RFP No.180000001030 Award Letter and Synopsis FINAL.pdf

07/26/16

Recommendation of Award

The Department of Technology, Management, & Budget’s Procurement office has completed the evaluation of Request for Proposal (RFP) No. 180000001030 for Administration Services for Vision Insurance for Civil Service Commission (CSC) and has recommended an award to EyeMed Vision Care, LLC in the amount of $29,000,000.00 pending State Administrative Board approval, if applicable. More information on the State Administrative Board can be found at: State Administrative Board.

Bidders who were not recommended for the award are encouraged to schedule a debriefing session with the Solicitation Manager. The debriefing session will provide the bidder with the State’s rationale on why the bidder was not recommended for the award. The Solicitation Manager may be contacted as follows:

Mary Ostrowski, Solicitation Manager ostrowskim@michigan.gov

(517) 249-0438

Background Information:

This RFP was to solicit responses for selection of a Contractor to provide Administration Services for Vision Insurance for State of Michigan employees, retirees, and their dependents. The term of this contract is 3 Years, with up to 5 – 1 Year renewal options.

Bidders:

The RFP was posted on SIGMA VSS on February 7, 2018 for 4 weeks and 5 days. The following bidders submitted proposals by the published due date of March 12, 2018.

Bidder Address City, State Zip

SDVOB*

Avesis Third Party Administrators, Inc.

(Avesis)

10324 South Dolfield Road Owings Mills, Maryland 21117

N

Blue Cross Blue Shield of Michigan (BCBS) 600 E. Lafayette, Detroit, MI 48243

N

Davis Vision, Inc.

175 E. Houston St., San Antonio, TX 78205 N

EyeMed Vision Care, LLC (EyeMed)

4000 Luxottica Place, Mason, OH 45040 N

*SDVOB: Service-Disabled Veteran Owned Business

STATE OF MICHIGAN

ENTERPRISE PROCUREMENT

Department of Technology, Management & Budget 525 W. Allegan, 1st Floor Lansing, MI 48913 PO Box 30026 http://www.michigan.gov/micontractconnect/0,4541,7-225-48756---,00.html

07/26/16

Evaluation Synopsis

I. Evaluation Process

A Responsible Vendor is a vendor that demonstrates it has the ability to successfully perform the duties identified by the solicitation. A Responsive proposal is one that is submitted in accordance with the solicitation instructions and meets all mandatory requirements identified in the solicitation.

Solicitation Instructions and Vendor Questions, Section 6, Mandatory Minimum Requirements.

To avoid disqualification, the bidder must:

1. The Contractor must duplicate the current Plan Design for the Plan Sponsor. See Schedule A Section

1.B.2.

2. The Contractor must be a licensed Third-Party Administrator (TPA) in the State of Michigan or insurance company licensed to do business in Michigan, or must qualify in any other capacity as an entity that is properly licensed by statute to provide administrative services only and cost-plus arrangements, or to act as a TPA. The Contractor must attach details regarding any statutory cites that permit the Contractor to meet this requirement. See Schedule A Section 1.A.2.

Only proposals meeting the mandatory minimum requirements will be considered for evaluation.

Solicitation Instructions, Section 7, Evaluation Process.

The State will evaluate each proposal based on the following factors:

Technical Evaluation Criteria Weight

1. Schedule A, excluding Sections: 3. Staffing, 4. Project

Management, and 6. Invoice and Payment.

2. Schedule A, Section 3. Staffing 10

3. Schedule A, Section 4. Project Management and

Schedule A, Section 6. Invoice and Payment

4. Vendor Questions, Section 2 Company Background and Vendor Questions, Section 5 Experience

Total 100

Proposals receiving 80 technical evaluation points will have pricing evaluated and considered for award.

The State may utilize all bidder information, without regard to a proposal’s technical score, to determine fair market value for goods or services sought. The State is not obligated to accept the lowest price proposal. If applicable, the State’s evaluation will include consideration of a bidder’s qualified disabled veteran (QDV) status under MCL 18.1261(8). Additional information on the QDV preference is available at:

http://michigan.gov/micontractconnect/0,4541,7-225-48677-123519--,00.html.

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

https://1.next.westlaw.com/Document/NDF51D9D11A6211E7AF4BCB5D36CD7FBD/View/FullText.html?transitionType=UniqueDocItem&contextData=(sc.Search)&userEnteredCitation=MCL+18.1261 http://michigan.gov/micontractconnect/0,4541,7-225-48677-123519--,00.html

The State may conduct an on-site visit to tour and inspect the bidder’s facilities; require an oral presentation of the bidder's proposal; conduct interviews, research, reference checks, and background checks; and request additional price concessions at any point during the evaluation process.

The full evaluation process is stated in the RFP Proposal Instructions.

II. Evaluation Method

Responses to this solicitation were reviewed by a Joint Evaluation Committee, which consisted of the following individuals:

Voting Advisory Mary Ostrowski Central Procurement Department of Technology, Management and Budget

Bethany Beauchine Employee Benefits Civil Service Commission

Rebecca Guyski Employee Benefits Division Civil Service Commission

Courtney Flores Central Procurement Department of Technology, Management and Budget

Chris DeRose Employee Benefits Division Civil Service Commission

Aleksandar Tomic Willis Towers Watson

Sarah Enz Office of Retirement Services Department of Technology, Management and Budget

Rita Dandridge Willis Towers Watson

Gerri Smith Office of State Employer

Ariane Houie Willis Towers Watson

Bob Kopasz Michigan State Employee Retirees Association

Dan Matusiak Willis Towers Watson

Tara Nichol Member Benefits Michigan Corrections Organization

Jacob Schaeffer Willis Towers Watson

Ryan Thimm Willis Towers Watson

III. Evaluation Results

A. Avesis The JEC determined that Avesis, based on a score of 80, met the requirements of this RFP. This determination was accomplished by evaluating their responses to the Technical Evaluation Criteria.

1. Schedule A – excluding Section 3. Staffing, 4. Project Management, and 6. Invoice and Payment Score: 49 / 60 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 1.A.11 Bidder provided ratings, but not an actual copy of the ratings, in their initial response.

-Section 1.C.7 Bidder did not sufficiently detail their process for handling overpayments and recoveries by not addressing payment to the provider and impact to members, in their initial response.

-Section 1.C.8 In their initial response, Bidder indicated that they will be the first payer, however this is inconsistent with the requirement to coordinate benefits.

-Section 1.D.2 Bidder did not sufficiently explain their Quality Assurance Program, in their initial response.

-Section 1.D.4 Bidder did not address how they ensure the providers comply with the Plan Design, in their initial response -Section 1.D.7 Bidder provided inaccurate data calculations in their GeoAccess Data. Numbers are not consistent with the analysis they provided.

-Section 1.D.9 Bidder did not provide the correct percentage for Active Provider disruption percent; Bidder stated 72% instead of 78%. The corrected percentage was used in the following percentages. Due to inconsistency in data provided to Bidders, areas where the spreadsheet didn’t have an address or zip code listed were removed from the analysis from all Bidders to provide more accurate data comparison. Data provided indicated a very significant provider disruption which averaged 79.7% for providers and 84.3% for members overall. (The original disruption analysis that included the inconsistent data averaged 79.7% for providers and 84.1% for members).

-Section 1.G.3 In their initial response, Bidder did not describe their processing of eligibility files;

instead Bidder only confirmed compliance with 834 files and stated the method in which files are accepted.

-Section 1.G.16 In their initial response, Bidder did not sufficiently describe their validation and quality control processes specifically regarding uploading, reading, and populating their system with data from Plan Sponsor and did not address the turnaround times stated in the requirement.

-Section 1.J.3 Bidder did not provide their disaster recovery plan in their initial response; instead Bidder provided an overview and indicated that a complete copy can be provided upon request.

-Section 1.L Bidder did not provide sufficient detail on their training capabilities and any training included in their proposal, in their initial response.

2. Schedule A – Section 3. Staffing Score: 6 / 10 The JEC determined that this section was not adequately addressed, and the following deficiencies were noted:

-Section 3.5.D Resumes provided were not chronological and did not indicate education, in their initial response.

-Section 3.6.A Bidder provided inconsistent information in their initial response, by not listing Linda LaPointe Controller (Billing Specialist) and Celest Kjespo (Eligibility Specialist) from the organizational chart in this table with the information requested.

-Section 3.7.Part 1 Bidder did not provide sufficient detail on the experience levels and responsibilities of the customer service representatives, in their initial response.

-Section 3.8. In their initial response, Bidder did not provide subcontractors on their organizational chart, and did not detail their function.

-Section 3.9.a-d Bidder did not disclose all subcontractors and their required information such as Iron Mountain in Section 1.D.5 and 1.J.1, in their initial response.

3. Schedule A – Section 4. Project Management and Schedule A Section 6. Invoice and

Score: 11 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 4.1.C

• Section 4: Bidder did not provide a detailed discussion on how to manage the transition process, and only mentions a conference meeting in Step one of their plan.

• Section 6: Bidder did not provide the project management approach, methods, tools, and processes intended for oversight and completion of the implementation.

• Section 7: Bidder did not sufficiently address how they convey issues/changes and the suggested resolution and mitigation strategies.

• Section 8: Bidder did not address or provide a detailed protocol and escalation communication process.

4. Vendor Questions, Section 2. Company Background and Vendor Questions, Section 5.

Experience Score: 14 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 5, Experience:

• Experience 2, Mayo Clinic: Bidder did not provide or explain any results obtained.

• Experience 3, City of Phoenix: Bidder did not provide or explain any results obtained.

Total Score: 80 / 100

B. Blue Cross Blue Shield of Michigan The JEC determined that Blue Cross Blue Shield of Michigan, based on a score of 75, did not meet the requirements of this RFP. This determination was accomplished by evaluating their responses to the Technical Evaluation Criteria.

Score: 45 / 60 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 1. Requirements:

• Bidder did not agree to all requirements in Schedule A; instead, Bidder agreed to respond to all requirements in Schedule A.

• Bidder did not agree to Section 2; they submitted exceptions to acceptance terms.

-Section 1.D.7 Bidder provided inaccurate data calculations in their GeoAccess Data. Numbers are not consistent with the analysis they provided. In every instance the numbers were inflated.

-Section 1.D.9:

• Bidder did not submit the correct Schedule G document to submit their provider disruption which included the NPI number.

• It was not clear whether some of the providers that are out of network, are changing to be in network as part of Bidder’s proposal. No points were deducted.

• Due to inconsistency in data provided to Bidders, areas where the spreadsheet didn’t have an address or zip code listed were removed from the analysis from all Bidders to provide more accurate data comparison.

-Bidder indicated that they do not record outbound calls due to a legal requirement of notification in regard to the requirements for the following two sections:

• 1.E.4

• 1.E.6

-Section 1.E.7 Bidder does not retain the calls for a minimum of one year; they only retain for 60 days.

-Section 1.F.4 Bidder did not address or agree that they will provide an electronic Provider Directory for placement on Plan Sponsors website; instead Bidder indicated that members can access on their www.vsp.com.

-Bidder’s response indicated that some of the programming elements are not currently stored or programmed into their membership system and indicated use of a workaround process in regard to the requirements in the following two sections:

• 1.G.1

• 1.G.6

-Section 1.G.10 Bidder stated they agreed with modification, however Bidder did not agree to the requirement as stated and instead modified it to say, “We will work with the plan sponsor to implement emergency updates to ensure that the member can receive services”.

-Section 1.G.14 Bidder indicated use of a “drop logic” for the term date of retroactive terminations, where the record is omitted from the file, and that omitted record would be considered a termination. This is not in compliance with the Plan Sponsor having the sole authority to determine the enrollment effective dates.

-Section 1.G.15 Bidder’s response indicated that compliance with their 834 testing and structure standards must be met in order for them to comply with the Plan Sponsors request of changes required to support the receipt and processing of enrollment and eligibility files.

Bidder did not agree to the requirements in the following sections by imposing a limitation on audit notification of 60 days for mail-in and 90 days for on-site:

• 1.G.15.a

• 1.G.15.b

• 1.H.2

-Section 1.G.16:

• Bidder did not agree to the requirement that discrepancy reporting must be in the format defined by the Plan Sponsor by stating it’s not available for external review by each Plan Sponsor.

• Bidder did not sufficiently describe their validation and quality control processes specifically regarding uploading, reading, and populating their system with data from Plan Sponsor. Bidder did not address the turnaround times stated in the requirement.

-Section 1.H.1 Bidder did not indicate agreement to the part of the requirement that states the Plan Sponsor reserves the right to change this approach without prior notice by stating they require 60 days’ notice for mail in audit and 90 days’ notice for onsite visit.

-Section 1.H.3 Bidder imposed a limitation of 1 audit annually with 60 days notification for mail in audits and 90-day notification for onsite visits.

-Section 1.H.4 Bidder indicated they would provide the data elements for the audit within 60 days of receiving the audit notification for a mail in audit and within 90 days for an on-site visit instead of 30 days from receipt of data request.

-Section 1.H.6:

• Bidder did not agree to the requirement by altering the language to state, “mutually agreed upon deficiencies” instead of “mutually agreed upon action plan”.

• Bidder did agree to respond to a report within 30 days but did not agree to respond to a report if a shorter response time is specified in the report.

-Section 1.H.7 Bidder did not specifically agree to all requirement language by only stating they agree to credit the plan sponsor for claim errors resulting in overpayments and/or duplicate payments discovered during the annual audit. Bidder did not address providing no more than four invoices and that the remainder would have to be paid in 45 days.

-Section 1.I.4:

• Bidder did not agree to SLA number 3 by changing the percent from 95% to 85%.

• Bidder did not agree to SLA number 5 by stating that written inquiries will be reported based on VSP’s book of business

• Bidder did not agree to SLA number 10 by changing “paid” to “priced”

• Bidder did not agree to SLA number 11 Part A by changing the timeframe to 48 hours instead of 1 business day

• Bidder did not agree to SLA number 11 Part B. Bidder indicated that the Plan Sponsor does not get to specify report format.

-Section 1.J.2 Bidder provided exception to the requirements in 7 areas.

-Section 1.J.3 Bidder did not provide their disaster recovery plan in proposal, instead they provided an overview.

-Section 1.J.4 Bidder agreed to the requirement although requested to mutually agree upon timeframe instead of 24 hours. No points were deducted.

-Section 1.K.1 Bidder did not provide a SSAE-16 or SAS-70, and instead provided a SOC 1 report.

Score: 9 / 10 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 3.2 Bidder indicated a cell phone number instead of a toll-free number.

-Section 3.6 Bidder did not provide sufficient detail on the roles of the additional staff.

-Section 3.8 Bidder did not provide detail of each person’s function on the organizational chart.

Score: 11 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 4.1.C Bidder indicated not applicable on providing an implementation plan due to being the incumbent. Bidder did not address items 1-3 on the implementation plan -Section 4.1.D Bidder indicated not applicable to the requirement regarding providing a final implementation plan.

-Section 4.3.B Bidder minimally described their reporting capabilities by just stating “electronic reporting”.

-Bidder provided exception to the following requirements by indicating they cannot provide a break-out for COBRA:

• 4.3.C

• 4.3.D

• 4.3.E.2.a-c

Score: 10 / 15 The JEC determined that this section was not adequately addressed, and the following deficiencies were noted:

-Section 5, Experience:

• Bidder provided three relevant transition experiences, although they did not provide full relevancy of a contract duration similar to the scope of this RFP. This section requests description of at least 3 relevant experiences from the last 5 years supporting their ability to successfully manage a contract of similar size and scope for the work described in this RFP.

• Bidder did not identify the live status dates on all three experiences, since transition months equal the time period identified.

• Experience 2, State of Michigan: Section 1 and Section 4. Bidder was not clear by indicating 110,000 members under description and scope of the project and stating “Number of lives 101,537 contracts and 199,732 members” for the approximate number of covered lives (total membership) at the end of the last plan year. No Points were deducted.

Total Score: 75 / 100

C. Davis Vision Note: Bidder only provided hardcopy responses for the following documents:

• Section 1.A.11 Attachment 9 Independent of financial strength

• Section 1.C.6 Attachment 10 Fraud, Waste and Abuse

• Section 1.D.11 Attachment 14 Vision Care Participating Network Providers

• Section 1.E.1.c Attachment 15 Daily Call Center Report and Weekly Call Stats

• Section 1.F.1.a.4 Attachment 8 Member Communication Materials

• Section 1.F.1.a.5 Attachment 18 Sample EOB

• Section 1.F.3.a Attachment 19 Member Satisfaction Survey and Attachment 20 2017 Survey

Results

• Section 1.G.2 Attachment 21 Benefit Manager Flyer

• Section 1.J.3 Attachment 22 Disaster Recovery Plan

• Section 3.8 Attachment 24 Organizational Chart

• Section 4.1.C Attachment 25 Draft Implementation Plan

• Section 4.1.C Attachment 26 Proposed Implementation Timeline

The JEC determined that Davis Vision, based on a score of 91, met the requirements of this RFP.

This determination was accomplished by evaluating their responses to the Technical Evaluation Criteria.

Score: 54 / 60 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 1. Requirements: Bidder did not state their agreement to the requirements; instead Bidder confirmed they included responses to each of the following requirements.

-Section 1.B.1 and 1.B.2 Bidder confirmed that they agreed to administer the plan in accordance with the Plan Design and duplicate the Plan Design. The Benefit Summary provided by Davis Vision indicated that there are proposed changes, including but not limited to a $7.50 copay for VDT spectacle lenses. After clarification, Bidder confirmed they will administer the plan design exactly as the State requires, and in accordance with the Plan design in Schedule C, however they provided a Best and Final Offer (BAFO) document of proposed benefits that included multiple items that are not in compliance with Schedule C, Plan design including but not limited to the following:

• Scratch-Resistant Coating, Ultraviolet Coating, however these are exclusions

• Tinting of Plastic Lenses (Solid / Gradient) indicates it is Covered, however only rose tint #1 and #2 is covered No points were deducted for Section 1.B.1 and 1.B.2.

-In initial response, Bidder indicated they will pursue recovery on an individual basis, directly with the member if necessary, when the requirement indicates they are not to be billed, in regard to the requirements in the following sections:

• 1.C.2

• 1.C.7

-Section 1.D.6 Bidder confirms the requirement although the detail they provided with it as part of their response, indicated otherwise. Bidder stated that they will bill the amount specified in this schedule without regard to the negotiated cost or the retail value of the services or materials selected by an eligible member.

-Section 1.D.9 Due to inconsistency in data provided to Bidders, areas where the spreadsheet didn’t have an address or zip code listed were removed from the analysis from all Bidders to provide more accurate data comparison. Data provided by Bidder indicated a significant provider disruption which averaged 31.7% for providers and 34.1% for members overall. (The original disruption analysis that included the inconsistent data averaged 31.9% for providers and 35.1% for members).

-Section 1.E.4 Bidder did not address logging and managing outbound member calls in their initial response; instead Bidder specifically addressed calls coming into their center.

-Section 1.E.6 In initial response, Bidder did not address recording outgoing member calls. They specifically addressed calls coming into their center.

-Section 1.H.2 In initial response, Bidder indicated a limitation on audits by stating they allow annual audits and within 90-day notice for onsite, 30 for remote, and 10 to produce data/documentation requests.

-Section 1.H.10 Bidder did not confirm their agreement to this requirement in their initial response; instead stated that they need a further understanding of parameters that may be required by the State.

-Section 1.K.1 Bidder agreed to provide a SSAE-16, although they didn’t provide a copy of their report upfront in proposal; they would provide SSAE-16 after they have a Contract in place.

Score: 9 / 10 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 3.8. Bidder did not provide subcontractors on their organizational chart, in their initial response.

-Section 3.9.a-d Bidder indicated use of Iron Mountain for record storage however did not disclose them as a subcontractor, including their required information for subcontractors in their initial response.

Score: 14 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 4.3.A Bidder did not confirm their agreement to the entire requirement in their initial response, by only stating that they confirm their ability to provide the reports outlined within this section within the timeframes specified.

-Section 4.3.D.3 Bidder did not confirm their agreement to the second part of the requirement in their initial response, which states that backup documentation must be retained by Contractor and provided to Plan Sponsor within the timeframe specified.

Score: 14 / 15 The JEC determined that this section was adequately addressed, although the following deficiency was noted:

-Section 5, Experience:

• Experience 3, New York State Vision Plan: Bidder stated they will be providing similar services to the State of Michigan but did not describe how or provide detail on what.

Total Score: 91 / 100

D. EyeMed The JEC determined that EyeMed, based on a score of 88, met the requirements of this RFP. This determination was accomplished by evaluating their responses to the Technical Evaluation Criteria.

Score: 56 / 60 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 1. Requirements: Bidder stated their agreement to the requirements except for where there is deviation noted.

-Section 1.A.11 Bidder provided ratings, but not an actual copy of the ratings in their initial response.

-Section 1.B.2 Bidder confirmed their agreement to duplicate the Plan Design as it is in Schedule C, although they provided three proposal attachments titled “State of Michigan Proposal”, “State of Michigan Safety Proposal”, and “State of Michigan VDT Proposal”. After clarification regarding a cost split between cosmetic contract lens, the fitting and suitability exam, it was determined to be in compliance with Schedule C, Plan Design. No Points were deducted.

-Section 1.D.2 Bidder did not explain their process for monitoring Network Providers in their initial response, only credentialing and re-credentialing.

-Section 1.D.5 Bidder did not describe their protocol and system, in their initial response.

-Section 1.D.9 Due to the inconsistency in data provided to Bidders, areas where the spreadsheet didn’t have an address or zip code listed were removed from the analysis from all Bidders to provide more accurate data comparison. No points were deducted.

-Section 1.H.8 Bidder placed a cap on the costs of the audit of $10,000.00, in their initial response.

-Section 1.I.4:

• Bidder submitted exception to SLA #3 by adding a definition on average speed of answer.

• Bidder submitted exception to SLA #5 by adding a break-out SLA for written inquiries, in their initial response.

-Section 1.J.2 Bidder took exception in 9 areas of Schedule J. After clarification, exception remained in 8 areas in Schedule J, Section H. Access Control.

-Section 1.J.3 Bidder did not provide their disaster recovery plan in their initial response, instead they provided an overview.

-Section 1.K.1 Bidder agreed to provide a SSAE-16 or SAS-70, and although they didn’t provide a copy of their report in proposal, they would provide SAS after they have a Contract in place.

Score: 8 / 10 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 3.5.D In their initial response, Bidder’s Key Personnel Resumes were not chronological and did not indicate timeframes.

-Section 3.6.A Bidder stated N/A for the name on the two non-key staff roles identified in the table, in their initial response.

-Section 3.7.Part 1 Bidder did not provide sufficient detail on the experience levels of the customer service representatives, in their initial response.

Score: 12 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 4.A In their initial response, Bidder did not explain their process for notifying clients of administrative changes in Bidder’s systems or procedures that impact the plan sponsor and/or members.

-Section 4.1.C In their initial response, Bidder’s implementation plan indicated it was for 120 days, however in the detail of the plan it went to 180-185 days.

Score: 12 / 15 The JEC determined that this section was adequately addressed, although the following deficiencies were noted:

-Section 5, Experience:

• Experience 1, State of South Carolina:

1) 3. Bidder stated similar size and scope but did not explain how.

2) Bidder stated confidential for the experience’s dollar value

• Experience 2, Michigan Public Schools Employee Retirement System:

1) 3. Bidder stated similar size and scope but did not explain how.

2) Bidder stated confidential for the experience’s dollar value

• Experience 3, Meijer, Inc.:

1) 3. Bidder stated similar size and scope but did not explain how.

2) Bidder stated confidential for the experience’s dollar value

Total Score: 88 /100

IV. Technical Evaluation Summary

Selection Criteria Avesis BCBS Davis Vision EyeMed 1 Schedule A – excluding Section 3.

Staffing, 4. Project Management, and

6. Invoice and Payment – 60 POINTS

49 45 54 56

2 Schedule A – Section 3. Staffing – 10

POINTS 6 9 9 8

3 Schedule A – Section 4. Project Management and Schedule A Section

6. Invoice and Payment – 15 POINTS

11 11 14 12

4 Vendor Questions, Section 2.

Company Background and Vendor Questions, Section 5. Experience –

15 POINTS

14 10 14 12

5 Total – 100 Available 80 75 91 88

VI. Pricing Summary

Pricing was evaluated for the bidders who passed the technical evaluation. The following is a summary of their price proposals:

Schedule B, Pricing and Schedule F, Provider Cost Claims Data (Repricing):

VII. Negotiations: Reductions were requested on the Administrative fee for the 3 passing Bidders and their final pricing is reflected in the table above. Of the three Bidders who passed the technical evaluation, two were able to provide a reduced Administrative Fee: Avesis and Davis Vision. EyeMed was able to provide a $65,000 allowance that may be used to cover the cost of the implementation audit and will perform this audit as directed by the Plan Sponsor. This audit must confirm that EyeMed’s system is configured only to allow benefits as outlined in Schedule C, Plan Design. This audit will include testing and validation without limitation to confirm the claims system is in alignment with Schedule C, Plan Design.

VIII. Award Recommendation:

Award recommendation is made to the responsive and responsible Bidder who offers the best value to the State of Michigan. Best value is based on the proposal meeting the minimum point threshold and offering the best combination of factors stated in Technical Evaluation Criteria, Section 7 Evaluation Process, and price.

EyeMed Vision Care met the minimum point threshold and offered the best combinations of factors, along with low network provider disruption, lowest Administrative Fee, and the lowest claims re-pricing estimate. Award Recommendation is made to EyeMed Vision Care in the amount of $29,000,000.00 with a Self-Insured Plan, which includes anticipated increased usage.

Fiscal Year

Total Contract Estimate

(1)

Months

Rate (Per Contract Per

Month Administration

Fee)

Total

Rate (Per Contract Per

Month Administration

Fee)

Total

Rate (Per Contract Per

Month Administration

Fee)

Total

FY 2019 101,592 12 $ 0.38 463,259.52$ $ 0.15 182,865.60$ $ 0.11 134,101.44$

FY 2020 101,592 12 $ 0.38 463,259.52$ $ 0.15 182,865.60$ $ 0.11 134,101.44$

FY 2021 101,592 12 $ 0.38 463,259.52$ $ 0.15 182,865.60$ $ 0.11 134,101.44$

$ 1,389,778.56 $ 548,596.80 $ 402,304.32 $ 31,620,495.00 $ 29,307,187.50 $ 23,010,599.46 $ 26,159,197.50 $ 24,868,357.50 $ 22,997,234.45

(2) For purposes of proposal comparison, estimates in the table above, and Schedule C were utilized. Bidders were to provide estimated claims cost by taking the average of their data entered for "Total Claims Amount" from FY16 & 17 in Schedule F. Also see above Note 1.

(3) Original value provided by Bidders

(4) Revised value after removal of potential data inconsistencies which included all procedure codes where any Bidder entered $0 in the "Rate Per Service" column, and removal of procedure code 92015 (Determ Refractive State) due to the fact that some Vendors do not bill this procedure code separately from procedure codes S0620 and S0621 (Routine Opthalmological Examination Including Ref).

3-Year Claims Estimate (2)(3) 3-Year Claims Estimate (2)(4)

(1) The State of Michigan does not guarantee a minimum or maximum volume of services, claims and conversions.

Notes:

Avesis Davis Vision EyeMed

Self-Insured Pricing

3-Year Administrative Fee Estimated Total