Medical_Telehealth_Pharmacy,_Wellness,_Health_Savings_Account_(HSA)_and_Health_Reimbursement_Arrangement_(HRA)_Administration,_Dental,_and_Employee_Assistance_Program_(EAP)_Coverage_(Addendum_#4_R.pdf

CITY OF TUCSON

REQUEST FOR PROPOSAL

260125

MEDICAL/TELEHEALTH/PHARMACY, WELLNESS, HEALTH SAVINGS

ACCOUNT (HSA) AND HEALTH REIMBURSEMENT ARRANGEMENT

(HRA) ADMINISTRATION, DENTAL, AND EMPLOYEE ASSISTANCE

PROGRAM (EAP) COVERAGE

Due Date: Friday, November 14, 2025

City of Tucson

255 W Alameda St

Tucson, AZ 85701

Procurement portal https://secure.procurenow.com/portal/tucson-az

Public Portal https://secure.procurenow.com/portal/tucson-az/projects/206076

PUBLISH DATE: October 10, 2025 https://secure.procurenow.com/portal/%7Bproject.government.code%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D

CITY OF TUCSON REQUEST FOR PROPOSAL NO. 260125

BUSINESS SERVICES DEPARTMENT Page 2 of 40 SHARED SERVICES PROCUREMENT DIVISION RESPONSIBLE CONTRACT OFFICER: Troy Rombough

255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ 85701 PH: (520) 837-4139

Attachments:

A - Offer and Acceptance C - 260125 Chapter 1A - Attachment Medical Questionnaires (MOA and QE)-RETURN

WITH BID

J - 260125 Chapter 1A - Medical Scope of Work K - IMPORTANT NOTE-Attachment A Request for Confidential Documents Form L - 260125 Chapter 1B - Attachment PBM Questionnaires (MOA and QE)-RETURN

WITH BID

M - 260125 Chapter 1C - Wellness Scope of Work N - 260125 Chapter 1C - Wellness Cost Proposal-RETURN WITH BID O - 260125 Chapter 1A - Medical Pricebook-RETURN WITH BID P - 260125 Chapter 1C - Attachment Wellness Questionnaires (MOA and QE)-

RETURN WITH BID

Q - 260125 Chapter 1E - Attachment - Dental Questionnaires (MOA and QE)-RETURN

WITH BID

R - 260125 Chapter 1A - Medical HSA Plan Booklet FY25 (SPD) - Retiree S - 260125 Chapter 1D - Attachment EAP Questionnaires (MOA and QE)-RETURN

WITH BID

T - 260125 Chapter 1B - PBM Scope of Work U - 260125 Chapter 1A - Medical Network Plan Booklet FY25 (SPD) - Retiree V - 260125 Chapter 1A - Medical Network Plan Booklet FY25 (SPD) - Employee W - 260125 Chapter 1D - EAP Scope of Work X - 260125 Chapter 1E - Dental Scope of Work Y - 260125 Chapter 1C - Welllness COT Incentives Earned Z - 260125 Chapter 1C - Wellness COT Incentives Redeemed AA - 260125 Chapter 1B - PBM Benefit Design BB - 260125 Chapter 1A - Medical HRA Plan Booklet FY25 (SPD) - Employees CC - 260125 Chapter 1A - Medical Plan changes eff 7-1-25 DD - 260125 Chapter 1E - Dental COT PPO Summary - All Other States FY26 EE - 260125 Chapter 1A - Medical Your Call Firefighter Program Flyer FF - 260125 Chapter 1D - EAP Cost Proposal-RETURN WITH BID GG - 260125 Chapter 1B - PBM Cost Proposal-REVISED-RETURN WITH BID HH - REVISED 260125 Chapter 1E - Dental Cost Proposal-RETURN WITH BID- 11.04.2025 II - 260125 Chapter 1B - PBM Standard-4-Tier PDL (Jan 2026) JJ - 260125 Chapter 1E - Dental COT HMO Patient Change Schedule W1SV9 AZ KK - 260125 Chapter 1A - Medical HSA Plan Booklet FY25 (SPD) - Employees LL - 260125 Chapter 1D - EAP Utilization MM - 260125 Chapter 1E - Dental COT PPO Summary - AZ

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NN - 260125 Chapter 1E - Dental Technical Workbook-RETURN WITH BID OO - 260125 Chapter 1E - Dental 3342685_City of Tucson_07.01.2025_AZ and CA members PP - 260125 Chapter 1E - CIGNA OHIP Flyer COT QQ - 260125 Chapter 1B - PBM Standard-4-Tier PDL (2025) RR - 260125 Chapter 1A - Medical HRA Plan Booklet FY25 (SPD) - Retiree SS - 260125 Business Associate Agreement

TT - REQUEST FOR CONFIDENTIAL DOCUMENTS FORM 260125

UU - 260125 10312025 COT Monthly Experience 2022-2025 VV - 260125 10312025 COT FI Enrollment by tier DHMO DPPO 2022 to 2025 WW - 260125 10312025 COT DPPO Enrollment by Tier 7.1.2025 to 10.1.2025 XX - 260125 10312025 2025-09 City of Tucson_Rolling 36 Claims and Enrollment YY - 260125 10312025 City of Tucson DHMO Report Jan23-June23 ZZ - 260125 10312025 City of Tucson DHMO Report 23-24 AAA - 260125 Chapter 1E - Amendment Attachment - DHMO Questionnaires (MOA) & Disruption-11.04.2025 RETURN WITH BID BBB - 260125 Dental Addendum 11042025

BUSINESS SERVICES DEPARTMENT Page 4 of 40

A. NOTICE

A.1. CITY OF TUCSON

NOTICE OF REQUEST FOR PROPOSAL NO 260125

TITLE: Medical/Telehealth/Pharmacy, Wellness, Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) Administration, Dental, and Employee Assistance Program (EAP) Coverage

SUBMITTAL DUE DATE: Friday, November 14, 2025 AT 2:00 P.M. LOCAL AZ TIME

PRE-SUBMITTAL MEETING DATE: NO VALUE

TIME: NO VALUE LOCAL AZ TIME

LOCATION: NO VALUE

QUESTIONS SHALL BE DIRECTED TO: Troy Rombough

(520) 837-4139 troy.rombough@tucsonaz.gov

Posted Date: Friday, October 10, 2025

Competitive sealed offers for the material or service specified in this solicitation must be submitted through the City’s online bidding system. No late submitted offer will be accepted or considered.

Reponses submitted in physical form or by facsimile or email will not be considered. Offerors are cautioned to commence the submittal process sufficiently ahead of time to allow for unanticipated delays resulting from things like a slow internet connection, internet outage, difficulty uploading large documents, differing system requirements, etc.

Questions about this solicitation must be addressed to the responsible Contract Officer listed herein.

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B. INTRODUCTION

B.1. Summary

The City of Tucson is soliciting proposals for Medical/Telehealth, Pharmacy, Wellness, Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) Administration, Employee Assistance Program (EAP), and Dental Coverage and services for employees and retirees for a July 1, 2026 effective date.

• Chapter 1A -- Medical/Telehealth (HSA/HRA Administration)

• Chapter 1B -- Pharmacy

• Chapter 1C -- Wellness

• Chapter 1D -- Employee Assistance Program (EAP)

• Chapter 1E -- Dental

Offerors may bid on one or more of the lines of service A-E. Offerors do not have to bid on all lines of service to be considered, however, offeror must provide ALL services of the group, i.e. Medical and Telehealth Third Party Administrator (TPA) and AND HSA/HRA Administration. Please note that the Wellness line of service may be awarded to more than one contractor.

MINIMUM REQUIREMENTS

Minimum Requirements as applicable to each Line of Service will be found in the Attachments. Please note that the requirements listed in the Scope of Work of each line of service Attachment are minimum service levels the City expects to receive through this solicitation. Any offeror may introduce enhanced services as part of their comprehensive response to this solicitation given that the minimum service levels are met.

Any offeror not meeting the minimum requirements will be rejected.

NO PRE-BID/PROPOSAL CONFERENCE: The City is foregoing a Pre-Bid/Proposal conference for this solicitation. Prospective bidders/offerors are invited to submit questions in the Question & Answer feature within this RFP in OpenGov Procurement. The deadline for questions is October 21, 2025 at 5:00 p.m. Local Arizona Time. Ordinarily, the purpose of this conference is to clarify the contents of this solicitation in order to prevent any misunderstanding of the City's position. Any doubt as to the requirements of this solicitation or any apparent omission or discrepancy should be presented to the Contract Officer before the submittal due date. The City will then determine the appropriate action necessary, if any, and issue a written addendum to the solicitation. Oral statements or instructions shall not constitute an addendum to this solicitation.

PLEASE NOTE:

Offerors must complete, sign, and return via email the attached "Request for Confidential Documents Form" to receive confidential documents such as repricing documents, census, claims, etc. Please see the form for specific instructions. This form must be submitted within one (1) week of RFP publication date.

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B.2. Background

The City currently offers benefits to approximately:

Overall -- approximately 4,174 benefit eligible active employees, and 2,306 benefit eligible retirees

Medical -- 4,498 employees/retirees (3,887 active employees/Cobra beneficiaries and 611 retirees) enrolled

Pharmacy -- 4,498 employees/retirees (3,887 active employees/Cobra beneficiaries and 611 retirees) enrolled

Wellness -- 4,466 employees/retirees (3,884 active employees/COBRA beneficiaries and 582 retirees under its medical plans)

EAP -- 4,158 employees and their household members (Approximately 1,133 police and 688 fire personnel) provided

Dental -- 8,386 eligible employees and retirees (Approximately 1,683 retirees have waived coverage but are eligible to enroll at a future date with proof of continuous coverage.) enrolled

The City’s general services include but are not limited to: police and fire services, parks and recreation, street maintenance, transportation, solid waste management, water and a broad range of administration, para-professional and professional municipal governmental activities and services.

UNDERWRITING INFORMATION:

Please see each Attachment for line of service specific Underwriting Information.

Attachments:

A. Lines of Service:

1. Medical/Telehealth, and HSA & HRA Administration

2. Pharmacy

3. Wellness

4. EAP

5. Dental

B.3. Contact Information

Troy Rombough Principal Contract Officer Email: troy.rombough@tucsonaz.gov Phone: (520) 837-4139 mailto:troy.rombough@tucsonaz.gov tel:(520)837-4139

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Department:

Business Services

B.4. Timeline

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Issue Date October 10, 2025

Question Submission Deadline October 21, 2025, 5:00pm

Submittal Due Date November 14, 2025, 2:00pm

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C. SCOPE OF WORK

C.1. Medical/Telehealth, and Health Savings Account (HSA) & Health Reimbursement Arrangement (HRA), Pharmacy Benefit Management (PBM), Wellness, Employee Assistance Program (EAP) and Dental Coverage

The Scope of Work in its entirety is available in each "Chapter", is agreed to by the Contractor. If the Contractor has any deviations, Contractor must note them on the Deviations Form located in each Chapter MS Word document.

Please see each Chapter for line of service specific Scope of Work.

Lines of Service:

A. Medical/Telehealth, and HSA & HRA Administration

B. Pharmacy Benefit Management (PBM)

C. Wellness

D. EAP

E. Dental

Refer to Attachments for each Chapter.

Please submit your questions into the Question and Answer feature in OpenGov Procurement

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D. INSTRUCTIONS TO OFFERORS

D.1. DEFINITION OF KEY WORDS USED IN THE SOLICITATION

For purposes of this solicitation and any subsequent contract, the following terms have the meanings set forth below:

City:The City of Tucson, Arizona

Contract:The legal agreement(s) executed between City and the Successful Offeror(s). The Contract will be deemed to include all the conditions and requirements set forth in this solicitation and any Addenda to the solicitation, all the Special Terms and Conditions and Standard Terms and Conditions, and all the terms of the Offer submitted by Offeror as finally negotiated and accepted by the City.

Contractor/Consultant:A Successful Offeror that enters into a Contract with the City.

Contract Representative:The City employee or employees who have been designated to act as the City contact for this solicitation process and who are responsible for monitoring and overseeing the Contractor's performance under the Contract.

Business Services Director:The contracting authority for the City, authorized to sign contracts and addenda thereto on behalf of the City.

May: Indicates something that is not mandatory but permissible.

May not:The indicated party is prohibited from taking the action.

Must: The action or condition is required.

Offer:Any proposal, statement of qualifications, bid, or other submission provided by an Offeror in response to this Solicitation.

Offeror: Each individual or entity that submits an Offer in response to this solicitation.

Successful Offeror: An Offeror who received a Notice of Award or a Notice of Intent to Award from the City.

Will:The indicated party is promising to take the action or abide by the condition.

D.2. PRE-SUBMITTAL MEETING

A Pre-Submittal Meeting will be held at the date and time stated on the cover page of this solicitation, if such a date and time is provided. Attendance at this meeting is not mandatory, but written minutes and/or notes regarding the meeting will NOT be provided, so attendance is encouraged. The purpose of this meeting will be to clarify the contents of this solicitation in order to prevent any misunderstanding of the City's position.

D.3. INQUIRIES

Any questions about this solicitation or the proposed Contract must be presented at the Pre-Submittal Meeting, if there is one (see above), or submitted in writing, via email, or through the online bidding system, to the Contract Officer by the Question Submission Deadline. The email must refer to the solicitation number and the paragraph number of the provision that the question concerns. The Contract

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Officer may respond by email or may, if they deem it appropriate, address the question in a solicitation addendum or response through the question and answer portal in the online bidding system. Offeror may not rely on oral interpretations or clarifications about the solicitation; only questions answered in an email by the Contract Officer, posted through the online bidding system, or posted as a formal solicitation addendum will be binding.

D.4. ADDENDUM OF SOLICITATION

Solicitation Addenda will be posted on the City’s link to the online bidding website. Offeror is responsible for checking the webpage regularly for new solicitation addenda and must acknowledge each addendum to this solicitation in its submittal. Please note that vendors who have registered with the Business Services Department at https://procurement.opengov.com/portal/tucson-az and follow the City of Tucson will receive email notifications of solicitation addenda.

D.5. UNDERSTANDING SCOPE OF WORK

Before submitting an Offer to this solicitation, Offeror must familiarize itself with the Scope of Work, laws, regulations, physical conditions, and other factors affecting the obligations – including the expense and difficulty of fulfilling those obligations – that Offeror will have under the Contract if awarded to Offeror. No adjustment to the financial or other terms of the Contract will be justified by Offeror’s failure to fully understand or appreciate the Contract requirements or other factors affecting Contract performance.

D.6. PREPARATION OF OFFER

A. Form and Organization. If Offer forms are included in this Solicitation, Offeror’s Submittal must be on those forms. Supporting documentation must be arranged in a manner that follows and clearly refers to corresponding sections of the solicitation. Offeror may copy the submittal forms in order to complete them electronically but may not alter or rearrange them or change any paragraph designations.

B. Confidential Information. Any information in its submittal that Offeror wishes to be treated as confidential must be clearly marked “CONFIDENTIAL.”

C. Offer Contents. Offeror’s submittal must contain responses to all sections of this solicitation, any Offer forms provided must be completed and any requested supporting documentation must be attached.

D. Signatures. Offeror must include in their submittal signed copies of the Offer and Acceptance page. Any cover letter accompanying the proposal documents must be signed. Offeror must initial each erasure, interlineation or other modification in the submittal. The person signing and initialing on behalf of Offeror must be a person authorized to legally bind Offeror.

E. Prices. Where a unit price is provided it will govern over any erroneous extension of the price.

F. Time Periods. Periods of time, stated as a number of days, will be calendar days unless specifically stated otherwise.

G. Accuracy. Mistakes in preparation of its submittal confers on Offeror no right to modify or withdraw its submittal after the Submittal Deadline.

https://procurement.opengov.com/portal/tucson-az

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H. Cost of Preparation. The City will not reimburse Offeror for the cost of developing, presenting, submitting or providing any response to this solicitation.

I. Subcontractors. Offeror must, in their submittal, list any subcontractors that it will utilize in the performance of the Contract if they are awarded the Contract and must describe their qualifications in detail.

J. Incomplete Information. Failure to include all requested information may have a negative impact on the evaluation of Offeror’s submittal.

D.7. PAYMENT DISCOUNTS

Payment discount periods shall be computed from the date of receipt of the material/service or correct invoice, whichever is later, to the date City’s payment warrant is mailed. Unless freight and other charges are itemized, any discount provided shall be taken on full amount of invoice. Payment discounts of twenty-one calendar days or more shall be deducted from the proposed price in determining the price points. However, the City shall be entitled to take advantage of any payment discount offered by a vendor provided payment is made within the discount period. The payment discount shall apply to all purchases and to all payment methods.

D.8. TAXES

The City is exempt from federal excise tax, including the federal transportation tax, but is not exempt from any other taxes, including state and local sales and excise taxes.

D.9. EXCEPTIONS TO CONTRACT PROVISIONS

By submitting an offer in response to this solicitation, Offeror is offering to enter into the Contract with the City. If Offeror wishes to modify any Contract terms and conditions, Offeror must, in its Offer, clearly identify the changes it is requesting. No requested modification will be deemed accepted by the City unless and until the City’s Business Services Director or their designee expressly accepts it in writing.

D.10. PUBLIC RECORD

Any documents submitted by Offeror in response to this solicitation will become the property of the City.

Except as set forth below with respect to Confidential Information, the Submittal will be deemed to be a public record available for review by the public after the award notification.

D.11. CONFIDENTIAL INFORMATION

The City is obligated to abide by the Arizona Public Records Law, A.R.S. §§ 39-101 through 39-161. If Offeror believes that any portion of its Offer, specification, protest or correspondence contains information that is confidential and subject to being withheld from disclosure in the event that the City receives a public records request to which the record is responsive, Offeror must, when the record is submitted, provide the Contract Officer written notification of that fact. The records or portions of records that Offeror wishes to be treated as confidential must also be clearly marked “CONFIDENTIAL” on their face. Pricing will not be treated as confidential.

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If the City, after award notification, receives a public-records request the scope of which includes a document submitted by Offeror and marked "CONFIDENTIAL", the Contract Officer will make a written determination regarding whether the document will be provided to the requestor. If the Contract Officer determines that the document should be released, City will notify Offeror in writing. Unless Offeror, within 10 days after the date of that notice, obtains and provides to City an order from a court of competent jurisdiction prohibiting the City from releasing the documents, the City may release the documents without any liability to Offeror.

D.12. WHEN AND HOW TO SUBMIT OFFERS

In order to be considered, Offeror must, no later than the Offer Submittal Deadline, submit its Offer electronically through the City’s online bidding system:

https://procurement.opengov.com/portal/tucson-az

NOTE: THE ENTIRE OFFER MUST BE IN "“SUBMITTED"” STATUS IN THE CITY’S ONLINE

BIDDING SYSTEM IN ORDER TO BE CONSIDERED. RESPONSES THAT HAVE BEEN CREATED

IN THE SYSTEM, BUT THAT ARE NOT IN "“SUBMITTED"” STATUS BY THE OFFER SUBMITTAL

DEADLINE WILL NOT BE CONSIDERED.

D.13. CERTIFICATION OF NONCOLLUSION; CONFLICTS OF INTEREST

Offeror will not communicate, orally or in writing, with any member of the Mayor and Council, or with any City staff outside the Procurement Division of the Business Services Department, regarding this Solicitation. By submitting an Offer, Offeror warrants that:

A. Preparation and submission of the submittal did not involve collusion or other anti-competitive practices.

B. Offeror has not given, offered to give, nor intends to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, meal or service to a public servant in connection with this solicitation.

C. No person has been employed or retained to solicit or secure a Contract under this solicitation upon a promise of a commission, percentage, brokerage, or contingent fee.

D. No employee of the City involved in this Solicitation process, or any family member of such an employee, has any substantial financial interest in Offeror’s firm. No member of the City of Tucson Mayor and Council who has, or whose family member has, any substantial financial interest in Offeror’s firm will participate in any action taken by the Mayor and Council with respect to this Contract. The terms “relative” and “substantial interest” have the meanings assigned in A.R.S. § 38-502

The City may disqualify Offeror from further participation in the solicitation process if the City determines that any City employee or official involved in this Solicitation process has an actual or apparent conflict of interest or if Offeror has engaged in any collusion or anti-competitive practices.

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D.14. WITHDRAWAL OF OFFER; BINDING OFFER

By submitting an Offer in response to this Solicitation, Offeror is offering to enter into the Contract with the City. Offeror may withdraw a submitted Offer at any time prior to the Offer Submittal Deadline.

Telephonic or oral withdrawals are not effective.

Offeror cannot withdraw an Offer that is in “submitted” status as of the Offer Submittal Deadline unless the Director of the Business Services Department consents in writing to the withdrawal. The Offer will be irrevocable for 90 days after the Offer Submittal Deadline.

D.15. DISCUSSIONS

The City may, at its discretion, conduct discussions with Offeror for the purpose of eliminating minor irregularities, informalities, or apparent clerical mistakes in Offeror’s submittal in order to clarify the offer and assure full understanding of, and responsiveness to, solicitation requirements.

D.16. VENDOR REGISTRATION; BUSINESS LICENSE

In order to be eligible for award of a Contract, Offeror must:

A. Register with the City’s Business Services Department. Registration can be completed at https://procurement.opengov.com/portal/tucson-az

B. Obtain a City of Tucson Business License or a written determination from the City's Business License Section that a license is not required. For questions contact the City's Business License Section at

(520) 791-4566 or email at license@tucsonaz.gov mailto:license@tucsonaz.gov

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E. OFFER EVALUATION AND CONTRACT AWARD

E.1. PROPOSAL EVALUATION CRITERIA – (listed in relative order of importance)

A. Each chapter has a unique set of evaluation criteria

E.2. INTERVIEWS

The City may interview some or all of the offerors at any point during the evaluation process. If interviews are conducted, information provided during the interview process will be taken into consideration in the evaluation process. The City will not reimburse the Offeror for any costs Offeror incurs during its participation in the interview process.

E.3. ADDITIONAL INVESTIGATIONS

The City may undertake any additional investigations it deems appropriate to evaluate the competence and financial stability of any offeror.

E.4. OTHER INFORMATION

Information that evaluation committee members have about an offeror beyond what is provided in the offeror’s Offer may be taken into consideration during the evaluation process.

E.5. PRICE

A. Tax Offset Policy. If applicable under Section 28-18(6) or Section 28-17(7)(d) of the Tucson Procurement Code, the City will include the amount of all business privilege taxes other than the City’s in evaluating the pricing component of each Offer.

B. Payment Discounts. Any discounts offered by Offeror for payments made within 21 calendar days or more will be deducted from the proposed price in evaluating an offeror’s pricing.

However, the City may take advantage of any early- or timely-payment discounts offered by a vendor. Any proposed payment discount will apply to all purchases and to all payment methods

E.6. CITY’S RIGHT TO WAIVE DEFECTS OR REJECT OFFERS

Notwithstanding any other provision of this solicitation, the City may:

A. Waive any immaterial defect or informality; or

B. Reject any or all submittals, or portions thereof; or

C. Reissue the solicitation.

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E.7. CONTRACT NEGOTIATIONS

At the City’s discretion, it may negotiate with one or more responsible offerors to agree upon the final conditions, terms and price of the Contract. In doing so, the City will treat offerors fairly and will not disclose to any offeror information from responses submitted by other offerors. Exclusive or concurrent negotiations do not constitute a contract award and do not confer any rights to the offerors participating in such negotiations. In the event the City deems that negotiations are not progressing, the City may formally terminate these negotiations and may enter into concurrent or exclusive negotiations with the next most qualified firm(s).

E.8. AWARD OF CONTRACT

A Contract is created when, and only when, it is formally awarded, which occurs when the Business Services Director and the City Attorney sign the Offer and Acceptance page of the Successful Offeror’s submittal. When a Contract is awarded, the City will send the Contractor a Notice of Award.

The City may first issue a Notice of Intent to Award to the Successful Offeror(s). Offeror, if it receives a Notice of Intent to Award from the City, must sign and file with the City, within ten (10) days after receipt of the Notice, all documents necessary for execution of the Contract. A Notice of Intent to Award does not create a contract. Only a subsequent formal award, as described above, creates a Contract.

E.9. MULTIPLE AWARDS

The City, at its sole discretion, may award multiple Contracts.

E.10. SUBMITTAL RESULTS

After the City issues a Notice of Award, the City will post the name(s) of the Successful Offeror(s) on the Business Services Department’s Internet site at https://procurement.opengov.com/portalucson-az/contracts

E.11. PROTESTS

Any interested party, may, in accordance with Article IX of the Tucson Procurement Code, protest either this solicitation or the award of a Contract under this solicitation. A protest based on alleged improprieties in this solicitation must be filed no later than five (5) working days before the Proposal Submittal Deadline. A protest of a proposed or actual award must be filed no later than ten (10) calendar days after the City issues a Notice of Intent to Award or, if no Notice of Intent to Award is issued, after the City issues a Notice of Award.

A protest must be made in writing and filed with the Contract Officer. It must include:

A. The name, address, and telephone number of the protestant;

B. The signature of the protestant or its representative;

C. The solicitation or Contract number;

D. A detailed statement of the legal and factual grounds for the protest along with copies of all relevant documents; and https://procurement.opengov.com/portalucson-az/contracts https://procurement.opengov.com/portalucson-az/contracts

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E. The form of relief requested.

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F. EVALUATION CRITERIA

F.1. Chapter 1A - Medical/Telehealth (HSA/HRA Administration)

No. Evaluation Criteria Scoring Method Weight (Points)

1. Network/Provider Access Please refer to the Chapter 1A Questionnaire attachment

N/A N/A

2. Method of Approach Please refer to the Chapter 1A Questionnaire attachment

N/A N/A

3. Costs, Discounts, & Performance Guarantees Please refer to the Chapter 1A Cost Proposal attachment

N/A N/A

4. Qualifications and Experience Please refer to the Chapter 1A Questionnaire attachment

N/A N/A

F.2. Chapter 1B - Pharmacy

No. Evaluation Criteria Scoring Method Weight (Points)

1. Method of Approach

Please refer to the Chapter 1B

2. RFP Questionnaire & Pricing Submission Please refer to the Chapter 1B Cost Proposal attachment

N/A N/A

3. Performance Guarantees Please refer to the Chapter 1B Questionnaire attachment

N/A N/A

4. Qualifications and Experience Please refer to the Chapter 1B

F.3. Chapter 1C - Wellness

1. Method of Approach Please refer to the Chapter 1C

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2. Cost and Guarantees

Please refer to the Chapter 1C Cost Proposal attachment

N/A N/A

3. Qualifications and Experience Please refer to the Chapter 1C

F.4. Chapter 1D - Employee Assistance Program

1. Network/Provider Access Please refer to the Chapter 1D Questionnaire attachment

N/A N/A

2. Method of Approach Please refer to the Chapter 1D Questionnaire attachment

N/A N/A

3. Cost and Guarantees Please refer to the Chapter 1D Cost Proposal attachment

N/A N/A

4. Qualifications and Experience Please refer to the Chapter 1D

F.5. Chapter 1E - Dental

1. Network/Provider Access Please refer to the Chapter 1E Questionnaire attachment

N/A N/A

2. Method of Approach Please refer to the Chapter 1E Questionnaire attachment

N/A N/A

3. Cost including ASO Fees & Discounts and Guarantees Please refer to the Chapter 1E Cost Proposal attachment

N/A N/A

4. Qualifications and Experience Please refer to the Chapter 1E

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G. SPECIAL TERMS AND CONDITIONS

G.1. COOPERATIVE PURCHASING

Contractor will, when requested, provide goods and services at the same prices and under the same terms and conditions as set forth in this Contract to any public or nonprofit agency that, at the time of request, has a Cooperative Purchasing Agreement with the City or participates in the Strategic Alliance for Volume Expenditures (SAVE) cooperative. See http://www.tucsonprocurement.com/coop_partners.aspx and click on “Cooperatives” for a list of agencies that have Cooperative Purchasing Agreements with the City; see http://www.mesaaz.gov/home/showdocument?id=23638 for a list of agencies participating in SAVE.

These lists are subject to change. Contractor may, however, charge an agency that is outside the Tucson Metropolitan Area for additional out-of-pocket expenses that will be incurred by Contractor in providing goods and services to the agency (i.e., freight charges, travel related expenses, etc.).

Each participating agency that orders goods or services under this Contract as provided above is solely responsible for paying Contractor for those goods and services. The City is not responsible for any disputes arising out of transactions made by others.

G.2. LIVING WAGE REQUIREMENTS

Contractor will comply with all applicable provisions of the City’s Living Wage Ordinance (Article XIV of the Tucson Procurement Code). Contractor will, upon request, affirm in writing that Contractor is in compliance and will provide City with information and documentation demonstrating that compliance.

The City’s Living Wage ordinance can be found at the following link:

https://codelibrary.amlegal.com/codes/tucson/latest/tucson_az/0-0-0-21930 The Living Wage rates for the current calendar year can be found at the following link: https://www.tucsonaz.gov/Departments/Business-Services-Department/Procurement/Living- Wage

G.3. PRICE ADJUSTMENT

The City will review fully documented requests for price adjustment after any Contract has been in effect for three

(3) years. Any price adjustment will only be made at the time of Contract renewal and/or extension and will be a factor in the extension review process. The City will determine whether the requested price adjustment or an alternate option, is in the best interest of the City. Any price adjustment will be effective upon the effective date of the Contract extension. The Contractor must provide any fee/rate changes in writing at least 180 days prior to the contract anniversary date (i.e., January 1 of the prior plan year for a July 1 effective date). Any requested increase must be provided in writing and must include the following with your renewal package:

A. Any contract language changes requested

B. Specific justification of fee/rate changes

C. Current enrollment by plan option, branch classification, and premium rate tier D. Supporting underwriting fee/rate development including monthly paid claims and enrollment, utilization statistics, and projection analysis.

E. Additional options for consideration

F. All underwriting caveats http://www.tucsonprocurement.com/coop_partners.aspx http://www.mesaaz.gov/home/showdocument?id=23638 https://codelibrary.amlegal.com/codes/tucson/latest/tucson_az/0-0-0-21930 https://www.tucsonaz.gov/Departments/Business-Services-Department/Procurement/Living-Wage https://www.tucsonaz.gov/Departments/Business-Services-Department/Procurement/Living-Wage

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G.4. TERM AND RENEWAL

The term of the Contract will commence when awarded to Contractor and remain in effect for a period of one (1) year, unless terminated, canceled or extended as otherwise provided herein. The City may, at its sole option, extend the Contract's term for up to six (6) additional one-year periods or portions thereof.

G.5. TRAVEL EXPENSE ALLOWANCES

The City’s allowance is limited to the total expense resulting from traveling directly to the destination and staying only the number of days necessary to conduct official business. The Consultant is encouraged to arrive earlier or stay longer than is necessary if doing so will result in savings to the City.

In some cases, because of airline discount terms, an additional day(s) of travel will result in substantial airfare savings -- enough savings to offset additional lodging and per diem costs. The Consultant shall fly coach when the flight includes both coach and first-class seats. First-class seats may be allowed if coach seats are not available and no other flight can be substituted. At travel destinations, the City will reimburse the Consultant for the use of airport limousines and taxis. No receipts are required for reimbursement of such expenses. Additional fees or fares incurred during air travel must be substantiated by a receipt. The total reimbursement for vehicular transportation shall in no case exceed the amount that would be incurred using air transportation. Travel by personal vehicle shall be reimbursed in accordance with the current Federal per diem rates. All vehicular parking or storage costs will be reimbursed. Receipts are not required. Vehicle expense reimbursements will be paid only to the vehicle owner. Passengers are not entitled to vehicular expense reimbursement.

The City will pay the actual cost of rooms including tax based upon the Federal Per Diem rates. Both the room rate and tax paid must be substantiated by a receipt that indicates payment has been made.

All in-state travel will be reimbursed at the City’s per diem rate. A complete list of the Federal GSA Per Diem rates are available at: http://www.gsa.gov/portal/category/100120.

For meals and miscellaneous expenses, the Consultant may choose to receive either (1) the Federal GSA per diem amount (a flat rate), or (2) a reimbursement for actual expenses. A higher dollar amount is allowed under the actual expense reimbursement option; however, receipts must be retained under this option. The Consultant is not required to keep receipts if the per diem option is chosen.

Only one method of reimbursement can be used for the entire trip (i.e., the Consultant cannot request a per diem amount for some days and actual expense reimbursement for other days).

Meals provided for by another agency or others will be subtracted, if the per diem allowance is elected.

For days of arrival and departure, the per diem amount will be determined by adding the amounts below for each meal the Consultant eats at the travel destination. The current FY meal per diem for Tucson, Arizona is as follows:

The Consultants who select the per diem option and spend less than the per diem amount are encouraged to request a reimbursement only for the amount actually spent. No receipts are required to receive actual reimbursement where the amount requested is less than or equal to the per diem amount.

Miscellaneous expenses include local phone calls, snacks, and gratuities. Miscellaneous expenses are included in the per diem rate. If the actual expense reimbursement option is chosen for out-of-state travel, receipts are required for miscellaneous expenses.

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Long distance telephone charges are allowed for official calls, and are governed by the following: Calls for official City business other than to City offices shall be paid by the Consultant. The Consultant will be reimbursed upon submission of appropriate documentation relative to cost and purpose of the call, and with the approval of the City Representative for this contract. Calls other than City business shall not be made at City expense.

The above is pursuant to City policy: Administrative Directive 3.03-1, Travel Authorization and Expense Allowance.

G.6. KEY PERSONNEL

It is essential that the Contractor provide adequate experienced personnel, capable of and devoted to the successful accomplishment of work to be performed under this Contract. The Contractor must agree to assign specific individuals to the key positions.

The Contractor agrees that, once assigned to work under this Contract, key personnel shall not be removed or replaced without written notice to and subsequent concurrence by the City.

If key personnel are not available for work under this Contract for a continuous period exceeding thirty calendar days, or are expected to devote substantially less effort to the work than initially anticipated, the Contractor shall immediately notify the City, and shall, subject to the concurrence of the City, replace such personnel with personnel of substantially equal ability and qualifications.

G.7. CLAIM RETENTION

The offer(ors) selected to underwrite and administer the benefit plans included in this RFP must maintain all pertinent claim records for up to seven years from the date of each case review. This is in conjunction with prudent business practice and provisions of the Employee Retirement Income Security Act of 1974 (ERISA).

G.8. HIPAA PRIVACY ACT

The contractor must perform all HIPAA privacy compliance tasks and include the cost in the premium rates proposed to the City.

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H. INSURANCE REQUIREMENTS

H.1. REQUIRED INSURANCE POLICIES

Contractor will obtain and maintain during the entire term of this Contract and for 2 years after the Contract term ends, the following insurance coverage from insurers that have an “A.M. Best” rating of not less than A-VII:

H.2. COMMERCIAL GENERAL LIABILITY

Policy must include Bodily Injury, Property Damage, Personal Injury and Broad Form Contractual Liability with coverage limits no lower than:

A. Each Occurrence: $1,000,000

B. General Aggregate: $2,000,000

C. Products & Completed Operations Aggregate: $2,000,000

D. Personal and Advertising Injury: $1,000,000

E. Blanket Contractual Liability: $1,000,000

H.3. COMMERCIAL AUTOMOBILE LIABILITY

Policy must include bodily injury and property damage, for any owned, hired, and/or non-owned vehicles used in performance of work under this Contract, with a Combined Single Limit no lower than $1,000,000.

H.4. WORKER'S COMPENSATION

Policy must have coverage limits no lower than:

A. Per Occurrence: Statutory

B. Employer's Liability: $1,000,000

C. Disease Each Employee: $1,000,000

D. Disease Policy Limit: $1,000,000

E. [If Contractor is a Sole Proprietor, include this waiver provision under A.R.S. § 23-961(M). To determine whether the Contractor is a Sole Proprietor, please request the Sole Proprietor/Independent Contractor form from the Contract Officer listed in the solicitation.] I am a sole proprietor, and I am doing business as [name of sole proprietor business]. I am performing work as an independent contractor for the City of Tucson. I am not the employee of the City of Tucson for workers' compensation purposes, and, therefore, I am not entitled to workers' compensation benefits from the City. I understand that if I have any employees working for me, I must maintain workers' compensation insurance on them.

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H.5. PROFESSIONAL LIABILITY (ERRORS & OMISSIONS)

Policy must have coverage limits no lower than:

A. Each Claim: $1,000,000

B. Annual Aggregate: $2,000,000

H.6. NETWORK SECURITY (CYBER) AND PRIVACY LIABILITY

Policy must have coverage limits no lower than:

A. Each Claim: $1,000,000

B. Annual Aggregate: $2,000,000

Such insurance shall include, but not be limited to, coverage for third party claims and losses with respect to network risks (such as data breaches, unauthorized access or use, ID theft, theft of data) and invasion of privacy regardless of the type of media involved in the loss of private information, crisis management and identity theft response costs. This should also include loss of use, breach notification costs, credit remediation and credit monitoring, defense and claims expenses, regulatory defense costs plus fines and penalties, cyber extortion, computer program and electronic data restoration expenses coverage (data asset protection), network business interruption, computer fraud coverage, and funds transfer loss.

In the event that the Network Security and Privacy Liability insurance required by this Contract is written on a claims-made basis, Contractor warrants that any retroactive date under the policy shall precede the effective date of this Contract and, either continuous coverage will be maintained, or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed.

H.7. MEDICAL PROFESSIONAL LIABILITY

If registered with the DEA and/or if Contractor has prescribing rights, medical professional liability is required.

Policy must have coverage limits no lower than:

A. Each Claim: $1,000,000

B. General Aggregate: $2,000,000

H.8. POLICY CHANGE NOTICE

Contractor will give the City 30 days advance written notice before any of the above policies are changed in any manner that is inconsistent with the requirements of this Contract. The notice must be sent directly to the Procurement Division of the Business Services Department.

H.9. ADDITIONAL INSURED

The Commercial General Liability, Commercial Automobile Liability and umbrella policies where applicable will include the City as an additional insured with respect to liability arising out of the

BUSINESS SERVICES DEPARTMENT Page 25 of 40 performance of this contract. The City must be covered to the full policy limits, even if those limits of liability are in excess of those required by this Contract. The coverage must be primary and any insurance carried by City is excess and not contributing.

H.10. CLAIMS-MADE COVERAGE

If any or part of the required insurance is written on a claims-made basis, any policy retroactive date must precede the date of the contract and the Contractor must maintain such coverage for a period not less than three (3) years following contract expiration, termination or cancellation.

H.11. ADDITIONAL REQUIREMENTS

Each insurance policy required by this Contract, excluding Professional Liability (Errors & Omissions), must include or be endorsed to include to provide the following:

A. A waiver of subrogation endorsement in favor of the City, for losses arising from work performed by or on behalf of the Contractor (Including Worker’s Compensation).

B. The policy is primary and any insurance carried by the City is excess and not contributing.

C. The coverage provided by the policy is not limited to the liability assumed under the indemnification provisions of this Contract.

D. The insurer will provide written notice to the City at least ten (10) calendar days before the policy is terminated or cancelled or the coverage is reduced.

H.12. PUBLIC ENTITIES

If Contractor or any sub-contractor is a public entity that self-insures as permitted by law, then the insurance requirements in this Section 8 will not apply to that entity and that entity must instead provide a Certificate of Self- Insurance.

H.13. SUBCONTRACTORS

Contractors’ insurance certificate(s) must include all subcontractors as insureds under its policies or Contractor must give the City separate certificates and endorsements for each subcontractor showing that each subcontractor has the insurance coverage described above.

H.14. SUFFICIENCY OF COVERAGE

The City in no way warrants that the required minimum insurer rating in this Contract is sufficient to protect the Contractor from potential insurer insolvency, nor that the required liability limits are sufficient to protect Contractor.

H.15. VERIFICATION OF COVERAGE

A. Contractor will give the City certificates of insurance (ACORD form or equivalent approved by the City), signed by an authorized representative of the insurer, showing that the Contractor has all the insurance required by this Contract.

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B. Contractor must deliver the certificates directly to the Procurement Division of the City’s

Business Services Department before the Contractor commences work under this Contract.

C. The certificates must contain the City project/contract number and project description.

D. The City reserves the right to require complete copies of all insurance policies required by this Contract at any time.

H.16. EMPLOYMENT PRACTICES LIABILITY

Policy must have coverage limits no lower than:

A. Each Claim: $1,000,000

B. Annual Aggregate: $1,000,000

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I. STANDARD TERMS AND CONDITIONS

I.1. ADVERTISING

Contractor will not advertise or publish information concerning this Contract without prior written consent of the City’s Business Services Director.

I.2. COMPLIANCE WITH LAWS

The parties will comply with all federal, state and local laws, rules, regulations, standards and Executive Orders including, without limitation, the following:

A. Americans with Disabilities Act. Contractor will comply with all applicable provisions of the Americans with Disabilities Act (Public Law 101-336, 42 U.S.C. 12101 -- 12213) and applicable Federal regulations under the Act, including 28 CFR Parts 35 and 36.

B. Workers’ Rights Laws. Contractor will comply with all applicable provisions of Federal and State Child Labor and Workers’ Rights laws and agrees if called upon to affirm in writing that they and any subcontractors working under this Contract are in compliance.

I.3. GOVERNING LAW AND VENUE

This Contract is governed by the laws of the State of Arizona and the City and Contractor will have all remedies afforded to each by the Tucson Procurement Code and the laws of the State of Arizona. Any lawsuits regarding this Contract must be brought in a court of competent jurisdiction in Pima County, Arizona.

I.4. ARBITRATION

Notwithstanding any other provision in this Contract, no agreement by the City to arbitrate a dispute is binding unless given expressly and in writing after execution of this Contract. However, if both parties agree, disputes may be resolved through arbitration following the process in A.R.S. § 12-1501, et seq.

Contractor must continue to perform under this Contract without interruption, notwithstanding the provisions of this section.

I.5. ASSIGNMENT

Contractor may not assign its rights or obligations under this Contract without the prior written permission of the City's Business Services Director. The City will not unreasonably withhold approval for a requested assignment.

I.6. SUBCONTRACTS

Contractor may not enter into any subcontracts for work under this Contract without the advance written approval of the City's Business Services Director. All subcontracts will incorporate all the terms and conditions of this Contract. Contractor is responsible for contract compliance and quality of work of any subcontractors used.

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I.7. PROTECTION OF CITY PROPERTY

If this Contract requires Contractor to perform any work on City-owned property, Contractor will use reasonable care to avoid damaging existing buildings, equipment, and vegetation (such as trees, shrubs, and grass) on the property. Contractor will replace or repair any damage caused by Contractor or any employee, agent, or subcontractor of Contractor, at no expense to the City. If Contractor fails or refuses to make such repair or replacement, the City will estimate the cost of repair and, upon receiving an invoice from the City for that estimated cost, Contractor will pay the City the invoiced amount. City may, at its discretion, instead deduct the amount from any payments due Contractor under this or any other City contract.

Contractor will, during the course of its work on City property, keep the work area, including any storage areas used by the Contractor, free from accumulation of waste material or rubbish. Upon completion of the work, Contractor will leave the work area in a clean and neat condition, free of any debris, and will remove any non-City-owned materials or equipment or other personal property that it has caused to be located on the City property.

I.8. COMMENCEMENT OF WORK

Contractor will not commence any billable work or provide any material or service under this Contract until Contractor receives a purchase order or is otherwise directed to do so, in writing, by…