da.ks.govda.ks.gov/purch/Contracts/Default.aspx?getfile=EVT... · Web viewWithin ninety (90) days of this order, all Executive Branch employees, interns, and contractors under the

Exhibit 1 – Technical ProposalBid Event #EVT0005965

Bid Response: (company name)Page 1 of 64

SECTION IRegistration, Event Notice and Acknowledgement of Addenda

The Event Document as posted on the Office of Procurement and Contracts website and the acknowledgement of addenda posted for the bid event must be submitted as Section One of the Technical proposal.

Vendors may also submit an executive summary not to exceed three pages, explaining why they feel they are the best option for the State Employee Health Plan (SEHP) Wellness Program.

The State of Kansas implemented a PeopleSoft Financial Management System (named SMART) in July 2010. In order to submit a response to any bid event, a vendor must be registered in SMART. It is very important for you to register your business with Procurement and Contracts, for the following reasons:

To bid on events, registered bidders must be invited in SMART by the Procurement Officer BEFORE the bid closes.

If invited, registered bidders will be able to receive bid event documents via e-mail. If not invited by the Procurement Officer, registered bidders will still receive notification of bid

events based on their category code registration.

Registration may be accomplished by:

1. Identifying the category codes you would like to be associated with your bidder record. This should be completed prior to completing the bidders registration.

A full list of category codes is available at: http://www.da.ks.gov/purch/SMARTCategoryCodes.xls Note that this is a large file (5mb). It may be beneficial to identify the applicable category codes prior to beginning the registration process. The State uses the UNSPSC category code system which includes over 40,000 codes. For ease of identifying codes that may apply to your business, you may search this document by selecting Ctrl+F on your keyboard, then typing key words that may apply to your business. If you find no results, select a different key word. For example, vehicles are listed under automobiles or cars.

2. Completing the form on the following website (to include the category codes that you have selected) http://admin.ks.gov/offices/procurement-and-contracts/bidder-registration

3. Submitting a completed W-9 Form.E-mail a copy of your signed and dated W-9 Form (with a signature no more than six (6) months old) to [email protected] or fax it to 785-296-7240. Your bidder registration will NOT be processed until we have the W-9 Form. You may download a copy of the current W-9 Form at the IRS website: http://www.irs.gov/pub/irs-pdf/fw9.pdf

Please do not submit another application once you have registered. If you need to make changes to your bidder record (i.e. changes to contact information, address changes, add/delete commodity codes, etc.) please email those changes to [email protected]. Please include your company name and taxpayer identification number to assure that the correct record is updated.

After your application has been processed, you will receive an email confirming that your application has been approved. If you have any questions regarding the bidder application, please call: 785-296-2376

mailto:[email protected]

http://www.irs.gov/pub/irs-pdf/fw9.pdf


http://admin.ks.gov/offices/procurement-and-contracts/bidder-registration

http://www.da.ks.gov/purch/SMARTCategoryCodes.xls



SIGNATURE SHEET

Item: Wellness ProgramClosing Date: 2:00 PM Central Time, August 30, 2018Agency: Kansas State Employees Health Care Commission

Certification of Capabilities:By submission of a bid and the signatures affixed thereto, the bidder certifies all products and services proposed in the bid meet or exceed all requirements of this specification as set forth in the request and that all exceptions are clearly identified.

Conflict of Interest:I hereby certify that I (we) do not have any substantial conflict of interest sufficient to influence the bidding process on this bid. A conflict of substantial interest is one which a reasonable person would think would compromise the open competitive bid process.

Addendums to the RFP: The undersigned acknowledges receipt of the following addenda:

#1( ) #2( ) #3( ) None ( )

Legal Name of Person, Firm or Corporation

Mailing Address City & State Zip

Toll Free Telephone Local Cell: Fax

Tax Number E-Mail

Signature Date

Typed Name Title

In the event the contact for the bidding process is different from above, indicate contact information below.

Bidding Process Contact Name



E-Mail



Back-up Contact Name



E-Mail

If awarded a contract and purchase orders are to be directed to an address other than above, indicate mailing address and telephone number below.



E-Mail



VENDOR CONTACT INFORMATION

To facilitate the Request for Proposal (bid event) process, we ask that each Vendor designate a main contact person as well as an alternate contact should the main contact be unavailable. Please complete the following regarding that designated persons. The State has designated contact information listed in this document.

Primary Contact: ____________________________________________

Title: ______________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone Number: ________________ Fax Number: _________________

Email Address: ______________________________________________

Alternate Contact: ___________________________________________

Title: ______________________________________________________

Address: ___________________________________________________ ___________________________________________________

Phone Number: ________________ Fax Number: _________________

Email Address: ______________________________________________



TAX CLEARANCEThe Health Care Commission in process of procurement per K. S. A. 75-6504, requests the Office of Procurement and Contracts to review tax clearance status of all Contractors. Per KSA 75-3740-(c), the Director of Procurement and Contracts may reject the bid of any bidder who is in arrears on taxes due the State of Kansas. The Office of Procurement and Contracts will confirm tax status of all potential Vendors and subcontractors prior to the release of a purchase order or contract award. The State of Kansas reserves the right to allow a bidder an opportunity to clear tax status within ten (10) calendar days, or to proceed with award to the next lowest responsive bidder, whichever is determined by the Director of Procurement and Contracts to be in the best interest of the State. The Secretary of Revenue is authorized to exchange such information with the Director of Procurement and Contracts as is necessary to determine the bidder’s tax clearance status, notwithstanding any other provision of law prohibiting disclosure of the contents of taxpayer records or information.

Instructions on how to check Tax Clearance Status can be found at the following website: http://www.ksrevenue.org/taxclearance.htm

Information about Tax Registration can be found at the following website: http: //www.ksrevenue.org/busregistration.htm

http://www.ksrevenue.org/busregistration.htm

http://www.ksrevenue.org/taxclearance.htm



Contact Information: Please provide the attached contact information for use should the State of Kansas need to contact the appropriate officials within your company to discuss your tax clearance / registration status.

VENDOR

Contact Person for Tax Issues:

Company Name: Tax Number:

Mailing Address

City & State Zip Code


E-Mail

SUBCONTRACTOR(S)

Contact Person for Tax Issues:

Company Name: Tax Number:

Mailing Address

City & State Zip Code


E-Mail

Additional pages may be added, as required, indicating the same information for multiple subcontractors. All subcontractors must be identified.



CERTIFICATION REGARDINGIMMIGRATION REFORM & CONTROL

All Contractors are expected to comply with the Immigration and Reform Control Act of 1986 (IRCA), as may be amended from time to time. This Act, with certain limitations, requires the verification of the employment status of all individuals who were hired on or after November 6, 1986, by the Contractor as well as any subcontractor or sub-subcontractor. The usual method of verification is through the Employment Verification (I-9) Form. With the submission of this bid, the Contractor hereby certifies without exception that Contractor has complied with all federal and state laws relating to immigration and reform. Any misrepresentation in this regard or any employment of persons not authorized to work in the United States constitutes a material breach and, at the State’s option, may subject the contract to termination and any applicable damages.

Contractor certifies that, should it be awarded a contract by the State, Contractor will comply with all applicable federal and state laws, standards, orders and regulations affecting a person’s participation and eligibility in any program or activity undertaken by the Contractor pursuant to this contract. Contractor further certifies that it will remain in compliance throughout the term of the contract.

At the State’s request, Contractor is expected to produce to the State any documentation or other such evidence to verify Contractor’s compliance with any provision, duty, certification, or the like under the contract.

Contractor agrees to include this Certification in contracts between itself and any subcontractors in connection with the services performed under this contract.

____________________________________________ ______________________Signature, Title of Contractor Date



Policy Regarding Sexual Harassment

WHEREAS, sexual harassment and retaliation for sexual harassment claims are unacceptable forms of discrimination that must not be tolerated in the workplace; and

WHEREAS, state and federal employment discrimination laws prohibit sexual harassment and retaliation in the workplace; and

WHEREAS, officers and employees of the State of Kansas are entitled to working conditions that are free from sexual harassment, discrimination, and retaliation; and

WHEREAS, the Governor and all officers and employees of the State of Kansas should seek to foster a culture that does not tolerate sexual harassment, retaliation, and unlawful discrimination.

NOW THEREFORE, pursuant to the authority vested in me as Governor of the State of Kansas, I hereby order as follows:

1. All Executive Branch department and agency heads shall have available, and shall regularly review and update at least every three years or more frequently as necessary, their sexual harassment, discrimination, and retaliation policies. Such policies shall include components for confidentiality and anonymous reporting, applicability to intern positions, and training policies.

2. All Executive Branch department and agency heads shall ensure that their employees, interns, and contractors have been notified of the state’s policy against sexual harassment, discrimination, or retaliation, and shall further ensure that such persons are aware of the procedures for submitting a complaint of sexual harassment, discrimination, or retaliation, including an anonymous complaint.

3. Executive Branch departments and agencies shall annually require training seminars regarding the policy against sexual harassment, discrimination, or retaliation. All employees shall complete their initial training session pursuant to this order by the end of the current fiscal year.

4. Within ninety (90) days of this order, all Executive Branch employees, interns, and contractors under the jurisdiction of the Office of the Governor shall be provided a written copy of the policy against sexual harassment, discrimination, and retaliation, and they shall execute a document agreeing and acknowledging that they are aware of and will comply with the policy against sexual harassment, discrimination, and retaliation.

5. Matters involving any elected official, department or agency head, or any appointee of the Governor may be investigated by independent legal counsel.

6. The Office of the Governor will require annual mandatory training seminars for all staff, employees, and interns in the office regarding the policy against sexual harassment, discrimination, and retaliation, and shall maintain a record of attendance.

7. Allegations of sexual harassment, discrimination, or retaliation within the Office of the Governor will be investigated promptly, and violations of law or policy shall constitute grounds for disciplinary action, including dismissal.

8. This Order is intended to supplement existing laws and regulations concerning sexual harassment and discrimination, and shall not be interpreted to in any way diminish such laws and regulations. The Order provides conduct requirements for covered persons, and is not intended to create any new right or benefit enforceable against the State of Kansas.



9. Persons seeking to report violations of this Order, or guidance regarding the application or interpretation of this Order, may contact the Office of the Governor regarding such matters.

Agreement to Comply with the Policy Against Sexual Harassment, Discrimination, and Retaliation.

I hereby acknowledge that I have received a copy of the State of Kansas Policy Against Sexual Harassment, Discrimination, and Retaliation established by Executive Order 18-04 and agree to comply with the provisions of this policy.

____________________________________ ___________________________________ Signature and Date Printed Name



CERTIFICATION OF COMPANYNOT CURRENTLY ENGAGED IN A BOYCOTT OF GOODS or SERVICES FROM ISRAEL

In accordance with HB 2482, 2018 Legislative Session, the State of Kansas shall not enter into a contract with a Company to acquire or dispose of goods or services with an aggregate price of more than $100,000, unless such Company submits a written certification that such Company is not currently engaged in a boycott of goods or services from Israel that constitutes an integral part of business conducted or sought to be conducted with the State.

As a Contractor entering into a contract with the State of Kansas, it is hereby certified that the Company listed below is not currently engaged in a boycott of Israel as set forth in HB 2482, 2018 Legislature.

____________________________________________ ______________________Signature, Title of Contractor Date

____________________________________________Printed

____________________________________________Name of Company



Kansas Open Records Act (KORA)This bid process will follow Kansas law, including the Kansas Open Records Act (KORA),

K.S.A. 45-215 et seq., Per K.S.A. 45-217, “public records” include any information held by a

state agency. As outlined in 1.14 of the instructions for the bid document included with the RFP

and in compliance with guidance from the Kansas Department on Administration, (SEHP / HCC)

will consider all documents included with any submitted proposals as “public records” and

subject to release under KORA.

SEHP will apply two limited exceptions. First, submitted materials will not be released while the

bid process is ongoing. This exception ends for all bidders once a contract award is made and

the vendor contract is signed. Second, the information that is specifically responsive to the

questions stated in Exhibit 3 of the RFP will be considered confidential and destroyed upon the

award of a contract. After destruction of the Exhibit 3 responses, the remaining technical and

cost proposal materials will be treated as public records and available under KORA.

Please confirm your understanding that your entire bid will be open and subject to KORA except for the exceptions noted above. If this is not acceptable, please do not submit your bid.

ACKNOWLEDGE AND ACCEPT

I hereby acknowledge that I have read the KORA requirements above and comply with the provisions of this policy.

_________________________________________________Authorized Signature of Vendor

_________________________________________________Date



SECTION IIVendor Qualifications

If you believe that a particular question is not applicable to the services you are bidding, please briefly explain why. If you have described a program/service or other content and it applies to multiple questions, simply refer us to the prior description. Please do not repeat your answers. 2.01 Organizational Structure and History

2.01.1 Provide a brief history of your organization including: date established; ownership (public, partnership, subsidiary, etc.) nature of business and any additional programs/products offered in addition to the health benefit programs proposed; licenses and certifications held; awards earned.

Answer: 2.01.2 Is your organization part of a national or regional organization or affiliated with any other

company? If yes, provide the corporation’s name and address. Describe these relationships and how it impacts your operation and delivery of services.

Answer: 2.01.3 List each subcontractor and/or sister corporation performing work on this contract and the

location where the work will be done. Disclose any services under this RFP or your operations that are related to this RFP that are to be provided by workers outside of the United States.

Answer: 2.01.4 Describe the number and nature of personnel, full and part time, assigned to this project by

function and job title. If awarded a contract, indicate who within your organization will be assigned responsibility to manage or service the State account. Provide a brief bio about each person who will be assigned responsibility for the State account including their education and work experience, years with the company and areas of specialization, if any.

Answer: 2.01.5 Provide an executive level organizational chart for the company. Provide a unit chart, including

the group to be assigned responsibility for this contract, if awarded. Answer: 2.01.6 In your experience what are the essential elements of a successful partnership for an employee

wellness program. Answer: 2.01.7 What is the annual turnover rate by year for the past five (5) years for each of the following units:

Account Management Customer Service IT Staff

Answer:

2.02 References 2.02.1 Provide references from three current clients (implementation within the past 3 years, if possible)

to whom you are or have provided similar services proposed in this RFP. Public sector clients with over 10,000 covered lives are preferred. Also preferred would be clients who have worked with the person to be assigned to this account. Information should include:

Company Name Contact Person Address Phone number Email Services provided

If terminated, reason for terminationAnswer: 2.02.2 Provide references from three former clients (within last 3 years) to whom you have provided



similar services proposed in this RFP. Public sector clients with over 10,000 covered lives are preferred. Also preferred would be former clients who have worked with the person to be assigned to this account. Information should include:

Company Name Contact Person Address Phone number Email Services provided

If terminated, reason for terminationAnswer: 2.02.3 Indicate the size of groups in your corporate book of business.Answer:

Group Size in Covered Lives

# of Groups in Book of Business

# of Groups with Coinsurance based plan

designs

# of Group Plans with integrated

medical/pharmacy benefits

< 5,000

5,001 – 10,000

10,001 – 25,000

25,001 – 50,000

50,001-100,000

over 100,000

2.02.4 How many public sector groups does your company service?Answer: Types of Public Sector Groups: # of Groups

Local Government Entity - Please describe each typeState Government Public UniversitiesPublic School DistrictsOther – Please describe




have reviewed the Vendor Qualifications section of the Request for Proposal and acknowledge that the document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this section of Request for Proposal, subject to the modifications, conditions and limitations I have listed below.

Authorized Signature of Vendor

Printed Name of Signatory

Title

Date



Section IIIDA-146a, Sample Contract, and Business Associate Agreement

Please review the follow information prior to completing this section.

Vendors are expected to closely read the DA-146a, sample contract and BAA and provide a binding signature of intent to comply with such terms and conditions. The DA-146 is a required part on all State of Kansas contracts. All Vendors are required to agree to these provisions without modification. Any modifications of the DA-146 will result in the rejection of your bid.

The SEHP is not obligated to negotiate the provisions of the contract or BAA and reserves the right to accept or reject any bid that has made revisions or modifications in the required language. These provisions are a standard part of all State Employee Health Plan contracts. Any requested modifications to the contract or BAA must be submitted in red-line. It is expected that this will be done in red colored font so that the changes are easy to identify.

Note: If no edits are requested to the contract or BAA documents, please return the document marked “no edits required.”

Bidders agree by submitting a proposal in response to this RFP, the SEHP will draft the contract, including the HIPAA Confidentiality Agreement or Business Associate Agreement (BAA) as appropriate. Any negotiations regarding the contract and BAA documents will occur prior to the contract award. Once a contract is awarded, the State will draft the contract and the vendor is expected to sign it within 10 business days.

Should the SEHP be prevented or enjoined from proceeding with the acquisition before or after contract execution by reason of any litigation or other reason beyond the control of SEHP, Vendor shall not be entitled to make or assess claim for damages by reason of said delay.



DA – 146aState of Kansas Department of Administration DA-146a (Rev. 06-12)

CONTRACTUAL PROVISIONS ATTACHMENT

Important: This form contains mandatory contract provisions and must be attached to or incorporated in all copies of any contractual agreement. If it is attached to the vendor/contractor's standard contract form, then that form must be altered to contain the following provision: "The Provisions found in Contractual Provisions Attachment (Form DA-146a, Rev. 06-12), which is attached hereto, are hereby incorporated in this contract and made a part thereof."

The parties agree that the following provisions are hereby incorporated into the contract to which it is attached and made a part thereof, said contract being the _____ day of ____________________, 20_____.

1. Terms Herein Controlling Provisions: It is expressly agreed that the terms of each and every provision in this attachment shall prevail and control over the terms of any other conflicting provision in any other document relating to and a part of the contract in which this attachment is incorporated. Any terms that conflict or could be interpreted to conflict with this attachment are nullified.

2. Kansas Law and Venue: This contract shall be subject to, governed by, and construed according to the laws of the State of Kansas, and jurisdiction and venue of any suit in connection with this contract shall reside only in courts located in the State of Kansas.

3. Termination Due To Lack Of Funding Appropriation: If, in the judgment of the Director of Accounts and Reports, Department of Administration, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, State may terminate this agreement at the end of its current fiscal year. State agrees to give written notice of termination to contractor at least 30 days prior to the end of its current fiscal year, and shall give such notice for a greater period prior to the end of such fiscal year as may be provided in this contract, except that such notice shall not be required prior to 90 days before the end of such fiscal year. Contractor shall have the right, at the end of such fiscal year, to take possession of any equipment provided State under the contract. State will pay to the contractor all regular contractual payments incurred through the end of such fiscal year, plus contractual charges incidental to the return of any such equipment. Upon termination of the agreement by State, title to any such equipment shall revert to Contractor at the end of the State's current fiscal year. The termination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the agency or the contractor.

4. Disclaimer Of Liability: No provision of this contract will be given effect that attempts to require the State of Kansas or its agencies to defend, hold harmless, or indemnify any contractor or third party for any acts or omissions. The liability of the State of Kansas is defined under the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.).

5. Anti-Discrimination Clause: The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 et seq.) and the Kansas Age Discrimination in Employment Act (K.S.A. 44-1111 et seq.) and the applicable provisions of the Americans With Disabilities Act (42 U.S.C. 12101 et seq.) (ADA) and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission or access to, or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "equal opportunity employer"; (c) to comply with the reporting requirements set out at K.S.A. 44-1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract



or purchase order so that they are binding upon such subcontractor or vendor; (e) that a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration; (f) if it is determined that the contractor has violated applicable provisions of ADA, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration. Contractor agrees to comply with all applicable state and federal anti-discrimination laws. The provisions of this paragraph number 5 (with the exception of those provisions relating to the ADA) are not applicable to a contractor who employs fewer than four employees during the term of such contract or whose contracts with the contracting State agency cumulatively total $5,000 or less during the fiscal year of such agency.

6. Acceptance Of Contract: This contract shall not be considered accepted, approved or otherwise effective until the statutorily required approvals and certifications have been given.

7. Arbitration, Damages, Warranties: Notwithstanding any language to the contrary, no interpretation of this contract shall find that the State or its agencies have agreed to binding arbitration, or the payment of damages or penalties. Further, the State of Kansas and its agencies do not agree to pay attorney fees, costs, or late payment charges beyond those available under the Kansas Prompt Payment Act (K.S.A. 75-6403), and no provision will be given effect that attempts to exclude, modify, disclaim or otherwise attempt to limit any damages available to the State of Kansas or its agencies at law, including but not limited to the implied warranties of merchantability and fitness for a particular purpose.

8. Representative's Authority To Contract: By signing this contract, the representative of the contractor thereby represents that such person is duly authorized by the contractor to execute this contract on behalf of the contractor and that the contractor agrees to be bound by the provisions thereof.

9. Responsibility For Taxes: The State of Kansas and its agencies shall not be responsible for, nor indemnify a contractor for, any federal, state or local taxes which may be imposed or levied upon the subject matter of this contract.

10. Insurance: The State of Kansas and its agencies shall not be required to purchase any insurance against loss or damage to property or any other subject matter relating to this contract, nor shall this contract require them to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.), the contractor shall bear the risk of any loss or damage to any property in which the contractor holds title.

11. Information: No provision of this contract shall be construed as limiting the Legislative Division of Post Audit from having access to information pursuant to K.S.A. 46-1101 et seq.

12. The Eleventh Amendment: "The Eleventh Amendment is an inherent and incumbent protection with the State of Kansas and need not be reserved, but prudence requires the State to reiterate that nothing related to this contract shall be deemed a waiver of the Eleventh Amendment."

13. Campaign Contributions / Lobbying: Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement.




I have reviewed the DA146a and acknowledge that the document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this document.


_________________________________________________Printed Name of Signatory

_________________________________________________Title

_________________________________________________Date



CONTRACT TO PROVIDE

______________________________________

FOR THE KANSAS STATE EMPLOYEE HEALTH PLAN FOR

20___, 20___, and 20___

THIS CONTRACT is made and entered into this ______ day of _____________, 20_____, by and between the Kansas State Employees Health Care Commission (hereinafter referred to as “HCC”) and _________________________________ (hereinafter referred to as “Contractor”).

WHEREAS, the HCC wishes to provide _________________ for the self-funded Kansas State Employee Health Plan (hereinafter referred to as “Plan”);

WHEREAS, the State Employee Health Plan Staff within the Kansas Department of Health and Environment, Division of Health Care Finance (hereinafter referred to as “SEHP”) has been designated by the HCC to direct the day-to-day operations of the Plan;

WHEREAS, Contractor is a company holding itself out as having expertise in __________________________________ and desires to provide its services and expertise to the HCC; and,

WHEREAS, it has been determined by the HCC that the best interest of the HCC will be served by awarding a contract to Contractor to provide these services.

THEREFORE, in consideration of the mutual agreements contained below, the HCC and Contractor agree as follows:

1. Acceptance: Subject to the terms and conditions of this Contract, the HCC hereby accepts the offer of Contractor as expressed by:

a. Contractor’s Response to Request for Proposal #_______; b. Contractor’s technical proposal; and, c. Contractor’s Response to Request for Proposal #_______ involving pricing, as set forth

in Exhibit A, submitted to the HCC in response to Request for Proposal #_______ (hereinafter referred to as “RFP”).

2. Contract Documents: A. This Contract consists of the following documents, incorporated herein by direct or

indirect reference and in the following precedential order:(1) The DA146a;(2) The Business Associate Agreement;(3) The terms of this Contract; (4) The Addenda to the RFP, if any;(5) The RFP, which includes all Exhibits and Attachments; and(6) The Contractor’s Technical and Cost Proposal(s), including pricing schedules and

clarifications.



B. In the event of a conflict between or among the terms of the Contract Documents, the term in the Contract Document with the highest precedence will prevail. For example, the DA146a will have the highest precedence in relation to the other listed documents.

C. The documents identified in Section 2.a above constitute the entire agreement between

the parties and supersede all prior oral or written statements or agreements.

3. Term : The term of this Contract shall be 3 years beginning on January 1, ___________ and ending on December 31, ___________.

4. Deliverables: Contractor will provide ___________________ as specified by this Contract and the documents noted in Section 2 above. Pursuant to the RFP and documents noted in Section 2 above, Contractor will:

a. ____________________________________________; b. __________________________________________; c. (as many as needed to describe deliverables);

5. Deliverable Options: Contractor may have provided several options of deliverables to the HCC for services under this Contract in the cost proposal. The HCC reserves the option to select or deselect any of the proposed deliverables contained within the cost proposal during the term of the Contract.

6. Fees: a. For services provided by the Contractor under this Contract, the payment to the

Contractor shall be based on the Contractor’s Best and Final Offer that was presented to and accepted by the HCC and documented by the documents noted in Section 2 of this Contract.

b. The HCC agrees to pay the amount billed by the Contractor that is in conformance with this Contract and fee schedule subject to subsections c and d below.

c. Payment will be made in response to a monthly receipt of an invoice setting forth the total monthly fees and any retroactive adjustments, credits or fees and transmitted by a mutually agreeable method to an address designated by the HCC.

d. Contractor shall also provide the HCC or its delegee, SEHP, the billing data specified by the RFP and/or documents noted in Section 2 of this Contract in a mutually agreeable electronic format. Payment will not be made to the Contractor until the electronic data is submitted in the agreed-upon format to and received by the HCC or its delegee, SEHP.

e. Payment will be made as soon as possible after the receipt of an invoice that meets the requirements of subsections b, c, and d above. The HCC will follow the Kansas Prompt Payment Act (K.S.A. 75-6401 et seq.).

7. Overpayment:

a. HCC assumes that the Contractor shall perform its duties and obligations under this Contract in a timely, careful and reasonable manner.

b. In the event of an overpayment of fees, Contractor shall indemnify the Plan. As used in this Contract, “overpayment” means any amount which has been mistakenly or wrongly paid from the Plan, including duplicate payments, mistaken payments, payments in excess of that actually owed, and any other amount not required to be paid under the terms of the Plan.

c. The HCC and Contractor will cooperate in efforts to recover overpayments when they are



as a result of a third-party. Contractor shall not seek legal action against a Plan participant to collect an overpayment without the HCC’s prior consent.

d. In the case of a dispute on an overpayment between the SEHP and Contractor, there should be an attempt to resolve the dispute by trying to reach an agreement. If the SEHP and Contractor cannot reach agreement, the dispute may be resolved through alternative dispute resolution. The intent is to resolve the dispute at the lowest level possible.

e. Contractor shall not be allowed to collect any overpayment due to its misapplication of the plan’s deductible, co-payment or co-insurance requirements unless it explains the reason for the overpayment in writing to the participant within a reasonable time after the date of service, but not to exceed 15 months after the date of service.

f. The provisions of this section will survive termination of this Contract.

8. Quality and Innovation: The HCC is interested in quality health care and innovative plan designs and projects. During the course of this Contract, the Contractor agrees to work with the HCC in the development, implementation, and evaluation of quality improvement projects and innovative plan designs or projects as authorized by the HCC. Contractors are encouraged to bring ideas on improving the quality of health care and innovative plan design ideas to the HCC for consideration. The HCC may negotiate with Contractors with regard to any expense related to or resulting from pursuit of these projects.

9. Reports: Contractor will work with the SEHP to develop meaningful management reports, making modifications to report structures and contents as necessary to meet the needs of the HCC and SEHP.

10. Retention of Records: a. Unless the HCC specifies in writing a shorter period of time, the Contractor agrees to

preserve and make available all of its books, documents, papers, records and other evidence involving transactions related to this Contract for a period of five (5) years from the date of the expiration or termination of this Contract.

b. Matters involving litigation shall be kept for one (1) year following the termination of litigation, including all appeals, if the litigation exceeds five (5) years.

c. The Contractor agrees that authorized federal and state representatives, including but not limited to, personnel of the using agency and independent auditors acting on behalf of state and/or federal agencies shall have access to and the right to examine records during the Contract period and during the five (5) year post-Contract period. Delivery of and access to the records shall be at no cost to the HCC.

d. State and/or federal law may require the retention of records for longer periods. In which case Contractor will follow applicable law.

11. Review and Hearings: The Contractor agrees to advise the HCC of the number and type of complaints made known to the Contractor for services provided under this Contract. The HCC has the discretion to require the Contractor to participate in any review, appeal, hearing, or litigation involving issues related to this Contract.

12. Solicitation of Members: The Contractor shall not use the names, home addresses or any other information obtained about participants of this plan for the purpose of offering for sale any



property or services which are not directly related to services negotiated in this bid event without the express written consent of the HCC.

13. Performance Standards: Service performance standards set forth in the RFP establish expectations regarding certain areas of the Contract between Contractor and the HCC. These performance standards are designed to assure that all parties involved in providing services know what the standards are and that Contractor will provide guarantees based on these standards. Contractor accepts these standards as agreed upon in the RFP, attached hereto.

14. Acceptance of RFP Terms & Conditions: All proposals are subject to the terms and conditions outlined in the RFP. All responses will be controlled by such terms and conditions and the submission of other terms and conditions, price lists, catalogs, or other documents or exceptions as part of Contractor’s response are waived and have no effect either on the Request for Proposal or this Contract. By submitting an executed response, the Contractor specifically agreed to the conditions set forth in this paragraph.

15. Warranties: Contractor represents and warrants to the HCC that (a) services shall be rendered in a professional manner consistent with standards of professionals in Contractor’s industry; (b) services will be delivered in compliance with all standards and conditions presented by HCC to Contractor; and (c) Contractor is under no obligation or restriction, nor will it assume any obligation or restrictions that would in any way interfere or be inconsistent with the performance of the services.

16. Conflict Resolution: a. Intent: In the event that there is a dispute between the parties to this Contract, the intent

of the parties is to resolve the dispute at the earliest and lowest level possible. The lowest level would be a mutual agreement between the parties resolving the dispute. If the SEHP and Contractor cannot reach agreement, the dispute may be resolved through alternative dispute resolution. A last resort would be litigation in court.

b. HCC authority on deliverables: In the event the parties cannot mutually agree to a resolution of any controversies or claims between the parties regarding the provision of services and completion of deliverables, the HCC, at its sole discretion and judgment, will make the final determination as to whether deliverables have been satisfactorily completed or other services provided in accordance with the Contract.

c. Jurisdiction: i. Should legal proceedings be required between the parties as a result of this

Contract, the jurisdiction for the legal proceeding will be in the State of Kansas. If the venue would be a state court, the legal proceeding would be in the District Court of Shawnee County, Kansas. The United States District Court for the State of Kansas sitting in Topeka, Shawnee County, Kansas, would be the venue for any appropriate federal action or proceeding arising hereunder.

ii. Contractor waives all defenses of lack of personal jurisdiction and forum non

conveniens to any legal matters that arise between the parties as a result of this Contract. Process may be served on Contractor in the manner authorized by applicable Kansas law or court rule.



d. Eleventh Amendment: The Eleventh Amendment of the United States Constitution is an inherent and incumbent protection held by the State of Kansas and need not be reserved, but prudence requires the HCC to reiterate that nothing related to this Contract shall be deemed a waiver by the HCC or SEHP of the protections accorded a state entity under the Eleventh Amendment.

17. Employment of Counsel and Resolution of Litigation and Legal Fees:a. In the event of litigation involving the services under this Contract not covered by Section

16 above and where the HCC, SEHP, State of Kansas, or the Contractor are named as a party to the litigation (“Litigation” hereafter), the HCC and Contractor each:

1. Reserve the right to select and retain counsel at its own expense to protect its interests;

2. Will promptly notify the other party to this Contract after learning of the Litigation;

3. Will cooperate fully by providing the other party with all non-confidential relevant information and documents within its control as requested; and

4. Will reasonably assist the other party in the defense of the Litigation.

b. In the event the HCC, the State of Kansas or any of its staff, or Contractor is the sole named defendant in Litigation related to the services provided under this Contract, such party shall have discretion to defend, settle, compromise or otherwise resolve such Litigation consistent with the terms of this Contract and of the SEHP. Such party shall keep the other party informed of the status of the Litigation and any decision to settle, compromise or otherwise resolve the Litigation shall be communicated to and discussed with the other party prior to any such settlement, compromise or other resolution.

c. In the event the HCC, the State of Kansas or any of its staff and Contractor are codefendants in Litigation, the parties will cooperate fully with each other to defend, settle, compromise or otherwise resolve such Litigation consistent with the terms of this Contract and the SEHP.

d. In the event any entity other than the HCC, the State of Kansas, any of its staff or Contractor, is named as a defendant in Litigation, the HCC can elect to defend, settle, compromise or otherwise resolve such Litigation with respect to those other entities consistent with the terms of this Contract and of the SEHP.

e. The provisions of this section will survive termination of this Contract.

18. Conformance with Law: Contractor shall comply with all applicable federal, state and local laws, rules and regulations as they exist or as they may be amended, including those not specifically mentioned in this Contract.

19. Contractor: The Contractor shall be deemed the sole source of contact for the Contract. Contractor shall include all subcontractors, subsidiaries, affiliates, partners and sister corporations, etc. Contractor is solely responsible for all actions and work performed by other entities involved in performing work under this Contract. All terms, conditions and requirements of the Contract shall apply without qualification to any services and work performed on behalf of the Contractor under this Contract.



20. Kansas Open Records Act: The laws of the State of Kansas require public information be placed in the public domain at the conclusion of the selection process, and be available for examinations by all interested parties. Contractor acknowledges that its response to the RFP under this Contract is considered an open record under the Kansas Open Records Act, K.S.A. 45-215 et seq.

21. Banking: The Contractor shall not open a bank account in the name of the State of Kansas, the HCC, or the Kansas State Employee Health Plan. Any bank account that the Contractor opens for the administration of this program or under this Contract shall be in the name of the Contractor only and solely the responsibility of the Contractor.

22. Duty to Mitigate: The parties to this Contract acknowledge their duty to mitigate damages when appropriate and reasonable.

23. Electronic Accessibility Protocols: The State policy on accessibility standards can be found at: http://oits.ks.gov/kito/itec/Policies/itecitpolicy1210.htm . All web and print based services available to Plan Participants must be handicap accessible and meet the state accessibility policy.

24. Advertising: The Contractor will not use the award of a contract as part of any news release or commercial advertising without the HCC’s prior written permission.

25. Implied Requirements : All products and services not specifically mentioned in the RFP, response and this Contract, but which are necessary to provide the functional capabilities described by the specifications, shall be included.

26. Off-Shore Sourcing: If, during the term of the Contract, the Contractor moves work previously performed in the United States to a location outside of the United States, the Contractor shall immediately notify the HCC in writing, indicating the new location and the percentage of work relocated.

27. Criminal or Civil Offense by Contractor: Any conviction for a criminal or civil offense that indicates a lack of business integrity or business honesty must be disclosed to the HCC. This includes:

a. Conviction of a criminal offense as an incident to obtaining or attempting to obtain a public or private contract or subcontract or in the performance of such contract or subcontract;

b. Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, or receiving stolen property;

c. Conviction under state or federal antitrust statutes; and

d. Any other offense that reasonably would be expected to affect the ability to function as a State Contractor.

e. For the purpose of this section, an individual or entity shall be presumed to have control of a company or organization if the individual or entity directly or indirectly, or acting in concert with one or more individuals or entities, owns or controls 25 percent or more of its

http://oits.ks.gov/kito/itec/Policies/itecitpolicy1210.htm



equity, or otherwise controls its management or policies. Failure to disclose an offense may result in termination of the Contract.

28. Confidentiality and Access : Contractor shall not disclose to any other person, firm, or corporation or entity (other than to the HCC) or use for its own benefit, except as provided in this Contract and the Business Associate Agreement, any data, Protected Health Information (hereinafter referred to as “PHI”) and/or other confidential information it receives from the HCC. Notwithstanding the Business Associate Agreement, such data and information may be disclosed to contract workers, employees, consultants and agents of the Contractor who have a need to know or have access to such data or information in the performance of this Contract and who have executed written agreements with the Contractor obligating them to treat such information in a manner consistent with the terms of this Contract. Contractor shall return any and all data furnished by the HCC promptly at the request of the HCC in whatever form required by the HCC. On the termination of this Contract, Contractor will not use any of such data or any material derived from the data for any purpose and, where so instructed by the HCC, will destroy or render such data or material unreadable. In the event Contractor discloses any of the HCC’s proprietary and/or personal identifiable information, the HCC may immediately terminate the Contract and pursue legal action recourse. The restrictions and obligations contained herein shall continue in perpetuity from the date of this Contract unless the HCC provides a written release to Contractor.

29. Data Ownership: The Contractor understands and agrees that all data provided by the HCC, or by the HCC’s contracted vendors authorized by the HCC, is owned by the HCC and will be used by the Contractor solely for the purposes described in this Contract. All data created in any form as part of this Contract will be the property of the HCC and will be available to the HCC at all times. Upon termination of the Contract, and to the extent feasible, all data associated with this Contract will be transferred to and accepted by the HCC prior to final payment to the Contractor. Under no circumstances will the Contractor share the data with any other entity without the HCC’s prior written authorization.

30. Copyrights: All deliverable items produced pursuant to this Contract that are produced solely and exclusively for the HCC are the exclusive property of the HCC. The Contractor will not assert a claim of copyright or other property interest in such deliverables. The Contractor shall indemnify the HCC against any and all claims for infringement of any copyright or patent occurring in connection with or in any way incidental to or arising out of the occupancy, use, service, operations or performance of work under this Contract.

31. Termination Right:

a. Notwithstanding any other provisions of this Contract, the HCC reserves the right to terminate this Contract at the end of any month by giving thirty (30) days advance notice thereof in writing to Contractor.

b. In the event of termination of this Contract, Contractor will, unless the HCC directs and Contractor otherwise agrees:

1. Complete the pricing of all deliverables incurred prior to the effective date of termination and the HCC shall pay Contractor for all applicable fees in respect to such deliverables priced.



2. Release to the HCC, in a format acceptable to the HCC, all records and files relating to deliverables priced under the SEHP health plan pursuant to this Contract.

c. If Contractor uses any patented, trademarked or copyrighted designs, devices, materials or other property, tangible or intangible in connection with its performance of its obligations under this Contract it shall provide for such use in an approved legal manner by making a proper agreement with the patentee or owner of such trademark or copyright and shall defend and hold the HCC harmless on any claim relating to such items. Contractor also grants the State of Kansas, and its departments, agencies, affiliates, agents, employees and licensees a non-exclusive, royalty-free, non-revocable perpetual license to use and copy for any reason Contractor’s bid and proposal and any other document(s) submitted to the HCC that may be related to this Contract.

32. Independent Contractor : Both Contractor and the HCC, in the performance of this Contract, are and shall be acting in an individual capacity and not as agents, employees, partners, joint ventures or associates of one another. The employees or agents of one party shall not be deemed or construed to be the employees or agents of the other party for any purpose whatsoever except the Contractor's employees shall be deemed agents of the State of Kansas for the purpose of maintaining confidentiality of private or confidential data, software and equipment maintained by the HCC.

33. Indemnification: The Contractor will hold and save the State, its officers, agents, and employees acting within the scope of their employment, harmless from liability of any kind, including all claims and losses accruing or resulting to any other person, firm, or corporation furnishing or supplying work, services, materials, or supplies in connection with the performance of this Contract, and from any and all claims and losses accruing or resulting to any person, firm or corporation that may be injured or damaged by the Contractor in the performance of this Contract. The Contractor acknowledges that any liability of the State’s agents or employees while acting within the scope of their employment is covered by the Kansas Tort Claims Act, K.S.A. 75-6101 et seq.

34. Accounts Receivable Set-Off Program: If, during the course of this Contract the Contractor is found to owe a debt to the State of Kansas, agency payments to the Contractor may be intercepted / setoff by the State of Kansas. Notice of the setoff action will be provided to the Contractor. Pursuant to K.S.A. 75-6201 et seq., Contractor shall have the opportunity to challenge the validity of the debt. If the debt is undisputed, the Contractor shall credit the account of the agency making the payment in an amount equal to the funds intercepted. K.S.A. 75-6201 et seq. allows the Director of Accounts and Reports to setoff funds the State of Kansas owes Contractors against debts owed by the Contractors to the State of Kansas. Payments setoff in this manner constitute lawful payment for services or goods received. The Contractor benefits fully from the payment because its obligation to the State is reduced by the amount subject to setoff.

35. Liability: Subject to the limitations set forth below, Contractor shall assume full responsibility for damage, including mitigation expenses, security breaches, or misuse of all State and Contractor property, including any private or confidential data, software and equipment maintained by Contractor and any equipment, supplies, accessories, software or parts furnished by Contractor while such property is in Contractor’s care. Contractor shall also assume full responsibility for compliance with the standards for security of privacy of confidential records, data, software, software code, or equipment used or maintained by the Contractor, as set forth in federal and



State statutes which mandate implementation of strict measures to ensure physical and electronic security of the same.

36. Hold Harmless : Contractor shall save, hold harmless and indemnify the HCC against any and all liability, claims for injury to, or death of any persons and for loss or damage to any property and for infringement of any copyright or patent occurring in connection with or in any way incidental to or arising out of Contractor’s performance under the terms of this Contract.

37. Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties contained herein will survive the Contract expiration or termination date unless specifically provided otherwise herein, or unless superseded by applicable federal or State statutes of limitation.

38. Waiver : In the event of breach of this Contract, or any provision hereof, failure of the HCC to exercise any of its rights or remedies under the Contract shall not be construed as a waiver of any such provision of the Contract breached or as acquiescence in the breach. The remedies herein reserved shall be cumulative and in addition to any other remedies at law or in equity.

39. Legislative Requests: Contractor will provide support to the HCC in responding to information requests and fiscal notes or impact statements needed by the Legislature. Responses shall be given within two (2) business days.

40. Audits and Access to Records: The HCC reserves the right to conduct annual, or more frequently if needed audits of Contractor’s records and files related to the performance or cost of this Contract. The Contractor will make available to the HCC any person, record or file deemed necessary by the HCC to validate either performance or cost. The Legislative Division of Post Audit will have access to persons and records as a result of all contracts or grants entered into by State agencies or political subdivisions. There will be no fee from the Contractor to complete such audits. All third-party auditors will enter into a confidentiality agreement reasonably acceptable to Contractor and permitted under the Kansas Open Records Act.

41. Beneficiaries: Except as herein specifically provided otherwise, this Contract will inure to the benefit of and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the terms and conditions of this Contract, and all rights of action relating to such enforcement, will be strictly reserved to the HCC and the named Contractor. Nothing contained in this document will give or allow any claim or right of action whatsoever by any other third person. It is the express intention of the HCC and Contractor that any such person or entity, other than the HCC or the Contractor, receiving services or benefits under this Contract will be deemed an incidental beneficiary only.

42. Amendment: This Contract shall be amended only by the written agreement of the parties. No alteration or variation of the terms and conditions of this Contract shall be valid unless made in writing and signed by the parties. Every amendment shall specify the date on which its provisions shall be effective.

43. Option to Renew: The HCC shall have the option, by mutual written agreement of the HCC and Contractor, to renew this Contract in such a manner mutually agreed upon, in writing, by the parties.



44. Joint Drafting: No provision of this Contract shall be construed more harshly or unfavorably against any party hereto regardless of which party drafted the provision or for whose benefit the provision was included.

45. Captions: The captions or heading in this Contract are for reference only and do not define, describe, extend or limit the scope or intent of this Contract.

46. Validity and Waiver: The invalidity in whole or in part of any provision of this Contract shall not affect the validity of other provisions. A waiver of a breach of any provision or performance guaranty of this Contract shall not constitute a waiver of any subsequent breach of that provision or a breach of any other provision of this Contract. The failure of the HCC to enforce at any time or from time to time any provision of this Contract shall not be construed as a waiver thereof.

47. Force Majeure: Contractor or the HCC shall be excused from performance under this Contract for any period that Contractor or the HCC is prevented from performing any services, in whole or part, as a result of an act or event not within the reasonable control of the party prevented from performing.

48. Travel Expenses: Contractor will be responsible for all expenses, including travel mileage, meals, lodging and other travel expenses incurred in the performance of this Contract.

49. Notices: The notice addresses of the parties are as follows:

HCC:Director of the State Employee Health Plan900 SW Jackson St., Ste. 900-NTopeka, KS 66612

Contractor:(Name of Contractor) ___________________________(Address of Contractor) ___________________________

___________________________

50. Transition Assistance : In the event of Contract termination or expiration, Contractor shall provide all reasonable and necessary assistance to the State to allow for a functional transition to another vendor.

51. Signatures: Signatures herein shall serve to bind the parties to this Contract. The parties represent and warrant that they have read and thoroughly understand the terms and conditions and they are represented by counsel and the terms and conditions of the RFP and Contract have been fully explained to them by counsel. This Contract shall be binding on any person or entity that is a successor or purchaser of Contractor.

SIGNATURES ON NEXT PAGE



CONTRACTOR - (Name of Contractor)

By: ____________________________________ Date: ______________________

Printed Name: ____________________________

Title: ____________________________________

KANSAS STATE EMPLOYEES HEALTH CARE COMMISSION

By: _____________________________________ Date: ______________________

(Printed Name) _______

(Title)____________________________

I have reviewed the Sample Contract and acknowledge that the document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this section of RFP, subject to the modifications, conditions and limitations I have made in redline format above.



_________________________________________________ Title

_________________________________________________



BUSINESS ASSOCIATE AGREEMENT

THIS AGREEMENT is made and entered into by and between the Kansas Department of Health and Environment (hereinafter referred to as “KDHE”) and ------------------------------------------------------------- (hereinafter referred to as “Business Associate”).Notwithstanding Section V of this Business Associate Agreement (hereinafter referred to as “BAA”), the term of this BAA shall run concurrently with the Underlying Contract between the parties and shall have the same effective date and termination date as the Underlying Contract.

RECITALSThe Parties to this BAA have a relationship whereby KDHE may provide the Business Associate access to Protected Health Information (hereinafter referred to as “PHI”), which may include electronic Protected Health Information, that Business Associate will use to fulfill its contractual obligations to KDHE. KDHE and Business Associate acknowledge that each party has certain obligations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended, including those provisions of the American Recovery and Reinvestment Act of 2009 (“ARRA”), specifically the Health Information Technology for Economic and Clinical Health Act (“HITECH”), and the statutes implementing regulations to maintain the privacy and security of PHI, and the parties intend this BAA to satisfy those obligations including, without limitation, the requirements of 45 CFR 164.504(e).KDHE, with its three divisions, self-identifies as a Hybrid Entity under HIPAA with the Division of Health Care Finance containing Covered Entity functions. Therefore, a Business Associate would not be permitted to use or disclose health information in ways that KDHE could not. This protection continues as long as the data is in the hands of Business Associate. Business Associate acknowledges that for the purposes of this BAA, Business Associate is a “business associate” as that term is defined in 45 CFR § 160.103, and therefore the requirements of HIPAA apply to Business Associate in the same manner that they apply to KDHE pursuant to 42 USC § 17931(a).NOW THEREFORE, in consideration of the mutual promises below and other good and valuable consideration the parties agree as follows:I. DEFINITIONS

a) “Administrative Safeguards” shall mean the administrative actions, policies and procedures to manage the selection, development, implementation and maintenance of security measures to protect PHI and to manage the conduct of Business Associate’s workforce in relation to the protection of that PHI.

b) “Breach” shall mean any disclosure which compromises an individual’s protected health information (PHI) in a way that creates risk of harm to the individual.

c) “Business Associate” shall have the same meaning as the term “Business Associate” as defined in 45 CFR 160.103.

d) “Data Aggregation Services” shall mean, with respect to PHI created or received by Business Associate in its capacity as a Business Associate of KDHE, the combining of such PHI by the Business Associate with the PHI received by the Business Associate in its capacity as a business associate of another covered entity, to permit data analyses that relate to



the health care operations of the respective covered entities, as defined in 45 CFR § 164.501 and as such term may be amended from time to time in this cited regulation.

e) “Designated Record Set” shall mean a group of records maintained by or for KDHE that consists of the following: (a) medical records and billing records about Individuals maintained by or for a health care provider; (b) enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or (c) records used in whole or in part, by or for KDHE to make decisions about Individuals. For these purposes, the term “record” means any item, collection, or group of information that includes PHI and is maintained, collected, used, or disseminated by or for KDHE.

f) “Disclosure” shall mean the release, transfer, provision of, access to, or divulging in any other manner of PHI outside the entity holding the information.

g) “HIPAA” shall mean the Health Insurance Portability and Accountability Act of 1996, the implementation regulations promulgated thereunder by the U.S. Department of Health and Human Services, the HITECH (as defined below) and any future regulations promulgated thereunder, all as may be amended from time to time.

h) “Individual” shall have the same meaning as the term “individual” as defined in 45 CFR 160.103, and any amendments thereto, and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

i) “Physical Safeguards” shall mean the physical measures, policies and procedures to protect KDHE’s electronic information systems and related buildings and equipment from natural and environmental hazards and unauthorized intrusion.

j) “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and Part 164.

k) “Protected Health Information” shall have the same meaning as the term “protected health information,” as defined in 45 CFR 160.103 and any amendments thereto, limited to the information created or received by Business Associate from or on behalf of KDHE.

l) “Required by Law” shall have the same meaning as the term “required by law” in 45 CFR 164.103.

m) “Secretary” shall mean the Secretary of the United States Department of Health and Human Services or his/her designee.

n) “Security Incident” shall mean the attempted or successful unauthorized access, use, disclosure, modification or destruction of information or interference with system operations in an information system.

o) “Security Rule” shall mean the Standards for Security of Electronic Protected Health Information at 45 CFR Parts 160, 162 and 164.

p) “Technical Safeguards” shall mean the technology and the policy and procedures for its use that protect PHI and control access to it.

q) “Underlying Contract” means any written contract for services between KDHE and Business Associate.



r) “Use” shall mean, with respect to PHI, the sharing, employment, application, utilization, examination, or analysis of such information within any entity that maintains such information.

s) Capitalized terms used, but not otherwise defined, in this BAA shall have the same meaning ascribed to them in HIPAA, the Privacy Rule, the Security Rule, or HITECH or any future regulations promulgated or guidance issued by the Secretary.

II. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATEa) Use and Disclosure . Business Associate agrees to not use or disclose PHI other than as

permitted or required by this BAA or as Required by Law.

b) Safeguards to be in Place . Business Associate agrees to use appropriate safeguards to prevent the use or disclosure of PHI other than as provided for by this BAA. Additionally, Business Associate shall implement Administrative, Physical and Technical Safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of the PHI that it creates, receives, maintains or transmits on behalf of KDHE as required by the Security Rule.

c) HIPAA Training . Business Associate agrees to ensure all members of its workforce, including subcontractor workforce members, that will or potentially will provide services pursuant to the Underlying Contract will be appropriately trained on the requirements of HIPAA.

d) Duty to Mitigate . Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this BAA or the Privacy Rule and to communicate in writing, such procedures to KDHE.

e) Business Associate’s Agents and Subcontractors . Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received from, or created or received by Business Associate on behalf of KDHE agrees, in writing in the form of a Business Associate Agreement, to the same restrictions and conditions that apply through this BAA to Business Associate with respect to such information, including implementation of reasonable and appropriate safeguards to protect PHI. Business Associate agrees that it is directly liable for any actions of its subcontractors that result in a violation of this Agreement. Business Associate also agrees to make available to KDHE any contracts or agreements Business Associate has with any subcontractors to whom Business Associate provides PHI under this BAA. Business Associate may redact proprietary and financial information from said contracts before providing them to KDHE.

f) Duty to Provide Access . To the extent Business Associate has PHI in a Designated Record Set, Business Associate agrees to provide access, at the request of KDHE, to the PHI in the Designated Record Set to KDHE or, as directed by KDHE, to the Individual, in order to meet the requirements under 45 CFR 164.524. Any denial by Business Associate of access to PHI shall be the responsibility of, and sufficiently addressed by, Business Associate, including, but not limited to, resolution of all appeals and/or complaints arising therefrom.

g) Amendment of PHI . Business Associate agrees to make any amendment(s) to PHI in its possession contained in a Designated Record Set that KDHE directs or agrees to pursuant to 45 CFR 164.526 at the request of KDHE or an Individual, and within a reasonable time and manner.



h) Duty to Make Internal Practices Available . Business Associate agrees to make its internal practices, books and records, including policies and procedures relating to the use and disclosure of PHI, and any PHI received from, or created or received by Business Associate on behalf of KDHE, available to the Secretary, in a time and manner designated by the Secretary, for purposes of the Secretary determining KDHE’s compliance with the Privacy Rule.

i) Documenting Disclosures/Accounting . Business Associate agrees to document any disclosures of PHI and information in its possession related to such disclosures as would be required for KDHE to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR 164.528. Business Associate agrees to provide to KDHE information collected in accordance with Section II(f) of this BAA, to permit KDHE to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR 164.528.

j) Reporting Breaches and Security Incidents to KDHE . In addition to the duty to mitigate under Section II(d), Business Associate agrees to report to KDHE any use or disclosure which compromises PHI and creates risk of harm including any Security Incident of which it becomes aware, as soon as practicable but no longer than five (5) business days after the discovery of such event(s). Notice to KDHE shall consist of notifying the KDHE Privacy Officer by phone or email of the occurrence of an unauthorized use, disclosure or security incident.

k) Notification of Breach . Business Associate shall notify Covered Entity within three (3) business days after it, or any of its employees, subcontractors, or agents, reasonably suspects that a breach of unsecured PHI as defined by 45 CFR 164.402 may have occurred, irrespective of any occurrence or non-occurrence of harm. Notice to KDHE shall consist of notifying the KDHE Privacy Officer by phone or email of the occurrence of a Breach or suspected occurrence of a Breach. Business Associate shall exercise reasonable diligence to become aware of whether a breach of unsecured PHI may have occurred and, except as stated to the contrary in this Section, shall otherwise comply with 45 CFR 164.410 in making the required notification to Covered Entity. Business Associate shall cooperate with Covered Entity in the determination as to whether a breach of unsecured PHI has occurred and whether notification to affected individuals of the breach of unsecured PHI is required by 45 CFR 164.400 et seq., including continuously providing the Covered Entity with additional information related to the suspected breach as it becomes available. In the event that Covered Entity informs Business Associate that (i) Covered Entity has determined that the affected individuals must be notified because a breach of unsecured PHI has occurred and (ii) Business Associate is in the best position to notify the affected individuals of such breach, Business Associate shall immediately provide the required notice (1) within the time frame defined by 45 CFR 164.404(b), (2) in a form and containing such information reasonably requested by Covered Entity, (3) containing the content specified in 45 CFR 164.404(c), and (4) using the method(s) prescribed by 45 CFR 164.404(d). In addition, in the event that Covered Entity indicates to Business Associate that Covered Entity will make the required notification, Business Associate shall promptly take all other actions reasonably requested by Covered Entity related to the obligation to provide a notification of a breach of unsecured PHI under 45 CFR 164.400 et seq. Business Associate shall indemnify and hold Covered Entity harmless from all liability, costs, expenses, claims or other damages that Covered Entity, its related corporations, or any of its or their directors, officers, agents, or employees, may sustain as a result of Business Associate’s breach, or Business Associate’s subcontractor’s or agent’s breach, of its obligations under this Agreement.

III. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE



a) General Use and Disclosure Provisions . Except as otherwise limited in this Agreement, Business Associate may use or disclose PHI on behalf of, or to provide services to, Covered Entity for the purposes set forth in III(b), if such use or disclosure of PHI would not violate the Privacy Rule if done by Covered Entity.

b) Specific Use and Disclosure Provisions .

1. Business Associate may use and disclose PHI to perform services for Covered Entity, including specific services, as set out in the Underlying Contract, and any additional services necessary to carry out those specific services in the Underlying Contract.

2. Business Associate may use PHI in its possession for the proper management and administration of Business Associate and to carry out the legal responsibilities of Business Associate.

Business Associate may disclose PHI in its possession for the proper management and administration of Business Associate, provided that disclosures are Required by Law. Business Associate may only de-identify PHI in its possession obtained from Covered Entity with Covered Entity’s prior written consent, in accordance with all de-identification requirements of the Privacy Rule.

3. Business Associate may use PHI to report violations of law to appropriate federal and state authorities, consistent with 45 CFR 164.502(j)(1). Covered Entity shall be furnished with a copy of all correspondence sent by Business Associate to a federal or state authority.

4. Except as otherwise limited in this Agreement, Business Associate may use PHI to provide Data Aggregation Services to Covered Entity.

5. Any use or disclosure of PHI by Business Associate shall be in accordance with the minimum necessary policies and procedures of Covered Entity and the regulations and guidance issued by the Secretary on what constitutes the minimum necessary for Business Associate to perform its obligations to Covered Entity under this Agreement and the Underlying Contract.

IV. OBLIGATIONS OF COVERED ENTITYa) Covered Entity shall notify Business Associate of any limitation(s) in its Notice of Privacy

Practices of Covered Entity in accordance with 45 CFR 164.520, to the extent that such limitation(s) may affect Business Associate’s use or disclosure of PHI.

b) Covered Entity shall notify Business Associate in a timely manner of any changes in, or revocation of, permission by an Individual to use or disclose PHI to the extent that such change may affect Business Associate’s permitted or required use or disclosure of PHI.

c) Covered Entity shall notify Business Associate in a timely manner of any restriction to the use and/or disclosure of PHI, which the Covered Entity has agreed to in accordance with 45 CFR 164.522, to the extent that such restriction may affect Business Associate’s use or disclosure of PHI.

d) Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the Privacy Rule if done by Covered Entity.

V. TERMINATION



a) Term. The term of this Agreement shall run concurrently with the Underlying Contract with Covered Entity and shall terminate upon termination of the Underlying Contract and when all of the PHI provided by Covered Entity to Business Associate, or created or received by Business Associate on behalf of Covered Entity, is destroyed or returned to Covered Entity, or, if it is infeasible to return or destroy the PHI, protections are extended to such information, in accordance with the termination provisions of Section V(c)(2).

b) Termination for Cause. Upon either party’s knowledge of a material breach by the other party, such party shall either:

1. Provide an opportunity for the breaching party to cure the breach, end the violation, or terminate this Agreement if the breaching party does not cure the breach or end the violation within five (5) business days;

2. Immediately terminate the Agreement if the breaching party has breached a material term of this Agreement and cure is not possible; or

3. If neither termination nor cure is feasible, the non-breaching party shall report the violation to the Secretary.

c) Effect of Termination.

1. Except as provided in paragraph V(c)(2) of this Agreement, upon termination of this Agreement, for any reason, Business Associate shall return or destroy all PHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. This provision shall apply to PHI that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of the PHI.

2. In the event that Business Associate determines that returning or destroying the PHI is infeasible, Business Associate shall provide to Covered Entity notification in writing of the conditions that make return or destruction infeasible. Upon verification that return or destruction of PHI is infeasible, Business Associate shall extend the protections of this Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as Business Associate maintains such PHI. If it is infeasible for Business Associate to obtain from a subcontractor or agent, any PHI in the possession of the subcontractor or agent, Business Associate must provide a written explanation to Covered Entity and require the subcontractors and agents to agree to extend any and all protections, limitations and restrictions contained in this Agreement to the subcontractors’ and/or agents’ use and/or disclosure of any PHI retained after the termination of this Agreement, and to limit any further uses and/or disclosures to the purposes that make the return or destruction of the PHI infeasible.

d) Judicial or Administrative Proceedings. Notwithstanding any other provision herein, Covered Entity may terminate the applicable Underlying Contract, effective immediately, upon a finding or stipulation in any criminal, administrative or civil proceeding in which the Business Associate is a named party that Business Associate violated any applicable standard or requirement of the Privacy Rule or the Security Rule or any other applicable laws related to the security or privacy of PHI, relating to the Underlying Contract.

VI. MISCELLANEOUS



a) Regulatory References . A reference in this Agreement to a section in the Privacy Rule or Security Rule means the section as in effect or as amended and for which compliance is required.

b) Amendment . No change, amendment, or modification of this Agreement shall be valid unless set forth in writing and agreed to by both parties, except as set forth in Section VI(l) below.

c) Indemnification . Business Associate shall indemnify Covered Entity for any and all claims, inquiries, costs or damages, including but not limited to any monetary penalties, that Covered Entity incurs arising from a violation by Business Associate, or a subcontractor or agent of Business Associate, of its obligations hereunder.

d) Survival. The respective obligations of Business Associate under this Agreement shall survive the termination of this Agreement.

e) Interpretation . Any ambiguity or inconsistency in this Agreement shall be resolved in favor of a meaning that permits Covered Entity to comply with the Privacy Rule, the Security Rule, and the HITECH sections contained within ARRA.

f) No Third-Party Beneficiaries . Nothing express or implied in this Agreement is intended to confer, nor shall anything herein confer, upon any person other than Covered Entity and its respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.

g) Notices . Any notices to be given to either party under this Agreement shall be made in writing and delivered via e-mail at the address(es) given below:

Business Associate: General Counsel –

Privacy Officer –

Covered Entity:Brian M. Vazquez – [email protected]

h) Headings . The section headings are for convenience only and shall not be construed to define, modify, expand, or limit the terms and provisions of this Agreement.

i) Governing Law and Venue . This Agreement shall be governed by, and interpreted in accordance with, the internal laws of the State of Kansas, without giving effect to its conflict of law provisions.

j) Binding Effect . This Agreement shall be binding upon, and shall inure to the benefit of, the parties hereto and their respective permitted successors and assigns.

k) Effect on Underlying Contract . If any portion of this Agreement is inconsistent with the terms of the Underlying Contract, the terms of this Agreement shall prevail. Except as set forth above, the remaining provisions of the Underlying Contract are ratified in their entirety.

l) Modification . The parties acknowledge that state and federal laws relating to electronic data security and privacy are rapidly evolving and that amendment of this Agreement may be required to ensure compliance with such developments. The parties specifically agree to take such action as may be necessary to implement the standards and




requirements of HIPAA and other applicable state and federal laws relating to the security or confidentiality of PHI as determined solely by Covered Entity.

In the event that a federal or state law, statute, regulation, regulatory interpretation or court/agency determination materially affects this Agreement, as is solely determined by Covered Entity, the parties agree to negotiate in good faith any necessary or appropriate revisions to this Agreement. If the parties are unable to reach an agreement concerning such revisions within the earlier of sixty (60) days after the date of notice seeking negotiations or the effective date of the change in law or regulation, or if the change in law or regulation is effective immediately, the Covered Entity, in its sole discretion, may unilaterally amend this Agreement to comply with the change in law upon written notice to Business Associate.

VII. OBLIGATIONS OF BUSINESS ASSOCIATE PURSUANT TO HITECHa) Access to PHI in an Electronic Format . If Business Associate uses or maintains PHI in

an Electronic Health Record, Business Associate must provide access to such information in an electronic format if so requested by an Individual. Any fee that Business Associate may charge for such electronic copy shall not be greater than Business Associate’s labor costs in responding to the request. If an Individual makes a direct request to Business Associate for access to a copy of PHI, Business Associate will promptly inform the Covered Entity in writing of such request.

b) Prohibition on Marketing Activities . Business Associate shall not engage in any marketing activities or communications with any individual unless such marketing activities or communications are allowed by the terms of the Underlying Contract and are made in accordance with HITECH or any future regulations promulgated thereunder. Notwithstanding the foregoing, any payment for marketing activities should be in accordance with HITECH or any future regulations promulgated thereunder.

c) Application of the Security Rule to Business Associate . Business Associate shall abide by the provisions of the Security Rule and use all appropriate safeguards to prevent use or disclosure of PHI other than as provided for by this Agreement. Without limiting the generality of the foregoing sentence, Business Associate shall:

(i) Adopt written policies and procedures to implement the same administrative, physical, and technical safeguards required of the Covered Entity; and

(ii) Abide by the most current guidance on the most effective and appropriate technical safeguards as issued by the Secretary.

If Business Associate violates the Security Rule, it acknowledges that it is directly subject to civil and criminal penalties.

VIII. ADDITIONAL OBLIGATIONS OF BUSINESS ASSOCIATE Business Associate shall not receive any remuneration, directly or indirectly, in exchange for any PHI, unless so allowed by the terms of the Underlying Contract and in accordance with HITECH and any future regulations promulgated thereunder.

IX. ENFORCEMENT



Business Associate acknowledges that, in the event it, or its subcontractor or agent, violates any applicable provision of the Security Rule or any term of this Agreement that would constitute a violation of the Privacy Rule, Business Associate will be subject to and will be directly liable for any and all civil and criminal penalties that may result from such violation.

IN WITNESS WHEREOF, the parties have executed this Agreement as of the date last noted below and for a term specified by Section V(a) above.

On behalf of:

KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT

By: _______________________________________ Date: _______________________Jeff AndersenSecretary Kansas Department of Health and Environment

BUSINESS ASSOCIATE - (Name of Contractor)

By: __________________________________________ Date: _______________________

Printed Name: ____________________________

Title: _____________________________________

I have reviewed the Sample BAA and acknowledge that the document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this section of RFP, subject to the modifications, conditions and limitations I have made in redline format above.





_________________________________________________ Title

_________________________________________________



SECTION IVProject Goal, Background and Scope of Work

InstructionsIn this section, the State Employee Health Plan is outlining the services desired under this Request For Proposal (RFP). Vendors should clearly identify any service or requirement that you are unable or unwilling to provide in Red Line. We need to be able to easily identify any items that you are not agreeing to provide. You do not need to accept each item. Please do not mark or comment on the items that you are able and willing to provide.

Project GoalThe State Employee Health Plan (SEHP) has offered the HealthQuest (HQ) wellness program for almost 30 years. We have advanced beyond the one size fits all wellness programs. We are looking for best in class vendors and programs that have demonstrated sustained behavior change and health improvements. We are not looking to buy the standard prepackaged websites and products used for all of your clients. We are not interested in products and services that cannot be tailored to meet SEHP’s needs and goals.

We value flexibility from our vendors in working with us to develop programs that are a positive experience for our members and that will improve their health. Therefore, we are not looking for one vendor to do all of the services but instead will be shopping for the vendors that are the best in class and have the best practices for where we are going with our program. One current example being offered by the SEHP is Naturally Slim, a specialty weight management program. Another example is the SEHP is interested in programs that will promote fitness and increased physical activity by covered members.

The purpose of this Request for Proposal is to open negotiations with potential vendor partners that offering wellness initiatives that meet the goals outlined above. Information about the current wellness program is available at: http://www.kdheks.gov/hcf/healthquest/default.htm. We are looking to move beyond where the program is today to the next generation of wellness program offerings so the information on the current program is just to provide you a look at where we have been. The SEHP seeks a combination of health and wellness program resources to be branded as “HealthQuest” for our members. Providers will be asked to participate with the SEHP and its selected vendors in the development of a new comprehensive HealthQuest program to be implemented for Plan Year 2019.

Background and History of the program

The Kansas State Employees Health Care Commission (Commission) provides for the purchase and administration of a comprehensive health benefit program for State of Kansas employees as well as employees of other public entities who have elected to participate in the State Employee Health Plan (SEHP).

Census: Current census of eligible active employees and covered spouses of the State and Non State Entities is included as Exhibit 11.

Earning Period: The Earning Period for the HealthQuest Premium Incentive Discount runs calendar year (January 1st – December 31st). Enrolled employees and enrolled spouses on Plans A, C, J, Q and N can earn a premium incentive discount by participating and earning the required number of credits each year. Employees and covered spouses enrolled in Plans C, J, Q and N can earn HSA/HRA contributions by participating in HealthQuest activities.

SEHP HealthQuest (HQ) Program History: The following is a brief summary of some of the programs that have been offered through the HQ program and are intended to provide a bit of the history.

http://www.kdheks.gov/hcf/healthquest/default.htm



The SEHP Wellness program, HealthQuest, is a well-established program focusing on improving the health of our population. The program began in 1988 offering a Health Risk Assessment with screenings and no incentive.

In the early 2000s we added the premium incentive discount on the health plan premium tied to non tobacco use.

Then activities for earning the premium incentive discount changed in to programs to promote healthy lifestyle and not just non tobacco use. New activities were added to offer a comprehensive wellness program with activities such as nurse line, wellness challenges, lifestyle coaching, disease management and more.

We offer over 220 onsite screening events at more than 100 different sites. Most recently, in 2017 the program added spousal incentives. Over time our program year has transitioned to the calendar or benefit year of January 1 st through

December 31st.for the premium incentive discount of up to $480 annually on their health insurance premium for the calendar year following as well as Plan C members and spouses can earn up to $500 each into their HSA/HRA account.

The SEHP added Naturally Slim by ACAP Health a video based weight loss program in 2017. Over 19,000 covered members participated and lost over 100,000 pounds. The program has been a huge success and the most popular wellness program or activity we have ever offered.

HQ has a network of “Wellness Champions” at locations throughout the state. The SEHP is working to promote wellness activities through monthly telephone conference calls.

Specifics on for the 2017 Earning Period and Year to Date for the 2018 Earning Period are included as Exhibits 5 of this RFP.

Other HealthQuest programs offered throughout the years Include: Health and Wellness Presentations A Weight Management Program Onsite Flu Vaccination Clinics Employee Assistance Program including: face-to-face short-term counseling, legal and financial

counseling, work-life resources, and elder care/child care information available to all members and families of the SEHP, also includes critical incident/stress management counseling sessions, a formal referral program and a conflict resolution program for state agencies. Note: the Employee Assistance Program must be integrated into the Wellness Program Portal, but is procured separately and is not up for bid at this time.

Eligibility to Participate in Wellness ProgramsThe following are eligible to participate:

Benefits eligible State and Non State employees who are enrolled in the medical portion of the State Employee Health Plan or who have waived coverage in the plan

Spouses of active employees who are 18 years or older who are enrolled in the medical portion of the State Employee Health Plan

At a minimum the following services are required:

Plan Materials: Vendor will be responsible for preparing necessary communications materials for approval by the SEHP to communicate the program to members and for use by the SEHP. Examples of necessary communications include but are not limited to Earning Period initiation, open enrollment, earning period closure and/or other program materials. Vendor must advise and assist the SEHP in the preparation of forms and other documentation necessary to fulfill reporting and disclosure requirements.

All plan materials and notices are to be mailed to the home address of each enrolled member. All materials must be approved by SEHP staff prior to use with SEHP plan members. Plan materials are to be approved and posted to the web by November 1 of each year to provide access to members and staff.



Plan Administration: For the services which you offer to the SEHP, you will provide complete plan administration, accounting, data processing, cost control, quality assurance, utilization review, marketing, customer service, fiscal and any other services necessary. All products and services not specifically mentioned in the RFP, response and this Contract, but which are necessary to provide the functional capabilities described by the specifications, shall be included.

Partner with SEHP: Vendor will assist in a consultative capacity with regard to the Wellness Program components and integration with the health plan(s) and related programs and any subsequent revisions of the Program design as deemed appropriate from time to time, including advice and assistance with respect to provisions relating to eligibility, effective dates, coverage and cessation of coverage under the program. Act in an advisory capacity to the Employee Advisory Committee upon request. Wellness vendor must demonstrate in their administration of the wellness program their ability to cooperative will all other SEHP vendors.

NOTE: Vendors may bid on only one service or multiple services being requested.

4.1 General Requirements4.1.01 Vendor shall be responsible for compliance with the privacy and security provisions of the

Health Insurance Portability and Accountability Act (HIPAA) and shall comply with other HIPAA provisions and regulations applicable to the SEHP, including all terms of the applicable Business Associate Agreement (hereinafter referred to as the “BAA”), as well as applicable terms of the Financial Services Modernization Act of 1999, the HITECH Act of 2009, and any other federal or State law pertaining to the protection of personally identifiable information. The Vendor shall accept full responsibility for providing adequate supervision and training to its agents and employees to ensure compliance with the Act.

4.1.02 Vendor must comply with the State policy on computer security found at: http//oits.ks.gov/security/policy.htm as well as with encryption standards specified in applicable state and Federal policy and law, including State of Kansas ITEC, HIPAA, HITECH, FISMA, NIST, and FIPS standards for the storage and transmission of confidential or restricted data.

4.1.03 Vendor shall commit to providing during the length of the contract written notice to the SEHP in advance of any major computer system conversion or other technology changes that may affect the delivery of services to the SEHP. This does not apply to any program fixes, modifications and enhancements.

4.1.04 Vendor coordination and cooperation: The SEHP contracts with several vendors to meet the needs of the SEHP. All Vendors are deemed partners and are expected to share information and data with one another to achieve a cohesive member experience for all lines of business. These may include but not be limited to:

Vendor agrees to exchange data feeds with other Vendors of the SEHP as required to advance the program integration of the SEHP. This may include but is not limited to health plan ASO vendors and insurance companies, wellness and transparency tool Vendors.

4.2 Account Management4.2.01 The Account team that will work in conjunction with the SEHP staff on all aspects of the

program must be able to devote the time needed to the account, including being available for frequent telephone and on-site consultation with SEHP.

4.2.02Each Vendor shall upon request and at no cost to the SEHP, have a representative at planning meetings, Health Care Commission meetings, Employee Advisory Committee meetings or other meetings as requested through and approved by the SEHP.



4.2.03The SEHP reserves the right to request the removal of any individual associated with the SEHP’s account for unsatisfactory performance as determined by SEHP.

4.2.04Vendors will establish and maintain secured e-mail communications protocols to facilitate program operations with SEHP.

4.2.05 Vendor will work with SEHP to develop meaningful reporting, making modifications to report structures and contents as necessary to meet the needs of SEHP.

4.2.06 No reports regarding this program may be published without the expressed written consent of the SEHP and the HCC.

4.2.07 Vendor agrees to advise the SEHP of the number and type of complaints made known to the Vendor.

4.3 Member Services4.3.01 Quality customer service for our members is a critical component of this contract.

Important characteristics will include promptness, courtesy and accuracy of responses. Customer service representatives (CSRs) should be able to handle questions and concerns regarding the portal, member status and technical support. Customer service should be able to troubleshoot any system issues and make appropriate referrals to others within the company to resolve any member issues. CSRs should be willing to initiate call-backs to customers when appropriate. Customer service is not to refer members to the SEHP, Agencies or Non-State Entities to resolve issues other than eligibility.

4.3.02 HealthQuest has an established toll-free number in which vendors will need to be a part of the phone tree for our participants. The toll-free number is owned by the SEHP and fees associated are covered by the vendors. Each vendor will be assigned a option number that will transfer the call to the vendor’s customer service center.

4.3.03At minimum members shall have access to customer service representatives answer the the toll-free number between the hours of 8:00 AM and 5:00 PM Central Time, Monday through Friday.

4.3.04If the Vendor elects to close due to inclement weather, natural disasters, other business reasons, or phone lines are unavailable, the Vendor will provide timely notification to the Senior Manager of Health Plan Operations, including the reason for closure or disruption and estimated time to restore service or function.

4.3.05Vendor shall not use the names, home addresses or any other information obtained about participants of this plan for the purpose of offering for sale any property or services which are not directly related to services negotiated in this RFP without the express written consent of the SEHP. Vendors are prohibited from using any of the member’s information or data without the express written consent of the SEHP. Data share with the vendor will be the minimum necessary to provide the services being requested.

4.3.06All materials, including all notices and mailings, must be pre-approved by the SEHP prior to distribution to SEHP members.

4.4 Eligibility4.4.01 The SEHP will make all determinations with regard to eligibility to participate in the wellness

program. The Vendor shall work quickly and efficiently to resolve all eligibility issues with the SEHP staff.

4.4.02 The SEHP and the Vendor must agree on the eligibility file layout. Any requests to modify this layout must be approved by the SEHP. The SEHP will work with the Vendor to establish the eligibility file layout to be used.

4.4.03 Vendor must be able to accept either change files or full files every work day in the agreed upon layout.

4.4.04 Vendor must be able to retrieve all files from the SEHP secure FTP server daily. Files will be placed on the SFTP server by 11:00 AM Central Time every weekday unless Vendor is otherwise notified of a schedule change. Vendor must notify SEHP staff within twenty-four (24) hours if information on the file received is incomplete or unreadable. Vendor will provide eligibility load reports to the SEHP staff within twenty-four (24) hours of file processing.



4.4.05 Vendor is responsible for establishing, maintaining and accurately updating eligibility records. Vendor agrees to process enrollment additions, changes and deletions within two (2) business days of the release date of the file. Eligibility files sent correctly by the SEHP staff but not processed correctly by the Vendor will be retroactively corrected back to the original effective date, even if the correction occurs more than sixty (60) days following the date of the original changes. Vendor will provide eligibility load reports to the SEHP staff within twenty-four (24) hours of file processing.

4.4.06 If regularly receiving change files, Vendor shall receive a periodic full file eligibility file for the comparison purposes. Currently the full eligibility file is provided monthly. SEHP may change the delivery schedule of the full file with notice to the Vendor. Vendor shall compare the full file with their eligibility records and provide the SEHP with a mismatch and reconciliation reports within ten (10) business days of receipt of file. Incomplete or unreadable information must be reported to the SEHP within twenty-four (24) hours. Once this report has been reviewed by SEHP Membership staff, the vendor may be directed to modify, terminate or add members as need to bring the eligibility in to alignment.

4.4.07 Reporting and Eligibility tracking for the SEHP is on the following membership divisions:o State of Kansaso Non State Entities

4.5 Website4.5.01 The website structure, pages and content shall be available by November 1 of the year

prior to the start of the contract program year, for review and usability testing. On and after the launch date, the web structure, pages and content shall be available 24-hours per day, seven days per week, except for reasonable maintenance periods. In the event of downtime, the Vendor shall immediately notify the SEHP of the nature of the delay and the expected duration of downtime. If possible, a notice should be posted on the website to notify users. Substantial changes to the website structure or content shall be coordinated with the SEHP staff prior to implementation.

4.5.02 Website shall be ADA compliant with 508 and WC3 standards.4.5.03 The SEHP would like to have single sign on to all of the Wellness programs and the

ability to do online registrations and event scheduling.4.5.04 Vendor shall have a secure messaging system for our members to contact customer

service from the web portal for questions.

4.6 Billing 4.6.01 Billing and Payment: Vendor will provide detailed and accurate billing invoices to the

State monthly. Preference is for the bills to be sent in electronic media to designated SEHP staff along with details of all program components and the cost associated with them. Payment will be made to the vendor within three (3) business days of the SEHP’s reconciliation of the invoice.

4.6.02All invoices must be sent electronically to the designated SEHP staff on the vendor’s letterhead or invoice format by no later than the 10 th of each month for the prior month’s activities. The programs billed on the invoice must be labeled in the same manner as the programs you identify in this Technical Proposal, the Cost Proposal Exhibit 2 of this RFP and any Best and Final documents associated with this RFP. If you bundle items for billing, you need to label the bundle in the same way in the Technical and Cost Proposal of this RFP as well as the Best and Final documents. If you list items on the invoice as line items, they must be listed in the Technical and Cost Proposal as well as any Best and Final documents in that manner. Each invoice must be for a set period such as a calendar month.

4.6.03Invoices are due by the 10th day of the month following the month for which services are provided or other timeline that is agreed to by both the SEHP and the vendor.

4.7 Data, Claim Information and Reporting – this is where we need to talk about the files we will



send them and the files they need to send to us. 4.7.01 Vendors must be able to track completion of activities and reporting on an ongoing basis

for the HQ Rewards program. Weekly and Monthly Participation (Employees/Spouses/State Agencies/Non-

State Agencies. Health Plan A, C, J, Q, and N)Quarterly and Annual Reporting

4.7.02 Vendors must be able to report weekly to the SEHP the amount of money to contribute to participants HRA/HSAs through activity and program completion. Refer to Exhibit 6 for the SEHP layout.

4.7.03 Vendors will need to work with the SEHP as well as individual agencies to report those who have not completed the program and reached their incentive goal as well as those who have not begun participation throughout the plan year.

4.7.04 Vendors must be able to report weekly to the SEHP the New Hires (less than 12 months employed) who earned the HQ reward. See Exhibit 10 for New Hire Policy

4.7.05 Vendor will need to be able to work with our medical, dental and flu vaccination vendors to process data regarding preventative exams and flu shots to award HealthQuest credits automatically.

4.7.06 Vendor will need to work with other contracted vendors to share activity completion data to upload credits.

4.7.07 Vendor will furnish a monthly biometric data file by the 10 th calendar day of the following month to the SEHP’s Data Management Vendor, in a format mutually agreed between the Vendor, the SEHP and the Data Management Vendor.

4.7.08 The wellness vendor must be responsive to the needs and desires of the SEHP. Be flexible in administering the program and provide options and opportunities for the SEHP HealthQuest program to personalize aspects of the website, programs and other functions.


I have reviewed the Scope of Work associated with the Request for Proposal, and acknowledge that the document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this section of Request for Proposal, subject to the modifications, conditions and limitations I have listed below.



_________________________________________________ Title

_________________________________________________Date



SECTION VVendor Questions

Instructions

We are looking for best in class vendors and programs. SEHP seeks a combination of health and wellness program resources to be branded as “HealthQuest” for our members. In Section V, answer the appropriate subdivisions for services and programs you, the vendor is bidding on.

The language or terms used to identify/describe services in the Technical Proposal (Exhibit 1) needs to match the language/terms used to describe the services outlined in the Cost Proposal (Exhibit 2). For example: if in the technical proposal we ask you to provide a flu shot, and you are providing a flu shot, you need to have listed as a flu shot with the cost in the cost proposal. So if selected, when you prepare your invoice for payment, you will bill the services as a flu shot and the pricing matches what is included in your cost proposal. If services are part of a bundle of services for billing, then you need to identify they are bundled in the same manner in the cost proposal and technical proposal so that we are clear on what your proposal provides and at what price.

5.1 Implementation and Transition

5.1.1 Provide a proposed implementation plan that includes both a project overview and details on specific tasks, timeliness and responsibilities. Clearly delineate the tasks you expect the State to perform and the information you expect the State to provide. Describe the steps that must be taken in order to assume all responsibilities as of the go-live date. At a minimum, address the following:

The project timeline including all standard tasks involved in the successful implementation of the program, a schedule of milestones and deliverables and the responsibilities of both the Vendor and the SEHP for each task. Assumptions and expectations should be provided for each key component of the Implementation Plan.

A roster of the implementation team members detailing each member’s primary work location, roles and responsibilities

A comprehensive description of activities related to information systems, including data interface/integration with critical systems, intake and assimilation of transition and eligibility data, and testing requirements and timelines.

A description of how the Vendor will work with the current Vendor to transition all pertinent member data for those member’s participating in the HealthQuest program components.

Answer:5.1.2 Please describe:

Your experience implementing product or service the implementation tasks you deem to be the most critical and or risky and your ability to successfully manage these tasks

Answer:5.1.3 For the proposed account team for this Contract:

Describe how a smooth transition will be assured when the implementation team is phased out and replaced by the ongoing Account Team. Provide projected dates for the transition. Will the onsite be part of the implementation?

Specify how you would implement a succession strategy in the event of a change in your customer service or account teams. How would you assure that vital information about the program has been transferred to the new team members.

Detail how the SEHP will play a role in the decision-making process for



underperforming staff. Does your corporate Human Resources policy conflict in any way with the State’s ability to request a change in staff, when the SEHP feels it is necessary?

Provide an overview of the evaluation tool(s) that the SEHP may use in providing formal written evaluation of the Account Team’s performance, the projected frequency of such feedback and how the feedback will be used to improve performance.

Answer:5.1.4 Discuss how data from a prior vendor can be incorporated into the web profiles to ensure

members have historical information to reference. Provide a timeline for incorporating the data files and any criteria that may affect your ability to upload this data. Or, if bidding on a stand-alone product, how data from your program can and will be integrated into the main platform of the HealthQuest program.

Answer:5.1.5 Data regarding the HealthQuest program and our members belongs to the SEHP.

Explain the process for transiting the data files and the timeline for transferring the data files to the SEHP and/or its designated vendor.

Answer:5.1.6 After this contract has end and the data transitioned to the SEHP and/or its designated

vendor, explain the timeline and process you would use to eliminate any outstanding SEHP member’s records containing PHI from your system.

Answer:5.1.7 Provide a sample of your standard bill you propose to use for billing the SEHP for

services. Answer:5.1.8 The HQ program is a calendar year based program. If the SEHP elects to implement the

new vendors mid-year, explain how this would affect the programs you offer and how you would transition members over to the new programs, sites, etc.

Answer:5.1.9 Talk with us about your experience in being part of a larger team of independent

contractors offering different parts of a wellness program? What worked well? What challenges did you experience in working in this environment?

Answer:

5.2 Account Management5.2.1 If you are proposing to have a staff member onsite in our offices to manage your program,

how soon will you have a person onsite? Will the SEHP participate in the selection of this staff person? Will this member come internally from your organization?

Answer:5.2.2 What lines of communication are utilized other than the portal? (Ex. Emails, Home

mailer). Describe how you will communicate with our members. What methods of communication are used? Please attach a few sample communication materials you have produced for your clients that you feel were the most successful. Are customized communications available? Is there a cost for customization?Note: All costs must be shown in the Cost Proposal section of your bid response.

Answer:5.2.3 The SEHP has a network of Wellness Champions to assist in promoting the HealthQuest

program throughout the various agencies and entities. Provide examples of Wellness Champion education, tools and resources used by your organization. How will you assist the SEHP to recruit, train and educate Wellness Champions?

Answer:5.2.4 How do you track and report program participation and completion? Satisfaction levels?Answer:5.2.5 What have you found to be the most meaningful measures of the success of your



program? Do you have scorecard or dashboard for use with your clients?Answer:5.2.6 The SEHP expectation is that the vendor will be able to produce reports based upon the

eligibility files sent that will show who has completed the program and who has not. We also will need data broken down by employment group (State agency or Non State Public employers). We expect the vendor to be able to identify which employees have not yet opened their accounts or completed their activities. Describe your abilities and experience in this area.

Answer:

5.3 Customer Service (both telephonic and e-mail)5.3.1 How is customer service reached? Do you offer support via phone and email?Answer:5.3.2 In your organization, is there a distinction between Customer Service and Tech Support?

If so, describe. How is customer service and tech supported contacted? (Phone/Email) What are the hours of operation?

Answer:5.3.3 Describe the training provided to members of the Customer Service Unit(s). How will you

assure that this unit is trained and ready for HealthQuest/SEHP member calls/emails prior to the start of the plan year as well as prior to the beginning of each new plan year?

Answer:5.3.4 Describe the process for development and launch of a group email to a target population.

Include the timeline and approval process for all phases of development (visuals, content, distribution list, etc.) Delineate what steps are internal to your organization and what steps are the responsibility of the SEHP. Are there limitations to your email system such as using images?

Answer:5.3.5 What are your normal customer service and technical support hours? The State requires

a minimum of Customer Service access from 8:00am to 5:00pm Central time, Monday through Friday. Will you be able to meet this minimum? Would expanded hours of 7:00am to 7:00pm, Central time, or something similar, be available?

Answer:5.3.6 Do you use an automated phone system? If yes, does the menu include talking to a ‘real

person’ or CSR? Would the menu, script and language your CSRs use be able to be customized to match the language standards the State has when responding to member calls?

Answer:5.3.7 What is the average time to answer the telephone? What is the average time a person

waits in queue to speak to a representative? What is the average time to receive and respond to an email?

Answer:5.3.8 What types of reports are provided to the State relative to customer service performance?

How are these calls tracked and reported to the State?Answer:5.3.9 Are calls recorded and reviewed? How long are the recordings stored? Emails? Are the

recordings available to be reviewed by the client if a situation should require that?Answer:5.3.10 If an immediate need arises, will the tech team or the CSRs have the ability to set up or

modify a member’s account over the phone?Answer:5.3.11 If the SEHP has a question related to a member interaction with your staff, will you allow

SEHP to listen to the call recording? If not, explain why not. Answer:5.3.12 Is both tech and customer support available by email? Explain how your customer service



representative handle member email contacts. How quickly are responses provided to the member? Do you track email contacts by members? If so, how are they reported?

Answer:

5.4 Eligibility/Membership Processing 5.4.1 Are you able to process week daily electronic eligibility files? Confirm your ability to pick up

eligibility files from the SEHP Secure FTP site.Answer:5.4.2 Review the eligibility file layout attached and comment on your ability to administer the file

as presented. (Exhibit 7). If you have a standard eligibility file that you use, please submit that layout with your proposal. The SEHP reserves the right to use whichever file is easiest for the SEHP.

Answer:5.4.3 Do you prefer daily update/change files or full files of all eligible members and

dependents? If you elect to receive daily change files, what is your process for a periodic true-up/reconciliation with SEHP’s membership?

Answer:5.4.4 Can your system process eligibility files with multiple transaction rows for one participant?Answer:5.4.5 Describe your procedures for changing a member’s status. For example, an employee’s

spouse has participated in the wellness program, but has now been hired as an employee in a benefits eligible position. How will you transfer credits earned as a spouse over to the employee’s account? What is the timeframe required for the transfer?

Answer:5.4.6 Provide samples of eligibility reports available to the SEHP. Answer:5.4.7 What fields from the SEHP eligibility file can a member be mapped on in your system?Answer:

5.5 Program and Data Integration5.5.1 The SEHP has been outsourcing some of the activities of the wellness program, such as

weight management, to another vendor. As indicated in the Scope of Work, we intend to purchase the programs or services that best meet the SEHP goals for improving our employees wellness and we intend to pursue best in class program that are stand alone programs. Describe your experience in working in an integrated environment with multiple vendors responsible for different parts of the program? If you are proposing an overall web portal for all services, there are additional questions on integration in section 5.8.

Answer:5.5.2 Does your company offer discount programs for fitness trackers, gym memberships or other

similar arrangements that can be extended to SEHP members for various programs? Please provide a thorough explanation of the services and how members access these services. If there are any cost associated with these discounts that would be charged to the plan, they must be included in Exhibit 2 the Cost Proposal.

Answer:5.5.3 Describe any ad hoc reporting capabilities and time frames for requesting special data runs.

If additional costs are required for ad hoc reporting, please place those costs in Exhibit 2 – Cost Proposal.

Answer:5.5.4 Would the SEHP Data team be able to access de-identified data on your system to run their

own queries and reports?Answer:



5.6 HIPAA 5.6.1 Please confirm your compliance with HIPAA privacy and security rules for data transferred

to outside parties. If you cannot confirm, please explain below.Answer:5.6.2 How do you maintain a secure environment for communicating and transacting business

with each audience (members, subcontractors, allied/integrated program offerings)? Briefly describe your privacy policy

Answer:5.6.3 Has your company experienced any data breaches in the last 5 years. Describe the

situation and how you assist member’s whose data may have been exposed. How did you remediate the issue to protect against future breaches?

Answer:5.6.4 Have you been investigated by a state or federal agency for issues involving HIPAA? Data

breaches?Answer:

5.7 ADA 5.7.1 Has your website been tested and certified for ADA compliance with 508 and W3C

standards? If not, will your website be compliant by 10/1/2018?Answer:5.7.2 What accommodations are available in your Customer Service department for those with

disabilities (e.g. TDD/TTY access) or for those whose primary language may not be English?

Answer:5.7.3 Describe in detail the testing protocols for ADA compliance, color blindness, contrast and

legibility and list all equipment on which your web application is tested. Is your web application compatible with industry standard ADA accessibility tools? i.e. JAWS Screen Reader?

Answer:5.7.4 Explain your procedures for reviewing administrative protocols and confirming program

compliance with project reporting requirements and federal guidelines for wellness programs and ADA compliance.

Answer:5.7.5 Explain how the service you are offering would accommodate someone with ADA

identified disabilities to allow for participating in you programs or service. Answer:

5.8 Rewards Tracking: Please complete for the services you are offering to the SEHP5.8.1 If you are proposing a web portal, please describe your rewards tracking system. How will

you ensure that all vendors programs can be eaily accessed on your portal? Answer:5.8.2 How will credits for completion of activities from independent vendor’s programs be

uploaded and displayed on your portal? Is this an automated or manual process? Describe the normal procedure used and timeline for uploading credits from outside vendors.

Answer:5.8.3 Based on the rewards that the SEHP offers for participation in the various wellness

activities, and if the SEHP adopted all of your best practice methods for communication and promotion, what would you project the participation to be in your program offerings?

Answer:5.8.4 Are you able to remit weekly reports detailing activity completion to the SEHP so that we

can process the member cash rewards into their HSA or HRA? Are you able to report a specific date when a member completed a reward activity to the portal vendor for display on their website? What is the timeline for reporting those activities to the SEHP so that we can



fund the HSA or HRA account?Answer:5.8.5 For the HQ rewards premium incentive reduction, explain how you will track and report on

this to the SEHP and to the web portal vendor. As new members have 12 full months to earn the premium incentive, how will you track this and report to the SEHP and web portal vendor once a new hire has earned the premium incentive discount? (Exhibit 10 for New Hire Policy)

Answer:5.8.6 If you are providing a service outside of the web portal itself, explain how you will track and

report member activities and report them to the web portal vendor. Provide a sample report. Answer:

5.9 Web Portal: Complete if you are proposing a web page or web portal for HealthQuest5.9.1 Provide your web address and a web address of a customized/personalized employer site.

Describe the features/activities/programs available. Provide links and log-in information needed to preview and demo your web resources.

Answer:5.9.2 Describe in detail your internet capabilities for:

Member inquiry capabilities Employer inquiry capabilities Linkage to other Vendors, including but not limited to any subcontracted specialty

networks such as an EAP program, a specialty weight loss program, financial program or an outsourced Tobacco Cessation program, challenge vendor.

Security/privacy issues Future plans/timeframes for enhancements.

Answer:5.9.3 Describe in detail the process for members to open an account on your webpage. Spouses

covered under the SEHP must use the employee’s identification number to verify their eligibility. Talk with us about how your system can be structured so the spouses can easily open and account. Do you have the ability to create a drop down box for selecting whether the person is an employee or a spouse?

Answer:5.9.4 Do you have the capability and willingness to create a personalized web experience

(incorporate third party content including challenges, programs, and upload transactions)? Can the SEHP change the color, placement of items, font type or size? How long will it take to make these changes? Is there additional cost involved? Is your platform customizable? Any potential fees for these services must be clearly outlined in Exhibit 2 the Cost Proposal of this RFP. Any fees not disclosed will not be payable by the plan.

Answer:5.9.5 Is the SEHP able to provide SEHP-specific information to be loaded on the site?Answer:5.9.6 How is your portal supported on mobile devices such as PDAs, tablets and smart phones?

Does the portal support and integrate with different apps? What types of apps are available and what mobile devices are supported?

Answer:5.9.7 Do you offer community message boards? If so, how many and in what areas of interest?Answer:5.9.8 What method(s) do you use to notify clients and participants of scheduled down-time for

the web applications? Non-scheduled down-time?Answer:5.9.9 Describe in detail how access will be provided to HealthQuest resources that are not

owned and/or administered by your company. Example: Links or SSOAnswer:5.9.10 What is the procedure for establishing Single Sign On (SSO) with other vendors used by



SEHP? Is SSO a possibility? (Ex. Medical Vendors, Pharmacy, Transparency tools)Answer:5.9.11 Do you offer any translation services for members who speak Spanish?Answer:5.9.12 Can participants access their own histories, including point/credit accumulation, challenge

participation, other program option participation? For what period of time will these histories available? If the SEHP is able to provide historic data for uploading, explain how you will use this data to provide member’s histories in your portal. If there are any requirement, please include those and if additional fees will apply, they must be reflected in your cost proposal

Answer:5.9.13 Do you provide automatic messaging to participants on activity/program completion?

Provide examples.Answer:5.9.14 Currently SEHP member are able to submit their results from their annual well person

exam for uploading and credit into the web portal by completing a submitting a report form. This activity may not be able to continue based on the recent AARP case. What is your company’s position on this case and credits for biometric values? Do you have experience in handling PHI such as this and keying it into the member’s account for credit?

Answer:5.9.15 Can the portal distinguish and report which biometric values are self-reported and which

are automatically uploaded and which method they were loaded from screening event, reporting form or home kit?

Answer:

5.10 Wellness Content and Challenges: Complete this section if you are bidding to provide web content for the HealthQuest webpage or Wellness Challenges

5.10.1 List and describe in detail the components that make-up your web-based interactive programing. How frequently are these programs updated? Are the programs graduated (e.g. a person completes a module and is invited to continue to a similar, more detailed, different program to support long term lifestyle changes)? What self-assessment tools are available to participants? (Ex. Progress Trackers)

Answer: 5.10.2 Provide samples of the content and challenges that you are proposing for the SEHP?

Answer:5.10.3 One of the goals for HealthQuest is promoting our employees to engage in physical

activities and healthy lifestyles. Talk with us about your experience in engaging members in being more active and physically fit. How is this reflected in the programs you are recommending to the SEHP? How do you use technology to further this goal?

Answer:5.10.4 Is there opportunity for team challenges or individual? If team, can employees create their

own teams? Can teams consist of only one individual?Answer:5.10.5 Can challenges be administered at various times or at different agencies? (Ex. Agency A

would like to have an HQ challenge for their specific agency at a different time than offered through HealthQuest or a new member starts employment and missed a challenge but would’ve liked to participate in it) Can your platform handle this?

Answer:5.10.6 If cardiovascular wellness challenges are an option is there a list of activities members can

choose from in order to log their activity? If so, is that list customizable by the client? Can the client or participant add/remove/create activities?

Answer:5.10.7 Can you provide some sample marketing materials regarding your wellness challenges?



Answer:5.10.8 What are your options for those to participate in wellness challenges that may have physical

limitations? Provide examples.Answer:5.10.9 Explain how you handle situations where members have entered data that is not reasonable

into a challenge? For example: Excessive number of hours of participation during a work day or activities that do not fit with the challenge? Do you monitor this type of behavior and how is it addressed?

Answer:5.10.10 For challenges that require logging a number of steps, minutes of exercise, etc is there a

way to put a maximum allowed? A daily limit or challenge limit? Can this be uploaded by activity tracker?

Answer:

5.11 Biometric Screening: Complete this section if you are bidding to provide onsite biometric screenings

5.11.1 The SEHP has typically offered onsite biometric screenings at locations throughout the State. Based on recent changes to the EEOC rules this may or may not be a future offering. Has your firm reviewed the AARP/EEOC ruling? What is your position on the ability to include such offerings in a wellness incentive program?

Answer:5.11.2 Does your company use its employees to provide biometric screenings, or are you

partnering in your bid with another provider or using contract workers? ExplainAnswer:5.11.3 What type of staff is used to conduct the biometric screening programs? Are they recruited

locally? Describe the required credentials. Describe the training provided prior to the beginning of an event schedule. How is the screening staff trained for events and counseling of members?

Answer:5.11.4 How do you ensure the privacy of the member and their health information during the

screening from others in the room? Address both privacy from view as well as from hearing a member’s confidential information.

Answer:5.11.5 Do you offer home screening kits for areas where biometric screenings are not offered or a

member isn’t able to attend a local screening? The SEHP requires that the cost for home kits be billed separately from the returned kit lab processing fees. Can you accommodate this request?

Answer:5.11.6 How do individuals order a home kit if offered? Online, fax, mail? The SEHP requires

reporting on the number of kits mailed and the number of kits returned. What is your best practice for promoting the return of kits.

Answer:5.11.8 Is there a minimum number of participants to host a screening? If so, what is that number?

Can it be tailored to our program as we have past participant data?Answer:5.11.9 Do you agree to work with the SEHP to develop the rewardable biometric values for our

members? For example the SEHP currently accepts a blood pressure reading equal to 120/80 as a normal reading regardless of the age of the member.

Answer:5.11.10 Do you provide a full-time supervisor to coordinate, attend and manage all events? If yes,

describe the training required for this position and provide a copy of the job description.Answer:5.11.11 Describe your recommended Biometric Screening staffing model (e.g. how many participants



can be screened per hour, number of staff, number of screening stations, etc.)Answer:5.11.12 Are the results of the biometric screening automatically uploaded into a wellness portal? If

so, what is the process and time frame for this activity and upload? Can the results be uploaded directly from the screening site in real time?

Answer:5.11.13 Provide a demo of your online scheduling service, including confirmation notice and time

frames for scheduling, rescheduling, canceling appointments. Is there a telephonic option to schedule appointments? Are walk-ins accommodated? (If so, any restrictions?)

Answer:5.11.14 The SEHP requires that biometric screening information be reported to the SEHP Data

Management Vendor at least monthly. Do you have similar protocols in place with other clients? Please confirm that you agree to work with the SEHP and the Data Management Vendor to develop a mutually agreed upon format.

Answer:5.11.16 If a member’s results are outside of acceptable range, describe the process for referring the

member for further medical evaluation. Do you follow-up with the member to see if they have received follow up care?

Answer:5.11.17 If a member is in a wheelchair or otherwise has a disability that prevents them from being

unable to stand to be weighed, do you have another means of estimating their weight? What other options have you provided these individuals?

Answer:5.11.18 Explain any reasonable accommodations for members with ADA issues or other disabilities

that might prevent them from participating in the screening event. Answer:

5.12 Health Assessment Questionnaire (HAQ): Complete this section if you are bidding to provide a HAQ

5.12.1 The SEHP has required completion of an HAQ to be eligible for the premium incentive discount. Given the recent AARP/EEOC case this may not be future offerings. Has your firm reviewed the AARP/EEOC ruling? What is your position on the ability to include such offerings in a wellness incentive program?

Answer:5.12.2 The SEHP has promoted preventive care as part of its health plan since well before the

passage of the ACA. Many of our employees are covered under medical homes by our health plan that already incent their health providers to make sure they get their preventive screenings. According to our medical vendors, our employees uses these preventive screenings at a higher than their average clients and higher than their book of business rate so we do know that the vast majority of our employees are getting their preventive care. So talk with us about why you think a HAQ adds value to the HealthQuest program.

Answer:5.12.3 Are you proposing to use a Health Assessment Questionnaire? If so is it developed internally

or is it procured from a third party? If a third party, please identify the company that has developed the HAQ. Provide samples of available questionnaires and explain why you would recommend this HAQ for our members.

Answer:5.12.4 Is the HAQ question set modifiable by the SEHP? What is covered under the proposed HAQ?

How many modules are included? Are there modules that are optional? Explain. Which modules would you recommend for the SEHP population?

Answer:5.12.5 Are biometrics a required module of the HAQ or can they be separate activities?Answer:5.12.6 For employees that already have their biometric values from their physician, explain the



process for integrating this information into the health assessment.Answer:5.12.7 If you are not selected to provide the Biometric Screenings for the SEHP population, explain

the process you will use to upload the values from the screening vendor into the HAQ? Include a timeline for this to occur and the results to be visible in the portal. Explain the process for uploading results from home kits and provide a timeline of how long will take before the results appear in the portal.

Answer:5.12.8 Do participants receive a summary report immediately upon completion of the Health

Assessment Questionnaire? If so, does the report reference further opportunities for health improvement available within your wellness programs? Explain and provide sample summary reports.

Answer:5.12.9 Provide examples of the summary report provided to the SEHP at the end of the program

year based upon completion of the Health Assessment Questionnaire. What information is available for year over year comparison? Will you prepare a cohort study for the SEHP based upon this information?

Answer:5.12.10 Is the Health Assessment Questionnaire available in paper format or telephonically for those

not wishing to use a computer for this feature? Please confirm that the data is input by vendor for the written questionnaire and while the member is on the phone for the telephonic version. How will this be uploaded into the web portal if you are not the web portal vendor?

Answer:5.12.11 Does the Health Assessment Questionnaire have to be completed in one sitting? Can a

person save the document, if interrupted, and come back to complete it later? How long does the Health Assessment Questionnaire take to complete, on average? (answer for the online, telephonic and paper versions)

Answer:

5.13 Health Improvement: Complete this section if you are bidding to provide Health Improvement programs and Condition Management

5.13.1 Provide a brief summary of the health improvement programs you offer. Do you offer online video classes? What are the options for members to engage in the program?

Answer:5.13.2 What is the average participation rates for each of your programs listed above? Do you collect

and measure member satisfaction with your programs. What type of reporting will be provided to the SEHP on member participation and satisfaction rates? Provide sample reports.

Answer: 5.13.3 On health improvement offerings for health conditions, how would a member be invited to

engage? Are their different levels for severity of condition to be included? What is offered for those that don’t meet this severity level?

Answer:5.13.4 Do you offer disease management services using connective devices with remote

monitoring? If so describe your program and how it works. What type of published results have you produced in other populations using this technology to better manage the patients’ health?

Answer:5.13.5 If health coaches are used, are you proposing onsite, telephonic, video chat or IM coaching?

How and when do they engage with members? Answer:5.13.6 If you are proposing health coaching, how will you address our members unwillingness to

participate in telephonic coaching and the SEHPs geographic diversity of our population that



makes face to face coaching impractical? How do you propose to achieve any measurable changes in the overall health of our population given these limitations? If you propose to do onsite visits, in your cost proposal you will need to include an estimated annual travel budget that includes all costs potentially billed to the SEHP for these services.

Answer:5.13.7 Are members able to customize the goals and activities? Explain.Answer;5.13.8 Is there a specific requirement to complete the program? Or is it tailored to the goals of the

individual? What is the average frequency of activities or classes? What is the average number of sessions completed per participant?

Answer:5.13.9 Is there a process to monitor and follow- up with individuals to ensure they are continually

engaged and completing activities? Or to re-engage? Answer:5.13.10 Describe the resources provided to or used by the member in the program? Examples: email,

online learning tools and video courses etc.Answer:5.13.11 How is success with these programs measured? What type of data is collected to measure

program success? Answer:5.13.12 What hours are your health improvement and coaching services available? Are they different

from your customer service hours? What different avenues are available for members to interact with the program and program staff?

Answer:5.13.14 Do you have the capability to upload and integrate claims data from the SEHP’s medical

plans? If so, describe procedures for identifying and managing risks and health conditions flagged through this source?

Answer:5.13.15 As previously indicated, many of our members are covered under medical home projects and

ACOSs. How does your program include the member’s physician in the educational process and programs provided? Describe.

Answer:

5.14 Tobacco Cessation: Complete this section if you are bidding to provide Tobacco Cessation 5.14.1 Briefly describe each your tobacco cessation program, the thresholds for inviting an individual

to participate, average participation rates, how individual satisfaction and health goals are measured and the coach qualifications.

Answer:5.14.2 How are individuals introduced to the coaching service and encouraged to participate?

Describe the outreach protocols and alternative methods for communicating program availability.

Answer:5.14.3 Is there a minimum criterion you use for determining participation in order for an individual to

be counted as enrolled in the program? What is the criteria for program completion?Answer:5.14.4 Do you offer any tobacco cessation assistance products with the program?Answer:

5.15 Other Programs and Service Offerings5.15.1 For other services that you offer that we may not have asked about you many include those

items here. Briefly describe the programs and at what population does the program serve. Answer:5.15.2 What makes this program a best practice and successful?Answer:



5.16 Disaster Recovery 5.16.1 Describe mechanisms in place for systems backup? Answer:5.16.2 Describe the mechanisms in place for disaster recovery.Answer:5.16.3 How do you maintain service and benefits for members and providers when a natural disaster

occurs in the area of your primary operations?Answer:


I have reviewed this section of the Request for Proposal and acknowledge that this document shall become part of the final contract by reference. I hereby acknowledge and accept responsibility for the accuracy of all responses, requirements, and conditions stated in this section of Request for Proposal, subject to the modifications, conditions and limitations I have listed below.

________________________________________________________Authorized Signature of Vendor

________________________________________________________Printed Name of Signatory

________________________________________________________Title



SECTION VIPERFORMANCE STANDARDS, GUARANTEES, LIQUIDATED DAMAGES

LIQUIDATED DAMAGES The purpose of liquidated damages is to ensure adherence to the performance requirements in the contract. No punitive intention is inherent. It is agreed by the State and the Vendor that, in the event of a failure to meet the performance requirements listed below, damage shall be sustained by the SEHP, and that it is and shall be impractical and extremely difficult to ascertain and determine the actual damages which the SEHP shall sustain in the event of, and by reason of, such failure; and it is therefore agreed that the Vendor shall pay the SEHP for such failures at the sole discretion of the SEHP according to the following:

Damages assessments are linked to performance of system implementation or operational responsibilities. For all self-reported metrics, the vendor should provide backup documentation along with performance report response for documentation. Where an assessment is defined as an ‘up to “$X” amount, the dollar value shall be set at the discretion of the SEHP. Written notification of each failure to meet a performance requirement that is measured by the SEHP shall be given to the Vendor prior to assessing liquidated damages. The Vendor shall have five (5) business days from the date of receipt of written notification of a failure to perform to specifications to cure the failure. However, additional days can be approved by the SEHP Contract Manager if deemed necessary. If the failure is not resolved within this warning/cure period, liquidated damages may be imposed retroactively to the date of failure to perform. Late reports will incur additional liquidated damages to the SEHP. Liquidated damage amounts will double for each five (5) business days that a report is delayed. The imposition of liquidated damages is not in lieu of any other remedy available to the SEHP.

If SEHP elects to not exercise or to reduce a damage clause in a particular instance, this decision shall not be construed as a waiver of the SEHP’s rights to pursue future assessment of that performance requirement and associated damages.

PERFORMANCE GUARANTEES: The following requirements are areas where the Vendor will guarantee performance for each plan offered. Measurement will be based on the SEHP account rather than the Vendor’s Book of Business unless otherwise noted. Failure to meet the required standards will result in the liquidated damages. Prompt resolution of problems or issues is expected but will not reduce or eliminate any liquidated damages imposed due to failure to meet the performance standards outlined below. Liquidated Damages may be enforced by reducing the premiums, fees, claims or any other amount owed to the Vendor by the SEHP.

Vendor will be held harmless if the reason for the late reports or other missed deadlines is due to the SEHP not providing the necessary data or other required information in a timely manner. In such case, a new due date for the report or other required performance will be mutually agreed upon by both parties.

If the Vendor fails to pay once notified by the SEHP of an amount owed due to Liquidated Damages, the Liquidated Damages may be enforced by reducing the administrative fees or other amounts owed to the Vendor.

6.1 Vendor Service Liquidated Damages

6.1.01 Telephone Response Time: At least ninety percent (90%) of all calls to the Customer Service Vendor will be answered within thirty (30) seconds; measured by the amount of time between the time a call is received into a customer service queue and the time the phone is answered by a Customer Service Representative (CSR).

$500 a quarter

6.1.02 First call resolution rate: Ninety-five percent (95%) of calls to the Customer Service Vendor will be handled to resolution on initial contact;

$1,000 per quarter



measured by the number of calls that are completed without need for referral or follow-up action divided by the total number of calls received

6.1.03 E-mail: One hundred (100) percent of emails acknowledged within 24 hours and the member provided information on when the response will be received. Ninety Nine percent of emails resolved with a response to the member within three (3) business days

$1.000 per quarter

6.1.04Participant Inquiries The Vendor will handle ninety-eight percent (98%) of all participant issues with the program (e.g., technical problem, HAQ difficulties, credits questions, programs etc…), without SEHP involvement. “SEHP involvement” does not include situations where SEHP staff received an initial call from a member and passed the issue to Vendor or one of its subcontractors.

$1,000 per quarter

6.1.05 Approval of Materials: All communication materials must be pre-approved by the State prior to distribution to participants of the State Health Plan. These materials include, but may not be limited to: emails, letters, envelopes, fliers, posters, etc.

$1,000 per incident

6.1.06 Legislative Requests: Vendor will provide support to the Commission and SEHP staff in responding to information requests made by the Legislature. Responses to Legislative Requests are due to the SEHP staff within two (2) business days.

$500 per incident

6.1.07 Protected Health Information: If a Vendor transmits Protected Health Information (PHI) using non secure transmission protocols such as an unencrypted email or a breach in security results in PHI of State members being released or obtained by others, the carrier will be subject to liquidated damages in addition to any fines imposed by State or Federal laws and regulations. This liquidated damage will apply in addition to any other requirements of law and provisions of this contract.

1 – 100 sent $1,000101 – 500 sent $2,000501 – 1,000 sent $3,0001,001 – 5,000 sent $5,0005,001 – 10,000 sent $10,000Over 10,001 sent is $25,000 per incident

6.1.08 Service to SEHP HealthQuest Staff:One hundred (100) percent of phone calls returned by account service representative by 5:00 p.m. on the next business day. One hundred (100) percent of issues received by phone call or email resolved within three (3) business days of receipt

$200 per incidentMax $15,000 per year

6.1.09 Website Availability and Modifications: The website structure, pages and content shall be available no later than two weeks prior to the launch of the new earning period for review by HealthQuest staff and preparation of communications materials. The website shall be available continuously thereafter. In the event of downtime, the Vendor shall immediately notify the SEHP of the expected duration of the downtime and post a notice on the website, if possible. The Vendor will notify the Contract Manager in SEHP of any substantial changes being made to the website prior to implementation.

Websites are to be ADA compliant with the Americans with Disabilities

$150 per incident



Act (ADA) pursuant to the State of Kansas Information Technology Policy 1210, Revision 2 (Policy 1210) requirements, by contract effective date of October 1, 2017. Verified reports of Non compliance will be subject to liquidated damages in accordance with the performance guarantee and liquidated damages fee percentages relating to ADA compliance set forth in this Agreement. Non compliance of Policy 1210 will be addressed by Vendor with a written action plan, including date of resolution, submitted to the SEHP contract manager within five (5) business days. Liquidated damages will be assessed for both lack of submitted action plan as well as failure to meet target resolution date in accordance with the performance guarantee and liquidated damages fee percentages relating to ADA compliance set forth in this Agreement . Non Compliance will be assessed by SEHP. If Vendor disputes a noncompliance finding by SEHP Vendor must submit the reasons for the dispute in writing to SEHP within ten (10) business days after being notified of noncompliance. Vendor and SEHP shall make reasonable efforts to act in good faith to resolve any dispute of noncompliance.

$150 per incident

6.1.10 Money Owed to the State of Kansas: Money owed to the State of Kansas shall be paid within thirty (30) calendar days from notification of Liquidated damages or monies owed. Vendor has thirty (30) calendar days to document any dispute of amounts owed. Amounts owed that are not received within thirty (30) calendar days will be subject to liquidated damages of $25 per day until paid. After thirty (30) days, SEHP may collect owed funds by deducting the amounts from the administrative fees or other payments made to the Vendor.

$100 per day

6.1.11 Billing: Vendor will provide complete and accurate monthly invoices to be received by the SEHP by the tenth (10th) business day of the month following month being billed or other billing cycle agree to by the SEHP and vendor at the time of implementation. All invoices will be email to the parties designated by the SEHP to received it.

$25 a day

6.1.12 InterVendor Cooperation: If a Vendors wishes to set up and receive a data feed with another SEHP vendor to share any PHI of the SEHP members, they request must be approved by the SEHP staff before contact with or data from the other vendor is transferred. In all cases proper data sharing agreements shall be in place before data is shared.

Once the SEHP has approved the data share and proper agreements are in place, the Vendors are expected to share data and claims information and other operational information as necessary for the smooth functioning of the SEHP. Vendors are expected to cooperate with the SEHP to develop procedures and protocols for shared information as necessary. Once procedures are in place, liquidated damages will accrue when such procedures are not followed.

$2,500 per incident

$1,000 per incident

6.1.13 Call Center Access: The Toll Free telephone access to customer shall be available during normal business hours except of legal holidays.

6.1.14 Implementation:(a) In the event of eligibility file format changes, standard testing

protocols will be implemented with testing to be completed within 30 business days.

(b) Customer service center with trained representatives and toll

$1,000

$1,000



free number must be open for members to call 30 days prior to the start of each earning period.

(c) Customized communications for project or event completed 45 days prior to start of such project or event. (Vendor to receive final version 30-days in advance of scheduled completion date.)

(d) Annual program changes/updates completed and activated prior to start of program year. (Final program design changes reviewed and approved at least 60-days prior to launch)

$2,000

$2,000

6.1.15 Notification of Center Closures: Vendor shall notify the HealthQuest management team of any scheduled customer service center closures at least thirty (30) days in advance of the customer service center scheduled closing (this includes holidays as well as in-service training days)

$250

6.1.16 Notification of Disruption: Vendor shall notify the HealthQuest management team of any disruption in Customer Service center availability or toll-free access regardless of reason for disruption, within one (1) hour of realization that a problem exists

$250

6.2 Data and File Format6.2.01 Daily Eligibility File: The Vendor agrees to process enrollment

additions, changes, and deletions correctly within two (2) business days of the generation date of the file. Vendor must notify SEHP within twenty-four (24) hours if information received is incomplete or unreadable.

Additions, changes, and deletions sent correctly by the SEHP but not processed correctly by the Vendor will be retroactively corrected back to original date, even if correction occurs more than sixty (60) days following date of the membership change.

The Vendor must be able to accept the SEHP Membership Eligibility file daily every business day in the SEHP standard file layout.

$1,000

6.2.02 Comparison Eligibility File: SEHP will periodically send a full eligibility file by the second Thursday of the month. This schedule may change based on SEHP needs with notice to the vendor.

Vendor shall not load this file. Vendor will compare files to their membership database and provide an enrollment mismatch report to the SEHP within ten (10) business days of the creation date of the full file.

SEHP will respond with information to make corrections in Vendor’s membership system. Vendor will make needed corrections within ten (10) business days of receipt of information. Premium and claims adjustments will be made by the Vendor and reported to the SEHP. Incomplete or unreadable information must be reported to the SEHP within twenty-four (24) hours.

$500

6.2.03 Verifying Members: Vendors will be able to verify eligibility for each member who calls the Vendor to enroll in or to inquire about a program. Verification means that appropriate identifying information is provided at the time of the call and the appropriate eligibility file accurately shows the member is in the file (i.e., the name, employee ID number and DOB



presented by the member or SEHP on the member’s behalf matches the information in the eligibility file

6.2.04 Open Enrollment Earned Discount File Earned Discount File: In a file format provided by SEHP, Vendor will supply a computer file with information regarding members who have earned the premium discount incentive for the following plan year. File must be provided to SEHP no later than five business days prior to October 1, to load for Open Enrollment processing and then each business day thereafter through the end of the HRA/HAS earning period. Then weekly until the end of the plan year and exam rollover (January 30th) A sample of the current incentive file layout is provided as Exhibit 8.

Earned Discount File corrections, updates or challenges: Vendor will ensure the accuracy of the file provided to SEHP. Vendor will also be responsible for reviewing all challenges to the file by members or agencies whose members question the presence or absence of a member on the file. All challenges will be researched and necessary corrections will be completed within two (2) business days of notification.

$500

6.2.05 Vendor will provide complete and accurate monthly data extracts of the biometric data and any future data elements that the SEHP desires in the format specified by SEHP’s Data Management Vendor (currently IBM Watson but moving to DXC) with the understanding that all of the wellness program data on SEHP member is owned by the SEHP. Files must be received by the tenth (10th) of each month. The Vendor will place no restraints on the use of the data provided, provided the SEHP has in place procedures to protect the confidentiality of the data consistent with HIPAA requirements. The files will contain the data elements and file layout as agreed upon between the Data Management Vendor and Vendor. Files will include all encounter data. The files will be submitted electronically in a layout and method determined acceptable to the Data Management Vendor.

$1,000

6.2.06 Incorrect File Layout/Unauthorized ChangesThe Data Management Vendor will notify SEHP if the Vendor’s files were submitted in an incorrect or incomplete file format. SEHP or the Data Management Vendor will request a new file in the proper format from the Vendor and liquidated damages will be assessed. Vendor will supply a corrected file within two business days of notification of the error.

$1,000

6.2.07 File ReloadIn addition to the liquidated damages described in 6.206, if the Vendors file is incorrect or incomplete or otherwise delayed, the Vendor will pay the entire cost of the reload/late load fees assessed by the Data Management Vendor for this and all associated files included within the KDHE-DHCF file load.

$1,000 per incident plus the cost of reloading the correct files by the data warehouse vendor.

6.3 Reporting6.3.01 Standard reports, as may be modified from time to time by agreement of

the Parties, will be provided by Vendor to SEHP. Service Standards:

Customer Service for SEHP participants (quarterly) Service to SEHP Contract Mgmt Team (quarterly)



Participant inquiries (quarterly) Website availability (quarterly) Daily eligibility file (quarterly) Health Screening (quarterly) Incentive Award (quarterly)

6.3.02 HealthQuest Reports Overall Outcomes Report (Annual) Quarterly Report (Quarterly) Utilization Report (Weekly) HRA/HSA Contribution Report (Weekly) Not Yet Qualified and Not Yet Registered Reports (Monthly) Screening Event Report (Weekly during screening period) Aggregated Screening Report (45-days after last screening

event) Home Kit reporting Aggregated Risk Profile (45-days after HA close date) Condition/Disease Management Report (Monthly)

6.3.04 Accuracy of ReportsThe SEHP relies upon the information provided within the reports from

vendors. Liquidated damages will be assessed for each report found to be in error:

Weekly Monthly Quarterly Annually

$500 per incident

6.4 Outcomes Measures for Wellness Programs: Fees At Risk6.4.01 Tobacco Cessation

Quit rate of 30% at 6 months

Recidivism rate of <= 4% after 1 year

90% satisfied or very satisfied

Quit Rate 15% of Tobacco Program fees

Recidivism rate 4% of Tobacco Program fees

Satisfaction 5% for every point below 90%

6.4.02 Chronic Condition Management Standards of care to be measured annually. Average of

three (3) successfully completed calls per actively engaged participant per year.

80% satisfied or very satisfied 2% admit reduction year over year. (HF, CAD, COPD)

10% fees at risk for not achieving 80% satisfaction

10% fees at risk for not achieving admission reduction

6.4.03 Population Risk Improvement - Net risk reduction of 4% year over year

Recommend liquidated damages

6.4.04 Other Program Offerings - You many provide an additional guarantee for your specific services here.

Recommend



6.3 PERFORMANCE GUARANTEES-OUTCOMES

Please state what additional Performance Guarantees you are prepared to offer SEHP and the parameters and responsibilities of the vendor/partner and SEHP for program outcomes including the percentage of fees you are willing to put at risk. Final Performance Guarantees-Outcomes will be a negotiated element of the vendor partner contract.

Reporting Due Dates: Condition Management annual outcomes 180 days (6 months) after the end of the operational

year (assuming time and complete receipt of data). Quarterly reports are due forty five (45) business days after the end of the quarter to be reported. Monthly reports are due ten (10) business days after the end of the month to be reported.


I have reviewed the Performance Guarantee and Liquidated Damages section of the Request for Proposal, and acknowledge that this document shall become part of the final contract. I hereby acknowledge and accept all of the provisions, requirements, and conditions stated in this section of Request for Proposal, subject to the modifications, conditions and limitations I have listed below.

________________________________________________________Authorized Signature of Vendor

________________________________________________________Printed Name of Signatory

________________________________________________________Title

________________________________________________________Date