CSP15-10870

For

CAPTIVE MANAGEMENT SERVICES

Background:

The MetroHealth System is one of the largest, most comprehensive health care providers in Northeast Ohio, serving the medical needs of the Greater Cleveland community for 175 years. More than 500 primary care and specialty care physicians practice within The MetroHealth System. Affiliated since 1914 with Case Western Reserve University School of Medicine, MetroHealth is a center for medical research and education, with all active staff physicians holding Case faculty appointments.

The MetroHealth System is composed of a major medical center, a rehabilitation hospital, two long-term care/skilled nursing centers, an outpatient surgery center, and a network of community-based health care centers.

MetroHealth Medical Center, located on the near west side of Cleveland, is a leader in trauma, emergency and critical care; women’s and children’s services, including high-risk obstetrical care and neonatal intensive care; comprehensive medical and surgical subspecialties; heart and vascular care; cancer care; senior health; stroke and rehabilitative health care services. MetroHealth Medical Center offers the most advanced techniques in treating complex medical problems.

MetroHealth Medical Center provides care to nearly 28,000 inpatients, including more than 3,400 newborns annually. More than 700,000 visits are recorded each year in the medical center’s outpatient centers. Patient visits to the emergency department exceed 100,000.

Engagement:

The MetroHealth System (MHS) is in the process of establishing a captive insurance entity for its program of self-insurance (the “Captive”). The Captive will provide professional and general liability coverage, and medical stop loss for the parent entity. MetroHealth seeks a firm to act as a manager (the “Captive Manager”) for the Captive.

Scope of Services/Specifications:

The Captive Manager will provide the fundamental administrative, accounting, record keeping and regulatory advisory services for the captive itself. These include:

  1. Coordination of the implementation process, including development of the business plan, application documents, pro-forma financial statements, budgeting and net present value cash flow analysis;
  2. Ongoing financial, underwriting, corporate, and program administration of the captive;
  3. Monitoring of claims and assistance in setting claim reserves
  4. Maintenance of unique client website portals for administrative and stewardship activities;
  5. Preparation of executive and board benchmarking reports including ongoing analysis of the viability of the captive structure;
  6. Preparation of regular periodic financial statements and financial transaction execution associated with captive operations;
  7. Coordination of services provided by captive vendors/partners including banking, legal, audit, tax, investment portfolio managers, fronting and reinsurance intermediaries, TPAs and others;
  8. Preparation and submission of regular filings, financial statements and registrations to the relevant regulatory authorities;
  9. Coordination of annual board meetings;
  10. Primary liaison with regulatory agencies as the captive’s licensed agent.

Contents of your Final Proposal:

  1. Proposal should describe your expertise and experience, by demonstrating the following:
  • A proven track record in managing captives in the health care market.
  • Familiarity with the requirements of captives formed by public entities.
  • Familiarity with operating and managing captives in common domiciles.
  • Significant experience in managing captive utilization for multiple lines of risk (Workers compensation, automobile liability, long term disability) for owners and related affiliates and groups.
  1. Please list at least three (3) references that we can contact who have experience regarding your services and capabilities related to the subject matter in this CSP.
  1. In addition to the scope of work, the Final Proposal must list your staff that will be dedicated to work with MetroHealth.

  1. Please propose both of the following:
  1. A monthly fixed retainer fee model; and
  2. An hourly rate model for each level of staff member who will provide the services.
  1. You may propose any additional fee models (fixed fee subprojects, fee caps, etc.).

Questions

Any questions on this bid must be submitted as per the instructions located in the Communication & Inquiries section of this CSP. If Bidder fails to comply with this section, MetroHealth may disqualify the Bidder’s submission.

Required Information with Proposal Submission:

In your response to the CSP, please follow the instructions as per the CSP Instructions document and address all items listed and your qualifications related to those specifications.

Please provide information on how you would provide these service(s). Please include references to how you would communicate with us, data that you would utilize and what access to resources within the organization you would need. Please include a projected timeframe, complete cost structure, clear definitions of project personnel, references and background information.

On the T1 Technical and Cost Offer document included in the CSP packet, provide detailed pricing as it applies to the various services to be providedidentified in the Scope of Services and Contents of Final Proposal. List any assumptions/aversions to these specifications on the form included in the CSP Instructions documents.

Note:

Pricing to be firm for a term of three (3) years “Initial Period”, with an option to extend for up to three (3) additional three (3) year periods under the exact pricing, terms and conditions as agreed upon in this agreement and correlating addendums or attachments if applicable.

Required elements of negotiations related to this CSP:

  1. Certain aspects of the selected firm’s actual work involve MetroHealth’s confidential information and trade secrets. Should your firm be selected to negotiate a final proposal, you must be willing to sign a non-disclosure agreement. A form of this Agreement is attached for your convenience.
  1. You must also be readily available to meet with the senior administration at MetroHealth to make presentations in support of your proposal, discuss certain confidential details, negotiate deliverables and milestones, and a final scope of engagement (together, “Final Proposal”).
  1. If selected for an award:
  1. You must negotiate and sign a general engagement letter or a contract with MetroHealth for your services which incorporates your Final Proposal. MetroHealth has standard agreement forms and encourages you to consider them. These are available on request;
  1. Initially and from time to time we will create projects or scopes of work under the agreement. For each project or scope of work, we may ask you, and you should be prepared, to estimate the portion of your services (and the related fees) that will be “advisory” in nature (i.e., where your opinion, advice and/or recommendation is a material deliverable).