J-9 Proposal Assumptions.docx

RFP 75FCMC24R0010

Attachment J-9, Proposal Assumptions

The offeror shall use the following assumptions when developing their proposal:

GENERAL ASSUMPTIONS

· Transition-In shall not exceed 12 months

· Assume contract award date of January 16, 2025.

· Network data and voice telecommunications connectivity and components will be provided to the contractor. CMS will support this infrastructure. Data network services are currently provided through GSA Enterprise Information Services (EIS). Voice network services are provide through the GSA EIS Contract. CMS currently uses a Verizon proprietary network based IVR application and Genesys in the Cloud Intelligent Call Routing.

· Desktop support requirements can be found online in the CMS Internet Only Manuals (Pub. 100-9). Offerors should account for this in their proposals.

· There will be a single address provided for written inquiries. For pricing purposes, offerors should assume that they would control the single address and that they would be responsible for answering 100 % of the written correspondence.

· CMS will provide a toll free number for fax inquiries sent by constituents.

· CMS will acquire the email domain.

· The Genesys agent setup is not a significant contributor to the transition. Agent set up time in Genesys takes approximately 5 minutes.

· Genesys will provide skills based priority routing, Real Time Monitoring and Historical Reporting.

· The Offeror shall reference the Statement of Work (SOW) Attachment 1 – Communication Channel Volumes for historical information.

· Offerors should assume that transition is complete when all inquiries are being handled.

DELIVERABLE PRICING ASSUMPTIONS

Phase-Out Plan

SYSTEMS/APPLICATIONS

The following timeframes should be taken into consideration:

· NDW: dependent on the implementation of CMSnet connectivity, this application does not require any additional installation requirements as it is a web based application with no software resident on the CCO computers.

· LMS: dependent on the implementation of CMSnet connectivity, this application does not require any additional installation requirements as it is a web based application with no software resident on the CCO computers.

· Next Generation Desktop: dependent on the implementation of CMSnet connectivity, this application does not require any additional installation requirements as it is a web based application with no software resident on the CCO computers.

· WebChat: dependent on the implementation of CMSnet connectivity, this application does not require any additional installation requirements as it is a component of the Next Generation Desktop.

· Medicare.gov: dependent on the implementation of internet connectivity, this application does not require any additional installation requirements as it is a web based application with no software resident on the CCO computers.

· Healthcare.gov: dependent on the implementation of internet connectivity, this application does not require any additional installation requirements as it is a web-based application with no software resident on the CCO computers.

GOVERNMENT PROPERTY

· Government Furnished Property and Data – Assume that none of the property currently in the possession of the incumbent contractor will be available until after full transition has occurred.

· Assume that CMS will provide the following for use in the performance of the CCO Contract:

· Access to Government owned databases (CSAMS, Inventory, Referrals, Complaints, etc.)

· CMSnet

· Learning Management System

· Standard Operating Procedures

· Customer Satisfaction Survey

· Medicare Plan Finder - Web Application

· Medicare Care Compare - Web Application

· Healthcare.gov – Web Application

· NGD Desktop/licenses (with maintenance)

· Voice Circuits

· Data Circuits

· Various Static Publications for CSR Reference

· CMS QA Standards & Guidelines

· Training Materials and manuals

· IVR with speech recognition

· Production Failover (Mirror Site)

TASKS/Sub-TASKS: The costs and fee associated with the functional areas identified shall be included under the specified TASK (e.g. 000101, 000102, etc.).

000101 Channels/Operations

· Telephone Inquiries

· Written Letters and Fax

· Email

· Web Chat

· Offline Research and Casework

· Disability Employment

· Agent Training

000102 Program Management

· Reporting

· Project Management

· Standard Operating Procedures

· Recruiting and Staffing

· Workforce Management

· Training Delivery

· Innovation and Pilot Program Management

· Quality Assurance

· Performance Management

· Business Continuity

· Call Center Innovations (Process Improvement)

000103 IT Telecom and Support

· Desktop Usage and Support

· Voice and Data Networking

· Hardware and Software Support

· Security

000104 Facilities

· Operations Infrastructure

· Relocation and Expansion

· Government Access

000105 Travel

TASK/Sub-TASK ASSUMPTIONS

TASK 000101 – Channels/Operations (applies to all tiers)

· FTE costs associated with handling inquiries (i.e., telephone, written letters and fax, email, web chat, and offline research and casework) should be included in the appropriate sub-TASK within TASK 000101.

· The contact center must be fully operational and handle all inquiries by March 2026.

· Offerors should use Statement of Work (SOW) Attachment 1 – Communication Channel Volumes for staffing calculations.

· Call volume needs assume a 7-day work week (meaning that staff must be available to receive calls 24x7).

· Call volumes provided to offerors are net of abandon rates (in other words, assume an abandon rate of 0% for FTE calculation purposes).

· Occupancy is the percentage of logged-in time a CSR is available to take calls, written correspondence or other direct customer related activities to include after call work.

· Transition Out - Offerors should assume full operations through the end of the period of performance (i.e. base period through the completion of all option periods). Transition costs will be negotiated and finalized during the last option period. The contract will be modified appropriately at that time.

Telephone Inquiries

· The offeror should assume historical AHT (SOW Attachment 1 Communication Channel Volumes).

· The offerors should outline their assumptions for handling calls including AHTs (i.e., number and types of tiers) and should ensure their assumptions are consistent with all areas of their technical proposal.

Written Letters and Fax

· The offeror should assume historical AHT (see SOW Attachment 1 Communication Channel Volumes).

· The offerors should outline their assumptions for handling written inquiries (i.e., number and types of agents) and should ensure their assumptions are consistent with all areas of their technical proposal.

· Offerors should assume the projected volumes outlined in SOW Attachment 1 – Communication Channel Volumes. For scanning and storage estimates, the offeror should assume an average of 4 pages per document.

Email

· There is currently no email workload. This Sub-TASK is established in the event that the channel is made available for future workload.

Web Chat

· The offeror should assume historical AHT (see appendix).

· The offerors should outline their assumptions for handling web chat (i.e., number and types of tiers) and should ensure their assumptions are consistent with all areas of their technical proposal.

Offline Research and Casework

· Telephone and written inquiries not handled by CSRs while on the phone with the caller will be sent offline via the NGD to be resolved.

· Offerors should assume that approximately 1% of all inquiries (telephone, written letters and fax, email, web chat) will be escalated to be worked in an offline research and casework process.

· Examples of offline escalations include:

· Advertising / Solicitations / Surveys

· Medicare Appeals and Redeterminations

· CMS Special Initiatives

· Current and Proposed Law Issues

· DME-related Casework (including 3-ways with DME Suppliers and Oxygen Suppliers)

· Specific Enrollment / Disenrollment issues

· Federal / State / Local Programs

· Media Calls

· Inquiries that Cannot be Addressed with Existing Scripts

· Medicare Premium Issues

· SSA Issues (include 3-ways with SSA)

· IRS Issues (including 3-ways with IRS)

· Upset Callers

· Escalations that are returned as inappropriate

· Complex inquiries that require MAC involvement (examples include Adjustment of Claims,*MSP Adjustments,*Reissue Checks,* BIU/Fraud Referrals,*FOIA Inquiries*) *Indicates inquiries that the CCO would escalate to the MACs; these items would not be handled by the offline research and casework process.

Disability Employment

· Any subcontract or FTE costs to support employing people with disabilities should be included in TASK 000101.

Innovation Workforce

· FTE costs associated with taking inquiries during a Pilot should be included in TASK 000101). Costs associated with managing and reporting on the various Pilots should be included in TASK 00102.

· Project management costs associated with developing, measuring, communicating on the Pilot should be include in TASK 000102.

· The offerors should assume at least 1 pilot is executed per quarter.

· The offerors should assume that pilots will be conducted for at least 1 month during the quarter.

· The offerors should outline the assumptions of their pilot as part of the pricing spreadsheet and ensure that their assumptions are consistent with their technical proposal.

Agent Training

· CSR time spent attending training (whether in class or computer-based) should be included in TASK 000101, staff responsible for conducting training should be included in TASK 000102.

· The Offeror should assume that annually there are 4 quarterly Essential Job Trainings (EJTs) per program (Medicare and Marketplace programs) and 18 required Open Enrollment EJTs (per program). Each of these required EJTs averages 60 minutes.

· If the offeror proposes a different tier structure and agent mix, assumptions for training should be included in this section.

TASK 000102 – Program Management

· The team identified for Program and Project Management activities will be responsible for the overall success of the program, from the initial transition phase through ongoing operations. It is envisioned that this team will provide the executive leadership and oversight.

Reporting

· No Sub-TASK-specific assumptions.

Project Management

· Sample activities are described below:

· Responsible and accountable for program delivery

· Manage all resources, schedules, and budget commitments

· Direct all personnel and subcontractors

· Provide a single point of contact for CMS

· Lead service delivery teams

· Ensure CMS performance goals are met or exceeded

· Ensure appropriate resource allocation across the organization

· Provide proactive and continuous improvement of operations and the customer experience

· Responsible for on-time delivery of all project milestones for the program

· Responsible for communicating project status with CMS

· Provide overall project management of work consolidation efforts, deliverables, and technology implementations.

· Manage CMS program change initiatives.

· Responsible for oversight of the training and quality programs deployed for the program.

· Responsible for performance analyses and development of performance improvement initiatives.

· Collaborate with CMS to enhance quality scoring system and standards.

· Provide trend analyses and contact quality improvement action plans.

· Responsible for contact center operations.

· Oversee agent hiring, training, and staffing.

· Provide day-to-day interface with CMS client contacts.

· Report on performance and progress.

· Provide financial management for the program.

· Provide administrative support for the program.

Standard Operating Procedures

· No Sub-TASK specific assumptions.

Recruiting and Staffing

· No Sub-TASK specific assumptions.

Workforce Management

· Offerors should break out any hardware, software, licensing costs and include in TASK 000104 Training Delivery

· CSR time spent attending training (whether in class or computer-based) should be included in TASK 000101, staff responsible for conducting training should be included in TASK 000102.

· Although some Learning & Development activities will be performed by an outside contractor, offerors will still be responsible for ensuring that:

· Their own trainers attend train-the-trainer sessions.

· Enough trainers are on staff to provide adequate training for CSRs.

· Every year there are 4 required quarterly Training Modules and 18 required Open Enrollment (preparation for OEP) (per program) trainings that are each on average of 60 minutes.

Innovation Program Management

· FTE costs associated with taking inquiries during a Pilot should be included in TASK 000101. Costs associated with managing and reporting on the various Pilots should be included in TASK 000102.

· Project management costs associated with developing, measuring, communicating on the Pilot should be include in TASK 000102.

· CMS expects that offerors will analyze contact center performance and provide recommendations for 3 pilots per quarter. Of those recommendations, Offerors should assume 1 pilot project per quarter is actually executed based on offerors recommendations.

· The offerors should assume that pilots will be conducted for at least 1 month during the quarter.

· The offerors should outline the assumptions of their pilot as part of the pricing spreadsheet and ensure that their assumptions are consistent with their technical proposal.

Quality Assurance

· Any QA support being supplied by a subcontractor should also be indicated in TASK 000102.

· Offerors should break out all/any hardware, software and managed service costs associated with conduction quality assurance in TASK 000102.

· Offerors should break out all/any costs associated with conducting quality monitoring and agent coaching in TASK 000102.

Performance Management

· Offerors should assume that it may be required to provide hard copy versions of reports on an “as requested” basis.

Call Center Innovations

· This TASK is reserved for any innovations and processes that are not specifically outlined in other TASKs.

· Offerors should include all costs associated with any process improvement or innovations that are being proposed if applicable. These costs should include staffing, hardware, software, subcontracting, and/or any managed services.

TASK 000103 – IT Telecom and Support

· Offerors should break out all hardware costs and include them in TASK 000104.

· Telecom / data line usage costs are funded by CMS through a separate contract (GSA EIS).

· Remediation of ST&E findings that result from regular system support activities, such as system patching, should be included in TASK 000103.

Desktop Usage and Support

· Although an outside contractor will be responsible for the most significant desktop functions, CMS expects Offerors to have staff available to handle daily desktop maintenance and problem resolution.

· Daily desktop maintenance and problem resolution refers to day-to-day issues that are within the desktop environment that require action, but do not require significant planning, development or testing efforts.

· Examples include:

· Identifying, troubleshooting (whether it be user error, training, or system related), documenting, and reporting potential system enhancements and/or defects to CMS and system maintainers through established communication channels.

· Tracking issue resolution and communicating necessary system changes to CSR staff.

· Managing CSR NGD user IDs and system profiles (creating new user IDs, adding/removing responsibilities, modifying, disabling, etc.).

· Performing password resets.

· Testing as necessary.

· Daily workstation computer maintenance and problem resolution are within the scope of this line item and should be included as part of desktop costs.

Hardware and Software Support

· Activities associate with this item might include:

· Installing voice circuits and related equipment

· Installing data circuits for both Genesys and NGD systems

· Maintenance of phone sets.

· Administration and maintenance of physical telecom equipment at agent stations

· Developing Agent profile builds, etc.

· Reporting Requirements Security

· Offerors should provide the appropriate FTEs necessary to comply with CMS security standards as well as physical security.

· Offerors should break out all hardware costs and include them in TASK000104.

· Remediation of ST&E findings that result from regular system support activities, such as system patching, should be included in TASK 000103.

TASK 000104 – Facilities

· Costs associated with Quality Assurance hardware, software and managed services should be included in TASK 000102.

· Telecom / data line usage costs are funded by CMS through a separate contract (GSA EIS).

· Offerors should document the total seat count available at each facility as well as proposed head count at each facility.

Operations Infrastructure

· Offerors should break out all hardware costs and include them in TASK 000104.

· Offerors should break out any/all supplemental software costs and include them in TASK 000104.

· Supplemental costs may include costs to support Workforce Management, reporting, staff management, etc. (except where otherwise noted in the TASK assumptions).

· Infrastructure costs may include (as applicable), but are not limited to:

· Furniture

· Computers and related hardware

· Telecommunications equipment

· Hardware

· Software

· Other infrastructure as determined by the offeror Relocation and Expansion

· No Sub-TASK specific assumptions.

Government Access

· No Sub-TASK specific assumptions.

Travel TASK 000105

· The Offeror should assume that CMS will visit each new contact center and be on site during the first week of operation.

· The Offeror should assume at a minimum quarterly meetings with CMS at CMS location in Baltimore, MD.

· The Offeror should assume that CMS will visit each call center at least 1 time annually after the site is operational.

· The Offeror should assume at least 2 additional "Guest" visits a year, where partners and/or external visitors request a call center tour. These visits typically last 1 day and require CMS and contractor personnel to provide onsite information.

· The Offeror should assume that no fees (base or award) are added to travel costs.

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