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Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
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, a general contract terms and conditions
document will be posted on the CTHIX website as soon
as it is completed.
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 10/24/2012
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 10/24/2012
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 10/24/2012
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 10/24/2012
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 10/24/2012
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 10/24/2012
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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.
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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.
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
39 10/24/2012 Appendi
ces- 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 Appendi
x 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 Appendi
x 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.
42 10/24/2012 Appendi
x 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 Appendi
x 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 Appendi
x 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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
45 10/24/2012 Appendi
x 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 Appendi
x 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 Appendi
x E 43
Appendix E – Notice of State Ethics Representations and Certifications Required of
Connecticut Health Insurance Exchange Vendors
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.
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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.
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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.
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.
Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012
Question #
Date of Answer
RFP Section
#
RFP Page #
RFP Text / Reference Question Answer
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.
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 Appendi
x 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 Appendi
x A 30 Who handles Tier 0?
This is the self service web portal.
76 10/24/2012 Appendi
x 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.
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77 10/24/2012 Appendi
x 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 Appendi
x A 33
Is the CRM in Tier 0 the call center vendor’s CRM?
No. The Portal is Tier 0.
79 10/24/2012 Appendi
x 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 Appendi
x A 35
Is the call center vendor expected to scan and index re-enrollment packets? In what document repository?
See answer to question #14.
81 10/24/2012 Appendi
x 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 Appendi
x 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 Appendi
x A 38
Who is the supervisor in Tier 3?
Tier 3 is supervised by the Exchange.
84 10/24/2012 Appendi
x 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 Appendi
x B Item #52
What is the purpose of the web cams?
For potential future use.
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86 10/24/2012 Appendi
x 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 Appendi
x B Item #65
What is the purpose of the IVR periodic call list?
This will be used for Customer satisfaction
surveys.
88 10/24/2012 Appendi
x 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 Appendi
x 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 Appendi
x 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.
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91 10/24/2012 Appendi
x 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 Appendi
x 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
93 10/24/2012 Appendi
x 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 Appendi
x 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 Appendi
x B Item #193
Whose online solution is
this?
Transferrable NextGen Healthcare Information Systems, LLC solution provided by Deloitte
Consulting LLP.
96 10/24/2012 Appendi
x B Item #199
What online solution is used to invoke the chat feature?
See answer to question 50 and 74
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97 10/24/2012 Appendi
x 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.
98 10/24/2012 Appendi
x 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
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104 10/24/2012
4.8. Cost/Pric
ing 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.
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
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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.
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 Appendi
x 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 Appendi
x 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 Appendi
x 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/Pric
ing 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-
Discrimination
Representations
and Warranti
es Required
of Connecti
cut Health
Insurance
Exchange
Vendors, Good Faith
Efforts, paragrap
h 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 Scenario
s and Cost
Proposal Templat
e
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 Templat
e
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 Templat
e
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 Templat
e
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 Exchang
e 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 Appendi
x 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 Appendi
x 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.