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MERCER AUGLAIZE BENEFIT
TRUST
MABT
Request for Proposals for
Employee Benefits Consultation Services
December 15, 2011
Project Manager:
Andrew Smith, Consortium Chairman
Mercer County ESC
441 E. Market St.
Celina, Ohio 45822
Tel (419) 586-6628
Fax (419) 586-3377
Email: smitha@mc.noacsc.org
Proposals are due on or
before 2:00 p.m., January 13, 2012
Proposals may be mailed or
hand delivered to the address provided above. If the proposal is
sent by mail, the respondent shall be responsible for actual
delivery of the proposal to the proper office before the deadline.
Late proposals shall not be considered. Proposals must be submitted
in a sealed envelope. Additional instructions for preparing a
proposal are provided herein.
1. Introduction
The MABT is seeking
proposals from benefits consulting firms to provide on-going
assistance in benefit plan selection, cost effectiveness, employee
education, and compliance with benefit laws and regulations. The
MABT offers the following combination of self funded and fully
insured benefits:
Medical Mutual of Ohio
(Medical/Dental insurance) (Self Funded)
Express Scripts
(Prescription Drug) (Self Funded)
Metropolitan
Educational Council (Life insurance) (Fully Insured)
The consultant will have
the primary responsibility of monitoring the performance of the
benefit plans and providers selected by MABT, making recommendations
regarding benefit plans and providers, requesting proposals from
benefit plans and providers and providing support to the MABT’s
individual districts in administering benefit plans, including all
eligibility functions.
The consultant will conduct
quarterly insurance meetings, as needed MABT Trust and subcommittee
meetings, present utilization/claims reports during those meetings,
analyze trends, and provide suggestions for cost containment and
plan selection.
The consultant will work
closely with the MABT’s Board and members of the MABT’s individual
districts administrative staff and will be expected to be available
during regular business hours to provide prompt support.
The selected consultant
will be required to enter into a Professional/Consultation Services
Agreement and a Business Associates Agreement with the MABT.
The MABT reserves the right
to reject any or all proposals and to award the contract in whole or
in part to the respondent determined by the MABT, in its sole
discretion, to be most responsive to the needs of the MABT and most
advantageous to the MABT.
The MABT is not liable for
any costs incurred by respondent associated with the preparation of
a proposal or the negotiation of a contract for services prior to
the issuing of the contract.
Respondents are advised
that proposals shall be binding on the respondent for 90 calendar
days from the proposal due date. A respondent may withdraw or modify
its proposal at any time prior to the proposal due date by a written
request signed by the same person who signed the proposal.
2. Background Information
The MABT is a consortium of
eleven (11) full-service school districts and two (2) educational
service centers with approximately 1,300 covered employees who are
eligible for group health and other benefits. The fiscal year for
the MABT begins January 1, and for the period ending December 31,
2010, spent $14.6 million on medical claims, $3.6 million on
prescription drug claims, and $1.1 million on dental claims.
The thirteen (13) entities
making up the MABT are:
Celina City Schools
St. Marys City
Schools
Coldwater Exempted
Village Schools
Fort Recovery Local
Schools
Marion Local
Schools
Minster Local
Schools
New Bremen Local
Schools
New Knoxville Local
Schools
Parkway Local
Schools
St. Henry Local
Schools
Waynesfield Local
Schools
Auglaize County ESC
Mercer County ESC
MABT currently has 5
self-funded medical plans; 1 prescription drug plan, and 2 different
dental plans that each school may offer.
The independent benefit
consultant is required to work closely with the Board to provide
suggestions, resources, and knowledge to assist the Board, as well
as assist the individual districts. The consultant will be paid a
fee by MABT and will be prohibited from receiving any commissions,
kickbacks, overrides or other forms of compensation or incentives
(other than fee for service) either directly or indirectly from any
third party administrator or insurance provider in any way related
to the provision of services to MABT.
MABT’s current benefit
plans and the renewal dates of such plans are as follows:
|
Plan |
Company |
Renewal Date |
|
Medical |
Medical Mutual of Ohio |
Annual |
|
Dental |
Medical Mutual of Ohio |
Annual |
|
Prescription Drug |
Express Scripts, Inc. |
Annual |
|
Life |
Metropolitan
Educational Council |
Annual |
3. Scope of Benefits
Consulting Services/Qualifications
The successful consultant,
in cooperation with the MABT and the consortium board, will be
responsible for reviewing and providing guidance in the evaluation
of current and future employee benefits needs of the MABT and the
best solutions for meeting those needs.
The main business activity
of the individual/firm selected by the MABT shall be employee
benefits consulting with considerable experience and emphasis in the
area of requesting and evaluating proposals for benefits (e.g. life,
health, dental, and prescription drug; benefit communication; plan
documents; coverage interpretations; rate setting and forecasting;
voluntary payroll deducted benefits; and Section 125 plans), as well
as membership duties.
Respondents should have
extensive experience with large public sector (especially school
consortiums with 1,000 or more employees) insurance programs.
At a minimum, the scope of benefits
consulting services shall include the following:
Develop requests for proposals and
solicit proposals from carriers / third party administrators
licensed in the State of Ohio to meet the benefits needs of the
MABT and its enrollees;
Provide independent recommendations to
the Board regarding plan selection;
Provide advice and recommendations
concerning benefits provided to employees of the MABT;
Solicit and negotiate most advantageous
renewal rates for benefits plans of the MABT;
Initiate annual contract renewals;
Review and approve for the MABT to pay
weekly claims;
Review and approve monthly
administrative invoices from carriers for the MABT to pay;
Monitor claims and utilization while
submitting monthly utilization reports to the Board;
Prepare monthly the:
I. Balance Sheet
II. Statement of
Changes in Trust Equity
III. Analysis of
Claims Experience
IV. Status Report
Maintain all
eligibility and notify each carrier of all eligibility changes.
Be the central point for any eligibility questions;
Serve as a liaison with carriers when
service problems occur;
Provide assistance with
difficult claim situations needing resolution;
Monitor, calculate and report to the
Board all funding rate structures and potential changes;
Monitor, report and recommend cost
savings proposals to the Board;
Provide services without receiving or
accepting any commissions, kickbacks, overrides or other forms
of compensation or incentives either directly or indirectly from
any third party administrator or insurance provider for any
client;
Provide educational and
informative seminars as required by MABT including annual HIPPA
training;
Attend meetings with
the Board as needed;
Be available to
participate in Insurance Committee Meetings between Management
and Union personnel to discuss benefit enhancement and cost
containment by school district;
Inform MABT of new
benefit designs and/or programs that may assist in keeping the
employees healthy;
Keep MABT informed on
Federal and State requirements concerning current or proposed
benefit programs;
Arrange for the annual
990 forms to be completed;
Arrange for the annual
ORC 9.833 forms to be completed.
4. Description of Proposal
Submission
Three (3) copies of the proposal must be
submitted to the address set forth on the first page of this RFP, in
a sealed envelope labeled Proposal for Employee Benefits
Consultation Services.
Faxed or emailed proposals will not be
accepted.
Only firms submitting proposals by the
deadline date will be considered. The proposals are due on or
before 2:00 p.m., Friday, January 13, 2012.
Each proposal must include the following,
in this order:
1. Title Page. A title page
indicating the date, subject, name of the firm, address, telephone
number, fax number, email address, name and title of the firm's
contact person.
2. Experience. An
outline of the firm's background, experience in providing benefits
consulting services. Include:
a.
When your firm was established.
b.
Describe your company and the services
your company provides.
c.
Describe the ownership of your company.
d.
Indicate the number and location of
offices of your company.
e.
Indicate the location of the office that
would service our account.
f.
What is your company's affiliation with
other firms or organizations?
g.
What recent changes in ownership have
occurred?
h.
Are there any pending or anticipated
ownership or leadership changes?
3.
Client Information
a.
Provide the current number of clients
serviced by your company as a whole.
b.
Provide the current number of clients
serviced by the office that would be servicing our account.
c.
List the public employers for whom you
have provided benefits consulting services, include the number
of employees covered by the public employer's benefit plans,
and indicate the years for which you provided those services.
4.
Performance
a.
Describe your capabilities in the area
of benefits consulting.
b.
In what area do you find your company to
be particularly proficient?
c.
Describe any relationships your firm has
with any insurance provider licensed in the State of Ohio.
d.
How are client/vendor questions
resolved?
e.
What is your knowledge and understanding
of Ohio Revised and Administrative Code sections relevant to
public employer groups?
f.
Do you have an actuary on your staff or
what actuarial firm do you use?
5.
Service Team
a.
Individuals
i.
Provide an organizational chart of
the individuals who would be responsible for servicing our
account.
ii.
Include brief biographies of
each individual responsible for the account, including:
a
Each individuals'
responsibilities and skills
b
Tenure with the company
c
Experience and education in
employee benefit consulting
d
Training and education
b.
How are these individuals kept
up-to-date on current law, etc.?
c.
Account Manager
Who would be the contact for our account?
i.
How many other accounts do they
manage?
ii.
If this manager left your
Company, how would a new manager be selected for our
account?
iii.
How much does this person
travel?
d.
Customer Service
i.
What are the hours that a service
representative can be reached?
ii.
What activities are managed
by your Company?
6. Conflict of
Interest. Disclose any current or past (within the last
three years) business relationships, which may pose a conflict
of interest.
a.
Is anyone in your firm an owner or
investor in any company that would be doing business as a
provider of a benefit or service to MABT?
b.
Has or would anyone in your firm ever receive any commission,
bonus, payment or any form of remuneration from a provider of
employee benefits?
c.
Would anyone in your firm ever receive any commission, bonus,
payment, or any form of remuneration from a provider of a
benefit or service to MABT?
d.
Does your company have any financial or other relationships or
agreements with any insurance provider licensed in the State
of Ohio?
7.
Fees
Outline how your
company is compensated for its services.
Provide a proposed fee
structure and indicate what services are included in that fee.
Itemize any services
for which there would be an additional fee.
How are additional fees
calculated?
Are you willing to
agree not to accept direct commissions earned on our account as
well as any override or
other compensation earned (i.e. trips, etc.)?
Do you accept direct
commissions, overrides or other compensation earned (i.e. trips,
etc.) on any of your
business?
What could cause an
increase in the fee structure?
What are your typical
increases?
How long is the fee
structure guaranteed?
8.
Disclosure
a.
Disclose whether your firm, or any employee, to your
knowledge, has been the subject of an investigation by the
State of Ohio, Department of Insurance or any other regulatory
agency within the past five (5) years. If the answer to this
provision is yes, please describe the details of each type of
litigation.
b.
Disclose whether or not your firm, or any of its employees are
currently, or in the past five (5) years a party to any
pending litigation, the subject of which directs itself to
your role as a consultant in the medical benefits area. If the
answer to this provision is yes, please describe the details
of each type of litigation.
9. Duly Authorized Signature.
The proposal must contain the signature of a duly authorized
officer or agent of the respondent’s organization, empowered
with the right to bind the respondent.
10.
Miscellaneous
a.
What steps have you taken to ensure confidentiality of health
information?
b.
Will you need to use subcontractors to provide any service? If
so, explain in detail when subcontractors will be used.
c.
Does your company carry Professional Liability insurance?
d.
How much Errors and Omissions coverage does your company have?
e.
Provide references from three current clients, preferably
public sector employers. Provide name, phone number, and email
address of a key contact and a description of the various
projects your company worked on with that client.
5. Evaluation of Proposals
The consultant must have
applicable experience and qualifications to perform the scope of
services. Experience with public sector agencies, is highly
desirable.
All proposals will be
evaluated on qualifications, background, and prior experience in
conducting similar services; project approach; references; and cost
of services. The lowest bid might not be the deciding factor in the
MABT’s final selection.
It is anticipated that a
consultant will be selected in February, 2012. Following
notification of the firm selected, it is expected that a contract
will be executed between both parties and be in place no later than
March, 2012.
Interested board members of
the Consortium may be involved in the selection process.
6. Terms and Conditions
All proposals submitted in
response to this request become the property of MABT and as such may
be subject to public review.
The MABT has the right to
reject any or all proposals, to engage in further negotiations with
any firm submitting a proposal, and/or to request additional
information or clarification.
The MABT is not obligated
to accept the lowest cost proposal and may reject all proposals.
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