HomeMy WebLinkAboutCity of Denton Stoploss RFP Scope of ServicesCity of Denton Stoploss RFP Scope of Services
Prepare and provide City of Denton with proposals for stop loss services. This includes both
individual and aggregate stop loss. The current plans are for the benefit of current employees and
their eligible dependents. The resulting contractual agreement will be between the approved
Proposer and City of Denton.
Proposers are required to submit proposals with individual and aggregate stop loss. The City is
requesting ISL quotes at $185k and ASL quotes at 125%. The ISL contract is currently a paid
contact and should to be quoted as a 36/12 contract. In addition, please submit additional options
(200k, 225k, 250k) for ISL deductibles. This request-for-proposal is intended to solicit proposals
for a multi-year agreement from a Proposer who is capable of providing the level of service and
expertise required for a group of City of Denton’s size.
Proposers must clearly state their limitations regarding co-existence with other Proposers, e.g.,
pharmacy benefit manager, 3rd party subcontractors or other insurance carriers. It is the intent of
this request-for-proposal to seek the best terms, most cost effective, ability to match/mirror the
SPD terms, and accurate management of a comprehensive stop loss policy.
Proposers must have the financial viability to perform under the contract. Proposers must also
have the technical resources in place to accurately and efficiently process large amounts of data,
and comply with the legislative and regulatory environments, including the Health Insurance
Portability and Accountability Act (HIPAA) and the Patient Protection and Affordable Care Act
(PPACA).
Proposer must manage all aspects of the stoploss contract with City of Denton from timely
implementation, ongoing plan oversight and management, tracking/reporting of claim activity,
and timely and accurate individual and aggregate stoploss reimbursements.
Specifications have been prepared outlining the coverage and services to be quoted. Alternative
service(s) may be submitted in addition to responses to the items requested in the outlined
specifications and should be preceded with a summary of how the alternative could be more
advantageous to City of Denton
Evaluation Criteria
Compliance with specifications, quality, reliability, characteristics to meet stated or implied
needs (FACTOR: 30%)
Compliance with the stated specification(s) coupled with the quality and reliability of the goods
and services such as fitness for use that meets or exceeds Owner's expectations and the
characteristics of the product or service that bear on its ability to meet the stated/implied needs.
Indicators of Probable Performance under contract (FACTOR: 10%)
Indicators of probable performance under the contract to include: past vendor performance,
financial resources and ability to perform, experience or demonstrated capability and
responsibility, references, and the vendor's ability to provide reliable agreements and support.
Price, Total Cost of Ownership (FACTOR: 60%)
The price of items, to include total cost of ownership, such as installation costs, life cycle costs,
and warranty provisions.