RFP- UEF2024-001.pdf

STATE OF MARYLAND

MARYLAND UNINSURED EMPLOYERS’ FUND (UEF)

REQUEST FOR PROPOSALS (RFP)

WORKER’S COMPENSATION THIRD PARTY CLAIMS

ADMINISTRATION PROFESSIONAL SERVICES

RFP NUMBER: UEF 2024-001

ISSUE DATE: DECEMBER 4, 2023

NOTICE

A Prospective Offeror that has received this document from a source other than eMarylandMarketplace (eMMA) https://procurement.maryland.gov should register on eMMA. See Section 4.2.

MINORITY BUSINESS ENTERPRISES ARE ENCOURAGED TO

RESPOND TO THIS SOLICITATION.

Workers Compensation Third Party Claims Administration Professional Services Solicitation #: UEF 2024-001

RFP Document

RFP for Maryland Uninsured Employers Fund (UEF) Page ii of 102

VENDOR FEEDBACK FORM

To help us improve the quality of State solicitations, and to make our procurement process more responsive and business friendly, please provide comments and suggestions regarding this solicitation.

Please return your comments with your response. If you have chosen not to respond to this solicitation, please email or fax this completed form to the attention of the Procurement Officer (see Key Information Summary Sheet below for contact information).

Title: Workers Compensation Third Party Claims Administration Professional Services Solicitation No: UEF 2024-001

1. If you have chosen not to respond to this solicitation, please indicate the reason(s) below:

� Other commitments preclude our participation at this time

� The subject of the solicitation is not something we ordinarily provide

� We are inexperienced in the work/commodities required

� Specifications are unclear, too restrictive, etc. (Explain in REMARKS section)

� The scope of work is beyond our present capacity

� Doing business with the State is simply too complicated. (Explain in REMARKS section)

� We cannot be competitive. (Explain in REMARKS section)

� Time allotted for completion of the Proposal is insufficient

� Start-up time is insufficient

� Bonding/Insurance requirements are restrictive (Explain in REMARKS section)

� Proposal requirements (other than specifications) are unreasonable or too risky (Explain in REMARKS section)

� MBE or VSBE requirements (Explain in REMARKS section)

� Prior State of Maryland contract experience was unprofitable or otherwise unsatisfactory.

(Explain in REMARKS section)

� Payment schedule too slow

� Other: __________________________________________________________________

2. If you have submitted a response to this solicitation, but wish to offer suggestions or express concerns, please use the REMARKS section below. (Attach additional pages as needed.)

REMARKS:

Vendor Name: ________________________________ Date: _______________________

Contact Person: _________________________________ Phone (____) _____ - _________________

Address: ______________________________________________________________________

E-mail Address: ________________________________________________________________

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STATE OF MARYLAND

MARYLAND UNINSURED EMPLOYERS’ FUND

(UEF)

KEY INFORMATION SUMMARY SHEET

Request for Proposals SERVICES - WORKERS’ COMPENSATION THIRD PARTY

CLAIMS ADMINISTRATION PROFESSIONAL SERVICES

Solicitation Number: UEF 2024-001

RFP Issue Date: December 4, 2023

RFP Issuing Office: Maryland Uninsured Employers’ Fund (UEF or the "Agency")

Procurement Officer: Amanda Longacre e-mail:

Office Phone:

Amanda.longacre1@maryland.gov 410-260-7681

Proposals are to be sent to: Submit via eMMA

Pre-Proposal Conference: December 14, 2023 10:00AM Local Time See Attachment A for information.

Questions Due Date and Time January 12, 2024 2:00 PM Local Time

Proposal Due (Closing) Date and Time:

February 2, 2024 Local Time Offerors are reminded that a completed Feedback Form is requested if a no-bid decision is made (see page iv).

MBE Subcontracting Goal: 5%

VSBE Subcontracting Goal: 0%

Contract Type: Indefinite quantity with fixed unit prices

Contract Duration: Five (5) Years.

Primary Place of Performance:

300 East Joppa Rd. Suite 402, Towson, MD 21286

SBR Designation: No

Federal Funding: No mailto:Amanda.longacre1@maryland.gov

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TABLE OF CONTENTS – RFP

1 Minimum Qualifications

1.1 Offeror Minimum Qualifications

2 Contractor Requirements: Scope of Work

2.1 Summary Statement

2.2 Background, Purpose and Goals

2.3 Responsibilities and Tasks

3 Contractor Requirements: General

3.1 Contract Initiation Requirements

3.2 End of Contract Transition

3.3 Invoicing

3.4 Liquidated Damages

3.5 Disaster Recovery and Data

3.6 Insurance Requirements

3.7 Security Requirements

3.8 Problem Escalation Procedure

3.9 SOC 2 Type 2 Audit Report

3.10 Experience and Personnel

3.11 Substitution of Personnel

3.12 Minority Business Enterprise (MBE) Reports

3.13 Veteran Small Business Enterprise (VSBE) Reports

3.14 Work Orders

3.15 Additional Clauses

4 Procurement Instructions

4.1 Pre-Proposal Conference

4.2 eMaryland Marketplace Advantage (eMMA)

4.3 Questions

4.4 Procurement Method

4.5 Proposal Due (Closing) Date and Time

4.6 Multiple or Alternate Proposals

4.7 Economy of Preparation

4.8 Public Information Act Notice

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4.9 Award Basis

4.10 Oral Presentation

4.11 Duration of Proposal

4.12 Revisions to the RFP

4.13 Cancellations

4.14 Incurred Expenses

4.15 Protest/Disputes

4.16 Offeror Responsibilities

4.17 Acceptance of Terms and Conditions

4.18 Proposal Affidavit

4.19 Contract Affidavit

4.20 Compliance with Laws/Arrearages

4.21 Verification of Registration and Tax Payment

4.22 False Statements

4.23 Payments by Electronic Funds Transfer

4.24 Prompt Payment Policy

4.25 Electronic Procurements Authorized

4.26 MBE Participation Goal

4.27 VSBE Goal

4.28 Living Wage Requirements

4.29 Federal Funding Acknowledgement

4.30 Conflict of Interest Affidavit and Disclosure

4.31 HIPAA - Business Associate Agreement

4.32 Nonvisual Access

4.33 Mercury and Products That Contain Mercury

4.34 Location of the Performance of Services Disclosure

4.35 Department of Human Services (DHS) Hiring Agreement

4.36 Small Business Reserve (SBR) Procurement

4.37 Maryland Healthy Working Families Act Requirements

5 Proposal Format

5.1 Two Part Submission

5.2 Proposal Delivery and Packaging

5.3 Volume I - Technical Proposal

5.4 Volume II – Financial Proposal

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6 Evaluation and Selection Process

6.1 Evaluation Committee

6.2 Technical Proposal Evaluation Criteria

6.3 Financial Proposal Evaluation Criteria

6.4 Reciprocal Preference

6.5 Selection Procedures

6.6 Documents Required upon Notice of Recommendation for Contract Award

7 RFP ATTACHMENTS AND APPENDICES

Attachment A. Pre-Proposal Conference Response Form

Attachment B. Financial Proposal Instructions & Form

Attachment C. Proposal Affidavit

Attachment D. Minority Business Enterprise (MBE) Forms

Attachment E. Veteran-Owned Small Business Enterprise (VSBE) Forms

Attachment F. Maryland Living Wage Affidavit of Agreement for Service Contracts

Attachment G. Federal Funds Attachments

Attachment H. Conflict of Interest Affidavit and Disclosure

Attachment I. Non-Disclosure Agreement (Contractor)

Attachment J. HIPAA Business Associate Agreement

Attachment K. Mercury Affidavit

Attachment L. Location of the Performance of Services Disclosure

Attachment M. Contract

Attachment N. Contract Affidavit

Attachment O. DHS Hiring Agreement

Appendix 1. – Abbreviations and Definitions

Appendix 2. Offeror Information Sheet

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1 Minimum Qualifications

1.1 Offeror Minimum Qualifications

There are no Offeror Minimum Qualifications for this procurement.

THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.

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2 Contractor Requirements: Scope of Work

2.1 Summary Statement

2.1.1 The Maryland Uninsured Employers’ Fund (UEF or the Agency) is issuing this

Request for Proposals (RFP) in order to obtain third party administrator services that will provide the full scope of all services necessary for the third party administrator to function as the processor, investigator and administrator for all relevant UEF claims. UEF claims shall include all workers compensation claims found compensable by the Maryland Workder’s Compensation Commision pursuant to in accordance with the provisions of Md. Code Ann., Title 9, Labor and Employment Article, where a claimant is found to have been employed by an uninsured employer, and the UEF is triggered to provide benefits per statute, or where the UEF has been implead as a party to the claim, as well as any other claims assigned to the UEF for administration by Maryland Law.

2.1.2 An Offeror shall provide deliverables, goods, and services specific to the needs and requirements of the UEF, including claims investigation, processing and management. The services to be provided by the third party claims administrator shall include, but not be limited to, the following: Workers Compensation claims administration; investigation; case preparation for litigation purposes; case management; bill review, including professional review and enhanced bill review; preferred provider network access; patient care; pharmacy benefit program; peer review and/or medical records review;

Medicare Reports and Medicare Set Asides; nurse triage; connected care services, processing and payment of all claim related benefits and/or expenses, and Independent Medical Examination referrals and scheduling.

2.1.3 It is the State’s intention to obtain goods and services, as specified in this RFP, from a Contract between the selected Offeror and the State.

2.1.4 The Agency intends to make a single award from this solicitation.

2.1.5 An Offeror, either directly or through its subcontractor(s), must be able to provide all goods and services and meet all of the requirements requested in this solicitation and the successful Offeror (the Contractor) shall remain responsible for Contract performance regardless of subcontractor participation in the work.

2.1.6 A Contract award does not ensure a Contractor will receive all or any State business under the Contract.

2.2 Background, Purpose and Goals

The Maryland Uninsured Employers’ Fund pays benefits on Workers Compensation claims of injured workers whose employers have failed to procure legally required Maryland Workers Compensation insurance, and on claims otherwise required by Maryland law.

The State is issuing this solicitation for the purposes of procuring claims administration that provides the full scope of services necessary to function as the claims administrators for the UEF claims, including investigations, claims processing and claims management.

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2.2.1 Project Goals

A. To timely, effectively and completely investigate all pending and/or open claims filed involving the UEF to ensure that all necessary parties are implead into pending cases in order to minimize or mitigate exposure of the UEF

B. To effectively manage and adjust all claims.

C. To insure all claim amounts paid are appropriate, legitimate and correct under law.

D. To achieve all possible savings on claims as appropriate.

E. To assist with the preparation and defense of all legal proceedings related to claims.

F. To periodically review all claims being paid.

G. To timely and completely prepare, file and monitor all reports required by law and regulation.

2.2.2 Current Environment

Third-party administrator contract with the CorVel Enterprise Corporation (CorVel) for a term of five (5) years ending on June 30, 2024.

2.2.3 Existing Data/Content Management/Historical Use

Data exists in CorVel’s proprietary systems, CareMC and MedChex, in paper files and in other miscellaneous forms.

Historical Monthly Averages for the three-year period from July 2020 through June 2023:

Total Open Claims (monthly average)

655.1

New Claims per Month 36.7

Claims Reopened per Month 6.0

Cases Marked Inactive per Month 51.6

Cases scheduled for Hearings per Month

60.1

Independent Medical Exams scheduled per Month

7.5

IME Addendums per month 1.1

IME No shows per month 4

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Medical Bills reviewed per Month 598.9

Translation services scheduled per month

0.4

Transportation services scheduled per month

1.9

Medicare Set Aside eval per month 0.2

Pharmacy Review scheduled per month

0.1

Cases reported to CMS per month 655.1

2.2.4 Existing Reporting

Reporting is required to various entities, including, as applicable, regular required reporting to the UEF, the Maryland Workers Compensation Commission (WCC), the State of Maryland and the United States Government.

2.2.5 State Staff and Roles

In addition to the Procurement Officer and Contract Monitor, the Contractor will interact with all other UEF staff members as required, including the Office of the Attorney General staff members assigned to the UEF.

2.2.6 Other State Responsibilities

A. The State will provide normal office working facilities and equipment reasonably necessary for Contractor performance under the Contract. Any special requirements (e.g., reprographic services, computer time, key data entry) shall be identified. Any equipment provided to the Contractor by the UEF must be cataloged on a signed document to be returned per Section 3.2.6 A.

B. The State is responsible for providing required information, data, documentation, and test data to facilitate the Contractor’s performance of the work to the extent that such is available and will provide such additional assistance and services as is specifically set forth herein.

2.3 Responsibilities and Tasks

2.3.1 An Offeror shall provide deliverables, goods, and services specific to the needs and requirements of the UEF, including claims investigation, processing and management. The services to be provided by the third party claims administrator shall include, but not be limited to, the following:

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Workers Compensation claims administration; claim investigation; case preparation for litigation purposes; case management; bill review, including professional review and enhanced bill review;

preferred provider network access; patient care; pharmacy benefit program; peer review and medical records review; Medicare Reports and Medicare Set Asides; 24/7 nurse triage; connected care services and processing and payment of all claim related benefits and/or expenses, and Independent Medical Examination referrals and scheduling.

2.3.2 The TPA relationship shall be one in which the UEF places special trust and confidence in the TPA and its staff. The relationship requires that the TPA and its staff uphold their fiduciary duty and protect the interest of the UEF. The TPA and its staff must treat the affairs, the money or other property of the UEF with the highest degree of care at all times. The TPA and its staff cannot in any way deal with UEF’s property with motives of self-interest and/or disclose any documentation or knowledge of the claim to any entity or individual that is not an interested party to the claim. The documentation and investigation process is completed by the TPA on behalf of the UEF and is prepared in anticipation of litigation and is considered privileged and confidential information.

2.3.2 The Contractor shall:

A. With input and agreement of the UEF, develop a Claims Handling Protocol document within thirty (30) calendar days of award of this Contract. This document shall contain, but is not limited to, deadlines, process descriptions, guidelines and instructions regarding use of the UEF’s online claims management reporting system, contact information, expectations, goals and benchmarks.

B. Have the ability to initiate data transfer from the existing proprietary software system to the system Contractor utilizes within 14 days of execution of the Contract, and to be completed within 90 days of the execution of the Contract.

C. Review all claims and process each claim report with respect to minimizing the UEF’s exposure, in accordance with applicable state and /or administrative regulations and in consultation with the UEF, and when necessary, Office of the Attorney General staff members assigned to the UEF.

D. Assign all claims to claims adjusters that are exclusively assigned to the UEF by the

Contractor. Contact with claimants/claimants’ counsel shall occur within seven days of receipt of claimant’s questionnaire, subject to normal business hours and reasonable extenuating circumstances.

E. Take recorded statements from claimants and/or witnesses for any matter involving questionable claims, occupational disease, serious injury to the back, neck, or knee, or any other claim as deemed necessary. Transcriptions of such statement will be at no additional cost of the UEF.

F. Conduct an investigation of each reported claim or loss to the extent deemed necessary to substantiate the validity of the claim, to facilitate returning the employee to work at the earliest possible date, and to identify all necessary parties and/or possible effective worker’s compensation coverage as of the date of the alleged injury. Provide a summary report and supporting documents related to the investigation (in tangible and electronic form) to the UEF and Office of the Attorney General staff members assigned to the UEF.

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G. Arrange for independent investigators or medical or other experts to the extent deemed necessary by and agreed to by the UEF in connection with processing any qualified claim or loss and in certain situations as requested by the UEF.

H. Investigate subrogation for all appropriate claims; preserve and support any loss recovery rights of the UEF and initiate and pursue subrogation proceedings to recover from third parties any amounts paid by or suffered by the UEF for which third parties may be legally liable. This will include placing third parties on notice directly, following up with the third party over the course of the claim, collecting the workers’ compensation lien from the third party, and cooperating with legal counsel in any legal action necessary to affect such recovery.

I. Pay medical and death benefits, temporary and permanent disability compensation and other losses and expenses, where the UEF specifically approves or directs such action. Any such payments should comply with current, applicable statutes, rules and regulations of the Maryland Workers’ Compensation Commission and applicable Maryland statutes.

J. Handle all claims to Conclusion or Conclusion of Service: All claim(s) occurring during the contract term will be handled and adjusted by the Contractor to conclusion of the claim(s), including periods of reopening, or until such time as service by the Contractor to the UEF is terminated, whichever occurs first. After final contract termination, the UEF retains the option to specify in writing to the Contractor claim files(s) that the UEF wishes to revert to the UEF’s control. If any runoff claims are left with the Contractor, the final contract year pricing will remain in effect.

K. Perform reasonable and necessary administrative and clerical work in connection with qualified claims.

L. Make available the Contractor’s adjuster (s), investigator (s) and/or supervisor as may be required for attendance of workers’ compensation hearings, settlement conferences and civil trials to provide testimony or evidence to support defense of claims.

M. Shall confer with the UEF on all settlements, stipulations and cases of questioned or unclear compensability or liability and follow the UEF’s direction for the disposition of such matters.

The UEF retains all claims settlement/stipulation authority and makes all final decisions regarding liability and compensability.

N. Meet regularly with the UEF’s Claims Administrator and any other UEF personnel the UEF deems appropriate to review open claims, to assist in preparing defense of litigation cases, to negotiate settlements and pursue subrogation or contribution actions. These regular meetings may occur at 30-day intervals and may be teleconference meetings. However, at a minimum, a quarterly meeting between the Contractor’s representative(s) and UEF personnel shall occur on-site at the UEF offices located at 300 E. Joppa Road, Suite 402, Towson, Maryland.

These meetings may require written reporting as required by the UEF. At the discretion of the UEF, the meetings may include the UEF’s workers’ compensation legal counsel.

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O. Monitor the treatment program recommended for physicians, specialists and other health care providers by reviewing all reports prepared by them and maintaining such contact with the providers as may be appropriate in the judgment of Contractor. With the input and approval of the UEF, refer appropriate cases for nurse case management services and or vocational rehabilitation services.

P. As the UEF directs, assist in interpreting medical reports to consider the circumstances under which an ill or injured claimant who desires to do so could return to work in the shortest period of time and provide assistance in placing employees in a modified duty program if available through the employer.

Q. Assist the UEF in arranging for rehabilitation or retaining of employees in appropriate cases, and in addition, provider will advise UEF of cases in which rehabilitation is an alternative.

R. With the input and permission of the UEF, maintain a current estimate of the expected total costs of each qualified claim or loss.

S. Provide narrative or analytical reports to the UEF of major or controverted cases.

2.3.3 The Contractor shall be prepared to provide additional resources, including, but not limited to, the items enumerated as follows:

A. Preparation of ad hoc or newly required statistical reports as required by the UEF, the WCC, the State of Maryland and the United States Government.

B. Preparation of the Case Management Service Report.

2.3.4:

A.

B.

2.3.5 General Requirements

2.3.5.1 A. Administration of UEF claims in accordance with the standards and procedures required by the workers compensation laws of Maryland contained in Title 9 of the Labor and Employment Article.

B. Administration of the UEF claims includes but is not limited to:

1. Claims adjusting and miscellaneous services supporting the claims adjusting process

2. Claimant payment administration

3. Claimant medical bill review

4. Claims investigation and preparation

C. Miscellaneous services to support interactions with the Maryland WCC

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2.3.5.2 A. Scheduling of Claimant Evaluations

1. Independent Medical Evaluations

2. Functional Capacity Evaluations

3. Vocational Rehabilitation Plans

4. Nurse Case Management Services

5. Translation Services for any of the above services as needed.

B. If interpretation or translation services are needed for any of the services listed in Section 2.3.5.2.A, UEF will provide the contact information for the Statewide Foreign Language Interpretation and Translation Services (FLITS) contractors to provide these services

Staffing- Key Personnel

2.3.6.1

A. Three (3) Fulltime Claims Adjusters B. One (1) Supervising Claims Adjuster C. Four (4)Full time Claims Investigators

The Contractor shall provide a minimum of 8 claims personnel for these positions. The Contractor may, with the agency’s approval, change the number of positions allocated between claims investigation and claims adjusting. The Contractor is also free to hire additional personnel in these positions, as necessary, although doing so would not increase, or otherwise impact, the fixed Administrative Fee.

2.3.6.2 Key Personnel shall be assigned exclusively to the UEF.

A. All Personnel shall work a 40 hour minimum week.

B. Claims Adjusters and Investigators will be expected to handle between 50-100 open claims a month.

C. In the event of any dispute between the UEF and the Contractor, the UEF will have final authority.

2.3.6.3 The UEF shall have the right to approve any claims personnel assigned to its claims by Contractor.

This right to approve may extend to interviews, reviews of resumes or employment background or any other method of review the UEF deems appropriate. The UEF shall also have the right to request removal or reassignment of any claims personnel if it determines that such personnel are exhibiting substandard performance. See RFP section 3.10 for additional details.

2.3.6.4 Contractor shall endeavor to provide stable, consistent claims personnel assignments over the period of the contract. In the interests of cost effective service, the UEF acknowledges that there may be a separate adjuster for medical-only claims and lost time or complex claims, but these adjuster assignments shall be

RFP for Maryland Uninsured Employers Fund (UEF) Page 9 of 102 permanent. Contractor shall also provide points of contact knowledgeable about the UEF’s claims in the absence of any claims personnel.

2.3.7 Reports

A. Maintenance of Claim Activity Notes. Maintain a file, computer-based, for each qualified claim or loss, which shall be available for review by the UEF at any reasonable time and provide the UEF and Office of the Attorney General staff members assigned to the UEF computer-based access to adjuster notes, transaction histories and any other electronic-based information the UEF may request and in an electronic format acceptable to the UEF. If Contractor has a completely paperless environment, the computer-based file shall have the ability to be downloaded and printed in its entirety by the UEF. In addition, the Contractor must undertake appropriate security and backup safeguards to avoid catastrophic loss.

B. Comprehensive management reports representing transaction activity. Contractor must act as a Responsible Reporting Entity for the UEF’s obligations under any Federal Medicare mandatory insurer reporting requirements and fully comply with any provisions under the Medicare, Medicaid and SCHIP Extension Act of 2007 and any other federal or state regulations that may apply at the time of award of this Contract or during the duration of this Contract.

Any fines, penalties or any other costs associated with errors in reporting requirements under these or any federal or state regulations and assessed to the UEF shall be paid by the Contractor and not the UEF.

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3 Contractor Requirements: General

3.1 Contract Initiation Requirements

A. Contractor shall schedule and hold a first kickoff meeting within 30 Business Days of NTP

(“Notice to Proceed”) Date. At this meeting, the Contractor shall furnish an updated Project Schedule describing the activities for the Contractor, the State, and any third parties for fully transitioning to the Contractor’s implementation of the Contract.

B. Contractor shall schedule and hold a second kickoff meeting within 15 Business Days of NTP Date. At this meeting, the Contractor shall furnish an updated Project Schedule describing the activities for the Contractor, the State, and any third parties for fully transitioning to the Contractor’s implementation of the Contract.

C. Contractor shall schedule and hold a final kickoff meeting within 5 Business Days of NTP Date. At this meeting, the Contractor shall furnish an updated and final Project Schedule describing the activities for the Contractor, the State, and any third parties for fully transitioning to the Contractor’s implementation of the Contract.

D. Contractor shall initiate procedure for data transfer from the existing Contractor’s proprietary software systems within 14 days after execution of the Contract, and complete data transfer within 90 days after execution of the Contract.

E. Contractor shall, with the UEF’s approval, create and implement security procedures to secure all sensitive information as required by Federal or State law and State policies. This includes, but is not limited to, any information in physical files, data, or other miscellaneous information kept by the Contractor. See RFP Section 3.7.4.

3.2 End of Contract Transition

3.2.1 The Contractor shall provide transition assistance as requested by the State to facilitate the orderly transfer of services to the State or a follow-on contractor, for a period up to ninety (90) days prior to Contract end date, or the termination thereof. Such transition efforts shall consist, not by way of limitation, of:

A. Provide additional services and support as requested to successfully complete the transition;

B. Maintain the services called for by the Contract at the required level of proficiency;

C. Provide updated System Documentation (see Appendix 1), as appropriate;

and

D. Provide current operating procedures (as appropriate).

3.2.2 The Contractor shall work toward a prompt and timely transition, proceeding in accordance with the directions of the Contract Monitor. The Contract Monitor may provide the Contractor with additional instructions to meet specific transition requirements prior to the end of the Contract.

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3.2.3 The Contractor shall ensure that all necessary knowledge and materials for the tasks completed are transferred to the custody of State personnel or a third party, as directed by the Contract Monitor.

3.2.4 The Contractor shall support end-of-Contract transition efforts with technical and project support to include but not be limited to:

A. The Contractor shall provide a draft Transition-Out Plan ninety (90) Business Days in advance of Contract end date.

B. The Transition-Out Plan shall address at a minimum the following areas:

1) Any staffing concerns/issues related to the closeout of the Contract;

2) Communications and reporting process between the Contractor, the Agency and the Contract Monitor;

3) Security and system access review and closeout;

4) Any hardware/software inventory or licensing including transfer of any point of contact for required software licenses to the the Agency or a designee;

5) Any final training/orientation of Agency staff;

6) Connectivity services provided, activities and approximate timelines required for Transition-Out;

7) Knowledge transfer, to include:

a) A working knowledge of the current system environments as well as the general business practices of the Agency;

b) Review with the Agency the procedures and practices that support the business process and current system environments;

c) Working knowledge of all technical and functional matters associated with the Solution, its architecture, data file structure, interfaces, any batch programs, and any hardware or software tools utilized in the performance of the Contract;

d) Documentation that lists and describes all hardware and software tools utilized in the performance of the Contract;

e) A working knowledge of various utilities and corollary software products used in support and operation of the Solution;

8) Plans to complete tasks and any unfinished work items (including open change requests, and known bug/issues); and

9) Any risk factors with the timing and the Transition-Out schedule and transition process. The Contractor shall document any risk factors and suggested solutions.

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C. The Contractor shall ensure all documentation and data including, but not limited to, System Documentation and current operating procedures, is current and complete with a hard and soft copy in a format prescribed by the Contract Monitor.

D. The Contractor shall provide copies of any current daily and weekly back-ups to the Agency or a third party as directed by the Contract Monitor as of the final date of transition, but no later than the final date of the Contract.

E. Access to any data or configurations of the furnished product and services shall be available after the expiration of the Contract as described in Section 3.2.5.

3.2.5 Return and Maintenance of State Data

A. Upon termination or the expiration of the Contract Term, the Contractor shall: (a) return to the State all State data in either the form it was provided to the Contractor or in a mutually agreed format along with the schema necessary to read such data; (b) preserve, maintain, and protect all State data until the earlier of a direction by the State to delete such data or the expiration of 90 days (“the retention period”) from the date of termination or expiration of the Contract term; (c) after the retention period, the Contractor shall securely dispose of and permanently delete all State data in all of its forms, such as disk, CD/DVD, backup tape and paper such that it is not recoverable, according to National Institute of Standards and Technology (NIST)-approved methods with certificates of destruction to be provided to the State; and (d) prepare an accurate accounting from which the State may reconcile all outstanding accounts.

The final monthly invoice for the services provided hereunder shall include all charges for the 90-day data retention period.

B. During any period of service suspension, the Contractor shall maintain all State data in its then existing form, unless otherwise directed in writing by the Contract Monitor.

C. In addition to the foregoing, the State shall be entitled to any post-termination/expiration assistance generally made available by Contractor with respect to the services.

3.2.6 Return of Equipment and Any Other State Property

A. Upon termination of expiration of the Contract Term, the Contractor shall return that any equipment provided to Contractor by the UEF within 30 days of the termination. Any and all other property, including but not limited to data, equipment and physical files, will be required to be returned to the UEF within 30 days of the termination of this contract.

3.3 Invoicing

3.3.1 General

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A. Administrative (Key Personnel) Invoicing: By the fifth (5th) of each month for the duration of the contract, the Contractor shall e-mail the original of each administrative invoice and signed authorization to invoice to the Contract Monitor, the Executive Director, and the UEF Chief Financial Officer (CFO). Email addresses will be provided upon contract award. Invoicing for the services relating to Atlantic and Pacific cases is to be made on a separate invoice. Although billed separately, those services are to be included in the total Administrative Fee in the Financial Proposal.

B. Payment Invoicing. On Friday of each week for the duration of the contract, the Contractor shall email the original of each payment invoice and signed authorization to invoice to the Contract Monitor, the Executive Director, and the CFO.

C. Miscellaneous Invoicing. Miscellaneous invoices are to be submitted on Payment Invoices weekly. These items include, but are not limited to, independent medical examination expenses, nurse case management expenses, transcription expenses, and any other claim related expenses.

D. Invoicing for medical payments. Medical payments are to be invoiced on weekly invoices. Each invoice for medical payments where savings are applied utilizing preferred provider agreements must include the original amount billed, the reduction, the percentage reduction per provider, and the amount paid by Contractor, and any identifying information necessary to allow the UEF to independently verify these payments.

E. All invoices for services shall be verified by the Contractor as accurate at the time of submission.

F. An invoice not satisfying the requirements of a Proper Invoice (as defined at COMAR 21.06.09.01 and .02) cannot be processed for payment. To be considered a Proper Invoice, invoices must include the following information, without error:

1) Contractor name and address;

2) Remittance address;

3) Federal taxpayer identification (FEIN) number, social security number, as appropriate;

4) Invoice period (i.e. time period during which services covered by invoice were performed);

5) Invoice date;

6) Invoice number;

7) State assigned Contract number;

8) State assigned (Blanket) Purchase Order number(s);

9) Goods or services provided;

10) Invoicing for Administrative Fee (Key Personnel) must include the following:

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a) The number of hours worked per individual personnel per week;

b) The hourly rate of each individual personeel for whom payment is requested;

11) Invoicing for Fixed Price items must include the following:

a) The claimant’s name;

b) The claim number as assigned by the Maryland Worker’s Compensation Commission;

c) Each invoice must specify the type of fixed price items (IME, , etc.) and must comport with the fixed unit price per the Contract.

d) Each invoice from the Contractor must also include the original invoice from the vendor hired to perform that service.

e) If a report was generated by the vendor, the report must be included with the invoice.

12) Invoicing for Payments made by Contractor must include the following:

a) The claimant’s name;

b) The claim number as assigned by the Maryland Worker’s Compensation Commission;

C) Payment type (medical, pharmaceutical, indemnity);

D) Any identifying information necessary for the UEF to utilize the Contractor’s claim system to obtain all supporting documentation for payments.

13) Amount due; and

14) Any additional documentation required by regulation or the Contract.

G. The Agency reserves the right to reduce or withhold Contract payment in the event the Contractor does not provide the Agency with all required deliverables within the time frame specified in the Contract or otherwise breaches the terms and conditions of the Contract until such time as the Contractor brings itself into full compliance with the Contract.

H. Any action on the part of the Agency, or dispute of action by the Contractor, shall be in accordance with the provisions of Md. Code Ann., State Finance and Procurement Article §§ 15-215 through 15-223 and with COMAR 21.10.04.

I. The State is generally exempt from federal excise taxes, Maryland sales and use taxes, District of Columbia sales taxes and transportation taxes.

The Contractor; however, is not exempt from such sales and use taxes and may be liable for the same.

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J. Invoices for final payment shall be clearly marked as “FINAL” and submitted when all work requirements have been completed and no further charges are to be incurred under the Contract. In no event shall any invoice be submitted later than 60 calendar days from the Contract termination date.

3.3.2 Invoice Submission Schedule

The Contractor shall submit invoices in accordance with the following schedule:

A. For items of work for which there is one-time pricing (see Attachment B

– Financial Proposal Form) those items shall be billed in the month following the acceptance of the work by the Agency.

B. For items of work for which there is monthly pricing, see Attachment B– Financial Proposal Form, those items shall be billed in equal monthly installments for the applicable Contract year in the month following the performance of the services.

3.3.3 For the purposes of the Contract an amount will not be deemed due and payable if:

A. The amount invoiced is inconsistent with the Contract;

B. The proper invoice has not been received by the party or office specified in the Contract;

C. The invoice or performance is in dispute or the Contractor has failed to otherwise comply with the provisions of the Contract;

D. The item or services have not been accepted;

E. The quantity of items delivered is less than the quantity ordered;

F. The items or services do not meet the quality requirements of the Contract;

G. If the Contract provides for progress payments, the proper invoice for the progress payment has not been submitted pursuant to the schedule;

H. If the Contract provides for withholding a retainage and the invoice is for the retainage, all stipulated conditions for release of the retainage have not been met; or

I. The Contractor has not submitted satisfactory documentation or other evidence reasonably required by the Procurement Officer or by the Contract concerning performance under the Contract and compliance with its provisions.

3.3.4 Travel Reimbursement

A. There shall be no reimbursement for Routine Travel. Contractor shall not be reimbursed for Non-Routine Travel without prior Contract Monitor approval.

B. Routine Travel is defined as travel within a 50-mile radius of the Agency’s base location, as identified in the RFP, or the Contractor’s

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C. Non-routine Travel is defined as travel beyond the 50-mile radius of Agency’s base location, as identified in the RFP, or the Contractor’s facility, whichever is closer to the consulting site. Non-routine travel will be reimbursed according to the State’s travel regulations and reimbursement rates, which can be found at: www.DBM.maryland.gov -search: Fleet Management. If non-routine travel is conducted by automobile, the first 50 miles of such travel will be treated as routine travel and as described in Section 3.3.7.A, and will not be reimbursed.

The Contractor may bill for labor hours expended in non-routine traveling beyond the identified 50-mile radius, only if so specified in the RFP or Work Order.

3.4 Liquidated Damages

3.4.1 MBE Liquidated Damages

MBE liquidated damages are identified in Attachment M.

3.4.2 Liquidated Damages other than MBE

THIS SECTION IS INAPPLICABLE TO THIS RFP.

3.5 Disaster Recovery and Data

The following requirements apply to the Contract:

3.5.1 Redundancy, Data Backup and Disaster Recovery

A. Unless specified otherwise in the RFP, Contractor shall maintain or cause to be maintained disaster avoidance procedures designed to safeguard State data and other confidential information, Contractor’s processing capability and the availability of hosted services, in each case throughout the Contract term. Any force majeure provisions of the Contract do not limit the Contractor’s obligations under this provision.

B. The Contractor shall have robust contingency and disaster recovery (DR) plans in place to ensure that the services provided under the Contract will be maintained in the event of disruption to the Contractor/subcontractor’s operations (including, but not limited to, disruption to information technology systems), however caused.

1) The Contractor shall furnish a DR site.

2) The DR site shall be at least 100 miles from the primary operations site, and have the capacity to take over complete production volume in case the primary site becomes unresponsive.

C. The contingency and DR plans must be designed to ensure that services under the Contract are restored after a disruption within twenty-four (24)

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D. The Contractor shall test the contingency/DR plans at least twice annually to identify any changes that need to be made to the plan(s) to ensure a minimum interruption of service. Coordination shall be made with the State to ensure limited system downtime when testing is conducted. At least one (1) annual test shall include backup media restoration and failover/fallback operations at the DR location. The Contractor shall send the Contract Monitor a notice of completion following completion of DR testing.

E. Such contingency and DR plans shall be available for the Agency to inspect and practically test at any reasonable time, and subject to regular updating, revising, and testing throughout the term of the Contract.

3.5.2 Data Export/Import

A. The Contractor shall, at no additional cost or charge to the State, in an industry standard/non-proprietary format:

1) perform a full or partial import/export of State data within 24 hours of a request; or

2) provide to the State the ability to import/export data at will and provide the State with any access and instructions which are needed for the State to import or export data.

B. Any import or export shall be in a secure format per the Security Requirements.

3.5.3 Data Ownership and Access

A. Data, databases and derived data products created, collected, manipulated, or directly purchased as part of a RFP are the property of the State. The purchasing State agency is considered the custodian of the data and shall determine the use, access, distribution and other conditions based on appropriate State statutes and regulations.

B. Public jurisdiction user accounts and public jurisdiction data shall not be accessed, except (1) in the course of data center operations, (2) in response to service or technical issues, (3) as required by the express terms of the Contract, including as necessary to perform the services hereunder or (4) at the State’s written request.

C. The Contractor shall limit access to and possession of State data to only Contractor Personnel whose responsibilities reasonably require such access or possession and shall train such Contractor Personnel on the confidentiality obligations set forth herein.

D. At no time shall any data or processes – that either belong to or are intended for the use of the State or its officers, agents or employees – be copied, disclosed or retained by the Contractor or any party related to the Contractor for subsequent use in any transaction that does not include the State.

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E. The Contractor shall not use any information collected in connection with the services furnished under the Contract for any purpose other than fulfilling such services.

3.5.4 Provisions in Sections 3.5.1 – 3.5.3 shall survive expiration or termination of the Contract. Additionally, the Contractor shall flow down the provisions of Sections 3.5.1-3.5.3 (or the substance thereof) in all subcontracts.

3.6 Insurance Requirements

The Contractor shall maintain, at a minimum, the insurance coverages outlined below, or any minimum requirements established by law if higher, for the duration of the Contract, including option periods, if exercised:

3.6.1 The following type(s) of insurance and minimum amount(s) of coverage are required:

A. Commercial General Liability - of $1,000,000 combined single limit per occurrence for bodily injury, property damage, and personal and advertising injury and $3,000,000 annual aggregate. The minimum limits required herein may be satisfied through any combination of primary and umbrella/excess liability policies.

B. Errors and Omissions/Professional Liability - $1,000,000 per combined single limit per claim and $3,000,000 annual aggregate.

C. Crime Insurance/Employee Theft Insurance - to cover employee theft with a minimum single loss limit of $1,000,000 per loss, and a minimum single loss retention not to exceed $10,000. The State of Maryland and the Agency should be added as a “loss payee.”

D. Cyber Security / Data Breach Insurance – The Contractor shall possess and maintain throughout the term of the Contractor and for three (3) years thereafter, cyber risk/ data breach insurance (either separately or as part of a broad Professional Liability or Errors and Omissions Insurance) with limits of at least five million dollars ($5,000,000) per claim. Any "insured

vs. insured" exclusions will be modified accordingly to allow the State additional insured status without prejudicing the State’s rights under the policy(ies). Coverage shall be sufficiently broad to respond to the Contractor's duties and obligations under the Contract and shall include, but not be limited to, claims involving privacy violations, information theft, damage to or destruction of electronic information, the release of Sensitive Data, and alteration of electronic information, extortion, and network security. The policy shall provide coverage for, not by way of limitation, breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations.

E. Worker’s Compensation - The Contractor shall maintain such insurance as necessary or as required under Workers’ Compensation Acts, the Longshore and Harbor Workers’ Compensation Act, and the Federal Employers’ Liability Act, to not be less than one million dollars ($1,000,000) per occurrence (unless a state’s law requires a greater

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F. Automobile or Commercial Truck Insurance - The Contractor shall maintain Automobile or Commercial Truck Insurance (including owned, leased, hired, and non-owned vehicles) as appropriate with Liability, Collision, and PIP limits no less than those required by the State where the vehicle(s) is registered, but in no case less than those required by the State of Maryland.

3.6.2 The State shall be listed as an additional insured on the faces of the certificates associated with the coverages listed above, including umbrella policies, excluding Workers’ Compensation Insurance and professional liability.

3.6.3 All insurance policies shall be endorsed to include a clause requiring the insurance carrier provide the Procurement Officer, by certified mail, not less than 30 days’ advance notice of any non-renewal, cancellation, or expiration.

The Contractor shall notify the Procurement Officer in writing, if policies are cancelled or not renewed within five (5) days of learning of such cancellation or nonrenewal. The Contractor shall provide evidence of replacement insurance coverage to the Procurement Officer at least 15 days prior to the expiration of the insurance policy then in effect.

3.6.4 Any…