RFP Document - Essex County Public Schools - 2-2024.pdf

Request for Proposals:

Benefits for Medical, Dental, Vision, EAP

RFP# 02082024

Essex County Public Schools

Requested by: Sylvia Fulford

REQUEST FOR PROPOSAL

Issue Date: 2/16/2024

Period of Contract: 7/1/2024 – 6/30/2025

Due Date: 3/1/2024

Delivery Address: Electronic Submissions Only

Electronic proposals will be received by Sylvia Fulford, One Digital by 5:00 p.m. on 3/1/2024 for furnishing the services described herein. Electronic copy to be received by: Sylvia Fulford, sylvia.fulford@onedigital.com.

All inquiries for information should be directed to:

Sylvia Fulford, 804-409-5362 or sylvia.fulford@onedigital.com by 5:00 p.m. on 2/22/2024.

In compliance with this Request for Proposal and to all the conditions imposed therein and hereby incorporated by reference, the undersigned offers and agrees to furnish the goods/services in accordance with the attached signed proposal or as mutually agreed upon by subsequent negotiation.

Name and Address of Firm:

Date:

By:

Name:

Signature in Ink

Title:

Please Print eVA Vendor ID or DUNS No.

Telephone No.

E-mail Address: FAX No.

Note: This public body does not discriminate against faith-based organizations in accordance with the Code of Virginia § 2.2-4343.1 or against a bidder or offeror because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to discrimination in employment.

Table of Contents

Section 1 Statement of Confidentiality Section 2 General Terms and Conditions Section 3 Special Terms and Conditions Section 4 Statement of Needs Section 5 Proposal Preparation and Submission Requirements Section 6 Method of Award Section 7 Questionnaire Section 8 Reporting Section 9 Attachments Section 10 Timeline

Appendage: Please see additional documentation available with

Request for Proposal.

Census Claims Data HCC Claims

Section 1: Statement of Confidentiality

The following information is proprietary and confidential. This proposal and its attachments should not be discussed with anyone outside your firm. Any organization violating this requirement will immediately be eliminated from consideration in the request for proposal process. Ownership of all data, materials, and documentation originated and prepared for ECPS pursuant to the RFP shall belong exclusively to ECPS and be subject to public inspection in accordance with the Virginia Freedom of Information Act. Trade secrets or proprietary information submitted by an offeror shall not be subject to public disclosure under the Virginia Freedom of Information Act; however, the offeror must invoke the protections of § 2.2-4342F of the Code of Virginia, in writing, either before or at the time the data or other material is submitted. The written notice must specifically identify the data or materials to be protected and state the reasons why protection is necessary. The proprietary or trade secret material submitted must be identified by some distinct method such as highlighting or underlining and must indicate only the specific words, figures, or paragraphs that constitute trade secret or proprietary information. The classification of an entire proposal document, line-item prices, and/or total proposal prices as proprietary or trade secrets is not acceptable and will result in rejection of the proposal.

Any questions regarding the proposal should be directed to Sylvia Fulford by 5:00 p.m. on 2/22/2024.

Sylvia Fulford

Phone: 804-409-5362 sylvia.fulford@onedigital.com

Section 2: General Terms and Conditions

A. Definitions:

1. Acceptance: Acceptance shall mean approval of contractor’s invoice for services by the Purchasing Agent's Technical Representative.

2. ECPS: Essex County Public Schools, its authorized representatives, and employee

3. Contract: The signed Contract, stating the Scope of the Contract wherein the Contractor shall provide the services to ECPS as set forth in the Contract Documents.

4. Contract Documents:

(a) The signed Contract.

(b) This Request for Proposals.

(c) Any Addenda issued.

(d) The Proposal.

(e) The Negotiated Scope of Services to include the Cost Agreement; and

(f) Modifications and/or Change Orders issued subsequent to the execution of the Contract.

5. Contractor: The individual, firm or organization which contracts with ECPS to perform the Work. As employed herein, the term "contractor" may refer to an individual, an organization, or to the contractor’s authorized representative.

6. Contract Sum: The total amount payable to the contractor for performance of the Work. The Contract Sum is stated in the Proposal and shall include any adjustments granted by amendment.

7. Final Payment: The payment of the balance of the Contract Sum, following the Acceptance of all Services delivered pursuant to this Contract.

8. Notice: As defined in Section 3, paragraph F.

9. Director of Accounting: Director of Accounting, or his designated representative, who shall serve as ECPS’s contracting officer.

10. Director of Accounting’s Technical Representative: The ECPS official who serves as the Director of Accounting's technical representative for purposes of administering the Contract.

11. Time(s) for Performance: The date(s) on which Services are required to be provided, in accordance with the Contract Documents.

12. Work: The Services required to be delivered by the Contractor pursuant to this Contract.

B. ECPS:

1. Authority of the Director of Accounting: The Director of Accounting shall be the contracting officer for ECPS, who is authorized to execute this Contract and any Change Orders issued pursuant to Section P. No Notice ECPS shall be effective unless a copy is delivered to the Director of Accounting in accordance with the terms of the Contract.

2. Authority of the Director of Accounting’s Technical Representative: The Contract shall be administered by ECPS, or its designated representative, who shall be referred to in the Contract Documents as "the Director of Accounting’s Technical Representative."

3. Additional Representatives: The Director of Accounting’s Technical Representative may designate one or more additional representatives to coordinate with the Contractor or to inspect the Work performed by the Contractor.

C. The Contractor:

1. Licensure: To the extent required by the State of Virginia or Essex County, Virginia, the Contractor shall be duly licensed to perform the Services required to be delivered pursuant to this Contract.

2. Key Persons: If any "Key Persons" are identified in the Proposal, those Key Persons shall be directly involved in the performance of Contractor’s Work hereunder.

No Key Person shall be changed without the written consent of ECPS unless such Key Person becomes unavailable to perform his or her duties because of death, disability, or termination of employment; provided however, that a Key Person shall be removed at ECPS’s request. If a Key Person is no longer capable of performing in the capacity described in the Proposal, or is removed by ECPS, ECPS and the Contractor shall agree on a mutually acceptable substitute.

D. Terms for Performance:

1. The Work: The Services required to be delivered pursuant to this Contract shall be in strict accordance with the Specifications included as part of the Contract Documents. All persons performing Services pursuant to the Contract shall be duly qualified to perform those Services and shall hold any licenses required by law for persons performing such Services.

2. Time for Performance: Time is of the essence of this Contract. The Contractor shall perform all Services at the time(s) and in the manner(s) specified in the Contract Documents.

E. Applicable Laws and Courts: This solicitation and any resulting contract shall be governed in all respects by the laws of the State of Virginia and any litigation with respect thereto shall be brought only in the courts of Essex County, Virginia. ECPS and the contractor are encouraged to resolve any issues in controversy arising from the award of the contract or any contractual dispute using Alternative Dispute Resolution (ADR) procedures (Code of Virginia of 1950, as amended, § 2.2-4366). The contractor shall comply with all applicable federal, state, and local laws, rules, and regulations.

F. Anti-Discrimination: By submitting their proposals, offerors certify to ECPS that they will conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of 1975, as amended, where applicable, the Virginians with Disabilities Act, the Americans with Disabilities Act and § 2.2-4311 of the Virginia Public Procurement Act (VPPA). If the award is made to a faith-based organization, the organization shall not discriminate against any recipient of goods, services, or disbursements made pursuant to the contract on the basis of the recipient's religion, religious belief, refusal to participate in a religious practice, or on the basis of race, age, color, gender or national origin and shall be subject to the same rules as other organizations that contract with public bodies to account for the use of the funds provided; however, if the faith-based organization segregates public funds into separate accounts, only the accounts and programs funded with public funds shall be subject to audit by the County. (Code of Virginia of 1950, as amended, § 2.2-4343.1E).

In every contract over $10,000 the provisions in 1. and 2. below apply:

1. During the performance of this contract, the contractor agrees as follows:

a. The contractor will not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to discrimination in employment, except where there is a bona fide occupational qualification reasonably necessary to the normal operation of the contractor. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

b. The contractor, in all solicitations or advertisements for employees placed by or on behalf of the contractor, will state that such contractor is an equal opportunity employer.

c. Notices, advertisements, and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting these requirements.

2. The contractor will include the provisions of 1. above in every subcontract or purchase order over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

G. Ethics in Public Contracting: By submitting their proposals, offerors certify that their proposals are made without collusion or fraud and that they have not offered or received any kickbacks or inducements from any other offeror, supplier, manufacturer or subcontractor in connection with their proposal, and that they have not conferred on any public employee having official responsibility for this procurement transaction any payment, loan, subscription, advance, deposit of money, services or anything of more than nominal value, present or promised, unless consideration of substantially equal or greater value was exchanged.

H. Immigration Reform and Control Act of 1986: By submitting their proposals, offerors certify that they do not and will not during the performance of this contract employ illegal alien workers or otherwise violate the provisions of the federal Immigration Reform and Control Act of 1986.

I. Debarment Status: By submitting their proposals, offerors certify that they are not currently debarred by the Essex County, Virginia from submitting proposals on contracts for the type of services covered by this solicitation, nor are they an agent of any person or entity that is currently so debarred.

J. Antitrust: By entering into a contract, the contractor conveys, sells, assigns, and transfers to ECPS all rights, title, and interest in and to all causes of action it may now have or hereafter acquire under the antitrust laws of the United States and the State of Virginia, relating to the particular services purchased or acquired by ECPS under said contract.

K. Clarification of Terms: If any prospective offeror has questions about the specifications or other solicitation documents, the prospective offeror should contact Sylvia Fulford, One Digital no later than 5:00 pm on February 22, 2024. Any revisions to the solicitation will be made only by addendum issued by the Director of Accounting. Each offeror shall be responsible for determining that all addenda issued by the Director of Accounting’s office have been received before submitting a proposal.

L. Payment:

1. Payment for Services: The contractor shall submit its invoice for the services performed during the previous month. The invoice shall bill for the services at the fixed monthly rate specified in the Contract Documents or shall detail those services provided and bill at the rates specified in the Contract Documents. The Director of Accounting's Technical Representative shall verify that the services have been performed in accordance with the Contract Documents and, if appropriate, will approve the invoice and initiate the process for payment.

2. Progress Payments: If authorized by the terms of the Contract, the contract may submit requests for progress payments at such times or upon the occurrence of such events as the Contract Documents may provide. Upon submission of the request for progress payment, the Director of Accounting's Technical Representative shall verify the Consultant's entitlement thereto and, if appropriate, shall approve the invoice and initiate the process for payment.

3. The contractor shall submit original invoices to the Director of Accounting's Technical Representative which clearly describe and itemize the services provided. In addition, invoices shall contain, at a minimum, the following information:

(a) The date of the Contract.

(b) The Contract Number.

(c) The total cost for these itemized services.

* Reserves the right to determine whether the invoice is clear and properly itemized.

However, if abbreviations or jargon are used on the invoice, the contractor shall provide a key printed directly on the invoice to explain the abbreviation or jargon.

4. Payment of Subcontractors: The Contractor agrees to take one of the two following actions within seven (7) days after receipt of amounts paid to the Contractor by ECPS for work performed by a subcontractor under this contract:

(a) Pay the subcontractor for the proportionate share of the total payment received by the Contractor attributable to the work performed by the subcontractor under this contract; or

(b) Notify ECPS and the subcontractor, in writing, of the Contractor's intention to withhold all or part of the subcontractor's payment with the reason for nonpayment.

The Contractor shall pay interest to the subcontractor on all amounts owed by the Contractor that remain unpaid after seven days following receipt by the Contractor of payment for work performed by the subcontractor under this contract, except for amounts withheld as allowed in (B) above. Unless otherwise provided under the terms of this contract, interest shall accrue at the rate of one percent per month. The interest charge shall not be deemed an obligation of ECPS, and a cost reimbursement claim may not include any amount for reimbursement for such interest charge.

The Contractor shall include in each of its subcontracts a provision requiring each subcontractor to include or otherwise be subject to the same payment and interest requirements with respect to each lower-tiered subcontractor.

M. Precedence of Terms: The following General Terms and Conditions: APPLICABLE LAWS AND

COURTS, ANTI-DISCRIMINATION, ETHICS IN PUBLIC CONTRACTING, IMMIGRATION REFORM

AND CONTROL ACT OF 1986, DEBARMENT STATUS, ANTITRUST, CLARIFICATION OF TERMS,

PAYMENT shall apply in all instances. In the event there is a conflict between any of the other General Terms and Conditions and any Special Terms and Conditions in this solicitation, the Special Terms and Conditions shall apply.

N. Qualifications of Offerors: ECPS may make such reasonable investigations as deemed proper and necessary to determine the ability of the offeror to perform the services and the offeror shall furnish to ECPS all such information and data for this purpose as may be requested. ECPS reserves the right to reject any proposal if the evidence submitted by, or investigations of, such offeror fails to satisfy to ECPS that such offeror is properly qualified to carry out the obligations of the contract and to provide the services contemplated therein.

O. Assignment of Contract: The contract shall not be assignable by the Contractor in whole or in part without the written consent of ECPS.

P. Changes to the Contract: Changes can be made to the contract by mutual agreement in writing to modify the scope of the contract (“Modification”), or unilaterally by the Director of Accounting instructing the Contractor to make changes (“Change Order”). An increase or decrease in the price of the contract resulting from such modification shall be agreed to by the parties as a part of their written agreement to modify the scope of the contract.

Q. Insurance:

1. The Contractor shall purchase and maintain in force, at his own expense, such insurance as will protect him and ECPS from claims which may arise out of or result from the Contractor's activities, whether such be by himself, his employees, agents, subcontractors, or by anyone for whose acts any of them may be liable. Insurance shall remain in effect until final payment and at all times thereafter when Contractor may be correcting, removing, or replacing defective work. All insurance coverages will be provided by insurance companies authorized by the Virginia State Corporation Commission to sell insurance in Virginia. The Contractor shall furnish as a minimum the hereinafter coverages and limits, and on forms and of companies which are acceptable to the ECPS Attorney and/or Risk Management and shall require and show evidence of insurance coverages on behalf of any subcontractors (if applicable), before entering into any agreement to sublet any part of the work to be done under this Contract.

MINIMUM INSURANCE COVERAGES AND LIMITS REQUIRED:

a. Workers’ Compensation - Statutory requirements and benefits, irregardless of being subject to Title 65.2 of the Code of Virginia of 1950 (Workers’ Compensation). Coverage shall include an “all states” endorsement and shall be provided for any proprietor, partner, executive officer, or member.

b. Employers’ Liability - $100,000 bodily injury by accident each accident

$100,000 bodily injury by disease each employee, $500,000 bodily injury by disease policy limit

c. Commercial General Liability - $1,000,000 per occurrence, $2,000,000 aggregate.

Commercial General Liability is to include bodily injury and property damage, personal injury and advertising injury, products and completed operations coverage, as well as contractual liability coverage. ECPS must be named as an additional insured and so endorsed on the policy.

d. Commercial Automobile Liability - $1,000,000 combined single limit each accident. Automobile Liability is to cover “any auto.”

2. Instructions Regarding Insurance Certificates: The Contractor and his insurance company should carefully review the insurance requirements applicable to this contract. All requirements must be met before ECPS will execute the contract. In particular, we would call your attention to the following:

a. Please note that the Insurance Certificate must state that the Commercial

General Liability and the Umbrella Liability Insurance Policies, as applicable, name the “Essex County Public Schools” as an additional insured. Many Certificates have a space headed "Description" where the language may be inserted as follows: the “Essex County Public Schools is additional insured” or that “Essex County Public Schools” is additional insured with respects to General Liability; and/or Umbrella Liability policies.”

b. The Certificate Holder should be listed as:

c/o Accounting Office 109 Cross Street PO Box 756 Tappahannock, VA 22560 Contract No. Benefits for Medical, Dental, Vision, EAP

c. The Contractor will provide an original, signed Certificate of Insurance, and such endorsements as prescribed herein.

3. Additional Insurance Requirements: Any additional specific insurance coverages to be provided by the Contractor are stated in the Supplementary General Conditions.

R. Drug-Free Workplace: During the performance of this contract, the contractor agrees to (i) provide a drug-free workplace for the contractor's employees; (ii) post in conspicuous places, available to employees and applicants for employment, a statement notifying employees that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition; (iii) state in all solicitations or advertisements for employees placed by or on behalf of the contractor that the contractor maintains a drug-free workplace; and (iv) include the provisions of the foregoing clauses in every subcontract or purchase order of over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

For the purposes of this section, “drug-free workplace” means a site for the performance of work done in connection with a specific contract awarded to a contractor, the employees of whom are prohibited from engaging in the unlawful manufacture, sale, distribution, dispensation, possession or use of any controlled substance or marijuana during the performance of the contract.

S. Nondiscrimination to Contractors: A bidder, offeror, or contractor shall not be discriminated against in the solicitation or award of this contract because of race, religion, color, sex, national origin, age, disability, faith-based organizational status, any other basis prohibited by state law relating to discrimination in employment or because the bidder or offeror employs ex-offenders unless ECPS has made a written determination that employing ex-offenders on the specific contract is not in its best interest. If the award of this contract is made to a faith-based organization and an individual, who applies for or receives goods, services, or disbursements provided pursuant to this contract objects to the religious character of the faith-based organization from which the individual receives or would receive the goods, services, or disbursements, ECPS shall offer the individual, within a reasonable period of time after the date of his objection, access to equivalent goods, services, or disbursements from an alternative provider.

T. Availability of Funds: It is understood and agreed between the parties herein that ECPS shall be bound hereunder only to the extent of the funds available, or which may hereafter become available for the purpose of this agreement.

U. Small Business, and Minority-, Women-, and Service-Disabled Veteran-Owned Business:

ECPS actively solicits small, and minority-, women-, and service-disabled veteran-owned businesses to respond to all Invitations for Bids and Requests for Proposals.

V. No Discrimination Against Faith-Based Organizations: ECPS does not discriminate against faith-based organizations as that term is defined in § 2.2-4343.1 of the Code of Virginia of 1950, as amended.

W. Taxes:

1. The Contractor shall pay all county, state and federal taxes required by law enacted at the time proposals are received and resulting from the work or traceable thereto, under whatever name levied. Said taxes shall not be in addition to the contract price between the ECPS and the Contractor, as the taxes shall be an obligation of the Contractor and not of ECPS, and ECPS shall be held harmless for same by the Contractor.

2. ECPS is exempt from the payment of federal excise taxes and the payment of State Sales and Use Tax on all tangible, personal property for its use or consumption. Tax exemption certificates will be furnished upon request.

X. Mandatory Use of Forms and Terms and Conditions: Failure to submit a proposal on the official forms provided for that purpose may be a cause for rejection of the proposal.

Modification of or additions to the General Terms and Conditions of the solicitation may be cause for rejection of the proposal; however, ECPS has the right to decide on a case-by-case basis, in its sole discretion, whether to reject such a proposal.

Y. Bankruptcy: If contractor should be adjudged bankrupt or make a general assignment for the benefit of its creditors, or if a receiver should be appointed on account of the contractor's insolvency, then ECPS may without prejudice to any other right or remedy, and after giving the contractor seven (7) calendar days written notice, terminate this contract and procure such goods or services from other sources. In such event, contractor shall be liable to ECPS for any additional cost occasioned by such failure or other default. In such cases, contractor shall not be entitled to receive any further payment. If the expense of finishing the contract requirements, including compensation for additional managerial and administrative services shall exceed the unpaid balance of the contract price, the contractor shall pay the difference to ECPS.

Z. SCC Identification Number: Each bidder or offeror organized or authorized to transact business in the County pursuant to Title 13.1 (Corporations) or Title 50 (Partnerships) of the Code of Virginia of 1950, as amended, shall include in its bid or proposal the identification number issued to it by the Virginia State Corporation Commission. Any bidder or offeror that is not required to be authorized to transact business in the County as a foreign business entity under Title 13.1 or Title 50 or as otherwise authorized by law shall include in its bid or proposal a statement describing why the bidder or offeror is not required to be so authorized.

AA. Entire Agreement: The Contract Documents constitute the entire agreement among the parties pertaining to the Work and supersede all prior and contemporaneous agreements and understandings of the parties in connection therewith.

BB. Royalties and Patents: The Contract Sum includes all royalties and costs arising from patents, trademarks, and copyrights in any way involved in the Work. Whenever the Contractor is required or desires to use any design, device, material or process covered by letters of patent or copyright, the Contractor shall indemnify and save harmless ECPS, its officers, agents and employees from any and all claims for infringement by reason of the use of any such patented design, device, tool, material, equipment, or process to be performed under this Contract, and shall indemnify ECPS, its officers, agents, authorized representatives, and employees for any costs, expenses and damages which may be incurred by reason of any such infringement at any time during the prosecution and after the completion of the Work.

CC. Severability: Should any provision of this Contract be declared invalid for any reason, such decision shall not affect the validity of any other provisions, which other provisions shall remain in force and effect as if this Contract had been executed with the invalid provisions(s) eliminated, and it is hereby declared the intention of the parties that they would have executed the other provisions of this Contract without including therein such provision(s) which may for any reason hereafter be declared invalid.

DD. Survival: Any provision of this Contract which contemplates performance subsequent to any termination or expiration of this Contract, including, without limitation, the provisions of Record Retention, Audit and Price Adjustment (VIII. A), and Indemnification (VIII. B) shall survive any termination or expiration of this Contract and shall remain in full force and effect according to their terms.

EE. Non-Waiver: The failure of Contractor or ECPS to exercise any right, power or option arising under this Contract, or to insist upon strict compliance with the terms of this Contract, shall not constitute a waiver of the terms and conditions of this Contract with respect to any other or subsequent breach thereof, nor a waiver by Contractor or ECPS of their rights at any time thereafter to require exact and strict compliance with all the terms thereof.

FF. Headings: Numbered topical headings, articles, paragraphs, subparagraphs, or titles in this Contract are inserted for the convenience of organization and reference and are not intended to affect the interpretation or construction of the terms thereof.

B. Purpose

a. The purpose of this Request for Proposals (herein, “RFP”) is to solicit proposals from highly qualified sources to establish a contract for Medical, Dental, Vision, and EAP services for all full-time eligible employees, and retirees in accordance with the enclosed specifications. The current benefits are bundled through The Local Choice program. Essex County Public Schools is interested in receiving both bundled and unbundled quotes for the services mentioned prior.

b. ECPS reserves the right to award more than one Offeror.

c. ECPS will select the firm(s) who they determine most closely satisfies their needs. There is no requirement for acceptance of the lowest cost of service offered, and specific requirements may be waived or amended at the discretion of ECPS.

C. Objectives

a. The primary objective of the Medical, Dental, Vision, and EAP services is to provide access to the following services for benefit eligible employees and their household dependents:

i. Provides eligible employees and dependents with quality and affordable plans.

ii. Ensure the Medical, Dental, Vision, and EAP services offers the most competitive arrangement as measured by benefits, provider discounts, administrative costs, customer service and processing accuracy.

iii. Maintain flexibility of plan design structure

iv. Maintain current model with reinsurance and pharmacy carved out of medical.

v. Maintain flexibility with preferred providers.

vi. Evaluate self-insured & fully insured proposals.

vii. Evaluate High Deductible Plan and H S A options.

viii. Seek opportunities for carrier investment into a wellness fund to help establish and support ongoing health management and improve outcomes.

ix. Evaluate specialty capabilities (disease management, population health management and wellness programs to ensure “Best in Class” programs are offered).

x. Provide ease of administration for ECPS.

xi. Processes eligibility records accurately, efficiently, and timely and provides accurate billing on a timely basis.

xii. Provides simplified communication resources.

xiii. Provides timely, responsive customer service to the plan members and to the ECPS.

xiv. Integrates and coordinates efficiently, timely and accurately with other related plan and service providers (i.e., reinsurance carrier, prescription drug plan, wellness, travel network, imaging services etc.)

xv. Provide fees associated with transfer of medical and pharmacy claims data to another vendor.

xvi. Have meaningful financial and service performance guarantees.

xvii. Maintain a dedicated account management team with highly skilled, qualified, and experienced personnel.

xviii. Motivates employees and dependents to make and maintain healthy lifestyle choices and efficacious, cost-effective healthcare decisions.

b. Products to be offered:

i. Medical Insurance

ii. Dental Insurance

iii. Vision Insurance

iv. EAP Services

c. ECPS will offer all benefits through payroll deduction.

d. Medical must coordinate with pharmacy and wellness benefits.

D. Background

a. ECPS currently offers all insurance options through The Local Choice.

i. Approximately 191 employees are eligible for all health benefit plans.

ii. Approximately 394 Active Employees are currently enrolled in the Active

Plan.

b. The reason out to market is due to the continual increase in pharmacy and medical costs, desire for an outcome-based wellness.

c. All benefits will be effective 7/1/2024.

Section 3: Special Terms and Conditions

A. Record Retention and Audit:

Audit: All records, reports and documents relating to this Contract shall be maintained by contractor for a period of five (5) years following Final Payment (the "Audit Period"). Such records, reports and documents shall be subject to review and audit by ECPS and the ECPS’s consultants or auditors at mutually convenient times.

B. Indemnification: The contractor hereby assumes all liability for and agrees to indemnify and hold harmless ECPS and its officers, authorized representatives and employees against any and all claims, losses, costs, damages, penalties, liabilities and fees (including reasonable attorneys’ fees) and expenses resulting from any material breach of the representations, warranties and covenants of the contractor contained in the Contract Documents or from any injuries to persons or property caused by the negligence or alleged negligence of the contractor or its subconsultant, employees, or authorized representatives, or in any other manner arising out of the performance of this Contract.

C. Right to Cancel or Reject: ECPS reserves the right to cancel this RFP and/or reject any or all proposals, to waive any informalities in any proposal, to award any whole or part of a proposal, and to award to the Offeror whose proposal is, at the sole discretion of the ECPS, determined to be in the best interest of the ECPS.

D. Proposer Expenses: ECPS will not be responsible for any expenses incurred by an Offeror in preparing and submitting a proposal.

E. Assignment / Subcontracting: The services furnished by the Contractor shall be neither assigned nor subcontracted without prior written consent by the ECPS.

F. Notice:

1. Written Notice: All Notices required by the terms of this Contract shall be in writing.

For purposes of this Paragraph, "writing" shall include facsimile transmissions and electronic mail, provided that reasonable care is used to ensure that the Notice is received by its intended recipient.

2. Notice to Contractor: Written Notice may be served on the Contractor by mail, courier, facsimile transmission, or electronic mail to the Contractor’s business address as stated in the Proposal cover sheet.

3. Notice to ECPS: Written Notice may be served ECPS by mail, courier, facsimile transmission, or electronic mail to the Director of Finance’s Technical Representative, with a copy to the Director of Finance.

G. Termination or Suspension:

1. Termination for Convenience: ECPS shall have the right to terminate this Contract at its own convenience for any reason by giving thirty (30) days prior written Notice of termination to the Contractor. Each subcontract shall contain a similar termination provision for the benefit of the Contractor and the ECPS. ECPS shall have the right to employ an independent accounting firm to verify any amounts claimed by the Contractor to be due under this Paragraph. ECPS shall have the right of audit (and Contractor shall have the obligations) stated in Section A, above, as far as they pertain to amounts claimed to be due hereunder.

2. Termination for Default: Essex County Public Schools may, by written Notice to the Contractor, terminate the whole or any part of the Contract in any one of the following circumstances:

(a) If the Contractor fails to perform the Services as specified in this Contract and does not cure such failure within a period of ten (10) days after receipt of Notice from the Director of Accounting nor his designee.

(b) If the Contractor fails to perform any of the other provisions of this Contract, and does not cure such failure within a period of ten (10) days after receipt of Notice from the Director of Accounting or his designee; or

(c) Without further notice, if the Contractor defaults in the performance of its duties pursuant to subsections (a) and/or (b) above more than twice within any consecutive twelve (12) month period, whether or not the Contractor subsequently cures such earlier defaults.

3. Non-Appropriation of Funds: This Contract is conditioned upon an appropriation made by the Essex County School Board of the County of Essex, Virginia of funds sufficient to pay the compensation due the Contractor under this Contract. If such an appropriation is not made in any fiscal year, and the ECPS lacks funds from other sources to pay the compensation due under this Contract, ECPS will be entitled, at the beginning of or during such fiscal year, to terminate this Contract. In that event, ECPS will not be obligated to make any payments under this Contract beyond the amount properly appropriated for Contract payments in the immediately prior fiscal year. ECPS will provide the Contractor written Notice of Termination of this Contract due to the non-appropriation of funds at least fifteen (15) calendar days before the effective date of the termination. However, ECPS's failure to provide such Notice will not extend this Contract into a fiscal year in which funds for Contract payments have not been appropriated.

4. Force Majeure: Except for defaults of subconsultants at any tier, the Contractor shall not be liable for any excess costs of failure to perform if the failure to perform this Contract arises from causes beyond the control and without the fault or negligence of the Contractor. Excusable causes include, but are not limited to, acts of God or of the public enemy and acts of the federal or state government in either their sovereign or contractual capacities. If the failure to perform is caused by the default of a subconsultant at any tier, and if the cause of the default is beyond the control of both the Contractor and the subconsultant, and without the fault or negligence of either, the Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted Services were obtainable from other sources in sufficient time for the Contractor to meet the required Time(s) for Performance

H. Compensation: The contractor shall be required to submit a complete itemized invoice on each delivery or service, which he may perform under the contract. Payment shall be rendered to the contractor for satisfactory compliance with the contract within forty-five (45) days after the receipt of the proper invoice.

I. Advertising: In the event a contract is awarded for services resulting from this proposal, no indication of such sales or services to ECPS will be used in product literature or advertising.

The contractor shall not state in any of its advertising or product literature that ECPS has purchased or uses any of its services, and the contractor shall not include ECPS in any client list in advertising and promotional materials.

J. Exceptions to the RFP: Any exception to any provisions of the RFP shall be explicitly identified in a separate “Exceptions to RFP” section of the proposal for resolution before execution of the contract. In case of any conflict between the RFP and any other contract documents, the RFP shall control unless the contract documents provide otherwise. Please identify below, or under separate cover, any “Exceptions to the RFP.”

K. Minority and Women-Owned Businesses – It is the intent of ECPS to facilitate the establishment, preservation, and small businesses and businesses by women and minorities and to encourage their participation in the ECPS’s procurement activities. Toward that end, ECPS encourages these firms to compete and encourages non-minority firms to provide for participation of small businesses and businesses owned by women and minorities through partnerships, joint ventures, subcontracts, and other contractual opportunities.

Offeror(s) are requested to include a statement indicating the planned use of such businesses in fulfilling this contract.

Section 4: Statement of Needs The purpose and intent of this RFP is to solicit proposals from qualified sources to establish a contract for Medical, Dental, Vision, and EAP Benefits for Essex County Public Schools through competitive negotiation. ECPS is interested in a financially aggressive option to replace the current benefits being offered.

A. Medical Proposed Plan Design Specifications:

a. The Offeror is requested to submit a proposal for only the following products:

i. Option 1 – All carriers/vendors are to provide either fully insured or self-insured medical proposals. If self-insured proposals are submitted, please include options without and with pharmacy and reinsurance carved out.

b. See attached plan design descriptions for full details on current medical and wellness plans.

c. Please submit proposals for fully insured and/or self-insured basis for Medical.

i. Option 1: $100k Specific Deductible include Aggregate Coverage

ii. Option 2: $125k Specific Deductible include Aggregate Coverage

d. Client is to have flexibility in desired plan design structure.

e. Details as to how to manage costs, encourage smart and effective utilization, improve healthy choices, and provide value to Essex County Public Schools and their employees.

f. Provide detail of wellness resources including educational support, employee and employer communications, engagement/activity-based programs, and outcome-based programs. Pricing is to be based on estimated utilization, not all eligible employees on a per member per month basis.

g. Plans must meet all Affordable Care Act and State Mandate requirements.

h. Three-year contract desired – Carrier can receive additional points in the evaluation if willing to offer future cost guarantees.

i. If your company cannot provide a quote for all plans listed above, it is acceptable to present an offer for one or more of the plans listed.

B. Dental Proposed Plan Design Specifications:

a. Please submit proposals for fully insured and/or self-insured basis for Dental.

b. Provide examples of benefit structure with submission

C. Wellness Objectives:

a. Keep work-force healthy, engaged, and productive.

b. Help mitigate risk by proactively managing “at risk” population.

c. Motivate and clinically support our employees and dependents to make and maintain healthy lifestyle choices and efficacious, cost-effective healthcare decisions.

d. Focus on outcome-based program.

e. Integrate and coordinate efficiently, timely, and accurately with other related plan and service providers including medical, pharmacy and reinsurance providers.

f. Improve morale and productivity, minimize absenteeism, and continue to build a culture of health and well-being.

g. Carriers that provide wellness dollars to help launch the program will be favored during the evaluation process.

h. Client to be able to use outside wellness vendor, if desired

i. Carrier to provide claims data to OneDigital, Wellness vendor, Pharmacy vendor, Reinsurance vendor and Data Warehouse vendors. Carriers must provide cost to provide claims data to these vendors.

D. Overview of Population Health Management Services to Include:

a. Targeted health programs

b. Health education sessions

c. Health promotion tool resources

d. Biometric screening options, clinical health risk assessment and patient consultation

e. Individual Score card report after completion of biometrics and health risk assessment

f. Aggregate Employer Report

g. Advanced Health Coaching

h. Integrated Telemedicine

i. Reporting of outcomes

j. Reward resources

Describe Population Health Management Service capabilities and costs listed above.

E. Performance Management:

a. Provide good key plan performance stats compared to solid benchmarks.

b. Provide average renewal rate increases for similar plan designs for comparable size groups.

c. Seamless, smooth implementation expected.

d. Provide ongoing support of the program along with reporting and outcome results of program.

F. Evaluation Criteria:

a. Total conformance with requests and requirements of RFP

b. Ability and experience of the offeror providing the requested products and services.

c. Demonstrated performance of the offeror related to requested products and services.

d. Demonstrated relevant experience and performance of employees to be assigned to the Essex County Public Schools account.

e. Demonstrated effectiveness of proposed products and services to achieve RFP objectives.

f. Demonstrated strategic, comprehensive, and efficacious and cost-effective wellness program.

g. Provide five (5) references of current clients who are similar in size, industry, and who are self- funded or fully insured in Virginia. Include client name, contact name, title, telephone number, email address, years with your company, plans offered and funding methodology.

h. Provide Year 1 cost (client desired 1 year contract with options to renew year 2 and 3)

i. Provide administrative and fixed cost fees for Years 1, 2 and 3

Section 5: Proposal Preparation and Submission Requirements

A. General Instructions

RFP Response:

Electronic proposal will be received by Sylvia Fulford, One Digital by 5:00 p.m., 3/1/2024 for furnishing the services described herein.

B. Proposal Preparation

a. An authorized representative of the Offeror shall sign proposals. All information requested should be submitted. Failure to submit all information requested may result in ECPS requiring prompt submission of missing information and/or giving a lowered evaluation of the proposal. Proposals which are incomplete or lack key information may be rejected by ECPS. Mandatory requirements are those required by law or regulation or are such that they cannot be waived and are not subject to negotiation.

b. Proposals should be prepared simply and economically, providing a straightforward, concise description of capabilities to satisfy the requirements of the RFP. Emphasis should be placed on completeness and clarity of content.

c. As used in this RFP, the terms "must", "shall", "should" and “may” identify the criticality of requirements. "Must" and "shall" identify requirements whose absence will have a major negative impact on the suitability of the proposed solution. Items labeled as "should" or “may” are highly desirable, although their absence will not have a significant impact and would be useful but are not necessary. Depending on the overall response to the RFP, some individual "must" and "shall" items may not be fully satisfied, but it is the intent to satisfy most, if not all, "must" and "shall" requirements. The inability of an Offeror to satisfy a "must" or "shall" requirement does not automatically remove that Offeror from consideration; however, it may seriously affect the overall rating of the Offerors proposal.

d. Ownership of all data, materials, and documentation originated and prepared for ECPS pursuant to the RFP shall belong exclusively to ECPS and be subject to public inspection in accordance with the Virginia Freedom of Information Act.

Trade secrets or proprietary information submitted by an Offeror shall not be subject to public disclosure under the Virginia Freedom of Information Act;

however, the Offeror must invoke the protections of § 2.2-4342F of the Code of Virginia, in writing, either before or at the time the data or other material is submitted. The written notice must specifically identify the data or materials to be protected and state the reasons why protection is necessary. The proprietary or trade secret material submitted must be identified by some distinct method such as highlighting or underlining and must indicate only the specific words, figures, or paragraphs that constitute trade secret or proprietary information.

The classification of an entire proposal document, line-item prices, and/or total proposal prices as proprietary or trade secrets is not acceptable and will result in rejection of the proposal.

e. Oral Presentation: Offerors who submit a proposal in response to this RFP may be required to give an oral presentation of their proposal to ECPS. This provides an opportunity for the Offeror to clarify or elaborate on the proposal. This is a fact finding and explanation session only and does not include negotiation. ECPS will schedule the time and location of these presentations. Oral presentations are an option for ECPS and may or may not be conducted.

C. Specific Proposal Instructions

a. Proposals should be as thorough and detailed as possible so that ECPS may properly evaluate your capabilities to provide the required services. Offerors should include in their Proposals a description of any significant task not listed in the Statement of Needs which they know to be necessary, either as reimbursable expenses under the Contract or as a service to be contracted for separately by ECPS. Offerors are encouraged to provide additional services which will enhance their ability to meet ECPS’s objectives. Offerors are required to submit the following items as a complete proposal:

Title Page

TAB I Executive Summary All signed documents from RFP and all addenda acknowledgements, if any.

TAB II Detailed Description of Coverages Quoted (including Limitations and Exclusions)

TAB III Medical Financial Rate Exhibits for years 1, 2 and 3

TAB IV Provider Disruption Report

TAB V Reinsurance Exhibit – Carriers/vendors quoting reinsurance on a carve-out basis are to complete.

TAB VI Overview of Wellness services, resources, and costs.

TAB VII Census exhibit

Section 6: Method of Award General RFP (Non-professional)

Award of Contract Selection shall be made of two or more offerors deemed to be fully qualified and best suited among those submitted proposals, based on the factors involved in the Request for Proposal, including price if so, stated in the Request for Proposal. Negotiations shall be conducted with each of the offerors so selected, Essex County Public Schools shall select the offeror which, in its opinion, has made the best proposal, and shall award in the Request for Proposal, awards may be made to more than one offeror.