Questionnaire/Compliance Form for COBRA Administration

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Corey Douglas
8 years ago
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1 Form for COBRA Administration Questionnaire/Compliance 1. General Information 1.1 Total number of employees in your company. 1.2 Your company shall submit renewal fees to the district no later than February 1 for the subsequent plan year and agrees that if this renewal deadline is not met, the existing fee structure will be maintained for the subsequent plan year. 1.3 Provide name of primary contact that would handle the account. 1.4 Provide location of servicing office and the 800# 1.5 How long has your company been in existence? Indicate your type of business (LLC, C Corp, S Corp). 1.6 Will you provide clients with access to an ERISA attorney at no cost? 1.7 Total # of Current COBRA Clients; Average size of current COBRA clients; total participating employees. 1.8 Indicate your company s hours of operation. 1.9 It is assumed that your company will provide legal assistance regarding COBRA questions. Verify It is assumed that you will coordinate all aspects of HIPAA as it pertains to COBRA services with outside vendors. Verify or explain Confirm your organization will handle the notification of open enrollment changes to current COBRA participants and anyone in the 60 day window. If your organization will not handle the open enrollment notification describe how your organization handles this process It is assumed your company will collect and remit all premiums to the appropriate vendors subject to the COBRA law requirements. Verify or explain.

2 1.13 Does your company provide indemnification protection for non-compliance as a result of an error on your part? 1.14 Describe your disaster recovery plan and business continuation plan Provide your standards for response to written inquiries, voic s and/or s Do you keep original documents on file? Briefly describe your documentation process. How long do you maintain copies of paperwork? 1.17 When are HIPAA notices sent out: a. When COBRA ends? b. Loss of active coverage? 1.18 Verify your company sends out initial COBRA notices to new hires What type of mail service is used to send qualifying event notices? 1.20 Will your company provide a COBRA procedure manual? Is it available online? 1.21 Describe any type of scheduled contact with district personnel (i.e. Newsletter, on-site visits, etc) that is included in your price quote Is all of the administration available over secure website? If not, explain Do you send a monthly bill to the COBRA participant? 1.24 Will you handle ALL COBRA eligible benefits regardless of insurance carrier? 1.25 Provide a copy of your hold harmless and/or client indemnification provision included in your administrative contract Do you keep 2% premium surcharge allowed under COBRA? 1.27 Do you support electronic data transfer, mailed or faxed

Briefly describe your documentation process. How long do you maintain copies of paperwork? 1.17 When are HIPAA notices sent out: a. When COBRA ends? b. Loss of active coverage? 1.18 Verify your company sends out initial COBRA notices to new hires.

3 COBRA notifications? 1.28 Describe your procedure for handling partial or incorrect payment from COBRA participants Describe your online access for COBRA administration for the employer and the participants Describe your best practice for mailing COBRA notices Describe your controls for meeting the COBRA timing requirements What is your goal for generating COBRA notices to participants upon receipt of proper notification? 1.33 Describe the documentation available in case of lawsuits, audits or other related COBRA disputes Describe your customer service measurements: How do you measure the quality of your customer Service? 1.35 Do you outsource any of your COBRA Administration? If yes, indicate service guarantees provided by your outsourcing vendors and the name of the vendor How does your company handle COBRA appeals and disputes? 1.37 Describe how your company would transition any current COBRA participants from the current Administrator to your system Describe your COBRA administration implementation process; provide a timeline How are compliance updates communicated to clients & participants? 1.40 Is your system HIPAA compliant? 1.41 Firm shall accept a Third Party Eligibility Feed either in custom format or in standard 834 file format at no cost. If there is a cost, indicate cost here By providing a response to this RFP, it is assumed your

1.33 Describe the documentation available in case of lawsuits, audits or other related COBRA disputes. 1.

4 company will begin implementation of an electronic data interface and provide file specifications for the development of the interconnectivity between your eligibility systems and benefitsconnect (including testing of files or interface) upon being notified of the client s intent to recommend an award for your services. If your company will require a signed employer application, first month s premium, or any other items before this process can begin please clearly outline here. If nothing is listed, we assume notification from bagnall of your award of business is all that is required to begin implementation when applicable Verify that your company will fund the $2,150 BenefitsCONNECT EDI File implementation fee per EDI File (this is based on the Carrier Requirements) and the $90 per month EDI maintenance fee per EDI File as part of your offer when applicable Your company agrees to allow the client to self-bill if so requested at any time by the client. Thus, your organization will not be required to generate a monthly invoice or adjust eligibility on behalf of the account. A monthly billing invoice, adjusted for enrollment and eligibility changes, will be generated by the account utilizing the benefitsconnect online enrollment software. A billing report will be generated from the benefitsconnect online enrollment platform and provided to you as backup for premium requirements. Indicate your willingness to accommodate this billing process and indicate the credit to your rates/premium that will result from the reduced administrative tasks due to this process. The District requires a 60 day rate/premium adjustment grace period for all retroactive eligibility changes when applicable.

If your company will require a signed employer application, first month s premium, or any other items before this process can begin please clearly outline here.

5 1.45 Verify that your organization will administer COBRA in accordance with all regulations and that you will provide such administration for ALL insurance programs, coverages, and/or services subject to the COBRA law. ANY discrepancies should be clearly noted in this section Indicate any Performance Guarantees and the Financial Penalty that would apply should the Performance Guarantee not be met. The following categories will be reviewed: Implementation, Claim Turnaround Time, Procedural Accuracy, Financial Accuracy, and Customer Service/Account Service Management Verify that your company has Errors and Omissions insurance in an amount not less than $2 million Include copy of Standard Service Contract Please confirm you have quoted $500 annual commissions as indicated in the RFP instructions. If not, please state the commissions quoted.

46 Indicate any Performance Guarantees and the Financial Penalty that would apply should the Performance Guarantee not be met.

Group Enrollment & Coverage Agreement - Conditions and Review

GROUP ENROLLMENT & COVERAGE AGREEMENT PART A - Group Letter of Agreement Federal Tax Identification # - McLaren Health Plan (MHP) will provide health care coverage to eligible persons enrolled through