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Agreement A-16-433 with Keenan Associates.pdf
Agreement No. 16-433 1 AGREEMENT 2 3 THIS AGREEMENT is made and entered into this 12th day of July, 2016, by and 4 between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter 5 referred to as "COUNTY", and Keenan & Associates, a California corporation, whose address is 6 2355 Crenshaw Blvd., Suite 200, Torrance, CA 90510, hereinafter referred to as 7 "CONTRACTOR". 8 WITNESSETH: 9 WHEREAS, Federal and State laws and regulations related to employee health care 10 and benefits plans are subject to changes; and 11 WHEREAS, the employee health care and benefit plan industry is a fluid market with 12 many new alternative products being offered; and 13 WHEREAS, the COUNTY has a need for employee health care and benefit plan 14 consulting services to assist the COUNTY in ensuring legal and regulatory compliance and 15 identifying and evaluating all health care and benefit plan alternatives; and 16 WHEREAS, CONTRACTOR has the expertise and resources to provide employee 17 health care and benefit plan consulting services; 18 NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions 19 herein contained, the parties hereto agree as follows: 20 1. OBLIGATIONS OF THE CONTRACTOR 21 A. CONTRACTOR shall, under this Agreement, provide COUNTY employee 22 benefit plan consultation services (hereinafter referred to as "Consultation Services") as described 23 in COUNTY's Request for Proposal (RFP) number 964-5439 (including Addendum number 1) 24 attached hereto as Exhibit "A" and incorporated herein by reference, and CONTRACTOR's 25 response to said RFP, excluding those services described in Appendix 2 of the CONTRACTOR's 26 response to said RFP, attached hereto as Exhibit "B" and incorporated by reference, including, but 27 not limited to: 28 1) Administrative Services for Health and Ancillary/Voluntary Benefit -1- 1 Plans 2 a. Benefit Design Assistance 3 b. Participant Communications 4 c. Legal & Regulatory Compliance Support 5 2) Vendor Relations for Health and Ancillary/Voluntary Benefit Plans 6 a. RFP/RFQ Development 7 b. Contract Development 8 c. Vendor Management 9 3) Data Analysis and Reporting for Health Benefit Plans 10 4) Actuarial, Underwriting and Fiscal Support for Health Benefit Plans 11 2. OBLIGATIONS OF THE COUNTY 12 A. COUNTY will authorize its health and benefit plan vendors to provide 13 CONTRACTOR with current health and benefits plan data and necessary information including, 14 but not limited to, the following: 15 1) COUNTY will direct CONTRACTOR in preparing the content or 16 scope of services to be specified in any health and benefits RFP and/or RFP to current insurance 17 carriers for renewing the provision of benefits each currently provides to active employees and 18 retiree members (living inside or outside of California) and their dependents. The COUNTY shall 19 provide final approval of requests for quotations (RFQ) and/or RFP before release to potential 20 vendors; 21 2) Health and benefit plan contracts, enrollment and relevant reports 22 and data as required for CONTRACTOR to provide Consultation Services. 23 B. COUNTY will make CONTRACTOR broker of record on all assignable 24 ancillary/voluntary benefits currently in place and will direct ancillary/voluntary commissions to 25 CONTRACTOR. CONTRACTOR shall also be assigned broker of record on any new policies 26 placed by CONTRACTOR and shall receive commissions earned from those policies. 27 3. TERM 28 The term of this Agreement shall be for a period of three (3) years, -2- 1 commencing on July 12t", 2016 through and including July 11t", 2019. This Agreement may be 2 extended for two (2) additional consecutive twelve (12) month periods upon written approval of 3 both parties no later than thirty (30) days prior to the first day of the next twelve (12) month 4 extension period. The Director of Human Resources or his or her designee is authorized to 5 execute such written approval on behalf of COUNTY based on CONTRACTOR'S satisfactory 6 performance. 7 4. TERMINATION 8 A. Non-Allocation of Funds - The terms of this Agreement, and the services to 9 be provided hereunder, are contingent on the approval of funds by the appropriating government 10 agency. Should sufficient funds not be allocated, the services provided may be modified, or this 11 Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written 12 notice. 13 B. Breach of Contract 14 1) The COUNTY may immediately suspend or terminate this Agreement 15 in whole or in part, where in the determination of the COUNTY there is an illegal or improper use 16 of funds. 17 2) Additionally the COUNTY may terminate this Agreement if, after 18 notice and a thirty (30) day cure period CONTRACTOR fails to correct any of the following: 19 a. A failure to comply with any term of this Agreement; 20 b. A substantially incorrect or incomplete report submitted to the 21 COUNTY; or 22 c. Improperly performed service. 23 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY 24 of any breach of this Agreement or any default which may then exist on the part of the 25 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the 26 COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of 27 the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR 28 under this Agreement, which in the judgment of the COUNTY were not expended in accordance -3- 1 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon 2 demand. 3 C. Without Cause - Under circumstances other than those set forth above, 4 this Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written 5 notice of an intention to terminate to CONTRACTOR. Under the terms of this paragraph 4.C, the 6 Director of Human Resources is authorized to terminate this Agreement on behalf of COUNTY. 7 5. COMPENSATION/INVOICING: 8 A. COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to 9 receive compensation as follows: COUNTY elects the compensation structure under "Option 2" 10 of CONTRACTOR's Cost Proposal contained in CONTRACTOR's response to COUNTY's RFP 11 #964-5439, which annual fees are as follows: 12 1) $55,000 in Year 1, beginning July 12, 2016 13 2) $57,500 in Year 2, beginning July 12, 2017 14 3) $60,000 in Year 3, beginning July 12, 2018 15 4) $60,000 in Year 4, beginning July 12, 2019 16 5) $62,500 in Year 5, beginning July 12, 2020 17 CONTRACTOR will receive said compensation every year in which 18 CONTRACTOR provides Consultation Services as set forth in this Agreement. In no event shall 19 the total annual fees paid by COUNTY to CONTRACTOR exceed $295,000.00 during the term of 20 this Agreement. 21 B. COUNTY will make CONTRACTOR broker of record on all assignable 22 Ancillary Benefit policies currently in place and any new policies placed by CONTRACTOR with 23 commissions being directed to CONTRACTOR. CONTRACTOR agrees that COUNTY will 24 select health and benefit policies that are beneficial to the COUNTY and its employees and that 25 this Agreement does not obligate the COUNTY to select policies which will pay commissions to 26 CONTRACTOR. For purposes of this agreement "Ancillary Benefits" are those benefits paid for 27 by the COUNTY. Commissions received by CONTRACTOR for the Ancillary Benefits 28 coverages placed by CONTRACTOR under this Agreement will be credited to COUNTY. At the -4- 1 end of each contract year ("Calculation Period"), recognizing that the County shall submit 2 quarterly payments of CONTRACTOR`s annual fee, CONTRACTOR will report all commissions 3 that have been received by CONTRACTOR from the placement of COUNTY's employer paid 4 benefits coverages ("Ancillary Commissions") and will forward to COUNTY an amount equal to 5 the amount reported within sixty (60) days following the end of the contract year. 6 C. COUNTY will make CONTRACTOR broker of record on all assignable 7 Voluntary Benefit policies currently in place and any new policies placed by CONTRACTOR with 8 commissions being directed to and retained by CONTRACTOR. The term "Voluntary Benefits" 9 means those voluntary benefits purchased by employees with their own funds, and "Voluntary 10 Commissions" means the commissions earned from the sale of Voluntary Benefits. Beginning 11 with Year 2, and continuing through Year 5 of the Agreement, CONTRACTOR's annual fee will 12 also be reduced, based upon the Voluntary Commissions received from Voluntary Benefits in the 13 prior year as follows: 14 1) $5,000.00 reduction, if prior year Voluntary Commissions are 15 between $10,000.00 and $35,000.00 16 2) $10,000.00 reduction, if prior year Voluntary Commissions are 17 between $35,000.01 and $50,000.00 18 3) $15,000.00 reduction, if prior year Voluntary Commissions are 19 between $50,000.01 and $75,000.00 20 4) $15,000.00 reduction plus a reduction equal to 50% of the Voluntary 21 Commissions in excess of$75,000.00 until the annual fee is reduced to $0. 22 CONTRACTOR shall perform a year-end reconciliation of all commissions 23 received by CONTRACTOR from the placement of COUNTY employee paid Voluntary Benefits 24 and notify the COUNTY in writing within 60 days of the beginning of Years 2 through 5 whether 25 there will be a reduction in the annual fee due CONTRACTOR from COUNTY. 26 D. Consistent with industry practices, insurers may also pay insurance 27 brokers, such as CONTRACTOR, indirect compensation based upon volume efficiencies, client 28 renewals, marketing services, product development, technology investments and other additional -5- 1 services. The parties agree that CONTRACTOR will not receive any such indirect compensation 2 related to any COUNTY health or benefit policy, either currently in place or placed by 3 CONTRACTOR. 4 E. CONTRACTOR shall submit quarterly invoices to the County of Fresno 5 Department of Human Resources-Employee Benefits, 2220 Tulare Street, 14th Floor, Fresno, CA 6 93721. Payment will be made within 45 days of receipt of invoice by the COUNTY. 7 F. It is understood that all expenses incidental to CONTRACTOR'S 8 performance of services under this Agreement shall be borne by CONTRACTOR. 9 6. INDEPENDENT CONTRACTOR: In performance of the work, duties and 10 obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and 11 agreed that CONTRACTOR, including any and all of the CONTRACTOR'S officers, agents, and 12 employees will at all times be acting and performing as an independent contractor, and shall act in 13 an independent capacity and not as an officer, agent, servant, employee, joint venturer, partner, or 14 associate of the COUNTY. Furthermore, COUNTY shall have no right to control or supervise or 15 direct the manner or method by which CONTRACTOR shall perform its work and function. 16 However, COUNTY shall retain the right to administer this Agreement so as to verify that 17 CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof. 18 CONTRACTOR and COUNTY shall comply with all applicable provisions of 19 law and the rules and regulations, if any, of governmental authorities having jurisdiction over 20 matters the subject thereof. 21 Because of its status as an independent contractor, CONTRACTOR shall have 22 absolutely no right to employment rights and benefits available to COUNTY employees. 23 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its 24 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely 25 responsible and save COUNTY harmless from all matters relating to payment of 26 CONTRACTOR'S employees, including compliance with Social Security withholding and all other 27 regulations governing such matters. It is acknowledged that during the term of this Agreement, 28 CONTRACTOR may be providing services to others unrelated to the COUNTY or to this -6- 1 Agreement. 2 7. MODIFICATION: Any matters of this Agreement may be modified from time to 3 time by the written consent of all the parties without, in any way, affecting the remainder. 4 8. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this 5 Agreement nor their rights or duties under this Agreement without the prior written consent of the 6 other party. 7 9. HOLD HARMLESS: CONTRACTOR agrees to indemnify, save, hold 8 harmless, and at COUNTY'S request, defend the COUNTY, its officers, agents, and employees 9 from any and all costs and expenses, damages, liabilities, claims, and losses occurring or 10 resulting to COUNTY in connection with the performance, or failure to perform, by 11 CONTRACTOR, its officers, agents, or employees under this Agreement, and from any and all 12 costs and expenses, damages, liabilities, claims, and losses occurring or resulting to any 13 person, firm, or corporation who may be injured or damaged by the performance, or failure to 14 perform, of CONTRACTOR, its officers, agents, or employees under this Agreement. 15 10. INSURANCE 16 Without limiting the COUNTY's right to obtain indemnification from 17 CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full 18 force and effect, the following insurance policies or a program of self-insurance, including but not 19 limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the 20 term of the Agreement: 21 A. Commercial General Liability 22 Commercial General Liability Insurance with limits of not less than One 23 Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars 24 ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require 25 specific coverages including completed operations, products liability, contractual liability, 26 Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed 27 necessary because of the nature of this contract. 28 -7- 1 B. Automobile Liability 2 Comprehensive Automobile Liability Insurance with limits for bodily injury of 3 not less than Two Hundred Fifty Thousand Dollars ($250,000.00) per person, Five Hundred 4 Thousand Dollars ($500,000.00) per accident and for property damages of not less than Fifty 5 Thousand Dollars ($50,000.00), or such coverage with a combined single limit of Five Hundred 6 Thousand Dollars ($500,000.00). Coverage should include owned and non-owned vehicles used 7 in connection with this Agreement. 8 C. Professional Liability 9 If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., 10 L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less 11 than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) 12 annual aggregate. 13 D. Worker's Compensation 14 A policy of Worker's Compensation insurance as may be required by the 15 California Labor Code. 16 CONTRACTOR shall obtain endorsements to the Commercial General Liability 17 insurance naming the County of Fresno, its officers, agents, and employees, individually and 18 collectively, as additional insured, but only insofar as the operations under this Agreement are 19 concerned. Such coverage for additional insured shall apply as primary insurance and any other 20 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be 21 excess only and not contributing with insurance provided under CONTRACTOR's policies herein. 22 This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance 23 written notice given to COUNTY. 24 Within Thirty (30) days from the date CONTRACTOR signs and executes this 25 Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated 26 above for all of the foregoing policies, as required herein, to the County of Fresno, (Name and 27 Address of the official who will administer this contract), stating that such insurance coverage have 28 been obtained and are in full force; that the County of Fresno, its officers, agents and employees -8- 1 will not be responsible for any premiums on the policies; that such Commercial General Liability 2 insurance names the County of Fresno, its officers, agents and employees, individually and 3 collectively, as additional insured, but only insofar as the operations under this Agreement are 4 concerned; that such coverage for additional insured shall apply as primary insurance and any 5 other insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, 6 shall be excess only and not contributing with insurance provided under CONTRACTOR's policies 7 herein; and that CONTRACTOR shall notify COUNTY within three (3) days following its first notice 8 or awareness of any actual or proposed termination or cancellation of, or material change in the 9 required insurance coverage. 10 In the event CONTRACTOR fails to keep in effect at all times insurance 11 coverage as herein provided, the COUNTY may, in addition to other remedies it may have, 12 suspend or terminate this Agreement upon the occurrence of such event. 13 All policies shall be issued by admitted insurers licensed to do business in the 14 State of California, and such insurance shall be purchased from companies possessing a current 15 A.M. Best, Inc. rating of A FSC VI or better. 16 11. AUDITS AND INSPECTIONS: The CONTRACTOR shall at any time during 17 business hours, and as often as the COUNTY may deem necessary, make available to the 18 COUNTY for examination all of its records and data with respect to the matters covered by this 19 Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to 20 audit and inspect all of such records and data necessary to ensure CONTRACTOR'S compliance 21 with the terms of this Agreement. 22 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR 23 shall be subject to the examination and audit of the Auditor General for a period of three (3) years 24 after final payment under contract (Government Code Section 8546.7). 25 12. NOTICES: The persons and their addresses having authority to give and 26 receive notices under this Agreement include the following: 27 COUNTY CONTRACTOR COUNTY OF FRESNO Keenan & Associates 28 Attention: Employee Benefits Attention: Steve Gedestad -9- 1 2220 Tulare Street, 14t" Floor 2355 Crenshaw Blvd., #200 2 Fresno, CA 93721 Torrance, CA 90501 3 All notices between the COUNTY and CONTRACTOR provided for or 4 permitted under this Agreement must be in writing and delivered either by personal service, by 5 first-class United States mail, by an overnight commercial courier service, or by telephonic 6 facsimile transmission. A notice delivered by personal service is effective upon service to the 7 recipient. A notice delivered by first-class United States mail is effective three COUNTY business 8 days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice 9 delivered by an overnight commercial courier service is effective one COUNTY business day after 10 deposit with the overnight commercial courier service, delivery fees prepaid, with delivery 11 instructions given for next day delivery, addressed to the recipient. A notice delivered by 12 telephonic facsimile is effective when transmission to the recipient is completed (but, if such 13 transmission is completed outside of COUNTY business hours, then such delivery shall be 14 deemed to be effective at the next beginning of a COUNTY business day), provided that the 15 sender maintains a machine record of the completed transmission. For all claims arising out of or 16 related to this Agreement, nothing in this section establishes, waives, or modifies any claims 17 presentation requirements or procedures provided by law, including but not limited to the 18 Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section 19 810). 20 13. GOVERNING LAW: Venue for any action arising out of or related to this 21 Agreement shall only be in Fresno County, California. 22 The rights and obligations of the parties and all interpretation and 23 performance of this Agreement shall be governed in all respects by the laws of the State of 24 California. 25 14. DISCLOSURE OF SELF-DEALING TRANSACTIONS 26 This provision is only applicable if the CONTRACTOR is operating as a 27 corporation (a for-profit or non-profit corporation) or if during the term of the agreement, the 28 CONTRACTOR changes its status to operate as a corporation. -10- 1 Members of the CONTRACTOR's Board of Directors shall disclose any self- 2 dealing transactions that they are a party to while CONTRACTOR is providing goods or 3 performing services under this agreement. A self-dealing transaction shall mean a transaction 4 to which the CONTRACTOR is a party and in which one or more of its directors has a material 5 financial interest. Members of the Board of Directors shall disclose any self-dealing 6 transactions that they are a party to by completing and signing a Self-Dealing Transaction 7 Disclosure Form, attached hereto as Exhibit C and incorporated herein by reference, and 8 submitting it to the COUNTY prior to commencing with the self-dealing transaction or 9 immediately thereafter. 10 15. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement 11 between the CONTRACTOR and COUNTY with respect to the subject matter hereof and 12 supersedes all previous Agreement negotiations, proposals, commitments, writings, 13 advertisements, publications, and understanding of any nature whatsoever unless expressly 14 included in this Agreement. In the event of any inconsistency in interpreting the documents which 15 constitute this Agreement, the inconsistency shall be resolved by giving precedence in the 16 following order of priority: (1) the text of this Agreement (excluding Exhibit "A", the COUNTY'S 17 RFP No. 964-5439 and Exhibit "B", the CONTRACTOR'S proposal in response thereto); (2) 18 Exhibit "A", the COUNTY'S RFP No. 964-5439; and (3) Exhibit "B", the CONTRACTOR'S 19 proposal made in response to COUNTY'S RFP No. 964.5439. 20 21 22 23 24 25 26 27 28 -11- I IN WITNESS WHEREOF, the parties hereto have executed this Agreement 2 as of the day and year first hereinabove written. 3 CONTRACTO COUNTY OFFRESNO 5 Steve Gedest Ernest Buddy Mendes 6 Municipality Practice Leader, Keenan &Associates Chairman, Board of Supervisors 7 8 2355 Crenshaw Blvd., Suite 200 Torrance, CA 90501 9 Mailing Address ATTEST: Bernice E. Seidel 10 Clerk, Board of Supervisors 11 12 DATE: 6/2 �� BY: �uSA.�. & 0•p DEPUTY 13 14 REVIEWED & RECOMMENDED FO APPROVAL 15 16 Paul Nerland Director of Human Resources 17 18 APPROVED AS TO LEGAL FORM APPROVED AS TO ACCOUNTING FORM 19 . L A fr 20 Daniel Cederborg Vicki Crow County Counsel Auditor-ControllerTTreasurer-Tax Collector 21 22 23 24 25 26 27 28 -12- Exhibit A COUNTY OF FRESNO REQUEST FOR PROPOSAL NUMBER: 964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES Issue Date: February 8, 2016 Closing Date: MARCH 109 2016 Proposal will be considered LATE when the official Purchasing time clock reads 2:00 P.M. Questions regarding this RFP should be directed to: Nick Chin, phone (559) 600-7113 or e-mail countypurchasinq(a-co.fresno.ca.us. Check County of Fresno Purchasing's website at https://www2.co.fresno.ca.us/0440/Bids/BidsHome.aspx for any future addenda. Please submit all Proposals to: County of Fresno - Purchasing 4525 E. Hamilton Avenue, 2nd Floor Fresno, CA 93702-4599 BIDDER TO COMPLETE Undersigned agrees to famish the commodity or service stipulated in the attached response at the prices and terms stated,subject to the attached `County of Fresno Purchasing Standard Instructions And Conditions For Requests For Proposals(RFP's)And Requests For Quotations(RFQ's)". COMPANY ADDRESS CITY STATE ZIP CODE TELEPHONE NUMBER FACSIMILE NUMBER E-MAIL ADDRESS SIGNATURE(IN BLUE INK) PRINT NAME TITLE PURCHASING USE:NC:ssj ORG/Requisition:89250200/8921600150 G:\Public\RFP\FY2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc PaO40(11/2015) Proposal No. 964-5439 COOP FMNO PURC IASM STANDARD INSTRUCTIONS AND CONDITIONS FOR REQUESTS FOR PROPOSALS(RFP'S)AND REQUESTS FOR QUOTATIONS(RFQ'S) Note:the reference to`bids"in the following paragraphs applies to RFP's and RFQ's GENERAL CONDITIONS By submitting a bid the bidder agrees to the following conditions. These conditions will apply to all subsequent purchases based on this bid. 1. BID PREPARATION contact for discussions or information pertaining to the RFP/RFQ. A) All prices and notations must be typed or written in ink No erasures Contact with any other County representative, including elected pen--Ited. Enos maybe crossed out,initialed and corrections printed officials,for the purpose of discussing this RFP/RFQ,its content,or in inkb eison s bid. any other issue concerning it, is prohibited unless authorized by ypg Purchasing.Violation ofthis clause,bythevendorhavingunauthorized B) Brand Names: Brand names and numbers when given are for contact(verbally or in writing)with such other Countyrepresentatives, reference.Equal items will be considered,provided the offer clearly may constitute grounds for rejection by Purchasing of the vendor's describes the article and how it digs from that specified. In the quotation. absence of such information it shall be understood the offering is The above stated restriction on vendor contact with County exactly as specified. representatives shall apply until the County has awarded a purchase C) State brand or make ofeach item lfbidding on other than specified, orderor contract to a vendoror vendors,except as follows.First,in the state make, model and brand being bid and attach supporting event that a vendor initiates a formal protest against the RFP/RFQ, literature/specifications to the bid. such vendor may contact the appropriate individual,or individuals who are managing that protest as outlined in the County's established D) Bid on each item separately. Prices shoukhbe stated in units specified protest procedures.All such contact must be in accordance with the herein. All applicable charges must be quoted;charges on invoice not sequence set forth under the protest procedures.Second,in the event quoted herein will be disallowed. a public hearing is scheduled before the Board of Supervisors to hear E) Time of delivery is a part of the consideration and must be stated in testimony prior to its approval of a purchase order or contract,any definite terms and must be adhered to. F.O.B. Point shall be vendor may address the Board. destination or freight charges must be stated D) Bids received after the closing time will NOT be considered. F) All bids must be dated and signed with the firm's name and by an E) Bidders are to bid what is specified or requested fast.If unable to or authorized officer or employee. unwilling to, bidder may bid altemative or option, indicating all G) Unless otherwise noted,prices shall be firm for one hundred eighty advantages,disadvantages and their associated cost. (180)days after closing date ofbid. 3. FAH RE TO BID 2. SUBMIT'MIGBIDS: A) Ynot bidding,return bid sheet and state reason for no bid or your A) Each bid mast be submitted on forms provided in a sealed name maybe removed fornmariling list envelope/package with bid number and closing date and time on the 4. TAXES,CHARGES AND EXIRAS: outside of the envelope/package. A) County of Fresno is subject to California. sales and/or use tax B) Interpretation:Should any discrepancies or omissions be found in the (8.225%).Please indicate as a separate line itemifapplicable. bid specifications or doubt as to their meaning,the bidder shall notify the Buyer in writing atonce. The County shall not be held responsible B) DO NOT include Federal Excise Tax County is exempt under for verbal interpretations. Questions regarding the bid most be Registration No.94-73-03401-K received by Purchasing stated within this document. All addenda C) County is exempt from Federal Transportation Tax Exemption issued shallbe inwriting,duly issuedbyPurchasing and incorporated certificate is not required where shipping papers show consignee as into the contract. County of Fresno. C) ISSUINGAGENUAUIHORIZEDCONTACE This RFP/RFQhas been D) Charges for transportation,containers,packing,etc.will not be paid issued by County of Fresno, Purchasing. Purchasing shall be the unless specified in bid. vendor's sole point ofcontact with regard to the RFP/RFQ,its content, and all issues concerning it. 5. W-9 —REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND All communication regarding this RFP/RFQ shall be directed to an CERTIFICATION&CALIFORNIAFORM590 WITHHOIDMEXEMPTION authorized representative of County Purchasing.The specific buyer CERTIFICATE: managing this RFP/RFQ is identified on the cover page,along with his Upon award of bid, the vendor shall submit to County Purchasing, a or her telephone number,and he or she should be the primary point of completed IRS Form W-9-Request for Tax raver Identification Number and lA Proposal No. 964-5439 Certification and a Califomia Form 590VAliholdngExemption Certificate if default.Vendor shallreimburse County farexpenses related todelivery not currently a County ofFresno approved vendor. ofnon-specified goods or services. 6. AWARDS: C) Regardless of F.O.B.point,vendor agrees to bear all risks of loss, A) Award(s)will be made to the most responsive responsible bidder, injuryordestnrctiontogoods andmaterials ordered hereinwhich occur however, the Fresno County Local Vendor Preference and/or the prior to delivery and such loss,injury or destruction shall not release Disabled Veteran Business Enterprise Preference shall take vendor from any obligation hereunder. precedencewhenapplicable. Said Preferences apply only to Request 11. DISCOUNTS: for Quotations for materials, equipment and/or supplies only (no Terms services);the preference do not apply to Request far Proposals.RFQ ofless than fifteen(15)days for cash payment willbe considered as evaluations will include such things as life-cycle cost, availability, net in evaluating this bid.Adis count for payment within fifteen(15)days or deliverycostsandwhoseproductand/orsen�iceisdeemedtobeinthe �rewill be considered indetemvning the award ofbid.Discount period will best interest of the County. The County shall be the sole judge in commence either the later of delivery or receipt of invoice by the County. Standard temps are Net forty-five(45)days. making such detemvnation. B) Unless bidder gives notice of all-or-none award in bid,County may 12. SPECIALCONDTTIONS INBID SCHEDULE SUPERSEDE GENERAL, accept any item,group ofitems or on the basis oftotal bid CONDITIONS. C) The County reserves the right to reject any and all bids and to waive The`General Conditions"provisions ofthis RFP/RFQ shallbe superseded if infamralities or irregularities in bids. in conflict with any other section ofthis bid,to the extent ofany such conflict. D) AwardNotices are tentative:Acceptance ofanoflermade inresponse 13. SPECIALREQUIR DM -. to this RFP/RFQ shall occur only upon execution ofan agreement by With the invoice or within twenty-five(25)days of delivery,the seller must both parties or issuance of a valid written Purchase Order by Fresno provide to the County a Nlaterial Safety Data Sheet for each product,which County Purchasing• contains any substance on "The List of 800 Hazardous Substances", E) Mer award,all bids shall be open to public inspection.The County published by the State Director of Industrial Relations. (See Hazardous assumes no responsibility for the confidentiality ofinfomrationoffered Substances Information and Training Act, California State Labor Code in a bid. Sections 6360 through 6399.7.) 7. TIE BIDS: 14. REC'YCIEDPRODUCTS/NIATERIALS: All other factors being equal,the contract shall be awarded to the Fresno Vendors are encouraged to provide and quote(with documentation)recycled County vendor or,if neither or both are Fresno County vendors,it may be or recyclable products/materials which meet stated specifications. awarded by the flip of coin in the presence ofwitnesses or the entire bid 15. YEAR CONPLIANCE WARRANTY maybe rejected and re-bid.Ifthe General Requirements ofthe RFQ state that they are applicable,the provisions ofthe Fresno County Local Vendor Vendorwarrants that anyproductfumishedpursuantto this Agreement/order Preference shall take priority over this paragraph. shall support a four-digit year format and be able to accurately process date and time data from, into and between the twentieth and twenty-first 8. PA=H)EMNTlY• centuries,as well as leap year calculations.'Product"shall include,without The vendor shall hold the County, its officers, agents and employees, limitation, any piece or component of equipment, hardware, fimmware, harmless from liability ofany nature or kind,including costs and expenses, nnddleware, custom or commercial software, or internal components or for infringement or use of any copyrighted or un-copyrighted composition, subroutines therein.This warranty shall survive termination or expiration of secret process, patented or unpatented invention, article or appliance this Agreement famished or used in connection with this bid hi the event of any decrease in product functionality or accuracy related to 9. SAM'IES: time and/or date data related codes and/or internal subroutines that impede the product from operating conectlyusing dates beyond December 31,1999, Samples,when required,must be fimmished and delivered free and,if not vendor shall restore or repair the product to the same level offunctionalityas destroyed by tests,will upon written request(within thirty(30)days ofbid warranted herein, so as to minimize interruption to County's ongoing closing date)be returned at the biddefs expense.In the absence of such business process,time being ofthe essence.In the event that such warranty notification, County shall have the right to dispose of the samples in compliance requires the acquisition ofadditional programs,the expense for whatever manner it deems appropriate. any such associated or additional acquisitions, which may be required, 10. RIGHTS AND REMEDIES OF COUNIYFOR DEFAULT. including,without limitation,data conversion tools,shallbe home exclusively by vendor.Nothing in this warranty shall be construed to limit any rights or A) In case of default by vendor,the County may procure the articles or remedies the County may otherwise have underthis Agreement withrespect service from another source and may recover the cost difference and to defects other than yearperforrmmance. related expenses occasioned thereby fiamanyunpaid balance due the 16. PARTICIPATION vendor or by proceeding against performance bond of the vendor,if any,or by suit against the vendor.The prices paid by the County shall Bidder may agree to extend the terms of the resulting contract to other be consideredthe prevailing market price atthe time suchpurchase is political subdivision,municipalities and tax-supported agencies. made. Such participating Governmental bodies shall make purchases in their own B) Articles or services, which upon delivery inspection do not meet name,make payment directlyto bidder,and be liable directlyto the bidder, specifications,will be rejected and the vendor will be considered in holding the County ofFresno harmless. 1B Proposal No. 964-5439 17. COIF DENI'TALTTY: 20. AUDITS&RETENTION: All services performed by vendor shall be in strict conformance with all The Contractor shall maintain in good and legible condition all books, applicable Federal, State of California and/or local laws and regulations documents,papers,data files and other records related to its perfornmance relating to confidentiality,including but not limited to,Calibmia Civil Code, under this contract.Such records shallbe complete and available to Fresno California Welfare and Institutions Code,Health and Safety Code,California County, the State of Califomia, the federal government or their duly Code ofRegulations,Code ofFederalRegulations. authorized representatives forthe purpose ofaudit,examination,orcopying Vendor shall submit to County's monitoring of said compliance. during the term of the contract and for a period of at least three(3)years followurgthe County's finalpaymentunderthe contract oruntilconclusionof Vendormaybe abusiness associate ofCounty,as thattermis definedinthe anypending matter(e.g.,litigation or audit),whicheveris later.Suchrecords `PrivacyRule"enactedbythe Health Insurance Portabllityand Accountabiluy mustberetainedmthe manner described above until all pending matters ate Act of 1996(HPAA).As a HIPAABusiness Associate,vendor may use or closed. disclose protected health information(`PIP)to perform functions,activities 21. DISCLOSURE—CRPvE,1ALH[STORY&CMACTLONS: or services for or on behalf of County as specified by the County,provided that such use or disclosure shall not violate HIPAA and its implementing Applies to Request for Proposal(RFP); does not apply to Request for regulations.The uses and disclosures ifPH[may not be more expansive Quotation(RFQ)unless specifically stated elsewhere in the RFQ document. than those applicable to County,as the`Covered Entity"under HIPANs Privacy Rule,except as authorized for management,administrative or legal �their proposal,the bidder is required to disclose if any of the following responsibilities ule, ofthe Business Associate. conditions apply to them,their owners,officers,corporate managers and partners(hereinafter collectively referred to as`Bidder'): Vendor shall not use or firrther disclose PHI other than as permitted or Within the three-year period preceding the proposal,they have been required by the County,or as required by law without written notice to the convicted of or had a civil judgment rendered against them for County. Vendor shall ensure that any agent,including any subcontractor,to which o fraud or a crunumal o$ense in connection with obtaining, vendorprovides PAlreceived from,or created orreceived bythe vendor on attempting to obtain,or performing a public(federal,state, behalfofCounty,shall complywith the same restrictions and conditions with or local)transaction or contract under a public transaction; respect to such information. o violation of a federal or state antitrust statute; 18. APPEALS: o embezzlement, Chet forgery, bribery, falsification, or Appeals must be submitted in writing within seven(7)working days after destruction ofrecords;or notification ofproposedrecommendations for award A`Notice ofAward"is o false statements or receipt of stolen property not an indication ofCounty's acceptance ofan ofiernrade in response to this RFP/RFQ.Appeals should be submitted to County of Fresno Purchasing, Within a three-year period preceding their proposal,they have had a public 4525 E. Hamilton Avenue, Fresno, California. 93702-4599 and in Word transaction(federal,state,or local)terminated for cause or default format to Qcomuelle(a)co.ficsno.ca.us.Appeals should address only areas regarding RFP/RFQ contradictions,procurement errors, quotation rating 22. DATASECURITY discrepancies, legality of procurement context, conflict of interest, and Individuals and/oragencies thatenterintoa contractual relationship with the inappropriate or unfair competitive procurement grievance regarding the RFP/RFQ process. COUNTY for the propose of providing services must employ adequate controls and data security measures,both internally and extemallyto ensure Purchasing will provide a written response to the complainant within seven and protect the confidential irrbmration and/or data provided to contractor by (7)working days unless the complainant is notified more time is required. the COUNTY,preventing the potential loss,misappropriation or inadvertent access,viewing,use or disclosure of COUNTY data including sensitive or If the protesting bidder is not satisfied with the decision of Purchasing, persomlclientinformation;abuse ofCOUNTYre s ource s;and/or disruption he/she shall have the right to appeal to the Purchasing Agent/CAD within to COUNTYoperations. seven(7)working days after Purchasing's notification;except it notified to appeal directly to the Board of Supervisors at the scheduled date and time. Individuals and/or agencies may not connect to or use COUNTY networks/systems via personally owned mobile, wireless or handheld If the protesting bidder is not satisfied with Purchasing Agent/CAO's devices unless authorized by COUNTY for telecom muting purposes and decision,the final appeal is with the Board of Supervisors. provide a secure connection,up to date virus protection and mobile devices 19. OBLIGATIONS OF CONTRACTOR must have the remote wipe feature enabled. Computers or computer peripherals including mobile storage devices maynotbe used(COUNTYor A) CONTRACTOR shall perform as required by the ensuing contract. Contractor device) or brought in for use into the COUNTY's system(s) CONTRACTORalso warrants on behalfofitselfand all subcontractors without prior authorization from COUNI'Y'sChieflnfammation Officer and/or engaged fortheperfomranceofthe ensuing contractthatonlypersons designee(s). authorized to work in the United States pursuant to the Immigration Reform and Control Act of 1986 and other applicable laws shall be No storage ofCOUNI Y's private,confidential or sensitive data on anyhard- employed in the performance of the work hereunder. disk drive,portable storage device or remote storage installation unless encrypted according to advance encryption standards (AES of 128 bit or B) CONTRACTOR shall obey all Federal,State,local and special district higher). laws,ordinances and regulations. The COUNTY will immediately be notified of any violations,breaches or potentialbreaches ofsecuuity related toCOUNTY's confidential hbanation, 1C Proposal No. 964-5439 data and/or data processing equipmentwhich stores orprocesses COUNTY The following language will be included in each applicable contract: data,internally or externally. "The contractor agrees to limit administrative cost to a maximum of 15%of COUNTY shall provide oversight to Contractor's response to all incidents the total program budget and to limit employee benefits to a maximum of arising from possible breach ofsecurity related to COUNIY's confidential 20%of total salaries for those employees working under this agreement clientinfommation. Contractor will be responsible to issue any notification to during the termofthis agreement.Faiil=toconformto this provision willbe affected individuals as required by lawor as deemed necessaryby COUNTY grounds for contract temvnationat the option ofthe County ofFresno." in its sole discretion. Contractor will be responsible for all costs incurred as a resod ofprovidmg the required notification. The above provision shallbe applied to renewal ormuhi-yearconhacts with non-profit organizations which primanly serve Fresno County and 23. PURCHASING LOCATION&HOURS: professional services contracts where Fresno County Purchasing is located at4525 E.Hamilton Avenue(second Fresno County is the sole client,such as: floor),Fresno, CA 93702. Non-holiday hours of operation are Nbnday a Co it based organization service contracts related to social through Friday,8:00 AM to 12:00 Noon and 1:00 P.M to 5:00 P.M PST; Purchasing is closed daily from 12:00 Noon to 1:00 P.M The following services,health services,or probation services. holiday office closure schedule is observed: . Cultural art program contracts. January 1* NewYeafs Day • Professional services contracts. Third Nbnday in January Nhrtin lather King,Jr.'s Birthday This policy will not apply to contracts between the County and the Federal or State governments;or one-time contracts.The Board of Supervisors will Third Nbnday in February Washington-Lincoln Day consider exemptions to this policy only upon the recommendation of the County Administrative Office. Nlireh 31* Cesar Chavez'Bnthday Mmasement Responsibility:It shall be the responsibility of any County Last Nbnday in Mty Nbrnorial Day official authorized by the Board of Supervisors to execute contracts or enter into agreements onbehalfofthe Countyto reviewallappficable contracts to July 4* Independence Day pure that this policy Y mil'enforced. First Nbnday in September Labor Day It shall be the responsibility of the County Administrative Officer to review November 11* Veteran's Day requests far exemptions to this policy and to make recommendations to the Board of Supervisors on such requests for exemption. Fourth Thursday in November Thanksgiving Day ADNIiI`I6STRATIVE POTTCYNUNBER 34 Friday following Thanksgiving Competitive Bids and Requests for Proposals December25* Christmas Fresno County Administrative PolicyNo.34provides thatnoperson,firm or subsidiary thereofwho has been awarded a consulting services contract *When this date fills on a Saturday, the holiday is observed the by the County,may submit a bid for, or be awarded a contract for,the preceding Friday. Ifthe date fills on a Sunday,the holiday is observed provision ofservices,procurement ofgoods orsupplies,or any other related the following Nbnday. actionwhichis required,suggested,orotheiwise deemed appropriate inthe end product ofthe consulting services contract.Any bidder that wishes an 24. FRESNO COUNTY BOARD OF SUPERVISORS ADNPUSTRATTVE exemption from this contract )imitation mast set forth the request for POLICIES: exemption,as well as a complete explanation ofwhy the exemption should ADNIiI`I6STRATM POLICYNUNBER 5 be granted, in the bidder's response to the RFP. Only the Board of Supervisors,on a four-fifths(4/5)vote finding that such waiver is in the best Contract Salary Limitation Fresno interests ofthe County,can waive this policy. County Administrative Policy No.5 provides that in contracts with non- Definitions:Purchasing Authority and Responsibility—In accordance with profit organizations that primanly serve Fresno County and professional the State of California Government Code Section 25500 et seq.,and the service contracts where Fresno County is the sole client,the contractors Fresno County Ordinance Code Chapter2.56,the BoardofSupervisois has must agree to the following contractlanguage:"The contractor agrees tolinbt established a County Purchasing Agent. The Board has designated the administrative cost to amaxurnunofl5%ofthe total programbudget and to County Administrative Officer as the Purchasing Agent.Unless otherwise limit employee benefits to a maximum of 20%of total salaries for those restricted,all necessary authority and responsibility has been delegated to employees workuig under this agreement during the term ofthe agreement. the Purchasing Agent to satisfy the acquisition requirements ofthe County. Failure toconformto this provision willbe grounds for contract temmiationat The Purchasing Agentmay defer day-to-day acquis ition management to the the option of the County of Fresno."Any bidder that wishes an exemption Purchasing Nhnager as appropriate. fiomthis contract requirements must set forth the request for exemption,as well as a complete explanation ofwhy the exemption should be granted,in Policy Statement: Competitive bids or requests for proposals shall be the bidder's response to the RFP. Only the Board of Supervisors can secured for at contracts for goods or services which are proposed to be approve such exemption. acquired by the County except when in unusual or extraordinary circumstances,a department head,requests an exception to competitive Policy Statement: Contractors shall be limited to a maximum 15% bidding.All such requests must be documented by the department head administrative cost as compared to the total programbudget and employee including a detailed description of the facts justifying the exception. The benefits shall be limited to a maximum of200/oof salaries. 1D Proposal No. 964-5439 request must receive concurrence ofthe procurementauthoritywhovAsign coordinated through the CountyCounsefs Office.The County Counsel shall that particular contract ie. the Board of Supervisors or Purchasing assist in securing a law firm with the requisite legal expertise and price Agent/Purchasing Nhnager. The following circumstances are examples structure thatwould provide the best service to the County.CountyCounsel which constitute`Suspension of Competition'1 shall be involved throughout the process of selecting a En-4 developing a • In an emergency when goods or services are immediately necessary contract,and monitoring the billing and services provided throughout the for the preservation ofthe public health,welfare,or safety,or for the contract period. protection of County property. Prohibited Bids Concerning End Product of Consulting Contracts • When the contract is with a federal, state, or local governmental No person,firm,or subsidiary thereofwho has been awarded a consulting agency. services contract by the County, shall be awarded a contract for the provision ofservices,procurement ofgoods or supplies,or any other related • When the department head,with the concurrence of the Purchasing action which is required,suggested,or otherwise deemed appropriate in the Agent,finds that the costofpreparing and administering a competitive end product ofthe consulting services contract.This policy may be waived bidding process in a particular case WA equal or exceed the estimated by the Board of Supervisors on a four-fifths (4/5)vote finding that such contract amount or$1,000 whichever is more. vuaiver is in the best interests of the County. • When a contract provides only for payment of per diem and travel Nlinagement Responsibility: The County Administrative Officer is expenses and there is to be no payment for services rendered. responsible for preparing and issuing written procedures to assure • When obtaining theservices ofexpertwitnesses for litigation orspecial compliance with this policy by all County officials and departments. counsel to assist the County. ADNff%RSTRATNE POUCYNUNDER 71 • When in unusual or extraordinary circumstances, the Board of Prohibiting the Use of Public Funds for Political Advocacy Supervisors orthe Purchasing Agent/Purchasing Nhnagerdetemmines thatthe best interests ofthe Countywouldbe servedbynot securing Fresno County Administrative Policy No. 71 provides that no County competitive bids or issuing a request for proposal. assets,including money,shallbe used for political campaigns ofany type. Political campaigns are defined as political advocacy for or opposition to a Contracts for services should not usually cover a period of more than one matter or person that has qualified for the ballot.No contract entered into by year although a longer period may be approved in unusual circumstances. the County shall provide for use of County monies for political campaigns. Nlrltgmle year contracts nnmst include provisions for early termination and must be contingent on available funding.Unless exempted as provided for Policy Statement:Government assets,including money,grant fiends,paid above,no contract for service shall extend,either by original contract or by stafftime,equipment and supplies,facilities or any other government asset extension,beyond three years unless competitive bids have been sought or shallnotbe used forpoliticalcampaigns ofanytype.Political campaigns are a Request for Proposal has been processed. defined as political advocacy for or opposition to a matter or person that has qualified for the ballot. During any competitive bidding procedure,all bids shall be opened publicly and the dollar amount of each bid shall be read aloud. Under no NhnaeementResponsibility:Departmentfleadsshallbeheldresponsrble circumstance shall a bid which is received at the designated place of for ensuring that government assets within their control are not used to opening after the closing time be opened or considered. advocate for or against anyinatter or person that has qualified for the ballot. Contracts fargoods orservices shallnotbe e$ective until approved bythe This section does not prohibit the expenditure of government assets to Board of Supervisors or,if appropriate,the Purchasing Agent/Purchasing create andprovide infamrationaloreducationalmaterials regarding a matter Nhnager. Contractors and vendors shall be advised by the responsible that has qualified for the ballot.Such information or educational materials department head that performance under the contract may not commence shall provide a fair, accurate and impartial presentation of relevant prior to such approval. information relating to the matter that has qualified for the ballot.However, government assets shall not be expended to create and provide such Nl dical Professional Contracts infammational or educational materials in the 90 days prior to the election The competitive recmitmentprocess,annual performance evaluation,and unless specifically authorizedbythe Board ofSupervisors orrequiredbythe periodic salary surveys are equivalent to competitive bids for independent Public Records Act or other law physicians contracting with the County on a fee for service basis. Asalary survey for physician services shall be conducted every two years. Contracts forphysician services shall not extend,either by original contract orbyextension,beyond five years unless competitive bids have been sought or unless exempted as provided above. Contracts for Legal Services The competitive recrritrnentprocess,annual performance evaluation,and periodic salary surveys are equivalent to competitive bids for independent law firms and attorneys contracting with the County on a fee for service basis. Asalary survey for legal services shall be conducted every two years. The selection ofand contracting with firms to provide legal services shallbe lE Proposal No. 964-5439 Page 2 TABLE OF CONTENTS PAGE OVERVIEW.....................................................................................................................3 KEYDATES ....................................................................................................................5 TRADE SECRET ACKNOWLEDGEMENT .....................................................................6 DISCLOSURE - CRIMINAL HISTORY & CIVIL ACTIONS.............................................8 REFERENCELIST........................................................................................................ 11 PARTICIPATION........................................................................................................... 12 GENERAL REQUIREMENTS ....................................................................................... 13 BIDDING INSTRUCTIONS AND REQUIREMENTS ..................................................... 19 SCOPEOF WORK........................................................................................................ 21 VENDOR RESPONSE SECTION .................................................................................25 COSTPROPOSAL........................................................................................................27 PROPOSAL CONTENT REQUIREMENTS................................................................... 28 AWARD CRITERIA ....................................................................................................... 31 CHECKLIST ................................................................................................................. 32 ATTACHMENTS ........................................................................................................... 33 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 3 OVERVIEW The County of Fresno is requesting proposals from qualified vendors to provide consulting services related to our health and benefits programs ("Health & Benefits Consultation Services"). The primary focus of the request for proposal is Health Benefit Consultation Services, but the County also requires consulting services for Ancillary/Voluntary Benefit Consultation Services (life, disability and voluntary benefits), Flexible Spending Accounts (Health Care, Dependent Care, and Commuter benefits), and the Employee Assistance Program (Ancillary/Voluntary and Flexible Spending Account enrollment is detailed in Attachment B). Proposals that include only health benefit consultation services will be considered. The County seeks a consultant that is well versed in the health benefits market (including self-funded plans), experienced in advising comparable public agencies, able to provide legislative updates on both proposed and new legislation, and that works well with various levels of labor, staff and management. The County has been in a contract with Gallagher Benefit Services since March, 2007 and at this time is requesting proposals for its health benefits consultant services consistent with the County's standard process of periodically re- bidding services. (In 2015 total health benefits consultant fees paid were$45,000.)The County seeks Health & Benefits Consultation Services provided on a flat fee retainer basis. Proposals that include consulting services for ancillary/voluntary benefits should assume being declared the County"broker of record"for these benefits allowing compensation on a commission basis to off-set the cost of health benefit consultation services. Vendors should submit proposals for both Health Benefit and Ancillary/Voluntary benefit consulting that includes pricing for Health Benefit consulting only and Health Benefit consulting with Ancillary/Voluntary benefits consulting. The County anticipates entering into a new agreement with the prospective vendor by June of 2016 and will require the consultant to be prepared to immediately engage in the health plan renewal process. The County of Fresno currently provides comprehensive health benefits for approximately 5,400 active employees and 1,100 retirees. Plans that expire at the end of 2016 include health, dental, vision, mental health and Pharmacy Benefit Management services. The prospective consultant will need to be prepared to solicit health vendor proposals upon contract execution. The County's annual Open Enrollment period for 2017 is scheduled for late October/early November and the plan year begins December 19, 2016. Currently the County's health benefits are administered through contracts with the following vendors: Population Ntdical Dental Vision Ntntal Health Prescription Blue Cross HN/D Active Blue Cross PPO Delta Dental PPO VSP Vision Included with US Script Employees Blue Cross HDPPO Delta Dental HIND (Anthem (Anthem HNID Only) the medical plan and PPO only) Kaiser Early Retirees Blue Cross HDPPO Delta Dental PPO VSP Vision Included with Included with the (Pre-65) Kaiser Dcha Dental HMO (Anthem Only) the medical plan medicalplan Nbdicare Delta Dental PPO Included with Supplement Hartford VSP Vision Express Scripts Retirees Dental�� the medical plan Ntdicare Kaiser Ntdicare Advantage Delta Dental PPO Included with Included with Included with the Advantage ugh and Low Options) Delta Dental HMD the medical plan the medical plan medical plan Retirees G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 4 COUNTY HEALTH BENEFITS PROGRAM Active Employee Health Insurance: On October 6, 2009 the County approved the execution of a Joint Exercise of Powers Agreement creating the San Joaquin Valley Insurance Authority (SJVIA)with the County of Tulare. The SJVIA currently has 25 participating entities and the County does have access to the claims information. The SJVIA offered the County reduced fixed costs and offered plans for employees and pre-65 retirees. The greater critical mass achieved in this arrangement allowed for cost savings and additional value-added services such as COBRA administration and eligibility tracking when compared with other alternatives. In 2012, the SJVIA moved to a "shared risk model". Through the SJVIA, the County currently receives Anthem Blue Cross medical plans (HMO, PPO, HDPPO) along with fully insured Kaiser medical plans. The County also receives prescription (US Script)for the Anthem HMO and PPO plans, vision (VSP) and dental (Delta Dental DPPO and DHMO). Each year, the County signs a one-year participation agreement with the SJVIA for plans and services. The County's consultant would be responsible for evaluating the best health insurance options available to the County. This would include an analysis of the proposed rates and plan design options from the SJVIA and soliciting bids from other carriers. Pre-65 Retiree Health Insurance: The County unblended the active and pre-65 health insurance rates in 2006 thereby eliminating the GASB 45 liability. The Anthem Blue Cross HDPPO and the fully insured Kaiser HMO plan are offered through the SJVIA. Both plans are up for renewal in 2016 and would require the solicitation of bids by the consultant. Post-65 Retiree Health Insurance: The County offers three plans to Medicare eligible County retirees and are not through the SJVIA. A Medicare Supplemental plan is offered by Hartford with Express Scripts handling the prescription coverage. Two Medicare Advantage plans are offered through Kaiser Senior Advantage with a high and low option. All three options are up for renewal and would require the solicitation of bids by the consultant. Pharmacy Benefit Management Services (Offered in conjunction with the Anthem Blue Cross HMO and PPO laps : The County of Fresno previously self-funded the prescription drug plan for the Anthem HMO and PPO participants. In 2013, the County contracted the prescription benefits through the SJVIA. The current carrier is US Script as the Pharmacy Benefits Manager(PBM). In 2015, after an extensive RFP process, the SJVIA approved another three year agreement with US Script. This service would require the solicitation of bids by the consultant upon the agreement's expiration. It should also be noted that the consultant is expected to actuarially develop the Pharmacy rates for the County. Dental Insurance (Employees & Retirees): The County contracts with the SJVIA for the dental insurance and has traditionally offered the option of both a PPO and HMO dental plan and currently contracts with Delta Dental. Delta Dental is in the first year of a two year contract with the SJVIA and will require the solicitation of bids by the consultant. Vision Insurance (Offered in conjunction with Anthem Blue Cross & Hartford plans): The County contracts with the SJVIA for vision insurance. The current carrier is Vision Service Plan (VSP), and would require the solicitation of bids by the consultant. Mental Health / Employee Assistance Program: The County's mental health is included with the medical plans. The Employee Assistance Program is contracted through Ann Clark International (ACI)and is in the fourth year of the current agreement. This would require the solicitation of bids by the consultant. Detailed enrollment information on all plans is included in Attachment A. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 5 KEY DATES RFP Issue Date: February 8, 2016 Vendor Conference: February 22, 2016 at 10:00 A.M. Vendors are to contact Nick Chin at(559) County of Fresno Purchasing 600-7113 if planning to attend vendor 4525 E. Hamilton Avenue, 2nd Floor conference. Fresno, CA 93702 Deadline for Written Requests for February 24, 2016 at 10:00 A.M. Interpretations or Corrections of RFP: E-Mail: CountyPurchasing(a.co.fresno.ca.us RFP Closing Date: March 10, 2016 at 2:00 P.M. County of Fresno Purchasing 4525 E. Hamilton Avenue, 2nd Floor Fresno, CA 93702 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 6 TRADE SECRET ACKNOWLEDGEMENT All proposals received by the County shall be considered "Public Record" as defined by Section 6252 of the California Government Code. This definition reads as follows: "...Public records" includes any writing containing information relating to the conduct of the public's business prepared, owned, used or retained by any state or local agency regardless of physical form or characteristics"Public records"in the custody of,or maintained by,the Governor's office means any writing prepared on or after January 6, 1975." Each proposal submitted is Public record and is therefore subject to inspection by the public per Section 6253 of the California Government Code. This section states that"every person has a right to inspect any public record". The County will not exclude any proposal or portion of a proposal from treatment as a public record except in the instance that it is submitted as a trade secret as defined by the California Government Code. Information submitted as proprietary, confidential or under any other such terms that might suggest restricted public access will not be excluded from treatment as public record. "Trade secrets" as defined by Section 6254.7 of the California Government Code are deemed not to be public record. This section defines trade secrets as: "...Trade secrets," as used in this section, may include, but are not limited to, any formula, plan, pattern, process, tool, mechanism, compound, procedure, production data or compilation of information that is not patented, which is known only to certain individuals within a commercial concern who are using it to fabricate, produce, or compound an article of trade or a service having commercial value and which gives its user an opportunity to obtain a business advantage over competitors who do not know or use it." Information identified by bidder as "trade secret"will be reviewed by County of Fresno's legal counsel to determine conformance or non-conformance to this definition. Such material should be submitted in a separate binder marked "Trade Secret". Examples of material not considered to be trade secrets are pricing, cover letter, promotional materials, etc. INFORMATION THAT IS PROPERLY IDENTIFIED AS TRADE SECRET AND CONFORMS TO THE ABOVE DEFINITION WILL NOT BECOME PUBLIC RECORD. COUNTY WILL SAFEGUARD THIS INFORMATION IN AN APPROPRIATE MANNER. Information identified by bidder as trade secret and determined not to be in conformance with the California Government Code definition shall be excluded from the proposal. Such information will be returned to the bidder at bidder's expense upon written request. Trade secrets must be submitted in a separate binder that is plainly marked "Trade Secrets." The County shall not in any way be liable or responsible for the disclosure of any proposals or portions thereof, if they are not(1)submitted in a separate binder that is plainly marked "Trade Secret" on the outside; and (2) if disclosure is required or allowed under the provision of law or by order of Court. Vendors are advised that the County does not wish to receive trade secrets and that vendors are not to supply trade secrets unless they are absolutely necessary. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 7 TRADE SECRET ACKNOWLEDGEMENT I have read and understand the above"Trade Secret Acknowledgement." I understand that the County of Fresno has no responsibility for protecting information submitted as a trade secret if it is not delivered in a separate binder plainly marked "Trade Secret." I also understand that all information my company submits, except for that information submitted in a separate binder plainly marked "Trade Secret," are public records subject to inspection by the public. This is true no matter whether my company identified the information as proprietary, confidential or under any other such terms that might suggest restricted public access. Enter company name on appropriate line: Has submitted information identified as Trade Secrets in (Company Name) a separate marked binder.** Has not submitted information identified as Trade (Company Name) Secrets. Information submitted as proprietary confidential or under any other such terms that might suggest restricted public access will not be excluded from treatment as public record. ACKNOWLEDGED BY: Signature(In Blue Ink) Telephone Print Name and Title Date Address City State Zip **Bidders brief statement that clearly sets out the reasons for confidentiality in conforming with the California Government Code definition. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 8 DISCLOSURE - CRIMINAL HISTORY & CIVIL ACTIONS In their proposal, the bidder is required to disclose if any of the following conditions apply to them, their owners, officers, corporate managers and partners (hereinafter collectively referred to as"Bidder"): • Within the three-year period preceding the proposal, they have been convicted of, or had a civil judgment rendered against them for: o fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; o violation of a federal or state antitrust statute; o embezzlement, theft, forgery, bribery, falsification, or destruction of records; or o false statements or receipt of stolen property • Within a three-year period preceding their proposal, they have had a public transaction (federal, state, or local)terminated for cause or default. Disclosure of the above information will not automatically eliminate a Bidder from consideration. The information will be considered as part of the determination of whether to award the contract and any additional information or explanation that a Bidder elects to submit with the disclosed information will be considered. If it is later determined that the Bidder failed to disclose required information, any contract awarded to such Bidder may be immediately voided and terminated for material failure to comply with the terms and conditions of the award. Any Bidder who is awarded a contract must sign an appropriate Certification Regarding Debarment, Suspension, and Other Responsibility Matters. Additionally, the Bidder awarded the contract must immediately advise the County in writing if, during the term of the agreement: (1) Bidder becomes suspended, debarred, excluded or ineligible for participation in federal or state funded programs or from receiving federal funds as listed in the excluded parties list system (http://www.el)ls.gov); or(2)any of the above listed conditions become applicable to Bidder. The Bidder will indemnify, defend and hold the County harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility Matters. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 9 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 10 CERTIFICATION (1)The prospective primary participant certifies to the best of its knowledge and belief, that it, its owners, officers, corporate managers and partners: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State or local)transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local)terminated for cause or default. (2)Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: Date: (in blue ink) (Printed Name &Title) (Name of Agency or Company) G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 11 VENDOR MUST COMPLETE AND RETURN WITH REQUEST FOR PROPOSAL Firm: REFERENCE LIST Provide a list of at least five (5) customers for whom you have recently provided similar services. Be sure to include all requested information. Reference Name: Contact: Address: City: State: Zip: Phone No.: ( ) Date: Service Provided: Reference Name: Contact: Address: City: State: Zip: Phone No.: ( ) Date: Service Provided: Reference Name: Contact: Address: City: State: Zip: Phone No.: ( ) Date: Service Provided: Reference Name: Contact: Address: City: State: Zip: Phone No.: ( ) Date: Service Provided: Reference Name: Contact: Address: City: State: Zip: Phone No.: ( ) Date: Service Provided: Failure to provide a list of at least five (5) customers may be cause for rejection of this RFP. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 12 PARTICIPATION The County of Fresno is a member of the Central Valley Purchasing Group. This group consists of Fresno, Kern, Kings, and Tulare Counties and all governmental, tax supported agencies within these counties. Whenever possible, these and other tax supported agencies co-op (piggyback)on contracts put in place by one of the other agencies. Any agency choosing to avail itself of this opportunity, will make purchases in their own name, make payment directly to the contractor, be liable to the contractor and vice versa, per the terms of the original contract, all the while holding the County of Fresno harmless. If awarded this contract, please indicate whether you would extend the same terms and conditions to all tax supported agencies within this group as you are proposing to extend to Fresno County. * Note: This form/information is not rated or ranked for evaluation purposes. Yes, we will extend contract terms and conditions to all qualified agencies within the Central Valley Purchasing Group and other tax supported agencies. No, we will not extend contract terms to any agency other than the County of Fresno. (Authorized Signature in Blue Ink) Title G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 13 GENERAL REQUIREMENTS DEFINITIONS: The terms Bidder, Proposer, Contractor, and Vendor are all used interchangeably and refer to that person, partnership, corporation, organization, agency, etc. which is offering the proposal. LOCAL VENDOR PREFERENCE: The Local Vendor Preference does not apply to this Request for Proposal. RFP CLARIFICATION AND REVISIONS: Any revisions to the RFP will be issued and distributed as written addenda. FIRM PROPOSAL: All proposals shall remain firm for at least one hundred eighty (180)days. PROPOSAL PREPARATION: Proposals should be submitted in the formats shown under"PROPOSAL CONTENT REQUIREMENTS"section of this RFP. County of Fresno will not be held liable or any cost incurred by bidders responding to RFP. Bidders are to bid what is specified or requested first. If unable to or unwilling to, bidder may bid alternative or option, indicating all advantages, disadvantages and their associated cost. SUPPORTIVE MATERIAL: Additional material may be submitted with the proposal as appendices. Any additional descriptive material that is used in support of any information in your proposal must be referenced by the appropriate paragraph(s)and page number(s). Bidders are asked to submit their proposals in a binder(one that allows for easy removal of pages)with index tabs separating the sections identified in the Table of Contents. Pages must be numbered on the bottom of each page. Any proposal attachments, documents, letters and materials submitted by the vendor shall be binding and included as a part of the final contract should your bid be selected. TAXES: The quoted amount must include all applicable taxes. If taxes are not specifically identified in the proposal it will be assumed that they are included in the total quoted. SALES TAX: Fresno County pays California State Sales Tax in the amount of 8.225% regardless of vendor's place of doing business. RETENTION: County of Fresno reserves the right to retain all proposals, excluding proprietary documentation submitted per the instructions of this RFP, regardless of which response is selected. ORAL PRESENTATIONS: Each finalist may be required to make an oral presentation in Fresno County and answer questions from County personnel. AWARD/REJECTION: The award will be made to the vendor offering the overall proposal deemed to be to the best advantage of the County. The County shall be the sole judge in making such determination. The County reserves the right to reject any and all proposals. The lowest bidders are not arbitrarily the vendors whose proposals will be selected. Award Notices are tentative: Acceptance of an offer made in response to this RFP shall occur only upon execution of an agreement by both parties or issuance of a valid written Purchase Order by Fresno County Purchasing. County Purchasing will chair or co-chair all award, evaluation and contract negotiation committees. Award may require approval by the County of Fresno Board of Supervisors. WAIVERS: The County reserves the right to waive any informalities or irregularities and any technical or clerical errors in any quote as the interest of the County may require. TERMINATION: The County reserves the right to terminate any resulting contract upon written notice. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 14 MINOR DEVIATIONS: The County reserves the right to negotiate minor deviations from the prescribed terms, conditions and requirements with the selected vendor. PROPOSAL REJECTION: Failure to respond to all questions or not to supply the requested information could result in rejection of your proposal. ASSIGNMENTS: The ensuing proposed contract will provide that the vendor may not assign any payment or portions of payments without prior written consent of the County of Fresno. BIDDERS LIABILITIES: County of Fresno will not be held liable for any cost incurred by vendors in responding to the RFP. CONFIDENTIALITY: Bidders shall not disclose information about the County's business or business practices and safeguard confidential data which vendor staff may have access to in the course of system implementation. DISPUTE RESOLUTION: The ensuing contract shall be governed by the laws of the State of California. Any claim which cannot be amicably settled without court action will be litigated in the U. S. District Court for the Eastern District of California in Fresno, CA or in a state court for Fresno County. NEWS RELEASE: Vendors shall not issue any news releases or otherwise release information to any third party about this RFP or the vendor's quotation without prior written approval from the County of Fresno. BACKGROUND REVIEW: The County reserves the right to conduct a background inquiry of each proposer/bidder which may include collection of appropriate criminal history information, contractual and business associations and practices, employment histories and reputation in the business community. By submitting a proposal/bid to the County, the vendor consents to such an inquiry and agrees to make available to the County such books and records the County deems necessary to conduct the inquiry. PERFORMANCE BOND: The successful bidders may be required to furnish a faithful performance bond. Bidders are to quote a separate price for a performance bond. ACQUISITIONS: The County reserves the right to obtain the whole system/services/goods as proposed or only a portion of the system/services/goods, or to make no acquisition at all. OWNERSHIP: The successful vendor will be required to provide to the County of Fresno documented proof of ownership by the vendor, or its designated subcontractor, upon request of the proposed programs/services/goods. EXCEPTIONS: Identify with explanation, any terms, conditions, or stipulations of the RFP with which you CAN NOT or WILL NOT comply. ADDENDA: In the event that it becomes necessary to revise any part of this RFP, addenda will be provided to all agencies and organizations that receive the basic RFP. SUBCONTRACTORS: If a subcontractor is proposed, complete identification of the subcontractor and his tasks should be provided. The primary contractor is not relieved of any responsibility by virtue of using a subcontractor. CONFLICT OF INTEREST: The County shall not contract with, and shall reject any bid or proposal submitted by the persons or entities specified below, unless the Board of Supervisors finds that special circumstances exist which justify the approval of such contract: 1. Employees of the County or public agencies for which the Board of Supervisors is the governing body. 2. Profit-making firms or businesses in which employees described in Subsection (1) serve as officers, principals, partners or major shareholders. 3. Persons who, within the immediately preceding twelve (12) months, came within the provisions of Subsection (1), and who were employees in positions of substantial responsibility in the area of service to G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 15 be performed by the contract, or participated in any way in developing the contract or its service specifications. 4. Profit-making firms or businesses in which the former employees described in Subsection (3) serve as officers, principals, partners or major shareholders. 5. No County employee, whose position in the County enables him to influence the selection of a contractor for this RFP, or any competing RFP, and no spouse or economic dependent of such employee, shall be employees in any capacity by a bidder, or have any other direct or indirect financial interest in the selection of a contractor. 6. In addition, no County employee will be employed by the selected vendor to fulfill the vendor's contractual obligations to the County. ORDINANCE 3.08.130— POST-SEPARATION EMPLOYMENT PROHIBITED: No officer or employee of the County who separates from County service shall for a period of one year after separation enter into any employment, contract, or other compensation arrangement with any County consultant, vendor, or other County provider of goods, materials, or services, where the officer or employee participated in any part of the decision making process that led to the County relationship with the consultant, vendor or other County provider of goods, materials or services. Pursuant to Government Code section 25132(a), a violation of the ordinance may be enjoined by an injunction in a civil lawsuit, or prosecuted as a criminal misdemeanor. EVALUATION CRITERIA: Respondents will be evaluated on the basis of their responses to all questions and requirements in this RFP and product cost. The County shall be the sole judge in the ranking process and reserves the right to reject any or all bids. False, incomplete or unresponsive statements in connection with this proposal may be sufficient cause for its rejection. SELECTION PROCESS: All proposals will be evaluated by a team consisting of representatives from appropriate County Department(s), and Purchasing. It will be their responsibility to make the final recommendations. Purchasing will chair or co-chair the evaluation or evaluation process. Organizations that submit a proposal may be required to make an oral presentation to the Selection Committee. These presentations provide an opportunity for the individual, agency, or organization to clarify its proposal to ensure thorough, mutual understanding. INDEPENDENT CONTRACTOR: In performance of the work, duties, and obligations assumed by Contractor under any ensuing Agreement, it is mutually understood and agreed that Contractor, including any and all of Contractor's officers, agents, and employees will at all times be acting and performing as an independent contractor, and shall act in an independent capacity and not as an officer, agent, servant, employee,joint venture, partner, or associate of the County. Furthermore, County shall have no right to control, supervise, or direct the manner or method by which Contractor shall perform its work and function. However, County shall retain the right to administer this Agreement so as to verify that Contractor is performing its obligations in accordance with the terms and conditions thereof. Contractor and County shall comply with all applicable provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof. Because of its status as an independent contractor, Contractor shall have absolutely no right to employment rights and benefits available to County employees. Contractor shall be solely liable and responsible for providing to, or on behalf of, its employees all legally required employee benefits. In addition, Contractor shall be solely responsible and save County harmless from all matters relating to payment of Contractor's employees, including compliance with Social Security, withholding, and all other regulations governing such matters. It is acknowledged that during the term of the Agreement, Contractor may be providing services to others unrelated to the COUNTY or to the Agreement. HOLD HARMLESS CLAUSE: Contractor agrees to indemnify, save, hold harmless and at County's request, defend the County, its officers, agents and employees, from any and all costs and expenses, damages, liabilities, claims and losses occurring or resulting to County in connection with the performance, or failure to perform, by Contractor, its officers, agents or employees under this Agreement and from any and all costs and expenses, damages, liabilities, claims and losses occurring or resulting to any person, firm or corporation G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 16 who may be injured or damaged by the performance, or failure to perform, of Contractor, its officers, agents or employees under this Agreement. SELF-DEALING TRANSACTION DISCLOSURE: Contractor agrees that when operating as a corporation (a for-profit or non-profit corporation), or if during the term of the agreement the Contractor changes its status to operate as a corporation, members of the Contractor's Board of Directors shall disclose any self-dealing transactions that they are a party to while Contractor is providing goods or performing services under the agreement with the County. A self-dealing transaction shall mean a transaction to which the Contractor is a party and in which one or more of its directors has a material financial interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are a party to by completing and signing a Fresno County Self-Dealing Transaction Disclosure Form and submitting it to the County prior to commencing with the self-dealing transaction or immediately thereafter. PRICE RESPONSIBILITY: The selected vendor will be required to assume full responsibility for all services and activities offered in the proposal, whether or not they are provided directly. Further, the County of Fresno will consider the selected vendor to be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract. The contractor may not subcontract or transfer the contract, or any right or obligation arising out of the contract, without first having obtained the express written consent of the County. ADDRESSES AND TELEPHONE NUMBERS: The vendor will provide the business address and mailing address, if different, as well as the telephone number of the individual signing the contract. ASSURANCES: Any contract awarded under this RFP must be carried out in full compliance with The Civil Rights Act of 1964, The Americans With Disabilities Act of 1990, their subsequent amendments, and any and all other laws protecting the rights of individuals and agencies. The County of Fresno has a zero tolerance for discrimination, implied or expressed, and wants to ensure that policy continues under this RFP. The contractor must also guarantee that services, or workmanship, provided will be performed in compliance with all applicable local, state, or federal laws and regulations pertinent to the types of services, or project, of the nature required under this RFP. In addition, the contractor may be required to provide evidence substantiating that their employees have the necessary skills and training to perform the required services or work. INSURANCE: Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the following insurance policies or a program of self-insurance, including but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA)throughout the term of the Agreement: A. Commercial General Liability: Commercial General Liability Insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including completed operations, products liability, contractual liability, Explosion-Col lapse- Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. B. Automobile Liability: Comprehensive Automobile Liability Insurance with limits for bodily injury of not less than Two Hundred Fifty Thousand Dollars ($250,000.00) per person, Five Hundred Thousand Dollars ($500,000.00) per accident and for property damages of not less than Fifty Thousand Dollars ($50,000.00), or such coverage with a combined single limit of Five Hundred Thousand Dollars ($500,000.00). Coverage should include owned and non-owned vehicles used in connection with this Agreement. C. Professional Liability: If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00)annual aggregate. This coverage shall be issued on a per claim basis. Contractor agrees that it shall maintain, at its sole expense, in full force and effect for a period of three (3)years following the termination of this Agreement, one or more policies of professional liability insurance with limits of coverage as specified herein. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 17 D. Worker's Compensation: A policy of Worker's Compensation insurance as may be required by the California Labor Code. Contractor shall obtain endorsements to the Commercial General Liability insurance naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by County, its officers, agents and employees shall be excess only and not contributing with insurance provided under Contractor's policies herein. This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written notice given to County. Within thirty (30) days from the date Contractor executes this Agreement, Contractor shall provide certificates of insurance and endorsement as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Personnel Services, Attn: David Joseph, 2220 Tulare Street, 16t" Floor, Fresno, CA 93721, stating that such insurance coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and employees will not be responsible for any premiums on the policies; that such Commercial General Liability insurance names the County of Fresno, its officers, agents and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned; that such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by County, its officers, agents and employees, shall be excess only and not contributing with insurance provided under Contractor's policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty(30)days advance, written notice given to County. In the event Contractor fails to keep in effect at all times insurance coverage as herein provided, the County may, in addition to other remedies it may have, suspend or terminate this Agreement upon the occurrence of such event. All policies shall be with admitted insurers licensed to do business in the State of California. Insurance purchased shall be purchased from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. AUDIT AND RETENTION: The Contractor shall maintain in good and legible condition all books, documents, papers, data files and other records related to its performance under this contract. Such records shall be complete and available to Fresno County, the State of California, the federal government or their duly authorized representatives for the purpose of audit, examination, or copying during the term of the contract and for a period of at least three years following the County's final payment under the contract or until conclusion of any pending matter(e.g., litigation or audit), whichever is later. Such records must be retained in the manner described above until all pending matters are closed. DEFAULT: In case of default by the selected bidder, the County may procure materials and services from another source and may recover the loss occasioned thereby from any unpaid balance due the selected bidder, or by any other legal means available to the County. BREACH OF CONTRACT: In the event of breach of contract by either party, the other party shall be relieved of its obligations under this agreement and may pursue any legal remedies. CONFIDENTIALITY All services performed by vendor shall be in strict conformance with all applicable Federal, State of California and/or local laws and regulations relating to confidentiality, including but not limited to, California Civil Code, California Welfare and Institutions Code, Health and Safety Code, California Code of Regulations, Code of Federal Regulations. Vendor shall submit to County's monitoring of said compliance. Vendor may be a Business associate of County, as that term is defined in the "Privacy Rule" enacted by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As a HIPAA Business Associate, vendor may use or disclose protected health information ("PHI")to perform functions, activities or services for or on behalf of County, as specified by the County, provided that such use or disclosure shall not violate HIPAA and its implementing regulations. The uses and disclosures of PHI may not be more expansive than G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 18 those applicable to County, as the"Covered Entity" under HIPAA's Privacy Rule, except as authorized for management, administrative or legal responsibilities of the Business Associate. Vendor shall not use or further disclose PHI other than as permitted or required by the County, or as required by law without written notice to the County. Vendor shall ensure that any agent, including any subcontractor, to which vendor provides PHI received from, or created or received by the vendor on behalf of County, shall comply with the same restrictions and conditions with respect to such information. APPEALS: Appeals must be submitted in writing within *seven (7)working days after notification of proposed recommendations for award. A"Notice of Award" is not an indication of County's acceptance of an offer made in response to this RFP. Appeals shall be submitted to County of Fresno Purchasing, 4525 E. Hamilton Avenue 2"d Floor, Fresno, California 93702-4599 and in Word format to gcornuelle(a_co.fresno.ca.us. Appeals should address only areas regarding RFP contradictions, procurement errors, proposal rating discrepancies, legality of procurement context, conflict of interest, and inappropriate or unfair competitive procurement grievance regarding the RFP process. Purchasing will provide a written response to the complainant within *seven (7)working days unless the complainant is notified more time is required. If the protesting bidder is not satisfied with the decision of Purchasing, he/she shall have the right to appeal to the Purchasing Agent/CAO within seven (7)working days after Purchasing's notification; except, if notified to appeal directly to the Board of Supervisors at the scheduled date and time. If the protesting bidder is not satisfied with Purchasing Agent/CAO's decision, the final appeal is with the Board of Supervisors. *The seven(7)working day period shall commence and be computed by excluding the first day and including the last day upon the date that the notification is issued by the County. RIGHTS OF OWNERSHIP: The County shall maintain all rights of ownership and use to all materials designed, created or constructed associated with this service/project/program. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 19 BIDDING INSTRUCTIONS AND REQUIREMENTS ISSUING AGENT: This RFP has been issued by County of Fresno, Purchasing. Purchasing shall be the vendor's sole point of contact with regard to the RFP, its content, and all issues concerning it. AUTHORIZED CONTACT: All communication regarding this RFP shall be directed to an authorized representative of County Purchasing. The specific buyer managing this RFP is identified on the cover page, along with his or her telephone number, and he or she should be the primary point of contact for discussions or information pertaining to the RFP. Contact with any other County representative, including elected officials, for the purpose of discussing this RFP, it content, or any other issue concerning it, is prohibited unless authorized by Purchasing. Violation of this clause, by the vendor having unauthorized contact (verbally or in writing)with such other County representatives, may constitute grounds for rejection by Purchasing of the vendor's quotation. The above stated restriction on vendor contact with County representatives shall apply until the County has awarded a purchase order or contract to a vendor or vendors, except as follows. First, in the event that a vendor initiates a formal protest against the RFP, such vendor may contact the appropriate individual, or individuals who are managing that protest as outlined in the County's established protest procedures. All such contact must be in accordance with the sequence set forth under the protest procedures. Second, in the event a public hearing is scheduled before the Board of Supervisors to hear testimony prior to its approval of a purchase order or contract, any vendor may address the Board. VENDOR CONFERENCE: On February 22, 2016 at 10:00 A.M., a vendor's conference will be held in which the scope of the project and proposal requirements will be explained. The meeting will be held at the office of County of Fresno Purchasing, 4525 E. Hamilton (between Cedar and Maple), 2nd Floor, Fresno, California. Addendum will be prepared and distributed to all bidders only if necessary to clarify substantive items raised during the bidders' conference. Bidders are to contact Nick Chin at County of Fresno Purchasing, (559)600-7113, if they are planning to attend the conference. NUMBER OF COPIES: Submit one (1) original and seven (7) copies of your proposal no later than the proposal closing date and time as stated on the front of this document to County of Fresno Purchasing. Each copy to be identical to the original, include all supporting documentation (e.g. literature, brochures, reports, schedules etc.). The cover page of each quotation is to be appropriately marked "Original" or"Copy". INTERPRETATION OF RFP: Vendors must make careful examination of the requirements, specifications and conditions expressed in the RFP and fully inform themselves as to the quality and character of services required. If any person planning to submit a proposal finds discrepancies in or omissions from the RFP or has any doubt as to the true meaning or interpretation, correction thereof may be requested at the scheduled Vendor Conference (see above). Any change in the RFP will be made only by written addendum, duly issued by the County. The County will not be responsible for any other explanations or interpretations. Questions may be submitted subsequent to the Vendor Conference, subject to the following conditions: a. Such questions are submitted in writing to the County Purchasing not later than February 24, 2016 at 10:00 a.m.Questions must be directed to the attention of Nick Chin, Purchasing Analyst. b. Such questions are submitted with the understanding that County can respond only to questions it considers material in nature. c. Questions shall be e-mailed to CountvPurchasing(a)co.fresno.ca.us. NOTE: The bidder is encouraged to submit all questions at the Vendor Conference. Time limitations can prevent a response to questions submitted after the conference. SELECTION COMMITTEE: All proposals will be evaluated by a team co-chaired by Purchasing. All proposals will be evaluated by a review committee that may consist of County of Fresno Purchasing, department staff, community representatives from advisory boards and other members as appropriate. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 20 The proposals will be evaluated in a multi-stage selection process. Some bids may be eliminated or set aside after an initial review. If a proposal does not respond adequately to the RFP or the bidder is deemed unsuitable or incapable of delivering services, the proposal may be eliminated from consideration. It will be the selection committee's responsibility to make the final recommendation to the Department Head. CONTRACT TERM: It is County's intent to contract with the successful bidder for a term of three (3)years with the option to renew for up to two (2)additional one (1)year periods based on mutual written consent. County will retain the right to terminate the Agreement upon giving thirty(30)days advance written notification to the Contractor. PAYMENT: The County of Fresno, if appropriate, may use Procurement Card to place and make payment for orders under the ensuing contract. AUDITED FINANCIAL STATEMENTS: Copies of the audited Financial Statements for the last three (3) years for the business, agency or program that will be providing the service(s) proposed. If audited statements are not available, complied or reviewed statements will be accepted with copies of three years of corresponding federal tax returns. This information is to be provided after the RFP closes, if requested. Do not provide with your proposal. CONTRACT NEGOTIATION: The County will prepare and negotiate its own contract with the selected vendor, giving due consideration to standard contracts and associated legal documents submitted as a part of bidder's response to the RFP. The tentative award of the contract is based on successful negotiation pending formal recommendation of award. Bidder is to include in response the names and titles of officials authorized to conduct such negotiations. NOTICES: All notices, payments, invoices, insurance and endorsement certificates, etc. need to be submitted as follows: referencing contract/purchase order number, department, position, title and address of administering official. EPAYMENT OPTION: The County of Fresno provides an Epay Program which involves payment of invoices by a secure Visa account number assigned to the supplier after award of contract. Notification of payments and required invoice information are issued to the supplier's designated Accounts Receivable contact by e- mail remittance advice at time of payment. To learn more about the benefits of an Epay Program, how it works, and obtain answers to frequently asked questions, click or copy and paste the following URL into your browser: www.bankofamerica.com/ei3avablesvendors or call Fresno County Accounts Payable, 559-600- 3609. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 21 SCOPE OF WORK The successful vendor will be expected to provide, at a minimum, the services to the County health and benefits programs detailed in this Scope of Work. Prospective bidders will note that while Health Benefits Consultation Services (Part A of this Scope of Work) is the primary focus of this RFP, the County is also requesting that bidders respond to Part B of this Scope of Work, which details the County's ancillary/voluntary benefit consulting needs: life, disability and other personal insurance benefits, Flexible Spending Accounts (Health Care, Dependent Care, and Commuter benefits), and Employee Assistance Program. Failure to respond to Part B will not disqualify bidders. Vendor will provide a summary of their understanding of the County's needs (as detailed in this Scope of Work) and how the vendor plans to meet these needs: 1. The County is seeking a summary that includes the vendor's broad understanding of the scope of the County's request and a summary of the vendor's entire proposal. 2. The summary will also include a statement that the vendor will provide all the services included in this Scope of Work. If the vendor is unable to provide any of the service(s), they will describe which of the service(s)they are unable to provide. PART A—SCOPE OF HEALTH BENEFITS CONSULTATION SERVICES I. ADMINISTRATIVE SERVICES: 1. Benefit Design Assistance a. Provide an initial in-depth review of the County's existing health insurance programs and assist in the development of long-range plans and financial, operational and utilization goals. Provide an annual assessment as to whether long term objectives are being met. b. Review and analyze vendor documents, including but not limited to contracts, policies and coverage booklets, provide interpretations and recommendations. c. Determine methods of reporting plan performance for the purpose of recommending strategies to lower cost and maintain quality. d. Recommend wellness and disease management strategy with a focus on measuring the return on investment of such efforts. e. Provide general guidance on trends in benefits offered and eligibility requirements. 2. Communications a. Provide editorial and compliance review of Open Enrollment and other County-produced benefit communications including memos, materials and presentations for employee meetings. b. Coordinate with vendors as necessary; leverage availability of vendor communication materials and resources. c. Review vendor's plan summaries and other materials for benefit accuracy and basic compliance. d. Provide assistance in the development and analysis of surveys to acquire employee feedback on the performance of plans. 3. Meeting Attendance & General Availability a. Attend quarterly meetings of the Health Benefits Advisory Committee (HBAC) (4 meetings per year). The HBAC consists of one representative from each County bargaining unit, as well as retiree and management members. b. Attend meetings of the San Joaquin Valley Insurance Authority (SJVIA)as needed (1 —2 meetings per year). c. The consultant shall assist in the preparation of a variety of materials required for labor negotiations including, but not be limited to, cost estimates for new or upgraded benefit programs, rate calculations, and written material such as analyses, summaries, and graphs/spreadsheets. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 22 d. Participate in conference calls with County staff no less than once per month. e. Provide prompt and effective responses to ad hoc requests from County staff for information or analysis. f. Assist County staff with technical issues affecting the administration and processing procedures of the benefit programs as they arise, including plan document interpretation and eligibility determination. 4. Legal & Regulatory Compliance Support and Updates a. Provide advice and interpretation on all local, state, and federal benefit regulations impacting the County health plans, including but not limited to: i. Patient Protection and Affordable Care Act(PPACA) ii. Family and Medical Leave Act (FMLA) iii. California Family Rights Act(CFRA) iv. Consolidated Omnibus Budget Reconciliation Act(COBRA) v. Health Insurance Portability and Accountability Act(HIPAA) vi. Americans with Disability Act(ADA) vii. Fair Employment and Housing Act(FEHA) viii. Uniformed Services Employment Reemployment Rights Act(USERRA) b. Notify the County of necessary steps towards compliance with new legislation impacting County health plans. c. Review plan documents and internal County policies to ensure compliance with appropriate laws and regulations and to ensure that the County is adhering to industry best practices. Make recommendations regarding necessary amendments to plan documents or internal policies and assist in their preparation. d. On an annual basis, audit the County's current health insurance administration practices (including, but not limited to, forms and communications to participants)to ensure compliance with applicable laws and regulations, as well as applicable plan documents and internal policies. Make recommendations regarding necessary changes to current practices. e. Assist in an advisory capacity in reviewing and ruling on appeals from members covered by the County's Cafeteria Plan (includes Health Insurance and Flexible Spending Accounts). II. DATA ANALYSIS AND REPORTING: 1. Monitor, analyze and report monthly claim experience, identifying trends and changes in large claims activity on a monthly basis. 2. Monitor, analyze and report claim utilization data in a format that is clear, concise and actionable. III. VENDOR RELATIONS: 1. RFP and Contract Development a. Development of requests for proposals (RFP) and submitting RFPs to viable medical (including mental health), dental, vision, and prescription providers. b. Review and evaluate vendor responses to RFP and present a summary of the results to the County. c. Assist in negotiating fee agreements with selected vendors and provide an executive summary report of results of negotiations and final rates/fees. d. Facilitate the transition to new vendor(if necessary). e. Please provide sample RFP materials (i.e., any evaluation tools you will use to accomplish the tasks described in paragraphs a—d above, as well as a sample timeline) G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 23 2. Vendor Management a. Establish appropriate vendor performance guarantees in collaboration with the County. b. Ensure that vendors are in compliance with the terms of their agreement with the County and monitor performance guarantees. c. Upon request of County staff or whenever appropriate, act as a liaison between the County and vendors, including but not limited to, participating in problem resolution and strategic planning. d. Conduct annual strategic sessions with vendors to discuss performance, opportunities, and updates. e. Attend meetings or conference calls with vendors as requested by the County, but no less than once per quarter. f. Monitor insurance companies for financial solvency where applicable. IV. ACTUARIAL, UNDERWRITING AND FISCAL SUPPORT: 1. Provide actuarial cost projections for various plan feature changes and improvements. 2. Analyze rates developed by the San Joaquin Valley Insurance Authority from an independent actuary perspective. 3. Analyze and recommend plan funding alternatives. 4. Prepare financial projections from alternative benefit designs and/or employee contributions. PART B—SCOPE OF OTHER BENEFIT CONSULTATION SERVICES Current benefits covered in this Part B include: 1. Group Insurance Policies Please note that, while the County has legacy insurance policies that may require "broker of record" services, the County is also open to group insurance policies that are executed directly between the carriers and either the County or individual participants. a. Life, Disability, Accident/Critical Illness Insurance b. Personal Property (i.e., Auto & Homeowner) Insurance 2. Benefit Programs a. Sections 125 & 132 Flexible Spending Program (Current Provider is ASIFlex) b. Employee Assistance Program (Current Provider is ACI Specialty Benefits) I. ADMINISTRATIVE SERVICES: 1. Benefit Design Assistance a. Provide an initial in-depth review of the County's existing insurance policies and benefit programs and assist in the development of long-range plans and financial, operational and utilization goals. Provide an annual assessment as to whether long term objectives are being met. b. Review and analyze vendor documents, including but not limited to contracts, policies and coverage booklets, provide interpretations and recommendations. c. Provide general guidance on trends in benefits offered and eligibility requirements. d. Act as broker of record for legacy insurance policies as needed. 2. Communications a. Assist in coordinating open enrollment efforts for voluntary insurance policies. b. Review vendor's plan summaries and other materials for benefit accuracy and basic compliance. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 24 c. Assist in communicating the resources available through the flexible spending account, wellness, and employee assistance programs, with the goal of expanding the utilization of each program. d. Provide assistance in the development and analysis of surveys to acquire employee feedback on the performance of plans. 3. Meeting Attendance & General Availability a. Provide prompt and effective responses to ad hoc requests from County staff for information or analysis. b. Assist County staff with technical issues affecting the administration and processing procedures of the benefit programs as they arise, including plan document interpretation and eligibility determination. 4. Legal & Regulatory Compliance Support and Updates a. Notify the County of necessary steps towards compliance with new legislation impacting County the Section 125 and Section 132 Flexible Spending Programs. b. Review plan documents and internal County policies to ensure compliance with appropriate laws and regulations and to ensure that the County is adhering to industry best practices. Make recommendations regarding necessary amendments to plan documents or internal policies and assist in their preparation. c. On an annual basis, audit the County's current benefits administration practices (including, but not limited to, forms and communications to participants)to ensure compliance with applicable laws and regulations, as well as applicable plan documents and internal policies. Make recommendations regarding necessary changes to current practices. d. Assist in an advisory capacity in reviewing and ruling on appeals from members covered by the County's Cafeteria Plan (includes Health Insurance and Flexible Spending Accounts). II. VENDOR RELATIONS: 1. RFQ/RFP Process a. Develop requests for quotations (RFQ)for Insurance Policies and requests for proposals (RFP) for Program Administrators/Providers in compliance with County purchasing requirements. b. Compile a Bidder List of viable providers for current programs. c. Review and evaluate vendor responses to RFP and contact vendor references. d. Present a summary of the results to the County and make finalist recommendations, if applicable. e. Assist in negotiating agreements with selected vendors. f. Facilitate the transition to new vendor. 2. Vendor Management a. Establish appropriate vendor performance guarantees in collaboration with the County. b. Ensure that vendors are in compliance with the terms of their agreement with the County and monitor performance guarantees. c. Upon request of County staff or whenever appropriate, act as a liaison between the County and vendors, including but not limited to, participating in problem resolution and strategic planning. d. Conduct strategic meetings or conference calls with vendors and County staff to discuss performance, opportunities, and updates, no less than once per quarter. e. Monitor insurance companies for financial solvency where applicable. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 25 VENDOR RESPONSE SECTION Vendor shall provide the following information in a separate section of their proposal entitled "VENDOR RESPONSE SECTION". Vendors shall restate each question then provide the vendor response. 1. Describe your firm's capabilities and qualifications as they relate to the programs described in the Scope of Work and list any characteristics of your firm that you feel make it unique from other employee benefits consulting firms. a. How long has your firm provided consultant services as described in the Scope of Work? b. Is your firm qualified and licensed (if applicable)to conduct business in California? Please provide appropriate documentation. 2. If the principal consultant were to leave your firm, how would service be provided? How soon would a new principal consultant be assigned to the County's account? Will you agree to give the County the right of approval of any staff member assigned to this account? 3. What resources do your firm have available in the area of developing employee communications? Provide an example of communication materials developed by your organization for use in a client's health benefit communication campaigns, including Open Enrollment and New Employee Orientation materials. 4. Does your firm publish newsletters and other informative publications that are routinely provided to clients? Have you prepared reviews of topics related to the health, life insurance and actuarial fields that are routinely provided to your clients? Describe your publication and provide sample copies. 5. Provide a description of any electronic or internet-based tools your firm provides to clients. 6. Describe your firm's view of the role wellness programs have on controlling health care costs. What resources and tools do you offer clients around wellness initiatives?What service does your firm provide for developing a Wellness Program? 7. Indicate your firm's ability to frequently(at minimum 8-10 times annually) meet face-to-face to discuss industry, regulatory and service issues with County of Fresno, including meetings with County executive and benefits staff, Health Benefit Advisory Council meetings, and other venues. 8. How many days of advance notice would your company require in order to attend ad-hoc meetings? Do you have any limitations with attending face to face meetings? 9. What is your firm's policy/standard for returning phone calls and providing responses to emails or written questions? 10. Describe your firm's experience with labor contract negotiations, as well as with a joint labor/management task force or committee. 11. Describe your firm's experience and expertise with the Patient Protection and Affordable Care Act (ACA). How have you provided assistance to your clients in monitoring compliance with the ACA? 12. Detail your ability to monitor regulatory and legislative developments at both the state and federal level as well as how your firm alerts clients of changes and assists in compliance. Describe or provide examples of these communications. 13. Describe your firm's legal research capabilities and ability to provide legal opinions. Does your firm have access to a benefits attorney who could render opinions to the County? 14. Tell us how you monitor and report on provider performance. Provide a sample of provider performance reports your firm has completed for current clients. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 26 15. Discuss your firm's experience conducting RFP/RFQ processes for health, life, and disability insurance carriers, as well as flexible spending account administrators. How many RFP projects for these providers/services did your firm complete in 2013, 2014, and 2015 for your clients? 16. Does your firm have a conflict of interest policy? If so, please provide a copy. Also, please describe any conflicts that have arisen within the firm and how they were resolved. 17. Please list any potential conflicts of interest that your firm foresees if you are selected as the successful Bidder or state affirmatively that you foresee none. 18. If your firm proposes to offset its fees through commissions on voluntary insurance products, discuss how your method of compensation will be transparent and reported to the County. How frequently will your firm report its commission-based revenue to the County? 19. Describe your company's organization, philosophy, management and provide a brief history. Describe your contractual relationships, if any, with organizations necessary to your proposal's implementation (e.g. actuarial services, data information services). 20. Provide the name(s)and title of all staff to be assigned to perform the work for the County of Fresno and a brief statement as to why each consultant is qualified to provide services to the County. The County understands that certain consultants will assist in certain areas of services, for example, consultants who perform a claims audit would not be expected to assist in the selection of vendors on which audits would be performed. Identify the area(s) of expertise for each consultant. 21. Provide the Number and location of offices, and total number of employees. State whether any of the services described herein will be performed at any firm office outside California, and if so, what services will be performed outside the State and where these services will be performed. 22. Confirm that you serve as a consultant or broker, independently, and are not affiliated with any insurance company, third party administrative agency or provider network. 23. A list of California public agencies your firm has provided similar services to within the past three (3) years. List the number of employees for each agency. Include the contact person and phone number for each agency listed. 24. Current Workload: Provide a listing of your individuals/firms current and projected workload. The bidder shall include a graph or other informational diagram/format indicating the allocated and available man-hours. Indicate how the County of Fresno account will fit into the total workload of the Consultant during the contract period. 25. It is expected that the final agreement between the winning bidder and the County will be in the model County contract format (Attachment C). Please list any exceptions your firm has to the terms and conditions of the model contract and the reasons. If there are no exceptions, please affirmatively state that there are no exceptions. 26. License Sanctions: List any regulatory or license agency sanctions within the past five (5)years. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 27 COST PROPOSAL Option 1 —Annual Consulting Fees WITHOUT Commissions from Voluntary Insurance Products; Broker of Record service is not provided A. Provide the annual flat fee retainer to provide consultant services to the County as described in the Scope of Work. B. Please provide pricing for the two contract terms described below and describe any details regarding guarantees for all proposed pricing. (a) Three-year contract term with two one-year renewals. (b) Five-year contract term. (c) Will your firm guarantee pricing during the length of each contract term? C. List all possible administrative charges that would not be included in the flat rate fee structure. Option 2—Annual Consulting Fees WITH Commissions from Voluntary Insurance Products; Broker of Record service is provided A. Provide all information requested in Option 1 above. B. Identify any and all potential revenues associated with broker of record services that would offset the fees to provide consultant services to the County as described in the Scope of Work. Please note that all commissions are required to be disclosed to the County to ensure maximum transparency. C. Future commissions from the universal life, disability and critical illness policies through Trustmark may be reassigned. The future commissions are as follows: (a) Universal Life: 5% per year (b) Disability: 6% per year (c) Critical Illness: 11% per year Please note that there are no commissions on the long-term disability insurance policy through Met Life and that the commissions on the current life insurance policies through CSAC-EIA and the personal property insurance policies though Liberty Mutual are not able to be reassigned. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 28 PROPOSAL CONTENT REQUIREMENTS It is important that the vendor submit his/her proposal in accordance with the format and instructions provided under this section. Doing so will facilitate the evaluation of the proposal. It will limit the possibility of a poor rating due to the omission or mis-categorization of the requested information. Responding in the requested format will enhance the evaluation team's item by item comparison of each proposal item. The vendor's proposal may be placed at a disadvantage if submitted in a format other than that identified below. Bidders are requested to submit their proposals in a binder(one that allows for easy removal of pages)with index tabs separating the sections identified. Each page should be numbered. Each binder is to be clearly marked on the cover with the proposal name, number, closing date, "Original" or"Copy", and bidder's name. Merely offering to meet the specifications is insufficient and will not be accepted. Each bidder shall submit a complete proposal with all information requested. Supportive material may be attached as appendices. All pages, including the appendices, must be numbered. Vendors are instructed not to submit confidential, proprietary and related information within the request for proposal. If you are submitting trade secrets, it must be submitted in a separate binder clearly marked "TRADE SECRETS", see Trade Secret Acknowledgement section. The content and sequence of the proposals will be as follows: I. RFP PAGE 1 AND ADDENDUM(S) PAGE 1 (IF APPLICABLE) completed and signed by participating individual or agency. II. COVER LETTER: A one-page cover letter and introduction including the company name and address of the bidder and the name, address and telephone number of the person or persons to be used for contact and who will be authorized to make representations for the bidder. A. Whether the bidder is an individual, partnership or corporation shall also be stated. It will be signed by the individual, partner, or an officer or agent of the corporation authorized to bind the corporation, depending upon the legal nature of the bidder. A corporation submitting a proposal may be required before the contract is finally awarded to furnish a certificate as to its corporate existence, and satisfactory evidence as to the officer or officers authorized to execute the contract on behalf of the corporation. III. TABLE OF CONTENTS IV. CONFLICT OF INTEREST STATEMENT: The Contractor may become involved in situations where conflict of interest could occur due to individual or organizational activities that occur within the County. The Contractor must provide a statement addressing the potential, if any, for conflict of interest and indicate plans, if applicable, to address potential conflict of interest. This section will be reviewed by County Counsel for compliance with conflict of interest as part of the review process. The Contractor shall comply with all federal, state and local conflict of interest laws, statutes and regulations. V. TRADE SECRET: A. Sign where required. VI. CERTIFICATION — DISCLOSURE—CRIMINAL HISTORY& CIVIL ACTIONS VI I. REFERENCES VIII. PARTICIPATION G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 29 IX. EXCEPTIONS: This portion of the proposal will note any exceptions to the requirements and conditions taken by the bidder. If exceptions are not noted, the County will assume that the bidder's proposals meet those requirements. The exceptions shall be noted as follows: A. Exceptions to General Conditions. B. Exceptions to General Requirements. C. Exceptions to Specific Terms and Conditions. D. Exceptions to Scope of Work. E. Exceptions to Proposal Content Requirements. F. Exceptions to any other part of this RFP. X. VENDOR COMPANY DATA: This section should include: A. A narrative which demonstrates the vendor's basic familiarity or experience with problems associated with this service/project. B. Descriptions of any similar or related contracts under which the bidder has provided services. C. Descriptions of the qualifications of the individual(s) providing the services. D. Any material (including letters of support or endorsement) indicative of the bidder's capability. E. A brief description of the bidder's current operations, and ability to provide the services. F. Copies of the audited Financial Statements for the last three (3)years for the agency or program that will be providing the service(s) proposed. If audited statements are not available, compiled or reviewed statements will be accepted with copies of three years of corresponding federal tax returns. This information is to be provided after the RFP closes, if requested. Do not provide with your proposal. G. Describe all contracts that have been terminated before completion within the last five (5)years: 1. Agency contract with 2. Date of original contract 3. Reason for termination 4. Contact person and telephone number for agency H. Describe all lawsuit(s)or legal action(s)that are currently pending; and any lawsuit(s)or legal action(s)that have been resolved within the last five (5)years: 1. Location filed, name of court and docket number 2. Nature of the lawsuit or legal action I. Describe any payment problems that you have had with the County within the past three (3) years: 1. Funding source 2. Date(s)and amount(s) 3. Resolution 4. Impact to financial viability of organization. XI. SCOPE OF WORK: A. Bidders are to use this section to describe the essence of their proposal. B. This section should be formatted as follows: G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 30 1. A general discussion of your understanding of the project, the Scope of Work proposed and a summary of the features of your proposal. 2. A detailed description of your proposal as it relates to each item listed under the "Scope of Work" section of this RFP. Bidder's response should be stated in the same order as are the "Scope of Work" items. Each description should begin with a restatement of the "Scope of Work" item that it is addressing. Bidders must explain their approach and method of satisfying each of the listed items. C. When reports or other documentation are to be a part of the proposal a sample of each must be submitted. Reports should be referenced in this section and submitted in a separate section entitled "REPORTS." D. A complete description of any alternative solutions or approaches to accomplishing the desired results. XII. COST PROPOSAL: Quotations may be prepared in any manner to best demonstrate the worthiness of your proposal. Include details and rates/fees for all services, materials, equipment, etc. to be provided or optional under the proposal. XIII. CHECK LIST G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 31 AWARD CRITERIA Selection of the winning bidder will be based on the following criteria. Please note that the list below is not ordered by level of importance; proposals will be judged on how well they meet all of the criteria. COST A. Cost, as submitted in the Cost Proposal section. Please note that the County intends to award the contract to the proposing firm whose proposal is determined to be most advantageous to the County, taking into account both technical merit and price. CAPABILITY AND QUALIFICATIONS A. Completeness of Response: Responses to this RFP must be complete and include all proposal content requirements identified within this RFP and subsequent addenda (if applicable). B. Proposing firm's inclination and ability to accept the terms and conditions of the model County of Fresno contract. C. The vendor has demonstrated that it has the qualifications, including staff, experience and resources to provide the consultation services requested by the County. D. The service descriptions address all the areas identified in the RFP, including the services as set forth in the Scope of Work that will fulfill County's consultation service needs. E. The vendor has clearly explained its knowledge and understanding of the needs of the County associated with providing the services requested, including: 1. The broad landscape of employee health benefits; 2. Employee Benefits product markets; 3. Applicable laws, regulations, statutes; and 4. Effective operating principles required to provide this consulting service. F. The vendor has current relevant experience in a comparable California County or similar public agency. MANAGEMENT PLAN A. The vendor has demonstrated that its organizational plan and management structure are adequate and appropriate for comprehensive implementation of the requested consultation services. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 32 CHECK LIST This Checklist is provided to assist vendors in the preparation of their RFP response. Included in this list, are important requirements and is the responsibility of the bidder to submit with the RFP package in order to make the RFP compliant. Because this checklist is just a guideline, the bidder must read and comply with the RFP in its entirety. Check off each of the following: 1. All signatures must be in blue ink. 2. The Request for Proposal (RFP) has been signed and completed. 3. Addenda, if any, have been completed, signed and included in the bid package. 4. One (1) original plus seven (7) copies of the RFP have been provided. 5. Provide a Conflict of Interest Statement. 6. The completed Trade Secret Form as provided with this RFP (Confidential/Trade Secret Information, if provided must be in a separate binder). 7. The completed Criminal History Disclosure Form as provided with this RFP. 8. The completed Participation Form as provided with this RFP. 9. The completed Reference List as provided with this RFP. 10. Indicate all of bidder exceptions to the County's requirements, conditions and specifications as stated within this RFP. 11. Lastly, on the LOWER LEFT HAND CORNER of the sealed envelope, box, etc. transmitting your bid include the following information: FCountysno RFP No. 964-5439 March 10,2016 2:00 P.M. r Service: Employee Benefits Consultant Services Return Checklist with your RFP response. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 33 ATTACHMENTS A. Current Health Insurance Enrollment B. Current Other Benefits Enrollment C. Model County Contract D. Gallagher Benefit Services Agreement E. 2016 Health Plans Agenda Item F. 2016 OE Active Packet G. 2016 OE Retiree Packet H. 2016 OE Cobra Packet G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc RFP 964-5439 Attachment A Page 1 HEALTH PLAN ENROLLMENT (01/01/2016) Active Employees Active Dependent Total Retirees Retiree Dependent Total Enrollment Enrollment Enrollment Enrollment Enrollment Enrollment Plan & Enrollment Tier Enrollment Enrollment Enrollment Plan & Enrollment Tier Enrollment Enrollment Enrollment Employee Only 1669 Retiree Only 159 Employee + Spouse 400 Retiree + Spouse 28 Employee + Children 1093 Retiree + Children 2 Employee + Family 427 Retiree + Family 8 Active HMO Subtotal 3,589 4,185 7,774 Retiree HDPPO Subtotal 197 55 252 Employee Only 153 Retiree Only 3 Employee + Spouse 21 Retiree + Spouse 0 Employee + Children 7 Retiree + Children 0 Employee + Family 0 Retiree + Family 0 Active PPO Subtotal 181 27 208 Retiree Kaiser Subtotal 3 0 3 Employee Only 378 Retiree Only 387 Employee + Spouse 16 Retiree + Spouse 102 Employee + Children 9 Retiree Hartford Subtotal 489 103 592 Employee + Family 11 Active HDPPO Subtotal 414 56 470 • Retiree Onl 255 Retiree + Spouse 94 Employee Only 751 Medicare Kaiser High Subtotal 349 93 442 Employee + Spouse 94 Employee + Children 347 M rTq Employee + Family 98 Retiree Only 53 Active Kaiser Subtotal 1,2901 1,166 2,456 Retiree + Spouse 14 Medicare Kaiser Low Subtotal 67 14 81 Total Active Employees 5,4741 5,4341 10,908 Total Retirees 1,105 265 1,370 ME SLUM Full Time Active Employees 1 5011 Combined Total Enrollment - Primary Dependents Total :::] Retirees 5806 Active 6,579 5,699 12,278 RFP 964-5439 Attachment B Page 1 Other Benefits Enrollment (12/21/2015) 2!a� Enrollment State Disability Insurance Benefits 5,990 Mandatory LTD for Management employees - Met Life 488 Mandatory Disability Total 6,478 Life Enrollment Mandatory Life/ADD policy for all employees - CSAC-EIA- $8,000 5,494 Mandatory Life for Management employees - CSAC-EIA- $51,000 488 Mandatory Life/ADD policy for Unit 30 employees - CSAC-EIA- $41,000 103 Mandatory Life Total 6,085 Other VoluntarV Policies Enrollment Optional Life/ADD policy for Units 19, 22 and 36 employees - CSAC-EIA- $50,000 206 Short-term Disability-Trustmark 318 Universal Life Insurance - Trustmark 917 Critical Illness -Trustmark 253 Auto Insurance.- Liberty Mutual 284 Home Insurance - Liberty Mutual 269 Voluntary Benefits Total 2,247 Flexible Spending AccountParticipants Health Care 1,600 Dependent Care 146 Parking/Transportation 33 Flexible Spending Total 1,779 RFP 964-5439 Attachment C 1 AGREEMENT 2 3 THIS AGREEMENT is made and entered into this day of[Month] , [Year] , by 4 and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, 5 hereinafter referred to as "COUNTY", and [Contractor] , a (Type of business) (Note to County 6 staff: Type of business the contractor is; such as a corporation — including the state in which they 7 are incorporated, e.g., a California corporation; a partnership; a private, non-profit corporation; or a 8 sole proprietorship), whose address is "[Contractor's Address]" , hereinafter referred to as 9 "CONTRACTOR". 10 WITNESSETH: 11 (Add WHEREAS Clauses) (Note to County staff: explains the need/purpose for the contract and 12 the process by which the Contractor was chosen) 13 NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein 14 contained, the parties hereto agree as follows: 15 1. OBLIGATIONS OF THE CONTRACTOR 16 A. 17 B. (etc.) 18 2. OBLIGATIONS OF THE COUNTY 19 A. 20 B. (etc.) 21 3. TERM 22 The term of this Agreement shall be for a period of three (3) years, 23 commencing on (Effective Date) through and including (Last day of three year period) . This 24 Agreement may be extended for two (2) additional consecutive twelve (12) month periods upon 25 written approval of both parties no later than thirty (30) days prior to the first day of the next twelve 26 (12) month extension period. The (Title of department head) or his or her designee is authorized 27 to execute such written approval on behalf of COUNTY based on CONTRACTOR'S satisfactory 28 performance. RFP 964-5439 Attachment C 1 4. TERMINATION 2 A. Non-Allocation of Funds - The terms of this Agreement, and the services to 3 be provided hereunder, are contingent on the approval of funds by the appropriating government 4 agency. Should sufficient funds not be allocated, the services provided may be modified, or this 5 Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written 6 notice. 7 B. Breach of Contract - The COUNTY may immediately suspend or terminate 8 this Agreement in whole or in part, where in the determination of the COUNTY there is: 9 1) An illegal or improper use of funds; 10 2) A failure to comply with any term of this Agreement; 11 3) A substantially incorrect or incomplete report submitted to the 12 COUNTY; 13 4) Improperly performed service. 14 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY 15 of any breach of this Agreement or any default which may then exist on the part of the 16 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the 17 COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of 18 the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR 19 under this Agreement, which in the judgment of the COUNTY were not expended in accordance 20 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon 21 demand. 22 C. Without Cause - Under circumstances other than those set forth above, 23 this Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written 24 notice of an intention to terminate to CONTRACTOR. 25 5. COMPENSATION/INVOICING: (Note to County staff: If sales tax is 26 applicable and to be paid to an out-of-state vendor, it must be separated from the total 27 compensation and the vendor must have a California Sales Tax Permit Number.) COUNTY 28 agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation as follows: -2- RFP 964-5439 Attachment C 1 "[Enter compensation]" . CONTRACTOR shall submit monthly invoices in triplicate to the County 2 of Fresno "[Enter Department Name]" . 3 In no event shall services performed under this Agreement be in excess of 4 "[Enter maximum contract amount]" during the term of this Agreement. It is understood that all 5 expenses incidental to CONTRACTOR'S performance of services under this Agreement shall be 6 borne by CONTRACTOR. (Note to County staff: If the number of days within which payment 7 must be made is specified, this paragraph must provide for payment after a minimum of forty-five 8 (45) days from date of receipt of invoice by the COUNTY.) 9 6. INDEPENDENT CONTRACTOR: In performance of the work, duties and 10 obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and 11 agreed that CONTRACTOR, including any and all of the CONTRACTOR'S officers, agents, and 12 employees will at all times be acting and performing as an independent contractor, and shall act in 13 an independent capacity and not as an officer, agent, servant, employee, joint venturer, partner, or 14 associate of the COUNTY. Furthermore, COUNTY shall have no right to control or supervise or 15 direct the manner or method by which CONTRACTOR shall perform its work and function. 16 However, COUNTY shall retain the right to administer this Agreement so as to verify that 17 CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof. 18 CONTRACTOR and COUNTY shall comply with all applicable provisions of 19 law and the rules and regulations, if any, of governmental authorities having jurisdiction over 20 matters the subject thereof. 21 Because of its status as an independent contractor, CONTRACTOR shall have 22 absolutely no right to employment rights and benefits available to COUNTY employees. 23 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its 24 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely 25 responsible and save COUNTY harmless from all matters relating to payment of 26 CONTRACTOR'S employees, including compliance with Social Security withholding and all other 27 regulations governing such matters. It is acknowledged that during the term of this Agreement, 28 CONTRACTOR may be providing services to others unrelated to the COUNTY or to this -3- RFP 964-5439 Attachment C 1 Agreement. 2 7. MODIFICATION: Any matters of this Agreement may be modified from time 3 to time by the written consent of all the parties without, in any way, affecting the remainder. 4 8. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this 5 Agreement nor their rights or duties under this Agreement without the prior written consent of the 6 other party. 7 9. HOLD HARMLESS: CONTRACTOR agrees to indemnify, save, hold 8 harmless, and at COUNTY'S request, defend the COUNTY, its officers, agents, and employees 9 from any and all costs and expenses, damages, liabilities, claims, and losses occurring or 10 resulting to COUNTY in connection with the performance, or failure to perform, by 11 CONTRACTOR, its officers, agents, or employees under this Agreement, and from any and all 12 costs and expenses, damages, liabilities, claims, and losses occurring or resulting to any person, 13 firm, or corporation who may be injured or damaged by the performance, or failure to perform, 14 of CONTRACTOR, its officers, agents, or employees under this Agreement. 15 10. INSURANCE 16 Without limiting the COUNTY's right to obtain indemnification from 17 CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full 18 force and effect, the following insurance policies or a program of self-insurance, including but not 19 limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the 20 term of the Agreement: 21 A. Commercial General Liability 22 Commercial General Liability Insurance with limits of not less than One 23 Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars 24 ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require 25 specific coverages including completed operations, products liability, contractual liability, 26 Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed 27 necessary because of the nature of this contract. 28 -4- RFP 964-5439 Attachment C 1 B. Automobile Liability 2 Comprehensive Automobile Liability Insurance with limits for bodily injury of 3 not less than Two Hundred Fifty Thousand Dollars ($250,000.00) per person, Five Hundred 4 Thousand Dollars ($500,000.00) per accident and for property damages of not less than Fifty 5 Thousand Dollars ($50,000.00), or such coverage with a combined single limit of Five Hundred 6 Thousand Dollars ($500,000.00). Coverage should include owned and non-owned vehicles used 7 in connection with this Agreement. 8 C. Professional Liability 9 If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., 10 L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less 11 than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) 12 annual aggregate. 13 D. Worker's Compensation 14 A policy of Worker's Compensation insurance as may be required by the 15 California Labor Code. 16 CONTRACTOR shall obtain endorsements to the Commercial General Liability 17 insurance naming the County of Fresno, its officers, agents, and employees, individually and 18 collectively, as additional insured, but only insofar as the operations under this Agreement are 19 concerned. Such coverage for additional insured shall apply as primary insurance and any other 20 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be 21 excess only and not contributing with insurance provided under CONTRACTOR's policies herein. 22 This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance 23 written notice given to COUNTY. 24 Within Thirty (30) days from the date CONTRACTOR signs and executes this 25 Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated 26 above for all of the foregoing policies, as required herein, to the County of Fresno, (Name and 27 Address of the official who will administer this contract), stating that such insurance coverage have 28 been obtained and are in full force; that the County of Fresno, its officers, agents and employees -5- RFP 964-5439 Attachment C 1 will not be responsible for any premiums on the policies; that such Commercial General Liability 2 insurance names the County of Fresno, its officers, agents and employees, individually and 3 collectively, as additional insured, but only insofar as the operations under this Agreement are 4 concerned; that such coverage for additional insured shall apply as primary insurance and any 5 other insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, 6 shall be excess only and not contributing with insurance provided under CONTRACTOR's policies 7 herein; and that this insurance shall not be cancelled or changed without a minimum of thirty (30) 8 days advance, written notice given to COUNTY. 9 In the event CONTRACTOR fails to keep in effect at all times insurance 10 coverage as herein provided, the COUNTY may, in addition to other remedies it may have, 11 suspend or terminate this Agreement upon the occurrence of such event. 12 All policies shall be issued by admitted insurers licensed to do business in the 13 State of California, and such insurance shall be purchased from companies possessing a current 14 A.M. Best, Inc. rating of A FSC VII or better. 15 11. AUDITS AND INSPECTIONS: The CONTRACTOR shall at any time during 16 business hours, and as often as the COUNTY may deem necessary, make available to the 17 COUNTY for examination all of its records and data with respect to the matters covered by this 18 Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to 19 audit and inspect all of such records and data necessary to ensure CONTRACTOR'S compliance 20 with the terms of this Agreement. 21 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR 22 shall be subject to the examination and audit of the Auditor General for a period of three (3) years 23 after final payment under contract (Government Code Section 8546.7). 24 12. NOTICES: The persons and their addresses having authority to give and 25 receive notices under this Agreement include the following: 26 COUNTY CONTRACTOR COUNTY OF FRESNO (click here to enter Contractorl 27 (click here to enter Countv Address] (click here to enter Contractor Address] 28 (click here to enter Countv Address] (click here to enter Contractor Address] -6- RFP 964-5439 Attachment C 1 [click here to enter County City/State] [click here to enter Contractor City/State] 2 All notices between the COUNTY and CONTRACTOR provided for or 3 permitted under this Agreement must be in writing and delivered either by personal service, by 4 first-class United States mail, by an overnight commercial courier service, or by telephonic 5 facsimile transmission. A notice delivered by personal service is effective upon service to the 6 recipient. A notice delivered by first-class United States mail is effective three COUNTY business 7 days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice 8 delivered by an overnight commercial courier service is effective one COUNTY business day after 9 deposit with the overnight commercial courier service, delivery fees prepaid, with delivery 10 instructions given for next day delivery, addressed to the recipient. A notice delivered by 11 telephonic facsimile is effective when transmission to the recipient is completed (but, if such 12 transmission is completed outside of COUNTY business hours, then such delivery shall be 13 deemed to be effective at the next beginning of a COUNTY business day), provided that the 14 sender maintains a machine record of the completed transmission. For all claims arising out of or 15 related to this Agreement, nothing in this section establishes, waives, or modifies any claims 16 presentation requirements or procedures provided by law, including but not limited to the 17 Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section 18 810). 19 13. GOVERNING LAW: Venue for any action arising out of or related to this 20 Agreement shall only be in Fresno County, California. 21 The rights and obligations of the parties and all interpretation and performance 22 of this Agreement shall be governed in all respects by the laws of the State of California. 23 14. DISCLOSURE OF SELF-DEALING TRANSACTIONS 24 This provision is only applicable if the CONTRACTOR is operating as a 25 corporation (a for-profit or non-profit corporation) or if during the term of the agreement, the 26 CONTRACTOR changes its status to operate as a corporation. 27 Members of the CONTRACTOR's Board of Directors shall disclose any self- 28 dealing transactions that they are a party to while CONTRACTOR is providing goods or -7- RFP 964-5439 Attachment C 1 performing services under this agreement. A self-dealing transaction shall mean a transaction 2 to which the CONTRACTOR is a party and in which one or more of its directors has a material 3 financial interest. Members of the Board of Directors shall disclose any self-dealing 4 transactions that they are a party to by completing and signing a Self-Dealing Transaction 5 Disclosure Form, attached hereto as Exhibit A and incorporated herein by reference, and 6 submitting it to the COUNTY prior to commencing with the self-dealing transaction or 7 immediately thereafter. 8 15. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement 9 between the CONTRACTOR and COUNTY with respect to the subject matter hereof and 10 supersedes all previous Agreement negotiations, proposals, commitments, writings, 11 advertisements, publications, and understanding of any nature whatsoever unless expressly 12 included in this Agreement. (If applicable, add the following: In the event of any inconsistency in 13 interpreting the documents which constitute this Agreement, the inconsistency shall be resolved 14 by giving precedence in the following order of priority: (1) the text of this Agreement (excluding 15 Attachment "A'; the COUNTY'S Request for Quotation/Proposal No. "[Enter RFQ/RFP No.]" and 16 the CONTRACTOR'S Quote/Proposal in response thereto); (2) Attachment 'A (3) the 17 COUNTY'S Request for Quotation/Proposal No. "[Enter RFQ/RFP No.]"; and (4) the 18 CONTRACTOR'S quotation/proposal made in response to COUNTY'S Request for 19 Quotation/Proposal No. "[Enter RFQ/RFP No.]".] 20 21 22 23 24 25 26 27 28 -8- RFP 964-5439 Attachment C 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as 2 of the day and year first hereinabove written. 3 CONTRACTOR COUNTY OFFRESNO 4 (Authorized Signature) Gary E. Cornuelle 5 Purchasing Manager 6 Print Name &Title 7 8 9 Mailing Address 10 DATE: DATE: 11 REVIEWED & RECOMMENDED FOR APPROVAL 12 Department Head's Signature 13 14 APPROVED AS TO LEGAL FORM APPROVED AS TO ACCOUNTING FORM 15 County Counsel Auditor-Controller/Treasurer-Tax Collector 16 17 FOR ACCOUNTING USE ONLY: 18 ORG No.: [click to type type org] Account No.: [click to type type account] 19 Requisition No.: [click to type requisition number] 20 FCMC 10/12 21 C:\USERS\SJOHNSTON\APPDATA\LOCAL\MICROSOFT\WINDOWS\TEMPORARY INTERNET FILES\CONTENT.OUTLOOK\VJ9QZL02WTTACHMENT C-MODEL COUNTY CONTRACT.DOC 22 23 24 25 26 27 28 -9- RFP 964-5439 Attachment C 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement 2 as of the day and year first hereinabove written. 3 CONTRACTOR COUNTY OF FRESNO 4 (Authorized Signature) Chairman, Board of Supervisors 5 6 Print Name &Title 7 8 9 Mailing Address 10 DATE: DATE: 11 REVIEWED & RECOMMENDED FOR APPROVAL 12 Department Head's Signature 13 14 APPROVED AS TO LEGAL FORM APPROVED AS TO ACCOUNTING FORM 15 County Counsel Auditor-Controller/Treasurer-Tax Collector 16 17 FOR ACCOUNTING USE ONLY: 18 ORG No.: [click to type type org] Account No.: [click to type type account] 19 Requisition No.: [click to type requisition number] 20 FCMC 06/11 C:\USERS\SJOHNSTON\APPDATA\LOCAL\MICROSOFT\WINDOWS\TEMPORARY INTERNET 21 FILES\CONTENT.OUTLOOK\VJ9QZL02WTTACHM ENT C-MODEL COUNTY CONTRACT.DOC 22 23 24 25 26 27 28 -10- RFP 964-5439 Attachment D AGT. # 12-271 1 HEALTH BENEFIT SERVICES A G R E E M E N T 2 3 THIS AGREEMENT is made and entered into this 5th day of June, 2012, by and 4 between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter 5 referred to as "COUNTY", and Gallagher Benefit Services, Inc., whose address is 45 E. Park 6 Place West, Suite 408, Fresno, CA 93720, hereinafter referred to as "CONTRACTOR". 7 WHEREAS, employee health and benefit related Federal and State regulations are 8 subject to legislative changes; and 9 WHEREAS, the health and benefit industry is a fluid market with many new alternative 10 products being offered; and, 11 WHEREAS, the COUNTY has a need for employee health and benefit plan consulting 12 services to assist the COUNTY in ensuring regulatory compliance and identifying and evaluating 13 all health care and benefit plans alternatives; and 14 WHEREAS, CONTRACTOR has the knowledge and skills to provide employee health 15 and benefit programs consulting services. 16 NOW, THEREFORE, the parties hereto agree as follows: 17 COUNTY hereby engages CONTRACTOR, and CONTRACTOR hereby accepts 18 such engagement, to perform those services specified in this Agreement required in connection 19 with the health and benefit programs consultation services under the terms and subject to 20 conditions provided in the Agreement. In the performance of the Agreement, CONTRACTOR will 21 utilize systems, practices and procedures which recognize the specific health and benefit 22 programs consultation services required. 23 24 WITNESSETH: 25 1. OBLIGATIONS OF THE CONTRACTOR 26 A. CONTRACTOR shall, under this Agreement, provide COUNTY Employee 27 Benefit Plan (hereinafter referred as "Benefits Plan") consultation services as described in 28 COUNTY's Request for Proposal (RFP) number 964-5031 (including Addendums 1,2 and 3) -1- FP 964-5439 Attachment D 1 attached hereto as Exhibit A and incorporated herein by reference, and CONTRACTOR's 2 proposed response to said RFP, attached hereto as Exhibit B and incorporated by reference, 3 including but not limited to- 4 1) Administrative Services including strategic plan design, vendor 5 administrative oversight, legal compliance and legislative updates, review Evidence of Coverage 6 and Summary Plan documents, and provide health and benefit plan education resources and 7 services; 8 2) Data Analysis and Reporting Services, including review of prior-year's 9 utilization information to prepare models/data showing trends on claims and utilization including 10 medical, dental, vision and pharmaceutical (mail order and retail) coverages and provide 11 recommendation to the COUNTY for optimizing future health benefits while controlling costs; 12 3) Conduct ongoing health benefit plans claims and utilization analysis, 13 interpret outcomes and develop reports for the COUNTY; 14 4) Vendor Relations Services including health benefit plans (and other 15 benefit plans as requested) RFP and contract development; health and benefit plans initial and 16 renewal analysis and negotiations; review of vendor contracts, participation in vendor meetings 17 and services to assist in management of vendor compliance, and monitoring vendor performance 18 guarantees and service delivery; 19 5) Actuarial and Underwriting Services including actuarial cost projects 20 for various health benefit plan design features, actuarially developed rates for self-funded 21 programs, analyze rates developed by the San Joaquin Valley Insurance Authority, prepare 22 financial projections from alternative benefit designs and/or employee contributions; 23 6) Voluntary Benefits Consultation Services including life, disability and 24 other voluntary benefits market analysis, COUNTY voluntary benefit assessments and analysis, 25 plan design recommendations, voluntary benefit RFP and contract development, potential vendor 26 analysis, and act as Broker of Record for plans executed with COUNTY; 27 7) Meet frequently (at a minimum 12-15 times annually) face-to-face 28 with COUNTY to discuss industry, regulatory and service issues, including meetings with the -2- �tFP 964-5439 Attachment D i 1 COUNTY executive and benefits staffs and Health Benefit Advisory Counsel; and 2 8) Acts on behalf of the COUNTY, as needed, between COUNTY and 3 health and benefits plan vendors. 4 2. OBLIGATIONS OF THE COUNTY 5 COUNTY will authorize its health and benefit plans vendors to provide CONTRACTOR with 6 current health and benefits plan data and necessary information, including but not limited to the 7 following: 8 A. COUNTY will direct CONTRACTOR in preparing the content/scope to be 9 specified in any health and benefit RFP and/or RFP to current insurance carriers for renewing the 10 provision of benefits each currently provides to active employees and retiree members (living both 11 in and outside California) and their dependents. The COUNTY shall provide final approval of 12 requests for quote (RFQ) and/or RFP before release to potential vendors; 13 B. Health and benefit plans contracts, enrollment and relevant reports and 14 data as required for CONSULTANT to provide consultation services. 15 COUNTY will make CONTRACTOR broker of record on all assignable ancillary/voluntary 16 benefits currently in place and will direct ancillary/voluntary commissions to CONTRACTOR. 17 CONTRACTOR shall also be assigned broker of record on any new policies placed by 18 CONTRACTOR and shall receive commissions earned from those policies. 19 3. TERM 20 A. This Agreement shall become effective on the 5t" day of June, 2012 and 21 shall terminate on the 4t" day of June, 2015. 22 B. This Agreement shall automatically be extended for a period of not more 23 than two (2) additional one (1) year terms beyond termination date upon the same terms and 24 conditions herein set forth unless either the COUNTY or the CONTRACTOR gives at least thirty 25 (30) days advance written notice prior to the expiration of the term. 26 4. TERMINATION 27 A. Non-Allocation of Funds - The terms of this Agreement, and the services to 28 be provided thereunder, are contingent on the approval of funds by the appropriating government -3- FP 964-5439 Attachment D 1 agency. Should sufficient funds not be allocated, the services provided may be modified, or this 2 Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written 3 notice. 4 B. Breach of Contract - The COUNTY may immediately suspend or terminate 5 this Agreement in whole or in part, where in the determination of the COUNTY there is: 6 1) An illegal or improper use of funds; 7 2) A failure to comply with any term of this Agreement; 8 3) A substantially incorrect or incomplete report submitted to the 9 COUNTY; 10 4) Improperly performed service. 11 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY 12 of any breach of this Agreement or any default which may then exist on the part of the 13 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the 14 COUNTY with respect to the breach or default, The COUNTY shall have the right to demand of 15 the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR 16 under this Agreement, which in the judgment of the COUNTY were not expended in accordance 17 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon 18 demand. 19 C. Without Cause - Under circumstances other than those set forth above, 20 this Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written 21 notice of an intention to terminate to CONTRACTOR. 22 5. COMPENSATION/INVOICING 23 COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to 24 receive compensation as follows: COUNTY elects CONTRACTOR's annual fee under Scenario 2 25 as proposed by CONTRACTOR in Exhibit B, which annual fee is $45,000 each year 26 CONTRACTOR performs the Scope of Services set forth in Exhibit A. Benefits plan consultation 27 services shall include Ancillary/Voluntary benefits consulting, and COUNTY will make 28 CONTRACTOR broker of record on all assignable Ancillary/Voluntary benefits currently in place -4- i RFP 964-5439 Attachment D 1 and any new policies placed by CONTRACTOR with commissions being directed to 2 CONTRACTOR. The combination of the consulting fee and AncillaryNoluntary commissions 3 received by CONTRACTOR shall not exceed $80,000 annually. Any excess commissions 4 received by CONTRACTOR will be applied to offset or eliminate the annual consulting fee. 5 CONTRACTOR shall submit monthly invoices, in arrears, to the County of Fresno Personnel 6 Services-Employee Benefits, 2220 Tulare Street, 14'`' Floor, Fresno, CA 93721. Invoice terms 7 shall be Net 45 days. 8 In no event shall services performed under this Agreement be in excess of 9 $225,000 during the term of this Agreement. It is understood that all expenses incidental to 10 CONTRACTOR'S performance of services under this Agreement shall be borne by 11 CONTRACTOR, 12 6. GUARANTEE 13 CONTRACTOR warrants that it will perform the Scope of Services set forth in 14 Exhibit A to the satisfaction of the COUNTY. If in the sole determination of the COUNTY, the 15 COUNTY is not satisfied with CONTRACTOR's performance of Scope of Services, then COUNTY 16 shall provide written notice to CONTRACTOR of said dissatisfaction. Said written notice may be 17 provided to CONTRACTOR at any time during any current Year of Service period, but not later 18 than 30 days after the ending of the Year of Service period for which COUNTY's determination of 19 dissatisfaction applies. Not later than 45 days following CONTRACTOR's receipt of said notice of 20 dissatisfaction from COUNTY, CONTRACTOR shall reimburse the COUNTY an amount not to 21 exceed 10% of the total annual fee for that Year of Service. 22 ; 7. INDEPENDENT CONTRACTOR 23 In performance of the work, duties and obligations assumed by 24 CONTRACTOR under this Agreement, it is mutually understood and agreed that CONTRACTOR, 25 including any and all of the CONTRACTOR'S officers, agents, and employees will at all times be 26 acting and performing as an independent contractor, and shall act in an independent capacity and 27 not as an officer, agent, servant, employee, joint venturer, partner, or associate of the COUNTY. 28 Furthermore, COUNTY shall have no right to control or supervise or direct the manner or method -5- FP 964-5439 Attachment D 1 by which CONTRACTOR shall perform its work and function. However, COUNTY shall retain the 2 right to administer this Agreement so as to verify that CONTRACTOR is performing its obligations 3 in accordance with the terms and conditions thereof. 4 CONTRACTOR and COUNTY shall comply with all applicable provisions of 5 law and the rules and regulations, if any, of governmental authorities having jurisdiction over 6 matters the subject thereof, 7 Because of its status as an independent contractor, CONTRACTOR shall have 8 absolutely no right to employment rights and benefits available to COUNTY employees. 9 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its 10 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely 11 responsible and save COUNTY harmless from all matters relating to payment of 12 CONTRACTOR'S employees, including compliance with Social Security withholding and all other 13 regulations governing such matters. It is acknowledged that during the term of this Agreement, 14 CONTRACTOR may be providing services to others unrelated to the COUNTY or to this 15 Agreement. 16 8. MODIFICATION 17 Any matters of this Agreement may be modified from time to time by the written 18 consent of all the parties without, in any way, affecting the remainder. 19 9. NON-ASSIGNMENT 20 Neither party shall assign, transfer or sub-contract this Agreement nor their 21 rights or duties under this Agreement without the prior written consent of the other party. 22 10. HOLD HARMLESS 23 CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY'S 24 request, defend the COUNTY, its officers, agents, and employees from any and all costs and 25 expenses, damages, liabilities, claims, and losses occurring or resulting to COUNTY in connection 26 with the performance, or failure to perform, by CONTRACTOR, its officers, agents, or employees 27 under this Agreement, and from any and all costs and expenses, damages, liabilities, claims, and 28 losses occurring or resulting to any person, firm, or corporation who may be injured or damaged -6- FP 964-5439 Attachment D 1 by the performance, or failure to perform, of CONTRACTOR, its officers, agents, or employees 2 under this Agreement. 3 11. INSURANCE 4 Without limiting the COUNTY's right to obtain indemnification from 5 CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full 6 force and effect, the following insurance policies throughout the term of the Agreement: 7 A. Commercial General Liability 8 Commercial General Liability Insurance with limits of not less than One 9 Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars 10 ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require 11 specific coverages including completed operations, products liability, contractual liability, 12 Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed 13 necessary because of the nature of this contract. 14 B. Automobile Liability 15 Comprehensive Automobile Liability Insurance with limits for bodily injury of 16 not less than Two Hundred Fifty Thousand Dollars ($250,000.00) per person, Five Hundred 17 Thousand Dollars ($500,000.00) per accident and for property damages of not less than Fifty 18 Thousand Dollars ($50,000.00), or such coverage with a combined single limit of Five Hundred 19 Thousand Dollars ($500,000.00). Coverage should include owned and non-owned vehicles used 20 in connection with this Agreement. 21 C. Professional Liability 22 If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., 23 L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less 24 than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) 25 annual aggregate. 26 D. Workers' Compensation 27 A policy of Workers' Compensation insurance as may be required by the 28 California Labor Code. -7- FP 964-5439 Attachment D 1 CONTRACTOR shall obtain endorsements to the Commercial General Liability 2 insurance naming the County of Fresno, its officers, agents, and employees, individually and 3 collectively, as additional insured, but only insofar as the operations under this Agreement are 4 concerned. Such coverage for additional insured shall apply as primary insurance and any other 5 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be 6 excess only and not contributing with insurance provided under CONTRACTOR's policies herein. 7 This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance 8 written notice given to COUNTY. 9 Within Thirty (30) days from the date CONTRACTOR signs and executes this 10 Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated 11 above for all of the foregoing policies, as required herein, to the County of Fresno, (Employee 12 Benefits Manager, Personnel Services, 2220 Tulare Street, 14" Floor, Fresno, CA 93721), stating 13 that such insurance coverage have been obtained and are in full force; that the County of Fresno, 14 its officers, agents and employees will not be responsible for any premiums on the policies; that 15 such Commercial General Liability insurance names the County of Fresno, its officers, agents and 16 employees, individually and collectively, as additional insured, but only insofar as the operations 17 under this Agreement are concerned; that such coverage for additional insured shall apply as 18 primary insurance and any other insurance, or self-insurance, maintained by COUNTY, its 19 officers, agents and employees, shall be excess only and not contributing with insurance provided 20 under CONTRACTOR's policies herein; and that this insurance shall not be cancelled or changed 21 without a minimum of thirty (30) days advance, written notice given to COUNTY. 22 In the event CONTRACTOR fails to keep in effect at all times insurance 23 coverage as herein provided, the COUNTY may, in addition to other remedies it may have, 24 suspend or terminate this Agreement upon the occurrence of such event. 25 All policies shall be issued by admitted insurers licensed to do business in the 26 State of California, and such insurance shall be purchased from companies possessing a current 27 A.M. Best, Inc. rating of A FSC VII or better. 28 -s- FP 964-5439 Attachment D 1 12, AUDITS AND INSPECTIONS 2 The CONTRACTOR shall at any time during business hours, and as often as 3 the COUNTY may deem necessary, make available to the COUNTY for examination all of its 4 records and data with respect to the matters covered by this Agreement. The CONTRACTOR 5 shall, upon request by the COUNTY, permit the COUNTY to audit and inspect all of such records 6 and data necessary to ensure CONTRACTOR'S compliance with the terms of this Agreement. 7 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR 8 shall be subject to the examination and audit of the Auditor General for a period of three (3) years 9 after final payment under contract (Government Code Section 8546.7). 10 13. NOTICES 11 The persons and their addresses having authority to give and receive notices 12 under this Agreement include the following: 13 14 COUNTY CONTRACTOR COUNTY OF FRESNO GALLAGHER BENEFIT SERVICES, INC. Paul Nerland LeRov H. Tucker, Jr.. Area President 15 2220 Tulare Street, 14t" Floor 45 E. Park Place West, Suite 408 16 Fresno. CA 93721 Fresno, CA 93720 17 18 Any and all notices between the COUNTY and the CONTRACTOR provided 19 for or permitted under this Agreement or by law shall be in writing and shall be deemed duly 20 served when personally delivered to one of the parties, or in lieu of such personal services, when 21 deposited in the United States Mail, postage prepaid, addressed to such party. 22 14. GOVERNING LAW 23 Venue for any action arising out of or related to this Agreement shall only be in 24 Fresno County, California. 25 The rights and obligations of the parties and all interpretation and performance 26 of this Agreement shall be governed in all respects by the laws of the State of California. 15. DISCLOSURE OF SELF-DEALING TRANSACTIONS 27 28 This provision is only applicable if the CONTRACTOR is operating as a -9- FP 964-5439 Attachment D 1 corporation (a for-profit or non-profit corporation) or if during the term of this agreement, the 2 CONTRACTOR changes its status to operate as a corporation. 3 Members of the CONTRACTOR'S Board of Directors shall disclose any self- 4 dealing transactions that they are a party to while CONTRACTOR is providing goods or 5 performing services under this agreement. A self-dealing transaction shall mean a transaction to 6 which the CONTRACTOR is a party and in which one or more of its directors has a material 7 financial interest. Members of the Board of Directors shall disclose any self-dealing transactions 8 that they are a party to by completing and signing a Self-Dealing Transaction Disclosure Form 9 identified as Exhibit C hereto, which is incorporated by reference and made part hereof, and 10 submitting it to the COUNTY prior to commencing with the self-dealing transaction or immediately 11 thereafter. 12 13 16, ENTIRE AGREEMENT 14 This Agreement constitutes the entire agreement between the CONTRACTOR 15 and COUNTY with respect to the subject matter hereof and supersedes all previous Agreement 16 negotiations, proposals, commitments, writings, advertisements, publications, and understanding 17 of any nature whatsoever unless expressly included in this Agreement. In the event of any 18 inconsistency in interpreting the documents which constitute this Agreement, the inconsistency 19 shall be resolved by giving precedence in the following order of priority: (1) the text of this 20 Agreement; (2) the COUNTY'S Request for Proposal No. 964-5031, including Addendums No. 1, 21 2 and 3, (Exhibit A); (3) the CONTRACTOR'S proposal made in response to COUNTY'S Request 22 for Proposal No. 964-5031(Exhibit B). 23 24 25 26 27 28 -10- P 964-5439 Attachment D 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of 2 the day and year first hereinabove written. 3 CONTRACTOR COUNTY OFFRESNO 4 GALLAGHER BENEFIT SERVICES, INC. 5 �,_ � _ AbT�&kQ . (Ajthorized Signature) Chairman, Board of S ervisors rrj 6 ` Print Name &Title (Chairman of the Board, or ATTEST: 8 President, or any Vice President) s �� 7�r BERNICE E. SEIDEL, Clerk 9 DATE: _-- Z -- Board of SUpervisors 10 BY&UIA 11 (Authorized Signatur Deput 12 r Print Name &Title (Secretary (of Corporation), or 14 any Assistant Secretary)] 15 DATE: 5 I SDI I 1618 � r 17 Mailing Address 19 20 21 22 23 24 25 PLEASE SEE ADDITIONAL SIGNATURE PAGE ATTACHED 26 27 28 FP 964-5439 Attachment D 1 REVIEWED & RECOMMENDED FOR APPROVAL 2 4x'A. 3 Beth Band Deputy Director of Personnel Service 4 5 APPRO1D AS TO LEGAL FORM 7 Kevin B nggs County ounsel 8 , 9 APPROVED AS TO ACCOUNTING FORM 10 O'L 11 Vicki Crow - Auditor-Controller/Treasurer- x Collector 12 13 FOR ACCOUNTING USE ONLY: 14 15 ORG No.: 89250200 Account No.: 7295 — Professional & Sp. Serv. 16 Requisition No.: 8921200135 17 18 19 G:IEMEMPLOYEE BENEFITSVIGENOA ITEMS\2012%11EALTH BENEFIT CONSULTATION SERVICES-GALLAGHER12012 GALLAGHER AGREEMENT-FINAL OOC 20 21 22 23 24 25 26 27 28 -12- CO(�� 964-5439 Attachment E Page 1 Board Agenda Item 44 0 1856 p DATE: October 27, 2015 TO: Board of Supervisors SUBMITTED BY: Paul Nerland, Interim Director of Personnel Services SUBJECT: County Health Plans for Plan Year 2016 RECOMMENDED ACTION(S): 1. Authorize the Chairman to execute Participation Agreement with the San Joaquin Valley Insurance Authority(SJVIA), for the purpose of participating in the SJVIA health insurance (Anthem Blue Cross and Kaiser), pharmacy program (US Script), dental insurance (Delta Dental) and vision insurance (Vision Service Plan) for employees and retirees, effective December 7, 2015 through December 31, 2016. 2. Authorize the Chairman to execute an Agreement with Kaiser Permanente for group medical services for the period January 1, 2016 through December 31, 2016, for retirees. 3. Authorize the Chairman to execute an Agreement with Hartford for group medical services for the period January 1, 2016 through December 31, 2016, for retirees. 4. Authorize the Chairman to execute an Agreement with Express Scripts for Part D Medicare prescription services for the period January 1, 2016 through December 31, 2016, for retirees. 5. Authorize the Chairman to execute an Agreement with Chimienti &Associates Insurance Services for Medicare retiree eligibility, billing, and accounting services, effective January 1, 2016 through December 31, 2016. 6. Approve the biweekly premiums for active employees and dependents for Plan Year 2016, effective December 7, 2015 (Exhibit A). 7. Approve the monthly premiums for retirees and dependents for Plan Year 2016, effective January 1, 2016 (Exhibit B). 8. Authorize the Director of Personnel Services, or designee, to execute related health plan documents, agreements, amendments, thereto, subject to review and approval by County Counsel and the Auditor-Controller/Treasurer-Tax Collector. ALTERNATIVE ACTION(S): Your Board may choose to consider benefit modifications that would reduce premiums but increase copayments or deductibles. SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT: On June 16, 2015, your Board made a finding that it was in the best interest of the County to waive the County of Fresno Page 1 File Number:15-1677 File Number: 15-1677 964-5439 Attachment E Page 2 competitive bidding process consistent with Administrative Policy No. 34 under the"unusual or extraordinary circumstances" exception for the solicitation of health benefits plan proposals for Plan Year 2016. This allowed the County the flexibility needed to negotiate directly with health insurance providers and maximize cost effective alternatives that best meet the needs of the County, its active employees, retirees, and their dependents. FISCAL IMPACT: Appropriations and related projected revenue of$73.3 million has been included in the Risk Management Org. 8925 FY 2015-16 Adopted Budget for pass-through health insurance premiums of County employees, retirees, and dependent coverage. Of this amount, approximately$64.5 million is for active employees and $8.8 million is for retirees. In accordance with Budget Instructions, County Departments included appropriations in their FY 2015-16 Adopted Budgets for the County-portion of active employee premiums. However, the net County cost(NCC)for this contract period is subject to the County contribution applied toward the total premium rate as well as the funding source(s)for each County department/Org (i.e. NCC vs. grant/state/federal funded departments/Orgs). The County contribution is subject to the meet and confer process and staff will return to your Board to approve that amount at its conclusion. DISCUSSION: The discussion will summarize options considered and recommended actions by category. 1. Health Plans -Active & Pre-65 Retirees: a. Anthem Blue Cross (SJVIA): Since Plan Year 2010, the County has participated in the San Joaquin Valley Insurance Authority (SJVIA). The SJVIA is a Joint Powers Authority and has allowed for lower fixed costs and additional value-added services. The SJVIA Board approved rate increases of 13.15%for the Anthem Blue Cross HMO and 4.90%for the Anthem Blue Cross PPO and HDPPO (active employees and pre-65 retirees)for Plan Year 2016. This includes prescription coverage through US Script and mandated cost increases by the Patient Protection &Affordable Care Act(PPACA). b. Kaiser(SJVIA): Kaiser proposed, and the SJVIA Board approved, a rate increase of 7.74% for Plan Year 2016. c. Administrative Services (SJVIA): The SJVIA continues to offer additional services as part of the total rate structure, including COBRA Administration and Billing, Family Medical Leave Aci (FMLA) Billing and Consolidated Eligibility/Billing Services. Recommended Action 5 would execute the Chimienti &Associates contract which is in the second year of a three-year rate guarantee to match pricing and services offered through the SJVIA, ensuring consistency and efficiency in services offered with the health plans. Recommended rates for Anthem Blue Cross and Kaiser are detailed in Exhibits A and B and summarized in Exhibit C. The Health Rate Change reflects the rate increase for only the health plans; the Overall Rate Change is the aggregate and includes the following components in addition to the health rates: vision, mental health, dental coverage, life insurance and health administration. 2. Health Plans- Post-65/ Medicare Retirees: The County offers two types of plans to Medicare eligible retirees called Medicare Supplemental (Hartford/Express Scripts)and Medicare Advantage (Kaiser Senior Advantage High/Low). After evaluating options available and with valuable input from retirees participating in the Health Benefits Advisory Committee (HBAC), the following recommendation is being made: County of Fresno Page 2 File Number.15-1677 File Number: 15-1677 964-5439 Attachment E Page 3 a. That the County maintain and continue to offer a Medicare Supplemental plan through Hartford/Express Scripts with an increase of 6.92% and two Medicare Advantage plans through Kaiser Senior Advantage with a decrease to the Kaiser High plan of 0.79% and a decrease to the Kaiser Low plan of 0.88%. The County has received positive feedback from retirees enrolled in the plans. Recommended rates for Hartford/Express Scripts and Kaiser are included in Exhibit B and summarized in Exhibit C. The Overall Rate Change includes the following components in addition to the health rates: vision, dental coverage and health administration. 3. Dental Plans (SJVIA): For 2016, Delta Dental through the SJVIA offered a rate decrease of 4.11%for the DPPO plan and an increase of 5.38%for the DHMO plan. The DHMO offers a limited network of providers in exchange for enhanced coverage, whereas the DPPO offers access to an expanded network of providers and specialists in exchange for higher deductibles. The dental renewal rate change is summarized in Exhibit C. Recommended Action 1 would authorize the Chair to execute a Participation Agreement with the SJVIA which would include Delta Dental DPPO and DHMO for Plan Year 2016. 4. Vision Plan (SJVIA): Employees enrolled in the Anthem Blue Cross HMO, PPO and HDPPO, pre-65 retirees enrolled in the Anthem Blue Cross HDPPO, and post-65 retirees enrolled in the Hartford/Express Scripts plan all receive vision coverage through the SJVIA and an agreement with Vision Service Plan (VSP). VSP offered a rate pass (no increase)with small benefit modifications for 2016 approved by the SJVIA Board, and this is included in Recommended Action 1. OTHER REVIEWING AGENCIES: The Health Benefits Advisory Committee (HBAC) has reviewed the recommendations contained in this item. The Auditor-Controller/Treasurer-Tax Collector has reviewed and approved the health administration rates included in Recommended Actions 6 and 7. REFERENCE MATERIAL: BAI #53, June 16, 2015 - Solicitation of Health Benefits Plan Proposals for 2016 BAI #25, October 7, 2014 - County Health Plans and Rates for Plan Year 2015 BAI #35, July 9, 2013 -Amended & Restated SJVIA Agreement BAI #9, October 6, 2009- SJVIA Agreement jointly purchasing health insurance ATTACHMENTS INCLUDED AND/OR ON FILE: Exhibit A Exhibit B Exhibit C CAO ANALYST: Sonia De La Rosa County of Fresno Page 3 File Number.15-1677 964-5439 Attachment E Page 4 ACTIVE EMPLOYEE AND DEPENDENT PREMIUMS - BIWEEKLY Effective Pay Period Beginning December 7, 2015 Anthem Blue Cross HMO Anthem Blue Cross PPO Anthem Blue Cross HDPPO Kaiser HMO US Scripts RX US Scripts RX Anthem RX Kaiser RX Anthem Mental Health Anthem Mental Health Anthem Mental Health Kaiser Mental Health VSP Vision VSP Vision VSP Vision Kaiser Vision Delta Dental DeltaCare Delta Dental DeltaCare Delta Dental DeltaCare Delta Dental DeltaCare DPPO DHMO DPPO DHMO DPPO DHMO DPPO DHMO Employee Only $345.85 $334.20 $443.43 $431.78 $257.33 $245.68 $330.52 $318.87 Employee + Spouse $606.20 $589.02 $915.49 $898.31 $529.15 $511.97 $579.46 $562.28 Employee + Child(ren) $535.71 $523.43 $829.01 $816.73 $474.44 $462.16 $512.11 $499.83 Employee + Family $796.01 $777.45 $1,259.94 $1,241.38 $718.85 $700.29 $761.05 $742.49 Please note: The employee rates are the biweekly premium totals and do not reflect the biweekly employee cost, which is the total premiums less the County contribution. The County contribution is negotiated with employee bargaining units separately. 964-5439 Attachment E Page 5 RETIREE AND DEPENDENT PREMIUMS - MONTHLY Effective January 1, 2016 Anthem BC HDPPO Kaiser HMO Anthem BC RX Kaiser RX Anthem BC Mental Health Kaiser Mental Health VSP Vision Kaiser Vision Non-Medicare Retirees Delta Dental DeltaCare Delta Dental DeltaCare (Under Age 65) DPPO DHMO DPPO DHMO Retiree Only $762.72 $737.47 $1,281.47 $1,256.22 Retiree + Spouse $1,335.18 $1,297.95 $2,326.34 $2,289.11 Retiree + Child(ren) $1,181.04 $1,154.42 $1,955.47 $1,928.85 Retiree + Family $1,751.30 $1,711.07 $2,975.25 $2,935.02 Hartford / Benistar Kaiser Senior Adv. - High Kaiser Senior Adv. - Low Express Scripts RX Kaiser RX Kaiser RX Hartford Mental Health Kaiser Mental Health Kaiser Mental Health VSP Vision Kaiser Vision Kaiser Vision Medicare Retirees Delta Dental DeltaCare Delta Dental DeltaCare Delta Dental DeltaCare (Over Age 65) DPPO DHMO DPPO DHMO DPPO DHMO Retiree Only $552.95 $527.70 $382.55 $357.30 $351.75 $326.50 Retiree (M) + Spouse (M) $1,068.82 $1,031.59 $729.29 $692.06 $667.69 $630.46 964-5439 Attachment E Page 6 Medical Renewal Rate Change Summary — Active and Pre-65 Retirees Health Plan Option Health Rate Change Overall Rate Change ACTIVE EMPLOYEES Anthem Blue Cross HMO + 13.15% + 13.26% Anthem Blue Cross PPO + 4.90% + 5.25% Anthem Blue Cross HDPPO + 4.90% + 5.53% Kaiser HMO + 7.74% + 8.13% --7 Anthem Blue Cross HDPPO + 4.90% + 5.49% Kaiser HMO + 7.74% + 7.99% Medical Renewal Rate Change Summary — Post-65 / Medicare Retirees Health Plan Option Health Rate Change Overall Rate Change Hartford / Express Scripts + 6.92% + 7.64% IKaiser Senior Advantage — High - 0.79% + 1.09% Kaiser Senior Advantage — Low - 0.88% + 1.20% Dental Renewal Rate Change Summary Dental Plan Option Dental Rate Change Delta Dental — DPPO - 4.11% DeltaCare — DHMO + 5.38% RFP 964-5439 Attachment F caU OPEN .� IENXX I' �� I I \ I I \ I o 1$56 0 EM LOYEE PLAN YEAR 4 0 oo .t4.if �t 41{l it 11l1 RFP 964-5439 Attachment F Page 2 TABLE; OF CONTENTS co Dates to Remember..................................................................................2 lJ Health and Wellness Fair..................................................................2 Frequently Asked Questions.......................................................3 Flexible Spending Accounts.....................................................4 BiweeklyPremiums...................................................................5 T�( Medical Coverage............ ........................................6 Prescription Coverage..............................................................6 o is56 c� -�- Dental Coverage...........................................................................7 VisionCoverage...............................................................................7 "Rt Health Plan Contact Information.........................................Back Cover DATES TO REMEiN(IBEx October OPEN HEALTH & OPEN OPT OUT NEW ENROLLMENT WELLNESS ENROLLMENT FORMS PLAN YEAR BEGINS FAIR ENDS DUE BEGINS -.At WEDNESDAY, OCTOBER 28, 2015 7:30am - 2:OOpm HULTH 6WELLNESSFA R+ (County Plaza Building Ballroom) FOReXPRESNO COUNTY EMPLOYEES to This is your opportunity to obtain information from several different vendors all at one location. FREE flu shots will be provided on a first come, first served basis due to limited availability. ANY QUESTIONS? Please contact Employee Benefits at (559) 600-1810 or email us at Person nel-Benefits@co.fresno.ca.us. Additionally, you can visit our Open Enrollment website at www.co.fresno.ca.us/openenrollment. The site is very informative and includes detailed summaries, provider information, rates, forms and much more! RFP 964-5439 Attachment F Page 3 FREQUENTLYASKED QUESTIONS What is Open Enrollment? Open Enrollment is the one time during the year that you may make changes to your health insurance plans, add or delete dependents without a qualifying event, and enroll in the dependent care and/or health care flexible spending accounts for the 2016 plan year. What changes are there for plan year 7ni F;? There are no health plan changes for the 2016 plan year. If you do not wish to enroll, make any changes to the health insurance plans you are currently enrolled in, opt out, or enroll in an FSA, no action is required on your part. How do I make changes to my health insurance plan or enroll in a Flexible Spending Account (FSA)? You can make changes to your health insurance or enroll in an FSA one of the following ways: Option 1: Login to PeopleSoft on a County Computer and use the Self Service feature under Main Menu, then click on Benefits followed by Benefits Enrollment. Tutorials are available at co.fresno.ca.us/openenrollment. Option 2: Complete the applicable form(s) and submit to Employee Benefits, along with any required supporting documents via: ♦ Email: Person nel-Benefits@co.fresno.ca.us ♦ Fax: (559) 455-4787 ♦ In person: On the 14th Floor of the County Plaza Building ♦ Stop mail: Stop 188 ♦ USPS mail: 2220 Tulare Street, 14th Floor, Fresno, CA 93721 Please note: All forms and supporting documents, excluding opt out forms, must be received by Employee Benefits no later than 5:00pm on Friday, November 13, 2015. Employee Benefits is not responsible for forms sent through stop mail or USPS mail that are lost or delayed and therefore not received by the deadline. It is your responsibility to ensure that all forms and supporting documents, if applicable, are received by the deadline. In order to confirm receipt of forms and/or supporting documents, please contact Employee Benefits at (559) 600-1810 or email Personnel-Benefits@co.fresno.ca.us. Can I opt out of the Countv's health insurance plan? All employees who wish to opt out during the 2016 plan year (including those that are currently opted out), must submit a completed 2016 Opt Out Form and provide current, written proof of other employer- sponsored group health insurance coverage. Proof is subject to approval by Employee Benefits staff and must include the employee's name. All opt out forms and supporting documents must be received by Employee Benefits no later than 5:00pm on Friday, December 4, 2015. When do Ooen Enrollment changes take effect? Health plan changes you make during Open Enrollment will take effect on December 7, 2015 and applicable premium changes will appear on your December 31, 2015 paycheck. Flexible Spending Account changes will take effect January 1, 2016 and deductions will first appear on your January 15, 2016 paycheck. Continued on next page IL RFP 964-5439 Attachment F Page 4 Continued from previous page Who is eligible to be covered on my health insurance plan Below is a list of eligible dependents and the supporting documents required to add them to your health insurance plan. Dependent children are eligible until they reach 26 years of age. ELIGIBLE DEPENDENT. REQUIRED DOCUMENTS) Spouse' A copy of the Certified Marriage Certificate Registered Domestic Partner A copy of the Declaration of Domestic Partnership filed with the California Secretary of State Child A copy of the Certified Birth Certificate Adopted Child A copy of the Adoption Order or the Certified Birth Certificate A copy of the Certified Birth Certificate and a copy of the Certified Stepchild Marriage Certificate or Declaration of Domestic Partnership showing your spouse or registered domestic partner as the child's parent Child of Legal Guardianship A copy of the Letters of Guardianship filed with the courts Please note: The required documents listed above must be submitted each time a dependent is added to your health insurance, regardless if the dependent has been covered under your plan previously. Can I make changes to my health insurance plan once Open Enrollment closes? Once Open Enrollment closes, plan changes will only be permitted if you experience a qualifying event (e.g. loss or gain of other employer-sponsored coverage, marriage, birth of a child, etc.) as defined by the IRS. If you experience a qualifying event, you must submit the required documentation to Employee Benefits within thirty 30 days of the qualifying event date. For more information on qualifying events, please contact Employee Benefits. FLEXIBLE SPENDING ACCOUNTS (FSA) FSAs allow you to set aside money from your paycheck on a pretax basis to pay for medical and dependent care, transit and parking expenses. A Health Care FSA is used to pay for out-of-pocket medical, dental, vision and prescription expenses for you, your spouse and any of your eligible tax dependents (even if they are on a different insurance plan). Check the Eligible Expense list at www.asiflex.com for more information. You can set aside up to $2,550 per year in the Health Care FSA and use these dollars for eligible expenses you incur throughout the year.* A Dependent Care FSA is used to pay for work-related child care expenses, and expenses for older tax dependents who are not capable of self-care. Eligible expenses include daycare, summer day camps (overnight camps are NOT eligible), babysitting, before and after school care, nursery school, preschool and Pre-K expenses that are primarily for the protection and well-being of the dependent. You can set aside up to $5,000 per household, per calendar year ($2,500 if married and filing separate income tax returns).* A Transit and Parking FSA is used to pay for work-related commuting expenses, such as bus, train, subway, van pooling and even parking expenses. You can set aside up to $250 per month into your parking account.* You can set aside up to $130 per month into your transit/van pooling account.* *Note: I ne montmy anci annual limits are set by the Ihj eduii yed, cmu are sublecL w u1a11Ve. 1 The term"spouse"includes same-sex spouses, pursuant to IRS Revenue Ruling 2013-17. RFP 964-5439 Attachment F Page 5 '16- 13IWEEKLY PREMIUMS As of the date of publication, negotiations were not completed for the County contribution toward biweekly health insurance premiums. Therefore, the 2015 contribution rates of$223 per pay period for employee only coverage, $318 for employee plus spouse coverage, $318 for employee plus child(ren) coverage, and $323 for employee plus family coverage are included on this chart for comparison purposes only. Upon completion of negotiations and Board approval, the 2016 rates, including County contribution, will be made available. These rates do not apply to part-time employees who are eligible for health insurance. For a copy of part- time rates, please visit the Open Enrollment website at www.co.fresno.ca.us/openenrollment or call Employee Benefits at (559) 600-1810. The premiums listed below are paid by the employee via payroll deduction on a biweekly basis. PLAN I ]PLAN 2 Medical/Mental Health Anthem Blue Cross HMO Anthem Blue Cross PPO Prescription US Script US Script Vision Vision Service Plan (VSP) Vision Service Plan (VSP) Dental Plans Delta Dental DeltaCare USA Delta Dental DeltaCare USA or or DPPO DHMO DPPO DHMO EMPLOYEE •ST EMPLOYEE COST Employee Only 0: Employee+ . .use $288.20 $271.i $20S.43 $511.01 $498.73 PLAN 3 PLAN 4 Medical/Mental Health Anthem Blue Cross HDPPO Kaiser Permanente Prescription Anthem Blue Cross Kaiser Permanente Vision Vision Service Plan (VSP) Kaiser Permanente Dental Plans Delta Dental DeltaCare USA Delta Dental DeltaCare USA or or DPPO DHMO DPPO DHMO EMPLOYEE •ST EMPLOYEE COST Employee • SpouseEmployee+ , . B6. FtWloyee 4- Familul $395.85 - Ili $377.29 $438.05 J& $419.49 As an employee, the health benefits available to you represent a significant component of your compensation package. They provide important protection for you and your family in case of illness or injury. The County offers a series of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format to help you compare options. The SBC is available on the web at www.co.fresno.ca.us/summarybenefits. A copy is also available, free of charge, by calling Employee Benefits at (559) 600-1810. ou RFP 964-5439 Attachment F Page 6 MEDICAL COVERAGE ................................................ Choosing a medical plan that is right for you and your family is an important decision. The County of Fresno offers four (4) different plans to allow you to select the coverage that best meets your needs. ANTHEM BC HMO ANTHEM BC PPO ANTHEM BC HDPPO KAISER PERMANENTE (IN-NETWORK) (IN-NETWORK) Individual Deductible $0 $250 Plan Year $3,000 Calendar Year $0 Family Deductible $0 $500 Plan Year $6,000 Calendar Year $0 Preventive Care $0 $0 $0 $0 Office Visit Copay $15 $20 $0 After Deductible $15 Emergency Room Visit $100 $100 $0 After Deductible $100 Inpatient $0 $0 $0 After Deductible $0 X-ray and Lab $0 $0 $0 After Deductible $0 Allergy Testing $0 $0 $0 After Deductible $15 Chiropractic $10 $0 $0 After Deductible $10 Mental Health Inpatient $0 $0 $0 After Deductible $0 Mental Health Outpatient $15 $20 $0 After Deductible $15 This chart is only a summary of benefits. Please see the Evidence of Coverage(EOQ for a full description of benefits. If there are any discrepancies between this summary and the EOC, the EOC will prevail. PRESCRIPTION COVERAGE ............................................................. Under US Script, you may receive prescriptions through major pharmacies including, but not limited to: CVS, Rite Aid, Walmart, Costco, Target and in-network independent pharmacies. You can also fill your ninety (90) day prescription at any of the following chains: CVS, Walmart, Rite Aid, and Walgreens. 1 US SCRIPT US SCRIPT ANTHEM BLUE CROSS KAISER PERMANENTE Generic $10 $10 $0 After Deductible $10 Preferred/Brand $20 $20 $0 After Deductible $20 Non-Preferred $35 $35 $0 After Deductible N/A RFP 964-5439 Attachment F Page 7 DENTAL / ORTHODONTIC COVERAGE ...................................................................................... Good oral hygiene is important to your overall health. The County of Fresno offers two (2) choices in dental plans: Delta Dental DPPO, which is a fee-for-service plan with the best discounts provided within the Delta Dental DPPO network; and DeltaCare USA DHMO which has set copays for services when provided by your primary care dentist. The DeltaCare USA DHMO has far fewer providers, but costs less than Delta Dental DPPO. DELTA DENTAL DPPO DELTACARE USA DHMO Annual Deductible $50 Per Person/$150 Per Family No Deductible Maximum Benefits $2,500 Per Person Per Year No Annual Maximum Preventive Services 0% PPO Provider/10%Non-PPO Provider $0 Most Services $0 Most Services Basic Services 10%PPO Provider/ 10% Non-PPO Provider *Copay may be required for upgraded materials/services Major Services $0 Most Services (Includes Periodontic, Endodontic, and Oral 50% *Copay may be required for upgraded materials/services Surgery) Orthodontia Child $1,660 Copay $1,700 Copay Adult $1,880 Copay $1,900 Copay Once per lifetime Pre-and post-treatment services Max 24 months of treatment have additional copayments VISION COVERAGE .......................................... If you are in an Anthem health plan, your vision insurance is through Vision Service Plan (VSP). Eye exams support eye health and overall health. It is important to have an exam once a year to ensure that your eyes are healthy. IN-NETWORK OUT-OF-NETWORK Exam Copay/Frequency $10/Every 12 Months Up to$45/Every 12 Months Contact Allowance/Frequency $150/Every 12 Months Up to$105/Every 12 Months Frame Allowance/Frequency $150/Every 24 Months Up to$70/Every 24 Months Lenses Copay/ Frequency Single Vision $0/Every 12 Months Up to$30/Every 12 months Lined Bifocal $0/Every 12 Months Up to$50/ Every 12 Months Lined Trifocal $0/Every 12 Months Up to$65/ Every 12 Months Standard Progressive $55/Every 12 Months Up to$50/every 12 Months Kaiser Permanente members receive a $175 allowance for Optical Eyewear every 24 months. Members must access services at a Kaiser facility, unless otherwise approved by Kaiser. • COUNTY OF FRESNO Personnel Services Department Employee Benefits Division 1 aaao Tulare Street, 14th Floor J Fresno CA 937Zl OPIEN ]ENROLLMENT OCTOBER ?8 9015 • C9-015 If you need further information, please contact the plans listed be MEA I AlISIO ANTHEm BLUE CROSS AL VISION SERVICE PLAN (VSP) H Num er 275341H001/ Phone (800) 888-8288 0028675/ Phone (800) 877-7195 PPO Group Number 275341M450/ Phone (800) 888-8288 www.vsp.com HDPPO Group Number 275341M660/ Phone (866) 207-9878 www.anthem.com/ca PRESCRIPTION - 000/ Phone (800) 464-4000 Group Number 202720/ Phone (866) 264-4161 www.kaiserpermanente.org www.usscript.com DENTAfF FLEXIBLE SPENDING ACCOUNTS DELTA DENTAL . • • . Group Number 05879-00001/ Phone (800) 765-6003 Phone (800) 659-3035 www.deltadf.olali www.asiflex.com DELTACARE USA DHMO ro e - 001/ Phone (800) 422-4234 www.deltadentalins.com OPEN IENx-N.OLLTINIIIIIIENT • OCTOBER 28 - NOVEMBER 13, 2015 RETIREE PLAN YEAR 2016 �lli.L711 A i -1 RFP 964-5439 Attachment G MMEMPage 2 TABLE OF CONTENTS Dates to Remember.............................................................................................2 CO Frequently Asked Questions..................................................................3 MonthlyPremiums.............................................................................4 Non-Medicare Medical and Prescription Coverage....................5 Medicare Medical and Prescription Coverage.............................6 O1856 O Dental Coverage................................................................................7 All VisionCoverage.....................................................................................7 Health Plan Contact Information................................................Back Cover DATES TO REMEMBER October October • November 22nd 28th 13th L :LSt REFCO OPEN HEALTH & OPEN NEW LUNCHEON ENROLLMENT WELLNESS ENROLLMENT PLAN YEAR BEGINS FAIR ENDS BEGINS WEDNESDAY, OCTOBER 28, 2015 7:30 am — 2:00 pm County Plaza Building Ballroom HMTH 6WELLNESSFA k 2220 Tulare St, Fresno, CA 93721 ANY QUESTIONS? Please contact Employee Benefits at (559) 600-1810 or email us at Personnel- Benefits@co.fresno.ca.us. Additionally, you can visit our Open Enrollment website at www.co.fresno.ca.us/openenrollment. The site is very informative and includes detailed summaries, provider information, rates, forms and much more! RFP 964-5439 Attachment G Page 3 Ill K_LQ GENTI Y Anot*' EY) OUESTiONS %W What is Open Enrollment? Open Enrollment is the one time during the year that you may make changes to your health insurance plans and add dependents without a qualifying event for the 2016 plan year. Please note: dependents may be deleted without a qualifying event at any time during the plan year. What changes are there for plan year 2016? There are no health plan changes for the 2016 plan year. If you do not wish to enroll or make any changes to the health insurance plans you are currently enrolled in, no action is required on your part. How do I make changes to my health insurance plan? Complete the applicable form(s) and submit to Employee Benefits, along with any required supporting documents via: ♦ Email: Person nel-Benefits@co.fresno.ca.us ♦ Fax: (559) 455-4787 ♦ In person or USPS mail: 2220 Tulare Street, 14th Floor, Fresno, CA 93721 Please note: All forms and supporting documents must be received by Employee Benefits no later than 5:00pm on Friday, November 13, 2015. Employee Benefits is not responsible for forms sent through USPS mail that are lost or delayed and therefore not received by the deadline. It is your responsibility to ensure that all forms and supporting documents, if applicable, are received by the deadline. In order to confirm receipt of forms and/or supporting documents, please contact Employee Benefits at (559) 600-1810 or email Person nel-Benefits@co.fresno.ca.us. Who is eligible to be covered on my health insurance plan? Below is a list of eligible dependents and supporting documents required to add them to your health insurance plan. Dependent children are eligible until they reach 26 years of age. ELIGIBLE DEPENDENTS REQUIRED DOCUMENTS) Spouse* A copy of the Certified Marriage Certificate Registered Domestic Partner A copy of the Declaration of Domestic Partnership filed with the California Secretary of State Child A copy of the Certified Birth Certificate Adopted Child A copy of the Adoption Order or the Certified Birth Certificate A copy of the Certified Birth Certificate and a copy of the Certified Stepchild Marriage Certificate or Declaration of Domestic Partnership showing your spouse or registered domestic partner as the child's parent Child of Legal Guardianship A copy of the Letters of Guardianship filed with the courts Please note: The required documents listed above must be submitted each time a dependent is added to your health insurance, regardless if the dependent has been covered under your plan previously. Continued on next page *The term"spouse" includes same-sex spouses,pursuant to IRS Revenue Ruling 2013-17. IL RFP 964-5439 Attachment G Page 4 Continued from previous page When do Open Enrollment changes take effect? Any changes you make during Open Enrollment will take effect on January 1, 2016. Can I make changes to my health insurance plan once Open Enrollment closes? Once Open Enrollment closes, you will not be permitted to enroll or make changes until the next Open Enrollment period, unless you experience a qualifying event (e.g. marriage, becoming Medicare eligible, etc.), as defined by the IRS. If you experience a qualifying event, you must submit the required documentation to Employee Benefits within thirty (30) days of the qualifying event date. It is important to note that if you become Medicare eligible at any time throughout the year, you will be permitted to enroll in one of the retiree Medicare plans effective the 1st of the month you are Medicare entitled. It is recommended that you contact our office as soon as you receive your Medicare card. For more information on qualifying events, please contact Employee Benefits. MONTHLY PREMIUMS NON-MEDICARE PLANS (UNDERAGE 65) PLANT I PLAN 2 Medical/Mental Health Anthem Blue Cross HDPPO Kaiser Permanente Prescription Anthem Blue Cross Kaiser Permanente Vision Vision Service Plan (VSP) Kaiser Permanente Dental Plans Delta Dental DeltaCare USA Delta Dental DeltaCare USA or or DPPO DHMO DPPO DHMO RETIREE COST RETIREE COST Retiree Only , SpouseRetiree + 0, MEDICARE PLANS (AGE 65 AND OVER) PLAN 3 PLANT 4 PLAN 5 Medical/Mental Health Hartford/Benistar Kaiser Permanente High Kaiser Permanente Low Prescription Express Scripts Kaiser Permanente Kaiser Permanente Vision Vision Service Plan (VSP) Kaiser Permanente Kaiser Permanente Dental Plans Delta DeltaCare Delta DeltaCare Delta DeltaCare Dental DPPO or USA DHMO Dental DPPO or USA DHMO Dental DPPO or USA DHMO RETIREE COST RETIREE COST RETIREE COST Retiree • i Not all Retiree rate categories are included in this comparison sheet. Please contact Employee Benefits at (559) 600-1810 if your situation is not identified. RFP 964-5439 Attachment G Page 5 As a retiree, the health benefits available to you provide important protection for you and your family in case of illness or injury. The County offers a series of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format, to help you compare options. The SBC is available on the web at www.co.fresno.ca.us/summarybenefits. A paper copy is also available, free of charge, by calling Employee Benefits at (559) 600-1810. NON-MEDiCAKE MEDICAL & YKESCRIPTION COVERAGE ...................................................................................... ANTHEM BLUE CROSS HDPPO KAISER PERMANENTE IN-NETWORK OUT-OF-NETWORK Individual Deductible $1,500 Calendar Year $1,500 Calendar Year $0 Family Deductible $3,000 Calendar Year $3,000 Calendar Year $0 Individual Annual $3,000 $10,000 $1,500 Out-of-Pocket Max* Family Annual $5,000 $15,000 $3,000 Out-of-Pocket Max* Preventive Care $0 40%After Deductible $0 Office Visit Copay 20%After Deductible 40%After Deductible $15 Emergency Room Visit 20%After Deductible 40%After Deductible $100 Inpatient 20%After Deductible 40%After Deductible $0 X-ray and Lab 20%After Deductible 40%After Deductible $0 Allergy Testing 20%After Deductible 40%After Deductible $15 Chiropractic 20%After Deductible 40%After Deductible $10 Hearing Aid (1 Aid Per Ear 20%After Deductible 40%After Deductible $1,000 Allowance Per Ear Every 3 Years) Mental Health Inpatient 20%After Deductible 40%After Deductible $0 Mental Health Outpatient 20%After Deductible 40%After Deductible $15 Generic Prescription 20%After Deductible 40%After Deductible $10 Preferred/Brand 20%After Deductible 40%After Deductible $20 Prescription Non-Preferred Prescription 20%After Deductible 40%After Deductible N/A *Includes Deductible and Rx This chart is only a summary of benefits. Please see the Evidence of Coverage(EOC)for a full description of benefits. If there are any discrepancies between this summary and the EOC, the EOC will prevail. EL &_ RFP 964-5439 Attachment G MEDICARE MEDICAL & PRESCRIPTION COVERAGE ........................................................................................ Over the years, you've learned what is best for you and your family. That is why the County of Fresno offers three (3) different Medicare medical plans to allow you to select the coverage that best meets your needs. The Hartford plan is supplemental to your Medicare coverage and helps pay the Medicare-eligible deductibles, copayments and out-of-pocket medical expenses not covered by Medicare. Kaiser Permanente High and Low Options are Senior Advantage plans that serve as a private insurance alternative to Original Medicare and allow you to get all your Part A and Part B benefits through one plan. It is important to note that the Medicare plans require you to have Medicare Parts A and B. The County Medicare plans have prescription drug coverage (Part D) included. Therefore, if you enroll in one of these Medicare plans, do not sign up for another Part D program as this will cancel your coverage through the County of Fresno. ARTFORD/BENISTAR & KAISER PERMANENTE KAISER PERMANENTE EXPRESS SCRIPTS HIGH OPTION Low OPTION Preventive Care $0 $0 $0 Office Visit Copay $0 $15 $15 Emergency Room Visit $0 $50 $50 Inpatient $0 $0 $0 X-ray and Lab $0 $0 $0 Allergy Testing $0 $15 $15 Chiropractic $0 $10 $10 Hearing Aid (1 Aid Per Ear Not Covered $1,000 Allowance Per Ear $1,000 Allowance Per Ear Every 3 Years) Mental Health Inpatient $0 $0 $0 Mental Health Outpatient $0 $15 $15 Generic Prescription $10 $5 for 100 Day Supply $10 for 30 Day Supply Preferred/Brand $20 $20 for 100 Day Supply $25 for 30 Day Supply Prescription Non-Preferred Prescription $30 N/A N/A This chart is only a summary of benefits. Please see the Evidence of Coverage(EOC)for a full description of benefits. If there are any discrepancies between this summary and the EOC, the EOC will prevail. RFP 964-5439 Attachment G Page 7 DENTAL / ORTHODONTIC COVERAGE ...................................................................................... Good oral hygiene is important to your overall health. The County of Fresno offers two (2) choices in dental plans: Delta Dental DPPO, which is a fee-for-service plan with the best discounts provided within the Delta Dental DPPO network; and DeltaCare USA DHMO which has set copays for services when provided by your primary care dentist. The DeltaCare USA DHMO has far fewer providers, but costs less than Delta Dental DPPO. DELTA DENTAL DPPO DELTACARE USA DHMO Annual Deductible $50 Per Person/$150 Per Family No Deductible Maximum Benefits $2,500 Per Person Per Year No Annual Maximum Preventive Services 0%PPO Provider/10%Non-PPO Provider $0 Most Services $0 Most Services Basic Services 10% PPO Provider/ 10% Non-PPO Provider *Copay may be required for upgraded materials/services Major Services (Includes Periodontic, $0 Most Services Endodontic, and Oral 50% *Copay may be required for Surgery) upgraded materials/services Orthodontia Child $1,660 Copay $1,700 Copay Adult $1,880 Copay $1,900 Copay Once per lifetime Pre-and post-treatment services Max 24 months of treatment have additional copayments VISION COVERAGE .......................................... If you are in an Anthem health plan, your vision insurance is through Vision Service Plan (VSP). Eye exams support eye health and overall health. It is important to have an exam once a year to make sure that your eyes are healthy. .V-NETWORK OUT-OF-NETWORK Exam Copay/Frequency $10/Every 12 Months Up to$45/Every 12 Months Contact Allowance/Frequency $150/Every 12 Months Up to$105/Every 12 Months Frame Allowance/Frequency $150/Every 24 Months Up to$70/Every 24 Months Lenses Copay/Frequency Single Vision $0/Every 12 Months Up to$30/Every 12 months Lined Bifocal $0/Every 12 Months Up to$50/ Every 12 Months Lined Trifocal $0/Every 12 Months Up to$65/ Every 12 Months Standard Progressive $55/Every 12 Months Up to$50/every 12 Months Kaiser Permanente members receive a $175 allowance for Optical Eyewear every 24 months. Members must access services at a Kaiser facility, unless otherwise approved by Kaiser. COUNTY OF FRESNO Personnel Services Department Employee Benefits Division ` aaao Tulare Street, 14th Floor Fresno, CA 937Z1 OPEN ] OCTOBER 28, 2015 - NOVEMBER • If you need further information, please contact the plans listed below: NON-MEDICARE MEDICAL MEDICARE MEDICAL ANTHEM BLUE CROSS HDPPO HARTFORD / BENISTAR Group Number 275341M760/ Phone (866) 207-9878 Group Number AGP-3829/ Phone (800) 236-4782 www.anthem.com/ca www.benistar.com KAISER PERMANENTE KAISER PERMANENTE SENIOR ADVANTAGE HIGH Group Number 580-0001/ Phone (800) 464-4000 Group Number 604334-0000/ Phone (800) 443-0815 www.kaiserpermanente.org www.kaiserpermanente.org DENTAL KAISER PERMANENTE SENIOR ADVANTAGE LOU DELTA DENTAL DPPO Group Number 604334-0001/ Phone (800) 443-0815 Group Number 05879-00002/ Phone (800) 765-6003 www•kaiserpermanente.org www.deltadentalins.com VISION DELTACARE USA DHMO VISION SERVICE PLAN (VSP) Group Number 06744-00002/ Phone (800) 422-4234 Group Number 30028675 / Phone (800) 877-7195 www.deltadentalins.com www.vsp.com RFP 964-5439 Attachment H OPTN N '� •C � I I II\ \ o isg6 0 IX NOVEMBER 13, 2015 ;0911 %...* OBRA PLAN YEAR 2016 a I '� lolrun1111 loll al ' Ithi as nunn■ I • -46 if%:7 ,s I RFP 964-5439 Attachment H TABLE OF CONTENTS CO T T Dates to Remember.........................................................................2 lJ Frequently Asked Questions...................................................3 MonthlyPremiums.............................................. Medical Coverage............................................................6 Prescription Coverage.....................................................6 O1856 Dental Coverage................................................................7 Vision Coverage.......................................................................7 RE Health Plan Contact Information..................................Back Cover DATES TO REMEMBER October October November Pe w IL OPEN HEALTH & OPEN NEW ENROLLMENT WELLNESS ENROLLMENT PLAN YEAR BEGINS FAIR ENDS BEGINS ^ rr WEDNESDAY, OCTOBER 28, 2015 7:30 am — 2:00 pm MCounty Plaza Building Ballroom HULTH ELLNE FA2220 Tulare St, Fresno, CA 93721 ANY QUESTIONS? Please contact Employee Benefits at (559) 600-1810 or email us at Personnel- Benefits@co.fresno.ca.us. Additionally, you can visit our Open Enrollment website at www.co.fresno.ca.us/openenrollment. The site is very informative and includes detailed summaries, provider information, rates, forms and much more! RFP 964-5439 Attachment H Page 3 Elk- fwr, LJENTT,YAz5t(17n OUESTiomS What is Onen Enrollment? Open Enrollment is the one time during the year that you may make changes to your health insurance plans and add dependents without a qualifying event for the 2016 plan year. Please note: dependents may be deleted without a qualifying event at any time during the plan year. What changes are there for plan year z016: There are no health plan changes for the 2016 plan year. If you do not wish to make any changes to the health insurance plans you are currently enrolled in, no action is required on your part. How do I make changes to my health insurance plan Complete the applicable form(s) and submit to Employee Benefits, along with any required supporting documents via: ♦ Email: Person nel-Benefits@co.fresno.ca.us ♦ Fax: (559) 455-4787 ♦ In person or USPS mail: 2220 Tulare Street, 14th Floor, Fresno, CA 93721 Please note: All forms and supporting documents must be received by Employee Benefits no later than 5:00pm on Friday, November 13, 2015. Employee Benefits is not responsible for forms sent through USPS mail that are lost or delayed and therefore not received by the deadline. It is your responsibility to ensure that all forms and supporting documents, if applicable, are received by the deadline. In order to confirm receipt of forms and/or supporting documents, please contact Employee Benefits at (559) 600-1810 or email Personnel-Benefits@co.fresno.ca.us. JUho is eligible t, jc %.Vvc,cu my health insurance plan Below is a list of eligible dependents and supporting documents required to add them to your health insurance plan. Dependent children are eligible until they reach 26 years of age. ELIGIBLE DEPENDENTS REQUIRED DOCUMENTS) Spouse* A copy of the Certified Marriage Certificate Registered Domestic Partner A copy of the Declaration of Domestic Partnership filed with the California Secretary of State Child A copy of the Certified Birth Certificate Adopted Child A copy of the Adoption Order or the Certified Birth Certificate A copy of the Certified Birth Certificate and a copy of the Certified Stepchild Marriage Certificate or Declaration of Domestic Partnership showing your spouse or registered domestic partner as the child's parent Child of Legal Guardianship A copy of the Letters of Guardianship filed with the courts Please note: The required documents listed above must be submitted each time a dependent is added to your health insurance, regardless if the dependent has been covered under your plan previously. Continued on next page *The term"spouse" includes same-sex spouses, pursuant to IRS Revenue Ruling 2013-17. RFP 964-5439 Attachment H Page 4 Continued from previous page When do Open Enrollment changes take effect? Any changes you make during Open Enrollment will take effect on January 1, 2016. New payment coupons will be mailed out in November. Can I make changes to my health insurance plan once Open Enrollment closes? Once Open Enrollment closes, you will not be permitted to enroll or make any changes until the next Open Enrollment period, unless you experience a qualifying event (e.g. marriage, becoming Medicare eligible, etc.), as defined by the IRS. If you experience a qualifying event, you must submit the required documentation to Employee Benefits within thirty (30) days of the qualifying event date. For more information on qualifying events, please contact Employee Benefits. COBRA The Consolidated Omnibus Budget Reconciliation Act (COBRA) is the Federal Law that allows you and/or your covered dependent(s) the opportunity to continue your health insurance coverage when you experience a qualifying event resulting in a loss of coverage. Coverage is continued at the same benefit level immediately preceding the qualifying event; however, you and/or your covered dependent(s) will assume the full premium cost. You and/or your covered dependent(s) are eligible for up to thirty-six (36) months of COBRA coverage; with the first eighteen (18) months covered under Federal COBRA, and the second eighteen (18) months covered under Cal-COBRA. Federal COBRA and Cal-COBRA coverage can be canceled at any time. However, once terminated, you are no longer eligible to re-elect coverage under COBRA. If you are retired from the County, you can enroll in a County retiree plan within thirty (30) days of the termination date or choose to seek other coverage. Once active coverage terminates, you and/or your covered dependent(s) have sixty (60) days to elect COBRA coverage. COBRA premiums are paid on a monthly basis to the County of Fresno's third party administrator, Administrative Solutions Inc. (ASI). The County offers a series of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format, to help you compare options. The SBC is available on the web at www.co.fresno.ca.us/ summarybenefits. A paper copy is also available, free of charge, by calling Employee Benefits at (559) 600- 1810. Administrative Solutions Inc. (ASI) Phone: (559) 256-1320 Address: 555 W. Shaw Ave #C1, Fresno, CA 93704 Website: www.asibenefits.com RFP 964-5439 Attachment H Page 5 FEDERAL COBRA PREMIUMS ..................0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000 Participant Participant + Participant Participant+ Only Spouse Children) Family Anthem Blue Cross HMO Delta Dental DPPO $763.57 $1,338.95 $1,183.18 $1,758.44 Anthem Blue Cross PPO Delta Dental DPPO $979.22 $2,022.50 $1,831.37 $2,783.71 Anthem Blue Cross HDPPO $567.94 $1,168.69 $1,047.77 $1,587.91 Delta Dental DPPO Kaiser Permanente $729.69 $1,279.87 $1,131.03 $1,681.18 Delta Dental DPPO Anthem Blue Cross HMO $737.82 $1,300.98 $1,156.03 $1,717.40 DeltaCare USA DHMO Anthem Blue Cross PPO $953.47 $1,984.52 $1,804.22 $2,742.68 DeltaCare USA DHMO Anthem Blue Cross HDPPO $542.18 $1,130.71 $1,020.62 $1,546.87 DeltaCare USA DHMO Kaiser Permanente $703.93 $1,241.89 $1,103.87 $1,640.15 DeltaCare USA DHMO CAL-t..OBRA PREMIUMS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0*0*0*0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Participant Participant + Participant + Participant + Only Spouse Child(ren) Family Anthem Blue Cross HMO $759.90 $1,340.96 $1,184.60 $1,762.27 Anthem Blue Cross PPO $992.46 $2,078.11 $1,883.63 $2,867.95 Anthem Blue Cross HDPPO $548.92 $1,157.33 $1,038.58 $1,578.36 Kaiser Permanente $653.14 $1,162.63 $1,027.02 $1,533.69 Note: Cal-COBRA coverage excludes dental and vision coverage. The County does not offer separate dental and vision coverage; however, retired employees may contact REFCO at (559) 456-2697 or visit their website REFCO.org for information on other plans that may be available to them. EL I RFP 964-5439 Attachment H Page 6 MEDICAL COVERAGE ................................................ Choosing a medical plan that is right for you and your family is an important decision. The County of Fresno offers four (4) different plans to allow you to select the coverage that best meets your needs. ANTHEM BC HMO ANTHEM BC PPO ANTHEM BC HDPPO KAISER PERMANENTE (IN-NETWORK) (IN-NETWORK) Individual Deductible $0 $250 Plan Year $3,000 Calendar Year $0 Family Deductible $0 $500 Plan year $6,000 Calendar Year $0 Preventive Care $0 $0 $0 $0 Office Visit Copay $15 $20 $0 After Deductible $15 Emergency Room Visit $100 $100 $0 After Deductible $100 Inpatient $0 $0 $0 After Deductible $0 X-ray and Lab $0 $0 $0 After Deductible $0 Allergy Testing $0 $0 $0 After Deductible $15 Chiropractic $10 $0 $0 After Deductible $10 Mental Health Inpatient $0 $0 $0 After Deductible $0 Mental Health Outpatient $15 $20 $0 After Deductible $15 This chart is only a summary of benefits. Please see the Evidence of Coverage(EOQ for a full description of benefits. If there are any discrepancies between this summary and the EOC, the EOC will prevail. PRESCRIPTION COVERAGE ............................................................. Under US Script, you may receive prescriptions through major pharmacies including, but not limited to: CVS, Walmart, Costco, Target and in-network independent pharmacies. You can also fill your ninety (90) day prescription at any of the following chains: CVS, Walmart, Walgreens, and Rite Aid. US SCRIPT US SCRIPT ANTHEM BLUE CROSS KAISER PERMANENTE AGenis $10 $10 $0 After Deductible $10 Preferred/Brand $20 $20 $0 After Deductible $20 Non-Preferred $35 $35 $0 After Deductible N/A A��RRFP 964-5439 Attachment H Page 7 DENTAL / ORTHODONTIC COVERAGE -.......-- - - - - - - - - .......... - ...................... ....... .................... - - Good oral hygiene is important to your overall health. The County of Fresno offers two (2) choices in dental plans: Delta Dental DPPO, which is a fee-for-service plan with the best discounts provided within the Delta Dental DPPO network; and DeltaCare USA DHMO which has set copays for services when provided by your primary care dentist. The DeltaCare USA DHMO has far fewer providers, but costs less than Delta Dental DPPO. DELTA DENTAL DPPO DELTACARE USA DHMO Annual Deductible $50 Per Person/$150 Per Family No Deductible Maximum Benefits $2,500 Per Person Per Year No Annual Maximum Preventive Services 0%PPO Provider/10%Non-PPO Provider $0 Most Services $0 Most Services Basic Services 10%PPO Provider/ 10% Non-PPO Provider *Copay may be required for upgraded materials/services Major Services $0 Most Services (Includes Periodontic, Endodontic, and Oral 50% *Copay may be required for upgraded materials/services Surgery) Orthodontia Child $1,660 Copay $1,700 Copay Adult $1,880 Copay $1,900 Copay Once per lifetime Pre-and post-treatment services Max 24 months of treatment have additional copayments VISION COVERAGE .......................................... If you are in an Anthem health plan, your vision insurance is through Vision Service Plan (VSP). Eye exams support eye health and overall health. It is important to have an exam once a year to make sure that your eyes are healthy. IN-NETWORK OUT-OF-NETWORK Exam Copay/Frequency $10/Every 12 Months Up to$45/Every 12 Months Contact Allowance/Frequency $150/Every 12 Months Up to$105/Every 12 Months Frame Allowance/Frequency $150/Every 24 Months Up to$70/Every 24 Months Lenses Copay/Frequency Single Vision $0/Every 12 Months Up to$30/Every 12 months Lined Bifocal $0/Every 12 Months Up to$50/ Every 12 Months Lined Trifocal $0/Every 12 Months Up to$65/ Every 12 Months Standard Progressive $55/Every 12 Months Up to$50/every 12 Months Kaiser Permanente members receive a $175 allowance for Optical Eyewear every 24 months. Members must access services at a Kaiser facility, unless otherwise approved by Kaiser. COUNTY OF FRESNO Personnel Services Department Employee Benefits Division ` aaao Tulare Street, 14th Floor Fresno CA 937Z1 OPEN ]ENROLLMENT OCTOBER 28, 2015 - NOVEMBER • If you need further information, please contact the plans listed below: MEDICAL VISION ANTHEM BLUE CROSS VISION SERVICE PLAN (VSP) HMO Group Number 275341H006/ Phone (800) 888-8288 Group Number 30028675 / Phone (800) 877-7195 PPO Group Number 275341M455/ Phone (800) 888-8288 www.vsp.com HDPPO Group Number 275341M666/ Phone (866) 207-9878 www.anthem.com/ca PRESCRIPTION KAISER PERMANENTE US SCRIPT Group Number 580-7002 / Phone (800) 464-4000 Group Number 202720/ Phone (866) 264-4161 www.kaiserpermanente.org www.usscript.com DENTAL DELTA DENTAL DPPO Group Number 05879-00003 / Phone (800) 765-6003 www.deltadentalins.com DELTACARE USA DHMO Group Number 06744-00003 / Phone (800) 422-4234 www.deltadentalins.com COUNTY OF FRESNO ADDENDUM NUMBER: ONE (1 ) RFP NUMBER: 964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES Issue Date: March 8, 2016 IMPORTANT: SUBMIT PROPOSAL IN SEALED PACKAGE WITH PROPOSAL NUMBER, CLOSING DATE AND BUYER'S NAME MARKED CLEARLY ON THE OUTSIDE TO: COUNIYOF FRESNO,PURCHASING 4525 EAST I IANILTON AVENUE,2"d Floor FRESNO,CA 93702-4599 CLOSING DATE OF PROPOSAL WILL BE AT 2:00 P.M., ON MARCH 2212 PROPOSALS WILL BE CONSIDERED LATE WHEN THE OFFICIAL PURCHASING TIME CLOCK READS 2:00 P.M. All proposal infonnation will be available for review after contract award. Clarification of specifications is to be directed to: Nick Chin, phone (559) 600-7113 or e-mail CountyPurchasin�4(cr)co.fresno.ca.us. NOTE THE FOLLOWING AND ATTACHED ADDITIONS, DELETIONS AND/OR CHANGES TO THE REQUIREMENTS OF REQUEST FOR PROPOSAL NUMBER: 964-5439 AND INCLUDE THEM IN YOUR RESPONSE. PLEASE SIGN IN BLUE INK AND RETURN THIS ADDENDUM WITH YOUR PROPOSAL. ➢ The Bid Closing has been moved to March 22, 2016 at 2:00 P.M. PST ACKNOWLEDGMENT OF ADDENDUM NUMBER One (1) TO RFP 964-5439 COMPANY NAME: (PRINT) SIGNATURE (In BlueH,): NAME & TITLE: (PRINT) Purchasing Use:NC:ssj ORG/Requisition:89250200/8921600150 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC (10/2015) Addendum No. One (1) Page 2 Request for Proposal Number: 964-5439 March 8, 2016 QUESTIONS AND ANSWERS Q1. Is the County currently satisfied with the services provided by the current broker/consultant? A1. This is not relevant to the RFP. Q2. What qualities does the County value most in working with a broker/consultant partner? A2. The County values responsiveness to ad hoc issues that arise, open and honest communication between the consultant and staff, and knowledge of the complex issues facing entities similar to the County. Q3. Does the current broker receive compensation in addition to the flat fee disclosed in the RFP? (commissions or other forms of compensation) A3. Yes—the broker/consultant may receive commissions from voluntary benefit options;however, total compensation is not to exceed$80,000 per year. Q4. What is the total annual compensation amount paid to the current Broker/Consultant? A4. $45,000 plus commissions from voluntary benefit options. Total compensation, including commissions, is not to exceed$80,000 per year. Commissions that exceed this amount are used to offset the $45,000 consulting fee. Q5. Does the County currently participate in any wellness programs or initiatives? If so, please describe. A5. The County's wellness plan is administered in-house. A monthly calendar with a specific wellness focus is emailed to employees. The County also provides on-site mammograms and participates in an annual walking challenge with other SJVIA entities. Q6. How does the County handle enrollment? It appears that it is currently handled through both PeopleSoft online and paper enrollments A6. This is correct. Q7. As it relates to "RFP and Contract Development", is the County seeking only direct contract arrangements with vendors in the event that it exits the SJVIA? AT The County will consider all feasible options for current and future benefits, including the SJVIA. Q8. As it relates to "RFP and Contract Development", is the County considering other pooled purchasing options in the event that it exits the SJVIA? A8. The County will consider all feasible options for current and future benefits, including the SJVIA. Q9. Does the County have an established Benefits communication strategy? If so, what does the strategy entail? A9. The County uses email and standard mail, as well as our website to disseminate information regarding employee benefits. However, the County is open to, and would expect the consultant/broker to assist in crafting a robust communication strategy. Q10. Will the Broker/Consultant be responsible for drafting open enrollment materials and other participant communications? Will the printing and mailing of these materials be required under this contract? A10. The broker/consultant would be expected to provide input and assistance in drafting open enrollment and other communication materials. The County does not expect the broker/consultant to print or mail these materials. GRUBLIOR"TY2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD LDOC Addendum No. One (1) Page 3 Request for Proposal Number: 964-5439 March 8, 2016 Q11. What are the planned major activities for 2016-2017? A11. On-site mammograms will be offered to employees in April. "Walking Works"is a week-long walking challenge that is planned for May where County employees compete against other SJVIA entities. Open Enrollment is held in October. Q12. What are the top three Health and Benefit issues facing the County? A 12. The County is facing increased premiums due to lifestyle claims (obesity and diabetes) and specialty drugs. Q13. What are the amounts of annual commission for 2013, 2014, and 2015 for the voluntary plans? A13. The County began offering commission-eligible voluntary benefit plans in 2015. To date, our broker/consultant has stated that they are not able to provide commission information to the County. Q14. Are all of the County's Health and Welfare benefit plans currently net of commissions? A14. The commission schedule for the County's Health and Welfare benefit plans are as follows: • Future commissions from the universal life, disability and critical illness policies through Trustmark may be reassigned. The commissions are as follows: o Universal Life: 5%per year o Disability. 6%per year o Critical Illness: 11%per year • The commissions on the current life insurance policies through CSAC-EIA and the personal property insurance policies though Liberty Mutual are not able to be reassigned. • The long-term disability insurance policy through Met Life is not subject to commissions. • The medical, dental, vision, and prescription drug plans are not subject to commissions. Q15. Does the current broker receive any commissions for medical, dental,vision, and prescription drug plans? If yes, what are the annual amounts for 2013, 2014, and 2015? A15. The medical, dental, vision, and prescription drug plans are not subject to commissions. Q16. Are there any consulting service issues the County is looking to improve upon with the issuance of this RFP? A16. See the answer to Question #2. Q17. Is this RFP being released due to procurement policy (required after a set number of years)? A17. This is not relevant to the RFP Q18. Over the past two plan years, what were the total dollars paid to the current brokers/consultants for Health and Welfare Benefit Consulting? A 18. The County paid the current vendor a total of$90,000 for 2014 and 2015 ($45,000 each year). The current vendor received an additional$35,000 in commission-based income for 2015. Q19. Over the past two plan years, what was the average number of service/consulting hours recorded to service the County? A 19. An hour or two per week. During contract and rate reviews, it will increase to approximately five to six hours per week. GRUBLIGR"TY2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD LDOC Addendum No. One (1) Page 4 Request for Proposal Number: 964-5439 March 8, 2016 Q20. When is the last time each of the County's benefit plans were competitively bid in a formal RFP process? How often does the County typically conduct RFPs for each of its benefits? A20. The health insurance benefits are competitively bid every year. Dental and vision benefits are purchased through the SJVIA and are multi-year contracts. Flexible spending account administration goes out to bid every three to five years, and is in the second year of a maximum five year agreement. Q21. Is the County required (by procurement rules)to bid each coverage within a certain number of years? (How many?) A21. The County's guidelines regarding service agreements are that they are no longer than five years in length (usually set up as a three-year agreement with two, one-year renewals). Q22. What is the average number of total onsite meetings specified by type and quantity(Meetings with County Staff, Board of Supervisors, committees, employee organizations, and other meetings)the consultant/broker should plan to attend annually? How many hours are each of the types of meetings? Please specify the number of"known" meetings and separately estimate the "unknown" meetings. (Detailed meeting information will allow us to provide the most accurate and competitive pricing.) A22. Annual meetings: a.Attend four quarterly meetings of the Health Benefits Advisory Committee. These meetings are approximately two hours each. b.Attend meetings of the San Joaquin Valley Insurance Authority(SJVIA) as needed(one or two meetings per year). These meetings are approximately two hours each. c. Attend bi-monthly meetings with the County and its vendors (approximately six per year). d. The County does not anticipate that there will be additional on-site meetings required of the consultant, unless there is an extraordinary event. Q23. When was the last time a claims audit was performed for each of the self-insured plans? A23. The County has not performed a claims audit. Q24. What Open Enrollment support is necessary? Who currently creates the Open Enrollment booklets? Would the consultant be required to create (including graphics, etc.)the employee booklets, or only perform technical reviews of booklets? Does it mean creating and delivering the presentations? A24. The County currently creates the Open Enrollment materials in-house. The consultant would be expected to provide input and assistance in drafting open enrollment and other communication materials. The consultant would not be expected to deliver presentations. Q25. What department within the County is responsible for benefit communications? A25. The Employee Benefits division of the Personnel Services Department. Q26. What support with the development of plan documents is necessary?Will the broker/consultant be asked to create revised documents from scratch, or only perform consultative and technical reviews? A26. The consultant is expected to review the existing plan documents and provide feedback on areas that need to be updated. In addition, the consultant is expected to help the County interpret provisions of the plan document based on their knowledge of applicable laws and regulations and industry best practices. Q27. Does the current broker receive any commissions for medical, dental, vision, and prescription drug plans? If yes, what is the annual amount? A27. The medical, dental, vision, and prescription drug plans are not subject to commissions. G:\PUBLIC\RFP\FY2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD LDOC Addendum No. One (1) Page 5 Request for Proposal Number: 964-5439 March 8, 2016 Q28. Does the County have a Benefits Committee? Would the consultant be asked to attend those meetings? If yes, how often do they meet and how long are the meetings? A28. The County has a Health Benefits Advisory Committee, which consists of one representative from each County bargaining unit, as well as retiree and management members. The consultant is expected to attend four quarterly meetings per year. Q29. If the consultant is required to issue an RFP, is there a public procurement procedure that must be adhered to, and what is that procedures? A29. For the health, dental, vision, and prescription benefits, as well as other voluntary benefits, the County has waived the procurement rules in the past, although that practice is subject to change. In selecting a flexible spending account administrator, the County has utilized the standard procurement process. For more information on the County's procurement process, please visit the County Purchasing website at http://www.co.fresno.ca.us/DepartmentPage.aspx?id=15075. Q30. May the bid include an isolated charge per RFP in its bid under retainer services such that fees would be lower if an RFP is not issued and each RFP would be billed at a separate amount? A30. Yes, although if this is the case, please thoroughly detail what your fees are for each RFP process and for ongoing consulting services. Q31. What are the current employer contributions for the Employee Benefits plans? Rates on the open enrollment paperwork for Active employees (page 73 of attachment) indicate that the rates listed on that page are not the 2016 rates, and states that 2016 rates including County Contribution will be available. The Bi-weekly rates are included (page 66), but don't indicate employee contribution. Can you update the rates with the employee contribution? A31. The contribution rates were confirmed by the Board of Supervisors after the creation of the Attachment F. Therefore, the employee contribution rates on Page 73 are correct. Q32. What is the County's current budget for Employees Benefits communications? A32. The County does not have a budget specifically for communications. Q33. Specifically what advice, tools or assistance has been provided by the current Broker Consultant to comply with the Affordable Care Act including IRS 1064 and 1065 reporting in 2015 and 2016? A33. The current consultant has provided reporting tools, FAQ's and general advice. Q34. What is the County's current GASB 45 OPEB Liability? A34. The County does not have liability under GASB 45 OPEB, as we separated retiree benefits from our active employee benefits. Q35. Is the current vendor compensated by commissions? A35. The current vendor is partially compensated by commissions. See answers to Questions#3 and#4. Q36. Does the current vendor receive a service fee? A36. Yes-$45,000 per year. Q37. Does the current vendor intend to submit a bid on the RFP? A37. The current vendor is free to submit a bid on this RFP. Q38. Is there a budget for consultant compensation? A38. The County does not have a budget specifically for consulting services. G:\PUBLIC\RFP\FY2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD LDOC Addendum No. One (1) Page 6 Request for Proposal Number: 964-5439 March 8, 2016 Q39. Can two firms collaborate on a single bid? A39. The County will consider bids from a firm subcontracting certain responsibilities to a different firm. However, the bidding/winning firm would be considered the main point of contact and would be expected to facilitate the transfer of information or services from the subcontracted firm to the County. Q40. Does the County of Fresno have a local vendor preference? A40. Yes, the County of Fresno does have a local vendor preference. However, it does not apply to this RFP. G:\PUBIIC�RFP\FY2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD LDOC Exhibit B NUMBER:COUNTY OF FRESNO REQUEST FOR PROPOSAL 5439_ BENEFITSEMPLOYEE Issue Date: February 6, 2016 Closing ate® MARCH 10, 2016 Proposal will be considered LATE when the official Purchasing time clock reads 2:00 P.M. Questions regarding this RFP should be directed to: Nick Chin, phone(559)600-7113 or e-mail e n ytEr lasirr ertc .ca.tr . Check County of Fresno Purchasing's website at for any future addenda. Please submit all Proposals to: County of Fresno-Purchasing 4525 E. Hamilton Avenue, 2"d Floor Fresno, CA 93702-4599 BIDDER TO COMPLETE Undersigned agrees to furnish the commodity or service stipulated in the attached response at the prices and terms stated,subject to the attached "County of Fresno Purchasing Standard Instructions And Conditions For Requests For Proposals(RFP's)And Requests For Quotations(RFQ's)". Keenan &Associates COMPANY 2355 Crenshaw Blvd., Suite 200 ADDRESS Torrance CA 90501 CITY STATE ZIP CODE 800.654.8102 310.212.0333 kpippard@keenan.com TELEPHONE NUM FACSIMILE NUMBER E-MAILADDRESS t SIGNA E(ItV BLUE INK) Keith Pippard Corporate Secretary PRINT NAME TITLE PURCHASING USE:NC:ssj ORG/Requisition:8925020018921600150 G:1PublicIRFPIFY 2015-161964-5439 Employee Benefits Consultant Services1964-5439 Employee Benefits Consultant Services.doc PD-040(1112015) COUNTY OF FRESNO NUMBER: ADDENDUM ONE (1 ) RFP NUMBER: 964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES Issue Date: March S, 2016 IMPORTANT: SUBMIT PROPOSAL IN SEALED PACKAGE WITH PROPOSAL NUMBER,CLOSING DATE AND BUYER'S NAME MARKED CLEARLY ON THE OUTSIDE TO: COUNTY OF FRESNO, PURCHASING 4525 EAST HAMILTON AVENUE, 2nd Floor FRESNO, CA 93702-4599 1CLOSING DATE OF PROPOSAL WILL SE AT :00 P.M., ON MARCH 229 20 PROPOSALS WILL BE CONSIDERED LATE WHEN THE OFFICIAL PURCHASING TIME CLOCK READS 2:00 P.M. All proposal information will be available for review after contract award. Clarification of specifications is to be directed to: Nick Chin, phone (559) 600-7113 or e-mail CountyPurchasing@co.fresno.ca.us. NOTE THE FOLLOWING AND ATTACHED ADDITIONS, DELETIONS AND/OR CHANGES TO THE EQUIREMENTS OF REQUEST FOR PROPOSAL NUMBER: 964-5439 AND INCLUDE THEM IN YOUR RESPONSE. PLEASE SIGN IN BLUE INK AND RETURN THIS ADDENDUM WITH YOUR PROPOSAL. The Bid Closing has been moved to March 22, 2016 at 2:00 P.M. PST ACKNOWLEDGMENT OF ADDENDUM NUMBER One (11 TO RFP 964-5439 COMPANY NAME: Keenan &Associates (PRINT) SIGNATURE (In Blue Ink): V Ilk NAME & TITLE: �h ippard, Corporate Secretary (PRINT) Purchasing Use:NC:ssj ORGIRequisition:89250200/8921600150 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC (10/2015) 2355 Crenshaw Blvd. 310.212.3344 Keenan Suite 200 310.328.6793 fax Main Torrance,CA 90501 www.keenan.com A` °` `° ''`� License#0451271 T March 21, 2016 Mr. Nick Chin Purchasing Manager County- of Fresno—Purchasing 4525 E. Hamilton avenue 2nd Floor Fresno, Ca 93702-4599 RE: RFP No. 964-5439 for Employee Benefits Consultant Services Dear Mr. Chun: Keenan & Associates is pleased to present our Proposal to provide Employee Benefits Consultant Services to the County of Fresno. We are confident that our forty-four year history as a niche insurance brokerage and consulting firm that was founded to serve the unique needs of California public agencies makes us the most experienced and capable agency to address the insurance needs of Fresno County. Keenan is confident that the unbiased technical expertise we provide together with our understanding of how to manage Public Agency Employee Benefits Joint Powers Authorities OPAs) will exceed the requirements outlined in the scope of services listed 111 the County RFP. Most insurance brokerage and consulting firms have some public agency clients. Keenan is unique in that it was founded and has developed into the largest privately held brokerage firm in California by serving the unique needs of California public agencies and JPAs. In order to present the County-of Fresno with a best-value solution—providing a high level of service,while remaining cognizant of the value of the taxpayer dollar—we have enlisted the support of Buckman-Mitchell, Inc. as our subcontractor, as detailed in this proposal. Together, Keenan & Associates and Buckman- Mitchell, Inc. are confident that we can provide the County with unparalleled service and innovative solutions for your benefits program. Keenan's JPA experience is uniquely qualified to work in the County's behalf without any conflict of interest. We are concerned that your current consulting agreement that allows you to receive compensation when there are voluntary- commissions over a certain amount is illegal. We have offered an alternative that should meet your objective. Keenan & Associates is a corporation, incorporated in California in 1972. This letter is signed by Keith Pippard, Corporate Secretary for Keenan, who is authorized to bind Keenan to a contract with the County. Additionally, Steve Gedestad, Municipality Practice Leader, is authorized to sign a contract on behalf of Keenan. Questions regarding this proposal should be directed to Steve Gedestad at 800.338.5247, ext. 5160 or e-mail or, Howell Southmayd at 510.986.6761, ext. 8190 or e-mail at 11sOuthunavd,u:keenari.coin. Both Steve and Howell are authorized to represent Keenan in discussions on this proposal. Sincerely Keith Pippard Corporate Secretary, Keenan &Associates a m" t�. .. —— z:a.�.�....� arras, I. RFP PAGE 1AND ADDENDUM(S)..........................................................................i II. COVER LETTER................... III. TABLE OF CONTENTS ........................................................................................iv IV. CONFLICT OF INTEREST STATEMENT.................................................................1 V. TRADE SECRET....................................................................................................2 VI. CERTIFICATION-DISCLOSURE-ETC.....................................................................4 VII. REFERENCES.......................................................................................................6 VIII. PARTICIPATION...................................................................................................9 IX. EXCEPTIONS ......................................................................................................11 X. VENDOR COMPANY DATA.................................................................................12 XI. SCOPE OF WORK................................................................................................25 PART A—SCOPE OF HEALTH BENEFITS CONSULT_-1TION SERVICES.....................................26 I. Administrative Services....................................................................................................26 IL Data Analysis And Repor ling.........................................................................................42 IILVendor Relations.............................................................................................................44 IV. Actuarial, Underwriting and.Fiscal Support....................................................................47 PART B—SCOPE OF OTHER BENEFIT CONSULTATION SERVICES.........................................49 L Administrative Services....................................................................................................49 ILVendor Relations.............................................................................................................50 XII. COST PROPOSAL................................................................................................52 OPTION1 ........................................................................................................................................52 OPTION2........................................................................................................................................53 XIII. CHECK LIST.......................................................................................................56 VENDOR RESPONSE SECTION.......................................................................................58 REPORTS.......................................................................................................................84 APPENDICES .................................................................................................................85 APPENDIX1....................................................................................................................................86 APPENDIX2....................................................................................................................................96 APPENDIX3..................................................................................................................................110 APPENDIX4..................................................................................................................................129 APPENDIX5..................................................................................................................................135 APPENDIX6..................................................................................................................................139 APPENDIX7..................................................................................................................................141 APPENDIX8..................................................................................................................................144 APPENDIX9..................................................................................................................................150 APPENDIX10................................................................................................................................192 y u o s The Contractor may become Involved in situations [where conflict of interest could occur due to Individual or o.ggwniZational actin"ities that occur within the Corinn': The Contractor must provide a statement addressing the potential, if any, for conflict of interest and indicate plans, if applicable, to address potential conflict of interest. This section will be reviewed by County Counsel for compliance with conflict of interest as part of the retiieiv process. The Contractor shall comply with all federal, state and local conflict ofititerest laws, statutes and regulations. There are no existing or perceived potential conflicts-of-interest that would arise from a contract between Keenan &Associates and the County of Fresno. Furthermore, Keenan will be utilizing the services of a subcontractor, Buckman-Mitchell, Inc. for components of our proposed solution (as detailed throughout this proposal), and Buckman-Mitchell has no existing or perceived potential conflicts-of-interest that would arise from a contract, if Keenan should be awarded. Keenan &Associates, and our subcontractor, will comply with all federal, state and local conflict of interest laws, statutes and regulations. mmw A, Sign where required Keenan's signed Trade Secret form is included on the next page. Proposal No. 964-5439 Page 7 TRADE SECRET ACKNOWLEDGEMENT I have read and understand the above"Trade Secret Acknowledgement." I understand that the County of Fresno has no responsibility for protecting information submitted as a trade secret if it is not delivered in a separate binder plainly marked"Trade Secret." I also understand that all information my company submits, except for that information submitted in a separate binder plainly marked "Trade Secret,"are public records subject to inspection by the public. This is true no matter whether my company identified the information as proprietary, confidential or under any other such terms that might suggest restricted public access. Enter company name on appropriate line: Has submitted information identified as Trade Secrets in (Company Name) a separate marked binder.`* Keenan & Associates Has D.QLsubmitted information identified as Trade (Company Name) Secrets. Information submitted as proprietary confidential or under any other such terms that might suggest restricted public access will not be excluded from treatment as public record. ACKNOWLEDGED BY: 800.654,8102 C. Signature(In Blue Ink) Telephone Keith Pippard, Corporate Secretary March 7, 2016 Print Name and Title Date 2355 Crenshaw Blvd., Suite 200 Address Torrance CA 90501 City State Zip **Bidders brief statement that clearly sets out the reasons for confidentiality in conforming with the California Government Code definition. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Keenan's signed Certification form is included on the next page. Proposal No. 964-5439 Page 10 CERTIFICATION (1) The prospective primary participant certifies to the best of its knowledge and belief,that it, its owners, officers, corporate managers and partners: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State or local)transaction or contract under a public transaction;violation of Federal or State antitrust statutes or commission of embezzlement, theft,forgery, bribery, falsification or destruction of records, making false statements,or receiving stolen property; (c) Have not within a three-year period preceding this application/proposal had one or more public transactions(Federal, State or local)terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: ``� Date: (in blue ink) March 7, 2016 Keith Pippard, Corporate Secretary Keenan & Associates (Printed Name &Title) (Name of Agency or Company) G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc - 4,= , c WIN, ... .. w , Keenan's completed Reference form is included on the next page. Additionally, as we are utilizing the services of Buckman-Mitchell, Inc. as a subcontractor for this proposal, we have included a reference form from them immediately following Keenan's form. Proposal No. 964-5439 Page 11 VENDOR MUST COMPLETE AND RETURN w TH REQUEST FOR PROPOSAL Firm: Keenan &Associates REFERENCE LIST Provide a list of at least five (5)customers for whom you have recently provided similar services. Be sure to include all requested information. Reference Name: City of Clovis Contact: Robert Ford Address: 1033 Fifth Street City: Clovis State.Zip: 93612 Phone No.: (_5 59.324.2840 )Date: 2010 to present Service Provided: Current broker/consultant for all lines of employee benefits coverage including medical,dental,vision,life/AD&D and STD.. Keenan also provides consulting on Health Care Reform issues and the County's award winning Wellness Program. Reference Name: County of Sacramento Contact: Dave Comerchero Address: 700 H Street,#4667 City: Sacramento State:Zip: 95814 Phone No.: (916.874.4529 )Date: 2008 to present Service Provided: Current broker/consultant for all lines of employee benefits coverage including medical,dental,vision,life/AD&D and EAP program. Keenan also provides consulting for Health Care Reform issues and their wellness program. Reference Name: County of Mendocino Contact: Cherie Johnson Address: 501 Low Gap Road, Room 1326 City: Ukiah State:Zip: 95482 Phone No.: ( 707.234.6618 )Date: 2011 to present Service Provided: Current broker/consultant for all lines of employee benefits coverage including medical, dental, vision,stop loss, life/AD&D and E, Keenan also provides consulting on Health Care Reform issues and the County's award winning Wellness Program. Reference Name: City of Berkeley Contact: Margarita Zamora Address: 2180 Milvia Street City: Berkeley State:Zip: 94704 Phone No.: (510.981.6821 )Date: 2009 to present Service Provided: Current broker/consultant providing services for all lines of employee benefit coverage including medical,dental,vision,life/AD&D,disability,EAP p s.125 and voluntary life/AD&D. Keenan also provides consulting for Health Care Reform issues. Reference Name: City of Glendale Contact: Matt Doyle Address: 613 East Broadway City: Glendale State.Zip: 91206 Phone No.: (818.548.2110 _ )_Date: 2009 to present Service Provided: Current broker/consultant providing services for all lines of employee benefit coverage including medical,dental,vision,life/AD&D, LTD and Voluntary Life/AD&D. Keenan also provides consulting for Health Care Reform issues. Failure to provide a list of at least five(5) customers may be cause for rejection of this RFP. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Proposal No. 964-5439 Page 11 VENDOR MUST COMPLETE AND RETURN WITH REQUEST FOR PROPOSAL Firm: Buckman-Mitchell, Inc. - Financial & Insurance Services REFERENCE $ Provide a list of at least five (5) customers for whom you have recently provided similar services. Be sure to include all requested information. Reference Name: Kaweah Delta Health Care District Contact: Jean Born- Director HR Address: 520 W. Mineral King City: Visalia State: CA Zip: 93291 Phone No.: ( 559 ) 624-5904 Date: 2006- Present Service Provided: Employee Benefits consulting including RFP's to carriers, claims reviews, customer service support for staff, health care reform consulting, strategic planning and data analysis for medical, dental, vision, prescription, disability, and life insurance products. Reference Name: City of Visalia Contact: Charlotte Dunn- Risk Manager Address: 220 N. Santa Fe City: Visalia State: CA Zip: 93292 Phone No.: ( 559 ) 713-4335 Date: 1987- present Service Provided: Employee Benefits consulting for both Administration and bargaining units. Assists in benefit explanations and service, health care reform consulting, strategic planning and benefit analysis of all employee benefit programs. Assists with RFP process upon request. Reference Name: Visalia Unified School District Contact: Tamara Ravalin-Asst. Supt. HR Address: 5000 West Cypress Avenue City: Visalia State: CA Zip: 93291 Phone No.: (559 ) 730-7559 Date: 1990- Present Service Provided: Employee Benefits consulting for both Administration and bargaining units. Assists in benefits explanation and service, health care reform consulting, monthly insurance committee meetings, strategic planning and benefit analysis of medical, dental, vision, and life insurance plans. Reference Name: Tulare County Office of Education Contact: John Caudle- Deputy Supt.-Admin Services Address: 6200 South Mooney Blvd. City: Visalia State: CA Zip: 93277 Phone No.: ( 559 ) 733-6300 Date: Service Provided: Employee benefits consulting services including review and explanation of benefits, educating employees on their options, health care reform consulting, assist with any claims issues, provide customer support to administration and employees. Reference Name: Merced City School District Contact: David Perkins- Risk Manager Address: 444 West 23rd Street City: Merced State: CA Zip: 95340 Phone No.: ( 209 ) 381-2820 Date: 2008- Present Service Provided: Employee benefit consulting services including review and exlanation of benefits, RFP services, educating employees on benefit options, health care reform consulting, claims assistance, attends and provides data for monthly insurance meetings/review Failure to provide a list of at least five(5) customers may be cause for rejection of this RFP. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Keenan's completed Participation form is included on the next page. Ree-n-an Proposal No. 964-5439 Page 12 PARTICIPATION The County of Fresno is a member of the Central Valley Purchasing Group. This group consists of Fresno, Kern, Kings, and Tulare Counties and all governmental,tax supported agencies within these counties. Whenever possible, these and other tax supported agencies co-op(piggyback)on contracts put in place by one of the other agencies. Any agency choosing to avail itself of this opportunity,will make purchases in their own name, make payment directly to the contractor, be liable to the contractor and vice versa, per the terms of the original contract, all the while holding the County of Fresno harmless. If awarded this contract, please indicate whether you would extend the same terms and conditions to all tax supported agencies within this group as you are proposing to extend to Fresno County. Note:This form/information is not rated or ranked for evaluation purposes. EYes,we will extend contract terms and conditions to all qualified agencies within the Central Valley Purchasing Group and other tax supported agencies. ❑ No, we will not extend contract terms to any agency other than the County of Fresno. (Authorized Signature in Blue Ink) Keith Pippard, Corporate Secretary, Keenan &Associates Title G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc This portion of the proposal Trill note ani, exceptions to the requirements and conditions taken by the bidder. If exceptions are not noted, the County brill assurrle that the bidder's proposals meet those requirements. The exceptions shall be noted as follois: A. Exceptions to General Conditions. B. Exceptions to General Requirements. C Exceptions to Specific Terms and Conditions. D. Exceptions to Scope of Mork. E. Exceptions to Proposal Content Requirements. F Exceptions to ant,other part of this RFA Keenan takes no exception to any of the requirements related to items A through F above. 1w, This section should include: A. A narrative which demonstrates the vendor's basic farniKarity or experience wit/7 problems associated u th this service/project. The County of Fresno's RFP requests a full range of benefits services that includes benefits acquisition, implementation, maintenance, communication and overall improvement of the County's employee benefits. Keenan & Associates plans to execute the scope of services outlined in this RFP by bringing to bear the most appropriate resources to fit each requirement. That begins with the team chosen to work with the County and extends to all of Keenan's ample resources. TEAM St;MMARY The solution presented to meet the County's requirements uZcludes the services and expertise of Keenan &Associates as well as Buckman-Mitchell, Inc. Keenan is the Prime contractor proposing on this proposal, and Buckman-Mitchell will be acting as a subcontractor, supporting specific requirements of any contract resulting from this proposal. — The largest privately-held broker/consultant in California — 22nd Largest in the United States Prime Contractor — 100% owned by employees — More than 700 employees supporting public agencies — Founded in 1972 — One of the largest independent insurance agencies in the West Subcontractor — More than 80 licensed insurance professionals — Founded in 1916 Companies' History Founded December 2, 1972, Keenan & Associates is in our 44`d year of consulting to California public agencies. Statewide, we provide services to more than 950 public agencies including 65 trusts and Joint Powers Authority QPA) programs. Keenan is: 0 The largest privately-held broker/consultant in California a 22"`�Largest in the United States s 100% owned by employees Phl c e s 0 Ranked 16`h in Los Angeles Business Journal's Best Places to Work toWork 2015 Large Employer Category 0 Finalist for Cotporade Social Responsibility Award 2015 for the Los - - - Angeles Business Journal Unlike other firms, Keenan has been dedicated almost exclusively to the insurance needs of California public employers'. We were founded to specifically provide employee benefits consulting and brokerage services to California public agencies and today approximately 90% of Keenan's clients are California public agencies, with the remaining 10% being California-based health care organizations (many of which are subject to similar challenges as public agencies). ; t. . M ��,: -, t- ,I Buckman-Mitchell, Inc. is one of the largest independent insurance agencies in the West and we employ over 80 licensed insurance professionals. Buckman-Mitchell, Inc. was founded by C.T. "Clem" Buckman and Hyman Mitchell in 1916. The firm today has established itself as a leader ui the insurance industry. Buckman-Mitchell, Inc. is built upon the tradition of integrity, industry leadership and excellence. We are committed to delivering tailored insurance solutions with thoughtful strategic planning, valuable professional services and technology-based solutions that result in sustained customer satisfaction. Through initiative and follow-through, we help our customers find answers,implement solutions and anticipate consequences. Buckman-Mitchell has been recognized for its superiority in customer service and business practices for many years. Buckman-Mitchell was awarded the "Excellence in Business Award" in 1997 by the Fresno Bee and was recognized by the IIABA Best Practice as one of the "Leading Insurance Agencies in the United States"in 2004. Buckman-Mitchell, Inc. has assembled the finest staff of professionals whose experience is matched by their intelligence and integrity. We further arm our staff with continuous education, training and cutting-edge technical resources. These highly specialized consultants have helped us build our reputation for excellence and fuel our growth. Buckman-Mitchell, Inc. is dedicated to providing quality insurance products while operating with a philosophy that relationships-,vith clients and community matter most. SERVICE STRUCTURE In order to provide the County of Fresno with a best-value solution for your employee benefits needs,we have structured this solution as follows. Contract Oversight All services and solutions to the County of Fresno will be overseen by Keenan, as the primary contractor proposing in this proposal. Day-To-Day Service All day-to-day service will be facilitated by Buckman-Mitchell's expert service team based in Visalia, with additional support provided by Keenan's municipality team located in Rancho Cordova. Following are the address details of these offices. Buckman-Mitchell, Inc. Keenan &Associates 575 E. Locust Ave. Suite 204 2868 Prospect Park Drive, Suite 600 Fresno, CA 93720 Rancho Cordova, CA 95670 Keenan &Associates Corporate Office 2355 Crenshaw Boulevard, Suite 200 Torrance, CA 90501 In addition to our local service team we have assigned several corporate resources to work with the local service team in order to provide you with the highest levels of consulting expertise at the most affordable cost. Key among those resources is Keenan's Benefits Underwriting and Actuarial Services Department. Our underwriters and actuaries will work with us as we create a strategic plan that will meet your needs both now and into the future. Keenan's methodology is based on our proven record and experience serving public agencies. The strategic work plan deliverable will successfully address each requirement and need as described in the County of Fresno's RFP. T 7 i.lcenan B. Descriptions of any similar or related contracts sander Frhlch the bidder has provided services. Please see our completed Vendor References Form for similar or related contracts which Keenan &Associates and Buckman-Mitchell, Inc. have provided services. C. Descriptions of the qualifications of the Indiv diml(s)prof diz pg the services. Keenan provides services through a dedicated team, supplemented by corporate resources. For purposes of this proposal, Keenan is utilizing the support of our subcontractor, Buckman-Mitchell, Inc. The primary broker / consultant would be Howell Southmayd, and local day-to-day support will be supported by both Howell and the team from Buckman-Mitchell. Following is the Keenan Team that will support the County. * Stephen Gedestad—Municipality Practice Leader * Howell Southmayd—Vice President / Consultant Stacey Comerchero—Senior Account Manager ® Steve Balentine—Vice President,Labor Relations .srdS...j13. ..i I f Jo, 11. _._K:n a�\—All : � .. ~ �.. ® Judy Fussel, RHU—President of Life, Health, and Financial Services ® JoeAnna Todd, RHU ChHC—Vice President Justin Workman—Assistant Vice President Leslie Anderson, RHU—Senior Account Manager * Linda Clower—Senior Account Manager EXTENDED SERVICE SUPPORT TEAM-KEENAN CORPORATE OFFICE ® Jovita Juanillo — Senior Vice President,Underwriting&Actuarial Tom Edwards—Senior Vice President, Underwriting&Actuarial * Christine Hough, FSA, MAAA Vice President/ Actuary * Michael Ahn—Vice President, Underwriting&Actuarial * Eugene Yu, RHU — Underwriting Consultant, Benefits Underwriting & Actuarial * Ralph Gowen—Vice President, Client Technology Robin Rager—Director of Health Management / Wellness Program Consulting * Amy B. Donovan, Esq. —Vice President of Legislative and Regulatory Affairs Jerry Healy—Chief Employee Benefits Counsel Bios for these Key Personnel are included in Appendix 1. Following is an organizational chart of these Kev Personnel. ifft I ................... .................... ....... FINE V M Primary Service Team and Contract Oversight—Keenan Team Additional Local Support Buckman-Mitchell, Inc. Additional Keenan Corporate Resources Keenan AccOUNT TEAM ROLES AND RESPONSIBILITIES �, ,�. ".�r�z5 .�.���.�.�asa.' .•�*::�.�... �'^� $�t�a� -�,�. � . a�' `. a.R�.r..,t"�,���..*c:. ,r c, Steve Gedestad— - Municipalities Practice Leader Municipality Practice - Assist with coordination of Keenan resources,in order to fulfill Leader the Scope of Services - Subcontractor OversiLyht Howell Southmayd Lead Consultant for the County -� � Lead Consultant - Coordination of Keenan resources,in order to fulfill the scope of services - Responsible for providing ongoing account management to the County - Ongoing training and quality assurance review of service team - Ongoing quality assurance review of underwriting team -- Ongoing quality assurance review of the wellness team in conjunction with the KeenanWell team Responsible for providing day to day carrier/vendor oversight Responsible for providing and executing comprehensive renewal strategies - Responsible for providing ongoing plan review and cost savings strategies EResponsible for reviewing all legislative changes,including 3 i Affordable Care Act Preparing Fringe Benefit Committee Meetings in conjunction with Executive Director Stacey Cornerehero mA Facilitating collection of benefit plan renewal data W _ ( Senior Account Manager / - Assisting with employee communications I i Day-to-Dav Account - Assist with preparation for Fringe Benefit Committee Meetings Management - Coordinates open enrollment meetings with the County Coordinates Health and Wellness Fairs with the County i - Review contracts and benefit booklets Assist the County with health care advocacy for the County and 1 their em lovees $ teven Balentine _--- -Assist with communications between labor groups and County I Vice President of Labor management 1 Relations _. . ._„_ __ : , Attend JLMBC � z 010 4 v Judy Fussel, RHU - Coordination of Buckman-Mitchell resources President of Life, Health, - Oversight for day-to-day support from Buckman-Mitchell 1 and Financial Services, - Consulting Support for the County in partnership with Howell I k Buckman-Mitchell Southmavd and Steve Gedestad JoeAnna Todd, RHU� - Assist with day-to-day support ChHC - Coordination with Keenan Team Vice President, - Consulting Support for the County in partnership with Howell Buckman-Mitchell Southmayd and Steve Gedestad Justin Workman - Assist with day-to-day support Assistant Vice President, - Coordination with Keenan Team e Buckman-Nitchell - Consulting Support for the County in partnership with Howell- Southmayd and Steve Gedestad -- - - -� Leslie Anderson, RHU - Assistance for the facilitating collection of benefit plan renewal Senior Account Manager, data Buckman-Mitchell - Assisting with employee communications - Assist with preparation for Fringe Benefit Committee Meetings - Coordinates open enrollment meetings with the County - Coordinates Health and Wellness Fairs with the Count= 3 - Review contracts and benefit booklets - Assist the County with health care advocacy for the County and their employ,ees Linda�Clower rn - Assistance for the facilitating collection-of benefit plan renewal f Senior Account Manager, data Buckman-Mitchell - Assisting with employee communications Assist with preparation for Fringe Benefit Committee Meetings ; - Coordinates open enrollment meetings with the County- - Coordinates Health and Wellness Fairs with the County f i - Review contracts and benefit booklets - Assist the County with health care advocacy for the County and their employees _� Jovita Juanillo — Provides undenvriting and actuarial support, as needed Senior Vice President, — Oversees all resources from Benefits Undenvriting and Actuarial Benefits Undenvriting and Department Actuarial Department — Supports analysis of all lines of insurance coverage that includes medical, dental,vision, fully-insured, self-funding, pharmacy, mental health,life/AD&D,LTD and STD — Provides actuarial analysis support Tom Edwards — Provides undenvriting and actuarial support, as needed Senior Vice President, — Supports analysis of all lines of insurance coverage that includes Benefits Undenvriting and medical, dental,vision, fully-insured, self-funding,pharmacy, Actuarial Department mental health,life/AD&D,LTD and STD — Provides actuarial analysis support Christine Hough, FSA, — Actuarial Support MAAA — Support analysis of all lines of insurance coverage that includes Vice President/Actuary medical, dental,life/AD&D, and LTD Michael Ahn — Undenvriting and Actuarial Support Vice President, — Support analysis of all lines of insurance coverage that includes Underwriting&Actuarial medical, dental, life/AD&D, and LTD Eugene Yu, RHU — Undenvriting and Actuarial Support Undenvriting Consultant, — Support analysis of all lines of insurance coverage that includes Benefits Undenvriting& medical, dental, life/AD&D, and LTD Actuarial Ralph Gowen — Product Manager; technology solutions Vice President, Client — Configuration and implementation of BenefitBridge,if Technology appropriate, and/or Personal Choices portal Robin Rager, Ph.D — Evaluates existing disease management and/or wellness programs Director of Health — Identifies options for disease management and wellness programs, Management and implementation,when required Amy B. Donovan — Assistance with legislative and regulatory compliance issues Vice President,Legislative — Provide briefings and meetings, as needed regarding these types &Regulatory Affairs of issues Jerry Healy — Legal support and advice related to all employee benefits issues Chief Employee Benefits — Plan document support Counsel ,-'eenan �t D. f$np material includin,- letters of support or endorsement) indicative of the bidder's capability We have provided references on the required form, which serve as letters of recommendation from current clients for both Keenan and Buckman-Mitchell. Following are the innovative solutions that will serve as an example of the solutions which can be provided to the County. UNIQUE PROGRANis DESIGNED FOR PUBLIC AGENCIES As a proven leader in California public sector consulting, Keenan's database of public employers is unmatched in California. In addition to our extensive experience with virtually eveli, type of managed care program and every funding variation (e.g., self- funded, flex funded, experience rated, minimum premium, fully insured) available, we have developed a number of proprietary programs designed to meet the unique needs of the public sector. While not all of our 'innovative solutions fit the specific requirements for every client, we work closely to identify the appropriate services to ensure the best quality of service at a competitive price. Our unique and proprietary, services 'include: * BenefitBridge—A more robust, proprietary Web-based technology solution for employee benefits administration, eligibility, enrollment, billing, reporting, and employee communications. * PersonalChoices — PersonalChoices places important benefits 'information online for employees and dependents to access, enabling them to become more self-sufficient in understanding their benefits. PersonalChoices is provided at no cost to the County. * Individual and Family Plan — A solution that greatly assists Part Time employees as well as employees with dependents over age 26 is Keenan's Individual and Family Plan Division. Using and/or our licensed, certified customer service staff, individuals can check their subsidy eligibility and sign up for insurance with any carrier in or out of Covered California. Keenan Direct could also assist the County's general uninsured population. * KeenanWell — A comprehensive health management program incorporating wellness and disease management including online tracking, personal health strategies and coaches along with an engaging site-based programs,if desired. * Futuris Caresm — Specifically designed for public agencies, Futuris Cares"" is a comprehensive approach to controlling GASB 43/45 retiree liabilities, enhancing access to Medicare plans, and providing useful resources to seniors and their families. Futuris Care *includes a suite of services, such as access to a post-65 health exchange, and valuable consulting services. Keenan Keenan Pharmacy Purchasing Coalition (KPPC) — An innovative pharmacy program that delivers cost savings and the most advanced prescription management capabilities. In just four years, K_PPC has grown to more than 275,000 members and has saved over$55 iydffion for participating plans. Keenan Saver Rx — A discount drug card for part-time employees, friends and family without pharmacy coverage, Keenan Saver Rx, powered by GoodRx, allows anyone to purchase pharmaceuticals for 5-60% off retail at over 60,000 pharmacies nationwide. Keenan Saver Rx is available for no additional fee and includes access to both a Web and mobile app that allows users to find discounted prices in their. area. Additionally, Keenan Saver Rx can be branded specifically for your agency for a fee. BridgeFront — A HIPAA Employer Compliance Center. BridgeFront is included for no additional fee. Keenan HR Reference Room —Keenan has partnered with the Bureau of National Affairs (BNTA) to provide extensive Human Resources support to our clients. The Keenan HR Reference Room brings together BNA's specialized news, legal affairs and analysis with extensive human resource tools. As the leading 'independent publisher of print and electronic news, analysis, and reference products, BNA has provided intensive coverage of new developments for more than 70 years. The Keenan HR Reference Room provides streamlined access to BNA's web-based services, HR tools and e-mail newsletters related to HR topics. Leave of Absence Administration — Keenan provides legislative and compliance updates related to Family and Medical Leave Administration on an ongoing basis. Additionally, Keenan partners with Qcera, a leader in comprehensive leave management, to offer co-sourced administration to reduce administrative burdens while allowing you to maintain control and contact with your employees requesting leave. We have provided additional 'information on these programs in Appendix 2. E. A brief description of the bidder's current operations, and ability, to provide the Sefviees. Having the largest single block of California public agency clients has afforded us a significant amount of data with which we have been able to analyze that data to identify,, trends, major cost drivers and areas for potential savings through plan design and program structure. We have found it critical to our clients' benefits programs to continually track employee benefit data year round in order to ensure that we can present information to our clients that are valuable during renewal periods, regardless of what time of year their renewals are scheduled. We will keep you abreast of necessary changes that need to be made as well as present 'innovative solutions to meet new requirements Ke rep n a n while mitigating the impact to the quality and cost of your benefit programs while giving appropriate recommendations as needed. BENEFITS UNDERWRITING AND ACTUARIAL SERI,ICES DEPARTINIENT Keenan's Benefits Underwriting and Actuarial Services Department (BUAD) is comprised of subject matter experts related to analysis, actuarial support and plan design for benefit plans. BUAD provides high-level analysis of benefit programs and their performance; reviews data trends and works with the primary service team to provide alternative plan design options; and, supports the primary service team with stop loss quotes, marketing plans to carriers, actuarial support and other technical services. Overall, BUAD provides underwriting and actuarial work including, but not limited to, renewal analysis, reserve estimates, plan change pricing and claim utilization analysis. This department also monitors industry trends and provides federal and state legislative updates on a regular basis. Members of BUAD will be available to participate as necessary to help with the presentation of any technical data or information. The primary services of this department include: * Underwriting — Trend Analysis — Renewals (existing business) — Funding Rate Development (new business) — Renewal Audits (fully insured plans) — Rate Negotiations — Benefit&Rate Comparisons (new and existing clients) — Premium and Rate Validations Select Product Marketing — Private Label Pool Products / off-the-shelf — Stop Loss Programs * Financial and Experience Reporting — Loss Ratio Reports — Premium & Claims Reports — Utilization Reports — IBNR Reporting — Industry Trend Reporting — Client Presentations Private Label Program Maintenance — Annual Pool Renewals — Annual Renewal Binder — Pool Marketing Technical Consulting — Prospective Group Funding Calculations — Pricing Calculations for Plan Changes — Rate Stabilization Reviews — General consulting services for all benefit plans SUPPORTING LABOR MANAGEMENT NEGOTIATIONS As previously detailed, Keenan has extensive experience with supportin the joint labor 1 9 management negotiation process. Following is a surnmary, of the expertise of out dedicated team that supports this process, headed up by Steve Balentine, Vice President of Labor Relations. Building Consensus Between Labor and Management is a Keystone of Keenan's Solutions — We have more specific experience than any other consultant in the marketplace in building and maintaining the critical communication between Labor and Management groups. — Keenan Staff Traini-ig — All Keenan Personnel are trained on how to facilitate effective joint Labor Management Benefit Committees ULMBC). F Copies of the audited Financial Statements for the last three (3) years e , forthe agency of program that will be providing the semice(s) proposed. If audited statements are not available, compiled or reviemed statements iTill be accepted with copies of three years of correspondii g federal tax returns. This information is to be provided after the RFP closes, if requested Do not provide with your proposal If requested, Keenan & Associates is fully prepared to provide the County with audited financial statements for the last three (3) years. G. Describe all contracts that have been terminated before completion ITitllin the last ft ve (5)years: L Agency contract u-ith Z. Date oforiginal contract 3. Reason for termination 4. Con tactperson and telephone number for agenc�j,, No contracts have been terminated prior to completion Within the last five (5) years. Keret n a n A H. Describe all lawsuit(s) or legal action(s) that are currentIv pending; and 11.7v IaR•suit(s) or legal action(s) that have beery resolved ccritliin d7c last five (5)years: L Location filed, name of court and docket iunnber 2. Nature of the laic suitor legal action There are no investigations, lawsuits, claims or complaints pending against Keenan & Associates which would impact our ability to provide services to the County. As a normal incident to conducting its business, Keenan has historically been involved with and has successfully resolved various investigations, claims, or complaints, none of which had a material adverse effect on Keenan or our ability to provide services to our clients. Keenan & Associates continues to maintain general liability, and errors & omissions insurance covering our business activities and anticipated potential liabilities. I Describe ant,paynIent problers that you have had with the County cc thin the past diree (3) years: L Funding source 2. Date(s) and arnount(s) J. Resoh.rtion 4. Irnpact to financial c-iabilitc%oforganiz�ition. Keenan &Associates has not had any payment problems with the County. + p e I �' 4 � x � A. Bidders are to use this section to describe the essence of their proposal B. This section should he formatted as follows: Z A general discussion of your understandik g of the project, the Scope of Mork proposed and a summary of the features of-slur proposal Please see below. A detailed description of j-our proposal as it relates to each item listed under the ",Scope of Work"section of this RFP Bidder's response should he stated in the salve order as are the "Scope of[fork"items. Each description should begin with a restatement of the "Scope of Mork-" item that it is addressit15 Bidders must explain their approach and method of sdtis#%11Ig each of the listed items. Please see below. .Scope of Work- Vendor will provide a summaly of their understanding of the County's needs (as detailed in this,Scope of Work) and horn the vendor plans to meet these needs: The County is seelffng a summ air that includes the vendor's broad understanding of the scope of the Coma]-'s request and a sunnnaly of the vendor's entire proposal The County of Fresno's RFP requests a full range of benefits services that includes benefits acquisition, implementation, maintenance, communication and overall unprovement of the County's employee benefits. Keenan &Associates plans to execute d-ie scope of services outlined in this RFP by bringing to bear the most appropriate resources to fit each requirement. That begins with the team chosen to work with the County and extends to all of Keenan's ample resources. As noted earlier, the solution presented to meet the County's requirements includes the services and expertise of Keenan & Associates as well as Buckman-Mitchell, Inc. Keenan is the Prime contractor proposing on this proposal, and Buckman-Mitchell will be acting as a subcontractor, supporting specific requirements of any contract resulting from this proposal. In addition to the local service team we have assigned several corporate resources in order to provide you with the highest levels of consulting expertise at the most affordable cost. Key among those resources is Keenan's Benefits Underwriting and Actuarial Services Department. Our underwriters and actuaries will work with us as we create a strategic plan that will meet your needs both now and into the future. Keenan's methodology is based on our proven record and experience serving public agencies. The strategic work plan deliverable will successfully address each requirement and need as described in the County of Fresno's RFP. Health Care Reform is the number one employee benefits issue facing employers today. With Federal guidance on implementation of Health Care Reform changing, sometimes daily, Keenan clients rely on our legal department's regularly issued written Brie&ngs for communication and implementation advice. Keenan's legal department also provides our clients with access to webinars on all health care issues of interest to our clients. Another of the resources available to the County is our comprehensive communications and training on legislative and regulatory issues that impact your benefit plans. This training and communication assistance is provided by the legal department. Your Keenan team also has significant experience working with joint labor-management groups. 2 The summary will also include a statement that the vendor mall provide all the services included in this Scope of tTorh. If the vendor is unable to provide an.V of the service(s), they «rill describe which of the service(s) then are unable to provide. Keenan &Associates will provide all the services included in this Scope of Work. PART A—SCOPE OF HEALTH BENEFITS CONSULTATION SERVICES I. ADMINISTRATIVE SERVICES h Benefit Design Assistance a. Provide an initial in-depth revien- of the County s existing health insurance programs and assist in the development of long-range plans and financial, operational and utilization goals. Provide an annual assessment as to mhether lont-terni objectives are being met As a major component of any new client engagement, Keenan Utilizes a four-phase approach to analyzing existing coverage and identif-,ing or developing cost-saving alternative benefit strategies and plans. Our four-phase action plan is illustrated in the following exhibit. ¢ Discovery/Fact Finding •Develop understanding of Counry,s current benefits and previous benefits h •Meetings with stakeholders (e.g.,management,labor groups,insurance committee " 3 etc.) ,� •Timeline-30 days { a '2E b= } AS •Analysis and Evaluation •Keenan's consulting,technical and administrative staff conduct in-depth review of programs •Reveiw of plans'historical performances •Review of employee communication pieces for accuracy and legislative compliance •Timeline-30 days $'.. -npva1`�'-.^�vwvYa�¢,�^w"e..N.Cn'ah'v:`:h'vS,sN�.GY!.utr:.r'am:,:s,'+.x.^.TMviAuv:'sue.5.:..:�`ac3!.u,^nvss2'e„vvv..uK+`s.Rt^.rs'.'�r...b.'s..Y.Gae-..a.sst...r..,un..vases.^k.sw:✓..:.ekt.�."=..ivzzv.„+>sYrexs�'e. 1� •Recommendations/Action Plan t •Presentation of recommendations to joint labor-management committee -Define an action plan and timeline for any changes to the benefits program •Timeline-60 days •Implementation •Negotiations with incumbent carriers and/or other insurance markets -Identification and pricing of options that result in cost savings -Development of a communications program •Assistance to staff throughout the year in support of the ongoing program -Timeline-varied based on action plan developed Using all of the information identified in Phases I through IV of our four phase action plan, a two-year strategy will be developed. This plan will be more of a "work in progress" as budgetary and collective bargaining conditions change. Using our knowledge of the California public sector marketplace, our annual surveys of public sector benefit programs and trend forecasts, changes in the existing programs will be recommended and adjusted to meet the County's projected budgets. n re,e n a n tj ... i ,.,..... ee...._. .�._"�......._..... Additionally, your account team will create an annual stewardship report that will be presented and explained to the appropriate County representatives. The purpose of the stewardship report is to define and summarize Keenan's role and actions related to: Renewal negotiations * Marketing Implementation of new plans Carrier liaison Technology Solutions — BenefitBridge Online Enrollment and Eligibility System (if applicable) — Personal Choices portal (if applicable) Review plan documents, applications, employee communication * Requirements that had been specifically detailed by the County Review of training webinars on topics such as COBRA., Healthcare Reform, HIPAA, GASB, FMLA, that had been presented in the previous year * Service support to the County's Benefits Staff that had been provided — Review and consult on employee communications — Technology support with plan implementation and maintenance — Review of Federal and State Compliance actions that had occurred or will be required in the following year We have included a sample Stewardslnip Report in the Reports Section. One the Counties major issue is the solvency of the SJVIA which the County of one of the founders and largest participant. Keenan has formed a number of JPAs over the years and currently manages over 50 around the State of California. As the JPA manager we get involved in all aspects including conducting RFPs for JPA services, underwriting, financial analysis, accounting, and marketing to grow the JPA. All of this experience uniquely qualifies Keenan to be your advocate to SJVIA. An important aspect of running a successful JPA is understand what financially is happening within the JPA and proper rate setting. Below is a description of how we do that. MONITORING ExPERIENCE TRENDS Our Benefits Underwriting and Actuarial Services Department (BUAD) constantly monitors and reports on all relevant financial aspects of each benefit plan. This department provides underwriting and actuarial work including, but not limited to renewal analysis, reserve estimates, plan change pricing and claim utilization analysis. Keenan & Associates is cominitted to monitoring vendor performance on an on-going basis. As part of BUAD's underwriting & actuarial support, Keenan thoroughly reviews carriers experience and utilization data to validate budgeted benefit funding and costs on a monthly, quarterly, and annual basis. Tlnis is important to ensure that the funding development is appropriate and so that we can identify emerging trends to ensure that there are no unexpected cost drivers. We will keep the County informed of the insurance carriers' and health care service plans' performance by: ® Performing monthly, quarterly, and annual review reviews of plan administrator's experience, utilization data, reserve factors, and reserve estimates. Preparing quarterly or annual actuarial reserve attestations. We require an actuary with a Fellow, Society of Actuary, professional designation to review or certify a client's funding and reserve estimate. Validating and developing summary reports simplifying the complex reports and data presented by the plan administrators and carriers. Developing and implementing customized financial benchmarks and interactive experience/utilization dashboards, as may be necessary, to allow the client to see their own plan trends and cost drivers at any time. Please find a sample copy of the financial dashboard in Appendix 3. * Reviewing plan benefit design options and determine financial impact of these changes in the benefit program. Presenting benefits program trends, experience, and utilization in-person or via telephone conference calls with the Keenan account team. * Working with client to design customized carrier fully-insured or self-insured operational and claims audits. Reviewing provider network utilization to determine cost outlier or evaluate feasibility of creating narrow or quality networks. Assist in the design of member surveys to validate emerging trends and program effectiveness. Our BUAD utilizes two unique underwriting and actuarial tools for rate/funding validation and reserve estimates: Conducting underwriting analyses to `drill down' on the plan design and key cost drivers is a core component of Keenan's brokerage services. We utilize a proprietary actuarial system to determine the estimated Incurred But Not Reported (IBNR) reserves for the program under review. Our IBNR model was developed by our consulting actuary using the Bornhuetter-Ferguson method of claims reserving and utilizes actual claim lag reports where available to determine the appropriateness of the IBNR estimates. For rate Keenan 3t; benchmarking and budgets, Keenan utilizes a proprietary pricing model developed by Milliman, Inc. Keenan's proprietary actuarial tool is developed and calibrated by Milliman USA. Milliman USA started in 1947 and is one of the premier actuarial firms in the United States. Our unique Keenan-Milliman actuarial model allows us to perform in-depth and high accuracy pricing analysis on behalf of our clients by determining the value of over 100 variations of benefit plan designs, assessing cost enrollment/migration impact, providing fully-insured vs. self-funded cost-analysis, identifying the cost of carved-out benefits, and validating the claim cost factors utilized by carriers in their renewal rate development. Carrier renewals and rates are also validated and benchmarked using Keenan's proprietary actuarial tool as developed and calibrated by Milliman USA. Milliman USA started in 1947 and is one of the premier actuarial firms in the United States. Our unique Keenan-Milliinan actuarial model allows us to perform in-depth and high accuracy pricing analysis on behalf of our clients by determining the value of about 100+ variation of benefit plan designs, assessing cost enrolhnent/migration impact, providing fully- insured vs. self-funded cost-analysis, identifying the cost of carve-out benefits, and validating the claim cost factors utilized by carriers in their renewal rate development. UNIQUE MARKETPL.AcE KNOWLEDGE For more than 40 years, as a service enhancement to our more than 950 public agency clients, Keenan & Associates has prepared a health and welfare employee benefits survey. Upon completion, we present the results to our clients throughout the state. In our experience, this has proven to be a valuable tool in negotiations and an effective management tool in ascertaining parity in benefit levels, cost and design. Many agencies use this as their primary standard in establishing consistency of benefit offerings with their benchmark agencies. This survey has been, and will continue to be, provided at no cost to our clients. MERE/ANA LYTI CS Keenan Public Agency Data Initiative Keenan is piloting a study uniquely with Kaiser, to provide our clients with expanded analysis and reporting of Kaiser Claims data. In addition, we are using this information to provide a side-by-side common format for data comparison against Anthem, Blue Shield, Health Net, and other non-Kaiser HMOs. We find that the common format is truly valuable to compare multi-HMO plan performance. This is a first of its kind initiative being piloted by Kaiser and they selected Keenan as their partner. It will enable Kaiser's performance to be bench marked on an "apples to apples" basis with other Health Plans such as Anthem's. Mede/Analytics is a third party data warehouse technology company with expertise in creating reports that assist customers make informed decisions out of complicated data. Keenan is engaged in this pilot with the goal to be able to take Kaiser's current PUR underwriting and experience reports, that now only, benchmarks against Kaiser's book of business, as well as Keenan's Kaiser book of business this is new and sig doesn't have it yet, and to extend that to allow benchmarking to occur between Kaiser and non-Kaiser plans. Non-Kaiser data can also be entered into Mede/Analytics for more detailed cost analytics and comparison. b. Review and analyze vendor documents, including but not limited to contracts, policies and cover.rge booklets, provide interpretations and recommendations. Keenan's Benefits Underwriting and Actuarial Services Department (BUAD) is comprised of subject matter experts related to health plan operations, analysis, actuarial support and plan design for benefit plans. BUAD provides high-level analysis of benefit programs and their performance; reviews data trends and works with the primary service team to provide alternative plan design options; and, supports the primary service team with stop loss quotes, marketing plans to carriers, actuarial support and other technical services. Our senior underwriting staff each have an experience of more than 20 years. BUAD supports the account management team in thoroughly reIN7 iewiiig plan benefit contracts, benefit descriptions, member materials, funding agreements, stop loss contracts, and provide suggested changes and recommendations. We also design plan performance financial guarantees. c. Determine methods of' -reporting plan performance for the purpose of reconimendin gstm strategies to lots cost and maintain quality. Your account team will be available to participate as necessary to help with the presentation of any technical data or information. As previously identified, we will also provide the County with a stewardship report which will 'include summaries of past performance as well as details related to forecasting. Keenan's BUAD Department also develops 'interactive financial dashboards, customized for the client's benefit data needs. Our underwriters/actuary will extract, interpret, and present plan or carrier data in a meaningful and easy to understand way so the client can view their own data and trends through an intemet based solution 24 hours a day. Please note that we will require 6-8 months from design to delivery of interactive dashboards. Keenan generates several different reports and presentations to evaluate plan performance, experience, and funding levels and recommend initiatives and solutions to the client. They are based on the desired frequency and specific needs of our clients. Annual Renewal Report or Interactive Financial Dashboards — Covers all financial aspects of the plan performance, including claims analysis, claim lag studies and reserve calculations, recommended fundi-rig and contribution levels (includi-rig COBRA and AB528), suggested plan changes, trend analysis, etc. a Monthly, Quarterlv, and Annual Financial Funding Cost Budget vs. Actual Costs 0 Projected Plan Cost Increases and Benefit changes a Annual Year-end Analysis —Examines in detail the actual performance compared to stated objectives, a re-examination of the renewal to determine whether the action taken was appropriate, claim utilization data and appropriate recommendations for plan changes 0 A report that analyses the demographics for each County bargaining unit or group. This analysis provides a lot of insight into utilization. This segmentation and detail helps us identify problem areas to focus on programs that can help reduce cost. We combined data derived from claims utilization and demographics to provide the necessary insights in developing programs to reduce costs to meet the special needs of the County d Recommend wellness and disease management strdte�Oy- with ;I focus on MedS11ri12,-the TCtIlTD 017 iDlIeStflzlent OfSUC12 efforts. Keenan has been an industry leader in identifying employee benefits related programs that assist clients in controlling continuously escalating costs. As a significant part of this effort, Keenan has invested resources in wellness and disease management programs that are geared toward improving your employee populations' health, and thereby impacting your premium rates. Our efforts include the development and implementation of comprehensive wellness programs through our array of KeenanWell health management consulting, best-in-class and third-party vendor partnerships. Keenan has a team of dedicated subject matter experts that specifically focus on analyzing, crafting and implementing wellness programs for our California public agency clients. Additionally, all of our service team personnel are certified by the Wellness Council of America (WELCOA). WELLNESS PROGRAM SUTPORT EXAMPLES County of Mendocino Over the past decade, the County of Mendocino has developed a broad-based employee wellness initiative through its Mendocino County, Working on Wellness (NICWOW) Program, with the primary goals of enhancing individual health, safety, and morale; reducing lifestyle-related illnesses and diseases; developing healthier work environments; and reducing the County's costs for medical care. Although a variety of onsite wellness activities were being offered, when the County of Mendocino (CA) became a Keenan client in 2011, the MCWOW program was struggling to be viable, with less than 40% of its employees participating in any aspect of the program. One of the primary reasons for the low participation was the complex and Ka-snan confusing incentive system that the county had been utilizing in its attempts to drive program engagement. It just wasn't motivating the employees. To increase employee participation and impact, the KeenanWell health management consulting team assisted the County on making two major changes to its program in 2012: 1) It brought to the County, at deeply discounted Keenan pricing, a third-party vendor to provide a wellness platform that offered health risk assessment, telephonic lifestyle coaching, wellness challenges, health/fitness trackers, and other online resources to serve as a center piece for its program. 2) It worked with the County to redesign its wellness program rewards system that was streamlined, easier for employees to understand, and more focused on uicenti-,,izing outcomes-based behavior change. The KeenanWell team assisted the County in designing and implementing a wellness activities point system, which is tracked through the wellness platform, to encourage participants to stay engaged in wellness year round. The point system focuses on behavior modification activities like coaching, challenges, and onsite nutrition and exercise classes to assist individuals with making healthy changes in their lives that can result in better outcomes. Through the restructured incentive system, employees were required to meet just three criteria each year for receiving a medical premium reduction: 0 Completing a biometric screening 0 Completing a health risk assessment e Earning 100 wellness points over a specific timeframe The enhanced MCWOW program currently provides a host of interventions to assist employees on their journey to improved health, and emphasizes the importance of completing a health risk assessment and biometric screening, which serge as tools for tracking employee risk data as well as informing employees about their current health risk status. Program components include onsite monthly health and wellness classes, online wellness web portal, telephonic and online health coaching, county--wide wellness challenges, negotiated fitness center discounts, an onsite wellness lending library, a MCWOW program Web site,inclusion of dependents in health education and awareness through home mailings, and EAP/wellness program integration, Furthermore, MCWOW has a wellness participation policy which allows employees to attend many wellness activities during work time. As a result of these changes that the KeenanWell team has helped them to make, the MCWOW program has seen an increase in employee participation in its annual biometric screening from 38% in 2011 to over 60% in 2014, and overall participation in the program has climbed to more than 80%. In addition, the county's wellness initiatives have also impacted the surrounding community. Under the direction and coordination of the County's wellness program coordinator, the County has partnered with major employers in the area to offer a county-wide weight loss challenge to employees and their families who work and live i_n er,"', V _._ __.___ the community. The program has been very successful, with employees from participating organizations losing a combined total in 2014 of about 2,500 pounds. Since Keenan began serving at the County's benefits broker in 2011, the KeenanWell consulting team has assisted the county in developing and implementing an innovative, awarding-winning employee wellness program that won the American Heart Association "Fit Friendly Worksite" Platinum and Gold Awards and the Healthyroads "Fit Company" Silver and Gold Awards during 2012, 2013, and 2014. San Joaquin Regional Transit District When Keenan became the benefits broker for the San Joaquin Regional Transit District (SJRTD) in 2013, the transit district's fledgling one-year-old employee wellness and condition management program — named "Wellness Starts With Me" — had several program components in place: online wellness resources and onsite blood pressure screening provided by their health care carrier, onsite condition management counseling via a registered nurse, and some onsite health and fitness events. However, those components were not organized into a cohesive, coordinated approach, and there was no comprehensive program plan to guide the program's development. The KeenanWell health management consulting team began working with SJRTD to establish program goals and objective and a multi-year, outcomes-based strategic plan. First, the team analyzed the Kaiser reports generated for the transit district to track the primary health risk factors among the employee population, and found a very high obesity rate. Next, the team conducted an audit of the wellness program resources currently, being used by SJRTD, including those provided by Kaiser as well as the condition management nurse coach services provided through a third-party vendor — Patient Advantage. Based on these analyses and audits, the KeenanWell team collaborated with SJRTD to craft a health management strategic plan to roll out a more integrated, more cohesive program. To help support the enhanced program, the team helped the transit district to optimize the resources available from Kaiser, including biometric screenings, health risk assessment, onsite health education workshops, and the Thrive Across America physical activity challenge. In addition, to provide a more intensive response to the obesity prevalence in the workforce, the KeenanWell team solicited no-cost and low-cost services from community health organizations, including the American Diabetes Association and American Heart Association, with a focus on exercise, nutrition, and weight management. To help provide support, direction, and advocacy for the program, Keenan helped to establish and coordinate a formal wellness committee. The condition management nurse coach was also integrated into this initiative to promote the weight management counseling services offered to employees. Lastly, the KeenanWell team helped SJRTD to implement a cohesive communications strategy that pulled all of the program components under the "Wellness Starts With Me" branding, which unproved employee awareness of the array of resources available to them and promoted their participation. To further promote employee engagement, Are,v�n a n Keenan is also helping the transit district to identify effective incentives design options that would receive the support of management as well as organized labor. As two indicators of the impact of the high level of program "touch" and the resultant increase in employee engagement in the program, there has been improvement in the number of employees who are current on their preventive care screenings and in the medication adherence rates among employees with chronic conditions. The KeenanWell health management consulting team has assisted the San Joaquin Regional Transit District in developing and implementing an innovative employee wellness program that has won two awards in 2015: the American Heart Association's "Fit Friendly Worksite" Gold Award and the Stockton Chamber of Commerce as FRESH (Fitness Rejuvenates Employee Sustainability & Health) Employer of the Year Award. e. Provide general guidance on trends in benefits offered rind ck ibilin requirements. For more than 40 years, as a service enhancement to our more than 950 public agency clients, Keenan & Associates has prepared a health and welfare employee benefits surrey. Upon completion, we present the results to our clients throughout the state. In our experience, this has proven to be a valuable tool in negotiations and an effective management tool in ascertaining parity in benefit levels, cost and design. Many agencies use this as their primary- standard in establishing consistency of benefit offerings with their benchmark agencies. Tlus survey has been, and will continue to be, provided at no cost to our clients. We have seen a number of major trends; • A dramatic increase in Rx cost with rising prevalence of specialty drugs. • Solutions to deal with Retiree Health coverage • Activity to comply with ACA and plan for the implementation of the Cadillac tax • Medical plans being offered by the providers themselves. 2. Communications a. Provide editorial and compliance review- of ®Pen Enrollment and other County-produced benefit comnl[Inlcatlons including rnernos, materials and presentations for employee meetings. Keenan has provided communication services for employee benefit plans since our inception in 1972. In order to support the specific communication needs of our clients, Keenan maintains a Marketing Communications Department (Marketing Department) that is staffed with communication experts in a variety of disciplines. Keenan's award winning Marketing Department assists with the development and delivery of communication materials. This includes communication pieces that are both S + Pc+7 c_a FO!' P11)P01:11 NO, "'64. .`•Iard2 ..: 1f, i�i;It1T::,i..173Ct'r• electronic and hard copy for benefit enrollment guides, health fair announcements, employee education meetings and other related communications activities. Public agency workforces are diverse, and include personalities that differ in how they wish to seek out benefits information, and how they absorb the information. Comprised of Millennials, Generation X,Baby Boomers, etcetera, these employees all have different preferences as to how they want to receive information. Additionally, these diverse groups have different desires when it comes to how much information they want on their program options. Some want to know what time it is (i.e., just the bottom line), while others want to know how the clock works (i.e., they want to know every detail of a specific benefit). In order to facilitate an efficient communication strategy, Keenan looks to a multi- medium approach to ensure that each eligible employee can obtai i the information they need in order to make a decision. These mediums include: ® Traditional printed material, mailed or delivered to the employee • Mobile-friendly documents that can be easily reviewed from smart phones or tablets • Web-based flyers, briefings, and other informative materials regarding benefits programs and issues 0 Videos and webinars that explain benefits and/or enrollment processes i. These are just some of the examples of the innovative approach that Keenan has included in a communication strategy. Ultimately Keenan discusses recommended strategies with our clients, in order to provide the most cost-efficient and effective strategy. Initial Communications Challenges 8 To ensure a smooth transition to the benefits program for new employees To communicate with employees in remote areas or on schedules not conducive to in-person meetings The Solution In order to efficiently communicate with these new staff, Keenan can provide the following communication strategies: Introductory Letters Printed Benefit Guides and other Benefit Related Informative Materials ® Online,mobile-ready enrollment education materials * Conducted in-person enrollment education meetings 30 Keenan o, W?l__ / �f1/lrlt`ETL=r't' .S tlilJlllJI1.� ;?1Cj71i'llJtl l�17�`:r __. provided webiars to educate employees on benefits — addressing employees in remote areas or who worked schedules not conducive to attending in-person meetings Next Steps Based on feedback through surveys with Open Enrollment: Wha employees and input from the benefits eed to Know personnel at the client, Keenan is now developing additional resources to continue to build on the successful transition of future new employees. This can 'include a video series. The video series' goal is to provide short-form "bite-size" segments to reach the employee on any platform ("i idco Duvel"-wd h" Bw;n` Roqcd 0� �,w (e.g., mobile, desktop, tablet, etc.) when convenient for that employee. b. Coordinate with vendors as necessa�y leverage availability of rendor comm unica tion materials and resources. Keenan can and will comply with this requirement. C. Revien-vendor's plan summaries and other materials for benefit;Iccuracj, and basic compliance. Keenan can and will comply with this requirement. d. Provide assistance in the development and analysis of sun7evs to acquire employee feedback on the perforniance ofplans. Keenan ,Till provide assistance in the development and analysis of employee surveys.We regularly utilize Survey Monkey to illicit feedback on services, training programs and plan performance. 3. _AIeetingaAttendance & General A Yaibb&qr a. Attend quarterly meetings of the Health Benefits Adi7iswy Committee (HBAC) (4 nieetinos per gear). The HBAC consists of one representative from each Corimy barg aining unit, as vvell as retiree and management members. Keenan/BM1 will attend quarterly meetings of the HBAC. numan b. Attend meetings of the San Joaquin 17alley Insurance Authority (SJTYA) as needed(1—2 meetings per year). Keenan/BMI will attend meetings of the SJVIA as needed. c. The consultant shall assist in the preparation of yarieo,ofmaterials required for labor negotiations including, but not be limited to, cost estimates for new or upgraded.benefit programs, rate calculations, and «Titten material such as analyses, summaries, andgraphs/spreadsheets. Our dedicated Benefits Underwriting and Actuarial Services Department supports your Consulting Team in the in-depth and detailed study of County's benefit expenditures in preparation for labor negotiations. This includes statistical benefit plan reports as a key tool to support the decision-making process. Keenan will present this information upon request. d Participate in conference calls ryith Count--Staff no less than once per month. Keenan/BMI will participate in conference call with the County staff no less than once per month. e. Provide prompt and effective responses to ad hoc requests from County staff for information or analysis. Keenan can and will provide prompt and effective responses to ad hoc requests from the County staff for information or analysis. f. Assist Count}• staff with technical issues affecting the administration 4rnd processiru,;procedures of the benefit programs as they arise, including plan document interpretation and elrgubrhtQ%determination. The Keenan Service Department devotes its attention and expertise to resolving problems and meeting the day-to-day administrative needs of our clients including assistance with claims, eligibility and billing problems that may arise. Your Keenan team will work directly with staff and employees when they have not received a satisfactory response from the carrier or claims administrator. Our Service Representatives meet regularly with Administrative Staff, Management and Benefit Committees to review the operation of benefit plans and helps in monitoring how well plans are meeting strategic objectives. 4 Legal&Re¢ulatmy Compliance Support and Updates a. Provide advice and interpretation on all local, state, and federal benefit regulations impacting the County health plans, including but not 11112pted to: i. Patient Protection and Affordable Care Act(PPACA) ii. Family and Medical Leave Act(FAILA) iit. California Family Rights Act(CFRA) Av. Consolidated Omnibus Budget Reconciliation Act(COBRA) T 1 Health Insurance Portability and Accountability Act(HIPAA) T-i. Americans with Disability Act(ADA) vi. Fair Empkyment and Housing Act(FELL4) fill. Zinlforined Services Employment Reepnplovtnent Rights Act (L%SERRA) Keenan's Legal Department maintains dedicated personnel who regularly track both pending and newly enacted Keenan legislation in order to provide updates to our clients in a � � � �� timely manner. Communication of legislative issues isa provided by Brielhigs, webinars and onsite meetings. We have included sample Bri�hi itl Appendix 4. Keen at`a Our website features a section specifically devoted to California public agencies. Webulars can be viewed and downloaded f resourceti t t __ We also offer our comprehensive Health Care " Reform web page, an online resource for all our clients regarding new Affordable Care Act (ACA) legislation Information is organized by subject (e.g., Administration, Employer Requirements, Cost Drivers) making it easy to locate information on a w w specific topic of this wide reaching subject. Keenan has produced more than 14 webinars specifically on Health Care Reform and these can be iewed and downloaded from the Tool Section (hrr :lt'`��� ��.l:eerlan.cf�t�1r'heels}1 c��re-ret«ri�'�idros;'). Presented by our subject matter experts, these webinars offer in depth exploration of the ACA and how it will affect Counts- and your employees. Other examples of our approach in this area,which have been provided to our clients as the legislation was enacted, are: COBRA administration manual specifically designed for public entities ra HIPAA overview and compliance services through our BridgeFront program Analysis of Social Security Coverage (OBRA 1990) legislation and the development of alternative plans for part-tune employees Keenan * The ongoing monitoring of Section 125 regulations and how they affect members plans � .r * Development of retiree liability regulations and � � • i compliance with Governmental Accounting Standards Board (GASB) requirements * AB88—Mental Health Parity Medicare Modernization Act .. All of Keenan's service team personnel are briefed on current legislative issues and potential changes to legislation and regulations. As critical legislation is enacted, Keenan will provide the County with comprehensive resources to ensure you receive the information needed to keep abreast of the changes. Our services include access to webinars, trainings and manuals,based on the type of issues being covered. Keenan provides an array of educational, training, communication and support services to our clients. Our structure is built in such a way that our staff is exposed to ongoing, consistent statewide training to bring the most up to date information to the County staff and management. Below is a description of our service structure and the detailed training and support service we provide. Today's focus is on plan years beginning an 1/1/15. Topics: Keenan regularly distributes Compliance Advisories EmployerMandate-Meeting the 95%Threshold designed to inform clients of news and legislation that may impact them. During the past three years, ; Keenan has conducted many client seminars and MEC-Minimum Essential Coverage . educational programs, provided at no cost to our MV--Minimum Value(60Q • Affordable--Self•onty coverage that costs no more than 9.5% clients. Topics include: of housphold incomp • ALE-Applicable Large Employer(50 FP Employees A FTEs( ® Health Care Reform Webinars and F Trainings: Keenan has been closely trackingeettcrt health care reform legislation and its potential impact on our clients and the marketplace ina general. Since 2010, our Training and Legal a a a Departments have presented the details of the various legislative proposals and �... ' requirements of the Affordable Care Act. Ke C---v na-V 6-� G Workers' Compensation Symposiums: Day-long workshops on topics relating to workers' compensation and the California regulatory environment. 0 GASB Retiree Health Liability Lunch & Learns: An *introduction to the requirements for accounting for and reporting future benefit liabilities and strategic solutions for funding and investment. (conducted in numerous local community groupings throughout the state). 0 Family and Medical Leave Client Workshop: These cover legal requirements, leave management and integration of claims relating to FNIIA and other forms of statutory employee leaves. a Health Benefit Webinars and Trainings: Keenan conducts webinars and trainings throughout each year for our clients that cover topics 'including: health care reform; Hll?,A_ik; FNILA; CFRA, COBRA (and ARRA COBRA subsidy changes); and, pending legislation. In addition, Keenan holds a periodic sui-riffuit for our clients. The Keenan Summit addresses key public policy issues that may impact their programs related to various lines of insurance and benefit programs. The discussions typically include Health Care Reform and federal and state initiatives for the Affordable Care Act and focuses on the importance of understanding millennials in the workplace. b. Notifv the County of necessary steps towards compliance vvith new legislation Impacting cozlnjj7 health Plans. As mentioned above, Keenan's Legal Department maintains dedicated personnel who regularly track both pending and newly enacted legislation in order to provide updates to our clients in a timely manner. Communication of legislative issues is provided by Biiefings,webinars and onsite meetings. c. RevicTv plan documents and internal Count,policies to ensure compliance with appropriate laivs and regulations and to ensure that the Coulln, is ad, hering to industry best practices. Afake recommendations regarding necessary amendments to plan documents or internal policies and assist in their preparation. Our professional contract specialist and service team are ready to assist the County in reviewing the insurance provisions in your SPDs and EOCs. We review to make sure that the provisions the County applied and contracted for are correctly included and that compliance disclosures have been incorporated in the documents. Ke n an d. On an annual basis, audit the Countv's current licalth insurance administration practices (including, but not limited to, forms and communications to participants) to ensure compliance Stith applicable Javus and regulations, a as well as applicable plan documents and internal policies. Make recommendations regardin,,,necessan-changes to current practices. Keenan can and will comply with this requirement. e. Assist in in advisory capacity in revieu-ing and ruling on appeals from members covered by the Counn7',,; Cafeteria Plan (includes Health Insurance and Flexible Spending Accounts). Keenan can and will comply with this requirement. 11. DATA ANALYSIS AND REPORTING 1. Monitor, analyze and report monthly claim experience, identifying trends and changes in large claims activin7 on a monthly basis. Your Keenan account team will provide semi-annual estimates of renewal rates, cost trends and other assistance in preparation of budget figures. Working solely with public entities helps our team understand the unique timetable on which these public sector entities operate. Your account team will be available to participate as necessary, to help with the presentation of any technical data or 'information. As previously identified, we will also provide the County with a stewardship report which will 'include summaries of past performance as well as details related to forecasting. Keenan generates several different provider performance reports based on the desired frequency and specific needs of our clients. This is the same information as the answer above—see page 29 —JJ do we eliminate this section since this was covered on Paige 29 . * Annual Renewal Report — Covers all financial aspects of the plan performance, including claims analysis, claim lag studies and reserve calculations, recommended funding and contribution levels (including COBRA and AB528), suggested plan changes, trend analysis, etc. * Benefits Utilization Analysis Report ® Preliminary Renewal Reports—Where appropriate ® Annual Year-end Analysis—Examines in detail the actual performance compared to stated objectives, a re-examination of the renewal to determine whether the action taken was appropriate, claim utilization data and appropriate recommendations for plan changes Kerej n a n Ad-hoc reports to meet specialized needs of the County 2. Monitor, anahze and report claim utilization data in a format that is clear, concise and actionable. Keenan consistently monitors and reviews carrier reporting on your claims experience (if available). The importance of appropriate, accurate, and timely analysis cannot be overstated. In addition to our professional staff in the Torrance office, our Benefits Underwriting and Actuarial Services Department constantly monitors and reports on all relevant financial aspects of each benefit plan. This department provides underwriting and actuarial work 'including, but not limited to renewal analysis, reserve estimates, plan change pricing and claim utilization analysis. Keenan & Associates is committed to monitoring vendor performance on an on-going basis. We will keep the County informed of the insurance carriers' and health care service plans' performance by: ® Performing quarterly reviews of plan administrators to assure compliance with contract performance guarantees * Developing annual report formats for each of the vendors based on the County's needs * Developing and implementing Quality of Care benchmarks and report cards for benefit plans. Distribute results to plan participants ® Providing revised annual financial projections quarterly for the benefits program (both calendar year and fiscal year projections) based on current enrollment levels and cost trends. Comparing financial projections to approved budgets and advising the County with respect to potential corrective measures to balance the budget,if necessary * Analyzing financial experience with respect to risk sharing cost targets * Monitoring their AM Best and Standard & Poor's and other financial and claim payin9 payin capabilities ratings g * Preparing annual summary reviews of health vendors' performance for the contract Ke C--s nan III. VENDOR RELATIONS 1 RFP and Contract Development a. Development of requests for proposals (]?FP) and subrnittino-PFPs to viable medical(includrng mental health), dental, vision, and prescription providers. We have significant experience in designing public sector benefit programs. Our standard process begi is by collaborating with clients to understand their financial and benefit objectives. Once the objectives are defined, we work-,with the client to determine a customized scoring aligned with their objectives. This is important as we understand that every client is different and priorities may change. We articulate what is most important for our clients in the RFP, not simply using a standard RFP template. Once the objectives of the RFP and the scoring systems are developed, we start our electronic questionnaire process for creating the proposal and prepare the client's benefit program data for the RFP. A sample RFP questionnaire with RFP timeline is attached, however, we believe that every client is different and we customize the questionnaire according to our client's specific needs and objectives. The number of questions range from 25 to over 200 depending on the type of RFP and our clients' need. We routinely require at least 2-3 weeks turnaround time for formal RFPs. Responses must be received in the stated requirements and formats and also incorporate Q&A time and in-person provider presentations. Our significant market presence with carriers gives Keenan the opportunity to get more detailed information for our clients. Kaiser is providing us detailed claim experience on all our accounts to justify rating and renewals. We successfully implemented the first account that Sutter Health Plus wrote. Keenan then provides a summarized version of the responses to the questionnaire which is analyzed by our account management and underwriters and also reviewed in-depth with the client so the}- can provide feedback. A proposed rating of each provider is presented to the client but that rating can be revised or changed by the client after the in- person provider presentations have been concluded. Our consulting team and the client will then finalize the scoring and select the winning provider by the results of the overall scores. Once a vendor is selected, we then ensure that financial and service guarantees are in place. A significant amount of financial risk is attached to a first year's program implementation and standard guarantees on subsequent Sears. Following are the key issues that Keenan considers when preparing for the marketing of benefit programs. 0 Your philosophical objective 0 The collective bargaining environment a Financial objectives including enhanced investment opportunities 0 Assessment of results generated by existing programs Projection of plan design change, claim and cost impact 0 Measurement of results versus objectives 0 Identification of areas of benefit utilization where savings may be generated 0 Comparison with other programs throughout the state Following is an overview of the steps and responsible personnel for the marketing of benefit plans. a Creation of RFP — RFP Creation by: Account Service Team Support from BUAD • BenefitPoint used to release RFP — Lead consultant enters the RFP into the BenefitPoint system Fn.elist Scoring — Online system that releases the RFP to any carriers in the marketplace that have been targeted x m — Aggregates responses to the RFP 'D ` " `' — Allows for review of criteria included x i 1 1�s§xlrxr'rsc xx�tAce�x cmrw � t`r fiS .� for other RFPs released by Keenan for benefits clients `' ® Evaluation of Responses — Performed by: 0 Account Team 19 BUAD Presentation of Objectives, Recommendations and Timeline — Performed by: 13 Account Service Team b. Rei en-and evdIn to vendor responses to RFP and present a summarq,of the results to die County. As mentioned in our previous answer, Keenan will review and evaluate vendor responses to RFPs and present the County a summary of the results. Keenan — c. Assist in nt, otiatifl,c, fee agrectnents xvith selected vendors and provide an executive sum-marvreport of results of negotiations and final rates1fees, Carrier renewals and rates are also validated and benchmarked using Keenan's proprietary actuarial tool as developed and calibrated by Millirnan USA. Our expertise in underwriting and premium evaluation allows us to work with carrier underwriters on their own level and to negotiate favorable rates and conditions for our clients from a position of strength. Final negotiations are completed far enough in advance for benefit communication, payroll and billing requirements to be completed. Final rates are also checked by the Service Representative and formally documented for your records and ours. All proposed contracts are reviewed and evaluated to ensure appropriate compliance and liability. An executive surninanT report of the negotiation results will be presented to the County. d. Facilitate the transition to neiv vendor(Ynecessapz). With more than 44 years of industry experience, Keenan has developed a detailed action plan to ensure that our clients' transition to our services is smooth, avoiding any impact to their workflow. Our process for implementing a smooth transition begins with a post- award meeting during which we identify critical milestones and responsible parties. Our overall transition plan follows a timeline that details necessary steps for notifications to carriers, communications with employees and retirees (4 applicable) and the implementation and training for County personnel on any technology related solutions. implemel I Immediately upon award, your Keenan Account Team will work with the County to Implement a timeline based on the County's upcoming renewal schedule. e. Please provide sample RFPtnaterials (i.e., anv evaluation tools you u-0 use to accomplish the tasks described in paragraphs a —d above, as well as a sample tirn eEn e) We have provided a sample RIP in Appendix 5. Z. Vendor Alanagem en t a. Establish appropriate vendor performance guarantees in collaboration with the County. Keenan will establish appropriate vendor performance guarantees in collaboration with the County. Keenan b. Ensure that vendors are in compliance with the terms of their agreement mitI7 the Coun�r and monitor performance guarantees. Keenan will monitor and evaluate performance measures and guarantees for your providers. Furthermore, when specific measures are not being met we will make recommendations to the County that will help get the specific providers back on track. c. Upon request of County staff or whenever appropriate, act as a liaison between the Countj, and�vendors, including but not limited to, participating in problem resolution and strategic planning` The Keenan account management team provides day-to-day consulting support to the client's benefit staff to ensure the administrative needs of our clients are being met. We will work directly with County staff to address a specific benefit question or claim concern that the County is unable to successfully resolve directly with the carrier or administrator. After reviewing the circumstances and evaluating the contract and booklet provisions, we discuss the benefit question or claim concern with the County and carrier or administrator to determine the appropriate action and follow through until the problem is resolved. We will also meet regularly with the executive and administrative staff to review the operation of benefit plans and help to monitor how well plans are meeting strategic objectives, specifically in the area of the carrier's or administrator's customer service or claims support metrics to ensure they are meeting contracted performance standards. d Conduct annual strategic sessions with vendors to discuss perforalmce, opportunities, and updates. Keenan can and will comply with this requirement. c. Attend meetings or conference calls north vendors as requested by the County, but no less than once per quarter. Keenan can and will comply with this requirement. f 31orzitor insurance companies for financial solvencj,7 inhere applicable. Keenan can and will comply with this requirement. IV. ACTUARIAL,UNDERWRITING AND FISCAL SUPPORT L Provide actuarial cost projections for various plan feature changes and improvements. Keenan's Benefits Underwriting and Actuarial Department capabilities provides out clients with state-of-the-art underwriting and actuarial systems designed specifically to meet the needs of public agencies. 4 Ke rev n a n We have a staff of 10 including actuaries, senior underwriters, and technical analysts. A senior underwriter with a minimum of 10 years experience and a benefits actuary with a minimum of 10 years experience and a Fellow of the Society of Actuaries (FSA) will be jointly assigned to perform the monthly and annual underwriting and actuarial services needed for the County's health program and self-funded accounts. Our Benefits Underwriting and Actuarial team is accustomed to handling benefits and actuarial work related to the County's actives/retirees fully-insured and self-funded plans, and working with benefit and advisory committees. We study, underwrite, and set reserves for more than 250 California public entity self-funded benefit programs and a majority of our clients have trusted us for 20-30 years. We will work closely with the County to determine the format and timing of all necessary analyses and reports and one of our underwriting/actuarial staff members will be available for meetings and presentations as necessary to explain analysis and results or to assist with 9i ear multi-y strategic planning. 1 Our team members are experts in the following areas: * Developing underwriting and actuarial cost projections provided monthly, quarterly, or annually. * Developing quarterly or annual reserve analysis and certifications. * Developing and providing monthly experience and reporting. * Analyzing benefit designs, contribution scenarios, the impact of Health Care Reform mandated benefits, and plan comparisons against Covered California (Health Insurance Exchange). We use a proprietary actuarial model that can model hundreds of benefit designs, contribution, and network scenarios. * Analyzing experience and cost efficiency of Stop Loss programs. * Analyzing cost efficiency of provider networks *including discounts and Coordination of Benefits. * Analyzing pharmacy experience and rebates. * Studying the financial impact of narrow provider networks, direct contracting, Onsite clinics, wellness and disease management programs, and carved out pharmacy,behavioral health, and other specialty programs. * Overseeing and monitoring claims or financial audits. ® Monitoring and reviewing TPA performance financial guarantees. "r r Ate 0,nan f.0 Lill! 1V rtHS j\(' 1'•'`)11.`•t In I\Cil U, 1 1' 1'1 )I)( 1:i ..;I IL]1 ....._.. ._'}i tt i'S-I'i�?Ii SI'CC i3c tc i�I- 1t,f:t I II Si;n 11.c Monitoring and reviewing Stop Loss Reinsurer experience and administrative performance. Z. Analyze rates developed by Me San Joaquin lWallev Insurance Authorin,from an independent actuary perspective. Keenan can and will comply with this requirement. As mentioned before, besides the actuarial review of the rates, we have unique experience on how a JPA should be rated and how that would affect an individual agency. 3. Analyze and recommendplan funding alternatives. Due to our public agency focus, we have considerably more information than any other California broker or consultant regarding best practices on program designs, plan options, funding alternatives, cost containment procedures, network maintenance, claim practices, administration, reserve levels, trend factors and other critical components of a plan's operation. We know which carriers or vendors have the best performance in a particular region,which networks offer superior coverage,what plan designs and options have proven successful with public agency plans and which managed care networks offer the most stability. 4 Prepare financial projections from alternative benefit designs and/or emplovee contributions. We are prepared to review and present all funding options. PART B—SCOPE OF OTHER BENEFIT CONSULTATION SERVICES Keenan and Buckman-Mitchell can provide all support as required, based on the requirements of the PART B scope included in the RFP from the County. Both Keenan and Buckman-Mitchell have significant experience with voluntary benefits, and we can present options if the County requires a change to current in-force programs. I. ADMINISTRATIVE SERVICES All administrative services for other benefit consultation services required and defined in the RFP from the County, are provided in a similar manner detailed previously in this proposal, for Part A. 49 Keenan I J:?'1i.�i, 045 t / fliljtl't!!II't S0, ,f 1 ol/.s. F_11C/It1'/, P"' 5.e 13 c i a r r f 11. VENDOR RELATIONS 1. RFQII?FP Process a. Develop requests for quotations (RFQ) for Insurance Policies and requests for proposals (RFP) for Prq4,mun Adniitiistrator,5lProi-iders in compliance wilt Coiinnpitreliasingrequirements. We have previously detailed our abilities with regard to developing request for quotations. b. Compile a Bidder List of viable providers for current programs. Keenan has access to all vendors in the marketplace and our systems allow us to send targeted R-FP/RFQ requests to appropriate vendors and/or carriers. c. Review and evaluate vendor responses to RFP and contact vendor references. We have detailed our capabilities throughout this proposal. d. Present a summary of the results to the Count and make finalist recommendations, if applicable. We have detailed our capabilities throughout this proposal, and we will provide recommendations based on our industry knowledge. e. Assist in negotiating agreementswith selected vendors. We have detailed our capabilities throughout this proposal. f Facilitate the transition to new vendor. We will support this requirement, as detailed throughout this proposal. 2. TendorAlanagement a. Establish appropriate vendor performance guarantees in collaboration 11ith the CO I in 4'. We will support this requirement, as detailed throughout this proposal. b. Ensure that vendors are in compliance ivitli the terms of their agreement Tvith the County and monitor performance guarantees. We will support this requirement, as detailed throughout this proposal. Keenan i.y7licnever appropriate, -let as a liaison c. Upon request of County staff or between the Countv and vendors, including but not limited to, participating I in problem resolution on and s tra tegic planning. We will support this requirement, as detailed throughout this proposal. d. Conduct strategic meetings or conference calls with vendors and County staff to discuss performance, opportunities, and updates, no less than once per quarter, We will support this requirement, as detailed throughout this proposal. C, Monitor insurance companies for financial solvency n-here applicable. We will support this requirement, as detailed throughout this proposal. C [Mien reports or other documentation are to be a part of the proposal sample of each must be submitted Reports should be referenced in this section and submitted in a separate section entitled "REPORTS. " All reports and/or other documentation have been included in the Reports Section of this RFP response. D. A complete description of ai.7y- alteruatitc solutions or approaches to accomplishing the desired results. We believe that we have detailed all available options throughout this proposal. KeMan R ,..>. 9F . . n... .e — .a„. (quotations may be prepared in any manner to best demonstrate the worthiness of your proposal. Include details and rates/fees for all services, materials, equipment, etc. to be provided or optional under the proposal. OPTION 1 Annual Consulting Fees WITHOUT Conunuissions from Voluntaiv Insurance Products;Broker of Record service is not provided A. Provide the annual flat fee retainer to provide consultant services to the County as described in the Scope of[Fork. Following are the proposed consulting fees for the County of Fresno, for the services required and detailed throughout this proposal. 4 - $60,000 $65,000 B. Please provide pricing for the two contract terms described below and describe ant,details regarding guarantees for all proposed pricitug (a) Three year contract term with two one year reneFvals. A three-year contract would be the same as indicated in A above, with the following Renewal year pricing. Mt � WK 67,500 . (b)Fiveyear contract term. Following is the proposed pricing for a five-year contract term. $60,000_ 62,500 65,000 am65,000 (c) Will.your 17tm guarantee pricing during the length of each contract term? Yes, Keenan will guarantee pricing during the length of the length of each contract term. C List all possible administrative cha�,es that ivould not be included in the flat rate fee structure. There are no administrative charges. OPTION 2 Annual Consultii�g, Fees TVITH Con2missions from Voluntary Insurance Products; Broker of Record service is provided A. Provide allinforn2ation requested in Option 1 above. A. provide the annual flat fee retainer to provide consultant services to the Counter as described in the Scope of Work. Following are the proposed consulting fees for the County of Fresno, for the services required and detailed throughout this proposal. IN; ii IN $55,000 $57,500 $60,000 B. Please provide pricin,- for the two contract terms described belovy,and describe an v details regardinggliarantees for all proposed pricing; (a) Three-year contract term with nuo one-year renemids. A three-year contract would be the same as 'indicated in A above, with the following Renewal year pricing- $60,000 $62,500 Keenan (b)Vibe-near contract term. Following is the proposed pricing for a five-year contract term. v 55,000 60,000 000 000 (c) Will your firm guarantee pricing during the length of each contract terra? Yes C: List all possible administrative charges that would not be included in the flat rate fee structure. There are no administrative charges B. Identi6l, any, and all potential revenues associated v ith broker of record services that would offset the fees to provide consultant services to the County as described in the Scope of Work. Please note that ald commissions are rewired to be disclosed to the County to ensure maximurla transparency. Keenan would receive the commissions on all voluntary coverages. The law does not allow for any, employee paid/voluntary revenue to be paid back to the employer. Keenan, by contract, can agree that your contract can change at some future date based on other revenue sources. We would propose that your contract would be reduced in the following contract year based on the following. NO w 5 000 )000 � �. �_ .: _ <, 50% of the additional revenue until the County contract is $0. *each contract reduction row is additive Ix,ere,n a n C, Future commissions from the universal life, disab&07 and critical illness policies through Trustmark fnav be reassigned. The future commissions are as follows: (a) Universal LiYe:5%per Year (b)Disability 6%perYear (c) Critical Illness:11%per year Please note that there are no commissions on the long-term disability insurance polio7 through Met Life and that the commissions on the current life insurance policies through CSAC-EIA and the personal propeqv insurance policies thougli Liberty Alu tual are not able to be reassigned. All commission income will be provided in a stewardship report 60 days after the end of the contract year. Keenan reserves the right to reevaluate the compensation if the County, purchases their medical outside of SJVIA. Kere-wan Our completed Check List form is included on the next page. Keenan y:�i Proposal No. 964-5439 Page 32 CHECKLIST This Checklist is provided to assist vendors in the preparation of their RFP response. Included in this list, are important requirements and is the responsibility of the bidder to submit with the RFP package in order to make the RFP compliant. Because this checklist is just a guideline, the bidder must read and comply with the RFP in its entirety. Check off each of the following: 1. X All signatures must be in blue ink. 2. X The Request for Proposal(RFP) has been signed and completed. 3. X Addenda, if any, have been completed, signed and included in the bid package. 4. X One(1)original plus seven (7)copies of the RFP have been provided. 5. X Provide a Conflict of Interest Statement. 6. X The completed Trade Secret Form as provided with this RFP(Confidential/Trade Secret Information, if provided must be in a separate binder). 7. X The completed Criminal History Disclosure Form as provided with this RFP. 8. X The completed Participation Form as provided with this RFP. 9. X The completed Reference List as provided with this RFP. 10. X Indicate all of bidder exceptions to the County's requirements, conditions and specifications as stated within this RFP. 11. X Lastly, on the LOWER LEFT HAND CORNER of the sealed envelope, box, etc, transmitting your bid include the following information: County of Fresno RFP No. 964-5439 Closing Date: March 10, 2016 Closing Time: 2:00 P.M. Commodity or Service: Employee Benefits Consultant Services Return Checklist with your RFP res op nse. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc x sm- le,&.411m; Vendor shallprovide the follomigg information in a separate section of their proposal entitled "VENDOR RESPONSE SECTION". Vendors shall restate each question then provide the vendor response. L Describe your firm-s capabilities and qua&Ycatioas as they relate to the proo,rams described in the Scope of IT,7ork and list any% characteristics ofyoprr arm that You feel make it unique from other emplc T ee benefits consulting firrrrs. As a proven leader in California public sector consulting, Keenan has more experience with a wide variety of medical plan designs than any other broker or consultant in the state. Our database of public employers is unmatched in California, and we know the impact of potential plan changes based on actual experience. In addition to our extensive experience with virtually every type of managed care program and every funding variation (e.g., self-funded, flex funded, experience rated, minimum premium, fully insured) available, we have developed a number of proprietary programs designed to meet the unique needs of the public sector. While not all of our innovative solutions fit the specific requirements for every client, we work closely to identify the appropriate services to ensure the best quality of service at a competitive price. Our unique and proprietary services include: Personal Choices — Our employee benefits information portal provides cost effective, convenient employee communications and self-service resources for participants. Personal Choices implementation is included at no additional fee for your medical, dental and vision plans. BenefitBridge—A more robust, proprietary Web-based technology solution for employee benefits administration, eligibility, enrollment, billing, reporting, and employee communications. Individual and Family Plan — A solution that greatly assists Part Time employees as well as employees with dependents over age 26 is Keenan's Individual and Family Plan Division. Using and/or our licensed, certified customer service staff, individuals can check their subsidy eligibility and sign up for insurance with any carrier in or out of Covered California. Keenan Direct could also assist the County's general uninsured population. ® KeenanWell — A comprehensive health management program incorporating wellness and disease management including online tracking, personal health strategies and coaches along with an engaging site-based "Thinner Winner" program,if desired. * Keenan Pharmacy Purchasing Coalition (KPPC) — An innovative pharmacy program that delivers cost savings and the most ad-%TanCed prescription management capabilities. In just four years, KPPC has grown to more than 225,000 members and has saved over $55 million for participating plans. * Keenan Saver Rx — A discount drug card for part-time employees, friends and family without pharmacy coverage, Keenan Saver Rx, powered by GoodRx, allows anyone to purchase pharmaceuticals for 5-60% off retail at over 60,000 pharmacies nationwide. Keenan Saver Rx is available for no additional fee and includes access to both a Web and mobile app that allows users to find discounted prices in their area. Additionally, Keenan Saver Rx- can be branded specifically for your agency for a fee. * BridgeFront — A HIPAA Employer Compliance Center. BridgeFront is included for no additional fee. * Keenan HR Reference Room —Keenan has partnered with the Bureau of National Affairs (BNA) to provide extensive Human Resources support to our clients. The Keenan HR Reference Room brings together BNA's specialized news, legal affairs and analysis with extensive human resource tools. As the leading independent publisher of print and electronic news, analysis, and reference products, BNA has provided intensive coverage of new developments for more than 70 years. The Keenan HR Reference Room provides streamlined access to BNA's web-based services, HR tools and e-mail newsletters related to HR topics. * Leave of Absence Administration — Keenan provides legislative and compliance updates related to Family and Medical Leave Administration on an ongoing basis. Additionally, Keenan partners with Qcera, a leader in comprehensive leave management, to offer co-sourced administration to reduce administrative burdens while allowing you to maintain control and contact with your employees requesting leave. We have detailed these programs in Appendix 2. Kecel n a n a. Hou.7 Iona has your him provided consultant services as described in the Scope of Work? Keenan & Associates has been providing benefits consulting and broker of record services for California public agencies for more than 44 years. b. Is vour firm qualified and licensed (if applicable) to conduct business in C.qlifornia.P Please provide appropriate documentation. Keenan & Associates is a licensed broker in the State of California. Our California Department of Insurance License Number is 0451271. A copy of our current license is included in Appendix 6. Furthermore, Keenan is not employed by any insurance company, third party administrative agency or provider network.We are 100% employee owned. 2. If the principal consultant were to leave your firn2, bow would service be provided? Hoiv soon would a neu, principal consultant be assigned to the coljnj�"s account? Mill 1,011 agree to give the county the right of approval of'I'm staff me-mber assigned to this account? Keenan will notify the County immediately should there be any need to change personnel. We would work to ensure that there is no disruption in services and consulting to the County. 3. ITIhat resources do your Iiri have available in the area of developing ennp1Qvce conimunications.P Provide an e.yample of communication materials developed by your organization for use in a client's health benefit conlinunication callipaigns, including Open Enrollment and NevvEn2pkvec Orientation materials. We have previously detailed our communication support capabilities. A snapshot of general communication samples for an open enrollment are included in Appendix 7. The first five pages of a sample enrollment guide are included in Appendix 8. 4. Does your firm publish newsletters and other informative publications that are routinely provided to clients?Have you prepared reviews of topics related to the health, life insurance and actuarial fields that are routinely- provided to Your clients?Describe your publication and provide sample copies. es. Keenan's Legal Department maintains dedicated personnel who regularly track both pending and newly enacted legislation in order to provide updates to our clients in a timely manner. Communication of legislative issues is provided by Briefings, webinars and onsite meetings. We have included sample Mefings in Appendix 4. Our Web site features a section specifically devoted to California public agencies. Webinars can be viewed and downloaded (ji rr12:/ \%-,,vw.ke C I I all.Co 11-1 ZI-es oil 17C C webill"I rs Keenan 1/ .-P We also offer our comprehensive Health Care Reform web Keenan page, an online resource for all our clients regarding The Patient Protection and Affordable Care Act (ACA) legislation Information is organized by subject (e.g., Administration, Employer Requirements, Cost Drivers) making it easy to locate information on a specific topic of this wide reaching subject. Keenan Keenan has produced more than 16 webinars specifically, on Health Care Reform and these can be viewed and downloaded from the Tool Section care- rcf(,)nii/\-1deos/` Presented by our subject matter experts, these webinars offer in depth exploration of the ACA and how it will affect the County and your employees. Keenan regularly distributes Compliance Advisories designed to inform clients of news and legislation that may impact them. During the past three years, Keenan has conducted many client seminars and educational programs, provided at no cost to our clients. Topics include: Health Care Summits: Keenan brings together leading experts in the health care field to present the latest developments and creative strategies for addressing .rising medical costs. K'eenan's suinn-dt also addresses keN, public policy issues that may impact their programs related to various lines of 'insurance and benefit programs. Important topics of discussion included exploring potential workers' compensation reforms under California's new leadership. * GASB Retiree Health Liability Lunch & Learns: An introduction to the requirements for accounting for and reporting future benefit liabilities and strategic solutions for funding and investment. (conducted in numerous local community groupings throughout the state) * Health Benefit Webinars and Trainings: Keenan conducts webinars and trainings throughout each year for our clients that cover topics including: health care reform; HIP,-VA; F1\1LA; CFRA, COBRA (and ARRA COBRA subsidy changes); and,pending legislation. * Family and Medical Leave Client Workshop: These cover legal requirements, leave management and 'integration of claims relating to FNILA and other forms of statutory employee leaves. 7' 7' Ateenov .5 Provide a description of any electronic or irate-met-based tools Your firm pro Tides to Clients. Keenan can provide the County with two technology solutions created by Keenan * Personal Choices — a portal provided at no cost that assists employees with education on benefits options. * BenefitBridge — a Web-based enrollment, administration, and eligibility system which is available for an additional fee. Following is an overview of both of these options. Persona PersonalChoices places important benefits l Choices information online for employees and dependents to access, enabling them to become more self- sufficient in understanding their benefits. PersonalChoices links employees to other critical resources to assist them in dealing with such issues as long-term care/eldercare, location of accredited skilled nursing care facilities, location of child care facilities, provider look-up tools, and links to relevant sources like carrier networks and Social Security. PersonalChoices will enhance the quality of how you communicate to your employees and members. Access to this portal is as easy as a link that can be placed on the agency's internet or intranet site. Here is a summary of the information and resources available on the website: Benefit Plan Information — Lists benefit plans offered to employees. '��j'Pejsonal Choices Plan information can be viewed individually or use the compare tool to view two or more plans (i.e.: Blue Cross HMO vs. Kaiser HMO or a current plan to a pending plan, if available). 6axt.. Let.Event: Aasmr.c Life Events — Provides employees with information for specific life events such as Having a Baby or Getting Married. The section also provides a variety of topics like Family and Relationships and Finances. Resources —This section provides a link to Federal& State Programs and a link to Calculators. The Federal and State Programs section provides a variety of links to governmental programs including FMI--,k, HIPAA and other current topics. The calculator links can be used for budgets, FSA elections, credit lines, retirement, etc. Kec,-j n a n Keenan made a strategic decision over 12 years ago to build our own benefits administration system for our customers, BenefitBridge. After an extensive evaluation process where we considered buying a benefits administration company, or licensing one from a benefits administration provider, or building one ourselves, we determined that building one ourselves was the best way to best serve our customers. Public Agencies and jPAs have too many nuances that most commercial benefits administration systems are not equipped to support. Further, Keenan determined that we needed to own and control the development resources so that we could warrant the systems' performance ourselves, and to make any needed coding/functionality changes whenever we determined it was needed for our customers. None of this is possible when a company outsources this functionality to another company. Development and software upgrades simply are placed into a development release cycle with limited assurances that they are actually completed or when. As such, Keenan developed and owns BenefitBridge to be more responsive to our public agency's benefits administration needs. Keenan continually invests in upgrading our benefits administration platform that has further been implemented in over 250 public agencies including 200 school districts in California, with over 500,000 public agency members using the system today. The most recent enhancements released in the first week of October include new features and tools to improve the platform's consumer/member functionality and experience as well as dashboards to simplify such important data as ACA fees and taxes, 'including the Cadillac Tax, and unfunded OPEB liabilities. The BenefitBridge employee benefits portal provides administrative automation and on- demand information for our clients' employee benefits needs in a Web-based, total technology solution. Through a single online portal BenefitBridge integrates benefits enrollment, eligibility, participant communications, and employee self-service tools to maximize the effectiveness of benefit plans and resources. Saves Time. Saves Money. Your benefits department has too much work for too few employees. BenefitBridge saves your HR department from making entries in multiple systems and faxing or emailirig eligibility information to a variety of carriers. The BenefitBridge single-point-of- entry system enables you to enter the 'information once and transmit it to multiple carriers—reducing the amount of time spent entering data and reducing the possibility of data errors. Adds Value to Your Benefits Program With BenefitBridge, employees have access to their benefits 'information 24/7 from any computer with Internet access. The system provides tools to educate users about the benefits and perform a side by side comparison of benefit plans enabling them to make informed choices. BenefitBridge also provides access to a health and wellness libraii, Ke n an which includes 'information regarding life events ranging from new babies to new houses. Since BenefitBridge is a Web-based system there is no technology 'investment required for implementation. Following are the key features and functionality of BenefitBridge as it relates to both Employee self-serve features as well as Employer features. Below is a sample of the new enhanced homepage. pa 1W Www" BenefitBridge is available on all platforms including mobile devices. The application 'des in provides access to valuable information for the employees to access while they are on the go 'including: * Plan designs for all plans offered by their employer * Summaries of the plans they are currently enrolled in and who is covered * Links to wellness 'information and tips and links to any discounts available for wellness benefits Employee Features Include ® Online enrollment in benefit plans for new hires, open enrollment and life events * Identifying which plans they are currently enrolled in and which of their dependents are covered in those plans Kerman G Viewing and comparing plan designs within a plan year and between plan years ® Use of an online encyclopedia covering a wealth of health and wellness topics 0 Reviewing guidelines for handling life events and their impacts on an employee's benefits 0 The ability to download any form or document pertaining to their benefits, to perform cost comparisons between plans, to print a copy of their selected benefits. The many self-service features of BenefitBridge xvill help to free-up your benefits administration staff to handle other functions as employees shift to self-service for selected benefit changes. Employer Features Include Beti�flfflridge , 4-- - C C uz Cc pkbr R&part 1 CWrirT DWORMWrA CV= Ss U-ia EMPI Yvm WiFmt COVO.-AW 1 Fnm1W SubwAbl by P� Mad Enroll Cermn M�VZWXMMMMMMLA nor-omm rraaeafecis O-Mp Rathe AV Chingn Np..A..Ag.L -0--4- ECTUkbrLa by Cli2m asa .. Soy �2 11 1rom re n a n Using the integrated online interface, the Human Resources Administrator will be able to: * Manage employee demographic and employment information * Manage employee's dependent information * Make enrollment changes including adds,waivers, terminations and changes * Provide a system of record for all eligibility data regardless of carrier, greatly sirnphf ing customer scivicc ® Review employee entered enrollment records * Automatic transmittal of all eligibility data including retroactive cntolhnent changes to relevant carriers * Automatic creation of Carrier Billing Reports, greatly, simplifying carrier billing reconciliation and enabling self-billing for plans in some situations (e.g., volume based bills for voluntary life 'insurance). * Manage overage dependents 9 Identify personnel requiring Cobra notification * Produce benefits summaries for employees which include the employer contribution towards the employee's benefits * Provide a large number of management reports for ad hoc data analysis including census, enrollment,payroll, dependent, and retiree data. * Links to provider networks enabling the employee to find doctors, dentists and other service providers and to look up claims 'information * ACA Excise Tax and Fee Dashboards which can summarize the ACA Taxes and Fees for the County. These taxes and fees are based upon it's the unique bargaining agreements and premium levels. NI Ke n a n ACA Excise Tax & Fee Calculators (Dashboard Example) -------- 2016 Plan Cost 534S4C`AK1 s= " WCR Annual fees 5ax;re� .... �� Summary Breakdown es�ota.Ex n,Xea ttGR Ferns$) %B, Tc4.:N1 Ccs.",I.FOm($k "m§ 3'"... F *•,.r^�^* k 0 '�,�' RON a BenefitBridge has the ability to serve all classifications of employees in our platform. The system is uniquely designed to serve the entire continuum of members ranging from part-time employees all the way through post-65 Medicare retirees as highlighted below. This workflow demonstrates simply the various classifications of employees/members our benefits administration system serves. Demographic Classification er,"%n a n 1 '','0, I Z: fr � e S BenefitBridge will enable members through sophisticated decision support tools to answer some basic questions and in return be presented plans and options that most closely align with that individual's circumstance. HEALTH STATUS We have developed additional educational mediums such as video chalkboard technology that explains important health insurance benefit issues such as the differences, pros and cons of an HMO vs. a PPO, or a high deductible plan. Such tools are common in today's electronically connected world. These videos can be customized specifically for the County. HMO or PPO? Question of now to manage your health care 4P, ......... T;r nan f/ CO of t -CI - A�t,)T.IMS bare on controlling Describe your f7rai s view of role TV ICSS P R Ilealt]) care costs. Mhat resources and tools do Vou offer clients arourid weRriess initiatives? Wlh;it service does your firm Provide for developing a Iflell-ness Prqgra,rn? Keenan has been an 'industry leader in identifying employee benefits related programs that assist clients in controlling continuously escalating costs. As a significant part of this effort, Keenan has invested resources in wellness and disease management programs that are geared toward improving your employee populations' health, and thereby impacting your premium rates. Our efforts 'include the development and implementation of comprehensive wellness programs through our array of KeenanWell health management consulting, best-in-class and third-party vendor partnerships. In addition to its dedicated KeenanWell team that assists clients with designing implementing, and evaluating wellness and disease management programs (see names, tides, and qualifications below), Keenan continues to educate its benefits service personnel in the application of population health management as a primary, opportunity for cost-savings. All of Keenan's Service Teams have worksite wellness program training certification by the Wellness Council of America (WELCOA). Through our strategic health management approach, Keenan assists our clients in developing wellness program leadership teams with representation from the organization's management, organized labor, employee benefits, and health plans. The responsibility of this team is to a) demonstrate the support and commitment of these entities to the program through collaborative efforts, b) help provide coordination of and direction for the program toward meeting the wellness goals and objectives, c) obtain funding for the program from 'internal and external sources, and d) serve as advocates for the program. Keenan has found that the key to garnering effective involvement and support from these groups is to identify the respective goals they want to attain through provision of the wellness program, and then facilitate collaboration on how they can collectively support those goals through their joint efforts so that everybody wins. Regardless of the program design, KeenanWell focuses on the primary, n I goals of improving employee health and productivity, and providing an optimal return on investment (RO1). Keenan's best-practice program designs for its clients, and the re-design of existing programs, has resulted in substantial growth in employee engagement and positive program outcomes. As a result, several Keenan clients have received recognition for the quality and effectiveness of their wellness programs by receiving the American Heart Association's Fit Friendly Company Gold and Platinum Awards. Keenan' clients in Northern California who have received this award over the past two years include the County of Mendocino, Port of Oakland, City of Fairfield, City of Livingston, San Joaquin Regional Transit District and the County of Sacramento. An overview of the types of wellness and disease management programs support that Keenan can provide are identified below. Clients who have utilized the offerings noted Ke U/71 n a n �J below in the last 24 months include the County of Mendocino, The County of Sacramento and the Port of Oakland. WELLNESS AND DISEASE MANAGEMENT By an population health management strategies for wellness and disease management that have proven effective in engaging employees and their dependents, Keenan Well help its clients to have a positive unpact on employee health status, productivity, and quality of life, and ultimately achieve a positive return on investment for the organization. KeenanWell strategic health management consulting capabilities include: Conducting a needs assessment. * Performing an audit of an organization's wellness culture and its current resources (available through carriers and other entities). * Developing a multi-year program blueprint to guide the organization's health management initiatives. * Determining what additional resources are needed and helping the organization to acquire them. * Identifying effective engagement and incentive strategies to assure optimal participation in the programs. ® Promoting the wellness culture throughout the organization. * Assisting with coordination of the program and carriers/vendors a Conducting program evaluation by identifying, tracking, and assessing appropriate metrics. Providing guidance on health care reform and regulations related to wellness programs, preventive services,rewards, and value-based benefit designs. Through KeenanWeTs third-party preferred vendors, clients are also offered a variety of options to meet their particular health management needs: a wellness program only, a condition management program only, or an integrated wellness and condition management program (population health management). Other separate or integrated ancillary services available to clients through Keenan's preferred vendors include: • Biometric screening (onsite and offsite options) • Wellness and/or disease management coaching (onsite, online, and telephonic options) • Wellness program management (onsite program manager) Accnan _. _ -- Fitness facilities design and equipment acquisition These program services can serve as either stand-alone health management components or as a complement to the employer's health plan carrier resource. 7. Indicate your frrm's ability to frequently (at minimum 8-1© times annually) meet face-to-face to discuss industry, regulatory and service issues faith County of Fresno, including meetings avith County executive and benefits staff, Health Benefit Advisort,Council meetings, and other venues. Keenan can comply with this requirement. 8. How many days of advance notice would your company require in order to attend ad--hoc meetings? Do you have any limitations with attending face to face meetit cgs? We prefer at least 24 hours notice for meetings, and we will be available when required. 9. What is your fitm's policy/standard for returning phone calls and providing responses to MMR5 or written questions? Our offices are open Monday through Friday from 7:30 AM to 5:00 PM. Phone calls, e- mails and written communications are returned within 24-hours. During contract implementation, we will provide you with contact information for your entire account team,including off-hour and high priority hotline numbers. 10. Describe your firm's experience avith labor contract negotiations, as well as with a jointlabor/management tads force or committee. Keenan has extensive experience in the collaborative work process involved with employee benefits committees. Understanding and communicating new program options, concerns and successes through an active Benefits Committee leads to the most successful relationships throughout the organization. Our consulting and service team has extensive experience working with management and labor to develop consensus around benefit design issues. Keenan has built best practice models including mission statements, agendas, minutes, educational programs, etc. Our commitment to this process is manifest by the recent development of our Labor Relations Department headed by Steve Balentine, Vice President/Labor Relations. Prior to his move to Keenan, Steve spent his 30-year career working in the ranks of CTA and CSEA. He brings great perspective and experience in the field of labor relations. Still,we know the relationship between management and labor is a sensitive area. Our philosophy- is to work first at your management team's direction. When strategy is created, we have realized great successes in augmenting both Keenan's and agency relationships with labor and in building the necessary consensus among all constituent members to create stability and good will. Ke res n a n Building Consensus Between Labor and Management is a Keystone of Keenan's Solutions — We have more specific experience than any other consultant in the marketplace in building and maintaining the critical communication bet\veen Labor and Management groups. — Keenan Staff Training — All Keenan Personnel are trained on how to facilitate effective Joint Labor Management Benefit Committees QLMBC). Dedicated Labor Relations Division Lead by Vice President Steve Balentine — Steve has more than 30 years of experience as a Labor Representative ® United Paramedics of Los Angeles (UPLA) California Teachers Association (CTA) ® California School Employees Association (CSEA) — Served as leadership for: Metropolitan Employees Benefit Association (MEBA), Representing over 20,000 lives California Purchasers Health care Coalition (CPHCC), Representing over 300,000 lives ° California Health Care Coalition (CHCC), Chair, Representing over 4.5 million lives 11. Describe j>our lirrn'.s experience and expertise with the Patient Protectiori and Affordable Care Act (ACA). Hoar have you provided assistance to your clients ill monitoring compliance ii;tli the ACAP Recognizing the significant impact Health Care Reform (HCR) would have on our clients, Keenan committed resources early on to providing consulting and education services around HCR for our clients. Starting in 2010 when the ACA was signed into law, we began conducting extensive and continuing internal training dedicated to the ACA to prepare our field teams to work with our customers. We have a full time attorney and research team specializing in employee benefits and the provisions of the ACA. As regulations are released, we developed numerous consulting tools used to educate clients and analyze the benefit plan and workforce characteristics that will affect critical decisions. These capabilities combine to give our clients approaches and solutions that individually fit their objectives and philosophy. 12, Detail your ability-to monitor regulatory and legislative developments at both the state and federal level as well as bon, Your Krin alerts clients of changes and assists in compliance. Describe otprovide examples of these communications. We have detailed our abilities at length, including Keenan's legal team that is dedicated to monitoring legislative and regulatory changes. 13. Describe vour fum's! legal research capabilities and ability to provide leg;al opinions. Does your Arin have access to a benefits attorney ivfio could tender Opinions to the C0111.1typ Keenan provides multiple training and communication pieces to our clients to ensure that they are 'informed of the ever-changing benefit landscape. In addition to Briefings,we also conduct webinars on a regular basis regarding high priority, issues. However, it is important to note that Keenan & Associates is not a Law Firm and therefore does not dispense legal advice. 14. Tell us bow you monitor and report on pro viderperfortnance. Provide a sample of provider performance reports your filmy has completed for current clients. A sample stewardship report is 'included in Appendix 9. 15, Discuss Your firm's experience conducting RFPIRFQ processes for health, life, and disability insurance carriers, as well as flexible spending account administrators. Hory really RFP projects for these providers/services did your firm complete in 2013, 2014, and 2019 for your clients? We have detailed our abilities with the RFP/RFQ process. Keenan conducts more than 50 of these projects each j,ear for California public agencies. 16. Does your firm have a conflict of interest policy? If so, please provide a cope,. Also, please describe any conflicts that have arisen vvithin the firm and bow t11tj7 were resolved Please see Appendix 10 for a copy of Keenan's conflict of'interest policy. 17 Please list any potential conflicts of interest that your firm foresees if you are selected as the successful Bidder or state affirmatively that youforesee none. There are no eXisting or perceived potential conflicts-of-interest that would arise from a contract between Keenan and County of Fresno. 18, If ur firin proposes to offset its fees throij�, -olz t _Vo !h commissions on i in aj:i insurance products, discuss how your method of compensation hill be transparent and reported to the County, How frequentlg, frill your firm report its commission-based revenue to the Counts? All commission income will be provided in a stewardship report 60 days after the end of the contract year. The schedule is provided in the fee schedule. 19. Describe Your coinpanj,'s organization, philosophy, management and provide a brief histo_i�,. Describe Your contractual relationships, if any, w ith organizations necessary to tour proposal's implementation (e.,g. actuarial services, data information semices). Founded December 2, 1972, Keenan & Associates is in our 44 th year of consulting to California public agencies. Statewide, we provide services to more than 950 public agencies including 65 trusts and joint Powers Authority UPA) programs. Keenan is: 0 The largest privately-held broker/consultant in California 0 22 nd Largest in the United States Best 0 100% owned by employees Places G Ranked 16t" in Los Angeles Business journal's Best Places to Work toWo k 2015 Large Employer Category a Finalist for Corporate Sotial Responsil)i# ., A)vard 2015 for the Los Angeles Business journal Unlike other firms, Keenan has been dedicated almost exclusively to the insurance needs of California public employers'. We were founded to specifically provide employee benefits consulting and brokerage services to California public agencies and today approximately 90% of Keenan's clients are California public agencies,with the remaining 10% being California-based health care organizations (many, of which are subject to similar challenges as public agencies). Investing in Our Communities is Investing in Our Clients It is easy to tl-,Link of corporate responsibility as being an add-on, a nice thing that companies do on the side. And that is the way community investment used to be treated by many companies. Keenan approaches community service in a different way. How we have an impact that is bigger than us is simply an extension of our core *inspiration: we treat people like family. We are invested 111 the communities that we serve because we are part of these communities; out children attend your schools, our safety is ensured by your police and fire departments, and we are recipients of the services that our clients provide every day. Tr I iroe%n a n That core inspiration drives all we do, from our products and services, to our culture, to our community engagement,volunteering and monetary contributions. DEDICATED DivisiONS In order to develop and implement solutions for our clients, Keenan has segmented services into the following divisions: Municipalities & Schools • Approximately 90% of Keenan's clients are California public agencies. • This Division is separated into the following specialty business segments: — Municipalities &Special Districts — Schools and Community- Colleges • Solutions provided include high quality, cost-effective insurance, employee benefits, communications, and financial services. TPA Operations • Works in partnership «%ith Public Agency and HealthCare divisions when appropriate. • Provides TPA services for the following areas: — Employee Benefits (including: COBRA/DirectBill) — Workers' Compensation — Property&Liability Keenan Financial Services This Division of Keenan works in partnership with our Public Agency and HealthCare divisions when appropriate. ® Solutions provided include: — Social Security replacement programs for part-time employees — GASB 74& 75 compliance program — Alternative funding strategies (e.g., HRA, HSA, etc.) — Early retirement incentive plans 20. Provide the name(s) and title of all staff to be assi*,�ncd to perform the Tvork for the Counti,of Fresno and a brief statement as to ivhy each consultant is quaEfled to provide services to the County: The Countf, understands that certain consultants will assist in certain areas of services, for e_yunple, consultants who perform a claims audit would not be e.Ypected to assist in the selection of vendors on which audits irould be performed Identify the area(s) of evpertise for each consultant. Following is the Keenan Team and their corresponding functional roles for support of requirements for the County. Pf�,I N4 A i C! S Irl-H"N �i" A NA" % c;� I c, , 0 Stephen Gedestad—Municipality Practice Leader ® Howell Southmayd—Vice President / Consultant 0 Stacey Comerchero—Senior Account Manager 0 Steve Balentine—Vice President,Labor Relations ® Judy Fussel, RHU—President of Life, Health, and Fniiancial Services 0 JoeAnna Todd, RHU ChHC—Vice President e Justin Workman—Assistant Vice President Leslie Anderson, RHU—Senior Account Manager Linda Clower—Senior Account Manager EXTENDED SERVICE SUPPORT TEAM—KEENAN CORPORATE OFFICE • jovita juaniflo —Senior Vice President, Underwriting&Actuarial • Tom Edwards—Senior Vice President, Underwriting&Actuarial • Christine Hough, FSA, MAAA—Vice President/Actuary • Michael Ahn—'\Tice President, Underwriting&Actuarial • Eugene Yu, RHU — Underwriting Consultant, Benefits Underwriting & Actuarial • Ralph Gowen—Vice President, Client Technology • Robin Rager—Director of Health Management / Wellness Program Consulting • Amy B. Donovan, Esq. —Vice President of Legislative and Regulatory Affairs • Jerry Healy—Chief Employee Benefits Counsel Bios for these Key Personnel are 'included in Appendix 1. Ke n a n 21. Proiide the Dumber and location of offices, and total number of emplQvees. State u7bether aiiY of the scri-ices described herein vvill be performed at any Firm office outside California, and if so, what sera-ices will be performed outside the State and w here these seri4ces will be performed. None of the services described in this RFP response will be performed outside of California. An employee-owned company, Keenan maintains a network of nine (9) offices strategically located throughout California and a staff of more than 670 benefits consultants and insurance specialists. Our employee population has grown about 5% over the last five years. These offices include Keenan's corporate headquarters, located in Torrance, and eight (8) additional regional offices. Currently, Keenan maintains more than 700 employees statewide. KEENAN OFFICES Northern California Offices MEN, Lf W9 041121MMIN RMIMMA 2868 Prospect Park Drive, Suite 600 1111 Broadway, Suite 2000 - Rancho Cordova, CA 95670 Oakland, CA 94607 800.343.0694 800.344.8507 '1�ffi M,11 SEEM%, 3-1, 1740 Technology Drive, Suite 300 1791 Broadway San Jose, CA 95110 Redwood City, CA 94063 800.334.6554 650.306.0616 I WMIM-1 1-7111,W P I I I MIT-1 ME P.O. Box 2486 1105 Sixth Street, Suite A Dublin, CA 94568 Eureka, CA 95501 925.225.0611 707.268.1616 Southern California Offices IF 2355 Crenshaw Blvd., Suite 200 Torrance, CA 90501 800.654.8102 MWELIM-011 WE,EUM ME 01 4204 Riverwalk Parkway, Suite 400 901 Calle Amanecer, Suite 200 Riverside, CA 92505 San Clemente, CA 92673 800.654.8347 800.338.5247 Are�relnan BuCKNIAN-MI'T`CHELI.OFFICES I EMEN 500 N. Santa Fe 575 East Locust Avenue, Suite 204 Visalia, CA 93292 Fresno, CA 93720 800.828.3795 800.333.7545 22. Confrn4 that you senJe as a consultant or Broker, independently; and are not affiliated mith any insurance compaaa�; thud party administrative agency or provider netri ork. Keenan & Associates confirms that we serve as a consultant/broker, independently. We are not affiliated with any insurance company, outside third party administrative agency or provider network. 23. A list of California public ;,;envies _your firm has provided similar services to within the past three (3) _years. List the number of crnployees for each agency. Include the contact person and phone number for each agency listed. Currently, Keenan provides services to more 950 public agencies including 65 trusts and joint power authority QPA) programs. We provide consulting services for all lines of coverage including medical, dental, vision, life, long-term disability, long-term care, section 125, employee assistance and retiree programs. The number of covered employees per client ranges from 50 to more than 23,000. Following is contact information for Keenan clients that closely, match the County in size and scope. KEENAN REFERENCES w y < �. Robert Ford General Services_Director rObcl- L(-a c.ttl ofdoyl,".chill 559.324.2840 2010 to present_.-_,�.._�.�,..�..._� __-- prox. 450 employees ' All lines are full--funded Current broker/consultant for all lines of employee benefits coverage including medical, ' dental, vision, life/AD&D and STD. Keenan also provides consulting on Health Care Reform issues and the County's award winning Wellness s � Pro atn iteenan .� • �: ����� ����� ...�.,� . tea-.� � Fill--' " '' Dave Comerchero mployee Benefits ManaRer ,0111ffclicrod L(�:saccoitnt%-.nct 16:874.4529 008 to present pprox. 11,000 employees U lines are fully-funded " Current broker/consultant for all lines o I employee benefits coverage including medical, dental, vision, life/AD&D and EAP program. Keenan also provides consulting for Health Care Reform issues and their wellness program. Keenan I helped stabilize the County's medical plan 0 expenditures and reduce its dental and life 1, insurance costs. Keenan was successful in I negotiating approximately �2 million in savings to their group Life plan and the return of$2.3 million , Cherie Johnson _Human Resources Mana-aer S11------ 07.234.6618 2011 to present rox em loyees Self-funded: medical; full funded: dental and vision;Life/AD&D and Current broker/consultant for all lines of employee benefits coverage including medical, r dental, vision, stop loss, life/AD&D and -AP. � ���, r � ��� �� Keenan also provides consulting on Health Care Reform issues and the County's award winning Keenan Margarita Zamora Actin Em to lee Relations Officer _510.981.682_1 2009 to present _..�.__.�.,.. .�..�..,�_._.��.._.-..�...�. m ._ rox. 1400 employees All lines are fully-funded Current broker/consultant providing services for all lines of employee benefit coverage including medical, dental, vision, life/AD&D, disability, EAP program, s.125 and voluntary life/AD&D. . �. Keenan also provides consulting for Health Care MIM Matt Doyle Director of Human Resources t aC sf 171C�(a\lc{eL'"r1CIIdaIC Ca.s')-o 818) 548-2110tl _ ' 2009 to present n r A rox. 2,300 employees All lines are fuliv-funded , Current broker/consultant providing services for „- all lines of employee benefit coverage including A medical, dental, vision, life/AD&D, LTD and Voluntary Life/AD&D. Keenan also provides consuldn for Health Care Reform issues BuChN'LkN-M1TC11ELL REFERENCES Additionally, since Keenan is utilizing the services of our subcontractor, Buckman- Mitchell, Inc., we have included references from them in this section of the proposal as well. Jean Born Director HR x.. 559.624.5904 520 W. Mineral King Visalia, CA 93292 ;. 2006 to present Employee Benefits consulting including RFP's to carriers, claims reviews, customer service support for staff,health care reform consulting, strategic planning and data analysis for medical, dental,vision, ' rescri tion disabilityand�life insurance roducts. Charlotte Dunn Risk Man er y 559.713.4335 220 N. Santa Fe v Visalia, CA 93292 1987 to present Employee Benefits consulting for both Administration and bargaining units. Assists in benefit explanations and service,health care reform consulting, strategic planning and benefit analysis of all employee benefit z "s . ' q ro ams. Assists with RFP rocess u on re nest. Kerep n a n Tamara Ravalin Assnstant Superintendent Human Resources iiiL(z;vusd.k I 2.ca.gs 559 30..7559 West Cypress Avenue Visalia, CA 93291 ---------- 1990 to present Employee Benefits consulting for both Administration and bargaining units. Assists in benefits explanation and service, health care reform consulting, monthly insurance committee meetings, strategic planning and o � � benefit analysis of medical, dental,�rision, and life 01 1111111 INNER' I - 15,11,11EX V M I MR, lmll MS.,MASON 0- 11116r. John Caudle Deputy _Superintendent-Administrative Services 1111 C(U`t Coe.or 559.733.6300 6200 South Mooney Blvd. Visalia, CA 93277 1990 to present Employee benefits consulting services including review and explanation of benefits, educating employees on their options,health care reform consulting, assist with any claims issues, provide customer support to David Perkins Risk 'an,a er IIICS(jjk 12.CIAIS 81.2820 444 West 23rd Street Merced, CA 95340 2008 to present Employee benefit consulting services including review and exIanation of benefits,RFP services, educating employees on benefit options, health care reform consulting, claims assistance, attends and provides data for monthl insurance meetin s review KeMan 24. Current tFlorkloa& Provide a Asting of your individudIsIfirins current and projected vvor)d oad The bidder shall include a graph or other informational dia,ara-u.71forniat indicatiiig the allocated and available man-hours. Indicate hon, the County of Fresno account will fit into the total n-orldoad of the Consultant during the contractperiod 5 15% 10, 9 25% 10 20% 10 20% 0 5% 29. It is expected that the final agreement between the winning bidder and the County will be in the model Counts, contract format (Attachment Q. Please list any exceptions.VOIfr firm has to the terms and conditions of the model contract and the reasons. If there are no exceptions, please affirmatively state that there are no exceptions. There are no exceptions 26 License Sanctions:List any regulatory or license agency sanctions within the past five-C(9)years. Keenan & Associates has had no regulatory or license agency sanctions since our founding in 1972. nre,e n a n When reports or other documentation are to be a part of the proposal a sample of each inust be submitted. Deports should be referenced in this .section and submitted in a separate section entitled "DEPORTS, " The follo«ing reports are included in the appendices of this proposal * Financial Dashboard Samples (Appendix 3) * Stewardship Report Sample (Appendix 9) s ,.,m.� o Appendix 1 Key Personnel Blos Appendix 2 Keenan's Innovative Solutions Appendix 3 Financial Dashboard Samples Appendix 4 Client Briefing Samples Appendix 5 Marketing of Plans RFP Sample Appendix 6 Keenan's Department of Insurance License Appendix 7 Open Enrollment Communications Snapshot Appendix 8 Enrollment Guide Sample (First 5 Pages) Appendix 9 Stewardship Report Sample Appendix 10 Keenan's Conflict of Interest Policy KEY PERSONNEL Bios Keenan Stephen Gedestad is the Municipality Practice Leader of Keenan's Municipalities Division. Steve has more than 40 years of experience with employee benefits 'including the last 32 years with Keenan. He has worked with all stakeholders to provide innovative solutions to public agencies. Steve has particular experience in managing retiree health liabilities. Steve graduated from the University of California at Davis with a Bachelor of Science degree in Economics. He is a member of the League of Californian Cities and on the Executive Committee of the League's Partners Program and a Board Member of California City Managers Foundation (CCMF). He is a member CALPELR-Zk, California Transit Association, CSMFO and the International Foundation of Employee Benefit Plans. Howell Southmayd has been a member of Keenan's public agency's employee benefits division since 2009. Prior to joining Keenan, Howell was a member of PwC's Healthcare practice as a senior account manager. Howell has significant experience including deep managed care (payor, provider) and life science industry expertise, claims and imaging systems, clinical information systems and business consulting. Prior to that, Howell was a director for Deloitte & Touche and First Consulting Group (FCG) where he developed relationships overseeing major Healthcare clients in 10 western states. Additionally, Howell was the top rated account executive for PacificCare of California for a 10-year period. Howell has a Bachelor of Arts in Economics from Denison University, Granville, Ohio Stacey has more than 33 years in the health care 'insurance industry. She started her health care career at Prudential Insurance in 1982. Positions 'included managing the new group implementation units at a start up California *insurance company and Blue Cross of California. Her responsibilities included streamlining and coordinating all processes and procedures needed for successful enrollment of new group business. She held an Account Manager position at both Blue Cross of California and Lincoln National Health Plans. For the past seven years, Stacey has served as an Account Manager with Keenan, and is currently supporting many municipal clients, *including the Superior Court of California, Sacramento County and Sacramento Regional Transit District. Kerman Prior to joining Keenan & Associates, Stacey spent 12 years with Delta Dental of California. As a Manager for the Northern California DHMO network, responsibilities included the ongoing service of contracted professionals, maintenance of the network, and utilization analysis. Steven Balentine joined Keenan & Associates in August of 2011. Prior to joining Keenan, Steve most recently served as Executive Director of the North Orange County United Teachers - California Teachers Association (CTA). Steve brings more than 30 years of union experience with both the CTA and the California School Employees Association (CSEA). He was closely involved in all aspects of district fiscal administration, benefits negotiations and health care issues. Steve's role at Keenan is to form mutually, supportive alliances with union organizations statewide, and demonstrates Keenan's commitment to Labor Associations. Steve has a long and very successful history working with CTA and CSEA. He served on the Board of Directors for the Metropolitan Employee Benefit Association (MEBA), a joint Labor-Management trust for over 10 years. MEBA has eight school districts and over 20,000 lives. Steve's responsibilities as a board member included working closely with the carriers, consultants, and administrators; regularly reviewing plan designs and pricing alternatives; evaluating and analyzing bids and bidders in the RFP process; regularly reviewing and analyzing claims experience data and claims service; and ensuring that government mandated requirements and state and federal laws and regulations were adhered to, such as HIPPA and the Patient Protection and Affordable Care Act. Additionally, during Steve's tenure with MEBA, he worked closely with the Santa Ana Educators Association (SAEA) and its Insurance committee. Several years ago, as the District faced sharp Increases to its health benefits costs and significant cuts to its Base Revenue Limits, Steve worked directly with the SAEA insurance committee to help modifh the plan designs and change the existing model for employee contributions. This was done to alleviate pressures facing both the District and Association in the collective bargaining process. Most of the recommended changes made by Steve and his team were adopted by SAEA and Implemented in the Collective Bargaining Agreement. Steve also has extensive experience working with both Labor and Management outside of CTA and MEBA. Steve served as an Executive Officer on the Board of Directors for the California Public Employer-Employee Health Care Coalition (CPEEHCC) and the California Health Care Coalition (CHCC). As the CPEEHCC Conference Chair, Steve developed curriculum and helped secure speakers for its annual conference. The conference is attended by 300 attendees every year and serves as a mechanism to keep Labor and Management informed about the latest developments and best practices in the health care. �'J i I I'A A j) 1 0 N!"I L 0('-k 1,S I1' 1 1 3 t I NC. Judy's career with Buckman-Mitchell began in 1985 after working with a national insurance company for over 10 years. Judy provides employee benefits consulting and brokerage services for many public sector clients in California including over 50 public school districts. Judy is a Licensed Life & Health Agent, Registered Health Underwriter (RHU), and Chartered Healthcare Consultant candidate (ChHC). She is a Member of the National Association of Health Underwriters (NAHU), Member of America's Health Insurance Plans, Member of National Association of Insurance and Financial Advisors, Member of Society of Financial Service Professionals and Board Member of the Visalia Y1\1CA and the Visalia Chamber of Commerce. JoeAnna joined Buckman-1\4itchell, Inc. in 2000 and has been serving in current role, as Vice President, since 2013. She works in the Life & Health department and uses her knowledge and expertise to come up with creative, personalized solutions for her clients based on their needs. JoeAnna works with a variety of businesses including hospitals, physician groups, non- profit organizations and public school districts. Having been in the insurance and employee benefits industry since 1997,JoeAnna knows and understands the importance of customer service to her clients, no matter their size. Her goal is to make sure her clients have all of the 'information needed to make 'informed decisions regarding their employee benefits package. JoeAnna obtained her Registered Health Underwriter (RHU) designation in 2003, and her Chartered HealthCare Consultant designation in 2013. She is a graduate of Leadership Visalia, serves as a Board member for Family Services of Tulare County and the COS Foundation, and actively serves as a member of Soroptimist International of Visalia. Are,re,n a n RA,sp()n R cq ticst I-(m 1 1r', rr,aI Nc )(,41 5 4,", Justin joined Buckman-Mitchell in 2007 as an employee benefits Broker. He has spent his time working with both large and small businesses. His focus is in the field of Group Medical Insurance, where he takes pride in providing his customers with the best possible product to fit their needs and the supreme service that they deserve. It is important to Justin that he researches all of the areas to provide the best possible solutions, assessing each client's individual needs. Justin current serves on the Board of "Wish upon a Star", Visalia, a non-profit organization designed to raise funds and grant wishes to children afflicted with high-risk and life-threatening illnesses. Leslie is a 10-year veteran of the insurance 'industry. After graduating with a bachelor's degree from Azusa Pacific University in 2005, she returned to Visalia and began her career at a local insurance agency as a customer service representative and producer. In 2008, she 'joined Buckman-Mitchell and began working in the life and health department. Leslie has her Life & Health insurance license, Property & Casualty insurance license, and has completed the requirements for the Series 6 & 63 Securities license. In 2010, she became appointed as a Registered Representative with Financial Network- Investment Corporation. Linda has been with Buckman-Mitchell since 2007 but brings more than 17 years of experience to the industry. She has been a licensed Life Insurance Agent since 1999. Linda specializes in Group Health Insurance including medical, dental, vision, life and disability. She enjoys the opportunity to build and maintain strong relationships with her clients. Linda's goals are to continue to build the group health insurance business and believes that, to do so, it's important to work with 'integrity and provide excellent customer service every opportunity she gets. Ke e in a n EXTENDED SERVICE SUPPORT TEANI—KEENAN CORPORATE OFFICE t e t t e • a � : Jovita Juanillo, Senior Vice President of our Benefits Underwriting and Actuarial Department, is responsible for managing Keenan's Health Care Reform products, various Keenan purchasing coalition programs and Joint Powers Authority plans, including Keenan's Dental and Vision Coalition programs, and Stop Loss/Excess Risk Coalition Program. Prior to joining Keenan & Associates, Jovita was the Director of Pricing Analytics for Ultralink, an employee benefits consulting firm. She was the chief employee benefits negotiator for Fortune 100 employer clients such as American Airlines, Union Pacific, Lucent Technologies, Avaya, Reed Elsevier, Dow Chemicals, Owens Corning, Eaton, Ingersoll-Rand, and others. Jovita began her health care career in 1983 as an underwriter for CIGNA HMO and Indemnity products. She has held various senior underwriting roles at CIGNA, Blue Cross of California (WellPoint), and CareAmerica (now Blue Shield). She also served as the Director of Underwriting for United Healthcare's Pacific Region and was involved in three start-up insurance operations in California and Nevada. ® t e t e • ® : Tom Edwards, Senior Vice President at the Torrance office, is responsible for Statewide Technical Consulting and Strategic Planning for our largest and most significant clients. Toms responsibilities cross all three of our specialty lines; schools, municipalities and hospitals. He is also responsible for company-wide group benefit research and development, and maintenance and development of insurance carrier relationships. Prior to joining Keenan & Associates in 1987, he worked for The Equitable as underwriting consultant for the northern California region. Tom began his career in the employee benefits industry in 1980 with Transamerica, as Senior Underwriting Consultant and Manager of the Group Contracts department. He has conducted numerous benefit seminars on a wide variety of subjects and contributed articles to several publications. Tom graduated from California State University, Northridge with a degree in Business Administration. He is also a Fellow of the Life Management Institute (FLMI). Christine Hough, a Vice President in the Torrance office, has more than 20 years of consulting experience in the employee benefits field. She supports the Account Executives at Keenan in the design and analysis of all lines of insurance coverage that includes medical, dental, vision, hfe/AD&,D, and LTD. Prior to joining Keenan, Christine was with Mercer and Towers Watson where she provided actuarial valuation and consulting services. Her clients included leading companies in the aerospace/defense, energy, motion pictures, banking, engineering/construction, and automotive industries. Christine is a Fellow of the Society of Actuaries, a member of the American Academy of Actuaries and a Fellow of the Conference of Consulting Actuaries. She has a Bachelor of Science degree in Computer Science and Engineering and a Master of Science degree in Electrical Engineering from California State University,Long Beach. jig!MEN= Michael Ahn, Vice President and Senior Underwriting Consultant, Keenan Benefits Underwriting and Actuarial Services Department, provides underwriting and analytical support to Sales and Service teams for Keenan's Public Agency and Healthcare clients. Mike joined Keenan in 2010 and brought with him more than 20 years of insurance background including large group underwriting and consulting experience. He previously worked for Blue Shield of CA, Blue Cross of CA (Anthem), MetLife,AON, and Towers Perri. Additionally, Mike has assisted clients in various industries including public entities, union, private sector and healthcare. Mike graduated from the University of California, Los Angeles with a Bachelor of Science degree in Applied Mathematics. NIMW R= BE= Eugene Yu, Underwriting Consultant, has over 10 years of experience in the employee benefits consulting 'industry. He provides underwriting and analytical support to Sales and Service teams for Keenan's Public Agency and Healthcare clients. Eugene 'joined Keenan in 2010 and brought with him specialized insurance knowledge towards self-funded underwriting and stop loss consulting experience. He previously worked as an underwriter for Alliant Insurance where his focus of work was with municipalities and school districts. Eugene holds a Registered Health Underwriter certification. He graduated from the University of California, InTmie with a Bachelor of Science degree in Applied Mathematics. T 7' Ralph L. Gowen has more than 30 years of technology and management consulting experience including software solutions directly, supporting the employee benefits industry. He has held various senior management positions throughout his career within the technology/consulting industry. Ralph's responsibilities at Keenan include the overall Product Management of technology solutions supporting the Employee Benefits practices such as BenefitBridge. In that capacity, Ralph guides the overall direction of the products including software development, marketing and sales support, vendor management, and coordinates with the Keenan implementation and service teams ensuring the product remains best of class and is tailored to meet the explicit and unique requirements of Keenan's clientele. In September 1999, Ralph joined a technology startup called BenefitPomt, Inc. in San Francisco, CA. as Vice President of Service. BenefitPoint, Inc. created an e-infrastructure platform using the Internet to create a common ASP platform upon which many of the nation's leading insurance carriers and brokers are able to negotiate and purchase group insurance benefits. In this capacity, Ralph was responsible for creating and managing the service infrastructure of BenefitPoint, Inc. Ralph led the development of the web-based training materials, the implementation of BenefitPoint at hundreds of brokerage and carrier offices throughout the country, and creation of the customer service tools and procedures to support BenefitPoint. Ralph is an experienced technology and management consulting professional having previously served as the Vice President of Professional Services for Avinon, Inc., a web services software startup and having consulted independently and as a Director/Practice Leader of Cambridge management Consulting. Ralph's area of focus has been the management and technology surrounding Customer Relationship Management and e- commerce. He has consulted with leading companies in many industries including Kaiser, Bank of America, Apple Computer, Hewlett Packard, Cisco, First Data Corporation, Chevron, the United States Navy and Southwest Bell. He earned an Master of Business Administration degree in Finance from California State University, Hayward in 1994 and graduated in 1983 with a Bachelor of Arts degree in Mathematics from the University of California,Berkeley. Dr. Robin Rager joined Keenan in 2010. Robin has been involved in the field of health promotion for nearly 24 years, both as a consultant and as college professor. His consulting and academic activities have focused on individual and population health assessment, and the design and evaluation of effective health promotion and disease management programs in a variety of populations and settings -ranging from health care systems to railroad workers to military personnel to migrant farm workers. Robin supports both Public Agency and HealthCare current and prospective customers He also holds a Ph.D. in Health Education, has taught at two universities over a 15 year period, authoring numerous articles on wellness. Prior to joining Keenan, Robin was the owner of Optimum Health Management, which provided health management services to businesses and health care organizations, including needs assessment, program design, marketing, online and onsite health promotion services, and program evaluation. His research and development projects have included a variety of workforce studies related to the impact of health risk reduction and disease management interventions (e.g., smoking cessation, weight management, diabetes management, sleep/fatigue and alertness, depression/anxiety management, injure prevention, health-related impairment in worker productivity), nutritional supplement product efficacy; the design of online health risk assessment instruments; the design of health care claims analysis systems; and the development and management of a risk-rated employee wellness incentive program. During his two decades in academia, Robin was a health education professor at Penn State University and Texas Woman's University, and served as the Director of PSU's Center for Worksite Health Enhancement. He has been honored as a Fellow of the Association for Worksite Health Promotion (FAWHP), served as chair of the American Public Health Association's Worksite Health Promotion Committee, and participated in the development of the Healthy People 2010 Objectives for the Nation as a member of the Worksite Health Promotion Work Group. c Amy Donovan is Keenan & Associates' primary source for legislative and regulatory research, analysis, and advocacy. Am), authors the firm's Briefings and position papers on emerging legislation, regulation and litigation and works with stakeholders at a state and national level to advocate on issues that impact the firm and its clients. She has addressed Keenan clients throughout the state on such topics as the ACA, Family and Medical Leave Act, Section 125 Cafeteria Plans. She has been with the film since 2006. Prior to working at Keenan, Ain), worked for 11 years as a civil litigator and litigation manager in New Jersey. Among her areas of expertise are employment discrimination and employee benefits. Through her volunteer work with the New Jersey Junior Leagues, Amy also advocated for legislation impacting children's health and safety. Amy graduated from Smith College with a Bachelor of Arts in American Studies and received her Juris Doctorate from Seton Hall University School of Law, where she worked as a research assistant for then-Congressman Charles E. Schumer of New fork. She is admitted to the bar in both California and New Jersey. Jerry Healy, Legal Counsel in Keenan's in-house legal department, serves as Employee Benefits Counsel.Jerry provides critical legal support and advice related to all employee benefits issues, including plan design and documentation, tax and ERISA compliance, COBRA determinations, discrimination testing and regulatory requirements. With more than 30 years of industry experience,Jerry began his employee benefits career with the law firms of Kelley Drye & Warren LLP and LeBoeuf, Lamb, Greene & MacCrae LLP. His practice areas have included pension and 401(k) plans, health and welfare plans and executive and director compensation. Jerry, has also held senior legal positions at First Interstate Bancorp and Countrywide Financial Corporation. Most recently,Jerry has been a legal consultant providing advice to The Walt Disney Company and Kaiser Permanente about a variety of benefits and compensation matters. Jerry is a graduate of Adelphi University in Garden City, New York and the Quinnipiac University School of Law in Hamden, Connecticut, and is a member of the bar in the states of California,New York and Connecticut. e EENAN'S INNOVATIVE SOLU,'TIONS BenetitBridge The BenefitBridge employee benefits portal provides administrative automation and on- demand information for our clients' employee benefits needs in a Web-based, total technology solution. Through a single online portal BenefitBridge 'integrates benefits enrollment, eligibility, participant communications, and employee self-service tools to maximize the effectiveness fig err of benefit plans and resources. tz Saves Time. Saves Money. Your benefits department has too much work for too few employees. BenefitBridge saves your HR department from making entries in multiple systems and faxing or emailin9 eligibility information to a variety of carriers. The BenefitBridge single-point-of-entry system enables you to enter the information once and transmit it to multiple carriers—reducing the amount of time spent entering data and reducing the possibility of data errors. Adds Value to Your Benefits Program With BenefitBridge, employees have access to their benefits 'information 24/7 from any computer with internet access. The system provides tools to educate users about the benefits and perform a side by side comparison of benefit plans enabling them to make informed choices. BenefitBridge also provides access to a health and wellness library, which includes information regarding life events ranging from new babies to new houses. Since BenefitBridge is a Web-based system there is no �Al RE HIRE W HiLP,U 1 IND I HE IMOPYLADUN you f4tv. technology investment required for implementation. Following are the key features and functionality of BenefitBridge as it relates to both Employee self-serve features as well as Employer features. Employee Features Include ® Online enrollment in benefit plans for new hires, > open enrollment and life events ® Identifying which plans they are currently enrolled in and which of their dependents are covered in those plans Kerman ® Viewing and comparing plan designs within a plan year and between plan years a Use of an online encyclopedia covering a wealth of health and wellness topics ® Reviewing guidelines for handling life events and their impacts on an employee's benefits ® The ability to download any form or document pertaining to their benefits, to perform cost comparisons between plans, to print a copy of their selected benefits. The many self-service features of BenefitBridge will help to free-up your benefits administration staff to handle other functions as employees shift to self-service for selected benefit changes. Employer Features Include Using the integrated online interface, the Human Resources Administrator will be able to: • Manage employee demographic and employment information ® Manage employee's dependent information • Make enrollment changes including adds,waivers, terminations and changes • Provide a system of record for all eligibility data regardless of carrier, greatly simplifying customer service • Review employee entered enrollment records f • Automatic transmittal of all eligibility data ` "�° "° including retroactive enrollment changes to relevant carriers ® Automatic creation of Carrier Billing Reports, greatly simplifying carrier billing reconciliation and enabling self-billing for plans in some situations (e.g., volume based bills for voluntary 3 life insurance). ;a •, E ® Manage overage dependents ® Identify personnel requiring Cobra notification • Produce benefits summaries for employees which include the employer contribution towards the employee's benefits ----------- ------- -------------- ------ --------- Provide a large number of management reports for ad hoc data analysis including census, enrollment, payroll, dependent, and retiree data. Available Reporting From BenefitBridge Dependent Age Changes i Benefit Terminations Age-Rated Premium Changes Retiree Age Changes COBRA Qualifying Events COBRA Scheduled Termination Benefit Additions Benefit Summary Batch Retiree Scheduled Report Termination Employees with Coverage Employees without Coverage Census - Carrier Based Census-Status Based Over-Age Dependents Carrier Enrollment Census ----------------------------- ----------------- Enrolled Subscriber by Plan Summary Count Open Enrollment New Hires IMM,11,-1"01111 MEN Carrier Billing PayrollDeductions by Employee Classification -------------- ------- Payroll Deductions by Carrier Payroll Deductions Discrepancy Report T 7' Ileenan dUll(M' Plit t!!C Pe ne mIt A I^:e<'=nan Salutic, PersonalChoices is an employee Web-portal that contains employee benefit information and a multitude of decision-support tools. Resources include: m Benefit Plan Information—Lists benefit plans offered to your employees. Plan information can be viewed individually or use the compare tool to view two or more plans (e.g., Blue Cross HMO vs. Kaiser HMO or a current plan to a pending plan, if available). ® Life Events —Provides employees with information for specific life events such as Having a Baby or Getting Married. The section also provides a variety of topics like Family and Relationships and Finances. ® Resources—This section provides a link to Federal& State Programs and a link to Calculators. The Federal and State Programs section provides a variety of links to governmental programs including FMLA, HIPAA and other current topics. The calculator links can be used for budgets, FSA elections, credit lines, retirement, etc. 14,R)Personal Choices „cvre Welcome to your Personal Choices Employee Benefits Portal provided by Keenan! anti _:..a,.v?yo_:ra ;erya`t_ >,..._ I lustrj News O Contpensatiion and RenkPlts 1 htnencan Families Just$45 D(Alars Better Off In Ten Years . Because OF RIWV Health cat Costs Benefits Life Events Resources 1 e,$Tc.t ezmn lm u.a rce, C11,1M. -3 Y :#1ma v^ r.4.5;.'e;�Rd-!;.nsbq, �,allh "Al fica?Homes tmuro,c.s 0.t Ome'An-4. tD .t^'enteC C.'>i;Crrn enasrs f arad::rare Pmarnms / ECT Pita.e Lfke$y'se��L!.=..e2£sy Uninsured T;z=.maa Pat,ems For FcAow-Up tare Loss Of Health Insurance Throxilt Uhemploymetrt 1.1,ans litany Skm Neeced Fieafth Care At+.utirnpaet of state.t:aseai tnstt.�s3ve Ezctwrres i+t 201.t t• Ke 1 a n ` e o. 0451-1 iry tia eII Keenan Sol tic Creatingand Supporting A Culture of Wcllnu Best Practices According to recent research studies, the key to having a healthy and productive workforce and achieving optimal outcomes is building and maintaining culture of wellness in an organization.-Io accomplish that goal,a comprehensive,coordinated program. of best-practice interventions,along with an environment supportive of health and well-being, must be pursued at the workplace. KeenanW,("'/l provides consultation and prograrn delivery serlvices to provide flexible, efficient, and customized wellness programs for < alifomias public agencies. The } , unique characteristics and needs of public agencies are i Establish Goals/objectives Needs addressed through the utilization of wellness services and resources available through Keenan and its besr-in-class t w third-party preferred vendors. �^^ Through its comprehensive array of employee. health ` ' management consulting services,Keenan Mell can help - i .�, employers to achieve and maintain optimal health and productivity for their workers,and create and support a wellness culture throughout the workforce. Population Health Management Strategies By applying population health management strategies that have proven effective in engaging employees and their dependents, Keenan will help public agencies to have a positive impact on employee health status, productivity, and quality of life, and ultimatek , achieve a positive return on investment for the organization. KeenanW/ell strategic health management consulting capabilities include: Conducting needs assessment. Performing an audit of an organization's wellness culture and its current resources. • Developing a multi-year program blueprint to guide the organization's health management initiatives. • Determining what additional resources are needed and helping the organization to acquire them. • ldentifying effective engagement and incentive strategies to assure optimal participation in the programs. • Promoring the wellness culture throughout the organization. • Conducting program evaluation by identifying, rracking, and assessing appropriate metrics. Keenan will also provide guidance on regulations and opportunities related to health care reform, which encourages employers to make a.commitment to the well-being of their workers through provision of preventive services, rewards, and value-based insurance designs. Keenan., Licenst' No. 04512 71 ani)(1!?ali"C Sohf17r. lis' P'71dlf ill a' Principles. -,sscciates 09) Ke e n a n We 11 Wellness and Condition Management 'Through k'cewii,,Well's third-part} preferred vendors,clients are offered a variety of options to meet their particular � health management heeds: wellness program orlly, coiiditiOn mat1A.gement protiraIIl orlly, or integrated «wellness and condition management proram. 71hese programs care serve as either a stand-alone health management Ifliriarive or as a complement to the erTiplovers health plaIl resources- providrn,a comprehensive, integrated Wellness platform for coordinating and distributing programming to employees at all locations. Regardless of' the program design, K(Y;I,'MV%ell focuses on the primary IYilals of improving empl(Wee health and prodtictirin, and providing an optimal Return oil invest nem ROI;r. Biometric Screening �.�� • r � Kee;ia,, tk cIl ofcrs on-Site and alternative-options hiometric screemnf>services through Its )referred hrometrlc screeIlin- �, i � . vendors. Effective coordination of the screenings by kee;ia;A''ells health management team, along with appropriately.designed incentives, has resulted in high screeliing participation rates afriolig its clients. For nnore information, please contact Robin Rager, Ph.D., Director of Health Management, at (310) 212-0363 ext 3305 or rragerCa)keenan.conn. AR-.-j--- "" "'wan E-,L, Ar,�v >r3ies 2.355 C:renshaxv Blvd., Sttite 200 Torrance CA, 90501 (800) 654-8102 License No. 0451271 vvwwv.keenan.corrt I 'Lut-man Associarr-s turts Y.C=` W c Comprehensive Retiree Solutions Specifically Designed For Public Agencies Futuris Cares"" is a comprehensive approach to controlling GASB 43/45 retiree liabilities, enhancing access to Medicare plans, and providing useful resources to seniors and their families. Reward your loyal employees for their service while maintaining the cost effectiveness of your retirement program. Futuris Cares' integrates these services to deliver value to retirees and help you meet the challenges of health care reform: ® Retiree Medical Consulting — expert assessment and customized implementation of retiree solutions to fit the needs of your agency, retiree population and budget • Defined Contribution Plans — flexible, tax-advantaged arrangements for employers to provide affordable retiree health care programs • Medicare Exchange —plan and rate comparisons, decision-making tools and direct enrollment for selecting Medicare plans available where each retiree lives ® Prefunding GASB 45 Liability - a program providing all required elements from a single source wlvle providing assistance with your fiduciary obligations. • Retiree Drug Subsidy (RDS) — determine if the prescription drug plan covering your Medicare eligible retirees qualifies for a federal subsidy under the RDS program with an actuarial equivalence test performed by our qualified actuary ® Supplemental Early Retirement Plan (SERP) —revitalize your staff and minimize layoffs by encouraging employees to retire earlier than planned. Qualified agencies may optionally be able to use remaining paid time off (PTO) accumulation to offset payroll taxes and spread out the cost over five years • Caregiver Resources — reliable information and referral services for those taking care of senior family members Our experts help navigate you through all the issues of your retiree benefit program. At the same time,you will be offering your retiring employees valuable enhancements that benefit them and their families. UKPPC Keenan Pharmacy Purchasing Coalition (KPPC) is an innovative pharmacy program that delivers cost savings and the most advanced prescription management capabilities for self- funded clients. The Coalition currently has an enrollment of over 275,000 and growing! The size and negotiating strength of KPPC allows our members to take advantage of volume discount pricing and the most generous manufacturer rebates. Since its inception on January 1, 2007, KPPC has accounted for over $200 million of total drug spend and has saved our customers more than $55 million. Based on group size and participation, this equates to a 12%-18% average annual drug spend savings. KPPC's membership has grown from its initial 40,000 members, to more than 275,000. We attribute these exceptional savings and growth to our ability, to ensure that coalition pricing is competitive in today's turbulent economic times. These successes include: 0 Volume-based purchasing — The lowest dispensing fees available in California for pharmacy purchasing. And, our pricing improves as coalition membership increases ® Higher guaranteed manufacture rebates-The KPPC program is transparent. A professional third party pharmacy auditing company will verify that the rebates you are entitled to on vour specific drug spend are accurate. a Annual market checks ® Independent pharmacy audit—Monthly audits on 100% of claims a Comprehensive specialty management a Dedicated Keenan and Express Scripts service teams and clinical pharmacist As our membership increases, we continue to improve upon this proven cost-saving solution for our plan sponsors and members,without mandating plan design changes. The KPPC Program In addition to the compelling financial proposition, there are many custom features inherent to KPPC that provide additional, ongoing value to KPPC clients: a Multiple levels of Service and Account Management— Coalition members have both a KPPC Account Service Team and a dedicated ESI Account Team. This combined team provides clients with implementation support, annual review of PBM services, real-time analysis of plan performance, account management services and full underwriting support. s Solid Benefit Guidance (SBG) — SBG, an independent consulting firm specializing in PBM contracting and audits, performs quarterly audits of all paid claims to monitor contract compliance and rebate administration, ensuring that our clients receive the savings and rebates promised. Keenan has negotiated for ESI to pay the full cost of this program. There is no cost to coalition members for this service. Keenan ® Implementation & Transition — ESI has a dedicated and experienced implementation team committed to KPPC. We have successfully transitioned over 275,000 members and 60 plans sponsors into the coalition since January 1, 2007.The team is compensated based on the success of each implementation. KPPC also features implementation performance guarantees. Up to $60,000 will be paid to each client if implementation is not accurate and timely; a pro rata share of$10,000 is paid for the set up of the group structure and benefit plan design, eligibility load, ID Cards, creation of toll-free number, communication of implementation status, and accuracy. ® Pharmacy Management Fund (PMF) — ESI will reimburse KPPC clients for costs associated with transition and implementation expenses such as consulting fees, eligibility file transfers, member communications and other expenses. These funds are also available throughout the life of the contract to cover the cost of ongoing communications and educational programs, including: member ID cards, physician intervention programs, formulary printing and mailing expenses, pharmacy outreach programs, member mailings to promote mail order and usage of generics, member education materials, and expenses for an on-site pharmacist, etc. The amount of funds available is equivalent to $5.00 per member, or a minimum of$8,000. ® $0 Generic Copay Program — A member-friendly way to shift utilization from higher-cost brands and non-formulary- brands to lower-cost, therapeutically equivalent generics. Specific classes of drugs will be targeted for this program ESI will waive the generic copay for the targeted drugs for the first six (6) fills as an incentive for members to try a generic alternative. Typically, plan sponsors cover the cost of the copay waivers; however, as a value-added feature of the KPPC, Keenan has negotiated with ESI to fund this program for members of the coalition. ® Generic Utilization Guarantee — ESI is confident in their generic strategy and will guarantee a generic utilization increase (shift from brand) of 4% in contract year one, 2% shift in contract year two, and 1% in contract year three. The guarantee is $2.00 per member for every 0.5% away from the guarantee target, to a maximum of$10.00 per member. To put this in perspective, if a client has no improvement in generic utilization (0% shift from brand) in the first year, ESI would pay a performance guarantee penalty of$10.00 x total members. ® Annual Performance Guarantees — ESI has placed $10.00 per member at risk for satisfactory performance in the areas of Account Management, Call Center Service, Mail Order Service, and Data Systems Availability&Adjudication. ® Dedicated Toll-Free Number — Each KPPC client receives a dedicated toll-free Customer Service number which is available 24 hours a day, 365 days a year covering 160 language options. Over 275,000 KPPC members have saved more than $55 million since the program began in 2007. ,oq%g' W! Keenan Saver Rx A Kc-enan Sohlfllcn The Keenan Saver Rx program is powered by GoodRx. The Keenan Saver RX program is a free service available to part-time employees; friends and family members who are uninsured or under insured; retirees who have reached the Medicare "doughnut hole"; and individuals with pharmacy benefits when purchasing any non-covered pharmaceuticals. Keenan has chosen GoodRx, a pharmacy benefits management company that leads the industry with pharmacy discount card programs, as the administrator of Keenan Saver Rx. GoodRx is: ® Built by former Facebook,Yahoo, and health care executives 0 Over 1 billion prices for 6,000 drugs at 60,000+ U.S. pharmacies 0 Prices: Cash (U&C), *insurance and Medicare co-pays, discount programs, more 0 3 million monthly unique visitors a Patient education: Class and 30 tabfiat5 of 20mg Upitor(atorwastatin) CVS Pitarmacy to St Nar,* condition tools, price trends, alerts, Kniart shortages and recalls, more 0 Doctor and pharmacist-reviewed content WHAT THE PROGRAM PROVIDES is Tell patients exactly what their prescription will cost • Find deep discounts (55%+) for drugs ® Beat employee co-pays (low U&C) ® Illustrate generic and alternative therapy options ® Highlight savings tips; send price alerts • Super-simple web and mobile 'interface WHAT IT MEANS ® Reduced PBM/pharl-nacy margin = employee and employer savings c'mix * Increased compliance / engagement M ® Benefits extended to non-covered employees, spouses, dependents, 10mo ww3c pets Q raym�ft t 10.40 Cost— 112252 ADDITIONAL BENEFIT JaYC Amh�e Drug Your Agency can co-brand the Web 'interface for your own program, so you can provide discount cards under your name, like Anyloivti Saner kv. Co- branded Web site can be provided under a separate contract with your agency. Ke re!n a n BRIDGEFRONT—HIPAA EMPLOYER COMPLIANCE CENTER To assist you with your compliance activities, Keenan now provides a Web-based portal the HIPAA Employer Compliance Center. This resource by BridgeFront HIPAA Compliance Solutions is available to Keenan benefits clients at no additional cost. The BridgeFront resource is customized to help self-funded and fully-insured health plans —and their sponsors -- achieve the required level of HIPAA compliance. BridgeFront adapts to the exposure that your organization has to Protected Health Information (PHI), which determines your specific compliance burden. The new HIPAA Employer Compliance Center includes the following resources: • Training — Cost-effective, time saving employee online training is available through the Compliance Center. As a Keenan client, your organization will receive at no cost one self-paced, online training course for the staff member you select; additional training courses can be purchased at a minimal cost for other members of your staff, if desired. • Reference Tools — The Compliance Center provides fast, searchable answers to your questions about HIPAA- compliance, and guidance for how to respond in the event of a security breach. 0 Structural Compliance Tools — At the Compliance Center you'll also find easy to checklists to lead you step-by-step through the process.understand p irf`VTacy guide You'll also find forms, agreements, policies and procedures documents formatted in MS Word that can be customized to your specific needs. • Documentation — The sample forms and documents found at the Compliance Center will help you create and maintain evidence of your HIPAA compliance initiative and education activities. • Customer Support—While the Compliance Center is designed with robust self-help tools, access to assistance with functionality and HIPAA questions is just a phone call away. -Ka',nan ------------- --------------- ------ KEENAN HR REFERENCE Room Keenan has partnered with the Bureau of National Affairs (BNA) to provide extensive Human Resources support to our clients. The Keenan HR Reference Room brings together BNA's specialized news, legal affairs and analysis with extensive human resource tools. As the leading 'independent publisher of print and electronic news, analysis, and reference products, BNA has provided intensive coverage of new developments for more than 70 years. The Keenan HR Reference Room provides streamlined access to BNA's Web-based services, HR tools and e-mail newsletters related to HR topics. BNA's Web site provides: ® Access to BNA's exclusive HR content. • Help navigating through complicated HR issues. a • Quick solutions to more than 2000 questions with BNA's exclusive Fast AnswerSTM. • Easily facilitated searches through a broad range of topics,including: — Benefits and Compensation — Compliance — Performance and Productivity, — Employee Relations — Recruiting, Selecting, and Staffing — Risk Management and Safety The BNA portal allows for: • Detailed, topical analysis and discussion from BNA lawyer-editors. ® Law summaries from 50 states written in easy-to-read,plain English. ® Model documents such as policies, notices, forms,job applications, and more. ® Weekly updates onn'-nportant HR news and trends. Kei?--nan LeaveSource FMLA and Leave Administration Keenan is pleased to introduce LeaveSource"' by Qcera, Inc., a unique co-source administration of FMLA and leave of absence tailored specifically for employers who want to reduce their administrative burden while maintaining control and contact with their employees requesting leave. Employers know that ensuring FMI.A compliance is complex business. Non-compliance can lead to loss of productivity-, out of control absenteeism and even high cost litigation. Qcera offers peace of mind because FNILA compliance is our business. LeaveSource is designed to be simple and cost-effective. It provides Web-based administration and automation using industry leading software, ilimebanki". Employers have access to real-time information on all leaves, leave balances, certifications, letters, emails and reporting. Leave specialists, dedicated to providing fair and consistent administration of each leave of absence staff Qcera's LeaveSource service. Outsourcing to Qcera allows employers to focus on their core business, "while Qcera focuses on FINILA compliance. Key Service Benefits ® FMLA, State, and company leave policies administered by experienced leave of absence specialists ® Electronic data upload of employee information to simplify data entry of leave requests • Employer has real time access to all leaves administered in iTimebank ® Eligibility determination within 2 days based on length of service and hours worked • Consistent and uniform management of leave certifications ® Coordination with disability carrier's approvals and denials • Status communication through letters and emails to employee and employer ® Return-to-work verification on employee's expected return to work date ® Initiation of recertification for extensions and changes in health conditions ® Intermittent and reduced schedule leave management and tracking ® Timely email communication to employers on employee leave status • Clear documentation of all events related to the leave administration ® Clinical experts review the provider certification information when required • FMLA and State leave administration supported by expert legal advisors LeaveSourcesm service charges per leave of absence managed plus a one-time implementation fee. FINANCIAL DASHBOARD SAMPLES Tr Financial Dashboard Sampleliens � � K�,�er A��11�aer:n �1e11,fe VSn . ,� _. 4 Executive Surnmary Overall 77777,1-1117,,, 9 30 h 0 dt $w" 4 6 5lfs1 110.i `9r& ?161 �i+Aal a le 4,8 -$ �t s i'� ' 1 1 r " 63 i � r fl n s c C � ^� s r 1 thcnl HMO i 511,4'S,4_4 � ��,1 �� 13 e ��I36i ...S,1059,459 kg1 526463 A ^3 P CJ lia ,ref h1'-PPS G - f .�1 s�� $ia - sx li-. $;- ,Q5�a, .146,011 123 lw 9 t 11cE1 ft ) SOS62,5114 I i t'> SS 0(11 i 01.41 ITSS6,9 v IS 811 3u,11 s 12 W �i R9 - ssP $66 6 05 c-1 0F $6 =�w $5 555� a, 7" ct��E 9 crt� 7 , Tt}1 4 4 s"1,034,137 91, � 046 dot 4+ k6223 St 2°a 932 614, 1R1 594,962,590 114 9'Va 'U`.h'SY"5 X1' 5 Anhe n H7,10 it for I°.jAr Rnxtts SpA?e;ueet tv;dt Pas.5 antl intludoi,Cavi azion Fees a Anthem PPO u c!rYPd Sbe,Cud PlAn iot Eit R ees and Pet ee w.+Fact u aend R .eers�nh)Bret A and P As thmi 2010 sxidi Ut 1=W d Medncua F*an.-'01-,arid,2013 he.%,e cace L.TO pl m pn, ,ra&m llc&eut:emnb a:aexnr-ir h.3tet data,ve kx,a f err tht a .cak c s "t ass 6 Amthen eA it bas d en'.A Nwrit iiv n» a$R-por-i artir3 Cbanv faxes Rgott,, O�Va*#t6dA@eCP 1Ay�tx•€P17d1{�f#4�"df.�{,7 M?3 Uflrdnfetf 7s ol�M©v�enk�r 7OT�t ,� I I / Kaiser Total Paid Claims Sample Client Executive Summary Cassss K;'�,s+teen•��`�s-4t.,,....,,.,..,.�...,.,..., 9....,...� �.�..,._.. ,..�,�,....,,�,. _m.....�.„�,m Total Claims Summary$PMP 1 w. �`Get, &"lsd.,i .,.8€. -U5S" :' .a¢r� . € "Un Pons' i 1 ....,..111'A rest $& s # :;.` e cs .r,>iilt ..1 .0'' ' i r �a♦w♦dodsrdb{p Kc!♦��or ffi Axx♦cdf!♦c tdS>€C,�F�si��crl d�aer�r�ds�a 3a1•d Keenan Kaiser Inpatient Claims Hom Sample Client e �tg� �.»�.� �Ao o d._ _. 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Nwmar ! «tea �•F $ `r w7w " € d ?mot S.t+Rt 2taa ,...Ww» o ; ...». ...�.. ,�t,�° Devoloped 6y tPcw an Associates Uodotod,,m rst 1W-aaPsraP Pr2,a44 1Mwftww So&*" lu&*P"*w Kee ' i - e.+ Kaiser Large Claims Rome Anthem "ettife VSP Sample Client High$1aarn*-2011 Nigh cial frs "12 JUgh CIAI IS 2013 ���1{"&saaxaa��� �?�aae+s�x� � � k?�#.artssa� jT?»aa �as 2�b3�t"Iaaramat F i at& zee"m Mote kcute C3m 1r,LI nw srmr H&ax rx sr s w� 3 A.0.x Rtr�icat'r-,F*#8h t; ,,,.,.«.,,....,,.,.M. a�,, n..� .m,,..e.rc..,.,. -.�.....,.,.,»..�..«.»,.-a....=.:.,............ .< ,.. 1 C f aF a at ri n e ezrA Xurvd-t a�t Mof&ls Ism-4—sa2sij p� ��.c cl ��f X"rcuac�3Ixa�sr 0 �»4 rs -�.4-a vrtr +fax'FO am atana k 9 aCcat��4i, kereacic+eat,u,3t1s:;ra�>.�� s+ % Fat,.t .�.> d � i.i» w. »,«....w....„,..,.., u..... ra-,y t*ir u. rat+'M 4"^%`3S�' ..� t� tm .-aeY-' .!+ �.a. t� s'.y t zrs r Xhr, "� '^� .r s-xut i s i` x+.;ea�f ► , sH ;. f,1tE�Frh.T.(aHa°>t dfy Yd'q'IAlalfi�i 4k&�t�i alaa� ltdsT'LrY'ked a1A 9!M6ri*nreat9�f:tL#iA I I � w Kaiser Prescription Drugs Sample lient ��,# A,th<,,, ,��if� VSP SGtrf; Ph arre}a cV /IWlxfA .. .. Al `JIX?3Y{Y�i.YS3Yk�1'�9�6"MtTdi z � fi a,a; ag s6,6' G x `�.or F rr-szrrr"441 KT .,a,38a,FIE , , V EJ+�v`dap d i} K��Ix en w9sxvcl Yt t rF rks#s r!j.a sxf Mt monrt yr 70 / I , 1 � Kaiser — Prescription Drugs (Brand/Formulary Drugs Utilization) 7 -0 ample Client Anthr n..,,,...,, WA Lift. VSP „ .�. 'if � 6dwttral,efaet°mxdv�ry i �XC.[2S`�' hLN1 t".�S@S:.'F�w.l.. .�.-_..._. -....�,--•�. G .._._... 2� 'f�g s� 3,yRd � a},�� �,ES �...� :. 7Osal#gikAM"r[9c+,'MSP46 ft ��L'4TPC+fldldd+iF`y'Ka��dA�tl��4ffid3t'f`dt�# IlR7dJ'C4xYE&A k�OA�'G'16UFI1Ik+�°Y 30d'! OAS!. Keena Kaiser — Prescription Drugs (Top Therapeutic Classes) Sample Client An born rya tUfo VS "f uAyc CJ*arexxV + Endocrine F2 $lSI, lU.1 a 207,81 Antineoplastics 36 Sig-o'la3,3t Analgesics,Anti-lnllar-ornatory or Antipyretic 56 $105,028,10 51wS�5,5t3 k llernatological Agents 186 S9t,,``8,q 95 S52 ,3 Anti-Infective Agents 43 � S94,77191 S'201 ar Therapy Agents a $89,319 76 $236.30 Multiple Sclerosis Agents 2 $8 ,390,10 531-20•.32 Central Nervous System Agents 55 S83,155,93 S1,51175 t, Respiratory Therapy Agents 158 $64,008,51 $405,12 astrointestinal I herapy Agents 24 524,126kr S1 -5,25 1 _ fjCV �bp '4 bV MI.I nIn'A Rlvg-o!'es Updated of Navriviber 2OX4 Kaiser Prescription Drugs (Top Therapeutic Classes) um � 3i�31L �f�ses�z w t a q Anthem PfleWfe ._.,.�s �...aw,,... ..,U..t� 3 ,�.ti yti, �.._. __ .....,...,.�.»..,.. ,......,,�,.. m_..�,..._,. .,,.,.,�.,.�. ,..._.....w.,..- Lown. #..�.�sfiscv9t�4r�ta9"�#YWa-rrpy�4�t� R,T=Pds,r,?aePgY'T"E,mta+pi^AfIg Ix Ga;'.-I Mm°�aa#ax poRt,.a•,31.,} ar? .. 4s4w>`i tT<Pas 4 w3r„»ssi�Aq-sstT. ,... Plerrgra,ak�lir�t o�.�•� .n Average POW Per S<dpt e.el�3mi,ay�a€ax6te.s ,,,, �y bleveto erdP by K nan t1 Agwelate &JptP,A todbfi i3J NSYN6U'PtAi,,�f`2QI4 LXWMM r Keenan Anthem — HMO Total Paid Claims Sample mom r 1 tilt>rs� HQtE gtt Y�5#t Client W. . M M XeCLItive summary FIONr c°mbett leis 11 i ::31 n. I 3 Aw.0wit^ti=Laputor.? >t .{�_ � &4,�,3s,* .x _Z4Tvs IT-11i7l:4 Cagtax r $4,t F1,�C 9.4°,x $a S�ti",aS 1 VI il $4 -26 : ees t ra aria S G^r; 8+6',r 1 F Cast swft Irx-PATN s=ix` x xpatae2 Fac ate 11?P4? § e 34 6 94 r hxtpaarmta e#� P�tP�i` $t, w <S, Al " 3?a 5" ztr E y raxrsssrsixl C 1 ac PLC�r $33 &3 '. E- —� as 6�,5 2d�O s a " _a • ._. r � ae401ir Pia,, S7"A001 00,111, siry"SKIA 00 �at�nLW � w, t+ t} s "..`a ,♦ d?•�v n!' (f Cry tf rt•�sr R�� Ueirrf Vpdared os of?#c+vemtwr 2014 Keenan . A�wF� i'a dR(�+^ti*sRalip} P`!tb 4l5'Sa�� Anthem HMO Inpatient Claims gi Executive Summary C +rr�a t„ireaFtac,; w� 4 , Ptt Pat Pt �r'wat<c. 94 s,r.i5'a ..,.,.. 15-FT k i=``=wr K> P.r, SAI TIN q� p +stl b "T0411 rXid PNIVV 3i %kv L+i+v��t�pzct txy#�tt�n&oL6�usa.9les il��d�das�JP�cv�:rra�wr�d?i^� I I Anthem HMO Large Claims =Sample Client y < a Pne,am ttsdac L. ai Fes'V Stu€ Encmr, TS55 ;kaljc C em drex r tt <c Gz rd., a� taws_v tee:t"atEa dus;±.ta3 1"td,��rtrr�tka� � �- Renal Dtscait>End Stae, � �,.cn� �stz;t� ���tx Cl;emaatz�eta r� Inum=odtficivKv Met dIn Rm d'rcu]3 -,Ia&A-ar ' a5a7 eta st +ia dtt7e.� tx rant v ea e has thex asp tiaus c Cot 1 .rut:£a vabndw� d I Carct l x.Esc T aar an i ari l"a;rr Total � � � cnts, n c P a tSc Cizcrak sta Lttcstr`Pews¢aet Aelk:rs wIObttnuctis: Y, Nhual tP;t;ve Ln3st%tA,:,,tt%"itr Ott=��,� s ntmt SE Ac,at Mi O IIa Ant Wall tni,P c Cate C 5peczt ed Acute Rent FuWte. .0 ` Galt Nllal Lc,.iphonta Urn€SFtr•Extra,d a C}thez��t RaY;���ta�t�n Fatcsec?aae E entt,Amin oplastic GT&tmothtu 'vend 01,1,Sc Prophylactic 5€e.attst � r DevoJttped by Komar?$A--, Aclavfcg Updated 85 of Novembee 2014 '*? Keenan s Anthem HMO Prescription Drugs (Generic vs. Brand) r , Saline en }$*at'4t �x'EEX i'°r �_ tt $� S<S 'EE.If$" U�t lo .,,»..m..,a a.,-._............ ...e........_ ,.sr.__...M..,....., iwzo- �..w ..._...._..,...._.,_.......,_,. _,wa..r,,. .........,....,, '�i i *fit' Poo(�'S�.s1.5u4tp2 .. Ppo(LPPO) Sejoeta by Ck,"Mlr vs ftrand { \unbro# cci Paid I r 2a �11 1, }" a ' d W 23„6 ¢ 4646. . }1691x5r1,35,} afi92a k} ;' �, �s9,3}2 , a" a8;a}691, 3}C;93 5}3,41} veza t Paid c Script p33.94 S 177,73 s19.3,50 S �l? LII-10 $G.0A) S 21AS *S302.34, S74 57 \iasbxr t�3 Scripts Paid 3 7,G23 fib 7j 1,alrx�' _ 93 Pold 19,3V 4 61,109 S �-4,302 S11 162 i 69 W; ,a. $47tiV 1 S9 1 r S 901 66 S 414 1s W855 3 1 6' $20,19} S44, $ 9t7 4 15� 8, au 'B 99350 $'�ti )}. 1,e Patin 1r`rrint 59 49 "3 S ��,.�,.�., ombi� sed \—ber eat �� .P�ud t 9 f 23„134 8,679 1,026 23"r""9? G,13a 9�� 23wF9? � � 633 Pala _ i6 4 } °�F S2,V 9 8a5 69.Ua w1 ! 6 51 G'�9 13 fig a€Sa1 1� c} ?69 as c Paar3 P ev cs Pt aV�w G1 31, 5239.E} 6 .34 S 21-7,31 S i,5 5, .N S 23.6' $35663331 $11;'.1 ,�. D.-No I'lllt'a naar d3t Assa+cl.�f E3y+ct�;a^..T� ctl h'tf'mcXrNlT�r?t3Rd Anthem HMO Prescription Drugs (Combined $ Paid) Sample Brit ��ar,le K�lt� $� #' ��A���� VSP ��, fiE a aA . .:i +d'Wo pair Script. #4 i@ rftf $Pad A of Ordor- *vt""P ast Y#"Sevipt f €sates rlr P*6 virt * _ ,. d�ruaxdaglArdtsy+ltra�uenn ffi rts�a�datres atprt,:ralcfa�t�fNesr.smLra.xilfi� I I / r � w Anthem HMO Prescription Drugs (Number of Scripts Paid) Sample Client Home t4ett43x v5P eY 0 t= PA t t-*Avtr000 f1bid per kAVA i "°'' v man O"w S Avers",0*4 x kriot 4 9 Paid Cku , Aa2rsfca �tf�, fte�rr�ra d�R.��crclxte A3 f° Sr,Ferf�ter#ms tat dtawrarofr�u�dtXs Keenan 04 ACA Progress Overview District Details District Level Progress Update --------- District 1 ,overage District 2 District i District 2 District 3 District 3 { District 4 District 5 District 6 mmims z, 0% 20°Io 40% 60°10 80% � 100% 120% �I jM FTE Determination 1094/1095 Progress Offer of Coverage 31 ACA Compliance Process �g3 Documentation Status f� 3 t�t E3 i• i f� "s x I Page, 1 of 4 . 06i°epi�rt+ te Qi ►ad 4 w:. we �. 1094[1095 IRS ReportingMonthlyACA FTEs & Percent Offered Coverage 9 - District i Progress Report District 1 ACA Progress Overview f � 1 1 Form Completion �,�oo 120.OQ°to >i Payroll Data ; 1,004 , o EEE Benefit Data cao 3 60.OQ lu , o su Form Data ion QAD of € 3 E' I Ready To Submit To IRS ,,gin oo 1. _ __ __, _____ 60 00 f 1 .w Sri v Ln � u a U) °° � a -�� _�� ,�� ......_� i � �, «^# �+ �� fit r-t M-+ +-t r-� .M �,•t � � <� } I r ah 01 t�s . a l , Progress incomplete ACA FTE ' ', FTEs Covered Percent Covered ACA Compliance Status � 1, �� ,".�,• �. ». � ,',. .; ,,.,,�•,.,., ,�., �, ;, �,, � � :,., "�y"�.��'�x�'t�� :> ��x����"x'xa��G�n'`au����>s�+s's��w'4-.x��r`�'� rs i A fi kr tl r a rr r� ttr�a 1 � ; 6i j "'yE�x�� � Sx�'�����'•�: *ws,-�.x i a ?�` r� �Fk,�c�'`' a�#- �i'x .r�„txstrs,'� •E; v >•,"' 43tf 'C C' CUS`#1� �, ,,; % ,� �` y w.,># �kaa.�€-a,�,k* �a-as�s�`,- w?-`5r*...`'L.:'de'>4fir�' h»`t,=s`: j i' 3l« 6cl 2 _ = >`� ,,' .., „ .,".,.'� �„ � ���," ,,,,, � „`,, ���� jss,,,x;`�,�c,T;y�'rs.+,Yt-�4`i.,r�r.<2��^r" ,<.�,5y>,�+r�,,:~�.,�"�L�'}�"xr,�''-r}.�r'? �,.�+'<•,�,7>y?��� �.�'I Progress ;, Incomplete t� ( ,,.`- y s.. a 2�. ,-�.1 �t -x .�...�»•n � -�.Ht! tix�r � '' ,���� �'�"Y�2i�,�'���� ���.. s� � [ 'hRiW�� +44�'.t3y"£:3 q&Y"'a`.n'R.4Si4�C'C^� IGta"k"itr,13,�Y,Z3HS[Pori�:Y?i5 4 Ac r"��al'�"�.�,�.'�a4 kr�+ � �"A'N'a... �M.. t;'44,.315 SiT4�»✓^ K4.. i'-1'm fivY�, �„', �Gm `tn,-. > .- A .,�'tk'�kis.• �f'..,¢'i '.&•�,M^'+r?� � .Sd�'u5.<a- 'i'Ef �+.tib',Kki�+k Y+�S'�+,�F-"RM"xn'i%rb'3 �ts"�.# Page 2 of 4 hho as WC 1094/1095 IRS Reporting Monthly ACA FTEs & Percent Offered Coverage District 2 Progress Report District 2 ACA Progress Overview { Form Completion �" ��„ ,�„, .,. 1,400! T 120, 0% I 1,000 J Payroll Data � , r �' " 60.000/D 6-00 3 � I Benefit Data goo 0.004,,D � . � �. Form Data �, _ ! � (200) t u9 Ica ir5 u� lfl u) ir 60.000/6 i 5 Ready TO Submit TO IRS r, a" �ti 0% 20% 40% 60% 80% 100%120% c- M O z c� g i ! M 9� [,, Progress Incomplete ACA FTE 71. FTEs Covered Percent CoveredaMl I g. f ACA Compliance Status � '' "�,'�t �� Q�6` U#�@�Yk�!'d��t�i�'E���Ct -,> ' �>„- � � ^.t �•m� �s �e 5.. r ;_ z x � ;+fi3f �ALfi!#i £J}, aT�'cii #vifi9 6 5 ' 4 i Y ;` � � C ��' LYtC3�C� itSt�'." i rt �,�1.�. �dv rS4z�`aa��,'r�a-u3 �.'�r•���z'.,;. 'r''4,�&-7 "fl�'r�„xn�`x -fhii:r t` }:-'� e ! ! s 0 20 l 0 60 l 80 / 100 0 0 ¢ 0/ b 0 D 1200% Progress F`1 Incomplete i } ,- awe a. w a�«, .,,y,.«�+s ..waw,y,,... ,�ca.�f+r,"''u"""`««wr:.- �x„w�, ..,.,.�.....,� •� �? � � r;: >r a �3 F t-. 5s,�.�+ -r�zY��;r�r:- k4"w,.��v5✓✓-. '�.�i'�,r'���, s�kr�.'tx-}a�,. 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M + a. qJ 0 a f> 0 rQ 20 r'Q 40 !'Q 60 /Q 30 /0 100 1Q120 lQ �` LL �i 0 IN Progress Incomplete FA ACA FTE FTEs Covered Percent Covered ACA Compliance Status _ 6 4 3 j - 5: 1 r. pprk. e 0% 20% 40% 60% 80% 100% 1200f6 sf Progress ra i Incomplete t �.,..,.,.:.:�.:...u�_ ,a„>„ � � ..�...=a� v.r�,�:..7....._.�:.. .::- .�.x :x.raer,Y:a zce -, .....e..�;;;,�s'r;� ,.,w....�=rzx.,, `�'; �w� .�..rsv:���,a�. a ,.�r,�z:aan�a r•.r:r-s.,. rf,:ri..;rxa {xm>n-.w,...":....,ayn-s t�.�n..e�,?•', ..a'!=.Page 4 of 4 CLIEN'r BRIEFING SAMPLES t I t,T tre in ca in Keenan BRIEFING ; , -F , ,,: SEPTEMBER 2015 e • Under the clairrls and appeals regulations of the Affordable Care Act (ACA) issued in 2011 (IRS Technical Release 2011-02), self-funded non-grandfathered government plans could elect to use either (i) the private accredited Independent Review Organization process established by the Department of Labor (DOL), or (ii) the U.S. Department of Health and Human Services (HHS) administered Federal External Review Process. In either case, sponsors had to notift HHS of their decision. If the HHS process was chosen, additional information (including contact information) had to be provided to the U.S. Office of Personnel Management (OPM) and the Centers for Medicare &Medicaid Services via e-mail. On June 15, 2015, new instructions were issued regarding the notification process to elect the Federal External Review Process or update previously submitted information. This I3riellttd describes the method that must be used to inform HHS about the election or submit updated information. INITIAL ELECTION OF FEDERAL EXTERNAL REVIEW PROCESS Plans that have elected to use the federally--administered External. Review Process are required to submit (r" information regarding their election to HHS via the Health Insurance Oversight System (HIOS) no later than the date on which such plans intend to begin using the Federal External Review Process. Instructions for electing the Federal External Review Process within HIOS for both new and existing users can be found at: harp://-,er\vW.ems oy/(:(::IIO/Resource-s/Regulations--,tnd-(Tuidancc/Downlo,icls/20150G0S-l-II-iS-SRG-on- elcctirails-FIN.NL-G-S-15- l'\I508.pdf UPDATING INFORMATION Sponsors who previously registered for the Federal External Review Process via e-mail must submit any updated information via HIOS. If no information needs to be updated, then no action is required at this time. Please contact ��our Keenan Account Manager for questions regarding thus Bliefitig or if you require am additional information regarding the affordable Care Act. Keenan &.Associates is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Clients are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities,including the interpretation of any statute or regulation,or its application to the clients'business activities. ©2015 Keenan&Associates I License No.0451271 1 Innovative Solutions, l`riduring Principles. Keenan BRIEFING JULY 12O14 HI-AITH CARt RufORIM: I RC §49&)H DIJURMINNGFutt-Tq� The affordable Care Act (s�Czk) added section 4980H to the Internal Revenue Code (IRC). Under IRC section 4980H, an Applicable Large Employer (-kLE) may°be subject to a penalty if it fails to offer its ACA defined full- time emplovees, and their dependents, minimum essential coverage (I�IEC) that is affordable and provides minilmun value (MIS . Since an employer's obligations are to its full-time employees, the final regulations for IRC: section 4980H provide two methods for tracking employees and deternniniing their full-tire status — the I\Ionthly Measurement 1�lethod and the Look-Back Measurement Method. This Bawling, the first in a six-part series, describes the illonthly A1casurement Method. MONTHLY MEASUREMENT METHOD—IN GENERAL Under the Monthly Nleasurennent %Method, an emplovice's hours of service are totaled at the end of each calendar nnonth to determine the employee's full-time status for that month. While tlnis method is administratively straightforward, the disadvantage is that full-tiinne status is determined at the end of the month when it is too late to offer coverage for that month. As a result, an emplm er mad- be subject to a penalo for failing to offer coverage to some of its ACA defined full-time employees. For example, an employer with employees whose hours vaiy month-to-month would not know whether any- of those employees averaged at least 30 hours per week until the end of the calendar month. Those employees averaging 30 hours per week, who were not offered 'NIEC for that calendar month, could trigger a penalty if an} purchased subsidized coverage through the public Exchange. While the method has its disadvantages, the final regulations for IRC section 4980H provide some clarity, as well as some relief, that may make this nnethod workable for Al-Es with stable components to their workforce. MAY USE COMBINATION OF MONTHLY AND LOOK-BACK MEASUREMENT METHODS Under the proposed regulations for IRC section 4980H, it appeared that an _'ALE could only use one method for its entire workforce, i.e., if the employer wanted to use the Look-Back Measurement Method (discussed in parts two through five of this Brig fiq series), it had to do so for all employees. The final regulations clari67 that employers may use either the i\Lonthly Measurement Method or Look-Back Measurement Method for the following categories of employees: • Salaried and hourly a Collectively- bargaiined and non-collectively bargained • Groups covered by separate collective bargaining agreements • Employees whose prunaiy places of emplovnnent are in different states For example, an ALE whose salaried employees work regularly scheduled 40-hour weeks may use the Montlnh° Measurement Method for all of its salaried employees while using the Look-Back Measurement Method for all of its hourly employees. ©2014 Keenan cC.-\ssociates I License No.045'1271 Keenan However, an_ALE cannot use the Nlonthly Measurement Nlethod for its employees with more predictable hours of service and the Look-Back 'Measurement Method for its variable hour and seasonal employees. 1,or example, an employer cannot use the Monthly Measurement Method for all of its employees, both salaried and hourly-, who work the standard 40 hour week while using the Look-Back Measurement Method for all its employees, both salaried and hourly,whose hours vary-week-to-week. EMPLOYEE FIRST OTHERWISE ELIGIBLE FOR AN OFFER OF COVERAGE An ALE will not be subject to a penalty under IRC section 4980H for three calendar months, starting with the first calendar month in which an employee is first otherwise eligible for coverage, if that employee is offered MEC that is affordable and provides NI' no later than the first day of the fourth calendar month. First otherwise eligible for coverage means the employee: 1. Meets all of the requirements under the terms of the plan to be eligible for that calendar month (excluding am-waiting period); and 2. Was not previously eligible for coverage Linder the plan during the current period of employment. Example: Employer Z hires Employee A on Januan, 1, 2015. Employee A averages 20 hours of service per week for each calendar month in 2015 and is not otherwise eligible for coverage sunder the terms of the employer's plan for 2015. Effective january 1, 2016, Employee .A is promoted to a position that is eligible for coverage following completion of a 90-day waiting period. On April 1, 2016, Employee A is offered coverage, which is affordable and provides Nam'. Employer Z is not subject to a penaln> under IRC section 4980H for Januaiv 2016 through March 2016 since it offered h"mploiee A coverage that is affordable and provides NIA' by the first day of the fourth calendar month following the date Employee A first became otherwise eligible for coverage. REHIRE AND BREAK-IN-SERVICE RULES The limited period during which IRC section 4980H liabiht}- is not assessed on an employee who is first otherwise eligible for coverage applies only once during the employee's current period of employment. However, if the employee is treated as a nevv employee under the rehire or break-in-service rules, then this limited non-assessment period may apply again. In general, the rehire and break-inn service rules apply in two situations: (1) an employee terminates employment but is later rehired by the same ALE, or (2) an employee, without terminating employment, takes a leave of absence during which no hours of service are credited. 'the question these rules address is whether the S�Lh may treat an employee who is rehired or returns after a break-in-service as a new employee. These rules apply differently to ALES that are educational organizations versus non-educational organizations. ' C2014 Keenan&Associates I License No.0451271 2 � rr Reenan i t3r ilt' Non-educational organizations may treat an employee who is rehired after terminating employment or returns after a break-in-service as a new employee if: 1. The employee was not credited with an hour of service for at least 13 consecutive weeks immediately before resuming work; or 2. For periods shorter than 13 consecutive weeks, the employee was not credited with an hour of service for a period: (i) of at least four consecutive weeks, and (ii) that is longer than the employee's prior period of employment. For educational organizations, the period is at least 26 consecutive weeks rather than 13 weeks. While these rules are similar to the rehire and break-in-service rules used under the Look-Bach Measurement Method, the rules for averaging hours of service for special unpaid leave and employment break periods for educational organizations do not apply under the Monthly Measurement Method. The rules for special unpaid leave and employment break periods for educational organizations are discussed in part five of this Br-.fines series. The rehire and break-in-service rules are only applicable for determining whether an individual should be treated as a continuing or new employee and not whether the employee is full-time. If the employee is considered a new employee under these rules, then the ALI - can take advantage of the "first otherwise eligible for coverage" relief discussed earlier. If the employee is a continuing employee under the rules, who is also a full-time employee, the ALE should offer coverage as of the first day that the employee is credited with an hour - of service or as soon as administratively practicable. Offering coverage no later than the first day of the calendar _ month following resumption of services is deemed to be as soon as administratively practicable. USE OF WEEKLY PERIODS The Monthly Measurement Method may take into account payroll periods. Under the final regulations for IRC section 4980H, an ALE can deterinine the full-time status of its employees for a calendar month based on the hours of service over successive one-week periods that either: 1. Begin on the first day of the week that includes the first day of the calendar month, but excludes the week in which the last day of the calendar month falls unless that week ends with the last day of the calendar month; or 2. Begin on the first day of the week immediately_ subsequent to the week that includes the first day of the calendar month (unless the week begins on the first day of the calendar month, in which case it is included) provided the period includes the week with the last day of the calendar month. Under this method, full-time status for certain calendar months is based on hours of service over four-week periods while for other calendar months it is based on hours of service over five-week periods. For months calculated using four-week periods, an employee with at least 120 hours of service is full-tune. For months calculated using five-week periods, an employee with at least 150 hours of service is full-tune. Example: Employer Z uses the period of Sunday through Saturday as its weekly period and includes the week with the first day of the calendar month but excludes the week with the last day of the calendar month (except ui cases 0 2014 Keenan&_associates I License No. 0451271 3 fnno;,,,atk.+e Sohitions. .'t:t t:a t;tg Princi plcl . Keenan when the last day of the calendar month is on Saturday). For this example, we will use the calendar months of May and June of 2014. • For Mav 2014, Employer Z measures from April 27`h through N1aN, 31". It includes the week with the first day of Nlay but also includes the week with the last day of the calendar month because that day is Saturday. Since this is a fine-week period, if an employee has at least 150 hours of seivice (30 hours x 5 weeks) during that time,the employee is full-tithe for May. ® For June 2014, Employer X measures from.Junc 1" through June 28`h. It includes the first day of June but excludes the last day of_June. Since this is a four-week period, if an employee has at least 120 hours of service (30 hours x 4 weeks) during that time, the employee is full-time for June. FINAL CONSIDERATIONS The Monthly Measurement Method will likely be unpractical for employers whose workforce liours fluctuate because it limits the employer's ability to prospectively manage its risk exposure under IRC section 4980H. However, some employers with stable components of their workforce, and that fall within the permissible categories, may, find the method appealing given the administrative complexities of the Look-Back Measurement Method. But employers should also consider the additional administrative burdens involved if employees change from a position that uses one method to a position that uses the other method. As discussed in part six of this 13rzr/rrg series, there are several intricate rules that govern employees transitioning from one method to another due to a change in position. Please contact your Keenan Account Manager for questions regarding this Briefing or if you require any additional information regarding the Affordable Care Act. Keenan &,Associates is not a lave firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Clients are advised to consult urith their own attorney for a determination of their legal rights, responsibilities and liabilities,including the interpretation of anv statute or regulation,or its application to the clients'business activities. 0 2014 Keenan&_Associates ( License No. 0451271 4 Innor.a"i7v Solutions. ElIduring princiIplc^s. MARKETING OF PLANs RFP SAMPLE Kec-,-%nan Keenan 3550 Vine Street 951 788-0330 Suite 200 951 715-0166 fax GS Riverside, CA 92507 www.keenan.com wl 0n License No. 0451271 June 4,2009 TO: ALL MEDICAL MARKETING CARRIERS RE: SAMPLE COUNTY/ANYTOWN, CA 90501 REQUEST FOR PROPOSAL—MEDICAL& RX BENEFITS EFFECTIVE DATE: JANUARY 1,2010 PROPOSAL DUE DATE: JUNE 26,2009 To V-1om It Nlay Concern: Sample County has requested for Keenan&Associates to obtain competitive, fully insured HMO and POS quotes as well as self funded ASO options to replace the current fully insured HMO and POS plans offered to the Sample County employees and Early Retirees through PacifiCare. It is the intent of Sample County to retain the current Kaiser plans and to replace either one or both of their current non-Kaiser carrier plans based on a competitive proposal process. However, they are open to looking at complete Kaiser takeover quotes as well. The effective date for coverage outlined in this Request for Proposal is January 1,2010 and rates must be guaranteed through December 31,2010. Laurie LoFranco is the Account Executive responsible for Sample County. Ms. LoFranco is located in Keenan's Riverside office,which is also where all service personnel for this account are located. SCOPE OF PROPOSAL We are requesting that you provide proposals that match current plan designs and any benefit options that could reduce the cost of the County's Medical programs. The County is interested in reviewing Self Funded options as well. Proposals should quote benefits for Active employees &Early Retirees (non Medicare eligible). Medicare- eligible Retirees are not being included in the proposal process at this time. All current plan designs have been attached for your convenience through Benefit Point. Active and Early Retiree rates are currently blended and should be kept as such. ALL PROPOSALS SHOULD BE QUOTED NET OF COMMISSIONS. CARRIER HISTORY The Sample County has been with PacifiCare&Kaiser since approximately 1999. Sample County—Medical RIP Letter June 4,2009 Page 2 CONTENTS OF THIS REQUEST FOR PROPOSAL The following have been included to assist you in the preparation of your proposal: ❖ Current Plan Designs—built through BenefitPoint as well as actual stunmaries from Medical carriers ❖ Benefit Eligibility Provisions—Including Contributions Information (2 attachments) ❖ Two years of rate history (see table of rates below) ❖ PacifiCare&Kaiser Experience&Large Claims Information ❖ Employee Medical Census Reports—2 attachments total- 1 for Actives & 1 for Early Retirees TWO YEARS MEDICAL RATE HISTORY PacifiCare HMO—Active Employees PacifiCare HMO—Early Retirees (Non-Medicare) Single Single Two Part- Two Party Family Family Kaiser HMO-Active Employees Kaiser HMO—Early Retirees (Non-Medicare) Single Single Two ParMEN Two Party Family Family PacifiCare POS—Active Employees PacifiCare POS—Early Retirees (Non-Medicare) Single Single Two Party Two Party Family Family PacifiCare HMO—Active Employees PacifiCare HMO—Earl Retirees (Non-Medicare Single Sul le Two Partv Two Parts, Family Family Kaiser HMO-Active Employ ees Kaiser HMO—Earl Retirees on-Medicare single Single Two Parr Two Party Family Family PacifiCare POS—Active Employees PacifiCare POS—Earl y Retirees on-Medicare Single Single Two Party Two Party Family Family REDACTED OTHER PLAN:— ctive Employees— Kaiser HDHP HMO—HSA Compatible—Early Retirees new plan as of 1/1/09 (Non-Medicare)—new plan as of 1/1/09 (Not offered to Earl Retire (Not offered to Active Po Population) Sin le Sin le Two Party Two Party Fan—Lily Family Sample County—Medical RFP Letter June 4,2009 Page 3 SPECIFICATIONS 1. Please quote rates on a monthly basis 2. ALL PROPOSALS SHOULD BE QUOTED NET OF COMMISSIONS 3. Please quote Active & Early Retiree rates blended and unblended—3 tier rates 4. All rates for Active Employees must be divisible by two (for payroll purposes) 5. Quote to match all current plan designs as closely as possible, assuming the following scenarios: ➢ Replace only PacifiCare population and applicable plans Replace all plans (PacifiCare&Kaiser) 6. Quote both Fully Insured&Self Insured Options—For Self Insured,please quote EPO plans to closest match current HMO designs,providing PPO options as well 7. Quote additional Active Employee and Early Retiree alternative plan designs to include: Providing design changes that would reduce current rates by 5%or more Provide proposals for any High Deductible Health Plans -including HSA&/or HRA compatible options 8. Provide% decrements for the following options: ➢ Higher Emergency Room copays/ coinsurance ➢ Higher Outpatient Surgery copays ➢ $150 Calendar Year Deductible Pharmacy Plan Option ➢ Higher Inpatient Hospital per admit/ Deductible options ❖ Please note: Alternative plan design options should apply to all rate quote scenarios as noted in Specification #5 above 9. Provide all proposed rates with pharmacy benefits carved in and out. 10. Please include a GEOACCESS report to include 2 PCPs within 8 miles, 2 specialists within 10 miles and 1 hospital within 20 miles. PROPOSAL PARAMETERS 1. All exceptions to terms,vendor conditions,or other requirements should be clearly stated in a separate section at the front of the proposal,even if identified elsewhere in the proposal. 2. Your proposal must specifically describe any and all differences between your coverage and the current plans. 3. The proposal should be effective January 1,2010 and rates should be guaranteed through December 31, 2010. Please reply to this proposal request via Benefit Point or by email to ANALYST NAME if necessary,with a hard copy to follow, no later than 5:00 p.m. on June 26, 2009. If you should need assistance with working through Benefit Point,please let us know and we can forward instructions. If you are declining to quote,please provide a letter of declination on your letterhead. EENAN's DEPARTMENT OF NSU RANGE LICENSE k-lafif rnia Department of Insurance KEENAN & ASSOCIATES License #0451271 DBA: KEENAN HEALTHCARE INSURANCE SERVICES DBA: REGENCY CLAIMS SERVICE Pursuant to the requirements of the State of California Insurance Code, KEENAN &ASSOCIATES is authorized to act in the following capacity. License Effective Date Expiration Date Resident Insurance Producer 12/12/1972 10/31/2017 Qualifications Accident and Health Agent 12/12/1972 Casualty Broker-Agent 11/21/1973 Life-Only Agent 12/12/1972 Property Broker-Agent 11/21/1973 Registered Administrator 03/30/1978 Surplus Lines Broker 11/26/1980 Variable Contracts Agent 04/27/1973 Business Address:2355 Crenshaw Blvd Suite 200,Torrance,California 90501 r �w Dave Jones h Iral Commissioner �� • Please note:To validate the accuracy of this license you may review the individual or business entity's license record on the California Department of Insurance's website at www.insurance.ca.gov"Check License Status." OPEN ENROLLMENT COMMUNICATIONS SNAPSHOT 14 i Keenan 1)j 5 1 ?7 I fw Solaiiolls� gee«w el s tir1�. en-s�31«t z� INC �liEi fair C ' 7,it' cmplC ycc �.. Or Coo, wFu mw tiJ_ [vn &enan E mt Lyo 11:11 it V! .,.. Keenan too 4. RI personal O N"I ca'd Mu—! 01 i€ o ' Keenan It tj Avsk:7 Keenan P a c t N C.d HrilW Q—CD title title emplo C " _ fair 1(xjflol, Keenan Client I ocn Fh��r Ke nan 1 re A t _ 1tilnlb•€{.arc; 7r,i,,16 Pmuard Keenan •� w Admix(D ENROLLMENT GUIDE SAMPLE (FIRST 5 PAGES) Keenan ut IV A f"I" PLOYEESVA e " 4 C U 0 Y y � > ACTIVE EMPLOYEES 2015 FBO*"h E '1k\j' E F I Tbd� GUIDE General information 1. Introduction 2. Employee Benefits Web Site 4. About Your Coverage what's inside 6 Core Benefits 6. Medical 10. Dental 12. Vision 14 Other Benefits 14, Health and Wellness 16. KeenanDirect.com 17. Flexible Spending Accounts (FSA) 21. Long Term Disability(LTD) 23. Life/Supplemental Life 25. Employee Assistance Program (EAP) 27. 457 Plan 28 Miscellaneous 28. Potential Retirees 29. Health Care Reform Update 30. Covered California 32. Legal Notices 38. Contact Information 1f you 'and 'oryour d6 i�Clen7Sl have Medicare GC you will become eligible 1Jr Medicare i 1 The Cic:xt 12 months, a Federal low gives you more choices about your pescription dlu coveracie. i Please see pace 36 for more details. This Guide gives you an overview of your benefits Including eligibility,plan options,rates,how to enroll and other important information. More detailed Information is available in the official plan documents, in the event of a conflict between this information and your plan contract the terms of the contract will prevail. City of Glendale I Active Employees i n T r o d. -ct t. i io ni Annual Enrollment for What Else Should You Know Current Employees Before You Enroll? Getting the most value from your benefits depends on how Before you make any decisions,take a moment to review well you understand your plans and how you use them. this helpful"To Do" List. Benefits are important; they provide support to you when you need it the most. They're also a personal choice;your Read the material in this enrollment guide. life circumstances change from year to year and your • Share the material with your family members and financial and protection needs may change as well. discuss your family needs. Take action during the City's open enrollment to review your ' Review your benefits summary in GEMS: family's changing needs, evaluate your existing coverage Main Menu > Self-Service > Benefits> and decide whether to continue with your current choices Benefits Summary, or make a change. Use the many resources available to . Decide if you're going to make any changes for make well-informed decisions about your benefits for the 2015,or keep the coverage you have in place, coming year. Being proactive now will ensure that you and your family have the coverage you need throughout the • If you decide to make enrollment changes, see year ahead. "Open Enrollment Assistance"on page 2. Important Dates ®o You need to Do Anything? This year's Open Enrollment period will occur April 20,2015 The answer is"no"unless you want to: through May 11, 2015 for online enrollment. The benefits . Change your plan election you elect during open enrollment will go into effect June 1, 2015, • Add or delete coverage for an eligible dependent See"Making Mid-Year Changes to Your Benefits" on page 5 for more information. Keep in mind that after the Open Enrollment period,you cann change your benefit elections during the year unless you have a qualifying life event. Removing Dependents he, "fe -'eye i � ro. �i:�',rcrr -n en .l be r?'::fir Ji ihle Cl`lor lr.�i„'` i ,_ e. ri C7L<le.�ve ., iti , .S:ve de; -;SQ...,i. `liit� .. _ _, 11`�' l,_,n� VV!r�g City of Glendale ( Active Employees i employee benefolts Open Enrollment will be held online this year through our teed Help with the Site? Web Portal - BenefifiBridge, This portal contains helpful information and a multitude of decision-support tools. The Keenan & Associates can help. Contact the Help Desk BenefifiBridge web portal also offers information on the City at benefitbridge@keenan,com, or call 800.814,1862, of Glendale's benefit plans,and links to Anthem Blue Cross Monday through Friday, 8:00 AM to 5:00 PM. of California,Kaiser Permanente,Guardian Dental and VSP to access provider directories. Open Enrollment Assistance Employees are able to make benefit selections for the For additional questions on enrollment and eligibility, 2015-2016 plan year from home. Its fast and easy. Once the benefits staff will be available to help you. They will you login, you will be able to view and compare plans, provide enrollment forms and provider directories, They download documents and forms, and utilize a variety of can be reached by calling at 818.548,2160 or via e-mail health and wellness resources such as: at benefits@glendoleca.gov, • Benefits: This section lists benefit plans offered to the Enrollment and Change Forms are also available on City of Glendale employees, as well as a detailed the City of Glendale's employee intranet, which can be description of each plan, This section can be used accessed through the following: to compare and contrast different plans, • Resources: Contains news on a variety of health topics, as well as world news articles and important fm benefits documents, From work • Life Events: Provides employees with information for specific life events such as having a baby or getting married. This section also covers a variety of topics such as: family and relationships,health education, 0 finances and insurance, and purchases. The Life Events page also contains a Health and Wellness Click on the Internet Explorer iconto get to Glendale's home page section, which provides links to health and wellness websites such as WebMD and wellness.com. On April 20, 2015, log onto BenefifiBridge to establish your password, as well as view your benefit options and Click on"Employee Services", then click"Benefits" complete enrollment for the upcoming plan year. You will not be able to access BenefifiBridge until April 20, 2015, Logging On Dependent Documentation From the internet,visit www.benefithridge.com/gendole to If you are enrolling a spouse, a domestic partner, or complete the registration process. child(ren)for whom you have legal custody,you will need to provide supporting documentation with your enrollment applications. See the "About Your Coverage" section on page 4 for documentation requirements, 2 City of Glendale I Active Employees employee benefits web site tconfinueC` Online Benefits Enrollment made Easy with GEE'MenerhBridge BenefitBridge is a personalized,benefits resource system which allows employees to complete their benefits enrollment online. Accessed from any computer with an Internet connection,you are also able to view currently enrolled benefits,compare plan options,access quick links to carrier websites,open and print benefits-related employer documents;and,utilize a health-related resource library and other interactive tools. Registration and Login Registration is easy-just three simple steps! Access your Flenefit8ridge website at www,benefitbridge,c�M&Ilen��Ie, then follow the on-screen Instructions: Select"Continue"to Select"Register to Create a Username access BenefitBridge Step 1 Step 2 _111. Step 3 Create an Account and Password (print page with ---------- —------_-- account information) Resources and Enrollment Benefiffiridge Portal Contents-Where Do I find? Carrier website links;Current Benefit Enrollments;Employer Announcements: open Enrollment-End Dote and lime and Passwora/E-moil Reset Benefits Carrier Plan Options;"Compare'Plans toot;Benefits Documentation and Forms; other Health-Related Ws and links, 1 Enrollment this is your online enrollment!. Access and complete Your Benefit Elections Here. Access Vcif enrdirrent I vio - Follow on-scree.^,instructions,completing information on the five enrollment screens. the EnTalirnent(tab)or 'Enroll Bene in Ali trs'— button(on Home poge). Personal E6_x_e� P5�tlonai_ EA-e-o-W-71 Enrollment Center E3 Review coffier offetr9s - Important Reminder: On Review screen,don't forget to check"I Agree"and submit enrollment'. Rem:cu,elt&,wMs Your Approval: F_ I AGREE(Check to confirm your final approval.) D�Veice E3 cr.P-e Pim car,,ns E Health&wellness7 Health information Research;Calculator tools, ! Resources Life Events Information;Medical Information Resource links, Need Help? Contact Benefit8ridge Support at 800.814.1862; Monday through Friday, 8:00 am-5:00 pm PST. City of Glendale Active Employees 3 f=,o Keenan • ' 1„1 r �•,w OK dw ANK f z � a e City 2015 Group • Renewal • • I and Stewardship Report Agenda ® Your Keenan Benefit Team — Keenan's Role ® Stewardship Report — 2015 Renewal Highlights — 2016 Strategic Planning ® Additional Keenan Value-Added Services , Your Keenan Benefits Team ... e M � � F w w • w Purpose of Stewardship Report — Define and Summarize Keenan 's Role • Renewal negotiations • Marketing • Implementation of new plans • Carrier liaison • Technology Solutions — BenefitBridge Online Enrollment and Eligibility System — Personal Choices Web Portal • Review plan documents, applications, employee communication • Requirements Stewardship Purpose of Define Keenan 's ® Training webinars on topics such as COBRA, Healthcare Reform, HIPAA, GASB, FMLA ® Service support to the City's Benefits Staff as needed — Review and consult on employee communications — BenefitBridge and Personal Choices support with plan implementation and maintenance — Keep the City current on Federal and State Compliance California Survey ® The proportion of California employers offering coverage has declined significantly over the last decade, from 71 % in 2002 to 60% in 2012 • Higher offering rates are associated with larger firms, firms with higher wages, and firms with fewer part-time workers ® Since 2002, premiums in California rose by 169.7%, more than five times the 31 .5% increase in the state's overall inflation rate Sources:Centers for Medicare and Medicaid(CMS),Office of the Actuary;California Employment Development Department,Labor Market Information;NORC/CHCF California Employer Health Benefit Survey,2012. California Foundation Survey • More than one-quarter of workers in small firms had a deductible of $1 ,000 or more for single coverage in 2012, up from just 7% in 2006. In large firms, only 8% had a deductible of $1 ,000 or more. • Twenty-one percent of California firms reported that they increased workers' share of the premium in the preceding year, while 17% reduced benefits or increased cost-sharing. ® Average monthly premiums for single coverage in California were $545 in 2012, compared to $468 nationally. For family coverage, monthly premiums were $1 ,386 in California and $1 ,312 nationally. Sources:Centers for Medicare and Medicaid(CMS),Office of the Actuary;California Employment Development Department,Labor Market Information; NORC/CHCF California Employer Health Benefit Survey,2012 City of Sample 2015 Key benefit Initiatives • Renewal negotiations with Health Net and Kaiser • Mitigate continued migration into Kaiser • Replacement of Blue Shield plans • VSP renewal and voluntary options • Affordable Care Act (ACA) — Regulatory compliance • 2014 Open Enrollment administered via BenefitBridge HR Portal — 100% reenrollment of all members — Carrier support for multiple onsite enrollment fairs Keenan Medical Plan Renewal and Marketing 2015 Renewal Highlights • Blue Shield non-renewed • ACA fees included in all rates • ACA mandated Preventive Care added to medical plans • Implemented Mental Health Parity • Health Net replaced by Sutter Health Plus and Western Health Advantage with minimal disruption in the provider network • Retirees 65+ moved to United HealthCare Medicare plans • Voluntary Vision plan available for HDHP members • Increased dependent age to 26 on Prudential Life plan Kaiser Renewal .,lion The "as is" renewal - 2.67% increase on both the HMO and HDHP. The optional rate exhibit included: ® 3 and 4 tiers ® Unblended rates — Actives — less than 1 % increase — Early Retirees — 30% increase ® with and without vision on the HMO — 1 % less without vision Kaiser Renewal & Options (continued ) • Implementation of ACA mandated preventive care — No additional cost • Implementation of Mental Health Parity — 0.3% increase Health Net Renewal & Options The "as is" initial renewal - 15.7% increase The optional rate exhibit included: ® Take-over of Blue Shield enrollment - 14.7% increase ® ACA mandated preventive care - Included in Blue Shield take over rates ® Implement Mental Health Parity - Included in Blue Shield take over rates ® 3 and 4 tier rates Health Net Renewal & Options (continued ) • Unblended rates — 10.2% increase — 52.5% increase • High copay plan provided for intermittent employees • High deductible PPO plan to replace Blue Shield PPO — 26.7% higher than current Blue Shield plan • Would not quote alongside Western Health Advantage or Sutter Health Plus • Would not quote Medicare only plans Health Net Negotiated Renewal ® Keenan's underwriting analysis determined that the Health Net trend was higher than the norm and that the renewal should be closer to a 9.06% increase ® With the analysis as back up and the marketing activity, Keenan negotiated a 5% reduction in the renewal to a final increase of 9.7% Medical Marketing • A Request for Proposal (RFP) was released to other medical carriers to be offered alongside Kaiser or in a triple carrier scenario • United Healthcare, Anthem Blue Cross and Aetna declined based on current contribution strategy for the actives and the Kaiser penetration — Sutter Health — provided a quote — Western Health Advantage — provided a quote — United Healthcare — provided a Medicare quote Keenan Western Health WHA agreed to quote in either a dual or triple carrier scenario. The original proposal included: ® Standard HMO plan — closest match to current plans — 4.38% lower than the current Health Net HMO ® Standard HDHP plan — 35% lower than the current Blue Shield HDHP ® 3 and 4 tier rates ® Blended and unblended for HMO and HDHP ® Nationcare plan options for out of area employees and retirees 0 Health Equity for HSA administration Western Health Advantage (WHA) WHA provided a revised proposal based on Keenan's negotiations to match the existing plans and the marketing activity with Sutter Health Plus. The Final Proposal included: ® Customized HMO plan and HDHP matching existing benefits ® NationCare plan for out of area employees and early retirees ® HMO rates 27% lower than Health Net's renewal rates ® HMO rates within 1 % of Kaiser's rates. ® The HDHP matches Kaiser benefits with lower rates Sutter Health Plus Sutter Health Plus is a new carrier affiliated with the Sutter network of medical providers. Quotes were available starting in August of 2013. Sutter agreed to quote alongside both WHA and Kaiser. The proposal included: ® Customized HMO and HDHP matching existing benefits ® 3 and 4 tier rates ® US Bank for HSA administration ® Second year rate cap of 9% ® Rates 28% lower than Health Net HMO ® Rates within 1 % of the Kaiser HMO and HDHP 10 01 Self-Funded PPO ® Keenan was asked to find a PPO option to replace the Blue Shield PPO option that was going away as a result of Blue Shield declining to renew the plan ® After a review of the marketplace it was determined that no carriers were willing to quote a fully insured PPO for the City due to the level of risk within that risk pool. ® Keenan was directed to find a vehicle to create a Self-Insured PPO for the City ® UHC was willing to provide the TPA services for a self-insured program with the following restrictions: — UHC would pay claims only — UHC would not provide stop loss coverage — Utilization review, Medical Management, etc. would need to be outsourced — No excess carrier was willing to provide Stop Loss coverage for the proposed plan ® Ultimately it was decided that the risk to the City was too great to continue a PPO Plan option on a self-insured basis r ® Medicare United HealthCare — Keenan requested a proposal from United HealthCare for their Medicare plans as an alternative to the Blue Shield and Health Net Medicare plans offered to retirees over age 65. The proposal included: ® A custom Senior supplement and Part D plan — $334.93 per retiree per month ® Medicare Advantage plan matching Health Net - $170.81 per retiree per month ® Medicare Advantage plan matching Blue Shield - $145.09 per retiree per month ® National PPO Plan $252.56 per retiree per month 2015 Savings - Actives & Special Districts 201S RL`ne�Nal x with Health tvet and Kaiser* Enrollment 11tC0``ihly Premium Annual Premium Kaiser #### $### $### Health Net #### $### $### Totals #### $### $### 261�Renewal n 'Pr wit w' :r " e -`A ua a irim h 1Vex.rrs, " : . : Erollment'.;:`,-': :-;; lt�ritlyPr m u►ri r� 1 m Kaiser #### $### $### Sutter Health Plus #### $### $### Western Health Advantage #### $### $### Total Premium #### $### $### Esti mated Ann ua I Savings = $##�###�### 'Based on enrollment at time of renewal 2015 Sa - Rebrees 20'"1leewai w'th-Hrith Nit and Kiser IWn�ollment Monthly Preen' ul Premium rum Arai;, Kaiser #### $### $### Health Net #### $### $### Totals #### $### $### 2014 RerteWai w# ir�ew�arrirsnrailinent Monthl .pwemium Annuai Premium Kaiser #### $### $### Sutter Health Plus #### $### $### Western Health Advantage #### $### $### United Health Care #### $### $### Total Premium ##I $### $### ## Estimatecl Annual Savings = $#Yff Note:Estimated savings take into account the difference of 216 retirees between the 2014 renewal and 2014 enrollment Dental and Vision Renewals VSP The "as is" renewal rates came in with a reduction of 26%. The rate exhibit included: ® Plan options with increased allowances and frequencies ® Further reduction in rates with the addition of the Kaiser membership ® 36 month rate guarantee — exclusive of ACA fees ® Added contract lens fitting allowance; Diabetic Eyecare Plus and increased out of network reimbursement. ® Voluntary rates for employees that waive medical or enroll on a HDHP VSP (continued ) ® A cost analysis of the current Kaiser vision plan vs. VSP as the only vision carrier was done to see if there were any savings to moving all vision to VPS exclusively. The difference in the Kaiser rates with and without vision was approximately 1 %. ® The final determination was to keep the Kaiser vision in place for the HMO members and VSP for all other HMO members. The rates remain the same with an increase in the allowance to $130 and frequency change to 12/12/24. VSP will also be offered on a voluntary basis to those that waive medical coverage or enroll on a HDHP. Delta Dental and Principal Dental • Delta Dental increased the current rates by 2% to cover the new ACA fees — 1 % was added to the rate and the other 1 % was added to the administration cost • Principal Dental is in the second year of a 2 year rate guarantee and did not increase the rates to cover the new ACA fees New Carrier Implementation Keenan worked with the City, WHA, Sutter Health Plus and United Healthcare for a smooth implementation of the new plans. Administrative services included: • Weekly scheduled calls with each new carrier • Assistance with completion of carrier applications • Proofing of carrier materials including SBCs and Benefit Summaries • Coordination of health fair participation and special presentations MT Benefit Bridge ® The Benefit Bridge team worked diligently with the City staff and the representatives from all 3 new carriers to prepare for open enrollment ® In addition to having the system ready for open enrollment there were a couple new enhancements added to the system including: — A zip code search that allows for an employee to determine which plans they are eligible for based on the carrier service area — UHC Medicare enrollment will be done through Benefit Bridge eliminating the need for paper enrollment forms starting mid-March 201 5 Strategic Planning 2015 Strategic Planning • What are the Goals — with ACA in mind — Minimize cost over all else? — Preserve current program? — Ensure competitive benefits that attract and retain? — Contribution philosophy? — Cost savings for Retirees? — On line benefit administration and enrollment? Additional Keenan Value Add Solutions and Services Legislation 2013-2014 Legislation .�.._,_, _,___.a_ w___� � B R I F F I N G _r_ enan ( R1 li Keenan B R I f Keenan F31�11 fE [ I 1 ) x i 4, i:.,: (11.' ! i 1 I 111\I tli t,t tti IiO,.I „` - t' 60, it 1 t IIS II 1 .} 14 U I.„, t :,�r r. ..i f ,' :"•f..ti ,(-„I. ..,' i i tilt IVI Iirnitl,1:-1;u�cue:-.I>�v.l.,,�„N..I I)i,:,rJ.r ui Auu.m � 1 O"F et,�.rlis, I ,1.I" I. t 1 t r,i I I itt Inl i 5 .. . I 1 ,,r 1 1 , f-r,vi, i • -�li[I u,F ..i-.:t,:s gl` ci Vi if, c+ All l6li 11r 1,1,S;nrc<:ur nruQce fnfcn,l�t� 1 .t 1 • t Al- , I - } t i E 1t1 .II f _ I. i:,: t 1= it ` t t ,E i ! _ il i t . 3. d t -', ' It I. ,. ,I r i ! r }t " �� a 3 ,- - ter - „ .. ,. .. c;nnnih„ a 3 i I I t -1 i i l c i ( f i' { ''�� I' t 1 j ,.,,i, 3 ;S-,�, � 5:`� .,.�.,rs,s.-�r..,-i-, , , �-,,.:,i •...I.t.f,}c f,rl Ni,,.:. 1'. } 11�_4 f., f . :�{ i I)e,lucrrt•i„ I I [ f ,+„ :t r�,,.- E ,i t I. ! 1 3 ,It t ,,, i- f , : +0-11 It f i 1 t at I.: ,. 1,.,. h, r r I i hl:n.p r:odr-r"'d 1-+h M,i a,r- i i l , l,,It-d:i,Id: .k Ill, 2012-2013 Legislation Health are Reform: Taxing Employers a I: Introduction February 4, 2013 ® Health Care Reform: Taxing Employers -- Part II: Definitions Overview February 4, 2013 ® Health Care Reform: Special Rule ForOff-Calendar Year Cafeteria Plans February 13, 2013 ® Health Care Reform: Exchange Notification Requirement Postponed February 13, 2013 Health are Reform: Department of Labor Issues Model Notice of Exchange May 13, 2013 ® Health Care Reform: What Are PCORI Fees? The Patient CenteredOutcomes Research Institute June 19, 2013 Legislation (confinuea ) 2012-2013 United tates Supreme Court Issues Rulings on DOMA and Proposition 8 Cases June 27, 2013 ® 2013 HIPAAOmnibus Rule September 10, 2013 ® California Legislative Update for Bills Related to Health and DisabilityInsurance October 28, 2013 ® Health Flexible Spending Arrangements: Carryover and More November 1 , 2013 ® 2014 Benefit Limits for Health & Welfare Plans November 15, 2013 ® SB 1 — Amendment to the BrownAct: Promoting Greater Transparency in Public Agencies December 6, 2013 Webinars 2013-2014 Webinars Ifeenan } WEBIMARS .terry Healy is the employe e e Affordable Care Act: Workforce Analysis - benefits counsel at Keenan and has practiced employee benefits ° Strategic Planning for Full-Time Employees aw for many years and has m , u. •F„„�n .... ","" served as Keenan's Health Care - 7 e •- --- a COMPLIMENTARY 90 minute webinar Reform expert since passage of Wednesday May 15,at 10:00 AM the taw,prior to coming to - - - Keenan,Jerry served as a legal consultant to Kaiser Permanents and The waft Disney Company. Presenters: Cynthia Stribling Training r lerrV Healy-Keenan expDirector,he over 30 years of Cynthia Stribhnq-Keenan benefit in the employee --•----- - � --• } ., bertaf;fatd.She is a Certified s,� Employee Benefit Specialist and Regardless of your strategic approach as to the new Health Care has worked as a benefits ..... Reform rules,at the end of 2014 there are bvo new reports that all manager,health plan employers with more than 50 employees are responsible for representative,brakes consultant,college extension instructor and r, completing to determine whether they are subject to tax penalties. trainer. _ Employers must know the full-time/part-time status,as defined by the Affordable Care Act(ACA),of all their employees in order to complete these reports...and time is running out. .. -., Are you at risk for ACA Penalties?What you know today can save you money in 2014!Analyzing your workforce requires understanding of: • Look-Back Rules • Standard Measurement Periods • Interim Measurement Periods • Administrative Periods and • "Variable Hour"employees This informative webinar will give you an overview of these new terms and an introduction to some new tools that can assist you in your,task. Fr!�;f Pr tncl ly+ IN I IMAM" 2012-2013 Webinars (confinued ) ® Navigating the New Healthr I ti r Wellness Programs March 19, 2013 ® Affordable CareAct: Workforce Analysis — Strategic Planningr Full- Time e Iyee May 15, 2013 ® ACA "Notice f Coverage Options" it — Are September 4. 2013 ® GASB 43/45 — Before You Get Too Comfortable January 22, 2014 �a �r E a H 1 Oth Annual Keenan Summit 1Oth Annual Keenan Summit DA][S & LOCATIONS: Southern CA-Burbank Nnrthern CA-Oakland ?ut�sday,March 25 WednegdaVv,March 26 8:30 a.M.-3:30 ra.m. 8:30 a.m.-3:30 prn. DurbankAirpcul Marriott Oakland City Center Maidott Featured Speakers: Peter Lee Execut4ve Drmeto;Ccuc.rod Ca0cm a(Fuss frank) JOhn Chiang Ga�forrn,J Stzrte t„prrtrp'-�cr(F3tat�avnk) David Sayen R-r^'r IX A i.ni tratw r eni t oxs,of mcxtc, M d,c rid sown e (t.axj rrx) 3 h Guy YaW it wght Loader n-1 M:t - rr n vncl wcE,6 h fc,Ft(7 a ea To 5(r`.MPts ai xi Ja m(a £4¢t j -�,p Ke e.i r S t rn t nn,-,e u v h air l US 1 3 Oogo CT rf s t iU to O.L)lrr, ,, r i-. l r an t ,i h !h..e,rn , ti r / jw r Thank You ! We truly appreciate your business and look forward to working with you and your employees for many years to come. We believe in forming a mutually beneficial partnership and welcome your constructive comments on how we may serve you better. . e Ern to ee Handbook Ke1 nt aft ORIGINAL REVISED PAGE �j DATE: DATE: NUMBER: 03/90 03/2007 1 of 2 SUBJECT: Conflict of Interest Each employee has a responsibility to be free and to appear to be free from the influence of any interest,which conflicts with that of Keenan. The Company has a substantial investment in all of its business ventures and activities and must maintain policies that are designed to protect its financial interests, as well as the interests of the employees who depend upon the Company's ongoing success for continued employment. Employees at all levels throughout the organization are therefore required to comply with this Conflict of Interest policy. Keenan insists upon the undivided loyalty of their employees throughout their employment. In keeping with this right, Keenan requires the following commitments from all employees, subject to the provisions of all applicable State, Federal, and local laws. 1. Every employee of the Company has an ethical responsibility to promote the Company's best interests. No employee may engage in any conduct or activities that are inconsistent with the Company's best interests or that in any manner disrupt, undermine, or impair the Company's relationships with any customers or prospective clients or any outside organization,persons or entity with which the Company has or proposes to enter into an arrangement, agreement or contractual relationship of any kind. 2. Employees must also agree that, both during and subsequent to their employment with the Company, they will not interfere with, disrupt, or impair any relationship between the Company and any employee, consultant, representative or any outside organization with which it has or proposes to enter into a contractual relationship of any kind. 3. The protection of confidential information, sensitive information, and trade secrets (further referred to as confidential information) is essential to the Company, its clients, and the future security of its employees. Employees may not disclose any confidential information. Employees who improperly disclose any confidential information are subject to disciplinary action up to and including termination as stated in the Employment Agreement signed upon hire. 4. The Company requires the complete commitment of all employees. Employees may not engage in any outside activity or accept work in any outside position that either interferes with their ability to devote their full and best efforts to the Company's interests or raises an actual or potential conflict of interest or the possible appearance of a conflict of interest. Employees who have any questions regarding this policy or the potential impact of outside employment or outside activities on their position with the Company should contact the Human Resources Department before accepting any outside position or engaging in such an activity. 5. The Company reserves the right to determine that other relationships that are not specifically- covered in this policy represent actual or potential conflicts of interest. In any case where the Company determines,in its sole discretion, that a relationship between an employee and a non-employee, or an employee and an outside organization or individual, presents an actual or potential conflict of interest, the Company may take whatever action it determines to be appropriate to avoid or prevent the continuation of the actual or potential conflict of interest. Such action may include, but is not necessarily limited to, transfers, reassignments, changing responsibilities or, where it deems such action appropriate, disciplinary action up to and including termination. In the event a situation arises where there may potentially appear to be a real or apparent conflict of interest, you should ask your Supervisor or the Human Resources Department for guidance. r Exhibit C SELF-DEALING TRANSACTION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as "County"), members of a contractor's board of directors (hereinafter referred to as "County Contractor"), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the County. A self-dealing transaction is defined below: "A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest" The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1) Enter board member's name,job title (if applicable), and date this disclosure is being made. (2) Enter the board member's company/agency name and address. (3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the County. At a minimum, include a description of the following: a. The name of the agency/company with which the corporation has the transaction; and b. The nature of the material financial interest in the Corporation's transaction that the board member has. (4) Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5) Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). (1)Company Board Member Information: Name: Date: Job Title: (2)Company/Agency Name and Address: (3)Disclosure(Please describe the nature of the self-dealing transaction you are a party to): (4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a): (5)Authorized Signature Signature: Date: