Proposal for Kerr County Medical Stop Loss, TPA Services, Life Insurance and AD&D Prepared by: Bryan Finley & Associates 625 Sidney Baker St. P.O. Box 291305 Kerrville, TX 78028 Phone: (830) 896-4400 Fax: (830) 257-5833 _ ~. . _ . , Introduction ~.-'° ' Biography Request for Proposal Specific Aggregate Stop Loss Insurance ~ Third Party Medical Claims Administration Group Term Life & AD&D Health Reimbursement Account • Cafeteria Plan (IRS Code 125) Administration Prescription Benefit Management Online Services • .~ ~~~; ~ K ' ~, Air Evac Lifeteam l ,i` t' NSURANCE '~'" AND * FINANCIAL SERVICES ~~~~~ ~o~~~~o~ ~~~~c~o~~~~ November 13, 2007 Kerr County 700 Main Street, BA-104 Kerrville, TX 78028 Thank you for giving Bryan Finley & Associates the opportunity to respond to the Kerr County Request for Proposal. It has been our pleasure to work with Kerr County and it's employees for several years. Our relationship has been centered on providing quality benefits supported by convenient, local service. If there is any specific area in our response to the RFP that needs further clarification, we will be happy to provide the addition information requested. We look forward to continuing to provide benefits and service for Kerr County. Thank you, 7 _ - ~,,,e,r " ~;f/ -,~ ~, ~rvan,~~inlev _. Curtis Fi ey Invesh7unt Advisor Representative with and securities and invesh7ient advisory services offered through InterSecurities, Inc., Member NASD, SIPC & Registered Investment Advisor 625 SIDNEY BAKER, P.O. BOX 291305, KERRVILLE, TEXAS 78029-1305 (830) 896-4400 Fax (830) 257-5833 NSURANCE ~"` A N D * FINANCIAL SERVICES ~~~~~ ~o~~~~o~ Q~~~c~o~~~~ BRYAN FINLEY & ASSOCIATES BRYAN FINLEY & ASSOCIATES has been providing insurance and financial services for South and Central Texas organizations since 1954. We are an experienced association of professionals, providing capable, personalized service to our clients. We endeavor to acquaint ourselves fully with each client's unique set of needs and address those needs with financial programs to achieve specific goals. Within the scope of our operations, we provide a broad range of financial services programs. Our office at 625 Sidney Baker Street in Kerrville is open from 8:00 A.M. to 5:00 P.M. Monday through Friday, as well as other times by appointment. We are committed to providing the best service possible for our clients. Our goal is to build and maintain along-term relationship. BRYAN FINLEY has been providing insurance and financial services to public and private firms for over 50 years. He is a Registered Financial Consultant and an Investment Advisor Representative. Bryan has been active in civic affairs in Kerrville, where he has resided since 1971. His activities have included serving as Outstanding Citizen of the Year in 1979, President for the Texas Arts & Crafts Foundation, and the Chairman of the Citizens Bond Issue Advisory Committee for the Kerrville Independent School District. Bryan has been an active member of Kiwanis since 1954. He is a former Trustee of Hardin Simmons University, presently serving on the Board of Development. CURTIS FINLEY holds a Bachelor's Degree in Finance from Hardin Simmons University. He has been with Bryan Finley & Associates since 1989 providing clients with employee benefits and retirement services. Activities in civic affairs include Leadership of Ken County Class of 1994, member of Kiwanis since 1985, former YMCA Board Member, a Boy Scout Leader, Chamber of Commerce Board, Booster Club Board and serves on the Hardin Simmons University Board of Development. Curtis is also a Registered Financial Consultant and an Investment Advisor Representative. DAVID BRANTLEY has been in the financial services industry and a practicing comprehensive financial planner for the past 16 years. He has a Bachelor's Degree in Finance from Texas State University and is a Registered Representative and an Investment Advisor Representative. Investment Advisor Representative with and securities and investment advisory services offered through InterSecurities, Inc., Member NASD, SIPC & Registered Investment Advisor 625 SIDNEY BAKER, P.O. BOX 291305, KERRVILLE, TEXAS 78029-1305 (830) 896-4400 Fax (830) 257-5833 NSURANCE ~ AND * FINANCIAL SERVICES ~~~~~ ~0~0~~0~ Q~~~c~o~~~~ COURTNEY REAL is an Administrative Assistant and licensed insurance agent who as been with Bryan Finley & Associates since 2003 and oversees day-to-day operations. She maintains contact with clients and product providers. TAMBRA MORRISS is an Administrative Assistant who works closely with group and individual accounts. She assists clients with benefit questions and claim filing. LEAH HOLEKAMP is a General Office Assistant to all administrative and executive staff. Bryan Finley and Associates has been providing employee benefits and related services to the public sector for over 40 years. We currently work with five school districts (including Kerrville and Ingram LS.D.), Kerr County, the City of Kerrville, as well as other organizations such as Schreiner University and Sid Peterson Memorial Hospital. Investment Advisor Representative with and securities and investment advisory services offered through InterSecurities, Inc., Member NASD, SIPC & Registered Investment Advisor 625 SIDNEY BAKER, P.O. BOX 291305, KERRVILLE, TEXAS 78029-1305 (830) 896-4400 Fax (830) 257-5833 REQUEST FOR PROPOSALS ~P) SPECIFICATIONS Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management Kerr County Courthouse 700 Main Kerrville, Texas 78028 EFFECTIVE DATE: January 1, 2008 Page 1 of 1 Kerr County REQUEST FOR PROPOSAL TABLE OF CONTENTS Page Request for Proposal Legal Notice .............................................................................................. 3 Acknowledgement of Receipt of RFP, Certifications,Ccx>sict of Interest Questionnaire ................ 4 - 7 Notice to Proposers ..................................................................................................................... 8 General Information, Timetable .................................................................................................. 9 - 13 Background ............................................................. 14 ................................................................... RFP Assumptions, Questionnaires, and Submission Forms .......................................................... 15 -27 Attachments: The following files are also included on CD Claim Experience ................................................................................................................. Summary Plan Documents ................................................................................................... Census ................................................................................................................................. ASO Agnren-ei~t ............................................................................................... Ifyou do not have access to an Internet system you may obtain a hard copy of the Request for Proposal from: Gary R Looney, 3201 Cheery Ridge Rd, Suite D 405, San Antonio, Texas 78230 Ph: Z 10-930-6665 Page 2 of 2 Kerr County Request for Proposal Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IlZS code 125) Administration Prescription Benefit Management Kerr County will accept sealed proposals for listed items individually or corporately until 11:00 A.M. local time, NOVEMBER 14 2007 County Judge Pat Tinley's office, County Courthouse 700 Main Kerrville, Texas 78028. Proposals will be opened and acknowledged publicly on NOVEMBER 14, 2007. This is a procurement of insurance through the competitive sealed proposal procedure outlined in the Texas Local Government Code 262 including terms and conditions specified in Sections 262.030; 262.025; 262.026; At the proposal opening, only the identity of the proposers will be disclosed by KERB COUNTY. The proposals will be forwarded to KERB COUNTY'S insurance consultant for review, tabulation and analysis. The contents of each proposal will not be disclosed in order to protect the integrity of the negotiation process. To obtain the best fmal offer(s), revisions by short-listed candidates may be permitted after original proposal submission, and before the the contract award. All proposals will be later made available to the public for inspection after the contract is awarded. if a proposer indicates and justifies in his proposal(s) that certain information is proprietary, KERB COUNTY will not release the materials for public inspection after the contract award. Clarification of RFP may be obtained from: Gary R Looney, 3201 Cherry Ridge Rd, Suite D 405, San Antonio, Texas 78230 Ph: 210-93 0-6665 glooney@alamoinsgrp. com Please mark on the outside of the submitted envelope/box: "SEALED PROPOSAL FOR KERR COUNTY MEDICAL STOP LOSS, TPA SERVICES, LIFE INSURANCE AND AD&D, NOVEMBER 14 11:00 AM" and send or deliver to the attention of "Kerr County Commissioner's Court, C/O County Judge Pat Tinley County Courthouse 700 Main Kerrville, Texas 78028" KERR COUNTY reserves the right to reject any or all competitive sealed proposals ,waive any irregularities contained therein and to accept any competitive sealed proposals deemed most advantageous to KERR COUNTY. Any competitive sealed proposal received after 11:00 am., local time, NOVEMBER 14, 2007, will be automatically rejected and returned to the proposer unopened. KERB COUNTY will not be responsible in the event that the U.S. Postal Service or any other carrier system fails to deliver the sealed proposal to KERR COUNTY by the given deadline above. Page 3 of 3 Kerr County Specific and Aggregate Stop Loss Ir-sutance Third Patty Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management PLEASE ACKNOWLEDGE RECENING THIS RFP BY RETURNING THIS FORM In order to allow a fair and competitive bid process proposer will not be allowed to access markets prior to the release date of this RFP. The official date and time of release is Tuesday October 30, 2007, 10:00 AM. It is your responsibility to return this intent to bid with the proper means of contacting you or your organization. Communicating any questions, answers, or amendments to this RFPwill be made through the process you provide on this form. FAX or Mail TO: Gary Looney REBC Insurance Consultant 3201 Cherry Ridge Dr Suite D 405 X WILL RESPOND* WILL NOT RESPOND COIvIl~tENTS: ~r~ AGENT NAME: Bryan Finley & Curtis Finley Agent Email: finlev(a~ktc.com Agertf$ignature L.- COMPANY NAfVIE COMPANY FAX San Antonio, Texas 78230 Fax: 210-930-1838 COMPANY CONTACT EMAIL: TUBE Print Agent Name (830) 896-4400 Company Phone Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Page 4 of 4 Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management PLEASE FILL IN THE FOLLOWING INFORMATION NEEDED AND SUBMIT WITH PROPOSAL. The undersigned proposer, by signing and executing this proposal, certifies and represents to Ken• County that proposer has not offered, conferred or agreed to confer any pecuniary benefit, as defined by (1.07 (a) (6) of the Texas Penal Code, or any other thing of value as consideration for the receipt of information or any special treatment of advantage relating to this proposal; the proposer also certifies and represents that the proposer has not offered, conferred or agreed! to confer any pecuniary benefit or other thing of value as consideration for the recipient's decision, opinion, recommendation, vote or other exercise of discretion concerning this proposal, the proposer certifies and represents that proposer has neither coerced nor attempted to influence the exercise of discretion by any officer, trustee, agent or employee of Kerr County concerning this proposal on the basis of any consideration not authorized by law; the proposer also certifies and represents that proposer has not received any information not available to other proposers so as to give the undersigned a preferential advantage with respect to this proposal; the proposer further certifies and represents that proposer has not violated any state, federal, or local law, regulation or ordinance relating to bribery, improper influence, collusion or the like and that proposer will not in the future offer, confer, or agree to confer any pecuniary benefit or other thing of value of any officer, trustee, agent or employee of Kerr County in return for the person having exercised their person's official discretion, power or duty with respect to this proposal; the proposer certifies and represents that it has not now and will not in the future offer, confer, or agree to confer a pecuniary benefit or other thing of value to any officer, trustee, agent, or employee of Kerr County in connection with information regarding this proposal, the submission of this proposal, the award of this proposal or the performance, delivery or sale pursuant to this proposal. The Proposer represents that he, his agent(s), nor any corporate employee has contacted any officer, trustee, elected County official or any other County employee with the intent to discuss, influence, or in any manner affect the outcome of the bid process. The proposer shall defend, indemnify, and hold harmless Kerr County, all of its officers, agents and employees from and against all claims, actions, suits, demands, proceeding, costs, damages, and liabilities, azising out of, connected with, or resulting from any acts or omissions of contractor or any agent, employee, subcontractor, or Supplier of contractor in the execution or performance of this 1ZFP. I have read all of the specifications and general proposal requirements and do hereby certify that all items submitted meet specifications. COMPANY: Brun Finiey& Associates AGENT NAME: Bt an F' inl AGENT SIGNATURE: ~ -, ADDRE5S: 625 Sidney Baker ~ _.. CITY: Kerrville STATE: TX ZIP CODE: 78028 TELEPHONE: X30) 896-4400 Fax: (830) 257-5833 FEDERAL TlN#: AND/OR SOCIAL SECURITY #: 45446-6073 Page 5 of 5 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IlZS code 125) Administration Prescription Benefit Management PLEASE ACKNOWLEDGE RECEIVING THIS RFP BY RETURNING THIS FORM In order to allow a fair and competitive bid process proposer will not be allowed to access markets prior to the release date of this RFP. The official date and time of release is Tuesday October 30, 2007, 10:00 AM. It is your responsibility to return this intent to bid with the proper means of contacting you or your organization. Communicating any questions, answers, or amendments to this RFPwill be made through the process you provide on this form. FAX or Mail TO: Gary Looney rn;sc Insurance Consultant 3201 Cherry Ridge Dr Suite D 405 San Antonio, Texas 78230 Fax: 210-930-1838 X WII,L RESPOND w>Z.L NoT RESPOND colvnvtENTS: Micah Ho~~ and - MetL' e ales Rep AGENT NAME: Bryan Finley & Curtis Finley Agent Phone: (830) 896-4400 ~ finley@ktc.co~ Agent Email: t--- K' f_i F.t rte` ~1 ~ ~ Print Ao nt Name COMPANY NAIGfE: _MetLife COMPANY FAX 866-224-6621 Company Phone972-246-1630 COMPANY CONTACT EMAIL: mhoward2@metlife.com SIGNAT Page 4 of 29 DEVIATIONS FROM SPECIFICATIONS IF ANY (Attach documents as necessary or state No Deviations): ~, Kerr County ' Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS Name Of Entity: The prospective participant certifies to the best of its knowledge and belief that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency: b) Have not within a three year period preceding this proposal been convicted of had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, Local) with commission of any of the offenses enumerated in paragraph (I) (b) of this certification; and d) Have not within a three year period preceding this application/proposal had one or more public transactions (Federal, State, Local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 USC Section 1001, a false statement may result in a fine up to a $ 10,000.00 or imprisonment for up to five (5) years, or both. Richard J Lorenz Vice President Group Sales Name and Title of Authorized Representative (Typed) 4 ~T November 13, 2007 Signature of Authorized Representative Date I am unable to certify to the above statements. My explanation is attached. Page 7 of 73~ DEVIATIONS FROM SPECIFICATIONS IF ANY (Attach documents as necessary or state No Deviations): ~„ Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS Name Of Entity: MetLife The prospective participant certifies to the best of its knowledge and belief that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency: b) Have not within a three year period preceding this proposal been convicted of had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local} transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, Local) with commission of any of the offenses enumerated in paragraph (I) (b) of this certification; and d) Have not within a three year period preceding this applicationlproposal had one or more public transactions (Federal, State, Local) terminated for cause or default. 'err I understand that a false statement on this certification ma}- be grounds for rejection of this proposal or termu~atiou of the a«~ard. hi addition, under 18 USC Section 1001. a false statement ma~~ resl~lt ui a foie up to a $ 10.000.00 or imprisomuent for up to fi~~e (~) ~~ears, or bot I`~ iClch ~bW0.~G Name and Title of Authorized Representati~ e (T} ped) Si tah~re of Authorized Represeutati~ e Date r f • ~ 3 • oZ d ~ I am uinable to certifc to the abo~~e statements. M}~ esplaik~tion is attached. ~tirr Page 6 of 6 Conflict of Interest Questionnaire For Vendor or Other Person Doin¢ Business with a Local Government Entitv This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with a government entity. ~~ By law this questionnaire must be filed with the records administrator of the local government not later than the 7`h business day after the date the person becomes aware of the facts that require the statement to be filed. See section 176.006, Gocal Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C Misdemeanor. 1. Name of person doing business with local govemment entity. 2. ^ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which the activity described in Section ] 76.006(a) Local Government Code, is pending and not later than the 7~' business day after the originally filed questionnaire becomes incomplete or inaccurate.) 3. Describe each affiliation or business relationship with an employee or contractor of the local govemment entity who makes recommendations to a local government officer of the local govemment entity with respect to expenditure of money. 4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local govemment officer of the local govemment entity that is subject of this questionnaire. 5. Name of local govemment officer with whom filer has an affiliation or business relationship. (Complete this section only if the answer to A, B or C is YES) This section, item 5 including subparts A, B, C & D must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional s as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of this questionnaire? ^ ygS ~-X NO B. Is the filer of the questionnaire receiving or likely to receive taxable income ftom or at the direction of the local government officer named in this section? ^ YES ^X NO C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director or holds an ownership position of 10% or more? ^ YES ^ X NO D. Describe each affiliation or business relationship. 6. Describe any other affiliation or business relationship that might cause a conflict of interest. 7. Signatures T November 13, 2007 Signature of person doing business with the Date Governmental entity `Wr- Page 9 of 93~ Conflict of Interest Questionnaire For Vendor or Other Person Doin¢ Business with a Local Government Entity This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with a government entity. Bylaw this questionnaire must be filed with the records administrator of the local government not later than the 7`h business day after the date the person becomes aware of the facts that require the statement to be filed. See section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C Misdemeanor. 1. Name of person doing business with local government entity. N/A 2. ^ Check this box if you are filing an update to a previously filed questionnaire. N/A (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than Se~tember 1 of the year for which the activity described in Section 176.006(a) Local Government Code, is pending and not later than the 7 business day afrer the originally filed questionnaire becomes incomplete or inaccurate.) 3. Describe each affiliation or business relationship with an employee or contractor of the local government entity who makes recommendations to a local government officer of the local government entity with respect to expenditure of money. N/A 4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local government entity that is subject of this questionnaire. N/A 5. Name of local government officer with whom filer has an affiliation or business relationship. (Complete this section only if the answer to A, B or C is YES) N/A This section, item 5 including subparts A, B, C & D must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional s as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of this questionnaire? ^ yES ^ NO B. Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section? ^ YES ^ NO C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director or holds an ownership position of 10% or more? ^ YES ^ NO D. Describe each affiliation or business relationship. 6. Describe any other affiliation or business relationship that might cause a conflict of interest. 7. Signatures Date Signature of person doing business with the Governmental entity ~~ ~~~ Page 7 of 7 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IlZS code 125) Administration Prescription Benefit Management NOTICE TO PROPOSER Information provided in these specifications is to be used for purposes of preparing a proposal detailing costs of providing the services and insurance specified. It is further expected that each proposer will read these specifications with care, since failure to meet each condition or a combination of specified conditions may disqualify proposal. Information provided by Kerr County includes: I . Current census 2. Plan documents 3. Rate history 4. Standard Loss Information 5. High Claim Losses KERR COUNTY reserves the right to reject any or all proposals or any portion thereof and to accept the proposal deemed most advantageous to KERR COUNTY. Proposer is required to submit quotations on the basis of these specifications. Alternative quotations (for service on a basis different from requested in these specifications) will receive consideration if such alternatives are clearly explained. Any exceptions to coverage requested herein must be clearly noted in writing and be included as a part of the proposal. ~- KERR COUNTY believes that the data contained in these specifications is sufficient for preparation for a proposal. The information is believed to be accurate and is based upon the latest available information, but it is not to be considered in any way as a warranty. Requests for additional information should be directed in writing to Gary Loonev REBC Insurance Consultant, 3201 Cherry Rid a Drive Suite D 405 San Antonio Texas 78230 Phone (2 1 01 930-6665 Fax (2101930 1838 Email address gloone~na alamoins~rp.com Page 8 of 8 Ken County Specific and Aggregate Stop Loss Instu-ance Third Party Medical Claims Administration Group Term Life and AD&D Heahh Reimbtusement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management GENERAL INFORMATION and INSTRUCTIONS 1. The information contained in these specifications is confidential and is to be used only in connection with preparing a proposal for all or part of the following employee benefit plans: Specific and Aggregate Stop Loss Insiuarice, Third Party Medical Claims Administration, Group Term Life and AD&D, Heahh Reimbiuseiuent Airuigement, Cafeteria Plan (IRS code 125) Aclininistration, Prescription Benefit Management 2. KERR COUNTY reserves the right to accept or reject all or any part of the proposals, waive minor technicalities, and award the proposal to best serve the interest of KERR COUNTY. KERR COUNTY also reserves the right to waive or dispense with any of the formalities contained herein. 3. Proposals are to be submitted on the basis of the specifications contained herein. Alternate proposals will also be considered, if the alternatives are clearly explained. All deviations from the specifications must be clearly identified and explained. 4. The information contained herein is believed to be accurate and up-to-date, but is not intended to be an express or implied warranty. 5. No telephone or fax proposals will be accepted. Proposals will only be accepted if delivered by U.S. Postal Service, contract carriers, hand delivery, etc. KERR COUNTY will not be responsible for missing, lost or late mail. Any proposals received after the deadline will be returned to the proposer unopened. 6. At the proposal opening, only the identity of the proposers will be disclosed by KERR COUNTY. The contents of each proposal will not be disclosed in order to protect the integrity of the negotiation process. 7. To obtain the best final offer(s), revisions by short-listed candidates may be permitted after original proposal submission, and before contract award. g. All proposals will later be made available to the public for inspection after the contract is awarded. If a proposer indicates and justifies in his proposal(s) that certain information in the proposal(s) is confidential or a trade secret, KERB COUNTY will review those materials with the proposer prior to releasing the materials for public inspection after the contract award. 9. Gary R Looney REBC is the independent insurance consulting agent providing technical assistance to Kerr County during the RFP process. Gary R Looney is compensated by KERB COUNTY on a fee basis, and is not compensated by the service provider. 10. Vendors are cordially invited to the proposal opening, but are not required to attend. Page 9 of 9 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management TIMETABLE 1. These specifications are to be released for action at 10:00 am October 30, 2007. 2. One original and two (2) copies of the proposals are to be delivered or mailed to Kerr County Courthouse, C/O Judge Pat Tinley, 700 Main, Kerrville, Texas 78028 to arrive by NOVEMBER 14, 2007, 11:00 am. 3. Consideration and action on the Proposals will be presented to the Commissioner's Court on or about November 19, 2007. 4. The successful proposer will be notified on or about November 19, 2007. 5. Coverage is to be effective January 1, 2008. 6. Policies or contracts are to be provided to KERR COUNTY no later than 30 days after such effective date. 7. The contract term desired is three years with years two and three subject to County Commissioner's Court approval. PREPARATION OF PROPOSAL The proposer shall prepare their proposal in one original and two (2) copies on the attache proposal form with attachments as necessary to fulfill the specifications contained herein. Unless otherwise stated, all blank spaces on the proposal or as applicable to the subject specification, must be correctly filled. A unit price must be stated for each item, either typed in or written in ink. Any exceptions or deviations from the requested services must be cleazly indicated in writing and submitted with and form a part of the proposal form. Failure to follow these instructions will be grounds for disqualifications of a proposal. Complete and sign all documents provided including the Conflict of Interest Questionnaire (CIQ) which is included in the information you have received. Page 10 of 10 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Atrangememt Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management WITHDRAWAL OF PROPOSAL Proposers may withdraw their proposals anytime up to the time specified as the closing time for acceptance of proposals. However, no proposer shall withdraw or cancel their proposal for a period of 60 days after said closing date for acceptance of proposal nor shall the successful proposer withdraw or cancel or modify their proposal, except at the request of KERB COUNTY, after having been notified that KERB COUNTY has accepted the said proposal. Withdrawal or cancellation of a proposal after the closing date for acceptance of proposals shall result in the forfeiture of the bid security. CRITERIA USED IN EVALUATING PROPOSALS L No insurance proposals will be accepted from insurers without a Best's Rating, of at least an "A-" in the most recent edition of BEST'S KEY RATING GUIDE FOR LIFE/I~ALTH,. 2. Any insurers, agents or third party administrators shall be duly licensed by the state of Texas, and comply with all applicable state insurance laws and requirements or duly constituted applicable insurance regulatory authorities. A local government self-insurance pool organized under the Texas Interlocal Cooperation Act or other state law shall also be an acceptable provider. 3. The proposal must be in easily understood format with coverage clearly outlined. ~ ' 4. Proposals will be first evaluated on technical factors other than cost, including but not limited to coverage, benefits, services and financial stability. After a preliminary evaluation of the technical criteria, cost will be included in the evaluation process. Cost will be evaluated on an equal basis with the technical criteria. For the evaluation of cost, fixed administrative cost for athree-year period will be considered first; followed by total fast year cost for stop loss insurance premiums and maximum claim cost. For aggregate stop loss insurance maximum claim cost, additional specific deductibles (lasers) will be added to maximum claim cost, if not an allowable claim expense for aggregate maximum claim cost. Page 11 of 11 Kerr County Specific and Aggregate Stop Loss Insurance Third. Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management QUALIFICATION OF COMPANIES AND AGENTS SUBMITTING PROPOSALS. All companies and agents submitting proposals must be licensed by the state of Texas and have demonstrated level of good performance with municipalities, school district or other public entities in Texas. The company or agent must have an Errors and Omissions (E&O) policy with a minimum limit of $1,000,000. An agent submitting a proposal must maintain a fully staffed office for the servicing of the program. The agent must have been in business for at least five years and must assign a minimum of one qualified account representative to service KERR COUNTY to include assisting with enrollment responsibilities. This representative must have a minimum of five years experience in employee benefits, or hold the CLU, CEBS and or RHU designation. DEVIATION FROM SPECIFIED COVERAGE OR SERVICE Proposals are to be submitted on the basis of the specifications contained herein. Proposer MUST include the RFP Submission Forms with its proposal. All costs to be incurred and billed to KERR COUNTY will be firm and included in these forms. Alternative proposals will also be considered, provided the alternatives are clearly explained. All deviations from the specifications must be clearly identified and explained. UNDERWRITING DATA KERR COUNTY has assembled the underwriting exposure, and loss data included in these specifications. While every effort has been made to ensure the accuracy of this information, it cannot be guaranteed. It shall be the responsibility of the successful proposer to review this information and work with KERB COUNTY on an ongoing basis to ensure all relevant exposures are included in KERB COUNTY's program. If it becomes necessary to revise any part of this proposal, a written addendum will be provided to-all proposers who have submitted an "Intent to Bid Form". KERR COUNTY is not bound by any oral representation, classifications, or changes made in the written specifications by KERB COUNTY employees, unless such classification or change is provided to proposers in a written addendum from an authorized representative of KERB COUNTY or KERB COUNTY'S insurance consultant. COMPLIANCE WITH LAWS All proposers involved shall observe and comply with all regulations, laws ordinances, etc., of local, state, and federal government as they apply to this proposal process Page 12 of 12 Kerr County Specific and Aggregate Stop Loss Insurance Third Pasty Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management TERM OF CONTRACT AND EXTENSION/RENEWAL RIGHTS The term of the contract for insurances or service shall be for not less than one year, subject to earlier termination as provided by the law and by the terms of the contract. In addition, unless otherwise specified in the proposal, the award of this proposal shall include the right at the option of KERR COUNTY, and contingent upon the agreement by both parties, to any change in premium costs or benefits to renew and extend this contract on a year to year basis as may be permitted by applicable law and Commissioner's Court approval as may be in the best interest of KERB COUNTY; if the maximum term of this contract and all renewals of it shall be not more than three years before such contract must again be offered for competitive bidding. AUTHORIZED SIGNATURE All proposal forms must be signed by persons who have legal authority to bind the insurer and administrator to the services proposed. DISQUALIFICATION AND REJECTION OF PROPOSALS Failure to comply with the requirements or the procedures set forth herein, or to satisfy the insurance and servicing criteria as set forth in the specifications, may result in disqualification. It is not intended that exceptions to the specification will, in and of themselves, result in disqualification. CONTINUITY OF COVERAGE All employees, retirees and dependents covered by the current plan are to receive immediate coverage under the new plan. Continuity of coverage for current participants is to be on a "no loss no gain" basis for all insurance coverage. In addition, proposers must waive the actively at-work provisions. In fulfilling the Continuity of Coverage requirement fair credit must be allowed for all or any part of health insurance deductibles or co-insurance satisfied, and accumulated lifetime maximum amounts before the contract effective date. Page 13 of 13 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management Background Information Kerr County is located North West of San Antonio in the Texas Hill Country. The majority of the 200+ insured employees, retirees and COBRA participants participating in KERR County's self-funded health benefit plan use the services of providers located in Kerr County and San Antonio. Mutual of Omaha has provided Administrative Claim Services, COBRA, HIPAA administration, HRA administration for the Health Plan since January of 2005. The plan has been self-insured for several years. In 2005 the County instituted an HRA plan for all employees, changed the previous three option plan to two options both with HRA accumulation accounts. In 2007 the plan options were offered however, no employees enrolled in the $1,500 deductible plan. The HRA account expenses are not included in the losses attributed to the specific or aggregate insurance coverage. The County is very interested in providing a proactive wellness program for their employees. Be certain to provide a description of a wellness plan that you feel would impact the employees of Kerr County. The basic group term life insurance amount is $20,000 per employee and includes accidental death and dismemberment. A copy of the plan of benefits is included in the attachments. The rate is $.20/$1,000 for basic life coverage and $.02/$1,000 for accidental death and dismemberment. KERB COUNTY desires to receive proposals for continuation of the self-funded health plan based on duplication of existing Plan of Benefits unless other specified. KERR COUNTY currently provides medical plan benefits for retirees. The current retirees will be grandfathered for coverage. Future Retirees will be provided with a limited plan of benefits not to exceed the level of the Specific Deductible. Retirees are shown on census as Class R001. ~r Page 14 of 14 Kerr County Specific and Aggregate Stop Loss Insurance Third Party Medical Claims Administration Group Term Life and AD&D Health Reimbtusement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management Individual Stop Loss Insurance (ISL)/Aggregate Stop Loss Insurance (ASL) Request for Proposal Submission Form RFP ASSUMPTIONS: I. Proposal is to be based on the duplication of the existing Plan of Benefits, unless otherwise specified, Any deviations must be clearly identified and explained. All proposals will be assumed to have been submitted without any deviations unless clearly noted. 2. Proposal is to be based on the provided census. 3. Contract effective date is to be January 1, 2008. All participants enrolled in the insurance plan as of December 31, 2007 are to be covered on a "no loss/no gain" basis. "No loss/no gain" for participants are to include credit/debit for accumulated deductible, coinsurance, and lifetime maximum benefits. 4. KERB COUNTY desires to receive proposals for a three (3) year period on one of the following basis: • Fixed price for the three (3) year period, or • Two annual renewal adjustments determined by formula at the time the contract is awarded, or • One (1) year contract with two annual renewal options for rate and premiums deemed to be favorable to KERR COUNTY. Renewal rates are to be provided to KERR COUNTY by October 1 (90 days prior to anniversary date). 5. KERB COUNTY will only consider stop loss insurance policies meeting the following: ~rr° a Specific and Group Aggregate Policy on a 15/12; paid/12; 24/l2 or paid /IS basis for Medical and Drug (Rx). We do not wish to see an aggregating specific. b. Medical and Drug (RX) Specific Coverage with $40,000; $50,000; $60,000 Stop loss. c. Medical and Drug Aggregate Coverage at 120% and 125% of expected claims d Final determination on all lasers, if any, including deductible amounts and conditional lasers should be clearly identified and provided with RFP response based on provided claims data e. Insurance Company Quotation Document with all terms clearly listed E. Waive Actively at Work Provisions 6. Renewal rate must be received by KERB COUNTY at least 90 days prior to date of rate change. 7. Any estimated savings, performance or other guarantees should be specific, quantifiable and should include a method for validation. QUESTIONS: 1. Describe the business entity submitting the proposal: a. Insurance Company Name: Lafa ette Life Insurance Co. b. Address: 1905 Teal Road Lafa •ette IN 47905 c. Contact Person: Jim Bennett d. Telephone Number: 713-783-2383 e. Year Founded (Ins. Co): err Kerr County Page 17 of 17~ Specific and Aggregate Stop Loss Insurance f. What percentage of overall business is Health related? 0 g. Managing Underwriter's Name: N/A h. Year Founded (Managing Underwriter): N/A i. Number of Years for Representing Insurance Company: N/A 2. Describe Financial Stability of Insurance Company offering stop loss coverage: a. Financial Rating Service Current Rating Prior Year Rating A.M. Best A++ A++ Standard & Poors AA+ AA+ Mood 's N/A N/A b. Is Insurance Company authorized to do business in Texas? Yes 3. Provide three (3) Texas client references (preferably public entities): Company Name: Lamaz CISD Company Contact information: Name-Colleen Martin Phone Number 832-223- 0314 Company Name: Fort Bend Company Contact information: Name Darlene Wi~~iat Phone Number 281-341- 8632- Company Name: United ISD Company Contact information: Name Robert Chapa Phone Number 956-717- 6390 4. Describe the business entity submitting the proposal: a. Name of Business Entity: Lafayette Life Insurance Company b. Current Business Address: 1905 Teal Road Lafayette IN 47905 c. Mailing Address: PO Box 7007 Lafayette IN 47905 d Contact Person: Jim Bennett e. Telephone Number: 713-783-2383- f. Type of Business Entity: -Corporation -General Partnership Sole Proprietorship Registered Limited Liability Partnership _ Limited Liability Company 5. a. Has the business entity been a defendant in any lawsuit in any state or federal court during the preceding five (5) Yew? Yes X= No Page 18 of 18-1- If yes, identify each lawsuit by party, case number, court, subject matter, and disposition: b. Does the business entity have any claims filed against it which are unresolved and presently pending before any State of Texas Administrative agency? _ Yes X =-No If yes, please provide a full description of the charges 6. FmancialInformation: a. Has the business entity filed a voluntary or involuntary petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) yYars X No If yes, please describe: b. Has any owner, member, or partner of the business entity filed a petition in bankruptcy, obtained an order fo~ relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years. - Yes X _ No If yes, please describe: 7. Describe insurance coverage (include copy of Insurance Certificate): a. The business entity must provide satisfactory evidence of existing insurance coverage in the amount of $1,000,000.00 for Errors and Omissions or other fiduciary liability. If the business entity is selected to provide services it must provide evidence that such coverage will be in effect for the duration of the agreement. 8. Describe ISL and ASL claim payment: N/A a. Where will claims be paid? b. What is the defmition of "paid claim" to be eligible for reimbursement? c. Can KERB County's HR Director and consultant speak directly to claim examiner for questions related to payment of claim? Yes No Comment: d. What is the normal processing time for ISL claim? e. What is normal processing time for ASL claim? N/A f. What expenses related to investigation of claim are eligible for reimbursement (e.g. hospital audit, medical records, etc) by the stop loss carrier? N/A g. If KERB COUNTY has negotiated with providers, will these discounts be accepted, in lieu of doing a hospital or other audit? N/A Yes No h. Describe documentation needed for ISL claim reimbursement: N/A 9. Describe Underwriting: N/A Page 19 of 19~ 1- a. Will any claimants be excluded or assigned a higher deductible (lasered)? N/A Yes No If so, please describe: 10. Did you provide a Specimen Stop Loss Contract? N/A Yes No 11. Does your Stop Loss insurance contract have any exclusions or limitations that are more restrictive than those used in KERR County's booklet? N/A Yes No If so, please describe: 12. Are the active-at-work and disabled dependent provisions waived for the effective date of the contract? Yes X _ No 13. If Centers of Excellence are used for your transplant coverage, please provide specific information for facilities cost and procedures to be used: Please attach a schedule with complete information: N/A 14. Please state any variations to the Request for Proposal Assumptions or other qualifications for your quote: N/A 15. After the ISL deductible is reached will the stop loss carrier pay claims directly to vendor or require Kerr County to pay claim and be reimbursed? N/A If reimbursed what is turnaround time? N/A 16. For what period of time are quoted rates guaranteed? 24 months 17. Is a longer rate guarantee available? Yes X No If so, please describe: 18. Are quoted rates net of agent commission? X Yes No If no, please describe: 19. Do quoted rates include advance funding for: a. Specific Claims? N/A -Yes No If no, additional cost to provide: b. Aggregate Claims? N/A _ Yes No If no, additional cost to provide: 20. Is the quote based on the services of a specific provider network? N/A _ Yes _ No 21. Please give rate differential to use the following networks: N/A Specific Aggregate a. PHCS b. Healthsmart c. BCBS d. CNN e. Beechstreet f. ~t~°r~-*~e7Texas True Choice- Page 20 of 20~ 21. The following rate exhibit may be used for rate submission however included with the CD or available by Internet is an Excel Spreadsheet titled, "Self Funded Quote Spreadsheet". Complete this spreadsheet as it will be used for bid analysis. N/A N/A BASIC PLAN $ Specific Deductible Basis for Deductible: Incurred Paid Number of Rates Monthly Premium Annual Premium Partici ants Specific Premium: Single Family Com osite Aggregate Premium Com osite Aggregate Attachment Pts. Single Family HIGH PLAN $ Specific Deductible Basis for Deductible: Incurred Paid Number of Rates Monthly Premium Annual Premium Partici ants Specific Premium: Single Family Com osite Aggregate Premium Com osite Aggregate Attachment Pts. Single Family Page 21 of 21 ~-1- Kerr County Third Party Administration Questionnaire This section does not apply to Lafayette Life TPA Organization 1. Name, Address, City, State, Zip Code and Telephone Number of Firm. 2. Is your firm owned or operated by a parent company? If yes, please identify the parent and its primary business. 3. How long has your firm been in business? How long have you done claims administration? 4. Who are the principal officers in your firm? How long have they been in their positions? 5. Is this a branch facility? If so, please identify the main office location. 6. How many claim processors are Full Time employees in your firm? 6a. How many claim processors will be appointed to service this account? 6b. Of those approximately how many years of experience does each have with medical claims processing? 7. Do you have bilingual claims personnel available to plan participants who call your office for customer service and/or claims processing? 8. How many clients do you perform claim administration services for? What is the average size? 9. Do you carry Errors & Omissions coverage? Provide a copy of your current policy. Claims Administration 1. What are your claim office performance standards for claim accuracy and turnaround time? 2. What is your average turnaround time? 3. What is your current per day production minimum expected of your claims processor? 4. What are your internal audit procedures? 5. What edits and controls are used to avoid duplicate payments? 6. What safeguards exist to protect against claims abuse and fraud? 7. What program do you use to unbundle claims? 8. What coordination of benefits (COB} procedures do you follow? 9. What database do you use to determine Reasonable and Customary fee allowances? How frequently do you update your R&C screens? 10. Describe your procedures for professional Medical claims review? 11. Explain your hospital bill audit procedures. 12. Describe your procedures for tracking and reporting excess claims? 13. Explain how you handle subrogation and third party disbursements? Page 22 of 22~ t6. What are your normal hours of operation to answer calls for claim inquiries? 17. Describe your customer service process when an employee calls with a claim inquiry. 18. If you have a separate customer service unit, what are your standards for: Answer Time: Abandon Rate: 19. What submission rate has been assumed when calculating your fee? 20. Does your fee assume a first year claim lag? If so, what is the cost to purchase mature claim year administration? 21. Does your fee assume any excess loss carrier overrides? Eligibility System 1. How is an insured's eligibility assigned and maintained? 2. How often can eligibility information be updated? 3. Do you maintain information on each of the family members separately, as well as the employee? 4. What is your accuracy standard and turnaround time for loading new groups, updates, and changes? System Capabilities 1. Is your claim processing system completely automated? 2. Are there any significant manual activities required to process claims? 3. Describe your claims payment system, including hardware and software? 4. Do you own or rent your claim payment system software? 5. How is a person's claim history tracked? 6. How many benefit components (IE -separate deductible, totals, lifetime benefits, etc.) can be maintained by the system? 7. Can the system track number of visits by procedure? 8. Can the system handle different benefit levels for PPOs? 9. How many PPOs can the system handle for one client? 10. Can your system accept Electronic Data interchange claim submissions? 11. What percentage of your claims is currently accepted on an electronic basis? Banking Arrangements 1. Do you require the use of a specific bank for claim accounts? If so, please provide the name, address, and phone number of the bank. 2. Is an initial claims payment deposit required to establish banking arrangements? ~~+' 3. Will you perform bank account reconciliations? Page 21 of 21 4. Are there any additional costs to the banking? (LE.: -EFT charges, monthly charges, etc.) 5. What is the cost of the check stock you provide? 6. How many checks are provided in your cost assumptions? Utilization Review L What U.R. services are performed in-house? 2. What outside U.R. services do you use? How long have you used them? 3. Indicate which U.R. services you have assumed in your proposal? Pre Notification Preadmission Review Concurrent Review - On Site or Off Site Retrospective Review Large Case Management Discharge Planning 4. Can you accommodate Pre-Notification for the following? Specialty Care referrals Home Health Care Ancillary Services Inpatient Surgical procedures Outpatient Surgical procedures Lab & X-ray procedures Inpatient Mental Health and Substance Abuse Outpatient Mental Health and Substance Abuse Preferred Provider Organizations 1. Do you have capabilities to process PPO discounts in-house? 2. Which PPOs do you have access to processing in-house? 3. Can you install PPO discounts for Duect contracts with providers? If so, what is the charge? 4. How many different PPOs do you interface with currently? Who are they? 5. Which PPOs are you currently using? (attach directory or website access) Reporting 1. Provide a list of reports available in your standard reporting package. What is the cost of these reports? 2. Can you generate customized reports? Are reports available through Internet? What is the charge? 3. How are paid claims reported? 4. How does your firm report claims to Excess Loss carriers? 5. Can you report on PPO savings? Page 22 of 22 General l . What is the cost for producing a plan document? Is it included in your cost assumptions? 2. What is the cost for producing a Summary Plan Description? Is it included in your cost assumptions? 3. What is the cost of having the Plan Document and SPDs changed due to regulatory changes? Is it included in your cost assumptions? 4. What is the cost of printing the 500 Summary Plan Descriptions for the plan participants? Is it included in your cost assumptions? 5. What is the cost for printing 1000 ID cards? Is it included in your cost assumptions? 6. What is the cost of Explanation of Benefits: Is it included in you cost assumptions? If so, how many do you assume? 7. Is there an initial set-up fee charged for the installation of our plan? 8. Please disclose any additional fees or expenses that are borne by the client including but not limited to any contractual reimbursements, capitated fees or other fees paid to the TPA , e.g. Rx reimbursements . 9. Do you offer assistance in the administration of COBRA benefits? HIPPA Certificates? Please explain the type of assistance and/or administration duties you provide. HRA Questionnaire 1. Do you offer HRA administration in conjunction with your claims administration? 2. How often do you reimburse a claimant for expenses incurred that are filed on a paper claim form? 3. Do you provide a debit card for all participants? 4. Do you require the use of a specific banking institution? 5. Is there a minimum funding requirement? If so what? 6. Please describe your HRA administration in relationship to your medical claims administration. 7. Identify all costs associated with your HRA administration package to include all costs and services provided. 8. Do you include access to accounts via the Internet? At what additional cost if any? Prescription Benefit Mana;~er Questionnaire Please find the current prescription drug plan design in the medical plan summary attachment. I. Please describe your retail pharmacy network (number of independents and number of chains; are all chains in the network?) including its relationship to you (e.g. owned or leased). 2. Please confum that prescription drugs prescribed by any licensed health care provider, including dentists, will be covered by the pharmacy program. 3. Is the use of a formulary mandatory? Please attach a copy of the formulary for review. 4. Does the retail brand discount include savings from formulary, network spread, clinical savings, DUR savings? 5. Is the brand discount a hard discount? Page 23 of 23 6. Is the brand discount an average? Is it based on 11 digits NDC? 7. Is the brand discount at mail order based on 100 units or actual acquisition NDC? 8. Is the mail discount based on 11 digit NDC? 9. Is pricing for retail brand and overall generic effective rate guaranteed? 10. Your quote MUST include a traditional pricing model and a transparency full pass-thru model. Is the pricing guaranteed? 11. What is the discount for specialty drugs? What is the dispensing fee? IS the specialty drug program apass-thru under a transparency model? Are supplies included in the pricing? 12. Please provide your definition of "generic". Also provide a defmition of the generic included in the overall generic guarantee. 13. What quantity is an AWP based on for mail order? 14. How are manufacturer rebates handled? Will KERB COUNTY share in the rebates? If so, what percentage? 15. Do rebates have a minimum guarantee per claim? Per brand? 16. Are rebates paid quarterly? If not, when? 17. Under transparency pricing model, are rebates a 100% pass thru of Gross? 18. Will coverage of OTC impact rebates? If so, how much? 19. Do rebates survive termination? When are they paid after termination? 20. Are rebates paid on specialty drugs? 21. Do you contract directly with manufacturers for formulary rebates or do you use another PBM? If yes, who handles? 22. Please describe how the drugs for the formulary are selected, and who is responsible for the selection. 23. Do you own your own mail service? If not, who do you sub-contract with and do you retain revenue? 24. Do you own your own Specialty Pharmacy? Or subcontract? If yes, who handles specialty pharmacy? 25. What is the average turnaround time for mail order pharmacy? 26. Can mail order pharmacy be ordered on-line? 27. Does the PBM allow 90-day fills at retail in addition to mail order? If so, what contracted pharmacies participate? What is the discount to KERR COUNTY fora 90-day network? What plan design is used? 28. Do you offer alternatives in the pharmacy program that can help control or reduce the plan costs? If so, please provide details and approximate savings for each feature. 29. Please explain your Drug Utilization Review process for these programs: a. Prospective b. Concurrent c. Retrospective 30. Please submit a sample of your standard reporting package. Attach samples of your standard reporting package that ~ is included in your quote. Please note if your paid claims numbers are based on paid or incurred claims figures. Page 24 of 24 31. Include in your response a PPI report, a specialty drug report, and a net cost per day for mail or retail report w/ specialty and acute weds removed. 32. How do you propose getting members to look at alternative brands that have generics available and do your manufacturer contracts preclude you from providing this type of information to members? 33. What fmancial advantage would KERR COUNTY gain if we limited the pharmacy network to several large chains? Could exceptions be made in outlying areas? 34. Is electronic billing available? Reports on line? Is an interactive website available? Can members compare pricing of drugs on line? 35. Will the PBM provide assistance with developing a communication piece? 36. Provide all materials used in marketing your product. 37. Do your administration fees include the following: a. Postage (in D below) b. Claim forms c. ID cards, (medicaUrx combo cards?) d. Mailing to participants homes e. Participating provider directories f. Customer service representatives specific to KERR COUNTY. g. Mail order forms h. l - 800 number to call center i. Standard report packages 38. Does your plan currently offer on-line access to claims and eligibility information for employees? Is there a separate charge for this to the plan? 39. Will any revenue be paid to a third party administrator for services, fees, disease state management or other vendor ~''` services by the PBM? Will all compensation to third parties be disclosed? Is an implementation allowance paid to the payor? If so, how much per member or head of household? 40. Will you audit the pharmacy data? Specifically, as a payor, what independent source will audit claims? What are the fees associated with an independent audit? 41. Will you provide consultative modeling and forecasting annually? 42. Will atrue-up of guarantees be performed annually? If so, when can KERB COUNTY expect payment of true-ups above guarantees under transparency model? 43. Will the mail service provider provide to KERB COUNTY copies of their suppliers (wholesaler or manufacturer) invoices showing net invoice for medications? 44. Will your firm detail its total revenue from all sources for administering the KERB COUNTY pharmacy benefit plan and allow an independent audit by the KERR COUNTY? 45. The 3 finalist will be required to make a presentation to KERR COUNTY and answer questions to fully explain the specifics of the program offered. 46. Will your firm contractually guarantee that the amount you reimburse to pharmacy providers is the exact same amount that is billed to the plan sponsor? ATTACH A SAMPLE DRAFT OF THE PBM CONTRACT Page 25 of 25 4j. The 3 finalist will be required to make a presentation to KERR COUNTY and answer questions to fully explain the specifics of the program offered. 46. Will your firm contractually guarantee that the amount you reimbtuse to pharmacy providers is the exact same amount that is billed to the plan sponsor? ATTACH A SAMPLE DRAFT OF THE PBM CONTRACT Cafeteria Plan Administration 1. Name, address, cirnational Lane, MadisoneWl 53704. 00-422-4661 8 Regional Offices in TexasSeveral othery TASC, 2302 Irate Regional Offices spread across the U. S. 2. Is your company awholly-owned subsidiary or a division of another tympany? If sv, please identify the company name and address. In addition, please list all owners (if not publicly owned), and all affiliated companies. No. Don (Father) and Dan (Son) Radtke are the owners of TASC. Additionally TASC's affiliated companies are: AB- TASC and EBM-TASC. 3. Have any principals of the firm ever been named in a lawsuit dealing with the management/administration of a Section 125 Cafeteria Plan? No. err ~ 4. How many clients are currently served? Please provide the largest group, the smallest group and the number of employees covered. TASC currently has 167,497 enrolled in our section 125 Plot. TASC has over 45,000 Clients and a Participant count in excess of over 200,000. 5. What is the maximum processing time that will occur between receipt of claims and reimbursements to the members? Reimbursement requests are processed with a 24-48 hour turnaround time on claim processing. Disbursement to vendors only occurs if the Participant swipes their debit card at a valid merchant TASC will not disperse to vendors; this is the Participant's responsibility. 6. What guarantee will you provide to Kerr County that this fimction will be completed wnthin this time frame'? TASC has a 24-48 hours turnaround time an claim reimbursements. Claims received by 2:OOpm CST wilt be processe the same day, claims received after 2:OOpm CST will be processed the following business day. 7. What is the size of yotu staff:' TASC currently has 316 Employees. 60+ Employees are dedicated to our F1e~System product. 8. List staff experience of the employees that will be handling Kerr County's account. TASC's Customer Service and Administration staff go through an extensive training course when hired, including several shadowing and merttoring sessions. TASC has continuing education meetings weekly and a high level of cross training. Page 27 of 27 9. List the office location intended to service Kerr County. TASC's Administration and Service is handled at our Madison WI Corporate Headquarters. 10. Is there a toll free number for employees and/or Kerr County to speak to a customer service representative? If so, what are the hours? Yes. TASC's normal customer service hours, from 8-5 on Mondays, Tuesdays and Thursdays; and 9-5 on Wednesdays and Fridays in all time zones. 11. Does your firm perform discrimination studies as to eligibility, contributions and benefits under the plan? If so, how frequently? Yes. TASC will perform the testing once a worksheet has been completed and submitted. TASC will then send a passlfail letter informing the client of the results and the actions that would need to be taken accordingly from those results. This is done yearly up 12. Does your company offer debit card services? If so, please explain in detail. Yes. TASC offers up to 2 cards per household per Enrollee. The cost of the card is $1.60 per person monthly. The card i an alt or nothing option, all get the card even if only half want it. TASC claims are auto-adjudicated_ Once the transaction is completed the claims is reviewed by our vendor to make sure the claim is for an eligible expense. Any claim found to be ineligible; TASC will notify the Participant and temporally inactivate their card until the claim is repaid. ,~ ~ ADMINISTRATION I. Describe the computerized system used to collect, assimilate and integrate the data of the program. TASC's administration software is proprietary. TASC has a state of the art website that was designed and is maintained by our technical department. 2. Provide a sample of your Administrative Service Agreement. Please see Exhibit D FlexSystem Plan Application. (service agreement is page 4) 3. Pro~ride a sample of your Plan Doctunent. Because the Plan Document is very large a Sample Summary Plan Description has been provided_ (Exhibit E) 4. Describe your capabilities for Direct Deposit. TASC offers direct deposit and is completely free of charge. Direct deposit occurs within 48-72 lYdUrS upon receipt of the claim. 5. Provide samples of worksheets and/or any materials that will be provided to Kerr County for educational purposes. Please see Exhibit C FlexSystem Client Administration Manual (starting on page 34) 6. Describe your process for entering enrollment information intoyotu system. TASC offers on-line enrollment. The Employees c~tr- enroll electronically on our website, or the Employer can ente elections on the website. Additionally we have an excel spreadsheet which can be completed and uploaded to oiu website. Finally TASC does have hard copy enrollment forn~s which can be completed and faxed into TASC, however we prefer the Employee's enter this information electronically as there is less room far error. 7. What electroiuc or Web-based services does your company offer? Can chums be filed ~~ia fax or through other electronic means? Do you charge additional fees for this service'? Page 28 of 28 TASC offers online capabilities for the Employer and Employee. The Employee can access their Account Balance, Claim History, Contribution History, Direct Deposit information just to name a few. The Employer can access everything the Employee can except the Employer has access to subnut Payroll Verification Reports online, Balances and Exposures, Invoice and Billing information, Administrative forms, etc. 8. Does your firm provide monthly, quarterly, or annual account statements directly to the participating employees? If so, ~, please explain in detail the process and if there are any additional fees associated with Employee Account Status statements. No. This is due to the information being available at your fingertips 24/7 on our website. 9. Provide a sample of Section 125 reports generated for employees and Kerr County. Provide a sample of any other reports that you believe may be useful to Kerr County on a regular basis. Please provide sample reports that would be utilized for bank reconciliation. Not Applicable. On-line based. ORGANIZATION STRUCTURE 1. Any Administrator must have filed and be approved with the State of Texas_ If a TPA is Later rejected by the State, it wil be considered grounds for dismissal. TASC is a licensed TPA in the state of Texas. 2. Is your organization for profit or non-profit? • For profit. 3. Are you an affiliate of an insurance carrier or independently owned and managed? No. Independently owned and managed. 4. If you are a multiple site organization, are certain services delegated to specific locations or are all services available at any location? Specific regional and sales offices assist with the relationship establishment and continuous relationship building, while the complete Administration and Customer Service, including Management are located in Madison WI at our Corporate Headquarters. LIABILITY PROTECTION & BANKING REFERENCE I. Please disclose the amount of liability insurance protection currently in force. The selected Adrinistrator must provide confirmation of coverage. Please see Exhibit F TASC Insurance Coverage's. 2. Is the company and all employees bonded? If so, please pro~~ide details. Yes. Please see Exhibit F. 3. Are employees covered by workers compensation insurance while performing services on site at Kerr County? a. { X }Yes { }No PRICES/FEES I . Provide schedules of fees for each Plan. Indicate whether fees or services are contingent upon the sale of any products t Kerr County and the conditions under which the products would be sold. 2. Are the fees due payable on the first of the month, quarterly, annually or combination of these'? TASC can bill monthly, quarterly or annually and are due upon receipt. 3. Is a fee stn-cture available that incorporates various levels of participation'? Yes. 4. Do you intend to receive any commissions from the vendors servicing Kerr Count`? Page 29 of 29 No. 5. Explain any methods to be utilized to control expense. On-line capabilities allow TASC to keep ow cost to serve down, and in turn keep the pricing competitive in nature. 6. Provide a fee for administering the Medical and Dependent Care Spending Accounts with and without a Debit Card option. No Set-up fee $3.25 per participant per month $30.00 monthly ntunimum Additional charge of $1.60 per participant monthly -debit card. No Renewal fee HISTORY 1. Briefly explain the development of your organization and your corporate business objectives. Please see Exhibit g TASC Corporate Profile. 2. Explain how tong you have been in business and how long you have been providing Section 125 Administration services. We have been in business for more than 30 years. Our success is based on cost-effective administrative procedures that still allow us to provide the Iughest level of customer service possible. TASC products are endorsed, supported and used by many national accounting organizations, national insurance organizations and state and local trade associations. UNIQUE CHARACTERISTICS 1. Wlu~-t do you feel is nuique about }•oiu firm tl>z~tt will offer the best value to Kerr Count} for Section L25 Adnni~istration ser< lees? • TASC offers a state of the art ~~ebsite ~.~ ~~,,~ .tasa~iiline.co~n. Additionally TASC' has been adnninustertng Ennplo}-ee Benefits for the past ,(1 }-ears. vnd offers several cost contiugenc} strategies. TASC is one mf the top ^a[ionall} recognuzed TPA~s iu the industn. 2. Please comment on any other characteristics of your organization that are considered unique in the industry. TASC Provides world-class Customer Ser~zce, has Spanish speaking representatives, offers availability through our call center for contacts from 8-Spm in all time zones. Additionally TASC offers several electronic based communications and constantly notifies Employers of any regulation changes or rulings that affect the plains. WELLNESS AND PREVENTION QUESTIONNAIRE: I. Provide an executive sununary of the wellness services you provide. 2. Are wellness and prevention medical services your main tine of business? If not, please explain in detail where and how wellness fits into your business plan. 1-IEALTH RISK ASSESSMENT (HRA) SERVICES: 1. Describe the Health Risk Assessment (1IIZA) tool your organization offers. Please attach a sample. 2. In what languages are your I-IRA, website, and employee materials available? 3. What is the average participation rate for youur clients? 4. Explain your experience designing incentive systems to drive participation, including your most successfully designed incentive program. ~1/ ~. Please complete the grid below ~r ith a checkmark or specific answer if your 1-fftA includes the feature described. Page 30 of 30 Michael Tucker Senior Sales Representative November 13, 2007 Curtis Finley Kerrville, TX Via Email: finleyC~ktc.com RE: Kerr County Dear Curtis, E(FL;~ li ;:ffitG ,, re 7600 N. Capital of Texas Highway Building B, Suite 335 Austin, TX 78731 Telephone: (512) 338-7100 Facsimile: (S 12) 342-8535 MichaeLTuckerCC~cigna.com Thank-you for considering CIGNA Healthcare as the employee benefit provider for your client, Kerr County. CIGNA Healthcare is unable to offer a competitive quote at this time. Although we could not assist you in this instance, we value our relationship and look forward to the opportunity to quote on your future business. Feel free to call me at (512) 338-7100 with any questions regarding this decision. Sincerely, ~ ;:~ ~; ~. 'I I~ ~ ~~ - Michael Tucker Senior Sales Representative MT/sf A'rouri Nati[srral Sport.cur nfdFrr hfrrrcFe of~irsres 4tinl~drtrcricea ... flee t4'a[k t1~af Saves B'nbics "CIGNA"and "CIGNA Healthcare" are registered sen~ce marks and refer to various operating subsidiaries of CIGNA Corporation. Products and sen'ices are provided by these subsidiaries and not by CIGNA Corporation. 'these subsidiaries include Connecticut General Life Insurance Company, CIGNA Vision Care, Inc., "fel-Deus;, Inc. and its affiliates, CIGNA Behavioral Health, Inc, lnt[acorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc. -.~ , ~ ~ , ,.~. 9050 Capital of TX Hwy. North Austin, TX 78759 Bianca Humada Account Executive 512-342-6905 860-754-0437 Fax November 12, 2007 Bryan Finley & Associates P.O. Box 291305 Kerrville, TX 78029 RE: Kerr County -Effective 01/01/2008 Dear Mr. Finley: Thank yvu for allowing Aetna the opportunity to provide a quote for the above referenced group, however, we are respectfully declining to quote at this time. After careful review of your request for a proposal, we have determined that we are unable to provide a competitive quote at this time, due to time constraints. Ifyou feel that we are overlooking an important factor pertaining to this case, please call me at your earliest convenience. Your interest in pursuing a proposal through Aetna is greatly appreciated. We look forward to working with you in the near future. Sincerely, ~G'ince Satisotta Vince Sansotta Senior Account Executive UnitedHeal~heare~ a ~;»~ai~. c~a co~~r 6200 Northwest Parkway San Antonio, TX 78249 November 13, 2007 Courtney Real Bryan Finley & Associates P.O. Box 291305 Kerrville, TX 78029 RE: Kerr County Dear Courtney: Thank you so much for your interest in health coverage through UnitedHealthcare, and for submitting the Request for Proposal for your client. We have reviewed the data, and we cannot offer a quote due to our alliance with Texas Municipal League/Intergovernmental Employee Benefits Pool. On groups with under 1000 employees, seeking a self funded quote, it must be provide by the TML. Therefore we cannot provide a self funded quote for Kerr County at this time. We appreciate your interest in UnitedHealthcare, and hope that you might consider our plan again in the future. Respectfully, Dennis Ellis Account Executive (210) 478-4966 ~J GUARDIAN' November 8, 2007 Curtis Finley Bryan Finley & Associates P. O. Box 291305 Kerrville, TX 78029 Re: Kerr County Dear Curtis: John E. Hand Regional Manager Jeff Moore Sales Representative Lewis Cochius Sales Representative Ken Dodge Client Relationship Specialist Thank you for the opportunity to quote on the above referenced group. However, we are unable to provide you with a competitive quote due to the industry of this group. I am sorry I could not be of service for your request, but please keep the Guardian in mind for your future group insurance needs. Sincerely, Jeff K. Moore Sales Representative Jxi~l/dZ Kerr County Courtney Real Subject: FW: Kerr County ----Original Message----- From: Kelly Kolodzey [mailto:KellyK@county.org] Sent: Thursday, November 08, 2007 3:41 PM To: Hector_Licon@BCBSTX.COM; Curtis Finley Cc: Bill Norwood; Maria Castillo; Johnnjalyn Jones@bcbstx.com; Bill Henry; Ernesto Martinez Subject: Kerr County Based on large claims doubling in the last 3 months, we will be unable to quote this group. This gets too near the attachment point and underwriters cannot recommend going further. We have had communications with the county and Bill Norwood will be sending a letter directly to the Judge indicating our decision and other information he will find helpful as they move forward. I appreciate you hanging in there with me, I had hoped to be able to make this happen but our Pool owners are our first priority. Thanks for the effort. Kelly Kelly Crews Kolodzey Texas Association of Counties Employee Benefits Marketing Specialist 512-478-8753; 615-8944 Direct 800-456-5974 (in Texas); 512.481-8481 Fax Public Employee Benefits Alliance pEBA@county.org The information contained in this communication is confidential, private, proprietary, or otherwise privileged and is intended only for the use of the addressee. Unauthorized use, disclosure, distribution or copying is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately at 512.478.8753 or 1-800-456-5974. 11 /13/2007 MetLife Basic Life/AD&D Cost and Benefit Summary for Kerr County "~r_ffective Date of Coverage: January 1, 2008 Proposal Date: November 13, 2007 Number of Eligible Em to ees: 241 Gass ©escription Employee EFigiblity Contribution 1 All Eli ible Em loyees 0% All Active Fuli Time Employees Class e~asic ure • --~- Maximum 000 Flat $20 Same as Basic Life $20,000 $20,000 , 1 ~: ~ • j ~ Rate per $1000: $0.179 $0.027 $0.206 Estimated Volume: $4,694,000 23 $840 $4,694,000 $126.74 $966.97 Estimated Monthl Premium: . Rate Guarantee Period: 2 years Hou Age Reduction Formula: 35% at Age 65, 50% at Age iu (Active employees) Medical evidence of insurability is required for amounts in excess of the non-medical maximum and for late entrants. .__ ~__._:_:,.... Continuous Protection to 65 I Ulsavnny r.v..~.~••- Total Control Account is rovided for all Life and AD&D benefits of $5,000 or more_ Accelerated Benefits Qption provided for life amounts of $20,000 or more. Life Advice® AD&D Plan Features: Air Bag Brain Damage Child Care Center Coma Common Carrier Paralysis Seat Belt AD&D ends at retirement. MetLife is easier. Submit complete enrollment materials by the 15 of the month preceding the effective date to ensure Underwritin ap royal b the effective date. r- , - Far the Effective Date Of Coverage shown above, proposal is effective for 90 days from date of quote. Final rates will be based on actual enrollment and contribution levels. For contributory plans, the employer's contribution must equal at least 25% of the cost of the insurance and at least 75% of all eli ible emplo ees must enroll. Definition of Earnings: Thoss annual rate ofapay from thenemployer~excl ding overtime and otheraextra payaBasic means the employee's g annual salary for a ogtloece t 24 month 1eerlod ple may include commissions and/or bonuses, which shall be avers ed fir the m Please Hate: Individuals 70 ears of a e and older must submit proof of full time employment Conversion rivilege INTERMEDIARY COMPENSATION NOTICE MetLife enters into arrangements concerning the sale, servicing and/or renewal of MetLife group insurance and certain other group-related products ("Products") with brokers, agents, consultants, third-party administrators, general agents, associations, and other parties that may participate in the sale, servicing and/or renewal of such Products (each an "Intermediary"). MetLife may pay your Intermediary compensation, which may include base compensation, supplemental compensation and/or a service fee. MetLife may pay compensation for the sale, servicing and/or renewal of Products, or remit compensation to an Intermediary on your behalf. Your Intermediary may also be owned by, controlled by or affiliated with another person or party, which may also be an Intermediary and who may also perform marketing and/or administration services in connection with your Products and be paid compensation by MetLife. Base compensation, which may vary from case to case and may change if you renew your Products eitheM atlLife, may be payable to your Intermediary as a percentage of premium or a fixed dollar amount. In addition, supp compensation may be payable to your Intermediary. Under MetLife's current supplemental compensation plan, the amount payable as supplemental compensation may range from 0% to 2.25% of premium. The supplemental compensation percentage may be based on: (1) the number of Products sold or inforce through your Intermediary during ~'"''a prior one-year period; (2) the amount of premium or fees with respect to Products sold or inforce through your Intermediary during a prior one-year period; and/or (3) a fixed percentage of the premium far Products as set by MetLife. The supplemental compensation percentage will be set by MetLife prior to the beginning of each calendar year and it may not be changed w ~~ not exlceed 2 25%nundeethe current upplemental ompensat on plan. percentage may vary from year to year, but The cost of supplemental compensation is not directly charged to the price of our Products except as an allocation of overhead expense, which is applied to all eligible group insurance products, whether or not supplemental compensation is paid in relation to a particular sale or renewal. As a result, your rates will not differ by whether or not your Intermediary receives supplemental compensation. If your Intermediary collects the premium from you in relation to your Products, your Intermediary may earn a return on such amounts. Additionally, MetLife may have a variety of other relationships with your Intermediary or its affiliates that involve the payment of compensation and benefits that may or may not be related to your relationship with MetLife (e.g., consulting or reinsurance arrangements). More information about the eligibility criteria, limitations, payment calculations and other terms and conditions under MetLife's base compensation and supplemental compensation plans can be found on MetLife's Web site at www.whymretei{i feservbcekcorm op f your wou d I kelto speak tol someone about Inte pmed atry compensalt on,eplease call ask4met _ (800) ASK 4MET. L08074801[exp1208][All States] This proposal is based on the contractual provisions contained in the (Form GCERT2000) issued to each insured employee. ,..This cost and benefit summary is only to be used as part of the Benefits Description for Basic Life/AD&D. ................................................................. .. ........................................................................... MetLife Enhanced Optional Life Cost and Benefit Summary for kerr county Effective Date of Coverage: 01/01/2008 ligibility: 30.0 Hours Actively at Work `'~r!Vumber of Eligible Employees: 241 Employee Contributions: 100.000% Schedule of Benefits Enhanced Optional Life / AD&D: $10,000 Increments Coera~e Non - M~ Enhanced Optional Life: $100,000 Rate Information: Employee monthly rate per $1,000: Plan Maximum* $500,000, not to exceed Sx Salary Abe Optional Life A e g Optional Life - < 30 $0.090 50-~d $0.?t)0 30-34 $0.170 ~~-S9 $0.$60 35-39 $0.150 60-64 $1.280 40-44 $0.190 65-69 $1.720 45-49 $0.290 70+ $3.040 Rate Guarantee Period: 2 ~-ears O ~tional AD&D $0.0320 (all ages) Hi~hli~hts: Date Quoted: 11/09/2007 • For the effecti~-e date sho~ti-n abo~°e, tlus proposal is valid for 90 dati~s from date of quote. Final rates will be based on actual enrollment, participation, contribution levels, and the effective date of coverage. Enhanced Optional Life coverage requires 25% participation and at least 10 covered lives. ~': Enhanced Optional Life Age Reduction: At age 65, the coverage amount reduces by 35% and at age 70, coverage reduces to 50% of the original coverage amount. * Employee benefit cannot exceed the plan maximum or Sx Base Annual Earnings, whichever is less. Portability is included in this quote. The minimum benefit that can be continued is $20,000. The Portability Option is not available to employees who reside in Minnesota or Vermont. Non-Medical Maximum -Medical Evidence of Insurability is required for amounts in excess of the amount indicated above. • Non-Medical issue is only applicable to employees who are actively at work and who have not been hospitalized in the 90 days prior to the date the employee makes a request for benefits. • Accelerated Benefits Option (ABO) provided for life amounts of $20,000 or more. • Total Control Account is provided for all life and AD&D benefits of $5,000 or more. Continued Death Benefits for Total Disability (for active employees}: CP65. • The MetLife TravelAssistances"' program is included as a standard feature of this quote. Definition of Earnings: This proposal was based on a standard definition of earnings where basic annual salary means the employee's gross annual rate of pay from the employer, excluding overtime and other extra pay. Basic annual salary for employees who are salespeople may include commissions and/or bonuses which shall be averaged for the most recent 12 month period. MetLife's 2-year contestability clause will apply as permitted by law. • AD&D benefits are identical to Life benefits. AD&D coverage can not be excluded by an employee if included in the plan. • Enhanced Optional Life is subject to MetLife's standard 2-year suicide provision where permitted by law. State Laws -For covered employees residing in any state outside the situs state, which validly exercises extraterritorial jurisdiction, the plan will be modified to meet applicable laws. • Conversion Privilege - 31 day application period. • Enhanced Optional Life and Enhanced AD&D terminate(s) at retirement. • This proposal is based on the contractual provisions contained in the Group Policy (Form GPNP99) sitused in TX with certificates of insurance (Form G.23000) issued to each insured employee. INTERMEDIARY COMPENSATION NOTICE MetLife enters into arrangements concerning the sale, sen~icing andlor rene~~-a1 of MetLife group ins<~rance and certain other group-related products ("Products `)1~-ith brokers. agents. consultants. third-parh~ aduuiustrators. general agents. associations. and other parties that ma~~ participate in the sale, servicing and/or rene~~-a1 of such Products (each an "Iutennedian~''). MetLife mad pay' ti.our Intermediary compensation, «-luch ma~• include base compensation, supplemental compensation and%or a sen-ice fee_ MetLife ma~• pay compensation for the sale. sen~icuig and/or renewal of Products. or remit compensation to an Litenuediarr- on .-our behalf. Your Intermediary may also be o~~-ned by. controlled by or affiliated «-ith another person or party. «-hich may also be au Intermediary and Who may also perform marketing and/or aduii-ustratiou ser<•ices in comiection ~sith your Products and be paid compensation by MetLife. Base compensation. «~luch nta~~ ~-ary from case to case and may change if you rene~~ your Products ~~•ith MetLife. may be payable to ~ our Intermediary as a percentage of prenuum or a fixed dollar amoiuit. In addition. s?. LOo047W W 1(exp0408)MLIC-LD Metrooolitan Life Insurance Company. 200 Park Ave., New York. NY 10166 Conte t of Interest Questtonnare For Vendor or Other Person Doing Sasmess with a Local Government Entity This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with a government entity. Bylaw this questionnaire must be filed with the re arch th~requirethe s atement~o be fi ed.t See section 176.006, Loco[ ss day after the date the person becomes aware of th Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C Misdemeanor. '`r/ A. Ls the local government officer named in this section receiving or likely to receive taxable income from the filer of this questio wire? NO ^ YES B. Ls the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the: local government officer named in this section? o NO ^ YES C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local goverrarnent officer serves as an officer or director or holds an ownership posNOn of 10% ar more? ^ YES 1J. Describe each affiliation or business relationship. 6 pesaibe any other affiliation or business relationship that might cause a conflict of interest. ~. Signatures 1. Name of person doing business with local government entity. N/A 2, ^ Check this box if you aze filing an update to a previously filed questionnaire. NIA (The law requires that you de ~ n Section 176.006(a) Local Govtemment Codeais pending and not 1 ter thanbthe 7~busirtess day after yeaz for which the activity lete or inaccurate.) the originally filed questionnaire becomes income 3. Describe each affiliation or business relationship with an employee or contractor of the local government entity who makes recommendations to a focal government officer of the local government entity with respect to expendittnre of money. N1A ints 4 pescribe each affiliation or business relationship with a person who is a local government officer and who appto or employs a Local government officer of the local government entity that is subject of this questionnaire. N/A 5, Name of local government officer with whom filer has an affiliation or business relationship. (Complete this se3ction only if the answer to A, B or C is YES) N/A This section, item 5 including subparts A, B, C & D must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional s as necessary. Sigftattue of person doing business with the Governmental entity . _ ~~ ~~~~ Date Page 7 of 7 DEVIATIONS FROM SPEC>FICATIONS IF ANY (Attach documents as necessary or state No Deviations): Kerr County `~`~""' Specific and Aggregate Stop Loss Insurance Third party Medical Claims Administration Group Term Life and AD&D Health Reimbursement Arrangeme~ Cafeteria Plan (IRS code 125) Administration Prescription Benefit Managemertt CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBII-IT'Y MATTERS The prospective Name Of Entity: MetLife participant certifies to the best of its knowledge and belief that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transacteo ~ preceding this proposal been convicted of had a civil b) Have not within a three year p judgment rendered against them for commission of fraud or a cri Stat ~or local) transaction oe obtaining, attempting to obtain, or performing a public (Federal, contract under a public transaction; violafalsification or destruction of recordsemaking false' of embezzlement, theft, forgery, bribery, statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, Local) with commission of any of the offenses enumerated in paragraph (I) (b) of this certification; and d) Have not within a three year period preceding this application/proposal had one or more public transactions (Federal, State, Local) terminated for cause or default. I tuiderstand that a false statetent on this certification ma~~ be grounds for rejection of this ~' proposallolli ~r~ iiOto a ~ 10 )(3~.fifi oa~ upriso uue rt fors p t fire (~ OveT s? or boteluent nsa~~ resu P ~ ; . _ ~ ~owa~rd Nanze and Title of Authorized RepresentarJ~ e (T} ped) ~~~- Date r' i 3~ a b o Si h-re of Authorized Representative I a>u ui><~ble to certif!" to the above statements. M}- etplai><~tiou is attached. Page 6 of 6 Kerr County Specific and Aggregate Stop Loss Insurance Third party Medical Claims Administration Group Term Life and AD&D Health Reimbursem~-t Arrangemerrt Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management PLEASE ACKNOWLEDGE RECEIVING THIS RFP BY RETU~~G THIS FORM In order to allow a fair and competihc aldaterand timre of releasee isoTuesday O tober 30SS2007,~10 00 AM. the release date of this RFP. The off It is your responsibility to return this intent to bid with the proper means of contacting you or your organization. Communicating any questions, answers, or amendments to this RFPwill be made through the process you provide on this form. FAX or Mail TO: Gary Looney xESc Insurance Consultant 3201 Cherry Ridge Dr Suite D 405 San Antonio, Texas 78230 Fax: 210-930-1838 X WILL RESPOND* W1LL NOT RESPOND COBS: Micah o~~~ard - Me ~ e es Rep AGENT NAME: Bryan Finley & Curtis Finley Agent Phone: (830) 896-4400 Agent Email: finley@ktc.com Agent Signature Print Agent Name COMPANY NAME: _MetLife COMPANY FAX 866-224-6621 Company Phone972-246-1630 CO PANY CONTACT EMAIL: mhoward2@metlife.com SIGNA Page 4 of 29 ~. The Lafayette Life Insurance Company Kerr County Group Life and AD&D Proposal Option 1 Schedule of Benefits Class 1) Description of Class All Eligible Employees Life Benefit Flat: 20,000 AD&D Benefit Flat: 20,000 Reduction: Life and AD&D amounts will be reduced by 35% @ 65; 60% @ 70; 70% @ 75; 80% @ 80; 85% @ 85; 90% @ 90; 95% @ 95 and will terminate upon retirement. All reduction percentages indicated apply to amounts in effect at age 64. Coverage Rate Volume Monthly Premium Life $0.190 per $1,000 1D&D $0.020 per $1,000 ~rr- 241 Employees $4,674,000 $888.06 $4,674,000 $93.48 Total Monthly Premium $981.54 Miscellaneous Provisions 1. Life proposal includes Waiver of Premium to age 65. 2. Standard Actively-at-Work Provision will apply (30 hours per week). 3. Written notification of a sold case must be submitted within 15 days of the proposed effective date. 4. Includes 24 Hour AD&D Coverage. 5. Coverage is to be effective January 1, 2008. 6. The Non-Medical Maximum for this group is $20,000. 7. *Rates guaranteed for 24 months. 8. This proposal is valid through February 4, 2008. 9. This proposal is contingent on compliance with Lafayette Life's Electronic Administration System. 10. This is anon-contributory plan. 11. This proposal assumes that all participants are residing and performing the duties of their occupation in the U.S.A. *The rates are guaranteed to the rate guarantee date listed above, assuming there are none of the following benefit structure changes: no more than a 20% change in enrollment, there is no addition deletion of a unit, there is no lapse in the report of monthly census changes, or there is no payment of monthly premium other than as billed. A rate guarantee does not otherwise alter or amend the terms or conditions of the policy. The rate guarantee is good only as long as the policy is in force. his quote shows a summary of proposed benefits, rates and miscellaneous provisions. It is not part of the group policy or a legal contract with ~cafayette Life Insurance Company. ~~ ~afayeite Lrf~ vl Insurance Company v 1905 Teal Rnad ~~ 1'.O. Bax 7007 Lafayette, lrutuina 47903 ® (800) 443-8793 (76SJ 477-7411 Group FAX (765) 477-3369 ADDITIONAL LIFE INSURANCE for Kerr County Employee Benefits Choice of $10,000 to $500,000 in $5,000 increments, not to exceed five times annual Base Salary. Employee life insurance is convertible/portable. (See policy for eligibility requirements). Spouse Benefits Choice of $5,000 to $125,000 in $5,000 increments, not to exceed 50% of the Employee benefit Child(ren) Benefits Choice of $2,500, $5,000, $7,500 or $10,000 (10% of the full benefit for child(ren) under 6 months). Maximum Benefit Minimum Requirement Participation Guarantee Issue Evidence of Insurability Requirements Evidence of Insurability ~. Also Required for Additional Life Step Rates Reduction Waiver of Premium (Employee Only) Eligibility GP1233 (01/06) Employee: $500,000 Spouse: $125,000 Child(ren): $10,000 15% participation needed, 10 life minimum Group Size: <50 50-99 100-499 500-749 750+ Employee: $50,000 $75,000 $100,000 $125,000 $150,000 Spouse: $25,000 (regardless of group size) Child(ren): All guarantee issue *Guarantee Issue for employees and spouses ages 60-69 is limited to 50% of the above stated GI limits. No Guarantee Issue for employees or spouses at or over the age of 70. Up to $125,000 over guarantee issue -Short form, MIB, APS (only if questions) More than $125,000 over guarantee issue - Blood test, complete medical history, Short Form, MIB, APS. 1) Late Entrants 2) Increases in Amounts 3) Employees age 70+ Age Emolovee / Spouse Rates aer $1.000 00-24 0.10 25-29 0.11 30-34 0.12 35-39 0.15 40-44 0.23 45-49 0.37 50-54 0.63 55-59 1.06 60-64 1.54 65-69 2.58 70-74 4.54 75-79 7.56 Child(ren) $0.48 per $2,500 unit Employee: Std ADEA65 -Terminates the earlier of age 80 or retirement Spouse: 35% at age 65, terminates the earlier of age 70 or when employee ceases to be eligible Child(ren): Terminates at earlier of age 21 (23 for full-time student) or when employee coverage terminates Terminates at age 65 (must be disabled prior to age 60) Employee: Actively at work, performing normal duties at least 20 hours per week. Spouse and Children: Not hospital confined nor disabled Standard ~5 `~+ Laf a ette ~.y Life . Insurance Company Lafayette Life Financial Ratings • A.M. Best A++(Superior) Fitch AA+ (Very Strong) • Standard & Poors's AA+ (Very Strong) • Comdex Ranking 98 Lafayette Life's Strengths 100 + years of history • Member of Western & Southern Financial Group • Assets owned and under management in excess of $38 billion • Small company culture with large company financials • Strong company expertise, commitment and integrity • Strong industry ratings Lafayette Life's Focused Vision • Focus on strong relationships • Focus on providing extraordinary value • Synergistic support o Local consultant o Home office experts • Full service provider of Employee Benefits • Simplicity v`..- ~4, L of a ette Fy :__r L i e i. Insurance Company Active References Lamar Consolidated Independent School District 3911 Avenue I; Rosenberg, TX 77471 Contact: Colleen Martin 832-223-0314 School District; 1,620 lives Mission Consolidated Independent School District 1201 Bryce Drive; Mission, TX 78572 Contact: Sylvia Cruz 956-323-5545 School District; 3181ives United Independent School District 201 Lindenwood; Laredo, Texas 78045 ' Contact: Robert Chapa 956-717-6390 School District; 2,354 lives Fort Bend County 4520 Reading Road #A; Rosenberg, TX 77471 Contact: Darlene Wieghat 281-341-8632 Executive Offices; 1,651 lives Knauf Insulation One Knauf Drive; Shelbyville, IN 46176 Contact: Susan Baker 317-398-4434 Plastic Materials and Rasins; 1,223 lives Walker County 101 Duke St.; Lafayette, GA 30728 Contact: Briggett Garrett 706-638-1437 Executive Offices; 321 lives Mac Papers 3300 Philips HWY US #1 South; Jacksonville, FL 32247 Contact: Darnell Babbitt 904-348-3384 Printing and Writing Paper; 9361ives ~.r tj Lafa ette y t Life .Insurance Company Schnuck Markets, Inc. 11420 Lackland Road; St. Louis, MO 63146 Contact: Ed Keady 314-994-4407 Grocery Store; 450 lives McAllen Independent School District 2000 North 23rd Street; McAllen, TX 78501 Contact: Andres Silva 956-632-3241 School District; 3,511 lives Mississippi Valley 4703 State Highway 157; Edwardsville, IL 62025 Contact: Rue Foe 618-692-4412 Group of School Districts; 3,8381ives Cancelled References Positronic Industries, Inc. 423 N. Campbell; Springfield, MO 65801 Contact: Sharon Peterson 417-866-2322 Electronic Components; 475 lives Wahl Clipper Corporation P.O. Box 578; Sterling, IL 61081 Contact: Connie Henry 815-625-6525 Manufacturing Industry; 7091ives Lewis Brothers Bakeries, Inc. 500 N. Fulton Avenue; Evansville, IN 47710 Contact: Debbie Tieken 812-425-4642 Bakery Products; 1,2821ives G Q F ~ ~ ~ ~ O V~ Oo J G~ to A W N ~+ N ~ OV C J O~ A W N r N .-+ ~• O ~O Oo ~J O. to A W N r N .+ ~ r O ~O Jo J O. to A W N '+ N" ro ~ \ \ \ \ \ \ \ \ \ \ \ \ \ \ N \ \ \ \ \ N\N \ \ \ \N \ \ \ \ \ \ \ \ \N \ \ [\p~ \ \ \ \ O J N[p~J p r 0 S S S pp p p O O C S O S Q S S O O "~ p p O C O O p O O G G O O S O O G O G C O S G S O O O S ^O S S O O O N N N N N N N N N N ~-` ^' 0 ~ O O S ~' O O ~~~ w~ N W W to to A A - A A A A A A A A A A ~++ ~+' w ~+' V' ~" ~" ~"~ "~ w w ~"~ N N 4+ O O N W 0 0 O O O S O O O O O O S O O O O S O S O 0 0 0 0 0 O O S O S O O C O S O O~ O O O S O 0 0 0 0 0 ~ ^^ V, r~ l1 z ~~op~po~~p~oo~0 S S 0000000p°o°°o O O S O S S O °a°oooooo~oo S O S O ~ 0 0 0 0 0 0 0 b o°p°ooopoo~aab O S S O O O S O O S O O Y ~ ~ C O O S S C O O O O O G O O O 3 !n n O O O O G O O O~ O C Op~ S O O O S S O 0 O p0 0 0 0 0 0 0 0~ O O O S O O O S O S O S S O O pOp O O O O?p 0 0 0 0 0 0 O O S 0 0 0 0 0 0 0 0 0 O O O O O O O O O O O O n O O O O O O O S O 0 0 0 ~. 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'~ 9 n ~ o p o o~ o 0 0 0 0 0 0 0 0 0 o p o o- o p o p p ? o c p o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -~ ~ ~o~oo~o°o~°~ $8~ggo~o~goo °8ag$g88oogo goo°~°ogo°o8^ `~r+, Kerr County Specific and Aggregate Stop Loss Insttratice Third Party Medical Claims Administration Group Term Life and AD&D ~,. , Health Reimbursement Arrangement Cafeteria Plan (IRS code 125) Administration Prescription Benefit Management Individual Stop Loss Insurance (ISL)/Aggregate Stop Loss Insurance (ASL) Request for Proposal Submission Form RFP ASSUMPTIONS: 1. Proposal is to be based on the duplication of the existing Plan of Benefits, unless otherwise specified, Any deviations must be clearly identified and explained. All proposals will be assumed to have been submitted without any deviations unless clearly noted. 2. Proposal is to be based on the provided census. 3. Contract effective date is to be January 1, 2008. All participants enrolled in the insurance plan as of December 31, 2007 are to be covered on a "no loss/no gain" basis. "No loss/no gain" for participants are to include credit/debit for accumulated deductible, coinsurance, and lifetime maximum benefits. 4. KERR COUNTY desires to receive proposals for a three (3) year period on one of the following basis: • Fixed price for the three (3) year period, or • Two annual renewal adjustments determined by formula at the time the contract is awarded, or • One (1) year contract with two annual renewal options for rate and premiums deemed to be favorable to KERB COUNTY. Renewal rates are to be provided to KERR COUNTY by October 1 (90 days prior to anniversary date). 5. KERR COUNTY will only consider stop loss insurance policies meeting the following: ~11rr' g ~)- a Specific and Group Aggregate Policy on a 15/12; paid/12; 24/12 or paid /15 basis for Medical and Dru We do not wish to see an aggregating specific. b. Medical and Drug (RX) Specific Coverage with $40,000; $50,000; $60,000 Stop loss. c. Medical and Drug Aggregate Coverage at 120% and 125% of expected claims d Final determination on all lasers, if any, including deductible amounts and conditional lasers should be clearly identified and provided with RFP response based on provided claims data e. Insurance Company Quotation Document with all terms clearly listed £. Waive Actively at Work Provisions 6. Renewal rate must be received by KERB COUNTY at least 90 days prior to date of rate change. 7. Any estimated savings, performance or other guarantees should be specific, quantifiable and should include a method for validation. QUESTIONS: 1. Describe the business entity submitting the proposal: a. Insurance Company Name: Lafayette Life Insurance Co. b. Address: 1905 Teal Road Lafayette 1N 479(?5 c. Contact Person: Jim Bennett d. Telephone Number: 713-783-2383 e. Year Founded (Ins. Co): 1905 ~o-' Kerr County Page 17 of 17a1- Specific and Aggregate Stop Loss Insurance f. What percentage of overall business is Health related? 0 g. Managing Underwriter's Name: N/A h. Year Founded (Managing Underwriter): N/A i. Number of Years for Representing Insurance Company: N/A 2. Describe Financial Stability of Insurance Company offerui~ stop loss coverage: a. Financial Rating Current Rating Prior Year Rating Service & Poors b. Is Insurance Company authorized to do business in Texas? Yes 3. Provide three (3) Texas client references (preferably public entities): Company Name: Company Contact information: Name-Colleen Mart Phone Number 832-223- ~r-, 0314 Company Name: Fort Bend Coun - Company Contact information: Name Darlene Wieghat Phone Number 281-341- 8632- CompanyName: United ISD Company Contact information: Name Robert Chana Phone Number 956-717- 6390 4. Describe the business entity submitting the proposal: a. Name of Business Entity: Lafayette Life Insurance Company b. Current Business Address: 1905 Teal Road Lafayette 1N 47905 c. Mailing Address: PO Box 7007 Lafayette IN 47905 d Contact Person: Jim Bennett e. Telephone Number: 713-783-2383- f. Type of Business Entity: -Corporation -General Partnership Sole Proprietorship Registered Limited Liability Partnership -Limited Liability Company ~, 5. a. Has the business entity been a defendant in any lawsuit in any state or federal court during the precld~ Xfive No (5) years? -- Page 18 of 183 If yes, identify each lawsuit by party, case number, court, subject matter, and disposition: b. Does the business entity have any claims filed against it which are unresolved and presently pend~ Sg befo No y State of Texas Administrative agency? - fir' If yes, please provide a full description of the charges 6. Financiallnformation: a. Has the business entity filed a voluntary or involuntary petition in bankruptcy, obtained an order for relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seven (7) years? Yes X No If yes, please describe: b. Has any owner, member, or partner of the business entity filed a petition in bankruptcy, obtained an ord ears? relief, or received a discharge on any debt under the U.S. Bankruptcy laws during the preceding seY~ (X Y No If yes, please describe: Describe insurance coverage (include copy of Insurance Certificate): a. The business entity must provide satisfactory evidence of existing insurance coverage in the amount of $1,000,000.00 for Errors and Omissions or other fiduciary liability. If the business entity is selected to provide services it must provide evidence that such coverage will be in effect for the duration of the agreement. 8. Describe ISL and ASL claim payment: N/A a. Where will claims be paid? b. What is the definition of "paid claim" to be eligible for reimbursement? c. Can KERB County's HR Director and consultant speak directly to claim examiner for questions related to payment of claim? Yes No Comment: d. What is the normal processing time for ISL claim? e. What is normal processing time for ASL claim? f. What expenses related to investigation of claim are eligible for reimbursement (e.g. hospital audit, medical records, etc) by the stop loss carrier? N/A g. If KERB COUNTY has negotiated with providers, will these discounts be accepted, in lieu of doing~e hospitNloor other audit? N/A h. Describe documentation needed for ISL claim reimbursement: N/A ~/ 9. Describe Underwriting: N/A Page 19 of 19~ 'll an claimants be excluded or assigned a higher deductible (lasered}? N/A Yes No L a Wt Y If so, please describe: yes No I 10. Did you provide a Specimen Stop Loss Contract? N/A 11. Does your Stop Loss insurance contract have any exclusions or limitations that are more restrictive than thY eas used inNo KERB County's booklet? N/A If so, please describe: 12. Are the active-at-work and disabled dependent provisions waived for the effective date of the contract? Yes X _ No 13. If Centers of Excellence are used for your transplant coverage, please provide specific information for facilities cost and procedures to be used: Please attach a schedule with complete information: N/A I 14. Please state any variations to the Request for Proposal Assumptions or other qualifications for your quote: N/eA 15. After the ISL deductible is reached will the stop loss carrier pay claims directly to vendor or require Kerr County to pay claim and be reimbursed? N/A If reimbursed what is turnaround time? N/A 16. For what period of time are quoted rates guaranteed? 24 months I Yes X No ~r 17. Is a longer rale guarantee available? If so, please describe: X Yes No 18. Are quoted rates net of agent commission? if no, please describe: 19. Do quoted rates include advance funding for: a. Specific Claims? N/A If no, additional cost to provide: b. Aggregate Claims? N/A If no, additional cost to provide: Z0. Is the quote based on the services of a specific provider network? 21. Please give rate differential to use the following networks: N/A Specific Aggregate a. PHCS b. Healthsmart c. BCBS d. CNN e. Beechstreet Yes No Yes No N/A Yes No f n~ti ~~~^m°,Texas True Choice- Page 20 of 20~- Tn~u nr ~~r IllV111 LC11~ ~ Specific Deductible Basis for Deductible: Incurred Paid Number of Rates Monthly Premium Annual Premium Partici ants Specific Premium: Single Family Com osite Aggregate Premium Com osite Aggregate Attachment Pts. Single Family ,. Page 21 of 21~1- 21. The following rate exhibit may be used for rate submission however included with the CD or available by Internet is an Excel Spreadsheet titled, "Self Funded Quote Spreadsheet". I Complete this spreadsheet as it will be used for bid analysis. N/A Kerr County Third Party Administration Questionnaire This section does not apply to Lafayette Life TPA Organization 1. Name, Address, City, State, Zip Code and Telephone Number of Firm. 2. Is your firm owned or operated by a parent company? If yes, please identify the parent and its primary business. 3. How long has your firm been in business? How long have you done claims administration? 4. Who are the principal officers in your firm? How long have they been in their positions? ~ 5. Is this a branch facility? If so, please identify the main office location. 6. How many claim processors are Full Time employees in your firm? 6a. How many claim processors will be appointed to service this account? 6b. Of those approximately how many years of experience does each have with medical claims processing? 7. Do you have bilingual claims personnel available to plan participants who call your office for customer service and/or claims processing? 8. How many clients do you perform claim administration services for? What is the average size? 9. Do you carry Errors & Omissions coverage? Provide a copy of your current policy. Claims Administration 1. What are your claim office performance standards for claim accuracy and turnaround time? 2. What is your average turnaround time? 3. What is your current per day production minimum expected of your claims processor? 4. What are your internal audit procedures? 5. What edits and controls are used to avoid duplicate payments? (,. What safeguards exist to protect against claims abuse and fraud? 7. What program do you use to unbundle claims? 8. What coordination of benefits (COB) procedures do you follow? 9. What database do you use to determine Reasonable and Customary fee allowances? How frequently do you update your R&C screens? 10. Describe your procedures for professional Medical claims review? 11. Explain your hospital bill audit procedures. 12. Describe your procedures for tracking and reporting excess claims? ~'' 13. Explain how you handle subrogation and third party disbursements? Page 22 of 22~ No Bid 45. The 3 finalist will be required to make a presentation to KERR COUNTY and answer questions to fully explain the specifics of the program offered. 46. Will your firm contractually guarantee that the amo~ult y°ou reimburse to pharmacy providers is the exact same amount that is billed to the plan sponsor? ATTACH A SAMPLE DRAFT QF THE PBM CONTRACT Cafeteria Plan Administration 1. Name, address, city, state, zip code and telephone number of home office of firn1. Branch office location(s), if any. TASC. 2302 International Lane, Madison WI 53704. 800-422-4661. 8 Regional Offices in Texas. Several other Regional Offices spread across the U. S. 2. Is your company awholly-owned subsidiary or a division of another wmgany? If so, please identify the company name and address. In addition, please list all owners (if not publicly owned), and all affiliated companies. • No. Don (Father) and Dan (Son) Rashke are the owners of TASC. Additionally TASC's affiliated companies are: AB- TASC and EBM-TASC. 3. Have any principals of the firm ever been named in a lawsuit dealing with the management/administration of a Section t25 Cafeteria Plan? • No. 4. How many clients are currently served? Please provide the largest group, the smallest group and the number of employees covered. • TASC currently has 167,497 enrolled in our section 12> Plan. • TASC has over 45,00() Clients and a Participant count in excess of over 200,000. 5. What is the maximum processing time that will occur between receipt of claims and reimbtusements to the members? • Reimbursement requests are processed with a 24-48 hour ttunarotmd time on claim processing. Disbursement to vendors only occurs if the Participant swipes their debit card at a valid merchant. TASC will not disperse to vendors; this is the Participant's responsibility. 6. What guarantee will you provide to Kerr County that this fimction will be completed vzthin this time frame? • TASC has a 24-48 hours turnaround time on claim reimbursements. Claims received by 2:OOpm CST will be processed the same day, claims received after 2:OOpm CST w7ll be processed the following business day. 7. What is the size of your staff? • TASC currently has 316 Employees. 60+ Employees are dedicated to our FlexSystem product. 8. List staff experience of the employees that will be handling Kerr Count_y's account. TASC's Customer Service and Administration staff go through an extensive training course when hired, including several shadowing and mentoring sessions. TASC. has continuing education meetings weekly and a `'~` high level of cross training. Page 27 of 27 9. List the office location intended to service Kerr County. TASC's Administration and Service is handled at otu Madison WI Corporate Headquarters. 10. Is there a toll free number for employees and/or Kerr County to speak to a customer service representative? If so, what are the hours? • Yes. TASC's normal customer service hours, from 8-i on Mondays, Tuesdays and Thursdays; and 9-5 on Wednesdays and Fridays in all time zones. 11. Does your firm perform discrimination studies as to eligibility, contributions and benefits under the plan? )f so, how frequently? • Yes. TASC will perform the testing once a worksheet has been completed and subnutted. TASC will then send a passlfail letter informing the client of the results and the actions that would need to be t~lcen accordingly from those results. This is done yearly up 12. Does your company offer debit card services? If so, please explain in detvl. • Yes. TASC offers up to 2 cards per household per Enrollee. The cost of the card is ~ 1.60 per person monthly. The card is an all or nothing option, all get the card even if only half want it. TASC claims are auto-adjudicated. Once the transaction is completed the claims is reviewed by our vendor to make sure the claim is for an eligible expense. Any claim found to be ineligible; TASC will notify the Participant and temporally inactivate their card until the claim is repaid. 1. Describe the computerized system used to collect, assimilate and integrate the data of the program. • TASC's administration software is proprietary. TASC has a state of the art website that was designed and is maintained by our technical department. ADMINISTRATION 2. Provide a sample of your Administrative Service Agreement. • Please see Exhibit D FlexSystem Plan Application. (service agreement is page 4) 3. Provide a sample of your Plan Document. • Because the Plan Document is very large a Sample Stunmary Plan Description has been provided. (Exhibit E) 4. Describe your capabilities for Direct Deposit. • TASC offers direct deposit and is completely free of charge. Direct deposit occurs within 48-72 hours upon receipt of the claim. ~. Provide samples of worksheets and/or any materials that will be provided to Kerr County for educational purposes. • Please see Exhibit C FlexSystem Client Administration Manual (starting on page 34) 6. Describe your process for entering enrollment information into your system. • TASC offers on-line enrollment. The Employees can enroll electronically on our website, or the Employer can enter elections on the website. Additionally we have an excel spreadsheet which can be completed and uploaded to our website. Finally TASC does have hard copy enrollment forms which can be completed and faxed into TASC, however we prefer the Employee's enter this information electronically as there is less room for error. 7. What electroiuc ar Web-based services does your company offer? Can claims be filed via fax or through other electronic ~,, means? Do you charge additional fees for this service? Page 28 of 28 TASC offers online capabilities far the Employer and Employee. The Employee can access their Account Balance, Claim History, Contribution History, Direct Deposit infornation~ust to name a few. The Employer can access everything the Employee can except the Employer has access to submit Payroll Verification Reports online, Balances and Exposures, Invoice and Billing infornation, Administrative forms, etc. 8. Does your firm provide monthly, quarterly, or annual account statements directly to the participating employees? If so, '~' please explain in detail the process and if there are any additional fees associated with Employee Account Status statements. No. This is due to the information being available at your fingertips 24/7 on our website. 9. Provide a sample of Section 125 reports generated for employees and Kerr County. Provide a sample of any other reports that you believe may be useful to Kerr County on a regular basis. Please provide sample reports that would be utilized for bank reconciliation. • Not Applicable. On-line based. ORGANIZATION STRUCTURE 1. Any Administrator must have filed and be approved with the State of Texas. If a TPA is later rejected by the State, it will be considered grounds for dismissal. • TASC is a licensed TPA in the state of Texas. 2. Is your organization for profit or non-profit? • For profit. 3. Are you an affiliate of an insurance carrier or independently owned and managed? • No. Independently owned and managed. 4. If you are a multiple site organization, are certain services delegated to specific locations or are all sen~ices available at any location? • Specific regional and sales offices assist with the relationship establishment and continuous relationship building, while the complete Administration and Customer Service, including Management are located in Madison WI at our Corporate Headquarters. LIABILITY PROTECTION & BANKING REFERENCE 1. Please disclose the amount of liability insurance protection currently in force. The selected Administrator must provide confirmation of coverage. Please see Exhibit F TASC Insurance Coverage's. 2. Is the company and all employees bonded'? If so, please provide details. • Yes. Please see Exhibit F. 3. Are employees covered by workers compensation insurance white performing services on site at Kerr County'? a. { X }Yes { }No PRICES/FEES 1. Provide schedules of fees for each Ptan. Indicate whether fees or services are contingent upon the sale of any products to Kerr County and the conditions under which the products would be sold. 2. Are the fees due payable on the first of the month, quarterly, annually or combuiation of these? • TASC can bill monthly, quarterly or annually and are due upon receipt. 3. Is a fee stricture available that incorporates various levels of participation? • Yes. 4. Do you intend to receive any commissions from the vendors servicing Kerr County? Page 29 of 29 • No. 5. Explain any methods to be utilized to control expense. • On-line capabilities allow TASC to keep our cost to serve down, and in turn keep the pricing competitive in nature. 6. Provide a fee for administering the Medical and Dependent Care Spending Accounts with and without a Debit Card option. • No Set-up fee • $3.25 per participznt per month • $30.00 monthly minimum • Additional charge of $1.60 per participant monthly -debit card. • No Renewal fee HISTORY 1. Briefly explain the development of your organization and your corporate business objectives. • Please see Exhibit g TASC Corporate Profile. 2. Explain how long you have been in business and how long you have been providing Section 125 Administration services. • We have been in business for more than 30 years. Our success is based on cost-effective administrative procedures that stilt allow us to provide the highest level of customer service possible. TASC products are endorsed, supported and used by many national accounting organizations, national insurance organizations and state and local trade associations. UNIQUE CHARACTERISTICS 1. ~'VI>r~t do you feel is unique about your firm that ~~ ill offer the best value to Kerr Count< for Section 12~ Adnumstrahon sel~-ices? • TASC offers a state of the art ~cebsite t~~~~~.t_~sconl~«e.col~~. Additionally TASC has been admix®istering Employee Benefits for the past ~() dears.. and offers several cost coutingenc} strategies. TASC is one of the top ~ ~r+' I uationalh recognized TPA~s in the industry. 2. Please comment on any other characteristics of your organization that are considered unique in the indus~lry. • TASC Provides world-class Customer Service, has Spanish speaking representatives, offers availabilEity through our call center for contacts from 8-rpm in all time zones. Additionally TASC offers several electronic based communications and constantly notifies Employers of any regulation changes or rulings that affect tie plans. WELLNESS AND PREVENTION QUESTIONNAIRE: 1. Provide an executive summary of the wellness services you provide. 2. Are wellness and prevention medical services your main Iine of business? If not, please e.}cplain in detait where and how wellness fits into your business plan. HEALTH RISK ASSESSMENT (HRA) SERVICES: I. Describe the Health Risk Assessment (HRA) toot your organization offers. Please attach a sample. 2. In what languages are your HRA, website, and employee materials available? 3. What is the average participation rate for your clients? 4. Explain your experience designing incentive systems to drive participation, including your most successfrillly designed incentive program. ~ 5. Please complete the grid below tivith a checkmark or specific answer if your HRA inchides the feature described. Page 30 of 30 EXHIBIT C i ~' Contents ;~ yy ~3cs it ~?tiicii n ........................................... s v..-v.7~7 ... ..... ~t.s >'~ ss [ l•t,c,e~5ttd~ [-'S: t.nt T~d~lc [.isle ......., ...................................................... {~~i `, .,..,,,., i tom:-.J~ 3~C,u ~}~. ii l?i.L~ ....................................................... ................................................ .............. ............ ; C~ ~ [exS4~~~ern Reimbur~~ment~ ....................... ........................ 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