![State of Connecticut](../../images/stofct2.gif)
Background Information
This document is a Request for Information (RFI) for plan administration and
marketing/sales services for the Municipal Employee Health Insurance Program (MEHIP). The
selection process for administration, sales and marketing organizations will be a two step
process. The first step will be to gather preliminary information on qualified
organizations through responses to this RFI. The second step will be to obtain detailed
proposals, including fee arrangements to be used in selecting the successful vendors for
MEHIP.
The purpose of this RFI is to determine the organizations which are both interested in
and capable of performing the administrative and marketing services for the MEHIP. The
information gathered in response to this RFI will be used to determine those organizations
which will be sent the Request for Proposals. The response to the RFP will be the basis of
the final selection of the successful organization or combination of organizations.
This RFI will provide potential proposers with a description of the services being
sought as well as a preview of the information that will be required in response to an
RFP. This RFI is divided into three sections. Section I is the request for plan
administration services; Section II is the request for marketing/sales services; and
Section III is the requirements of all vendors.
Because it is critical that the administration function and the marketing function
operate smoothly and present the appearance of being fully integrated to MEHIP customers,
the ideal selected vendor would be able to perform both the administration and the
marketing/sales functions. If two separate vendors are chosen for these functions, they
would be required to work very closely with each other; excellent communication and
rapport between the two organizations is critical to the success of the program. However,
because there are a limited number of organizations with capability to perform both
functions at the level of service expected, MEHIP will consider all proposals from vendors
that wish to propose on only one of the two functions. We request that all vendors
responding to one of the functions review the RFP for the other function in detail to gain
greater understanding of their role.
History of MEHIP
MEHIP was created by the Connecticut Legislature under Public Act Number 96-234 which
was passed on July 1, 1996, "An Act Opening the State Employee Health Plan to
Municipal and Small Business Employees." Its purpose was to enable the State to
create a cost effective health care plan for the State's municipalities through its
relationships with its health care vendors. It empowered the Comptroller to take steps to
create a health care program for municipalities to help reduce municipal health insurance
costs by opening the State Employee Health Plan to municipal and small business employees.
The MEHIP will be operational on July 1, 1997. Coverage under MEHIP is not mandatory; the
program simply creates another option for public employers in the insurance marketplace.
MEHIP is managed by the Office of the Comptroller, which is the state agency responsible
for administering the state employee benefits program. A coalition committee will work
with program staff at the Office of the Comptroller to assist with overall program
direction and policy.
There are approximately 350 to 400 public jurisdiction groups and more than 100,000
public employees (and 250,000 members) eligible for MEHIP. Eligible groups include school
districts, cities, townships and other local jurisdictions. State employees are not
eligible for MEHIP. Exclusive representatives can join MEHIP on behalf of their
represented employees or an employer can choose to join MEHIP on behalf of all employees.
It is expected that the most common way for groups to enroll is as a whole group -- with
both employer and exclusive representatives in agreement. Individual public employees
cannot participate in MEHIP unless the group in which they are employed enrolls in MEHIP.
On behalf of MEHIP, the State of Connecticut will contract with private Connecticut
insurance carriers and managed care organizations to provide the insurance benefits and
services. The carriers are Blue Cross Blue Shield of Connecticut, MD Health Plan and
Kaiser Permanente.
A unique feature of MEHIP is that the selection of health plans is done at the employee
level. Employees can choose any plan (depending on the availability in their location),
while employers only have to contract with one program. The health plans offered are high
quality managed care plans, each with similar benefits, but a different network of doctors
and care providers. If there are areas of the state where there are no managed care plan
options, MEHIP plans to offer a comprehensive major medical plan.
I. Request for Plan Administration Services
A. Services Required of Selected Administration Vendor
The services required of the selected administration vendor are outlined below. The
contract would be effective through July 1, 1999.
New Business Set-up
- Create appropriate employer, enrollee and commission records for all sold business from
the group application and underwritten enrollment forms.
- Produce new business acceptance kits, including:
- Listing of employees with coverage elections and rates
- Benefit summaries
- Initial employer instructions
- Transmit claimant eligibility files to appropriate carriers by disk or tape.
- Assemble employer billing/administration kits.
Premium Billing and Collection
Each group will have its own set of rates depending upon the demographics of that
group. Groups are billed as either two-tier or three-tier rate structures.
- Prepare and mail consolidated employer bills by the 15th of the month prior to the
premium due date.
- Collect premium payment, including:
- Reconciliation of billed and received amounts.
- Allocation and remittance to appropriate carriers, Comptroller and marketing
organization.
- Enforcement of delinquency and termination procedures including, but not limited to,
free-form and system generated letters.
Claimant Eligibility Maintenance
- Update claimant eligibility file based on billing changes such as single/family status.
- Update other status changes such as student status that may be determined by carriers
during claims processing.
- Transmit updated eligibility file to appropriate carriers on tape or disk weekly.
- Serve as interface between carriers and employers concerning questions regarding
claimants eligibility.
Commission Payments
- Determine appropriate commission payments and send checks on monthly basis to selling
agent and marketing support agency. MEHIP will allow for commission payments for
independent agents/brokers beside the marketing support agency.
- Perform necessary accounting for commission payments, including preparation and
distribution of IRS Form 1099.
Customer Service
- Establish and maintain a toll-free customer service line with the capability to transfer
calls to participating vendors and/or providers.
- Serve as day-to-day focal point for employers for all premium billing questions,
eligibility questions and/or the overall operations of the plans.
- Provide ongoing instructions/information to insured employers as needed.
Reports to MEHIP Staff
- Management reports are provided monthly to MEHIP staff. Management Reports will be
developed in accordance with precise needs of the MEHIP. This could involve both standard
and newly programmed reports. Expected reports include:
- Monthly billing information
- Enrollment by plan
- Other group-specific data as requested
- Prepare (Form 5500) Schedule A information as required and provide to employers on a
timely basis.
- Specific eligibility information will be required for MEHIP to administer the
Retrospective Risk Adjustment Model that has been developed by MEHIP. The selected vendor
will work with MEHIP staff and outside consultants as determined appropriate by the state.
It is anticipated that the reporting elements will be finalized before the end of July,
1997.
Recordkeeping
- Employee/spouse dependent data must be stored by employer unit or group. Data must also
be separated into various groups such as:
- Actives;
- Retirees (Medicare-eligible and non-eligible);
- Continuation/COBRA participants; and
- Surviving spouses.
- Data must include at a minimum:
- Name and address of employer (including county);
- Name and address of bargaining unit;
- Premiums by group within employer unit (single/family or employee/employee +
spouse/employee + child/family);
- Employee name, address, date of birth, social security number, eligibility date;
- Spouse/dependent names, social security number, date of birth;
- History of membership changes (i.e., additions, deletions, terminations).
Positive ID File
The selected vendor must establish and maintain a master eligibility file for MEHIP.
The file will have unique positive identifiers for MEHIP and will also maintain employer
specific identifiers. The selected vendor will maintain separate subgroup files for
participating employers as may be requested by MEHIP.
The Office of the Comptroller stipulates a standard of twenty (20) days from date of
sale to actual enrollment of each eligible employee and other eligible individuals in the
health plan of their choice. It is the responsibility of the selected vendor to perform
the enrollment activities in a timely manner to assist the carriers to meet this standard.
Upon notification of a sale, the selected vendor will notify all carriers by providing a
listing with the name of the employer group, the number of members specific to each
carrier and the effective date of coverage. After entry of all appropriate claimant
eligibility data into the master eligibility file, the selected vendor will configure the
data into a format specific to each carrier and transfer the data no later than weekly.
The selected vendor will also make known to each health carrier the individual(s)
designated as the selected vendor's customer service resource for MEHIP. The selected
vendor will send a letter of confirmation to each participating employer who enrolls in
MEHIP. The letter of confirmation must include: (1) a list of subscribers and their
carrier of choice, and (2) confirmed effective date and billing rates, and (3) other
information as specified by the Office of the Comptroller.
Maintenance of the Master Eligibility File
The selected vendor will be required to act on all enrollment and termination
transactions for MEHIP related to new hires, terminations, approved late entrants, COBRA
beneficiaries and retirees reported to it by the agent or a participating employer, in
order to maintain the accuracy of the master eligibility file. The selected vendor shall
execute these transactions within five (5) days after receipt of the information and shall
forward the transactions to the appropriate carrier(s). The selected vendor shall
reconcile the eligibility file with each carrier on a quarterly basis.
Full-Time Students
Full-time student status must be verified for eligible dependents age 19 through 24
years. The selected vendor will mail a notice of confirmation in October, February and May
of each year to each enrolled eligible dependent or employee who must verify full-time
student status within thirty (30) days. If there is no response within the thirty (30)
days, the selected vendor shall cancel coverage effective the first day of the next month
and the subscriber and health carrier will be notified.
Dependent Verification
Upon receipt of enrollment form, the selected vendor will verify the dependent status
of any dependent who is able to be identified as a grandchild, stepchild, illegitimate
child or child with a handicapping condition. This verification will be done before the
child is added to the eligibility file. After all subscribers are enrolled, the
participating carriers will be advised if they identify any dependent who was not
originally identified as a step child, grandchild, illegitimate child or child with a
handicapping condition.
Coverage Effective Dates and Premium Charges
All coverage for employees and dependents eligible on the effective day of coverage
under MEHIP shall begin the first day of the first month of eligibility for the employer
group under the MEHIP. New hires and approved late entrants shall be effective on the
first day of the month following the day their eligibility for health insurance begins
through the participating employer. Approved late entrants shall be effective on the first
day of the month following the day coverage is approved.
Eligible additions to an employer group due to marriage, the addition of first
dependent children or other eligible reason are effective on the first day of eligibility;
premium payments become payable on the first day of the month coinciding with or next
following the effective date of the change.
Terminations effective at any time during a month of coverage will not be calculated as
a refund for partial month coverage. Terminations will not be prorated.
Premium Collection and Billing Statements
The administrator will be responsible for all premium collection activities. They will
produce and mail a consolidated premium billing statement to each participating employer
by the fifteenth (15th) of each month for prepayment of the following month's premium. The
notice shall state that payment from the participating employer is due by the twenty-fifth
(25th) of the month preceding the coverage month.
Delinquency Notices
If a participating employer does not make the required payment, a notice of delinquency
will be mailed by the fifteenth (15th) of the month of coverage. The notice shall state
that coverage will be terminated retroactive to the first of the coverage month if payment
is not received by the selected vendor within ten (10) calendar days, and shall state that
premium for the following months is also due by the 25th of the coverage month, the
selected vendor shall mail a termination notice retroactive to the first of the coverage
month to the participating employer for receipt before the end of the coverage month. This
notice shall also state that the participating employer is ineligible to participate in
MEHIP for a period of two (2) years from the effective date of termination.
By the tenth (10th) day of the coverage month, the selected vendor shall provide
carriers with a listing of all participating employers who are delinquent in paying
employer premiums for the coverage month. By the 25th of the coverage month, the selected
vendor shall provide carriers with a listing of each participating employer who continues
to be delinquent so the carriers can release letters to the affected subscribers with
notification of termination of coverage within the time period required for notification
and grace period under the relevant licensing statutes.
Monthly Funds Distribution
Each month the selected vendor shall distribute the collected employer premiums as
follows:
- The selected vendor shall pay the carrier premium due to each health carrier within
three (3) working days after the date that the selected vendor makes its initial
determination of which participating employers are delinquent as described above.
- The selected vendor shall pay commissions to licensed agents within ten (10) working
days after completion of the monthly accounting and reconciliation.
- The selected vendor shall pay all remaining funds to the Office of the Comptroller
within ten (10) working days after completion of the monthly accounting and
reconciliation.
B. Cost Analysis
This section B is provided to assist potential proposers in obtaining an understanding
of the Office of the Comptroller regarding expectations of how charges might be assessed
by the successful organization(s). Vendors who will be responding to both the
administration and the marketing/sales RFP will be welcome to submit cost in
non-traditional formats. Any combination of commission, flat fees or per member per month
charges can be used. However, the Office of the Comptroller will need to understand the
split of cost of these services.
The Office of the Comptroller expects that the MEHIP will compensate the Enrollment
& Billing Administrator a fee of $xxxx per month for each employee enrolled in MEHIP.
Vendors who are planning to propose only on the administrative section must submit charges
using the following fee structure format.
Administration Fees by Service |
New Group Set-up and Renewal Changes |
$____PEPM |
- Establish MEHIP and Program identifiers on computer system.
- Maintain employer-specific identifiers on computer system within each Program.
- Recalculate and verify rates based on enrollment of new group.
- Advise employer and marketing organization if rates are to be modified.
- Advise carriers of new groups immediately upon notification of the sale.
- Create and maintain a common claimant eligibility file for all carriers.
- Convert claimant eligibility date to a format compatible to each carrier.
- Send a rate confirmation notification to each employer along with an employer
administration guide.
- Implement eligibility edits and controls to prevent fraud and abuse.
|
|
Premium Billing, Collection and Accounting |
$____PEPM |
- Produce and mail consolidated premium bill to employer on the 15th of each month for
prepayment of the following month's premium.
- Advise carriers within 10 days after the premium due date of the employer's failure to
pay premium, and again by the 25th of the delinquency month of the employer's continued
failure to pay and the termination of coverage effective on the first of the following
month.
- Handle premium collection activities.
- Create billing and payment histories.
|
|
Customer Service |
$____PEPM |
- Handle all premium billing, enrollment and eligibility matters; will refer callers to
specific carrier contacts for all claims-related matters.
|
|
COBRA Administration and State Mandates (Optional) |
$___ PEPM |
- Administer eligibility for COBRA continuation and prepare notices.
- Administer premium billing.
- Inform Carriers of eligibility as "terminate/reinstate."
|
|
Claimant Eligibility Maintenance |
$___ PEPM |
- Continuously transmit updated eligibility date to each carrier at least weekly,
including new hires, terminations, approved late entrants, COBRA beneficiaries and
retirees.
|
|
Management Reporting and Program Maintenance |
$___PEPM |
- Create and maintain premium and eligibility reports to use at the end of the plan year
for the Retrospective Risk Adjustment Models.
|
|
Commission Payments and Accounting |
$___ PEPM |
TOTAL |
$___ PEPM |
In addition, please identify and list any other additional charges that you believe
would be required to effectively administer the MEHIP.
C. Criteria for Evaluation -- Plan Administration
Submissions in response to the RFP will be evaluated by the following criteria. The
order listed does not reflect the order of priority.
- Cost of services provided;
- Extent of services provided;
- Capability to handle several lines of coverages and several distinct units per employer
within a complex environment;
- Prospective quality of providing billing, collection and accounting for multi-unit plan,
- Experience in dealing with several insurers, sales support and other support
organizations; and
- Experience in COBRA administration.
D. Office of Comptroller Staff Responsibilities
- To adhere to the general conditions and specifications of the contract.
- To define and develop general operating guidelines to ensure compliance and overall
efficiency.
- To ensure that the program is being properly administered by the participating vendors.
- To assist in annual rebidding\renewal of insurance company and other vendor contracts
and rates.
- To provide various organizations, including the state legislature, with initial and
ongoing enrollment/membership data.
E. Questionnaire for Plan Administration Respondents
Please include complete responses in your proposal to the following questions.
General Questions
- How many years has your organization administered each of the following programs?
- Medical
- Managed Care Arrangements
- COBRA Administration
- Managed Health Care Programs
- Dental
- Life Insurance
- What is the name and title of the person who would be ultimately responsible for the
MEHIP account?
- Where is this person located?
- Please provide a description of that person's qualifications, tenure and experience.
- What level of decision-making and contracting authority does this individual hold in
your organization?
- Does your organization provide clients with up-to-date information on legislative
changes that could impact their plan or their plan's administration (for example,
interpretations of COBRA legislation)? How is this accomplished? Provide an example.
- Does your standard contract contain a termination clause? If so, under what conditions
can you cancel a contract?
- Please include a list of ten accounts serviced by the office which will be providing
services to MEHIP with enrollment of at least 1,000 employees. Please provide the name,
address, and phone number of an individual from each group who is familiar with the
administration of the program and the level of service provided. Please indicate whether
these accounts are multi-employer plans.
Plan Administration Questions
- Describe the organizational structure of your administrative division. What level of
training, expertise and background is required of your employees?
- What methods do you suggest for collecting initial enrollment data? How will this
information be entered and maintained on your computer system?
- Describe procedures for processing enrollment changes, including marriage, birth,
divorce, death and ineligible dependents.
- How will accuracy of data be confirmed? How frequently will this need to be conducted?
- Describe the computer system you are currently using for enrollment/billing processes.
What enhancements are you planning within the next two years?
- List the standard information you retain on employers and employees. What additional
fields of information are available?
- What type of standard data do you retain on spouses/dependents? How will you maintain
up-to-date records on spouse/dependent information?
- How much time do you estimate for the data collection and data entry phases? What
conditions would either shorten/lengthen this time frame?
- Please provide sample enrollment and change forms
- How will Medicare-eligible/ineligible employees be coded?
- How will enrollment information be communicated to the Marketing/Sales organization and
the insurance organizations? Describe frequency and options (i.e., tape, disk, hard copy).
- COBRA Administration. If you recommend offering plan wide COBRA administration, please
respond to the following:
- Describe your administration of COBRA continuation.
- Describe procedures for monitoring age limits of dependents. How will the employee be
notified? When?
- Explain the conversion procedures for termination of coverage. Provide sample forms.
- Please include sample notification letters, premium billings, etc.
- Describe the procedures for monitoring completion of forms. What happens if an
enrollment/change form is incomplete or unsigned? What are the time frames in which to
resolve or correct the missing information?
- Describe your billing division staff-level of expertise, training, evaluation and
compensation, turnover rate.
- Describe the billing process including cut-off dates, when invoices and membership lists
are generated and when this information is mailed to employers.
- Describe your accounting and reconciliation procedures.
- How are errors on the bill to be reported and corrected?
- Explain your policies and practices on premium refunds/credits.
- Include sample invoices, membership lists, reconciliation reports.
- Describe the banking transactions that will take place upon receipt of payment.
- How will carriers be paid?
- School districts will need special billing arrangements during the summer months. How do
you propose to modify the billing process to account for this three month lapse?
- Describe the organizational structure of your customer service division. What level of
training, expertise and background is required of these employees?
- Describe current response time and follow-up time for existing clients?
- Describe your quality control procedures and programs. Provide results of recent
efforts.
- Are you willing to sign a contract which contains performance measures and penalty
clauses? Do you have contracts of this nature with other large clients? Please include
names and telephone numbers of the clients that can be contacted for references.
II. Request for Marketing/Sales Services
A. Required Marketing/Sales Functions
The functions required of the selected marketing/sales vendor are outlined below. The
selected vendor will be required to work very closely with the administration vendor and
with MEHIP staff at the Office of the Comptroller to ensure smooth operations and
successful enrollment experiences for customers. Most marketing brochures, forms and
training materials will be prepared by, and at the expense of, the marketing organization.
The Office of the Comptroller will be directly involved in the development and production
of these materials and will be included in all review processes. The selected vendor will
also be expected to attend all quarterly MEHIP advisory committee meetings as requested
and will prepare a full report on the status of current marketing activities.
Because the Office of the Comptroller has determined that the success of MEHIP will
rely heavily on positive agent/broker involvement, the selected vendor will be expected to
work closely and in a non-threatening manner with agents and brokers authorized to sell
MEHIP. Agent relations are extremely important and the selected vendor will be expected to
go to great measures to build positive relations with the agent community. This trust
level must be maintained and must be a high priority and capability of the selected
vendor. The selected vendor cannot market competing products to agents' customers and
cannot interfere with existing agent/customer relations. Part of the contract will include
specific non-compete clauses; in addition the role of the marketing/sales organization
will be monitored very closely by the Office of the Comptroller staff to ensure
appropriate and effective marketing practices are occurring. The contract with the
selected marketing/sales vendor will be effective no later than July 1, 1997. The selected
vendor will:
- Provide a pro-active, experienced and licensed statewide sales force so that all areas
of the state will be covered.
- Establish and staff a central 1-800 telephone line which will be used for all marketing
and administrative questions and that will transfer calls directly to MEHIP
vendors/carriers. This line will be required to follow minimum standards of service and
operation specified by the state. The line must be answered by service representation
between the hours of 8 a.m. and 5 p.m. Monday through Friday, excluding normal business
holidays. The selected vendor will be expected to maintain appropriate staffing levels and
provide MEHIP-specific training for each staff person. Due to the importance of providing
superior service for MEHIP customers, voice mail is not acceptable for the toll-free line
at any time.
- Prepare and mail information packets to prospective customers within 48 hours of initial
inquiry, using brochures, forms and other materials approved by Office of the Comptroller
staff. The selected vendor may be asked to prepare some materials for mailing and will
always pay for postage involved.
- Calculate, draft and distribute all rate proposals (preliminary and final) within time
standards (expectation is one week) as determined by the Office of the Comptroller. It is
expected that the rate proposal will include not only the rate page, but a several page
proposal that highlights program policies and is custom-tailored to each individual group.
The selected vendor will work closely with the Office of the Comptroller staff to develop
the proposal format and all marketing materials to be used by the selected vendor in
marketing the program. Proposals must look professional and be minus any typos, errors or
miscalculations. There will be penalties to the selected vendor if quality control
measures are not taken. The Office of the Comptroller retains the right to audit
procedures and resulting products on an ongoing basis.
- Conduct agent training sessions for MEHIP: at least ten per year conducted on an as
needed basis (throughout the state). The Office of the Comptroller reserves the right to
review and refine content of seminars and agent training materials.
- Represent MEHIP at key conferences at least once per year with an exhibit booth, speaker
and/or panel presentation.
- Support MEHIP agent network: answer all questions, send out materials as needed,
maintain & update agent database, monitor eligibility of agents & authorize their
ability to sell MEHIP.
- Provide superior customer service: answer all questions and/or direct customer
immediately to appropriate resource, prepare and mail follow up materials, coordinate and
schedule presentations to customers and prospective customers as needed.
- Provide weekly (during the first six months) and monthly (thereafter) marketing reports
to the Office of Comptroller staff. Reports must include, but are not limited to:
- New leads report.
- Proposals issued report.
- Proposal follow-up or activity report.
- Competitive analysis report.
- Registered agent report.
- Maintain database of sales leads so that information can be sorted by industry, group
size, geographic location and insurance renewal date, to be used for marketing purposes as
directed by the Office of the Comptroller staff. Prepare direct mail pieces for database
and also employ telemarketing techniques to utilize existing data.
- Mail information packets to all leads generated through direct mail brochures.
- Conduct enrollment meetings for all new groups: Must go to the group's worksite and
explain the features of the program, including how to complete enrollment forms. An
explanation of the health plans must be presented in an unbiased manner so as not to
impact enrollment choices. Collect and verify the completeness of all enrollment forms and
follow up with employees and /or agent to ensure completeness of each form. Submit
completed forms in a timely manner to the selected administration vendor. On occasion, an
Office of the Comptroller staff person will also attend the enrollment meeting and assist
in assuring that the group is satisfied with the product and service.
- Develop follow-up action plan for sales leads of groups with more than ten employees:
call the employer, verify that they received the information, encourage them to fill out
census form for rates.
- Follow up on all proposals mailed to groups of more than ten employees: call the
employer or agent, highlight the program's selling features, obtain competitive feedback
on why the group did or did not join. Maintain database of group feedback; supply to the
Office of the Comptroller staff as requested.
- Handle all annual group insurance renewals, including preparation of renewal rates and
materials and conducting of renewal meetings at each group location: Gather eligibility
and experience data, calculate and draft written rate renewals, set-up "open
enrollment" meeting with employer and/or employees to discuss plan selection options,
verify completeness of all renewal forms, and forward forms to the enrollment &
billing vendor. Work closely with administrative underwriting staff on each renewal,
including faxing materials and rates for review/approval. Also include local agent (if
any) in planning process and in information loop so that agent/client relations are not
disrupted and/or displaced.
B. Cost of Services
It is expected that vendors proposing only on the marketing/sales functions will
require a percentage of conventional equivalent premium in order to provide sales support
for MEHIP. This expense will be reflected in the overall premium charged by the program.
Vendors who are proposing on both administration and marketing/sales services may submit
non-traditional cost proposals.
Because the Office of the Comptroller has determined that the success of the MEHIP will
rely heavily upon positive agent/broker involvement, it is expected that the compensation
structure will reinforce that expectation. As a result, it is anticipated that the
sales/marketing agency will receive a small fee if an independent agent sells MEHIP. If an
independent agent is not involved in a MEHIP sale, the sales/marketing agency receives
100% of the base commission.
At this time, the compensation to independent agents/brokers has not been determined.
As part of the RFI process, we are asking for your suggestions based upon your experience
and knowledge of the public employer marketplace for a suggested commission schedule.
MEHIP Independent Agent/Broker Commission Schedule
Number of Employees |
Per Employee Per Month |
Percentage of Carrier Premium |
2 to 10 |
|
|
11-29 |
|
|
30-49 |
|
|
50-100 |
|
|
101-300 |
|
|
300-499 |
|
|
500 or more |
|
|
Assume that commissions are payable for each employee/retiree which enrolls in MEHIP.
C. Criteria for Evaluation
Proposals submitted will be evaluated by the following criteria. The order listed does
not reflect the order of priority.
- Level of fees required;
- Ability to provide statewide sales support;
- Extent and quality of services provided;
- Experience in working with government organizations and/or purchasing pools;
- Previous experience in administering/marketing health insurance; and
- Ability to handle short and long-term sales campaigns and databases.
D. Office of Comptroller Staff Responsibilities
- To adhere to the general conditions and specifications of the contract.
- To define and develop general operating guidelines to ensure compliance and overall
efficiency.
- To ensure that the program is being properly administered by the participating vendors.
- To assist in annual rebidding\renewal of insurance company and other vendor contracts
and rates.
- To provide various organizations, including the state legislature, with initial and
ongoing enrollment/membership data.
E. Sales Plan and Questionnaire
(Will be required for all vendors responding to marketing/sales RFP)
Proposers responding to the RFP will be required to submit a detailed marketing/sales
plan for MEHIP outlining the following. Please label the plan accordingly:
- A description of project objectives and scope as seen by proposer.
- A description of proposed progress reports and proposed working relationship with MEHIP
staff and other vendors involved.
- Your organization's estimated annual budget for enrollment assumptions:
- 1,000 employees.
- 5,000 employees.
- 10,000 employees.
- 25,000 employees.
- 50,000 employees.
Marketing/Sales Questionnaire
Potential proposers providing a proposal in response to the RFP will need to be
prepared to include complete responses to the following questions.
- How do you propose to handle the statewide marketing needs of MEHIP? Do you currently
have a statewide network of sales agents in place? Please describe.
- What experience has your organization had in administering and/or marketing
state-sponsored insurance purchasing pools?
- Who are your major clients, and how many clients do you currently serve statewide?
Nationwide? Please list the type of services you currently perform for each of your major
clients.
- Please describe how the commission structure/incentive pay/bonuses would work for
agents/brokers/employees in your organization.
- Customer service is extremely important to the success of MEHIP. Please provide a brief
statement about your customer service/sales philosophy.
- How do you train your network of sales agents/employees and what kinds of mechanisms do
you have in place to monitor their performance and activities?
- What types of reports do you currently generate in your organization to track sales
activities?
- Which insurance carriers does your organization currently represent?
- How many agents/brokers would you provide to sell MEHIP? Please provide brief histories
and qualifications of each. How would you propose to handle MEHIP and the added agent
relations function? What additional staff would you add to serve MEHIP customers
specifically? How many of these will you need to add to your existing arrangements?
Include a sales staff to employee ratio.
- . Please summarize your organization's experience in:
- Group medical
- Plan administration (i.e., initial enrollment)
- Group dental
- Group life insurance
- Provide your ideas for developing a pro-active agent relations program for MEHIP.
III. Requirements of All Vendors
A. Limitations of the RFI Process
The Office of the Comptroller seeks proposals for informational purposes only from
prospective organizations and will not willfully omit any qualified proposers. The Office
of the Comptroller shall be held harmless for any failure to solicit responses from
potential proposers.
This RFI does not commit the Office of the Comptroller to award a contract, to pay any
costs incurred in preparing an informational proposal for this request or to procure a
contract for services or supplies. The Office of the Comptroller reserves the right to
accept or reject any or all proposals received as a result of this request.
The Office of the Comptroller will be held harmless for any intentional or
unintentional misrepresentation of the MEHIP in any ensuing circumstances. Responses to
this RFI will be used to determine the qualified organizations which will receive the RFP.
Responses to the RFP will be used to select the successful vendors for the MEHIP.
B. Vendor Compliance with Statutes
Potential proposers will be expected to conform to all State Statutes. Connecticut
State Statute is the enabling legislation for MEHIP.
In accordance with the provisions of Connecticut Statutes, potential proposers will be
required to submit an affirmative action plan in response to the RFP.
C. Office of the Comptroller Approval of Key Vendor Staff
The Office of the Comptroller will reserve the right to be involved in the selection of
and/or replacement of all key vendor staff that will represent MEHIP. The Office of the
Comptroller will have authority to request the removal of vendor staff person(s) from the
account with just cause and will also be included in the final interview process for
candidates to replace any removed staff persons. Any changes in key staff the vendor makes
must be done with 30 day notice and approval of the Office of the Comptroller.
D. RFI Response Timetable and Specific Response Instructions
Response Deadline and Timetable
Timing |
Task |
February 10, 1997 |
Informational meeting and release of RFI. |
February 24, 1997
4:30 PM |
Responses to RFI due at Deloitte & Touche. |
Week of
March 10, 1997 |
RFP released to qualified potential proposers. |
Before the end of
March 1997 |
Responses to the RFP due. |
Early April 1997 |
Analysis of proposals received. |
Mid-April 1997 |
Finalists will be notified and may be asked to supply additional
information and make a presentation to the selection committee. |
Late April 1997 |
Selected vendor(s) announced. |
No later than
July 1, 1997 |
Effective date of vendor contracts. |
Instructions and Procedures for RFI Responses
- Responses to the RFI must be completed and submitted only to the offices of Deloitte
& Touche LLP by 4:30 p.m., February 24, 1997. An executive officer of your company
must sign your response submission in ink. Three copies should be placed in a sealed
envelope and labeled appropriately as either MEHIP Administration Proposal,
Marketing/Sales Proposal, or both. Proposals should be submitted to:
- Mr. Nick Paulish
- Senior Manager
- Deloitte & Touche LLP
- Stamford Harbor Park
- PO Box 10098
- 333 Ludlow Street
- Stamford, CT 06902-6982
- Questions regarding the RFI can be directed to:
- Mr. Nick Paulish
- Senior Manager
- Deloitte & Touche LLP
- Stamford Harbor Park
- PO Box 10098
- 333 Ludlow Street
- Stamford, CT 06902-6982
- Telephone: (203) 708-4691
- Fax: (203) 708-4506
In no event should questions be directed to the Office of the Comptroller.
- Any restrictions on the use of data contained within your RFI response must be clearly
stated in the proposal itself. All data, documentation, and innovations become the
property of the State of Connecticut.
E. Required Elements of the Potential Vendors' Responses to
this RFI
Potential vendors must provide as part of their response to this RFI the following
information requested below. This information will be the only submission required in
response to the RFI. (Questions displayed in Sections I and II are to acquaint potential
vendors with the RFP requirements.)
- General Questions
- What is the name and address of your organization? Please describe the ownership of the
organization, the number of employees employed, and the geographic regions served.
- Which functions are your firm intending to propose on?
- How many years has your organization administered each of the following programs?
- Group Medical
- Managed Care Arrangements
- COBRA Administration
- Group Dental
- Group Life Insurance
- What is the name and title of the person who would be ultimately responsible for the
MEHIP account?
- Where is this person located?
- Please provide a description of that person's qualifications, tenure and experience.
- What level of decision-making and contracting authority does this individual hold in
your organization?
- What experience has your organization had in administering and/or marketing
state-sponsored insurance purchasing pools?
- What experience has your organization had in administering and/or marketing health
insurance purchasing pools?
- Who are your major clients, and how many clients do you currently serve statewide?
Nationwide? Please list the type of services you currently perform for each of your major
clients.
- Please include a list of ten accounts serviced by the office which will be providing
services to MEHIP with enrollment of at least 1,000 employees. Please provide the name,
address, and phone number of an individual from each group who is familiar with the
administration of the program and the level of service provided. Please indicate whether
these accounts are multi-employer plans.
- Plan Administration Questions
- Describe the organizational structure of your administrative division.
- Describe the computer system you are currently using for enrollment/billing processes.
- Describe your billing division staff-level of expertise, training, and turnover rate.
- Describe your accounting and reconciliation procedures.
- Include sample invoices, membership lists, reconciliation reports.
- Describe the organizational structure of your customer service division. What level of
training, expertise and background is required of these employees?
- Describe current response time and follow-up time for existing clients?
- Describe your quality control procedures and programs.
- Marketing/Sales Questionnaire
- How would you propose to handle the statewide marketing needs of MEHIP? Do you currently
have a statewide network of sales agents in place? Please describe.
- Please describe your suggestions based upon your experience and knowledge of the public
employer marketplace for a suggested commission schedule.
MEHIP Independent Agent/Broker Commission Schedule
Number of Employees |
Per Employee Per Month |
Percentage of Carrier Premium |
2 to 10 |
|
|
11-29 |
|
|
30-49 |
|
|
50-100 |
|
|
101-300 |
|
|
300-499 |
|
|
500 or more |
|
|
- Customer service is extremely important to the success of MEHIP. Please provide a brief
statement about your customer service/sales philosophy.
- How do you train your network of sales agents/employees and what kinds of mechanisms do
you have in place to monitor their performance and activities?
- What types of reports do you currently generate in your organization to track sales
activities?
- Which insurance carriers does your organization currently represent?
- How many agents/brokers would you provide to sell MEHIP?
- Additional Information
- Please provide any additional information which you believe would be critical to
assisting the Office of the Comptroller and Deloitte & Touche in understanding the
qualifications of your firm to provide administrative and/or marketing/sales services to
the MEHIP.
- Contact information:
Contact Name: __________________________
Contact Title: ___________________________
Contact Telephone: ______________________
Contact Fax: ___________________________
Authorized Signature: _____________________
Title: _________________________________
Date: ________________________________
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