State of Connecticut

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 STATE OF CONNECTICUT 
OFFICE OF THE STATE COMPTROLLER

REQUEST FOR PROPOSAL

HEALTH BENEFITS CONSULTING SERVICES

I. STATEMENT OF OBJECTIVES

The State of Connecticut, acting through the Office of the State Comptroller (OSC) is publishing this Request for Proposal (RFP) for a Health Benefits Consultant Contractor (Contractor). The Contractor may be an individual or organization providing consulting services for public sector health benefits programs. The Contractor selected will provide a full range of consulting services in conjunction with the Comptroller's responsibility to arrange and procure health insurance benefit programs for 1. State employees, retirees, and eligible dependents, and 2. enrollees in the Municipal Employees Health Insurance Program (MEHIP). The contract period will commence on or about October 1, 2005 and expire on September 30, 2009.

II. BACKGROUND INFORMATION

The State Comptroller is empowered by Connecticut General Statutes to arrange and procure "a group hospitalization and medical and surgical insurance plan" for State employees and retirees with approval of the Attorney General and the Insurance Commissioner. The Retirement and Benefits Services Division (RBSD) of the Office of the State Comptroller (OSC) administers the State health insurance program for employees and retirees. The Comptroller also procures health coverage for enrollees of the Municipal Employees Health Insurance Program (MEHIP). The Contractor will be expected to provide a complete range of consulting services to the Office of the State Comptroller in concert with the Comptroller's responsibility to administer and manage the State health insurance program for employees and retirees, including assisting the State with health plan vendor contract negotiations, and managing the MEHIP. 

III. STATE HEALTH PLAN AND CURRENT VENDORS

For many years, the State offered its employees, retirees and their eligible dependents a traditional indemnity plan along with several health maintenance organizations (HMO) options. In response to budgetary pressures, the State and coalition of its employee unions agreed to pursue managed care alternatives. Currently there are 188,000 covered lives in the plan. Under this arrangement, employees and retirees choose from the below-described point of enrollment (POE), point of service (POS) or preferred provider organization (PPO) plans. Annually, the State conducts an open enrollment period in May and June during which employees and retirees can make changes to their coverage. 

MEDICAL BENEFITS

The current vendors participating in the State health plan for medical coverage are United Healthcare/Oxford, Health Net and Anthem. For the 2005-2006 plan year there were changes in the medical plan offerings, however, the medical benefits of all the plans remain aligned and unchanged from the prior coverage year. United Healthcare/Oxford, Health Net and Anthem offer Point of Service (POS), Point of Enrollment (POE) and Point of Enrollment-Gatekeeper (POE-G) plans.

Point of Service Plans (POS) - health care services are available both within and outside a defined network of providers; no referrals are necessary to receive care from participating providers. Health care services obtained outside the defined network may require pre-authorization and are reimbursed at the rate of 80% of the plan allowable cost after the annual deductible has been met.

Point of Enrollment Plans (POE) - health care services are available only from a defined network of providers; no referrals are necessary to receive care from participating providers; health care services obtained outside the defined network may not be covered.

Point of Enrollment Gatekeeper Plans (POE-G) - health care services are available only from a defined network of providers; a primary care physician (PCP) must be chosen to coordinate all care; referrals are required from the PCP for all specialist services.

Out of State - Employees whose permanent residence is outside of Connecticut will be allowed to choose from two Out of Area Plans: the United Healthcare/Oxford USA Plan and the Anthem State Preferred Out of Area Plan.

The MEHIP uses the same carriers, but offers a broader array of plan designs and premium costs, than the State health insurance program.

DENTAL BENEFITS

United Healthcare is the carrier for the Basic Dental Plan. The Basic Plan is an open access type of plan that allows employees to visit any dentist. Dentists who serve State employees and retirees do not have to belong to the United Dental Network to be reimbursed for services.

United Healthcare Enhanced Dental Plan which is a PPO Plan featuring preventive and diagnostic care covered at 100%. There is also coverage for orthodontia. To maximize the benefits available under this plan, employees may utilize a select network of contracted dentists and specialists. There is an out of network feature.

The Aetna Dental Maintenance Organization (Aetna Dental DMO) is a dental HMO. The primary care dentist coordinates the employee or retiree's care. 

PHARMACY BENEFITS

PharmaCare is the State's pharmacy benefits provider. PharmaCare has a network of over 52,000 chain and independent retail pharmacies. 

IV. SCOPE OF WORK

The Contractor will assist the OSC in the ongoing management of its health insurance program. In this capacity, the Contractor will be responsible for monitoring the State's health insurance program, interfacing with health plans as necessary, and holding meetings with State staff at least monthly, including support for, and attendance at the monthly HCCCC meetings. The Contractor will conduct and present its analyses of health vendor data, brief OSC staff on new developments in public sector health benefit issues, and make recommendations for improvements.

Preferred qualifications are past experience and demonstrated proficiency in providing the services described below for public sector clients. The Contractor will be expected to provide services including, but not limited to, the following general services: 

  1. Provision of data-gathering and analytic support to representatives of the Comptroller's Office for administration, review, and evaluation of the State health plans and the MEHIP;
  2. Development of analytic reports using data from State health insurance vendors for the Comptroller's Office and the HCCCC;
  3. Review of existing programs and identification of recommendations for changes in plan provisions, alternative deliver systems, financing alternatives, employee contributions, and other areas, as appropriate;
  4. Management of the competitive marketing process including development of the RFP documents, drafting performance guarantees, analyzing proposals, summarizing bid findings, conducting interviews with finalists, and assisting in the selection of the successful health plans;
  5. Assistance with the implementation of new plans and vendors;
  6. Provision of ongoing program management support services.

V. PROPOSAL SUBMISSION REQUIREMENTS

Each proposal must include the following:

1. Title Page

A title page indicating the date, subject, name of the Contractor, central office address and the local office address - if a local office will be performing the contracted services - and the address, telephone number, name and title of the Contractor's contact person for the purpose of clarifying any information submitted.

2. Organizational Structure

A general description of the Contractor's organization, including the legal structure (corporation, partnership, franchise, etc.), the number of professional and support staff employed and the primary business functions (benefits consulting, actuarial consulting, asset management, insurance provider, etc.).

3. Experience

A description of the Contractor's experience specific to the services requested in this RFP, including the relevant experience of the staff/principal(s) who would be assigned to this project. List all comparable governmental agencies, corporations, and organizations that the staff members designated for the engagement of services sought by this RFP have provided these services to within the past two (2) years, specifying those with a unionized workforce. In addition, the listing should include the number of years that the Contractor has been retained by comparable governmental agencies, corporations, and organizations to provide such services. Contractors are encouraged to identify other experience, factors, or strengths that they possess which may assist the State in its selection process.

4. References

Names, addresses, and phone numbers of individuals who can serve as references. References should be managers and union officials who have worked directly with the Contractor in engagements relevant to the scope of the work proposed in the RFP.

5. Computer Systems

Description of on-site computer system Contractor will be using.

6. Backup Equipment

Description of alternative backup for all equipment which may be used by Contractor.

7. Subcontracts

Identification of the subcontractor(s), if any, to be utilized in meeting the service requirements of this RFP and a listing of the specific tasks to be assigned to the subcontractor(s).

8. Recommended Workplan

A statement of the Contractor's capacity to provide each of the deliverables specified in Section IV of this RFP within the expressed time frame.

9. Work Samples

A sample of any relevant publications, reports, policy and procedural recommendations, memoranda, etc. from previous consulting engagements that the Contractor transmits to clients on a regular basis concerning the scope of work proposed in this RFP.

10. Fee Structure

Provide aggregate hourly and per diem rates, along with the a total maximum, not to exceed cost estimate. The State is not responsible for any costs incurred by any party in responding to this RFP.

The State of Connecticut is exempt from the payment excise, transportation, and sales tax imposed by the Federal Government and the State; accordingly, such taxes must not be reflected in the proposed price.

11. Conflict of Interest

Disclose any current or past (within the last ten years) business relationships which may pose a conflict of interest.

12. Regulatory Issues

Disclose any regulatory problems experienced in the past ten years. 

13. Affirmative Action

The proposal must include a summary of the Contractor's experience with Affirmative Action including a summary of the Contractor's affirmative action plan and the Contractor's affirmative action policy statement.

Regulations of Connecticut State Agencies Section 46a-68j-30(10) require agencies to consider the following factors when awarding a contract that is subject to contract compliance requirements:

  1. The Contractor's success in implementing an affirmative action plan;
  2. The Contractor's success in developing an apprenticeship program complying with Section 46a-68-1 to 46a-68-17 of the Connecticut General Statutes, inclusive;
  3. The Contractor's promise to develop and implement a successful affirmative action plan;
  4. The Contractor's submission of employment statistics contained in the "Workforce Analysis Affirmative Action Report," indicating that the composition of its work force is at or near parity when compared to the racial and sexual composition of the work force in the relevant labor market area; and
  5. The Contractor's promise to set aside a portion of the contract for legitimate small Contractors and minority business enterprises, where applicable. (See CGS 32-9e)

The State of Connecticut's Contract Compliance Forms applicable to State contracts are available at http://www.ct.us/chro/metapages/legalprot/CC-Forms.htm , please click on the four forms indicated below to download the pdf files from the CHRO web page:

This document gives notice that the contract to be awarded is subject to the contract compliance requirements mandated by State statutes and regulations.

This employment information form is used to report the racial and sexual composition of a firm's or corporation's workplace. The form must be completed by the Contractor and submitted with the proposal.

Upon award of a contract, this form is used to document the good faith efforts of a Contractor to include minority business enterprises as subcontractors (including suppliers) on the State contract.

This notice concerns the prohibition of discrimination in employment practices. Upon award of a State contract, the notice must be posted by the Contractor in conspicuous places accessible to all employees and applicants for employment.

More information about the State of Connecticut's Contract Compliance requirements is available on the Commission on Human Rights and Opportunities' website at www.state.ct.us/chro under "Contract Compliance."

14. Authorized Agent

An authorized agent for the Contractor with authority to negotiate and contractually bind the Contractor must sign the proposal; such individual's title, address, and telephone number must also be provide. 

15. Gift/Campaign Contributions Affidavit

Pursuant to Public Act 04-245 and Governor M. Jodi Rell's Executive Order No.1, large State contracts - defined as more than $500,000 in a calendar or fiscal year - must be accompanied by the appropriate Gift/Campaign Contribution Affidavit. All proposals must include the "Bid / Proposal Affidavit" attached herein as Attachment I.

B. The Contractor must submit one original, one unbound, plus 10 copies of their proposal in a sealed envelope upon which a clear indication has been made of the RFP reference title and the date and time the proposal is submitted. The envelope should be delivered to:

Andrea Jackson-Brooks, Executive Assistant
Retirement & Benefit Services Division
Office of the State Comptroller
55 Elm Street, Third Floor
Hartford, Connecticut 06106

C. Contractors who have questions regarding this RFP should submit them by email to the following address: osc.hbcrfp@po.state.ct.us no later than 4:00 p.m. on August 5, 2005. Answers to questions will be transmitted to all Contractors by 4:00 p.m. on August 12, 2005. No phone calls will be accepted relative to this RFP.

D. Proposals must be received no later than 4:00 p.m. on September 1, 2005.

VI. SELECTION PROCESS AND SCHEDULE

Request for Proposal Questions and Response Phase

July 22, 2005 Release of RFP by OSC
August 5, 2005 Questions, if any, due by 4:00 p.m. @ osc.hbcrfp@po.state.ct.us

August 12, 2005 OSC provides e-mail response to questions received
September 1, 2005 Proposals due at OSC

Proposal Review and Contractor Selection Schedule

September 5 - 9, 2005 Reading and Scoring of Proposals
September 13- 15, 2005 Finalist Interviews
September 20, 2005 Contract Awarded

VII. TERMS AND CONDITIONS / INSTRUCTIONS TO CONTRACTORS

Contractors responding to this RFP must be willing to adhere to the following conditions and must affirmatively state their adherence to these requirements with a transmittal letter appended to their proposal response.

  1. Acceptance or Rejection by the State - The State reserves the right to accept or reject any or all proposals submitted for consideration. All proposals will be kept sealed and safe until the deadline for submission has passed.
  2. Conformance with Statutes - Any contract awarded as a result of this RFP must be in full conformance with statutory requirements of the State of Connecticut and the Federal Government.
  3. Ownership of Proposals - All proposals submitted in response to this RFP are to be the sole property of the State, and subject to the applicable Freedom of Information provisions of Connecticut General Statutes, Sections 1-19. Contractors are encouraged not to include any information that is proprietary or not readily available to the public from other sources. If any of the information requested herein is of a proprietary or confidential nature so that it would be exempt from disclosure under the applicable Freedom of Information provisions of Connecticut General Statutes, the Contractor is advised to isolate the information from the other material and label that portion of the submission CONFIDENTIAL.
  4. Ownership of Subsequent Products - Any product, whether acceptable or unacceptable, developed under a contract award as a result of this RFP is to be the sole property of the State of Connecticut, unless explicitly stated otherwise in the RFP or contract.
  5. Availability of Work Papers - All work papers and data used in the process of performing this project must be available for inspection by the State of Connecticut Auditors of Public Accounts for a period of three (3) years or until audited.
  6. Timing and Sequence - All timing and sequence of events resulting from this RFP will ultimately be determined by the State.
  7. Stability of Proposed Prices - Any price offerings from Contractors must be valid for a period of one hundred eighty (180) days from the due date of the Contractor proposals.
  8. Oral Agreements - Any alleged oral agreement or arrangement made by a Contractor with any agency or employee will be superseded by the written agreement.
  9. Amending or Canceling Requests - The State reserves the right to amend or to cancel this RFP prior to the due date and time, if such action is deemed to be in the best interest of the State.
  10. Rejection for Default or Misrepresentation - The State reserves the right to reject the proposal of any Contractor that is in default of any prior contract or for misrepresentation.
  11. State's Clerical Errors in Awards - The State reserves the right to correct inaccurate awards resulting from its clerical errors.
  12. Rejection of Qualified Proposals - Proposals are subject to rejection in whole or in part if they limit or modify any of the terms and conditions and/or specifications of the RFP.
  13. Contractor Presentation of Supporting Evidence - A Contractor, if requested, must be prepared to present evidence of experience, ability, service facilities and financial standing necessary to satisfactorily meet the requirements set forth or implied in the proposal.
  14. Changes to Proposal - No additions or changes to the original proposal will be allowed after submittal. While changes are not permitted, clarification at the request of the State may be required at the Contractor's expense.
  15. Expenses Incurred - The State will not reimburse any Contractor for any costs or expenses incurred in preparing proposals or in any other connection with the RFP, including travel expenses relating to an oral presentation. All expenses incurred by the Contractor in preparing and submitting proposals are the sole responsibility of the Contractor.
  16. Collusion - By responding to this RFP, the Contractor implicitly states that the proposal is not made in connection with any competing Contractor submitting a separate response to the RFP, and is in all respects fair and without collusion or fraud. It is further implied that the Contractor did not participate in the RFP development process, had no knowledge of the specific contents of the RFP prior to its issuance, and that no employee of the agency participated directly or indirectly in the Contractor's proposal preparation.
  17. No Contractor or Contractor's representative may contract an employee of the State or member of the HCCC or their representatives regarding their proposal until final selections have been have been made. Until such time as final selections are made, any such contact will be considered collusion under the "Terms and Conditions" herein and may be grounds for disqualification of the Contractor's proposal.

  18. Conformance to Instructions - All responses to the RFP must conform to the instructions herein. Failure to provide any required information, provide the required number of copies, meet deadlines, answer all questions, follow the required format, or failure to comply with any other requirements of this RFP may be considered appropriate cause for rejection of the response.
  19. Appearances - In some cases, Contractors may be asked to appear to give demonstrations, interviews presentations or further explanation to the RFP's screening committee.
  20. Standard Contract and Conditions - The Contractor must accept the State's standard contract language and conditions. See Standard Contract and Conditions.
  21. Entire Agreement - The contract will represent the entire agreement between the Contractor and the State and will supersede all prior negotiations, representations or agreements, alleged or made, between the parties. The State shall assume no liability for payment of services under the terms of the contract until under the terms of the contract until the successful Contractor is notified that the contract has been accepted and approved by the Office of the State Comptroller and by the Office of the Attorney General. The contract may only be amended by means of a written signed agreement by the Office of the State Comptroller, the Contractor, and the Office of the Attorney General.
  22. 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.

VIII. STANDARD CONTRACT TERMS AND CONDITIONS

Be advised that the State has certain contract requirements. Contractors responding to this RFP must be willing to adhere to the following contract requirements and must affirmatively state their adherence to these terms and conditions with a transmittal letter appended to their proposal response.

Attached as Attachment II are the Terms and Conditions which must be strictly adhered to. In addition, the Contractor must agree that the contract shall be governed by, construed, and enforced in accordance with the laws and court decisions of the State of Connecticut without giving effect to its principles of conflicts of laws. Under no circumstances may a State contract contain limited liability and/or binding arbitration provisions. The State may not indemnify a Contractor or waive its sovereign immunity.

Additionally, please be advised that the State will require the following provision: 

At all times, Contractor shall utilize approved, qualified personnel necessary to perform the services under this Agreement. 

Contractor shall advise the State promptly, in writing, of any labor related occurrence known to Contractor involving Contractor's employees which may reasonably be expected to affect Contractor's performance of services under this agreement. Notwithstanding such occurrence, the Contractor shall at all times assign competent personnel/staff to perform the services contracted for under this agreement. If at any time the State in its sole discretion determines that the personnel/staff assigned to perform the services under this agreement is incompetent, dishonest or uncooperative, State reserves the right to request that Contractor reassign personnel/staff and arrange for an employee(s) or subcontractor(s) satisfactory to State to provide the services otherwise performable by the Contractor hereunder. 

Contractor shall review any requests by State to reassign personnel/staff. In requesting such reassignment of personnel/staff, State shall give thirty-days (30) notice to Contractor of State's desire for such reassignment. Contractor will then have fifteen (15) days to investigate the situation and attempt, if it so desires, to resolve the situation to the mutual satisfaction of the parties. Should the parties not reach a mutual resolution, then fifteen (15) days thereafter, or thirty (30) days from the date of the notice of reassignment, the State may terminate this agreement by providing written notice. 

XI. 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 OSC's requirements:

  1. Contractor's experience with and ability to perform the required services, including experience in working on similar projects with joint labor - management entities.
  2. Contractor's understanding of the project's purpose and scope, as evidenced by the proposed approach and level of effort.
  3. Competitiveness of proposed cost.
  4. Availability and competence of Contractor's personnel.
  5. Conformity with specifications contained herein.
  6. Contractor's ability to keep the OSC informed of significant changes in the laws and regulations governing public health benefit administration.
  7. Demonstration of Contractor's commitment to affirmative action by full compliance with the regulations of the Commission on Human Rights and Opportunities.
  8. At the option of the Screening Committee, Contractor's oral presentation.