This page was last updated on: June 22, 2015
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.
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.
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.
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:
V. PROPOSAL SUBMISSION REQUIREMENTSEach 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.
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:
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: email@example.com 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. @ firstname.lastname@example.org|
|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.
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.
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: