REQUEST FOR PROPOSALS
RFP-0615-EHBHP
EMPLOYEE HEALTH BENEFITS- HEALTH PRODUCTS
Addendum #1
1) RFP lists Mercer as the Consultant and Gallagher as the Agent of Record. RFP also request that all questions be sent to Gallagher (AOR) but that the Consultant (Mercer) will be reviewing.
Gallagher is the consultant, agent services are not being requested at this time and no agent will be selected.
2) There are conflicting statements regarding commissions/fees? Please verify if commissions/fees are allowable.
No commissions of fees will be allowed
3) Contract Effective Date: September or October 2014?
Currently the administration and stop loss have two different effective dates however they will be consolidated to 9/1/15
5) Month to Month Claims:
Attached
6) Large Claims Information:
Attached
7) Please provide a copy of the full stop-loss policy. Only the application for stop-loss is provided. Again, verify effective date of contract. Stop-loss does not coincide with Plan Year.
Currently the administration and stop loss have two different effective dates however they will be consolidated to 9/1/15
8) ABA Contract list Admin fee for 10/1/2013 contract year to be $29.65 and 10/1/2014 contract year to be $30.65. Does the Admin Fee include UR, COBRA and Large Case Management fees? If not, what are the current fees for these services? If LCM is not provided for a monthly fee, what is the hourly rate? Please provide TPA Administrations Services Agreement.
All inclusive admin fee
9) Will San Benito ISD continue to provide the On-Site Clinic for their employees?
Possibly, no determination has been made on the clinic
10) Under the “Census with Data” provided, are there any COBRA participants? If so, please provide the date COBRA benefits will end.
Not at this time
11) Is the District willing to consider fully insured offers?
Yes the District will consider all offers
12) Benefits Paid by Month Report shows M&N, Expense and Other amounts. What do these dollar amounts represent?
Capitation, clinic, and unspecified expenses
13) Is SBCISD soliciting proposals for dental administration?
Dental administration quotes will be accepted
14) Please provide both RFP - 0615 EHBHP and San Benito CISD - Medical
Benefits RFP Forms in a Word Document format.
Not available
15) Does SBCISD current have a Disease Management program?
Yes
16) Under SECTION H: PREFERRED PROVIDER NETWORK CONTRACTS, the following
is requested:
Please demonstrate your network strength in Cameron, Hidalgo and Willacy Counties
17) Your Plan Documents indicate that the SBCISD Plans are
"Grandfathered." Is it the intention of the district to continue
"grandfather" status for the 2015-2016 Plan Year?
Potentially, however cost is a greater consideration
18) Due to the lack of information that has been provided in the RFP, we
are asking than the June 16, 2015 RFP deadline be extended.
The deadline cannot be extended.