneficiaries to providers who demonstrate quality outcomes while meeting health plan administrative standards (such as electronic claims processing, return of clear and legible consultation reports when requested, appointment availability, secure communications with patients).

L.6.2.1.4. The Offeror’s proposal will include its approach for maintaining an accurate network provider directory that complies with the contract requirements. The Offeror shall include in its proposal how network provider directory accuracy shall be measured. The Offeror shall include in its proposal its proposed accuracy percentage (which shall be inserted into Section C.2.1.3 upon contract award).

L.6.2.1.5 The Offeror’s proposal will describe its approach, required by Section C.2.1.7, to facilitate the timely return of network provider consultation reports to the MTFs.

L.6.2.2. Subfactor 2 – Referral Management:

L.6.2.2.1. The Offeror will describe its process for managing referrals from/to the MTF/civilian sector in accordance with the TRICARE Operations Manual (TOM), Chapter 8, Section 5. The Offeror will include its approach on how its referral management process directs TRICARE-eligible beneficiaries to the MTF; how this process will be supported through network management activities; and how the Offeror proposes to meet the referral processing requirements.

L.6.2.3. Subfactor 3 – Medical Management:

L.6.2.3.1. The Offeror will describe its design and approach for implementing/maintaining integrated medical management programs for all TRICARE-eligible beneficiaries receiving care in the civilian sector. This description will include how the programs will complement the medical management services available in the MTFs. The Offeror will describe how its process will objectively document improvements in clinical outcomes.

L.6.2.3.2. The Offeror will describe its approach for implementing a Utilization Management program for TRICARE-eligible beneficiaries. The Offeror will describe systems and processes for identifying, preventing, and reducing or eliminating occurrences of over- or underutilization.

L.6.2.3.3. The Offeror will demonstrate how its case management program for TRICARE-eligible beneficiaries will support and manage the healthcare of individuals with high-cost

HT9402-15-R-0002 Page L-18 of L-31 Amendment 000009 conditions or with specific diseases for which evidenced-based clinical management programs exist.

L.6.2.3.4. The Offeror will describe its chronic care/disease management program and explain how that program will improve the clinical and satisfaction outcomes for TRICARE-eligible beneficiaries and reduce healthcare costs for the Government.

L.6.2.3.5. The Offeror will provide its approach in providing a Network Prime beneficiary-centric data warehouse and industry analytic tools/system (including predictive analytics) which incorporates a data analysis technique with evidence-based algorithms. The Offeror will describe its integrated systems and processes that will be utilized to comprehensively discover and correct gaps in care, medical errors, and potential quality issues for Network Prime beneficiaries. The Offeror will describe how its approach will enable extraction of actionable data from large databases of information that can improve quality of care and patient perception of care.

L.6.2.3.6. The Offeror will describe its approach for implementing a clinical quality management and patient safety program for TRICARE-eligible beneficiaries. The Offeror will describe systems and processes for standardizing error reduction, as well as maintain transparency and adherence to evidence-based medicine.

L.6.2.4. Subfactor 4 –Customer Service:

L.6.2.4.1. The Offeror will describe its approach in providing accurate, comprehensive customer service with knowledgeable, courteous, and responsive staff. The Offeror will describe its approach for providing customer service via multiple, contemporary avenues of access.

L.6.2.4.2. The Offeror will describe its approach for establishing and maintaining optimal beneficiary, provider, and MTF satisfaction in a manner that meets the contract requirements throughout the period of performance. The Offeror shall not propose beneficiary or provider surveys.

L.6.2.4.3. The Offeror will describe its approach to identifying and responding to beneficiary and provider educational needs consistent with the contract requirements.

L.6.2.5. Subfactor 5 – Claims Processing:

L.6.2.5.1. The Offeror will describe its approach for providing a readily adaptable, scalable claims processing system which incorporates industry best practices.

L.6.2.5.2. The Offeror will describe how their proposed claims processes/methods will ensure that claims processing timeliness and accuracy standards are met.

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L.6.2.6. Subfactor 6 – Program Planning and Control:

L.6.2.6.1. The Offeror shall describe its management approach for establishing and maintaining, throughout the life of the contract, qualified, experienced key personnel, in the following areas.

Within this approach, where knowledge and experience in integrating the purchased care system with the direct care system is essential for successful contract performance, the Offeror shall describe how it will ensure it has key personnel with this knowledge and experience.

• Establishing/Maintaining Networks

• Referral Management

• Medical Management

• Enrollments

• Customer Service

• Claims Processing

• Management

The Offeror shall not submit resumes of, or otherwise summarize qualifications of individual key personnel in response to this criterion.

L.6.2.6.2. The Offeror shall describe its Quality Management/Quality Improvement Program which, at a minimum, includes the major components of the program: quality control activities, quality assurance functions, organizational responsibilities for quality management, written process to be followed to ensure a consistent outcome, and how identified quality problems will be monitored and resolved. The Offeror shall demonstrate its approach to communicating with the Government any problems and resolutions identified by the Quality Management/Quality Improvement Program. The Offeror shall provide a copy of its Quality Management/Quality Improvement Program Plan with the written technical proposal. (Note: The Quality Management/Quality Improvement Plan does not count towards the page limitation for the written technical proposal.)

L.6.2.7. Subfactor 7 – Transition:

L.6.2.7.1. The Offeror shall provide an Integrated Master Plan…