STATE OF NEW HAMPSHIRE 2013-EG-03 REQUEST FOR PROPOSALS PLAN MANAGEMENT CONSULTANTS

Transcription

1 STATE OF NEW HAMPSHIRE 2013-EG-03 REQUEST FOR PROPOSALS PLAN MANAGEMENT CONSULTANTS INTRODUCTION The New Hampshire Insurance Department (NHID) is requesting proposals for contractors to provide plan management capacity to the NHID. Pursuant to the submitted proposal, the NHID Cooperative Agreement to Support Establishment of a New Hampshire Plan Management Partnership Exchange (referred to herein as the Establishment Grant ); the NHID seeks assistance for project management and capacity enhancement to establish a plan management partnership exchange. The contractor(s) shall be provided office space at the NHID, a workstation, and support as needed to perform the contracted services for the NHID. If the Establishment Grant is funded, NHID will need to obtain approval for spending funds from the Joint Legislative Fiscal Committee and approval to accept the grant funds from the Governor and Executive Council. It is anticipated the arrangement will continue on a part-time basis beginning as early as March 1, 2013 and extending through the end of February GENERAL INFORMATION/INSTRUCTIONS The contractors are expected to increase the capacity of NHID to implement the certification and regulation of Qualified Health Plans (QHPs) as described under the Patient Protection and Affordable Care Act (PPACA). Bidders are welcome to provide a proposal for one or more of the positions described below. However, the proposal should clearly identify which of the contracted positions is being proposed in the bid. The NHID is seeking proposals from individual contractors or firms with a desire to provide services as described below. The NHID is open to a mix of on-site and off-site project work although we expect that during the first four months of the project a majority of the tasks will require the work to be done on-site. Proposals should be prepared simply and economically, providing a straightforward, concise description of bidder capabilities. Emphasis should be on completeness and clarity of content. Electronic proposals will be received until 4 pm local time, on February 8, 2013, at the New Hampshire Insurance Department, 21 South Fruit Street, Suite 14, Concord, New Hampshire, s should be sent to [email protected] and include in the subject line: RFP for Establishment Grant Plan Management Consultant Services. SERVICES REQUESTED Project Manager The contractor will lead the effort in the Division of Compliance and Consumer Services to evaluate existing workflows, resources, production standards and tools; to create an implementation plan with new workflows, production standards and tools to support certification 1

2 and regulation of QHPs; provide training and guidance to NHID staff; work with NHID staff to fine-tune the new standards; and issue periodic status reports to senior management at NHID. Amount of time services are needed: The contractor is expected to dedicate up to four days per week in the first four months of the project management activities. The following months will require approximately one day a week (total not to exceed 1000 hours). The contractor is expected to participate in training in the use of the National Association of Insurance Commissioners System for Electronic Rate and Form Filing (SERFF) system. We expect to Compliance Examiner The contractor is expected to increase the capacity of NHID to implement the certification and regulation of Qualified Health Plans (QHPs). The contractor(s) will work within the Division of Compliance and Consumer Services to support certification and regulation of QHPs by providing an increased capacity for examining insurance policy forms, riders, endorsements and advertising to assure compliance with established federal and state laws and regulations. Amount of time services are needed: Capacity is needed to provide compliance examination services three to four days a week (not to exceed 1500 hours in total) to ensure increased production needs of implementing certification and regulation of QHPs. Specifically, to examine insurance policy forms, riders, endorsements and advertising to assure compliance with established federal and state laws and regulations; to prepare communications for issuance through the NAIC electronic database; and to assist Department personnel and the Project Manager with implementation of new plan management processes and workflows. This contractor is expected to participate in training in the use of the National Association of Insurance Commissioners System for Electronic Rate and Form Filing (SERFF) system. Market Analysis and Examination The contractor is expected to increase the capacity of NHID to implement the certification and regulation of Qualified Health Plans (QHPs). The contractor(s) will work within the Division of Compliance and Consumer Services to support certification and regulation of QHPs by providing an increased capacity for achieving the milestones required of a plan management partnership exchange and to assure compliance with established federal and state laws and regulations. Amount of time services are needed: Capacity is needed to provide market analysis and examination two to three days a week (not to exceed 1000 hours in total) to ensure increased production needs of implementing certification and regulation of QHPs. Specifically, to examine state network adequacy requirements and ACA requirements for the identification of provider and service area requirements to meet QHP requirements; to identify reporting requirements and identify tools and data sources necessary to track and report market conduct investigations and examinations related to ACA; to assist in the implementation of new tools and standards; and to assist Department personnel and the Project Manager with implementation of new plan management processes and workflows. This contractor is expected to participate in training in the use of the National Association of Insurance Commissioners System for Electronic Rate and Form Filing (SERFF) system. 2

3 BACKGROUND INFORMATION The New Hampshire Insurance Department submitted a proposal to the U.S. Department of Health and Human Services, Center for Consumer Information and Insurance Oversight (CCIIO) for funding to establish a plan management partnership exchange. The proposal is available on our webpage at and bidders are encouraged to read the proposal to understand the scope of the work being requested. The services will be provided within the context of the Division of Compliance and Consumer Services at the NH Insurance Department. Staff expected to be involved in the project include an Administrator, three Life, Accident and Health Insurance Examiners, a Research Assistant, and two Program Assistants. The experience of these staff range from a newly hired examiner to an Administrator with 28 years of experience. Job descriptions for these positions are available on the State of NH website at The NHID currently accepts rate and file forms using the National Association of Insurance Commissioners System for Electronic Rate and Form Filing (SERFF) system. This is an essential tool of the Division of Compliance and Consumer Services. EVALUATION OF BID PROPOSALS Evaluation of the submitted proposals will be accomplished as follows: (A) General. An evaluation team will judge the potential contractor capabilities and appropriateness for the services to the NHID. Officials responsible for the selection of a contractor shall insure that the selection process accords equal opportunity and appropriate consideration to all who are capable of meeting the specifications. Failure of the applicant to provide in its proposal all information requested in this request for proposal may result in disqualification of the proposal. (B) Specific. A comparative scoring process will measure the degree to which each proposal meets the following criteria: (1) Project Management Specific skills needed for completing the following tasks: a) At least five years of experience in the area of insurance regulatory compliance b) Ability to assess current workflows, tools and standards of health plan management; identify the need for new workflows, tools and standards; and incorporate changes into current structure; 3

4 c) Project management experience including project start-up and implementation; ability to meet timelines and coordinate effectively with NHID staff; d) Experience in training and educating staff; e) Proven communication and organizational skills; f) Documentation and reporting skills for drafting grant reports to the US Department of Health and Human Services; g) Facilitating the collection of data and reporting to Office of Consumer Information & Insurance Oversight as required by law; (2) Compliance Examiner and Market Analysis Specific skills needed for completing the following tasks: a) At least five years of experience in the area of insurance regulatory compliance and/or examination; b) High technical skill for review and analysis of health plans; and or c) High technical skill for examination of network adequacy requirements; d) Knowledge of reporting requirements, tools and data sources necessary to track and report market conduct investigations and examinations; e) Ability to maintain productivity standards and quality standards set by NHID; f) Ability to make decisions based on relevant facts, findings, federal and state laws, regulations and bulletins. g) Ability to meet timelines and coordinate effectively with NHID staff; h) Experience in training and educating of staff; i) Proven written and oral communication skills; Human and administrative resources currently available to NHID employees shall be made available to the contractor. In some cases, responsibilities assigned to the contractor, or that the contractor is responsible for supervising, may be performed by a vendor performing work for the NHID. If the contractor anticipates specific tasks which the contractor is responsible for that will need to be performed by staff of the NHID or an external vendor, those tasks should be clearly specified in the proposal. 50 percent (3) General qualifications and related experience of the contractor. Knowledge of health insurance regulations, plan management review and examination processes, New Hampshire insurance laws, Patient Protection and Affordable Care Act (PPACA), and health insurance benefit designs. Knowledge or experience with the National Association of Insurance Commissioners System for Electronic Rate and Form Filing (SERFF) system desired. Good communication skills and a demonstrated ability to work with both industry and regulatory personnel to achieve appropriate and adequate insurance industry regulation in New Hampshire. Industry experience required. The proposal must 4

5 include a summary of experience, including current curriculum vitae. 25 percent (4) Derivation of cost for the Contractor time. The proposal should include the hourly or daily rate for the Contractor, and the days the Contractor will be in attendance at the NHID. Days per week may be specified or unspecified, and may be based on an average assuming that the workload will vary based on the week. The proposal shall also specify for what time period the Contractor will be available to the NHID, including the start date and end date. The proposal must include amounts for any material expenses related to performing the work (e.g. specialized computer hardware or software) and any expected out-of-pocket or travel expenses. The proposal must include not-to-exceed limits, through contract termination. No benefits in addition to payment for services other than those specifically identified above or included in the proposal shall be provided by the NHID under the contract. 25 percent (C) Conflict of Interest. The applicant shall disclose any actual or potential conflicts of interest. (D) Other Information. The proposal must include a listing of references of recent engagements of the Contractor that reflect the skills appropriate for work on this project, including telephone numbers and specific persons to contact. Potential contractors may be interviewed by staff of the NHID. The New Hampshire Insurance Department will accept written questions related to this RFP from prospective bidders with the deadline being February 1, Questions should be directed to Al Couture via at [email protected]. Please include in the subject line: RFP for Establishment Grant Plan Management Consultant Services. A consolidated written response to all questions will be posted on the New Hampshire Insurance Department s website by February 5, The successful bidder or bidders will be required to execute a state of New Hampshire Contract. A form P-37 contains the general conditions as required by state of New Hampshire purchasing policies and the Department of Administrative Services. Proposals received after the above date and time will not be considered. The state reserves the right to reject any or all proposals. 5

6 Bidders should be aware that New Hampshire s transparency law, RSA 9-F, requires that state contracts entered into as a result of requests for proposal such as this be accessible to the public online. Caution should be used when submitting a response that trade secrets, social security numbers, home addresses and other personal information are not included. 6