4050 Esplanade Way Tallahassee, FL 32399-0950 Tel: 850-488-2786 Fax: 850-922-6149 Rick Scott, Governor Erin Rock, Secretary Addendum Number 2 to the following Invitation to Negotiate (ITN): Health Reimbursement Account Administrative Services DMS-17/18-030 Date: March 20, 2018 To: From: Subject: Prospective Respondents to ITN # DMS-17/18-030 Abraham Alvarado, Procurement Officer Amendments to ITN and Questions and Answers 1. The Invitation to Negotiate for Health Reimbursement Account Administrative Services, ITN No. DMS-17/18-030, C,, is amended as follows: a. Section 4. Minimum Service Requirements, Item 1. Account Management Services, subsection b., is revised as follows: Providing a designated Account Management Team that shall include an executive sponsor, an account manager, claims manager, and customer service manager. While it is not mandatory, it is the Department s preference to have a dedicated Account Management Team. s: Questions and Answers Document TO THE EXTENT THIS ADDENDUM GIVES RISE TO A PROTEST, FAILURE TO FILE A PROTEST WITHIN THE TIME PRESCRIBED IN SECTION 120.57(3), FLORIDA STATUTES, OR FAILURE TO POST THE BOND OR OTHER SECURITY REQUIRED BY LAW WITHIN THE TIME ALLOWED FOR FILING A BOND SHALL CONSTITUTE A WAIVER OF PROCEEDINGS UNDER CHAPTER 120, FLORIDA STATUTES. Page 1 of 13
Invitation to Negotiate Health Reimbursement Account Administrative Services DMS-17/18-030 QUESTIONS & ANSWERS FAILURE TO FILE A PROTEST WITHIN THE TIME PRESCRIBED IN SECTION 110.123(3)(d), FLORIDA STATUTES, OR FAILURE TO POST THE BOND OR OTHER SECURITY REQUIRED BY LAW WITHIN THE TIME ALLOWED FOR FILING A BOND SHALL CONSTITUTE A WAIVER OF PROCEEDINGS UNDER CHAPTER 120, FLORIDA STATUTES. The Department s responses to timely submitted questions are below. Question Number Section Page Number Question Response 1 2 3 Whether companies from Outside Switzerland can apply for this? (like,from India or Canada) Whether we need to come over there for meetings? Can we perform the tasks (related to RFP) outside Switzerland? (like, from India or Canada) Yes, but all vendors must meet the Mandatory Responsiveness Requirements of the ITN. See also answer to Question 3. Per Section 4.3.4, Vendor Attendance at Negotiations, of the ITN, the Department may require in person vendor attendance at the negotiation sessions. See Section 3.2.6, Locations, No Offshoring of Data, of A of the ITN for restrictions regarding performance of Services and treatment of data outside of the U.S. 4 Can we submit the proposals via email? See Section 3.2, Submittal of Replies, of the ITN. Page 2 of 13
5 7 11 6 7 8 4d minimum requirements 4 j minimum requirements Page 8 C Page 8 C Can you provide more detail on the card services you have today? What vendors do you integrate with to automatically adjudicate card transactions? Do you offer automatic claims payment? Where the administrator receives the carrier file and automatically reimburse participants out of pocket expenses? Could you clarify limiting information We need to ascertain a member is who they say they are prior to releasing confidential information Per our legal and compliance department, it would be a violation of HIPPA to allow an employer to listen in on any CS calls, or for our company to provide any audio recording or transcripts of employee calls, as PHI/PII information could be relayed without members consent. Would the State consider removing this requirement, as it could result in a violation of HIPPA rules and regulations? For the Department's current Flexible Spending Account (FSA) and Health Savings Account (HSA) services, Participant funds are loaded onto a benefit card that uses the SIGIS-Inventory Information Approval System (IIAS). This system is designed so the benefit card is only accepted at approved providers. If the provider is not a SIGIS-IIAS registered member, the Participant can't use the card at that provider. The current FSA and HSA provider utilizes co-payment matching reports provided by the State which is integrated into their system for auto-adjudication purposes. No. We do not send carrier files to the administrator for payment to the Participants. Examples of "limiting information" are People First ID, last five digits of Social Security Number, Date of Birth, and home address. For purposes of the HRA, the Department is the covered entity pursuant to HIPAA, and the awarded vendor will be a business associate performing services on the Department s behalf. Page 3 of 13
9 10 4 k minimum requirements Section 2 g Section 3 Page 8 C Page 7-8 C Per our legal and compliance department, it would be a violation of HIPPA to allow an employer to listen in on any CS calls, or for our company to provide any audio recording or transcripts of employee calls, as PHI/PII information could be relayed without members consent. We respectfully request to remove this requirement as it could result in a violation of HIPPA rules and regulations. We offer a simple approach to the funding process for our clients. Employer groups can set up their own bank to be used to pay for claim reimbursements, pay for administrative fees, and to make contributions to funded accounts. Different bank accounts can be used for any of these three options, as well as for different locations within the group if applicable. Further pays claims daily based on contribution file reports, for account holders, and the employer is invoiced weekly for the prior week s paid claims. The invoice is emailed, and the employer can also view the detailed invoice report on the employer portal. When ACH is set up for claim reimbursements, an email is sent to the group s billing contact to advise that an electronic transfer of the claim amount (push or pull) will take place in two banking business days. For purposes of the HRA, the Department is the covered entity pursuant to HIPAA, and the awarded vendor will be a business associate performing services on the Department s behalf. Per Section 3.4, Format of Reply, Tab 5 of the ITN, The advantage of our approach: No pre-fund or impress fund is required. Page 4 of 13
11 12 13 1.2 Overview of Program 1.2 Overview of Program 1.2 Overview of Program 4 4 4 Clients utilize their preferred bank account and retain interest accrued Easy reporting provides list of participants who spent funds and what methods used We have found this to be a best practice among our clients and ask the State if they would consider this simplified streamline process for ease of use. How and when will enrollment into the HRA plan be determined? Is there a time prior to the beginning of the plan year where an employee will choose to enroll in the cost share program, so enrollment would begin Jan.1, 2019, or does enrollment for an employee begin only after he or she has had a cost share event and a cost share contribution has been received? Is the HRA the only option for a cost share contribution, or would an HSA be utilized if the employee is enrolled in an HDHP with an HSA? What types of expenses (i.e., medical, dental, vision) will be eligible under the HRA? Enrollments into the Health Reimbursement Account (HRA) will be captured during open enrollment and any time throughout the year. The Participant only has a HRA opened for them when they have a cost share event and a Reward Payment is allocated to them. Per section 110.12303, Florida Statutes, "Cost savings payable to an enrollee may be: a. Credited to the enrollee s flexible spending account; b. Credited to the enrollee s health savings account; c. Credited to the enrollee s health reimbursement account; or d. Paid as additional health plan reimbursements not exceeding the amount of the enrollee s out-of-pocket medical expenses." Medical, dental, and vision expenses will be eligible for reimbursement under the HRA. Page 5 of 13
14 Section 9 44 15 16 C Statment of Section 14 Section 3.5 page 4 In regards to Tab 9, does DMS require individual files for attachments 9-1 through 9-11 or can the answers be included in a single file without need for separate attachments? Does the State anticipate that the HRA enrollment be part of the 2018 open enrollment period? Would the state consider quarterly reporting on Performance Guarantees? Separate files for attachments 9-1 though 9-11 are not necessary. Yes. Per Section 3.4, Format of Reply, Tab 5 of the ITN, 17 18 Section 4.1.k Section 3 page 4 question 3 How many enrollment fairs are anticipated? Describe how the State envisions the communications to be delivered to enrollees regarding the entire shared savings program, use of the estimator tools and qualification for savings that if achieved, would be deposited in the HRA account. Is the State interested in creating a global communication approach that would throroughly address all aspects of the Shared Savings program, including the HRA account administration to avoid fragmentation in messaging to the enrollee or is the State In 2017, there were 19 benefit fairs. While it is anticipated that the number of fairs for 2018 and future years would be similar to this number, the number of fairs cannot be guaranteed at this time. Communication strategies around the Shared Savings Program have not yet been finalized. The State is open to discussing options around communications. Per Section 3.4, Format of Reply, Tab 5 of the ITN, Page 6 of 13
19 20 21 22 23 24 Section 4 page 5 question 1b Section 4 page 6 question 1I Section 4 Question 2D page 7 Section 4 Question 26 page 19 requiring each vendor to address communications separately? Please clarify if by dedicated your expectation is that the required Account Management Team members are to work exclusively on the State of Florida contract. Please advise if the State intends to have a single, State branded website where all vendors responsible for the administration of the Shared Savings Program (Transparency, Bundled Services, HRA) will provide content and links or is it the State's intent to have each vendor maintain a separate customized website for the State for just their portion of the administrtion of the overall Shared Savings Program? Please clarify if the welcome packet is mailed to every member who elects to open and use the HRA for reward of Shared Savings regardless of whether the member actually earns a shared savings incentive through an event for that calendar year Please describe the departmen'st audit processes with your third party vendor and expected frequency of audits within in the calendar year can you estimate the number of individuals you expect to enroll in the new HRA plans? What is the determining factor(s) in how dollars are credited to the HRA? See revisions to in Addendum 1. While it is not mandatory, it is the Department s preference that the Contractor have a dedicated Account Management Team. The Department intends to support a stand-alone website for Shared Saving Program enrollments whereby all Shared Savings Program vendors may provide content and / or links to their websites. Per 2.d, Section 4 of the, the Department intends for the welcome packet to be mailed to the Participant only when "the HRA has been opened and Reward Payments have been earned and deposited." The Audit procedure is described in Section 33,. Audit frequency is at the discretion of the Department. See B, Financial Reply - "Projected HRA Enrollment". The determining factors in how dollars are credited to the HRA are participation in a Shared Saving Program event, enrollment in the HRA, and the amount of funds "saved" through the event. Page 7 of 13
25 26 27 28 29 30 1.7 ITN Page 7 31 1.7 ITN Page 7 Please identify what the HRA will reimburse? How often (frequency) will funding be applied toward participants accounts? Who will track funding provided to the employees? Are physical mailings of a welcome packet to each Participant electing an HRA through the Shared Savings Program and the HRA has been opened and Reward Payments have been earned and deposited required or will electronic dissemination be considered? How will HRA funding, per employee, be determined (what will be the basis per individual account)? Will the State consider amending the RFP so that Vendors may take exceptions to the General Contract Conditions (PUR 1000, 2006 version)? Will the State consider amending the RFP so that Vendors may include additional documents submitted to be incorporated into the contract that is relevant to the services being provided? Medical, dental, and vision expenses will be eligible for reimbursement under the HRA. Funding will be applied toward Participants accounts each time they earn a Reward Payment through a shared savings event. The selected HRA Administrative Services vendor is expected to track funding provided to HRA Participants. Per Section 3.4, Format of Reply, Tab 5 of the ITN, Funding will be applied toward Participants accounts each time they earn a Reward Payment through a shared savings event. Per Sections 3.3.2 and 3.3.3 of the ITN, the Respondent must certify that it accepts the contract terms and conditions as set forth in A Proposed Contract and C, without qualification or exception and that it is in compliance with the modified Section 9 of the PUR 1001 form. The Department, in its sole discretion, may entertain modifications to the contract terms and conditions during the negotiation phase of this procurement. See Section 1.7, Contract Formation, of the ITN: No additional documents submitted by a Vendor will be incorporated in the Contract. During the solicitation period, the Department may specifically identify and incorporate by reference any additional documents which are to be incorporated into the Contract. See Page 8 of 13
32 2.12 33 3.1 34 3.3.2 ITN Page 12 ITN Page 17 ITN Page 17 Will the State consider amending the RFP so that Vendors may take exceptions to PUR 1001 (General Instructions to Respondents)? Will the State consider amending the RFP so that Vendors may take exceptions to mandatory requirements? Will the State consider amending the RFP so that Respondent may propose exceptions or qualifications to A Proposed Contract? also Section 3.4, Format of Reply, Tab 5 of the ITN, See also answer to Question 34. No. No, the Department will not amend the ITN for this purpose. However, per Section 3.4, Format of Reply, Tab 5 of the ITN, "Vendors may propose an alternate approach for any minimum service requirement and provide an explanation in Section 5. The Department, in its sole No, the Department will not amend the ITN for this purpose. However, per Section 3.5, Proposed Contract, of the ITN, " A is the Department s Proposed Contract. Vendors should not make alterations or edits to the Department s Proposed Contract. Any attempts to red-line or modify the terms of the Department s Proposed Contract will be disregarded and ignored by the Department during the evaluation phase. The Department may decide, in its sole discretion, to consider and negotiate red-line edits or modifications during the negotiation phase." Page 9 of 13
35 3.3.2 36 3.3.9 37 Section 4. 1. k. 38 Section 6.e. ITN Page 17 ITN Page 18 C: Statement of Page 6 C: Statement of Page 10 Will the State consider amending the RFP so that Respondent may propose exceptions or qualifications to C? In lieu of a performance bond or irrevocable letter of credit, will the State permit a Vendor to carry appropriate levels of liability, error and omissions, and cyber liability insurance coverage? How many Open Enrollment benefit fairs held annually? In how many different locations? In total, how many days? Participant statements are available ondemand for the participant s convenience. Does this satisfy the requirement for providing monthly participant statements? No, the Department will not amend the ITN for this purpose. However, as C is the Minimum Service Requirements, Per Section 3.4, Format of Reply, Tab 5 of the ITN, No. In 2017, there were 19 benefit fairs. It is anticipated that the number of fairs for 2018 and future years would be similar to this number. In 2017 the fairs were held in 15 different locations over 12 days. The number of locations and days can also not be guaranteed at this time. Per Section 3.4, Format of Reply, Tab 5 of the ITN, Page 10 of 13
39 Section 12.e 40 Section 23 41 Section 5 C: Statement of Page 14 C: Statement of Page 19 C: Statement of Page 24 Is the Department asking for single-sign on functionality between the People First website to the Contractor s HRA website or mobile application? The Contractor receives nominal interchange fees, as all third party administrators do, on debit card transactions. These fees are used to help offset the cost of card production, card issuance/mailing, and card processing fees. Does this provision mean that the Contract would prohibit the Contractor from receiving such compensation for cards issued to participants? May the Contractor propose alternative measurements and amounts at risk for performance metrics? Single-sign on functionality between the People First website and the Contractor's website is desirable Per Section 23, "Contractor agrees that the only compensation to be received by or on behalf of its organization in connection with this Contract shall be that which is paid directly by the State." (emphasis added) Yes. Per Section 3.4, Format of Reply, Tab 5 of the ITN, 42 Section 14 PUR 1000 43 Is this 1% Transaction Fee applicable to this contract? If yes, is the 1% applicable only to invoices for service fees or is also applicable to the funding amounts that the State would provide for the HRA participant accounts? What are your current fees? Yes, the Transaction Fee is applicable to this contract and applies only to invoices for service fees. The Transaction Fee, as of the date of this Addendum, is set at.7%, and is subject to future fluctuation. The Department does not currently offer a HRA. Page 11 of 13
44 45 46 F16877_HRAIT N2.pdf 47 2 48 49 F8398_HRAITN CSta tementof Section 3 F8398_HRAITN CSta tementof Section 3 2 7 10 What is the reason for this going out to bid? Are you happy with your current provider? If not, what are the issues? Current vendor People First system and PFNG contract since FSA 2005/HSA 2007. Do they offer HRA? Why are they marketing HRA? Is a COBRA/DB quote needed? e. Issuing a HRA benefit card when the HRA has been opened and Reward Payment have been earned and deposited through the Shared Savings Program. Question: Expand on card features required? Is this a debit card or credit card? q. Processing payment to the benefit card processing company if the claim is paid by benefit card. Question: Expand on this process. Per page 5 of the ITN, "During the 2017 Florida Legislative Session, the Florida Legislature passed Senate Bill 7022 (Chapter No. 2017-88, Laws of Florida) which directed the Department to implement additional benefit offerings to Members and to implement a Shared Savings Program which necessitates procurement of a Health Reimbursement Account (HRA)." The Department does not currently offer a HRA. Yes, the current vendor for the Department's People First FSA / HSA services offers a HRA to other clients. The Department is unable to speak to why the current vendor is marketing HRA." No. This would be a benefit card that is loaded with reward payments and Participants are able to swipe at SIGIS- IIAS providers for eligible services covered under the HRA. The current FSA / HSA administrator uses a card that can be swiped as credit or debit (a Personal Identification Number is required for debit usage). The vendor would be required to have the Participants funds loaded to the card. When the Participant swipes the card, the provider is to be paid at the point of sale. The vendor is responsible for paying the card processing company. Page 12 of 13
50 51 F8398_HRAITN CSta tementof HRA Benefit Card Process Account Establishment and Administration Item 7f Item 2a Modifying the benefit card and benefit card mailer as requested by the Department, within the applicable Visa / MasterCard guidelines. What customizations are required for the benefit card mailer? Since we are not the HSA administrator, how will the information be provided to PayFlex with regard to the election of the Savings Reward Payment Credit that would be going to the HRA or postdeductible HRA of choice by the account holder. The need for customizations to the benefit card and benefit card mailer have not been determined, or defined at this time. Per Section 3.4, Format of Reply, Tab 5 of the ITN, "Vendors may propose an alternate approach for any minimum service requirement and provide an explanation in Section 5. The Department, in its sole Election information and Reward Payment Credit information will be provided to the HRA vendor via file transfer from the People First system. END OF ADDENDUM NUMBER 2 Page 13 of 13