RFP SECTION XI: LIFE AND DISABILITY REQUEST FOR PROPOSALS LIFE & DISABILITY COVERAGE RFP #: 15-32025 RFP Issue Date: June 15, 2015 Life & Disability Proposal Due Date: July 16, 2015 Effective Date: January 1, 2016 1
TABLE OF CONTENTS Page No. A. Current Plan Information... 4 B. Proposed Plan Designs... 6 C. Fully Insured Life & Disability Questionnaire... 7 D. Life & Disability Exhibits... 8 E. Proposed Cost Exhibits... 8 F. Signature Page... 8 2
QUESTIONNAIRES Vendors MUST complete ALL of the Questionnaires applicable to the coverage(s) quoting and include them in the proposal(s). Fully Insured Life & Disability Questionnaire RESPONSE EXHIBITS Vendors MUST complete ALL of the Exhibits applicable to the coverage(s) quoting and include them in the proposal(s). Exhibit 1: Exhibit 2: Exhibit 3: Exhibit 4: Proposal Response Form Submission Checklist Proposed Cost Exhibits Signature Page 3
A. Current Plan Information LIFE & DISABILITY CURRENT PLANS / VENDORS / FUNDING ARRANGEMENTS Please refer to the charts below for an overview of San Juan College s Life and Disability plan information. San Juan College Website: www.sanjuancollege.edu Vendor Plans Tier Structure Funding Contribution Mutual of Omaha Basic Life & AD&D $50,000 Fully Insured 100% Employer Paid Mutual of Omaha Mutual of Omaha Mutual of Omaha Short Term Disability Long Term Disability Supplemental Life EE, Spouse, & Dependents Fully Insured Fully Insured Fully Insured 100% Employer Paid 100% Employer Paid 100% Employee Paid Life Coverage: Amount : $50,000 Guarantee Issue: $50,000 AD&D: Matches life $50,000 Benefits Terminate Upon Retirement Eligibility: Employees working 20 hours or more are eligible. Spouse Coverage: $10,000- Paid 100% by Employee Dependent Child: $5000 14 days to age 19 or 23 if Full Time Student- 100% Employee Paid Short Term Disability: Eligibility: Employees working 20 hours or more are eligible. Maximum Weekly Benefit: 60% of weekly salary up to $500 per week Maximum Duration: 22 Weeks Elimination Period: 29 days Accident & Illness Other Sources is Income Reduction: Yes Long Term Disability: Eligibility: Employees working 20 hours or more are eligible. Maximum Weekly Benefit: 40% of monthly salary up to $2000 per month Maximum Duration: 2 yr/ Age 70 Elimination Period: 180 days Other Sources is Income Reduction: Yes Own Occupation: 24 months Limitations: Mental Illness 24 months; Substance Abuse 24 months; Specified Illness No limit CURRENT COST: Basic Life is combined with Short and Long Term Disability for $16.82 per month. 4
Voluntary Life: Amount: 1X, 2X, 3X, 4X,5X your annual salary Minimum Amount: $10,000 Maximum Amount $500,000 Guarantee Issue: The lesser of $250,000 or 5X Salary AD&D: Matches the Supp Election Age Banded Rates Supplemental Attained Age Rate per $1,000 of Benefit Life Only Life + AD&D < 25 $0.060 $0.080 25-29 $0.060 $0.080 30-34 $0.090 $0.110 35-39 $0.090 $0.110 40-44 $0.130 $0.150 45-49 $0.190 $0.210 50-54 $0.320 $0.340 55-59 $0.530 $0.550 60-64 $0.900 $0.920 65-69 $1.460 $1.480 70-74 $3.590 $3.610 75-79 $3.590 $3.610 80-99 $15.560 $15.580 ELIGIBILITY, EFFECTIVE DATE, CONTIBUTIONS Eligibility: One month of continuous active work. CENSUS The Acknowledgment of RFP must be completed and submitted as instructed in order to receive the census. Once the Acknowledgment has been received the Census, Current Plan Information, Rates, and Claims Data will be sent to the Carrier. 5
B. Proposed Plan Design Options CONTRACT EFFECTIVE DATES The effective date of the new Life & Disability contracts will be: January 1, 2016 PROPOSED PLAN DESIGNS Please provide a quote for the following: 1. Fully insured, non-contributory Basic Life & AD&D Plan for San Juan College Assume the current plan design $50,000 Assume 100% Employer Paid Please provide 1 additional plan design quotes. Please provide quotes net of commission. 2. Fully insured, non-contributory Short and Long Term Disability Plan for San Juan College Assume the current plan design Assume 100% Employer Paid Please provide 1 additional plan design quotes (with shorter elimination period on STD). Please provide quotes net of commission. 3. Fully insured, Voluntary Life & AD&D Plan for San Juan College Assume this is in addition to the Basic Life Plan Assume 100% Employee Paid Please provide quotes net of commission. Life & Disability Plans Notes: 1. Respondents may respond to all or some of the plan designs/coverages contained in the RFP. All responses meeting the minimum requirements will be evaluated. 6
C. Fully Insured Life & Disability Questionnaire FIRM/ORGANIZATION 1. How many trained examiners do you employ at the site where claims will be paid? What is their average length of experience?. What is the volume of claims paid per day per examiner? What is your average annual turnover? % 2.. Show the number of employer groups you service, at your claims office, in each of the size categories below: 250 500 EEs 1,000 5,000 EEs 5,000 + EEs 3. Will you agree to have retention increase at general CPI or some other factor, independent of Life & Disability trend? 4 Will experience be based on actual paid claims (rather than incurred or estimated incurred?) Yes No 5 Is your quote fully pooled/experience rated or have you proposed both? Pooled Experience Rated Blended Both If blended, specify percentage attributed to group's experience. % 6 For the first year and each renewal year, what periods of time will be used as the basis for determining renewal recommendations? Specify weightings to be applied to applicable periods. 7 Confirm that any adjustment of reserves will be suppported by/aligned with current triangulation studies. 8 In the event the account produces a deficit in any one year, will your company seek, in any way, to recoup the deficit? Yes No Please explain in detail. 7
D. LIFE & DISABILITY EXHIBITS VENDORS MUST COMPLETE ALL REQUESTED EXHIBITS IN THIS SECTION. PROPOSAL RESPONSE FORM Complete Exhibit 1. SUBMISSION CHECKLIST Complete Exhibit 2 E. PROPOSED COST EXHIBITS Complete the Proposed Cost Exhibit Exhibit 3. (3a, 3b, 3c, 3d) F. SIGNATURE PAGE Complete the Signature Page contained in Exhibit 4. 8
Pl Please LIFE & DISABILITY RFP SECTION XI EXHIBIT 1 LIFE& DISABILITY RFP Proposal Response Form VENDORS MUST COMPLETE THIS SECTION. Please check (X) the boxes for the coverages / services included in your proposal. Proposal Includes Quotes for the Following Fully Insured Plans Offerings based on Existing Plans Up to one (1) additional plan designs Company Name / Title Date NOTE: Your typed name and date above will be considered a valid signature for this RFP. Contact information for questions related to your proposal. To whom should questions related to your proposal be directed? Name / Title Email Address Phone Number
Life & Disability Submission Checklist LIFE & DISABILITY RFP SECTION XI EXHIBIT 2 This Submission Checklist is a summary of the forms and materials required as part of your proposal. You are urged to thoroughly read the entire RFP and complete the checklist to ensure compliance with the submission requirements. APPLICABLE TO ALL LINES OF COVERAGE Refer to Proposal Organization RFP Section III.A.1 Consideration RFP Section Reference Check if Included 1. Acknowledgement of RFP Form RFP Section I V, and Appendix A 2. Included signed Letter of Transmittal RFP Section III. A 2 3. Included signed Campaign Disclosure Form RFP Section I V. and Appendix C 4. Provided all required materials As requested throughout RFP Sections I V 5. Completed Minimum Requirements RFP Section VI 6. Completed General Questionnaire RFP Section VII APPLICABLE TO MEDICAL RFP (SECTION VIII) Consideration RFP Section Reference Check if Included 1. Completed and signed Proposal Response Form LIFE & DISBILITY RFP, Exhibit 1 2. Completed and signed Submission Checklist (this document) LIFE & DISABILITYRFP, Exhibit 2 3. Reviewed and completed all Questionnaires as outlined in the Table of Contents LIFE & DISABILITY RFP, Questionnaires 4. Completed All Medical Response Exhibits as outlined in the Table of Contents LIFE & DISBILITY RFP, Response Exhibits 1 4 5. Reviewed and signed all Addenda Addenda as released 6. Formal proposal, including all items indicated above and all requested information. As requested in RFP Sections I V, and Section XI 7. Proposal copies submitted and distributed as RFP Section II, B 5 requested. 8. LIFE & DISABILITY Proposal submitted by As requested in RFP Section II, A deadline: 12:00 Noon M.D.T. on July 16, 2015. 9. CD of Reporting Samples RFP Section II, B 5 Company Date Name / Title
PROPOSED COST EXHIBITS BASIC LIFE PLAN PROPOSAL LIFE DISABILITY SECTION XI EXHIBIT 3 January 1, 2016 PROPOSED PROPOSED PROPOSED PROPOSED Eligibility Life / AD&D Benefit Maximum Amount Guarantee Issue Seat Belt Benefit (AD&D) Airbag Benefit (AD&D) Waiver of Premium Benefit Reduction At Age 65: At Age 70: At Age 75: Volume of Insurance Life Rate per $1,000 AD&D Rate per $1,000 Total Monthly Premium $0.00 $0.00 $0.00 $0.00 Total Annual Premium $0.00 $0.00 $0.00 $0.00 Renewal Date
PROPOSED COST EXHIBITS VOLUNTARY LIFE PLAN PROPOSAL LIFE DISABILITY SECTION XI EXHIBIT 3a January 1, 2016 PROPOSED PROPOSED PROPOSED PROPOSED Life Amount Increments Employees: Spouse: Child(ren) 14 days 6 months: Child(ren) over 6 months: Maximum Life Amounts Employees: Spouse: Child(ren) 14 days 6 months: Child(ren) over 6 months: Guarantee Issue Amounts Employees: Spouse: Child(ren): Age of Insured < 20: 20 24: 25 29: 30 34: 35 39: 40 44: 45 49: 50 54: 55 59: 60 64: 65 69: 70 74: Child(ren) per Unit AD&D per $1,000 Minimum Participation Rate per $1,000 Rate per $1,000 Rate per $1,000 Rate per $1,000 Employee Spouse Employee Spouse Employee Spouse Employee Spouse
PROPOSED COST EXHIBITS SHORT TERM DISBILITY PLAN PROPOSAL LIFE DISABILITY SECTION XI EXHIBIT 3b January 1, 2016 PROPOSED PROPOSED PROPOSED PROPOSED Eligibility Benefits Begin Accident: Illness: Percentage of Earnings Maximum Weekly Benefit Minimum Weekly Benefit Benefit Duration Period Occupational Coverage Covered Benefit Rate per $10 Total Monthly Premium $0.00 $0.00 $0.00 $0.00 Total Annual Premium $0.00 $0.00 $0.00 $0.00 Renewal Date
PROPOSED COST EXHIBITS LONG TERM DISBILITY PLAN PROPOSAL LIFE DISABILITY SECTION XI EXHIBIT 3c January 1, 2016 PROPOSED PROPOSED PROPOSED PROPOSED Eligibility Elimination Period Percentage of Earnings Maximum Monthly Benefit Minimum Monthly Benefit Definition of Disability "Own Occ" Benefit Duration Period Earnings Test (Own Occ/Any Occ) Return to Work Incentive Survivor Benefit Mental/Nervous Limitation Special Conditions Limitation Employee Assistance Program Pre Existing Limitation Covered Monthly Payroll Rate per $100 Total Monthly Premium $0.00 $0.00 $0.00 $0.00 Total Annual Premium $0.00 $0.00 $0.00 $0.00 Renewal Date
LIFE & DISABILITY RFP SECTION XI EXHIBIT 4 LIFE & DISABILITY SIGNATURE PAGE VENDORS MUST COMPLETE THIS SECTION. All deviations from the specifications and other standards included in the RFP MUST be specifically outlined and defined in this section of the RFP. An Officer of your organization must sign this Signature Page. In the absence of any identified deviations, your organization will be bound to all of the terms and conditions outlined in the RFP. We certify that our proposal complies with the contents of this Request for Proposal, unless noted in the following list of exceptions. 1. 2. 3. 4. 5. 6. Company Name: Name: Title: Phone Number: E-mail Address: Signature: Date: NOTE: In the case of an electronic proposal submission, your typed name and date above, will be considered a valid signature for this RFP. 1