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HomeMy WebLinkAboutAgreement A-16-433 with Keenan & Associates.pdf -1- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 A G R E E M E N T THIS AGREEMENT is made and entered into this 12th day of July, 2016, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as "COUNTY", and Keenan & Associates, a California corporation, whose address is 2355 Crenshaw Blvd., Suite 200, Torrance, CA 90510, hereinafter referred to as "CONTRACTOR". W I T N E S S E T H: WHEREAS, Federal and State laws and regulations related to employee health care and benefits plans are subject to changes; and WHEREAS, the employee health care and benefit plan industry is a fluid market with many new alternative products being offered; and WHEREAS, the COUNTY has a need for employee health care and benefit plan consulting services to assist the COUNTY in ensuring legal and regulatory compliance and identifying and evaluating all health care and benefit plan alternatives; and WHEREAS, CONTRACTOR has the expertise and resources to provide employee health care and benefit plan consulting services; NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein contained, the parties hereto agree as follows: 1. OBLIGATIONS OF THE CONTRACTOR A. CONTRACTOR shall, under this Agreement, provide COUNTY employee benefit plan consultation services (hereinafter referred to as “Consultation Services”) as described in COUNTY’s Request for Proposal (RFP) number 964-5439 (including Addendum number 1) attached hereto as Exhibit “A” and incorporated herein by reference, and CONTRACTOR’s response to said RFP, excluding those services described in Appendix 2 of the CONTRACTOR’s response to said RFP, attached hereto as Exhibit “B” and incorporated by reference, including, but not limited to: 1) Administrative Services for Health and Ancillary/Voluntary Benefit -2- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Plans a. Benefit Design Assistance b. Participant Communications c. Legal & Regulatory Compliance Support 2) Vendor Relations for Health and Ancillary/Voluntary Benefit Plans a. RFP/RFQ Development b. Contract Development c. Vendor Management 3) Data Analysis and Reporting for Health Benefit Plans 4) Actuarial, Underwriting and Fiscal Support for Health Benefit Plans 2. OBLIGATIONS OF THE COUNTY A. COUNTY will authorize its health and benefit plan vendors to provide CONTRACTOR with current health and benefits plan data and necessary information including, but not limited to, the following: 1) COUNTY will direct CONTRACTOR in preparing the content or scope of services to be specified in any health and benefits RFP and/or RFP to current insurance carriers for renewing the provision of benefits each currently provides to active employees and retiree members (living inside or outside of California) and their dependents. The COUNTY shall provide final approval of requests for quotations (RFQ) and/or RFP before release to potential vendors; 2) Health and benefit plan contracts, enrollment and relevant reports and data as required for CONTRACTOR to provide Consultation Services. B. COUNTY will make CONTRACTOR broker of record on all assignable ancillary/voluntary benefits currently in place and will direct ancillary/voluntary commissions to CONTRACTOR. CONTRACTOR shall also be assigned broker of record on any new policies placed by CONTRACTOR and shall receive commissions earned from those policies. 3. TERM The term of this Agreement shall be for a period of three (3) years, -3- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 commencing on July 12th, 2016 through and including July 11th, 2019. This Agreement may be extended for two (2) additional consecutive twelve (12) month periods upon written approval of both parties no later than thirty (30) days prior to the first day of the next twelve (12) month extension period. The Director of Human Resources or his or her designee is authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR’S satisfactory performance. 4. TERMINATION A. Non-Allocation of Funds - The terms of this Agreement, and the services to be provided hereunder, are contingent on the approval of funds by the appropriating government agency. Should sufficient funds not be allocated, the services provided may be modified, or this Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written notice. B. Breach of Contract 1) The COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of the COUNTY there is an illegal or improper use of funds. 2) Additionally the COUNTY may terminate this Agreement if, after notice and a thirty (30) day cure period CONTRACTOR fails to correct any of the following: a. A failure to comply with any term of this Agreement; b. A substantially incorrect or incomplete report submitted to the COUNTY; or c. Improperly performed service. In no event shall any payment by the COUNTY constitute a waiver by the COUNTY of any breach of this Agreement or any default which may then exist on the part of the CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR under this Agreement, which in the judgment of the COUNTY were not expended in accordance -4- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon demand. C. Without Cause - Under circumstances other than those set forth above, this Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written notice of an intention to terminate to CONTRACTOR. Under the terms of this paragraph 4.C, the Director of Human Resources is authorized to terminate this Agreement on behalf of COUNTY. 5. COMPENSATION/INVOICING: A. COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation as follows: COUNTY elects the compensation structure under “Option 2” of CONTRACTOR’s Cost Proposal contained in CONTRACTOR’s response to COUNTY’s RFP #964-5439, which annual fees are as follows: 1) $55,000 in Year 1, beginning July 12, 2016 2) $57,500 in Year 2, beginning July 12, 2017 3) $60,000 in Year 3, beginning July 12, 2018 4) $60,000 in Year 4, beginning July 12, 2019 5) $62,500 in Year 5, beginning July 12, 2020 CONTRACTOR will receive said compensation every year in which CONTRACTOR provides Consultation Services as set forth in this Agreement. In no event shall the total annual fees paid by COUNTY to CONTRACTOR exceed $295,000.00 during the term of this Agreement. B. COUNTY will make CONTRACTOR broker of record on all assignable Ancillary Benefit policies currently in place and any new policies placed by CONTRACTOR with commissions being directed to CONTRACTOR. CONTRACTOR agrees that COUNTY will select health and benefit policies that are beneficial to the COUNTY and its employees and that this Agreement does not obligate the COUNTY to select policies which will pay commissions to CONTRACTOR. For purposes of this agreement “Ancillary Benefits” are those benefits paid for by the COUNTY. Commissions received by CONTRACTOR for the Ancillary Benefits coverages placed by CONTRACTOR under this Agreement will be credited to COUNTY. At the -5- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 end of each contract year (“Calculation Period”), recognizing that the County shall su bmit quarterly payments of CONTRACTOR‘s annual fee, CONTRACTOR will report all commissions that have been received by CONTRACTOR from the placement of COUNTY’s employer paid benefits coverages (“Ancillary Commissions”) and will forward to COUNTY an amount equal to the amount reported within sixty (60) days following the end of the contract year. C. COUNTY will make CONTRACTOR broker of record on all assignable Voluntary Benefit policies currently in place and any new policies placed by CONTRACTOR with commissions being directed to and retained by CONTRACTOR. The term “Voluntary Benefits” means those voluntary benefits purchased by employees with their own funds, and “Voluntary Commissions” means the commissions earned from the sale of Voluntary Benefits. Beginning with Year 2, and continuing through Year 5 of the Agreement, CONTRACTOR’s annual fee will also be reduced, based upon the Voluntary Commissions received from Voluntary Benefits in the prior year as follows: 1) $5,000.00 reduction, if prior year Voluntary Commissions are between $10,000.00 and $35,000.00 2) $10,000.00 reduction, if prior year Voluntary Commissions are between $35,000.01 and $50,000.00 3) $15,000.00 reduction, if prior year Voluntary Commissions are between $50,000.01 and $75,000.00 4) $15,000.00 reduction plus a reduction equal to 50% of the Voluntary Commissions in excess of $75,000.00 until the annual fee is reduced to $0. CONTRACTOR shall perform a year-end reconciliation of all commissions received by CONTRACTOR from the placement of COUNTY employee paid Voluntary Benefits and notify the COUNTY in writing within 60 days of the beginning of Years 2 through 5 whether there will be a reduction in the annual fee due CONTRACTOR from COUNTY. D. Consistent with industry practices, insurers may also pay insurance brokers, such as CONTRACTOR, indirect compensation based upon volume efficiencies, client renewals, marketing services, product development, technology investments and other additional -6- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 services. The parties agree that CONTRACTOR will not receive any such indirect compensation related to any COUNTY health or benefit policy, either currently in place or placed by CONTRACTOR. E. CONTRACTOR shall submit quarterly invoices to the County of Fresno Department of Human Resources-Employee Benefits, 2220 Tulare Street, 14th Floor, Fresno, CA 93721. Payment will be made within 45 days of receipt of invoice by the COUNTY. F. It is understood that all expenses incidental to CONTRACTOR'S performance of services under this Agreement shall be borne by CONTRACTOR. 6. INDEPENDENT CONTRACTOR: In performance of the work, duties and obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of the 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 venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no right to control or 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 this Agreement, CONTRACTOR may be providing services to others unrelated to the COUNTY or to this -7- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Agreement. 7. MODIFICATION: Any matters of this Agreement may be modified from time to time by the written consent of all the parties without, in any way, affecting the remainder. 8. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties under this Agreement without the prior written consent of the other party. 9. HOLD HARMLESS: 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 who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents, or employees under this Agreement. 10. 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-Collapse-Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. -8- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. 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 signs and 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, (Name and Address of the official who will administer this contract), stating that such insurance coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and employees -9- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 CONTRACTOR shall notify COUNTY within three (3) days following its first notice or awareness of any actual or proposed termination or cancellation of, or material change in the required insurance coverage. 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 issued by admitted insurers licensed to do business in the State of California, and such insurance shall be purchased from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. 11. AUDITS AND INSPECTIONS: The CONTRACTOR shall at any time during business hours, and as often as the COUNTY may deem necessary, make available to the COUNTY for examination all of its records and data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to audit and inspect all of such records and data necessary to ensure CONTRACTOR'S compliance with the terms of this Agreement. If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR shall be subject to the examination and audit of the Auditor General for a period of three (3) years after final payment under contract (Government Code Section 8546.7). 12. NOTICES: The persons and their addresses having authority to give and receive notices under this Agreement include the following: COUNTY CONTRACTOR COUNTY OF FRESNO Keenan & Associates Attention: Employee Benefits Attention: Steve Gedestad -10- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2220 Tulare Street, 14th Floor 2355 Crenshaw Blvd., #200 Fresno, CA 93721 Torrance, CA 90501 All notices between the COUNTY and CONTRACTOR provided for or permitted under this Agreement must be in writing and delivered either by personal service, by first-class United States mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by personal service is effective upon service to the recipient. A notice delivered by first-class United States mail is effective three COUNTY business days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the sender maintains a machine record of the completed transmission. For all claims arising out of or related to this Agreement, nothing in this section establishes, waives, or modifies any claims presentation requirements or procedures provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section 810). 13. GOVERNING LAW : Venue for any action arising out of or related to this Agreement shall only be in Fresno County, California. The rights and obligations of the parties and all interpretation and performance of this Agreement shall be governed in all respects by the laws of the State of California. 14. DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTOR is 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. -11- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 this agreement. 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 Self -Dealing Transaction Disclosure Form, attached hereto as Exhibit C and incorporated herein by reference, and submitting it to the COUNTY prior to commencing with the self -dealing transaction or immediately thereafter. 15. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous Agreement negotiations, proposals, commitments, writings, advertisements, publications, and understanding of any nature whatsoever unless expressly included in this Agreement. In the event of any inconsistency in interpreting the documents which constitute this Agreement, the inconsistency shall be resolved by giving precedence in the following order of priority: (1) the text of this Agreement (excluding Exhibit "A", the COUNTY'S RFP No. 964-5439 and Exhibit “B”, the CONTRACTOR'S proposal in response thereto); (2) Exhibit "A", the COUNTY'S RFP No. 964-5439; and (3) Exhibit “B”, the CONTRACTOR'S proposal made in response to COUNTY'S RFP No. 964.5439. 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement 2 as of the day and year first hereinabove written . 3 COUNTY OF FRESNO 4 5 6 7 8 2355 Crenshaw Blvd ., Suite 200 Torrance, CA 90501 9 Mailing Address 10 11 12 13 14 15 16 17 DATE: I I · 18 APPROVED AS TO LEGAL FORM 19 20 21 22 23 24 25 26 27 28 -12- ATTEST: Ernest Buddy Mendes Chairman, Board of Supervisors Bernice E. Seidel Clerk , Board of Supervisors BY: .Su ~. bA~ctp DEPUTY REVI EWED & RECOMMEND~D FO ~APPROVAL --,~~ Paul Nerland Director of Human Resources APPROVED AS TO ACCOUNTING FORM Vicki Crow Auditor-ControllerfTreasurer-Tax Collector Exhibit A G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc PD-040 (11/2015) COUNTY OF FRESNO REQUEST FOR PROPOSAL NUMBER: 964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES Issue Date: February 8, 2016 Closing Date: 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 countypurchasing@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 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)”. 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 Proposal No. 964-5439 1A CCOOUUNNTTYY OOFF FFRREESSNNOO PPUURRCCHHAASSIINNGG 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: A) All prices and notations must be typed or written in ink. No erasures permitted. Errors may be crossed out, initialed and corrections printed in ink by person signing bid. B) Brand Names: Brand names and numbers when given are for reference. Equal items will be considered, provided the offer clearly describes the article and how it differs from that specified. In the absence of such information it shall be understood the offering is exactly as specified. C) State brand or make of each item. If bidding on other than specified, state make, model and brand being bid and attach supporting literature/specifications to the bid. D) Bid on each item separately. Prices should be stated in units specified herein. All applicable charges must be quoted; charges on invoice not quoted herein will be disallowed. E) Time of delivery is a part of the consideration and must be stated in definite terms and must be adhered to. F.O.B. Point shall be destination or freight charges must be stated. F) All bids must be dated and signed with the firm’s name and by an authorized officer or employee. G) Unless otherwise noted, prices shall be firm for one hundred eighty (180) days after closing date of bid. 2. SUBMITTING BIDS: A) Each bid must be submitted on forms provided in a sealed envelope/package with bid number and closing date and time on the outside of the envelope/package. B) Interpretation: Should any discrepancies or omissions be found in the bid specifications or doubt as to their meaning, the bidder shall notify the Buyer in writing at once. The County shall not be held responsible for verbal interpretations. Questions regarding the bid must be received by Purchasing stated within this document. All addenda issued shall be in writing, duly issued by Purchasing and incorporated into the contract. C) ISSUING AGENT/AUTHORIZED CONTACT: This RFP/RFQ has been issued by County of Fresno, Purchasing. Purchasing shall be the vendor’s sole point of contact with regard to the RFP/RFQ, its content, and all issues concerning it. All communication regarding this RFP/RFQ shall be directed to an authorized representative of County Purchasing. The specific buyer managing this RFP/RFQ 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/RFQ. Contact with any other County representative, including elected officials, for the purpose of discussing this RFP/RFQ, its 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/RFQ, 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. D) Bids received after the closing time will NOT be considered. E) 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. 3. FAILURE TO BID: A) If not bidding, return bid sheet and state reason for no bid or your name may be removed from mailing list. 4. TAXES, CHARGES AND EXTRAS: A) County of Fresno is subject to California sales and/or use tax (8.225%). Please indicate as a separate line item if applicable. B) DO NOT include Federal Excise Tax. County is exempt under Registration No. 94-73-03401-K. C) County is exempt from Federal Transportation Tax. Exemption certificate is not required where shipping papers show consignee as County of Fresno. D) Charges for transportation, containers, packing, etc. will not be paid unless specified in bid. 5. W-9 – REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND CERTIFICATION & CALIFORNIA FORM 590 WITHHOLDING EXEMPTION CERTIFICATE: Upon award of bid, the vendor shall submit to County Purchasing, a completed IRS Form W-9 - Request for Taxpayer Identification Number and Proposal No. 964-5439 1B Certification and a California Form 590 Withholding Exemption Certificate if not currently a County of Fresno approved vendor. 6. AWARDS: A) Award(s) will be made to the most responsive responsible bidder; however, the Fresno County Local Vendor Preference and/or the Disabled Veteran Business Enterprise Preference shall take precedence when applicable. Said Preferences apply only to Request for Quotations for materials, equipment and/or supplies only (no services); the preference do not apply to Request for Proposals. RFQ evaluations will include such things as life-cycle cost, availability, delivery costs and whose product and/or service is deemed to be in the best interest of the County. The County shall be the sole judge in making such determination. B) Unless bidder gives notice of all-or-none award in bid, County may accept any item, group of items or on the basis of total bid. C) The County reserves the right to reject any and all bids and to waive informalities or irregularities in bids. D) Award Notices are tentative: Acceptance of an offer made in response to this RFP/RFQ shall occur only upon execution of an agreement by both parties or issuance of a valid written Purchase Order by Fresno County Purchasing. E) After award, all bids shall be open to public inspection. The County assumes no responsibility for the confidentiality of information offered in a bid. 7. TIE BIDS: All other factors being equal, the contract shall be awarded to the Fresno County vendor or, if neither or both are Fresno County vendors, it may be awarded by the flip of a coin in the presence of witnesses or the entire bid may be rejected and re-bid. If the General Requirements of the RFQ state that they are applicable, the provisions of the Fresno County Local Vendor Preference shall take priority over this paragraph. 8. PATENT INDEMNITY: The vendor shall hold the County, its officers, agents and employees, harmless from liability of any nature or kind, including costs and expenses, for infringement or use of any copyrighted or un-copyrighted composition, secret process, patented or unpatented invention, article or appliance furnished or used in connection with this bid. 9. SAMPLES: Samples, when required, must be furnished and delivered free and, if not destroyed by tests, will upon written request (within thirty (30) days of bid closing date) be returned at the bidder's expense. In the absence of such notification, County shall have the right to dispose of the samples in whatever manner it deems appropriate. 10. RIGHTS AND REMEDIES OF COUNTY FOR DEFAULT: A) In case of default by vendor, the County may procure the articles or service from another source and may recover the cost difference and related expenses occasioned thereby from any unpaid balance due the 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 be considered the prevailing market price at the time such purchase is made. B) Articles or services, which upon delivery inspection do not meet specifications, will be rejected and the vendor will be considered in default. Vendor shall reimburse County for expenses related to delivery of non-specified goods or services. C) Regardless of F.O.B. point, vendor agrees to bear all risks of loss, injury or destruction to goods and materials ordered herein which occur prior to delivery and such loss, injury or destruction shall not release vendor from any obligation hereunder. 11. DISCOUNTS: Terms of less than fifteen (15) days for cash payment will be considered as net in evaluating this bid. A discount for payment within fifteen (15) days or more will be considered in determining the award of bid. Discount period will commence either the later of delivery or receipt of invoice by the County. Standard terms are Net forty-five (45) days. 12. SPECIAL CONDITIONS IN BID SCHEDULE SUPERSEDE GENERAL CONDITIONS: The “General Conditions” provisions of this RFP/RFQ shall be superseded if in conflict with any other section of this bid, to the extent of any such conflict. 13. SPECIAL REQUIREMENT: With the invoice or within twenty-five (25) days of delivery, the seller must provide to the County a Material Safety Data Sheet for each product, which contains any substance on “The List of 800 Hazardous Substances”, published by the State Director of Industrial Relations. (See Hazardous Substances Information and Training Act, California State Labor Code Sections 6360 through 6399.7.) 14. RECYCLED PRODUCTS/MATERIALS: Vendors are encouraged to provide and quote (with documentation) recycled or recyclable products/materials which meet stated specifications. 15. YEAR COMPLIANCE WARRANTY: Vendor warrants that any product furnished pursuant to this Agreement/order 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 centuries, as well as leap year calculations. "Product" shall include, without limitation, any piece or component of equipment, hardware, firmware, middleware, custom or commercial software, or internal components or subroutines therein. This warranty shall survive termination or expiration of this Agreement. In the event of any decrease in product functionality or accuracy related to time and/or date data related codes and/or internal subroutines that impede the product from operating correctly using dates beyond December 31, 1999, vendor shall restore or repair the product to the same level of functionality as warranted herein, so as to minimize interruption to County's ongoing business process, time being of the essence. In the event that such warranty compliance requires the acquisition of additional programs, the expense for any such associated or additional acquisitions, which may be required, including, without limitation, data conversion tools, shall be borne exclusively by vendor. Nothing in this warranty shall be construed to limit any rights or remedies the County may otherwise have under this Agreement with respect to defects other than year performance. 16. PARTICIPATION: Bidder may agree to extend the terms of the resulting contract to other political subdivision, municipalities and tax-supported agencies. Such participating Governmental bodies shall make purchases in their own name, make payment directly to bidder, and be liable directly to the bidder, holding the County of Fresno harmless. Proposal No. 964-5439 1C 17. 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 if PHI may not be more expansive than 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. 18. 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/RFQ. Appeals should be submitted to County of Fresno Purchasing, 4525 E. Hamilton Avenue, Fresno, California 93702-4599 and in Word format to gcornuelle@co.fresno.ca.us. Appeals should address only areas regarding RFP/RFQ contradictions, procurement errors, quotation rating discrepancies, legality of procurement context, conflict of interest, and inappropriate or unfair competitive procurement grievance regarding the RFP/RFQ 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. 19. OBLIGATIONS OF CONTRACTOR: A) CONTRACTOR shall perform as required by the ensuing contract. CONTRACTOR also warrants on behalf of itself and all subcontractors engaged for the performance of the ensuing contract that only persons authorized to work in the United States pursuant to the Immigration Reform and Control Act of 1986 and other applicable laws shall be employed in the performance of the work hereunder. B) CONTRACTOR shall obey all Federal, State, local and special district laws, ordinances and regulations. 20. AUDITS & 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 (3) 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. 21. DISCLOSURE – CRIMINAL HISTORY & CIVIL ACTIONS: Applies to Request for Proposal (RFP); does not apply to Request for Quotation (RFQ) unless specifically stated elsewhere in the RFQ document. 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. 22. DATA SECURITY: Individuals and/or agencies that enter into a contractual relationship with the COUNTY for the purpose of providing services must employ adequate controls and data security measures, both internally and externally to ensure and protect the confidential information and/or data provided to contractor by the COUNTY, preventing the potential loss, misappropriation or inadvertent access, viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of COUNTY resources; and/or disruption to COUNTY operations. Individuals and/or agencies may not connect to or use COUNTY networks/systems via personally owned mobile, wireless or handheld devices unless authorized by COUNTY for telecommuting purposes and provide a secure connection; up to date virus protection and mobile devices must have the remote wipe feature enabled. Computers or computer peripherals including mobile storage devices may not be used (COUNTY or Contractor device) or brought in for use into the COUNTY’s system(s) without prior authorization from COUNTY’s Chief Information Officer and/or designee(s). No storage of COUNTY’s private, confidential or sensitive data on any hard- disk drive, portable storage device or remote storage installation unless encrypted according to advance encryption standards (AES of 128 bit or higher). The COUNTY will immediately be notified of any violations, breaches or potential breaches of security related to COUNTY’s confidential information, Proposal No. 964-5439 1D data and/or data processing equipment which stores or processes COUNTY data, internally or externally. COUNTY shall provide oversight to Contractor’s response to all incidents arising from a possible breach of security related to COUNTY’s confidential client information. Contractor will be responsible to issue any notification to affected individuals as required by law or as deemed necessary by COUNTY in its sole discretion. Contractor will be responsible for all costs incurred as a result of providing the required notification. 23. PURCHASING LOCATION & HOURS: Fresno County Purchasing is located at 4525 E. Hamilton Avenue (second floor), Fresno, CA 93702. Non-holiday hours of operation are Monday through Friday, 8:00 A.M. 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 holiday office closure schedule is observed: January 1* New Year's Day Third Monday in January Martin Luther King, Jr.’s Birthday Third Monday in February Washington - Lincoln Day March 31* Cesar Chavez’ Birthday Last Monday in May Memorial Day July 4* Independence Day First Monday in September Labor Day November 11* Veteran's Day Fourth Thursday in November Thanksgiving Day Friday following Thanksgiving December 25* Christmas * When this date falls on a Saturday, the holiday is observed the preceding Friday. If the date falls on a Sunday, the holiday is observed the following Monday. 24. FRESNO COUNTY BOARD OF SUPERVISORS ADMINISTRATIVE POLICIES: ADMINISTRATIVE POLICY NUMBER 5 Contract Salary Limitation Fresno County Administrative Policy No. 5 provides that in contracts with non- profit organizations that primarily serve Fresno County and professional service contracts where Fresno County is the sole client, the contractors must agree to the following contract language: “The contractor agrees to limit administrative cost to a maximum of 15% of the total program budget and to limit employee benefits to a maximum of 20% of total salaries for those employees working under this agreement during the term of the agreement. Failure to conform to this provision will be grounds for contract termination at the option of the County of Fresno.” Any bidder that wishes an exemption from this contract requirements must set forth the request for exemption, as well as a complete explanation of why the exemption should be granted, in the bidder’s response to the RFP. Only the Board of Supervisors can approve such exemption. Policy Statement: Contractors shall be limited to a maximum 15% administrative cost as compared to the total program budget and employee benefits shall be limited to a maximum of 20% of salaries. The following language will be included in each applicable contract: "The contractor agrees to limit administrative cost to a maximum of 15% of the total program budget and to limit employee benefits to a maximum of 20% of total salaries for those employees working under this agreement during the term of this agreement. Failure to conform to this provision will be grounds for contract termination at the option of the County of Fresno." The above provision shall be applied to renewal or multi-year contracts with non-profit organizations which primarily serve Fresno County and professional services contracts where Fresno County is the sole client, such as:  Community based organization service contracts related to social services, health services, or probation services.  Cultural art program contracts.  Professional services contracts. 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 consider exemptions to this policy only upon the recommendation of the County Administrative Office. Management Responsibility: It shall be the responsibility of any County official authorized by the Board of Supervisors to execute contracts or enter into agreements on behalf of the County to review all applicable contracts to insure that this policy is fully enforced. It shall be the responsibility of the County Administrative Officer to review requests for exemptions to this policy and to make recommendations to the Board of Supervisors on such requests for exemption. ADMINISTRATIVE POLICY NUMBER 34 Competitive Bids and Requests for Proposals Fresno County Administrative Policy No. 34 provides that no person, firm or subsidiary thereof who has been awarded a consulting services contract by the County, may submit a bid for, or be awarded a contract for, the provision of services, procurement of goods or supplies, or any other related action which is required, suggested, or otherwise deemed appropriate in the end product of the consulting services contract. Any bidder that wishes an exemption from this contract limitation must set forth the request for exemption, as well as a complete explanation of why the exemption should 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 interests of the County, can waive this policy. Definitions: Purchasing Authority and Responsibility – In accordance with the State of California Government Code Section 25500 et seq., and the Fresno County Ordinance Code Chapter 2.56, the Board of Supervisors has established a County Purchasing Agent. The Board has designated the County Administrative Officer as the Purchasing Agent. Unless otherwise restricted, all necessary authority and responsibility has been delegated to the Purchasing Agent to satisfy the acquisition requirements of the County. The Purchasing Agent may defer day-to-day acquisition management to the Purchasing Manager as appropriate. Policy Statement: Competitive bids or requests for proposals shall be secured for all contracts for goods or services which are proposed to be acquired by the County except when in unusual or extraordinary circumstances, a department head, requests an exception to competitive bidding. All such requests must be documented by the department head including a detailed description of the facts justifying the exception. The Proposal No. 964-5439 1E request must receive concurrence of the procurement authority who will sign that particular contract i.e. the Board of Supervisors or Purchasing Agent/Purchasing Manager. The following circumstances are examples which constitute “Suspension of Competition”:  In an emergency when goods or services are immediately necessary for the preservation of the public health, welfare, or safety, or for the protection of County property.  When the contract is with a federal, state, or local governmental agency.  When the department head, with the concurrence of the Purchasing Agent, finds that the cost of preparing and administering a competitive bidding process in a particular case will equal or exceed the estimated contract amount or $1,000 whichever is more.  When a contract provides only for payment of per diem and travel expenses and there is to be no payment for services rendered.  When obtaining the services of expert witnesses for litigation or special counsel to assist the County.  When in unusual or extraordinary circumstances, the Board of Supervisors or the Purchasing Agent/Purchasing Manager determines that the best interests of the County would be served by not securing competitive bids or issuing a request for proposal. Contracts for services should not usually cover a period of more than one year although a longer period may be approved in unusual circumstances. Multiple year contracts must include provisions for early termination and must be contingent on available funding. Unless exempted as provided for above, no contract for service shall extend, either by original contract or by extension, beyond three years unless competitive bids have been sought or a Request for Proposal has been processed. During any competitive bidding procedure, all bids shall be opened publicly and the dollar amount of each bid shall be read aloud. Under no circumstance shall a bid which is received at the designated place of opening after the closing time be opened or considered. Contracts for goods or services shall not be effective until approved by the Board of Supervisors or, if appropriate, the Purchasing Agent/Purchasing Manager. Contractors and vendors shall be advised by the responsible department head that performance under the contract may not commence prior to such approval. Medical Professional Contracts The competitive recruitment process, annual performance evaluation, and periodic salary surveys are equivalent to competitive bids for independent physicians contracting with the County on a fee for service basis. A salary survey for physician services shall be conducted every two years. Contracts for physician services shall not extend, either by original contract or by extension, beyond five years unless competitive bids have been sought or unless exempted as provided above. Contracts for Legal Services The competitive recruitment process, 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. A salary survey for legal services shall be conducted every two years. The selection of and contracting with firms to provide legal services shall be coordinated through the County Counsel's Office. The County Counsel shall assist in securing a law firm with the requisite legal expertise and price structure that would provide the best service to the County. County Counsel shall be involved throughout the process of selecting a firm, developing a contract, and monitoring the billing and services provided throughout the contract period. Prohibited Bids Concerning End Product of Consulting Contracts No person, firm, or subsidiary thereof who has been awarded a consulting services contract by the County, shall be awarded a contract for the provision of services, procurement of goods or supplies, or any other related action which is required, suggested, or otherwise deemed appropriate in the end product of the consulting services contract. This policy may be waived by the Board of Supervisors on a four-fifths (4/5) vote finding that such waiver is in the best interests of the County. Management Responsibility: The County Administrative Officer is responsible for preparing and issuing written procedures to assure compliance with this policy by all County officials and departments. ADMINISTRATIVE POLICY NUMBER 71 Prohibiting the Use of Public Funds for Political Advocacy Fresno County Administrative Policy No. 71 provides that no County assets, including money, shall be used for political campaigns of any type. Political campaigns are defined as political advocacy for or opposition to a matter or person that has qualified for the ballot. No contract entered into by the County shall provide for use of County monies for political campaigns. Policy Statement: Government assets, including money, grant funds, paid staff time, equipment and supplies, facilities or any other government asset shall not be used for political campaigns of any type. Political campaigns are defined as political advocacy for or opposition to a matter or person that has qualified for the ballot. Management Responsibility: Department Heads shall be held responsible for ensuring that government assets within their control are not used to advocate for or against any matter or person that has qualified for the ballot. This section does not prohibit the expenditure of government assets to create and provide informational or educational materials regarding a matter that has qualified for the ballot. Such information or educational materials shall provide a fair, accurate and impartial presentation of relevant information relating to the matter that has qualified for the ballot. However, government assets shall not be expended to create and provide such informational or educational materials in the 90 days prior to the election unless specifically authorized by the Board of Supervisors or required by the Public Records Act or other law. Proposal No. 964-5439 Page 2 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc TABLE OF CONTENTS PAGE OVERVIEW ..................................................................................................................... 3  KEY DATES .................................................................................................................... 5  TRADE SECRET ACKNOWLEDGEMENT ..................................................................... 6  DISCLOSURE – CRIMINAL HISTORY & CIVIL ACTIONS ............................................. 8  REFERENCE LIST ........................................................................................................ 11  PARTICIPATION ........................................................................................................... 12  GENERAL REQUIREMENTS ....................................................................................... 13  BIDDING INSTRUCTIONS AND REQUIREMENTS ..................................................... 19  SCOPE OF WORK ........................................................................................................ 21  VENDOR RESPONSE SECTION ................................................................................. 25  COST PROPOSAL ........................................................................................................ 27  PROPOSAL CONTENT REQUIREMENTS ................................................................... 28  AWARD CRITERIA ....................................................................................................... 31  CHECK LIST ................................................................................................................. 32  ATTACHMENTS ........................................................................................................... 33  Proposal No. 964-5439 Page 3 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Medical Dental Vision Mental Health Prescription Active Employees Blue Cross HMO Blue Cross PPO Blue Cross HDPPO Kaiser Delta Dental PPO Delta Dental HMO VSP Vision (Anthem Only) Included with the medical plan US Script (Anthem HMO and PPO only) Early Retirees (Pre-65) Blue Cross HDPPO Kaiser Delta Dental PPO Delta Dental HMO VSP Vision (Anthem Only) Included with the medical plan Included with the medical plan Medicare Supplement Retirees Hartford Delta Dental PPO Delta Dental HMO VSP Vision Included with the medical plan Express Scripts Medicare Advantage Retirees Kaiser Medicare Advantage (High and Low Options) Delta Dental PPO Delta Dental HMO Included with the medical plan Included with the medical plan Included with the medical plan Proposal No. 964-5439 Page 4 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 plans): 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. Proposal No. 964-5439 Page 5 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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) 600-7113 if planning to attend vendor conference. County of Fresno Purchasing 4525 E. Hamilton Avenue, 2nd Floor Fresno, CA 93702 Deadline for Written Requests for Interpretations or Corrections of RFP: February 24, 2016 at 10:00 A.M. E-Mail: CountyPurchasing@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 Proposal No. 964-5439 Page 6 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 7 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 a separate marked binder.** (Company Name) Has not submitted information identified as Trade 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. (Company Name) 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. Proposal No. 964-5439 Page 8 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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.epls.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. Proposal No. 964-5439 Page 9 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 10 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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: (in blue ink) Date: (Printed Name & Title) (Name of Agency or Company) Proposal No. 964-5439 Page 11 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 12 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Proposal No. 964-5439 Page 13 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 14 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Proposal No. 964-5439 Page 15 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Proposal No. 964-5439 Page 16 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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-Collapse- 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. Proposal No. 964-5439 Page 17 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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, 16th 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 Proposal No. 964-5439 Page 18 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 2nd Floor, Fresno, California 93702-4599 and in Word format to gcornuelle@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. Proposal No. 964-5439 Page 19 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 CountyPurchasing@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. Proposal No. 964-5439 Page 20 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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/epayablesvendors or call Fresno County Accounts Payable, 559-600- 3609. Proposal No. 964-5439 Page 21 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 22 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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) Proposal No. 964-5439 Page 23 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 24 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 25 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 26 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 27 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 28 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 VII. REFERENCES VIII. PARTICIPATION Proposal No. 964-5439 Page 29 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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: Proposal No. 964-5439 Page 30 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Proposal No. 964-5439 Page 31 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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. Proposal No. 964-5439 Page 32 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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: 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 response. Proposal No. 964-5439 Page 33 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 Active Employees Active Enrollment Dependent Enrollment Total Enrollment Retirees Retiree Enrollment Dependent Enrollment Total 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 Only 255 Retiree + Spouse 94 Employee Only 751 Medicare Kaiser High Subtotal 349 93 442 Employee + Spouse 94 Employee + Children 347 Employee + Family 98 Retiree Only 53 Active Kaiser Subtotal 1,290 1,166 2,456 Retiree + Spouse 14 Medicare Kaiser Low Subtotal 67 14 81 Total Active Employees 5,474 5,434 10,908 Total Retirees 1,105 265 1,370 Full Time Active Employees 501 Primary Dependents Total Retirees 5806 6,579 5,699 12,278 Combined Total Enrollment - Active Actives SJVIA/Anthem HMO Actives SJVIA/Anthem PPO Actives SJVIA/Anthem HDPPO Actives SJVIA/Kaiser Waived Coverage Retiree SJVIA/Anthem HDPPO Retiree SJVIA/Kaiser Retiree Medicare - Hartford Retiree Medicare Kaiser High Retiree Medicare Kaiser Low HEALTH PLAN ENROLLMENT (01/01/2016) RFP 964-5439 Attachment A Page 1 Disability 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 Voluntary 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 Account Participants Enrollment Health Care 1,600 Dependent Care 146 Parking/Transportation 33 Flexible Spending Total 1,779 Other Benefits Enrollment (12/21/2015) RFP 964-5439 Attachment B Page 1 RFP 964-5439 Attachment C -1- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 A G R E E M E N T THIS AGREEMENT is made and entered into this day of [Month] , [Year] , by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as "COUNTY", and [Contractor] , a (Type of business) (Note to County staff: Type of business the contractor is; such as a corporation – including the state in which they are incorporated, e.g., a California corporation; a partnership; a private, non-profit corporation; or a sole proprietorship), whose address is "[Contractor's Address]" , hereinafter referred to as "CONTRACTOR". W I T N E S S E T H: (Add WHEREAS Clauses) (Note to County staff: explains the need/purpose for the contract and the process by which the Contractor was chosen) NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein contained, the parties hereto agree as follows: 1. OBLIGATIONS OF THE CONTRACTOR A. B. (etc.) 2. OBLIGATIONS OF THE COUNTY A. B. (etc.) 3. TERM The term of this Agreement shall be for a period of three (3) years, commencing on (Effective Date) through and including (Last day of three year period) . This Agreement may be extended for two (2) additional consecutive twelve (12) month periods upon written approval of both parties no later than thirty (30) days prior to the first day of the next twelve (12) month extension period. The (Title of department head) or his or her designee is authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR’S satisfactory performance. RFP 964-5439 Attachment C -2- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4. TERMINATION A. Non-Allocation of Funds - The terms of this Agreement, and the services to be provided hereunder, are contingent on the approval of funds by the appropriating government agency. Should sufficient funds not be allocated, the services provided may be modified, or this Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written notice. B. Breach of Contract - The COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of the COUNTY there is: 1) An illegal or improper use of funds; 2) A failure to comply with any term of this Agreement; 3) A substantially incorrect or incomplete report submitted to the COUNTY; 4) Improperly performed service. In no event shall any payment by the COUNTY constitute a waiver by the COUNTY of any breach of this Agreement or any default which may then exist on the part of the CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR under this Agreement, which in the judgment of the COUNTY were not expended in accordance with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon demand. C. Without Cause - Under circumstances other than those set forth above, this Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written notice of an intention to terminate to CONTRACTOR. 5. COMPENSATION/INVOICING: (Note to County staff: If sales tax is applicable and to be paid to an out-of-state vendor, it must be separated from the total compensation and the vendor must have a California Sales Tax Permit Number.) COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation as follows: RFP 964-5439 Attachment C -3- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 "[Enter compensation]" . CONTRACTOR shall submit monthly invoices in triplicate to the County of Fresno "[Enter Department Name]" . In no event shall services performed under this Agreement be in excess of "[Enter maximum contract amount]" during the term of this Agreement. It is understood that all expenses incidental to CONTRACTOR'S performance of services under this Agreement shall be borne by CONTRACTOR. (Note to County staff: If the number of days within which payment must be made is specified, this paragraph must provide for payment after a minimum of forty-five (45) days from date of receipt of invoice by the COUNTY.) 6. INDEPENDENT CONTRACTOR: In performance of the work, duties and obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of the 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 venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no right to control or 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 this Agreement, CONTRACTOR may be providing services to others unrelated to the COUNTY or to this RFP 964-5439 Attachment C -4- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Agreement. 7. MODIFICATION: Any matters of this Agreement may be modified from time to time by the written consent of all the parties without, in any way, affecting the remainder. 8. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties under this Agreement without the prior written consent of the other party. 9. HOLD HARMLESS: 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 who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents, or employees under this Agreement. 10. 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-Collapse-Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. RFP 964-5439 Attachment C -5- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. 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 signs and 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, (Name and Address of the official who will administer this contract), stating that such insurance coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and employees RFP 964-5439 Attachment C -6- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 issued by admitted insurers licensed to do business in the State of California, and such insurance shall be purchased from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. 11. AUDITS AND INSPECTIONS: The CONTRACTOR shall at any time during business hours, and as often as the COUNTY may deem necessary, make available to the COUNTY for examination all of its records and data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to audit and inspect all of such records and data necessary to ensure CONTRACTOR'S compliance with the terms of this Agreement. If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR shall be subject to the examination and audit of the Auditor General for a period of three (3) years after final payment under contract (Government Code Section 8546.7). 12. NOTICES: The persons and their addresses having authority to give and receive notices under this Agreement include the following: COUNTY CONTRACTOR COUNTY OF FRESNO [click here to enter Contractor] [click here to enter County Address] [click here to enter Contractor Address] [click here to enter County Address] [click here to enter Contractor Address] RFP 964-5439 Attachment C -7- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 [click here to enter County City/State] [click here to enter Contractor City/State] All notices between the COUNTY and CONTRACTOR provided for or permitted under this Agreement must be in writing and delivered either by personal service, by first-class United States mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by personal service is effective upon service to the recipient. A notice delivered by first-class United States mail is effective three COUNTY business days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the sender maintains a machine record of the completed transmission. For all claims arising out of or related to this Agreement, nothing in this section establishes, waives, or modifies any claims presentation requirements or procedures provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section 810). 13. GOVERNING LAW: Venue for any action arising out of or related to this Agreement shall only be in Fresno County, California. The rights and obligations of the parties and all interpretation and performance of this Agreement shall be governed in all respects by the laws of the State of California. 14. DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTOR is 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 RFP 964-5439 Attachment C -8- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 performing services under this agreement. 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 Self-Dealing Transaction Disclosure Form, attached hereto as Exhibit A and incorporated herein by reference, and submitting it to the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter. 15. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous Agreement negotiations, proposals, commitments, writings, advertisements, publications, and understanding of any nature whatsoever unless expressly included in this Agreement. [If applicable, add the following: In the event of any inconsistency in interpreting the documents which constitute this Agreement, the inconsistency shall be resolved by giving precedence in the following order of priority: (1) the text of this Agreement (excluding Attachment "A", the COUNTY'S Request for Quotation/Proposal No. "[Enter RFQ/RFP No.]" and the CONTRACTOR'S Quote/Proposal in response thereto); (2) Attachment "A"; (3) the COUNTY'S Request for Quotation/Proposal No. "[Enter RFQ/RFP No.]" ; and (4) the CONTRACTOR'S quotation/proposal made in response to COUNTY'S Request for Quotation/Proposal No. "[Enter RFQ/RFP No.]" .] RFP 964-5439 Attachment C -9- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first hereinabove written. CONTRACTOR COUNTY OF FRESNO (Authorized Signature) Gary E. Cornuelle Purchasing Manager Print Name & Title Mailing Address DATE: DATE: REVIEWED & RECOMMENDED FOR APPROVAL Department Head's Signature APPROVED AS TO LEGAL FORM APPROVED AS TO ACCOUNTING FORM County Counsel Auditor-Controller/Treasurer-Tax Collector FOR ACCOUNTING USE ONLY: ORG No.: [click to type type org] Account No.: [click to type type account] Requisition No.: [click to type requisition number] FCMC 10/12 C:\USERS\SJOHNSTON\APPDATA\LOCAL\MICROSOFT\WINDOWS\TEMPORARY INTERNET FILES\CONTENT.OUTLOOK\VJ9QZLO2\ATTACHMENT C - MODEL COUNTY CONTRACT.DOC RFP 964-5439 Attachment C -10- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first hereinabove written. CONTRACTOR COUNTY OF FRESNO (Authorized Signature) Chairman, Board of Supervisors Print Name & Title Mailing Address DATE: DATE: REVIEWED & RECOMMENDED FOR APPROVAL Department Head's Signature APPROVED AS TO LEGAL FORM APPROVED AS TO ACCOUNTING FORM County Counsel Auditor-Controller/Treasurer-Tax Collector FOR ACCOUNTING USE ONLY: ORG No.: [click to type type org] Account No.: [click to type type account] Requisition No.: [click to type requisition number] FCMC 06/11 C:\USERS\SJOHNSTON\APPDATA\LOCAL\MICROSOFT\WINDOWS\TEMPORARY INTERNET FILES\CONTENT.OUTLOOK\VJ9QZLO2\ATTACHMENT C - MODEL COUNTY CONTRACT.DOC RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D RFP 964-5439 Attachment D Board Agenda Item 44 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 Page 1 County of Fresno File Number: 15-1677 964-5439 Attachment E Page 1 File Number: 15-1677 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 Act (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: Page 2 County of Fresno File Number: 15-1677 964-5439 Attachment E Page 2 File Number: 15-1677 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 Page 3 County of Fresno File Number: 15-1677 964-5439 Attachment E Page 3 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 DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare 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 ACTIVE EMPLOYEE AND DEPENDENT PREMIUMS - BIWEEKLY Effective Pay Period Beginning December 7, 2015 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 4 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 (Under Age 65)Delta Dental DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare 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 (Over Age 65) Delta Dental DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare DHMO Delta Dental DPPO DeltaCare 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 5 Medical Renewal Rate Change Summary – Active and Pre-65 Retirees Medical Renewal Rate Change Summary – Post-65 / Medicare Retirees Dental Renewal Rate Change Summary 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% PRE-65 NON-MEDICARE RETIREES Anthem Blue Cross HDPPO + 4.90% + 5.49% Kaiser HMO + 7.74% + 7.99% Health Plan Option Health Rate Change Overall Rate Change Hartford / Express Scripts + 6.92% + 7.64% Kaiser Senior Advantage – High - 0.79% + 1.09% Kaiser Senior Advantage – Low - 0.88% + 1.20% Dental Plan Option Dental Rate Change Delta Dental – DPPO - 4.11% DeltaCare – DHMO + 5.38% 964-5439 Attachment E Page 6 OPEN ENROLLMENT Plan Year 2016 Employees October 28 — November 13, 2015 RFP 964-5439 Attachment F Page 1 Open Enrollment Begins Health & Wellness Fair Open Enrollment Ends October 28th October 28th November 13th December 4th December 7th Opt Out Forms Due New Plan Year Begins Dates to Remember………………………………..……………………………………..2 Health and Wellness Fair………………………………………………………...2 Frequently Asked Questions……………………………………………….3 Flexible Spending Accounts…………….……………………………….4 Biweekly Premiums……………………………………….…………………5 Medical Coverage………………………..…………….…….……………..6 Prescription Coverage…………...…………………….………………….6 Dental Coverage……………………….…………………….…..……………..7 Vision Coverage………………..……….………………………………………….7 Health Plan Contact Information………………….……….……...Back Cover 2 DATES TO REMEMBER TABLE OF CONTENTS 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! WEDNESDAY, OCTOBER 28, 2015 7:30 am — 2:00 pm (County Plaza Building Ballroom) 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. RFP 964-5439 Attachment F Page 2 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 2016? 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: Personnel-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 County’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 Open 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 FREQUENTLY ASKED QUESTIONS 3 RFP 964-5439 Attachment F Page 3 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. 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. 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: The monthly and annual limits are set by the IRS each year and are subject to change. Eligible Dependents Required Document(s) Spouse1 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 Stepchild A copy of the Certified Birth Certificate and a copy of the Certified 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. 4 1 The term “spouse” includes same-sex spouses, pursuant to IRS Revenue Ruling 2013-17. FLEXIBLE SPENDING ACCOUNTS (FSA) RFP 964-5439 Attachment F Page 4 BIWEEKLY PREMIUMS 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. PLAN 1 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 DPPO or DeltaCare USA DHMO Delta Dental DPPO or DeltaCare USA DHMO Employee Cost Employee Cost Employee Only $122.85 $111.20 $220.43 $208.78 Employee + Spouse $288.20 $271.02 $597.49 $580.31 Employee + Child(ren) $217.71 $205.43 $511.01 $498.73 Employee + Family $473.01 $454.45 $936.94 $918.38 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 DPPO or DeltaCare USA DHMO Delta Dental DPPO or DeltaCare USA DHMO Employee Cost Employee Cost Employee Only $34.33 $22.68 $107.52 $95.87 Employee + Spouse $211.15 $193.97 $261.46 $244.28 Employee + Child(ren) $156.44 $144.16 $194.11 $181.83 Employee + Family $395.85 $377.29 $438.05 $419.49 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. 5 RFP 964-5439 Attachment F Page 5 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. 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. MEDICAL COVERAGE 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. Anthem BC HMO Anthem BC PPO (in-network) Anthem BC HDPPO (in-network) Kaiser Permanente 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 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 6 RFP 964-5439 Attachment F Page 6 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. 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. 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 Basic Services 10% PPO Provider / 10% Non-PPO Provider $0 Most Services *Copay may be required for upgraded materials/services Major Services (Includes Periodontic, Endodontic, and Oral Surgery) 50% $0 Most Services *Copay may be required for upgraded materials/services Orthodontia Child Adult $1,660 Copay $1,880 Copay Once per lifetime Max 24 months of treatment $1,700 Copay $1,900 Copay Pre- and post-treatment services have additional copayments 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 Lined Bifocal Lined Trifocal Standard Progressive $0 / Every 12 Months $0 / Every 12 Months $0 / Every 12 Months $55 / Every 12 Months Up to $30 / Every 12 months Up to $50 / Every 12 Months Up to $65 / 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. 7 RFP 964-5439 Attachment F Page 7 COUNTY OF FRESNO Personnel Services Department Employee Benefits Division 2220 Tulare Street, 14th Floor Fresno CA93721 OPEN ENROLLMENT October 28, 2015 — November 13, 2015 If you need further information, please contact the plans listed below: MEDICAL Anthem Blue Cross HMO Group Number 275341H001 / Phone (800) 888-8288 PPO Group Number 275341M450 / Phone (800) 888-8288 HDPPO Group Number 275341M660 / Phone (866) 207-9878 www.anthem.com/ca Kaiser Permanente Group Number 580-0000 / Phone (800) 464-4000 www.kaiserpermanente.org DENTAL Delta Dental DPPO Group Number 05879-00001 / Phone (800) 765-6003 www.deltadentalins.com DeltaCare USA DHMO Group Number 06744-00001 / Phone (800) 422-4234 www.deltadentalins.com VISION Vision Service Plan (VSP) Group Number 30028675 / Phone (800) 877-7195 www.vsp.com PRESCRIPTION US Script Group Number 202720 / Phone (866) 264-4161 www.usscript.com FLEXIBLE SPENDING ACCOUNTS ASIFlex Phone (800) 659-3035 www.asiflex.com RFP 964-5439 Attachment F Page 8 OPEN ENROLLMENT Retirees October 28 — November 13, 2015 Plan Year 2016 RFP 964-5439 Attachment G Page 1 Open Enrollment Begins Health & Wellness Fair REFCO Luncheon October 22nd October 28th October 28th November 13th January 1st Open Enrollment Ends New Plan Year Begins 2 TABLE OF CONTENTS Dates to Remember…………………………………………………………………….…………..2 Frequently Asked Questions………….…………….……………………………….3 Monthly Premiums……………………………….…………………….……………4 Non-Medicare Medical and Prescription Coverage………………..5 Medicare Medical and Prescription Coverage………….…………….6 Dental Coverage………………………………………….….…….………………..7 Vision Coverage………………………………………………………………………….7 Health Plan Contact Information……………………………….....…….Back Cover 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! WEDNESDAY, OCTOBER 28, 2015 7:30 am — 2:00 pm County Plaza Building Ballroom 2220 Tulare St, Fresno, CA 93721 ANY QUESTIONS? DATES TO REMEMBER RFP 964-5439 Attachment G Page 2 FREQUENTLY ASKED QUESTIONS 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: Personnel-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. 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 Document(s) 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 Stepchild A copy of the Certified Birth Certificate and a copy of the Certified 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. 3 *The term “spouse” includes same-sex spouses, pursuant to IRS Revenue Ruling 2013-17. Contfnued on next page RFP 964-5439 Attachment G Page 3 MONTHLY PREMIUMS Contfnued 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. 4 PLAN 3 PLAN 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 Dental DPPO or DeltaCare USA DHMO Delta Dental DPPO or DeltaCare USA DHMO Delta Dental DPPO or DeltaCare USA DHMO Retiree Cost Retiree Cost Retiree Cost Retiree Only $552.95 $527.70 $382.55 $357.30 $351.75 $326.50 Retiree + Spouse $1,068.82 $1,031.59 $729.29 $692.06 $667.69 $630.46 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. PLAN 1 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 DPPO or DeltaCare USA DHMO Delta Dental DPPO or DeltaCare USA DHMO Retiree Cost Retiree Cost 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 Medicare & Non-Medicare $1,293.76 $1,256.53 MEDICARE PLANS (AGE 65 AND OVER) NON-MEDICARE PLANS (UNDER AGE 65) RFP 964-5439 Attachment G Page 4 5 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 Out-of-Pocket Max* $3,000 $10,000 $1,500 Family Annual Out-of-Pocket Max* $5,000 $15,000 $3,000 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 Every 3 Years) 20% After Deductible 40% After Deductible $1,000 Allowance Per Ear Mental Health Inpatient 20% After Deductible 40% After Deductible $0 Mental Health Outpatient 20% After Deductible 40% After Deductible $15 Generic Prescriptfon 20% After Deductible 40% After Deductible $10 Preferred/Brand Prescriptfon 20% After Deductible 40% After Deductible $20 Non-Preferred Prescriptfon 20% After Deductible 40% After Deductible N/A *Includes Deductfble and Rx 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-MEDICARE MEDICAL & PRESCRIPTION COVERAGE 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 5 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. MEDICARE MEDICAL & PRESCRIPTION COVERAGE 6 Hartford/Benistar & Express Scripts Kaiser Permanente High Option Kaiser Permanente 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 Every 3 Years) Not Covered $1,000 Allowance Per Ear $1,000 Allowance Per Ear Mental Health Inpatient $0 $0 $0 Mental Health Outpatient $0 $15 $15 Generic Prescriptfon $10 $5 for 100 Day Supply $10 for 30 Day Supply Preferred/Brand Prescriptfon $20 $20 for 100 Day Supply $25 for 30 Day Supply Non-Preferred Prescription $30 N/A N/A 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 Hartiord plan is supplemental to your Medicare coverage and helps pay the Medicare-eligible deductfbles, copayments and out-of-pocket medical expenses not covered by Medicare. Kaiser Permanente High and Low Optfons are Senior Advantage plans that serve as a private insurance alternatfve 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 prescriptfon 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. RFP 964-5439 Attachment G Page 6 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 dentfst. The DeltaCare USA DHMO has far fewer providers, but costs less than Delta Dental DPPO. VISION COVERAGE 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 Basic Services 10% PPO Provider / 10% Non-PPO Provider $0 Most Services *Copay may be required for upgraded materials/services Major Services (Includes Periodontfc, Endodontfc, and Oral Surgery) 50% $0 Most Services *Copay may be required for upgraded materials/services Orthodontia Child Adult $1,660 Copay $1,880 Copay Once per lifetime Max 24 months of treatment $1,700 Copay $1,900 Copay Pre- and post-treatment services have additional copayments 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 Lined Bifocal Lined Trifocal Standard Progressive $0 / Every 12 Months $0 / Every 12 Months $0 / Every 12 Months $55 / Every 12 Months Up to $30 / Every 12 months Up to $50 / Every 12 Months Up to $65 / Every 12 Months Up to $50 / every 12 Months 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. Kaiser Permanente members receive a $175 allowance for Optfcal Eyewear every 24 months. Members must access services at a Kaiser facility, unless otherwise approved by Kaiser. 7 RFP 964-5439 Attachment G Page 7 COUNTY OF FRESNO Personnel Services Department Employee Benefits Division 2220 Tulare Street, 14th Floor Fresno, CA 93721 OPEN ENROLLMENT October 28, 2015 — November 13, 2015 If you need further informatfon, please contact the plans listed below: NON-MEDICARE MEDICAL Anthem Blue Cross HDPPO Group Number 275341M760 / Phone (866) 207-9878 www.anthem.com/ca Kaiser Permanente Group Number 580-0001 / Phone (800) 464-4000 www.kaiserpermanente.org DENTAL Delta Dental DPPO Group Number 05879-00002 / Phone (800) 765-6003 www.deltadentalins.com DeltaCare USA DHMO Group Number 06744-00002 / Phone (800) 422-4234 www.deltadentalins.com MEDICARE MEDICAL Hartford / Benistar Group Number AGP-3829 / Phone (800) 236-4782 www.benistar.com Kaiser Permanente Senior Advantage High Group Number 604334-0000 / Phone (800) 443-0815 www.kaiserpermanente.org Kaiser Permanente Senior Advantage Low Group Number 604334-0001 / Phone (800) 443-0815 www.kaiserpermanente.org VISION Vision Service Plan (VSP) Group Number 30028675 / Phone (800) 877-7195 www.vsp.com RFP 964-5439 Attachment G Page 8 OPEN ENROLLMENT COBRA October 28 — November 13, 2015 Plan Year 2016 RFP 964-5439 Attachment H Page 1 Open Enrollment Begins Health & Wellness Fair Open Enrollment Ends October 28th October 28th November 13th January 1st New Plan Year Begins 2 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! ANY QUESTIONS? DATES TO REMEMBER WEDNESDAY, OCTOBER 28, 2015 7:30 am — 2:00 pm County Plaza Building Ballroom 2220 Tulare St, Fresno, CA 93721 Dates to Remember…………..…..…………….…..……………………….…..2 Frequently Asked Questions…………….………………………….….3 Monthly Premiums…………..………….……………………………5 Medical Coverage………..…..………….………………………….6 Prescription Coverage…….……………………………………….6 Dental Coverage…………………………..…………………………..7 Vision Coverage………………………….…….…………..……………….7 Health Plan Contact Information…………………………….Back Cover TABLE OF CONTENTS RFP 964-5439 Attachment H Page 2 FREQUENTLY ASKED QUESTIONS 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 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: Personnel-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. 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. 3 Eligible Dependents Required Document(s) 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 Stepchild A copy of the Certified Birth Certificate and a copy of the Certified 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. *The term “spouse” includes same-sex spouses, pursuant to IRS Revenue Ruling 2013-17. Continued on next page RFP 964-5439 Attachment H Page 3 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. 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. 4 COBRA 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 4 CAL-COBRA PREMIUMS 5 Participant Only Participant + Spouse Participant + Child(ren) Participant + 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 Delta Dental DPPO $567.94 $1,168.69 $1,047.77 $1,587.91 Kaiser Permanente Delta Dental DPPO $729.69 $1,279.87 $1,131.03 $1,681.18 Anthem Blue Cross HMO DeltaCare USA DHMO $737.82 $1,300.98 $1,156.03 $1,717.40 Anthem Blue Cross PPO DeltaCare USA DHMO $953.47 $1,984.52 $1,804.22 $2,742.68 Anthem Blue Cross HDPPO DeltaCare USA DHMO $542.18 $1,130.71 $1,020.62 $1,546.87 Kaiser Permanente DeltaCare USA DHMO $703.93 $1,241.89 $1,103.87 $1,640.15 Participant Only Participant + Spouse Participant + Child(ren) Participant + 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 FEDERAL COBRA PREMIUMS 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. RFP 964-5439 Attachment H Page 5 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. 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. MEDICAL COVERAGE 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. Anthem BC HMO Anthem BC PPO (in-network) Anthem BC HDPPO (in-network) Kaiser Permanente 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 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 6 RFP 964-5439 Attachment H Page 6 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. 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. 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 Basic Services 10% PPO Provider / 10% Non-PPO Provider $0 Most Services *Copay may be required for upgraded materials/services Major Services (Includes Periodontic, Endodontic, and Oral Surgery) 50% $0 Most Services *Copay may be required for upgraded materials/services Orthodontia Child Adult $1,660 Copay $1,880 Copay Once per lifetime Max 24 months of treatment $1,700 Copay $1,900 Copay Pre- and post-treatment services have additional copayments 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 Lined Bifocal Lined Trifocal Standard Progressive $0 / Every 12 Months $0 / Every 12 Months $0 / Every 12 Months $55 / Every 12 Months Up to $30 / Every 12 months Up to $50 / Every 12 Months Up to $65 / 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. 7 RFP 964-5439 Attachment H Page 7 COUNTY OF FRESNO Personnel Services Department Employee Benefits Division 2220 Tulare Street, 14th Floor Fresno CA 93721 OPEN ENROLLMENT October 28, 2015 — November 13, 2015 If you need further information, please contact the plans listed below: MEDICAL Anthem Blue Cross HMO Group Number 275341H006 / Phone (800) 888-8288 PPO Group Number 275341M455 / Phone (800) 888-8288 HDPPO Group Number 275341M666 / Phone (866) 207-9878 www.anthem.com/ca Kaiser Permanente Group Number 580-7002 / Phone (800) 464-4000 www.kaiserpermanente.org 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 VISION Vision Service Plan (VSP) Group Number 30028675 / Phone (800) 877-7195 www.vsp.com PRESCRIPTION US Script Group Number 202720 / Phone (866) 264-4161 www.usscript.com RFP 964-5439 Attachment H Page 8 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC (10/2015) 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: COUNTY OF FRESNO, PURCHASING 4525 EAST HAMILTON AVENUE, 2nd Floor FRESNO, CA 93702-4599 CLOSING DATE OF PROPOSAL WILL BE AT 2:00 P.M., ON MARCH 22, 2016. 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 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 Blue Ink): NAME & TITLE: (PRINT) Purchasing Use: NC:ssj ORG/Requisition: 89250200 / 8921600150 Addendum No. One (1) Page 2 Request for Proposal Number: 964-5439 March 8, 2016 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC 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? A7. 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. Addendum No. One (1) Page 3 Request for Proposal Number: 964-5439 March 8, 2016 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC 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? A12. 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? A18. 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? A19. An hour or two per week. During contract and rate reviews, it will increase to approximately five to six hours per week. Addendum No. One (1) Page 4 Request for Proposal Number: 964-5439 March 8, 2016 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC 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. Addendum No. One (1) Page 5 Request for Proposal Number: 964-5439 March 8, 2016 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC 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. Addendum No. One (1) Page 6 Request for Proposal Number: 964-5439 March 8, 2016 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSULTANT SERVICES\964-5439 ADD 1.DOC 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. Exhibit B c ES REQUEST FOR PROPOSAL UNTY FF NUMBER: 964-5439 EMPLOYEE BENEFITS CONSUL TANT SERVICES Issue Date: f ebruary 8, 2016 Closing Date: MARCH 1 o, 2016 Proposal will be consjdered LATE when the officja! 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 ~~~.lil.!.li!~.l0!..1.1.~~.:...u.~~--· 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 CITY PURCHASING USE: NC:ssj CA 90501 STATE ZIP CODE kpippard@keenan,com E-MAIL ADDRESS Corporate Secretary TITLE ORG/Requisition: 89250200 / 8921600150 G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc PD-040 (1112015) UN FF E ADDENDUM NUMBER: ONE (1) RFP NUMBER: 964-5439 EMPLOYEE BENEFITS CONSUL TANT 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: COUNTY OF FRESNO, PURCHASING 4525 EAST HAMILTON AVENUE, 2nd Floor FRESNO, CA 93702-4599 !CLOSING DATE OF PROPOSAL WILL BE AT 2:00 P.M., ON MARCH 22, 201&.I 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 ..:;...::;...=.J.,;......;;;.;.;;...;:;.;=.;.;.;...;J.;;;:;;...::..:::..:.:.;;..;:;..:;..;..;..;;:;.;c;;;..;:;;.;..=- 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 ... ESPONSE. 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 REP 964-5439 COMPANY NAME: Keenan & Associates (PRINT) SIGNATURE (In Blue Ink}: NAME & TITLE: (PRINT) Purchasing Use: NC:ssj ORG/Requisition: 89250200 I 8921600150 G:\PUBLIC\RFP\FY 2015-16\964-5439 EMPLOYEE BENEFITS CONSUL TANT SERVICES\964-5439 ADD 1.DOC (10/2015) March 21, 2016 Mr. Nick Chin Purchasing Manager County of Fresno -Purchasing 4525 E. Hamilton Avenue 2nd Floor Fresno, Ca 93702-4599 2355 Crenshaw Blvd. Suite 200 Torrance, CA 90501 License# 0451271 RE: RFP No. 964-5439 for Employee Benefits Consultant Services Dear Mr. Chin: 310.212.3344 310.328.6793 fax Main www.keenan.com Keenan & Associates is pleased to present our Proposal to provide Employee Benefits Consultant Services to the County of Fresno. \X'e are confident that our forty-four year history as a niche insurance brokerage and consulting fmn 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 QPAs) will exceed the requirements outlined in the scope of services listed in 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- IV1itchell, 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 sgcdcstad(il:kccnan.com; or, Howell Southmayd at 510.986.6761, ext. 8190 or e-mail at hsouthm:mJi(l:.kccnan.com. Both Steve and Howell are authorized to represent Keenan in discussions on this proposal. S~ce~~ ~~---·· Keith Pippard Corporate Secretary, Keenan & Associates I. RFP PAGE 1ANDADDENDUM(S) .......................................................................... i II. COVER LETTER ................................................................................................. iii 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. VENDORCOMPANYDATA ................................................................................. 12 XI. SCOPE OF WORK ................................................................................................ 25 P,-\RT A-SCOPE OF HE\LTH BENEFITS CONSULTATION SERVICES ..................................... 26 I. Ad1ninistrative S en1ices .................................................................................................... 26 II. Data Anafysis And Reporting ......................................................................................... 42 III. Vendor Relations ............................................................................................................. 44 IV. Adt1aria!, Undenvtiting and .Fiscal S t1pport .................................................................... 4 7 P:\RT B-SCOPE OF OTHER BENEFIT CONSULTATION SERVICES ........................................ .49 I. Adv1inistrative Services .................................................................................................... 4 9 II. "Vendor Relations ............................................................................................................. 50 XII. COST PROPOSAL ................................................................................................ 52 OPTION 1 ........................................................................................................................................ 52 OPTION 2 ........................................................................................................................................ 53 XIII. CHECK LIST ....................................................................................................... 56 VENDOR RESPONSE SECTION ....................................................................................... 58 REPORTS ....................................................................................................................... 84 APPENDICES ................................................................................................................. 85 APPENDIX 1 .................................................................................................................................... 86 APPENDIX 2 .................................................................................................................................... 96 Keenan { j _APPENDIX 3 .................................................................................................................................. 110 APPENDIX 4 .................................................................................................................................. 129 APPENDIX 5 .................................................................................................................................. 135 APPENDIX 6 .................................................................................................................................. 139 1\PPENDIX 7 .................................................................................................................................. 141 APPENDIX 8 .................................................................................................................................. 144 J\PPENDIX 9 .................................................................................................................................. 150 _APPENDIX 10 ................................................................................................................................ 192 Keenan Tiu· Contr;1ctor may become involved in situations where c011Dict of interest could occur due to individual or or._ganizatiomzl ;1ctivities that occur within the County. The Contractor must provide a statement addressing the potential, if ;my, for c011flict of interest ;md indicate pLms, if ;1pplicablc, to :1ddress potential c011flict of intei-est. This sectio11 nil/ be reviewed by County Counsel for compli;mce nith c011Dict of interest HS p<?rt of the review process. The Contnzctor shall comply with all federal, st<lte ;md loc;zl conflict of iruerest laws, statutes ;md regulation.<;. "); 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-Ivlitchell, 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. Keenan A. S.(t;11 wbere required. Keenan's signed Trade Secret form is included on the next page. Keenan 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 _(_C_o_m-pa_n_y_N-am_e_) ____________ a separate marked binder.** Keenan & Associates Has n.m..submitted information identified as Trade -(""'C,....o-m-pa_n_y.,...,N-am_e_,.)------------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: ~ v~v~~ L~ Signature {In Blue Ink) Keith Pippard, Corporate Secretary Print Name and Titie 2355 Crenshaw Blvd., Suite 200 Torrance City Address ) 800.654.8102 Telephone March 7, 2016 Date CA 90501 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. enan 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: (in blue ink) Keith Pippard, Corporate Secretary (Printed Name & Title) Date: March 2016 Keenan & Associates (Name of Agency or Company) G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc 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 fonn. Keenan ., /i( Proposal No. 964-5439 VENDOR MUST COMPLETE AND RETURN WITH REQUEST FOR PROPOSAL Firm: Keenan & Associates REFERENCE LIST Page 11 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: _C~ity~of_C_lo_v_is _______ Contact: Robert Ford Address: 1033 Fifth Street City: _______ C_lo_v_is _____________ State:.Zip: 93612 Phone _______ Service Provided: ( 559.324.2840 )_Date: 2010 to present No.: 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: _C_o_u_n_t_y_o_f_S_a_c_ra_m_e_nt_o ____ Contact: Dave Comerchero Address: 700 H Street, #4667 City: _______ s_a_cr_am_e_n_to ____________ 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: _______ u_k_iah ____________ --"'State:Z,ip: 95482 Phone No.: ( 707.234.6618 ) Qate: 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: _C_i~ty_o_f_B_e_r_ke_l_e~y ______ Contact: Margarita Zamora Address: 2180 Milvia Street City: ______ B_e_rk_e_le-'y ___________ State:Zip: 94704 Phone No.: ( 510.981.6821 ) DaJe: 2009 to present -------=S""'ervice 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: _C_i~ty_o_f_G_le_n_d_a_le ______ Contact: Matt Doyle Address: 613 East Broadway City: _______ G_1e_nd_a_1e _____________ 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 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: 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--=R=F=p=•s---,-to-ca_r_r,.-ie-rs-,-c....,.la...,i,..m_s_r_e_v.,..ie-w-s, 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: _1_98_7_--'p_r_es_e_n_t ______ _ 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.: ( 5filL_ ) 730-7559 Date: _1_9_9_0_-_P_re_s_e_n_t ______ _ 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.: ( .5.5.9_ ) 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 School District Contact: David Perkins-Risk Manager Address: 444 West 23rd Street City: Merced State: CA Zip: 95340 ------ PhoneNo.: ( 209 ) 381-2820 Date: _2_00_8_-_P_r_es_e_n_t ______ _ 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. ) Keenan 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 L.:J Purchasing Group and other tax supported agencies. 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 Tbis portio11 of tbe pr-opos:lf will note any exceptions to tbe requirements ;wd co11ditions take11 by tbe bidder. If exceptions are not rwted, tbe County will :1ssw11e tbat tbe bidder's proposals meet those requirement<;. Tbe exceptions shall be noted as follorvs: A. Exceptions to Gener:1l Conditions. B. Exceptions to Genenzl Requirements. C. Exceptions to Specific Terms and Conditions. D. E...::ceptions to Scope of U7011<. E. E...::ceptions to Proposal Co11tent Requirements. F. E...::ceptions to any other part of tbi'i RFP. Keenan takes no exception to any of the requirements related to items A through F above. Keenan (,!,' J' Tl1is section should include: A. A narrative which demom;trates the vendor's b;:1sic famili::irity or experience witb problems associ:ued wit11 this service/project. ·~ j The County of Fresno's RFP requests a full range of benefits services that includes benefits acqms1tlon, 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. The solution presented to meet the County's requirements includes the se1-vices and expertise of Keenan & Associates as well as Buckman-1V1itchell, 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. Prime Contractor Subcontractor The largest privately-held broker/ consultant in California 22nd Largest in the United States 100% owned by employees More than 700 employees supporting public agencies Founded in 1972 One of the largest independent insurance agencies in the West More than 80 licensed insurance professionals Founded in 1916 Keenan ·I. i.i I Companies' History Founded December 2, 1972, Keenan & Associates is in our 44r<1 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: The largest privately-held broker/ consultant in California 22"d Largest in the United States 100% owned by employees Ranked 16th in Los Angeles Business Journal's Best Places to \X/ork 2015 Large Employer Category Finalist for Cmporate Social Responsibility Aivard 2015 for the Los Angeles Business Journal Pl Best aces ork 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). Buckman-Mitchell, Inc. is one of the largest independent insurance agencies in the West and we employ over 80 licensed insurance professionals. Buckman-l'vlitchell, Inc. was founded by C.T. "Clem" Buckman and Hyman Mitchell in 1916. The firm today has est:'lblished itself as a leader in 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 integ11.ty. 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. Keenan -,--i I Buckman-Mitchell, Inc. is dedicated to providing quality insurance products while operating with a philosophy that relationships with clients and community matter most. SERVICE 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-I\fitchell'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. 575 E. Locust Ave. Suite 204 Fresno, CA 93720 Keenan & Associates 2868 Prospect Park Drive, Suite 600 Rancho Cordova, CA 95670 i!nfrU.Ufii,ifib 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 \Vith 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. ·---·---------·-----------------------------------·-------- Keenan B. Descriptio11s of a11y similar or rel:ued contracts under wbic11 tbe bidder bas 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. Descriptio11s of tbe qualifications oft11e i11dividw1l(s) providing tbe 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-:tvfitchell. Following is the Keenan Team that will support the County. • Stephen Gedestad -Municipality Practice Leader • Howell Southmayd -Vice President / Consultant o Stacey Comerchero -Senior Account Manager • Steve Balentine -Vice President, Labor Relations • Judy Fussel, RHU -President of Life, Health, and Financial Services e JoeAnna Todd, RHU ChHC -Vice President • Justin Workman -Assistant Vice President e 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 & Actua11.al • Ralph Gowen -Vice President, Client Technology s Robin Rager -Director of Health Management/ Wellness Program Consulting • Amy B. Donovan, Esq. -Vice President of Legislative and Regulatory Affairs e Jerry Healy -Chief Employee Benefits Counsel Bios for these Key Personnel are included in Appendix 1. Following is an organizational chart of these Key Personnel. Keenan \.if' ;, \ ! J! " Rali:ifi Gowen NIP Glient>Fedinology, y Micnael/'\nn VP Unoerwriting Primary Service Team and Contract Oversight -Keenan Team Additional Local Support -Buckman-Mitchell, Inc. Additional Keenan Corporate Resources Keenan Steve Gedestad - Municipality Practice Leader Howell Southmayd Lead Consultant AND Stacey Comerchero Senior Account Manager / Day-to-Day Account Management 't-.-•uPn Balentine Vice President of Labor Relations ' / Municipalities Practice Leader Assist ;,v.ith coordination of Keenan resources, in order to fulfill the Scope of Services Subcontractor Lead Consultant for the County 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 Keenan\'{! ell 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 Responsible for reviewing all legislative changes, including Affordable Care Act Preparing Fringe Benefit Committee Meetings in conjunction with Executive Director Facilitating collection of benefit plan renewal data 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 Review contracts and benefit booklets Assist the County with health care advocacy for the County and Assist with communications between labor groups and County management ( OJ Keenan \ u ,' Fusst;l, RHU President of Life, Health, and Financial Services, Buckman-I'vfitchell Todd,RHU ChHC Vice President, Buckman-Mitchell Workman Assistant Vice President, Buckman-1\fachell Leslie Anderson, RHU Senior Account Manager, Buckman-Mitchell Linda Clower Senior Account Manager, Buckman-Mitchell Coordination of Buckman-Mitchell resources Oversight for day-to-day support from Buckman-Mitchell Consulting Support for the County in partnership with Howell Steve Gedestad Assist with day-to-day support Coordination with Keenan Team Consulting Support for the County in partnership with Howell Steve Gedestad Assist with day-to-day support Coordination with Keenan Team Consulting Support for the County in partnership with Howell Steve Gedestad Assistance for the facilitating collection of benefit plan renewal data Assisting with employee communications Assist \vith preparation for Fringe Benefit Committee Meetings Coordinates open enrollment meetings with the County Coordinates Health and Wellness Fairs with the County Review contracts and benefit booklets Assist the County \v-ith health care advocacy for the County and their Assistance for the facilitating collection of benefit plan,.,,,..'"""' data 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 Review contracts and benefit booklets Assist the County with health care advocacy for the County and their Keenan Jovita Juanillo Senior Vice President, Benefits Underwriting and Actuarial Department Tom Edwards Senior Vice President, Benefits Underwriting and Actuarial Department Christine Hough, FSA, MAAA Vice President/ Actuarv Michael Ahn Vice President, Underwriting & Actuarial Eugene Yu, RHU Underwriting Consultant, Benefits Underwriting & Actuarial Ralph Gowen Vice President, Client Technology Robin Rager, Ph.D Director of Health Management Amy B. Donovan Vice President, Legislative & Regulatory Affairs Jerry Healy Chief Employee Benefits Counsel Provides underwriting and actuarial support, as needed Oversees all resources from Benefits Underwriting and 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 Provides underwriting and actuarial support, as needed 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 Actuarial Support Support analysis of all lines of insurance coverage that includes medical, dental, life/ AD&D, and LTD Underwriting and Actuarial Support Support analysis of all lines of insurance coverage that includes medical, dental, life/ AD&D, and LTD Underwriting and Actuarial Support Support analysis of all lines of insurance coverage that includes medical, dental, life/ AD&D, and LTD Product Manager; technology solutions Configuration and implementation of BenefitBridge, if appropriate, and/ or Personal Choices portal Evaluates existing disease management and/ or wellness programs Identifies options for disease management and wellness programs, and implementation, when required Assistance with legislative and regulatory compliance issues Provide briefings and meetings, as needed regarding these types of issues Legal support and advice related to all employee benefits issues Plan document support Keenan D. A.r.~y m;Ueri[J/ (i11cluding letters of support or e11dorsement) i11dicative of tbe 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. FOR PUBLIC 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 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: • BenefitBridge -A more robust, proprietary \'Veb-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. <111 KeenanWell -A comprehensive health management program inco1porating 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 Care5M 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 se1vices. Keenan «11 Keenan Pharmacy Purchasing Coalition (KPPC) -An innovative pharmacy program that delivers cost savings and the most advanced prescription management capabilities. In just four years, KPPC has grown to more than 275,000 members and has saved over $55 million for participating plans. 1\11 Keenan Saver Rx -A discount drug card for part-time employees, friends and family without pharmacy coverage, Keenan Saver R.x, powered by GoodRx, allows anyone to purchase pharmaceuticals for 5-60% off retail at over 60,000 pharmacies nationwide. Keenan Saver R.x 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. 1\11 BridgeFront -A HIPAA Employer Compliance Center. BridgeFront 1s 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. <11 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 descriptio11 of the bidder's curre11t operatio11s, and ability to provide the services. 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 ctitical 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 '\, !:, f: while mitigating the impact to the quality and cost of your benefit programs while giving appropriate recommendations as needed. BENEFITS AND 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 underw1-iting 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: e Underwriting Trend Analysis Renewals (existing business) Funding Rate Development (new business) Renewal Audits (fully insured plans) Rate Negotiations Benefit & Rate Compa1-isons (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 Keenan "' Technical Consulting Prospective Group Funding Calculations Pricing Calculations for Plan Changes Rate Stabilization Reviews General consulting services for all benefit plans l'.V1ANAGEIV1ENT NEGOTlATl ONS As previously detailed, Keenan has extensive experience with supporting the joint labor management negotiation process. Following is a summary of the expertise of our dedicated team that supports this process, headed up by Steve Balentine, Vice President of Labor Relations. !ii 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 Training -All Keenan Personnel arc trained on how to facilitate effective Joint Labor Management Benefit Committees OLMBC). F. Copies of tl1e audited Fimwcial St:1tements for the hst three (3) years for the agency or program th::tt niU be providing the service(s) proposed. If audited smtements are not avm1able, compiled or reviewed stateme11ts nill be accepted nith copies of three years of corresponding federnl t;:1x returns. This ii1formation is to be provided after the RFP closes-., if requested. Do not provide rvith 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 co1Jtracts that lwve been terminated before completion nithin the l:1st five (5) _ve:1rs: 1. Age11c_v contract nith 2. Date of origim1l contmct 3. Rei1so11 for termination 4. Contact person and telepl1011e number for agency No contracts have been terminated prior to completion within the last five (5) years. Keenan !!. } / ·' u' H Describe all J:nvsuit(s) or k--g;ll :1ction{..4>) that :Ire currently pending; m1d ;my lmrsuit(s) or legal <1ctio11(<;) th<lt have been resolved within tbe last five (5) years: 1. Location filed, mune of court m1d docket number 2. Nature of the lawsuit or legal action There are no investigations, lawsuits, claims or con1plaints 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 \vith 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. L Describe any p:1y111e11t problems that you kwe had with the County nitbin the p:Jst three (3) .vears: 1. Fundi1ig source 2. Date(s) :md f:l1110unt(s) 3. Resolution 4. I111p:1ct to financial vi:1bility of or._ga11iz:.1tio11. Keenan & Associates has not had any payment problems with the County. Keenan ·1.-(! '" {' A. Bidders ;1re to use tl1i,;; section to describe the esse11ce of their proposal B. Tl1is section should be fornwtted ;1s foJJows: 1. A general discussion of.vour cmderstandin,g of the project, t11e Scope of Work proposed :md a sum1w:uy of tl1e fe;Jtures ofyozuproposal Please see below. 2. A detailed description of your proposal as it rel:ltes to e:u.:h item listed under the "Scope of Work" section of this RFP. Bidder's response should be stated in the s;une order as :ire the "Scope of l~ork" items. E;1ch description slwuld begin with ;1 rest;1tement of the "Scope of lllork" item th:u it i,;; addressii~g. Bidders must explmi1 their ;1ppro:1ch :wd method of s;1tis/j·'ing each of the listed items. Please see below. Scope of Work Vendor iviJJ prm,ide ;1 summary of their understanding of the Coz111ty's needs (;1s deta11ed i:11 this Scope of lflork) and how the ve11dor plans to meet these r1eeds: 1. The Cozmty is seeldng a summ:uy that includes tl1e vendor's broad m1derstm1ding of the scope of the Cow1t;r's request and ;1 sum111a1y 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 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. As noted earlier, the solution presented to meet the County's requirements includes the services and expertise of Keenan & Associates as well as Buckman-l'vlitchell, Inc. Keenan is the Prime contractor proposing on this proposal, and Buckman-l'v1itchell '.Vill 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 .1, {J; 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 Briefings 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 summ;uy will also include ;1 statement th;Jt the ve11dor nill p1·ovide ;1J/ the services included ii1 this Scope of lVork. If the vendor is w1able to provide ;wy of the service(s), they nill describe which of the service(s) they are wiabk· 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 1. Benefit Desig11 Assistance a. Provide an initi::1l in-depth revien· of the Comity's existing healtb insurance programs :wd :.1ssist i11 tbc development of long-range plans :md financial, openztional and utilization go:.IL-;. Provide ;m annw1l Hssessn1ent as to whetber long term objectives ::1re being met. As a major component of any new client engagement, Keenan Utilizes a four-phase approach to analyzing existing coverage and identifying or developing cost-saving alternative benefit strategies and plans. Our four-phase action plan is illustrated in the following exhibit. ·~--------·---·------- Keenan \fl, •Discovery /Fact Finding •Develop understanding of County's current benefits and previous benefits •Meetings with stakeholders (e.g., management, labor groups, insurance committee, etc.) •Timeline -30 days •Analysis and Evaluation •Keenan's consulting, technical and administrative staff conduct in-depth review of programs • Reveiw of plans' historical performances •Review of employee commm1ication pieces for accuracy and legislative compliance • Timeline -30 days •Recommendations/ Action Plan •Presentation of recommendations to joint labor-management committee •Define an action plan and timefu1e for any changes to the benefits program • Timeline -60 days •Implementation •Negotiations \Vi th 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. ----------- 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 e Marketing • Implementation of new plans Carrier liaison @ Technology Solutions BenefitBridge Online Enrollment and Eligibility System (if applicable) Personal Choices portal (if applicable) 111 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, HIP AA, GASB, FMLA, that had been presented in the previous year e 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 \Ve have included a sample Stewardship Report in the Reports Section. One the Counties major issue is the solvency of the SJVV\ which the County of one of the founders and largest participant. Keenan has formed a number of JP As 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 JP A services, underwriting, financial analysis, accounting, and marketing to grow the JP A. All of this experience uniquely qualifies Keenan to be your advocate to SJVIA. An important aspect of running a successful JP A is understand what financially is happening within the JP A and proper rate setting. Below is a description of how we do that. MONITORING EXPERIENCE -, J Our Benefits Underwriting and Actuarial Services Department (BU.AD) 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. As part of BUAD's underwriting & actuarial support, Keenan tl10roughly reviews carriers experience and utilization data to validate budgeted benefit funding and costs on a monthly, quarterly, and annual basis. This is important to ensure tl1at the funding r I Keenan f,t), ;/ ! 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. <11 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. <11 Validating and developing summary reports simplifying the complex reports and data presented by the plan administrators and carriers. 11 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. tt Reviewing plan benefit design options and determine financial impact of these changes in the benefit program. <1.1 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. <11 Revie"ving provider network utilization to determine cost outlier or evaluate feasibility of creating narrow or quality networks. 111 Assist in the design of member surveys to validate emerging trends and program effectiveness. Our BUAD utilizes two uruque underwriting and actuarial tools for rate/ funding validation and reserve estimates: Conducting unde1writing 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 Bomhuetter-Ferguson method of claims reserving and utilizes actual claim lag reports where available to determine the approp1iateness of the IBNR estimates. For rate Keenan ·' u /;): benchmarking and budgets, Keenan utilizes a proprietatT pricing model developed by I\1illiman, 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 194 7 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 about 100+ variation of benefit plan designs, assessing cost enrollment/ 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. MARKETPLACE KNO\X;LEDGE 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. 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 \Vill enable Kaiser's performance to be benchmarked 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 Keenan {) l ! _-,, ~-·· / /} ') / 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 :md ::ma{vze vendor documents, including but not limited to contr;1cts, policies and cover:1ge booklets, provide interpret:1tions ;wd recon1111end::1 tions. Keenan's Benefits Underwriting and Actuarial Services Department (BU.AD) 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 perfonnance; 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 reviewing 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 recommending strntegies to lower cost and rmlint::zin quality. Your account team will be available to participate as necessary to help \v--ith the presentation of any technical data or information. As prev--iously 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 internet 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. e 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 funding and contribution levels (including COBRA and AB528), suggested plan changes, trend analysis, etc. Keenan ~ Monthly, Quarterly, and Annual Financial Funding Cost Budget vs. Actual Costs ft Projected Plan Cost Increases and Benefit changes @ 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 €1 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 n1elfness ;md disease 111a11ageme11t strategy witb ii focus on 1:neI1suring tbe return 011 i11vest111e1u of sucb 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 Keenan Well 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). 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 (1v£CWOW) 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 Keenan 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 incentivizing 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: e Completing a biometric screening e 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 serve as tools for tracking employee risk data as well as informing employees about their current health risk status. Program components include onsite mond1ly 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 libra1y, 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 IvfCWOW 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 tl1eir families who work and live in 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 \Vhen 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 Keenan\Vell team collaborated witl1 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 optinUze 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 tl1e 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 tl1e program components under the "Wellness Starts With Me" branding, which improved employee awareness of the array of resources available to them and promoted their participation. To further promote employee engagement, Keenan ·\, ii, / 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 Keenan Well health management consulting team has assisted the San Joaquin Regional Transit District in developing and in1plementing 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. Prol'ide general guidance on trends Ill benefits offered :md eli._t;ibility require111en t8. 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. We have seen a number of major trends; "' A dramatic increase in Rx cost with rising prevalence of specialty drugs. fl Solutions to deal with Retiree Health coverage fl Activity to comply with ACA and plan for the implementation of the Cadillac tax fl Medical plans being offered by the providers themselves. 2. Communic:uion8 ;1. Provide editori!ll !ind compliance revieiF of Open Enrollme11t and other Comity-produced benefit communications includinl{ me11108, material.-, and pre8e1Jt;1tions 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 Keenan 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 obtain the information they need in order to make a decision. These mediums include: • Traditional printed material, mailed or delivered to the employee e Mobile-friendly documents that can be easily reviewed from smart phones or tablets 111 \X!eb-based flyers, briefings, and other informative materials regarding benefits programs and issues Videos and webinars that explain benefits and/ or enrollment processes 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 111 To ensure a smooth transition to the benefits program for new employees e To communicate with employees in remote areas or on schedules not conducive to in-person meetings The Solution In order to efficiently communicate witl1 these new staff, Keenan can provide the following communication strategies: 111 Introductory Letters 111 Printed Benefit Guides and other Benefit Related Informative Materials 111 Online, mobile-ready enrollment education materials 11; Conducted in-person enrollment education meetings Keenan (it Provided webinars 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 employees and input from the benefits 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 (e.g., mobile, desktop, tablet, etc.) when convenient for that employee. Open Enrollment: Wha eed to Know b. Coordinate nith vendors as necess:uy; lever:1ge avail;1bility of vendor co1n1nunication nwte1i:1ls <Wd resources. Keenan can and will comply with this requirement. c. Review vendor's pl:1n su1nnu1ries and other m:lteriHl'> for benefit :1ccuracy :wd b:tsic compliance. Keenan can and will comply with this requirement. d. Provide assista11ce in the development and analysis of surveys to :1cquire emplo_ylee feedback 011 the perfornwnce of pl:ws. Keenan will 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. Af eeting Attendance & General Availability a. Atte11d quarter{v meetings of the Health Benefits Advisory Committee (HBAC) (4 meetings per year). The HBAC co11sists of one representative from each County b:1rgaining w1it, as well as retiree and mam1geme11t niembers. Keenan/BMI will attend quarterly meetings of the HBAC. Keenan '-" N; ! b. Attend meetings of the San ]0:1qui11 Valley Insur:mce Authority (S]VIA) as nec·ded (1-2 meetings per ye:1r). Keenan/BMI will attend meetings of the SJVIA as needed. c. Tht• consult:wt sh:.111 :1ssist iii the prep;1ration of a variety of materials required for l:Jbor negotiations ii1cluding, but not be limited to, cost estimates for new or upgraded be11efit programs, rate c:Jlculations, and v.Titte11 11wteri:ll such as :wa{vses, summ:uies, m1d graphs/spre::idsheets. 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. P:1rticip;1te in conference calls with County staff no less tlw11 once per month. Keenan/BMI will participate in conference call with the County staff no less than once per month. e. Prmide prompt :md effective re6ponses to ad hoc requests from County st:1ff for inform:Jtion or ana{vsis. Keenan can and will provide prompt and effective responses to ad hoc requests from the County staff for information or analysis. i Assist County staff nith technirnl issues affecting the admi11i<>tratio11 :wd processi11g procedures of the benefit programs ::1s they :Hise, including plan document interpretation :wd eligibility 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 witl1 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. Keenan fl '. ,,~ 4. Legal & Regulatory Compliance Support and Upd:ues a. Provide advice ;wd i11terpretation on all local, st:lte, and federal benefit regulations imp:1cting the County health plcws, including but not limited to: 1. Patient Protection :wd Affordable C.tre Act (PPACA) n F:m1ily and Medirnl Leave Act (FA1LA) 111. Califomia Fami{v Rights Act (CFRA) JV. Consolid:tted Omnibus Budget Reconciliation Act (COBRA) v. Healt11 Ir1sunmce Port:1bility :md Account;1bilit;' Act (HIPAA) VJ. Americans vvit11 Dis:1bility Act (ADA) vii. Fair Employment and Housing Act (FEH4) v111. Uniformed Services Employment Reemployment Ri._l(hts Act (USERRA) LEGISLATIVE AND 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 1s provided by Bri~jings, webinars and onsite meetings. We have included sample Brie.fings in Appendix 4. J{e:_emw Our website features a section specifically devoted to California public agencies. Webinars can be viewed and downloaded 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 ls 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 has produced more than 14 webinars specifically on Health Care Reform and these can be viewed and downloaded from the Tool Section Presented by our subject matter experts, these webinars offer in depth exploration of the ACA and how it will affect County 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 Keenan ·' {1,·: 111 HIP AA overview and compliance services through our BridgeFront program 111 Analysis of Social Security Coverage (OBRA 1990) legislation and the development of alternative plans for part-time employees 111 The ongoing monitoring of Section 125 regulations and how they affect members plans 111 Development of retiree liability regulations and compliance with Governmental Accounting Standards Board (GASB) requirements 111 AB88 -]'vlental Health Parity it Medicare Modernization Act Kee mm 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 on l/1/16. 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 Reform Webinars and Trainings: Keenan has been closely tracking health care reform legislation and its potential impact on our clients and the marketplace in general. Since 2010, our Training and Legal Departments have presented the details of the various legislative proposals and requirements of the Affordable Care Act. Topiss: • Cmpk>yer Mandate-Me€ting the 95% Threshold • MEC ~, Minimum Ess-ential Coverage • MV --Minimum Value (60'%) • Affordable-" Seff~only coverage that costs no more than 9.5'% of household incom.-. • ALE-Applicable Largo Employer (50 FT Employe<OS & FTEsl • FT Eln!''-·-- • FTE-F Keenan 111 Workers' Compensation Symposiums: Day-long workshops on topics relating to workers' compensation and the California regulatory environment. 111 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). 111 Family and Medical Leave Client Workshop: These cover legal requirements, leave management and integration of claims relating to FMLA and other forms of statutory employee leaves. Ill Health Benefit Webinars and Trainings: Keenan conducts webinars and trainings throughout each year for our clients that cover topics including: health care reform; HIP.AA; FMLA; CFRA, COBRA (and ARRA COBRA subsidy changes); and, pending legislation. In addition, Keenan holds a periodic summit 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. Notity the County of11ecessaty steps torv:uds compHance nith new legislation imp:1cti11g County health pl:ws. 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 B1iefings, webinars and onsite meetings. c. Review pl:w docur11erJts :wd inten1al County poHcies to ensure co1npli:wce with appropri:ue laws ;md re/gulations at1d to ensure that the Cowuy is :zdhering to industty best pn1ctices. A1ake 1·ecomme11d;Jtions reg:irding necessaq' amendments to plan docu111e11ts or internal policies a11d :1ssist i11 their prepan1tio11. 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. Keenan l' i' 1;, d. On an a11mwl basi'>, ;mdit the County's current health insur:mce administration pmctices (including, but 110t limited to, forms :md comnwnirntions to participants) to ensure compli:mce rvith czpplicable laws ai1d regulations, as rvell :1s applicable plan docume11ts and iiuemal polides. lklake recommendations regardi11g necess:uy changes to current practices. Keenan can and will comply with this requirement. e. Assist in :w :1dT,iS01J' rnp<1city in revieni11g and ruling on appeals from members covered by the County's C:ifeteri:1 Plan (includes He:lith Insunmce and Flexible Spending Accounts). Keenan can and will comply with this requirement. II. DATA ANALYSIS AND REPORTING 1. Monitor, am1lyze :wd report month{v cl:1im experience, ide1uifjdng trends and changes in large claims activity on ii month{v 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. o Benefits Utilization Analysis Report • Preliminary Renewal Reports -Where appropriate 111 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 Keenan (II Ad-hoc reports to meet specialized needs of the County 2. Monitor~ ana{vze and report claim utilization d:Jta in a fo1mat tlwt i:,, clear, concise and ::1ctionable. 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: !lO 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 e Developing and implementing Quality of Care benchmarks and report cards for benefit plans. Distribute results to plan participants Ill Providing revised annual financial projections quarterly for the benefits program (both calendar year and fiscal year projections) based on current enrolhnent 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 Ill Analyzing financial experience with respect to risk sharing cost targets 111 Monitoring their AM Best and Standard & Poor's and other financial and claim paying capabilities ratings Ill Preparing annual summary reviews of health vendors' performance for the contract Keenan "i III. VENDOR RELATIONS 1. RFP :md Contn1ct Development a. Development of requests for propos:lls (RFP) ;wd submitting RFPs to viable medical (including ment:il bealtb)~ dent:11, vi<>ion, and prescription providers. We have significant experience in designing public sector benefit programs. Our standard process begins by collaborating with clients to understand their financial and benefit objectives. Once the objectives are defined, we work \Vith 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 sin1ply 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 \veeks 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 they 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 years. Following are the key issues that Keenan considers when preparing for the marketing of benefit programs. 1& Your philosophical objective 1\11 The collective bargaining environment • Financial objectives including enhanced investment opportunities • Assessment of results generated by existing programs 111 Projection of plan design change, claim and cost impact 111 l\feasurement of results versus objectives e Identification of areas of benefit utilization where savings may be generated 111 Comparison \vith other programs throughout the state Following is an overview of the steps and responsible personnel for the marketing of benefit plans. Creation of RFP RFP Creation by: Account Service Team Support from BUAD 111 BenefitPoint used to release RFP Lead consultant enters the RFP into the BenefitPoint system Online system that releases the RFP to any caniers in the marketplace that have been targeted Aggregates responses to the RFP Allows for review of criteria included for other RFPs released by Keenan for benefits clients 111 Evaluation of Responses Performed by: s Account Team s BUAD Finalist Scoring 111 Presentation of Objectives, Recommendations and Timeline Performed by: 111 Account Service Team b. Revien-alld eFaluate vendor responses to RFP ai1d pn:.'sent :1 sun1niary of the results to the Cou11ty. 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 i11 11egoti:1ti11g fee :-1greeme11ts nith selected vendors ;md provide a11 executive summary repon ofJ·esults of 11egotiatio11s a11d fi11al r::ltes/fees. Carrier renewals and rates are also validated and benchmarked using Keenan's proprietary actuarial tool as developed and calibrated by Milliman 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 summary report of the negotiation results will be presented to the County. d. Facilitate the tra11sitio11 to 11elv vendor (if 11ecess;:11y). 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 (if applicable) and the implementation and training for County personnel on any technology related solutions. 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 smnple RFP 1mlteri:lis (ie., :my ev;1lw1tion tool'i you nill w;e to :1cco111plisb tbe tasks described it1 p:w1graplis <l -d above, ;1s ivell as il s:-1mple timeline) We have provided a sample RFP in Appendix 5. 2. Vendor A,fa11;igement :1. Estilblisb approptiute ve11dor perfo1n1H11ce gmwwtees in coll:1bon1tio11 nitli the County. Keenan \Vill establish appropriate vendor performance guarantees in collaboration with the County. enan ' ~ ·, " f/ j ,. / )i) b. Ensure that Fe11dors are in compli:wce nith the tams of their agreement with the County and rnonitor perforn1ance gwuantees. 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 ::1ppropri:1te, :ict as a liaison betrveen the County and vendor:'>, including but not limited to, participiiting in problem resolution and strategic pla1111i11g. 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 revie\vmg the circumstances and evaluating tl1e contract and booklet provisions, we discuss the benefit question or claim concern with the County and carrier or administrator to determine tl1e appropriate action and follow through until the problem is resolved. We will also meet regularly with tl1e 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 annw1l strategic sessions with vendors to discuss perfom1ance, opportunities, and updates. Keenan can and will comply with this requirement. e. Attend meetings or confere11ce call<:; nith vendors as requested /J_v the County, but 110 less tlw11 once per quarter. Keenan can and will comply with this requirement. i Aio11itor insurance companies for fin:wcial solvency where :1pplic:1ble. Keenan can and will comply with this requirement. IV. ACTUARIAL, UNDERWRITING AND FISCAL SUPPORT 1. Provide actuari:il cost projections for· v;irious plan fe:Uure changes :wd improven1c·nts. :; ! Keenan's Benefits Underwriting and Actuarial Department capabilities provides our clients with state-of-the-art underwriting and actuarial systems designed specifically to meet the needs of public agencies. Keenan 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 "\vith a minimum of 10 years experience and a Fellow of the Society of Actuaries (FSA) will be jointly assigned to perform tl1e 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 tin1ing 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 multi-year strategic planning. Our team members are experts in tl1e following areas: e 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. e Analyzing pharmacy experience and rebates. 0 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 TP A performance financial guarantees. Keenan i < 111 Monitoring and reviewing Stop Loss Reinsurer experience and administrative performance. 2. .A.twlyze i-ates devc.·loped by tile S:m ]011qui11 Valley Insura11ce Authority from ;w independe11t actuaryrperspt•ctive. Keenan can and "vill comply with this requirement. As mentioned before, besides the actuarial review of the rates, we have unique experience on how a JP A should be rated and how that would affect an individual agency. 3. Ana{vze :wd recommend plan funding altermltives. 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. \'V'e 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. Pi-ep:zre fimwcial projections from alteriwtive benefit des{g11s :wd/oi-employee 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. AD.MINISTRATIVE 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. Keenan · .. II. VENDOR RELATIONS 1. RFQ/RFP Process :1. Develop requests for quotMions (RFQ) for Insurance Policies and requests for proposals (RFP) for Pro_gr:.m1 Administrators/Providers it1 compliHnce with County purchasing requirements. 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 RFP /RFQ requests to appropriate vendors and/ or carriers. c. Review :u1d ev:llwzte vendor responses to RFP :u1d contact vendor references. \Y./ e have detailed our capabilities throughout this proposal. d. Present a swnm:uy of tl1e results to the County and nwke finalist recommendations, if applic:1ble. We have detailed our capabilities throughout this proposal, and we will provide recommendations based on our industry knowledge. e. Assist in 11egotiating :~greeme11ts with selected vendors. We have detailed our capabilities throughout this proposal. i F:1cilitate the tnwsition to tJCIF vendor. We \v1.ll support this requirement, as detailed throughout this proposal. 2. Vendor A:f:uwgeme1Jt "· { j ! ,, :1. Establi'ib appropriate vendor petfonmmce gmuantees it1 collaboration witb the County. We will support this requirement, as detailed throughout this proposal. b. Ensure tli:u vendors are in compliance with tbe tenns oftbeir agreement witb the County :wd mo11itor performance guarantees. We will support this requirement, as detailed throughout this proposal. Keenan c. Upon request of Cowlty st:lff or Trbenever appropriate, act as ::z liaison between the County m1d vendors, including but not limited to, particip;:1tir1g in problem resolution and strategic planning. We will support this requirement, as detailed throughout this proposal. d. Co11duct strategic meetings or conference c::lil'l nith vendors ai1d County staff to discu88 performance, opportunitie8, and updates, no Jess tlwn once per quarter. We will support this requirement, as detailed throughout this proposal. e. li1onitor insurance comp;1nie8 for financial solvency n11ere ::1pplicable. We will support this requirement, as detailed throughout this proposal. C. if:7hen report.'! or other documentation ;ue to be <1 part of the proposal a s;1mple of e;1ch must be submitted. Report8 should be referenced in this sectio11 :md submitted in a separ::1te 8ection entitled "REPORTS." All reports and/ or other documentation have been included in the Reports Section of this RFP response. D. A complete description of ;my alteniative solutio118 or appro::u:hes to accomplishing the desired results. We believe that we have detailed all available options throughout this proposal. Keenan ,; -,.; Quotations may be prepared in any m::mner to best demonstrate the 1vorthiness of your proposal lt1clude details and rates/fees for all sen,.ices, materials, equipwent, etc. to be provided or optiomd under the proposal OPTION 1 A1111wil Consulting Fees if7ITHOUT Commissions from Volw1tary Insur:mce Products; Broker of Record service is not provided A. Provide the 'm11ual flat fee retainer to provide consultant services to the County 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. B. Please prm,ide pricing for the tn~o co1uract terms described below and describe :wy details regarding guarantees for ::ill proposed pricing. (a) Three-year contract term with two one-ye;u re11ew:lis. A three-year contract would be the same as indicated in A above, with the following Renewal year pricing. (b) Five-year co11tract term. Following is the proposed pricing for a five-year contract term. Keenan -''\ .( ; f (c) lfliJJ your fitm guanwtee pricing during the le11gth of e:1ch co1urnct term? Yes, Keenan will guarantee pricing during the length of the length of each contract term. C List all possible ;1dmi11istr:ztive charges tlzat would not be i11cluded i11 the D:lt rate fee structure. 111ere are no administrative charges. 0PTION2 fj Annmll Co11sulting Fees lf7ITH Commissio11s from Volunt:1ry I11sura11ce Products; Broker of Record service is provided A. Provide ;.l/J inforimltion requested in Option 1 :czbove. A. Prm,ide the :mnual fiat fee retainer to provide consult;mt services to tl1c Cowuy :c1s described in the Scope of lflork. Following are the proposed consulting fees for the County of Fresno, for the services required and detailed throughout this proposal. B. Please provide pricing for the tTFo contract terms described belmv and describe any details regarding gm1rantees for all proposed pric1i1g. (a) Three-year co11tract term with tTFo one-ye;u renew;1/s. A three-year contract would be the same as indicated in A above, with the follO\ving Renewal year pricing. Keenan (b) Five-year co11tn1ct term. Following is the proposed pricing for a five-year contract te1m. (c) lflillyour firm gwua11tee prici11g duri11g tlie le11gtb of e;1cb co11tn1ct te1m? Yes C. Li•it all possible admi11istutive ckuges tlut would 11ot be included i11 tlie fi:1t rate fee structure. There are no administrative charges B. lde11tify a11y a11d all pote11tial reve11ues associMed with broker of record se11ices that would of£c;et tbe fees to provide co11sulta11t services to tbe Cow1ty as described i11 the Scope of Work. Please note tlwt :11/ commissio11s :ire required to be disclosed to tbe County to e11sure maximum transpare11cy. 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. 50% of the additional revenue until the County contract is $0. *each contract reduction row is additive Keenan C. Future commissions from the universal life, di'iability and critical ili11ess policies tluough Trustmitrk may be reassigned. The future commi'isions are ;1s follows: (a) Universal Life: S% pei-year (b) Disability: 6% per year (c) Critical Illness: 111f/i) perye;tr Ple;1se note th;u tl1ere <tre no commissions 011 the long-term dis<1bility i11sur:mce poli(y through Met Life and that the commi'isions 011 the current life insurance policies through CSAC-EIA ;wd the pcrsomli prope1·ty insiwwce policies thougl1 Liberty ftfutwil are not able to be 1·eass{trned. 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 SJVlA. Our completed Check List form is included on the next page. Keenan 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. 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_ 7. x 8. _x_ 9. x 10. x 11. x The completed Trade Secret Form as provided with this RFP (Confidential/Trade Secret Information, if provided must be in a separate binder). The completed Criminal History Disclosure Form as provided with this RFP. The completed Participation Form as provided with this RFP. The completed Reference List as provided with this RFP. Indicate all of bidder exceptions to the County's requirements, conditions and specifications as stated within this RFP. 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 REP response. G:\Public\RFP\FY 2015-16\964-5439 Employee Benefits Consultant Services\964-5439 Employee Benefits Consultant Services.doc Ve11dor shall provide the folloHing information it1 a sepanite section of t11eir propm;al et1titled "VENDOR RESPONSE SECTIONn. Vendors sb:11l restate eac11 questio11 the11 provide the vendor response. ) J 1. Describe your firm·:., cap:zbilities :wd qualific:1tio11s :1s tlu.y rel:zte to the programs described it1 the Scope of lliork :wd list :my chan1cteristics of your firm thM you feel make it unique from other emplo_vee benefit'> consulting firins. As a proven leader in Califomia 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. o BenefitBridge -A more robust, proprietary Web-based technology solution for employee benefits administration, eligibility, enrolhnent, billing, reporting, and employee communications. o Individual and Family Plan -A solution that greatly assists Part Time employees as well as employees witl1 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 healtl1 management program incorporating welh1ess and disease management including online tracking, personal health strategies and coaches along with an engaging site-based "Thinner Winner" program, if desired. 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, KPPC has grown to more than 225,000 members and has saved over $55 million for participating plans. ill Keenan Saver Rx -A discount drug card for part-time employees, friends and family without pha1macy 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 R." 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. e BridgeFront -A HIPAA Employer Compliance Center. BridgeFront 1s included for no additional fee. ill 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. Keenan ;z. Hmr long has your firm provided consult;111t se1vices :1s described i11 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 your firm qualified :wd licensed (if ::1pplirnble) to conduct business m California? Please provide appropriate document:ltion. 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 firm, how would service be provided? How soon rrould a 11ew principal consultant be assigned to the County's account? lV'ill you agree to give the County the right of approval of :wy staflmember ::1ssigned to this 11ccm111t? 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. lflhat resources do your fitm have available in the area of developing employee communic;:ltio11s? Provide an example of commw1icatio11 m:ueri:1l'> developed b_v .vour org:wization for use in a clie11t~'> he;1lt11 benefit communic;itio11 cm11paigns, including Ope11 Eruollment a11d Nei-v En1ployee Orientation 1m1teri::lis. 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 publirntio11s tlwt are routine{v provided to clients? H;we you prepared reviews of topics rel:1ted to tbe healtil, life insunwce ::111d actwui::li fields tbat are 1m1ti11e{v provided to your clients? Describe your publirntion :wd provide sample copies. [ .:; 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 Briefings in Appendix 4. Our Web site features a section specifically devoted to California public agencies. Webinars can be viewed and downloaded \"-'-!.~'-'--'--'-'-'-'-"'-'-'-'-~=='-"'-'~'-"=''-'-"'"'-"-''-"-'-...!.!..:"'""-'=~-r \ IJ, We also offer our comprehensive Health Care Reform web 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 has produced more than 16 webinars specifically on Health Care Reform and these can be viewed and downloaded from the Tool Section 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. ! -- Keenan's summit also addresses key 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. Ill 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) 111 Health Benefit Webinars and Trainings: Keenan conducts webinars and trainings throughout each year for our clients that cover topics including: health care reform; HIPAA; Fl'vfLA; 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 FMLA and other forms of statutory employee leaves. Keenan .5. Provide a descriptio11 of ally electm11ic or i11temet-based tools your firm provides to clients. Keenan can provide the County with two technology solutions created by Keenan e 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. ~,;;np [ Ch • PersonalChoices places important benefits ~. ersona oices information online for employees and dependents ·1 I ,_ 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: e Benefit Plan Information -Lists benefit plans offered to employees. 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). @ 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. 1!:;;Pcrso11al Clwices 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, HIP _AA and other current topics. The calculator links can be used for budgets, FSA elections, credit lines, retirement, etc. Keenan 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 BcnefitBridge 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 f cw employees. BenefitBridge saves your HR department from making entries in multiple systems and faxing or emailing eligibility information to a variety of carriers. The BencfitBridge 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. BcnefitBridge also provides access to a health and wellness librai')', Keenan '\ ! - 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. BenefitBridge is available on all platforms including mobile devices. The application provides access to valuable information for the employees to access while they are on the go including: G Plan designs for all plans offered by their employer • Summaries of the plans they are currently enrolled in and who is covered e 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 ----~--·--~---~-----~--~---··--~---·-------------- Keenan 111 Viewing and comparing plan designs within a plan year and between plan years o 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 ---- Keenan Using the integrated online interface, the Human Resources Administrator will be able to: • Manage employee demographic and employment information 111 Manage employee's dependent information 111 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 !!I Automatic transmittal of all eligibility data including retroactive enrollment changes to relevant carriers !!I 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). !!I Manage overage dependents e Identify personnel requiring Cobra notification @ Produce benefits summaries for employees which include the employer contribution towards the employee's benefits !!I 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 tl1e employee to find doctors, dentists and other service providers and to look up claims information 111 ACA Excise Tax and Fee Dashboards which can summarize the ACA Taxes and Fees for tl1e County. These taxes and fees are based upon it's the unique bargaining agreements and premium levels. ! l ACA Excise Tax & Fee Calculators (Dashboard Example) 5''"'·60 HCR Annual Fees 2016 Plan Cost o 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. / i) f1ll 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. HEAL TH STATUS 0 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 how to manage your health care Keenan \ \fl, 6. Describe your firnr's view of the role wellness prognuns lwve 011 controllit1g healtl1 care costs. lVhat resources and toolc; do you offer clients around well11ess initiatives? lVku service does _vour firm provide for developing ;1 lfleJJness Progm111? 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 Keenan Well 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, titles, 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 witl1 representation from tl1e organization's management, organized labor, employee benefits, and health plans. The responsibility of tlus 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 tl1e 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 tl1e key to garnering effective involvement and support from these groups is to identify the respective goals they want to attain through provision of the welh1ess program, and tl1en facilitate collaboration on how tl1ey can collectively support those goals through their joint efforts so that everybody wins. Regardless of the program design, Keenan Well focuses on the pri.mai-y goals of improving employee health and productivity, and providing an optimal return on investment (ROI). Keenan's best-practice program designs for its clients, and the re-design of existing programs, has resulted in substantial growtl1 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 Nortl1ern 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 tl1e County of Sacramento. An overview of tl1e types of welh1ess and disease management programs support that Keenan can provide are identified below. Clients who have utilized the offerings noted Keenan 11) !d below in the last 24 months include the County of Mendocino, The County of Sacramento and the Port of Oakland. AND By applying 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 impact 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: e Conducting a needs assessment. • Performing an audit of an organization's wellness culture and its current resources (available through carriers and other entities). e 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. 111 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 111 Conducting program evaluation by identifying, tracking, and assessmg appropriate metrics. • Providing guidance on health care reform and regulations related to wellness programs, preventive services, rewards, and value-based benefit designs. Through KeenanWell's 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: ! ' 111 Biometric screening ( onsite and off site options) e Wellness and/ or disease management coaching ( onsite, online, and telephonic options) • Wellness program management (onsite program manager) 1t 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 fim1's :1bility to frequent{v (at minimum 8-10 times :mm1al{v) meet £'Ice-to-face to discuss ii1dustry; regulato1y and service issues with County of Fresno, including meetings with County executive and benefits staff, He:lltl1 Benefit Advisory Council meetings, and other venues. Keenan can comply with this requirement. 8. How m:wy d~z~vs of adv:wce notice lvould your company require in order to attend :1d-1Joc meetings? Do you kwe :my Jimit:ltio11s with attending face to face meetings? We prefer at least 24 hours notice for meetings, and we will be available when required. 9. What is· your firm's po1ic_v/st:mdard for returni11g phone c:lll.;; :wd providing responses to email<J or written que8tions? Our offices are open Monday through Friday from 7:30 AM to 5:00 PM. Phone calls, e- mails and written communications are returned \vithin 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 with labor contract negotiations, as well :c1s with ;i joint labo1/manageme11t task foJ"Ce 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. ·-·----------- Keenan • 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 Training -All Keenan Personnel are trained on how to facilitate effective Joint Labor Management Benefit Committees QLTvfBC). • Dedicated Labor Relations Division Lead by Vice President Steve Balentine Steve has more than 30 years of experience as a Labor Representative Ill Ill United Paramedics of Los Angeles (UPLA) California Teachers Association (CTA) California School Employees Association (CSEA) Served as leadership for: ill 1Vfctropolitan 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. Desc1ibe your fim1's experience and expertise nith the Patient Protection ;wd Affordable Care Act (ACA). How lwve you provided assist;wce to your clients ii1 monitoring compli:mce nith the ACA? 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. Keenan 12. Det::lil your abilit:y to monitor regulatoiy and legi<>lative developme11ts at both the state and feder::Jf leirel as well as how your firm alerts clients of ch:mges :md assists in compliance. Describe or· provide ex::1mples of t11ese commw1ic:1tions. We have detailed our abilities at length, including Keenan's legal team that is dedicated to monitoring legislative and regulatory changes. 13. Describe your fim1~9 legal rese;1rch c;1p::1bilities ::md ability to prmidt• leg::il opinions. Does your fin11 liaire access to a benefits ::1ttor11e_y rv110 could render opinio11s to the Cowuy? 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 how you monitor ::md report on provider performance. Provide ::1 sample of provider pcrform:mce reports your fin11 has completed for current clients. A sample stewardship report is included in Appendix 9. 15. Discuss your firm's experie11ce conducting RFP/RFQ processes for healthJ life, :md disability insurance c::1rriers, as well as flexible spending :1ccow1t :1dmi11istrators. How many RFP projects for these providers/senices did your firm complete in 2013J 2014, and 2015 for your clients? We have detailed our abilities with the RFP /RFQ process. Keenan conducts more than SO of these projects each year for California public agencies. 16. Does your fim1 klVe a conflict of intere8t polity? If so, ple;;1se prmide a copy. Al9oJ please describe any conflicts tku h::1ve ::1n~r;;e11 within the finn ::md how tlu..y were resolved Please see Appendix 10 for a copy of Keenan's conflict of interest policy. 17. Please li9t ::w_v pote11ti::1I conflicts of interest that your firm foresees if you are selected as the successful Bidder or state ;1ffim1:uively that _vou foresee none. There are no existing or perceived potential conflicts-of-interest that would arise from a contract between Keenan and County of Fresno. Keenan 18. If your firm proposes to offSet its fees through commissio11s 011 volunt:11y insunwce p1·oducts, discuss how your 111etl10d of con1pe11satio11 will be tw11sparent and reported to the County. Hmv frequently will your firm report its commission-based revenue to the County? 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. Desciibe your comp:my's or._ganizatio11, philosophy, m::1m1geme11t a11d provide ;i brief history. Describe your contractual rel:1tiom;hips, if ;my, nith organiz:1tio11s necessary to your proposal's implement<lfio11 (e.g. ::1ctwiri:1l services, data information se1vices). Founded December 2, 1972, Keenan & Associates is in our 44 1h year of consulting to California public agencies. Statewide, we provide services to more than 950 public agencies including 65 trusts and Joint Powers Authority (JP A) programs. Keenan is: The largest privately-held broker/ consultant in California 2211d Largest in the United States 100% owned by employees Ranked 16th in Los Angeles Business Journal's Best Places to Work 2015 Large Employer Category Finalist for Corporate Socia/ fusponsihili!J A1vard 2015 for the Los Angeles Business Journal Pl Best aces to Work 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 think 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 in the commurutles that we serve because we are part of these communities; our 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. --------~------------------·----· --------------------------------- Keenan That core inspiration drives all we do, from our products and services, to our culture, to our community engagement, volunteering and monetary contributions. In order to develop and implement solutions for our clients, Keenan has segmented services into the following divisions: Municipalities & Schools e Approximately 90% of Keenan's clients are California public agencies. <11 This Division is separated into the following specialty business segments: Municipalities & Special Districts Schools and Community Colleges e Solutions provided include high quality, cost-effective msurance, employee benefits, communications, and financial services. TPA Operations • Works in partnership with Public Agency and HealthCare divisions when appropriate. • Provides TP A services for the following areas: Employee Benefits (including: COBRA/DirectBill) Workers' Compensation Property & Liability Keenan Financial Services <~ ! ., e 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 I J 20. Provide the name(s) and title of all staff to be assigned to perform the work for the County of Fresno ::md a brief st::1te111e11t :1s to ivhy each consultant is qw11ified to provide servict'S to the County. The County underst::wds that ccrt:lin consultants will assist in cert:1in :.1reas of services, for es::unple, consultants rvho perform :1 claims audit rvould not be expected to ::zssist in the selection of vendors on ivhic/1 ::wdits rrould be performed. Identilj? the :ire;1(s) of expertise for each co11sultant. Following is the Keenan Team and their corresponding functional roles for support of requirements for the County. * Stephen Ge des tad -Municipality Practice Leader * Howell Southmayd -Vice President / Consultant e Stacey Comerchero -Senior Account Manager • Steve Balentine -Vice President, Labor Relations @ Judy Fussel, RHU -President of Life, Health, and Financial Services 111 JoeAnna Todd, RHU ChHC -Vice President 111 Justin Workman -Assistant Vice President • Leslie Anderson, RHU -Senior Account Manager • Linda Clower -Senior Account Manager EXTENDED SERVICE SUPPORT TEAM-KEENAN CORPORATE OFFICE 111 Jovita Juanillo -Senior Vice President, Underwriting & Actuarial • Tom Edwards -Senior Vice President, Underwriting & Actuarial • Christine Hough, FSA, MAAA -Vice President/ Actuary <Ill 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 e Jerry Healy-Chief Employee Benefits Counsel Bios for these Key Personnel are included in Appendix 1. Keenan ' ,,1 21. Provide the Number a11d locatio11 of office8, :md total 11umber of employee8. St:ue whether :w_v of the 8ervice8 de8cribed herei11 nil/ be performed at :my firm office out8ide Califor11ia, and if 80~ Trhat services nil/ be performed out8ide the State :wd where these services 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 Northern California Offices 2868 Prospect Park Drive, Suite 600 Rancho Cordova, CA 95670 800.343.0694 17 40 Technology Drive, Suite 300 San Jose, CA 9 5110 800.334.6554 P.O. Box 2486 Dublin, CA 94568 925.225.0611 Southern California Offices 1111 Broadway, Suite 2000 Oakland, CA 94607 800.344.8507 1791 Broadway Redwood City, CA 94063 650.306.0616 1105 Sixth Street, Suite A Eureka, CA 95501 707.268.1616 2355 Crenshaw Blvd., Suite 200 Torrance, CA 90501 4204 Riverwalk Parkway, Suite 400 Riverside, CA 92505 800.654.834 7 800.654.8102 901 Calle Amanecer, Suite 200 San Clemente, CA 92673 800.338.524 7 500 N. Santa Fe Visalia, CA 93292 800.828.3795 575 East Locust Avenue, Suite 204 Fresno, CA 93720 800.333.7545 22. Co11firm that you serve ;1s a co11sult:wt or broker, indepe11de11tly;y a11d are 11ot :dfiliated with any i11sur;mce compa11y, third p:trty admiI1istr:ltive :-1ge11(y or provider 11envork. 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 li'>t of C1lifor111a public age11cies your firm has provided simil:u services to withi11 the past three (3) years. List the 11mnber of employees for each age11cy. I11clude the co11tact perso11 atld phone mzmber for each agency h:'>ted. Currently, Keenan provides se1vices 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. REFERENCES 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 w11111111g Wellness 2008 to present A ~<?x. 11,000 empJ.9yees ___ " __ .. " __ _ All lines are 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. Keenan helped stabilize the County's medical plan expenditures and reduce its dental and life insurance costs. Keenan was successful in negotiating approximately $2 million in savings to their group Life plan and the return of $2.3 million in their Dental ro am. 2011 to present .::.~prox.1_~---------­ Self-funded: medical; fully-funded: dental and vision; Life/ AD&D and EAP -~-----·~~----~·-~·-----~---·- Current broker/ consultant for all lines of employee benefits coverage including medical, dental, vision, stop loss, life/ AD&D and EAP. Keenan also provides consulting on Health Care Refonn issues and the County's award winning Wellness Pro am. l ~ ' 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 Reform issues 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 consultin for Health Care Reform issues. Keenan Additionally, since Keenan is utilizing the services of our subcontractor, Buckman- l'vlitchell, Inc., we have included references from them in this section of the proposal as well. Keenan Employee Benefits consulting for both Admillistration 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 lans. John Caudle ___ !?_<:P_l1_!r__?_l1P.<:~~<:1?:i<:1?:~_-:__-0_~~-a_~~<:_§<:~i£<:s ___________ _ iohncl//'tu ic .orp 559.733.6300 6200 South Mooney Blvd. CA 93277 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 admillistration and em lo rees. 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 monthl insurance meetin s/review en an -! _, /) \ l 24. Curi·e11t lflo1klo;1d: Provide a listii~g of your i11dividuals/firms curre11t a11d projected workload. The bidder shall include ;1 gnlph or other i11formatiomll di::1grn111/for111at indirnti11g the allocated a11d :zvm1:1ble 1111w-hours. 111dicate lwvv the County of Fres110 accou11t will fit into the tot;li worldoad of the Consult:lnt durh1g the contnu:t peiiod. 10 10 ·---·-----··--·-···-- 0 25% 20% 20% 5% 25. It is expected that the final agreement between the ninning bidder ;wd the County if/ill be in the model County contwct format (Att:1chment CJ. Please h~'lt any exceptions your firm has to the terms :wd conditions of the model contract ;md the reasons. If the1·e are 110 exceptions, ple:1se :1ffirmative{v state th;zt there are 110 exceptions. There are no exceptions 26. License Sanctions: List :wy regulatory or license Hge1uy s:.mctions within the p:zst five (5) yeHrs. Keenan & Associates has had no regulatory or license agency sanctions smce our founding in 1972. Keenan ,1 ,\ (!-' 1? ! W'l1e11 reports or other docwnent::1tio11 ;ire to be ;1 part of the proposal :-1 s;m1ple of e:1ch mm;t be submitted. Reports should be referenced in this 8ectio11 ;.wd submitted in a sepawte secdo11 entitled "REPORTS. " The following reports are included in the appendices of this proposal e Financial Dashboard Samples (Appendix 3) • Stewardship Report Sample (Appendix 9) ;,l j - Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Appendix 7 Appendix 8 Appendix 9 Appendix 10 Key Personnel Bios Keenan's Innovative Solutions Financial Dashboard Samples Client Briefing Samples Marketing of Plans RFP Sample Keenan's Department of Insurance License Open Enrollment Communications Snapshot Enrollment Guide Sample (First 5 Pages) Stewardship Report Sample Keenan's Conflict of Interest Policy Keenan ' !! ,f' --~--·-------· ------~·----·· -- Keenan ' n, ; 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 CALPELRA, 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 l\fanager 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. Keenan -J u' 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 witl1 union organizations statewide, and demonstrates Keenan's commitment to Labor Associations. Steve has a long and very successful history working with Cf A 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 clainls experience data and claims service; and ensuring that government mandated requirements and state and federal laws and regulations were adhered to, such as HIPP A and the Patient Protection and Affordable Care Act. Additionally, during Steve's tenure with MEBA, he worked closely witl1 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 modify 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 tl1e 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 witl1 botl1 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. Keenan i > l i / 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 Undenvriters (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 Thf CA and the Visalia Chamber of Commerce. JoeAnna joined Buckman-Mitchell, 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. Joe.Anna works \vith a variety of businesses including hospitals, physician groups, non- profit organizations and public school districts. Having been in the insurance and employee benefits industi-y since 1997, J oeAnna 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 Undenvriter (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. Keenan Justin joined Buckman-I'vlitchell 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-I'vlitchell 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. Keenan EXTENDED SERVICE SUPPORT TEAM -KEENAN CORPORATE OFFICE 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. 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. Tom's 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). Keenan ;' } f 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, life/ 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. 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 Perrin. Additionally, Mike has assisted clients in various industries including public entities, union, private sector and healthcare. lvfike graduated from the University of California, Los Angeles with a Bachelor of Science degree in Applied Mathematics. li!i#§·4'''''*"•WJ&C.Qimii4imMiitM6M~il1i§tfdlJm&;;q;n1.q~1+!4HHtuftl 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, Irvine with a Bachelor of Science degree in Applied Mathematics. Keenan 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 industi-y. 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 se1-vice teams ensuring tl1e 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 BenefitPoint, Inc. in San Francisco, CA. as Vice President of Service. BenefitPoint, Inc. created an e-infrastructure platform using tl1e 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 healtl1 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 tl1e 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 Healtl1 Education, has taught at two universities over a 15 year period, authoring numerous articles on wellness. Keenan 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, injury 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 \X'oman'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 (F AWHP), 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. pm.5,1eM.ti@iij§md Amy Donovan is Keenan & Associates' primary source for legislative and regulatory research, analysis, and advocacy. Amy 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 fum since 2006. Prior to working at Keenan, Amy 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 York. She is admitted to the bar in both California and New Jersey. Keenan 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 4010<) 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. Keenan -l \ ( f' . ,; IONS Keenan l / \ I ,,,,., ;; ( The BenefitBridge employee benefits portal provides administrative automation and on- demand infonnation 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. Benefit:Bridge saves your HR department from making entries in multiple systems and faxing or emailing 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 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 Keenan • 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 e Reviewing guidelines for handling life events and their impacts on an employee's benefits e The ability to download any form or document perta11ung 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: e Manage employee demographic and employment information • Manage employee's dependent information e Make emolhnent 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 enrolhnent records • Automatic transmittal of all eligibility data including retroactive emolhnent 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 voluntaty life insurance). • Manage overage dependents • Identify personnel requiring Cobra notification • Produce benefits summaries for employees which include tl1e employer contribution towards the employee's benefits Keenan • 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 Benefit Terminations Age-Rated Premium Changes \ ''· l) / "'' ! Retiree Age Changes COBRA Qualifying Events COBRA Scheduled Termination Benefit Additions Benefit Summary Batch Report Retiree Scheduled Census -Carrier Based Census -Status Based Over-Age Dependents Carrier Enrolhnent Census ............... -··············-'······················· Enrolled Subscriber by Plan Carrier Billing Payroll Deductions by Carrier Summary Count Payroll Deductions by Employee Classification Payroll Deductions Discrepancy Report Keenan ·Personal Choices PersonalChoices is an employee Web-portal that contains employee benefit information and a multitude of decision-support tools. Resources include: • 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 Hl'vfO or a current plan to a pending plan, if available). • Life Events -Provides employees with infom1ation 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 Fl\.1LA, HIPAA and other current topics. The calculator links can be used for budgets, FSA elections, credit lines, retirement, etc. 1fi;Personal Choices Benefits Life Events Persona! Choices Employee provided by Ke-emml Resources EJ and Rene fits Keenan eenanITTll Best Practices According to recent research studies, the to a healthy and productive workforce and achieving optimal outcomes is building and m<lintaining culrure of wellness in an organiz.ation. l(J accomplish rhar goal, a comprehensive, coordinated program of best-practice inrervenrions, along with an environment supporrive of health and well-being, must be pursued at the workplace. provides consultation and program delivery services to provide flexible, dnciem, and cusromiz.ed wellness programs fix California\ public agencies. ·foe unique characteristics and needs of public zigencies are addressed through the utilization of wellness services and resources available through Keenan and irs besr-in-class rhird-pany preferred vendors. Through its comprehensh'e array of employee managemem consulting services, Keenan \ri:'ll can help employers to achieve and maintain optimal health and productivity for their workers, and create and support a wellness culture throughout rhe workforce. Population Health Managen1ent Strategies By applying population health management strategies that have proven dtccrive in engaging employees and their dependents, Kernan will help public agencies to have a positive impact on employee health status, productivity, and quality of life, and ultimately achieve a positive return on invesunent for the organization. Ketnan capabilities include: • Conducring needs assessment. suaregic health management consulting • Performing an audit of an organiz.ation's wellness culture and its current resources. Developing a multi-year program blueprint rn guide the organiz.ation's health management initiatives. 0 Determining what additional resources are needed and helping the organization to acquire them. 0 ldemif}1 ing effective engagen1ellt and incentive strategies to assure optirnal participation in the programs. • Promoting the wellness culture throughout the organization. • Conducting program evaluation by identif)1 ing, tracking, and assessing appropriate merrics. 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. eenanWell Wellness and Condition Management 'flirough J(ceili!ll third-parry preferred vendors. dienrs are offered a variety of options ro meet their particular healrh manag~>ment needs: wellness program condition management program only, or integrated wellness and condition management program. These programs can serve as either a stand-alone health management iniri~uive or as a cornplemem to employer's health plan resources -pmviding a comprehensive, integrated wellness platform for coordinating and distributing programming to employees at alt locations. Regardless rhe program cksign. Kcc11m1 on the primar~· goals improving employee health and producti\·iry, and providing an optinul return on investment (ROI). Biometric Screening J(cmrm V?e!i ofters on-site and alternative-options biometric screening services rhrough its preferred biomerric screening vendors. Effective coordination rhe screenings by Kceiinn health management ream. along with ;ippropriarelv designed incentives. has resulted in high screening participation rares among irs clients. For more information, please contact Robin Rager, Ph.D., Director of Health Management, at (310) 212-0363 ext 3305 or rrager@>keenan.com. 5 Crenshaw Blvd .. Suire 200 Torrance CA, 90501 (800) 654-8102 License No. 0451 \VW\v.keenan.com Keenan Fitturis Care-· Comprehensive Retiree Solutions Specifically Designed For Public Agencies Futuris Care5 M 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 Care5 l\ 1 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 while 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. Keenan / ' ") 0.\fi\';,J Keenan Pharmacy Purchasing Coalition (K.PPC) is an innovative phamiacy 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 pncmg 1s competitive in today's turbulent economic times. These successes include: e Volume-based purchasing -The lowest dispensing fees available in California for pharmacy purchasing. And, our pricing improves as coalition membership increases 111 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 your specific drug spend are accurate. e Annual market checks • Independent pharmacy audit -Monthly audits on 100% of claims e Comprehensive specialty management e 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: • 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 perfonnance, account management services and full undenvriting support. • 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 } j \,11, ( 111 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. I<:PPC 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 in1plementation 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 minimw11 of $8,000. e $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. e 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 perfonnance guarantee penalty of $10.00 x total members. e 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. Keenan aver The Keenan Saver Rx program is powered by GoodR.x. The Keenan Saver R.X 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 Face book, Yahoo, and health care executives • Over 1 billion prices for 6,000 diugs at 60,000+ U.S. pharmacies • Prices: Cash (U&C), insurance and Medicare co-pays, discount programs, more • 3 million monthly unique visitors • Patient education: Class and condition tools, price trends, alerts, shortages and recalls, more • Doctor and pharmacist-reviewed content WHAT THE PROGRAM PROVIDES • 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/ pharmacy margin = employee and employer savings • Increased compliance / engagement • Benefits extended to non-covered employees, spouses, dependents, pets ADDITIONAL BENEFIT Your Agency can co-brand the Web interface for your own program, so you can provide discount cards under your name, like A!!JfOJJJ!l Saver R'\". Co- branded Web site can be provided under a separate contract with your agency. i ! Costc:o Keenan 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 HIP AA 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 HIP .AA compliance, and guidance for how to respond in the event of a security breach. • Structural Compliance Tools -At the Compliance Center you'll also find easy to understand privacy guide checklists to lead you step-by-step through the process. You'll also find forms, agreements, policies and procedures documents formatted in l'vfS 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 HIP AA compliance initiative and education activities. • Customer Support -While the Compliance Center is designed with robust self-help tools, access to assistance with functionality and HIP AA questions is just a phone call away. Keenan 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. • Quick solutions to more than 2000 questions with BNA's exclusive Fast Answers™. e Easily facilitated searches through a broad range of topics, including: Benefits and Compensation Compliance Performance and Productivity Employee Relations Recmiting, Selecting, and Staffing Risk Management and Safety The BNA portal allows for: • Detailed, topical analysis and discussion from BNA la"\vyer-editors. • Law summaries from SO states written in easy-to-read, plain English. • Model documents such as policies, notices, forms, job applications, and more. • \Y/ eekly updates on important HR news and trends. Keenan J ,, i l, Keenan is pleased to introduce LeaveSourcesM 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 FMLA 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 FMLA compliance is our business. LeaveSource is designed to be simple and cost-effective. It provides Web-based administration and automation using industry leading software, iTimebank1 l\ 1 • 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 FI'vILA compliance. Key Service Benefits Ell 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 GI 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 e Return-to-work ve11.fication on employee's expected return to work date e 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 GI 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 SM · LeaveSource se1v1ce charges per leave of absence managed plus a one-time implementation fee. 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Page 4 of 4 Keenan ·1; ' ,, nan BRIEFING SEPTEMBER 12015 Under the claims and appeals regulations of the Affordable Care Act (AC\) issued in 2011 (IRS Technical Release 2011-02), self-funded non-grandfathered govermnent 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 notify HHS of their decision. If the FIHS process was chosen, additional information (including contact information) had to be provided to the U.S. Office of Personnel I\fanagement (OPM) and the Centers for Medicare & Medicaid Services via e-mail. On June l 5, 2015, new instructions were issued regarding the notification process to elect the Federal External Review Process or update previously submitted information. This I31i~filtg 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 rec1uired to submit information regarding their election to HHS via the Health Insurance Oversight System (BIOS) 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: UPDATING lNFORiv1ATION Sponsors who previously registered for the Federal External Review Process via e-mail must submit anv updated information via HIOS. If no information needs to be updated, then no action is required at this time. Please contact your Keenan Account Manager for c1uestions regarding this Bridi1zg or if you rec1urre any 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 BRIEFING JULYj2014 The ,\ffordable Care Act (1\CA) added section 4980H to the Internal Revenue Code (IRC). Under IRC section 4980H, an Applicable Large Employer (ALE) may be subject to a penalty if it fails to offer its .r\C\ defined full- t:ime employees, and their dependents, minimum essential coverage (I\IEC) that is affordable and provides minimum value (MV). Since an employer's obligations are to its full-time employees, the final regulations for IRC section 4980H proYide two methods for tracking employees and determining their full-time status -the l\Ionthly Measurement Method and the Look-Back Measurement Method. This B1i~filzg, the first in a si.;;.-part series, describes the Monthly Measurement Method. MONTHLY MEASUREJV!ENT METHOD -IN GENERAL L'nder the Monthly Measurem.ent Method, an employee's hours of service are totaled at the end of each calendar month to determine the employee's full-time status for that month. \Xlhile this method is ad1ni11istratiYely straightforward, the disadvantage is that full-time status is determined at the end of the month when it is too late to offer cm-erage for that month. "\s a result, an employer ni.ay be subject to a penalty for failing to offer coverage to some of its :\CA defined full-time employees. For example, an employer with employees whose hours ,-ary m.onth-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 ayeraging 30 hours per \Veek, who were not offered l\IEC for that calendar month, could trigger a penalty if any purchased subsidized coverage through the public Exchange. While the method has its disadvantages, the final regulations for IRC section 4980H pro,-ide some clarity, as \vell as some relief, that may make this method workable for ALEs 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 \Vorkforce, i.e., if the employer wanted to use the Look-Back Measurement Method (discussed in parts two through five of this B1i~jl1~g series), it had to do so for all employees. The final regulations clarify that employers may use either the l\Ionthly Measurement Method or Look-Back Measurement l\fethod for the following categories of employees: • Salaried and hourh· • Collectively bargained and non-collectively bargained • Groups cm·ered by separate collective bargaining agreements • Employees \Vhose prima1-y places of employment are in different states For example, an ALE whose salaried employees work regularly scheduled 40-hour weeks may use the Monthly Measurement Method for all of its salaried employees while using the Look-Back Measurement Method for all of its hourly employees. © 2014 Keenan & :\ssociates I License ""o. 0451271 na However, an 1\LE cannot use the l\fonthly l\Icasurcment IVIethod for its employees with more predictable hours of service and the Look-Back Measurement Method for its variable hour and seasonal en1ployces. For example, an employer cannot use the l\fonthly 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, \vhosc hours \•ary 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 pro\'ides l\IV no later than the first day of the fourth calendar month. First otherwise eligible for coverage means the employee: 1. l\Ieets all of the requirements under the terms of the plan to be eligible for that calendar month (excluding any waiting period); and 2. \X!as not previously eligible for coverage under the plan during the current period of employment. Example: Employer X hires Employee A on January 1, 2015. Employee A anrages 20 hours of se1Tice per week for each calendar month in 2015 and is not otherwise eligible for coverage under the terms of the employer's plan for 2015. E!.ffective January 1, 2016, En1ployee :\ is promoted to a position that is eligible for coverage follO\ving completion of a 90-day waiting period. On April 1, 2016, Employee A is offered coverage, which is affordable and provides MV. Employer Xis not subject to a penalty under IRC section 4980H for January 2016 through March 2016 since it offered Employee.-\ coverage that is affordable and provides MV by the first day of the fourth calendar month follO\ving the date Employee A first became othenvise eligible for coverage. REHIRE AND BREAK-IN-SERVICE RULES The limited period during which IRC section 4980H liability is not assessed on an employee \vho 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 new employee under the rehire or break-in-service rules, then this limited non-assessment period may apply again. In general, the rehire and break-in 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 se1Tice are credited. The question these rules address is whether the ALE may treat an employee who is rehired or returns after a break-in-service as a ne\v employee. These rules apply differently to ALEs that are educational organizations versus non-educational organizations. <0 2014 Keenan & .\ssociates I License No. 0451271 2 Non-educational organizations may treat an employee who is rehired after terminating employment or returns after a break-in-se1Tice as a new employee if: 1. The employee \Vas not credited with an hour of service for at least 13 consecutive \Veeks immediatelv before resuming work; or 2. For periods shorter than 13 consecutive weeks, the employee was not credited \Vith 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 \Veeks. \Xlhile these rules are similar to the rehire and break-in-service rules used under the Look-Back Measurement I'viethod, the rules for averaging hours of service for special unpaid leave and employment break periods for educational organizations do not apply under the l\fonthly Measurement l\Iethod. The rules for special unpaid leave and employment break periods for educational organizations are discussed in part five of this l31iq/i11g 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 ALE can take advantage of the "first otherwise eligible for coverage" relief discussed earlier. If the employee is a continuing ernployee 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 administrati,Tly practicable. Offering coverage no later than the first day of the calendar month follmving resumption of services is deemed to be as soon as administratively practicable. USE OF WEEKLY PERIODS ·rhe ivionthly Measurement Method may take into account payroll periods. Under the final regulations for IRC section 4980H, an ALE can determine the full-time status of its employees for a calendar month based on the hours of service over successive one-\veek periods that either: 1. Begin on the first day of the week that includes the first day of the calendar month, but excludes the \veek in which the last day of the calendar month falls unless that week ends with the last day of the calendar month; or Begin on the first day of the \Veek immediately subsequent to the week that includes the first day of the calendar month (unless the \Veek begins on the first day of the calendar month, in which case it is included) provided the period includes the week \Vith the last day of the calendar month. Under this method, full-tin1e status for certain calendar months is based on hours of service over four-week periods \vhile 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 se1Tice is full-time. For months calculated using five-week periods, an employee with at least 150 hours of service is full-time. Example: Employer X uses the period of Sunday through Saturday as its weekly period and includes the \Veek with the first day of the calendar month but excludes the week with the last day of the calendar month (except in cases © 2014 Keenan & Associates I License No. 0451271 3 nan when the last clay of the calendar month is on Saturday). For this example, we will use the calendar months of l\fay and June of2014. • For May 2014, Employer X measures from April 27'h through May 31 't. It includes the week with the first clay of l\fay but also includes the week \Vith the last clay of the calendar month because that clay is Saturday. Since this is a five-week period, if an employee has at least 150 hours of service (30 hours x 5 \Veeks) during that time, the employee is full-time for May. • For June 2014, Employer X rneasures from June 1" through June 28'h. It includes the first clay of June but excludes the last clay 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 I\Jonthly Measurement Method \Vill likely be impractical for employers whose workforce hours 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 n1ethod. As discussed in part six of this Bti~fing series, there are several intricate rules that govern employees transitioning from one method to another clue to a change in position. Please contact your Keenan Account Manager for questions regarding this Briefing or if you reqmre any additional information regarding the Affordable Care Act. Keenan & .. \ssociates 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. © 2014 Keenan & _-\.ssociates I License ?\:o. 0451271 4 OF "----··-----"-·----·-~·-··-------·~---~---~--·----- Keenan J, June 4, 2009 TO: ALL MEDICAL MARKETING CARRIERS RE: SAMPLE COUNTY/ ANYTOWN, CA 90501 3550 Vine Street Suite 200 Riverside, CA 92507 REQUEST FOR PROPOSAL -MEDICAL & RX BENEFITS EFFECTIVE DATE: JANUARY 1, 2010 PROPOSAL DUE DATE: JUNE 26, 2009 To \'V'hom It May Concern: 951 788-0330 951 715-0166 fax GS www.keenan.com License No. 0451271 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 HlvIO 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 \V'e 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 RFP 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 summaries from lVIedical 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 IVIedical Census Reports - 2 attachments total -1 for .Actives & 1 for Early Retirees TWO YEARS MEDICAL RATE HISTORY PacifiCare HMO -Active Em Sin le Two Partv Family Two Partv Familv Famil, PacifiCare POS -Active Em Sin le Two Party Two Partv Famil, Sample County -?vfedical RFP J .ettcr 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: Y Replace only PacifiCare population and applicable plans Y 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: Y Providing design changes that would reduce current rates by 5% or more Y Provide proposals for any High Deductible Health Plans -including HSA &/or HRA compatible options 8. Provide % decrements for the following options: Y Higher Emergency Room copays/ coinsurance Y Higher Outpatient Surgery copays Y $150 Calendar Year Deductible Pharmacy Plan Option Y 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 proposa~ 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. OF enan 'f ., ; : License --- Resident Insurance Producer Qualifications Califcornia Department cof Insurance KEENAN & ASSOC/A --rES License # 0451271 OBA: KEENAN HEALTHCARE INSURANCE SERVICES OBA: REGENCY CLAIMS SERVICE Pursuant to the requirements of the State of California Insurance Code, KEENAN & ASSOCIATES is authorized to act in the following capacity: Effective Date 12/12/1972 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 Expiration Date 10/31/2017 Please note: To validate the accuracy of this license you may review the inclivklual or business entity's license record on the California Department of Insurance's website at www.insurance.ca.gov "Check License Status." f ! / Triioki \dmin Client Lugo '" 0 Dav-Datt' Keenan Keenan Keenan Hn!dt'r Dav -Date Keenan ['o~ter Triiold Keenan Admin ( D UIDE 5 Keenan ,, :: .<~}-. ,_;::·~ 2'.i ;•1 1 5 :: ClfA~'.E 1 . EMf>tO'lE~ES ~ ' 1 ' ' . ' ' ·--. - ACTIVE EMPLOYEES BENEFIT GUIDE what's inside If l. 2. 4. Introduction Employee Benefits Web Site About Your Coverage 6. Medical 10. Dental 12. Vision 14. Health and Wellness 16. KeenanDirect.com 1 7. Flexible Spending Accounts (FSA) 21. Long Term Disability (LTD) 23. Life I Supplemental Life 25. Employee Assistance Program (EAP) 27. 457 Plan 28. Potential Retirees 29. Health Care Reform Update 30. Covered California 32. Legal Notices 38. Contact Information t-1ave Medicare or you you more choices Please see page 36 for more details. This Guide gives you an oveNiew of your benefits Including eligib//ify, 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 pion contract. the terms of the contract will prevail. City of Glendale I Active Employees Annual Enrollment for Current Employees Getting the most value from your benefits depends on how well you understand your plans and how you use them. Benefits are important; they provide support to you when you need it the most. They're also a personal choice; your life circumstances change from year to year and your financial and protection needs may change as well. Take action during the City's open enrollment to review your family's changing needs, evaluate your existing coverage and decide whether to continue with your current choices or make a change. Use the many resources available to make well-informed decisions about your benefits for the coming year. Being proactive now will ensure that you and your family have the coverage you need throughout the year ahead. Important Dates This year's Open Enrollment period will occur April 20, 2015 through May 11, 2015 for online enrollment. The benefits you elect during open enrollment will go into effect June l, 2015. City of Glendale I Active Employees What Else Should You Know Before You Enroll? Before you make any decisions. take a moment to review this helpful "To Do" List. • Read the material in this enrollment guide. • Share the material with your family members and discuss your family needs. • Review your benefits summary in GEMS: Main Menu > Self-Service > Benefits > Benefits Summary. • Decide if you're going to make any changes for 2015, or keep the coverage you have in place. • If you decide to make enrollment changes. see "Open Enrollment Assistance" on page 2. Do You Need to Do Anything? The answer is "no" unless you want to: • Change your plan election • 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 QQODQJ: change your benefit elections during the year unless you have a qualifying life event. 2 Open Enrollment will be held online this year through our Web Portal -BenefitBridge. This portal contains helpful information and a multitude of decision-support tools. The BenefitBridge web portal also offers information on the Ciiy of Glendale's benefit plans, and links to Anthem Blue Cross of California, Kaiser Permanente, Guardian Dental and VSP to access provider directories. Employees are able to make benefit selections for the 2015-2016 plan year from home. Ifs fast and easy. Once you login, you will be able to view and compare plans, download documents and forms, and utilize a variety of health and wellness resources such as: • Benefits: This section lists benefit plans offered to the Ciiy of Glendale employees, as well as a detailed description of each plan. This section can be used to compare and contrast different plans. • Resources: Contains news on a variety of health topics, as well as world news articles and important benefits documents. • Life Events: Provides employees with information for specific life events such as having a baby or getting married. This section also covers a varieiy of topics such as: family and relationships, health education, finances and insurance, and purchases. The Life Events page also contains a Health and Wellness section, which provides links to health and wellness websites such as WebMD and wellness.com. On April 20, 2015, log onto BenefitBridge to establish your password, as well as view your benefit options and complete enrollment for the upcoming plan year. You will not be able to access BenefitBridge until April 20, 2015. logging On From the internet, visit www.benefitbridge.com/glendale to complete the registration process. Need Help with the Site? Keenan & Associates can help. Contact the Help Desk at benefitbridge@keenan.com, or call 800.814. 1862, Monday through Friday, 8:00 AM to 5:00 PM. Open Enrollment Assistance For additional questions on enrollment and eligibiliiy, the benefits staff will be available to help you. They will provide enrollment forms and provider directories. They can be reached by calling at 818.548.2160 or via e-mail at benefits@glendaleca.gov. Enrollment and Change Forms are also available on the City of Glendale's employee intranet, which can be accessed through the following: From Work Click on the Internet Explorer icon to get to Glendale's home page Click on "Employee Services", then click "Benefits" Dependent Documentation If you are enrolling a spouse, a domestic partner, or 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. Ci1y of Glendale I Active Employees Online Benefits Enrollment made Easy with fliJtfl~!l«;fltBridge 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. and Registration is easy -just three simple steps! Access your BenefitBridge website at www.benefitbridge.com/glendale, then follow the on-screen instructions: Step 1 Select "Register" to Create an Account Create a Username and Password Select "Continue" to access BenefitBridge (print page with account information] Resources and Enrollment (Benefits I Enrollment Center j G Revle\'/ Ccrfier Offerings E3 ReWel/1 Current Beneffts El Compore ?km Des>gns ( Health & Wellness ( Resources BenefitBridge Portal Contents -Where Do I find? Carrier websi1e links: Curren! Benefit Enrollments; Employer Announcements: Open Enrollment -End Date end Time ond Possword/E·moil Rese1 Carrier Pion Op1ions; "Compare" Plans tool; Benefits Documentotion and Forms; other Health-Related tools and links. ihis ~ your online enrollment: Access and Comple1e Your Benefil Elections Here. • Follow on-screen instructions. completing information on the five enrollment screens. I Personal j I Dependents I ~ I Optional ! I Review I Important Reminder: On Review screen, don't forget to check "I Agree" and submit enrollmenf' Your Approval: I I AGREE (Check 10 confirm your final approval.] Ok Submit for Coverage Heoltn Information Research; Calculator tools. life Events Information; Medical lnformotion Resource links. Need Help? Contact BenefitBridge Support at 800.814.1862; Monday through Friday, 8:00 am -5:00 pm PST. City of Glendale I Active Employees 3 Keenan 2015 Group Renewal and Stewardship Report I { ; 1; \ ' I ! ~ " \! " '\ ~ ~ ""' ( \ , :, , " \ ,_ j \ j i0f*"'d-f!i ',,'' fiioernse l!lo, lr45~2il~ , , , , 'il'llnO'J!tilitk mo'kt'/fnns, 'Ji!mlluti11g/fhi1Wfl/t£ ~-,: i , , ll! w~,l?"9t,~ihm , j / ( l l ~ g nda • Your Keenan Benefit Team -Keenan's Role Stewardship Report -2015 Renewal Highlights -2016 Strategic Planning • Additional Keenan Value-Added Services our en an .............. .............. .. .. ··· .·· n fits a .............. ····· .... ···· ...... . ar ship • mar1 • Renewal negotiations • Marketing • Implementation of new plans • Carrier liaison • Technology Solutions p rt- nan's -BenefitBridge Online Enrollment and Eligibility System -Personal Choices Web Portal • Review plan documents, applications, employee communication • Requirements ~; \ ~ ! ! ~ ;; i \ ~ ' 7"' "if!''!!; ( ; ' ·· ~IG<imse 1110. ©'151 lliin • · · . . !lin110;v1ttd<i 'S'°'kttions. 'iliJiti!n.ii11,/!/JiJ.Jdllvi:J,Yor. f(~ftfl. ,' ' ' ' ' ' ill $l:f:/l1fcefl/IJiht j ~ " i ' j " urp s f fin and t ardship ep um ari e nan's I • 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 l I ' I \\ j \ \ cc ( '< ' J l l \) ~ I ~ " ,j'Jf" ~t')l : , ;ieemse 15Jo, ©%15n2m~ , , ' WttltOtltltZVe ~Ott:ltZonm 1JJn'fffltt1ti'IJl!J fm~in'(f,~l1il•, ·~IJJf~/filifllll , , , , ' WSfiJJ,,F,kitt't"eS ' 0 ii J 1 \i alif rnia urv y e lthcar undation 012 • The proportion of California employers offering coverage has declined significantly over the last decade, from 71 o/o in 2002 to 60°/o 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°/o, 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. lif rnia urv y althcar F undati n 01 • 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°/o 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 ~ " " j ~ 1 ' ! ~ ;;'Jf; =0 1 \ , :sense No, 0!!51WM ' , fli1111111!d!i:o• ~'ttt!irms. '/!f,wit1ri11E 'ii?,,-i111ffJJjM ~~11!71 , ' 'f!P1iw1{1 q,,~1 itJt es "' l ) ! 0 ~ "' ,, ity f mpl 201 ey en fit 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 Medical Plan Renewal and Marketing · :ioense 1110. 045111,~~ . •. • . • . . . • ~novdJidoY:tt;o~, Wtuing, L"1rittr.il{tps. ~fl(, , ' , ' ' IM1.!'i~i?,Jil~!:t'tl!)~ , ~ " ( \ " : !; j " 0 015 en al ighli hts • 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 D a1s r n wal pti ns The "as is" renewal -2.67°/o 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 " a1s r n w I pti ns ( c ntinued) • Implementation of ACA mandated preventive care -No additional cost • Implementation of Mental Health Parity -0.3% increase l " ~ y ; ~ * r 1 x t 6 ," )ti*'\?;" " ; 1 ~" . ' :cense ~c. ID~5~2iin , , . ·., , ~1ttta!!11lif!f. .f:ii?litfOJ!if, 1J/?;1filzllin~ ~•tincffl.Y"'· ~~:711(: '. ' , ; ', , ' ' ' ti1'(~ll,,'f,,c;IJ11ie:s '. ( K ! I '" ; ~ 1 1 J' I ) ~ { ~ ;; a Ith t ne al pti ns The "as is" initial renewal -15. 7°/o 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 a Ith t n al pti ns ( c ntinued) • Unblended rates -10.2°/o 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 a Ith t otiat d en al • 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°/o increase • With the analysis as back up and the marketing activity, Keenan negotiated a 5°/o reduction in the renewal to a final increase of 9.7% M dical Mark ting • 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 est rn alth dvantag ( ) 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°/o lower than the current Health Net HMO • Standard HDHP plan -35°/o 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 • Health Equity for HSA administration W stern alth dvantag (W ) 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 27o/o lower than Health Net's renewal rates HMO rates within 1°/o of Kaiser's rates. The HDHP matches Kaiser benefits with lower rates utt r a Ith lus 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°/o • Rates 28% lower than Health Net HMO • Rates within 1°/o of the Kaiser HMO and HDHP elf-und d • 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 nit d alth ar -Medicar I ans 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 15 Ill av1n s-ctives ecial istri t 2015 Renewal with Health Net and Kaiser* Enrollment Monthly Premium Annual Premium Kaiser #### $### $### Health Net #### $### $### Totals #### $### $### 2014 Renewal with New Carriers ·. Enrollment Monthly Premium Annual Premium Kaiser #### $### $### Sutter Health Plus #### $### $### Western Health Advantage #### $### $### Total Premium #### $### $### Esti ated nnual Savings $##,###,### *Based on enrollment at time of renewal 2 15 1111 VI s-tir 2014 Renewal with Health Net and Kaiser Enrollment Monthly Premium Annual Premium Kaiser #### $### $### Health Net #### $### $### Totals #### $### $### 2014 Renewal with New Carriers Enrollment Monthly Premium Annual Premium Kaiser #### $### $### Sutter Health Plus #### $### $### Western Health Advantage #### $### $### United Health Care #### $### $### Total Premium #### $### $### Estimated nnual Savings $#,###,### Note: Estimated savings take into account the difference of 216 retirees between the 2014 renewal and 2014 enrollment Dental and Vision Renewals 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 • 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°/o. • 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. I ~ " { f ~ H l ( '°' 0 I \ ; fA l J ' :~cems~ ~ •. 1!'4512i1!1 · . • • · . . '. • 'lim101lll'!hre O~dlrltfJ1tr.s. flJm'llttfiilJJ?/firim:l!j//l!ir. ~-91.: ' ' ' ifi1m11c,p,nt'tes , ' > < 1 0:; 0 : ~ elta ntal and rinci al ntal • 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 ew arri r lmpl m ntati n 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 n fit a r1 g • 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 ; " " "' " ): l "' t "' Yi i '0 {; ~ ' :: ••••• ~o. ®s~ 2;ii . . . · . • • • 'J!n.qof!llti1do1111iom' "lffj >trlm#itfl!. 'if2rin,fttle.r. ~WI '' , , , ' :11'1£~pf;'f:'it'tl!iS c "' ~ "' 1 ' ' f ? l I "' 2015 Strategic Planning i r " ~ V) { ~ n 1 ' 1 < t , 1 .. ::.;,ose l'la. 0!!51~i!1 · . . • . ~'llflowftive. ~tllat!io11s. ~~ 'J?flinGfJi/•& . ~~ft ; c ; t I ; < ; 'r/1JJ;~iliit_'t'a tJts 2015 trat • IC lanning • 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 ,K ;, ! 1 ) ' ': :~cease Ill~, Oll5~2'lrt ' ' · U!nnoJid!!hM So'littlions. Ww'fluting ~loo, ~'filf!lli: , ' , ' ilf\ffS,D~{Jt'ft:s & t ( ~ ! Legislation 2 13-2 1 L gislati n BRIEFINC BRI Ocie HH Rj }01 J BRI 111'\Ulll~o\rtHr;r SI~ 12(1 -I ft',1!1h (;"-"' f :mvr.IJ.!T: J)n~·!•ipnwnt<>I I )i~<>nfn ,,, Auu"ru 2012-2013 L islati n ( c ntinu ) Health Care Reform: Taxing Employers -Part I: Introduction February 4, 2013 Health Care Reform: Taxing Employers -Part II: Definitions Overview February 4, 2013 Health Care Reform: Special Rule For Off-Calendar Year Cafeteria Plans February 13, 2013 Health Care Reform: Exchange Notification Requirement Postponed February 13, 2013 Health Care Reform: Department of Labor Issues Model Notice of Exchange May 13, 2013 • Health Care Reform: What Are PCORI Fees? The Patient Centered Outcomes Research Institute June 19, 2013 2012-013 L gislati n (continued) • United States Supreme Court Issues Rulings on DOMA and Proposition 8 Cases June 27, 2013 • 2013 HIPAA Omnibus Rule September 10, 2013 California Legislative Update for Bills Related to Health and Disability Insurance October 28, 2013 Health Flexible Spending Arrangements: $500 Carryover and More November 1, 2013 2014 Benefit Limits for Health & Welfare Plans November 15, 2013 0 SB 751 -Amendment to the Brown Act: Promoting Greater Transparency in Public Agencies December 6, 2013 : \ "« ' s I I "' ; A,, f . :~oemSe Hlo. misn 21;rn Ff1mnva'li.1m '&rll!ilio'11f, rfff.1iflut!ff1!J 'fi>tlfw#pfar, ~fl· ' ' ' , ' !f/1'/is,f!;,~,t,U!'tce:s ' ', f f " ;, ,,_ ! ;-* " 0 I ~ ! ;; / i " 0 ' Webinars BfZ ' , , " ' , ' filiceose Ma, @15~2%~ , '. ,' , ' , , , , ~'ntlot!tlli11e .. £dl/tttio1M, 'IE!!,n'!Jm!f'll/I, ~itf!ffes, ~~-if!IJ', , ' , , ' " , 'l!'l1I;~lii!J1l'ties , 2 13-2 14 Keenan WEBINARS binars Affordable Care Act: Workforce Analysis - Strategic Planning for Full-Time Employees a COMPLIMENTARY 90 minute webinar Wednesday May 15, at 10:00 AM Presenters: Jerry Healv ~ Keenan Cynthia Stribling · Keenan Regardless of your strategic approach as to the new Health Care Reform rules, at the end of 2014 there are two new reports that all employers with more than 50 employees are responsible for completing to determine whether they are subject to tax penalties. Employers must know the full-time/part-time status, as defined by the Affordable Care Act (ACA), of all their employees 1n order to complete these reports ... and time 1s 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 Penods 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. lerry Healy i5 the ~mployee benefit.c; counsel at Keenan and has practiced employee benefits law for many years and has: served es Keenan•s Health Care Reform expert since passage -of the law. Prior to eomi:ng to Keenanr Jerry served as a legal consultant to Kaiser Permanente l!lnd The Walt Disney Company. Cynthia Stribling, Training Director, has over 30 years of experience in the employee b•nelit field. She ;, • Certified Employee Benefit Spedt9list and has worked as a benefits manager, health plan representative, broker consultant, college exteMion instructor and trainer. ~ "' > ; l \ ' ·· :~cense ~o. G4512~1 ' , • · , , ' ' . • 'htnollliltve 'iN!JY.ttlians. IJflm!ill1'inJ1 'Rtindfil~1. , ~Ji.· ' ' , % , ' W11ftrs:a,aj;a'~es , f ) ~ ~ J \ "t ! O K1db\ "' 2 12-13 binars ( continu d) • Navigating the New Health Care Regulations for Wellness Programs March 19, 2013 • Affordable Care Act: Workforce Analysis -Strategic Planning for Full .. Time Employees May 15, 2013 • ACA "Notice of Coverage Options" Requirement -Are you Ready? September 4. 2013 • GASB 43/45 -Before You Get Too Comfortable January 22, 2014 10th nnual eenan u mit 10th Annual Keenan Summit Di\TTS & L.OCJ\TIONS: Southern CA • Burbank TtH"sday, Marci 1 13::JO a.m. '..UO p 1n. Ourbank Airport Maniotl Featured Speakers: Peter Lee Nonllern CA Oakland Wednr"sdav. Marcil ;'6 tl::lO a.m. '.l:'.lO p.1n. Oakland City Center Marriott hank u! 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. ;;y > I " l ~ \ )\ "" " f ~ ~ j ~ 'l ;:'ij , ::emse mo. ©~en2mrt , . , ' ~·nnov1:t'tive fldlzi'timts. UJJm?f!zt~n!fi. U2i;·itrci:JYes. ·~,~~l/!jJJl/f, ' , , , ' '!ll~B,'f4:i!'1tf es ; ( l 0 \ ~ ;; ;. ' " ~ OF Keenan -, } Employee Handbook Keenan ORIGINAL REVISED PAGE DATE: DATE: NUMBER: 03/90 03/2007 1 of2 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, undetmine, 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. 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 corporat ion 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 ap plicable 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: