STATE OF TENNESSEE

DEPARTMENT OF FINANCE & ADMINISTRATION, BENEFITS ADMINISTRATION

REQUEST FOR PROPOSALS #31786-00186

AMENDMENT #FOUR FOR SHORT-TERM DISABILITY

AND LONG-TERM DISABILITY INSURANCE

DATE: October 22, 2025

RFP #31786-00186 IS AMENDED AS FOLLOWS:

1. This RFP Schedule of Events updates and confirms scheduled RFP dates. Any event, time, or date containing revised or new text is highlighted.

EVENT TIME

(central time zone)

DATE

1. RFP Issued

August 29, 2025

2. Disability Accommodation Request Deadline 2:00 p.m. September 8, 2025

3. Pre-response Conference 1:00 p.m. September 10, 2025

4. Notice of Intent to Respond Deadline 2:00 p.m. September 11, 2025

5. Written “Questions & Comments” Deadline

*NOTE: Submit written questions and comments on Appendix 7.11 the written questions and comments template.

2:00 p.m.

September 17, 2025

6. State Response to Written “Questions &

Comments”

October 22, 2025

7. Round 2 Written “Questions &

Comments” Deadline

*NOTE: Respondents may submit no more than five (5) questions to the State in the 2nd round of Written Questions and Comments.

October 29, 2025

8. State Response to Written “Questions &

Comments” Round 2

November 14, 2025

9. Response Deadline 2:00 p.m. November 21, 2025

10. State Completion of Technical

Response Evaluations

January 6, 2026

11. State Opening & Scoring of Cost Proposals 2:00 p.m. January 7, 2026

12. Negotiations 4:30 p.m. January 12-14, 2026

13. State Notice of Intent to Award Released and RFP Files Opened for Public Inspection

2:00 p.m.

January 22, 2026

14. End of Protest Period

January 29, 2026

15. State sends contract to Contractor for signature

January 30, 2026

16. Contractor Signature Deadline 2:00 p.m. February 6, 2026

2. State responses to questions and comments in the table below amend and clarify this RFP.

Any restatement of RFP text in the Question/Comment column shall NOT be construed as a change in the actual wording of the RFP document.

RFP SECTION QUESTION / COMMENT STATE RESPONSE

1. Are we able to obtain monthly premium, lives, and volume from Metlife.

See Appendix 7.4.

2. Please provide annual enrolled lives on the LTD experience report

Enrollment in the LTD plan can be found in

Appendix 7.4.

3. Please provide an LTD experience exhibit that breaks out the 2021 and 2022 experience periods into two distinct periods within the incurred exhibit

The State has revised Appendix 7.8 to separate 2021 and 2022 experience periods.

See amendment item #23.

4. Please provide date of birth or age at disability on the LTD claims listing

The State has revised Appendix 7.8 to include year of birth for each LTD claim.

See amendment item #23.

5. Please provide an explanation as to the difference between Monthly Gross Benefit and Regular Monthly Benefit on the LTD claims listing.

The amount for Monthly Gross Benefit is the calculated monthly benefit to be paid prior to any offsets. The Regular Monthly Benefit includes offsets.

6. Please provide the following additional fields on the LTD claim listing: Date of Birth; Class/Plan Election; Total Paid Claims; Offset Type and Amount; Reserve Amount.

The State has revised Appendix 7.8 to include year of birth, plan election, total paid claim amount, and reserve amount. The difference between Monthly Gross Benefit and Regular Monthly Benefit is the total amount of all offsets. Details on the type of offset is not available.

See amendment item #23.

7. Please provide an STD claim listing with the following information: Date of Disability, Date of Birth, Gender, Class/Plan Election, Total Paid Claims.

The State has revised Appendix 7.8 to include an STD Claim Listing, with each claim’s payment(s), that includes Date of

Disability, Year of Birth, Gender, and Plan

Election. The total amount paid per claim is not included on this STD Paid Claim Listing because open STD claims are not finalized and thus a total can’t be determined.

See amendment item #23.

8. Please provide an STD claim payment file with the following information: Date of Disability, Date of Birth, Gender, Check Date, Check Amount, Class/Plan Election.

The State has revised Appendix 7.8 to include an STD Claim Listing, which includes Date of Disability, Year of Birth, Gender, and Plan Election. The amounts in

Column L are amounts for each payment made and there could be several payments for each claim. Column K shows when

(check date) the amounts (check amount) in

Column L were paid out.

See amendment item #23.

9. Please describe what 02 Waiting and 04 Inactive claim statuses represent on the LTD claim listing. Are these approved claims?

“02 Waiting” is a claim that cannot be approved yet; it typically occurs when the claimant is working and rehabilitation calculations are needed or if there financial information to still be provided. “04 Inactive” indicates a claim that can be approved, but is indicated as inactive due to different updates being required before it can leave inactive status.

10. LTD Paid Claims and Reserves needed at Claimant level. The State has revised Appendix 7.8 to include a paid claim listing that provides reserves at the claimant level.

See amendment item #23.

11. Please provide individual reserves for all open LTD claims.

See answer to question #10.

12. Please provide 24-36 months of submitted STD claim counts.

From October 2023 to August 2025, there were 443 STD claims submitted.

13. Please provide the following in reference to LTD experience:

• LTD Class codes by individual claimant.

• LTD Paid Amounts by individual claimant.

• LTD Reserves by individual claimant.

• Verification as to what status “NC” means on the individual listing.

Verification as to status “Waiting” and how that is different that “pending” on the individual listing.

“Waiting” is a claim that cannot be approved yet; it typically occurs when the claimant is working and rehabilitation calculations are needed or if there financial information to still be provided. “Pending” is a claim status that also cannot be approved yet, but for different reasons other than those listed above for a “Waiting” claim.

14. Provide plan LTD Certs for plan(s) in effect prior to 1/1/2024.

The State has added new Appendices 7.12, 7.13, 7.14. See Amendment item #23.

15. Please provide a recent billing statement showing lives, premiums and volume for STD and LTD.

The State has added new Appendix 7.15.

See Amendment item #23.

16. Please provide a current billing statement for all lines of coverage.

The State has added new Appendix 7.15.

See amendment item #23. The contractor does not bill the state. The state creates a purchase order based upon premiums collected.

17. Please provide complete date of birth on the census file including day, month, and year.

The state can provide year of birth only. The

State has revised Appendix 7.5. See amendment item #23.

18. Please confirm which eligible group each employee falls in on the census (Central State Government, State Higher Education, State Offline Agencies).

All numeric Business Unit Codes are

Central State Government. “HETBR” and

“HEUTN” are State Higher Education.

“STOLA” is State Offline Agencies.

Please note that Contributory LTD (LTD-C) is no longer being requested under this

RFP. The State has updated language in

RFP Section 1.1 and Pro Forma Contract

Section A.1. See amendment items #3 and

#5.

19. Provide census with complete DOB – month and day as well as year.

See answer to question #17.

20. Is it possible to provide a census with actual elections by Plan (#1, 2, 3 & 4) for enrollment prior to 1/1/2024.

The State has added new Appendix 7.18.

See amendment item #23.

21. Include an Identifier on the census in terms of Central State Government, State Higher Education and State Offline Agencies.

See answer to question #18

22. Please indicate on the census who are the State Offline Agency employees.

Contributory LTD (LTD-C) is no longer being requested under this RFP. The State has updated language in RFP Section 1.1 and Pro Forma Contract Section A.1. See amendment items #3 and 5.

23. Can the State provide a full census for each State Offline Agency with DOB, PT/FT status, annual pay, occupation, STD enrollment status, and LTD enrollment status?

See answer to question #22.

24. Please address the following questions applicable to the provided census:

• Please identify which present plan option is STD “plan A” vs “plan B”

• LTD plan Option #4 can be either Employee paid (Contributory) / or Employer Paid (Non-Contrib).

Please identify Option #4 Employees who are Contrib vs Non-Contrib.

• Please confirm what “WP” means in the LTD enrollment column.

• Nearly 20% of the group is listed with an occupation of “Insurance participants” please verify occupations or explain.

• Please confirm if coverage extends to Employees working outside the United States, if so, please provide the following for the aforementioned:

o Work Country (Province if in Canada) o Country of Citizenship & Residence

• “STD-A” = present plan option STD

Plan A and “STD-B” = present plan option STD Plan B

• Present plan LTD Option #4 is always Employee-paid

(Contributory). Present plan LTD

Option #3 can either be contributory or non-contributory. All budget code rows that are not “STOLA” are enrolled in Employer-Paid LTD 3, if

“LTD-03” is shown. All budget code o Confirmation if specific Employees are on U.S. Payroll

Length of Assignment rows that are “STOLA” are enrolled in Employee-Paid LTD 3, if LTD-03 is shown.

• WP = Waiver of Premium

• Insurance Participant is used as a default job title for State Higher

Education or State Offline Agency employees because job titles are not tracked for these employees in

Edison.

• Enrollment is allowed for those that meet the definition of “Eligible

Class(es)” as defined in Appendix

7.6.

o There are no enrolled employees outside of the

United States.

25. Please indicate employment zip codes on the census. The State has revised Appendix 7.5. See amendment item #23.

26. Can more time be allotted towards allowing our attorneys to review the Pro Forma Contract and prepare their responses/edits? Our legal team has not had enough time to submit their edits. Normally they would have at least 30 days to review and reply based on their current work load.

The State adheres strictly to the established

Schedule of Events in RFP Section 2.1. The timeline for this procurement was designed to reflect the overall project requirements and deadlines that must be met.

Any additional questions, comments, objections, and redlines should be submitted by the Round 2 Written

Questions and Comments listed on the RFP

Schedule of Events, Section 2.1. Please note that in Round 2 of Questions and

Comments, Respondents are limited to five

(5) questions and/or comments, which include suggested redlines. There will be no negotiations after the contract award. In addition, a response must not include alternate contract terms and conditions. If a response contains such terms and conditions, the State, at its sole discretion, may determine the response to be a non-responsive counteroffer and reject it.

27. Plan change in the RFP document states it took place 7/1/2024 but experience from MetLife suggests this took place 1/2024. Please confirm the effective date of the LTD plan change

Premium payment by the state of

Tennessee for LTD-Option 3 was effective

January 1, 2024. RFP Section 1.1 has been revised. See amendment item #3 below.

28. Please confirm if there have been any plan changes for the experience period, and what those changes were.

There appears to have been a significant plan change that impacted eligibility eff 1/1/2024. Is it possible to obtain a pre-plan design change 1/1/2024 census?

There has been no change in the plan benefit design. The change on January 1, 2024, was when the state of Tennessee began paying the premiums for LTD-Option

3 for central state government and state higher education employees and state higher education began participating in the

LTD program.

29. Please provide all inforce rates for LTD and Voluntary

STD

The State has added new RFP Appendix

7.16. See amendment item #23 below.

30. Provide Inforce Rate(s) by Option for both STD & LTD. See answer to question #29

31. Please provide inforce rates by line of coverage, as well as rate history (changes) for the last 3-5 years.

See answer to question #29

32. Are state employees currently enrolled in the LTD plan eligible for any STRS or PRS plans/benefits?

Yes, central state government and state higher education employees are eligible for the Tennessee Consolidated Retirement

System. State higher education employees may alternatively choose to enroll in the

Optional Retirement Program. See appendix 7.1 for details on each program.

33. If employees are eligible for STRS/PRS, are they also eligible for Social Security benefits?

Yes

34. If employees are eligible for STRS/PRS, please provide detailed offset information for all LTD claims on the claims listing that outlines which offsets are related to the

STRS/PRS.

The difference between Monthly Gross

Benefit and Regular Monthly Benefit is the total amount of all offsets. Details on the type of offset is not available.

35. Please confirm the name and number of the State Teacher Retirement System plan (STRS) and or Public

See appendix 7.1.

Employees Retirement System plan (PERS) that state employees are required to pay into (if applicable).

Please confirm if Employees are required to also pay into Social Security.

Yes, employees are required to pay into

Social Security.

36. Please confirm if the group participates in and offsets LTD benefits for PERS/STRS, SS, or both?

Yes, LTD benefits are offset by any paid pension benefits and/or Social Security benefits.

37. Are the STD and LTD plans currently governed by

ERISA?

No

38. What Benefit Admin platform does the State use for enrollment? What other technology partners, if any, does the State work with for file transfers, etc.? Examples:

Workday; ADP; UKG.

Oracle People Soft Enterprise Resource

Planning. The state does not work with any other vendors for file transfers. The

Contractor will access the secure Edison server to retrieve the weekly enrollment full population file.

39. Please address the following questions specific to Enrollment:

• Is your upcoming Annual Enrollment going to be an active (all employees must take action and accept/decline benefits) or passive (only employees that need to make a change need to take action) enrollment?

• If passive – what % of your employees usually make a change during their Enrollment period?

• How do you educate and communicate to your employees about benefits and benefit changes?

o In person (benefit fairs, group meetings, other) o Paper (benefit guide, posters, postcards, other)

• The upcoming Annual Enrollment period is passive.

• 1,186 of the 73,335 (1.6%) eligible employees made an enrollment change during the Annual

Enrollment period that occurred in

2024 that went into effect in the

STD or LTD program. Enrollment changes that required Evidence of

Insurability, but was not submitted o Electronic strategy (email, webinars, text, social media, other)

• Are any decision support tools used? If so, please describe.

• During your previous annual enrollment was it:

o Open – where all employees were able to elect coverage up to the GI?

o Modified – where all employees were able to elect one increment without EOI?

o Traditional Underwriting – where all employees submitted EOI?

• When was the last true “open enrollment” for Contributory LTD/STD (if applicable)? (“open” defined as late entrants/increases not subject to proof of good health/E of I)

• Please describe how your employees enroll in their benefits?

o In person (individual meetings, group meetings, or outsourced – If outsourced – who is the vendor?)

o Paper (personalized enrollment forms, generic enrollment forms provided by carriers, other) o Self-Service enrollment platform (name of platform used and is SSO integrated into platform)

Call-center (HR assisted or outsourced? If outsourced – who is the vendor?)

or approved, are not included in this number.

• All three methods of in-person events, paper and electronic communications are used to educate employees about benefits.

• Decision support tools are not used for enrollment.

• The previous annual enrollment period was “modified” such that new STD enrollment or changing from STD-B to STD-A required EOI, but changing from STD-A to STD-B did not require EOI. For LTD, Central State Government and

State Higher Education employees were not required to submit EOI for any LTD selection. Employees of

State Offline Agencies were required to submit EOI for new LTD enrollments or when switching from a lesser to greater LTD plan.

• The only “open enrollment” for STD and LTD, all options, was during the

2018 Annual Enrollment held in the fall of 2017 for the initial go-live of the disability insurance plan.

• Employees enroll in their benefits through Edison (Oracle PeopleSoft

Enterprise Resource Planning) Self-

Service enrollment platform or use their agency’s Agency Benefits

Coordinator to submit enrollment on their behalf. SSO is not integrated into this platform.

• The Benefits Administration (BA) call center is staffed by BA employees, who are available to answer calls during operating hours of 8a-4:30p CT, Monday – Friday.

The Human Resources office for each employee is also not outsourced.

40. Please confirm enrollment rules at takeover and during subsequent annual enrollment periods for both STD and contributory LTD. Will the requested rules differ from current practices? When was the last true open enrollment held?

The enrollment rules for moving to the next contract and during subsequent annual enrollment periods are covered in Contract

Section A.1.

Contributory LTD (LTD-C) is no longer being requested under this RFP. The State has updated language in RFP Section 1.1 and Pro Forma Contract Section A.1. See

Amendment items #3 and 5.

The only “open enrollment” for STD and

LTD, all options, was during the 2018

Annual Enrollment held in the fall of 2017 for the initial go-live of the disability insurance plan.

41. It was mentioned on the pre-proposal conference call that the Contractor would be required to retrieve the eligibility file feed from a secure site verse it being sent automated and electronically. Are you able to provide a copy of the file feed for review and provide any additional information/details on this process?

The State will work with the Contractor to develop a mutually agreeable full population enrollment file layout. The weekly enrollment file will be created by the State and placed on the State’s Edison secure server for retrieval by the Contractor. The

Contractor will be provided with credentials to access the State’s Edison secure server.

42. Please disclose any plan design and/or rate changes from 1/1/2021 to current and provide associated policy amendment documents. There look to have been multiple rate and plan changes on the LTD coverage specifically.

There has been no change in the plan benefit design. The change on January 1, 2024, was when the state of Tennessee began paying the premiums for LTD-Option

3 and state higher education began participating in the LTD program. The State has added new RFP Appendix 7.16 for the premium rates for calendar years 2018 through 2026. See amendment item #23.

See RFP Appendices 7.3.a, 7.3.b, 7.3.c, 7.12, 7.13, and 7.14 for the certificates of coverage.

43. Please confirm the current/requested premium grace period.

Each premium due from the policyholder after the effective date of the policy may be paid up to 31 days after its premium due date.

44. Please confirm if there is a goal for minority-owned or women-owned business partners for this RFP. If so, is this a requirement to be considered?

There is not a requirement for minority-owned or women-owned business partners for this RFP.

45. Is the State requesting an implementation credit to aid with the financial burden of changing carriers? If so, how much are they requesting?

No

46. Are Implementation Credits requested and if so, what is the dollar amount?

No

47. Are tech credits or implementation credits being requested? If so, what are the amounts?

No

48. Confirm that all employees work in the State of Tennessee There are a few central state government and state higher education employees whose work assignment is outside the state of Tennessee. The State has revised

Appendix 7.5. See amendment item #23 below.

49. Leave of Absence is stated as “… up to the earlier of the Policyholder’s general practice, or 60 months”. Do employees continue to receive income during an extended

No, employees do not receive income because they are in a leave without pay

LOA? If not, what is coverage based on? What is the State’s ‘general practice’ concerning LOA’s?

status. Coverage is based on an employee’s salary when they were actively receiving pay. For insurance purposes, an employee on an extended leave of absence without pay is eligible to continue on the plan as a direct bill employee for 24 months.

If the employee does not return to work at the end of the 24-month direct bill, benefits are terminated.

50. With the requested plan change to move STD duration from 26 weeks to 13, what is the plan for those employees still covered under LTD 180 Day EP plan(s)?

Employees whose disability and elimination period began prior to January 1, 2027, will be covered under the provisions of the current contract. Employees enrolled and not on disability will be automatically moved to the only LTD plan (90-day/63% elimination) as of January 1, 2027.

51. Will the current employee funded options continue? The employer funded option for LTD is anticipated to continue as long as the state legislature appropriates the funds. The contributory LTD plans will be discontinued as all central state government and state higher education employees will be enrolled in the non-contributory LTD plan and the state offline employees will no longer be eligible for the STD or LTD plan. The STD plan premiums will continue to be 100% employee paid.

52. Provide Rate History (back to 1/2021) by Option for both

STD & LTD.

The State has added new Appendix 7.16.

See amendment item #23.

53. Provide a current Invoice. The contractor does not invoice the state.

The State has added new Appendix 7.15 for the most current purchase order created by the state based upon premiums collected.

See amendment item #23.

54. Confirm FICA Taxes (STD) are billable back to the State. There are no FICA Taxes on STD as premiums are collected from the employees on a post-tax basis.

55. Please provide the history rate back to the inception of the STD and LTD plans.

The State has added new Appendix 7.16.

See amendment item #23.

56. What is the average employee turnover rate of the Government entity (or an approximate number of new hires onboarded annually)?

As of 9/23/2025, the turnover rate in 2025 for central state government is 11.70% and is predicted to be 14.00% at years’ end.

57. What is the average employee turnover rate of the Higher Ed entity (or an approximate number of new hires onboarded annually)?

There were 5,069 state higher education employees hired in calendar year 2024.

58. Please provide the latest Marketing and Communications Plan.

The State has added new appendix 7.19.

See amendment item #23 below.

59. Please provide the latest Marketing and Communications Results Report.

The State has added new appendix 7.20.

60. Please share the latest Service Level Agreement Scorecard.

The State has added new appendix 7.21.

61. What are historical LTD/STD rates from 2014-present? The State has added new Appendix 7.16.

62. Please confirm any layoffs due to the present pandemic past or present; if any future ones are planned, please confirm estimated impact on eligible population.

We are unaware of any layoffs due to the present pandemic past or present.

63. Please confirm if a 4 or 5-year rate guarantee is a requirement.

See Attachment 6.3 Cost Proposal which requires a guarantee of the rates proposed for each of the five years indicated.

The State has revised Attachment 6.3 Cost

Proposal. See amendment item #26.

64. Please confirm “evaluation factor” is not applicable to insurer to build into costs.

The “evaluation factor” is not applicable to the insurer to build into costs. It is for state use only.

65. If specific plan provisions cannot be mirrored except by single case filing and are subsequently rejected by the

The Contractor will provide the minimum benefits and services per the pro forma

State of Tennessee for single case filing, will alternatives be acceptable?

contract in RFP 31786-00186. It is anticipated that the Contractor will submit single case filing for the benefits. The state will review alternatives to any plan provisions approved by State - Benefits

Administration in the draft certificate which are subsequently rejected by the

Tennessee Department of Commerce and

Insurance.

66. Please confirm if the request to quote should only include alternatives, and not the inforce STD and LTD plans.

The request to quote is for the STD and

LTD plans as detailed in the RFP to be effective January 1, 2027.

67. Please confirm Short Term Disability provides 24-hour coverage (covers work related disabilities).

Yes, STD provides 24-hour coverage.

68. Sick leave is presently offset from STD and LTD. Is there any requirement that an Employee must exhaust his or her sick leave so that disability benefits may commence?

Yes, subject to certain employer practices.

69. Does the State of Tennessee have a specific/specialized RTW program? If yes, please provide either a flowchart or description of the process.

The State does not have a specific/specialized RTW program. The

State coordinates the RTW with the current contractor and will work with the Contractor procured through this RFP.

70. Please share any current challenges the State of Tennessee is experiencing with their current carrier and looking to resolve with this marketing.

There are no concerns with the current carrier’s administration of the state’s disability insurance plan.

71. Has your current carrier had to pay any penalties for missed execution on the performance guarantees over the last 2 years?

Yes

72. Please confirm who the State’s technology vendor is. The State uses Oracle PeopleSoft

Enterprise Resource Planning for administration of payroll and benefits.

In round 2 of questions and comments, please clarify to which specific technology vendor you are referring. The State works with multiple vendors across various platforms and services, so identifying the context will help us provide an accurate response.

73. Is the requested mobile app a deal breaker? Yes, as stated in RFP Attachment 6.1, the

Statement of Certifications and Assurances, the Respondent will provide all services as defined in the Scope of the RFP Attachment

6.6., Pro Forma Contract for the total

Contract Term.

Also, see response to Question #103.

74. Please provide samples of the current customized STD, LTD communications the State of Tennessee is looking to mirror. Are fully customizable communications considered a deal breaker for the State?

The State has added Appendix 7.22. See amendment item #23.

Yes, as stated in RFP Attachment 6.1, the

Statement of Certifications and Assurances, the Respondent will provide all services as defined in the Scope of the RFP Attachment

6.6., Pro Forma Contract for the total

Contract Term.

#2 - RFP

schedule of events and

RFP

Soliciation

Notice

75. Pg 8 line #9 – Response Deadline states: 2:00 pm - November 12, 2025

Pg 1 of August 28, 2025, RFP Solicitation Notice states a Response Deadline of December 12, 2025. Please confirm the date that our complete responses are due?

The response deadline is November 21, 2025 as stated in RFP Section 2.1

Schedule of Events.

confriRFP

4.4.1

76. Will the State agree to the following revisions: the definition of “subcontractor” applies to those entities with whom the Contractor contracts to provide services solely to the State?

The State would not agree to the requested revision.

RFP 77. Please confirm the response delivery. Can both the Technical Response and the separate Cost Proposal be uploaded as separate digital documents to the digital submission platform/file sharing link that the State provided in the “Digital Submission Instructions” document?

Please review RFP section 3.2, Response

Delivery. The Technical Response and Cost

Proposal should be uploaded as separate documents.

RFP 78. Please confirm you want the entire Technical Response to be in one (1) PDF document.

Please review RFP section 3.2, Response

Delivery. The technical Response document should be in the form of one (1) digital document in “PDF” format properly recorded on its own otherwise blank USB flash drive or uploaded to our digital submission platform.

RFP Section

3.2.2.1

79. Please confirm the following instruction from Section

3.2.2.1 – “one (1) digital copy of the Technical Response each in the form of one (1) digital document with separate individual corresponding appendices or exhibits in PDF format”. Do you want any corresponding appendices or exhibits from the Technical Response uploaded separately in individual PDF documents to the file sharing link? Therefore, would we be uploading the Technical Response as 1 PDF doc and then uploading any corresponding appendices or exhibits as separate documents? Can those appendices/exhibits be in a zip file?

Please refer to RFP section 3.2, Response

Delivery. Upload the technical response as a single PDF and submit any appendices or exhibits separately—either individually or bundled in a ZIP file.

RFP Section

3.3.1

80.

3.3. Response & Respondent Prohibitions

3.3.1. A response must not include alternate contract

terms and conditions. If a response contains such terms and conditions, the State, at its sole discretion, may determine the response to be a nonresponsive counteroffer and reject it.

Will the State except the following caveat?

Agreed, provided any exceptions or deviations [REDACTED] submits at the Questions and Comments Deadlines, which are approved by the State or which the State deems as points for future negotiation/consideration may be incorporated into the resulting Contract.

Any written responses provided by the State to written questions and comments that necessitate revisions to the contract language shall be incorporated into the final executed contract.

There will be no negotiations after the contract award.

RFP Section

4.4.1

81.

4.4. Assignment & Subcontracting

4.4.1. The Contractor may not subcontract, transfer, or

assign any portion of the Contract awarded as a result of this RFP without prior approval of the State. The State reserves the right to refuse approval, at its sole discretion, of any subcontract, transfer, or assignment.

[REDACTED] identifies subcontractors as suppliers who are performing a core business function performed in the

The State would not agree to the requested language.

normal course of business and has no subcontractors.

However, to the extent [REDACTED] proposes to hire contractors to perform services solely for the State, [REDACTED] agrees to obtain the State’s approval prior to hiring such contractor.

RFP Section

4.5

82.

4.5. Right to Refuse Personnel or Subcontractors

The State reserves the right to refuse, at its sole discretion and notwithstanding any prior approval, any personnel of the prime contractor or a subcontractor providing goods or services in the performance of a contract resulting from this RFP. The State will document in writing the reason(s) for any rejection of personnel.

We will make every effort to notify and consult with the State at least 14 days prior to any change in the Account Management team. New team members will undergo training and become well-versed in the State's plan and administration. Any changes will be communicated to you by phone and in writing. Respondent retains ultimate responsibility for its personnel decisions.

The State would not agree to the requested revision.

RFP

Attachment

6.1

83.

RFP ATTACHMENT 6.1. - STATEMENT OF

CERTIFICATIONS AND ASSURANCES

3. The Respondent, except as otherwise provided in this RFP, accepts and agrees to all terms and conditions set out in the RFP Attachment 6.6., Pro Forma Contract that are lawful and in keeping with relevant business practice in providing insurance services.

The State would not agree to the requested revision.

RFP

Attachment

6.2

84.

RFP ATTACHMENT 6.2. — Section A A.3 Provide a current bank reference indicating that the Respondent’s business relationship with the financial institution is in positive standing. Such reference must be

No, this RFP does not include a finalist round. Requirements for RFP question A.3 written in the form of a standard business letter, signed, and dated within the past three (3) months.

Will the State except that we can provide banking references once named a finalist?

should be submitted by the response deadline listed in the schedule of events.

RFP Question

C.17.

85. Can we please have some clarification on the retiree population mentioned? It is not our intention to quote a retiree plan so is this perhaps in reference to Port/Conversion fulfillment?

Retirees are not eligible. RFP Question

C.17. has been deleted. See amendment item #4.

RFP Question

C.30.

86. What points of customization are you requesting for the “Claims processing system?” Intake script? Branding?

Claims triage?

The state is not requesting specific customization of the respondent’s system.

The state is asking if the respondent can fully customize its system to handle all features of the state’s plan and if there is a plan provision change in the future, can your system be customized to accommodate the specific change.

Pro forma contract A.2 -

Definitions &

A.4 – Call

Center

87.

Is the State amenable to adjustments or negotiations concerning some of the Call Center performance measurements and criteria noted in these two sections?

The state does not agree. However, see answer to question #92.

Pro forma contract A.2.rr

88.

Do additional State Offline entities exist that are not included in this list because they do not participate in the voluntary STD/LTD? Is there a possibility that additional State Offline agencies will have the opportunity to participate in the voluntary STD/LTD within the contract period?

Contributory LTD (LTD-C) is no longer being requested under this RFP. The State has updated language in RFP Section 1.1 and Pro Forma Contract Section A.1. See

Amendment items #3 and 5.

Pro forma contract A.3

89.

A.3. Staffing At the State’s request, In Writing, the Contractor must replace staff members or subcontractors providing core services. Core services are defined as those that touch or affect Members, specifically Member customer services, Member call center, mail services, and appeals processing at all levels. Also included are any services that affect the State, such as the Contractor’s account team that routinely interacts with the State. The decision of the State on these matters shall not be subject to appeal.

Confirmed; however, [REDACTED] retains ultimate responsibility for its personnel decisions.

The State recognizes the Contractor has the final decision in personnel matters for its employees or subcontractors;

however, Pro forma contract A.3.e.

provides the State with the option of requiring the Contractor to remove identified staff from handling the State’s account.

Pro forma contract

A.3: e

90.

Will the State agree to the following revisions: that Contractor reserves the right to make final decisions regarding our own employees, but that Contractor will perform regular check-ins and accept feedback on employees and will provide ample notice prior to any staff changes?

See answer to question #89

Pro forma contract

A.3: e

91.

We will work with you to ensure that our employees servicing your account meet and exceed your expectations. We hope to establish regular check-ins to ensure that is happening. We will gladly provide reasonable notice of any changes of any personnel prior to the change going into effect. However, will the State agree for us to be allowed to reserve the right to make final decisions regarding Contractor employees?

See answer to question #89 contract A.4: c

(2)

92.

Will the State agree to the following revisions, “The Contractor’s call center(s) shall maintain a quarterly average Call Abandonment Rate of five percent (4%) or less. Quarterly results will be calculated for a quarterly score as shown in Contract Attachment D #2. The quarterly Call Abandonment Rate shall be calculated by dividing the number of abandoned calls with a duration of five seconds or greater by the total number of inbound calls with a duration of ten seconds or greater during the quarter and multiplying by 100. “

The state does not agree. However, Pro forma contract sections A.2.h.has been revised. See amendment item #6.

Pro forma contract

A.4: g

93.

Will the State agree that “caller identification” is defined as the phone screen displaying an individual’s or organizations’ phone number?

Yes

Pro forma contract

A.4: h

94.

Will the State agree that the Contractor complies with applicable privacy and confidentiality laws in determining whether the State can access particular call recordings?

The State does not agree.

Pro forma contract

A.6.g.

95.

Is it possible to be more specific regarding the customization of the enrollment materials? Insurance carriers are bound legally by what can and cannot be said in marketing materials and we would need to be involved in determining the final language prior to distribution.

The State and the Contractor will work together to customize enrollment materials.

The State will take into consideration legal requirements expressed by the Contractor and/or legal sources, and the State will provide final approval of the material.

Pro forma contract

A.6: h

96.

Will the State agree to the following revisions, “The Contractor will make a good faith effort to design Member materials at the sixth (6.0) grade level using the Flesch- Kincaid Index if such material may be so designed while still meeting insurance advertising regulatory requirements. The Contractor shall evaluate materials…”

The State does not agree. The State will work with the Contractor on each marketing and communications item to reach an acceptable reading level and may approve items in some instances that are above the sixth (6.0) grade level.

Pro forma contract A.6: i

97.

Will the State agree that postings made to online platforms, to be augmented with printed copies to employees if requested by the member?

The State agrees that the Contractor may print and mail at the Contractor’s expense printed copies to employees and other individuals upon request.

Pro forma contract

A.7.b.

98.

“the Contractor shall print and distribute any mass mailings developed by the State within fourteen (14) Business Days.” How many mailings per year would be anticipated?

The State does not anticipate any mass mailings by the Contractor of material developed by the State. However, if it is later decided that a mass mailing is necessary, this contract section will apply.

Pro forma contract

A.8: a

99.

Will the State agree Contractor has final authority to ensure compliance with state insurance advertising laws?

The State agrees the Contractor has final authority to ensure compliance with state insurance advertising laws. However, the

State retains authority to approve final drafts of communication items after the

Contractor has submitted to the State materials declared to be in compliance with state advertising laws.

Pro forma contract

A.8.b.

100. “As a new Member(s) joins the Program, they shall be mailed a welcome kit no later than ten (10) Business Days.” We would like to define exactly what would go into each packet for new enrollees as it seems that population would not need the level of communication of those who would be onboarded for the Go Live date.

Pro forma Contract Section A.8.a. describes what is required for each welcome packet.

This section has been revised. See amendment item #8.

contract

A.9.a.

101. “The Contractor shall maintain a Landing Page and Plan Microsite.” Would a landing page and a microsite not be the same? Do you have the current set up you can show us to help us reference?

See definitions for Landing Page and Plan

Microsite in Pro forma contract section A.2.

For current set up, see metlife.com/StateOfTN.

Pro forma contract

A.9.n.

102. “Contractor shall have a Member Website accessible via a Member log-in portal on the Landing Page so Members can view Member-specific documents, including but not limited to, the certificates of coverage and other material.”

Whether we have certain docs accessible via the landing page versus the EE Portal, will it matter in the end as long as all necessary docs are accessible somewhere? We want to clarity if you have one specific way of accessing documents, or whether this method is flexible.

The certificates of coverage should be accessible from both the Plan Microsite and the Member Website for reference by non-members and members without having to switch between platforms. Other material shall be posted on one or both of the platforms depending upon the target of the information (non-members, members, or both).

Pro forma contract

A.9: o

103.

Will the State agree to mobile-compatible web pages in lieu of a dedicated application?

Yes, the state agrees. See amendment item

#32.

Pro forma contract A.9: s

104.

Will the State agree that, due to legal and compliance obligations, we cannot give revision authority to an outside party?

The State does not agree. However, pro-forma contract section A.9.s. has been revised. See amendment item #9

Pro forma contract

A.10: h

105.

The Contractor’s policy allows for appeals request in writing, to be reviewed by a specialized team and clinical resources. Updates are provided regularly during the course of the review. Does the State anticipate additional grievance procedures being necessary?

The State does not at this time anticipate additional grievance procedures being necessary. During the course of business, it https://www.metlife.com/info/stateoftn is possible other grievance procedures needed may be identified.

Pro forma contract

A.10: k

106.

Will the State agree to terms that allow the Contractor to modify its Master Group Insurance Policy and certificates as it deems necessary to ensure compliance with changes in law or regulations?

The state does not agree. The Contractor shall submit to the State drafts of revised policy and/or certificates with notations as to the changes in law or regulations necessitating the revisions in the

Contractor’s opinion. The State has final approval authority of the revised drafts before the Contractor submits the policy and/or certificates to the Tennessee

Department of Commerce and Insurance for formal approval.

Pro forma contract

A.10: l

107.

Will the State agree that the Contractor cannot relinquish control over our own media or legislative presence, and may not always be legally permitted to give notice when we are required to comply with regulatory or legal requests?

The State does not agree. The Contractor will be expected, of course, to comply with regulatory or legal requests. However, all media and legislative inquiries concerning the Plan shall be referred to the State. The

Contractor should not speak on behalf of the State’s Plan in either of these situations.

Pro forma contract

A.10: n

108.

Will the State agree to language that Contractor shall use reasonable efforts to ensure that the State does not receive undelivered mail?

The state agrees. See amendment item #

10.

contract

A.10: o

109. Will the State agree to definitions for these metrics as follows:

Claims Payment Accuracy: The measurement of total dollars paid accurately divided by the total dollars payable for all claims with payments in the audited population.

Quarterly internal audit performed by the Contractor on a statistically valid sample.

Claims Processing Accuracy: The measurement claims processed without any type of error divided by the total number of claims in the audited population. Quarterly internal audit performed by the Contractor on a statistically valid sample.

The state does not agree.

Pro forma contract A.11

110.

A.11. Information Systems

Will the State except the following redline?

The Contractor’s systems shall have the capability of adapting to any future changes reasonably necessary as a result of modifications to the design of the Plan or this Contract and its requirements, including e.g., data collection, records and reporting based upon unique identifiers to track services and expenditures across population types/demographic groups, regions/parts of the state. The systems shall be scalable and flexible so they can be adapted as needed, within negotiated timeframes, e.g., in response to changes in Contract requirements or increases in enrollment estimates. The Contractor’s system architecture shall facilitate rapid application of the more common changes that can occur in the Contractor’s operation, including but not limited to:

1) Changes in payment methodology;

2) Additions and deletions of in-scope services;

3) Changes in program management rules, e.g., eligibility for certain services; and

4) Standardized contact/event/service codes.

The state does not agree.

contract A.11

111.

A.11. Information Systems

Will the State except the following redline?

d. Upon the State’s request and timeline and subject to applicable data privacy laws, the Contractor shall be able to generate a listing of all Members (including each Member’s Edison identification number) that were sent a particular document, the date and time that the document was generated, and the date and time that it was sent to particular Members or groups thereof. The Contractor shall also be able to generate a sample of said document.

The State does not agree.

Pro forma contract A.11

112.

A.11. Information Systems

Will the State except the following redline and caveats?

e. Retention and Accessibility of Information

1) The Contractor shall maintain a comprehensive information retention plan that is in compliance with state and federal requirements and provide to the State if requested.

2) The Contractor shall maintain information on-line for a minimum of three (3) years, based on the last date of update activity, and update detailed and summary history data monthly for up to three (3) years to reflect adjustments.

3) The Contractor shall provide forty-eight (48) hour turnaround or better on requests for access to information that is between

The State does not agree.

one (1) year and three (3) years old, and seventy-two

(72) hour turnaround or better on requests for access to information that is between four (4) and five (5) years old.

Such requests for information shall be made by the State or its authorized designee.

4) If an audit or administrative, civil or criminal investigation or prosecution is in progress or audit findings or administrative, civil or criminal investigations or prosecutions are unresolved, information shall be kept in electronic form until all tasks or proceedings are completed.

We would not want to differentiate the response time based on the age of the data- we would want to land on one period and the language is not clear as to whether this is full response back in 72 hours or if it is an acknowledgement within 72 hours.

[REDACTED] has a Record Retention Policy and Retention Schedule which is designed based off regulations, legislation and business purpose; we do not provide copies of these documents as they are considered company confidential. This Policy and Schedule inform employees how to handle records including how long to retain records prior to deletion. [REDACTED] may retain a copy of Company confidential data as required by auditors, reinsurers or regulators or to comply with any

The State does not agree, but the State has revised A.11.e(3). See amendment item

#11.

federal, state or local requirements governing the retention of records and materials. For such reason, Company confidential data that was transmitted, read or stored electronically may not be able to be deleted from [REDACTED’S] computer systems or equipment in certain instances. It is [REDACTED] policy to take commercially reasonable steps to maintain the confidentiality of such Company confidential data. Such steps shall be no less rigorous than those used to protect [REDACTED’S] own similar information.

[REDACTED] will retain records, including website materials, for a period required by applicable law and our record retention policies and procedures.

Pro forma contract A.11

113.

A.11. Information Systems

Will the State except the following caveat?

f. Information Ownership. All information, whether data or documents, and reports that contain or make references to said information, involving or arising out of this Contract is owned by the State. The Contractor is expressly prohibited from sharing or publishing State information and reports or releasing such information to external entities, affiliates, parent company, or subsidiaries without the prior consent of the State In Writing.

However, [REDACTED] will own all records and customer information derived from insurance transactions and as required by applicable law. Upon termination of the insurance contract and to the extent permitted by applicable law, [REDACTED] will transfer to the new insurance carrier necessary records and information not proprietary to [REDACTED].

contract A.11

114.

A.11. Information Systems

Will the State except the following redlines?

f. 1. Upon termination of this Contract and request by the State, subject to applicable law, the Contractor shall provide to the State or its designated agent, pertinent data identified by the State for Members to support a transition of the Plan from the Contractor. The information shall be furnished in a mutually agreeable format and medium as is compatible with the data processing system maintained by the State or its designated agent.

contract A.11

115.

A.11. Information Systems

Will the State except the following redlines?

g. System Availability

1) The Contractor shall ensure that Member, provider and other web-accessible and/or telephone-based functionality and information, including the website described in Contract Section A.9., are available to the applicable system users…