RFP Document.pdf

STATE OF SOUTH DAKOTA

BUREAU OF HUMAN RESOURCES AND ADMINISTRATION

500 EAST CAPITOL AVENUE

PIERRE, SOUTH DAKOTA 57501-3182

SOUTH DAKOTA STATE EMPLOYEE HEALTH PLAN ACTUARY AND BENEFITS CONSULTANT

PROPOSALS ARE DUE NO LATER THAN 5:00 PM, CDT ON FEBRUARY 21, 2025

RFP #:

24RFP10766

State POC: Bureau of Human Resources and Administration - Angi Kappenman

EMAIL: 24RFP10766@state.sd.us

READ CAREFULLY

FIRM NAME: AUTHORIZED SIGNATURE:

ADDRESS: TYPE OR PRINT NAME:

CITY/STATE: TELEPHONE NO:

ZIP (9 DIGIT): FAX NO:

E-MAIL:

PRIMARY CONTACT INFORMATION

CONTACT NAME: TELEPHONE NO:

FAX NO: E-MAIL:

1.0 GENERAL INFORMATION

1.1 PURPOSE OF REQUEST FOR PROPOSAL (RFP)

The State of South Dakota Bureau of Human Resources and Administration (“BHRA”) invites qualified bidders to submit proposals for health plan strategy, plan design consulting, and actuarial services.

The South Dakota State Employee Health Plan (“SDSEHP”) operates as a self-funded health plan, administered by BHRA. To ensure effective management, the State requires annual actuarial services to project claims activity, assess reserve requirements at fiscal year-end, and support the financial and strategic planning of the health plan.

The selected vendor will:

• Provide claims activity projections and determine reserve levels needed at the close of each fiscal year.

• Deliver a Statement of Actuarial Opinion and an Actuarial Memorandum, including a range estimate for liabilities related to Incurred But Not Reported (“IBNR”) claims for the SDSEHP.

• Evaluate the actuarial soundness of the SDSEHP to ensure compliance with federal, state, and local laws.

Additionally, the vendor will offer comprehensive actuarial and consulting services, including:

• Modeling cost projections for proposed benefit design changes.

• Recommending annual premium rate adjustments or assessing fiscal impacts of benefit modifications.

• Developing blended premium rate structures for plan participants, if requested.

• Monitoring and reporting on actual income and expenses compared to projections.

• Advising the State on alternative strategies to equalize risks and/or costs among the health plans offered.

Timeliness and responsiveness are crucial, particularly during high-demand periods from August to October and January to March. During these times, the selected vendor must deliver prompt support for budget modeling, plan design evaluation, and legislative inquiries.

By aligning with these objectives, the chosen offeror will enable the State of South Dakota to maintain a financially sustainable, compliant, and effective health benefits program for its employees.

The State’s Philosophy of Employee Benefit Plan Management

The State manages its employee benefits plan on a business-like basis to equal benefit of the member and taxpayer, working to achieve hard savings by avoiding waste, having a TPA agreement with Wellmark BC/BS, direct contracts where appropriate to support population health strategies, and educating employees for efficient use of health care spend. The offeror will help ensure the efficient operation of the State’s prescription drug benefit services as part of the SDSEHP.

1.2 ISSUING OFFICE AND RFP REFERENCE NUMBER

The Bureau of Human Resources and Administration is the issuing office for this document and all subsequent addenda relating to it, on behalf of the State of South Dakota, Bureau of Human Resources and Administration.

The reference number for the transaction is RFP #24RFP10766. This number must be referred to on all proposals, correspondence, and documentation relating to the RFP.

1.3 SCHEDULE OF ACTIVITIES (SUBJECT TO CHANGE)

Description Due Date RFP Publication January 6, 2025 Deadline for Submission of Written Inquiries January 24, 2025 Responses to Offeror Questions January 31, 2025 RFP proposals due February 21, 2025 Oral Presentations/discussions/Site Visit in Pierre (if required)

March 24-April 11, 2025

Anticipated Award Decision/Contract Negotiation May 9,2025

1.4 SITE VISITS

The State may require site visits for offerors. BHRA expect these visits, if desired, will be held March 24 – April 11, 2025. The offeror will be contacted to schedule a site visit if one is required for selection.

1.5 SUBMITTING YOUR PROPOSAL

All proposals must be completed and received by the Bureau of Human Resources and Administration by the date and time indicated in the Schedule of Activities.

Proposals received after the deadline will be late and ineligible for consideration.

The offeror must provide one (1) copy of their entire proposal, including all attachments, in Microsoft Word, EXCEL or PDF electronic format by email to 24RFP10766@state.sd.us. Additionally, an original and four (4) identical copies of the proposal along with any attachments shall be submitted in hardcopy format to the address below.

All proposals must be signed, in ink, by an officer of the responder, legally authorized to bind the responder to the proposal, and sealed in the form intended by the respondent. Proposals that are not properly signed may be rejected. The sealed envelope should be marked with the appropriate RFP Number and Title. Proposals should be addressed and labeled as follows:

Request for Proposal #24RFP10766 Proposal Due February 21, 2025 Angi Kappenman, Director Total Rewards SD Bureau of Human Resources and Administration 500 East Capitol Avenue Pierre, SD 57501-5070

No proposal shall be accepted from, or no contract or purchase order shall be awarded to any person, firm or corporation that is in arrears upon any obligations to the State of South Dakota, or that otherwise may be deemed irresponsible or unreliable by the State of South Dakota.

1.6 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION

– LOWER TIER COVERED TRANSACTIONS

By signing and submitting this proposal, the offeror certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation, by any Federal department or agency, from transactions involving the use of Federal funds. Where the offeror is unable to certify to any of the statements in this certification, the bidder shall attach an explanation to their offer.

1.7 NON-DISCRIMINATION STATEMENT

mailto:24RFP10766@state.sd.us

The State of South Dakota requires that all contractors, vendors, and suppliers doing business with any State agency, department, or institution, provide a statement of non-discrimination. By signing and submitting their proposal, the offeror certifies they do not discriminate in their employment practices with regard to race, color, creed, religion, age, sex, ancestry, national origin or disability.

1.8 CERTIFICATION RELATING TO PROHIBITED ENTITY

For contractors, vendors, suppliers, or subcontractors who enter into a contract with the State of South Dakota by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, is not an entity, regardless of its principal place of business, that is ultimately owned or controlled, directly or indirectly, by a foreign national, a foreign parent entity, or foreign government from China, Iran, North Korea, Russia, Cuba, or Venezuela, as defined by SDCL 5-18A. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response.

The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.9 RESTRICTION OF BOYCOTT OF ISRAEL

For contractors, vendors, suppliers, or subcontractors with five (5) or more employees who enter into a contract with the State of South Dakota that involves the expenditure of one hundred thousand dollars ($100,000) or more, by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, has not refused to transact business activities, has not terminated business activities, and has not taken other similar actions intended to limit its commercial relations, related to the subject matter of the bid or offer, with a person or entity on the basis of Israeli national origin, or residence or incorporation in Israel or its territories, with the specific intent to accomplish a boycott or divestment of Israel in a discriminatory manner. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response. The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.10 CERTIFICATION OF NO STATE LEGISLATOR INTEREST

Offeror (i) understands neither a state legislator nor a business in which a state legislator has an ownership interest may be directly or indirectly interested in any contract with the State that was authorized by any law passed during the term for which that legislator was elected, or within one year thereafter, and (ii) has read South Dakota Constitution Article 3, Section 12 and has had the opportunity to seek independent legal advice on the applicability of that provision to any Agreement entered into as a result of this RFP. By signing an Agreement pursuant to this RFP, Offeror hereby certifies that the Agreement is not made in violation of the South Dakota Constitution Article 3, Section 12.

1.11 MODIFICATION OR WITHDRAWAL OF PROPOSALS

Proposals may be modified or withdrawn by the offeror prior to the established due date and time.

No oral, telephonic, telegraphic or facsimile responses or modifications to informal, formal bids, or Request for Proposals will be considered.

1.12 OFFEROR INQUIRIES

Offerors may email inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the Schedule of Activities. Inquiries must be emailed to Angi Kappenman at 24RFP10766@state.sd.us with the subject line “RFP #24RFP10766”.

The State will respond to offeror’s inquiries (if required) via e-mail. In addition, all inquiries and the State’s response will be posted on the state’s e-procurement system. Offerors may not rely on any other statements, either of a written or oral nature, that alter any specification or other term or condition of this RFP. Offerors will be notified in the same manner as indicated above regarding any modifications to this RFP.

1.13 PROPRIETARY INFORMATION

The proposal of the successful offeror(s) becomes public information. Proprietary information can be protected under limited circumstances such as client lists and non-public financial statements. An entire proposal may not be marked as proprietary. Offerors must clearly identify in the Executive Summary and mark in the body of the proposal any specific proprietary information they are requesting to be protected. The Executive Summary must contain specific justification explaining why the information is to be protected. Proposals may be reviewed and evaluated by any person at the discretion of the State. All materials submitted become the property of the State of South Dakota and may be returned only at the State's option.

1.14 LENGTH OF CONTRACT

The State is requesting proposals for a period of five (5) years effective July 1, 2025, through June 30, 2030, with the State having the option to renew for two (2) additional one (1) year periods.

1.15 GOVERNING LAW

Venue for any and all legal action regarding or arising out of the transaction covered herein shall be solely in the State of South Dakota. The laws of South Dakota shall govern this transaction.

1.16 DISCUSSIONS WITH OFFERORS (ORAL PRESENTATION/NEGOTIATIONS)

An oral presentation by an offeror to clarify a proposal may be required at the sole discretion of the State.

However, the State may award a contract based on the initial proposals received without discussion with the Offeror. If oral presentations are required, they will be scheduled after the submission of proposals. Oral presentations will be made at the offeror’s expense.

This process is a Request for Proposal/Competitive Negotiation process. Each Proposal shall be evaluated, and each respondent shall be available for negotiation meetings at the State’s request. The State reserves the right to negotiate on any and/or all components of every proposal submitted. From the time the proposals are submitted until the formal award of a contract, each proposal is considered a working document and as such, will be kept confidential. The negotiation discussions will also be held as confidential until such time as the award is completed.

2.0 STANDARD CONTRACT TERMS AND CONDITIONS

Any contract or agreement resulting from this RFP will include the State’s standard terms and conditions as listed below, along with any additional terms and conditions as negotiated by the parties:

2.1 The Contractor will perform those services described in the Scope of Work, attached hereto as Section 3 of the RFP and by this reference incorporated herein. The Contractor’s response to this RFP shall be considered part of the Work Plan.

2.2 The Contractor’s services under this Agreement shall commence on July 1, 2025, and end on June 30, 2030, unless sooner terminated pursuant to the terms hereof. The State will have the option to renew this Agreement for two (2) additional one (1) year periods as mutually agreed upon by all parties.

Renewal Options: At a minimum, renewal is contingent upon satisfactory performance of the contract by the Contractor as determined by the State. The Parties agree that the State may renew this Agreement at its option under the same terms and conditions, unless otherwise modified by a special contract term, condition, specification, or amendment. Notice of intent to renew will be given by the State to the Contractor at least 90 days prior to the end of the current contract term. If the notice of intent to renew is given, the Agreement will renew unless terminated by either party pursuant to the Termination provision of this Agreement.

2.3 The Contractor will not use State equipment, supplies or facilities. The Contractor will provide the State with its

Employer Identification Number, Federal Tax Identification Number or Social Security Number upon execution of this Agreement.

2.4 The State will make payment for services upon satisfactory completion of the services. The TOTAL CONTRACT

AMOUNT is an amount not to exceed $________________. The State will not pay Contractor's expenses as a separate item. Payment will be made pursuant to itemized invoices submitted with a signed state voucher.

Payment will be made consistent with SDCL ch. 5-26.

2.5 The Contractor agrees to indemnify and hold the State of South Dakota, its officers, agents and employees, harmless from and against any and all actions, suits, damages, liability or other proceedings that may arise as the result of performing services hereunder. This section does not require the Contractor to be responsible for or defend against claims or damages arising solely from errors or omissions of the State, its officers, agents or employees.

2.6 The Contractor, at all times during the term of this Agreement, shall obtain and maintain in force insurance coverage of the types and with the limits as follows:

A. Commercial General Liability Insurance:

The Contractor shall maintain occurrence based commercial general liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each occurrence. If such insurance contains a general aggregate limit it shall apply separately to this Agreement or be no less than two times the occurrence limit.

B. Professional Liability Insurance or Miscellaneous Professional Liability Insurance:

The Contractor agrees to procure and maintain professional liability insurance or miscellaneous professional liability insurance with a limit not less than $1,000,000.00.

C. Business Automobile Liability Insurance:

The Contractor shall maintain business automobile liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each accident. Such insurance shall include coverage for owned, hired and non-owned vehicles.

D. Worker’s Compensation Insurance:

The Contractor shall procure and maintain workers’ compensation and employers’ liability insurance as required by South Dakota law.

Before beginning work under this Agreement, Contractor shall furnish the State with properly executed Certificates of Insurance which shall clearly evidence all insurance required in this Agreement. In the event a substantial change in insurance, issuance of a new policy, cancellation or nonrenewal of the policy, the Contractor agrees to provide immediate notice to the State and provide a new certificate of insurance showing continuous coverage in the amounts required. Contractor shall furnish copies of insurance policies if requested by the State.

2.7 While performing services hereunder, the Contractor is an independent contractor and not an officer, agent, or employee of the State of South Dakota.

2.8 Contractor agrees to report to the State any event encountered in the course of performance of this Agreement which results in injury to the person or property of third parties, or which may otherwise subject Contractor or the State to liability. Contractor shall report any such event to the State immediately upon discovery.

Contractor's obligation under this section shall only be to report the occurrence of any event to the State and to make any other report provided for by their duties or applicable law. Contractor's obligation to report shall not require disclosure of any information subject to privilege or confidentiality under law (e.g., attorney-client communications). Reporting to the State under this section shall not excuse or satisfy any obligation of Contractor to report any event to law enforcement or other entities under the requirements of any applicable law.

2.9 This Agreement may be terminated by either party hereto upon ninety (90) days written notice. In the event the

Contractor breaches any of the terms or conditions hereof, this Agreement may be terminated by the State at any time with or without notice. If termination for such a default is effected by the State, any payments due to Contractor at the time of termination may be adjusted to cover any additional costs to the State because of Contractor's default. Upon termination the State may take over the work and may award another party an agreement to complete the work under this Agreement. If after the State terminates for a default by Contractor it is determined that Contractor was not at fault, then the Contractor shall be paid for eligible services rendered and expenses incurred up to the date of termination.

2.10 This Agreement depends upon the continued availability of appropriated funds and expenditure authority from the

Legislature for this purpose. If for any reason the Legislature fails to appropriate funds or grant expenditure authority, or funds become unavailable by operation of law or federal funds reductions, this Agreement will be terminated by the State. Termination for any of these reasons is not a default by the State nor does it give rise to a claim against the State.

2.11 This Agreement may not be assigned without the express prior written consent of the State. This Agreement may not be amended except in writing, which writing shall be expressly identified as a part hereof, and be signed by an authorized representative of each of the parties hereto.

2.12 This Agreement shall be governed by and construed in accordance with the laws of the State of South Dakota.

Any lawsuit pertaining to or affecting this Agreement shall be venued in Circuit Court, Sixth Judicial Circuit, Hughes County, South Dakota.

2.13 The Contractor will comply with all federal, state and local laws, regulations, ordinances, guidelines, permits and requirements applicable to providing services pursuant to this Agreement, and will be solely responsible for obtaining current information on such requirements.

2.14 The Contractor may not use subcontractors to perform the services described herein without the express prior written consent of the State. The Contractor will include provisions in its subcontracts requiring its subcontractors to comply with the applicable provisions of this Agreement, to indemnify the State, and to provide insurance coverage for the benefit of the State in a manner consistent with this Agreement. The Contractor will cause its subcontractors, agents, and employees to comply, with applicable federal, state and local laws, regulations, ordinances, guidelines, permits and requirements and will adopt such review and inspection procedures as are necessary to assure such compliance.

2.15 Contractor hereby acknowledges and agrees that all reports, plans, specifications, technical data, miscellaneous drawings, software system programs and documentation, procedures, or files, operating instructions and procedures, source code(s) and documentation, including those necessary to upgrade and maintain the software program, and all information contained therein provided to the State by the Contractor in connection with its performance of services under this Agreement shall belong to and is the property of the State and will not be used in any way by the Contractor without the written consent of the State. Papers, reports, forms, software programs, source code(s) and other material which are a part of the work under this Agreement will not be copyrighted without written approval of the State.

2.16 The Contractor certifies that neither Contractor nor its principals are presently debarred, suspended, proposed for debarment or suspension, or declared ineligible from participating in transactions by the federal government or any state or local government department or agency. Contractor further agrees that it will immediately notify the State if during the term of this Agreement Contractor or its principals become subject to debarment, suspension or ineligibility from participating in transactions by the federal government, or by any state or local government department or agency.

2.17 Any notice or other communication required under this Agreement shall be in writing and sent to the address set forth above. Notices shall be given by and to Angi Kappenman, Director of Total Rewards on behalf of the State, and by ________________, on behalf of the Contractor, or such authorized designees as either party may from time to time designate in writing. Notices or communications to or between the parties shall be deemed to have been delivered when mailed by first class mail, provided that notice of default or termination shall be sent by registered or certified mail, or, if personally delivered, when received by such party.

2.18 In the event that any court of competent jurisdiction shall hold any provision of this Agreement unenforceable or invalid, such holding shall not invalidate or render unenforceable any other provision hereof.

2.19 All other prior discussions, communications and representations concerning the subject matter of this Agreement are superseded by the terms of this Agreement, and except as specifically provided herein, this Agreement constitutes the entire agreement with respect to the subject matter hereof.

2.20 The State, through any authorized representative, will have access to and the right to examine and copy all records, books, papers or documents or files in paper or electronic form related to services rendered under this Agreement. The Contractor will retain all books and records related to the services performed for a period of not less than the greater of any applicable federal law retention requirement or six (6) years following termination of the Agreement.

2.21 The Contractor certifies that it is currently in and will maintain full compliance with Health Insurance Portability and

Accountability Act of 1996 and all subsequent amendments:

a. Administrative simplification standards relating to electronic data transfers.

b. Regulations protecting the privacy of individually identifiable health information.

2.22 The Contractor agrees to establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.

2.23 Upon termination of this Agreement and following a written request from the State, the

Contractor will provide data and other pertinent records related to services performed under this Agreement, including, without limitation, the Personal Information (collectively, “Service Information”) to the State or a designee chosen by the State (“Recipient”) within thirty (30) days, unless otherwise mutually agreed upon. The transfer of Service Information will be conducted in accordance with all applicable laws and regulations.

Following termination of this Agreement with the State, and notwithstanding the transfer of Service Information to the Recipient, the Contractor will not retain the right to use and disclose any of the Service Information collected or otherwise received by the Contractor during the Term of this Agreement.

2.24 In the event of the termination of this Agreement, the Contractor will turn over all plan records, whether in paper or electronic form, to the State within ninety (90) days following the termination of the Agreement.

3.0 SCOPE OF WORK

The SDSEHP provides medical and pharmacy health benefits to its employees and dependents. Coverage under the SDSEHP is available to eligible employees and their dependents. The SDSEHP has approximately 26,700 members.

12,250 members are employees with an approximately 4,100 spouses and 10,350 dependents. The SDSEHP is funded jointly by contributions from the State employees and the South Dakota State Legislature. The SDSEHP has no specific stop-loss insurance or re-insurance currently.

The SDSEHP currently offers eligible state employees and their families access to four health plan options including a zero deductible health plan, a low deductible health plan, and two (2) high deductible health plans with a Health Savings Account (“HAS”) to eligible members. In addition, members may enroll in voluntary Vision, Dental, Short-Term Disability, Critical Illness, Hospital Indemnity and Major Injury Protection which are all fully insured. All voluntary benefits are employee funded except for dental which has a portion covered by a state subsidy.

The State has entered into Administrative Agreements with a Third-Party Administrator (“TPA”) Wellmark Blue Cross and Blue Shield of South Dakota to provide comprehensive claims, administration services, reporting and pharmacy benefits administration.

The State expects qualified bidders to have an existing robust data analytic capability to receive and analyze annual volume of 600,000 or more claims from the State employee health plan (annual total of medical plus pharmacy claims).

The exhibits in the chart below are included to provide information required to generate a proposal for the State.

Exhibit Document Response Required A Business Associate Agreement (BAA) Bidders must review and indicate on

Exhibit A if they cannot agree to anything in the BAA

B FY24 Decision Guide N/A C Summary Plan Description (SPD) Document N/A D Deviations and Exceptions Vendor list any deviations or exceptions to

State standard policies or contract terms

The scope of the actuary’s services will include but are not limited to the following services (“Services”):

3.1 Provide an evaluation of the actuarial soundness of the SDSEHP.

3.2 Prepare annual Actuarial Certification and State exhibits as required by the State.

3.3 Upon request, prepare a written actuarial analysis of claim liability for the SDSEHP (medical and prescription drugs) broken out by employee group (active and COBRA) and low and high deductible plans.

3.4 Use standard actuarial methods to provide evaluation of entire SDSEHP and make recommendations to the State for rates prior to open enrollment each year. Calculate employee contribution rates and develop COBRA rates.

Note that annual enrollment is generally scheduled for May 1 through May 15 each year.

3.5 Prepare a forecast of the number of expected claims, estimate the value of expected payments, develop overall trend and insurance inflation factors, estimate the lag in Incurred But Not Reported claims (“IBNR”) and estimate the lag in payment of claims. Provide reports of incurred claim liability. The actuary shall be responsible for reviewing outstanding reserves and IBNR estimates to assure that the State has established adequate reserves for each of the major types of exposures and estimate of the present value of current reserves for claims.

3.6 Analyze historical loss and industry data to calculate and trend future benefit payments in order to evaluate the reasonableness either to acquire or to end stop-loss coverage and make a recommendation on attachment point.

3.7 As required, the offeror must model program costs and be prepared to:

a. Aggregate and sort the data into meaningful analysis categories for the purposes of assessing total program costs and employer and employee contributions;

b. Provide actuarially based projections for plan alternatives under variable enrollment assumptions, contribution strategies, and benefit design changes; and

c. Evaluate the cost impact of changes in plan design and suggest cost saving changes. Budgetary and legislative processes often dictate that this analysis be performed under tight deadlines. The offeror may have to respond on very short notice to ad hoc requests for data or analysis.

3.8 Collaborate with BHRA/Benefits staff to develop health plan strategy, regularly review and modify strategy as needed, and provide guidance on the impact of government regulatory changes which impact the SDSEHP.

3.9 Continuously monitor SDSEHP claims costs and provide BHRA/Benefits monthly cost analysis reports which include medical and prescription drug claims and SDSEHP administrative expenses.

3.10 Implement accurate and comprehensive forecasting methodology to be used to prepare SDSEHP budget projections.

3.11 Assist BHRA/Benefits staff with the development of member SDSEHP communications.

3.12 Provide assistance to the State with developing health plan and employee benefits related request for proposals as requested and analyzing cost proposals and support contract negotiations.

3.13 Provide clinical Subject Matter Experts (SMEs) for pharmacy and medical services to support strategy and hospital and PBM contracting.

3.14 Participate in quarterly and annual onsite meetings in Pierre or Sioux Falls, SD with other State health plan vendors.

3.15 Regularly provide input to State regarding South Dakota and national health industry developments, recommendations for strategic initiatives to improve health plan cost and quality and collect and report data and metrics for monitoring plan performance.

4.0 PROPOSAL REQUIREMENTS AND COMPANY QUALIFICATIONS

4.1 The offeror is cautioned that it is the offeror's sole responsibility to submit information related to the evaluation categories and that the State of South Dakota is under no obligation to solicit such information if it is not included with the proposal. The offeror's failure to submit such information may cause an adverse impact on the evaluation of the proposal.

4.2 Offeror's Contacts: Offerors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc. to the buyer of record indicated on the first page of this RFP. Offerors and their agents may not contact any state employee other than the buyer of record regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements.

Offerors and their agents who have questions regarding this matter should contact the buyer of record.

4.3 Provide the following information related to at least three previous and current service/contracts, performed by the offeror’s organization, which are similar to the requirements of this RFP. The offeror must provide this information for any service/contract that has been terminated, expired, or not renewed in the past three (3) years:

a. Name, address and telephone number of client/contracting agency and a representative of that agency who may be contacted for verification of all information submitted;

b. Dates of the service/contract; and

c. A brief, written description of the specific prior services performed and requirements thereof.

4.4 Describe the offeror’s firm’s history, size, locations, and number of employees.

4.5 Location of the office from where consulting services would be provided.

4.6 The offeror must provide the names of their team members who would be assigned to the State’s audit and include the following information:

a. Team members’ education and any related credentials (e.g. ASA, AAA, MBA, etc.); and

b. Number of years work experience as a health plan actuary or health benefits consultant.

4.7 Proposals must include performance guarantees to ensure the offeror will complete the obligations of its proposal. Performance guarantees must be provided for sections 3.1 through 3.12 of the Scope of Work.

The State requires offerors to include in their proposal performance guarantees that the offerors feel are most pertinent to the services solicited in this RFP. They should address conformance to the requirements and terms and conditions outlined in this RFP.

Please provide your proposed performance standards and liquidated damages in the format below.

4.8

Type of Performance Guarantee

Performance Measurement Period

Service Objective

Liquidated Damages Amount

4.8 Proposals must list staff members, qualifications, and experience.

4.9 Explain the operational and financial data utilized to monitor the health plan and your organization’s monitoring procedures and capabilities. Provide your predicted trends versus actual trends for at least three (3) specific, but unidentified clients for the last five (5) years.

4.10 Please explain how you calculate recommended reserve levels and incurred but not reported losses.

4.11 Please provide a detailed description of the census, eligibility and other reports you would require from the SDSEHP or Third-Party Administrator. Explain the purpose of each report and how it relates to the product that will be presented to the SDSEHP.

4.12 Please describe and list all standard reports and provide examples of each. Copies of your reports should be provided as an attachment to your proposal.

4.13 Please describe the process for requesting custom and/or ad hoc reports and list the turnaround time for each.

4.14 The offeror must be a member of the American Academy of Actuaries or an Associate of the Society of Actuaries.

4.15 The offeror must follow HIPAA guidelines and be willing to sign a Business Associate Agreement with the State.

5.0 PROPOSAL RESPONSE FORMAT

5.1 The offeror must provide their entire proposal, including all attachments, in Microsoft Word, Excel, or PDF electronic format by email to a secure location where the State can electronically obtain these documents.

The offeror must also send an original and four (4) identical copies of the proposal along with any attachments in hard copy format to Angi Kappenman.

The offeror is cautioned that it is the offeror's sole responsibility to submit information related to the evaluation categories and that the State of South Dakota is under no obligation to solicit such information if it is not included with the proposal. The offeror's failure to submit such information may cause an adverse impact on the evaluation of the proposal. The offeror should respond to each point in the Scope of Work and Deliverables in the order they were presented.

Offerors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all questions or comments regarding the RFP or the evaluation to the buyer of record indicated on the first page of this RFP. Offerors and their agents may not contact any state employee other than the buyer of record regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and exclusion from specific procurements. Offerors and their agents who have questions regarding this matter should email the buyer of record at 24RFP10766@state.sd.us.

The offeror may be required to submit a copy of its most recent audited financial statements upon the State’s request.

The proposal should be page numbered and should have an index or a table of contents referencing the appropriate page number. Each of the sections listed below should be tabbed.

Offerors are cautioned that use of the State Seal in any of their documents is illegal as per South Dakota Codified Law § 1-6-3.1. Use of seal or facsimile without authorization prohibited--Violation as misdemeanor. No person may reproduce, duplicate, or otherwise use the official seal of the State of South Dakota, or its facsimile, adopted and described in §§ 1-6-1 and 1-6-2 for any for-profit, commercial purpose without specific authorization from the secretary of state. A violation of this section is a Class 1 misdemeanor.

5.2 All proposals must be organized and tabbed with labels for the following headings:

5.2.1 RFP Form. The State’s Request for Proposal form (1st page of RFP) completed and signed.

5.2.2 Executive Summary. The one (1) or two (2) page executive summary is to briefly describe the offeror's proposal. This summary should highlight the major features of the proposal. It must indicate any requirements that cannot be met by the offeror. The reader should be able to determine the essence of the proposal by reading the executive summary. Proprietary information requests should be identified in this section.

5.2.3 Detailed Response. This section should constitute the major portion of the proposal and must contain at least the following information:

mailto:24RFP10766@state.sd.us

5.2.3.1 All exhibits requested in the questionnaire.

5.2.3.2 A complete narrative of the offeror's assessment of the work to be performed, the offeror’s ability and approach, and the resources necessary to fulfill the requirements. This should demonstrate the offeror's understanding of the desired overall performance expectations.

5.2.3.3 A specific point-by-point response, in the order listed, to each requirement in the RFP.

The response should identify each requirement being addressed as enumerated in the RFP.

5.2.3.4 A clear description of any options or alternatives proposed.

5.2.3.5 Offeror’s qualifications to perform health plan actuarial services and benefit design consulting. Specify if the offeror has prior experience with public entities (e.g. state, county, or municipal government).

5.2.4 The State is requesting proposals for a contract period of five (5) years effective, July 1, 2025 through, June 30, 2030, with the State having the option of (2) one-year extensions for a total of 7 years maximum. A maximum fee guarantee is required for the initial five (5) year term of the contract. The State is not obligated to renew should the State determine prior to the end of the five (5) year contract period to procure a Benefits Support Tool vendor.

5.2.5 Cost Proposal. Cost will be evaluated independently from the technical proposal. Offerors may submit multiple cost proposals. All costs related to the provision of the required services must be included in each cost proposal offered. Offerors must guarantee the proposed fees for the entire five (5) year agreement period.

See section 7.0 for more information related to the cost proposal.

6.0 PROPOSAL EVALUATION AND AWARD PROCESS

6.1 After determining that a proposal satisfies the mandatory requirements stated in the Request for Proposal, the evaluator(s) shall use subjective judgment in conducting a comparative assessment of the proposal by considering each of the following criteria on a 1,000-point scale and point values for each criterion are listed below:

6.1.1 Specialized expertise, capabilities, and technical competence as demonstrated by the proposed approach and methodology to meet the project requirements (250 points);

6.1.2 Resources available to perform the work, including any specialized services, within the specified time limits for the project (200 points);

6.1.3 Record of past performance, including price and cost data from previous projects, quality of work, ability to meet schedules, cost control, and contract administration (100 points);

6.1.4 Availability to the project locale (75 points);

6.1.5 Familiarity with the project locale (75 points);

6.1.6 Proposed project management techniques (25 points);

6.1.7 Ability and proven history in handling special project constraints (50 points); and

6.1.8 Cost (225 points).

6.2 Experience and reliability of the offeror's organization are considered subjectively in the evaluation process.

Therefore, the offeror is advised to submit any information which documents successful and reliable experience in past performances, especially those performances related to the requirements of this RFP.

6.3 The qualifications of the personnel proposed by the offeror to perform the requirements of this RFP, whether from the offeror's organization or from a proposed subcontractor, will be subjectively evaluated. Therefore, the offeror should submit detailed information related to the experience and qualifications, including education and training, of proposed personnel.

6.4 The State reserves the right to reject any or all proposals, waive technicalities, and make award(s) as deemed to be in the best interest of the State of South Dakota.

6.5 Award: The requesting agency and the highest ranked offeror shall mutually discuss and refine the scope of services for the project and shall negotiate terms, including compensation and performance schedule.

6.5.1 If the agency and the highest ranked offeror are unable for any reason to negotiate a contract at a compensation level that is reasonable and fair to the agency, the agency shall, either orally or in writing, terminate negotiations with the contractor. The agency may then negotiate with the next highest ranked contractor.

6.5.2 The negotiation process may continue through successive offerors, according to agency ranking, until an agreement is reached, or the agency terminates the contracting process.

7.0 COST PROPOSAL

7.1 Cost proposal must detail cost breakdown for the actuarial services and benefits strategy and design consulting services.

7.1.1 Cost proposal must provide cost breakout for travel, conference call time, and professional services time related to the Account Manager.

7.1.2 Cost proposal must breakout cost related to subject matter expert(s) professional services time, conference call time, and travel expenses.

7.2 The State asks bidders to submit an annual retainer (with a not-to-exceed maximum) for Scope of Work sections 3.1-3.7, 3.9-3.10,3.12-3.15 and an hourly rate for Scope of Work sections 3.8 and 3.10-3.11 and projected annual hours for each year of the agreement.

7.3 The intent of this RFP is to contract with the selected vendor in which the State pays fees for services only, with no provision for any brokerage commissions or other indirect methods of compensation for the vendor.