FINANCE DEPARTMENT Mayor · Per the RFP instructions, you have requested 11 binders and 11 USBs in Part IV of the RFP. We have been closely monitoring the spread of COVID-19 and taking

CITY OF HOUSTON FINANCE DEPARTMENT Strategic Procurement Division

Sylvester Turner

Mayor

Jerry Adams Chief Procurement Officer P.O. Box 1562 Houston, Texas 77251-1562 T. 832.393.9126 https://purchasing.houstontx.gov

Council Members: Amy Peck Jerry Davis Abbie Kamin Carolyn Evans-Shabazz Dave Martin Tiffany D. Thomas Greg Travis Karla Cisneros

Robert Gallegos Edward Pollard Martha Castex-Tatum Mike Knox David W. Robinson Michael Kubosh Letitia Plummer Sallie Alcorn

Controller: Chris B. Brown

July 17, 2020 Subject: Letter of Clarification No. 1 Medicare Advantage, Medicare Supplement, and Medicare Part D Plans Reference: Request for Proposals (RFP) No.: S76-T29422 To All Prospective Proposers: This Letter of Clarification is issued for the following reason:

To answer the following questions:

1. Question

a) In the newest version of the Offer and Submittal word docurment, it contains extra pages w/subcontractors and references list. Is this the correct version? b) The version from last summer included the same pages, however on the title, it listed EXHIBIT I - OFFER AND SUBMITTAL, REFERENCES, PROPOSED SUBCONTRACTORS but the title of the newest version does not. Should those pages be disregarded, as the info is also requested in the questionnaire?

Answer:

a) Yes. b) No. Please complete Exhibit I in its entirety and respond to the questions in the Questionnaire.

2. Question

Regarding 10.1.3.7 How many new group MA-PD and/or Med-Supp + PD members did your organization add effective January 1, 2019 and January 1, 2020? We enroll members throughout the year; are you asking only for January enrollments for 2019 and 2020, which will be just one months worth? Or are you asking for total enrollment (EGWP) for all of 2019 and all of 2020? These would not necessarily be added in January, but throughout the year. Thank you.

Answer: We are asking for total enrollment count as of January 1, 2019 and January 1, 2020.

https://purchasing.houstontx.gov/




3. Question:

Would the City consider RFP responses from a a third-party administrator (TPA) proposing benefits administration services, benefits strategy, etc. in partnership with a Medicare carrier?

Answer:

The City is not looking for TPA services in this RFP.

The City is seeking a vendor(s) experienced in partnering with public sector employers to provide group Medicare Advantage Plans plus Part D prescription drug services (MA-PD) and/or Medicare Supplement Plans F and G plus Part D prescription drug services (Med Supp + PD) with respect to such group insurance coverages, plans and programs.

Proposers are encouraged to identify and propose features or enhancements that provide additional value without adding cost. Proposers are encouraged to propose any creative solution that will achieve the City’s goals.

4. Question: Would a third-party administrator (TPA) be a qualified vendor to respond to this RFP?

Answer: See response to Question 3 above.

5. Question Could we please obtain a copy of the Medicare census with the employees’ date of birth included?

Answer: A complete census file for Medicare-eligible retirees is provided in Attachment 2 – Census. For HIPAA purposes, a 5-year age band of medicare eligible retirees was given rather than the date-of-birth.

6. Question:

We received the RFP for the City of Houston and understand that both the commercial (non-retirees) and retirees are out to bid. We’d be thrilled to bid on the non-retirees to supplement our retiree offer. Can you confirm it’s okay for us to participate in the commercial RFP?

Answer: Only the retiree Medicare Advantage and Medicare Supplement plans that include Part D are out to bid.

7. Question: Should bidder questions be directed to you?

Answer:

All questions should be directed to Bridget Cormier, [email protected]. Questions can also be posted on Proposal Tech prior to the deadline on July 13, 2020 at 2:00 p.m.

8. Question: Is it OK for me to add my proposals team to the proposal tech system?

Answer: Yes. Please refer to Part 4 Section 1.2 Proposal Tech.

mailto:[email protected]




9. Question: Is there any chance the proposal submission deadline will be extended?

As of today, we do not foresee an extension of the proposal due date.

10. Question:

It says on one of the RFP documents that there at 25,000 employees. By our calculations, that would be about 57,500 covered lives including dependents. Can you confirm that is roughly the number of lives we’d be bidding on under the commercial side? *It’s important for us to know this from an underwriting perspective. If that number is off, can you advise (ballpark) what the correct number would be?

Answer: Medicare Plan headcounts are highlighted in the Scope of Work. Please refer to the answer to Question 6 above.

11. Question: Can you advise, or give a general idea as to who the competitors would be for PBM services for the commercial population?

Answer: Separate PBM services are not being procured through this RFP. Please refer to the answer to Question 6 above.

12. Question:

Are there specific things that City of Houston is prioritizing and valuing most in this procurement process? To combat things like member issues, lack of clinical offerings, lack of flexibility/transparency, etc? Any insight as to hot buttons/areas of focus would be greatly appreciated as we’d ideally look to bridge those gaps.

Answer:

The City is seeking vendors who can perform the items listed in the Scope of Work. Proposers are also encouraged to identify and propose features or enhancements that provide additional value without adding cost. Proposers are encouraged to propose any creative solution that will achieve the City’s goals.

13. Question: Is the City required to go out to bid or is this their choice for a competitive renewal? If not a required RFP, is it a required market check?

Answer: The current contracts are expiring December 31, 2020.




14. Question:

Like many organizations across the Country, in furtherance with general public health guidance, we have transitioned much of our workforce to work from home in light of COVID-19. Our team that assembles hard copy presentations is located in a state with a “Stay at Home” executive order.

a. As a result, would you be willing to accept electronic submissions only via proposal tech or another method (FTP site)?

b. If hard copies are required, what is the due date for them? The proposal tech deadline is 7/30/2020, so would binders be due at a later date?

c. If hard copies are required, could you please provide a contact name and location of the City Secretary’s Office to ensure the boxes arrive at the exact location? Please also confirm someone will be at the building to receive these boxes.

Answer:

a. No b. July 30, 2020 at 4 p.m. (CT) is the due date. There is no later date/time. c. No contact name required. The address of the City Secretary’s Office can be found in Part IV of the RFP. Someone will be present at the City Secretary’s Office up to the Solicitation due date/time to receive all boxes.

15. Question: Please confirm that someone with binding authority can sign all forms; looking to confirm that anyone who has signature authority on behalf of the company can sign all forms, regardless of being an offcer or not.

Answer: The proposal must be signed by a representative of the firm, who is authorized to bind the firm to a contract in the event of the award. All rates, fees, and terms presented will be considered legally binding.

16. Question: Please confirm that the MWBE spend goal of 3% is based on the total administration costs.

Answer: Confirmed.

17. Question:

Regarding the request for Medicare Supplement plus Part D quotes:

a. If a bidder elects to bid on just the Part D portion of this, how

would they handle the sample contract review (Medicare

Supp+Pharmacy_RFP Contract Sample-2021.pdf document)

since it is a combination of Medicare Supp and Part D?

b. How would section 10.3 be handled since the Medicare

Supplement questions would not apply?




Answer:

Separate Part D services are not being procured through this RFP. The City seeks proposals from qualified vendors who can partner with the City to provide Medicare Advantage Plans and Medicare Supplement Plans that include Medicare Part D Prescription Drug Services.

18. Question:

Within the “Attachment 1 - Vendor Exhibits.xlsx” spreadsheet, would

bidders who are only quoting a PPO plan be required to complete the Top

150 HMO Medical Providers tab?

Answer: Yes.

19. Question:

Per the RFP instructions, you have requested 11 binders and 11 USBs in Part IV of the RFP. We have been closely monitoring the spread of COVID-19 and taking actions where possible to reduce the risk of exposure in our communities. In addition, some delivery companies have temporarily suspended guaranteed delivery times. Please confirm if you will accept an electronic proposal response via email in place of the requested hard copies and/or CDs/USBs. If email is acceptable, please provide us with an email address of a contact for us to submit our proposal response. We will also submit through ProposalTech as requested.

Answer: No. Electronic proposal responses via email in place of the requested hard copies and/or CDs/USBs will not be accepted.

20. Question:

If binders are required, will you accept requested attachments and/or sample documents on a CD instead of printed hard-copy?

Answer: No.

21. Question:

Our best practice for executing our proposal documents is via electronic signatures, which are legally binding in the United States. There are two Acts that establish this legality of electronic signatures – the U.S. Electronic Signatures in Global and National Commerce Act (ESIGN, 2000) and the Uniform Electronic Transactions Act (UETA, 1999). Both ESIGN and UETA establish that electronic records and signatures carry the same weight and legal effect as traditional paper documents and handwritten signatures stating: A document or signature cannot be denied legal effect or enforceability solely because it is in electronic form.

We endeavor to meet your proposal requirements as closely as possible – in regards to signatures on your proposal documents, will you accept an electronic signature from the appropriate executive at our company?

Answer: Yes.

http://www.gpo.gov/fdsys/pkg/PLAW-106publ229/html/PLAW-106publ229.htm

http://www.gpo.gov/fdsys/pkg/PLAW-106publ229/html/PLAW-106publ229.htm

http://www.docusign.com/esign-act-and-ueta

http://www.uniformlaws.org/shared/docs/electronic%20transactions/ueta_final_99.pdf

http://www.docusign.com/esign-act-and-ueta




22. Question:

The Exhibit I requires a notary. We have been closely monitoring the spread of COVID-19 and taking actions where possible to reduce the risk of exposure in our communities. Please confirm if we can return this form electronically signed without being notarized. Once the COVID-19 pandemic has minimized and our government officials have cleared businesses to return to “business as usual,” we will provide the notary and original signature, if requested.

Answer:

An electronic signature without notarization will be acceptable at this point in the solicitation process. The City reserves the right to require a notarized signature from the final recommended vendor(s) for award prior to the item appearing before City Council.

23. Question:

Will the City accept multiple plan proposals from a single carrier, and is the

city open to considering a HMO POS plan design?

Answer:

Yes. The City would like to receive proposals for the following plan options:

National MA-PD PPO, and/or

Local MA-PD HMO, and/or

Med-Supp Plans F and G + PD

24. Questions

a.) Would you be open to having the out of pocket charges net of any LIS entitlement paid directly to you instead of having the low income subsidy paid directly to members?

b.) Could you also please explain the rationale for having the LIS paid directly to the member?

Answer:

a. No b. For administrative purposes, the City prefers the Low-Income

Subsidy (LIS) is paid directly to members and not included as a discount on the invoice to the City.

25. Question:

Could you please share when we would expect to receive the monthly

eligibility file? We bill in advance, beginning on the 6th of the month (e.g. 7/6

for August coverage).

Answer:

Within 90-180 days of the signed contracts, the City of Houston desires to self-invoice for all subscribers / members in the Medicare Advantage Plans program. The City will provide electronic eligibility files of our retiree member database monthly. The City will work with the successful Proposer(s) on timing, format and medium of delivery of an eligibility file in support of the calculation of the premium amount paid for that month and will wire transfer the calculated premium.




26. Question:

Could you please ensure SelectCare of Texas/Centene is included as in

attendance for the Pre-Proposal conference?

o Andy Dow, Senior Director, Group Sales Strategy,

[email protected]

o Luis Luna, Director, Strategic Initiatives,

[email protected]

o Jonathan Liu, Manager, Proposal Unit,

[email protected]

Answer: The deadline to submit your contact information to be added to the attendee list and posted to our Ebid site was close of business, Thursday, July 9, 2020.

27. Question: Is Attachment 2 – Census available to bidders who have completed the NDA process? If so, please provide this attachment.

Answer: Once the NDAs have been processed by the Strategic Procurement Division, Proposers that have executed an NDA will be provided with the access to the detailed data via a secure website.

28. Question: Are the states in which the City has plan members included on Attachment 2 – Census? If so, please provide a copy.

Answer: Yes.

29. Question: Please provide the number of sites and open enrollment meetings the selected Proposer(s) will be asked to support.

Answer: One site up to two meetings. However, selected proposer(s) should be prepared for virtual open enrollment meetings.

30. Question: Please clarify the types of reporting of member claims and member service data that the City requests

Answer: Please refer to the Scope of Work item 2.9 “Data and Reporting Requirements” and the General Questionnaire item 10.1.7 “Reporting to the City”.

31. Question: Please provide the current plan designs for MA-PD PPO, MA-PD HMO, and Med Supp plus PD plans.

Answer: Please refer to the City’s website at: http://www.houstontx.gov/hr/benefits/retiree_medicare.html

32. Question: Please provide counts by month for the number of members changing plan

options.







Answer: Counts by month are not available. The City experiences approximately 2 to 5 enrollment changes per month.

33. Question:

The RFP allows Proposers to submit additional related services. Please clarify section of the RFP in which the additional related services should be addressed.

Answer: Additional related services should be addresses when responding to applicable questions in Exhibit X-General Questionnaire and Exhibit XIV-Price Proposal Table(s).

34. Question: Would the City of Houston accept electronic only submission due to COVID-19 concerns?

Answer: No.

35. Question: Please clarify if one printed original of the Price Proposal Table(s) is also required.

Answer: The RFP Submission should include one original (marked ‘Original’) of the Price Proposal Table(s) and ten printed copies of the Price Proposal Table(s).

36. Question:

Please clarify which tab should include the Questionnaire, since several items in section 2.0 Submission Requirements refer to the Questionnaire (i.e., 2.4 General Company Information, 2.5 Key Personnel, etc.).

Answer: Proposers have discretion to organize submission requirements based on the information included in their submitted proposal.

37. Question:

Please clarify whether the thumb drives are permitted to be enclosed within the technical proposal submission, as long as the thumb drives are included in a separate sealed envelope.

Answer: Yes.

38. Question: Please clarify whether this information should be provided in addition to the information on Exhibit I (References – List of Previous Customers)

Answer: Yes.

39. Question:

Please clarify whether the NDA (Exhibit VIII) is to be redlined (if applicable), or if any exceptions should be noted on Exhibit XI (Agreement/Exceptions and Deviations to the Terms and Conditions). If the latter, should Proposers submit a copy of Exhibit VIII as is (without markings or signature)?

Answer:

Exceptions to the NDA should not be noted on Exhibit XI.




40. Question:

Item #22 on Exhibit XII states “Other Requested Items.” Please clarify any other items that Proposers should include on this checklist and submit with their proposal materials.

Answer: The checklist just serves as a minimum proposal submittal requirement. “Other requested items” refers to other materials, samples, or documents, etc. requested throughout the RFP.

41. Question: Please clarify whether any response is needed from the Proposer on the sample universal enrollment form.

Answer: Yes. See Exhibit X-General Questionnaire Section 10.1.8.10.

42. Question:

Please clarify the correspondence related to terminations as referenced in question 10.1.5.18. Is this referring to member terminations or disenrollment, provider terminations, or another type of termination?

Answer: Member terminations or disenrollment.

43. Question

Please confirm that the ProposalTech system will allow Proposers to submit their response if they leave Section 10.2 unanswered because they are quoting on the Med-Supp + PD portion of this RFP only.

Answer: Confirmed.

44. Question: Is Attachment 3 – Current Formularies available to bidders who have completed the NDA process? If so, please provide this attachment.


45. Question: Is the Medical and Rx Top 50 Providers file available to bidders who have completed the NDA process? If so, please provide this attachment.


46. Question:

If Proposers respond “no” to any of the performance guarantees, please clarify how any exceptions or alternative language should be included (i.e., on Exhibit XI).

Answer: Include any exceptions or alternative language in Exhibit XI Agreement/Exceptions and Deviations to the Terms and Conditions.

47. Question:

The Price Proposal states: “Proposers may offer a bid for medical and Rx in an EGWP + Wrap format. Quotes for PD plans only will not be accepted.” Please clarify whether this applies to PDP plans.

Answer: Quotes for Prescription Drug (PD) plans only will not be accepted.




48. Question:

The Top Prescriptions list indicates “Top 200” but only includes 100 drugs, is there another list we should consider?

Answer: No there is no other list. “Top 200” was a typo and should be labelled “Top 100”.

49. Question:

Will the city provide medical claims information on the UHC Plan F and G plans?

Answer: No, this information is not available.

50. Question: Will the city provide enrollment counts for those on UHC Supplement plans F & G

Answer: Please see Scope of Work for Medicare Plans Headcounts and Premiums.

51. Question:

Will you provide information /percentages of the claims that were paid Out-of-Network vs. In-Network on the current PPO plan?

Answer: No, this information is not available.

52. Question:

Since the majority of premium is paid to providers vs. the administration of the plan, please confirm what portion of the premium amount should be used to calculate the 3% MWBE obligation. Please see the excerpt from Letter of Clarification #2 from the 2019 Medicare RFP that was cancelled.

Answer:

Administrative cost will be computed as 11% of total premium. Contractor shall make good faith efforts to award subcontracts and supply agreements of at least 3% of the value of the administrative costs to certified MWBEs.

53. Question: Could we please obtain an updated census that includes date of births?


54. Question:

Would electronic signatures be acceptable in lieu of wet signatures? Our team has greatly reduced physical interactions and document handling in order to prevent spreading the virus.




Answer: Yes.

55. Question: Would the City considered requiring USB drives in lieu of binders to minimize the number of individuals who touch the documents?

Answer: No.

56. Question:

Is it permissible for carriers to submit a quote for both the Medicare Advantage

HMO and PPO plans?

Answer: Yes.

57. Question: Is it permissible for carriers to submit a PDP-only quote?

Answer: No. Quotes for Prescription Drug (PD) plans only will not be accepted.

58. Question: Does the City intend to have an active (requiring plan election) or passive enrollment?

Answer: Active.

59. Question: What is the current contribution level of the employer? (percent and dollar amount of premium – if it varies by years of service, please provide average years of service and average employer monthly funding).

Answer: 75%

60. Question: What is the City’s anticipated employer contribution for 2021?

Answer: 75%

61. Question: Will the City consider replacing the current Medicare Supplement plans with Medicare Advantage plans?

Answer:

The City would like to receive proposals for the following plan options:

National MA-PD PPO, and/or

Local MA-PD HMO, and/or

Med-Supp Plans F and G + PD

62. Question: Does the City intend to potentially replace the current carrier plans or make available more plan options in addition to the current carrier plan available for 2021?

Answer: Yes.




63. Question: Why did the City’s Aetna Medicare Advantage plan premiums change from $396.67 in 2019 to $253.77 in 2020? This seemed like a very large single year reduction.

Answer: This information is not available.

64 Question: How many Medicare eligible age-ins does the City have per year?

Answer: The City typically adds approximately 10 to 20 new retirees or dependents per month.

65. Question:

Page 13, items: states vendor to provide an educational newsletter. Is the requirement for the vendor to produce a newsletter or are other forms of member communication acceptable such as SmartSummary statements? (Note, these global forms of communication would not be customizable.)

Answer: The Proposer should provide educational newsletters and printed materials that are customizable to the City, and within CMS guidelines.

66. Question: Page 15, 8.2 Data and Reporting Requirements, item b: a.Clarify what the City means by “additional copays and other member cost sharing customizations”? b. Does this extend beyond applying deductible and/or copay/coinsurance?

Answer: a. The City did not request additional copays. b. The City is requiring the Proposer has the ability to administer copays

and other member cost sharing in a customized manner.

67. Question:

In regards to the “Approval of Communications” Performance Guarantee Request in Exhibit IX, what pieces of communication does the City expect to review? Member engagement campaigns will be shared prior to mailing for approval in normal course.

Answer:

The City must review and approve all communications materials (including letters, brochures, electronic, website, etc.) prior to being sent to members and providers. All materials must be in compliance with and are subject to CMS guidelines.

68. Question:

Please confirm that the Approval of Communications Performance Guarantee

in Exhibit IX excludes the following correspondence: CMS required letters,

communications for Clinical Program participation, and Stars outreaches.

Answer:

Correspondence and information (whether written, electronic, telephonic, or in any other medium or form) developed by the Contractor and intended for Members, (e.g., open enrollment materials, network changes) must be reviewed and approved by the City prior to dissemination. This standard will be measured quarterly if any communications materials were developed during the previous quarter.




69. Question: Please clarify if members switch plans mid-year should accums transfer.

Answer: No.

70. Question: Please clarify if members may switch plans at will on a monthly or if a SEP is required? If SEP, please provide the City’s SEP rules that would allow a members to switch plans mid-year.

Answer: They are allowed to switch plans monthly. A SEP is not required.

71. Question:

Like many organizations across the Country, in furtherance with general public

health guidance, we have transitioned much of our workforce to work from home

in light of COVID-19 including our team that assembles hard copy

presentations. Would you be willing to accept electronic copies of the proposal

as opposed to hard copies?

Answer: No.

72. Question: Based on the unprecedented times we are in with the Covid-19 pandemic, would you at minimum be willing to accept electronic signatures on all documents?

Answer: Yes.

73. Question: National PPO steerage plan requested. Is the City opposed to a Passive PPO plan in which in-network benefits are the same as out of network benefits?

Answer: The City is not opposed.

74. Question:

MWBE – Is the 3% still attributable to 11% of premium as determined in last

year’s RFP?

Answer: Yes.

75. Question: We have not received the data and questions are due today 7/13. Given this timing issue, will the City allow us to ask additional questions purely related to the data that we have not had an opportunity to analyze as of yet?

Answer: No.

76. Question:

For the selected carriers, what opportunities (in person, enrollment meetings, virtual, direct mailing/contact) will the plans have to educate members on their benefits?

Answer: All of the above.




77. Question:

In the data provided – Attachment 1 – Vendor Exhibits, the file provided for the PPO is named “Top 100 PPO Medical Providers” not “Medical and RX Top 100 Providers”. Also, it DOES NOT provide the Tax ID numbers which is a requirement in order for us to complete the analysis. Please advise how we should proceed.

Answer:

You are correct. Please use the information on the "Top 100 PPO Medical Providers" tab. The Provider Tax IDs for the PPO based providers are not available. For this reason, we have included the street address which we believe to be the site address rather than the billing address. Please use this information to complete as much as possible.

78. Question:

The file provided for the HMO is named “Top 150 HMO Medical Providers” not “Medical and Rx Top 50 Providers” as stated in the question. We need to confirm that we should indeed use the files named differently in the Vendor Exhibits to perform our analysis? Again, we also need Tax ID numbers in order to complete the analysis. Please advise how we should proceed.

Answer:

You are correct. Please use the information in the "Top 150 HMO Medical Providers" tab. The Provider Tax IDs for the HMO based providers are shown in Column A of that tab.

This Letter of Clarification will be considered part of the solicitation referenced on the first page of this document. All revisions, responses, and answers incorporated into the Letter(s) of Clarification are collaboratively from both the Strategic Procurement Division and the Human Resources Department. It is the responsibility of each proposer to obtain any previous Letter(s) of Clarification associated with this solicitation. By submitting a response to this solicitation, proposers shall be deemed to have received all Letter(s) of Clarification and have incorporated them into this solicitation

If you have any questions or if further clarification is needed regarding this Request for Proposals, please contact Bridget Cormier at 832.393.8715. Regards, Jerry Adams Chief Procurement Officer Cc: File: T29422




Documents

FINANCE DEPARTMENT Mayor · Per the RFP instructions, you have requested 11 binders and 11 USBs in Part IV of the RFP. We have been closely monitoring the spread of COVID-19 and taking