~ DFW =-" :::----:::: - ~~~

(1)

April?, 2015 ADDENDUM NO. 5

~

DFW

= - " :::----:::: - ~~~ DALLAS/FORT WORTH INTERNATIONAL AIRPORT

Re: Solicitation No. 8004998 - Health Plan Administration inclusive of Medical, Dental, Vision, Flexible Benefits Administration, Pharmacy Benefrt Management, Group Life and AD&D Coverage (Basic, Supplemental and Dependent)

Q

=

Question, Inquiry or Request A = Answer or Response

Please be advised of the following changes or clarifications to the above referenced Solicitation: CHANGES:

1. The proposal due date and time has changed to April14, 2015, at 2:00p.m. (Central Time). 2. Request for PBM Account Management Plan (Aon-produced document) has been added as an

attachment to the solicitation website.

3. Companies are requested to email Ron Duncan confirming their intent to submit a proposal in response to this RFP. Confirmations are requested by 3:00p.m. (Central Time), April9, 2015. Companies that do not respond to this request are still eligible to submit a proposal(s).

CLARIFICATIONS:

Q1 Medical RFP 013 is requesting SQuote worksheet to be completed. Please provide worksheet. A1. Please refer to Worksheets DFW Medicai_Stoploss_RFP1_WS.XLS posted on 3/16/2015. In that

workbook there are three tabs, Current Plan Designs, Admin Quote and Stop Loss.

02. Medical RFP 037, Provider TIN listing. Please provide for disruption purposes.

A2. Due to HIPAA Privacy, TINs are not posted. However they will be sent securely to Medical and Dental vendors via secure email from Aon.

03. Please provide files for medical, pharmacy and dental disruption reports requested in the RFP. A3. TINs will be sent directly to the vendor for Medical and Dental disruption. No Disruption report is

required for Pharmacy. TINS cannot be posted due to HIPAA Privacy.

04. Medical RFP 043- 51. Explanation column contains an 'x'. Please clarify if an explanation can be provided for any of these items and if the 'x' can be deleted.

(2)

05. Medical RFP Q16 - Explanation worksheet not provided, can we insert Explanation Tab into the excel doc as in Life and PBM RFPs?

A5. The Explain worksheet is included -refer to the Tab Medical, Column Q and Tab FSA/COBRA

Column E. If additional space is needed it is acceptable to attach separate document clearly

indicating the question and response.

Q6. Medical Questionnaire, 0174 and 0175, refer to designated providers by specialty and designated facilities. Is there a list of providers and facilities?

A6. These questions refer to your providers who have been designated as having roet quality and cost

metrics to be considered Tier 1, Premium, or Designated Providers. If you do not have this

program, indicate in the Explain section what you provide or recommend as an alternative.

Q7. Medical RFP, question 178: Provider number of Kiosks suggested for the Board population and cost per Kiosk per year. What services do the Kiosks offer to Board members and how would they be funded?

A7. Kiosks refer to wellness kiosks where employees can take weight, BP, Heart Rate, readings. If

these are available, you should provide the cost per unit and suggest how many would be appropriate for the DFW population.

08. Medical RFP, question 38: Using the census data provided, prepare a list to indicate which employees reside within and outside of your service area. Name the file [Your Organizations Name_ServiceAreaSummary. Please clarify if it is intended to provide the GeoAccess in excel report for this response or if a site match is being requested.

A8. This is similar to a geo access report, but specifically asking how many employees Oust the

number) would fall outside the service area you are offering. A geo access report is also requested -please refer to the ReadFirst tab in the Medical FSA COBRA.xlsx document posted previously. 09. PBM RFP - Account Management Section, 075 reference is made to complete an Account

Management worksheet. Please provide worksheet.

A9. This has been provided.

Q1 0. PBM RFP Officer Section 03 - reference is made to an Officer Statement worksheet. Please

provide worksheet. A10. This is not required.

011. Dental RFP - Explanation worksheet not provided, can we insert Explanation Tab into the excel

doc as in Life and PBM RFPs?

A11. Please insert any explanations to questions in cell next to question.

012. Dental Questionnaire: Document Checklist. Please confirm whether this should be included in our

response.

A12. This is not required

013. Dental Questionnaire: Final Step. Please confirm whether this should be included in our response.

A13. This is not required

Solicitation No. 8004998 Addendum No. 5 Page 2 of9

(3)

014. Please provide Proposed ISL and ASL levels.

A14. Please refer to Worksheets DFW Medicai_Stoploss_RFP1_WS.XLS posted on 3/16/2015. In that

workbook there are three tabs, Current Plan Designs, Admin Quote and Stop Loss. The Stop Loss

tab has this information.

015. Medical RFP, question 33: List participating Acute Care Hospitals for the geographic locations as

shown in the worksheet 'Hasp'. Will this worksheet be provided or is there a missing provider file?

A15. Please provide a listing of acute care hospitals for the DFW population. Worksheet is not required

- attach separate listing titled Acute Hospitals.

016. Medical RFP, question 34: Provide the number of participating physicians by specialty for the

geographic locations shown in the worksheet 'Doc'. Will this worksheet be provided or is there a

missing provider file?

A16. No worksheet is required - please provide the number

of

specialists by specialist participating in

your proposed network.

017. Medical RFP, question 54- Please clarify the format and purpose of data being sent and provide

example.

A17. Refers to vendor's willingness to provide any required data to a third party as selected by the

Board. This may be in relation to specific claim review, audit or other purposes as the Board/DFW

requires.

018. Dental RFP, 024: You have provided the DPPO geo access run on the basis specified. Access

Standards were not included in the RFP. Please confirm if the standard of 2 General Dentists in 10

miles and 1 Specialist in 15 miles can

be

used.

A 18. Request for Geo Access and Access Standards will be sent to vendors directly from Aon via secure

email.

019. Dental RFP, 026 You have provided the DHMO geo access run on the basis specified. Access

Standards were not included in the RFP. Please confirm if the standard of 2 General Dentists in 10

miles and 1 Specialist in 15 miles can be used.

A 19. See response in A 18.

Q20. Wanted to check and see if there is a provider file to compare against for disruption. Since Aetna is the incumbent, the data should have been produced off our reporting information. Since the RFP

does ask for disruption reporting we would need to perform this duty as a response on the RFP.

A20. See response in A2 and A3.

021. Can you respond if a provider file has been issued OR is it something coming out soon? A21. See response in A2 and A3.

022. In the Medical Questionnaire, Section Ill Question 33 references a document called "Hasp." Do you

have that?

(4)

Q23. In the Medical Questionnaire, Section Ill Question 34 references a document called "Doc" Do you have that?

A23. See response in A16.

Q24. In the Medical Questionnaire, Section V, Question 51 b refers to a voice enrollment system. Can you please tell us more about this system?

A24. The Board is not currently utilizing a voice enrollment system. Please disregard this question. Q25. In regards to the Medical Questionnaire, Question 53, what specifically are you looking for on the ID

card?

A25. Health Plan agrees to share data to produce one ID card that includes Medical,

Rx,

Advocacy, EAP and other carve out vendor. This refers to vendor's willingness to put 800 numbers to any other vendor such as Advocacy, RX and EAP on the medical card.

Q26. In Question 24 of the Dental Questionnaire, you request a Geo to be run on the basis specified. We did not see the specifications. Can you please provide the specifications you would like the dental geo to be run on?

A26. See response in A 18.

Q27. In Question 75 of the Pharmacy Questionnaire, you reference an Account Management Plan Worksheet. We did not see this. Can you please provide this?

Q28. In Question 3 in the Officer section of the Pharmacy Questionnaire, you reference an Officer Statement worksheet. Can you please provide this?

A28. This is not needed.

Q29. The DFWIA Pharmacy (RX) Formulary zip file provided with Addendum 1 does not contain any data files. Could you please provide the files?

A29. The

Rx

Formulary worksheet was included with Addendum 1. Please complete the worksheet as requested.

Q30. Please confirm our proposal should be quoted net of commissions. A30. All quotes are net of commission.

Q31. Please provide a month-by-month break out of the experience for the past 3-5 years for each billed product, including the following information:

Lives

Paid premiums (broken out by line of coverage including Basic, Supplemental Employee, Supplemental Spouse and Supplemental Life for children)

Volumes

A31. The information that is available from the current vendor has been posted. Additional information from the prior vendor is included in this posting.

Q32. Please provide a rate history for 1/1/2010 through 12/31/2012.

Solicitation No. 8004998 Addendum No. 5 Page 4 of9

(5)

A32. Basic Life $.18 per $1,000 - No rate changes during this period, AD&D $.03 per $1,000 - No rate changes during this period.

Q33. Can we get better Aetna claims experience? Something showing lives/premium history?

A33. Available Aetna premium history and claims experience was posted with the original RFP posting.

Q34. The RFP asks us to describe our ability to integrate Rx data with On-site Clinic Vendor. In order to do so, we will need Concentra to provide pharmacy utilization information. Does Concentra have onsite pharmacies that dispenses medication, or are prescriptions filled at retail pharmacies? Also, please provide more specific Information regarding the services provided by the clinic, and the level of integration required.

A34. The current wellness program and OM programs are administered by DFWs own team. The onsite

clinic is administered by Concentra. Please refer to the Open Enrollment guides for additional

information. Employees can have preventive exams, immunizations, etc ... performed at the Onsite

clinic, and the current medical vendor is used for lab services. The Board/DFW may require data obtained in either the medical, PBM, on-site clinic or dental provider be provided to a third party data warehouse or may require other integration. The question is specific to your ability to comply

with data sharing as directed by the Board/DFW.

Q35. In regard to the question below, with regards to this RFP, what entity Is being referred to when noting the medical or wellness vendor? How do they anticipate this working and why would the data be needed? "For the DPPO, you agree that dental claims data can be shared with Medical Vendor and/or wellness vendor for OM and Wellness program compliance."

Q36. For question 175 in the medical questionnaire: "Provide listing of Premium designated facilities and

their specialty in Dallas, Tarrant, Denton and Collin County.» What is the premium network

referenced?

Q37. The following tabs referenced within the Medical Questionnaire Tab seem to be missing. Can these tabs be created or should these questions be disregarded.

For self-Insured quotes, provide your financial quotation in the worksheet(s), "SQuote."

For self-insured coverages, provide a quote for stop loss coverage in the worksheet, "Stop Loss." List participating Acute Care Hospitals for the geographic locations as shown in the worksheet(s), "Hosp".

Provide the number of participating physicians by specialty for the geographic locations shown in

the worksheet(s), "Doc".

A37. Please refer responses in A 15, and A 16.

Q38. For the questionnaires, can we expand the column widths to fit lengthier responses or should we

create a supplementary exhibit to include those lengthier responses?

A38. Yes, columns can be widened to accommodate more text however we would like responses to be

brief and to the point. If additional information must be provided, attach a separate document

indicating Question.

039. Please confirm the R&C for DPPO is the 85th percentile.

(6)

040. Which DHMO schedule does Aetna provide the Board?

A40. Aetna DHMO Schedule 67.

041. It is requested that retirees are encouraged to buy own part D programs - is this currently being provided to employees today or is this a product currently out to bid?

A41. Retirees purchase their own Part D plan and this is not anticipated to change.

042. In the spreadsheet, there is a statement: Review and detail deviations from the proposed plan design shown in the worksheets, "Plan Design". There is no tab for this. Do you want us to create one or will there be an update?

A42. Refer to the Tab DPPO Provisions and Tab DHMO Provisions for plan design and deviations. 043. Please confirm the R&C out of network for DPPO as 85th percentile.

A43. Confirmed

044. Actual Aetna DHMO schedule -looks like a 67 but would like to confirm. A44. Confirmed

045. Will they be supplying a report in an excel format for disruption to include name, address, tin at a minimum?

A45. See responses in A2 and A3.

046. Will there be detailed medical and pharmacy claims file for disruption and repricing? A46. See response in A32 for disruption. Repricing is not requested.

047. Per question 37 of the medical questionnaire: "Please note a Provider TIN listing has been provided. Have you provided an excel based disruption report showing which providers would be in or out of network?" Will the Board be supplying a report in an excel format for disruption to include name, address, tin at a minimum?

A47. See response in A2 and A3.

048. Please clarify question 51.a of the medical questionnaire: "Design, submit for the Board's approval, and print forms with the Board's logo for claims submission, where required."

A48. This question refers to the vendor's willingness to create custom forms or materials requested. 049. Please clarify question 51.b of the medical questionnaire: "Provide network service area zip codes

and electronic directories for the Board's voice enrollment system." A49. See response in A24.

050. Dental: Have there been any plan design changes over the past three years? If so, please provide details and dates of any changes. Please provide current ASO fee. Please provide three years of experience for PPO plan (Monthly claims, lives, and fees).

Solicitation No. 8004998 Addendum No. 5

(7)

A50. There have not been any plan design changes. The ASO fee was provided in the document titled

DFW Experience Report 2012·2014 PDF. The PPO claims and lives by month was provided in the

document titled DFW Experience Report 202-2014 PDF. Q51. What is the current ASC fee for the dental PPO plan?

Q52. For the dental PPO plan, please provide the most recent 24-36 months of #claims, $ claims paid and enrollment by month that does not include the DHMO data.

Q53. Have there been any plan changes for the experience period provided? If yes, what were the

changes and their effective date?

A53. No changes have been made to plan design.

Q54. Is Aetna keeping a portion of the claims savings from the network being accessed to cover the cost

of this network? If yes, what was the amount retained for the most recent 24·36 months?

A54. Information is not available.

Q55. Does the current ASC fee include any charges for a leased network? This can also be presented

as a network access fee? If so, what is the amount?

A55. The ASC fee for dental does not specify any network fees.

Q56. Is the current carrier charging a separate claims fee (in addition to ASC fee and claims paid)?

A56. No

Q57. The Aon Excel document containing the pieces states: "Please refer to the Board RFP solicitation

for specific instructions. You must also complete the Excel workbooks for all coverages for which you are proposing. You will submit 1 original hard copy and 7 COs/flash drives containing all RFP

materials and the completed excel workbook and worksheets." The solicitation does not state

where to put the following forms: Dental Questionnaire, Performance Guarantees, Plan Design

worksheets, DHMO Copayment schedule, Rate worksheets, Bid questionnaire, Dental PPO

Questionnaire, DHMO Questionnaire, Disruption Analysis, and Discount Analysis.

A57. The Questionnaires and supporting worksheets and/or documents/attachments should be saved to

CD, disk, stick. One hard copy of all documents should be included in separate binder for DFW.

Q58. Are vendor references required for this solicitation? If so, please advise how many are needed.

A58. Three vendor references will only be required for finalists.

Q59. Life: Please confirm Guarantee Issue amounts for life coverages. Please confirm if the GF DEPL

listing {found in the document titles "DFW Life Grandfathered Life") is for employees that are AAW.

Any further explanation would be greatly appreciated.

A59. The Spouse Life Gl amount is $75K and the Child is $10K, no Supplemental AD&D on dependents.

The grandfathered group Is a closed class of active employees who have dependent supplemental life coverage but no coverage on themselves.

(8)

Q60. Please provide a volume, premium, rate and a detailed claims history listing for the last five years

for all Basic, Voluntary/Supplemental, and Dependent Life coverages separately.

A60. See response in A31, A32 and A33.

Q61. Please update or provide a census of the closed grandfathered group that includes gender and

date of birth; the current census only includes the insureds' name and their amounts.

Q62. Please clarify what differentiates the closed grandfathered dependent group from the remaining

dependent population. Should these groups be combined since the plan designs are identical?

A62. The grandfathered group is a closed class of active employees who have dependent supplemental

life coverage but no coverage on themselves.

Q63. If there are any employees working outside of the United States, please identify them on the census

and provide each employee's country of citizenship and country of employment.

A.63 There are no employees working outside of the US covered under the plan.

Q64. Please provide a recent monthly billing statement, which includes lives, volume and premium by

coverage.

A64. The account is self-billed.

Q65. Have there been any special enrollment events in the past 5 years? If so, please describe the offer

and timing of the offer.

A65. No

Q66. As the current incumbent, are we required to provide references where requested? A66. See responses in A58.

Q67. In Question 51d in the Medical Questionnaire, how often will new member orientations occur at the

worksite?

A67. This is not a required or current service, however approximately 1 per month may be expected.

Q68. In 53a in the Pharmacy Questionnaire, how many meetings do you anticipate occurring during the 2nd Monday in November to 2nd Monday in December time period?

A68. Please disregard this question- no response needed.

Q69. Please provide detailed claims data for Pharmacy claims.

A69. Top 50 most utilized and top 50 by claim count, as well as total claims data has been provided.

Q70. Please provide the total number of calls received by the following types of callers for the previous

year, 2014: members, pharmacies, providers

A70. This information is not available.

Solicitation No. 8004998

Addendum No. 5

(9)

071. Please provide the total number of pharmacy prior authorizations received via telephone during the previous year, 2014.

072. Please provide the total number of pharmacy prior authorizations received via fax during the

previous year, 2014.

073. Due to the outstanding data files needed to run the medical, pharmacy and dental disruption and

discount analysis, it will be difficult to provide a detailed response to many of the RFP questions

and requirements by the due date. Is it possible to get a one week extension?

A73. See Item #1 to the "CHANGES" Section of this Addendum No. 5.

NOTE:

A copy of this addendum shall be acknowledged by appropriate signature and attached to the

submitted proposal.

Company Name

Signed Date

If you have any questions regarding this matter, contact Ron Duncan at the email address of

[email protected]. Sincerely,

Ron Duncan Contracts Manager

(10)