RFI Attachment to 2223-001.pdf
PDF 211 KB Posted
- Attached to
- Group Health Insurance
- Solicitation number
- RFP-02728
- Issued by
- Seminole County, Florida
About this file
This document is a Request for Information (RFI) issued by the Suwannee River Water Management District (District) for Group Health Insurance. The District is seeking fully insured proposals from qualified insurance carriers to provide Group Health coverage for employees and retirees under the District's employee benefits program. The RFI outlines various requirements and questions for the respondents, including compliance with 120-day notice for rate changes, attending monthly meetings, providing monthly and annual claims experience reports, delivering ID cards to members, COBRA administration, assignment of a dedicated service representative, open enrollment support, disease/case management, health fairs and wellness initiatives, and network information for the Florida Northeast region.
The RFI also requests the respondents to complete a Network Discount Analysis for Suwannee, Columbia, and Alachua counties in Florida, provide details on the hospital benefits and member's maximum out-of-pocket costs, and explain the rating methodology and financial commitment for the District's benefits communications plan. The contract opportunity is specific to the State of Florida, with the primary jurisdictions being Suwannee, Columbia, and Alachua counties.
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Text version
SUWANNEE RIVER WATER MANAGEMENT DISTRICT
REQUEST FOR INFORMATION (RFI)
HEALTH INSURANCE RFP NO. 22/23-001
Yes No
1. Comply with 120 day notice requirement of any rate change/renewal?
2. Attend monthly meetings with Risk Management and Agent to discuss claims experience?
3. Provide monthly claims experience reports?
Provide other detailed experience reports annually, or as needed to evaluate claims and overall experience, trend, etc.?
4. Provide and mail ID cards to Members prior to renewal effective date?
5. Do you provide COBRA administration?
If Yes, what is the cost?
If No, can you contract with a Company/TPA to administer COBRA and what is the cost?
6. Will a Service Representative be assigned as a direct contact for Risk
Management and Agent to access for customer service, membership
& billing, and claims issues?
7. Will a Service Rep(s) be provided to assist with Plan Implementation and annual Open Enrollment meetings to explain benefits to employees?
8. Will Open Enrollment packets be developed and provided for employees annually?
9. Is a Mail Order Benefit included in your proposed Plans?
What is the copay amount and how many days supply?
What company provides your mail order service?
10. Do you provide Disease/Case Management for claimants? Explain how you contact claimants and provide information and services to them:
11. Provide Annual Health Fair, blood screenings and Health Risk
Assessment for employees?
12. Provide Health Coaches for employees to access 24 hours a day for assistance with health questions?
13. Provide an instructor to conduct health seminar/classes on various health wellness topics and also on explaining plan benefits monthly or semi-monthly?
14. Provide copies of Health and Wellness information to Risk
Management and Agent for distribution to employees and retirees?
15. Provide 5 copies of your Florida Northeast Region Provider
Directory.
16. List the hospitals in Suwannee, Columbia, and Alachua County, FL that are currently included in your network:
17. How many of your participating providers are accepting new patients?
18. What Independent clinical labs In Suwannee, Columbia, and Alachua County, FL are currently included in your Network?
19. In the plan designs proposed, how are independent clinical labs covered and what is the cost/coinsurance to members?
20. On the plans proposed, please clarify what the hospital benefit is? Is it a flat copayment per admission? Does the deductible apply? If so, how much? Is it deductible and coinsurance?
If so, how much?
21. Clarify what is included in the Member’s Maximum out of Pocket? Deductibles, copays, coinsurance, etc. If certain copays, etc., are not included, please specify what these are.
22. Complete the attached Network Discount Analysis for Suwannee, Columbia, and Alachua
County, FL. It is very important that this information be completed in full. This information is required to compare network discounts and the overall impact to claims experience.
23. Explain how members traveling or living out of State will access your network and how their patient dollar responsibility will be calculated.
24. Provide the rating methodology that your underwriters used to arrive at your proposed rates and the methodology that will be used for future renewals?
25. What financial commitment (stated in US dollars) are you willing to make to underwrite the cost of the District’s benefits communications plan? Will this be a one time commitment or annual?
Completed and submitted by:
Name and Title Date
| Yes1 Comply with 120 day notice requirement of any rate changerenewal: |
| No1 Comply with 120 day notice requirement of any rate changerenewal: |
| Yes2 Attend monthly meetings with Risk Management and Agent to discuss claims experience: |
| No2 Attend monthly meetings with Risk Management and Agent to discuss claims experience: |
| Yes3 Provide monthly claims experience reports: |
| No3 Provide monthly claims experience reports: |
| YesProvide other detailed experience reports annually or as needed to evaluate claims and overall experience trend etc: |
| NoProvide other detailed experience reports annually or as needed to evaluate claims and overall experience trend etc: |
| Yes4 Provide and mail ID cards to Members prior to renewal effective date: |
| No4 Provide and mail ID cards to Members prior to renewal effective date: |
| If Yes what is the cost: |
| and what is the cost: |
| Yes5 Do you provide COBRA administration If Yes what is the cost If No can you contract with a CompanyTPA to administer COBRA and what is the cost: |
| No5 Do you provide COBRA administration If Yes what is the cost If No can you contract with a CompanyTPA to administer COBRA and what is the cost: |
| Yes6 Will a Service Representative be assigned as a direct contact for Risk Management and Agent to access for customer service membership billing and claims issues: |
| No6 Will a Service Representative be assigned as a direct contact for Risk Management and Agent to access for customer service membership billing and claims issues: |
| Yes7 Will a Service Reps be provided to assist with Plan Implementation and annual Open Enrollment meetings to explain benefits to employees: |
| No7 Will a Service Reps be provided to assist with Plan Implementation and annual Open Enrollment meetings to explain benefits to employees: |
| Yes8 Will Open Enrollment packets be developed and provided for employees annually: |
| No8 Will Open Enrollment packets be developed and provided for employees annually: |
| undefined: |
| 10 Do you provide DiseaseCase Management for claimants Explain: |
| 11 Provide Annual Health Fair blood screenings and Health Risk Assessment for employees: |
| 12 Provide Health Coaches for employees to access 24 hours a day for assistance with health questions: |
| 13 Provide an instructor to conduct health seminarclasses on various health wellness topics and also on explaining plan benefits monthly or semimonthly: |
| 14 Provide copies of Health and Wellness information to Risk Management and Agent for distribution to employees and retirees: |
| 15 Provide 5 copies of your Florida Northeast Region Provider Directory: |
| 16 List the hospitals in Suwannee Columbia and Alachua County FL that are currently included in your network: |
| 17 How many of your participating providers are accepting new patients: |
| 18 What Independent clinical labs In Suwannee Columbia and Alachua County FL are currently included in your Network: |
| 19 In the plan designs proposed how are independent clinical labs covered and what is the costcoinsurance to members: |
| 20 On the plans proposed please clarify what the hospital benefit is Is it a flat copayment per admission Does the deductible apply If so how much Is it deductible and coinsurance If so how much: |
| 21 Clarify what is included in the Members Maximum out of Pocket Deductibles copays coinsurance etc If certain copays etc are not included please specify what these are: |
| 22 Complete the attached Network Discount Analysis for Suwannee Columbia and Alachua County FL It is very important that this information be completed in full This information is required to compare network discounts and the overall impact to claims experience: |
| patient dollar responsibility will be calculated: |
| 24 Provide the rating methodology that your underwriters used to arrive at your proposed rates and the methodology that will be used for future renewals: |
| Name and Title: |
| Date: |
| Date_2: |
| Completed and submitted by Name and TitleRow1: |
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
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