RFP 180000001030 Questions and Answers Final.docx

DOCX document 100 KB Posted Mar 12, 2018

Attached to: Vision Insurance Plan Administration for CSC
Solicitation number: RFP-171-180000001030-4
Issued by: Grand Traverse County, Lansing City, Michigan

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Written by GovTribe AI · Feb 13, 2025

This is a Questions and Answers document from the State of Michigan Enterprise Procurement Department of Technology, Management, and Budget regarding RFP No. 180000001030 for Vision Insurance Plan Administration for the Civil Service Commission. The document addresses 34 questions from potential bidders covering various aspects of the RFP, including proposal submissions which are due by 1:50 PM Eastern Time, requirements for submitting five copies each of technical proposals, attachments, and price proposals, and confirmation that oral presentations are not currently planned but may be required during evaluation.

The current administrative fee is $0.50 Per Contract Per Month (PCPM), with monthly administrative fees in 2016-2017 ranging from approximately $49,150 to $49,622. The plan is self-funded and utilizes the VSP Choice Network. The vision plan provides coverage for active employees and retirees, with identical benefits except for computer and safety glasses which are only available to active employees. Premium sharing varies by employment status: active full-time employees receive 100% state contribution, part-time employees receive either 100% or 50% based on hire date, retirees pay 10%, and COBRA participants pay 102%. Key performance guarantees include mailing ID cards within 10 calendar days and answering 95% of calls within 30 seconds.

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Other files

File	Type	Posted
Schedule D - GeoAccess Data Final_Rev 2-28-18.xlsx	XLSX spreadsheet	Mar 12, 2018
Standard Contract Terms Final.docx	DOCX document	Mar 12, 2018
Vision RPF Q&A #28.xlsx	XLSX spreadsheet	Mar 12, 2018
Vision RPF Q&A #33.xlsx	XLSX spreadsheet	Mar 12, 2018
Schedule A - Final.docx	DOCX document	Mar 12, 2018
Schedule C - Plan Design Final.docx	DOCX document	Mar 12, 2018
Schedule E - HIPAA 834 File Layouts Final.pdf	PDF	Mar 12, 2018
Schedule F - Provider Cost Claims Data Final.XLSX	XLSX spreadsheet	Mar 12, 2018
Schedule J Safeguard Requirements of Confidential Data Final.docx	DOCX document	Mar 12, 2018
Proposal Instructions and Vendor Questions Worksheet Final.docx	DOCX document	Mar 12, 2018
Schedule B - Pricing Matrix Final.xlsx	XLSX spreadsheet	Mar 12, 2018
Schedule G - Provider Location Data for Disruption Analysis Final_Rev 2-28-18.xlsx	XLSX spreadsheet	Mar 12, 2018
Schedule H - Sample Claims Report and Invoice Format Final.xlsx	XLSX spreadsheet	Mar 12, 2018
Schedule I - SLA Reporting Format Final.pdf	PDF	Mar 12, 2018

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STATE OF MICHIGAN

ENTERPRISE PROCUREMENT

Department of Technology, Management, and Budget

525 W. Allegan St., Lansing, Michigan 48913

P.O. Box 30026 Lansing, Michigan 48909

Bidder Questions & Answers RFP No. 180000001030 Vision Insurance Plan Administration for the Civil Service Commission

Q #

Document Name

Section #

Page #

Requirement #

Bidder Question

Answer

Schedule G

Disruption Actives/Disruption Retiree

All

We need Tax Identification or NPI (National Provider Identifier) to run a disruption.

See “Schedule G – Provider Location Data for Disruption Analysis Final_Rev 2-28-18” for NPI information.

Note: NPI information is not available for Out-of-Network providers.

Schedule G

Disruption Actives/Disruption Retirees

All

Do you want one disruption or a combined disruption report?

There should be a disruption report for the active members and one for the retiree members, as indicated on Schedule G (provide results on the applicable tabs).

Schedule B

Pricing Matrix

Please provide current ASO Fee.

$0.50 Per Contract Per Month (PCPM).

Schedule C

All

Plan Design

Please provide Vision Certificate of Insurance.

There is not a Vision Certificate of Insurance;

see hyperlinks listed below for the vision plan booklets:

State Vision Plan for Employees State Vision Plan for Retirees

Schedule C

All

Plan Design

Is the State of Michigan open to plan design suggestions? Not recommending enhancements, just updated language.

Contractor must be able to duplicate the State Vision Plan Design; Contractor can also notate suggested language changes in the applicable Bidder response box(es).

Schedule C

All

Plan Design

Please confirm, active and retirees have the same plan design. The second plan design is for computer glasses, and the third plan design is for safety glasses.

State of Michigan (SOM) active and retired employees have the same vision plan design with the exception of computer and safety glasses; these benefits are only available to active employees and not applicable to dependents.

Schedule A

Background

Please confirm State of Michigan contributes 100% for actives, 90% for retirees and 50% for part-time employees.

This information is not necessary for Bidder to submit a response, as this is a self-funded plan.

The premium share for the State Vision Plan is as follows:

Active employees; SOM – 100%, Employee – 0%

Part-time employees (working at least 40% of full-time) hired prior to 1/1/2000: SOM 100%, Employee – 0% Part-time employees (working at least 40% of full-time) hired on or after 1/1/2000: SOM 50%, Employee – 50%

Retiree: SOM – 90%, Retiree – 10%

COBRA: SOM – 0%; COBRA Participant 102%

Proposal Instructions and Vendor Questions Worksheet

RFP Timeline

Please advise if you will be holding finalist presentations?

At this time, oral presentations are not planned, however the State reserves the right to required oral presentations at any point during the evaluation process per Proposal Instructions Section 7 Evaluation Process.

Schedule A

D. Provider Network

Can you advise the percentage of claims which go to Ophthalmologists?

12.5% of claims are for Ophthalmologists’ services.

Schedule A

Section I Performance Guarantees / Service Level Agreements (SLAs)

Is the State open to allowing for slight variations to meeting SLA’s?

Contractor must agree to the SLAs as outlined in Schedule A. If a Contractor takes exception to the SLAs as stated, they must clearly identify any deviation in the applicable Bidder response box. Exceptions will be a proposal deficiency and will impact evaluation scoring.

Terms and Conditions

Is there flexibility in being able to negotiate the Terms and Conditions to language that is mutually agreeable? (As an example, the requirements in the Safeguard Requirements of Confidential Data Info Security – there may be a need to modify language to meet both SOM and VSP business partner needs.)

The State strongly encourages strict adherence to the Contract Terms. The State reserves the right to deem a bid non-responsive for failure to accept the Contract Terms. Nevertheless, the Bidder may submit proposed changes to the Contract Terms in track changes (i.e., visible edits) with an explanation of the Bidder’s need for each proposed change. Failure to include track changes with an explanation of the Bidder’s need for the proposed change constitutes the Bidder’s acceptance of the Contract Terms. General statements, such as that the Bidder reserves the right to negotiate the terms and conditions, may be considered non-responsive.

Schedule E - File Layouts Final

Schedule E - HIPAA 834 File Layouts Final

Please confirm which Schedule E should be reviewed.

Schedule E, HIPAA 834 File Layouts applies and Schedule E – File Layouts does not apply.

RFP

RFP Timeline

Proposal Deadline & Time Due

Please clarify the time the proposal is due. The RFP Timeline table states 1:50pm EST, but the footnote then states proposals received after 3:01pm EST are considered late.

Are proposals due by 1:50pm EST or 3:00pm EST?

The correct time is 1:50PM Eastern Time. Proposals received after 1:50PM Eastern Time are considered late.

RFP

Proposal Instructions

5. Delivery of Proposal

RFP states "Bidder should submit [5] copies of its technical proposal, attachments, and separately sealed price proposal."

Please clarify if Bidders are to include [5] copies of the Technical Proposal AND [5] copies of the separately sealed Price Proposal.

Bidders must submit [5] copies of their complete proposal:

[5] of technical proposal [5] of any attachments [5] of price proposal

RFP

Proposal Instructions

1. Proposal Preparation

Please provide separate lists of the exact documents to be included within:

a. Technical Proposal

b. Price Proposal

Please specifically address where to include the following:

-Schedule F -Supporting attachments requested by the state -FOIA-EXEMPT file Technical Proposal:

· Vendor Questions Worksheet

· Schedule A, Statement of Work

· Schedule D, GeoAccess Data,

· Schedule G, Provider Location Data for Disruption Analysis

Price Proposal:

· Schedule B, Pricing Matrix

· Schedule F, Provider Cost & Claims Data

The State does not anticipate FOIA-EXEMPT information, however Bidders must follow the requirements in Proposal Instructions Section 15 Freedom of Information Act. In addition to following those requirements, Bidders must include it within the portion of the proposal that it applies.

RFP

Proposal Instructions

1. Proposal Preparation

Please confirm that Bidders may include additional supporting documents within their submission, and that they are to be included within the Technical Proposal.

Bidders may include additional supporting documents within their submission; Bidders must clearly reference their documents within the response box in Schedule A for which the additional supporting documents are being provided and relevant to. All documents provided must be clearly labelled.

RFP

Proposal Instructions

15. Freedom of Information Act

Please clarify if Bidders are required to provide both a hard copy and electronic version of the FOIA-EXEMPT file.

If hard copies are required, and are to be separate from the Technical Proposal, please clarify the number of "FOIA-EXEMPT" hard copies to be provided.

See the answer to Questions 14 and 15. [5] copies of Bidder’s complete proposal, including any potential FOIA-Exempt files, must be provided.

Schedule A

1. Requirements, A. General Requirements

1.A.2

Please confirm that Bidders may provide a copy of their Certificate of Good Standing for the State of Michigan to meet the following requirement: "details regarding any statutory cites that permit the Contractor to meet this requirement"

The Bidder must be a licensed Third Party Administrator (TPA) under the Third Party Administrator Act (MCL 550.901), an insurance carrier licensed in Michigan accepted from the TPA Act’s licensure requirements, a non-profit health care corporation under the Non-Profit Health Care Corporation Reform Act (MCL 550.1101), or authorized by another statute. The Bidder must cite which statute authorizes it to perform the services in the RFP and is encouraged to provide any additional certification supporting its claim of authorization.

Schedule A

1. Requirements, F. Member Communications Materials and Meetings

1.F.2.a & 1.F.2.b

Please provide an estimate of the total number of events that occur per year for both Plan Sponsor meetings and Member Support organizations.

Onsite meeting will vary from year to year and may include retiree and employee group meetings; it is estimated that it should not be greater than 4 events in any given year.

In addition, Insurance Open Enrollment events are held jointly with other carriers at split cost site rentals and materials in which Contractor would have the opportunity to participate.

Schedule A

1. Requirements, I. Performance Guarantees / Service Level Agreements (SLAs)

SLA #1

Please clarify if ID Cards are to be mailed within 10 business days or 10 calendar days.

ID Cards must be mailed within 10 calendar days.

Schedule A

1. Requirements, I. Performance Guarantees / Service Level Agreements (SLAs)

SLA #3

The metric name is listed as Average Speed to Answer, however, the guarantee language is regarding service level.

Please clarify if you are asking:

All calls be answered in an average of 30 seconds

95% of calls be answered in 30 seconds 95% of the calls must be answered in 30 seconds or less, otherwise the Contractor would not meet the SLA requirement, which would result in a penalty of 1.5% of the admin fee for each month missed.

Schedule A

1. Requirements, I. Performance Guarantees / Service Level Agreements (SLAs)

SLA #5

Please confirm this standard is regarding written inquiries.

SLA #5 is applicable to all member inquires, not just written inquiries.

Please be advised, SLA #2 states “95.00% or greater of Member calls to Contractor’s toll-free telephone line must be resolved within 24 hours of a Customer Service Representative’s receipt of the call. A call is considered unresolved if a Member calls Contractor’s toll-free telephone line with the same ‘reason for call’ within the immediately subsequent five day period.”.

Therefore, the other 5% of calls that are not resolved within that timeframe would fall into the SLA #5 category, which states “Contractor must resolve 95.00% of all Member Inquiries within five Business Days of receipt; 100.00% of all Inquiries must be resolved within 10 Business Days. Inquiries will include those forwarded to the Contractor by the Plan Sponsor and the receipt date will be considered the date the inquiry is received by the Contractor.”

So in addition to member calls, SLA #5 also is applicable to emails, written inquires, etc.- all member inquires

Schedule C

Eyeglass Lenses

Replacement Schedule

What is the minimum level of prescription change for employees/dependents to qualify for new lenses every 12 months?

There is not a minimum level.

Schedule E

Entire file

All

N/A

Two separate Schedule E documents were provided. Please confirm that both files contain the same information.

See the answer to Question 12.

N/A

Please provide the current fee schedule

See the answer to Question 3.

N/A

Please provide the current ASO fees/administrative fees that are billed by month for 2016-2017.

Oct-16: $49,150.92

Nov-16: $49,376.81 Dec-16: $49,386.61 Jan-17: $49,388.57 Feb-17: $49,360.64 Mar-17: $49,420.91 Apr-17: $49,454.72 May-17: $49,507.15 Jun-17: $49,529.20 Jul-17: $49,622.30 Aug-17: $49,603.19 Sep-17: $49,594.86

N/A

Which VSP Network is currently utilized for vision coverage?

Choice Network

N/A

Please provide enrollment by tiers (ee only, ee + spouse, ee + child(ren), ee + family, waived, etc…) broken down by employee and dependents by month for the last two years.

See attachment “Vision RFP Q&A #28” for enrollment data broken down by tier/option codes for active employees and dependents, and retirees for CY16 & CY17.

Note: a breakdown between retirees and retiree’s dependents is not available.

Schedule A

1.F.1.a.1

The Contractor must create both a brief Plan Summary and a detailed Plan Booklet for members.

Are these items expected to be printed and distributed to employee’s homes? Is the booklet part of the overall benefit booklet or specific to vision? Do you have an example?

These documents are expected to be accessible to member electronically, however if hard copies are required for presentations or upon request of a member or the Plan Sponsor they must be made available in a timely manner, to be mutually agreed upon by the Program Manager and Contractor.

The booklets are specific to the State Vision plan.

See hyperlinks listed below for examples of the current booklets and summaries:

State Vision Plan for Employees State Vision Summary of Benefits for Employees State Vision Plan for Retirees State Vision Plan Summary of Benefits for Retirees

Schedule A

1.F.1.a.5

The Contractor must provide Explanation of Benefits (EOB) that detail charges, copays, outstanding benefit limits, and contact information for following up with questions or Appeal in easy-to-read language. Any denial of claims must have a detailed, understandable explanation of reason for denial.

Is electronic access to EOB’s acceptable or do you require hard copies be mailed to employee’s homes?

Access to electronic EOBs is acceptable as long as if/when a member or the Plan Sponsor requires that a hard-copy EOB be produced, the Contractor is able to provide this in a timely manner, to be mutually agreed upon by the Program Manager and Contractor.

Schedule A

1.F.2.a.

Contractor must provide speakers at meetings designated by Plan Sponsor at no additional charge to the Plan Sponsor. Meeting requests may vary from year-to-year.

Can you please provide the 2017 event schedule? Is there any additional cost to vendors for meetings (i.e.: venue rental)?

See the answer to Question 19.

Schedule C

Plan Design

Materials frequency:

Once every 24 months or once every 12 months if prescription has changed.

Does the State require any formal documentation to justify a prescription change? Is this option provided to both employees and dependents? How many members qualified for the 12 month frequency in the last 2 years?

No, formal documentation does not need to be submitted directly to the SOM, however there would need to be documentation (i.e., prescription) presented to the Contractor in order to verify the prescription change.

This option is available to all members covered under the contract holder’s policy.

The specific data requested is unavailable, however from an underwriting standpoint, the current Contractor projects a 5% claim cost attributable to interim benefits.

Schedule C

Plan Design

VDT and Safety Glasses: Departmental employer must certify business need; not applicable to dependents or retirees.

Can you provide the number of VDT claims for the last 2 years? The number of safety claims?

Coverage of Computer and Safety glasses began under the State Vision Plan effective Oct. ’16, therefore information pertaining to this is only available for FY17.

See attachment “Vision RFP Q&A #33”.

Schedule D

GEOACCESS DATA

N/A

Please note that the State has revised Schedule D, GEOACCESS DATA to include separate sections for Optometrists, Ophthalmologists, and Retail locations data to be input on the Active and Retiree tabs. The attached revised Schedule D GeoAccess Data Final_Rev 2-28-18 replaces and supersedes the originally attached Schedule D GEOACCESS DATA.

Version 1 Revised Date: 7/28/2017 image1.jpeg

File details come from the government source that posted it. Updated Feb 13, 2025.