Inquiries and Answers for RFP AABA 2027-0049.pdf

DPA Solicitation #:

RFP AABA 2027*0049

Health and Welfare Actuarial and Broker Consultant for the

State of Colorado

INQUIRIES AND ANSWERS

Question 1: Reference: Exhibit B, Section 2.15

Question: Section 2.15 requests three (3) references representing the Offeror's three most recent terminated clients of comparable size to the State of Colorado.

If the Offeror does not have three recently terminated clients of comparable size, how would the State like the Offeror to respond? May the Offeror provide references for project-based engagements, clients of a smaller size, or otherwise identify the closest comparable references available?

Answer 1: Please use your best judgment and provide references that demonstrate your ability to perform the work requested. That may mean project-based engagements, clients of a smaller size, or otherwise identify the closest comparable references available.

Question 2: Reference: Exhibit B, Section 2.10

Question: As a privately held organization, our financial statements are only provided to our clients and prospects when requested and are not publicly available. When financials are requested in a public procurement process, we take a two-step approach to ensure those remain protected and are only accessible by individuals reviewing our proposal response. If acceptable by the State, these financial statements will be provided twice under a password protected file. The first submission would come prior to the due date of the solicitation to ensure there are no issues with the Procurement officer accessing the files. Once the file is received a member of our financial services team would reach out via phone to provide the password and instructions for opening the files. The second submission would be as part of our official response, and would follow the same process in providing a password via phone to access the files. The first submission is only done to ensure there are no issues with procurement being able to access the password protected files. We would just like to confirm that this process is suitable for the State and would align with acceptable procurement processes for this solicitation.

Answer 2: Yes, that is acceptable.

Question 3: Exhibit A, Sections 1.1.4 and 2.1.8

Please provide the historical volume of fiscal note requests received by the incumbent consultant during each of the last three legislative sessions. What percentage of these requests required response times of four hours or less?

Answer 3: This information is not tracked precisely, but here is the most useful data available. The State Benefits Team receives many bills every legislative session and the offeror will review each of them for fiscal impact, policy concerns, or conflicts with current law. The vast majority of the bills have no fiscal impact and raise no concerns; these bills do not take much time. Between 2020 and the most recent legislative session, 35 bills have had a fiscal impact. These bills required the broker/actuary to perform more work and analysis for the State.

Question 4: Exhibit A, Sections 1.1.6 and 1.5

Please describe the State’s expectations regarding strategic planning efforts, including the anticipated frequency of strategic planning exercises, executive presentations, benchmarking studies, and long-term benefit strategy development activities during a typical contract year.

Answer 4: We meet annually to discuss strategic planning efforts which informs our decisions during the budget cycle. During the budget cycle we meet frequently to discuss our strategy and adjust based on priorities. Executive presentations are on an as needed basis, but have occurred rarely in the past, this could change based on changes to the C-Suite. We expect data to be benchmarked to comparable employers but do not expect our consultants to perform benchmarking studies solely for our benefit.

Question 5: Exhibit A, Sections 1.1.14 and 2.1.11

Please provide historical information regarding the frequency of required in-person meetings, vendor meetings, negotiation sessions, and procurement activities attended by the incumbent consultant.

Answer 5: We meet in person at least once per year for our annual business review. In addition to that we meet in person at least once per year with 14 of our contractors. Vendors should plan on at least 15 in person meetings per year with the main point of contact.

Question 6: Exhibit A, Section 1.3.4

Approximately how many claims issues, eligibility disputes, or employee benefit escalations were referred to the incumbent consultant during the most recent contract year?

Answer 6: This data is not tracked precisely but the State estimates that 25 issues were escalated to the incumbent in the last year.

Question 7: Exhibit A, Sections 1.3.7 and 1.8.1

Please provide the State’s anticipated procurement schedule for the next five years, including any expected procurements for medical, pharmacy, dental, vision, disability, life, wellness, benefits administration, HSA, FSA, or other benefit-related services.

Answer 7: State contracts are one year long with a maximum of four one-year renewals. If the winning vendor’s contract is extended all four times then each contract will be solicited at least once.

Question 8: Exhibit A, Sections 1.3.7 and 1.8.1

During benefit-related procurements, does the State anticipate that the awarded contractor will serve as:

• A voting evaluation committee member

• A non-voting subject matter expert

• A procurement advisor only

Or will the role vary depending upon the solicitation?

Answer 8: Non-voting subject matter expert and procurement advisor. The contractor will also assist in drafting the solicitation and serve as a consultant during some negotiations.

Question 9: Exhibit A, Sections 1.5 and 1.8.2; Exhibit B

If a major vendor transition occurs during the contract period (e.g., medical carrier, PBM, benefits administration platform, or wellness vendor replacement), should implementation support be considered included within the annual fixed fee, regardless of project complexity?

Answer 9: Yes.

Question 10: Exhibit A, Section 1.6

Please provide additional information regarding the anticipated PBM consulting workload, including:

• Timing of the next PBM procurement

• Timing of any planned reverse auction process

• Frequency of PBM market checks

• Historical annual pharmacy audit effort

Answer 10: See below:

• Timing of the next PBM procurement

The next PBM contract will be effective 7/1/28

• Timing of any planned reverse auction process

The reverse auction contract will be effective 7/1/27

• Frequency of PBM market checks

Annually.

• Historical annual pharmacy audit effort

The reverse auctioneer is statutorily obligated to audit every claim. See

24-50-1201 - 1204, C.R.S.

Question 11: Exhibit A, Sections 1.7.5.1 through 1.7.5.3

Please provide historical workload metrics associated with the State of Health program, including:

• Weekly application volume:

• Annual participant counts:

• Number of coaching vendors:

• Average number of weekly reconciliations:

• Typical hours spent on wellness administration activities:

Answer 11: Exhibit A, Sections 1.7.5.1 through 1.7.5.3

Please provide historical workload metrics associated with the State of Health program, including:

• Weekly application volume: zero weekly, annual project work likely amounts to

80 hours/year

• Annual participant counts: 500 in the clinically integrated State of Health

Complete program with integrated advanced primary care, individual and group health coaching, personal training, and nutrition counseling

• Number of coaching vendors: We have three health coaching partner organizations with a combined total 9 health coaches on the team: Marathon

Health = 3, Kaiser = 3, Cigna = 3

• Average number of weekly reconciliations: zero

• Typical hours spent on wellness administration activities: There are no regular continuing duties provided by consultants. The work is project specific and is generally centered around our annual program evaluation: The evaluation assignments to consultant include data analysis (biometrics and health care utilization by condition for the top several chronic conditions)

Question 12: Exhibit A, Section 1.8

What benefits administration platform is currently utilized by the State, and does the State anticipate conducting a benefits administration system procurement during the initial contract term?

Answer 12: Benefits Solver. Yes, the State anticipates procuring and implementing a new benefits administration system in the next five years.

Question 13: Exhibit A, Section 1.8.8

The RFP requires the contractor to provide administrative support during open enrollment. Please provide historical information regarding:

• Hours utilized by the incumbent consultant

• Number of staff involved

• Typical duration of support

• Number of employee inquiries and escalations received during the most recent open enrollment cycle

Answer 13: This data is not tracked precisely and these are only estimates.

• Hours utilized by the incumbent consultant- 20

• Number of staff involved - 2

• Typical duration of support - during OE from April to May

• Number of employee inquiries and escalations received during the most recent open enrollment cycle - 2

Question 14: Exhibit A, Sections 2.1 and 2.2

Approximately how many ad hoc consulting requests did the incumbent consultant receive annually during the past three years? Please provide examples of the most common ad hoc requests and any significant projects that required substantial effort beyond routine recurring work.

Answer 14: This information is not tracked. Ad hoc requests are usually generated by staff outside of DPA, frequently from elected officials. One request that the incumbent worked on was a months-long project evaluating the possibility of negotiating hospital reimbursement based on Medicare-reference-based pricing, which was very time and resource intensive. Other ad hoc requests may be as simple as

“what are the three most-utilized hospitals in a specific county.” STATE OF

HEALTH annual program evaluation - data analysis support as described in

Question #11

Question 15: Exhibit A, Section 2.1.7

The actuarial scope requires development and maintenance of a Rate Modeler.

Please clarify:

• Whether the State currently has an existing model

• The platform currently used

• Ownership of the model and underlying assumptions

• Expected update frequency

Answer 15: See below:

• Whether the State currently has an existing model

Yes, the State has an existing model.

• The platform currently used

The model is in a spreadsheet.

• Ownership of the model and underlying assumptions

The State owns the model but the underlying assumptions may not be available to a new vendor.

• Expected update frequency

At least annually.

Question 16: Exhibit A, Sections 2.2.1 and 2.2.2

Can the State provide examples of the monthly and annual actuarial reports currently produced by the incumbent consultant, including representative report formats and level of detail?

Answer 16: Please see the additional attached files titled: Fiscal Year 2026 Actuarial Report &

Sample Monthly Actuarial Report

Question 17: Exhibit A, Section 2.2.2

Please provide summary information regarding the annual pharmacy claims audits currently performed, including any historical recovery amounts, payout discrepancies, or audit findings identified during recent years.

Answer 17: See 24-50-1201 - 1204, C.R.S. This service is performed by the reverse auctioneer, Truveris, and not by the broker/consultant.

Question 18: Exhibit B, Minimum Qualifications 1.1.2

The RFP indicates that Offerors may be required to perform ad hoc tasks, including non-routine and time-consuming research, as part of the annual fixed fee. How does the State define a “material expansion of scope” that may justify consideration of a contract amendment?

Answer 18: Vendors can always request a contract amendment and the State will work with them in good faith. That said, we have never had a broker/consultant ask for a contract amendment to increase compensation. There is not a bright line test for

“material expansion of scope.”

Question 19: Exhibit B, Section 3.2

Please confirm that the proposed annual flat fee should include all labor, travel, procurement support, actuarial services, wellness services, pharmacy consulting, implementation support, open enrollment support, compliance activities, and all anticipated ad hoc requests described in the Scope of Work.

Answer 19: Confirmed.

Question 20: Exhibit B, Sections 3.2 through 3.5

Please clarify whether Offerors should submit:

• A single annual fixed fee covering all services, or

• Annual pricing by contract year

Additionally, if the State exercises extension options, should Offerors assume pricing remains fixed throughout the potential five-year term, subject only to the adjustment provisions described in Section 3.5?

Answer 20: Please submit a flat annual fixed fee covering all services. The fee should be fixed for the initial term as well as all extension terms. Yes Offerors should assume pricing remains fixed throughout the potential five-year term, subject only to the adjustment provisions described in Section 3.5

Question 21: Exhibit B, Section 2.6

The RFP provides total incumbent consulting hours by labor category for the past four years. Please provide the incumbent contractor’s annual contract value and any contract amendments, change orders, or additional compensation received during that same period.

Answer 21: The flat fee is $792,000 per year. The total compensation per year has been

$792,000 per year; no amendments, change orders, or additional compensation has been authorized. The State does not expect to authorize any additional compensation to the new contractor.

Question 22: Exhibit B, Section 2.6

Can the State provide a breakdown of the historical consultant hours by major workstream, such as:

• Actuarial services

• Procurement support

• Pharmacy consulting

• Wellness program support

• Open enrollment support

• Compliance support

• Vendor management

• Legislative fiscal note support

• Benefits administration consulting

This information would greatly assist PCG in appropriately staffing the engagement.

Answer 22: This information is not available.

Question 23: Administrative Information — cover / 2.5.2.5

What is the correct solicitation number: AABA 2027-0049 or AABA 2027*0049.

Both are used in your documents and file, and folder names cannot contain an * character. Please advise on a standardized format.

Answer 23: Please name your folder AABA 2027-0049

Question 24: Administrative Information - 4.3.1.1.1.1

Please confirm the following should be in the singular proposal document, or whether these should be provided as separate attachments for the Technical

Proposal:

• Executive summary

• W-9

• Technical Proposal

Answer 24: Please provide separate attachments for the Technical Proposal

Question 25: Administrative Information - 5.4.1

The evaluation criteria listed do not have weights. We noticed the State commonly releases RFPs with weights for each category.

- Are you able to provide a weight that will be used for each criterion for this

RFP?

- Separately, what are your criteria for Accessibility evaluation?

Answer 25: Evaluation Criteria weights will not be released at this time. Please see Exhibit A

Section 5.1 for information regarding the Accessibility requirements.

Question 26: Exhibit A — Section 2: Scope of Work Overview

Please identify the specific ways in which the new scope of work is different from the current scope of work (based on RFP issued in 2022). What are any/all areas where the scope has materially expanded, contracted, or otherwise changed?

Answer 26: Prior RFPs are not relevant to this solicitation. Please provide a bid based on the scope of work included with this solicitation.

Question 27: Exhibit A - 1.2.1

“Provide observations and feedback on the scope of direct primary care services.”

Please clarify what you are looking for. Brokers/consultants do not provide primary care. They evaluate and support implementation of DPC. This is asking about providing primary care. If you are looking for something specific to consulting in this space, please elaborate on what you would like to know.

Answer 27: Review the State’s arrangement with our DPC provider, Marathon Health, and make suggestions for how we should expand or shrink our arrangement including an analysis of claims data, clinic-provided-services data, and return on investment analysis.

Question 28: Exhibit A - 1.6.3

Specific to the Reverse Auction process?

- Who is the current Reverse Auctioneer?

- So that we understand division of responsibilities, what are the responsibilities of the Reverse Auctioneer vs. the broker/consultant during the pharmacy RFP?

- Is the consultant expected to do an RFP for the Reverse Auctioneer?

Answer 28: The current reverse auctioneer is Truveris.

Truveris publishes and runs the reverse auction. The broker/consultant assists in drafting the reverse auction criteria and helps the State analyze the results and negotiates the contract with the winning bidder.

Yes, when the reverse auctioneer contract expires, the consultant will help draft the solicitation, negotiate the contract, and assist with implementing a new reverse auctioneer. The reverse auctioneer solicitation is heavily influenced by 24-50-

1201 - 1204, C.R.S.

Question 29: Exhibit A - 1.7.1–1.7.3

You asked a number of questions and requested recommendations for your current wellness program. Please elaborate on your current program structure, vendors you use, provide the State of Health framework and performance measures.

Answer 29:

The State of Colorado’s STATE OF HEALTH (SOH) program is a comprehensive, evidence-informed employee health and wellness initiative designed to improve health outcomes, reduce cardiometabolic risk, support chronic disease prevention and management, and promote sustainable health behaviors. The program integrates health risk assessments, biometric screenings, individualized health coaching, supervised exercise and physical activity interventions, health education, and coordination with primary care providers.

SOH is managed internally by the State, with services supported by contracted wellness and health coaching vendors, medical providers, and health plan partners, including Cigna, Marathon Health, and Kaiser Permanente. The program emphasizes a population health approach that connects risk identification with targeted interventions, ongoing engagement, and measurable health improvement.

Program performance is evaluated through a multidimensional framework that includes participation and engagement, health behavior changes, clinical and biometric outcomes, cardiometabolic risk reduction, and health care utilization.

Key measures include physical activity, health-related quality of life, blood pressure, glucose regulation, lipid profiles, body composition, and metabolic syndrome risk factors. The State conducts ongoing internal program monitoring and evaluation, with consulting support primarily focused on annual outcomes analyses. These evaluations integrate SOH clinical and participation data with health plan medical and pharmacy claims to assess health care utilization, chronic disease outcomes, and potential cost impacts among program participants relative to an appropriate comparison population. The State also seeks consultant recommendations regarding opportunities to strengthen program effectiveness, measurement strategies, clinical integration, and long-term population health value.

Question 30: Exhibit A - 1.7.2–1.7.4

What are the most significant population health challenges you have identified and priority employee populations for improvement?

Answer 30:

The State of Colorado has identified cardiometabolic health as a primary population health priority, including obesity, hypertension, dyslipidemia, prediabetes, type 2 diabetes, and related chronic conditions. Significant challenges include physical inactivity, modifiable health risk factors, chronic disease progression, and gaps in preventive care and sustained health behavior change.

Additional areas of concern include behavioral health, musculoskeletal conditions, and the increasing prevalence and cost of chronic disease.

Priority populations include employees with elevated cardiometabolic risk, multiple chronic conditions, potentially preventable health care utilization, and opportunities for meaningful improvement through early identification and targeted intervention. The State is particularly interested in identifying employees who may benefit from more proactive, integrated approaches to health improvement, including coordination among health plans, primary care providers, and health coaching services. Population health analyses should help identify emerging risks, opportunities for prevention, and strategies to improve health outcomes across the workforce.

Question 31: Exhibit A - 1.7.2–1.7.3

What are the current employee engagement metrics?

Answer 31:

The State of Colorado monitors employee engagement across its wellness initiatives using a variety of participation, utilization, and behavioral measures.

Within the STATE OF HEALTH program, metrics include enrollment, participation in health assessments and biometric screenings, engagement in health coaching and supervised exercise activities, program completion, and sustained participation over time. Additional measures include changes in physical activity, health behaviors, self-reported well-being, and progress toward individualized health improvement goals.

Engagement is evaluated not only through participation volume but also through the extent to which employees adopt and sustain meaningful health behavior changes. The State continues to refine its measurement approach to better understand engagement patterns, barriers to participation, and the relationship between program engagement, clinical outcomes, and health care utilization.

Specific participation and engagement data may be made available to the selected consultant as appropriate to support program evaluation and recommendations.

Question 32: Exhibit A - 1.7.2.3

What data sources (e.g., medical, pharmacy, wellness, biometric, behavioral health) will be available to the consultant to support population health analysis?

Answer 32:

Subject to applicable privacy, security, contractual, and data-sharing requirements, the State of Colorado anticipates making available relevant data from its medical and pharmacy benefit administrators, wellness program vendors, and other appropriate sources. These may include medical and pharmacy claims, health care utilization, chronic disease diagnoses, health risk assessments, biometric screening results, and STATE OF HEALTH participation, engagement, and clinical outcomes data. Behavioral health information may also be available through appropriate health plan claims and utilization datasets.

The availability, level of detail, and integration of these data sources will depend on the specific analytical objectives, vendor capabilities, and applicable data use agreements. The State expects consultants to demonstrate the ability to integrate and analyze multiple data sources, establish appropriate comparison populations, assess chronic disease prevalence and utilization trends, and evaluate the relationship between employee health interventions and clinical, utilization, and financial outcomes. All data access and analyses must comply with applicable

HIPAA requirements and State privacy and information security standards.

Question 33: Exhibit A - 1.8.1–1.8.3; Exhibit B - 1.5.10, 1.10

Are you actually wanting your broker to do an RFP and implementation for a benefit administration system? (This can take hundreds to thousands of hours)

- If so, we need a scope document specific to a ben admin system so we can price it.

- If not, what actual systems functions do you need someone to manage, and what administrative functions/support are required? (please break them out)

- What system do you currently use for HRIS and for Benefit Administration?

- Can this work be negotiated separately once it can be better scoped?

Answer 33: See below:

Are you actually wanting your broker to do an RFP and implementation for a benefit administration system? (This can take hundreds to thousands of hours)

The expectation would be for the winning vendor to act in an advisory capacity and be a subject matter expert on benefit administration systems currently on the market. Also, draft any recommendations to include in the RFP. The State will be providing a Project Manager to manage the full project.

- If so, we need a scope document specific to a ben admin system so we can price it.

This scope document is part of what the winning bidder will help develop.

A copy of the already published RFI AABA 2026-0029 is included as an additional attachment for your review.

- If not, what actual systems functions do you need someone to manage, and what administrative functions/support are required? (please break them out)

At a minimum, act as strategic consultants and technical subject matter experts. This could include attending implementation meetings, reviewing configuration rules, and validating core system logic.

- What system do you currently use for HRIS and for Benefit Administration?

We currently use Business Solver for benefits administration. They manage employee benefits enrollment, eligibility, and send file feeds to our benefits contractors and payroll systems. Business Solver also manages COBRA for the State.

- Can this work be negotiated separately once it can be better scoped?

No.

Question 34: Exhibit A - 1.8.4

Please clarify what you mean by “evaluate and recommend system changes”. This is extremely broad and without context so we do not understand the purpose or basis of evaluation.

- Please be more specific and provide examples.

- Are these changes from a user perspective, from a system perspective, or something else?

Answer 34: The winning Offeror will review the current system and recommend areas where the State can improve its utilization of the system or make changes to the system to improve customer experience or efficiency.

These could be changes from a user perspective, system perspective, or perspective of a vendor interacting with the system.

Question 35: Exhibit A - 1.8.8

The scope indicates to provide an administrative person to assist the Employee

Benefits Unit during open enrollment (typically: March - June).

- What is the estimated time (total hours March-June) that person has spent on the noted functions?

- What HRIS system and what Benefit Administration system(s) do you currently use?

Answer 35: The estimated time that the person spent on these functions is 680 hours

The State’s HRIS is a combination of several systems including:

● Colorado Personnel Payroll System for payroll,

● Colorado Operations Resource Engine for position control, headcount, budgeting

● Benefitsolver - the benefits portal for eligibility and COBRA

● Ultimate Kronos Group - time management

Question 36: Exhibit A - 1.8.8; Exhibit B - 1.10

Will there be HRIS system changes in the next 12-24 months? If so, please explain what those are and the role the consultant will play in those changes.

Answer 36: The State is seeking funding to replace the Benefit Solver system in the next 12-

24 months. The consultant will help draft the solicitation, strategize timelines and resources, review proposals and act as a subject matter expert to the evaluation committee, help with implementation by attending meetings with the State, attending meetings with the vendor, and ensuring a successful implementation.

Question 37: Exhibit A -1.8.8; Exhibit B - 3.6.5, metric 5

What kind of troubleshooting has been required historically? (please provide examples)

Answer 37: Examples include access issues, incorrect options or rates, missing or inaccurate carrier data, rejected files, HSA or payroll errors, and life-event or plan-year rollover issues.

Question 38: Exhibit A - 2.2.2

Does “Audit” for pharmacy refer to ongoing financial monitoring and reconciliation, or something broader? If broader, please explain what it includes.

Answer 38: The reverse auctioneer is statutorily obligated to audit every claim. See 24-50-

1201 - 1204, C.R.S. So the consultant will review the reverse auctioneer’s work and reports. In addition, the consultant will meet with the State and the State’s

PBM and provide ongoing financial monitoring.

Question 39: Exhibit A - Section 4, 5.1; Exhibit B 4.1

Please clarify the accessibility standard applicable to Contract deliverables.

Exhibit A, Section 4, 5.1 requires Level AA of the “most current version” of

WCAG incorporated in State technology standards, while Exhibit B 4.1 specifically requires WCAG 2.1 Level AA. Which standard should Offerors use when preparing their response and performing the Contract?

Answer 39: The standard that is reflected in Exhibit A and the Contract Template will be the standard for your response and performing the Contract.

Question 40: Exhibit B — Minimum Qualifications 1.1.3

The section indicates an FSA is required. However, actuarial standards require an

MAAA for signing statements of public opinion and both ASA and FSA designations are sufficient. We know that State has previously had ASAs (with an

MAAA) perform actuarial work. Would an ASA, MAAA be sufficient? If not, please explain the work requiring an FSA.

Answer 40: No, an ASA, MAAA is not sufficient for the lead actuary role; the requirement for an FSA remains.

While the State recognizes that an ASA, MAAA meets the baseline legal requirements for signing public statements of opinion, the scale, financial volatility, and complexity of this PBM procurement demand the advanced mastery and risk-management credentials demonstrated by a Fellowship (FSA) designation.

Question 41: Exhibit B – 1.12.10

The RFP requests work product examples. Please clarify whether each of the following needs to be specific to a particular type of solicitation/analysis/implementation, or if any work product is sufficient.

- “Please provide a copy of a solicitation you prepared for another state client”

- “... copy of the analysis you provide to help them make their decision”

- “... copies of implementation project plans”

Answer 41: Any product is sufficient, but the most useful examples will be projects that are similar to the projects you will work on for the State.

Question 42: Exhibit B — Technical Capabilities 1.19

“Provide details of how you would make recommendations for programs to reduce employee benefits cost, improve outcomes, and/or provide better service to

State employee.”

Please clarify whether you are looking for an explanation of a general process or if you want actual recommendations (or something else). If the latter, we would need claims and other data to evaluate your program.

Answer 42: We are looking for an explanation of a general process. The more specific information you can provide the more useful it would be to the State. Claims data will not be provided as part of this solicitation.

Question 43: Exhibit B — Management Capabilities 2.6

You provided a table with consulting hours (thank you; very helpful). We noticed not all positions that support the State are noted in the table. For example, pharmacy, compliance, anything systems/IT related, etc. are missing).

- Is the table inclusive of all consulting hours where other positions have been put into one of these buckets (e.g., compliance, pharmacy, ben admin, etc)?

- If not, can you provide approximate hours spent by the other types of functions such as those mentioned and others in your scope?

Answer 43: This information is not available.

Question 44: Exhibit B — Management Capabilities 2.7.9

Roles listed include “Project-specific personnel that would be available to the

State.” Please be more specific. What are examples of “project-specific personnel” (that are not covered by other roles you listed)?

Answer 44: If there are personnel that you might call in for a project that are not covered by the list provided then please provide them.

Question 45: Exhibit B — Management Capabilities 2.7.10

The roles lists “procurement and contracting experts” as required. Can these be the core service team members (Account Exec, Account Manager) since they do this work and are the experts? If you are looking for a different skill set, please explain what you need that would not be addressed by account management people.

Answer 45: The core service team can be the experts.

Question 46: Exhibit B — Management Capabilities 2.7.12

You requested an individual be designated IT expertise (and there is no reference to this title elsewhere). Since this is very broad, we would appreciate more information on:

• the specific work this person is expected to do (not clear what “manage” new systems means since that’s broad)

• the hours required (based on past work)

• specific system(s) the person would be working on

• what type of system acquisition you have planned

• whether that acquisition is in scope (because it’s not defined in current scope)

Answer 46: The State plans to solicit for a new benefits administration system in the next 12-

24 months (funding permitting). The State’s current system is Benefits Solver.

This is currently the primary, and pressing need. However, as technology evolves, the State may need more IT expertise as it procures products

See below:

• the specific work this person is expected to do (not clear what “manage” new systems means since that’s broad)

Assist with timelines, advise on resources we’ll need, help plan the budget, attend meetings with vendors, help with implementation, ensure files transfer smoothly.

• the hours required (based on past work)

This information is not available.

• specific system(s) the person would be working on

Benefits administration.

• what type of system acquisition you have planned

RFP or ITN.

• whether that acquisition is in scope (because it’s not defined in current scope)

Yes. This is in scope. Offerors should not expect any compensation outside of the flat annual fee.

Question 47: Exhibit B — Management Capabilities 2.7; Technical Capabilities 1.5.7, 1.7

A number of roles we typically see in client engagements are not identified in the scope or in the list of roles. Please comment on whether this work is in scope. If so, define what that scope is/what work is required.

• Communications consulting/design

• Disability/Leave consulting

• Voluntary benefits consulting

Answer 47: In general, the broker needs to be able to assist when called upon to do so. See below for specifics:

• Communications consulting/design

This work will be minimal.

• Disability/Leave consulting

Yes, the broker will need to assist with disability and leave consulting.

• Voluntary benefits consulting

The State does not currently offer voluntary benefits and does not plan to do so in the near future.

Question 48: Exhibit B — Management Capabilities 2.9

The question asks how the Offeror will “absorb ownership” of data collected from the State. Please provide detail on what is meant by “absorb ownership” and specific actions you need the bidder to take or protocols we should confirm.

Answer 48: Please tell us how you would define “absorb ownership” in your response. This question is specifically asking about plan and claims data.

Question 49: Exhibit B — Management Capabilities 2.10

Regarding disclosure of financials, we are a privately held organization and do not, nor have we ever, disclosed financials. However, we are happy to make them available for viewing through a secure portal at your convenience. In prior RFP responses to the State, this has been acceptable. Please confirm we the State will find this approach acceptable for this submission.

Answer 49: Yes, that is acceptable

Question 50: Exhibit B — Management Capabilities 2.11–2.11.1

This section requires disclosure of direct and indirect vendor compensation and asks how the Offeror will “make the State whole” for compensation earned from the State's business.

- If any eligible dollars are received, how would the State like to receive credit

(e.g., additional services, billing credit, etc)?

- How would you like compensation treated that is calculated on a national book of business basis, not specific to the State? The State would only be a small piece of this calculation and if the State membership (as one example) goes down, that would be a negative, meaning the State has reduced the amount we receive and arguably owe money.

- Since not all products that may include some form of compensation that is paid for by the State (e.g., voluntary benefits), brokers/consultants are prohibited from returning funds to a plan sponsor that did not originate from the plan sponsor.

o Do you view such compensation as in the scope of your question?

o If so, how would you like these commissions handled since we cannot return such funds to the plan sponsor?

Answer 50: See below:

- If any eligible dollars are received, how would the State like to receive credit

(e.g., additional services, billing credit, etc)?

We would need to discuss this, but likely as a billing credit or separate check.

- How would you like compensation treated that is calculated on a national book of business basis, not specific to the State? The State would only be a small piece of this calculation and if the State membership (as one example) goes down, that would be a negative, meaning the State has reduced the amount we receive and arguably owe money.

Offerors could agree to exclude the State from national book of business calculations or reimburse the State for any amounts paid based on the State’s membership. The State will not owe money under this calculation under any circumstance.

- Since not all products that may include some form of compensation that is paid for by the State (e.g., voluntary benefits), brokers/consultants are prohibited from returning funds to a plan sponsor that did not originate from the plan sponsor.

o Do you view such compensation as in the scope of your question?

The State is not requesting any funds that the broker cannot legally return. If a broker is unable to return the funds to the State then the broker would not be able to accept the funds in the first place.

o If so, how would you like these commissions handled since we cannot return such funds to the plan sponsor?

If the funds cannot be returned then the broker should not receive the funds in the first place.

Question 51: Exhibit B — Management Capabilities 2.15

How would you like respondents to handle termed references if we have not had any that fit your criteria?

Answer 51: Please use your best judgment. Proved references that are most comparable and useful to the State.

Question 52: Exhibit B — Cost Proposal 3.1.3, 3.5; draft Contract 2.C

These sections provide a process under which an Offeror may request an increase in pricing with 180 days' notice, while the sample Contract 2.C states that

Extension Terms are at the “same rates and under the same terms.” Please clarify whether pricing adjustments may in fact be negotiated for Extension Terms notwithstanding the sample Contract language.

Answer 52: The Option Letter allows the State to unilaterally extend a vendor’s contract at the same rates and terms. Vendors can always request a contract amendment and the

State will work with them in good faith. That said, the State has never had a broker/consultant ask for a contract amendment to increase compensation. Please bid on this contract with the expectation that you will only receive the flat annual fee.

Question 53: Exhibit B — Cost Proposal 3.6.5, metric 1

Metric 1 indicates we should guarantee “where year-end actual claims fall within

_____% of baseline projections.”

- Since a significant portion can be due to State-specific utilization, site of care, new technologies, profile of enrollment, and other factors outside of our control, can this metric be limited to those factors that are specific to those we can forecast? If not, how do you propose we account for unknown or random variation?

- Please define the “baseline projection”. What is it and who sets it?

- Who will determine noted adjustments for legislative changes, plan-design changes, membership shifts, catastrophic claims, vendor changes, or other factors outside the actuary's control? (Otherwise different bidders can propose superficially comparable accuracy guarantees based on different underlying assumptions.)

Answer 53: See below:

- Since a significant portion can be due to State-specific utilization, site of care, new technologies, profile of enrollment, and other factors outside of our control, can this metric be limited to those factors that are specific to those we can forecast?

No.

If not, how do you propose we account for unknown or random variation?

Offerors could have a higher % variation.

- Please define the “baseline projection”. What is it and who sets it?

The baseline projection is the final projection that the State uses to set its budget, provided by the Offeror during the budget cycle.

- Who will determine noted adjustments for legislative changes, plan-design changes, membership shifts, catastrophic claims, vendor changes, or other factors outside the actuary's control? (Otherwise different bidders can propose superficially comparable accuracy guarantees based on different underlying assumptions.)

The metric allows adjustments for “legislative or plan design changes.” It does not mention “membership shifts, catastrophic claims, vendor changes, or other factors outside the actuary's control.” These are all factors that the actuary should take into consideration when determining the baseline projection. If there are changes based on legislation then those changes will be priced by the actuary and reviewed by the State. If there are changes based on plan design changes, then those changes will be priced by the actuary and reviewed by the State.

Question 54: Exhibit B — Cost Proposal 3.6.5, metric 5

The Performance guarantee for Open Enrollment & Admin Support indicates we need to complete 100% of open enrollment resource gathering, vendor file feed testing, and troubleshooting on schedule.

- Please provide detail on what “OE resource gathering means”

- Please explain what vendor file feed testing entails (e.g., a current project plan or something of the like)

- Please provide examples of what troubleshooting has traditionally entailed.

Answer 54: See below:

- Please provide detail on what “OE resource gathering means”

Coordinate carrier materials, employee Q&A sessions, benefit administrator training, and website updates. The broker/consultant supports review of materials, rates, and plan documents/SPDs for accuracy and consistency with current offerings.

- Please explain what vendor file feed testing entails (e.g., a current project plan or something of the like)

Attend carrier meetings to review testing progress, identify issues, and coordinate resolution with the State and vendors.

- Please provide examples of what troubleshooting has traditionally entailed.

Examples include access issues, incorrect options or rates, missing or inaccurate carrier data, rejected files, HSA or payroll errors, and life-event or plan-year rollover issues.

Question 55: Exhibit B Section 1.1.4:

We have State of Montana with about 14,000 employees. Is that big enough to meet min quals?

Answer 55: That does not meet the minimum qualifications.