RP040_23 Ad1 .pdf

November 1, 2023

Addendum #1

RP040-23

Provision of On-Site Wellness Center Administration on an Annual Contract

Please see the below summation of questions and answers for the above solicitation.

Changes C1. RP040-23 Wellness Center RFP Read Me First, Page 2, Proposal Scope and Objective

• Delete: April 1, 2024

• Replace with: July 1, 2024

C2. RP040-23 Wellness Center RFP Read Me First, Pages 10, 16)

• Delete: Gwinnett plans to enter into an agreement with the selected service provider effective April 1, 2024 for an initial period of 9 months with four (4) options to renew for an additional 12 month period.

• Replace with: Gwinnett plans to enter into an agreement with the selected service provider effective July 1, 2024 for an initial period of 12 months with four (4) options to renew for an additional 12 month period.

C3. RP040-23 Wellness Center RFP Read Me First, Page 26, 1. TERM

• Delete: This contract shall commence April 1, 2024, for a nine-month period with four options to renew for an additional one-year period.

• Replace with: This contract shall commence July 1, 2024, for a twelve-month period with four options to renew for an additional one-year period.

C4. RP040-23 Gwinnett Wellness Center Administration RFP QUESTIONNAIRE FINAL, Question

# 21.

• Delete: April 1, 2024

• Replace with: July 1, 2024

C5. RP040-23 Gwinnett Wellness Center Administration RFP QUESTIONNAIRE FINAL, Question # 23.

• Delete: January 1, 2025

• Replace with: July 1, 2025

C6. RP040-23 Wellness Center RFP Read Me First, Page, Third Bullet, 2nd Sub bullet

• Delete: Option 2: employ a full-time physician to allow for an onsite dispensary. In the financial proposal, please include costs for stocking and maintaining a dispensary for all providers in the facility, including Kaiser providers.

• Replace with: Option 2: employ a full-time physician to allow for an onsite dispensary. In the financial proposal, please include costs for stocking and maintaining a dispensary for Aetna members only, excluding Kaiser members.

Addendum 1

Questions Q1. What are the non-negotiables of the Kaiser piece? If a Service Provider were to submit a proposal, stating Kaiser was responsible for all their vaccines, equipment, and supplies, would that deem the Service Provider nonresponsive or be scored accordingly?

A1. The Kaiser engagement is governed by the Kaiser contract. The current contract does not include Kaiser supplying vaccines, equipment, and supplies. Inclusion of vaccines, equipment, and supplies for the entire facility is part of RP040-23.

Q2. Is the County open to a full pharmacy or include it as an option in the staffing model?

A2. The intent is for the facility to include a dispensary, not a full pharmacy. The goal is to supply short term medications, e.g., antibiotics, cough & cold medications, etc., and some maintenance medications, e.g., high blood pressure, high cholesterol, first line diabetes medications, etc. via a convenient, low-cost mechanism for employees and their eligible family members.

Q3. Please provide the number of patient visits for Kaiser to allow so a Service Provider can estimate the shared supplies costs.

A3. Kaiser appointments fluctuate with the seasons and the needs of the Wellness Plan Year.

Prior to the biometric screening deadline in late July, Kaiser averaged 65 appointments per week since mid-February. Since that time, the average is down to 36 appointments per week. Kaiser appointments increase during cold and flu season to around 50 per week. Please refer to the Cost Tabulation exhibit in the original request for proposal release for the annual cost of supplies.

Q4. If a Service Provider employs an MD and dispenses medications, would the Service

Provider only dispense medications to the Aetna population or to the Kaiser population as well?

A4. See C6.

Q5. Does the approximately 2,700 Aetna members include the dependents under the age of

18? If the County wishes to add younger dependents, please provide the counts for dependents?

A5. There are approximately 2,700 dependents enrolled in the Aetna plan. Based on enrollment tiers, the County estimates approximately 1,550 dependents are under age 18 and approximately 1,150 dependents are 18+.

Q6. In order to provide a detailed ROI analysis, please provide the following:

o Please provide the number of enrolled members in the Aetna medical plan each month of the time period January 2021 – August 2023.

o Please provide a high-cost claimant report for January 2021 – August 2023.

o Please include diagnosis categories.

A6. The County is not asking for an ROI analysis as part of this request for proposal. Data needed for the chosen Service Provider to complete an ROI analysis should be included in the proposal response so that the County understands the parameters of the guarantee and what will be needed to calculate the measure.

Q7. Would the County accept the condition that if a contract is terminated after 9 months (1st term duration requested), payment for the full 12-month cost would be required?

A7. See C1-C5.

Q8. Would the County entertain a response solely for occupational medicine related services to be provided 5 days a week in the Wellness Center location?

A8. This solicitation, and subsequent contract, is intended to include both primary care and occupational medicine. Offering an occupational medicine only proposal will be scored accordingly.

Q9. Please share the hourly rates of the current staff.

A9. The County does not have information on the hourly rates of current Premise employees.

Q10. What is the main reason(s) for releasing a request for proposal for the Wellness Center?

A10. The County’s Purchasing guidelines mandate all contracts be fully reviewed, i.e., sent to

RFP, at least every 5 years. While the current contract with Premise is nearing its official end date the County has gone to market early. The closing of the dispensary and downstream drop in utilization marked a departure from the intended strategy and focus on primary care. The County is taking this opportunity to evaluate potential alternative models that may support this strategy.

Q11. What are current pain points for the Wellness Center?

A11. The closing of the dispensary has been a significant pain point and the County has seen utilization decrease since the dispensary closed in 2022. The County is looking for a partner that is focused on member engagement, an emphasis on managing chronic conditions, easier access to care, and primary care.

Q12. What is the current budget for Wellness Center operations?

A12. Please see the cost tab provided with the request for proposal documents.

Q13. Does the County wish to retain current staff?

A13. The County and the awarded Service Provider will determine the right staffing model and the appropriate staff once an award of the contract is made.

Q14. Does the current Service Provider have non-competes in place for staff?

A14. The County does not have knowledge of the details included in the current Premise staff contracts.

Q15. Is the County currently receiving any funding for the Wellness Center, including, but not limited to, wellness funds?

A15. There are no outside or supplemental funds used for the Wellness Center budget.

Q16. There was language in the request for proposal summary about a $30 coinsurance amount per clinic visit. Does this apply to everyone or just the HDHP participants?

A16. All Aetna participants are enrolled in a HDHP.

Q17. Is there a contract/BAA between Kaiser and the current Service Provider that specifies, for example, how the medications and supplies are accounted for? Please provide a copy of the contract.

A17. There was an agreement (not a BAA) in place between Kaiser and Premise when the dispensary was in place. Since the dispensary is no longer active, this agreement is no longer applicable.

Q18. Please provide the reports for Sharecare that include utilization and outcomes.

A18. Sharecare utilization through 10/17/2023 is below. The County does not have outcomes reporting yet since this is the first year of the Sharecare contract.

Benefits Enrolled (Current) Employee - 4,347 employees eligible Spouse - 2,061 eligible

Registrations 3,855 (88%) 1,388 (67%) RA Completion 3,747 (97%) 1,319 (95%) Sleep Tight Tonight 1,153/746 (65%) 395/273 (69%) Healthy Breakfast 1,394/1,042 (75%) 479/376 79%) Level Up 1,188/765 (64%) 388/277 (71%) Relationship Rejuvenation 771/503 (65%) 359/240 (67%) Healthy Hydration 785/585 (74%) 308/234 (76%) Community Team Steps 482/348 (71%) 197/145 (73%) Budgeting 191/86 (0%) 85/47 (0%)

Other engagement updates as of 10/17/23 (benefits enrolled employee and spouse)

• Average of 12 activities completed per registered member across all departments.

• Employees averaging 13 activities completed.

• Employees who have completed both RA and bio averaging 15 activities.

Pillar Completions as of 10/10 Completions as of 10/17

Mental 2,460 2,507 Coaching 2,282 2,320 Social 2,400 2,438 Finance 2,687 2,741 Physical 2,436 2,467 Community 2,140 2,156

Biometrics- Quest

Modality Scheduled/Downloaded Completed/Processed Service Centers 972 (966) 907 (902) Physician Forms 817 (817) 507 (503) Onsite Events 1,416 (1,416) 1,324 (1,324)

Q19. Can the County provide detailed medical & Rx claims data (at least 12 months) for the purpose of running an ROI?

A19. See A6.

Q20. Please provide a breakdown of the 450 occupational visits outsourced in 2022 by type.

A20. Please refer to the WC Utilization 2020-2022 excel file that was included with the request for proposal release. The last tab, labeled “Occ Health Outsourced Visits” categorizes these visits.

Q21. Is the current Premise Nurse Practitioner family certified and able to see children ages 6 and up?

A21. The County does not have knowledge of the current Premise staff licensure.

Q22. Is the current Occ Health Physician open to increasing clinic hours?

A22. The County does not have knowledge of the current Premise staff’s ability to shift or increase hours.

Q23. Does the County own all the current FF&E (especially equipment) including the occupational health equipment?

A23. Yes, the County owns all current equipment in the Wellness Center. A complete list of equipment is not currently available. The County will work with the awarded Service Provider if any additional equipment is deemed necessary.

Q24. Who is the County’s TPA for Workers’ Comp?

A24. Davies Claim Solutions, LLC

Q25. Please describe the primary goals, gaps and/or opportunities that the County would like to address regarding the provision of occupational health to employees?

A25. The primary goal of the Wellness Center is to become the true hub for prevention and wellness for all eligible participants. The County is also eager to achieve full utilization of Occupational Health services and to hear suggestions on how to more effectively use the Occ Health Physician.

Q26. What are the top three (3) reasons that the County is looking to consider a new Service

Provider for the Wellness Center?

A26. See A10.

Q27. What are the credentials of the “Health Advocate” position, and does this position perform the health coaching services?

A27. The current Health Advocate has multiple higher education degrees in the health sciences, certified health coach, and is an Exercise Physiologist. She performs health coaching services and chronic condition management for the entire eligible population.

The County is open to a resource with any appropriate credentials for health coaching, diet and nutrition counseling, and general wellbeing activities.

Q28. Does the County currently utilize any Physical Therapy services?

A28. No.

Q29. What areas, in terms of data and reporting, does the County want to improve?

A29. The County would like to validate the impact the Wellness Center is having on members’ health. For example, are the members engaged at the Wellness Center more compliant with medication? Tracking referrals and follow-ups with those referrals. Do these members have fewer emergency room visits? Is BMI going down? Is A1c more controlled?

Q30. Regarding insurance coverage: please define what is meant by ‘Medical Management

Decisions’ and ‘Provider Contracting’.

A30. Please use this space to confirm the Service Provider can meet the revised insurance requirements attached as part of this addendum.

Q31. Are there specific goals related to Public Safety Employees (law enforcement, corrections, fire/EMS, 911 telecommunicators, etc.) being eligible to use the Wellness Center? (e.g., recruitment/retention tool; cost containment, improving core health and reducing workplace injuries; reducing overall risk/liability costs).

A31. In general, the County promotes the Wellness Center as a recruitment/retention tool and supports the philosophy that there are opportunities to contain cost and improve core health and reduce cost, but currently there are no department specific metrics or goals.

The County welcomes ideas or recommendations within proposal submissions.

Q32. Are there specific health related metrics or reporting related to Public Safety Employees to measure outcomes and effectiveness of the Wellness Center operation? (For example, analysis of Public Safety Employee workplace injury rates, analysis of third-party liability claims.).

A32. This is not in place currently, but the County welcomes ideas or recommendations within proposal submissions.

Q33. Does the County have any specific utilization targets for Fire/EMS Personnel and Law

Enforcement Officers and their dependents?

A33. Currently, public safety and their spouses have the lowest Wellness Center and Wellness

Program utilization. However, the County welcomes ideas, strategies, and recommendations to increase utilization for these departments.

Q34. Please provide detail related to the Public Safety Physicals, pre-employment, annual, or otherwise including specific requirements of those exams, the time typically allotted for those exams, and whether they are typically completed in one or multiple visits.

A34. For public safety, most pre-employment screenings are made up of 2-parts and can take between 45-60 minutes each. The initial appointment would include a vision Titmus, audio, spirometry, EKG, drug screening, TB test, and labs. The follow-up appointment with the Occupation Health physician would include a full physical and TB reading.

Q35. Does the Wellness Center perform targeted outreach to specific types of employees such as fire/EMS, law enforcement, public works that is different than general outreach to the employee population? If so, please describe.

A35. No.

Q36. Does the Wellness Center provide targeted programming or services to support the health issues that can arise from specific types of occupations such as Fire/EMS, law enforcement, public works, etc.? If so, please describe.

A36. No.

Q37. Does the Wellness Center have a care philosophy for integrating occupational health, behavioral health, and primary care services generally and, in particular, for first responders? If so, please describe.

A37. The County currently does not have a philosophy, but the first responders are introduced to the Wellness Center for pre-employment physical and provided ongoing support for behavioral health through the EAP, multiple mental health solutions provided by Kaiser and Aetna, as well as a specialized First Responder Peer Support program. As part of the Wellness Program, first responders are also encouraged and incentivized to utilize the Wellness Center.

Q38. Do the Wellness Center staff currently participate in new employee orientation?

A38. Yes.

Q39. Does the current Wellness Center operation help patients navigate medical care when services are needed outside of the Wellness Center (i.e., subspecialty care) or other health and wellness resources such as an EAP program? If so, what protocols/resources are currently utilized?

A39. The County strives for the Wellness Center staff to be well versed on all the resources made available to employees to include referring to specialty care management programs and other mental health resources including EAP services. Specifics of the programs and protocols can be provided to the awarded Service Provider.

Q40. Does the current Wellness Center operation provide reporting on referrals to third-party providers? If so, please provide a sample copy.

A40. The Wellness Center currently provides limited reporting on third party referrals and follow-ups. The County is interested in more detailed reporting.

Q41. Has there been an increase in use of medical benefits and EAP programs through the work of the Wellness Center?

A41. This metric is not currently tracked but the County welcome any capabilities.

Q42. Does the County currently receive reports on patient referrals made by the Wellness

Center? If so, please provide an example.

A42. See A40.

Q43. How often does the County currently receive reporting on health outcomes? Is reporting on these outcomes reflected in the ROI? Please provide an example of this reporting.

A43. The County receives non-health related utilization reporting weekly and health outcomes reporting annually. Reporting on health outcomes is a metric the County would like to receive moving forward.

Q44. Does the County currently receive reporting on health plan costs attributable to members engaged with the Wellness Center versus non-engaged members? Please provide an example.

A44. No.

Q45. What is the current utilization of wellness visits for those on the self-funded plan?

A45. Please see the utilization reporting provided with the request for proposal supporting documents.

Q46. Please specify which Plan the 2,647 employees that require Occupational Health services are on.

A46. Generally, the employees who require Occupation Health are not yet enrolled in a medical plan because services are engaged pre-employment in the form of post offer physicals and fitness for duty. The Service Provider will serve the entire County population for Occupation Health regardless of health plan enrollment.

Q47. Financial Excel Form: Primary Care Cost tab – Line 38 “Supplies” line item includes

Vaccinations and Injections; A Service Provider typically bills these items as a pass-through expense monthly with the Labs and Dispensed Medications. Is it acceptable for Service Providers to include all of these items under line 49 “Billed as incurred consumables”?

A47. Yes

Q48. Financial Excel Form: Primary Care Cost tab – The top section of the form under the

Projected Eligible Participants is missing. Please provide the latest current annual utilization for each of the health center appointment types and the Eligible Participants?

The instructions state to base the estimated costs on the pre-determined information stated above, but the table is not populated.

A48. Please find an updated Financial Questionnaire along with this Addendum (RP040-23 Gwinnett Wellness Center Administration RFP FINANCIAL UPDATED 112023.XLSX).

Q49. The request for proposal requests three pricing options, but the cost tabs on the Financial

Excel form do not align with those three options. How does the County prefer Service Providers to present the pricing for all three options?

A49. See A48.

Q50. Financial Excel Form: “Utilities” line item 44, is the County expecting Service Providers to cover the annual cost of Gas/Electric and Water/Sewage services?

A50. No. The County pays for gas/electric/water/sewage/etc. Please disregard the request for “Utilities”.

Q51. Current Staff Model: Do the current 2.0 FTE Medical Assistants (listed on the Primary Care

Cost tab) provide support to the Occupational Medicine Physician and services? If not, should Service Providers include support staff for the requested Occupational Medicine services?

A50. Yes, the Medical Assistants provide support for the Occupation Medicine physician and services.

Q51. Financial Excel Form: Occupational Medicine 16hrs tab – Please provide the Quarterly

Average utilization including participants and Appointment types? The instructions request Services Providers to base annual cost for the services on the utilization provided, but the table above is blank.

A51. See A48.

Q52. Will the County indemnify the winning Service Provider for any supplies and pharmaceuticals purchased and passed to Kaiser?

A52. According to Georgia Law, the County cannot indemnify any other entity. For purposes of this solicitation, please disregard the Kaiser portion of the dispensary.

Q53. Can the County provide employee count by location?

A53. The County does not currently have this information available but can be provided to the awarded Service Provider.

Q54. Can the County provide current and proposed eligibility counts for the Premise operation broken out by: Employees age 18+; Spouses age 18+; dependents age 6+; dependents age 12+.

A54. The County does not maintain member level census data. There are approximately 2,700 dependents enrolled in the Aetna plan. Based on enrollment tiers, the County estimates approximately 1,550 dependents are under age 18 and approximately 1,150 dependents are 18+.

Q55. Can the County provide the current dollar incentive for biometric screenings; what is participation rate in biometric screenings; are the biometric screenings done in the Center or via 3rd party provided “events”.

A55. Completing a biometric screening and a wellness assessment can earn employees a health insurance premium reduction and acts as a gateway activity that unlocks their ability to earn additional incentive funding. Once the gateway activities are complete, employees and spouses can earn through completing activities within different wellness pillars, which converts to an incentive payout. Biometric screenings can be completed at the Wellness Center, personal physician, at a local Quest Diagnostic facility, or at an onsite County biometric event. See A18 for biometric screening utilization through 10/17/2023.

Q56. Can the County provide insight into utilization by month by visit type (e.g., 30-minute vs hour-long) for the current Premise operation?

A56. The utilization provided is the most detailed available. Generally, acute care and follow-up appointments are scheduled in 30-minute blocks, while annual physicals are typically scheduled for 60-minutes.

Q57. Can the County provide a footprint of the current Center setup; is there any adjacent/nearby space available either at this site or close by?

A57. Please see the clinic layout received with the request for proposal documents. There is no additional building space other than what is outlined.

Q58. Are the Kaiser patients (and Kaiser care team) located in the same physical space or in a separate area?

A58. Kaiser uses 2 exam rooms and Premise uses 2 exam rooms. The patients do not cross over exam rooms. The waiting area, the lab, and the dispensary are all shared spaces.

Q59. Will the awarded Service Provider be physically sharing space with Kaiser?

A59. See A58.

Q60. As the awarded Service Provider is responsible for supplies, how does the Service Provider charge Kaiser for supplies delivered to Kaiser patients?

A60. The awarded Service Provider will not charge Kaiser for the supplies. The supplies for

Kaiser care should be included as part of the proposal response.

Q61. What does the County classify as ancillary visits?

A61. Ancillary visits would be considered health coaching, wellness consultation, blood draws for follow-up appointments, and telemedicine.

Q62. The Read Me First document indicates that there is a 400-character limit next to each response cell on the RP040-23 Gwinnett Wellness Center Administration RFP QUESTIONNAIRE FINAL document; however, the cells currently allow 400+ characters without error. Please confirm if responses with more than 400 characters are accepted on the wellness center questionnaire tab in column F.

A62. Yes. However, the County is requesting responses be concise and not use excessive boiler plate information.

Q63. Please provide a breakdown of the number of spouses and dependents on the Aetna health plan.

A63. The County does not maintain member level census data. There are approximately 2,700 dependents enrolled in the Aetna plan. Based on enrollment tiers, the County estimates approximately 1,400 spouses.

Q64. What are the driving factors for the County to resolicit? Are there specific pain points/opportunities for service improvement?

A64. See A10

Q65. Given the contract effective date is now July, what will be the timeline for decision/selection of vendor partner?

A65. The County anticipates making a decision on a Wellness Center partner in early 2024.

This will allow a full 90 days for implementation.

Q66. Please describe the after-hours care and/or on call services that the County has access to today. Is the service provided by the current Wellness Center Service Provider or through the carrier? If that service is not currently provided, would there be an interest in adding that offering?

A66. The current Wellness Center administration contract does not include afterhours/on call services. However, for Kaiser members they have access to 24-hour nurse line and Aetna has access to Teladoc for all after-hours care. If a Service Provider recommends additional service as part of the proposed strategy, please outline applicable additional costs associated with this service in the Financial proposal.

Q67. What is the time frame allotted for appointments today? 15 minutes? 20 minutes? Longer?

A67. See A56.

Q68. Would the County be able to provide claims data to the Wellness Center Service Provider for closure of gaps in care and performance guarantee analysis?

A68. Upon contract award, downstream claims integration will be considered.

Q69. Does the supply, medication, vaccine and lab spend per the Cost Tabulation include Kaiser use or has that been parsed out?

A69. The medical supplies line item is the only item that includes Kaiser use. The medication dispensary was previously shared but that dispensary was discontinued as noted by the $0.00 listed in the cost tabulation.

Q70. Are members currently able to message the care team with questions?

A70. There are limited messaging capabilities and the County is unaware of current utilization.

Q71. What labs/metrics are included as part of the biometric screening program?

A71. Currently, the biometric screening at the Wellness Center includes a full blood panel, blood pressure, height, weight, and waist circumference.

Q72. Are there specific reporting requirements required of the Wellness Center Service Provider to assist with supporting the wellness incentive program?

A72. Yes, a monthly file is sent to our Wellness vendor on a monthly basis to trigger activities within the wellness program. The County would prefer these files to be delivered more frequently.

Q73. Is there a representative provided by the current Service Provider that assists with wellness and enrollment fairs, new hire orientations and stewardship meetings? If so, is that a member of the Wellness Center clinic staff or account management team?

A73. The current Health Advocate assists with orientations and events as needed and the providers assist in larger County events. The Account Management team facilitates stewardship meetings.

Q74. How are referrals to community specialists handled today?

A74. Referrals are given to members and it is up to the member to complete follow-up.

Q75. With the 450 occupational exams that were sent to outside providers, were those exams spread out throughout the year or is there a time of year where hiring is exceptionally busy?

A75. Please refer to the WC Utilization 2020-2022 excel file that was included with the request for proposal release. The last tab, labeled “Occ Health Outsourced Visits” categorizes these visits, with dates included.

Q76. With the seasonal employees (lifeguards) fit for duty, is there a compressed timeframe for those exams to be completed? What typically is the volume?

A76. Seasonal employees (lifeguards) are usually funneled through the Wellness Center within a 1-month block timeframe during the spring, which could exceed 100 candidates.

Q77. What is the biggest challenge associated with engagement?

A77. Awareness of services is a big challenge. The County is not confident all employees know about all the services available and that the Service Provider is thoroughly engaged and supportive with the current County culture that aligns with our overall strategy.

Q78. Is the County interested in a dedicated Account Manager as part of the staffing model to assist with the strategic vision of the Wellness Center programming and be available to participate in County sponsored events as a representative of the Wellness Center?

A78. An Account Manager to help implement the strategic vision is critical to the success of the facility. The County expects an Account Manager to be part of the staffing model but realize a dedicated Account Manager may not be viable.

Q79. For the financial response sheet, may a Service Provider add additional tabs to show recommended “ideal state” or does the County prefer the Service Provider add rows to the primary care tab of additional service lines available?

A79. If additional information is needed to demonstrate your ideal state, please add it.

Q80. What are the current performance guarantees included in the Premise contract?

A80. Current performance guarantees include metrics for 1) patient satisfaction, 2) administrative and financial measures, and 3) chronic condition testing, i.e., A1c testing and control, blood pressure testing and control, BMI screening and follow-up, and depression screening and follow-up.

Q81. On the financial exhibit there is a place for Furnishings, Fixture and Equipment under each section for implementation. Will there be any current furniture and/or equipment that will stay in place? If so, please provide that information.

A81. All furnishings, fixtures, and equipment will remain in the facility. The County owns everything inside the facility.

Q82. Has the County ever considered adding additional Wellness Center locations?

A82. In the past, additional locations were not considered, but the County is willing to hear any suggestions or recommendations to increase access to care for all County employees and families.

Q83. With the current staffing model, is there a receptionist in place? If yes, how many hours are worked per week?

A83. The Medical Office Assistants serve in the reception capacity and each work 40 hours per week.

Q84. Is there currently a part time or full time Clinic Manager for the Wellness Center? If no, is there a desire for a part time or full time Clinic Manager for the Wellness Center A84. Currently, Premise and Kaiser have Clinic Managers who are full time employees of each respective organization. The role of those Clinic Managers is to serve as a liaison between the County, the respective organization, and the Clinic Staff and support implementation of the strategy into the facility. However, the Premise Clinic Manager is the only one onsite and dedicated to the County.

Q85. Is there an interest in adding additional services such as mental health or physical therapy to the Wellness Center?

A85. There is currently an on-site counselor staffed as part of the County’s EAP contract.

Additional mental health or physical therapy will not be part of this contract in year one, but the County is interested in understanding capabilities as strategy evolves.

Q86. Do Service Providers need to print the excel portions of the proposal response?

A86. Yes. The physical copies should be identical to the digital copies of submittals.

Q87. Please explain the chart on Page 6 of the Read Me First regarding Medicare eligibility, blended families, and who is eligible for the Wellness Center.

A87. This chart was intended to explain the landscape of medical plan enrollment. Members enrolled in the Medicare Advantage plan are not eligible to utilize the Wellness Center.

Only those enrolled in an Aetna or Kaiser plan who are 18+ may utilize the Wellness Center. Blended Retiree plans indicate that there is one person enrolled in Medicare; the member not on Medicare in this case would be able to access the Wellness Center.

Attachments

• Professional Liability Insurance Requirements

• RP040-23 Gwinnett Wellness Center Administration RFP FINANCIAL UPDATED

112023.XLSX

Acknowledge receipt of this addendum on Page 16 of the Read Me First document.

Sincerely, Dana Garland, CPPB, FOII, NIGP-CPP Purchasing Division

PROFESSIONAL SERVICES I NSURANCE REQUIREMENTS

(For projects more than $5,000,000 but less than $10,000,000)

1. Statutory Workers' Compensation Insurance

(a) Employers Liability:

Bodily Injury by Accident - $100,000 each accident Bodily Injury by Disease - $500,000 policy limit Bodily Injury by Disease - $100,000 each employee

2. Commercial General Liability Insurance

(a) $1,000,000 limit of liability per occurrence for bodily injury and property damage

(b) The following additional coverage must apply:

1986 (or later) ISO Commercial General Liability Form Dedicated Limits per Project Site or Location (CG 25 03 or CG 25 04) Additional Insured Endorsement (Form B CG 20 10 with a modification for completed operations or a separate endorsement covering Completed Operations)

Blanket Contractual Liability Broad Form Property Damage Severability of Interest Underground, explosion, and collapse coverage Personal Injury (deleting both contractual and employee exclusions) Incidental Medical Malpractice Hostile Fire Pollution Wording

3. Auto Liability Insurance

(a) $500,000 limit of liability per occurrence for bodily injury and property damage

(b) Comprehensive form covering all owned, non-owned, leased, hired, and borrowed vehicles

(c) Additional Insured Endorsement

(d) Contractual Liability

4. Professional Liability Insurance (Medical Malpractice) - $5,000,000 limit of liability per claim and $20,000,000 aggregate.

Insurance company must be authorized to do business in the State of Georgia.

Dedicated Limits per Project Site or Location (CG 25 03 or CG 25 04 or some other form)

Coverage which meets or exceeds the minimum requirements shall be maintained, purchased annually, in full force and effect until three (3) years past completion of the entire construction phase unless such coverage becomes unavailable in the market on a commercially reasonable basis, in which case the ENGINEER shall notify the Insurance Manager. If the Director of the Department for which the ENGINEER is doing the work and the Insurance Manager both agree that such coverage is not commercially reasonably available (such agreement not to be unreasonable upheld, the ENGINEER may for the period such coverage is not commercially reasonably available, elect not to provide such coverage.

5. Gwinnett County Board of Commissioners (and any applicable Authority) should be shown as an additional insured on General Liability and Auto Liability policies.

6. The cancellation should provide 10 days notice for nonpayment and 30 days notice of cancellation.

7. Certificate Holder should read:

Gwinnett County Board of Commissioners 75 Langley Drive Lawrenceville, GA 30046-6935

8. Insurance Company, except Worker' Compensation carrier, must have an A.M. Best Rating of A-10 or higher. Certain Workers' Comp funds may be acceptable by the approval of the Insurance Unit. European markets including those based in London and domestic surplus lines markets that operate on a non-admitted basis are exempt from this requirement provided that the contractor’s broker/agent can provide financial data to establish that a market is equal to or exceeds the financial strengths associated with the A.M. Best’s rating of A-10 or better.

9. Insurance Company should be licensed to do business by the Georgia Department of

Insurance.

*See above note regarding Professional Liability

10. Certificates of Insurance, and any subsequent renewals, must reference specific bid/contract by project name and project/bid number.

11. The Contractor shall agree to provide complete certified copies of current insurance policy(ies) or a certified letter from the insurance company(ies) if requested by the County to verify the compliance with these insurance requirements.

12. All insurance coverage required to be provided by the Contractor will be primary over any insurance program carried by the County.

13. Contractor shall incorporate a copy of the insurance requirements as herein provided in each and every subcontract with each and every Subcontractor in any tier, and shall require each and every Subcontractor of any tier to comply with all such requirements.

Contractor agrees that if for any reason Subcontractor fails to procure and maintain insurance as required, all such required Insurance shall be procured and maintained by Contractor at Contractor's expense.

14. No Contractor or Subcontractor shall commence any work of any kind under this Contract until all insurance requirements contained in this Contract have been complied with and until evidence of such compliance satisfactory to Gwinnett County as to form and content has been filed with Gwinnett County. The Acord Certificate of Insurance or a preapproved substitute is the required form in all cases where reference is made to a Certificate of Insurance or an approved substitute.

15. The Contractor shall agree to waive all rights of subrogation against the County, the Board of Commissioners, its officers, officials, employees, and volunteers from losses arising from work performed by the contractor for the County.

16. Special Form Contractors’ Equipment and Contents Insurance covering owned, used, and leased equipment, tools, supplies, and contents required to perform the services called for in the Contract. The coverage must be on a replacement cost basis. The County will be included as a Loss Payee in this coverage for County owned equipment, tools, supplies, and contents.

17. The Contractor shall make available to the County, through its records or records of their insurer, information regarding a specific claim related to any County project. Any loss run information available from the contractor or their insurer relating to a County project will be made available to the County upon their request.

18. Compliance by the Contractor and all subcontractors with the foregoing requirements as to carrying insurance shall not relieve the Contractor and all Subcontractors of their liability provisions of the Contract.

19. The Contractor and all Subcontractors are to comply with the Occupational Safety and

Health Act of 1970, Public Law 91-956, and any other laws that may apply to this Contract.

20. The Contractor shall at a minimum apply risk management practices accepted by the contractors’ industry.

Surety Bonds (If Required)

All of the surety requirements will stay the same except the Surety Company must have the same rating as item 8 above.

Rev 06/11