RFP HR-26-755.pdf

Health Advocacy & Navigation Services | RFP - HR-26-755 | Template v3.14.25 | 1

City of

Long Beach Request for Proposals RFP - HR-26-755

Health Advocacy & Navigation Services

Health Advocacy & Navigation Services | RFP - HR-26-755 |

Template v3.14.25 | 1

Please read this entire document carefully as it contains important information essential to your proposal

Overview

Summary

The City of Long Beach is seeking proposals from qualified firms to provide health advocacy and navigation services to benefit eligible employees, retirees, and their family members. The services may include, but are not limited to, care coordination, physician locator, claims assistance, fee negotiation, and grievance advice.

Key Dates

Release Date: Tuesday, September 22, 2026

Questions Due to the City: 11:00 AM (PST), Tuesday, October 06, 2026

Proposals Due: 11:00 AM (PST), Wednesday, November 04, 2026

The City reserves the right to modify these dates at any time, with appropriate notice to prospective Contractors.

Proposal Information

Instructions for what to include in your proposal and how to submit it are detailed in Section 4.

Proposals must be submitted electronically via

LongBeachBuys.com.

This is a competitive process, and the City intends to award the opportunity based on the information submitted in the proposal that best meets the needs of the City.

Official Contact

Keisha Sanker

Template v3.14.25 | 2 rfppurchasing@longbeach.gov

All communication with the City related to this RFP must be directed to the contact listed above.

mailto:rfppurchasing@longbeach.gov

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Assistance & Resources For assistance using Long Beach Buys, please contact us directly

Customer Service Form rfppurchasing@longbeach.gov

(562) 570-6200

Additional support available for small businesses in Long Beach

BizCare

BizCare staff connect business owners and nonprofit leaders to important resources and information, such as grants, loans, technical assistance, information on City policies, and more.

562-570-4BIZ (4249)

4Biz@longbeach.gov

Request Assistance Form file:///C:/Users/casinoh/Downloads/longbeachbuys.com https://forms.office.com/Pages/ResponsePage.aspx?id=wxE_MWhCak-NO8fmUBg-eJhZqE0zY4JHucmtLMnWlxRUMzlJTVpROTNONUpZQ0tPMzVIQU5WQkk2Uy4u mailto:rfppurchasing@longbeach.gov https://longbeach.gov/economicdevelopment/business-development/bizcare-program/bizcare-request/ mailto:4Biz@longbeach.gov https://longbeach.gov/economicdevelopment/business-development/bizcare-program/bizcare-request/

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Contents

BizCare

1 The Opportunity

1.1 Project Summary

1.2 Background

1.3 Goals

1.4 Award Terms

2 Scope of Work

2.1 Description of Services

2.2 Performance Metrics & Contract Management

2.2.1 Performance Metrics

2.2.2 Contract Management

2.2.3 Contract Payment

3 How We Choose

3.1 Minimum Qualifications

3.2 Evaluation Criteria

4 Proposal Instructions & Content

4.1 Timelines & Instructions

4.2 Proposal Content

4.3 Narrative Proposal Template

5 Terms & Conditions

5.1 Acronyms/Definitions

5.2 Solicitation Terms & Conditions

5.3 Contract Terms & Conditions

5.4 Additional Requirements

5.5 Protest Procedures

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1 The Opportunity

1.1 Project Summary

The City of Long Beach (City) is seeking proposals from qualified firms to provide health advocacy and navigation services to benefit eligible employees, retirees, and their family members. Family members include the City’s defined eligible dependents in addition to parents, and mothers and fathers-in-law. The services may include, but are not limited to, care coordination, physician locator, claims assistance, fee negotiation, and grievance advice.

1.2 Background

The City is the seventh largest city in California and employs approximately 6,500 full-time and part-time personnel throughout 23 departments. The Employee Benefits Division, housed in the City’s Human Resources Department, oversees the implementation, monitoring, and compliance of 20+ benefit contracts that offer competitive and comprehensive benefits to City employees, retirees, and their dependents. In addition to the administration of benefit plans, staff in the Employee Benefits Division provide the following services:

• Benefits-related training to departmental staff

• Unemployment claims processing

• Citywide Benefit Education program

• Oversight/coordination of retirement counseling

Currently, there are approximately 4,942 benefit eligible active employees and 1,609 early retirees and Medicare retirees enrolled in the City’s retiree benefit plans (not including dependents). The City currently contracts with Health Advocate to provide Health Advocacy and Navigation services to eligible employees and retirees.

The City defines eligibility for active employees as permanent, full-time and permanent, part-time employees along with seasonal, part-time employees who meet the American

Care Act (ACA) eligibility. Furthermore, retirees are eligible for the Health Advocacy and

Navigation service if they continue benefit coverage through retirement with the City. In addition to City employees and retirees, the current contract covers employees and their eligible spouses, dependents, parents, and mothers and fathers in law.

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City of Long Beach’s Benefits Plans

The City is committed to providing comprehensive, high quality, and cost-effective benefit plans and programs that provide optimum value to the City, its employees, retirees, and their dependents.

The City pays into Social Security for most employees with some exceptions in safety classifications. The City does not pay into State Disability and instead provides benefits through The Standard Insurance.

The City offers the following core plan under its Benefits Package:

Active Population

• Medical

• Fully Insured HMO Premier Plan – Anthem Blue Cross

• Self-Funded PPO Plan – Anthem Blue Cross

• PPO Surgery Benefit

• Self-Funded PPO Surgery Benefit – Carrum Health

• Pharmacy Benefits Management (PBM)

• CVS Caremark is the pharmacy benefits provider on the Anthem Blue Cross

HMO and PPO plans.

• Dental

• Fully Insured HMO Plan – DeltaCare USA

• Self-Funded PPO Plan – Delta Dental

• Vision

• Self-Funded Vision Plan – Vision Service Plan (VSP)

• Employer-Paid Life Insurance

• Fully Insured $20,000 Basic Life – The Standard

• Fully Insured $20,000 Accidental Death and Dismemberment – The Standard

• Fully Insured Additional Life per MOU – The Standard

• Employer-Paid Short-Term Disability

• Fully Insured Short-Term Disability – The Standard

• Employer-Paid Long-Term Disability

• Fully Insured Long-Term Disability – The Standard

In addition to the core benefits listed above, the City offers the following voluntary benefits: The Standard Voluntary Life Insurance, MissionSquare Deferred Compensation

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457(b), MetLife Pet Insurance, Wellhub Gym and Wellness App, and ScholarShare529

College Savings Plan.

The following ancillary benefits are offered to City employees: LifeBalance Employee

Discount Program, Alliant Medicare Solutions Medicare Navigation Assistance, and Health

Advocate Employee Assistance Program (EAP).

The following benefits are offered to specific bargaining units who have negotiated the benefit: The Standard Short-Term Disability Buy-up, The Standard Long-Term Disability

Buy-up, MissionSquare Deferred Compensation 401(a), and MissionSquare Retired Health

Savings Plan.

In terms of retirement pension, the City offers a defined benefit retirement plan under the

California Public Employees’ Retirement System (CalPERS). Employees who are not eligible for CalPERS are enrolled in the Public Agency Retirement System (PARS), a defined benefit multiple employer program.

Retiree Population

Health Plans offered to retirees are separated into two categories: non-Medicare plans and

Medicare plans.

• Non-Medicare Retiree Medical Plans

• Fully Insured HMO Premier Plan – Anthem Blue Cross

• Fully Insured HMO Classic Plan – Anthem Blue Cross

• Self-Funded PPO Plan – Anthem Blue Cross

• Medicare Eligible Retiree Medical Plans

• Self-Funded Medicare Supplement PPO Plan – Anthem Blue Cross

• Fully Insured Medicare Advantage PPO Plan – United HealthCare (UHC)

• Fully Insured Medicare Advantage HMO Plan – SCAN

• Dental

• Fully Insured HMO Plan – DeltaCare USA

• Self-Funded PPO Plan – Delta Dental

• Vision

• Fully-Insured Vision Plan – Vision Service Plan (VSP)

• Self-Funded Vision Plan – Vision Service Plan (VSP)

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1.3 Goals

This RFP has the following stated goals:

• Maintain current service level outlined in Section 2.1, Description of Services.

• Enhance member understanding and utilization of existing health benefits.

• Improve care navigation and coordination across multiple services for members.

1.4 Award Terms

This contract will be for a period of two years with the option to renew for three additional one-year periods. The total contract term will not exceed five years.

2 Scope of Work

2.1 Description of Services

The City is seeking to partner with a single firm to provide health advocacy and navigation services that will complement the City’s existing carriers and Third Party Administrator (TPA) care management, advocacy, and engagement services. The awarded firm shall act as an integrator of all of the City’s existing benefits services to assist eligible employees and their family members in understanding their benefits as well as accessing the right services or resources for their healthcare needs.

Services included in the scope are listed below but are not limited to: personal health advocacy, medical and administrative support, care coordination, claims assistance, fee negotiations, grievance advice, pharmacy support, physician locating assistance, complex medical care assistance and navigation, and integrated call management.

Below are the tasks and responsibilities associated with each service category:

General Administrative Requirements

• Ability to comply with the Freedom of Information Act (FOIA) throughout the bidding process.

• Capability to integrate the following data types provided by the City, its service providers, and/or self-reported by individual members during implementation and at mutually agreed upon frequencies over the duration of the contract such as:

• Eligibility data

• Claims data

• Member data, including Personal Identifiable Information (PII) and Protected

Health Information (PHI)

• Changes to the City’s health benefits providers or plan designs

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• Provider data from the City’s health plans, plan administrators, pharmacy benefits manager, or other third-parties

• Ability to integrate all of the benefit plans and programs across the City’s entire benefit ecosystem to guide employees toward the most appropriate resources or services for their needs.

• Retain plan information for the current year, and from three years prior, to provide employees with accurate information including any plan changes or updates that may have occurred over time.

• During the contract term, the City will have no data restrictions and may obtain and share data with any third party.

• During the contract term, the City will retain control over plan design modifications, employee contribution methodology, and changes during the contract term except for state and federal required changes where applicable.

• Upon termination, send data and all relevant transfer files in a timely manner to the

City’s new vendor at no additional cost. Relevant data will include, but is not limited to, information on eligibility, claims history and any other pertinent information.

• Ensure full compliance with HIPAA and HITECH regulations regarding the security of protected health information.

• Protect the privacy and confidentiality of member personal and medical information by abiding by all applicable laws and regulations.

• Notify the City as soon as possible, and within ten (10) business days, upon the discovery of any unauthorized use or disclosure of confidential client and/or member information by the selected firm or any third-party.

• Ability to send and receive eligibility data electronically.

• Maintain full and accurate records with respect to all matters and services to the City for the entire duration of the contract and after contract termination or non-renewal.

Health Advocacy and Navigation

Provide dedicated health advocates to assist members with:

• Coordinating care among multiple physicians or medical institutions.

• Resolving billing issues and claims disputes.

• Negotiating fees with healthcare providers when necessary.

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• Filing appeals or grievances with their health insurer or health plan administrator with the understanding that submissions are determined with the expressed consent of the employee/member.

• Understanding their coverage options and other employer-paid benefits.

• Navigating prescription drug issues, including formulary or benefit questions.

• Identifying top medical institutions, specialized programs, and providers, as well as providing appointment scheduling assistance, for complex medical care.

• Understanding their medical test results, diagnoses, or treatment options.

• Locating in-network providers and scheduling appointments.

• Locating, reviewing, and arranging services with third-party vendors for services that are beyond the typical scope of healthcare benefits, such as transportation to and from medical appointments.

Member Communications and Engagement

• Provide members with a secure, ADA-compliant online platform and mobile application to connect with health advocates as well as access benefits information and resources.

• Provide members with the option to receive reminders and recommendations for preventive services, chronic condition management strategies, and identified gaps in care.

• Guarantee the online platform maintains at least 99% availability.

• Ensure 24/7 customer intake services with next-business-day follow-up available.

• Deliver culturally competent and inclusive services, including the availability of multi-lingual speaking representatives.

• Ability to support various member communication and engagement methods including, but not limited to, phone support, email, direct mailings, text messages, and push notifications.

• Participate in the City’s open enrollment Benefits Fair and other events or meetings as needed.

• Provide customized support or communication materials according to the City’s specific needs and preferences.

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Account Service Support

• Assign a highly experienced, dedicated, and accessible account management team to the City.

• Identify the physical locations of all primary account team members, including where they work day-to-day (e.g., onsite, regional office, headquarters, remote).

• Provide the professional qualifications, certifications, relevant experience, and roles of each team member assigned to support the City. Include tenure with the organization, areas of specialization, and healthcare advocacy or navigation-specific expertise.

• Ensure that at least one live account service team member will be available to the City between the hours of 8am and 5pm Pacific Time, Monday to Friday.

• Attend quarterly meetings with the City of Long Beach Human Resources staff, one annual in-person meeting with the City’s Health Insurance Advisory Committee, and ad hoc meetings as needed to discuss utilization, updates, and strategic initiatives related to the City’s objectives.

• Provide timely notification of any newly launched or updated online platforms and dashboards available to the City of Long Beach Human Resources staff, and provide training on the platforms as needed.

Reporting and Analytics

• Provide the City with standard management and utilization reports as well as non-standard or ad hoc reports upon request.

• Provide the City with access to a real-time client dashboard of aggregate data, insights, and comparative benchmarks related to cost, utilization, engagement, etc.

Audit Requirements

• Allow the City or its third-party representative (not subject to approval by the vendor) to access and audit all claims, utilization data, performance guarantee provisions, contracts, administrative fees, and other information relevant to account services at no additional cost. The City will cover any associated charges from the selected auditor.

• Inform the City of any and all aspects of the proposed services that cannot be included in the audit.

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• Ensure that all aspects of claims transacted for the City by the selected firm are subject to audit even if the firm deems the information to be confidential in nature, subject to a signed confidentiality agreement.

• Grant the City the right to audit records in any one given contract year for the entire term of the contract and up to one-year post-termination.

• Conduct periodic audits as part of the course of business. Provide the City with copies of any internal audits or quality assurance reports.

Exhibits

Exhibit 1_2026 COLB Actives Benefit Guide

Exhibit 2_2026 COLB Life and Disability Benefit Guide

Exhibit 3_2026 Non Permanent Benefit Guide

Exhibit 4_2026 COLB Retirees Benefit Guide

2.2 Performance Metrics & Contract Management

2.2.1 Performance Metrics

The table below highlights the targets that will be tracked and reviewed collaboratively with the Awarded Contractor during the contract. This list is an indication of the performance metrics of interest to the City, and is not exhaustive or final. As a part of a response to this

RFP, Proposers may propose additional or alternative performance metrics to be tracked on a regular basis. The final set of performance metrics and frequency of collection will be negotiated by the successful Proposer and the City prior to the finalization of an agreement between parties, and may be adjusted over time as needed.

METRIC DESCRIPTION TARGET DATA SOURCE

1. Implementation timeline

Total duration of contract implementation, including initial file and data transfer

Implementation complete within

60-90 days

To be determined during implementation

2. Account management satisfaction

Overall satisfaction with account team, reporting, and issue resolution

To be determined during implementation

To be determined

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3. Meeting attendance and preparation

Attendance and preparation of materials for required meetings

To be determined during implementation

Task Log for

Projects

4. Online platform availability

Availability and functionality of website and mobile application

Online platform available and functional at least

99% of the time

To be determined

5. Member digital engagement

Percentage of active members registered on the online platform

11% or higher To be determined

2.2.2 Contract Management

The awarded firm will receive consistent support and communications from a designated

City liaison through the duration of the contract. The liaison will serve as the primary contact for the awarded firm. The City’s designated liaison will send out reminders for upcoming deadlines for reports, invoices, and narrative metrics. These efforts aim to provide clarity and address any questions or concerns to ensure that any issues can be openly shared and resolved in a timely manner.

Kick Off Meeting

The awarded firm is required to participate in a project kickoff meeting, which will include the introduction of key project staff, a review of the project scope and timelines, an overview of the awarded firm’s invoicing and reporting requirements, and the establishment of a regular schedule for project meetings and reporting.

Milestones and Deliverables

The awarded firm shall submit the following deliverables to City staff by the designated deadline and receive approval before implementation. Final deadlines shall be negotiated and agreed upon during contract negotiations.

• Comprehensive report outlining the integration process, including timelines, milestones, and resource requirements to ensure readiness for the March 1, 2027, go-live date.

• Detailed outline of all implementation processes, project plans, data/file specifications, data sharing delivery timelines, and other testing/go-live support.

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• Detailed plan outlining strategies and procedures to maintain service delivery of scope of work.

Communications and Reporting

The awarded firm and City liaison shall meet regularly during the start of the engagement to review project status, address project issues, assess opportunities to improve effectiveness and efficiency. After the go-live date, the awarded firm and City staff shall meet quarterly to review project status and performance, address issues, assess opportunities to improve effectiveness and efficiency, and review service data and monitor performance.

2.2.3 Contract Payment

The City issues payment based upon services rendered. After a contract is finalized and work is performed, the Contractor should invoice the City. The City will remit payment within 30 calendar days of being billed.

3 How We Choose

3.1 Minimum Qualifications

Proposers must meet the following mandatory requirements to be eligible:

• Qualification to conduct business in the City.

• Not having been debarred by federal, state, or local government.

• Must possess all trade, professional, or business licenses as may be required by the work contemplated by this RFP.

• At least five (5) years of consecutive, verifiable experience providing health advocacy and navigation services for other large-scale government entities, municipalities, or public sector clients.

• Ability to keep records in accordance with any federal, state, or local mandates and document retention standards.

• Verifiable HIPAA-compliant practices and secure data management regarding the handling and transmission of PHI and PII.

• Attest that key personnel will be available to the extent proposed for the duration of the engagement, and acknowledge that no person designated as key personnel shall be removed or replaced without prior written notice and discussion with the City.

• Ability to provide the most recent Audited Financial Statement or Corporate Annual

Report and Business Tax Return.

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• Indication of the number and description of any outstanding legal actions pending against the firm’s organization with an explanation of how the firm will ensure that these actions will not disrupt business operations.

3.2 Evaluation Criteria

Proposals shall be consistently evaluated based upon the following criteria:

CRITERIA Weight

1. Organizational Capacity & Experience

• Demonstrated experience providing the services described in this RFP to similar clients

• Availability of skilled personnel with relevant administration and management experience in benefits education, care coordination, and claims resolution

• Evidence of strong organizational infrastructure and resources to support this project

30%

2. Method of Approach

• Demonstrated ability to maintain the scope of work (Note that for scoring and evaluation purposes, submitted proposals should be based solely on the City’s current plan design as outlined in Section 2.1

Description of Services).

• Detailed description of proposed methodology for integrating with existing systems and processes

• Demonstrated capability to ensure a March 1, 2027 go-live date

• Clear plan for addressing potential challenges or obstacles and implementing proactive risk mitigation measures

40%

3. Communications & Reporting

• Ability to participate in mandatory meetings

• Demonstrated ability and experience in data collection and reporting

• Comprehensive communication plan outlining regular updates, channels of communication, and escalation procedures

• Commitment to responsiveness and transparency in addressing City inquiries, feedback, and concerns throughout the contract term

20%

4. Reasonableness of Cost 10%

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4 Proposal Instructions & Content

4.1 Timelines & Instructions

MILESTONE

TIME

(PACIFIC) &

DATE LOCATION / ADDITIONAL INFORMATION

Release date Tuesday

September

22, 2026

Questions due to the

City

11:00 AM

(PST),

Tuesday, October 06,

• Submit all inquiries via email to rfppurchasing@longbeach.gov

Posting of the Q&A Tuesday, October 20,

• Responses to the questions will be posted on

LongBeachBuys.com.

Proposals due 11:00 AM

(PST),

Wednesday

November

04, 2026

• Proposals should be submitted electronically via LongBeachBuys.com.

• Late proposals, or proposals submitted through other channels will not be accepted.

• Proposers are responsible for submitting their proposals completely and on time.

o Proposers will receive an e-bid confirmation number with a time stamp from LongBeachBuys.com indicating that the proposal was submitted successfully. The City will only receive proposals that were transmitted successfully.

o For technical support, email or call the

City during normal business hours at

LBPurchasing@longbeach.gov or (562)

570-6200.

mailto:rfppurchasing@longbeach.gov file:///C:/Users/meid/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/X47PW9A6/LongBeachBuys.com file:///C:/Users/meid/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/X47PW9A6/LongBeachBuys.com file:///C:/Users/meid/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/X47PW9A6/LongBeachBuys.com mailto:LBPurchasing@longbeach.gov

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Evaluation of Narrative

& Cost Proposals

November -

December

• An Evaluation Committee will review Narrative

& Cost Proposals to select the proposal that best meets the needs of the City.

• Evaluations will be conducted using a methodology derived from the evaluation criteria listed in Section 3.2.

Interviews/ Demos December

• The City may interview or request demos from none, one, some or all Proposers.

Negotiation &

Contractor Selection

January -

February

• Selected Contractor(s) will be notified in writing.

• Any award is contingent upon the successful negotiation of final contract terms. If contract negotiations cannot be concluded successfully, the City reserves the right to negotiate a contract with another Contractor or withdraw the RFP.

• Negotiations shall be confidential and not subject to disclosure to Public Records Act requests unless and until an agreement is reached.

Estimated Contract

Execution

March 1, Proposer Debrief After

Contractor is Selected

• Successful and unsuccessful Proposers are encouraged to request phone call or in person meeting with the City to discuss the strengths and weaknesses of their proposal.

The intent of the debrief is to provide the

Proposer with constructive feedback to equip them with information to effectively meet the

City’s needs and be successful in future proposals.

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4.2 Proposal Content

Complete proposals will include the following. Proposers are encouraged to use this table as a checklist to ensure all components are included in their proposal. Please note proposals that are NOT complete will NOT be considered for the opportunity and will be deemed nonresponsive.

PROPOSAL

☐ Narrative

Proposal

The Narrative Proposal should be prepared using the provided template (4.3 Narrative Proposal Template). Proposers should provide a straightforward, concise delineation of capabilities to satisfy the RFP. Guidance on preparing a Narrative Proposal is detailed in Section 4.3.

• The Narrative Proposal must be named the following:

“Attachment #1_Narrative Proposal_Name of Firm.”

☐ Cost Proposal The Cost Proposal should provide a straightforward cost proposal. Proposers may use their preferred format.

• The Cost Proposal must be named the following:

“Attachment #2_Cost Proposal_Name of Firm”.

Include in the Cost Proposal,

• Any possible limitations of fee negotiations. Proposals should list whether they will “attempt” negotiations” or guarantee a target percentage of savings,

• List of services that may fall outside of the scope or offer services at an additional cost,

• Confirm whether custom material is included in base/standard fee or if there is an additional cost.

PROPOSAL APPENDICES

☐ Financial

Stability

Proposers should include one or more of the following financial statements to provide the City with enough information to determine financial stability of the Proposer and subcontractor.

• Most Recent Audited Financial Statement or Corporate

Annual Report

• Business tax return

• Statement of income and balance sheet

Implementation

Timeline

Proposers should provide an implementation timeline with milestones and estimated City staff time usage.

Sample

Reporting

Proposers should include sample reporting that demonstrates their capabilities.

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☐ Other Addenda

(if applicable)

Colored displays, promotional materials, and other collateral are not necessary or desired. However, if a complete response cannot be provided without referencing supporting documentation, it may be provided as an addendum clearly cited in the Narrative or Cost Proposal.

MANDATORY ATTACHMENTS | The following are included as Attachments in Long

Beach Buys. They must be signed by the individual legally authorized to bind the

Proposer.

☐ A. Authorization & Certification

☐ B. Equal Benefits Ordinance (EBO) Form

Attachments Which May be Submitted Upon Award | Upon award, Awarded

Contractors will be required to submit the following. We encourage you to take note of these requirements, and where possible, include available information as part of your proposal to expedite processing.

☐ C. W-9

☐ D. Business License

☐ E. Proof of Registration with the California Secretary of State

☐ F. Certificates of Insurance: [Refer to Section 5.3]

☐ Contact Information | Ensure your organization’s profile is up to date in Long Beach

Buys, including an email address, phone number, and for any classifications you may qualify for.

☐ Conformation of Attachments | Ensure you have checked ALL the attachments in

Long Beach Buys and have confirmed that all the required documents have been uploaded and labeled correctly.

4.3 Narrative Proposal Template

An editable version of the template below has been posted to Long Beach Buys. Proposers are required to use this editable template and submit it as their narrative proposal.

Proposers may submit other attachments as supporting documentation.

Confidential and/or Proprietary Information

Any information that a Proposer believes may be considered proprietary, confidential, or a trade secret should be labeled with term CONFIDENTIAL on that part of the proposal. All proposals and parts of the proposals which are not marked as confidential will be automatically considered public information after the Notice of Intent to Award has been posted and the protest period has been closed. The City will comply with the Proposer’s

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Public Information Act.

Organizational Capacity & Experience

PROPOSER CONTACT INFORMATION

Organization

Company Name

Company Address

Federal Tax ID Number

Website

Authorized

Representative

Name

Title

Email Address

Phone Number

Other Point of

Contact (if required)

Name

Title

Email Address

Phone Number

PROPOSER CAPACITY & EXPERIENCE

What type of enterprise is the organization?

☐ Non-Profit

☐ Sole Proprietorship

☐ General Partnership

☐ Corporation

State and Date of incorporation:

☐ Limited Liability Company

☐ Other _________________________________

Briefly describe your organization’s background, culture, and mission statement.

What other names, if any, has your organization operated under?

Describe why your organization is qualified to provide the services described in this RFP

(1-2 paragraphs)

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Describe the length of time your organization has been providing the services described in this RFP (1-3 sentences)

Describe your success with similar clients and explain where your organization value stands out compared to other services providers.

Provide a plan of overview for how the project will be staffed, including the percentage of time each employee will be allocated to the project and their titles, qualifications, and number of years with the organization.

Describe the backup support plan to ensure continuity of service in the event primary account team members are on leave, reassigned, or otherwise unavailable Include how responsibilities transition during coverage periods.

Where are the representative(s) that would service the City’s account located?

How is your client team structured?

What is your staff retention rate?

Are there any outstanding legal actions pending against your organization? If yes, explain the nature and current status of the action(s). Additionally, explain how your organization will ensure any outstanding actions will not disrupt it’s ability to provide services to the City.

Has your organization experienced a recent merger or acquisition activity within the last

24 months? If yes, please explain.

Does your organization anticipate any restructuring or reorganization in the next two years (e.g., major staff changes or office relocations or closings). If yes, please explain the anticipated changes and how they would impact business with the City.

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Has your organization ever filed for bankruptcy? If yes, when, and what is the current status of your filing?

Has your organization had a contract terminated for case or non-renewed within the last five (5) years? If yes, by whom and for what circumstances?

Provide the name and telephone number of any clients that have terminated your organization for cause in the last five (5) years.

REFERENCES

Reference 1

Company

Project Manager

Phone Number

Project Description

Project Start and

End Dates

Reference 2

Company

Project Manager

Phone Number

Project Description

Reference 3

Company

Project Manager

Phone Number

Project Description

SUB-CONTRACTOR CONTACT INFORMATION

Does the proposal include subcontractors?

☐ Yes

☐ No

If applicable, provide the following for all subcontractors included in this proposal.

Organization Company Name

Company Address

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Authorized

Representative

Name

Title

Email Address

Phone Number

Other Point of

Contact (if required)

Name

Title

Email Address

Phone Number

SUBCONTRACTOR CAPACITY & EXPERIENCE

What type of enterprise is the organization?

☐ Non-Profit

☐ Sole Proprietorship

☐ General Partnership

☐ Corporation

State and Date of incorporation:

☐ Limited Liability Company

☐ Other _________________________________

Which specific requirements of this RFP will the subcontractor perform?

Is the subcontractor registered with the

California Department of Industrial

Relations? If yes, provide registration number.

Please describe why the organization is qualified to provide the services described in this RFP (1-2 paragraphs).

Please describe the length of time the organization has been providing the services described in this RFP (1-3 sentences).

How many employees does the organization have nationally, locally, and residing in Long

Beach?

Where are the representative(s) that would service the City’s account located?

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Method of Approach

1. Provide an executive summary. It should demonstrate a clear understanding of the scope of work and describe how your organization will fulfill the requirements outlined Section 2 Scope of Work.

2. Describe your organization’s approach to assisting members in accessing the appropriate information or care to meet their needs. Which issues can your organization directly help members resolve, and which issues can your organization only advise members on and/or refer them back to the carrier, provider, or employer? Describe the typical procedures when health advocates are unable to resolve a member’s inquiry

3. Describe the qualifications, experience, tenure, and skill sets of your organizations health advocates.

4. Will the advocate assigned to an individual remain the same until the individual’s current issue is resolved? Will the same advocate also handle future inquiries with the same individual?

5. What is the average staffing ratio of health advocates to enrolled members?

6. Describe your best practices for driving engagement.

7. Describe your organizations approach to adhering to accessibility standards, ensuring website and mobile application usability for people with visual, hearing, motor, or other disabilities. Provide a link to a public website designed and developed for your firm that demonstrates the described manner of accessibility compliance.

8. What health plan data do you need to operate effectively? What is the frequency required for each data set? What is the typical time frame from receipt of such data to it being loaded and available in your system? What can you do with eligibility-only data?

9. Describe your data security standards and procedures regarding HIPAA compliance and the handling of PHI during and after the contract term.

Additionally, detail your notification procedures and risk mitigation plan in the event of a breach of confidential or sensitive data.

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10. Describe your organization’s current or anticipated use of emerging solutions and technologies in the delivery of its services (e.g., artificial intelligence [AI], machine learning, natural language processing, social determinants of health). If your organization uses AI, describe the specific functions performed by AI, how they improve member experience, and any related data protection measures. Note if clients and/or members can opt in or out of features that use AI.

11. Based on the City’s likely needs and your organization’s proposed implementation plan, identify three potential risks or challenges to implementation. Describe your mitigation strategy to prevent, monitor, and resolve each potential issue.

12. What would your organization need from the City to implement the contract successfully?

Communications & Reporting

1. Describe how your organization will proactively share standard and non-standard reporting and utilization reports with the City. Provide a list of available standard reports , describe the typical reporting frequency with similar clients, and outline the process for requesting customized reports.

2. Provide a detailed escalation process for service issues, complex member cases, data concerns, or operational challenges. Identify response-time expectations, and how escalations are documented, tracked, and resolved.

3. Describe how your organization measures and reports on engagement, identitied gaps in care, clinical outcomes, and/or financial outcomes.

4. Describe your organization’s approach to regularly reviewing reporting and dashboard data with the City to help proactively support employee well-being and reduce costs. How have you helped similar clients intentionally use data related to case volume, issue type, chronic conditions, recurring carrier issues, and other trends?

5. Does your organization provide real-time client dashboards? If yes, what trend data would the City be able to access from the dashboard? Please provide a guest login or examples of reporting available via the client dashboard.

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6. Describe your organization’s approach to enhancing member communication, including how you identified and shared opportunities for improved member engagement with similar clients. Include information of the employee opt-out process for focused communication.

7. The City requires that the Awarded Contractor provide proof of payment of any subcontractors used for this project. If the proposal includes subcontractors, please describe the plan for how the City will be notified of such payments.

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5 Terms & Conditions

5.1 Acronyms/Definitions

1. ADA: American with Disabilities Act

2. Awarded Contractor: The organization/individual that is awarded a contract with the

City of Long Beach, California for the services identified in this RFP.

3. City: The City of Long Beach and any department or agency identified herein.

4. Contractor / Proposer: Organization/individual submitting a proposal in response to this RFP.

5. Department / Division: City of Long Beach, Human Resources

6. Evaluation Committee: An independent committee comprised solely of representatives of the City established to review proposals submitted in response to the RFP, evaluate the proposals, and select a Contractor.

7. FOIA: Freedom of Information Act

8. HIPAA: Health Insurance Portability and Accountability Act

9. HITECH: Health Information Technology for Economic and Clinical Health

10. May: Indicates something that is not mandatory but permissible.

11. PHI: Protected Health Information

12. PII: Personal Identifiable Information

13. RFP: Request for Proposals.

14. Shall / Must: Indicates a mandatory requirement. Failure to meet a mandatory requirement will result in the rejection of a proposal as non-responsive.

15. Should: Indicates something that is recommended but not mandatory. If the

Proposer fails to provide recommended information, the City may, at its sole option, ask the Proposer to provide the information or evaluate the proposal without the information.

16. Subcontractor: Third party not directly employed by the Proposer who will provide services identified in this RFP.

17. TPA: Third-Party Administrator

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5.2 Solicitation Terms & Conditions

1. The City reserves the right to alter, amend, or modify any provisions of this RFP, or to withdraw this RFP, at any time prior to the award of a contract pursuant hereto, if it is in the best interest of the City to do so.

2. The City reserves the right to request clarification of any proposal term from

Proposers.

3. The City may contact the references provided; contact any Proposer to clarify any response; contact any current users of a Proposer’s services; solicit information from any available source concerning any aspect of a proposal; and seek and review any other information deemed pertinent to the evaluation process.

4. The level and term of documentation required from the Proposer to satisfy the City will be commensurate with the size and complexity of the contract and Proposers should submit accordingly. If the information submitted by the Proposer, or available from other sources, is insufficient to satisfy the City as to the Proposer’s contractual responsibility, the City may request additional information from the Proposer or may deem the proposal non-responsive.

5. The City reserves the right to waive informalities and minor irregularities in proposals received.

6. The City reserves the right to reject any or all proposals received prior to contract award.

7. The City’s determination of the Proposer’s responsibility, for the purposes of this RFP, shall be final.

8. Unless otherwise specified, the City prefers to award to a single Contractor but reserves the right to award contracts to multiple contractors.

9. The City shall not be obligated to accept the lowest priced proposal, but will make an award in the best interests of the City of Long Beach after all factors have been evaluated.

10. If the City receives a single responsive, responsible proposal, the City may request an extension of the proposal acceptance period and/or conduct a price or cost analysis on such proposal. The Proposer shall promptly provide all cost or pricing data, documentation and explanation requested by the City to assist such analysis. By

Health Advocacy & Navigation Services | RFP - HR-26-755 | Template v3.14.25 | 29 conducting such analysis, the City shall not be obligated to accept the single proposal.

The City reserves the right to reject such proposal or any portion thereof.

11. Any irregularities or lack of clarity in the RFP should be brought to the Purchasing

Division designee’s attention as soon as possible so that corrective addenda may be furnished to Proposers.

12. Proposals must include any and all proposed terms and conditions, including, without limitation, written warranties, maintenance/service agreements, license agreements, lease purchase agreements and the Proposer’s standard contract language. The omission of these documents may render a proposal non-responsive.

13. Alterations, modifications or variations to a proposal may not be considered unless authorized by the RFP or by addendum or amendment.

14. Proposals which appear unrealistic in the terms of technical commitments, lack of technical competence, or are indicative of failure to comprehend the complexity and risk of this contract, may be rejected.

15. Proposals may be withdrawn by written notice received prior to the proposal opening time.

16. The price and amount of this proposal must have been arrived at independently and without consultation, communication, agreement or disclosure with or to any other

Contractor or prospective Contractor.

17. No attempt may be made at any time to induce any firm or person to refrain from submitting a proposal or to submit any intentionally high or noncompetitive proposal.

All proposals must be made in good faith and without collusion.

18. Prices offered by Proposers in their proposals are an irrevocable offer for the term of the contract and any contract extensions. The Awarded Contractor agrees to provide the purchased services at the costs, rates and fees as set forth in their proposal in response to this RFP. No other costs, rates or fees shall be payable to the Awarded

Contractor for implementation of their proposal.

19. The City is not liable for any costs incurred by Proposers prior to entering into a formal contract. Costs of developing the proposals or any other such expenses incurred by the Proposer in responding to the RFP, are entirely the responsibility of the Proposer, and shall not be reimbursed in any manner by the City.

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20. In the event a Proposer received assistance from City staff or a representative of the City (technical assistance provider), the City is not responsible for any mistakes, inaccuracies, delays, or any other impact that the assistance provided did to impact the Proposer’s final product. Available technical assistance support services are only intended to provide advice and does not constitute a basis for any protest to this contract opportunity. It is solely the Proposer’s responsibility to prepare and submit a response to the RFP.

21. Proposal will become public record after the Notice of Intent to Award has been posted and the protest period has closed unless the proposal or specific parts of the proposal can be shown to be exempt by law. Each Proposer may clearly label all or part of a proposal as "CONFIDENTIAL" provided that the Proposer thereby agrees to indemnify and defend the City for honoring such a designation. The failure to so label any information that is released by the City shall constitute a complete waiver of any and all claims for damages caused by any release of the information.

22. A proposal submitted in response to this RFP must identify any subcontractors, and outline the contractual relationship between the Proposer and each subcontractor.

An official of each proposed subcontractor must sign, and include as part of the proposal submitted in response to this RFP, a statement to the effect that the subcontractor has read and will agree to abide by the Proposer’s obligations.

23. If the Contractor elects to use subcontractors, the City requires that the Awarded

Contractor provide proof of payment of any subcontractors used for this project.

Proposals shall include a plan by which the City will be notified of such payments.

24. Each Proposer must adhere to the City’s Vendor Code of Conduct, including, but not limited to, disclose any existing or potential conflict of interest relative to the performance of the contractual services resulting from this RFP. Any such relationship that might be perceived or represented as a conflict should be disclosed.

The City reserves the right to disqualify any Proposer on the grounds of actual or apparent conflict of interest. The Vendor Code of Conduct can be found at https://longbeach.gov/globalassets/finance/media-library/documents/business-info/purchasing-division/final-vendor-code-of-conduct-2023

25. Each Proposer must include in its proposal a complete disclosure of any alleged significant prior or ongoing contract failures, any civil or criminal litigation or investigation pending which involves the Proposer or in which the Proposer has been judged guilty or liable. Failure to comply with the terms of this provision will disqualify https://longbeach.gov/globalassets/finance/media-library/documents/business-info/purchasing-division/final-vendor-code-of-conduct-2023 https://longbeach.gov/globalassets/finance/media-library/documents/business-info/purchasing-division/final-vendor-code-of-conduct-2023

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Proposer’s prior history with the City or with any other party, which documents, without limitation, unsatisfactory performance,…