RFP 24-10-BG - Benefits Enrollment Service

SCOPE OF WORK

General

• Describe services provided including administration and outsourced services
• What does your company view as its largest competitive advantage?
• Who do you view as your top 3 competitors in this space and why?
• Describe your overall growth strategy?
• Describe your research and development strategy?  What percentage of profits is used for enhancements?
• What is your smallest client size supported and what is your largest client size supported?
• Total number of clients and total number of employees supported
• How many employees do you have?  How many are in customer service?
• What is your turnover in the past 12 months?
• What is your client retention rate for the past two years broken out by year?
• Do you specialize in specific industries?
• Describe any subcontractor or alliance partnerships you have?
• Do you have any reseller relationships?
• Are you or affiliated entities a licensed insurance brokerage?

• A dedicated and experienced client service representative as well as an implementation and client manager with expert and timely support is to be provided and required to meet in person, via phone, or via virtual meeting with the SRCDS Risk Management team on a regular and as needed basis.
• Company is to provide customization options which shall include logo and custom messages and links to other resources and notices.
• Company is to provide notices and/or host the annual or special enrollment periods as may be deemed necessary.
• Provide SRCDS Risk Management, Information Technology ERP Team, and broker team appropriate online or on-site training for systems operations.
• Provide a user guide/instruction manual with regular updates.
• Provide access to online enrollment and life qualifying event change services 365 days of the year/24 hours per day.
• Provide ongoing technical support to employees 8 a.m. to 5 p.m. CT, Monday through Friday.
• Provide a demonstration link (sandbox) for review by the RFP and district Insurance Committee members.
• Provide a test environment on the account platform prior to the defined operational date and ongoing.  Does the test environment mirror the production environment?  How often is it updated?

• Secure, user-friendly website with online enrollment capability that is HIPAA compliant and is available 365 days a year, 24 hours per day.
• The Online Enrollment and Benefit Administration System must have the ability to meet the following requirements:
  • • • • to interface with a variety of third-party vendors, with the ability to send and receive weekly data feeds and various monthly payroll feeds to and from carriers. Flexibility in working with carriers on file specifications is mandatory.
        • to interface with the FOCUS payroll system or another platform as determined by the district.
        • to support information in the payroll system that may have a variety of payroll schedules, payment cycles, contribution amounts, and special deduction codes.
        • to support the SRCDS School Board's business rules and policies regarding issues such as benefit eligibility, leave of absence, dependent eligibility, and contribution amounts.
        • the ability to save selections made during an interrupted online session as a pended selection.
• The selected platform must remain compatible with the SRCDS's network and updated versions of Microsoft Office, Adobe, and common browser tools such as Google Chrome, Internet Explorer, Safari, and Firefox.
• The company must be able to provide system alerts to the Risk Management office for issues such as pended enrollment information, qualifying event status, new employee deadlines, overage dependents, and other deadlines.
• The company must provide assistance in conducting dependent eligibility status audits. Automatic termination for overage dependents; however, system must allow for exception for disability exemption. The system should allow for different maximum age requirements based upon product type.
• The company must maintain remote backup storage and perform data restore testing.
• The system should have capabilities to record and document all information or coverage changes entered. Items to be documented include but are not limited to date and time; details of the change; user identification, mode of communication of change, etc.
• Capability for single sign on.
• How long has the technology platform been in existence?
• Is your solution single tenant or multi-tenant architecture?
• Is the system maintained and developed by your organization?  If not, what is the other vendor providing and who is the vendor?
• How often is the platform updated/upgraded?  Is there a cost for the upgrades?
• Does a client have the ability to opt-out of a new release?
• Have you ever experienced a portal crash during high volume times (Open Enrollment)?  If so please explain the length of time to get back up and running as well as why?
• Describe your ability to support defined contribution structures and any limitations of plan types that can be included.

• Employees should have an access tool that facilitates all aspects of the benefit selection process. This access should be available on all PC or mobile devices.
• Dedicated technology support during technical support hours under "Services" but also emergency support capability during non-work hours, weekends, and holidays.
• Identify employee and his/her unique benefit eligibility along with plan pricing.
• Determine dependent eligibility for each benefit by taking employee through a series of eligibility questions.
• Display all benefit options that employee is eligible to enroll in along with per pay period pricing.
• System should present to employee only those forms that will be needed during the enrollment process rather than just a list of forms.
• Links to voluntary benefit forms are able to be embedded in the enrollment platform.
• Use of district-created employee identification number and single sign on for active employees. Ability for user-created password for retirees.
• Ability for employee to electronically complete and submit any required forms.
• System should notify employee of any additional documentation that will be required. Preference is that the system allows the employee to upload any required document (e.g., marriage license, birth certificate).
• System should be able to capture beneficiary information and allow for multiple beneficiaries to be listed.
• Benefit amounts must be able to be capped by dollar amounts and premiums for some voluntary products must be able to be calculated based on salary and/or age.
• Updating of the demographic information by the employee can be customized by only allowing certain items to be updated. Special information to be provided if field is not available for update.
• Allow for addition of dependents if dependent has been determined as eligible for coverage.
• Education support for participants through the use of downloads and relevant linked content.
• The ability for SRCDS Risk Management staff to add, change, or delete announcements, forms, links, and plan documents on the enrollment website.
• System should be able to manage enrollment of benefits that will require evidence of insurability and are subject to issue limits.
• Ability to provide employees with a confirmation statement following the enrollment process that summarizes their elections and payroll deductions. Sample statement to be included with the proposal submission.
• Describe your modeling and decision support tools.  Can your decision support tool incorporate historical claims data to assist with plan guidance & selection?
• Describe your implementation process.

• Reporting and statistical capabilities that provide common data retrieval and ad-hoc reporting capabilities that provide for selective reporting.
• SFTP capability that provides customized reports and file downloads based upon the reporting needs of SRCDS.
• Ability to track the status of new hires in the new hire enrollment process. Ability to generate correspondence to the employee regarding this status.
• SRCDS must have the ability to pull open enrollment participation reports and open enrollment progress reports.
• The enrollment system must have the ability to provide reports on enrollment selections, changes in enrollment, and premium information on a group and an individual basis.
• Ability to provide exporting report capabilities using payroll deduction codes.
• System must have the capabilities to produce and distribute Form 1095-C in compliance with the Affordable Care Act.
• System must have the capabilities to perform the 1094-C/1095-C reporting requirements to the Internal Revenue Service.
• Secure mail capability.
• Ability to set up agency specific plans and eligibility criteria; report on various classifications or as a total group.
• Administrators and any designees must have access to a reporting portal to generate ad hoc eligibility, enrollment, census, and other reports necessary to manage the benefit plans.
• System should notify SRCDS Risk Management team of any mid-year changes based on newly attained age or salary changes.
• The enrollment system cost must be guaranteed for the initial year of the contract and is to include the terms outlined in the Scope of Services. The cost is to be stated on a Per Employee Per Month basis.
• Initial and annual fees must be disclosed. Any additional costs for services not addressed in the Scope of Services must be outlined.
• Proposed pricing must include the files to the carriers/providers utilized and the files for the applicable payroll system utilized by the School Board.

• How is the data stored and encrypted?
• How is the data protected?
• If the partnership terminates, what will happen to the data?
• When data is deleted, is it permanently erased?
• What are you currently doing to prevent security breaches?
• What security measures do you have in place and do you have a security certification?
• Have you ever had a security breach?  If so, how did it occur and what was the outcome?
• What are the results of your most recent external security audit?  Date of last external security audit?
• How do you inform clients of a security breach?
• What is your disaster recovery and business continuity plan?  How often is your plan tested?
• Do you have a risk assessment committee?  If so, please provide the names, titles and relevant credentials of the committee members.

• What are your system up-time guarantees?
• Do you offer any implementation timeline credits?