The provided document is a pricing schedule for a Long Term Disability (LTD) Insurance Administration Services contract opportunity issued by the State of Michigan. The contract will cover various state and local jurisdictions including Ingham County and the City of Lansing.
The pricing schedule outlines fixed annual rate and fixed term rate pricing options for the 4-year base contract term from 2025 to 2029. The schedule includes administrative costs per claimant per month, pass-through utilization cost estimates, and the option for a multi-contract discount if the vendor is also awarded a Workers Compensation contract. The document also includes historical data on LTD plan enrollments, claim closures, and plan types to assist vendors with their pricing proposals. Additionally, the State is considering a new 6-month maximum LTD/Short Term Disability benefit plan, and vendors may provide separate pricing for this potential plan design change.
The file's text, extracted by GovTribe without its formatting.
Informational Data Tab 1
State of Michigan LTD Plan Details & Statistics
Number of New Claims Filed
CY 2021
CY 2022
CY 2023
2,769
2,361
2,194
Number of Claims Closed
CY 2021
CY 2022
CY 2023
2,980
2,659
2,465
Total Claims Open Longer Than 24 Months
CY 2021
CY 2022
CY 2023
944
859
729
Average Total Approved Days of Claims Closed in CY
CY 2021
CY 2022
CY 2023
115.1
103.3
66.9
Average Number of Open Claims Per Year
CY 2021
CY 2022
CY 2023
1,881
1,769
1,554
Number of New Claims by Top 20 ICD9 Category
Category Description
CY 2021
CY 2022
CY 2023
BLOOD AND BLOOD-FORMING ORGANS
7
4
12
CIRCULATORY SYSTEM
122
106
111
CONDITIONS ORIGINATING IN THE PERINATAL PERIOD
2
5
2
CONGENITAL ANOMALIES
22
20
11
DIGESTIVE SYSTEM
151
120
112
ENDOCRINE, NUTRITIONAL, METABOLIC, IMMUNITY
88
97
74
GENITOURINARY SYSTEM
134
136
112
MENTAL/SUBSTANCE
840
720
592
MUSCULOSKELETAL
364
350
302
INFECTIOUS DISEASE
216
83
17
BACK/SPINE
142
131
130
TUMORS
139
87
104
FRACTURES/SPRAINS
111
104
134
NEUROLOGICAL
83
60
78
GASTROINTESTINAL
80
77
92
ENDOCRINE
72
65
62
PREGNANCY
69
43
44
CIRCULATORY DISEASE
66
82
69
SYMPTOMS
57
51
49
PELVIC DISEASE
55
40
60
SKIN DISEASES
18
15
16
RENAL DISEASE
18
14
10
EYE DISEASE
18
12
14
TRAUMA
17
15
17
RESPIRATORY DISEASE
16
20
16
GU DISEASE
14
9
8
BREAST DISEASE
14
8
9
CIRCUMSTANTIAL CAUSE
14
20
13
BLOOD DISORDER
11
4
9
EAR DISORDERS
6
6
3
EXTERNAL CAUSE
2
1
2
State of Michigan LTD Plan Types
Plan I
For employees who have fewer than 184 hours of accumulated sick leave
Plan II
For employees who have 184 or more hours of accumulated sick leave. An employee enrolled in Plan I who accrues 184 or more hours of sick leave is automatically enrolled in Plan II. Once an employee is enrolled in Plan II, the employee will not be reclassified to Plan I as long as the employee remains continuously enrolled in the LTD Plan even if the employee's accumulated sick leave balance falls below 184 hours.
State of Michigan LTD Plan Premiums
Premium Classes for Employees Enrolled in the Plan
An eligible employee enrolled in the LTD Plan must pay the premium required for the appropriate premium class:
Plan I Premium Class
Employees enrolled in Plan I having fewer than 184 hours of accumulated sick leave.
Plan II(A) Premium Class
Employees enrolled in Plan II having at least 184 hours of accumulated sick leave.
Plan II (B) Premium Class
Employees enrolled in Plan II having 528 hours or more of accumulated sick leave.
Plan II (C) Premium Class
Employees enrolled in Plan II whose accumulated sick leave balace has fallen below 184 hours.
Average Number of Employees Enrolled in LTD Plan
Plan Types
CY 2021
CY 2022
CY 2023
Plan I
13,115
13,480
13,760
Plan IIA
12,562
12,427
12,023
Plan IIB
7,171
7,122
7,156
Plan IIC
5,774
5,634
5,568
Total
38,622
38,663
38,507
LTD Plan Pricing
SCHEDULE B - PRICING
Request For Proposal No. 240000001383
Long Term Disability Services
1. Please provide a pricing schedule for the proposed Contract Activities using the 2 table formats below, Pricing Table 1: fixed annual rate (Calendar Year) and fixed term rate (Contract Term). The Bidder must only complete areas shaded in light green with numeric values and must not alter data or formulas in cells that are not shaded light green. Bidder must also enter your range of payable IME costs in the provided Table 3 below.
2. The pricing schedule should be submitted in a modifiable format (e.g., Microsoft Word or Excel); however, you may also submit an additional pricing schedule in a non-modifiable format (e.g., PDF). Failure to complete the pricing schedule as requested may result in disqualification of your proposal.
3. Price proposals must include all costs, including but not limited to, any one-time or set-up charges, fees, and potential costs that Contractor may charge the State (e.g., Payment Issuance Fee, Claim Filing Fee, shipping and handling, per piece pricing).
4. The Contractor is encouraged to offer quick payment terms. The number of days must not include processing time for payment to be received by the Contractor's financial institution.
Quick payment terms: Bidder is to indicate their quick payment terms in the underlined spaces provided:
Bidder Response: ________ % discount off invoice if paid within __________ days after receipt of invoice.
5. By submitting its proposal, the Contractor certifies that the prices were arrived at independently, and without consultation, communication, or agreement with any other Contractor.
6. The following historical data, and additional data on Tab 1 may be used to assist the Contractor with their pricing response.
7. Multi-Contract Discount: Bidder is to indicate their Multi-Contract Percentage Discount if awarded both Workers Compensation and Long Terms Disability contracts (include proposed discount in table below). See also Schedule A, Section 8.1.5.
Employee Census Data as of December of Each Year
Average Number of Enrollees per Month; Utilized for Evaluation Purposes Only
Average Number of Open Claims Per Year
Average Number of Open Claims per Month; Utilized for Evaluation Purposes Only
LTD Plan Types
CY 2021
CY 2022
CY 2023
Three Year Average Monthly Enrollment
CY 2021
CY 2022
CY 2023
Three Year Average
Number of Employees Eligible to Enroll in LTD - All Plans
47,107
47,105
47,966
3,949
1,881
1,769
1,554
1,735
LTD Plan I Enrollees Only
13,115
13,480
13,760
1,121
Number of Claims Closed in Each CY - Open Less Than 7 Months
Self-Funded - Table 2: Fixed Term Rate Pricing Proposal
Structure
2025 (9 months)
2026
2027
2028
2029 (3 months)
Total Cost over 4 Years
Administrative Costs
Base Contract Term - 4 Years
Calendar Year
Calendar Year
Calendar Year
Calendar Year
Calendar Year
Administrative Costs
Administrative Fee for Current Plan Design, All Plan Types - Per Claimant Per Month (PCPM)
Administrative Fee for Current Plan Design, All Plan Types - Per Claimant Per Month (PCPM)
Current LTD Plan Total Admin Fee for CY
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Current LTD Plan Total Admin Fee for CY
$ - 0
Pass-through Utilization Cost Estimate based on CY23 Claims Expenses
$17,140,162.50
$22,853,550.00
$22,853,550.00
$22,853,550.00
$5,713,387.50
$91,414,200.00
Pass-through Utilization Costs
$91,414,200.00
Total Estimated Contract Utilization for Current Plan Design
$ 17,140,162.50
$ 22,853,550.00
$ 22,853,550.00
$ 22,853,550.00
$ 5,713,387.50
$ 91,414,200.00
Total Estimated Contract Utilization for Current Plan Design
$ 91,414,200.00
Multi-Contract Discount
Total
Multi Contract Discount
Estimated Discount for Current Plan Design
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Estimated Discount for Current Plan
$0.00
Notes:
(1) The State of Michigan does not guarantee a minimum or maximum volume of enrollees, claimants and claims in any plan.
(2) For purposes of proposal comparison, estimates in the tables above will be utilized.
(3) No show fees and cancellation fees vary between physicians and will not be evaluated.
(4) IME Fees are evaluated separately from Administrative Fees as part of overall best value consideration.
IME - Table 3
Independent Medical Examinations (IME by Specialty) - Range for Michigan
2025
2026
2027
2028
2029
LOW
HIGH
LOW
HIGH
LOW
HIGH
LOW
HIGH
LOW
HIGH
PM &R
Neuro
Ortho
Psych
The Plan Sponsor is considering a potential plan design change to create a new self-funded six-month maximum LTD/Short Term Disability benefit plan. In this scenario, all eligible state employees would be automatically enrolled with the exception of Plan II enrollees who would have the option to remain in the current plan, which would continue. The new plan would go into effect no earlier than January 1, 2026. Bidders may offer separate pricing recognizing that the new plan would have shorter claims management needs with a higher total enrollment. If the following table is not populated, the Pricing included above will be considered for all plans with or without this plan design change.
Administrative Fee for New Plan Design (Six-month Plan Only) Per Claimant Per Month (PCPM)
Administrative Fee for New Plan Design (Six-month Plan Only) Per Claimant Per Month (PCPM)
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