Schedule B Pricing.xlsx
XLSX spreadsheet 26 KB Posted
- Solicitation number
- RFP 171 240000001383 2
- Issued by
- Michigan
About this file
This is a Schedule B Pricing document for the State of Michigan's Request for Proposal No. 240000001383 for Long Term Disability (LTD) Services. The contract covers administrative services for the State of Michigan's self-funded LTD plan with a base term of four years, spanning from 2025 through 2029 (9 months in 2025 and 3 months in 2029). The pricing schedule requires bidders to provide fixed annual rates and fixed term rates for administrative costs on a per claimant per month (PCPM) basis across all current plan types. Bidders must also provide pricing for Independent Medical Examinations (IMEs) by specialty, including Physical Medicine & Rehabilitation, Neurology, Orthopedics, and Psychiatry, with low and high ranges for each contract year. The State is also considering a potential plan design change effective no earlier than January 1, 2026, creating a new self-funded six-month maximum LTD/Short Term Disability benefit plan, for which bidders may offer separate pricing.
The current LTD plan covers approximately 38,500 employees across three plan types, with an estimated three-year average of 1,735 open claims per month. Historical utilization data from calendar year 2023 indicates estimated pass-through costs of $22,853,550 annually, with total estimated contract utilization of $91,414,200 over the four-year period. Bidders must include all costs in their proposals, including administrative fees, one-time setup charges, payment issuance fees, claim filing fees, and shipping and handling. The State encourages quick payment terms and requests bidders indicate their discount percentage and payment timeline. Bidders may also propose a multi-contract percentage discount if awarded both Workers Compensation and Long Term Disability contracts. The document specifies that the State does not guarantee minimum or maximum volumes of enrollees, claimants, or claims, and proposals must be submitted in a modifiable format such as Microsoft Excel or Word.
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Other files
| File | Type | Posted |
|---|---|---|
| Schedule I Sample 5 year Claims Report.xlsx | XLSX spreadsheet | |
| Department of Treasury Safeguard Requirements of Confidential Tax Data 7.doc | DOC document | |
| Hybrid Contract Terms.docx | DOCX document | |
| Schedule J LTD Enrollment Census.xlsx | XLSX spreadsheet | |
| IRS Publication 1075.pdf | ||
| 240000001383 LTD Questions Answers.pdf | ||
| Schedule D Service Level Agreements for Hybrid Purchases.docx | DOCX document | |
| Schedule G Section 2 Software Table.xlsx | XLSX spreadsheet | |
| Schedule H Service Availability Report.xlsx | XLSX spreadsheet | |
| Exhibit 7 Safeguarding Contract Language.pdf | ||
| Schedule E Data Security Requirements for Hybrid Purchases.docx | DOCX document | |
| Proposal Instructions Vendor Questions WorksheetREVISED.docx | DOCX document | |
| Non-disclosure-agreement.docx | DOCX document | |
| Schedule A Statement of WorkREVISED.docx | DOCX document | |
| Schedule C Insurance Requirements.docx | DOCX document | |
| Schedule F File Layout.doc | DOC document |
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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 | Three Year Average | ||||
| LTD Plan II Enrollees Only | ||||||||||
| (IIA, IIB & IIC plans) | 25,507 | 25,183 | 24,747 | 2,095 | 2,444 | 2,145 | 1,936 | 2,175 | ||
| Total LTD Plan Enrollees | 38,622 | 38,663 | 38,507 | 3,216 |
| Self-Funded - Table 1: 4-Year, Fixed Annual Rate Pricing Proposal: | 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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