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Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Connecticut Health Insurance Exchange Exchange Call Center RFP
QUESTIONS & ANSWERS
Memo: The document represents the final version of the submitted questions. No further questions will be accepted by the Exchange. The RFP response deadline remains 5:00pm Eastern Standard Time on November 5, 2012.
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
1 10/17/2012 - - -
Do we have an idea of the call volume the call center
can expect to receive either on per month, or per year
basis?
The Exchange has no historical data on call arrival
patterns or the expected variation in volume of calls
over the month and over the year. The State expects the
Responder to have the necessary expertise to
properly anticipate load and staffing requirements for the
Exchange Call Center.
2 10/17/2012 - - -
Do we have an estimated call duration – amount of
time spent on each call for a call center representative?
Please refer to question #1.
3 10/17/2012 - - -
Do you need to have an existing service contract with
the state in order to participate in this proposal?
The Call Center vendors do not need to have existing
state contracts in order to be eligible for consideration as the Call Center outsourced
vendor.
4 10/17/2012 - - -
Will the Exchange be making contract terms and
conditions available for review? They were not
included in the RFP document?
Yes, general contract terms and conditions documents
are now posted on the CTHIX website.
5 10/24/2012 General Evaluation Criteria
Will the advisory committee members be part of the
evaluation process? Can the Exchange please advise who is participating in the
evaluation?
The Exchange does not disclose the composition of the evaluation committee.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
6 10/24/2012 General Evaluation Criteria
Has the Exchange established evaluation
criteria for the Call Center RFP?
The proposals will be reviewed using the following
scoring criteria:
Total Score = 100% · Organizational Capability
10% · Approach and Methodology
15% · Level of Fit of the Proposed
Solution 35% · Project Timeline 10%
· Cost/Pricing Proposal 30%
7 10/24/2012 General Materials
Will the Exchange Call Center be responsible for creating materials in other
formats to comply with ADA requirements?
No.
8 10/24/2012 2.1.2 7
Services offered in this tier include answering questions about the
Exchange and health care reform, directing
existing Medicaid consumers to DSS
Benefits Center via IVR prompts or a “warm transfer”, as well as
routing and resolving complaints and appeals to the appropriate State agencies such as the
Connecticut Insurance Department (CID) and
Office of the Healthcare Advocate (OHA) via a
“cold transfer”.
What is your preferred method of call transfer
assuming an automated environment?
Warm transfer.
9 10/24/2012 2.1.2 7
Consumer Support Components highlighted
in red as one of the activities applicable to
the Exchange Call Center is insurance
shopping tools.
Will these tools be accessible via the Exchange Web Portal that is part of the
SHOP RFP and in which that vendor will be
responsible for providing or will the Call Center
Exchange vendor need to provide their own
comparison shopping tools for comparison and final cost
calculation?
The Web Portal will include the tools necessary for the
Call Center Representatives to pre-screen the consumers, determine their eligibility for
MAGI Medicaid, QHP, APTC, and enroll in QHP plans using
the comparison shopping tools to display the plans
relevant to consumers. SHOP BPO Vendor will have a separate Help Desk to provide assistance to employees of small
employers in plan selection and enrollment.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
10 10/24/2012 2.1.2 7 Tier 0 Website
Will the Exchange Call Center have full access to the exchange website in
order to complete eligibility and enrollment on behalf of consumers who are unable to complete processing on their own? How does the Exchange envision Call
Center agents accessing the Exchange and IE System?
The Exchange Call Center staff will use the web portal
with configured access rights to enroll the consumers into
the QHP selected by consumer.
11 10/24/2012 2.1.2 7
Services offered in this tier include answering questions about the
Exchange and health care reform, directing
existing Medicaid consumers to DSS
Benefits Center via IVR prompts or a “warm transfer”, as well as
routing and resolving complaints and appeals to the appropriate State agencies such as the
Connecticut Insurance Department (CID) and
Office of the Healthcare Advocate (OHA) via a
“cold transfer”.
What is the estimated percentage of calls that will need to be transferred to
State Agencies?
Please follow industry standards and benchmarks.
12 10/24/2012 2.1.2 7
Services offered in this tier include answering questions about the
Exchange and health care reform, directing
existing Medicaid consumers to DSS
Benefits Center via IVR prompts or a “warm transfer”, as well as
routing and resolving complaints and appeals to the appropriate State agencies such as the
Connecticut Insurance Department (CID) and
Office of the Healthcare Advocate (OHA) via a
“cold transfer”.
Please confirm that the Call Center vendor is not
responsible for tracking calls once they have been
transferred (warm or cold) to an external entity.
The Call Center vendor is not responsible to track the
transfers through resolution. However the Call Center vendor is responsible for
tracking where the transfers are made, as well as tracking
and reporting on related metrics (e.g. number of
transfers to CID on consumer complaints related to issuers/plans, etc.).
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
13 10/24/2012 2.1.2 8 Tier 2
Will the Tier 2 personnel be responsible for resolving
eligibility issues when clients apply on-line? For example citizenship verification that
needs the consumer to show verification so that can be verified through SAVE and similar appeal issues? Can the Exchange please clarify
the Call Center vendor’s responsibilities for
supporting routing and resolving eligibility issues?
The Federal Hub will be integrated in the application.
If paper verifications are
required on exception basis, the Call Center Vendor will
inform the consumers on in-bound paper channel to submit the verification
document. The Call Center Vendor will be notified through a workflow on verification documents
received once these are available in the system. At this point, the Call Center
vendor will follow up with the consumer to pick up the
enrollment process.
It is not expected that Call Center Vendor will access any additional electronic
sources that are not built into the system for the verification
purposes.
14 10/24/2012 2.2.2 10
RFP states the Exchange Call Center will perform activities necessary to receive,
log and track incoming communications
Will the Exchange Call Center be responsible for setting up complete end to end mailroom operations
which includes scanning all incoming documents,
sending outgoing documents such as re-enrollment
packets and requesting required verifications,
working return mail etc.? What does the Exchange anticipate would be the
volume for these mailings?
Call Center Vendor is not responsible for processing paper and fax verification
documents. Details on scanning and processing are
currently being addressed and will be shared with the
selected vendor.
15 10/24/2012 2.2.2 10
RFP states the Exchange Call Center will perform activities necessary to receive,
log and track incoming communications
Will the Exchange Call Center be responsible for establishing a PO Box and Business Reply envelope account for consumers to
send documents to the Exchange for processing? What does the Exchange anticipate would be the
volume for these mailings?
Yes. The majority of communications are expected
to be handled through electronic means or over the
phone.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
16 10/24/2012 2.2.2 10
RFP states the Exchange Call Center will perform activities necessary to receive,
log and track incoming communications
Will there be outreach materials that the Call
Center is responsible for mailing like plan comparison
charts? What does the Exchange anticipate would
be the volume for these mailings?
No. Anything needed will be available on the website.
17 10/24/2012 2.2.2 10 Figure 3: Future Environment
How will the agents in the Call Center connect to the
HIX system: Internet or private connection?
Internet.
18 10/24/2012 2.2.2 10 Figure 3: Future Environment
Will the HIX system deployed by the State have
the ability to be queried (using Web Services, for
instance) so that the IVR of the HIX Contact Center
contractor can provide more accurate information to the
callers?
Yes.
19 10/24/2012 2.2.2 10 Figure 3: Future Environment
Will the HIX system deployed by the State have the ability to be queried in
real time (using Web Services, for instance) so that the agents in the HIX Contact Center can get
accurate information about the caller on a pop-up
screen when they take a call?
Yes.
20 10/24/2012 2.2.2 10 Figure 3: Future Environment
Will the DSS ConneCT IVR remains client facing or will the Exchange be the only client facing IVR? If the
ConneCT IVR remains client facing how many calls will the Exchange IVR receive
from ConneCT?
These questions do not to apply to the scope of this
request.
21 10/24/2012 2.2.2 10 Figure 3: Future Environment
Please provide technical information about the
configuration of the ESB.
It will be provided to the selected vendor once it
becomes available.
22 10/24/2012 2.2.2 10 Figure 3: Future Environment
To support project planning and scheduling, what is the timing for availability of the
interfaces being supplied by the State’s System
Integrator?
It will be provided to the selected vendor once it
becomes available.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
23 10/24/2012 2.2.2 10 Figure 3: Future Environment
Can the Exchange provide additional information on the
existing IVR, including software and capabilities to assist the Call Center better
in planning integration?
At a later date, a design session will be conducted for selected vendors (finalists) before an award is made.
24 10/24/2012 2.2.2 10 Figure 3, Future Environment
In Figure 3, do the colors depict agency or vendor
responsibilities? If so, can the Exchange please clarify whether the responsibilities of the HIX Exchange Call Center do include a web portal or shared rules?
Web portal and shared rules are responsibility of the Systems Integrator. Call
Center vendor will utilize Web Portal that relies on the
shared rules to determine the client eligibility.
25 10/24/2012 2.2.3 11 Table 1- Estimated
exchange user population
Only the low income children population (CHIP) states
that the consumer will apply through the Exchange portal or the exchange Call Center. Should this statement apply
to all populations?
Should the Exchange Call Center be capable of
sending paper applications and accepting them to
process eligibility?
Yes. They would need to direct individuals.
26 10/24/2012 2.2.3 13-Oct SHOP Exchange
Can the Exchange confirm that the Exchange Call
Center will not be expected to be the primary Call Center for participants in the SHOP Exchange? If this is not true, and this RFP should cover
SHOP Exchange Call Center activities, can the Exchange please provide
similar volumes and assumptions for the SHOP Exchange as are found in
the RFP Section 2.2.3, Volumetrics?
The SHOP BPO Vendor will provide a Help Desk to assist
employees of small employers.
27 10/24/2012 2.2.3 11 Table 1 and 2
Can the Exchange please confirm that the population
estimates are based on annual totals?
Please follow industry standards and benchmarks.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
28 10/24/2012 2.2.4.2 13
Provide access to an up-to-date and
integrated client record across all programs at
each touch point.
Can the Exchange please clarify the scope and responsibilities for the
“integrated client record”?
Will the integrated client record be maintained by the IE / Exchange vendor with access by the Call Center
vendor?
Or is the Call Center Vendor required to maintain the
integrated client record as the “source of truth”? If so, will the Exchange and IE systems support real time interfaces to allow for the
maintenance of an integrated record?
"Integrated client record" is a record maintained by the call center vendor to provide data extracts or reports on clients who contacted the call center
and the type of request or services needed.
29 10/24/2012 2.2.4.4. 14 Capacity and Scalability
To help provide additional flexibility in a cost effective manner to quickly adjust to
call volumes, will the Exchange allow the use of at
home workers?
As part of the proposal, Call Center Vendor is expected to provide a staffing model that should include any off-site
locations and number of staff by location (4.4.3. Off-site
Services).
Include location of staff and which states at home workers will reside. In home workers will be expected to follow all
privacy laws and abide by the terms and conditions the
awarded vendor agrees to with the Exchange.
30 10/24/2012 2.5.1 15
As such, our anticipated goal for Exchange Call
Center operations requires go-live by no
later than September 1, 2013 in order for the
Exchange Call Center to be tested, modified,
promoted and fully integrated into the
eligibility determination process.
In order for bidders to accurately estimate staffing ramp up and training, does
the Exchange anticipate that the Exchange Call Center
will actually be taking consumer calls on
September 1, 2013? Or, as stated in RFP Section 2.5.1,
is the time between September 1 and
September 30, 2013 used only for testing,
modifications, promotion and integration with eligibility
determination processes?
Yes. The Call Center should be operational by September 1, 2013. The 1-800 number
will be advertised by the Exchange prior to that date,
and a level of consumer interest is expected prior to the open enrollment date.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
31 10/24/2012 2.6.2 16
The QA Vendor will also review Call Center
Vendor quality control procedures and
processes to develop, track and report on SLA
metrics.
Are SLAs in place for the other HIX components which
will affect Call Center performance (e.g. timely
resolution, system interfaces)?
Yes, SI has system performance metrics defined and will be held accountable for reaching these metrics.
These will be shared with the selected vendor.
32 10/24/2012 2.6.2 16
A QA Vendor will be working with the IEPMO to assist with the quality
assurance reviews of Exchange Call Center deliverables on behalf of the Exchange. The Call Center Vendor must fully cooperate
with the QA Vendor as it executes its
responsibilities.
Will the QA Vendor be responsible for procuring
licenses to our Call Center solution?
If the Call Center Vendor
should include licenses for the QA Vendor, please
provide the number of users and type of access we
should account for.
QA Vendor will not require licenses for Call Center solution. It is however
expected that QA Vendor will review items such Call Center
Vendor Deliverables, call center scripts, performance metrics, SLAs, consumer
survey results.
33 10/24/2012 4.1.1 20
Minimum font size: 11 point (except for
footnotes, headers, or footers)
RFP indicates 11pt font as the minimum size for text. Is
it allowed to use smaller than 11pt font for tables, exhibits, and graphics?
Yes, as long as it is legible upon printing.
34 10/24/2012 4.1.1 20
The proposal created by the Responder should
be formatted as follows:
• Requirements Traceability Matrix
should be submitted in MS Word format.
• Proposal should be submitted in either PDF
or MS Word format.
Appendix B, Requirements Traceability Matrix, is currently an MS Excel
document. Please confirm if it is acceptable for the
Prospective Responders to submit the Requirements Traceability Matrix in MS
Excel format instead of the MS Word format noted in the
RFP?
No. Please use Microsoft Excel for Requirements
Traceability Matrix submission.
35 10/24/2012 4.1.1 20
The Responder’s Exchange Call Center
proposal should consist of the following
sections, in the order
listed below: • Cover Letter
• Table of Contents • Executive Summary
• Organizational Capability
• Approach and Methodology
• Level of Fit of the Proposed Solution • Project Timeline
• Scope Exclusions • Cost/Pricing Proposal
Is it the State’s expectations to receive Six (6) hard copy binders that contain both the technical and cost proposals
as part of the RFP submission? Is it the State’s
expectation to receive ten (10) soft copies on CD-ROM that contains documents for both the Technical and Cost proposals on a single CD?
Yes. Please see answer to question 69.
36 10/24/2012 4.4.9 24
Provision of continuous operations of the
(including the underlying systems for which the Responder is
responsible)
What is the expected RTO/RPO of the Call
Center?
The State's RTO/RPO is 48 hours.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
37 10/24/2012 4.4.9 24
The Exchange’s involvement in
developing a Future State disaster recovery
plan
Is there an overall DR Plan that the Call Center would
be integrated into?
The Call Center vendor would be dependent on the State's
recovery.
38 10/24/2012 4.8 25-26
The Responder will provide in the cost
proposal a firm fixed price for the
development, certification, and deployment of all
Exchange Call Center components, including IVR system. The fixed
price should be representative of the “stand up” cost of the proposed Exchange Call Center solution.
In order for bidder’s to provide the most cost
effective proposal for the scope of work requested,
will the Exchange consider bidder’s proposals for
breaking up the firm fixed price for the “stand up” of the Call Center over a set number of milestones or deliverables during the
implementation?
Yes, as long as the total firm fixed price is clearly identified
in the cost proposal.
39 10/24/2012 Appendices- General 30-38 Future State Business
Process Models
The Generic Exchange Blueprint Process Models’
legend uses color to differentiate business areas (e.g. Financial Management,
Plan Management). However, there are only two
colors represented in the flow charts – process boxes are yellow and data storage
symbols are purple.
Does the color in the legend apply to these generic
blueprint models? Can the Exchange provide additional
guidance on what is Exchange vendor VS. Call
Center vendor responsibility within the flow?
Call Center process models is a subset of the Exchange
process models that currently exist. Consumer Assistance
process models that are applicable to Call Center
functionality are depicted in yellow.
The flows are high level and
do not include responsibilities of the Vendor vs. the
Exchange staff. The RFP provides sufficient level of
detail around the Call Center BPO vendor responsibilities.
40 10/24/2012 Appendix B Item 91
What is the role of the emergency helpdesk
support?
The role of the emergency helpdesk is similar to regular Call Center role, with different hours of operation to account
for unexpectedly high consumer demand.
41 10/24/2012 Appendix B Item 146
What external locations will need to interface with the Call Center CRM system?
What is the anticipated number of users?
Exchange Tier 3 consumer support group will be
interaction with Call Center CRM system. Estimated number of licenses is 20.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
42 10/24/2012 Appendix B Item 58
The system shall assist consumers through
Interactive Voice Response (IVR)
technology. IVR should be customized for
Exchange functionality, include the ability to
assist in eligibility determination, confirm enrollment, assist with
automated call transfers, etc.
Does the Exchange envision a direct, real time connection
to the Eligibility System to support these capabilities?
If so, can the Exchange provide information on the anticipated capabilities of the Eligibility System to support this interface?
Not in the short term. This capability may be developed
in the long term.
43 10/24/2012 Appendix B Item 59
The system shall have the ability to manage
outbound IVR campaigns.
How many outbound campaigns does the
Exchange anticipate per year? What is the
anticipated volume for each campaign?
Outbound IVR campaigns are expected to happen around
renewal periods or for customer satisfaction
surveys.
44 10/24/2012 Appendix B Item 64
The system shall have the functionality to
export IVR and CRM statistical data and contact information.
Is the export required to be a real time process or is a batch process sufficient?
Batch is acceptable.
45 10/24/2012 Appendix B Item 70
The system shall allow for Call Center and support staff to view
information about Exchange consumer
status (eligibility, enrollment, as well as
plan information).
Will the Call Center staff have role based access to
the Health Insurance Exchange and Eligibility System to support these
requirements or is the CRM required to support data
exchange with these systems to maintain the integrated client record?
Is the CRM required to maintain the “source of
truth”?
Call Center CSRs will have a role based access to the
Exchange system.
46 10/24/2012 Appendix C 40
“…has decided to submit its intention to
propose for such services on the terms
and conditions stated in the RFP and by the due
date stated therein.”
Appendix C asks the bidder to submit its intention to
submit a proposal under the terms and conditions stated in the RFP. However, there
does not appear to be a terms and conditions section
of the RFP, nor is there a model contract for bidders to review. Can the State please provide a model contract or
terms and conditions for review?
Please refer to question #4.
47 10/24/2012 Appendix E 43
Appendix E – Notice of State Ethics
Representations and Certifications Required of Connecticut Health
Please confirm that the Prospective Responders do
not need to submit the certifications listed in this
section within the proposal.
Please submit with the proposal.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
Insurance Exchange Vendors
48 10/24/2012 2.1.1 6 What is meant by “entrance significant channel into the
Exchange”?
Please read as "In addition to the Exchange website, the Exchange Call Center will
provide a significant entrance channel and will be utilized (in conjunction with the website) for a significant portion of the
consumers. "
49 10/24/2012
2.1.2 – Tier 1
Exchange Call
Center
7
What connectivity will be available to the vendor’s IVR
system? Will real-time transaction be possible between the IVR and
systems developed and maintained by the State or
its vendors?
It is expected that the IVR will make real-time calls to web
services or other types of IPI capabilities.
50 10/24/2012 2.1.2, Figure 1 7
The chart implies that Email and Chat are not functions supported by the Exchange Call Center. Is this correct? Who will handle email and
chat?
We do not envision chat capabilities rolled-out in the
short term. E-mail is supported.
51 10/24/2012 2.2.2 9
This sections says “…Medicaid enrollment-
related inquiries and inquiries from existing Medicaid clients will be
transferred over to the DSS Benefits Center via a “warm
transfer” as appropriate.” Please clarify what kinds of
inquiries from Medicaid clients, both new and
expansion, the Exchange Call Center will be expected to handle completely without
transfer.
Prescreen clients for QHP, MAGI Medicaid and CHIP,
APTC, CSR
Determine and re-determine eligibility for QHP, MAGI
Medicaid and CHIP, APTC, CSR
Enroll in QHP
52 10/24/2012 2.2.2 10
In Figure 3, who receives, scans, indexes and
processes paper and fax applications and verification
documents?
Please see answer to question #14
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
53 10/24/2012 2.2.2 10
Are licensed insurance brokers the only people who are allowed to assist callers
who have yet to make a decision to enroll in a
specific plan with their plan selection?
Yes. The call center will enroll clients who have
independently determined the plan in which to enroll. If clients are indecisive and
need consultative insurance advice, they should be
directed to licensed brokers for assistance.
54 10/24/2012 2.2.2 10
If licensed brokers are the only people allowed to assist
with plan selection, what kind of information or assistance should a
customer service representative offer a caller
who has questions about the health plan choices and the
enrollment process?
They can answer all questions with regard to
general information about each plan, but not provide
consultative advice or direction on which plan the
person should choose. Additionally, please refer to
question #53.
55 10/24/2012 2.2.3 11
What is the % of the estimated exchange user
population that is expected to access Tier 2 and Tier 3?
Please follow industry standards and benchmarks
and your professional experience. Please also
document any assumptions.
56 10/24/2012 2.2.3 11 What is the role of the Call Center in re-determination?
Conduct re-determinations and re-enrollments for clients
that require Call Center Assistance.
57 10/24/2012 2.2.3 11
Is the “Steady State Exchange” populations
shown in Table 2 in addition to the “Open Enrollment
Exchange” shown in Table 1? If so, should the 103,500
in Open Enrollment Exchange be added to the 931,105 total steady state
population?
These estimates are separate and do not overlap. One
estimate is for 5 months of initial enrollment, the other for
the steady state.
58 10/24/2012 2.2.3 11
How will the current Medicaid population be
rolled into the exchange? Will this occur on their
current anniversary date, starting in March 2014? Is it
expected that 616,655 current Medicaid members
will be brought into the exchange between March
2014 and September 2014, or will it be over 12 months?
Existing Medicaid population will go through the Exchange to re-determine their eligibility based on MAGI rules stating
March 2014.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
59 10/24/2012 2.2.3 11
Understanding that most of the Medicaid population will
be able to renew their benefits automatically, will Medicaid renewals in the
future follow the member’s current anniversary date, or will it coincide with the Oct-
Jan open enrollment period?
Medicaid renewals will happen throughout the year on the current anniversary
date for Medicaid enrollment.
60 10/24/2012 2.2.3 – Table 3 13
What specific transactions does the State expect to be automated through the IVR
and the Web Portal?
Web Portal: Shopping/plan comparison, eligibility
screening, actual enrollment in QHP.
IVR: Minimal IVR to expedite direct customer to call center
status and messages.
61 10/24/2012 4.1.1 20
To enhance presentation, is it permissible to include font sizes smaller than 11 point
in tables, charts, and exhibits, with the
understanding that the text is still clearly legible?
Please refer to question #33.
62 10/24/2012 4.1.1 20
Please confirm that we are to convert the Requirements Traceability Matrix provided with the RFP in Excel format
into MS Word format for submission with the
proposal.
Please refer to question #34.
63 10/24/2012 4.4.5 23
Is the Quality Assurance Plan required for submission
with the proposal or post-award?
The Quality Assurance Plan should be developed once
the vendor is onboard; however a high level approach for quality
assurance should also be included in the proposal.
64 10/24/2012 4.4.8 23 What is required for the proposal?
A standard, high level training plan should be submitted as referenced in section 4.4.8.
Please reference Appendix B for additional training
requirements. Once a vendor award is made, the exchange will work with that vendor to develop a comprehensive
training plan.
65 10/24/2012 4.4.11 24 What is meant by “as a separate document”?
Please include this as a separate attachment.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
RFP Page # RFP Text / Reference Question Answer
66 10/24/2012 4.4.11 24
Will the value add capabilities a Respondent
describes in this section be considered part of the
overall proposal and cost? Or are they items that the State could consider for future negotiations and possible subsequent incorporation into the
contract?
Value add services should not be considered as part of the overall proposal, and as such should not be priced. The State is interested in a
high level summary of additional capabilities related to the Exchange operations that the Vendor is capable
and has a history of providing.
67 10/24/2012 4.7 25
Please confirm that this section refers to any scope-
of-work items that the Respondent is explicitly
excluding from its proposal. If this is correct, can a
Respondent simply indicate “Not Applicable” for this
section if it is accepting the RFP scope of work “as is?”
If this is not a correct interpretation, please
provide additional clarification regarding what should be addressed in this
section.
Yes. You may indicate “not applicable" for this section if you are accepting the RFP
scope of work "as is."
68 10/24/2012 4.5 25
Does the Responder only have to indicate compliance
with the detailed requirements by completing
Appendix B, or does the Responder also have to
address these requirements in its response to Section 4?
Please provide response in both formats - within the requirements traceability matrix and a higher level
discussion of vendor capabilities in the narrative
proposal section 4.5 specifically related to
requirements detailed in this RFP.
69 10/24/2012 4.8 25
Should cost/pricing proposal be separately submitted or
included on the soft and hard copies of the proposal?
Please submit both proposals as one package - in separate
folders on a CD; and in separate sections of the hard
copy proposal.
70 10/24/2012 4.8 26
What is the estimate on the % of consumers requiring
licensed brokers to assist in selecting a QHP?
Please refer to question #1.
71 10/24/2012 4.8 26 In Pricing Structure 2, is the transfer to outside brokers a
warm or cold transfer? Cold.
72 10/24/2012 4.8 26
In Pricing Structure 2, will the broker be reimbursed on a one-time basis or will the
broker have ongoing responsibilities to support
the consumer?
This has not yet been determined.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/26/2012
Question #
Date of Answer
RFP Section #
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73 10/24/2012 4.8 26
Please confirm if the difference between Scenario 1 and Scenario 2 focuses on the level of activity of the call
center staff regardless of whether the brokers are on staff or outside of the staff.
The Vendor is expected to submit 2 estimates: 1 for
option 1 moderate automated interaction; 2 for option 2 -
highly automated interaction. These scenarios are based
on expected number of consumers that may access
call center services.
Based on the chosen staffing model (with in-house brokers; without in-house brokers), the
Vendors are expected to submit PMPM cost estimate
reflecting either or both of the pricing structures for both
client population scenarios.
74 10/24/2012 Appendix A 30
Is the Exchange Call Center expected to handle inquiries
via chat?
Please disregard the reference to chat. Currently, Exchange does not foresee using chat capabilities for
consumer assistance in the nearest future.
75 10/24/2012 Appendix A 30 Who handles Tier 0? This is the self service web
portal.
76 10/24/2012 Appendix A 33
What is the role of the Call Center vendor in building
and implementing the consumer satisfaction
survey?
The Call Center vendor will capture consumer satisfaction
on the events in which they manage.
77 10/24/2012 Appendix A 33 How will consumer
satisfaction be defined?
The Call Center vendor collaboratively with the
Exchange will determine the consumer satisfaction
feedback criteria.
78 10/24/2012 Appendix A 33 Is the CRM in Tier 0 the call
center vendor’s CRM? No. The Portal is Tier 0.
79 10/24/2012 Appendix A 33
Is the call center vendor expected to enter
applications into the IES portal directly or through post-call interface? If the
latter, via batch or real-time?
Direct entry.
80 10/24/2012 Appendix A 35
Is the call center vendor expected to scan and index re-enrollment packets? In what document repository?
See answer to question #14.
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81 10/24/2012 Appendix A 35
Under what circumstances would interviews be
needed? What percent of the total would need an
interview?
Please follow industry standards and benchmarks.
82 10/24/2012 Appendix A 37 What is meant by “Flag for
follow up in Tier 3”?
Tier 3 will flag an issue for follow-up with Tier 2
representatives as needed.
83 10/24/2012 Appendix A 38 Who is the supervisor in Tier
3? Tier 3 is supervised by the
Exchange.
84 10/24/2012 Appendix B
Items #51 and 92
Is it permissible to use staff members who are not
dedicated exclusively to the Exchange as part of our
approach to disaster recovery or for (1.)
temporary periods where calls are overflowed to a
different Call Center location to handle major outages and business releases, and (2.)
calls that overflow to a different Call Center location
and are handled by Call Center personnel who have
been trained and are knowledgeable on the
Exchange environment (see Appendix B, items 47 – 49.)
Yes as long as they are well trained and ready to assist in this event. Please reference section 4.3.4 of the RFP to provide a resource/staffing
plan to address.
85 10/24/2012 Appendix B Item #52 What is the purpose of the
web cams? For potential future use.
86 10/24/2012 Appendix B Item #56
This requirement states that call recordings shall be retained according to
Exchange records archival requirements. Please provide details on the
Exchange records archival requirements, including retention time for call
recordings.
The Exchange expects that the Call Center vendor
already retains call recordings for quality assurance
purposes. The Exchange also expects that the selected vendor will share its retention policies with the Exchange.
The Exchange and the selected vendor will then
work together to make any modifications necessary for
Exchange related call recordings.
87 10/24/2012 Appendix B Item #65 What is the purpose of the
IVR periodic call list?
This will be used for Customer satisfaction
surveys.
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88 10/24/2012 Appendix B
Item # 75-76
Are the speed of answer standards (90% of calls within 30 seconds, 95% within 45 seconds, etc) referring to the speed of answer by the IVR/ACD system or the speed of answer by a live agent?
The live agent.
89 10/24/2012 Appendix B
Item #74-85
If the answer to question #88 is “no”, would the state
consider changes to the requirements on average
speed of answer to become internally consistent with the
5% abandonment rate? (note that the ASA required will result in a much lower
abandonment rate than 5%)
The Exchange respectfully declines to consider changes
to the requirements.
90 10/24/2012 Appendix B
Item #75-76
Requirement 75 presents standards of 90% in 30
seconds, 95% in 45 seconds, and 99% in 60
seconds. Requirement 76 refers to standards for
average speed of answer for 20 seconds or less. These
two requirements are incompatible – meeting Requirement 76 would
cause the vendor to miss Requirement 75 which
implies a far lower average delay. Please clarify which
standard applies.
The State does not consider these requirements
conflicting, they are based on the industry standards and
both should be met.
91 10/24/2012 Appendix B
Items #78-79
Please provide the definition of first call resolution and the
way it must be measured.
First call resolution (FCR), a common CRM industry term, is when the call center is able to address the caller's need the first time they call, thus
not requiring a second call to the call center.
92 10/24/2012 Appendix B Item #85
Does the weekly average hold time cited (120 seconds) refer to the
average weekly wait time to speak to a live agent?
Yes
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93 10/24/2012 Appendix B Item #88
Which other agency call centers is the vendor
expected to integrate with seamlessly? What is the nature of the integration –
does the CRM or IVR need to be integrated with these
agencies? If so, please provide more information on the equipment and systems
used by these agencies.
The Exchange IVR is expected to be integrated
with DSS IVR.
94 10/24/2012 Appendix B
Items #182-188
To what extent is the call center vendor expected to
resolve problems, complaints, and appeals
before routing them to the appropriate State agency?
The call center vendor is expected to resolve
complaints such as client account set-up, password
reset, walking clients thought the web portal interface, answering FAQ, etc. As related to appeals and
complaints, the Call Center Vendor is expected to log,
resolve, and track complaints related to Exchange system,
Exchange performance, incorrect enrollment in the
QHP, etc. CID and OHA will resolve consumer complaints
related to insurance plans and issuers, e.g.. market
conduct, coverage, premium payments, etc.
95 10/24/2012 Appendix B Item #193 Whose online solution is
this?
Transferrable NextGen Healthcare Information Systems, LLC solution provided by Deloitte
Consulting LLP.
96 10/24/2012 Appendix B Item #199 What online solution is used
to invoke the chat feature? See answer to question 50
and 74
97 10/24/2012 Appendix B
Items #204-206
What is the role of the call center vendor in publishing FAQs to various channels (web portal, mobile portal,
phone, etc.), providing answers to FAQs, and
tracking usage of FAQs by consumers?
Call Center Vendor should be able to build a knowledge
base reflective of the information they are gathering from their interaction with the public. Exchange will update the knowledge base on the
Web Portal that is reflective of Call Center Vendor input.
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98 10/24/2012 Appendix B
Items #222 –
224 Please elaborate on what is
meant by the term “crisis”.
A definition of a "crisis" event should be leveraged from
industry standards and be a part of the disaster recovery plan. Exchange and selected call center vendor can agree upon a definition acceptable
by both parties.
99 10/24/2012 General NA
Please provide the contractual terms and
conditions governing this contract.
Please refer to question #4.
100 10/24/2012 General NA
Please provide the parameters for marking
portions of the proposal as confidential trade secrets
and therefore not subject to Freedom of Information Act
requests.
The final submitted proposal should have any sections, or
part of a section, that are confidential trade secrets, clearly identified as such.
The Exchange reserves the right to make public any
information that is necessary under applicable laws. All 10
submitted copies of the proposal should be identical.
101 10/24/2012 General NA
Please provide the evaluation criteria and the
proportion of weight between each of the
sections of the proposal.
Please refer to question #6.
102 10/24/2012 General NA
Is there a role for the HIX Call Center to support
employers and employees in the SHOP Exchange?
Please refer to question #26.
103 10/24/2012 4.4.9 24
The fourth bullet states: "Incorporation of the
Exchange's corporate standards/expectations for disaster recovery into the
initial and on-going disaster recovery plans." Can the
State please specify where the bidder can obtain the
Exchange's corporate standards and expectations?
The Exchange's Systems Integrator vendor is
responsible for developing a DR plan for the project. The Call Center BPO Vendor DR plan will have to be aligned
with and incorporated into the overall Exchange DR plan
104 10/24/2012 4.8.
Cost/Pricing
Proposal
25
Does the State intend to pay the vendor the total Fixed
Price to Stand Up upfront? If not, can the State please
provide the payment schedule for the Stand Up
effort?
Stand up cost can be broken down by milestones or by
monthly payments.
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105 10/24/2012 BP-CA-FS-05 34
Does the handoff between CA-FS-05.50 and CA-FS-05.55 take place between
the eligibility and enrollment specialist and the licensed
broker? Please clarify.
Yes
106 10/24/2012 BP-CA-FS-05 34
Does the licensed broker enroll after the enrollment
counseling? Or do they pass it back to the eligibility and
enrollment specialist for enrollment? Please clarify.
Licensed brokers will be able to enroll the consumers.
107 10/24/2012 BP-CA-FS-06 35 What system generates the
re-enrollment packet?
Most re-enrollments are expected to be done through
the web portal or the call center. It is expected that the
use of paper re-enrollment forms will be minimized.
108 10/24/2012 BP-CA-FS-06 35
What is the approximate size and weight of the re-
enrollment packet?
Most re-enrollments are expected to be done through
the web portal or the call center. It is expected that the
use of paper re-enrollment forms will be minimized.
109 10/24/2012 16 Appendix B
How should "size" be described for state
government clients?
Total size of the consumer base served; and a number of
consumers assisted by the Vendor
110 10/24/2012 18 Appendix B
What federal law or regulations require 18
months of licensure; is the 18 months related to
medical insurance only or can it relate to any kind of
insurance such as life, property or casualty?
Medical insurance.
111 10/24/2012 68 Appendix B
How is the idea of a ticket used in the context of the call center request for info
that is tracked in the CRM; is a ticket for a request or
event the same as a call center inquiry or assistance
with completing an application?
Yes
112 10/24/2012 91 Appendix B
For what technology would the emergency help desk
support? IVR and web portal
113 10/24/2012 92 Appendix B Do the on-staff brokers have
to be exclusively dedicated?
The number of brokers should be scaled to consumer
inquiries that need consultative insurance
advise.
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114 10/24/2012 104 Appendix B What is meant by "sourcing
arrangements"?
Business process outsourcing relationship between the Exchange and the Call Center Vendor and any
transfers/escalation procedures as defined and agreed upon between the
stakeholder parties.
115 10/24/2012 111 Appendix B
Is this referencing training that the vendor would
provide to the Exchange team? What is meant by the
"Exchange's governance team"?
The Vendor through maintaining a detailed knowledge base may
recommend specific topics to be covered in the overall
Exchange training program based on their everyday
experience with the consumer.
The Exchange's Governance Team refers to its leadership.
116 10/24/2012 140 Appendix B
Is the self-help for the IVR and website or would
consumers have access to the CRMs? For what purpose? Which call centers are included?
Yes, the self help is for the IVR and website.
The Call Centers references
are call centers of stakeholder agencies where
the Vendor will provide "warm" or "cold" transfer of
the consumers depending on the type of their inquiry.
117 10/24/2012 146 Appendix B
Please clarify what is meant by “all applicable locations
where the services are performed.”
CRM system should be centralized if the vendor uses several locations for its staff.
118 10/24/2012 146 Appendix B
Is “Exchange” referring to the Exchange staff or is it
meant to include consumers?
The Exchange staff.
119 10/24/2012 146 Appendix B
Is the knowledge database to be viewed by consumers?
Via what channels? For example, would the HIX portal have a link to the knowledge database?
Elements of the knowledge database will be shared on
the Web Portal.
120 10/24/2012 152 and 159
Appendix B
Please confirm that this is a requirement of the ACD
rather than the CRM.
This is a requirement of the ACD.
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121 10/24/2012 226 Appendix B
Per #226 in Appendix B – "The vendor shall actively
participate in the Exchange Change Management
process in coordination with the State's System Integrator Change
Management process." Can the State please provide
bidders with the Exchange's Change
Management process and the State's System
Integrator's Change Management process?
It will be provided to the selected vendor once it
becomes available.
122 10/24/2012 236 Appendix B
Per #236 in Appendix B – "The vendor shall provide an
Impact Analysis and Risk Management plan, including
mitigations and contingencies, to minimize the business and technical risks in the implementation
of the Exchange Call Center services." Can the State please clarify when this
plan is due?
Initial plan should be provided within 30 calendar days of the
Vendor on board. The Plan will have to be updated and
maintained throughput the life of the project.
123 10/24/2012 240 Appendix B
Per #240 in Appendix B – "The vendor shall ensure
that DR Plans comply with the Exchange external audit
requirements." Can the State please provide its
external audit requirements?
It will be provided to the selected vendor once it
becomes available.
124 10/24/2012 244 Appendix B
Per #244 in Appendix B – "The vendor shall test all DR processes at least annually against stated DR Service
Levels and provide a copy of test results comparing actual test recovery times to stated
DR Service Levels to the Exchange for review." Can the State please provide its DR Service Levels?
It will be provided to the selected vendor once it
becomes available.
125 10/24/2012 280 Appendix B
Please clarify the types of status updates envisioned. Since the web portal is not managed by the vendor,
how would status updates be provided via web link?
Status of open tickets could be communicated through e-
mail or other preferred method of communication that the client specified.
126 10/24/2012 304 Appendix B What is meant by "service,
region, and classification"?
The structure of the monthly report will be confirmed with
the selected vendor.
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127 10/24/2012 305 Appendix B
What is meant by requests? Is this the same as calls by
type? Yes.
128 10/24/2012 307 Appendix B Please clarify what is meant
by this requirement. Known system related errors
indentified by the clients
129 10/24/2012 313 Appendix B
Please provide examples of what is referred to as "open
request".
Specific categories of requests will be tracked by
the Vendor through resolution. These requests
will remain open until they are resolved and closed.
130 10/24/2012 321 Appendix B
Please clarify what is meant by "Skillset reports"--is this the same as level of activity
in each tier?
This is an industry term. Example skillset reports may
include number of calls handled by type of agent
skillset (e.g. broker skillset, tier 1 general inquiry, tier 2),
average call length by skillset, etc.
131 10/24/2012 329 Appendix B
What kind of "new Exchange requests" would this
involve?
The Exchange will require the vendor to have flexibility for changes and unforeseeable circumstances following the
roll out of the solution
132 10/24/2012 330 Appendix B What is meant by "market
information"? Please refer to question #10.
133 10/24/2012 NA General
What is the intention of the State concerning ownership of assets purchased for use
during the course of this project? Will the State be taking ownership of the
assets implemented during the course of the Stand Up
phase, or will that ownership be with the vendor?
Please propose pricing to cover purchased assets. The
State desires a vendor to leverage their own
infrastructure as much as possible.
134 10/24/2012 NA General
What is the role of the Exchange Call Center in
processing paper and faxed applications and handling
missing verifications?
Please refer to questions 14 and 52.
135 10/24/2012 2.2.4.1 13
Provide multichannel access into the State
including Web, IVR, and Web-chat through a “no wrong door” approach
for a seamless consumer assistance
experience.
Will the Call Center vendor have the capability to
integrate our existing Web chat solution with the
Exchange’s Web portal? Or will the Exchange implement a new Web chat solution the Call Center vendor will have
access to?
Please refer to question #50 and 74.
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136 10/24/2012 Appendix B Item 193
1. If approved by the Exchange, make the
knowledge base available online to
consumers for consumer self-help.
Does the Exchange envision the consumer-accessible
knowledge base as a separate web portal or will it be made available through
integration with the Exchange Web portal?
Consumer facing knowledge base will be available as part
of the web portal.
137 10/24/2012 Appendix B Item 195
3. Manage content in conjunction with the
Exchange knowledge owners to insure
continued accuracy applicability of
knowledge elements to the State environment.
Does the Exchange envision that the Call Center vendor
will be responsible for writing and getting all content for
the Knowledge Base approved by various state agencies or will the state
agencies be responsible for providing content? Or will the state agencies need write/edit access to the
Knowledge Base? If so, please provide guidance on the anticipated number of
agencies and users.
Elements of the knowledge base that are to be shared on
the web portal will be reviewed and approved by
the Exchange and other applicable state agencies.
It is not anticipated that the stakeholder agencies will
need write/edit access to the vendor knowledge base, however may request to
review materials contained within the knowledge base for quality assurance purposes.
138 10/24/2012 Appendix B Item 269
The vendor shall conduct random
surveys of consumers immediately after they
have used the Call Center, and report the results of the random
survey to the Exchange each month. With these
monthly surveys, the vendor will include a
minimum survey sample of 25 percent of the requests reported.
Are surveys the responsibility of the
Exchange/IES vendor? Are surveys conducted by phone, or via the Web
portal?
The surveys following the integration with the Call
Center personnel may be conducted by either phone/IVR or web.
Surveys conducted through
the web will be reported on by the Exchange/IES vendor.
Surveys conducted through the phone will be reported on
by the Call Center BPO vendor.
139 10/24/2012 - - Is it a preference for you to
have a call-center in the state of Connecticut?
Although it is not mandatory for the selected vendor to
build a call center in Connecticut, the call center
should be located in the United States (preferably
Connecticut), with staff who are fluent in American
English. There must be dedicated Spanish speakers
as well.
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140 10/24/2012 - -
To the extent that the state would prefer to host a call-center in Connecticut, we
would have a modest preference for an earlier project start data to nail
down long lead items like location and office facilities. Does the state see it in its
best interest to reserve such flexibility for itself or is it simply not a possibility to
begin certain targeted work ahead of April 1, 2013?
The Exchange would not be able to begin targeted work
with the vendor before April 1, 2013.
Additionally, please refer to
question #139.
141 10/24/2012 Figure 1
With reference to Figure 1, will the vendor be required
to develop some of the content and information for
customers relative to healthcare reform or will this all be supplied by the state?
The vendor will develop the script related to health care reform and will forward it to
the Exchange for review and approval.
142 10/24/2012 Figure 1
With reference to Figure 1, you have indicated that this
call-center will be responsible for providing a
view of the relative quality of programs to customers
across tiers. Will all of the data corresponding to such assistance be available on a dashboard that is part of the
state's technology infrastructure?
To be determined.
143 10/24/2012 2.2.1
With respect to the narrative on section 2.2.1 -- how large is the current DSS benefits center by way of number of customer service agents?
To be determined.
144 10/24/2012 Figure 3
Figure 3 implies that any issues related to premium
billing should be referred to external carriers. Are you expecting that carriers will also have access to the
subsidies available to each customer?
Yes.
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145 10/24/2012 - -
Is it a reasonable expectation that the eligibility
determination, plan selection, enrollment and all
other consumer facing functions will also be
available to the Level 1 and Level 2 customer support
representatives?
Yes, however Medicaid specific information is only viewable by DSS licensed
employees.
146 10/24/2012 4.8
Cost/Pricing
Proposal
25
For Exchange Call Center operations costs starting September 1, 2013, the Responder
will include a cost proposal at a capitated Per Member Per Month
(PMPM) fee for all services, hosting,
licensing, operations, maintenance and
enhancements of the solution. Note that the PMPM fee should be
derived from estimates using utilization for a
target population described in Section
2.2.3: Volumetrics and should account for the
two interaction scenarios. The State expects however that
the Responder has the necessary expertise to properly anticipate load
and staffing requirements for the
Exchange Call Center. Responder services and responsibilities included
in the PMPM fee are listed in Appendix B:
Requirements Traceability Matrix.
In order to calculate the PMPM fee for operations costs, Responders are
relying on the accuracy of the estimates using
utilization for a target population described in
Section 2.2.3: Volumetrics, as well as their expertise to
properly anticipate call volume, call duration, and
staffing needs. Given that all of these assumptions are
estimates and there are no true statistics upon which to base the fixed PMPM fee,
should the PMPM fee prove to be incorrect by a variance of ten percent (10%) higher or lower, will the Exchange
agree to negotiate an equitable adjustment to
Responder’s price through an amendment or change
order to the Contract?
The Exchange will take this under consideration and discuss further with the
vendor finalists.
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147 10/24/2012
Appendix D –
Notices of Affirmation and Non-Discrimina
tion Representations and Warrantie
s Required
of Connecticut Health Insurance Exchange Vendors,
Good Faith
Efforts, paragraph
4)
42
The Contractor agrees to comply with the
statutes and regulations cited above as they
exist on the date of the Contract and as they may be adopted or
amended from time to time during the term of this Contract and any amendments thereto.
The enactment of new or modification of existing
applicable laws that may occur during the term of the Contract is unknown by the
parties at this time. Contractors are unable to price for such changes in
current law or for the enactment of new laws, and
we request that the Exchange add language to the Contract that the parties will negotiate an amendment
or change order to the Contract in order for
Contractor to meet such new or changed laws. Such
change order and amendment should also
include an equitable adjustment to Contractor’s
price for the services. It would be impossible to price for such unknown risks and
unfair to expect the Contractor’s services to
remain compliant with such new or changed laws without compensating
Contractor.
This requirement is not unique to the Exchange or
this project. Non discrimination and affirmative action provisions are part of
every existing contract a vendor has with any state
agency in Connecticut. The Exchange views this as the
vendor’s cost of doing business in the state.
148 10/24/2012 General Proposed Terms and Conditions
Would the Exchange clarify whether it intends to
negotiate contract terms and conditions prior to awarding and executing the Contract?
In addition, would the Exchange clarify how
Responders are to submit, with the proposal, any
“contractual differences”, “exceptions” and “variations”
to the RFPs terms and conditions that Responder would like the Exchange to
consider for Contract negotiations?
It is our understanding that
the Contract terms and conditions will be posted on the Exchange’s website as
soon as it is completed.
Most of the contract Terms and Conditions are not negotiable due to state
requirements. If a vendor has questions or concerns related
to specific areas, please submit those in a separate
attachment titled "Terms and Conditions Exceptions" along
with the RFP response. Please note that the State will
be the final decision maker regarding what information is
to stay confidential.
The contract Terms and Conditions along with related
attachments are now available on the HIX website.
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149 10/24/2012
Table 3 – Consumer
Support Scenarios and Cost Proposal Template
13 and 26
Please explain how the contractor will actually be compensated. Will actual consumer interaction be compared to the planned
interaction of each scenario? Will the vendor be paid
based upon which is closer? How often will this
comparison be done?
Please propose a pricing methodology you would find
acceptable.
Please also refer to question #146.
150 10/24/2012
Table 1 and 2 –
Volumetrics and Cost Proposal Template
11 and 26
Please define a member for purposes of the denominator of the PMPM. In reference to those identified in Tables
One and Two, does it include:
• The open enrollment exchange population
• The DSS Medicaid Newly Eligible Population
• The Low-Income Children Population
• The Current Medicaid Population?
The vendor should scale up its operations (staff and otherwise) for the open
enrollment period.
For steady state, it is expected that the majority of
the current Medicaid population will be able to
renew their benefits automatically.
PMPM estimates should
account for both open enrollment and steady state.
151 10/24/2012
Table 1 and 2 –
Volumetrics and Cost Proposal Template
11 and 26
When does an individual become a “member” for PMPM purposes? For
example, if no enrollment is effective prior to January 1,
2014, should the vendor assume no PMPM for the
months of September through December 2013?
An individual becomes a member on September 1, 2013 for PMPM purposes.
An individual's benefits begin on January 1, 2014. See section 4.8 of the RFP for
further details.
152 10/24/2012
Table 1 and 2 –
Volumetrics and Cost Proposal Template
11 and 26 Would CT please provide an
estimate of members for each month of the contract?
The Exchange cannot provide an estimate at this time.
153 10/24/2012 4.8 Cost Proposal 26
Is the Contractor’s PMPM expected to remain the
same throughout the term of the contract including
extensions?
Yes.
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154 10/24/2012 4.8 Cost Proposal 26
Please elaborate on the inclusion of broker
compensation in the Bidder’s PMPM under
Scenario One.
Are the brokers to be employees of the contractor
and paid a salary by the contractor?
The Exchange will not compensate brokers for any
services under any circumstance.
155 10/24/2012 4.8 Cost Proposal 26
Would the State please elaborate on the Vendor’s
responsibilities regarding the brokers? Is the Call Center Vendor expected to recruit,
screen, hire, train and oversee the work of all brokers? Or, is the Call
Center Vendor expected to only provide office space and furniture for brokers?
This has not yet been determined.
156 10/24/2012 4.8 Cost Proposal 26
What responsibilities does the Call Center Vendor have
with regard to supervision for the brokers?
The State will bear no responsibility for the
supervision of brokers. Please follow industry
standards.
157 10/24/2012 4.8 Cost Proposal 26
Please elaborate on the inclusion of broker
compensation in the Bidder’s PMPM under
Scenario Two.
This has not yet been determined.
158 10/24/2012 2.2.3
Volumetrics
11
Does CT have an estimate of how of many of these
individuals will actually enroll in a QHP?
95,000 - 150,000 individuals
159 10/24/2012 2.2.3
Volumetrics
11 - 13
As it relates to the columns in table 3, please confirm
that the entire user population is expected to use the Exchange Call Center for the columns
labeled “simple inquiry or IVR support” as well as
“MAGI eligibility support”.
It is expected that the entire user population is expected to use the Exchange call center.
160 10/24/2012 2.2.3
Volumetrics
11 - 13
As it relates to the columns in table 3, please confirm that the column labeled “QHP plan enrollment”
would exclude all Medicaid and Husky B individuals as they would be enrolled by
DSS.
Yes.
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161 10/24/2012 2.2.3
Volumetrics
11 - 13
As it relates to the columns in table 3, please confirm that the Call Center would
assist those that have already made a plan choice, while licensed brokers must assist those who have not
yet chosen.
Yes.
162 10/24/2012 2.2.3
Volumetrics
13
Does CT have any estimates of the amount of time each Tier One or Tier
Two customer contact would take?
Please follow industry standards and benchmarks.
163 10/24/2012 2.2.3
Volumetrics
11
Please elaborate on the instances where the current
Medicaid population of 616,655 is expected to utilize the Call Center.
They might only call for an initial inquiry and then be
transferred to DSS.
164 10/24/2012 2.2.3
Volumetrics
11
Please elaborate on the instances where those newly
eligible for Medicaid on a regular basis are expected to utilize the Call Center.
Please refer to question #163.
165 10/24/2012 2.2.4.1
Simplified Citizen Access
13
This section mentions web-chat. Is the Call Center vendor is responsible for providing this service? It
does not appear so in table 2.1.2. Is the estimated
number of contacts included in the Table 3 data?
Please refer to question #50.
166 10/24/2012 Appendix B, Section 2.02, Item
75
4
Call Center standards have a direct bearing on price.
Would CT consider removing the 99%
requirement as the 90% and 95% standards still provide
quality service?
No. Please also refer to question #90.
167 10/24/2012 Appendix B, Section 2.02, Item
75
4
Call Center standards have a direct bearing on price.
Would CT consider relaxing or waiving standards during
initial and/or open enrollment, resulting in more competitive pricing to CT?
Please refer to question #166.
168 10/24/2012 Appendix B, Section 2.02, Item
76
4 (App B)
Please confirm that this standard relates to the amount of time for a
consumer to reach the IVR/recorded message and
that item 75 is the live answer standard after the caller clears this message.
The caller should reach the IVR within 20 seconds of calling. They should also reach a live rep within the
standards identified in Item 75.
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169 10/24/2012
Tier 1 Exchange
Call Center
and Appendix B, Item 81
12 and 5 – (app B)
It appears on page 12 that Tier One inquiries are
expected to be resolved in three minutes, while in Appendix B Item 81 it
appears that the standard for all Tier One calls is 9.5 minutes or less. Could CT
please provide the calculations and estimates for the MAGI Eligibility and QHP health plan support
Tier One calls that result in the overall standard
expected of 9.5 minutes?
These metrics will not be available until the Exchange
is fully operational.
170 10/24/2012 Appendix A BP-
CA-FS-06 35 of 43
In the business model it is noted the consumer will be
sent a consumer Re-enrollment packet. Will the
Call Center Vendor be expected to mail Re-
enrollment packets to the consumer or will the Call Center Vendor notify the
Exchange to send a packet? Will the Call Center Vendor
have responsibilities for mailing packets? If so, how
many packets should the Call Center Vendor
anticipate it will be mailing?
Please refer to question #14.
171 10/24/2012 Appendix A BP-
CA-FS-06 35 of 43
In the business model it is noted the Call Center
Vendor will receive and review completed Re-
Enrollment packets. What criteria should be used to
review the completed packet? Will the review
consist of ensuring all items are completed or is the
review a more sophisticated process? Will any
supporting verification documents be submitted in the Re-enrollment packets? Will the Call Center Vendor
be responsible for identifying that any supporting
documents are acceptable types of information? Will the Call Center Vendor be
required to verify any of the information supplied by the
consumer?
The Call Center is not responsible for enrollment or
re-enrollment collateral. These items may be provided
to the Call Center for reference or review only.
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172 10/24/2012 Appendix A BP-CA-
FS-07 36 of 43
In the business model it is noted the Call Center Vendor will receive a
notification to Change Status from EMS. The next step for the Call Center Vendor is to request a verification CA-
FS-07.30. Is the expectation the Call Center Vendor will call every consumer that
requests a change of status and verify the request generated by EMS?
What information is being
requested that will verify the change request?
Please refer to question #14.
173 10/24/2012 General Question n/a
Please elaborate on the contractor’s responsibilities related to SHOP, interaction with employers, and whether these have been reflected in
the volume estimates provided in the RFP.
The Call Center will have no responsibilities related to
SHOP.
174 10/24/2012 General Question
Does the CT HIX and/or its affiliates have a list of approved Connecticut
Licensed Health Insurance Brokers?
Yes. A list will be provided to the selected vendor.
175 10/24/2012 Appendix B #226
Where may a copy of the “System Integrator Change Management process” be
obtained?
This will be provided to the selected vendor.
176 10/24/2012 Appendix B #291
Where may a copy of the “State Approved Security Process” be obtained?
This will be provided to the selected vendor.
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177 10/24/2012 2.2.2 What is the CT HIX’s
definition of “warm transfer” and “cold transfer”?
A warm transfer is when a Call Center customer service representative transfers a call
and introduces the caller to the transfer party. A cold transfer is where a call is
transferred without introduction and the Call Center customer service
representative hangs up once the transfer is complete.
178 10/24/2012 2.2.2 10 Figure 3: Future Environment
What information will the IVR need to pass through to the ConneCT IVR during a
call transfer?
Please confirm that the State will be responsible for programming their IVR to receive any required data.
Please refer to question #60.
179 10/24/2012 2.2.2 10 Figure 3: Future Environment
Will the Exchange require single sign-on capabilities
between the Exchange and the CRM?
No.
180 10/24/2012 2.2.2 10 Figure 3: Future Environment
Please confirm that the Exchange Call Center vendor will utilize the
Exchange’s ESB to connect to information maintained by
the Exchange vendor or state systems as required to
support data exchange.
Please provide information on the ESB and web services capabilities.
Please refer to question #21.
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181 10/24/2012 2.2.2 10 Figure 3: Future Environment
Please clarify the responsibilities of the Call Center vendor in assisting the Exchange in accepting
payments.
Will the call center staff be required to accept payments
during enrollment utilizing the Exchange system?
Will the IVR be required to
accept payments? If so, can the call center vendor utilize
the
Exchange’s banking partner to do so instead of incurring
additional costs for a separate banking vendor?
No payments will be made to the Call Center or the
Exchange. The carriers will manage all billing and collection of payments.
182 10/24/2012 2.2.2 10 Figure 3: Future Environment
Will the state please confirm that there will need to be an
initial population of information to the CRM?
Will the Exchange be the anticipated source of this
initial information?
Is there additional information that needs to be converted from other state
systems?
If so, will the call center vendor be responsible for
that conversion?
What is the anticipated volume of that data?
No.
183 10/26/2012 Will the State consider
@Home as a possible agent delivery strategy?
Please refer to question #29
184 10/26/2012
Will chat and email also be available delivery channels?
If so, what percent of contacts are expected
through each.
Please refer to question #50.
185 10/26/2012
Regarding the facility requirement? dedicated,
secured, walled off, separate card access, etc?
The Exchange will work with the selected vendor to
determine the minimum security requirements at that
time.
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186 10/26/2012
What is the estimated Average Handle Time for tier
2 and licensed broker transactions?
Please follow industry standards and bechmarks.
187 10/26/2012
What is the language breakdown (ie. % English, % Spanish, other language line
estimates)
The State expects the Responder to have the necessary expertise to
properly anticipate load and staffing requirements for the
Exchange Call Center.
188 10/26/2012
Please clarify survey requirements. What
constitutes 25%, is 100% captured and 25% reported?
Yes.
189 10/26/2012
What percent of calls need to be recorded?
Are we required to record voice and screen?
How long do these need to be stored?
Please refer to question #86.
Only voice recordings are required.
190 10/26/2012
Is there a minimum number quality monitors to be
performed per agent per month or will that be
determined by the QA Vendor?
Please refer to questions #31 and #32.
191 10/26/2012 What is the estimated % or
number of escalations to tier 2, tier 3, licensed brokers?
Please refer to question #1.
192 10/26/2012
What percentage of the QHP Plan Enrollment calls
would need to be transferred to a broker?
Where are these brokers? Are they contracted by the
vendor in different locations or provided by Exchange
Call Center?
Please refer to question #1.
Please also refer to question #26.
193 10/26/2012
Standard background checks are as follows, please confirm that this
meets your requirements:
7 year criminal search SSN Trace (to develop
addresses for the criminal search)
OFAC (terrorist watch list) National Criminal Database
Search 5 panel drug test
The Exchange will work with the selected vendor to
determine the minimum background check
requirements at that time.
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194 10/26/2012
What isthe estimated training length assumption
for all skills in scope? Tier 1 Tier 2
Licensed Broker Other please specify
Are there additional nesting requirements?
Is there a required # of hours per month for ongoing
or up training?
Please refer to question #64.
195 10/26/2012 Please specify your physical
and logical security requirements?
Please refer to question #185.
196 10/26/2012
Are there required minimum support ratios or will we be expected to use our best practices to determine?
Please refer to question #1.
197 10/26/2012
The RFP was not widely available until Oct. 12 and it
is also rather complex. Further, responses to questions will have an
impact on design. Could the due date be extended until
11/19?
The RFP was made available to the public on October 5,
2012.
The due date remains 5:00pm EST, Monday,
November 5, 2012.
198 10/26/2012
Could you clarify the pricing methodology requested – PMPM fee? Would it be based on the 931,000
members in Steady State?
Please refer to question #150.
199 10/26/2012 Is prior medical/insurance
experience required for tier 2 agents or preferred?
While not required for all Tier 2 Call Center personnel, a
majority of all Tier 2 personnel should have prior
medical/insurance experience.
Also please refer to question
#64.