I. Statement of Objectives
The State of Connecticut, acting through Office of the State Comptroller (OSC) and the Health Care Cost Containment Committee (HCCCC) is seeking a consultant to provide claims recovery services relative to its self-insured health plan vendors for the period from April 1, 1992 to June 30, 1996.
The project consists of three major areas:
II. Background Information
The State Comptroller is empowered by the General Statutes to arrange and procure a "group hospitalization and medical and surgical insurance plan." The Comptroller's Retirement and Benefit Services Division administers the state health program.
HCCCC was established through collective bargaining in 1985 and is composed of six labor representatives, six management representatives, and a neutral chairperson. It is responsible for implementing cost control measures, monitoring and improving plan quality, and initiating health promotion and wellness programs for state employees, retirees, and their eligible dependents.
Prior to April 1, 1992, the state contracted with traditional hospital and medical service plans, indemnity insurers, and several Health Maintenance Organizations (HMO). On April 1, 1992 a plan underwritten by Blue Cross and Blue Shield of Connecticut (BC&BS), which covered approximately eighty percent of all state participants was converted from a fully-insured to an administrative services only (ASO) arrangement. On October 1, 1993, as an outcome of collective bargaining agreement, a Preferred Provider Organization (PPO) was created and elements of managed care were introduced into the state medical plan with the goal of restraining health care costs while improving access and quality of care. Currently, medical plans being offered include a Point of Service (POS) option (Blue Care State Preferred), three Point of Enrollment options (Blue Care State Premier, Blue Care State Advantage, and M.D. Health Plan), and a traditional HMO (Kaiser Foundation Health Plan). Each of these plans provides a supplement to Medicare- enrolled retirees. Prior to July 1, 1996, out-of-state employees and retirees were enrolled in a BC&BS indemnity plan; as of July 1, 1996, this plan is available only to retirees enrolled in Medicare who reside outside Connecticut; non-resident employees and retirees not enrolled in Medicare may choose either Blue Care State Preferred or, where available, Kaiser Foundation.
At present, the state dental program consists of a CIGNA Dental HMO and a BC&BS indemnity plan. The BC&BS plan is self-insured; CIGNA is fully-underwritten. Proposals for a new dental plan are currently under review.
All BC&BS plans and the M.D. Health Plan offering were self-insured during the period under consideration; M.D. Health Plan was converted from ASO to fully-underwritten as of July 1, 1995. These vendor agreements, which have been extended through June 30, 1999, contain risk-sharing arrangements and performance guarantees.
Appendix A provides enrollment totals, as well as claims expenditures, associated with the state's self- insured program for the following periods: April 1992 to September 1993; October 1993 to June 1994; and July 1994 to June 1995. Final data for the period from July 1995 to June 1996 will be available in January 1997.
Appendix B sets forth by plan year the health care offerings for which claims recovery services are required.
III. Consultant Tasks
The contractor selected will be required to perform the following tasks:
IV. CONSULTING ENGAGEMENT SCHEDULE
|Request for Proposals and Response Phase|
|December 16, 1996||Release of RFP by State Comptroller and HCCCC|
|January 6, 1997||Contractors Conference at Comptroller's Office (see note 1)|
|January 21, 1997||Proposals due at Comptroller's Office by 4:30 p.m.|
|Proposed Review and Selection Schedule (see note 2)|
|January 22 - 31, 1997||Reading and Scoring of Proposals by Screening Committee|
|February 5, 1997||Interviews with Finalists|
|February 14, 1997||Award of Contract|
|February 28, 1997||Commence Project|
|December 31, 1997||Conclude Project|
It is anticipated that the agreement negotiated as a function of this RFP will commence on February 28, 1997 and terminate on December 31, 1997.
|LOCATION:||Office of the State Comptroller|
|55 Elm Street, Third Floor|
|Hartford, CT 06106|
V. PROPOSAL SUBMISSION REQUIREMENTS
STATE OF CONNECTICUT
Retirement and Benefit Services Division
Office of the State Comptroller
55 Elm Street, Third Floor
Hartford, Connecticut 06106
Attention: Steven Weinberger, Division Director
A cover letter, including the name, address, telephone number, and facsimile number of the contractor's contact person, signed by an individual authorized to enter into a contract with the state on behalf of the contractor, and describing the office that would support the state's activities. This cover letter must also certify the accuracy of all information contained in the proposal, and disclose any assignments, relationships, or other employment that the contractor (including all employees) has which might create, or be perceived as, a conflict of interest.
A description of the contractor's approach and methodology, including a detailed work plan and project schedule. This section, which may not exceed twenty (20) one-sided pages, must also address the following:
Resumes of the personnel to be assigned to this project.
Submit at least three references for whom you performed consulting services during the last three years similar to those described in this RFP. For each, provide the name of a contact person and telephone number.
Discuss in detail your fees for performing the services requested herein. The state intends to compensate the contractor selected on a contingency basis with a pre-determined percentage of amounts recovered. Such contingency fees will not be paid until such time as the state has actually received the amounts recovered. Please be advised that workers' compensation recoveries will be excluded from the selected contractor's contingent fee arrangement as the state is self-insured for this purpose. The selected contractor will bear all expenses for such recoveries, including but not limited to investigation, retention of counsel, and the payers' reasonable costs incurred in transmitting claims data.
Proposals must include a summary of the contractor's experience with affirmative action. This information is to include a summary of the contractor's affirmative action plan and the contractor's affirmative action policy statement.
Section 4-114a-3(10) of the regulations of Connecticut State Agencies requires agencies to consider the following factors when awarding a contract which is subject to contract compliance requirements:
A "Notification to Contractors" form is attached, to be read, signed, and returned by the contractor. (Attachment I)
Also attached is a Contract Compliance Requirements reporting form, which the contractor must complete sign, and return; such form will be sent by OSC to the Commission on Human Rights and Opportunities (CHRO). (Attachment II)
At the contractor's option, an executive summary may be included in its proposal.
VI. INSTRUCTIONS TO CONTRACTORS
Conformance - All responses to this RFP must conform to these instructions. Failure to conform may be considered appropriate cause for rejection of the response.
Delivery of Responses - RFP responses must be in sealed envelopes upon which a clear indication has been made of the RFP reference title, as well as the date and time the proposal is due. The name and address of the vendor must appear on the envelope. FAX responses are not acceptable.
Structure of Response - Contractors must structure the responses as outlined in this RFP.
Exclusion of Taxes from Prices - The State of Connecticut is exempt from the payment of excise, transportation, and sales taxes imposed by the Federal Government and the State. Such taxes must be excluded from quoted prices.
Signature and Responsible Persons - The proposal must be signed by an authorized official. The proposal must also provide name, title, address, and telephone number for individuals with authority to negotiate and contractually bind the contractor, and for those who may be contacted for the purpose of clarifying the information provided.
"Not to Exceed" Quotations - All cost estimates will be considered as "not to exceed" quotations.
VII. TERMS AND CONDITIONS
Any contractor responding to this RFP must be willing to adhere to the following conditions and must so state in its submission:
VIII. EVALUATION OF PROPOSALS
Each proposal will be evaluated by a screening committee using the following criteria to determine which contractor is most capable of implementing the state's requirements:
IX. RIGHTS RESERVED TO THE STATE
The state reserves the right to award in part, to reject any and all proposals in whole or in part, to waive technical defects, irregularities and omissions if, in its judgement, the best interest of the state will be served.
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