QUESTIONS & ANSWERS. Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012. Date of Answer. Question # RFP Page # RFP Section #

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1 Connecticut Health Insurance Exchange Exchange Call Center QUESTIONS & ANSWERS Memo: The document represents the final version of the submitted questions. No further questions will be accepted by the Exchange. The response deadline remains 5:00pm Eastern Standard Time on November 5, Question Section Page Text / Reference Question 1 10/17/ Do we have an idea of the call volume the call center can expect to receive either on per month, or per year basis? The Exchange has no historical data on call arrival patterns or the expected variation in volume of calls over the month and over the year. The State expects the Responder to have the necessary expertise to properly anticipate load and staffing requirements for the Exchange Call Center. 2 10/17/ /17/ /17/ /24/2012 General Evaluation Criteria Do we have an estimated call duration amount of time spent on each call for a call center representative? Do you need to have an existing service contract with the state in order to participate in this proposal? Will the Exchange be making contract terms and conditions available for review? They were not included in the document? Will the advisory committee members be part of the evaluation process? Can the Exchange please advise who is participating in the evaluation? Please refer to question 1. The Call Center vendors do not need to have existing state contracts in order to be eligible for consideration as the Call Center outsourced vendor. Yes, general contract terms and conditions documents are now posted on the CTHIX website. The Exchange does not disclose the composition of the evaluation committee. Exchange Call Center Questions & s Final Last Updated 10/26/2012

2 Section Page Text / Reference Question The proposals will be reviewed using the following scoring criteria: 6 10/24/2012 General Evaluation Criteria Has the Exchange established evaluation criteria for the Call Center? Total Score = 100% Organizational Capability 10% Approach and Methodology 15% Level of Fit of the Proposed Solution 35% Project Timeline 10% Cost/Pricing Proposal 30% 7 10/24/2012 General Materials 8 10/24/ Services offered in this tier include answering questions about the Exchange and health care reform, directing existing Medicaid consumers to DSS enefits Center via IVR prompts or a warm transfer, as well as routing and resolving complaints and appeals to the appropriate State agencies such as the Connecticut Insurance Department (CID) and Office of the Healthcare Advocate (OHA) via a cold transfer. Will the Exchange Call Center be responsible for creating materials in other formats to comply with ADA requirements? What is your preferred method of call transfer assuming an automated environment? No. Warm transfer. 9 10/24/ Consumer Support Components highlighted in red as one of the activities applicable to the Exchange Call Center is insurance shopping tools. Will these tools be accessible via the Exchange Web Portal that is part of the SHOP and in which that vendor will be responsible for providing or will the Call Center Exchange vendor need to provide their own comparison shopping tools for comparison and final cost calculation? The Web Portal will include the tools necessary for the Call Center Representatives to pre-screen the consumers, determine their eligibility for MAGI Medicaid, QHP, APTC, and enroll in QHP plans using the comparison shopping tools to display the plans relevant to consumers. SHOP PO Vendor will have a separate Help Desk to provide assistance to employees of small employers in plan selection and enrollment. Exchange Call Center Questions & s Final Last Updated 10/26/2012

3 Section Page Text / Reference Question 10 10/24/ Tier 0 Website Will the Exchange Call Center have full access to the exchange website in order to complete eligibility and enrollment on behalf of consumers who are unable to complete processing on their own? How does the Exchange envision Call Center agents accessing the Exchange and IE System? The Exchange Call Center staff will use the web portal with configured access rights to enroll the consumers into the QHP selected by consumer /24/ /24/ Services offered in this tier include answering questions about the Exchange and health care reform, directing existing Medicaid consumers to DSS enefits Center via IVR prompts or a warm transfer, as well as routing and resolving complaints and appeals to the appropriate State agencies such as the Connecticut Insurance Department (CID) and Office of the Healthcare Advocate (OHA) via a cold transfer. Services offered in this tier include answering questions about the Exchange and health care reform, directing existing Medicaid consumers to DSS enefits Center via IVR prompts or a warm transfer, as well as routing and resolving complaints and appeals to the appropriate State agencies such as the Connecticut Insurance Department (CID) and Office of the Healthcare Advocate (OHA) via a cold transfer. What is the estimated percentage of calls that will need to be transferred to State Agencies? Please confirm that the Call Center vendor is not responsible for tracking calls once they have been transferred (warm or cold) to an external entity. Please follow industry standards and benchmarks. The Call Center vendor is not responsible to track the transfers through resolution. However the Call Center vendor is responsible for tracking where the transfers are made, as well as tracking and reporting on related metrics (e.g. number of transfers to CID on consumer complaints related to issuers/plans, etc.). Exchange Call Center Questions & s Final Last Updated 10/26/2012

4 Section Page Text / Reference Question The Federal Hub will be integrated in the application /24/ Tier 2 Will the Tier 2 personnel be responsible for resolving eligibility issues when clients apply on-line? For example citizenship verification that needs the consumer to show verification so that can be verified through SAVE and similar appeal issues? Can the Exchange please clarify the Call Center vendor s responsibilities for supporting routing and resolving eligibility issues? If paper verifications are required on exception basis, the Call Center Vendor will inform the consumers on inbound paper channel to submit the verification document. The Call Center Vendor will be notified through a workflow on verification documents received once these are available in the system. At this point, the Call Center vendor will follow up with the consumer to pick up the enrollment process. It is not expected that Call Center Vendor will access any additional electronic sources that are not built into the system for the verification purposes /24/ states the Exchange Call Center will perform activities necessary to receive, log and track incoming communications Will the Exchange Call Center be responsible for setting up complete end to end mailroom operations which includes scanning all incoming documents, sending outgoing documents such as re-enrollment packets and requesting required verifications, working return mail etc.? What does the Exchange anticipate would be the volume for these mailings? Call Center Vendor is not responsible for processing paper and fax verification documents. Details on scanning and processing are currently being addressed and will be shared with the selected vendor /24/ states the Exchange Call Center will perform activities necessary to receive, log and track incoming communications Will the Exchange Call Center be responsible for establishing a PO ox and usiness Reply envelope account for consumers to send documents to the Exchange for processing? What does the Exchange anticipate would be the volume for these mailings? Yes. The majority of communications are expected to be handled through electronic means or over the phone. Exchange Call Center Questions & s Final Last Updated 10/26/2012

5 Section Page Text / Reference Question 16 10/24/ states the Exchange Call Center will perform activities necessary to receive, log and track incoming communications Will there be outreach materials that the Call Center is responsible for mailing like plan comparison charts? What does the Exchange anticipate would be the volume for these mailings? No. Anything needed will be available on the website /24/ Figure 3: Future Environment How will the agents in the Call Center connect to the HIX system: Internet or private connection? Internet /24/ Figure 3: Future Environment Will the HIX system deployed by the State have the ability to be queried (using Web Services, for instance) so that the IVR of the HIX Contact Center contractor can provide more accurate information to the callers? Yes /24/ Figure 3: Future Environment Will the HIX system deployed by the State have the ability to be queried in real time (using Web Services, for instance) so that the agents in the HIX Contact Center can get accurate information about the caller on a pop-up screen when they take a call? Yes /24/ Figure 3: Future Environment Will the DSS ConneCT IVR remains client facing or will the Exchange be the only client facing IVR? If the ConneCT IVR remains client facing how many calls will the Exchange IVR receive from ConneCT? These questions do not to apply to the scope of this request /24/ Figure 3: Future Environment Please provide technical information about the configuration of the ES. It will be provided to the selected vendor once it becomes available /24/ Figure 3: Future Environment To support project planning and scheduling, what is the timing for availability of the interfaces being supplied by the State s System Integrator? It will be provided to the selected vendor once it becomes available. Exchange Call Center Questions & s Final Last Updated 10/26/2012

6 Section Page Text / Reference Question 23 10/24/ Figure 3: Future Environment Can the Exchange provide additional information on the existing IVR, including software and capabilities to assist the Call Center better in planning integration? At a later date, a design session will be conducted for selected vendors (finalists) before an award is made /24/ Figure 3, Future Environment In Figure 3, do the colors depict agency or vendor responsibilities? If so, can the Exchange please clarify whether the responsibilities of the HIX Exchange Call Center do include a web portal or shared rules? Web portal and shared rules are responsibility of the Systems Integrator. Call Center vendor will utilize Web Portal that relies on the shared rules to determine the client eligibility /24/ Table 1- Estimated exchange user population Only the low income children population (CHIP) states that the consumer will apply through the Exchange portal or the exchange Call Center. Should this statement apply to all populations? Should the Exchange Call Center be capable of sending paper applications and accepting them to process eligibility? Yes. They would need to direct individuals /24/ Oct SHOP Exchange 27 10/24/ Table 1 and 2 Can the Exchange confirm that the Exchange Call Center will not be expected to be the primary Call Center for participants in the SHOP Exchange? If this is not true, and this should cover SHOP Exchange Call Center activities, can the Exchange please provide similar volumes and assumptions for the SHOP Exchange as are found in the Section 2.2.3, Volumetrics? Can the Exchange please confirm that the population estimates are based on annual totals? The SHOP PO Vendor will provide a Help Desk to assist employees of small employers. Please follow industry standards and benchmarks. Exchange Call Center Questions & s Final Last Updated 10/26/2012

7 Section Page Text / Reference Question Can the Exchange please clarify the scope and responsibilities for the integrated client record? 28 10/24/ Provide access to an up-to-date and integrated client record across all programs at each touch point. Will the integrated client record be maintained by the IE / Exchange vendor with access by the Call Center vendor? Or is the Call Center Vendor required to maintain the integrated client record as the source of truth? If so, will the Exchange and IE systems support real time interfaces to allow for the maintenance of an integrated record? "Integrated client record" is a record maintained by the call center vendor to provide data extracts or reports on clients who contacted the call center and the type of request or services needed /24/ Capacity and Scalability To help provide additional flexibility in a cost effective manner to quickly adjust to call volumes, will the Exchange allow the use of at home workers? As part of the proposal, Call Center Vendor is expected to provide a staffing model that should include any off-site locations and number of staff by location ( Off-site Services). Include location of staff and which states at home workers will reside. In home workers will be expected to follow all privacy laws and abide by the terms and conditions the awarded vendor agrees to with the Exchange /24/ As such, our anticipated goal for Exchange Call Center operations requires go-live by no later than September 1, 2013 in order for the Exchange Call Center to be tested, modified, promoted and fully integrated into the eligibility determination process. In order for bidders to accurately estimate staffing ramp up and training, does the Exchange anticipate that the Exchange Call Center will actually be taking consumer calls on September 1, 2013? Or, as stated in Section 2.5.1, is the time between September 1 and September 30, 2013 used only for testing, modifications, promotion and integration with eligibility determination processes? Yes. The Call Center should be operational by September 1, The number will be advertised by the Exchange prior to that date, and a level of consumer interest is expected prior to the open enrollment date. Exchange Call Center Questions & s Final Last Updated 10/26/2012

8 Section Page 31 10/24/ /24/ Text / Reference Question The QA Vendor will also review Call Center Vendor quality control procedures and processes to develop, track and report on SLA metrics. A QA Vendor will be working with the IEPMO to assist with the quality assurance reviews of Exchange Call Center deliverables on behalf of the Exchange. The Call Center Vendor must fully cooperate with the QA Vendor as it executes its responsibilities. Are SLAs in place for the other HIX components which will affect Call Center performance (e.g. timely resolution, system interfaces)? Will the QA Vendor be responsible for procuring licenses to our Call Center solution? If the Call Center Vendor should include licenses for the QA Vendor, please provide the number of users and type of access we should account for. Yes, SI has system performance metrics defined and will be held accountable for reaching these metrics. These will be shared with the selected vendor. QA Vendor will not require licenses for Call Center solution. It is however expected that QA Vendor will review items such Call Center Vendor Deliverables, call center scripts, performance metrics, SLAs, consumer survey results /24/ Minimum font size: 11 point (except for footnotes, headers, or footers) indicates 11pt font as the minimum size for text. Is it allowed to use smaller than 11pt font for tables, exhibits, and graphics? Yes, as long as it is legible upon printing /24/ The proposal created by the Responder should be formatted as follows: Requirements Traceability Matrix should be submitted in MS Word format. Proposal should be submitted in either PDF or MS Word format., Requirements Traceability Matrix, is currently an MS Excel document. Please confirm if it is acceptable for the Prospective Responders to submit the Requirements Traceability Matrix in MS Excel format instead of the MS Word format noted in the? No. Please use Microsoft Excel for Requirements Traceability Matrix submission /24/ /24/ The Responder s Exchange Call Center proposal should consist of the following sections, in the order listed below: Cover Letter Table of Contents Executive Summary Organizational Capability Approach and Methodology Level of Fit of the Proposed Solution Project Timeline Scope Exclusions Cost/Pricing Proposal Provision of continuous operations of the (including the underlying systems for which the Responder is responsible) Is it the State s expectations to receive Six (6) hard copy binders that contain both the technical and cost proposals as part of the submission? Is it the State s expectation to receive ten (10) soft copies on CD-ROM that contains documents for both the Technical and Cost proposals on a single CD? What is the expected RTO/RPO of the Call Center? Yes. Please see answer to question 69. The State's RTO/RPO is 48 hours. Exchange Call Center Questions & s Final Last Updated 10/26/2012

9 Section Page 37 10/24/ /24/ Text / Reference Question The Exchange s involvement in developing a Future State disaster recovery plan The Responder will provide in the cost proposal a firm fixed price for the development, certification, and deployment of all Exchange Call Center components, including IVR system. The fixed price should be representative of the stand up cost of the proposed Exchange Call Center solution. Is there an overall DR Plan that the Call Center would be integrated into? In order for bidder s to provide the most cost effective proposal for the scope of work requested, will the Exchange consider bidder s proposals for breaking up the firm fixed price for the stand up of the Call Center over a set number of milestones or deliverables during the implementation? The Call Center vendor would be dependent on the State's recovery. Yes, as long as the total firm fixed price is clearly identified in the cost proposal /24/2012 Appendice s- General Future State usiness Process Models The Generic Exchange lueprint Process Models legend uses color to differentiate business areas (e.g. Financial Management, Plan Management). However, there are only two colors represented in the flow charts process boxes are yellow and data storage symbols are purple. Does the color in the legend apply to these generic blueprint models? Can the Exchange provide additional guidance on what is Exchange vendor VS. Call Center vendor responsibility within the flow? Call Center process models is a subset of the Exchange process models that currently exist. Consumer Assistance process models that are applicable to Call Center functionality are depicted in yellow. The flows are high level and do not include responsibilities of the Vendor vs. the Exchange staff. The provides sufficient level of detail around the Call Center PO vendor responsibilities /24/2012 Item 91 What is the role of the emergency helpdesk support? The role of the emergency helpdesk is similar to regular Call Center role, with different hours of operation to account for unexpectedly high consumer demand /24/2012 Item 146 What external locations will need to interface with the Call Center CRM system? What is the anticipated number of users? Exchange Tier 3 consumer support group will be interaction with Call Center CRM system. Estimated number of licenses is 20. Exchange Call Center Questions & s Final Last Updated 10/26/2012

10 42 10/24/2012 Section Page Item 58 Text / Reference Question The system shall assist consumers through Interactive Voice Response (IVR) technology. IVR should be customized for Exchange functionality, include the ability to assist in eligibility determination, confirm enrollment, assist with automated call transfers, etc. Does the Exchange envision a direct, real time connection to the Eligibility System to support these capabilities? If so, can the Exchange provide information on the anticipated capabilities of the Eligibility System to support this interface? Not in the short term. This capability may be developed in the long term /24/2012 Item 59 The system shall have the ability to manage outbound IVR campaigns. How many outbound campaigns does the Exchange anticipate per year? What is the anticipated volume for each campaign? Outbound IVR campaigns are expected to happen around renewal periods or for customer satisfaction surveys /24/2012 Item 64 The system shall have the functionality to export IVR and CRM statistical data and contact information. Is the export required to be a real time process or is a batch process sufficient? atch is acceptable /24/2012 Item 70 The system shall allow for Call Center and support staff to view information about Exchange consumer status (eligibility, enrollment, as well as plan information). Will the Call Center staff have role based access to the Health Insurance Exchange and Eligibility System to support these requirements or is the CRM required to support data exchange with these systems to maintain the integrated client record? Is the CRM required to maintain the source of truth? Call Center CSRs will have a role based access to the Exchange system /24/2012 C 40 has decided to submit its intention to propose for such services on the terms and conditions stated in the and by the due date stated therein. C asks the bidder to submit its intention to submit a proposal under the terms and conditions stated in the. However, there does not appear to be a terms and conditions section of the, nor is there a model contract for bidders to review. Can the State please provide a model contract or terms and conditions for review? Please refer to question /24/2012 E 43 E Notice of State Ethics Representations and Certifications Required of Connecticut Health Please confirm that the Prospective Responders do not need to submit the certifications listed in this section within the proposal. Please submit with the proposal. Exchange Call Center Questions & s Final Last Updated 10/26/2012

11 Section Page Text / Reference Question Insurance Exchange Vendors 48 10/24/ What is meant by entrance significant channel into the Exchange? Please read as "In addition to the Exchange website, the Exchange Call Center will provide a significant entrance channel and will be utilized (in conjunction with the website) for a significant portion of the consumers. " 49 10/24/ Tier 1 Exchange Call Center 7 What connectivity will be available to the vendor s IVR system? Will real-time transaction be possible between the IVR and systems developed and maintained by the State or its vendors? It is expected that the IVR will make real-time calls to web services or other types of IPI capabilities /24/ , Figure 1 7 The chart implies that and Chat are not functions supported by the Exchange Call Center. Is this correct? Who will handle and chat? We do not envision chat capabilities rolled-out in the short term. is supported /24/ This sections says Medicaid enrollmentrelated inquiries and inquiries from existing Medicaid clients will be transferred over to the DSS enefits Center via a warm transfer as appropriate. Please clarify what kinds of inquiries from Medicaid clients, both new and expansion, the Exchange Call Center will be expected to handle completely without transfer. Prescreen clients for QHP, MAGI Medicaid and CHIP, APTC, CSR Determine and re-determine eligibility for QHP, MAGI Medicaid and CHIP, APTC, CSR Enroll in QHP 52 10/24/ In Figure 3, who receives, scans, indexes and processes paper and fax applications and verification documents? Please see answer to question 14 Exchange Call Center Questions & s Final Last Updated 10/26/2012

12 Section Page Text / Reference Question 53 10/24/ Are licensed insurance brokers the only people who are allowed to assist callers who have yet to make a decision to enroll in a specific plan with their plan selection? Yes. The call center will enroll clients who have independently determined the plan in which to enroll. If clients are indecisive and need consultative insurance advice, they should be directed to licensed brokers for assistance /24/ If licensed brokers are the only people allowed to assist with plan selection, what kind of information or assistance should a customer service representative offer a caller who has questions about the health plan choices and the enrollment process? They can answer all questions with regard to general information about each plan, but not provide consultative advice or direction on which plan the person should choose. Additionally, please refer to question /24/ /24/ /24/ What is the % of the estimated exchange user population that is expected to access Tier 2 and Tier 3? What is the role of the Call Center in re-determination? Is the Steady State Exchange populations shown in Table 2 in addition to the Open Enrollment Exchange shown in Table 1? If so, should the 103,500 in Open Enrollment Exchange be added to the 931,105 total steady state population? Please follow industry standards and benchmarks and your professional experience. Please also document any assumptions. Conduct re-determinations and re-enrollments for clients that require Call Center Assistance. These estimates are separate and do not overlap. One estimate is for 5 months of initial enrollment, the other for the steady state /24/ How will the current Medicaid population be rolled into the exchange? Will this occur on their current anniversary date, starting in March 2014? Is it expected that 616,655 current Medicaid members will be brought into the exchange between March 2014 and September 2014, or will it be over 12 months? Existing Medicaid population will go through the Exchange to re-determine their eligibility based on MAGI rules stating March Exchange Call Center Questions & s Final Last Updated 10/26/2012

13 Section Page Text / Reference Question 59 10/24/ Understanding that most of the Medicaid population will be able to renew their benefits automatically, will Medicaid renewals in the future follow the member s current anniversary date, or will it coincide with the Oct- Jan open enrollment period? Medicaid renewals will happen throughout the year on the current anniversary date for Medicaid enrollment /24/ Table 3 13 What specific transactions does the State expect to be automated through the IVR and the Web Portal? Web Portal: Shopping/plan comparison, eligibility screening, actual enrollment in QHP. IVR: Minimal IVR to expedite direct customer to call center status and messages /24/ To enhance presentation, is it permissible to include font sizes smaller than 11 point in tables, charts, and exhibits, with the understanding that the text is still clearly legible? Please refer to question /24/ /24/ /24/ /24/ Please confirm that we are to convert the Requirements Traceability Matrix provided with the in Excel format into MS Word format for submission with the proposal. Is the Quality Assurance Plan required for submission with the proposal or postaward? What is required for the proposal? What is meant by as a separate document? Please refer to question 34. The Quality Assurance Plan should be developed once the vendor is onboard; however a high level approach for quality assurance should also be included in the proposal. A standard, high level training plan should be submitted as referenced in section Please reference for additional training requirements. Once a vendor award is made, the exchange will work with that vendor to develop a comprehensive training plan. Please include this as a separate attachment. Exchange Call Center Questions & s Final Last Updated 10/26/2012

14 Section Page 66 10/24/ Text / Reference Question Will the value add capabilities a Respondent describes in this section be considered part of the overall proposal and cost? Or are they items that the State could consider for future negotiations and possible subsequent incorporation into the contract? Value add services should not be considered as part of the overall proposal, and as such should not be priced. The State is interested in a high level summary of additional capabilities related to the Exchange operations that the Vendor is capable and has a history of providing /24/ Please confirm that this section refers to any scopeof-work items that the Respondent is explicitly excluding from its proposal. If this is correct, can a Respondent simply indicate Not Applicable for this section if it is accepting the scope of work as is? If this is not a correct interpretation, please provide additional clarification regarding what should be addressed in this section. Yes. You may indicate not applicable" for this section if you are accepting the scope of work "as is." 68 10/24/ /24/ /24/ /24/ /24/ Does the Responder only have to indicate compliance with the detailed requirements by completing, or does the Responder also have to address these requirements in its response to Section 4? Should cost/pricing proposal be separately submitted or included on the soft and hard copies of the proposal? What is the estimate on the % of consumers requiring licensed brokers to assist in selecting a QHP? In Pricing Structure 2, is the transfer to outside brokers a warm or cold transfer? In Pricing Structure 2, will the broker be reimbursed on a one-time basis or will the broker have ongoing responsibilities to support the consumer? Please provide response in both formats - within the requirements traceability matrix and a higher level discussion of vendor capabilities in the narrative proposal section 4.5 specifically related to requirements detailed in this. Please submit both proposals as one package - in separate folders on a CD; and in separate sections of the hard copy proposal. Please refer to question 1. Cold. This has not yet been determined. Exchange Call Center Questions & s Final Last Updated 10/26/2012

15 Section Page Text / Reference Question 73 10/24/ Please confirm if the difference between Scenario 1 and Scenario 2 focuses on the level of activity of the call center staff regardless of whether the brokers are on staff or outside of the staff. The Vendor is expected to submit 2 estimates: 1 for option 1 moderate automated interaction; 2 for option 2 - highly automated interaction. These scenarios are based on expected number of consumers that may access call center services. ased on the chosen staffing model (with in-house brokers; without in-house brokers), the Vendors are expected to submit PMPM cost estimate reflecting either or both of the pricing structures for both client population scenarios /24/2012 A 30 Is the Exchange Call Center expected to handle inquiries via chat? Please disregard the reference to chat. Currently, Exchange does not foresee using chat capabilities for consumer assistance in the nearest future /24/2012 A 30 Who handles Tier 0? This is the self service web portal /24/2012 A 33 What is the role of the Call Center vendor in building and implementing the consumer satisfaction survey? The Call Center vendor will capture consumer satisfaction on the events in which they manage /24/2012 A 33 How will consumer satisfaction be defined? The Call Center vendor collaboratively with the Exchange will determine the consumer satisfaction feedback criteria /24/2012 A 33 Is the CRM in Tier 0 the call center vendor s CRM? No. The Portal is Tier /24/2012 A 33 Is the call center vendor expected to enter applications into the IES portal directly or through post-call interface? If the latter, via batch or real-time? Direct entry /24/2012 A 35 Is the call center vendor expected to scan and index re-enrollment packets? In what document repository? See answer to question 14. Exchange Call Center Questions & s Final Last Updated 10/26/2012

16 Section Page Text / Reference Question 81 10/24/2012 A 35 Under what circumstances would interviews be needed? What percent of the total would need an interview? Please follow industry standards and benchmarks /24/2012 A 37 What is meant by Flag for follow up in Tier 3? Tier 3 will flag an issue for follow-up with Tier 2 representatives as needed /24/2012 A 38 Who is the supervisor in Tier 3? Tier 3 is supervised by the Exchange /24/2012 Items 51 and 92 Is it permissible to use staff members who are not dedicated exclusively to the Exchange as part of our approach to disaster recovery or for (1.) temporary periods where calls are overflowed to a different Call Center location to handle major outages and business releases, and (2.) calls that overflow to a different Call Center location and are handled by Call Center personnel who have been trained and are knowledgeable on the Exchange environment (see, items ) Yes as long as they are well trained and ready to assist in this event. Please reference section of the to provide a resource/staffing plan to address /24/2012 Item 52 What is the purpose of the web cams? For potential future use /24/2012 Item 56 This requirement states that call recordings shall be retained according to Exchange records archival requirements. Please provide details on the Exchange records archival requirements, including retention time for call recordings. The Exchange expects that the Call Center vendor already retains call recordings for quality assurance purposes. The Exchange also expects that the selected vendor will share its retention policies with the Exchange. The Exchange and the selected vendor will then work together to make any modifications necessary for Exchange related call recordings /24/2012 Item 65 What is the purpose of the IVR periodic call list? This will be used for Customer satisfaction surveys. Exchange Call Center Questions & s Final Last Updated 10/26/2012

17 Section Page Text / Reference Question 88 10/24/2012 Item Are the speed of answer standards (90% of calls within 30 seconds, 95% within 45 seconds, etc) referring to the speed of answer by the IVR/ACD system or the speed of answer by a live agent? The live agent /24/2012 Item If the answer to question 88 is no, would the state consider changes to the requirements on average speed of answer to become internally consistent with the 5% abandonment rate? (note that the ASA required will result in a much lower abandonment rate than 5%) The Exchange respectfully declines to consider changes to the requirements /24/2012 Item Requirement 75 presents standards of 90% in 30 seconds, 95% in 45 seconds, and 99% in 60 seconds. Requirement 76 refers to standards for average speed of answer for 20 seconds or less. These two requirements are incompatible meeting Requirement 76 would cause the vendor to miss Requirement 75 which implies a far lower average delay. Please clarify which standard applies. The State does not consider these requirements conflicting, they are based on the industry standards and both should be met /24/2012 Items Please provide the definition of first call resolution and the way it must be measured. First call resolution (FCR), a common CRM industry term, is when the call center is able to address the caller's need the first time they call, thus not requiring a second call to the call center /24/2012 Item 85 Does the weekly average hold time cited (120 seconds) refer to the average weekly wait time to speak to a live agent? Yes Exchange Call Center Questions & s Final Last Updated 10/26/2012

18 Section Page Text / Reference Question 93 10/24/2012 Item 88 Which other agency call centers is the vendor expected to integrate with seamlessly? What is the nature of the integration does the CRM or IVR need to be integrated with these agencies? If so, please provide more information on the equipment and systems used by these agencies. The Exchange IVR is expected to be integrated with DSS IVR /24/2012 Items To what extent is the call center vendor expected to resolve problems, complaints, and appeals before routing them to the appropriate State agency? The call center vendor is expected to resolve complaints such as client account set-up, password reset, walking clients thought the web portal interface, answering FAQ, etc. As related to appeals and complaints, the Call Center Vendor is expected to log, resolve, and track complaints related to Exchange system, Exchange performance, incorrect enrollment in the QHP, etc. CID and OHA will resolve consumer complaints related to insurance plans and issuers, e.g.. market conduct, coverage, premium payments, etc /24/2012 Item 193 Whose online solution is this? Transferrable NextGen Healthcare Information Systems, LLC solution provided by Deloitte Consulting LLP /24/2012 Item 199 What online solution is used to invoke the chat feature? See answer to question 50 and /24/2012 Items What is the role of the call center vendor in publishing FAQs to various channels (web portal, mobile portal, phone, etc.), providing answers to FAQs, and tracking usage of FAQs by consumers? Call Center Vendor should be able to build a knowledge base reflective of the information they are gathering from their interaction with the public. Exchange will update the knowledge base on the Web Portal that is reflective of Call Center Vendor input. Exchange Call Center Questions & s Final Last Updated 10/26/2012

19 Section Page Text / Reference Question 98 10/24/2012 Items Please elaborate on what is meant by the term crisis. A definition of a "crisis" event should be leveraged from industry standards and be a part of the disaster recovery plan. Exchange and selected call center vendor can agree upon a definition acceptable by both parties /24/2012 General NA Please provide the contractual terms and conditions governing this contract. Please refer to question /24/2012 General NA Please provide the parameters for marking portions of the proposal as confidential trade secrets and therefore not subject to Freedom of Information Act requests. The final submitted proposal should have any sections, or part of a section, that are confidential trade secrets, clearly identified as such. The Exchange reserves the right to make public any information that is necessary under applicable laws. All 10 submitted copies of the proposal should be identical /24/2012 General NA /24/2012 General NA Please provide the evaluation criteria and the proportion of weight between each of the sections of the proposal. Is there a role for the HIX Call Center to support employers and employees in the SHOP Exchange? Please refer to question 6. Please refer to question /24/ The fourth bullet states: "Incorporation of the Exchange's corporate standards/expectations for disaster recovery into the initial and on-going disaster recovery plans." Can the State please specify where the bidder can obtain the Exchange's corporate standards and expectations? The Exchange's Systems Integrator vendor is responsible for developing a DR plan for the project. The Call Center PO Vendor DR plan will have to be aligned with and incorporated into the overall Exchange DR plan /24/ Cost/Prici ng Proposal 25 Does the State intend to pay the vendor the total Fixed Price to Stand Up upfront? If not, can the State please provide the payment schedule for the Stand Up effort? Stand up cost can be broken down by milestones or by monthly payments. Exchange Call Center Questions & s Final Last Updated 10/26/2012

20 Section Page Text / Reference Question /24/2012 P-CA- FS Does the handoff between CA-FS and CA-FS take place between the eligibility and enrollment specialist and the licensed broker? Please clarify. Yes /24/2012 P-CA- FS Does the licensed broker enroll after the enrollment counseling? Or do they pass it back to the eligibility and enrollment specialist for enrollment? Please clarify. Licensed brokers will be able to enroll the consumers /24/2012 P-CA- FS What system generates the re-enrollment packet? Most re-enrollments are expected to be done through the web portal or the call center. It is expected that the use of paper re-enrollment forms will be minimized /24/2012 P-CA- FS What is the approximate size and weight of the reenrollment packet? Most re-enrollments are expected to be done through the web portal or the call center. It is expected that the use of paper re-enrollment forms will be minimized /24/ How should "size" be described for state government clients? Total size of the consumer base served; and a number of consumers assisted by the Vendor /24/ What federal law or regulations require 18 months of licensure; is the 18 months related to medical insurance only or can it relate to any kind of insurance such as life, property or casualty? Medical insurance /24/ How is the idea of a ticket used in the context of the call center request for info that is tracked in the CRM; is a ticket for a request or event the same as a call center inquiry or assistance with completing an application? Yes /24/ /24/ For what technology would the emergency help desk support? Do the on-staff brokers have to be exclusively dedicated? IVR and web portal The number of brokers should be scaled to consumer inquiries that need consultative insurance advise. Exchange Call Center Questions & s Final Last Updated 10/26/2012

21 Section Page Text / Reference Question /24/ What is meant by "sourcing arrangements"? usiness process outsourcing relationship between the Exchange and the Call Center Vendor and any transfers/escalation procedures as defined and agreed upon between the stakeholder parties /24/ Is this referencing training that the vendor would provide to the Exchange team? What is meant by the "Exchange's governance team"? The Vendor through maintaining a detailed knowledge base may recommend specific topics to be covered in the overall Exchange training program based on their everyday experience with the consumer. The Exchange's Governance Team refers to its leadership /24/ Is the self-help for the IVR and website or would consumers have access to the CRMs? For what purpose? Which call centers are included? Yes, the self help is for the IVR and website. The Call Centers references are call centers of stakeholder agencies where the Vendor will provide "warm" or "cold" transfer of the consumers depending on the type of their inquiry /24/ Please clarify what is meant by all applicable locations where the services are performed. CRM system should be centralized if the vendor uses several locations for its staff /24/ Is Exchange referring to the Exchange staff or is it meant to include consumers? The Exchange staff /24/ Is the knowledge database to be viewed by consumers? Via what channels? For example, would the HIX portal have a link to the knowledge database? Elements of the knowledge database will be shared on the Web Portal /24/ and 159 Please confirm that this is a requirement of the ACD rather than the CRM. This is a requirement of the ACD. Exchange Call Center Questions & s Final Last Updated 10/26/2012

22 Section Page Text / Reference Question /24/ Per 226 in "The vendor shall actively participate in the Exchange Change Management process in coordination with the State's System Integrator Change Management process." Can the State please provide bidders with the Exchange's Change Management process and the State's System Integrator's Change Management process? It will be provided to the selected vendor once it becomes available /24/ Per 236 in "The vendor shall provide an Impact Analysis and Risk Management plan, including mitigations and contingencies, to minimize the business and technical risks in the implementation of the Exchange Call Center services." Can the State please clarify when this plan is due? Initial plan should be provided within 30 calendar days of the Vendor on board. The Plan will have to be updated and maintained throughput the life of the project /24/ Per 240 in "The vendor shall ensure that DR Plans comply with the Exchange external audit requirements." Can the State please provide its external audit requirements? It will be provided to the selected vendor once it becomes available /24/ Per 244 in "The vendor shall test all DR processes at least annually against stated DR Service Levels and provide a copy of test results comparing actual test recovery times to stated DR Service Levels to the Exchange for review." Can the State please provide its DR Service Levels? It will be provided to the selected vendor once it becomes available /24/ Please clarify the types of status updates envisioned. Since the web portal is not managed by the vendor, how would status updates be provided via web link? Status of open tickets could be communicated through e- mail or other preferred method of communication that the client specified /24/ What is meant by "service, region, and classification"? The structure of the monthly report will be confirmed with the selected vendor. Exchange Call Center Questions & s Final Last Updated 10/26/2012

23 Section /24/ /24/ Page Text / Reference Question What is meant by requests? Is this the same as calls by type? Please clarify what is meant by this requirement. Yes. Known system related errors indentified by the clients /24/ Please provide examples of what is referred to as "open request". Specific categories of requests will be tracked by the Vendor through resolution. These requests will remain open until they are resolved and closed /24/ Please clarify what is meant by "Skillset reports"--is this the same as level of activity in each tier? This is an industry term. Example skillset reports may include number of calls handled by type of agent skillset (e.g. broker skillset, tier 1 general inquiry, tier 2), average call length by skillset, etc /24/ What kind of "new Exchange requests" would this involve? The Exchange will require the vendor to have flexibility for changes and unforeseeable circumstances following the roll out of the solution /24/ What is meant by "market information"? Please refer to question /24/2012 NA General What is the intention of the State concerning ownership of assets purchased for use during the course of this project? Will the State be taking ownership of the assets implemented during the course of the Stand Up phase, or will that ownership be with the vendor? Please propose pricing to cover purchased assets. The State desires a vendor to leverage their own infrastructure as much as possible /24/2012 NA General What is the role of the Exchange Call Center in processing paper and faxed applications and handling missing verifications? Please refer to questions 14 and /24/ Provide multichannel access into the State including Web, IVR, and Web-chat through a no wrong door approach for a seamless consumer assistance experience. Will the Call Center vendor have the capability to integrate our existing Web chat solution with the Exchange s Web portal? Or will the Exchange implement a new Web chat solution the Call Center vendor will have access to? Please refer to question 50 and 74. Exchange Call Center Questions & s Final Last Updated 10/26/2012

24 Section Page Text / Reference Question /24/2012 Item If approved by the Exchange, make the knowledge base available online to consumers for consumer self-help. Does the Exchange envision the consumer-accessible knowledge base as a separate web portal or will it be made available through integration with the Exchange Web portal? Consumer facing knowledge base will be available as part of the web portal /24/2012 Item Manage content in conjunction with the Exchange knowledge owners to insure continued accuracy applicability of knowledge elements to the State environment. Does the Exchange envision that the Call Center vendor will be responsible for writing and getting all content for the Knowledge ase approved by various state agencies or will the state agencies be responsible for providing content? Or will the state agencies need write/edit access to the Knowledge ase? If so, please provide guidance on the anticipated number of agencies and users. Elements of the knowledge base that are to be shared on the web portal will be reviewed and approved by the Exchange and other applicable state agencies. It is not anticipated that the stakeholder agencies will need write/edit access to the vendor knowledge base, however may request to review materials contained within the knowledge base for quality assurance purposes /24/2012 Item 269 The vendor shall conduct random surveys of consumers immediately after they have used the Call Center, and report the results of the random survey to the Exchange each month. With these monthly surveys, the vendor will include a minimum survey sample of 25 percent of the requests reported. Are surveys the responsibility of the Exchange/IES vendor? Are surveys conducted by phone, or via the Web portal? The surveys following the integration with the Call Center personnel may be conducted by either phone/ivr or web. Surveys conducted through the web will be reported on by the Exchange/IES vendor. Surveys conducted through the phone will be reported on by the Call Center PO vendor /24/ Is it a preference for you to have a call-center in the state of Connecticut? Although it is not mandatory for the selected vendor to build a call center in Connecticut, the call center should be located in the United States (preferably Connecticut), with staff who are fluent in American English. There must be dedicated Spanish speakers as well. Exchange Call Center Questions & s Final Last Updated 10/26/2012

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