REQUEST FOR PROPOSAL 3117 FOR Administration of Flexible Spending Accounts (TPA) Prepared by Community College of Allegheny County Purchasing Department – College Office 800 Allegheny Avenue Pittsburgh, Pennsylvania 15233 (412) 237-3146 RESPONSES TO THIS RFP MUST BE DELIVERED TO THE PURCHASING DEPARTMENT NO LATER THAN: 2:00 PM on, Wednesday, November 6, 2019 NO FAX OR ELECTRONIC RESPONSES ARE PERMITTED
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REQUEST FOR PROPOSAL 3117
FOR
Administration of Flexible Spending Accounts
(TPA)
Prepared by
Community College of Allegheny County
Purchasing Department – College Office 800 Allegheny Avenue
Pittsburgh, Pennsylvania 15233
(412) 237-3146
RESPONSES TO THIS RFP MUST BE DELIVERED TO THE
PURCHASING DEPARTMENT
NO LATER THAN:
2:00 PM on, Wednesday, November 6, 2019
NO FAX OR ELECTRONIC RESPONSES ARE PERMITTED
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SECTION ONE - PURPOSE OF THE RFP
I. INTENT/PURPOSE: The intent of this Request for Proposal (“RFP”) is to obtain information
regarding contractor services and firm prices for a Third Party Administrator (“TPA”) for flexible
spending accounts (“FSA”) for eligible employees at Community College of Allegheny County
(hereinafter “college” or “CCAC”).
II. GENERAL OVERVIEW: CCAC has high service expectations for a TPA who can provide
complete administrative and claims services for our health care and dependent care Flexible
Spending Accounts. Bidders must have a superior process for reconciliation of Flexible Spending
Account contributions and claims administration with excellent customer support to participants
and communication services. CCAC is seeking the following flexible spending account services,
but not limited to, the following:
1) Claims Administration
2) Web-based, online account inquiry and claims processing
3) Debit Card
4) Customer Service Local or 800 number (Service Center servicing employer and
participants must be located in the United States)
5) Communication materials
6) Dedicated Plan Administrator
7) Reporting Capabilities
8) Seamless implementation of program to CCAC and its participants
9) FSA COBRA administration
III. BACKGROUND: Founded in 1966, CCAC is a multi-campus public institution of higher
education located in Pittsburgh, Pennsylvania with approximately 2,000 employees of which
approximately 860 are eligible to participate in the FSA plan. The College has four campuses and
four centers located throughout Allegheny County and one center in Washington County. CCAC
currently serves approximately 26,000 credit and 18,000 non-credit students; nearly 44,000 total
unduplicated headcount.
The College offers health care flexible spending accounts and dependent care flexible spending
accounts. Participants can direct up to the maximum allowable limit pre-tax for each account.
Our employee enrollment experience in the FSA are as follows:
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C. The college shall conduct interviews of vendors as needed to evaluate qualifications.
Should the college reasonably find that any vendor does not have the capacity to perform
the work to the colleges satisfaction; the college may reject the vendor’s proposal.
SECTION THREE - TERMS AND CONDITIONS OF THE AWARDED CONTRACT
The following terms and conditions shall apply to any resulting award or consideration of an award.
I. GENERAL CONDITIONS OF AN AWARD:
A. Any terms and conditions of a responding vendor’s that are in conflict with the college’s
terms and conditions, inclusive of any specific contractual requirements, must be readily
identified within the vendor’s RFP response.
B. The college may negotiate the inclusion, exclusion, or alteration of any language, terms,
pricing, or conditions prior to the issuance of a signed contract, or throughout the term of
the contract.
C. Any final contract shall incorporate this RFP document and vendor’s response, any addenda
issued, and the proposal as submitted by the successful vendor and accepted by the college.
D. Vendors are cautioned that although the vendor’s terms may be submitted for consideration,
the college reserves the right to negotiate its preference of the same, or otherwise reject the
vendor’s proposal if the college is not able and/or willing to agree to the vendor’s terms.
E. The college further reserves the right after the execution of contract documents to evaluate
the contractor’s performance, physical equipment, staff and all other matters that in the
college’s opinion, have a bearing upon the contractor’s ability to continually perform the
terms of the contract. Should the college reasonably find that the contractor is not
performing to the college’s satisfaction, the college may exercise its right to terminate the
contract at any time with written notice to the vendor.
II. EVALUATION AND AWARD OF PROPOSALS
A. While each proposal shall be considered objectively, CCAC reserves the right to accept or
reject any proposal and to waive any formalities, informalities or technicalities in the RFP
process at its own discretion.
B. The college will not be bound by oral explanations or instructions given by any CCAC
employee or agent at any time during the competitive proposal process or after award.
C. Modifications to the specifications of this RFP shall only be valid if issued in writing by
the college, by way of an addendum.
D. CCAC reserves the right to award any resulting contract in any manner that is determined
to be in its best interest. Factors other than prices proposed may be considered by the
college when awarding the agreement (e.g.: experience, MWDBE participation, number of
available administrators, etc.).
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III. BOND AND INSURANCE REQUIREMENTS
A. PERFORMANCE BOND: A performance bond in the amount of $25,000.00 must be
submitted upon contract award and shall remain in place throughout the term of the
agreement, including any option years that the college may exercise.
The college will accept only bonds written by Surety Companies authorized to do business
in the Commonwealth of Pennsylvania and the County of Allegheny and included on the
United States Treasury Department Annual List of Surety Companies published July first
of each year. Limits for those companies appearing on the United States Treasury
Department list cannot be exceeded.
1) Irrevocable Letter of Credit: A contractor to the Community College of
Allegheny County may substitute an Irrevocable Letter of Credit in lieu of a
Performance Bond. If this option is chosen by the contractor, the Irrevocable
Letter of Credit must include the following terms.
a. The terms of payment must be stated as follows:
“The drafts must be accompanied by your (CCAC) signed statement
certifying that the contractor has not performed satisfactorily in accordance
with the specifications and conditions of the contract. Unsatisfactory
performance will be determined solely by the Community College of
Allegheny County”.
b. The Irrevocable Letter of Credit must be payable and confirmed through a
correspondent bank that has an office located in Allegheny County,
Pennsylvania and which has total assets of at least $5 billion.
c. The Irrevocable Letter of Credit shall not expire for a period of at least
ninety (90) days beyond the expiration date of the contract.
2) Certified or Cashier’s Check: In lieu of a performance bond or irrevocable letter
of credit, the college would accept a certified or cashier’s check I the amount of
$25,000, which would be held for the duration of the agreement and returned upon
completion.
B. INSURANCE REQUIREMENTS: The contractor must meet all Insurance and
Indemnification Requirements of the college as delineated in Form B (attached). An
applicable Certificate of Insurance must be provided to the College by the awarded contractor
prior to the start of any work and the required coverages must be maintained throughout the
duration of the contract, inclusive of any applicable option year term.
IV. TERM OF CONTRACT:
A. The college intends to award a contract for the initial term of January 1, 2017 through
December 31, 2017, with the right to exercise options for four (4) additional one-year terms
through December 31, 2018, December 31, 2019, December 31, 2020, and December 31,
2021.
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B. The contractor shall be advised in writing 60 days prior to the end of the expiring contract
period as to whether the college will exercise an option.
V. TERMINATION PROVISIONS:
A. The awarded contract may be terminated in whole or in part in writing by the college in the
event of the failure by contractor to fulfill its obligations under the terms and conditions of
the contract, or in the event that the contractor files for bankruptcy or otherwise becomes
financially insolvent, or breaches any material provision of the agreement (all in the
college’s sole opinion). The college shall provide the contractor with a written notice of
any conditions which violate or endanger the performance of the contract, and, if after such
notice, the contractor fails to remedy such conditions within thirty (30) days to the
satisfaction of the college, the college may exercise its option in writing to terminate the
contract without further notice to the Contractor.
B. The above stated thirty (30) day time to cure shall not be required of the college when the
violation or breach involves, in the college’s opinion, public safety risks, or immediate or
imminent danger or damage to the college’s facilities or equipment.
C. Upon receipt of a termination notice pursuant to the foregoing paragraphs, contractor shall
promptly discontinue all services affected and vacate the premises, unless otherwise
directed by the notice of termination. college shall have the right before or after termination
to (a) take over the work and prosecute the same to completion by agreement with another
party; (b) recover by law from contractor any and all damages sustained by reason of non-
compliance with or breach of the contract; (c) withhold any and all payments to Contractor
that may be outstanding and apply the same to offset any damages; and/or (d) invoke the
contractor’s performance bond.
D. Upon termination, the contractor acknowledges and agrees that it shall not be entitled to,
nor shall it make a claim for, lost profits or loss of anticipated earnings because of
termination. college shall have the right at their notion to terminate the contract without
any liability whatsoever on the part of college. The college shall be the sole judge as to
whether or not contractor has fully and faithfully complied therewith.
E. Good Faith Efforts: It is the college’s intent to procure and maintain a stable business
relationship with its Security contractor. The parties thereby agree to attempt, in good faith,
to resolve all disputes between them in an amicable and efficient manner.
VII. MISCELLANEOUS PROVISIONS OF THE CONTRACT
A. INDEPENDENT CONTRACTOR STATUS: It shall be expressly agreed that
contractor’s status hereunder an award is that of independent contractor. Neither contractor,
nor any person hired by contractor, shall be considered employees of the college for any
purpose.
B. AUTHORITY TO BIND: In the performance of the awarded services, contractor agrees
that the contractor shall not have the authority to enter into any contract or agreement to
bind the college in any way and shall not represent to anyone that the Contractor has such
authority.
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C. GOVERNING LAWS: Any resulting agreement shall be governed by and construed in
accordance with the laws of the Commonwealth of Pennsylvania.
D. CONTRACTOR INTEGRITY PROVISIONS: The awarded contractor must agree and
abide by the following integrity, confidentiality and non-disclosure provisions:
1) COLLEGE’S INTERESTS: contractor agrees that it will not during the term of the
resulting agreement engage in any activity which is contrary to and in conflict with
the best interests, goals and purposes of the college.
2) CONFIDENTIALITY: The contractor, and its employees, shall not disclose to
others any confidential information gained by virtue of the resulting contract.
3) COMPLIANCE WITH APPLICABLE LAW: The contractor shall maintain the
highest standards of integrity in the performance of the contract and shall take no
action in violation of state or federal laws, regulations, or any other requirements
that govern contracting with the college.
E. VERBAL AUTHORIZATIONS:
1) No verbal agreement or understanding with any officer, agent or employee of the
college, either before or after the execution of the contract, shall alter, amend,
modify, or rescind any of the terms or provisions contained in this RFP or any of
the contract documents.
2) However, the above provision shall not limit or affect the right of the college to
make changes or variations in the scope or general requirements of the contract.
Any such changes must be authorized in writing by the college.
F. COMMONWEALTH PROVISIONS
The contractor further agrees that every provision required by the laws, ordinances or
regulations of the Commonwealth of Pennsylvania or political subdivisions relating to
agreements entered into by a public body in the Commonwealth of Pennsylvania or political
subdivisions thereof, are to be inserted and made part of this RFP and any resulting
agreement and shall be deemed to have been inserted with force and affect as if all such
provisions and clauses were fully and specifically set forth herein. This RFP and any
resulting agreement shall be read, construed and endorsed as though the same were fully
set forth herein.
Pricing Sheet – Page 1 of 2
RFP No. 3117 – Third Party Administrator – Flexible Spending Accounts
The information requested in this Section (in addition to the RFP questionnaire) is required to support
the reasonableness of your proposed price.
Reflect the details of the expected total contract cost for the following plan years. The contract will take
the form of a three (3) year agreement, beginning to coincide with implementation of a go-live date for
January 1, 2021 plan year, and two (2) one-year options to extend the contract.
Include specifics regarding the following:
Competitive fees (although lowest cost is not necessarily the only decision-making factor)
Clear description of fee components and calculations
Administrative fee should be quoted on a per-participant-per-month (PPPM) basis and should be
all inclusive – no separate renewal fee, postage fees, run-out fees, etc.
Note: All “add-on” costs must be estimated and documented.
Plan: CY 2021 CY 2022 CY 2023 CY 2024 CY2025
HC FSA
DC FSA
Indicate yes or no if the services listed below are included in the above price quote. If not, can the
service by provided for an additional fee and provide proposed fee.
Service: Included in Admin Fees?
Yes or No
If no, explain.
Weekly claims processing and
reimbursement
Online employer and participant
account access
Quarterly participant account
statements
Direct Deposit
Debit card Fees
Debit card Replacement Fees
Direct vendor payment
FSA COBRA administration
Renewal Fees
Pricing Sheet – Page 2 of 2
RFP No. 3117 – Third Party Administrator – Flexible Spending Accounts
*Please be sure to include any other possible fee category that could be applicable to the services
requested in this RFP that is in addition to the PPPM charge
Data or Participant Account
Correction Fees
Brochures (printing, shipping,
postage, etc.)
Reporting Custom- Ongoing or Ad
Hoc
Video, CD, Webinars, other
Plan sponsor consultation on
participation issues
Conference calls/web conference with
plan sponsor
On-site Employee Meetings
If yes, how many? ______
Annual Benefit Fairs
*Other:
*Other:
*Other:
*Other:
*Other:
*Other:
*Other:
*Other:
*Other:
Interpreting Services – Submittal Form -1
RFP No. 3117 – Third Party Administrator – Flexible Spending Accounts
By submitting a proposal the vendor acknowledges that the following items are hereby
understood and agreed to:
The undersigned, having carefully examined all sections and attachments to this Request for Proposal
does hereby offer to furnish all labor, materials, equipment, supplies, insurance and bonds specified,
and services necessary to fulfill the contract in accordance with the RFP which is/are hereby
acknowledged by the signature below.
STATEMENT OF NON-COLLUSION
Finally, the undersigned also certifies that this proposal is made without previous understanding,
agreement or connection with any person, firm, or corporation making a proposal on this same service
and is in all respects, fair and without collusion or fraud.
SIGNATURE OF OFFEROR
(Must be signed by a duly authorized officer or agent of the responding company.)
Company
Name
_______________________________
Signed by
_____________________________
FEIN
_______________________________
Name
(printed)
_____________________________
Address _______________________________ Title _____________________________
_______________________________
Telephone
_____________________________
Zip + four
_______________________________
Fax
_____________________________
Date _______________________________ E-mail _____________________________
REQUEST FOR PROPOSAL
INSURANCE REQUIREMENTS
FORM “B”
Indemnification. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold
harmless the Community College of Allegheny County (CCAC), its agents, officers, employees, and
volunteers from and against all claims, damages, losses, and expenses (including but not limited to attorney
fees and court costs) arising from the acts, errors, mistakes, omissions, work or service of Contractor, its
agents, employees, or any tier of its subcontractors in the performance of this Contract. The amount and type
of insurance coverage requirements of this Contract will in no way be construed as limiting the scope of
indemnification in this Paragraph.
Insurance. Contractor shall maintain during the term of this Contract insurance policies described below
issued by companies licensed in Pennsylvania with a current A.M. Best rating of A- or better. At the signing
of this Contract, and prior to the commencement of any work, Contractor shall furnish the CCAC Purchasing
Department with a Certificate of Insurance evidencing the required coverages, conditions, and limits required
by this Contract at the following address: Community College of Allegheny County, Purchasing Department,
800 Allegheny Avenue, Pittsburgh, PA 15233.
The insurance policies, except Workers’ Compensation and Professional Liability, shall be endorsed to name
Community College of Allegheny County, its agents, officers, employees, and volunteers as Additional
Insureds with the following language or its equivalent:
Community College of Allegheny County, its agents, officers, employees, and volunteers are hereby
named as additional insureds as their interest may appear.
All such Certificates shall provide a 30-day notice of cancellation. Renewal Certificates must be provided
for any policies that expire during the term of this Contract. Certificate must specify whether coverage is
written on an Occurrence or a Claims Made Policy form.
Insurance coverages required under this Contract are:
1) Commercial General Liability insurance with a limit of not less than $1,000,000 per occurrence for
bodily injury, property damage, personal injury, products and completed operations, and blanket
contractual coverage, including but not limited to the liability assumed under the indemnification
provisions of this Contract.
2) Automobile Liability insurance with a combined single limit for bodily injury and property damage
of not less than $1,000,000 each occurrence with respect to Contractor’s owned, hired, and non-owned
vehicles.
3) Workers’ Compensation insurance with limits statutorily required by any Federal or State law and
Employer’s Liability insurance of not less than $100,000 for each accident, $100,000 disease for each
employee, and $500,000 disease policy limit.
Questionnaire
RFP No. 3117 – Third Party Administrator – Flexible Spending Accounts
Each bidder must answer the questions in Exhibit D – Questionnaire on a separate sheet of paper in their
bid response. The question must be included before the answer. For each question, bidder should
provide a full answer, however be short and concise as possible to facilitate our analysis and to avoid
confusion. Do not refer to other sections of your proposal, however if the questions was answered in a
previous question of a subsection, please note where specifically and elaborate as applicable; otherwise
include the applicable information in the response to the question. Please answer the following
questions in the various subsections as it relates to, or is applicable to, each category listed below:
1. Health Flexible Spending Account
2. Dependent Care Spending Account
Questionnaire
General Questions
1. Provide your name, primary business address, and company website address.
2. Provide an overview of your organization/firm, including at minimum: historical background, location(s) of business, main business activity, length of time in business, length in time administering FSA benefits, and organizational structure. Please limit to 500 words or less.
3.
Indicate the number of FSA plans your company has in force as of January 1, 2019. What is the average tenure of your client? What is the average size of those employers? Please separately identify those that are Higher Education Institutions along with the average percentage of participants enrolled in an FSA (separately for HCFSA, DCFSA)
4. Do you outsource any portions of the FSA administration?
5. Please provide a listing of all services you provide as it relates to Internal Revenue Codes 125 and 129.
6. What is your turnover rate for 2017 and 2018?
7. Are you publicly or privately held? If other, please describe.
8. Have you ever conducted business under another name? If so, what name? Is your company a subsidiary or affiliate of another company? If yes, please explain and provide full disclosure of any direct or indirect ownership or control by any administrative service agency.
9. Describe the current and future direction of your administrative services (i. e. Overall growth, new systems, new capabilities, projected availability dates, etc.).
10. Have your organization, employees, agents, independent contractors, or subcontractors been cited or fined or been threatened with citation or financial penalties within the last five years by federal or state regulators for violations of federal or state laws and/or failure to implement regulations? If yes, explain fully.
11.
Have you been involved in litigation in the last five years arising out of your performance in the administration of group sponsored FSA plans? (Exclude routine matters involving participants and benefits that do not reflect on your performance under the contract/agreement with your clients.) If the answer is yes, please explain fully. What is the current status? If it has been resolved, what was the outcome?
12. In the past 15 years, have you had any IRS or HIPAA audits that resulted in findings of noncompliance in the administration of FSA plans for any client? Summarize the details including dates of action and corrective measures required and taken.
13. Describe any pending arrangements to merge or sell your company.
14. Please include your most current annual report of your organization.
Questionnaire 15. Briefly indicate the main attributes that differentiate your company from your competitors.
16. How do you ensure client confidentiality consistent with current HIPAA requirements? How frequently does your staff complete HIPAA training? Is your system HIPAA compliant for data security? Explain how.
17. Have you or any business associate report a HIPAA breach involving 500 or more individuals in any given state or jurisdiction? If so, provide a statement.
18. Describe your record retention policy.
19. How do you ensure logical security and access to your programs, systems and data? What security controls do you have in place to protect customer data?
20. Explain your company’s plan for a system back‐up in the event of a system failure or disaster.
21. Do you obtain a service organization control report or other evaluation of the controls in place to protect customers’ data?
22. What type of information do you provide to clients on current laws and compliance issues; legislative updates?
23. Do you provide indemnification protection in the case of noncompliance? If yes, please indicate to what extent and include the contract language.
24. Please provide details of the contract termination language.
25. What type of client support is available after the client has cancelled services?
26. What performance guarantees would your organization provide for services contemplated under this RFP?
Communication and Education
27. Please list the communication and educational materials you provide to employees regarding Flexible Spending Accounts (flyers, brochures, video, etc.) and the purpose of each one. Please provide samples.
28. Do you have separate communications for the Flexible Spending Accounts Debit Card? What additional information does this cover (how claims are substantiated, when to use/when not to use the Debit Card, what to do when they can’t use the Debit Card, etc.)? Please provide copies of all of your printed materials.
29. Describe your notification process for claim denials and claim appeals.
30. How will the Debit Card be distributed to Participants?
31. Can you support and provide staffing for face to face educational meetings (i.e. multiple meetings at 5 different locations within Allegheny County scheduled over several days for a period of time) to all CCAC employees as determined by the College?
32. Can you participate and support one (1) Health Fair held around the Annual Open Enrollment Period?
33. Does your organization provide support and/or participate in open enrollment communications campaigns? Describe your involvement and how you will assist participants in learning about their benefit options. (Open enrollment at CCAC is held November 1 each year for two weeks).
34. Will Webinars be available for Employees? Is there an extra cost for this service? (Do not include fees in this section- all costs related information should be provided in the cost proposal.)
35.
List the types of employee communications you provide and include samples of such materials: a. Hardcopy handouts (welcome kits) b. Video-taped information c. On-site Seminars- if so, how many? d. Website address
36. What types of statements (including frequency) are provided to participants?
37. List the available technology used in servicing the account included in this proposal.
38. Will you provide voice response technology and/or internet access to participants for current account status information?
39. Do you provide electronic and/or on-line internet access to enrollment/change forms, claims and communications materials? Is it compatible to use on mobile devices such as iPad, smart phones, laptops, etc?
40. Do you provide a mobile application for participants? If yes, please explain what services are provided through the smartphone application.
Questionnaire 41. Is a monthly newsletter provided to the employer as part your service?
42. Do your quoted rates include the full cost of communications, including the production and distribution (including postage) of promotional materials?
Implementation/Administration
43. Please provide an implementation checklist based on a go-live date for the start of the FSA plan year beginning January 1, 2021.
44. Describe your approach to implementing our account, including time frames. Please explain how you would facilitate claims incurred between January 1, 2020 to March 15, 2020. How would you help with the grace period?
45. Identify the project team members that would service CCAC account during implementation. If different, also identify the service team who will work with the account after implementation. If not already provided, please provide resume for each member of both teams that will work on the account.
46.
Please provide a detailed description and flow chart of your FSA administrative process from annual enrollment, through reimbursement and forfeiture. Provide samples of the following documents:
a. Enrollment materials and other applicable communications documents b. Claim forms c. Quarterly balance statements
d. Year-end forfeiture warner letter
47. Does your FSA system allow for multiple individuals at the CCAC to have access to view and change information if needed? What daily functions are available?
48. Does your FSA system allow a feed or upload from CCAC for purposes of elections and/or qualifying events? Will a notice be provided that file submissions are received? How is that notice provided and within what timeframe?
49. If a conflict is found in a data feed, confirm that the conflict information will be reported back to CCAC within one business day so CCAC can correct and retransmit their records.
50. With regard to exchanging data, CCAC may include their system generated employee IDs for each individual person/member in the provided file format. Please confirm that your organization can store the CCAC-assigned employee ID’s, and include these data elements on any participant-level reporting to CCAC.
51. Does your system allow for direct and remote access, manual data entry, and correction of eligibility data by authorized CCAC contacts? Is there auditable tracking of who made manual changes available?
52. Is a website available to participants that allow them to do any of the following: check the status of their account, submit a claim, and check request for additional information for a pending claim. Please list any additional capabilities available.
53. Which internet browsers are supported by your organization?
54. Please provide a detailed description of how Employer and Participant contributions shall be provided to the Third Party Administrator and the timing.
55. How are the individual accounts funded? Will contributions be pulled from CCAC at the time of payroll deduction or when a claim is incurred? If yes, please explain how this is set up and the process.
56. Describe your practices for handling claims appeals. Please provide a copy of your appeals procedures.
57. How would renewal fees be evaluated?
58. Describe the escalation process for customer service satisfaction and grievances.
59. System – CCAC uses a benefits module through Ellucian Colleague. Please describe your capability and experience integrating with this system, if any.
60. Describe how your organization would determine employee eligibility and reimbursement eligibility, if applicable.
61. Describe your reimbursement process in detail. Include location of office(s), timelines, funds transfers and personnel responsibilities that would be involved.
62. Confirm that no minimum participation requirements will be imposed.
Questionnaire
Claims Administration
63. Please provide the number of FSA claims processed for 2016, 2017 and 2018 (Separately for Health Care and Dependent Care)
64. How frequently do you make claim reimbursements (daily, weekly, biweekly, semi-monthly or monthly)? Can CCAC determine frequency of reimbursements? Does the processing fee vary based upon the reimbursement frequency?
65. What is your average FSA claim turnaround time for the past 12 months (number of days from receipt of a clean claim)?
66. Describe the timeline for paying a clean claim. Start the timeline with your receipt of a clean claim on 2/1/19.
67.
What is your method of participant reimbursement (debit card, mailed check and/or direct deposit)? a. Is there a minimum reimbursement or claim amount? b. For mailed check and direct deposit, what is the frequency in payment for participants opting for either
method? c. Is there a charge to CCAC or CCAC participants for paper check reimbursement? If so, additionally detail
within the cost proposal.
68.
Are you able to accept rollover claims from medical, dental and/or vision providers? Describe your experience working directly with third-party administrators or insurers to automatically adjudicate an FSA reimbursement request when a claim is paid? Discuss briefly, indicating issues where the claims process is likely to have problems.
69. How are manual claims filed and processed?
70. Will you accept faxed, scanned emailed claims, and/or online submission via secure website or portal?
71. What is your definition of a covered expense? Can the participants define covered expenses or do you cover all services as defined by the IRS? What steps do you take to ensure that a submitted FSA claim is a covered expense under Section 125 and 129?
72. Do you investigate and analyze claims prior to payment? Describe the administrative process of claims review.
73. What claim documentation will you require from a participant in order to pay the claim?
74. Describe how you administer individual accounts in situations where the participant's request for reimbursement exceeds year-to-date contributions.
75. Describe your standard method for processing claim run-out after the plan year closes.
76. Describe how forfeitures are handled and the timeline for handling them.
77. Will you process all claims in accordance with applicable federal and state laws and regulations?
78. Will you generate detailed quarterly account statements to enrollees, and end-of-plan-year warning notices regarding forfeitures?
79.
Describe your processes for the following: a. Process to replace reimbursement checks or direct deposits into closed accounts. b. Handling of checks that have voided. c. Process and timeframe to replace lost or stolen checks.
80. Explain the time period for un-deposited or outstanding checks. What is your process for returning funds that have not cleared the bank within the established stale dated check timeframe?
81. Provide the process for month-end processing and reconciliation of all reimbursements issued and voided.
82. Describe your process for administration of Dependent Care Accounts.
83. Describe your website for online services.
84.
Confirm your team will, at no additional cost, initiate and provide at least annual meetings with CCAC employer contacts to present current plan and service performance, address any recent issues/challenges encountered, and discuss other pertinent topics to be identified prior to each meeting. At minimum, CCAC requests that an account team member closely involved in the daily operations of the CCAC account and a manager-level team member with oversight responsibilities attend all meetings.
Questionnaire
Debit Card and Functionality
85. Does your Debit Card system have the ability to substantiate claims from multiple carriers/plans? Can you load Medical, Dental, and Vision co-pays so the card will substantiate those claims?
86. Does your Debit Card work with both Health Care and Dependent Care Flexible Spending Account types? Please explain the functionality for each account type.
87. Are there different requirements for funding the debit cards?
88. How do participants have to substantiate claims under the debit card manually by submitting receipts or supporting documentation?
89. Describe your process for auto-adjudicating FSA claims. What types and percentages of your claims are auto adjudicated? What steps have been taken to reduce the need for substantiation and increase auto-adjudicated claims?
90. Please describe the process for collecting money from participants when they fail to submit receipts. What parts of the process do you manage, and what is the employer responsible for?
91. Please describe the process of turning off the card if a participant fails to submit receipts when asked. What is the timing of this and how do you communicate with the participant that this is happening?
92. Explain the grace or “run out” period after the end of the Plan Year and how the Debit Card works.
93. If a claim exceeds the balance in an account what is the process for funding the claim? Please describe for both health care and dependent care.
94. Does a participant automatically receive a debit card or do they request one? Does the participant have the choice to obtain a debit card?
95. Does a participant receive a debit card every plan year or are existing cards reloaded from year to year?
96. What is the process/adjudication for recurring or multiple transactions?
97. What is the process for non‐substantiated claims?
98. What is your minimum reimbursement claim amount?
99. What is the deadline for substantiated claims submission?
100. How is a participant notified when additional information is needed to process a claim?
101. What is the typical turnaround for reimbursements?
102. If a debit card claim is denied, other than time of transaction, how do you notify the claimant?
103. What appeals process is in place for a participant whose debit card claim transaction is denied?
104. What is the process and timeline for lost or stolen debit cards?
Reporting
105. Explain your reporting capability (Administrator Site with Query tool, canned reports, customized reports, etc.).
106. Please include a copy of standard reports that is provided to the employer as part of the program. What is the report frequency (monthly, weekly, quarterly)?
107. Confirm that you are able to customize reports and this is included in your quoted rate(s).
108. Is there a charge for ad hoc reporting? If so, please provide the cost methodology (e.g., per report, hourly charge, etc) and the average preparation time. (Do not include fees in this section- all costs related information should be provided in the cost proposal.)
109. Can you track and generate enrollment and eligibility reports at least quarterly? Reports should include participants’ balances, annual election amounts and per-pay-period contributions. Reports must be available no later than the end of the calendar month following the end of the quarter.
110. Can you provide reports of paid claims, contributions and expenses available on a monthly basis? How will the Employer know if it was a manual claim or a Debit Card claim?
111. Can you report the end of the year forfeitures by plan type?
112. Are reports available online? What are the download format options (e.g., Excel, PDF, etc)?
Questionnaire
Files
113. Do you have a specific interface file format? If yes, please provide the specifications.
114. How are the files submitted?
115. Do you require separate files for eligibility and participant contributions?
116. How often can you accept an eligibility file to ensure that Debit Cards are turned off in a timely manner?
117. What is required to be reported and the timeframe to ensure claims are processed timely?
118. What process ensures that terminated Participants’ Debit Cards are deactivated?
119. What is the ‘cut off’ time to receive files showing payroll deductions so any claims filed manually are processed by pay day?
Finance and Banking
120. What is the billing frequency?
121. What are your payment terms for administrative services and preferred method?
122. Please provide a sample detailed invoice.
123. Currently, CCAC remits payments via ACH debit and is provided a reconciling report from the vendor on transactions and amounts. Confirm that you are able to accept ACH debit and provide reconciling reporting on a daily frequency or based on claim activity, via secure website/portal.
Customer Service
124. Briefly describe your customer service training program.
125. How do you measure the quality of your customer service?
126. Do you provide a customer service unit with a local or toll-free participant services telephone line to answer questions for CCAC participants? Will this unit be dedicated solely to CCAC? Is the personnel for this unit located in the United States? Is this function outsourced? If so, provide the name of the outsourcer.
127. Please provide an address to the offices that will provide service and administration for CCAC employer representatives? Will a dedicated account manager or team be assigned? Can they be contacted via phone and/or e‐mail? Please list hours of operation and time zone. How are contacts “after hours” of operation handled?
128.
Please provide an address to the offices that will provide service and administration for CCAC participants? If the same as for employer representatives, simply indicate the “same as for employer”. Otherwise, please provide address. Will a dedicated account manager or team be assigned? Can they be contacted via phone and/or e‐mail? Please list hours of operation and time zone. How are contacts “after hours” of operation handled?
129. How many full-time staff members are located at the customer service office proposed for CCAC? How many are dedicated solely to FSA administration?
130. Describe the customer service available to participants.
131. What are your standards for responding to written inquires? Voicemails?
132. Will you contact and communicate directly with claimants as required to resolve problems or to respond to questions?
133. Are there special telephone features for the hearing impaired?
134. Are calls recorded and available for CCAC’s review upon request? If so, how many months will the recordings be made available? Can CCAC employer contact hear a specific call made to your call center if the CCAC staff person can provide a date and approximate time?
135. Describe your interactive voice response system capabilities and web, online capabilities for employers and participants.
136. Are participants and employer contacts able to easily opt out of any interactive voice response to speak to a live customer service person?
137. Describe your organizations participant satisfaction surveys and provide the most recent results.
Questionnaire
138. Confirm that you will acknowledge any and all inquiries and/or complaints from CCAC employer contacts, whether made via phone or email, within 2 business days. Additionally, you will initiate a resolution plan, and when requested, create a corrective action plan, within 3 business days of initial notification.
139. Confirm that 100% of claim inquiries and/or complaints will be acknowledged (return response) within 2 business days, and follow-up of resolution status within 3 business days, if not yet resolved.
140.
If COBRA services is not selected service administrated by vendor, will your organization provide COBRA informational/advising support to CCAC for questions and issues concerning the college’s administration of COBRA? Is there an additional fee? (Do not include fees in this section- all costs related information should be provided in the cost proposal.)
References
RFP No. 3117 –Third Party Administration-Flexible Spending Accounts Submit at least three current customer references (preferably of like size and operational structure as to that of
the college). CCAC is interested in working with a carrier that has experience with and a history of
administrating FSA Services to other higher education industry clients of similar size.
Provide this same information for two (2) recently terminated customers. Include the reason the engagement
was terminated.
Current Customers
Company Name: Contact Person:
Address: Telephone Number:
City, State, Zip: E-mail Address:
Services Provided / Date(s) of Service:
Number of eligible employees/Number of participants:
Company Name: Contact Person:
Address: Telephone Number:
City, State, Zip: E-mail Address:
Services Provided / Date(s) of Service:
Number of eligible employees/Number of participants:
Company Name: Contact Person:
Address: Telephone Number:
City, State, Zip: E-mail Address:
Services Provided / Date(s) of Service:
Number of eligible employees/Number of participants:
Terminated Customers
Company Name: Contact Person:
Address: Telephone Number:
City, State, Zip: E-mail Address:
Services Provided / Date(s) of Service:
Number of eligible employees/Number of participants:
Reason engagement was terminated:
Company Name: Contact Person:
Address: Telephone Number:
City, State, Zip: E-mail Address:
Services Provided / Date(s) of Service:
Number of eligible employees/Number of participants:
Reason engagement was terminated:
COMMUNITY COLLEGE OF ALLEGHENY COUNTY
800 ALLEGHENY AVENUE, PITTSBURGH PA 15233
Bond Number
P E R F O R M A N C E B O N D
Know all men by these Presents that we “TO BE COMPLETED ONLY BY AWARDEE”
(hereinafter called “Principal”) as Principal, and
authorized to do business in the Commonwealth of Pennsylvania (hereinafter called “Surety”) as Surety, are held and
firmly bound unto the Community College of Allegheny County, through its Board of Trustees,
in the sum of
to be paid to the said College aforesaid, its certain attorney, or assigns. To which payment will and truly be made, said
principal and said surety to bind themselves their respective successors or assigns jointly and severally, firmly by these
presents.
WITNESS our hands and seals, the day of 20 .
WHEREAS the above bounded
has filed with the Community College of Allegheny County, proposals
for the
The Condition of the above Obligation is such that if the said
shall perform
In accordance with the agreement between
and the Community College of Allegheny County of even date herewith and the specifications and proposals attached to
and made part of the agreement, and shall indemnify and save harmless the said Community College of Allegheny
County from all liens, charges, demands, loss and damages of every kind and nature, whatsoever. Then this obligation
to be void, otherwise to be and remain in full force and virtue.
Attest: (SEAL)
CONTRACTOR
(SEAL)
SECRETARY PRESIDENT
Signed, Sealed and delivered in presence of (SEAL)