REQUEST FOR PROPOSAL Professional Services. Benefits Administration Full Dependent Eligibility Audit. Purchase Requisition Number

Transcription

1 City of Toledo One Government Center 640 Jackson Street Toledo, Ohio REQUEST FOR PROPOSAL Professional Services Benefits Administration Full Dependent Eligibility Audit Purchase Requisition Number Issued By Department of Human Resources Date Issued February 10, 2014 Response Submission Date and Time Tuesday, March 4, 2014 at 1:30 PM EST Drop Off Location City of Toledo Division of Purchases and Supplies One Government Center 640 Jackson Street, Suite 1970 Toledo, Ohio Or submit online at 1

2 Section I GENERAL INFORMATION Background The City of Toledo ( City ) is a public employer that provides municipal services to a community of approximately 300,000 residents. This municipal government has approximately fifteen departments with a workforce of approximately 2,600 benefiteligible employees. The City s Department of Human Resources coordinates the City s healthcare benefits administration and dependent audit program. Scope The City of Toledo is soliciting proposals to conduct a full population audit, which is a one-time verification of the benefit eligible population who have any covered dependents. Covered dependents include (as specified under the City s plan): Spouse Common Law Spouse Eligible Plan or ACA Dependents Domestic Partner Eligible Children of Domestic Partner Legal Guardianship The Evaluation and Selection Committee shall recommend to the City s appropriate decision-makers the vendor whose proposal and oral presentation(s), if requested, demonstrate in their sole opinion, the clear capability to best fulfill the purposes of this RFP. The City of Toledo reserves the right to accept or reject proposals, in whole or part, and to negotiate separately, as necessary, in order to serve the best interests of the City of Toledo. This RFP does not obligate the City of Toledo to award a contract or complete the proposed project, and it reserves the right to cancel this RFP if it is considered to be in its best interest. General Selection Criteria The vendor selected for award will be the vendor whose proposal is deemed to be the most advantageous to the City of Toledo. The City of Toledo is not obligated to select the lowest priced proposal, if that proposal is not complimented with the best quality services, as determined by the City of Toledo, in its sole discretion. RFP Responses Submission In order to be considered, an RFP must be submitted to the City of Toledo Purchasing Office, 640 Jackson St., One Government Center, Suite 1970, Toledo, Ohio 43604, by Tuesday, March 4, 2014, before 1:30 pm and identified by title of proposal on the envelope. In addition to the original RFP, one copy of the RFP must be submitted, typewritten and signed by the individual authorized by the proposing vendor to commit the company. 2

3 Any proposal received after the exact closing date and time specified will not be opened and will not be evaluated regardless of the reason(s) or mitigating circumstances related to its lateness or degree of lateness. Neither a facsimile nor an transmission is an acceptable response to this RFP. Proposals made in pencil will be rejected. Alterations in cost figures used to determine the lowest priced proposal will be rejected, unless initialed in ink, by the person responsible for or authorized to make decisions as to price quoted. The use of whiteout is considered an alteration. Public Records Law The offeror is hereby advised that, upon completion of the evaluation process, all proposals and associated documentation will be made public pursuant to the Public Records Law (O.R.C ). Please do not include statements of confidentiality or proprietary information in your proposal. If proprietary information is requested and submitted, it must accompany the original response to the RFP, and be placed in a separate sealed file or envelope that is clearly marked as proprietary information. Questions from Potential Respondents Potential respondents must submit questions regarding this RFP by . Questions regarding specifications must be directed to Calvin W. Brown, Acting Commissioner, Department of Human Resources at calvin.brown@toledo.oh.gov. Questions regarding the RFP submittal procedure must be directed to Colleen LaChappelle, Purchasing Commissioner, at colleen.lachapelle@toledo.oh.gov. Contract Term The City of Toledo desires to enter into a contract with the successful vendor during The length of the contract shall be for the duration of the project (full dependent eligibility audit). Contract Termination The City of Toledo may cancel the contract upon 30 days written notice, with or without cause. Contract Assignment A contract or any part hereof entered into as a result of this RFP shall not be assigned, sublet, or transferred directly or indirectly, without prior written consent of the City of Toledo. 3

4 Authority to Obligate the City of Toledo The Mayor and City Council of the City of Toledo are the only entities that may legally commit the City of Toledo to the expenditure of funds. Neither the City of Toledo, members of City Council nor the Mayor shall incur cost chargeable to the proposed contract by the contractor before receipt of a fully executed contract signed by the Mayor, which indicates approval of the proposed contract expenditure. Authority to Bind Vendors The proposal must contain a declaration of those individuals having the authority to contractually bind the organization. The proposal must also list the person (s) to be contacted during the period of evaluation of the proposal by the City. The individual s name, title, address, , telephone and fax numbers should be included. Deviations and Exceptions Deviations from and exceptions to terms, conditions, specifications or the manner of this RFP shall be described fully on the vendor s letterhead stationery, signed and attached to the RFP submittal page(s), where relevant. In the absence of such statement, the vendor shall be deemed to have accepted all such terms, conditions and specifications or manner of this RFP prior to the RFP submission deadline, in the manner described, shall constitute a full ad final waiver of that vendor s right to raise the issue later, in any action or proceeding relating to this RFP. Duration of Offer All RFP responses must indicate they are valid for a minimum of one hundred eighty (180) calendar days from the date of the RFP opening, unless extended, by mutual written agreement, between the City of Toledo and the vendor. Prices and terms of the RFP, as stated, must be valid for the length of the resulting contract. RFP Rejection and Waiver of Information This RFP does not obligate the City of Toledo to award a contract or complete the proposed project and it reserves the right to cancel this RFP if it is considered to be in its best interest. The City of Toledo also reserves the right to waive minor informalities and, not withstanding anything to the contrary, reserves the right to: 1. Reject any and all proposals received in response to this RFP; 2. Select a proposal for contract negotiation other than the one with the lowest cost; 3. Negotiate any aspect of the proposal with any vendor; 4. Terminate negotiations and select the next most responsive vendor for contract negotiations; 5. Terminate negotiations and prepare and release a new RFP; 6. Terminate negotiations and take such action as deemed appropriate. 4

5 Contract Payment Schedule All prices shall be as stated in the contract. The City shall neither pay nor be liable for any additional costs including, but not limited to, taxes, shipping, insurance, interest, penalties, termination payments, attorney fees, liquidated damages, etc. Payment for any contract entered into as a result of the request for proposal will be made upon completion of the contracted services. In the event of termination, payment will be made only for charges and expenses incurred through the day of termination. Amendments to Contract No modification of any provision in the contract shall be made or construed to have been made unless such modification is mutually agreed to, in writing, by the vendor and the City s Department of Human Resources and incorporated in a written amendment to the contract approved by the City s Department of Human Resources, prior to the effective date of such modification. Vendor Liability The vendor shall be responsible for any and all damage as a result of the vendor s negligence involving any equipment or service provided under the terms of the contract. Indemnification The vendor shall defend, indemnify, and hold the city of Toledo harmless from and against all claims, losses, and liabilities arising out of personal injuries, including death, and damage to property which are incurred by any party as a result of services provided by the vendor, pursuant to the vendor. Errors and Omissions The vendor will be required to maintain insurance protecting it from claims the vendor may become legally obligated to pay resulting from any actual or alleged negligent act, error or omission, related to the vendor s professional services required under this contract. Conflict of Interest The vendor must provide a list of all entities with which it has relationships that creates, or appear to create, a conflict of interest with the work that is contemplated in this RFP. The list should indicate the names of the entity, the relationship, and a discussion of the conflict. 5

6 SECTION II VENDOR REQUIREMENTS (Please provide complete and succinct responses to items A O.) A. Company Profile 1. Provide the history of your organization. How many years have you been in business? 2. Please discuss your financial soundness. Are recent audited financial statements available for review? 3. Where is your company headquartered? List additional locations. 4. How many employees do you have? 5. Please describe the structure and ownership of your organization. 6. Is any part of the audit or security outsourced? Please describe any use of subcontractors or third-party relationships. 7. Is any part of the eligibility audit handled outside of the United States? Please describe. 8. Please describe any organization changes (mergers, acquisitions, divestitures) that have occurred within the past year, or are scheduled to occur within the next year, that may affect the way in which you deliver service. 9. How many clients utilize your full dependent audit services? Identify the number of clients of similar size and scope and similar sized contracts for full dependent verification services. B. Service Implementation 1. Please describe your account management philosophy. 2. How will the assigned account team be organized? 3. Describe the process for implementation of your audit service. Enclose a sample schedule. 4. What resources and responsibilities would be required of the City and/or its vendors during the implementation process? 5. Describe your quality assurance procedures. 6. Discuss any performance guarantees available, as they relate to system access time, system error, data transfers, accuracy, financial savings, timeliness, etc. C. Full Dependent Audit (All City of Toledo Employees with Dependents) 1. Describe the full dependent audit steps from beginning to end (a complete overview). Include what verification process(s) will be used, what communication will occur, when reporting will occur, etc. Enclose a sample schedule with timelines. 2. What resources and responsibilities would be required of the City and/or its vendors during the auditing process? 6

7 3. Will the full audit service include options for employees to call a toll-free number with questions and/or process required paperwork via US mail or fax as well as online/ ? 4. Describe how you will handle the storage of documents. D. Administrator Capabilities 1. How will the City s Benefits administrator(s) have access to auditing system? 2. Discuss how your system can minimize our liability associated with the inconsistent and inefficient administration of benefit plans and programs. 3. How is the administrator notified of eligibility inconsistencies? 4. Can the administrator specify the verification documentation requirements for each of the dependent types? 5. Is all stored information accessible and easily retrievable to administrators? E. Reporting 1. Please describe your standard reporting package and provide samples. 2. Are customized reports available? What is the process for developing such reports? Are there additional costs associated with custom reports? 3. Please describe the audit trails and how these trails are maintained and administered. 4. How often are reports updated? 5. Describe your company s security and disaster recovery/fault tolerance statements and describe back-up cycles for application and archiving. F. Communications 1. Describe the standard communication materials that are included in your service. 2. What information is distributed to employees prior to the audit, during the audit and after the audit and, in what manner? Describe the process by which those dependents that are to be cancelled are communicated to the client or its carriers. 3. Describe all phases and aspects of the communication pieces between employee and your company concerning the dependent audit. 4. Can the participants be surveyed to determine the effectiveness of the auditing process? Please describe how this will be accomplished and provided to the City. G. Call Center 1. Where is the call center located? What are the hours of live customer support? 2. Would you provide a dedicated toll-free number? 3. Please describe the way your call center is structured (i.e., dedicated or shared resources. etc.) 7

8 4. Are all calling center calls recorded? Do you record all contacts made (written, phone or self-service web changes) for historical purposes. How long do you keep the records? 5. Does your call center have a call escalation procedure? If yes, please describe. 6. Can the call center research, verify and/or resolve eligibility inquiries? 7. Will you provide call-tracking reports? H. Vendor Systems and Technology 1. Please provide an overview of your technology system used to perform services. 2. Please indicate that you acknowledge your company must be able to map, or otherwise make usable, the City s client census data as provided by its health plan carriers. 3. Also indicate your company s ability to accept the City s census data in formats other than the vendor s specified format. 4. Describe your experience and capability in the transmittal and receiving of data files electronically, both with clients and external vendors. How would you ensure data integrity and security? 5. Is there any limit on the number of client options in your system? Please explain. 6. Describe the process by which census information is imported into your system. Please attach your company s census import file specification. 7. Do you accept other census file formats, such as from carriers/vendors? 8. What security measures are taken during transmission? 9. Are you able to report eligibility to the vendor s specifications? 10. How do you ensure that data regarding dependents that are to be cancelled is kept synchronized with carriers? 11. Describe your recommended testing plan to ensure all carriers are receiving correct information. I. Substantiation Process 1. Describe how you will review and substantiate verification proofs provided by employees. 2. Does your system have a limit to the number of verification documents required for any dependent type? 3. Is all the verification documentation your company receives imaged or retained in digital format? Can you provide the City with all verification images on storage media? 4. Do you retain hard copy evidence of the verification beyond termination of services? If so, for how long? 5. Can the City direct your company to destroy the hardcopy evidence? If yes, please describe the process. 6. Describe how employees will be able to provide to your company the verification proofs required. 8

9 7. Describe your experience and capability in the transmittal and receiving of data files electronically, both with clients and external vendors. How would you ensure data integrity and security? 8. Please indicate your company s ability to retain an electronic record (and turnaround time in supplying such information) of all relevant documentation for use in response to potential cancelled employee/dependent litigation. Please describe/submit copies of this retention process and policy. J. HIPAA Compliance 1. Describe how your organization ensures that you and your clients are in compliance with the latest HIPAA regulations and guidelines? 2. Describe your processes and workflow with respect to the handling and disclosure of Protected Health Information (PHI). 3. Please provide names and background of your organization s privacy officer and HIPAA compliance team. 4. How are data-transmission files secured to comply with HIPAA standards? 5. Is your system HIPAA compliant for data security? Explain how. 6. Do terminations automatically generate HIPAA certificates? K. Technical Requirements 1. Describe your technical architecture. 2. Describe your server configuration. 3. What are the user interface system requirements? 4. Are applications available 24 hours a day, 7 days a week? 5. What user groups exist in the system (e.g. company, division, department)? 6. Describe any hardware and software requirements. 7. What Web browsers and versions are supported? 8. Which database(s) do you use to store or employee/company information? 9. Is there a limitation on the hardware or bandwidth resource per client? 10. What is the capacity of your system? How easily can the application be scaled? Please describe this in relation to the number of employee lives, customers, website hits and other capacity measured areas. L. Security (Please complete Exhibit A as well as respond to the questions below.) 1. Describe how data security is handled. 2. How does your company prevent data from being removed from your facilities? 3. What is the time between receiving documentation and completion of data entry? 4. How are multiple security levels and the security parameters defined? 5. Explain how users are authenticated. 6. Does your system support single sign on authentication? 9

10 7. What system security do you have in place to ensure privatization and confidentiality? 8. Please describe the system in place to monitor and prevent electronic, internal and physical breaches. 9. Describe the process for managing logins and passwords. 10. Describe the encryption methods your product utilizes. 11. Do you have audit tracking features that identify the specific changes made to a record? Do you have audit tracking features that reflect the individual who has completed this action? 12. What type of disaster recovery plan does your company have in place for these services? 13. Briefly describe your systems auditing procedures. If you have recently undergone a SAS 70 Type II audit, please disclose the results in an appendix to your response. M. Technical Support 1. Describe your technical support offering. 2. From what location will support be provided? 3. What are the hours of operation? 4. Describe your escalation procedures and standard response times. 5. Describe the help desk services that are available for employee and administrator support. N. References 1. Provide at least three current clients, preferably one or more public sector references, of comparable size, complexity and requirements to the City of Toledo that we may contact as references. Include name of contact, title, phone number, summary of services/applications and when services first began. O. Pricing The proposed system shall include all costs for completion of a full dependent audit. It should be noted the City of Toledo has approximately: 2121 Benefit Eligible Employees 2073 Benefit Enrolled Employees 3310 Dependents 1453 Benefit Eligible Employees with 1 or more Dependents 1. Describe in general, your approach to pricing. Please include a description of any types of requests or work that would be an additional expense to your proposal that may come up throughout the engagement. Give detailed examples. 10

11 2. What is the total cost of the Full Dependent Audit and how is it determined? Detail what is included in the cost (please list, in detail, what this fee covers). Please include all associated costs. 3. Are there separate ongoing postage, printing and fulfillment costs? If so, please list and detail. 4. Does your organization mark up any pass through charges beyond their actual cost to your organization? If so, please identify which costs are increased and the amount of such increase. 5. Please provide a sample contract for the services outlined in this RFP. SECTION III RESPONSE EVALUATION Responses to the RFP will be evaluated on the following criteria: Key Specifications 1. Minimal System(s) Requirements 2. Technical Components 3. Physical and Information Security Respondent Profile and Executive Summary 1. Vendor viability 2. Client References Desired System Functionality 1. Functionality 2. Documentation and associated support services Pricing and Cost in Relation to Services Provided 11

12 Exhibit A Key Specifications System Overview: The City of Toledo has seventy sites located throughout the Toledo area. The City sites are connected to Government Center using a variety of technologies, including private fiber, leased fiber, wireless, and IPSec VPN. Internet service is centralized at Government Center and two (2) separate Internet Service Providers provide redundant and stateful fallover for highly available internet access. Cisco firewalls secure the Internet connections. Cisco network intrusion prevention solutions have been deployed. Remote access VPN is provided to selected users and VPN access is integrated with directory services for authentication. Websense is used for content filtering. Symantec Anti Virus, which is centrally managed, has been deployed to all servers and workstations. Symantec Mail Security has been configured on the SMTP gate way servers. All servers are running Microsoft Windows 2003 or Windows 2008 Server. A Microsoft Exchange 2007 Server cluster has been deployed and GFI Mail Essentials provides SPAM filtering. One EMC NS120 Storage Area Networks have been deployed in a synchronous mirror with over 6TB of data. File Services are installed on the NS120. Symantec Netbackup, multiple Dell media servers, and multiple tape drives in the library are configured for a centralized backup solution. Microsoft terminal Server has been deployed, with applications published to provide remote sites access to rich client applications. VMware vsphere 5.1 has been deployed across four ESX hosts. The following are some of the servers hosted on VMware hosted: a centralized Fax server, VOIP Call Reporting server, Active Directory servers, SMTP gateways, Antivirus and Web Sense filtering servers. Physical and Information Security Overview: The vendor is required to recognize that on the performance of the contract, the vendor will become a holder of and have access to the City of Toledo s individual private data and nonpublic data. In performance of the contract, the vendor agrees it will comply with all applicable state, federal and local laws and regulations, and governing City of Toledo policies. The vendor agrees that its officers, employees and agents will be bound by the above confidentiality laws and that it will establish procedures for safeguarding the information. 12

13 The vendor agrees that its officers, employees or agents will not disclose or make public any information received by the vendor on behalf of the City of Toledo. The vendor shall recognize the City of Toledo s sole and exclusive right to control the use of this information. The vendor further agrees it shall make no use of any of the described information, for either internal or external purposes, other than which is directly related to the performance of the contract. The vendor agrees to indemnify and hold harmless, the City of Toledo from any and all liabilities and claims resulting from the unauthorized disclosure by the vendor, its officers, employees or agents, of any information required to be held confidential under the provisions of the contract. Physical and Information Security Criteria Yes No Explain: (Be as specific as possible to enable us to understand how this will be implemented; please do not simply refer to other material.) Key Specifications: XX XX N/A 1. Data transfers must be encrypted. Provide description of encryption methods employed. 2. Access to data must be restricted to only those individuals needed to fulfill contractual obligations. Describe information management and access control methods utilized. 3. Physical storage of data must be protected from unauthorized access. Describe physical storage security methods. 4. Data must be appropriately backed up and recoverable. Describe backup, recovery, and redundancy processes. 13