PUR 7776 Single Source with Special Markets Insurance Consultants, Inc..pdf

PUR 7776 (01/16) Page 1 of 4 60A-1.045, F.A.C.

DESCRIPTION OF INTENDED

SINGLE SOURCE PURCHASE

(PUR 7776)

AGENCY: Department of Environmental Protection

TITLE: Single Source with Special Markets Insurance Consultants, Inc (SMIC) Short description of the commodity or service desired: To provide Medical Coverage to AmeriCorps members as required by the Florida Conservation Corps and AmeriCorps Program through The Corps Network. Special Markets Insurance Consultants, Inc. (SMIC) is the only company providing Health Insurance Coverage that meets the requirements of the AmeriCorps Provisions and contracted to provide this service through The Corp Network. AmeriCorps members are not employees of the state per the National and Community Service Act of 1990, as amended, through 1999, 42 USC Section 101.12511.

CONTACT

Name: Belinda Croft Address: 3800 Commonwealth Blvd., MS93, Tallahassee, Florida 32399 Telephone: 850.245.2467 Email: Belinda.Croft@FloridaDEP.gov

Internal tracking number, if any: 2022SS011

Date posted: May 23, 2022 Last day for receipt of information: June 14, 2022

This description of commodities or contractual services intended for purchase from a single source is posted in accordance with Sections 120.57(3) and 287.057(3), Florida Statutes, and will remain posted for a period of at least 7 business days.

Commodity or Contractual Service Required (commodity or United National Standard Products and Services Code (UNSPSC), manufacturer, model, and description, as appropriate):

64122102 Group Health Insurance Policy

Quantity or Term (as appropriate):

July 1, 2022 - June 30, 2023

Requestor (division, bureau, office, individual, as appropriate):

Division of Recreation and Parks (Florida Park Service), Natural and Cultural Resources, Florida Conservation Corps (FLCC) (AmeriCorps)

Performance and/or Design Requirements (e.g. intended use, function or application, compatibility, requirements; reference to policy, rule, statute or other act of the Legislature, etc., as appropriate):

National and Community Service Act of 1990, as amended, through 1999, 42 USC Section 101.12511.

PUR 7776 (01/16) Page 2 of 4 60A-1.045, F.A.C.

Pursuant to the federal grant, the FDEP must make available health care coverage for the 65 AmeriCorps members serving a 1,700 hour full-term, who are not otherwise covered by a health care policy. Coverage provided must be provided for a period of no more than 364 days, and cannot be renewed or extended beyond that point. Coverage must include the following minimum benefits.

Special Markets Insurance Consultants is the only company that can provide access to the medical benefits through The Corps Network.

Single-source approval is requested for the period of July 2022 through the end of June 2023, subject to the continuation of the FLCC AmeriCorps program. The total single-source cost estimate is based on historical estimates of no more than 70% of the entire Corps enrolling in the provided health insurance coverage. There are 65 active members for the 2022-2023 program year, but only approximately 62% of the members enroll; 40 members x 11 months of service x $387.00 per month = ~$170,000.00. The current monthly charge for each covered member is $386.74.

Medical by Cigna, AD&D by Gerber | Medical Group Number: 3338030 The deductible and coinsurance for office visits will be waived and the following copays applied:

• Telehealth through MDLive: $5.00 copay

• Primary Care office visit: $10.00 copay

• Cigna Tier 1* Specialist office visit: $10.00 copay

• Cigna Preferred Specialist that is not a Tier 1 provider office visit: $20.00 copay *Tier 1 providers, when available, are clearly labeled in Cigna’s online provider directory

Medical, Prescription Drug and AD&D - Per Member, Per Month @ $386.74

Benefits / Provisions:

•Deductible Per Plan Year •(Applies to all services except in-network Preventive and Office Visits) •Out-of-Pocket Maximum (Includes Deductible) •Lifetime Maximum •Preventive (Routine) Care •Prescription Drugs (Express Scripts Value List) •Telehealth (MDLive includes Behavioral Health) •Office Visits Primary Care Tier 1 Specialist / Non-Tier 1 Specialist •Professional Services (Surgery, Lab & X-Ray) •Urgent Care •Ambulance •Emergency Room •Hospital (Inpatient pre-authorization required) •Mental Health (Inpatient and Outpatient) •Chemical Dependency (Inpatient and Outpatient) •Outpatient Rehabilitation - 20 visits per Plan Year (Physical, Speech, Occupational,Cardiac therapies and Chiropractic) •Employee Assistance Program (EAP)

PUR 7776 (01/16) Page 3 of 4 60A-1.045, F.A.C.

•AD&D

•Rate (Per Corpsmember, Per Month) paid by Division of Recreation and Parks (FloridaPark Service), Natural and Cultural Resources, Florida Conservation Corps (FLCC) (AmeriCorps)

Intended Single Source:

Special Markets Insurance Consultants (SMIC)

Estimated Dollar Amount:

Estimated to be $170,000.00

Justification for single source acquisition (what is necessary and unique about the product, service or source; steps taken to confirm unavailability of competition, as appropriate):

FY 2022/2023 AmeriCorps Single Source The Florida Department of Environmental Protection (FDEP) is a recipient of federal grant funds from AmeriCorps formally known and the Corporation for National and Community Service (CNCS) that is awarded through Volunteer Florida, the Governor's Commission on Volunteerism and Community Service. These federal grant funds support the Florida Conservation Corps (FLCC) AmeriCorps program. The AmeriCorps federal program's Catalog of Federal Domestic Assistance is 94.006 and is entitled "AmeriCorps State." The FLCC AmeriCorps grant award is directed toward providing service in areas of habitat restoration, trail accessibility improvements, environmental education, and volunteer recruitment. Additionally, FLCC AmeriCorps members provide disaster relief assistance across Florida when called. The FDEP has utilized federal grant funds from AmeriCorps to support this AmeriCorps program for 25 years. The program is made up of 65 members serving 1700 hour full-time terms of service. AmeriCorps members are not employees, and do not function in an employer-employee relationship within FDEP.

FLCC AmeriCorps members meeting certain participation requirements receive a modest living allowance, as well as health benefits, training and student loan deferment. Some members are eligible for child care benefits. Upon completion of service, members may receive an education award to help pay for continued education, or to pay back qualified student loans.

Pursuant to the federal grant, the FDEP must make available health care coverage for the 65 AmeriCorps members serving a 1700 hour full-term, who are not otherwise covered by a health care policy. Coverage provided must be provided for a period of no more than 364 days and cannot be renewed or extended beyond that point. Coverage must include the following minimum benefits:

A. Physician services for illness or injury B. Hospital room and board C. Emergency room D. X-ray and laboratory E. Prescription drugs F. Limited mental/nervous disorders G. Limited substance abuse coverage H. An annual deductible of no more than $175.00 per member I. No more than $2,750.00 total annual out-of-pocket per member

PUR 7776 (01/16) Page 4 of 4 60A-1.045, F.A.C.

J. A 20% co-pay or comparable fixed fee except for a 50% co-pay for mental and substance abuse care K. A maximum benefit of at least $50,000.00 per occurrence or cause

As an affiliate member of The Corps Network, Volunteer Florida and its AmeriCorps programs (of which FDEP is a recognized participant) are eligible to utilize the low-cost member health insurance that meets requirements for AmeriCorps. Although the AmeriCorps allows grantees to obtain healthcare from any provider, the FDEP must ensure that the coverage meets the above minimum benefits. It is critical for the FDEP to meet the minimum benefits established under the federal grant to maintain compliance with the federal grant terms and conditions. The extraordinary benefits and associated insurance coverage limits available only through Special Markets Insurance Consultants (SMIC) make them the only source available to provide comprehensive health insurance for such a varied group of individuals within AmeriCorps programs that meets or exceeds all AmeriCorps minimum benefit requirements Based on this need and Volunteer Florida’s acceptance of this insurance program, the FDEP is requesting single-source approval to utilize the health insurance program made available through The Corps Network. The Vendor providing access to this coverage is SMIC, Inc. which is underwritten by Cigna. The Department cannot purchase this insurance directly from the insurance company.

The Department of Management Services (DMS) attempted to procure this insurance coverage several years ago, but did not receive any bids, in part due to the limited number of participants for the insurance program. In 2021, it was confirmed by The Corps Network, the agency responsible for AmeriCorps grants, that SMIC is the only company providing health insurance coverage that meets the requirements of the AmeriCorps Provisions. AmeriCorps members cannot participate in the insurance coverage provided by DMS, as members are not employees of the state per the National and Community Service Act of 1990, as amended, through 1999, 42 USC Section 101.12511

Approved By (names & titles, as appropriate, e.g., requestor, requestor management, information systems, budget, purchasing):

Adriana Betancourt, FLCC Program Coordinator Suzanne Lane, Division Budget Coordinator Parks Small, Assistant Director Belinda Croft, Purchasing Specialist Supervisor

Prospective vendors are requested to provide information regarding their ability to supply the commodities or contractual services described. If it is determined in writing by the agency, after reviewing any information received from prospective vendors, that the commodities or contractual services are available only from a single source, the agency shall: provide notice of its intended decision to enter a single-source purchase contract in the manner specified in Section 120.57(3), F.S.