RockwoodSchool District

Employee Benefits

Request for Proposal

March 26, 2012

Background

RockwoodSchool District, recognized for Distinction in Performance by the Missouri State Department of Education, serves more than 22,000 students from parts of Western St. Louis and northern Jefferson counties. Eleven distinct communities are within Rockwood’s boundaries, including all or parts of Ballwin, Chesterfield, ClarksonValley, Ellisville, Eureka, Fenton, Manchester and Wildwood.

Students, staff, parents and community members collaborate in progressive schools where continuous improvement is the focus. The district is comprised of nineteen elementary schools, six middle schools, four high schools, an EarlyChildhoodCenter, a Center for Creative Learning and an IndividualizedLearningCenter.

The Rockwood School District (RSD) is soliciting sealed proposals for:

  • Specific and Aggregate Stop Loss
  • Administrative Services for self-funded medical plan
  • Online Enrollment/Eligibility System
  • Large Case Management/Disease Management
  • Utilization Review
  • Wellness Program/Incentive Program
  • Employee Assistance Plan
  • Mental Health/Substance Abuse
  • Fully Insured Vision Insurance

The plan year for the above benefits will be from November 1, 2012 to October 31, 2013,with two subsequent renewal years if agreeable with both parties. Full-time employees, spouses, dependents, retirees and cobra enrollees should be included in these coverage’s.

The purpose of this request for proposal is as follows:

  • To allow Rockwood School District the opportunity to evaluate its group health plan for the Plan Year beginning November 1, 2012
  • To provide a competitive benefit package for RockwoodSchool District’s employees while managing their health care costs.
  • To select a vendor that can efficiently administer RockwoodSchool District’s current Plan Document and meet the preferred financial arrangement for the Program.
  • For RockwoodSchool District’s employees to have an accessible group health plan and a Plan Administrator that provide superior service and at the same time minimizes Plan administrative processes

This proposal has been prepared by MFP Employee Benefits, an employee benefits consulting firm, which has been retained by RockwoodSchool District to assist in the selection, implementation, and on-going monitoring and administration of their employee benefit plans. MFP Employee Benefits will evaluate the RFP responses and negotiate with vendors on behalf of RockwoodSchool District. Rockwood School District will select the vendor determined to have the most attractive program in the overall evaluation at its sole and absolute discretion. RockwoodSchool District or MFP Employee Benefits will not be obligated to explain the results of the evaluation process to any vendor.

Rockwood School District is committed to offering all employees competitive benefits including quality health care at an affordable cost. With this proposal, RockwoodSchool District is seeking quotes from you to administer their medical program. Prescription Drugs are carved out of the current self-funded medical program through CaremarkPharmacy Benefit Manager and are not part of this bid process. Included in your administrative services should be your capability to integrate the prescription drug data for medical management purposes.

The following benefit program objectives are part of Rockwood School District’s core health care strategy:

  • Provide employees affordable health care
  • Maintain a high level of employee satisfaction with health care programs
  • Provide flexibility in the design of the benefit plans
  • Manage cost
  • Hold selected Plan Administrator accountable for performance
  • Provide an effective communication program for employees and retirees
  • Develop a long-term partnership and benefit strategy with a Plan Administrator

Vendor selection criteria include but are not limited to the following:

At this stage in the process, we are determining your company’s expertise in providing the given service and your ability to deliver quality performance to a client the size of Rockwood School District. Also, other critical issues such as network accessibility, control of benefit costs, administrative costs, and capabilities will be evaluated. Vendor selection will be based on the following key factors:

  • Aggressive fee quotes for a multi-year contract (All quotes should be net of commissions including stoploss coverage)
  • Specific and Aggregate Stop Loss reinsurance quote availability
  • Network with appropriate discount level
  • Ability to administer Rockwood School District’s Plan Document and provide meaningful plan design recommendations
  • Ability to integrate online eligibility/billing system with RSD’s payroll system, Business Plus.
  • Ability to provide a dedicated benefit specialist to Rockwood
  • Ability to provide a full-time on-site wellness coordinator to develop and implement health and wellness programs throughout the district.
  • Progressive Medical Management / Disease Management Programs
  • Demonstrated superior administrative capabilities
  • Financial performance guarantees
  • Vendor’s agreement to allow Rockwood School District, or its third party representative, to annually audit (if requested) all claims, Medical Management / Disease Management files, financial data, and any other information relevant to Rockwood School District’s account
  • Meaningful reporting/strategic consulting
  • State-of-the-art internet capabilities including on-line report access
  • Organized and proven approach to program implementation
  • Senior-level account management team

Proposal Process

To facilitate an objective evaluation, Rockwood School District requires that your organization respond to the requested information in the format specified herein. Please respond with brief, concise answers. Responses that require supplemental materials to describe your services and capabilities are also encouraged but should be supplied as an addendum and not inserted into the body of the RFP.

Any deviations must be clearly outlined in your proposal. Your organization will be bound to comply with the provisions in the RFP unless all deviations are explicitly stated in your proposal. Your responses to this RFP and any subsequent information relating to this RFP will be considered part of any executed contract with your organization.

RockwoodSchool District reserves the right to accept or reject any and all proposals and shall not be bound to accept the proposal with the lowest price. This proposal may be amended or withdrawn at any time without awarding a contract. RockwoodSchool District assumes no liability for any costs you may incur responding to this RFP.

The RFP and supporting material submitted will become the property of RockwoodSchool District and MFP Employee Benefits and will not be returned. All data contained in this RFP are provided for your information and are accurate to the best of our knowledge, however there is no guarantee regarding accuracy. All costs associated with preparation and submission of your RFP response and any meetings with RockwoodSchool District and MFP Employee Benefits are the sole responsibility of the bidder.

Following evaluation of your response, MFP Employee Benefits may request a meeting to discuss your proposal. Participants from the Vendor must include key management responsible for the specified areas outlined in this RFP, including members of the account management team, implementation team and medical management / disease management personnel. As part of the finalist process, should MFP Employee Benefits request a site visit of your organization, travel expenses for Rockwood School District and MFP Employee Benefits are to be paid by the vendor.

All information included in your RFP response, as well as other information disclosed to RockwoodSchool District during this process, shall be considered confidential. Information contained in this RFP must be considered confidential and should not be discussed with anyone except persons within your company, Rockwood School District or MFP Employee Benefits.

Proposal Requirements

  • All proposals/contracts are to be quoted without commissions, service fees, or override arrangements during all contract years. Response must be signed by an officer of your organization with an effective date of coverage of November 1, 2012. All documents must clearly indicate the name of the responding organization, as well as the name, address and telephone number of the primary contact at your organization for this bid.
  • The contract should be sitused in Missouri.
  • Medical is ASO with Specific and Aggregate coverage.
  • Vision is Fully Insured
  • Premium and claim reports should be available on a monthly basis and comprehensive claims/statistical reports on a semi-annual basis.
  • Future renewal actions should include a description of the renewal methodology used, a list of all renewal assumptions, and details on expense factors, claims administration expenses and non-claim administrative costs.
  • Rockwood School District expects to enter into a written Agreement with the selected vendor that shall incorporate its proposal. The terms and conditions of the Agreement will be negotiated with the vendor. If selected, an officer of your organization will be required to execute a Rockwood School District Agreement prior to the effective date. This Agreement will serve as the foundation between Rockwood School District and the selected vendor and will outline both parties' responsibilities and requirements under this Agreement.
  • The selected vendor shall be required to indemnify and hold Rockwood School District harmless from any and all claims, liability, losses, and causes of action, which may arise out of the fulfillment of the ensuing contract. Further, the company selected shall pay all claims and losses of any nature whatever in connection therewith, and shall defend all suits in the name of Rockwood School District when applicable, and shall pay all costs and judgments which may issue there from except those caused by sole negligence of Rockwood School District’s officers or employees or agents.
  • The selected vendor shall comply with all laws, ordinances, and regulations; applicable to the services contemplated herein. By responding to this RFP, you are stating that you are familiar with all federal, state, and local laws, ordinances, code rules, and regulations that may in any way affect the services and products to be provided.
  • Bids must be received on or before 4:00 p.m., local time, on Friday, April 13, 2012, at:

Rockwood School District, Administration Office

111 East North Street

Eureka, MO 63025

at which time all bids will be available for public inspection.

This date is a firm deadline and no extensions will be granted. Provide 3 copies of your quote/proposed materials. All responses must be submitted on the Questionnaire Forms and Rate Exhibits contained in the RFP.

In addition to the 3 paper copies an electronic proposal response (word document for Questionnaire and Excel for Rate Exhibits) must be sent by email to and

All questions concerning the RFP should be e-mailed to Susan Carpenter .

The questions will be compiled and responses posted to the RSD website on a periodic basis.

TIMETABLE

ACTIVITY / DATE
Distribution of RFP to Carriers/Vendors / March 26, 2012
Proposals Due from Carriers / April 13, 2012
Selection of Finalists / TBD
Insurance Committee Review / July 2012 (full committee)
Board Review and Approval / August 2012
Annual Enrollment / September 2012
Effective Date / November 1, 2012

The RockwoodSchool District reserves the right to award insurance or service contracts as a result of this request for proposal, as specified herein, as it deems to be in the best interest of the District and to reject any and all proposals and to waive informalities in the proposal process, if such proposals are not judged to be in the best interest of the District. By submitting a proposal, respondent specifically agrees that the decision of the RockwoodSchool District is final and binding.

The enclosed specifications and information prepared for respondents are open to any and all legal providers and no company, group, corporation or other entity will be given any preference, commission or agent of record status by the Rockwood School District.

Right to Audit Requirement

The selected vendor must provide copies of its internal audits, quality assurance reports and annual initiatives with timeline. If requested, vendor must provide copies of its annual independent audit Statement on Auditing Standards (SAS 70).

UNDERWRITING INFORMATION

MEDICAL AND RX

Current Carrier – Funding - Employer Contributions

  • Spec and Agg currently with Westport Insurance Corporation (Swiss-Re) through Alternative Risk Solutions(since 11/1/10)
  • ASO currently with Cigna(since 11/1/06)
  • $150,000 Spec – medical & Rx, unlimited LT max, $5,000,000 annual max.Specific increased from $125,000 to $150,000 on 11/1/07.
  • Aggregate – medical only (does not include the Rx); $1 mil max reimbursement on aggregate
  • Spec, Agg, ASO are currently Paid contracts
  • Aggregate has 25% margin
  • PBM currently with Caremark (since 11/1/08). Caremark transmits eligibility and claims to Cigna on a weekly basis. Prior PBM was MedTrak
  • Non-Medicare eligible retirees are covered under the specific & aggregate. Medicare eligible retirees covered under the aggregate only up to specific policy limit ($150,000).
  • The district is currently using the company, Cobrahelp, to bill & collect cobra premiums. .
  • Contributions
  • Actives - RSD pays 100% EE cost, 50% for dependents for Green and Tan plan.
  • Retiree pays 100% of their cost
  • Proposed Funding
  • Specific - $150,000, med & Rx, 15/12 contract, unlimited LT max, $5 millionannual max. Provide alternate of $175,000 spec level
  • Aggregate – med only, 15/12 contract, 25% margin
  • ASO – medical, 12/12 contract (Current carrier would administer runout). PBM arrangement and coordination with CareMark will continue.

Services the district requires from the claim administrator/TPA include:

-Online enrollment system access throughout the year

-Currently Cigna transmits eligibility on a weekly basis to the prescription provider (Caremark), Dental (Delta Dental), Life (Anthem), LTD (MetLife), and Vision Carrier (VBA). For third party eligibility vendors quoting only on eligibility management and online enrollment all lines of coverage will need to be transmitted to each carrier.

-Transmits accumulator data for the participants in the HSA plan to Caremark and receives prescription data from Caremark on a daily basis.

-Integrate online eligibility/billing system with RSD’s payroll system, Business Plus.

-Full-timededicated benefit specialist to maintain eligibility/resolve claims and administer the plan.

-Full-time on-site wellness coordinator to develop and implement health and wellness programs throughout the district.

-Include $20,000 in the ASO Fee for the design and printing of an enrollment book

-Participation in annual enrollment meetings.

-Mental Health/Substance Abuse and EAP network/services

Current & Proposed Benefits

  • See attachment Rockwood ASO Nov 2011 Green Plan SPD.pdf and Rockwood ASO Nov 2011 Tan Plan SPD.pdf for current benefits. Also attached is the Blue plan Summary of Benefits, however this plan was eliminated 11-1-11. Rockwood_2010 Blue Premium Plan 06-28-11.doc
  • See attachment Plan ChangesRSD.docfor plan changes over the last few years.
  • Your quote should duplicate the current Green and Tan plan benefits.

Rate History

Cigna Westport Insurance Westport Insurance

11/1/09-10/31/1011/1/10 – 10/31/1111/1/11 – 10/31/12

Spec$35.19$34.75$42.73

Agg Premium$1.95$1.11$ .43

Agg Factor$435.37$518.16$625.67

(Agg factor applies to all plans)

Cigna ASO

Total ASO fee$37.89$39.08$40.49

Stoploss InterfaceN/A$1.20$1.20

TOTAL$37.89$40.28$41.69

ASO fee includes – base admin fee, UR, Case Mgmt, 24 hour Nurse line, Network Access Fee, Disease Mgmt fee, Health & Wellness Program & Incentives, HIPAA certs, Mental Health Access fee, EAP Access fee, Online enrollment system, PBM Caremark & Ancillary Carriers eligibility coordination, FT benefits specialist, Dependent eligibility audit.

Claim Experience and Enrollment

See the following attachments for Monthly Claims, Employees, Large Claim info

  • RSD Cigna Clms by Bft Option 11-1-11 thru 1-31-12.xls
  • RSD Cigna Clms by Bft Option 11-1-10 thru 10-31-11.xls
  • RSD Cigna Clms by Bft Option 11-1-09 thru 10-31-10.xls
  • RSD Large Claims Dx Feb2011-Jan2012 for RFP.xls
  • RSD Large Claims Dx Feb2010-Jan2011 for RFP.xls

Cigna had the Specific and Aggregate risk until 11/1/10. The Monthly Experience Report by Benefit Option prior to 11/1/10 excludes pooled claims. For the time period 2/1/10-1/31/11 Cigna Pooled Claims totaled $558,714 (Green Plan), $152,323 (Tan Plan), $0 (Blue Plan). These amounts should be added to the Monthly Experience Report by Benefit Option to get total paid claims for 2/1/10-1/31/11.

Additional Information on Services Required by the Administrator

Online Enrollment & Eligibility System

Currently, RSD utilizes an online benefits enrollment/eligibility management system called ChoiceLynx from Cigna. This system provides year round open enrollment access, maintains the districts eligibility and transfers data on a daily and weekly basis to the carriers. RSD would like to continue to use online enrollment and eligibility systems. Bids must include an online enrollment system which matches the current capabilities. This can be through a third party vendor or it can be a budget allotted to the district to pay for the service from another vendor. One very important component is the ability to provide a file format which can be uploaded into the RSD General Ledger/Payroll/HR system called Business Plus. Please provide a detailed description of how this would be accomplished to make sure the human resources system, payroll and eligibility all synchronize. Additional questions will be required if selected as a finalist.

Full time Dedicated Benefit Specialist

Currently, RSD has a full-time person provided by Cigna who acts as a Benefits Specialist and works with all the district provided benefits. The position is funded by Cigna but the person works on-site every day with RSD. RSD will provide a desk and phone. The vendor will have to provide everything for their employee including computer, training, salary, benefits and any other necessary equipment. RSD would like to have $70,000 in a budget to cover the salary and benefits for the individual. The district reserves the right to approve the person.

Health & Wellness Program and Incentives

Currently, Cigna provides a wellness budget of $50,000 per year for the district to spend on health and wellness programs including biometric testing, flu shots, incentives for completion of health risk assessments, etc. If the entire budget is not spent then the remainder goes to the next year. Employees can go on-line to participate in wellness related activities such as HRAs, disease management, lifestyle management programs and physical activity programs. Employees earn points which can be redeemed for gift cards. Rockwood would like to continue to promote wellness and increase participation. To support the program RSD would like a full-time on-site wellness coordinator.Similar to the Benefits Specialist position RSD would like a budget of $70,000 and the person would be employed by the vendor.The vendor will have to provide everything for their employee including computer, training, salary, benefits and any other necessary equipment. The district reserves the right to approve the person.