928 South Ninth Street Springfield, IL 62703-2497 REQUEST FOR INFORMATION GROUP HEALTH BENEFITS RFI-2015-08 RESPONSES DUE: Friday, September 25, 2015 THIS IS NOT A SOLICITATION Page 1 of 7
TABLE OF CONTENTS PART I: EXECUTIVE SUMMARY 3 PART II: SPRINGFIELD MASS TRANSIT DISTRICT OVERVIEW 3 PART III: REQUEST FOR INFORMATION (RFI) REQUIREMENTS 4 Page 2 of 7
PART I: EXECUTIVE SUMMARY The Springfield Mass Transit District (District) is seeking information from qualified brokers and others with expertise in Defined Group Health Insurance Plans for use by municipal agencies. The purpose of this RFI document is to gain a better understanding of the current market for the Group Health Insurance, develop a better understanding of market costs for services required, and solicit feedback for alternative healthcare options that can meet the diverse needs of District employees and retirees. THIS IS NOT A SOLICITATION. No award will be issued as a result of this Request for Information (RFI). No priced offers or unsolicited proposals are sought. In addition, the District will not be responsible for any costs incurred by responders in furnishing any information requested herein or subsequently. This RFI is for planning purposes only and should not be construed as a solicitation for bids, proposals or offers. This RFI should not be construed as an obligation on the part of the District to award a contract, make a purchase or pay any costs incurred in preparation of responses nor should it be construed as a means to pre-qualify vendors. Any cost and/or price information submitted in response to this RFI will be used solely by the District for the purposes of performing a market analysis and establishing a budget for potential future procurement for a group health insurance broker. The District may engage in a formal procurement process for a broker for group health insurance in December 2015 with coverage expected by July 2016. The information gathered through the RFI process will assist the District with the development of a formal procurement solicitation for group health insurance. PART II: SPRINGFIELD MASS TRANSIT DISTRICT OVERVIEW I. Employee and Benefit Information A. Current Profile of Employees As of July 1, 2015, we have 140 employees who are eligible for health benefits described below. The District provides benefits for employees, retirees and dependents. In addition, the District has 59 retirees who are eligible for benefits. Amalgamated Transit Union (ATU) represents 94 employees and Service Employees International Union (SEIU) represents 22 employees. Employee benefits for these employees are subject to collective bargaining. Number of Employees covered Number of Dependents covered Number of Retirees covered by Group Health by Group Health by Group Health 91 58 59 (plus 9 spouses) B. Benefits Information The current plan year is July 1, 2015 June 30, 2015. Employees are covered by the below described benefit plan with covered population consisting of BlueCross BlueShield for group health, and Guardian for dental and vision. Group Health Plan: The District currently has a plan structure that involves Preferred Provider Plan with a $2,500 deductible, and a Total Deductible Plan with a $2,500 deductible. The District has a Health Reimbursement Arrangement that covers a portion of the employee s deductible, depending on the plan chosen. The District pays the premium for its employees at varying rates, Page 3 of 7
up to 100% per the Collective Bargaining Agreement and Administrative Employee Manual. All regular employees are eligible for group benefits upon the first of the month after their first full month of employment. Health Plans: BlueCross BlueShield NPPC2C26 BluePrint PPO BlueCross BlueShield NPC1807 BlueEdge HSA BlueCross BlueShield NPSE3A05 BlueEdge HSA Dental and Vision Plan: Guardian Dental Guard Preferred (Value) Guardian Dental Guard Preferred (NAP) offered for a higher employee rate Guardian VSP Choice Network II. Assumptions The District seeks to provide a group health insurance plan to employees and dependents. We have two groups, the first group consisting of part-time employees, will require benefits that meet the Minimal Essential Coverage (MEC) requirements established by the Affordable Care Act, the second group consisting of full-time employees, shall have benefits equal to or better than already existing coverage; The District seeks to provide health insurance that is affordable to the agency while offering a low cost-share option to employees; The District may pay the premium costs and deductibles at varying rates for the health insurance for each eligible employee/dependent; Employees may be responsible for copayments, deductibles; Health, Dental and Vision Insurance will be provided; 100% of all employees, dependents and retirees shall have access to at least one network primary care provider, hospital, mental health/substance abuse provider, pharmacy and specialists within 10 miles in an urban area and 30 miles in rural areas. PART III: REQUEST FOR INFORMATION (RFI) REQUIREMENTS All official correspondence from the District regarding this RFI shall be transmitted to and from the District s Grants and Procurement Manager. All inquiries, submissions and/or other correspondence regarding this RFI must be directed, in writing, to Shoun Reese. Questions regarding this RFI should be directed to Shoun Reese at the contact information provided below: Shoun Reese Springfield Mass Transit District Grants and Procurement Manager 928 South Ninth Street Email: sreese@smtd.org Springfield, IL 62703 Fax: (217) 789-9819 Letters of Interest in response to this RFI (Responses) are due no later than 3:00 pm (Central Time) on Friday, September 25, 2015 via U.S. Mail or other postal carrier; emailed submissions will not be accepted. Please note that the District reserves the right to extend the deadline for responses at its sole discretion. Respondents shall mark the outer most envelope of their submittal Letter of Interest for Group Health Insurance RFI 2015-08. Page 4 of 7
There will be NO site visit or interviews during the RFI process. When the District issues a formal procurement solicitation, an opportunity for a site visit will be offered during the formal solicitation period. Respondents to this RFI are encouraged to provide the following information to the District: I. QUESTIONS FOR RESPONDENTS In response to this RFI, please provide the following information: A. Introduction: Provide a cover letter, the Respondent s primary point of contact and contact information (name, title, address, telephone number(s), fax number and email address.) B. Requested Information and Responses: (Please reprint each questions with response.) 1. Describe Respondent s organization and the types of services provided. Provide information demonstrating ability to provide services relevant to this RFI. Include examples of successfully executing a plan for similar services within the past 5 years; provide a description of the client s industry, size and enrollment composition. 2. The District currently has a contract year, which coincides with its fiscal year, July 1 through June 30; however, its benefit year is based on the calendar year. When the current contract year ends, employees will be in the middle of their benefit year. Provide information describing a detailed plan for providing District employee health benefits without affecting their benefit year, specifically plan deductibles, out-of-pocket maximums, and any carry-over from the previous plan s last quarter. The plan should describe the financing and outsourcing of a defined contribution plan for the District Group Insurance Program. The plan must provide a single access point for plan participants to select any option available to them through a full cafeteria plan. 3. For the plan described in response to question two, provide an implementation timeline with a July 1 benefit plan effective date. The timeline should include key decisions to be made by the employer and an open enrollment period. If the benefit plan year is based upon a January 1 benefit plan year, describe the methodology(ies) to transition from a July 1 benefit plan year to a January 1 benefit plan year; be sure to describe in detail the all potential costs/savings to the District and/or benefit recipients. 4. Related to the plan described in response to question two, provide details regarding the design features for risk pooling which will prevent adverse selection, and provide information regarding the effects of these features on the District as well as plan participants. 5. Explain how the Respondent would accommodate and provide all necessary and appropriate interfaces with the District s systems. The Respondent should address the changes the District be required make and the adjustments the employees may face. Include information regarding the Respondent s ability to process multiple enrollment files within a coverage month, up to and including daily file transfers. Page 5 of 7
6. Describe in detail consumer-driven health products and other health insurance options, as well as all other qualified benefits that could be offered through the Respondent. 7. Describe how the Respondent can provide product portability. Include in response, the methodology for maintaining accurate records and ensuring data is updated. 8. Identify and describe how the Respondent can provide or offer incentives for healthy behaviors. The respondent should indicate if their healthy behaviors program conforms to industry trends or if they provide for innovation. 9. Identify and describe how the Respondent can provide for the management of chronic diseases and conditions. 10. Relative to the District Group Insurance Program s current offerings and structure, please describe the advantages and disadvantages of the plan described in response to question two. 11. With respect to transitioning other benefit recipients to the plan described in response to question two, please describe any key issues encountered, lessons learned and outcomes. 12. Describe what obstacles to procuring this service the Respondent has experienced and what recommendations does the Respondent have for overcoming those obstacles? 13. Explain your definition and understanding of deductible carry over as it relates to industry standards. Does deductible carry over vary by carrier and is this a negotiable item when selecting a carrier? 14. Explain your definition and understanding of employee out of pocket maximums as it relates to a June-July fiscal/contract year and a January-December benefit year. C. Sample Pricing Information: For the plan described in response to Section B question two, provide general pricing information (i.e., ranges and variables impacting price; not a specific price quote) and specific details regarding how the Respondent is compensated for the services. Include general pricing information for monthly per member administrative fees, other fees and charges, and any additional sources of revenue the Respondent would or could receive in connection to the services described. Describe for example, brokerage fees, override commissions or any other valuable consideration, in any and all forms, from any insurer, insurance agent, insurance broker, or any involved party when such fee proceeds from or may be attributable to the sale of insurance provided to or purchased by or on behalf of participants of the District s Group Insurance Program. PLEASE DO NOT PROVIDE A SPECIFIC PRICE QUOTE. To preserve Respondent s ability to bid on a future procurement related to this RFI it is important to provide general pricing information only (i.e., competitive ranges and variables impacting price; not a specific price quotes). Page 6 of 7
D. Recommended Required Submittals: Describe a list of submittals that the District should require from vendors and a list of criteria that the District should consider when selecting a vendor. E. Additional Information: Provide additional information Respondent believes will be helpful in evaluating whether and how to contract with a single vendor for the financing and outsourcing of a defined contribution plan for the District s Group Insurance Program. The District is especially interested in exploring other vendor relationships for insurance besides the basic insurance broker model. Provide information about services the Respondent could offer. Respondents should include information pertaining to consulting services or other arrangements that may be better suited to assisting the District in meeting the requirements of the Affordable Care Act. Respondents are asked to include information evaluating the feasibility and mechanics of the District developing a defined benefit system, which would allow District employees to obtain their own insurance on the open marketplace. Information that any interested party wishes to submit will be done so voluntarily and with the understanding that this RFI is for information gathering purposes only; this is not a formal solicitation. All responses that are received by the District in response to this RFI will be considered public record subject to the Illinois Freedom of Information Act (5 ILCS 140) and shall be open to public inspection upon the submission of a FOIA request. If respondent believes a portion of the information submitted is proprietary information, the respondent may request that the District keep confidential the proprietary information. For such information to be considered, the respondent must mark only the pages applicable as proprietary. The respondent should not mark the entire document as proprietary. In any event, the District under advice of legal counsel and in accordance with Illinois law shall determine whether information is proprietary. Please note that the District will not respond to questions about the policy issues raised in this RFI. The District may or may not choose to contact individual responders. Such communications would only serve to clarify written responses. Responses to this notice are not offers and cannot be accepted by the District to form a binding contract. Information obtained as a result of this RFI may be used by the District for program planning on a non-attribution basis. This RFI should not be construed as a commitment or authorization to incur cost for which reimbursement would be required or sought. All submissions become property of the District and will not be returned. II. TIMELINE TO RESPOND TO RFI ITEM DATE Release of RFI Friday, August 28, 2015 Final Date to Submit Questions for Clarification Friday, September 4, 2015 District Responses to Requests for Clarification Wednesday, September 9, 2015 Letter of Interest Responses to RFI Due Friday, September 25, 2015 Page 7 of 7