STATE OF MISSISSIPPI
STATE AND SCHOOLEMPLOYEES’HEALTH INSURANCE MANAGEMENT BOARD
REQUEST FOR PROPOSAL
TELEMEDICINESERVICES
June 21, 2016
Contact information for this request for proposal:
TelemedicineServices RFP
c/o DFA - Office of Insurance
501 North West Street
Suite 901-B Woolfolk Building
Jackson, Mississippi39201
TABLE OF CONTENTS
Section 1.INTRODUCTION
1.1Overview and Process
1.2Purpose and Goals
1.3Instructions to Proposers
1.4Important Dates
1.5Intent to Propose
1.6Questions and Acknowledgment of Responses
1.7Duration of Proposal
1.8Statutory Requirement
1.9Statement of Compliance Requirement
1.10Corrections and Clarifications
1.11Right of Negotiation
1.12Acknowledgment of RFP Amendments
1.13Consideration
1.14Mississippi Public Records Act/Confidentiality of Proposals
1.15Withdrawal of a Proposal
1.16Cost of Proposal Preparation
1.17Proposal Evaluation
1.18Post-Award Vendor Debriefing
1.19Right to Consider Historical Information
1.20Right to Reject, Cancel and/or Issue another RFP
Section 2.MINIMUM VENDOR REQUIREMENTS
Section 3.SCOPE OF SERVICES
3.1Medical Consultation Services
3.2Eligibility
3.3Claims Processing
3.4Prescriptions
3.5Staffing/Account Services
3.6Marketing/Communication Materials/Forms
3.7Ongoing Communications
3.8Standard/Ad Hoc Reporting
Section 4.QUESTIONNAIRE
4.1General
4.2Medical Consultation Services
4.3Optional Services
4.4Quality Assurance
4.5Reporting Capabilities
4.6Client Service and Communications
4.7Audit and Compliance
4.8Implementation
4.9Performance Standards
4.10References
4.11Fees
Section 5.FEE SCHEDULE
Section 6.STATUTORY REQUIREMENT
Section 7.STATEMENT OF COMPLIANCE
Appendices:
Appendix ADraft TelemedicineServicesContract
Appendix B2016 Plan Document
Section 1.INTRODUCTION
1.1Overview and Process
The Mississippi State and School Employees Health Insurance Management Board (Board) is seeking a Telemedicine Vendor (TM Vendor) to provide comprehensive telemedicine (TM) services for the Mississippi State and School Employees’ Health Insurance Plan (Plan). In this context, TM Vendor services will be used to offer Plan participants 24 hours a day/7 days a week access to nonemergent health care. These TM Vendor services are defined as the HIPAA-compliant delivery of health care services such as diagnosis, consultation, or treatment through the use of interactive audio, video, or other electronic media to improve a person’s health and well-being. The Mississippi Department of Finance and Administration’s (DFA) Office of Insurance provides administrative support to the Board, and is coordinating this Request for Proposal (RFP) with assistance from the Board’s consultant, PricewaterhouseCoopers LLP (PwC). The Board desires to contract with a qualified, experienced TM Vendor capable of providing the services as described in Section 3 – Scope of Servicesof this RFP
The effective date of this contract will be January 1, 2017. Theterm of this contract will be three years with two optional one-year renewals at the Board’s discretion.This contract shall be governed by the applicable provisions of the Mississippi Personal Service Contract Review Board (PSCRB) Rules and Regulations, a copy of which is available from the Mississippi State Personnel Board located at 210 East Capitol Street, Suite 800, Jackson, Mississippi, 39201 for inspection, or to downloadat
The purpose of this RFP is to solicit competitive proposals by defining the Board’s needs, providing potential proposerswith adequate information to develop proposals, describing the evaluation criteria by which proposals will be scored, and providing proposers with a draft contract for consideration. All proposals submitted must be valid for at least one hundred eighty (180) days subsequent to the date the proposals are due.
A copy of this RFP, including any subsequent amendments, along with a copy of all questions from proposers and responses to those questions, will be posted on DFA’s website at under the heading “Bid and RFP Notices”.Before the award of any contract, the proposer will be required to provide sufficient evidence to prove to the Board that it has the necessary capabilities to provide the services specified in this RFP at the time the contract is awarded.The proposer may also be required to provide additional client references, as well as related project experience detail in order to satisfy the Board that the proposer is qualified.The Board may make reasonable investigations, as it deems necessary and proper, to determine the ability of the proposer to perform the work, and proposer shall furnish to the Board all information that may be requested for this purpose. The Board reserves the right to reject any proposal if the proposer fails to satisfy the Board that the proposer is properly qualified to carry out the obligations of the contract and to complete the work described in this RFP.
The Plan is a non-ERISA, self-insured health insurance plan currently providing health insurance coverage to approximately 185,000 participants. Eligible participants include active, retired, and COBRA employees (and their enrolled dependents) of the State of Mississippi’s approximately 330 State agencies, public universities and community colleges, public school districts, and public library systems. Participants are primarily located within Mississippi, with a small number (less than 2%) of participants residing in other states. Participants include approximately 115,000 active employees, 1,000 COBRA participants, 9,500 non-Medicare retirees, 13,000 Medicare eligible retirees, and 46,000 dependents.
The Plan currently offers options of Base Coverage (HDHP) or Select Coverage (PCP Copay) for active employees, COBRA participants, and non-Medicare eligible retirees. Each coverage type is independent of the other. The details of the current Plan can be found in the 2016 Plan Document (see Appendix B). The Board considers potential Plan benefit changes at least annually, based on determined needs for benefit enhancements and revisions and/or fiscal factors.
The Board currently contracts with Blue Cross & Blue Shield of Mississippi (BCBSMS) for third party medical claims administration (TPA) services, and with Advanced Health Systems, Inc. (AHS), a subsidiary of BCBSMS, for provider network services, including management of an exclusive medical provider network. In addition, the Board contracts with Prime Therapeutics LLC (Prime) for pharmacy benefit management services.
1.2Purpose and Goals
The purpose of this solicitation is to contract with an organization that can provide comprehensive telemedicineservices described in Section 3 – Scope of Services of this RFP. The State and School Employees’ Health Insurance Plan is the provider of health insurance to the aforementioned participants, but is not the employer. As such, the Board is seeking proposals for the services described herein to be filed as medical claims with the Board’s TPA, much the same as any other network medical provider. The Board is not seeking per member per month pricing for the medical consultation services described herein, and will not consider such a proposal as responsive to this RFP.
1.3Instructions to Proposers
Proposals must be received in the DFA’s Office of Insurance in Jackson, Mississippi by 2:00 p.m. Central Daylight Time, August 23, 2016. Any proposal received after the deadline will not be considered. Proposals submitted by fax or by electronic mail will not be accepted.
1.Any proposal, including accompanying attachments, will be available for review by State of Mississippi personnel, the Board, members and staff of the Legislature and oversight boards, and the Board’s consultants.
2.Proposals must be submitted in writing to the following address:
Telemedicine Services RFP
c/o DFA - Office of Insurance
501 North West Street
Suite 901-B Woolfolk Building
Jackson, Mississippi 39201
3.Submit one clearly marked original response with signed proposal cover letter, signed Statutory Requirement disclosure statement (see Section 6), signed Statement of Compliance (see Section 7), signed Acknowledgement of Answers to Vendor Questions, and signed Acknowledgement of RFP Amendments (see Section 1), only if an amendment is posted. Include four identical copies of the original response in three-ring binders and include one electronic copy of the complete proposal including all sections in Microsoft Office ® format with appendices in the appropriate Microsoft Office ® format or Portable Document Format (PDF) on flash drive or compact disc. Failure to sign and return these required documents may result in disqualification of the proposal.
4.To prevent opening by unauthorized individuals, all copies of the proposal must be sealed in the package, and the package must be marked, “Proposals – Do Not Open.” A label containing the information from the RFP cover page must be clearly typed and affixed to the package in a clearly visible location.
5.Label and tab the sections of the proposal as follows:
Tab 1 - Introduction
Tab 2 - Minimum Vendor Requirements Confirmation
Tab 3 - Scope of Services Confirmation
Tab 4 - RFP Questionnaire with Responses
Tab 5-Fee Schedule
Tab 6 - Statutory Requirement
Tab 7-Statement of Compliance
Tab 8 - Acknowledgement of RFP Amendments, if any posted
Tab 9 - Acknowledgment of Answers to Questions, if any posted
Tab 10 - Resumes for Key Staff
Tab 11-Communication samples
Tab 12 - Sample Reports
Tab 13 -Any Additional Information
6.Number each page of the proposal. Multiple page attachments and samples should be numbered internally within each document, and not necessarily numbered in the overall page number sequence of the entire proposal. The intent of this requirement is that the proposer submit all information in a manner so that it is clearly referenced and easily located.
7.The Board requests that each page of the printed proposal that the proposer considers confidential be conspicuously marked by being printed on a different color paper than non-confidential pages and be marked in the upper righthand corner of each page with the word “CONFIDENTIAL.” Confidential information may be identified by alternate font color and/or type on electronic copies of the proposal. Failure to clearly identify trade secrets or confidential commercial or financial information will result in that information being released subject to a public records request. Failure to clearly identify trade secrets or confidential commercial or financial information will result in that information being released subject to a public records request (see Section 1.14).
8.Please respond to Section 3 – Scope of Services by restating each service listed and confirm your intention to provide the service as described by stating, “Confirmed”. If your organization can provide the service, but not exactly as described, state, “Confirmed, but with exceptions”, and state the specific exceptions. If your organization intends to provide a listed service through a subcontractor, state, “Confirmed, service will be provided through subcontractor”, and name the subcontractor. If your organization is currently unable to provide a listed service, respond by stating, “Unable to provide this service”. Any additional details regarding these services should be provided in your responses to the questionnaire, or as additional information included as an appendix to your proposal.
9.In preparing your written response to any RFP question or request for information, you are required to repeat each question, including the number, or requirement followed by your response. Please provide complete answers and explain all issues in a concise, direct manner. If you cannot provide a direct response for some reason (e.g., your organization does not collect or furnish certain information), please indicate the reason rather than providing general information that fails to answer the question. “Will discuss” and “will consider” are not appropriate answers.
10.If the proposer does not agree with an item(s) in any section of this RFP or draft Telemedicine Services Contract (see Appendix A), then the vendor must list the item(s) on the signed Statement of Compliance (see Section 7).
NOTE:Clauses in blue type in the draft Telemedicine Services Contract (see Appendix A) are required by PSCRB and/or DFA, and are not negotiable.
11.All information requested is considered important. If you have additional information you would like to provide, include it as an appendix to your proposal. It is the proposer’s sole responsibility to submit information relative to the evaluation of its proposal and the Board is under no obligation to solicit such information if it is not included with the proposal. The Board will use the information contained in your proposal in determining whether you will be selected for contract negotiations. The Board will consider the proposal an integral part of the contract and will expect the proposer to honor all representations made in its proposal.
12.The Board understands that the proposer may consider some of the information provided in the proposal to be proprietary. Therefore, the vendor must also include an additional electronic copy in PDF of the complete proposal, including all appendices and exhibits, with all trade secrets or confidential commercial or financial information redacted, to be provided to a requestor immediately upon receipt of a public records request for proposals.
13.If the Board determines that the proposer has altered any language in the original RFP, the Board may, at its sole discretion, disqualify the proposer from further consideration. The RFP issued by the Board is the official version and will supersede any conflicting RFP language submitted in proposals.
14.All documentation submitted in response to this RFP and any subsequent requests for information pertaining to this RFP shall become the property of the Board and will not be returned to the proposer.
15.Failure to provide all requested information and in the required format may result in disqualification of the proposal. The Board has no obligation to locate or acknowledge any information in the proposal that is not presented under the appropriate outline according to these instructions and in the proper location.
1.4Important Dates
June 21, 2016 / RFP ReleasedJuly 15, 2016 / Intent to Propose and Questions due at the DFA-Office of Insurance by 2:00 PM CDT
July 27, 2016 / Responses to Questions Released as they are received through this date
August 23, 2016 / Proposals Due at the DFA-Office of Insurance by 2:00 PM CDT
September 9, 2016 / Finalists Selected
September 19-23, 2016 / Presentations by Finalists and Site Visits*
September 28, 2016 / TM VendorSelected and Contract Award Notification
November 21, 2016 / Contract Executed and Implementation Commences
January 1, 2017 / Service Effective Date
*If deemed necessary by the Board, some proposers may be asked to make presentations in Jackson, Mississippi.You will be given sufficient notification if you are requested to make such a presentation. The Board will not incur any expense for such presentation. The Board may also determine the need to conduct site visits to verify the information provided in the proposal.
1.5Intent to Propose
All potential proposers are requested to submit their Intent to Propose no later thanJuly 15, 2016 by 2:00 PM CST. Notice may be submitted via email to . The Intent to Propose should indicate your organization’s primary contact, direct telephone number, and e-mail address. The submission of an Intent to Propose does not obligate your company to submit a proposal. Likewise, potential proposers are encouraged, but not required, to submit a Notice of Intent to Propose.
1.6Questions and Acknowledgment of Responses
Potential proposers must be submitted in writing via e-mail, and must be received no later than 2:00 PM CDT, July 15, 2016, in order to receive a response. Proposers are encouraged to submit questions prior to the deadline as they arise. Responses will be posted as soon as they are available. Responses to questions will be made available on DFA’s website at under “Bid and RFP Notices” no later thanJuly 27, 2016. Responses to questions will be treated as amendments to the RFP and will require acknowledgment. A copy of the questions and answers shall be sent to all proposers who submit an “Intent to Propose”. It is the proposer’s sole responsibility to monitor the website for responses to questions.
1.7Duration of Proposal
Within the introduction section of the proposal, you must state that the proposal is valid for a period of at least 180 days subsequent to the date proposals are due. The proposal shall become part of the contract in the event that the contract is awarded to your organization.
1.8Statutory Requirement
In accordance with Section 25-15-9(1)(a) of the Mississippi Code Annotated, each entity that submits a proposal in response to this RFP must provide a signed disclosure statement detailing any services or assistance it provided during the previous fiscal year to the Board and/or DFA in the development of the State and School Employees’ Health Insurance Plan. The statement must include a detailed description of the proposer’s participation in the development of the Plan, as well as any resulting compensation received from the Board and/or DFA during the previous fiscal year. If you did not provide such assistance to the Board and/or DFA, you must indicate in your signed disclosure statement that this provision does not apply to you. A list of persons, agents, and corporations who have contracted with or assisted the Board in preparing and developing the Mississippi State and School Employees’ Health Insurance Plan and a copy of the statutory requirement are contained inSection 6– Statutory Requirement.
1.9Statement of Compliance Requirement
Please carefully review the information located inSection 7– Statement of Compliance and include acopy signed by an officer, principal, or owner of the organization with your completed proposal. Failure to submit a signed Statement of Compliance may result in your proposal being eliminated from further consideration.If you object to any of the terms and conditions included in the draft Telemedicine Services Contract (see Appendix A), or any requirements listed in this RFP, please note and explain your objections on the Statement of Compliance. Clauses in blue type in the draft Telemedicine Services Contract (see Appendix A) are required by PSCRB and/or DFA, and are not negotiable.
1.10Corrections and Clarifications
The Board reserves the right to request clarifications or corrections to proposals. Any proposal received which does not meet the requirements in Section 1.3– Instructions to Proposers, the requirements inSection 2– Minimum Vendor Requirements, or comply with other proposal requirements of this RFP, including clarification or correction requests, may be considered non-responsive and eliminated from further consideration.
1.11Right of Negotiation
Discussions and negotiations regarding price and other matters may be conducted with a proposer who submits a proposal determined to have reasonable likelihood of being selected for award, but a proposal may be accepted without such discussions. The Board reserves the right to further clarify and/or negotiate with the proposer evaluated best following completion of the evaluation of proposals but prior to contract execution, if deemed necessary by the Board. The Board also reserves the right to move to the next best proposer if negotiations do not lead to an executed contract with the best proposer. The Board reserves the right to further clarify and/or negotiate with the proposer on any matter submitted.