S000000357 Plan Administration System RFP~2.pdf

STATE OF ARKANSAS

DEPARTMENT OF TRANSFORMATION AND SHARED SERVICES

OFFICE OF STATE PROCUREMENT

501 Woodlane St., Ste. 220

Little Rock, Arkansas 72201-1023

REQUEST FOR PROPOSAL

SOLICITATION DOCUMENT

SOLICITATION INFORMATION

Solicitation Number: S000000357 Solicitation Issued: October 29, 2024

Description: Plan Administration System & Related Services

Department: Transformation and Shared Services – Employee Benefits Division

SUBMISSION DEADLINE AND DELIVERY OF RESPONSE DOCUMENTS

Proposal Opening Date: November 25, 2024 Proposal Opening Time: 10:00 am, Central Time

Proposal submissions for this Request for Proposal must be submitted through ARBuy, the State’s eProcurement system. It can be accessed at arbuy.arkansas.gov. Proposals received after the submission deadline may be rejected as untimely.

LIVE PROPOSAL OPENING INFORMATION

Teams Meeting Link: Join the meeting now Meeting ID: 265 370 376 837 Passcode: t63xH Call in (audio only): +1 501-244-3310,,476795915# United States, Little Rock

TSS OFFICE OF STATE PROCUREMENT CONTACT INFORMATION

TSS OSP Procurement Specialist: Shane Phillips Procurement Specialist’s

Direct Phone Number: 501-324-9322

Email Address: Shane.Phillips@arkansas.gov TSS OSP’s Main Number: 501-324-9316

TSS OSP Website: transform.ar.gov/procurement/ https://arbuy.arkansas.gov/ https://teams.microsoft.com/l/meetup-join/19%3ameeting_N2FhMDc4ZTItN2YwYy00N2U0LTk1NGYtN2U4NzAwMDU5ZmI4%40thread.v2/0?context=%7b%22Tid%22%3a%225ec1d8f0-cb62-4000-b327-8e63b0547048%22%2c%22Oid%22%3a%2276b67dc6-870d-48b1-861f-b3cbdd49eeb2%22%7d tel:+15012443310,,476795915 mailto:Shane.Phillips@arkansas.gov https://www.transform.ar.gov/procurement/

Rev 5/2024

SECTION 1 – GENERAL INFORMATION AND INSTRUCTIONS

1.1 INTRODUCTION

This Request for Proposal (RFP) is issued by the TSS Office of State Procurement (TSS OSP) for the Employee Benefits Division (“EBD” or “Department”) to obtain pricing and a contract(s) with a Technology Provider for an integrated Plan Administration System.

The Contract will be awarded to the Prospective Contractor determined to have submitted the proposal that is the most advantageous to the State. Direct all questions, comments, or concerns regarding this solicitation to the TSS OSP, not the Department.

1.2 TYPE OF CONTRACT

A. As a result of this RFP, TSS OSP intends to award a contract to a single Contractor.

B. The anticipated starting date for any resulting contract is January 2025, except that the actual contract start date may be adjusted unilaterally by the State for up to three (3) calendar months. By submitting a signed proposal in response to the RFP, the Prospective Contractor represents and warrants that it will honor its proposal as being held open as irrevocable for this period.

C. The initial term of a resulting contract will be for three (3) year. Upon mutual agreement by the Contractor and Department, the contract may be renewed by TSS OSP for up to four (4) additional one-year terms or portions thereof, not to exceed a total aggregate contract term of seven (7) consecutive years.

1.3 DEFINITION OF TERMS

A. Unless otherwise defined herein, all terms defined in Arkansas Procurement Law have the same meaning herein.

B. “Prospective Contractor” means a responsible offeror who submits a proposal in response to this Solicitation.

C. The terms “Request for Proposal,” “RFP,” and “Solicitation” are used synonymously in this document.

D. “Requirement” means a term, condition, provision, deliverable, Specification, or a combination thereof, that is obligated under the Solicitation, resulting contract, or both.

E. “Responsive Proposal” means a proposal submitted in response to this Solicitation that conforms in all material respects to this RFP.

F. “Shall” and “must” mean the imperative and are used to identify Requirements.

G. “Specification” means any technical or purchase description or other description of the physical or functional characteristics, or of the nature, of a commodity or service. “Specification” may include a description of any Requirement for inspecting, testing, or preparing a commodity or service for delivery.

H. “State” means the State of Arkansas. When the term “State” is used herein to reference any obligation of the State under a contract that results from this Solicitation, that obligation is limited to the Department using such a contract.

1.4 SOLICITATION SCHEDULE

For informational purposes, TSS OSP is providing a Solicitation Schedule; however, dates listed and noted with an asterisk (*) are anticipated dates only and are subject to change at the discretion of the State. All times are listed in Central Time.

TABLE A: TENTATIVE SOLICITATION SCHEDULE

ACTIVITY DATE

RFP Release to Prospective Contractors October 29, 2024 Deadline for Prospective Contractor Questions November 5, 2024 Answers to Questions Posted to ARBuy* November 12, 2024 Proposal Due Date November 25, 2024 @ 10 am Evaluation Training November 25, 2024 Initial Proposal Evaluation* November 26, 2024 Interviews* December 2, 2024 Final Proposal Evaluation* December 2, 2024 Discussions Kick Off Meeting* December 4, 2024 Finalize Discussions* December 20, 2024 Post Anticipation to Award* December 20, 2024 Award Contract* January, 2025

1.5 CLARIFICATION OF SOLICITATION

A. Submit questions requesting clarification of information contained in this Solicitation via the

Solicitation posting in ARBuy by the date and time listed in Table A.

1. For each question submitted, Prospective Contractor should reference the specific Solicitation item number to which the question refers, as applicable.

2. Prospective Contractors’ written questions will be consolidated and responded to by the State as deemed appropriate. The State’s consolidated written response is anticipated to be posted to the Solicitation posting in ARBuy by the close of business on the date provided in Table A. If Prospective Contractor questions are unclear or non-substantive in nature, the State may request clarification of a question(s) or decline to answer.

B. The Prospective Contractor should notify the TSS OSP Procurement Specialist of any Requirements that precludes the Prospective Contractor from submitting a Responsive Proposal.

C. Prospective Contractors may contact the TSS OSP Procurement Specialist with non-substantive questions at any time prior to the proposal opening.

D. An oral statement by TSS OSP will not be part of any contract resulting from this Solicitation and may not reasonably be relied on by any Prospective Contractor as an aid to interpretation unless it is reduced to writing and expressly adopted by TSS OSP.

E. Only an addendum written and authorized by the State will modify the Solicitation.

1.6 RESPONSE DOCUMENTS

A. All proposal responses must be submitted through ARBuy, the State’s eProcurement system. The system can be accessed at arbuy.arkansas.gov.

1. Prospective Contractors must be registered in ARBuy to submit proposals responses.

B. Technical Proposal Packet

1. Prospective Contractors shall utilize the Technical Proposal Packet to submit their responses.

2. The following items are proposal Submission Requirements and must be submitted as part of a Prospective Contractor’s proposal response.

https://arbuy.arkansas.gov/

a. Signed Proposal Signature Page; signature may be ink or digital.

b. Technical Proposal response to the Information for Evaluation section included in the Technical Proposal Packet, which must be in the English language.

c. Completed Official Solicitation Price Sheet attached to the Solicitation in ARBuy.

i. Pricing must be proposed in U.S. dollars and cents.

ii. Quantities stated are estimates only and are not guaranteed. Prospective Contractor must submit unit price on the estimated quantity and unit of measure specified.

• The State may order more or less than the estimated quantity on term contracts, and the Contractor shall sell to the Department quantities ordered at no more than the submitted price.

iii. If pricing documents do not allow for accurate pricing, Prospective Contractor should notify the OSP Procurement Specialist at least seventy-two (72) hours before the proposal opening time.

iv. Prices must be firm offers.

v. Discount from list pricing is not acceptable unless requested elsewhere in the Solicitation.

vi. State or local sales taxes should not be included in the price. Trade discounts should be deducted from the unit price and the net price should be shown in the pricing response.

d. Recommended Options Form

i. The Recommended Options form included in the Technical Proposal Packet allows Prospective Contractors to identify any recommended options or optional service ideas that may benefit the State that were not included in the Requirements and the proposed solution.

e. Copy of Prospective Contractor’s Equal Opportunity Policy

i. Pursuant to Arkansas Code Annotated § 19-11-104, OSP requires a Prospective Contractor bidding on a state contract to submit a copy of the Prospective Contractor’s Equal Opportunity (EO) Policy.

ii. Prospective Contractors not required by law to have an EO Policy must submit a written statement to that effect.

f. Proposed Subcontractors Form (see SRV-1, section 14)

3. The following items, which must be submitted prior to a contract award to the Prospective Contractor, may also be included with the Prospective Contractor’s proposal:

a. EO 98-04: Contract and Grant Disclosure Form (see SRV-1, section 11)

b. Voluntary Product Accessibility Template (VPAT), if applicable

4. Prospective Contractors should not include any other documents or ancillary information, such as a cover letter or promotional/marketing information.

C. Redacted copy of the Technical Proposal Packet

1. One (1) redacted (marked Redacted) copy of the Prospective Contractor’s proposal response (see Proprietary Information), if applicable.

D. Prospective Contractors should not alter language in Solicitation document(s) or Official Solicitation Price Sheet provided by the State.

https://www.transform.ar.gov/wp-content/uploads/Services-Contract-SRV-1-Fillable-Form-V.3.6.27.22.pdf https://www.transform.ar.gov/wp-content/uploads/Services-Contract-SRV-1-Fillable-Form-V.3.6.27.22.pdf https://www.section508.gov/sell/vpat/

E. Prospective Contractor’s proposals cannot be altered or amended after the proposal opening except as permitted by law or rule.

F. Prospective Contractors may submit multiple proposals.

SECTION 2 – REQUIREMENTS

2.1 BACKGROUND AND CURRENT ENVIRONMENT

EBD is responsible for administering the State and Public-School employees’ health insurance benefits as a self-funded insurance plan. A fundamental financial objective of EBD is to ensure due diligence in managing the plan in a fiscally sustainable manner.

EBD uses their current Plan Administration System to house all member historical information, as a communication tool between vendors, and a form repository. The system sends confidential information between HR in the state and public-school systems that are associated with members to look at eligibility for coverage and set up/make changes.

TPA and PBMs pull up info on members and their accounts and share files on members. There is a repository of documents for every member – EOB and claims from TPA; EBD documents that system generates on timelines and other criteria.

As of February 2024, EBD has approximately 184,000 total covered participants and dependents (for its self-funded plan). The following table displays the self-funded counts:

SELF-FUNDED

PLAN ENROLLMENT as of February 15, 2024

Participant Dependent Total Count

STATE ACTIVE 23,363 15,869 39,232

PUBLIC SCHOOL

- ACTIVE 47,813 35,201 83,014

STATE RETIREES 13,227 3,476 16,703

PUBLIC SCHOOL

-RETIREES 19,345 2,232 21,577

STATE – COBRA 71 45 116

PUBLIC SCHOOL

- COBRA 100 63 163

STATE – NO

HEALTH 5,123 0 5,123

PUBLIC SCHOOL

– NO HEALTH 18,257 0 18,257

TOTAL 127,299 56,886 184,185

2.2 OBJECTIVES & GOALS

EBD seeks to hire a technology provider with experience working with member administration, customer relations, accounting, medical claims data, and pharmacy claims to implement a Plan Administration System and provide related services.

2.3 SCOPE OF SYSTEM ARCHITECTURE

A. The current system architecture is described below:

1. Server Information

a. Application Server OS: Red Hat Enterprise Linux release 9.3

b. Database Server OS: Red Hat Enterprise Linux release 9.3

c. Batch Server OS: Red Hat Enterprise Linux release 9.3

d. Change Management Server (JIRA) OS: Cloud based

e. EDI Server: Microsoft Windows Server 2019 Standard 10.0.17763

2. Technology Stack

a. Java: Open JDK 17.35

b. PostgreSQL: 14.10

c. Wicket: 7.9.0

d. JBoss: 7.4.

e. Jasper Reports: 6.1.0

f. Spring: 4.3.9

g. Hibernate: 5.3.24.Final

h. Jenkins: 2.426.2

i. Nexus: 3.61.0-02

j. Bitbucket: Cloud

k. Confluence: Cloud

l. ProEDI: 4.3.2

2.4 PROSPECTIVE CONTRACTOR MINIMUM QUALIFICATIONS

A. The Prospective Contractor shall have a minimum of five (5) years of experience related to providing technology to public entities and/or the healthcare insurance industry.

B. The Prospective Contractor shall have a minimum of five (5) years consulting experience with health care plans with a minimum of one hundred thousand (100,000) covered lives.

C. The Prospective Contractor shall possess at least three (3) years of development experience with a public sector customer using agile methodology, human centric design, accessibility, practice with similar size and scope to design and develop digital services applications.

D. The Prospective Contractor shall be appraised at Capability Maturity Model Integration (CMMI) Level 3 Development or CMMI Level 3 Services and shall maintain certification throughout the term of the contract..

E. The Prospective Contractor shall be an AWS Advanced Public Sector Partner and shall remain an AWS Advanced Public Sector Partner throughout the aggregate term of a resulting contract.

F. The Contractor shall have experience in compliance with all relevant healthcare and medical privacy laws and regulations, including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Patient Protection and Affordable Care Act (PPACA).

G. The Prospective Contractor shall disclose all breaches of HIPAA information over the last ten (10) years. The Prospective Contractor should include this information as part of the RFP response.

2.5 REGULATIONS & COMPLIANCE

A. The Contractor shall maintain compliance with all applicable State and Federal laws as they pertain to the administration and management of the services described herein.

B. The Contractor shall provide any changes and/or updates to the system to implement Federal or State required changes during the contract period. Changes and/or updates must comply with State or Federal implementation deadlines at no additional cost to the State. Any required updates must be implemented in a timely fashion and should be implemented outside of normal system operating hours to minimize disruptions to operations.

2.6 GENERAL REQUIREMENTS

A. The Contractor shall propose either a Commercial Off the Shelf (COTS) solution that is customizable and configurable to meet the requirements of the RFP or a custom-built solution.

B. The system must minimize and eliminate human error by automating functionality and eliminating reliance upon the Contractor for reporting requests, file and report submission, etc.

C. The system must provide a profile mechanism so that when the HIR calls in, claims and reviews they submitted are connected to them easily.

D. The system must have the ability to switch a member from “retiree” to “active” on same coverage level without starting their deductible over.

E. The system demographic notes must be simple and easy to translate.

F. The system must be efficient and reduce instances of redundancy, such as repetitive entry of dates and lack of editable document names.

G. The system must allow for direct note deletion by Supervisory roles, with a 2-step verification before deletion.

H. The system must allow the user to search for a task number.

I. The system shall handle file creation and transfers to the IRS and different vendors, including the resubmission of any corrected files. See Attachment A: Document Types for a list of example documents the system may need to create and transfer.

J. The system must flag errors on forms or within files for correction prior to allowing submission.

K. The system must allow users to save progress on a form or file for later completion, including forms or files with errors.

L. The system must have the capability to remove tasks that are no longer used.

2.7 PHARMACY REVIEW

A. The system must have Pharmacy Review functionality that includes, but is not limited to, the following:

1. Reviewing member claims

2. Import from and export to formats mutually agreed upon and approved by EBD (pharmacy and medical)

3. Uploading and categorizing documents

4. Viewing appeals

5. Attaching documents to a member's record

6. View/add call notes

7. Generate pharmacy audit queries

8. Create/view/respond to secure tasks

9. See member history as we currently can in the coverage bands. (This is needed for eligibility reconciliation in the PBM system.)

10. See if a member is on the MAPD plan versus the ARBenefits health plan.

2.8 ACCOUNTING

A. The system must have a dedicated Accounting Management Tool that includes but is not limited to:

1. Ability for end-users to run ad-hoc reports.

2. Financial Reporting Capabilities-Accounts Receivable/Accounts Payable

3. Display Customer Information with balances (HIRs)

4. Multiple payment options; eCheck, online, Automated Clearing House (ACH), wire, over the phone payments

5. Real time verification of online payments

6. Email notification of payment files and verification reports

7. Integrates with the general ledger system (currently SAP)

8. Ability to print and send customer statements (printed or electronically)

9. Ability to make changes and adjustments with an approval feature

10. Ability to email reports directly from software to multiple addresses

11. Ability to create and customize letter templates in systems

B. The system must have other Accounting tools that include but are not limited to:

1. Ability to customize by user information on dashboard

2. Integration with the EBD Eligibility requirements

3. Integration with AASIS, Bank Accounts, Efinance

4. Security Authorizations

5. Workflow approvals (automated)

6. Tracking System (Notification, Alert, Reminders)

2.9 FINANCIALMANAGEMENT

A. The system must have a dedicated Financial Management tool that includes but is not limited to:

1. Ability to communicate with online banking module (i.e. download cancelled checks and import banking transactions.)

2. Ability to process multiple cash streams and bank accounts.

3. Report generation

4. Ability to report on both fiscal year and calendar year basis.

5. Ability to email reports directly from software to multiple addresses

6. Ability for end-users to run ad-hoc reports.

2.10 COLLECTION MANAGEMENT TOOL

A. The system must have a dedicated Collection Management tool that includes but is not limited to:

1. Ability to set up, track, and report on receipts by customer.

2. Automated Refund payment system

3. Ability to electronically approve payment of invoices.

4. Multiple payment options; eCheck, online, Automated Clearing House (ACH), wire, over the phone payments

5. Ability for end-users to develop ad-hoc reports from queries (save, create, modify, etc.)

6. Ability for users to easily export data to Excel, CSV, PDF, etc.

7. Ability to email reports directly from software to multiple addresses

8. Ability to make changes and adjustments with an approval feature

9. Ability to print and send customer statements (printed or electronically)

10. Online Customer portal/dashboard with payment

11. Ability to create and customize letter templates in systems

12. Collections functionality (viewable status, account contact information, etc.)

2.11 CUSTOMER CARE SCREENS

A. The system must allow call center employees to view the same information that is visible to members in the Member Portal. The Customer Care Screens and Member Portal may be accessed through the same portal with Customer Care functionality restricted to EBD staff via user roles.

B. The system must provide accurate information quickly and easily for call center personnel to see a snapshot of what is occurring with a members account. This information must include but is not limited to:

1. Name of Health Insurance Representative (HIR)

2. State Agency/School District of employment

3. Retiree System, if applicable

4. Hire/start date and term date

5. Links to Agency HIRs with their contact information.

C. An integrated automated answering system for the beginning of a call is preferred.

D. The system must be able to handle complex eligibility, plans, and rate structures.

E. The system must have decision support tools to help employees make informed decisions about their benefits.

F. The customer account must include accounting information so that EBD can view the entire history of a member, including but not limited to payments, contracts (coverage bands by Plan Type, etc.), authorizations, premium rate total, the amount they pay (which would reflect the difference from the total and the amount their employer pays).

G. The system must have a category module that allows an increased efficiency in selecting appropriate bands/coverage plans based upon existing data.

H. The system must have contractual aspects to assist in defining and ultimately selecting appropriate coverage.

I. The system must contain a repository of documents that are managed in different categories.

Examples include but are not limited to Member Documents, EOB Documents, and System Generated Documents.

J. The system must handle notifications within its framework, allowing users to work entirely within the system.

K. The system must allow the user to utilize hot keys to navigate without picking up a mouse.

L. The system must allow users to move fluidly from one request to another when processing forms and information.

M. The system must allow for document reception, updating, and integration by members and HR.

N. The system must allow multiple users to access the same screen concurrently.

O. The system must allow users to have the same member screen open in multiple windows.

P. The system must allow a single user to access multiple accounts concurrently.

Q. The system must recognize when a user account is already open and have a tiered system for updating a user account, based upon order of opening, level of access, or other strategies approved by EBD.

R. The system must allow users to add and access Call Notes from the member’s records.

S. The system must allow for a repository of often-used language to be housed within and be viewable by users, to include customizable call scripts accessible to Call Center personnel.

T. The system must clearly indicate when information, forms, etc. pertain to a dependent rather than the Primary/subscriber.

2.12 MEMBER PORTAL

A. The system must contain a “Member Portal”, a semi-customizable screen that allows users and members to, at minimum:

1. View and update account details (Ex- address, phone, email)

2. View documents submitted

3. View authorizations on file

4. Link to vendor websites (Delta Dental, United Health Care, etc.)

5. View and update accounting information

6. View status of appeals made by members and providers

B. The system must allow the Member to print their Certificate of Credible Coverage (COCC) in their portal.

2.13 DASHBOARD

A. The system must produce a real-time functioning, viewer-friendly, customizable dashboard with activity summaries to support the EBD decision-making process, measure performance, and provide reports on program metrics.

B. Each EBD and HIR user needs a customizable dashboard that shows:

1. Tasks lists (the number of calls logged, forms processed, and open messages they need to address, etc.)

2. Open Items that have received a response.

3. At minimum, the past 10 members they have worked on

C. Each Dashboard should have a menu of the highest used areas in the system and the utility to access those areas.

2.14 PLAN DESIGN MODELING

The Contractor shall provide plan design modeling and requirements to be used for an annual comprehensive report which shall be required to be made as a formal presentation to plan officials.

2.15 REPORTING AND ANALYTICAL REQUIREMENTS

A. The Contractor shall ensure the system provides a robust ad-hoc and pre-defined reporting functionality for agency use.

B. The Contractor shall ensure EBD can define new reports in the system and edit as needed without assistance or ongoing support from the Contractor.

C. If the Contractor’s proposed solution requires the use of a third-party reporting tool such as Crystal

Reports, the costs of any and all required licenses to operate the reporting tool with the system must be included in the licensing cost proposed in the Official Bid Price Sheet.

D. The system must be capable of restricting reporting access by user roles.

E. The system must meet all State and Federal reporting requirements.

F. The system must provide real-time reporting options from intuitive queries for all aspects of employee benefits:

1. Accounting

2. Customer care

3. Employee oversight

4. Legislative oversight

5. Auditing – both internal and legislative

G. The system must allow advanced filtering on account or transaction characteristics.

1. Example 1: A count of the youngest to oldest active member for ASE and PSE, we would like to be able to run that report instead of relying on the vendor to run it for us

2. Example 2: Total number of dependents the age of 25 in the Classic plan as of XX/XX/XXXX.

H. The system must allow EBD to query data without needing to rely on vendor.

I. The system must be able to export report data to a variety of formats such as:

1. .xls

2. .csv (, | or tab delimited)

3. .txt

4. .pdf

5. Other standard export formats

J. The system must produce financial reports at the transaction, account, and aggregate levels, daily or as needed.

K. The system must provide real-time, time-stamped insights and reporting on user communication performance.

L. The system must have the ability to develop and save queries at any time for all reportable fields in the system.

2.16 AUDIT FUNCTIONALITY

A. The system must have a logging, auditing, and reporting function to capture changes to applicant information and application/transaction statuses.

B. The system must track all inquiries and data changes including, but not limited to, the following:

1. Date and time of inquiry/modification

2. Type of activity

3. Identification of the user

4. All fields inquired and/or modified

C. The system must provide a searchable log of every record viewed, including the above information.

D. Authorized Users shall have the ability to login and view the audit details online.

E. The system must be able to run quarterly and annual audit samples when needed.

2.17 STAFFING

A. The Contractor shall provide a Staffing Plan during the Discussions phase. The Staffing Plan must, at minimum, meet all requirements set forth in this section of the RFP.

B. The Contractor shall include in the Staffing Plan a Project Manager. The Project Manager shall have a minimum of two (2) years of project management experience working with the implementation of projects of similar size and scope to this RFP.

C. The Project Manager shall report to the State assigned project manager and manage the Contractor resources, produce project schedule/plan, status reports, attend meetings, and manage the software development life cycle.

D. EBD shall have the right to approve or reject proposed staff members prior to the finalization of the plan after Contract Award.

E. The Contractor shall include, in the Staffing Plan, a provision to address the vacancies of the Project Manager or other key personnel. In the event of the vacancy of a key person, the Contractor shall provide replacement candidates to EBD for review within fifteen (15) Calendar Days of the Contractor learning of the vacancy. EBD shall have the right to approve or reject proposed replacements if they do not meet the minimum requirements set forth in the RFP.

F. The Contractor shall replace key personnel upon request by EBD for justified reasons including but not limited to performance, behavior, and security.

G. The Contractor shall provide and maintain sufficient staffing resources to provide timely service for the life of the contract.

H. The Contractor shall not propose resources who are currently engaged full time on other contracts with the State. A single resource may not hold more than one full time position with the State.

I. Background Checks

1. At commencement of contract award and prior to the hiring of staff, the Contractor shall conduct Federal and State Criminal Background Checks for the state of jurisdiction where the employee is located on all personnel involved in any aspect of the process described in this

RFP.

2. Upon request, the Contractor shall provide ADEE with access to Criminal Background Checks (including fingerprints) on all key personnel and subcontractors who perform or supervise work on this contract for purposes of auditing. Criminal Background Checks shall be provided to ADEE within 72 hours of the request from ADEE.

3. ADEE shall have the right to refuse personnel based on results of the criminal background checks.

4. The State shall have the right to terminate the entire contract should Criminal Background Reports show evidence of being tampered with, i.e. sections blocked out, dates of greater time than 72 hours, etc.

2.18 IMPLEMENTATION AND TESTING

A. The Contractor shall provide a proposed Implementation and Testing Plan during the Discussions phase. The Implementation & Testing Plan must, at minimum, meet all requirements set forth in this section of the RFP.

B. The Contractor shall complete all implementation activities and deliverables by the Go-Live Date.

C. The Contractor shall coordinate with all stakeholders to provide a smooth transition with minimal disruptions in services to insureds, employers, and HIRs.

2.19 TRAINING

A. The Contractor shall provide a proposed Training Plan during the Discussions phase. The Training

Plan must, at minimum, meet all requirements set forth in this section of the RFP.

B. Contractor shall provide all training sufficiently in advance to the “Go-Live” of the proposed system such that all Users required to be trained have had a sufficient amount of exposure to capably use the system.

C. The Contractor shall provide online tutorials such as video presentations about how the system works for all user types.

D. The Contractor shall provide live training sessions to EBD administrators as needed.

2.20 DATA CONVERSION

A. The Contractor shall work directly with EBD and/or current vendor to assist in transfer of account data into the new system.

B. The Contractor shall manage data optimization to reduce unnecessary tables during data conversion and data migration.

C. The Contractor shall cleanse and de-duplicate the data before it is integrated into the system.

D. The Contractor shall provide a review process for EBD’s designated staff to review and disambiguate duplicate records and make corrections to converted records as necessary.

E. Converted information must be available for use at time of Go-Live as if that information had been originally captured in the system.

F. The Contractor shall ensure there is no data loss throughout the process.

G. The current data being collected includes, but is not limited to, the following:

1. Health Claims Data: EOB Files

2. Pharmacy Claims Data

3. Demographic Information

4. Accounting Transaction Data: Deduction, Adjustments, Check Processing

H. The current volume of data processed includes, but is not limited to, the following:

1. Daily EOB Files: Occurs 4x Day, ~2gb

2. Daily Demographic Files: ~10kb

3. Daily Check Processing Files: ~ 5kb

4. Daily Pharmacy Claims: ~ 15mb

5. Weekly Demographic Reconciliation Files: ~20mb

6. Weekly Health Claims Files: ~300mb

I. The current format for file data includes, but is not limited to, the following:

1. .xlsx

2. .csv (, | or tab delimited)

3. .txt

4. .bat

5. .dat

6. .gpg

7. .zip

J. The current data is saved onto PostgreSQL to be accessed as necessary in ARBenefits Portal.

2.21 MAINTENANCE AND SUPPORT

A. The Contractor shall provide a proposed Maintenance & Support Plan during the Discussions Phase.

The Maintenance & Support Plan must, at minimum, meet the requirements set forth in this section of the RFP.

B. The Contractor shall be responsible for providing ongoing maintenance of the system for the life of the contract.

C. The Contractor shall provide ongoing user and technical support such as via telephone and email beginning at the time of Go Live and continuing for the life of the contract.

D. The Contractor shall provide English speaking telephone support staff..

E. The Contractor shall provide properly trained User and Technical Support staff in sufficient quantities to support EBD.

2.22 HOSTING

A. The system must be hosted on the State’s Amazon Web Services account.

B. The Contractor shall perform all work on the proposed system from within the continental United States of America. The system must not be accessed from outside of the U.S.

C. The Contractor shall develop and implement the system and all dependent hosted hardware in such a manner that allows for direct network communications with the Contractor’s system and the exchange of data via approved industry standard protocols for interfacing with other systems as deemed necessary.

D. The Contractor shall provision all environments.

E. The system must be augmented by monitoring and cybersecurity tools.

F. The Contractor shall keep all hosting-related software current and up to date.

2.23 LICENSING AND INSURANCE

A. The Contractor shall maintain, with respect to the services provided under a resulting contract, professional liability (errors and omissions) insurance and general liability insurance in amounts reasonable and customary for the nature and scope of technology services. The Contractor shall provide evidence of such insurance upon EBD’s request.

B. The Contractor shall comply with all relevant federal and state laws, rules, and regulations, including but not limited to HIPAA and PPACA.

C. The Contractor shall maintain all licenses necessary to do business in the State of Arkansas and to perform the services required under a resulting contract.

D. The Contractor shall accept liability for any mistakes, errors, or omissions it makes in providing services to EBD and its members.

E. The Contractor shall maintain fidelity and surety insurance or bond coverage to protect EBD in the event of a loss.

2.24 DATA SECURITY

A. The Contractor shall provide a proposed Data Security Plan during the Discussions phase. The Data

Security Plan must, a minimum, meet the requirements set forth in this section of the RFP.

B. The Contractor shall sign EBD’s Business Associate Agreement (BAA) (Attachment B). The DSA must also contain The Cloud Data Sharing Policy found here: Cloud Security Oversight Policy.

C. The system must maintain compliance with laws and regulations related to data security and financial and banking data.

D. The system must adhere to all State Cybersecurity policies found here: State IT Policies and Standards.

E. The system must maintain compliance with laws and regulations related to HIPAA.

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F. The Contractor shall perform regular security audits as well as periodic scanning and penetration testing against the hosting environment and application components to identify and remediate any identified vulnerabilities or issues.

2.25 SYSTEM UPTIME & PERFORMANCE

A. The Contractor shall provide a proposed System Uptime and Performance Plan during the

Discussions Phase.

B. Dedicated bandwidth will not be provided for the proposed solution and the system must not negatively impact or interfere with services from other existing systems.

2.26 SYSTEM ACCESS

A. The Contractor shall provide user access to the system through a secure, web-based portal.

B. The system must provide a user-friendly administrative interface with automated workflows for common functions (applications, eligibilities, application review, expense review, reports, etc.).

C. The system should stress consistency across all the different modules so that the business process is easy to learn and understand.

D. The system must be browser and operating system neutral for all user types.

E. The system must function accurately on common modern browsers such as, Microsoft Edge, Mozilla Firefox, Google Chrome, and Safari.

F. The system must not require additional browser plug-ins, add-ons, or helper applications.

G. The system must have a Responsive User Interface (RUI) and be accessible and function normally for all features from mobile devices such as tablets, smartphones, and chrome books. This must include, but is not limited to, iPhones, iPads, and Android based phones and tablets.

2.27 USER ROLES

A. The system must authenticate and assign the appropriate level of access to users based on the appropriate user roles.

B. The system must, at minimum, support three levels of user access at time of Go-Live: User, Admin, and Representative.

C. System Administrators must be able to create custom user roles with security parameters that define access.

D. The system must be able to assign controls for multiple users via workgroup/roles.

E. The system must allow access levels to be custom defined.

2.28 DISASTER RECOVERY

A. The Contractor shall provide a proposed Disaster Recovery and Business Continuity Plan during the

Discussions phase. The Disaster Recovery and Business Continuity Plan must, at minimum, meet the requirements set forth in this section of the RFP.

B. The Contractor shall include the following in the final plan(s):

1. Plan Objectives

2. What situations and conditions are covered by the Plan

3. Technical considerations

4. System failover plans

5. Plan Testing strategy

6. Roles and responsibilities of Contractor staff

7. How and when to notify the Contract Monitor

8. Recovery procedures

9. Procedures for deactivating the Disaster Recovery Plan

C. The Contractor shall provide an updated Disaster Recovery and Business Continuity at the end of Implementation and runbook that addresses any changes made since the Discussions phase. This should include detailed instructions on how to recover during a Disaster Recovery event.

2.29 OPTIONAL ADDITIONAL ENHANCEMENTS

A. The Contractor should provide an hourly rate for providing optional additional enhancements to the system throughout the life of the contract. EBD may request the Contractor to provide or assist with improvements or enhancements to the system not outlined in this RFP or defined during the Discussion Phase of this Procurement. Upon request by EBD, the Contractor shall prepare a Scope of Work and estimated number of hours to complete the project using the rates proposed in Table 2 of the Official Bid Price Sheet.

2.30 LICENSING & OWNERSHIP OF CUSTOM-BUILT SOFTWARE

A. The State shall be the sole owner of any software developed under this contract with exclusive rights to use, alter, or distribute the software without restriction. The State’s ownership rights apply to source code, object code, and documentation.

B. The State may, at its sole discretion and upon request, grant the Contractor a nonexclusive license to use the State’s software, subject to mutually acceptable terms and license fees.

C. The State owns all rights, title, and interest in all of the intellectual property rights, including copyrights, patents, trade secrets, trademarks, and service marks in the works and documents created and paid for under this Contract. The documents must be the exclusive property of the State and all such documents must be immediately returned to the State by the Contractor upon completion or cancellation of this Contract. To the extent possible, those works eligible for copyright protection under the United States Copyright Act will be deemed to be “works made for hire.” The Contractor assigns all right, title, and interest it may have in the works and the documents to the State. The Contractor shall, at the request of the State, execute all papers and perform all other acts necessary to transfer or record the State’s ownership interest in the works and documents.

D. Each Party shall retain ownership of its respective Pre-Existing Intellectual Property. The Contractor grants the State a perpetual, irrevocable, non-exclusive, royalty free license for Contractor’s Pre- Existing Intellectual Property that are incorporated in the products, materials, equipment, deliverables, or services that are purchased through the Contract.

E. Notwithstanding any other indemnification obligations addressed within this Contract, the Contractor will indemnify; defend, to the extent permitted by the Attorney General; and hold harmless the State, at the Contractor’s expense, from any action or claim brought against the State to the extent that it is based on a claim that all or part of the works or documents infringe upon the intellectual property rights of others. The Contractor will be responsible for payment of any and all such claims, demands, obligations, liabilities, costs, and damages, including but not limited to, attorney fees. If such a claim or action arises, or in the Contractor’s or the State’s opinion is likely to arise, the Contractor must, at the State’s discretion, either procure for the State the right or license to use the intellectual property rights at issue or replace or modify the allegedly infringing works or documents as necessary and appropriate to obviate the infringement claim. This remedy of the State will be in addition to and not exclusive of other remedies provided by law.

2.31 DATA OWNERSHIP AND CONTRACT TRANSITION

A. The State shall retain sole ownership, right, title, and interest to all data collected and stored by the Contractor under a resulting contract, excluding intellectual property and exclusions governed by applicable State and Federal laws.

B. At the end of the contract and after confirmed transfer of 100% of the State-owned data, deliverables, and products the Contractor has created, developed, produced, and managed while performing the services outlined in this RFP back to the State or their designee, the Contractor shall destroy all copies of the State-owned data the Contractor possesses.

C. The Contractor shall ensure all data received as part of the Contract is used solely for the purpose of this contract and not shared, reused, or disseminated to any other party or entity without the express written consent of EBD designated representative or as otherwise required under applicable State and Federal laws.

D. Upon termination or expiration, should any subsequent contract for this or similar services be awarded to a provider other than the Contractor, the Contractor shall, to the greatest extent possible and reasonable, cooperate with EBD in initiating a smooth and orderly transition to the next contractor.

2.32 PERFORMANCE STANDARDS

A. State law requires that qualifying contracts for services include Performance Standards for measuring the overall quality of services that a Contractor shall provide.

B. The State may be open to negotiations of Performance Standards prior to contract award, prior to the commencement of services, or at times throughout the contract duration.

C. Performance Standards shall not be amended unless they are agreed to in writing and signed by the parties.

D. Failure to meet the minimum Performance Standards as specified will result in the assessment of damages.

E. In the event a Performance Standard is not met, the Contractor will have the opportunity to defend or respond to the insufficiency. The State has the right to waive damages if it determines there were extenuating factors beyond the control of the Contractor that hindered the performance of services. In these instances, the State has final determination of the performance acceptability.

F. Should any compensation be owed to the Department due to the assessment of damages, Contractor shall follow the direction of the Department regarding the required compensation process.

SECTION 3 – SELECTION

3.1 SELECTION PROCESS

A. TSS OSP will review each Technical Proposal Packet to verify Submission Requirements have been met. Technical Proposal Packets that do not meet Submission Requirements will be rejected and will not be evaluated.

1. The State may conduct cost checks based on the cost submitted by each Prospective Contractor on the completed pricing response.

a. Prospective Contractors submitting Responsive Proposals with a proposed cost that falls twenty-five percent (25%) or more from the average submitted cost may be asked to justify their submitted cost.

b. Should TSS OSP request clarification and/or additional information regarding cost, Prospective Contractors shall provide clarification and/or additional information as specified by the request.

B. A Department-appointed Evaluation Committee will evaluate and score Responsive Proposals.

Evaluation will be based on Prospective Contractor’s response to the Information for Evaluation section included in the Technical Proposal Packet and the pricing submitted by the Prospective Contractor.

1. Cost information will be provided to the members of the Evaluation Committee (Evaluators) to allow them to determine which proposal(s) is the most advantageous to the State.

2. Evaluators will individually review and evaluate proposals and complete an Individual Score Worksheet for each proposal. Individual scoring for each Evaluation Criteria will be based on the scoring description in Table B: Scoring Table.

TABLE B: SCORING TABLE

SCORE DESCRIPTION

10 The response provides metrics clearly establishing that the Prospective Contractor is reliable and capable of fully performing the required services.

The response provides metrics suggesting that the Prospective Contractor’s level of performance may be acceptable, but it does not clearly establish that the Prospective Contractor is reliable and capable of fully performing the required services.

0 The response provides metrics clearly establishing that the Prospective Contractor is unreliable and incapable of fully performing the required services.

3. After initial individual evaluations are complete, the Evaluators will meet to discuss their individual scores. At the initial consensus meeting, each Evaluator will be afforded an opportunity to discuss his or her score for each evaluation criteria.

4. After Evaluators have had an opportunity to discuss their individual scores with the committee, the Evaluators will be given the opportunity to change their initial individual scores, if they feel that is appropriate.

5. The final individual scores of the Evaluators will be recorded on the Consensus Scoresheets and averaged to determine the group or consensus score and rank for each proposal.

6. Other agencies, consultants, and experts may also examine documents at the discretion of the Department.

C. Prospective Contractors submitting Responsive Proposals will be contacted by TSS OSP to schedule an interview.

1. Prospective Contractors shall attend the interview as scheduled by TSS OSP.

2. Evaluators will complete an Individual Score Worksheet for each interview. Evaluation will be based on Prospective Contractor’s responses to questions presented during the interview Individual scoring for each interview will be based on the Scoring Descriptions in 3.1.B.1.

3. During a final consensus meeting, after all interviews are complete, Evaluators will have the opportunity to discuss the interviews and change their individual interview scores on the Consensus Scoresheet, if they feel that is appropriate.

a. The final individual scores of the Evaluators will be recorded on the Consensus Scoresheets and averaged to determine the group or consensus score and rank for each proposal.

4. Should the State receive only one (1) Responsive Proposal, the State may forgo the interview portion of the evaluation if the proposal has received the Maximum Weighted Score Possible for the Experience, Solution, and Risk subsections.

a. In this scenario, the proposal would automatically receive the maximum weighted score possible for the interview subsection.

D. Should the State request clarification and/or additional information Prospective Contractors’ responses, Prospective Contractors…