Proposals_Forms_and_Data-241218.xlsx
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- Solicitation number
- 25-016
- Issued by
- Charles County, Maryland
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Instructions
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Instructions |
| Please Read: | |
| NOTICE: | You must read these instructions in full and confirm you have read and understand them by entering your name and date in the appropriate fields at the bottom of this spreadsheet. |
| Instructions: | The following Proposal Forms in this workbook will be used to gather vendor responses in regards to your capabilities to provide the required services of this RFP to Charles County Government. Your responses will be compared and scored against the other vendors responses. |
| Please do not modify the tabs. Modifying the tabs or layout may eliminate your company from consideration. Please do not: |
- Add or Delete Cells
- Renumber or Add Questions
- Delete Questions - If you cannot respond to a question please just note - 'No Response Available' or 'N/A'.
Responses to questions should be brief and concise. 'Yes' or 'No' responses are encouraged when appropriate within the dropdown menu. The maximum amount of characters for a response is 500.
Disclaimer: By entering my name and date below I am confirming that I have read the above instructions in full regarding providing responses to the Questions in this workbook and completion of the proposal forms. I also confirm our firm understands the information provided in this Request for Proposal and all attachments is confidential and proprietary and will only be used to prepare a proposal response.
| Company Name: |
| Name: |
| Date: |
Disclaimer
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Indemnity Agreement |
| Vendor agrees to the following: | |
| Hold Harmless Agreement | Vendor shall indemnify and hold harmless the Client, its respective directors, officers, employees (acting in the course of their employment, but not as claimants) and agents, against any and all liability or expense (including the cost of legal defense or settlement) which was caused by (vendor’s) negligent or intentional misconduct, breach of this Agreement, fraud, or its breach of fiduciary responsibility, related to or arising out of this Agreement or the Client’s role as employer or Plan sponsor. |
| The party seeking indemnification under (a) above must notify the indemnifying party promptly in writing of any actual or threatened action, suit or proceeding to which it claims such indemnity applies. Failure to notify the indemnifying party shall be deemed a waiver of the right to seek indemnification. | |
| The party seeking indemnification may assume responsibility for the direction of its own defense at any time, including the right to settle or compromise any claim against it without the consent of the indemnifying party, provided that in doing so it shall be deemed to have waived its right to indemnification except in cases where the indemnifying party has declined to defend against the claim. | |
| The indemnification obligations of (vendor) shall terminate upon the expiration of the Agreement except as to any matter concerning which a claim has been asserted by notice to the other party at the time of such expiration or within 365 days after effective date of Agreement termination. | |
| Disclaimer: | By entering my name and date below I am confirming that I have read the above hold harmless language and the instructions to this RFP in full and certify that our response to Charles County Government's RFP is complete and accurate to the best of my knowledge and contains no material omissions or misstatements. |
| By signing below, you certify that bidder is able to comply with all the qualifications and requirements described in this RFP, and further, agree to maintain them for the entire contract term. I certify this RFP has not been separated, copied, changed or modified in any way. | |
| Company Name: | |
| Officer Name: | |
| Title: | |
| Phone: | |
| Email: | |
| Date: |
Info
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| RFP Information |
| RFP Information | |
| RFP Coverages: | Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Effective Date for all Lines: | July 1, 2025 |
| Current Carrier(s): | Metlife |
| Current Plans: | Basic Life |
| Supplemental Life - Employee | |
| Supplemental Life - Spouse | |
| Supplemental Life - Child | |
| Long Term Disability | |
| Proposed Plans: | Quote on all current plans |
| Pet Insurance | |
| Proposed Rate Guarantee: | Three (3) Years and optional 2 one-year renewal years |
| Objective: | To reduce cost with a long-term rate guarantee offering on all lines, matching current plans. |
| Notes: | Note that the county is seeking alternative rates for the supplemental life as outlined on tab TF2.2. |
Additionally, the county would like for the Spouse and Child Dependent life insurance be offered as separate coverage options, where Evidence of Insurability (EOI) is only required for a spouse’s coverage when applicable, while coverage for child(ren) can be added immediately without delay.
Proposal Due Date: See RFP Scope of Services
TF 1.0 Qualifications
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 1.0 - Qualifications |
| # | QUESTION | ACTION | RESPONSE | |
| Qualifications and Experience | ||||
| 1 | Offeror's Legal Name | Provide Response | ||
| 2 | Offeror's Marketing Name | Provide Response | ||
| 3 | City, State | Provide Response | ||
| 4 | Web Address | Provide Response | ||
| 5 | Offeror's Operational Date | Provide Response | ||
| 6 | Corporate Tax Status | Drop Down Box | ||
| 7 | Offeror's Ownership/Controlling Interest | Provide Response | ||
| Experience | ||||
| 8 | Confirm you have at least five years experience in administering comparable benefits for one or more clients of the same size | Provide Response | ||
| 9 | Do you provide the applicable coverages in this RFP to other government agencies? If, yes, how many? | Provide Response | ||
| 10 | What percent of your book of business is comprised of government agency employers? | Provide Response | ||
| 11 | Please confirm that you have at least five public school, state and/or local government clients for group term life and disability insurance with 5,000 or more covered lives. References to be provided as requested in Financial Bid Forms Proposal Forms. | Provide Response | ||
| 12 | Offeror shall confirm that it has at least 500,000 covered lives for group term life and disability insurance coverage across its book of business as of the proposal submission date. | Provide Response | ||
| 13 | Confirm you have the capabilities to insure and administer Group Term Life Insurance, Optional Life, Dependent Spouse Life, Child Life, and Group Long Term Disability, and/or Pet Insurance. | Provide Response | ||
| 14 | Confirm any resulting contract from this RFP shall be a direct contract between the Offeror and the Charles County Government, and clearly state whether there are any broker/agent, and/or commissions built into any of the quoted products. | Provide Response | ||
| 15 | Confirm your ability to interface with Charles County Government's BWIFT benefit administration application. | Provide Response | ||
| 16 | Please fill in details below of the person who will be assigned as the primary account executive: | |||
| 17 | Name | Provide Response | ||
| 18 | Title | Provide Response | ||
| 19 | Office Location (City, state) | Provide Response | ||
| 20 | Training, Education and Experience | Provide Response | ||
| 21 | What is the current case load (number of clients) of the designated account executive? | Provide Response | ||
| Financial Ratings | ||||
| 22 | For the prime entity that will be providing this coverage, provide your most recent financial ratings or filings and effective dates of the ratings from each of the following agencies: | |||
| 23 | A.M. Best: Rating Status | |||
| a. | Financial Rating (do not report credit rating) | Provide Response | ||
| b. | Financial Rating Modifiers (if applicable) | Provide Response | ||
| c. | Date Rating Effective (if rated; if not financially rated, leave response cell blank) | Provide Response | ||
| d. | Has your rating changed in the last 12 months? If so, please describe the action and why. | Provide Response | ||
| 24 | Standard & Poor's: Rating Status | |||
| a. | Financial Rating (do not report credit rating) | Provide Response | ||
| b. | Financial Rating Modifiers (if applicable) | Provide Response | ||
| c. | Date Rating Effective (if rated; if not financially rated, leave response cell blank) | Provide Response | ||
| d. | Has your rating changed in the last 12 months? If so, please describe the action and why. | Provide Response | ||
| 25 | Moody's: Rating Status | |||
| a. | Financial Rating (do not report credit rating) | Provide Response | ||
| b. | Financial Rating Modifiers (if applicable) | Provide Response | ||
| c. | Date Rating Effective (if rated; if not financially rated, leave response cell blank) | Provide Response | ||
| d. | Has your rating changed in the last 12 months? If so, please describe the action and why. | Provide Response | ||
| Legal | RESPONSE | ADDITIONAL RESPONSE | ||
| 26 | Please confirm that your organization has complied with all state insurance department filing requirements for all plans/products being offered in this quote in each state in which the County has employees. | Provide Response | <Select One> | |
| 27 | If the answer to the preceding question is "no", for all plans/products quoted in this RFP for which the required state insurance department filing requirements have not been met, please specify the applicable plan/product and corresponding state. | Provide Response | <Select One> | |
| We understand that terminology and contract provisions may vary from offeror to offeror. We will permit such alternative language, provided they are reviewed and approved by the Client. | ||||
| 28 | Confirm the contract will be sitused in Maryland | Provide Response | <Select One> | |
| 29 | There will be no restrictions or benefit limitations for pre-existing conditions applied to any employee covered under the plan. | Provide Response | <Select One> | |
| 30 | Offeror unconditionally agrees to provide coverage to all present participants enrolled on the program effective date. No active employees or disabled employees shall lose coverage as a result of a change in Offeror. Please provide specific wording of the no loss/no gain provision and include as an attachment. | Provide Response | <Select One> | |
| 31 | Any "actively at work" requirements will be waived for current covered employees. | Provide Response | <Select One> | |
| 32 | Any disabled employees or other leave-of-absence employees who are not disclosed in these specifications and who later are identified as eligible for benefits with the existing offeror will become the liability of the offeror selected through this marketing. | Provide Response | <Select One> | |
| 33 | Offeror certifies that it will comply with the Department of Labor's final claims procedure regulations, including the appropriate timeframes for (a) adjudicating claims, and (b) notice of appeal decisions. | Provide Response | <Select One> | |
| 34 | The Offeror agrees to assume claim fiduciary responsibilities, including appeals, for claim adjudication and defense of claim decisions. | Provide Response | <Select One> | |
| 35 | Offeror agrees to monitor federal and state legislation affecting the delivery of plan benefits to participants and to report to the County on those issues in a timely fashion, prior to the effective date of any mandated plan changes. | Provide Response | <Select One> | |
| 36 | All financial and claimant information will be kept confidential and will not be disclosed to any other party without the County's express approval. | Provide Response | <Select One> | |
| 37 | Offeror agrees to prepare and file all legal documents necessary to implement and maintain the plans, including policies, amendments, contracts, required state filings, and development of booklet/certificate formats. | Provide Response | <Select One> | |
| 38 | No Statement of health or medical evidence will be imposed upon the initial group of covered employees. | Provide Response | <Select One> |
TF 1.1 General Q
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 1.1 - Questionaire |
| # | QUESTION | ACTION | RESPONSE | ADDITIONAL RESPONSE |
| Administration | ||||
| 1 | Your company agrees to duplicate all current benefits/provisions as described in this RFP and accompanying documentation. Review and detail any deviations from the proposed plan designs shown in the provided Plan Design worksheets. | Provide Response | <Select One> | |
| 2 | Indicate your willingness to comply with the following services/statements: | |||
| a. | Accept the current coverage amounts in existence as of the program effective date. | Provide Response | <Select One> | |
| b. | No statement of health or medical evidence will be imposed upon the initial group of covered employees. | |||
| c. | Provide SPDs/booklets in an electronic format. | Provide Response | <Select One> | |
| d. | Revisions to booklets in subsequent years at no additional cost. | Provide Response | <Select One> | |
| e. | Accept Monthly self-billed premiums | Provide Response | <Select One> | |
| f. | Offeror will participate at employee meetings and annual benefit fairs if requested. It is expected that a member of your team will be required to attend two days of benefit fairs at the annual open enrollment fairs. | Provide Response | <Select One> | |
| g. | Bidder agrees to provide up to 3 virtual presentation/Q&A sessions to review the proposed benefits and value-added services. Bidder must also provide a pre-recorded brainshark video explaining these benefits as well. | Provide Response | <Select One> | |
| h. | Offeror agrees to be held liable for the performance of any subcontracted services. | Provide Response | <Select One> | |
| i. | List all subcontracted services and describe the service provided. | Provide Response | <Select One> | |
| j. | Provide copy of death certificate to the Client | Provide Response | <Select One> | |
| k. | Must offer a "user friendly/seamless" employer portal for claims filing. Include "demo" logon credentials for benefits staff to test and must offer live demonstration. | Provide Response | <Select One> | |
| 3 | Describe the process for keeping Client apprised of the status of EOI applications and how the Client will be notified of approvals. | Provide Response | <Select One> | |
| 4 | After the annual open enrollment period, or QE events throughout the year, confirm you can receive a batch file for any employee who elected coverage requiring EOI. Confirm if provided an email address for each employee that you can email the employee with a link to your online statement of health to be completed and submitted online by the employee. | Provide Response | <Select One> | |
| 5 | Indicate your willingness to offer the following web-based services: | |||
| a. | Enrollment and termination | Provide Response | <Select One> | |
| b. | Claim filing | Provide Response | <Select One> | |
| c. | Claim tracking | Provide Response | <Select One> | |
| d. | EOI form and submission | Provide Response | <Select One> | |
| e. | What are your participation requirements for each proposed line of coverage? | Provide Response | <Select One> | |
| Basic and Supplemental Life | ||||
| 6 | How are life insurance claims submitted? | Provide Response | <Select One> | |
| 7 | Will you accept current beneficiary designations and grandfather all current coverage amounts under the existing Basic and Voluntary Life plans? | Provide Response | <Select One> | |
| 8 | Describe your Evidence of Insurability (EOI) requirements, including guaranteed issue (GI) amounts for new hires, late entrants, and buy-up options during enrollment periods. | Provide Response | <Select One> | |
| 9 | Confirm that terminated employees and dependents (spouses and children) can port or convert their coverage. Describe the process and any applicable restrictions (e.g., illness or injury). | Provide Response | <Select One> | |
| 10 | What is the maximum age at which coverage can be ported? Is there a maximum age at which ported coverage reduces or terminates? If yes, describe any distinctions for employees and dependents. | Provide Response | <Select One> | |
| 11 | How are premiums determined for ported or converted policies, and what factors influence future rate changes? | Provide Response | <Select One> | |
| 12 | What happens to portability and conversion coverage if the County cancels its contract with you? | Provide Response | <Select One> | |
| 13 | When will a ported policy be cancelled by your organization? | Provide Response | <Select One> | |
| 14 | Describe the plan’s conversion benefit, including eligibility requirements, maximum conversion amounts, and associated charges (if any). Provide a detailed breakdown of any charges associated with conversions to individual policies, including how they are calculated. Confirm whether all conversion services are handled in-house or subcontracted, and provide details if subcontracted. | Provide Response | <Select One> | |
| 15 | What differentiates your company’s life insurance product from competitors? | Provide Response | <Select One> | |
| Long Term Disability | ||||
| 16 | Confirm your company’s agreement to duplicate all current benefits/provisions as described in this RFP and accompanying documentation. Detail any deviations from the proposed plan designs shown in the provided LTD Plan Design worksheet. | Provide Response | <Select One> | |
| 17 | Confirm that all eligibility provisions of the current plan, including those for employees not actively at work, are duplicated. | Provide Response | <Select One> | |
| 18 | Describe how LTD claims are submitted, what information is required to evaluate and approve claims, and the process for notifying employees and the client of approved or denied claims. | Provide Response | <Select One> | |
| 19 | How do you adjudicate claims that involve self-reported disabilities or other conditions not verifiable by standard tests? | Provide Response | <Select One> | |
| 20 | Please describe your process for ongoing follow-up to verify continued evidence of disability, including whether a paperless process is available. | Provide Response | <Select One> | |
| 21 | Describe your process for coordinating LTD benefits with other income sources, such as Worker’s Compensation, Social Security Disability, and pension offsets. | Provide Response | <Select One> | |
| 22 | Does your quoted rate assume a Cost of Living Adjustment (COLA)? If yes, please describe. If no, what is the rate adjustment to add your standard COLA? | Provide Response | <Select One> | |
| 23 | Define and describe your plan’s Work Incentive Benefit, Partial Disability provisions, and benefit formulas for claimants who are disabled but working. | Provide Response | <Select One> | |
| 24 | What rehabilitation or return-to-work services do you provide for LTD claimants? | Provide Response | <Select One> | |
| 25 | Confirm whether your plan includes a pre-existing condition clause, and describe any limits for mental health, musculoskeletal disorders, or other specific conditions. | Provide Response | <Select One> | |
| 26 | What age reduction schedule does your offer assume, and does it comply with ADEA regulations? | Provide Response | <Select One> | |
| 27 | Will all LTD claim services be handled in-house, or are any subcontracted? If subcontracted, identify the services and your relationship with the subcontractor. | Provide Response | <Select One> | |
| 28 | What differentiates your company’s LTD product from competitors? | Provide Response | <Select One> | |
| 29 | Does the plan include a survivor benefit or conversion benefit? If so, please describe. | Provide Response | <Select One> | |
| 30 | What changes, if any, are you proposing to the current benefits, including benefit limitations? | Provide Response | <Select One> | |
| 31 | Indicate your willingness to offer the following web-based services for LTD: | |||
| a. | Claim filing | Provide Response | <Select One> | |
| b. | Claim tracking | Provide Response | <Select One> | |
| 32 | Indicate your willingness to offer the following: | |||
| a. | Provide Long Term Disability certificates in an electronic format for access via internet. | Provide Response | <Select One> | |
| b. | Revisions to certificates in subsequent years at no additional cost. | Provide Response | <Select One> | |
| c. | Prepare booklet draft within 30 days of the effective date. | Provide Response | <Select One> | |
| 33 | Does the LTD policy include conversion? | Provide Response | <Select One> | |
| 34 | What differentiates your company’s LTD product from your competitors? Please summarize. | Provide Response | <Select One> | |
| Customer Service/Claims Centers | ||||
| 35 | List the location of your service center(s) that would be servicing Client employees and the corresponding geographic areas/regions covered by the respective location for services covered in this RFP. | |||
| a. | Location of claim service center | Provide Response | <Select One> | |
| b. | Geographic Region Covered | Provide Response | <Select One> | |
| 36 | Indicate specific times member service representatives are available to answer member questions. Use Eastern Standard Time (EST) for reporting all times below. Do not include hours for answering services, recordings or nurse/health information lines: | |||
| a. | Hours of operation weekdays | Provide Response | <Select One> | |
| b. | Hours of operation on Saturday | Provide Response | <Select One> | |
| c. | Hours of operation on Sunday | Provide Response | <Select One> | |
| 37 | Focusing specifically on the claim office(s) that would be used for Client, please provide your performance metrics for the standards below. | |||
| 38 | 2024 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 39 | 2023 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 40 | 2022 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 41 | Please state your average claim processing time (# of days) to issue payment once all death claim information and documentation is received by your organization. | Provide Response | <Select One> | |
| Additional Services Available to Plan Participants | ||||
| 42 | Does your company offer financial or legal advisory services to beneficiaries? | Provide Response | <Select One> | |
| a. | Are these services included at no additional cost? | Provide Response | <Select One> | |
| 43 | Confirm that the company providing financial advisory services will not sell investment products nor does it receive remuneration of any kind from a company to whom it refers sales of investment products. | Provide Response | <Select One> | |
| 44 | Does your company make financial and/or legal planning tools available to employees? | Provide Response | <Select One> | |
| a. | If yes, describe these tools. | Provide Response | <Select One> | |
| b. | Are access to these tools included in your rates? | Provide Response | <Select One> | |
| 45 | Does your organization offer a funeral concierge program? If yes, what vendor administers the program? | Provide Response | <Select One> | |
| 46 | Do you assist employees in filing for Social Security Disability when appropriate? What percentage of all LTD claimants (disabled two years or more) receive Social Security Disability? | Provide Response | <Select One> | |
| 47 | Identify any other value added services your company can offer to the County; briefly describe these services, and include an estimate of the cost, if any. | Provide Response | <Select One> | |
| Reporting | ||||
| 45 | Are reports available to Client online? | Provide Response | <Select One> | |
| 46 | Indicate the date for which you will guarantee delivery to Client of the above information, by time period (e.g., within 60 days of the end of the plan year) | Provide Response | <Select One> | |
| 47 | Indicate the date for which you will guarantee delivery to Consultant/Broker of the above information, by time period (e.g., within 60 days of the end of the plan year) | Provide Response | <Select One> | |
| 48 | Confirm the following information can be provided in standard reports: | |||
| a. | Line of coverage | Provide Response | <Select One> | |
| b. | Division | Provide Response | <Select One> | |
| c. | Covered lives by month | Provide Response | <Select One> | |
| d. | Paid claim and interest by line of coverage for each claimant | Provide Response | <Select One> | |
| e. | Pending claim amounts | Provide Response | <Select One> | |
| f. | Conversion charges applied to client experience | Provide Response | <Select One> | |
| g. | Demographics of claimants in each category | Provide Response | <Select One> | |
| h. | Incidence compared to client industry norms | Provide Response | <Select One> | |
| Attachments | Label each attachment with the corresponding letter and file description | |||
| A. | Attach sample management report(s) for all products that would be prepared and provided to the Client. Provide the frequency each report will be provided, including how the reports will be delivered to the client. | Provide Attachment / Response | <Select One> | |
| B. | Provide a detailed schedule and time frames to implement this program by the effective date, including key due dates and responsibilities of all parties. | Provide Attachment | <Select One> | |
| C. | Please provide sample applications, policies, bills and forms necessary to file a claim. | Provide Attachment | <Select One> | |
| D. | Provide specific wording of the no loss/no gain provision. | Provide Attachment / Response | <Select One> | |
| E. | Attach a description of premium billing procedures. Include information on the timing of billing, billing-payment reconciliations, and ability to provide for the County's self-billing. | Provide Attachment / Response | <Select One> | |
| Financial Questionnaire | ||||
| # | QUESTION | ACTION | RESPONSE | ADDITIONAL RESPONSE |
| Life Renewal/Underwriting | ||||
| 1 | Do you agree to provide the renewal no later than 120 days prior to the renewal date? | Provide Response | <Select One> | |
| 2 | Confirm claims experience will be provided with the renewal for all lines? | Provide Response | <Select One> | |
| 3 | What credibility blend will be used for renewals? Specify by line of coverage. | Provide Response | <Select One> | |
| a. | Basic Life and AD&D | Provide Response | <Select One> | |
| b. | Employee Optional Life | Provide Response | <Select One> | |
| c. | Dependent Life | Provide Response | <Select One> | |
| 4 | How many years/months of experience will be used in this client's renewal calculation? | Provide Response | <Select One> | |
| a. | Basic Life and AD&D | Provide Response | <Select One> | |
| b. | Employee Optional Life | Provide Response | <Select One> | |
| c. | Dependent Life | Provide Response | <Select One> | |
| 5 | 3 year Rate guarantee offered for all coverages with 2 one-year renewal option. | Provide Response | <Select One> | |
| 6 | What is your required retention percentage for a group of this size? | Provide Response | <Select One> | |
| 7 | What is the desired loss ratio for a group of this size? | Provide Response | <Select One> | |
| 8 | Describe how you estimate the reserve amount for waiver of premium claims. | Provide Response | <Select One> | |
| 9 | What factor, on average, is applied to the face amount to determine the value of the WOP reserve if applicable? | Provide Response | <Select One> | |
| 10 | How is IBNR determined? | Provide Response | <Select One> | |
| 11 | Describe the interest applied to claim payments and when the interest begins to accrue prior to the payment being made. | Provide Response | <Select One> | |
| 12 | Describe the terms and conditions under which you retain the right to modify the rates prior to the expiration of the quoted rates. If you need more space, please use the "Explanation" column and/or worksheet. | Provide Response | <Select One> | |
| 13 | What is the length of the grace period you will permit for late payment of fees/premiums. | Provide Response | <Select One> | |
| 14 | Indicate the interest charge used for late premium payments. | Provide Response | <Select One> | |
| 15 | Is the client charged for life conversion policies? | Provide Response | <Select One> | |
| a. | If so, is the charge to claims or retention? | Provide Response | <Select One> | |
| Long-Term Disability (LTD) | ||||
| 16 | Confirm LTD rates include Federal and State tax withholding and remittance to various government entities. | Provide Response | <Select One> | |
| 17 | Confirm LTD rates include issuance of annual W-2 forms. | Provide Response | <Select One> | |
| 18 | Do you agree to provide the renewal no later than 120 days prior to the renewal date? | Provide Response | <Select One> | |
| 19 | Confirm claims experience will be provided to justify renewal action for all lines? | Provide Response | <Select One> | |
| 20 | What credibility blend will be used for renewals? | Provide Response | <Select One> | |
| 21 | What is your required retention percentage for a group of this size? | Provide Response | <Select One> | |
| 22 | How many years/months of experience will be used in this client's renewal calculation? | Provide Response | <Select One> | |
| 23 | Will you use incurred or paid claims for the renewal calculation? | Provide Response | <Select One> | |
| Credits / Allowances | ||||
| 24 | Please provide an implementation credit to support the implementation of this program should you be awarded the contract. | Provide Response | <Select One> | |
| 25 | Please provide a discretionary credit should you be awarded the contract to be used to support future communications and technology initiatives. | Provide Response | <Select One> | |
| 26 | Please provide any other type of credit or allowance available under the term of the contract of this RFP (example premium holiday, etc.) | Provide Response | <Select One> | |
| 27 | Confirm if credit is available every year bidder is under contract with client | Provide Response | <Select One> | |
| 28 | Confirm any limitations to use of credit (example, for communications only, etc.) | Provide Response | <Select One> | |
| 29 | Confirm if documentation is required to receive credit | Provide Response | <Select One> | |
| 30 | Please provide a bundling discount if bidder is awarded all lines of coverage proposed | Provide Response | <Select One> |
TF 1.2 Pet Insurance
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 1.2 - Pet Insurance Questionnaire |
| # | QUESTION | ACTION | RESPONSE | ADDITIONAL RESPONSE |
| Pet Insurance | ||||
| 1 | Confirm your company’s ability to offer 1–3 plan options with varying levels of coverage (e.g., accident-only, accident and illness, comprehensive plans with wellness care). | Provide Response | <Select One> | |
| 2 | Please outline whether there are any minimum enrollment levels or participation rates requirements built into your offer. | Provide Response | <Select One> | |
| 3 | What types of pets are eligible for coverage (e.g., dogs, cats, exotic pets)? Are there any breed or age restrictions? | Provide Response | <Select One> | |
| 4 | Are there waiting periods for coverage to begin, and if so, please describe (e.g., accidents vs. illnesses vs. wellness/preventive care)? | Provide Response | <Select One> | |
| 5 | Provide details about any coverage exclusions (e.g., pre-existing conditions, elective procedures). | Provide Response | <Select One> | |
| 6 | What is the maximum annual benefit or claim limit for each proposed plan? Please specify whether these limits are per pet, per incident, or per policy year | Provide Response | <Select One> | |
| 7 | Are wellness/preventive services (e.g., vaccinations, dental cleanings) included? If not, are optional add-ons available? | Provide Response | <Select One> | |
| 8 | Describe the enrollment process for employees (e.g., during open enrollment, mid-year enrollments). | Provide Response | <Select One> | |
| 9 | Is coverage portable for employees who leave the organization? If so, describe the portability process. | Provide Response | <Select One> | |
| 10 | What methods are available for employees to submit claims (e.g., mobile app, online portal, mail)? | Provide Response | <Select One> | |
| 11 | How do you reimburse claims? (e.g., direct deposit, check, prepaid card). | Provide Response | <Select One> | |
| 12 | What is the average claim processing time from submission to reimbursement? | Provide Response | <Select One> | |
| 13 | Are there any maximum reimbursement rates or UCR limits for veterinary services? If so, please explain. | Provide Response | <Select One> | |
| 14 | Do you require itemized invoices or specific documentation for claim submissions? | Provide Response | <Select One> | |
| 15 | Does your platform include mobile app functionality for employees to manage their coverage, submit claims, and track claim status? | Provide Response | <Select One> | |
| 16 | Provide demo log-in credentials or screenshots of your employee and employer portals. | Provide Response | <Select One> | |
| 17 | Describe the availability of live customer support (e.g., phone, chat, email) and list your hours of operation in Eastern Standard Time. | Provide Response | <Select One> | |
| 18 | Provide data on the following metrics for 2023: | |||
| a. | Average claim processing time | Provide Response | <Select One> | |
| b. | Call response time for member inquiries | Provide Response | <Select One> | |
| c. | Call abandonment rate | Provide Response | <Select One> | |
| d. | Member satisfaction ratings | Provide Response | <Select One> | |
| 19 | Detail your procedures for resolving claim disputes and appeals. | Provide Response | <Select One> | |
| 20 | Describe the onboarding process for the employer and employees, including any communication materials you provide (e.g., flyers, webinars, FAQs). | Provide Response | <Select One> | |
| 21 | Are you able to provide virtual or in-person educational sessions during the open enrollment period? If so, how many sessions are included? | Provide Response | <Select One> | |
| 22 | Do you offer any additional value-added services (e.g., telehealth consultations for pets, behavioral training resources)? | Provide Response | <Select One> | |
| 23 | What differentiates your pet insurance product from competitors? | Provide Response | <Select One> | |
| 24 | Indicate your willingness to offer the following web-based services: | |||
| a. | Enrollment and termination | Provide Response | <Select One> | |
| b. | Claim filing | Provide Response | <Select One> | |
| c. | Claim tracking | Provide Response | <Select One> | |
| Network Adequacy | ||||
| 25 | What percentage of claims in the Southern Maryland region are processed out-of-network? | Provide Response | <Select One> | |
| 26 | Is the reimbursement rate for out-of-network providers tied to UCR (Usual, Customary, and Reasonable) rates? If so, what percentile is used? | Provide Response | <Select One> | |
| 27 | Based on the addresses provided in the census file, what is the average distance to an in-network provider in terms of miles driven? | Provide Response | <Select One> | |
| 28 | Conduct and provide a geo-access analysis showing the availability of in-network general veterinarians and specialists within 10 and 20 miles of employee zip codes. | Provide Response | <Select One> | |
| 29 | Confirm whether employees can visit out-of-network providers and describe the reimbursement process. Specify the reimbursement percentage and any tie to UCR rates | Provide Response | <Select One> | |
| 30 | Indicate the availability of 24/7 emergency care and specialty care providers in the coverage area. Include these in the geo-access analysis | Provide Response | <Select One> | |
| 31 | What is your network's average provider turnover rate? How do you ensure stability in the network | Provide Response | <Select One> | |
| 32 | Provide data on the percentage of claims processed in-network for the client’s primary zip code(s) | Provide Response | <Select One> | |
| 33 | Indicate whether your network includes specialist veterinarians. If so, list the specialties covered (e.g., cardiology, oncology, surgery). | |||
| 34 | Additionally, if specialists are included in your network, are referrals required for specialist care? | |||
| Customer Service/Claims Centers | ||||
| 35 | List the location of your service center(s) that would be servicing Client employees and the corresponding geographic areas/regions covered by the respective location for services covered in this RFP. | |||
| a. | Location of claim service center | Provide Response | <Select One> | |
| b. | Geographic Region Covered | Provide Response | <Select One> | |
| 36 | Indicate specific times member service representatives are available to answer member questions. Use Eastern Standard Time (EST) for reporting all times below. Do not include hours for answering services, recordings or nurse/health information lines: | |||
| a. | Hours of operation weekdays | Provide Response | <Select One> | |
| b. | Hours of operation on Saturday | Provide Response | <Select One> | |
| c. | Hours of operation on Sunday | Provide Response | <Select One> | |
| 37 | Focusing specifically on the claim office(s) that would be used for Client, please provide your performance metrics for the standards below. | |||
| 38 | 2024 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 39 | 2023 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 40 | 2022 | |||
| a. | Financial Dollar Accuracy | Provide Response | <Select One> | |
| b. | Procedural Accuracy | Provide Response | <Select One> | |
| c. | What % of complete/clean claims were paid in 10 business days or less. | Provide Response | <Select One> | |
| d. | Average time to answer calls from initial answer? | Provide Response | <Select One> | |
| e. | Call abandon rate | Provide Response | <Select One> | |
| 41 | Please state your average claim processing time (# of days) to issue payment once all death claim information and documentation is received by your organization. | Provide Response | <Select One> | |
| Attachments | Label each attachment with the corresponding letter and file description | |||
| A. | Attach sample management report(s) for all products that would be prepared and provided to the Client. Provide the frequency each report will be provided, including how the reports will be delivered to the client. | Provide Attachment / Response | <Select One> | |
| B. | Provide a detailed schedule and time frames to implement this program by the effective date, including key due dates and responsibilities of all parties. | Provide Attachment | <Select One> | |
| C. | Please provide sample applications, policies, bills and forms necessary to file a claim. | Provide Attachment | <Select One> | |
| D. | Attach a description of premium billing procedures. Include information on the timing of billing, billing-payment reconciliations, and ability to provide for the County's self-billing. | Provide Attachment / Response | <Select One> | |
| E. | Attach a description of premium billing procedures. Include information on the timing of billing, billing-payment reconciliations, and ability to provide for the County's self-billing. | |||
| Financial Questionnaire | ||||
| Pet Insurance | ||||
| 1 | Provide the monthly premium rates for each plan option (e.g., accident-only, accident & illness, comprehensive) across the following coverage tiers: - Single pet - Two pets - Three or more pets (if applicable). | |||
| 2 | Are premiums fixed for the policy year, or can they be adjusted mid-year? If adjustable, under what circumstances? | |||
| 3 | Detail any group discounts offered for employer-sponsored plans. Is the discount based on employee participation rates or employer contributions? | |||
| 4 | Specify any multi-pet discounts, including the percentage and how it applies (e.g., first pet, additional pets). | |||
| 5 | Outline any loyalty discounts or rate freezes for employees renewing coverage. | |||
| 6 | If the employer decides to subsidize premiums, can you administer contributions? Provide examples of subsidy structures. | |||
| 7 | Confirm your ability to accept monthly self-billed premiums from the employer. | |||
| 8 | Specify annual or lifetime reimbursement caps for each plan. | |||
| 9 | If reimbursements are tied to UCR (Usual, Customary, and Reasonable) rates, what percentile do you use (e.g., 80th, 90th)? | |||
| 10 | Are there any administrative or implementation fees for setting up the plan? Provide cost details. | |||
| 11 | Are there additional fees for claim appeals or escalations? | |||
| 12 | Are premium rates guaranteed for the first policy year? If not, explain circumstances for changes. | |||
| 13 | Provide rate guarantees or caps for multi-year contracts (e.g., years 2 and 3). | |||
| 14 | How frequently do premiums increase for enrolled employees? Is this tied to pet age, medical history, or external factors? | |||
| 15 | Confirm the payment terms for premiums (e.g., monthly, quarterly, annually). Is there flexibility in billing frequency? | |||
| 16 | If an employee leaves the employer mid-year, will they be billed directly for continued coverage? | |||
| 17 | Can employees customize coverage levels (e.g., accident-only for one pet, comprehensive for another)? How does this impact premiums? | |||
| 18 | Provide example premium quotes for the following scenarios: - A 3-year-old Labrador Retriever in a metropolitan area. - A 7-year-old domestic short-haired cat in a suburban area. - A 1-year-old mixed breed dog in a rural area. | |||
| 19 | Are there penalties for mid-year plan cancellations by the employer or employee? | |||
| 20 | Do you charge late fees for delayed premium payments? If so, provide details. |
TF 2.1 BLIFE and AD&D Design
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 2.1 - Plan Design - Basic Life and AD&D |
| Offeror Name: | 0 | |
| BASIC LIFE Plan Design | Current | Proposed - |
DEVIATIONS ONLY
| Eligiblity Definition | All Active full time employees who work at least 25 hours per week on a regularly scheduled basis |
| Eligibility Waiting Period | 1st day of active work |
| Life Benefit Amount | 1.5x annual earnings rounded to the nearest $1,000 |
| Maximum | $250,000 |
| AD&D | Included, Matches Life Benefit |
| Guaranteed Issue | Full Benefit for both Basic Life and AD&D |
| AGE REDUCTION Benefit Amount | Age 70: 35% |
Age 75: 50%
| Contributory | Non-contributory |
| Employer Contribution | 100% |
| Continuation | |
| Conversion | Included Basic Life Only |
| Portability | Included Basic Life Only |
| AD&D Benefits - % of Coverage Amount Per Accident | |
| Life | 100% |
| Both Hands or Both Feet or Sight of Both Eyes | 100% |
| One Hand and One Foot | 100% |
| Speech and Hearing in Both Ears | 100% |
| Either Hand or Foot and Sight of One Eye | 100% |
| Movement of Both Upper and Lower Limbs (Quadriplegia) | 100% |
| Movement of Both Lower Limbs (Paraplegia) | 75% |
| Movement of Three Limbs (Triplegia) | 75% |
| Movement of the Upper and Lower Limbs of One Side of the Body (Hemiplegia) | 50% |
| Either Hand or Foot | 50% |
| Sight of One Eye | 50% |
| Speech or Hearing in Both Ears | 50% |
| Movement of One Limb (Uniplegia) | 25% |
| Thumb and Index Finger of Either Hand | 25% |
| After reviewing the Plan booklet, please list any other deviations below or other provisions you may offer: |
TF 2.2 SLIFE Plan Design
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 2.2 - Plan Design - Supplemental Life |
| Offeror Name: | 0 | ||
| SUPPLEMENTAL LIFE Plan Design | Current | Requested Alternative Deviations | Proposed - |
DEVIATIONS ONLY
| Eligiblity Definition | All Active full time employees who work at least 25 hours per week on a regularly scheduled basis | |
| Dependent Eligibility | All Spouses including Domestic Partners. All Children under age 18 (or under age 26 if full-time student). | |
| Eligibility Waiting Period - Employee | The first day of the month following the date coverage was elected. Employee must be actively at work on the day the coverage takes effect. | |
| Eligibility Waiting Period - Spouse, Child(ren) | Same as Employee eligibility period, provided the spouse and child(ren) are performing normal activities and not confined, unless already insured with the prior carrier. | |
| Supplemental Life Benefits - Employee | ||
| Employee Benefit Amount | 1x, 2x, or 3x earnings | Increments of $10,000 |
| Maximum Benefit | 3x earnings or $500,000 | 3x earnings or $500,000 |
| Minimum Benefit | $10,000 | $10,000 |
| Dependend Benefit Amount - Spouse | Flat $20K | Increments of $5,000 |
| Maximum Benefit | n/a | $20,000 |
| Minimum Benefit | n/a | $5,000 |
| Dependend Benefit Amount - Child(ren) | Flat $10K | Increments of $5,000 |
| Maximum Benefit | n/a | $10,000 |
| Minimum Benefit | n/a | $5,000 |
| Contributory | Employee Paid - 100% | |
| Age Reduction - Employee Only | Age 70: 35% |
Age 75: 50%
| Guaranteed Issue | |
| Employee | Newly Eligible: The lesser of 3x annual earnings or $400,000 |
Currently Participating: Increase of up to 1x annual earnings, not to exceed the lesser of 3x annual earnings or $400,000
Previously Eligible, New Entrant: EOI Required
| Spouse | EOI under certain circumstances, see certificate for details |
| Children | All Guaranteed Issue |
| Continuation | |
| Conversion | Included |
| Portability | Included |
| After reviewing the Plan booklet, please list any other deviations below or other provisions you may offer: |
TF 2.3 LTD Plan Design
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 2.3 - Plan Design - LTD |
| Offeror Name: | 0 | |
| LONG-TERM DISABILITY Plan Design | Current | Proposed - |
DEVIATIONS ONLY
| Eligiblity Definition | All Active full time employees who work at least 25 hours per week on a regularly scheduled basis |
| Eligibility Waiting Period | The first day of the month following the date coverage was elected. Employee must be actively at work on the day the coverage takes effect. |
| Definition of Disability/Disabled | You are prevented from performing one or more of the Essential Duties of: |
1) Your Occupation during the Elimination Period;
2) Your Occupation, for the 24 month(s) following the Elimination Period, and as a result Your Current Monthly Earnings are less than 60% of Your Indexed Pre-disability Earnings
| Guaranteed Issue | Yes, subject to pre-existing condition exclusion |
| Contributory | Non-contributory |
| Employer Contribution | 100% |
| Core Benefit Amount | |
| Class 1 | 60% of monthly earnings |
| Maximum Monthly Benefit | $5,000 |
| Minimum Monthly Benefit | 10% of earnings or $100 per month |
| Provisions | |
| Pre-existing Condition Limitation | $45,629 |
| Elimination Period | 120 days |
| Limitations and Exclusions | |
| Mental or Nervous Disorders | 24 months |
| Alcohol, Drug or Substance Abuse or Addiction | 24 months |
| After reviewing the Plan booklet, please list any other deviations below or other provisions you may offer: |
TF 2.4 Pet Ins Plan Design
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 2.4 - Plan Design - Pet Insurance |
| 0 | 0 | 0 | |||
| Pet Insurance Plan Design | Proposed - | ||||
| Plan Design 1 | Proposed - | ||||
| Plan Design 2 | Proposed - |
Plan Design 3
| Plan Name |
| Coverage Type (e.g. Accident-Only, Accident & Illness, Comprehensive, etc.) |
| Annual Coverage Limit |
| Deductible & Basis (i.e. per incident per year) |
| Reimbursement Rate |
| Accident Waiting Period |
| Illness Waiting Period |
| Preventive Care Covered? |
| Veterinarian Network |
| Exclusions |
| Multi-Pet Discount |
| Behavioral Therapy |
| Telehealth |
| Alternative Therapy |
| Maximum Payout Type |
| Hereditary/Chronic Coverage |
| Pre-existing Conditions & Look-Back Period |
| Alternative Therapies Coverage & Limits |
| Claim Reimbursement Method |
| Wellness Benefits |
| Customer Service |
| Chronic Fatigue Conditions |
| Musculoskeletal And Connective Tissue Disorder Limitation: |
| Chemical And Environmental Sensitivities Limitation |
| If the table above does not have a specific and important aspect of the plan design listed, please list any other provisions below: |
TF-3.0 Pet Insurance Geo Access
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 3.0 - Geo-Access - Pet Insurance |
| Pet Insurance Geo Access - CARRIER RESPONSE REQUIRED |
| BASED ON ALL IN-NETWORK PROVIDERS |
| This sheet is designed for you to provide data regarding the geographic access you are proposing. Please complete this form and provide a complete GEO ACCESS Report for the defined standards in the RFP. Complete a separate tab for each network you are quoting. |
| A census of employee eligibility, enrollment and home zip codes is included with this RFP. We are requesting a network match based upon the residential zip code of all enrolled and eligible employees. BASE RESULTS ON DRIVING DISTANCES. | ||||||
| Name of Network: | ||||||
| Number of Employees | 2 General Veterinarians within 10 Miles (Driving Distance) | |||||
| Employees Matched | % Match | Employees Not Matched | # of Unique Providers | # of Unique Locations | ||
| Total Eligible | ||||||
| Total Enrolled | ||||||
| Number of Employees | 2 Specialist Veterinarians within 15 Miles (Driving Distance) | |||||
| Employees Matched | % Match | Employees Not Matched | # of Unique Providers | # of Unique Locations | ||
| Total Eligible | ||||||
| Total Enrolled |
TF-3.1 Pet Insurance by County
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Proposal Form 3.1 - Providers by County - Pet Insurance |
Please list the total number of providers in each County under each specialty. Each provider may only be counted ONE time per County, regardless of the number of offices maintained in that County. Providers can be counted more than once, if they have multiple county locations.
| Only respond for providers in the network included in this proposal. | |
| Network Name: |
Pet Insurance
| COUNTY | Number of Veterinarians | Number of Specialty Veteriarians | Number with Available Emergency Care or 24/7 Facilities |
| MARYLAND | |||
| Charles, MD | |||
| Calvert, MD | |||
| St. Maries, MD | |||
| Prince George's, MD | |||
| Anne Arundel, MD | |||
| Howard, MD | |||
| Montgomery, MD | |||
| Virginia | |||
| Fairfax, VA | |||
| King George, VA | |||
| Stafford, VA |
TF 4.0 References
| Charles County Government |
| RFP#25-016 |
| Basic Life and AD&D, Supplemental Life, LTD, and Pet Insurance RFP |
| Technical Form 4.0 - References |
| Offeror Name: | 0 | |
| References - Basic Life and AD&D, Supplemental Life, LTD, and/or Pet Insurance | ||
| Provide four (3) current and three (3) former clients of similar size for whom you provide administration for the benefit plans you are quoting. Provide requested references of similar sized contracts serviced during the past eighteen (18) months. | ||
| Current Client References | ||
| 1 | Client Name | |
| a | Contact Name(s) | |
| b | Title | |
| c | Contact Email Address | |
| d | Contact Phone Number | |
| e | Number of Years Since Implementation | |
| f | Number of Covered Lives | |
| g | List coverages in place similar to those in this RFP |
| 2 | Client Name |
| a | Contact Name(s) |
| b | Title |
| c | Contact Email Address |
| d | Contact Phone Number |
| e | Number of Years Since Implementation |
| f | Number of Covered Lives |
| g | List coverages in place similar to those in this RFP |
| 3 | Client Name |
| a | Contact Name(s) |
| b | Title |
| c | Contact Email Address |
| d | Contact Phone Number |
| e | Number of Years Since Implementation |
| f | Number of Covered Lives |
| g | List coverages in place similar to those in this RFP |
| Former Client References | |
| 1 | Client Name |
| a | Contact Name(s) |
| b | Title |
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