Technology Transfer System Project Overview

The Regents of the University of California

REQUEST FOR PROPOSAL

CHBRP Actuarial Services 2015 Date Issued: 8/5/2015

It is the Bidder’s responsibility to read the entire document, any addendums and to comply with all requirements listed herein. Any addenda to this Request for Proposal will be directed to all participating Bidders. It is the Bidder’s responsibility to watch their e-mail for any addendums, notices, or changes to the RFP or process.

Issued By: The Regents of the University of California

RFP Administrator: Karen Rhee Commodity Manager University of California, Office of the President 1111 Franklin Street, 10th Floor Oakland, CA 94607-5200

The information contained in this Request for Proposal (RFP) is confidential and proprietary to the University of California and is to be used by the recipient solely for the purpose of responding to this RFP.

1. INTRODUCTION

1.1 RFP Description and Scope The University of California (UC) is seeking a professional services firm (or firms) to provide actuarial services and consultative expertise to support analysis of legislation mandating or repealing health insurance benefits or services in the State of California, as well as to provide cost estimates related to other health insurance topics proposed by the California Legislature, which have been forwarded to UC for analysis. 1.2 About The California Health Benefits Review Program These actuarial services and cost analysis services are in support of the work of the California Health Benefits Review Program (CHBRP), a multi-disciplinary faculty-driven program administered by the University of California’s, Office of the President (UC OP). CHBRP provides independent evidence-based analysis to support California policymakers on health insurance-related topics. CHBRP responds to requests from the State Legislature to provide objective analyses of the medical, financial, and public health impacts of proposed health insurance benefit mandates and proposed repeals of health insurance benefit mandates, as well as consideration of other health insurance topics. CHBRP was established in 2002 to implement the provisions of Assembly Bill 1996 (California Health and Safety Code, Section 127660, et seq.) and was reauthorized by Senate Bill 1704 in 2006 (Chapter 684, Statutes of 2006),1 and again in 2015 by Senate Bill 125, Chapter 9, Statutes of 2015). Since 2004, CHBRP has produced more than 100 reports and has developed a reputation for rigor and impartiality. In the winter and spring of 2015, CHBRP produced 9 Reports and with its actuary, prepared an analysis on Essential Health Benefits, which was roughly average in terms of the number of requests. The State funds this work through an annual assessment of health plans and insurers in California. An analytic staff in the University of California’s Office of the President supports a task force of faculty and researchers from several campuses of the University of California. This taskforce receives funding to offset the time that members spend each year to perform CHBRP work on their campuses, each year. Each bill analysis team includes a CHBRP staff lead, and an average of 4-6 taskforce members, and is charged to complete each analysis within a 60-day or less period, usually before the Legislature begins formal consideration of a mandate bill. A robust review process occurs before analyses are submitted. A sample of CHBRP’s typical 60-day analysis timetable may be accessed at: http://www.chbrp.org/chbrp/analysis_methodology/uploads/60daytimeline.pdf. CHBRP’s Director is supported by two Lead Analysts, an Associate Director, and a Program Specialist, as well as intermittent contract staff and graduate interns. CHBRP’s staff provides interface with the Legislature and other stakeholders, project management and general oversight, and also contributes to the analyses. CHBRP staff, (along with research staff and faculty from our “cost team” UCLA, described below, also assembles various data necessary for the bill-specific analyses and the cost, coverage, and utilization model updated each year. The taskforce team collaborates with the actuary on the analyses, but the management and oversight of this contract lies with the Director. CHBRP also maintains a National Advisory Council (NAC), drawn from experts outside the State of California. This body provides input on CHBRP’s methodology on an annual basis and is designed to provide balanced representation among groups with an interest in health insurance benefit mandates. NAC Members review draft analyses to ensure their quality before they are transmitted to the Legislature. Each CHBRP analysis summarizes scientific evidence relevant to the proposed mandate, or proposed mandate repeal, but does not make recommendations, deferring policy decision making to the Legislature. A strict conflict-of- interest policy (applicable to faculty, staff, principal actuaries, who are responsible for report content, etc.) ensure that the analyses are undertaken without financial or other interests that could bias the results. A certified, independent actuary helps CHBRP estimate the financial impacts of a proposed benefit mandate

1 The statute defines a health insurance benefit mandate as a requirement that a health insurer or managed care health plan (1) permit covered individuals to obtain health care treatment or services from a particular type of health care provider; (2) offer or provide coverage for the screening, diagnosis, or treatment of a particular disease or condition; or (3) offer or provide coverage of a particular type of health care treatment or service, or of medical equipment, medical supplies, or drugs used in connection with a health care treatment or service 2 or repeal. The actuarial support is required to evaluate cost impacts on public and private payers resulting from proposed mandated benefits or proposed repeals of existing mandates. By statute, CHBRP is required to retain a certified, independent actuary (or of similar expertise) to help estimate the financial impacts: “In assessing and preparing a written analysis of the financial impact of legislation proposed to mandate a benefit or service and legislation proposing to repeal a mandated benefit or service pursuant to this paragraph, the Legislature requests the University of California to use a certified actuary or other person with relevant knowledge and expertise to determine the financial impact.” The financial impact section of each analysis has generally been drafted by the ‘Cost Team’ made up of faculty and research staff/analysts at the University of California’s Los Angeles (UCLA). The Cost Team is supported by actuarial services provided by an independent actuarial firm. The model used to compute the costs impacts on employers, individuals and the State is a collaborative effort between the UCLA campus, CHBRP staff, and the consulting actuary. In addition, the research conducted by the ‘medical effectiveness team’ usually at the University of California, San Francisco, and San Diego campuses helps inform the underlying assumptions used to model the coverage, utilization, and costs impacts of a particular bill. The basic model is updated annually in advance of each legislative session and the model is modified according to the particular factors relevant to the bill under consideration. UC’s expectation is that the new contract with the selected contractor would begin late October to early November. If a new actuary is selected, a transition period with the incumbent firm would occur between November 1, 2015 and January 31, 2015. All CHBRP reports, information about current requests from the California Legislature, and links to the California Cost and Coverage Model are available at the CHBRP Web site, www.chbrp.org.

2. SCOPE OF SERVICES

As noted above, CHBRP has developed a timeline for scheduling all of the work that needs to be accomplished within the prescribed 60-day time frame, and in some cases, fewer days. During the first week after a request is received, CHBRP conducts a review of all analytic participants' potential conflicts of interest and obtains appropriate recusals; identifies key aspects of the mandate that need to be considered in an analysis; consults with the bill author's staff to determine the nature of the problem the bill is trying to address; consults with appropriate experts (for example, a clinical expert helps to identify the scope of the medical effectiveness literature review); conducts an initial literature review; develops survey questions for health plans to determine baseline coverage of the proposed benefit mandate; begins identifying parameters of the cost analysis; and identifies and notifies a group of expert reviewers from the NAC.

After the first week, CHBRP spends the next month conducting and drafting its analysis of a mandate bill. The activities during these days - literature reviews and assessment of the medical effectiveness of the benefit, modeling of the cost impact, development of the public health impact, and analysis of input from health plans, insurers, and any public input received are highly coordinated. Faculty and researchers from each of the three teams (Medical Effectiveness, Cost, and Public Health), actuarial consultants, and CHBRP staff work together to develop interdependent sections of the analysis. The methods that CHRBP has developed for analyzing medical effectiveness, cost impact, and public health impact of proposed benefit mandates weigh the strength of research evidence in a rigorous and objective manner; CHBRP documents its methods to the public to support the transparency of its work. In addition, each complete analysis is reviewed internally by members of the Task Force.

For each request received by the California Health Benefits Review Program, the actuary will be required to assist the CHBRP faculty, researchers, and staff address the following2:

 The extent to which the mandate or repeal affects coverage of the benefit or service for California residents who have health insurance coverage subject to regulation.  The extent to which the coverage or repeal of coverage will increase the utilization and costs of the benefit or service, or will be a substitute for, or affect the utilization and costs of, alternative services.  The extent to which the coverage or repeal of coverage will increase or decrease the administrative

2 The consulting actuary is not responsible for writing content, but does offer review of the report for consistency and accuracy. 3 expenses of health care service plans and health insurers and the premium and expenses of subscribers, enrollees and policyholders.  The impact of this coverage or repeal of coverage on the total cost of health care.  The potential cost or savings to the private sector, including the impact on small employers as defined in paragraph (1) of subdivision (1) of Section 1357, the Public Employees’ Retirement System, other retirement systems funded by the state or by a local government, individuals purchasing individual health insurance, and publicly funded state health insurance programs, including the Medi-Cal program and the Healthy Families Program.  The extent to which costs resulting from lack of coverage or repeal of coverage are shifted to other payers, including both public and private entities.  The extent to which mandating the proposed benefit or service or repealing an existing mandate impacts access to those services.  The extent to which the benefit or service is generally utilized in the population.  The extent to which health care coverage for the benefit or service is generally available. In addition, the actuarial firm will assist the “public health team,” usually at the University of California’s Davis or San Diego campus, to determine to the extent possible, any underlying differences in the utilization rates by sub-populations. Due to the time sensitive nature of the legislative cycle, it has been requested that the University provide completed reports within 60 days after receiving a formal request for review. The actuary and/or subcontracting analytic specialists selected to participate in this program will, in turn, be required to commit to completing needed work within specified time frames.

Other Analytic/ Economic Forecasting Services:

In CHBRP’s recent reauthorization, the program’s scope has been formally broadened to include “other health insurance topics”. On occasion, these topics may not be as well served by CHBRP’s traditional cost analysis methodology, nor by its “traditional actuarial approach.” Thus, UC is seeking either in-house or a subcontractor to provide analytic or economic consulting to work with CHBRP staff and faculty to develop reasonable cost estimates and projections.

3. QUALIFICATIONS

3.1 Minimum Qualifications (for Actuarial Services) UC OP will only accept proposals from vendors who meet the following minimum qualifications. Bidders must certify in writing that they meet all of the minimum qualifications.  The bidder has on staff a Fellow of the Society of Actuaries or a member of the American Academy of Actuaries, who would be assigned to work on this contract.  The bidder has prior experience with health insurance pricing.  Subcontracting or in-house analytic consultants must have experience in estimating the costs of proposed state healthcare legislation and/or regulation. 3.2 Additional Qualifications Vendors which meet the minimum qualifications will be further evaluated as following: 1. Demonstrated knowledge of and experience, particularly in California, in health cost analysis using actuarial methods. a. Provide a statement describing the organization’s overall experience in the health actuarial field. Focus on major contracts in California and experience with health insurance programs and agencies. Please provide a brief description of any experience forecasting estimated costs of proposed or enacted legislation. b. If the bidder is a previous or current Contractor with UC OP, give the contract term dates, 4 contract number, contracting departments, services provided and contract amount of contracts for the prior five years. 2. Knowledge and experience of assigned professional staff. a. Identify the key personnel who will work on this project. Include resumes for each key person describing their experience and tenure that qualified them to work on this contract. b. Provide a statement describing the demonstrated ability of key personnel to work collaboratively with university-based staff, faculty, and researchers. 3. Organizational structure demonstrates overall accountability and accessibility of assigned staff. a. Provide an overall description of your organization – the date established, type of ownership, location of headquarters, and any major offices in California and number of employees engaged in actuarial consulting. b. Describe to what extent the key persons will be available and accessible (actuaries, assigned analysts if any, and internal peer-review process). c. Provide a statement and chart describing the organization’s structure and where the project staff fit into that structure. 4. Availability and relevance of data sources. a. Describe any relevant databases the bidder has “in house,” or has access to that would be relevant to and available for contract tasks. Include the year of the data, the size, and the type of data available. The relevant databases used by the incumbent actuary are provided for reference.3 b. Please describe experience analyzing prescription-drug related cost and utilization impacts, changes in formulary, and other utilization management programs. 5. Information gathered from references provided as part of the proposal. a. Provide three existing client references that are knowledgeable about the firm’s work on current or recent contracts. At least one should be a current or prior public sector or higher education client. The references should be selected for contracts that are similar in scope and complexity to the tasks for which the UC OP is seeking services. Provide the names, titles, addresses, phone number and e-mail address of the reference and indicate the purpose of the contract for each reference given. b. In addition, please provide two former client contracted references that are no longer doing business with your company. 6. Absence of professional relationships that pose potential conflicts of interests with the bidder’s obligations to the UC OP that cannot be managed consistent with the needs of UC OP. 3 Utilization and expenditure data sources: The utilization and expenditure data for the California Cost and Coverage Model are drawn primarily from multiple sources of data used in producing the Milliman Health Cost Guidelines (HCGs). The HCGs are a health care pricing tool used by actuaries in many of the major health plans in the United States. The guidelines provide a flexible but consistent basis for estimating health care costs for a wide variety of commercial health insurance plans. The HCGs are used nationwide and by several California HMOs and insurance companies, including at least five of the largest plans. It is likely that these organizations would use the HCGs, among other tools, to determine the initial premium impact of any new mandate. Thus, in addition to producing accurate estimates of the costs of a mandate, the HCG-based values should also be good estimates of the premium impact as estimated by the HMOs and insurance companies.

Most of the data sources underlying the HCGs are claims databases from commercial health insurance plans. In particular, the data come from health insurance companies, "Blues" plans, HMOs, self-funded employers, and from private data vendors. The data are mostly from loosely-managed health care plans, such as traditional indemnity-style plans and PPO plans. The HCGs are also based on data commonly used by health services researchers. CHBRP is open to considering alternative data sources.

5 a. Disclose any professional relationships (including but not limited to health industry clients) that pose a potential conflict of interest with the bidder’s obligations to the UC OP should the bidder be awarded this contract. For any interest or relationship disclosed, the bidder must provide a complete explanation of the steps the bidder would take, if awarded the contract, to ensure that there will be no actual conflict with bidder’s obligations to UC OP. NOTE: All principal actuaries will be required to complete a CHBRP conflict of interest disclosure form upon the contract award.

4. PERFORMANCE MEASURES

CHBRP reports are to be completed in time for the relevant Legislative Policy Committee hearings that usually occur during the months of April and May. This means that the peak production period for CHBRP reports usually occur from February to May. In order for CHBRP to ensure smooth workflow and operations, the following performance measures will be used to evaluate the Actuarial firm’s work.  Respond to communications from analytic team members in a timely fashion.  Supply spreadsheets to CHBRP staff of relevant sub-analysis and of the actuarial models for each Legislative bill analysis in Excel format. This may include analysis of baseline and projected utilization, coverage and costs impacts of the Legislative bill. Spreadsheets should be supplied to the Cost Team and CHBRP staff.  Meet deadlines for intermediate (or draft) and final deliverables.  Participate in conference calls as needed, usually between one and three times per week during the peak production period.  Ability to use CHBRP-secured Microsoft 2013 SharePoint Portal to share, review and revise documents relevant to report production.4

 Documents sources for assumptions and factors used to build bill-specific models  The actuary and analytic consultant provides notes in the models’ spreadsheets and other documentation of adjustments, data sources, etc.

5. FEE STRUCTURE

5.1 Actuarial Bidders must show their fee proposal on a complexity” level and hourly rate. For instance, “Scenario/Project A” may involve x hours of the principal actuary, and y hours of an actuarial analyst at (x and y dollars per hour).So that we may understand the underlying assumptions on which your rate is based, please include in your proposal any assumptions regarding the anticipated hours per analysis broken down by anticipated tasks and hourly rate. See the attached excel spreadsheet, and please include with your Response. 5.2 Analytic Consultants must show their fee proposal on an hourly rate basis.

6. OTHER REQUIREMENTS

 Proposals and actuarial reports will become the property of The Regents of the University of California.  The University reserves the right to reject any and all proposals received.  The University reserves the right to accept the proposal(s) that it considers to be in the best interest of the University. While cost is a consideration, the University reserves the right to award contracts on the basis of all relevant information and the University’s overall evaluation of each bidder’s ability to serve the University’s needs.  The University will not reimburse the recipients of this Request for Proposal for costs incurred in preparation of their response.  The actuarial review will be confidential between the parties. Rights to reproduce in whole or in part will

4 Microsoft SharePoint is a collaborative software tool (works with PCs and Apple Computers) that helps simplify content management, search, and sharing for intranet and internet sites. 6 be at the sole discretion of the University.  Any successive use of services provided to the University of California in bidder’s marketing will require prior written approval of the Director, California Health Benefits Review Program.  Actuaries specifically identified in the proposals will conduct the reviews. The primary actuary identified in the proposal is required to be a Fellow of the Society of Actuaries or a member of the American Academy of Actuaries.  The University is a public entity and may be required to release the actuarial report by law, statute, or regulation.  Actuary will be required to execute an “Independent Consultant Agreement” for each contract awarded. Please see Attachment 1 for this Agreement.  CHBRP’s overall annual and each bill-specific cost model remains the property of the University.

7. CONTENT OF PROPOSALS

Proposals should include the following information:  Description of services to be provided  Scope of work  Identification of key personnel & corresponding qualifications and experience  References  Sample of proposed budget for three bill analyses

8. RFP PROCESS TIME LINE

Bidders interested in submitting proposals in response to this RFP should do so according to the following schedule. A Bidder may be disqualified for failing to adhere to the dates and times for performance specified below; please note that dates are subject to change at UC’s discretion.

Release of RFP 8/5 Bidder Intent to Bid Due 8/14 Bidders Questions Deadline 8/21 UC Response to Questions (Distributed to all known 8/26 Bidders) Bids Due 9/4 Notify Finalists for Supplier Presentations 9/11 Finalists Presentations: In-person Oral delivery of RFP 9/21-9/30 response Contract Award 10/6 If awarded, attendance for 1 day Orientation/ Planning TBD in October or Meeting at UCLA with senior staff and cost team early November faculty Leads. If awarded, attendance for 2 day meetings in Oakland, Nov 12-13th. CA with Staff, faculty, and National Advisory Council.

The University does not guarantee the above schedule and reserves the right to modify this schedule to best meet its needs.

9. BIDDER INSTRUCTIONS

9.1 Notice of Intent to Respond 7 Any prospective Bidder intending to submit a proposal should submit a completed Notice of Intent to Respond by the date indicated on the RFP schedule above. The notice should state who the Bidder's principal representative will be throughout the remainder of the RFP process and provide full contact information (office address, phone, fax, and e-mail address). (Please find the Notice of Intent to Respond form in list of related documents posted on the RFP website. Forms must be submitted to Karen Rhee, UCOP Strategic Sourcing via email: [email protected] 9.2 Bidders’ Questions An opportunity to submit questions (all interested vendors will receive responses) will be allowed up to 8/21. 9.3 Bid Acceptance The bid must be complete, submitted on the forms provided or in the format indicated, and comply with all specifications and legal requirements set in this Request for Proposal.

The University reserves the right to reject any submittals which are:

 Incomplete or non-responsive  Generally unprofessional  Late (LATE BIDS ARE IMMEDIATELY REJECTED)

If at any time it is found that a person, firm or corporation in their response to this RFP, or to which a Agreement has been awarded, has colluded with any other party or parties, the University reserves the right to reject the proposal(s) and/or terminate any Agreement(s) so awarded and all parties involved in the collusion shall be liable to the University for all loss or damage which the University may have suffered. 9.4 Correspondence/Notifications All correspondence regarding this RFP must be written, not verbal, and delivered either by email to Karen Rhee.

All companies or affiliated groups of companies will be asked to submit the name and contact information for one (1) single-point-of-contact for all correspondence regarding this RFP. From that point until the award is announced, all RFP correspondence must occur only between that single point of contact from that company or affiliated group of bidding companies and the UC RFP Administrator, whose complete contact information appears on the cover sheet of this document. This single-point-of-contact approach will be strictly enforced and monitored to ensure equal and fair distribution of relevant information and RFP updates to all prospective bidders.

9.5 Modifications of the RFP Modifications and clarifications to the RFP document may be made by the University. Any modification will be done either as an amendment to the original document or as a “Q & A” clarification and sent by email to each prospective bidder’s single point of contact. Questions submitted by any one bidder will be supplied as an anonymously-submitted “Q&A” to all bidders. The University may extend the due date for all participants in light of significant revision(s) or amendment(s). The University reserves the right to withdraw or cancel the RFP at any time and to subsequently re-issue the RFP in the same or modified format. 9.6 Withdrawals or Modifications of Bids Once submitted, bid documents may not be modified. Bids may be withdrawn. To do so, submit a written request to that effect on company letterhead and signed by an authorized representative of your company to the RFP administrator (see above). 9.7 Submittal Costs The University of California is not liable for any costs incurred by prospective respondents. Respondent is responsible for all costs associated with information, proposals, evaluations, materials, visitations, and demonstrations and personnel furnished to comply with this bid requestor any subsequent request before issuance of an Agreement. 8 9.8 Disclosure of Records/Confidentiality of Information Bid response(s) which are incorporated into any resulting contract(s) with the University of California may be subject to the State of California Public Records Act (CA State Government Code 6250, et. seq.). This Request for Proposal, together with copies of all documents pertaining to any award, if issued, shall be kept for a period of five years from date of contract expiration or termination and made part of a file or record which shall be open to public inspection. Certain private, trade secret or confidential information may be considered exempt from the California Public Records Act. Any trade secret or company confidential information submitted as a part of this bid should be clearly marked “Trade Secret Information” or “Confidential Information.” Should a request be made of the University of California for access to the information designated confidential or trade secret by the bidder and, on the basis of that designation, UC denies the request, the bidder may be responsible for all legal costs necessary to defend such action if the denial is challenged in a court of law. 9.9 Bidder Classification and Certification In order to provide fair, open and efficient opportunities for all companies interested in doing business with the University of California, we ask all potential vendors to pre-qualify for any bidding or supplier activity. We can use the information provided to track supplier activity, to measure progress against goals for small business outreach efforts, to shorten the administrative timeline toward a mutually beneficial agreement, and to monitor compliance with required state and federal codes. Section D “Bidder Response to Request for Proposal” outlines several forms, included as attachments to this RFP, which are required along with a full and complete response to all questions, in order to be considered as a bidder for this scope of work. 9.10 Proposal Acceptance Period Offers submitted for all items specified herein shall remain valid for at least one hundred and sixty (160) days from the RFP bid submission (due) date. 9.11 University of California Estimates of Usage The University of California uses best efforts to provide a reliable estimate of usage. This estimate is provided in good faith to assist Bidders in developing a fair and competitive bid offering, but should in no way be construed as a guarantee of business or of actual usage in future years. The actual usage in future years could be higher or lower and may differ from the estimates provided in this RFP.

9.12 Alternative Proposals The University of California will weigh all factors noted in this RFP to determine the best course of action in awarding this part of the University’s business. If a Bidder sees an opportunity to propose a different, more efficient way to structure pricing and/or services covered in the scope of this RFP, while still meeting all stated requirements, we ask that the Bidder provide this as an “Alternative Proposal.” The University of California is committed to reviewing all proposals that meet stated requirements and which may also offer unanticipated benefits. Only those Bidders that respond to the entire RFP as written also qualify to bid an “alternative proposal” (Bidders may not only bid an “Alternative Proposal”).

10. Initial Contract Term and Extensions

It is anticipated that the initial term of any agreement resulting from this RFP will be for a period of One (1) year. The University of California may, at its option, extend or renew the agreement for an additional three (3) one-year periods under the same terms and conditions. The contracts will include provisions for either party to amend or cancel the contract by serving 90 days’ written notice upon the other party.

10.1 University of California Office of the Presidents Professional Services Agreement Template (“Appendix A”) The UCOP Professional Service Agreement template will be the governing contract terms and conditions and attached to this RFP as Appendix A.

9 10.2 University of California Terms and Conditions of Service (“Appendix B”) The University of California standard Terms and Conditions of Service (“Appendix A”), attached, will be incorporated into any contract that may result from this RFP and be referred to as Attachment A.

11. Pricing  Price Protection - The prices quoted in your proposal response shall be firm for at least the first twelve (12) months of any resulting contract. Longer time periods for price protection may be submitted as the original or as an alternative proposal to provide additional cost savings opportunities to the University in exchange for a long term agreement.  Price Quotes Per Project – Bidders should propose methods for how they will provide CHBRP estimates on a per-project basis before a specific project begins. For example, before beginning each legislative bill analysis for CHBRP, the contractor should propose a price estimate for the work they will perform depending on the complexity and scope of the analysis. See attached excel spreadsheet.

1. Minimal Effort: The bidder should provide a range of price estimates for work to provide a “minimal effort” analysis. This may apply to a legislative bill that is deemed to have negligible or no cost impacts on premiums. This may require, for example: i. Participating in 2-4 conference calls with faculty team and CHBRP lead analyst averaging 45 minutes each. ii. Conducting a review of a survey on coverage sent to the major health insurance carriers in California. iii. Monitoring and responding to about a dozen emails. iv. Conducting a review of the draft report.

2. Low Effort: The bidder should provide a range of price estimates for work to provide a “low effort” analysis. This may apply to a legislative bill that CHBRP has previously analyzed. This may require, for example: i. Participating in 5-8 conference calls with faculty team and CHBRP lead analyst averaging 45 minutes each, ii. Monitoring and responding to 18 substantive emails. iii. Conducting a review of a survey on coverage sent to the major health insurance carriers in California iv. Updating a cost impact model based on refined, data-driven assumptions and updated coverage, unit cost and utilization data v. Conducting a review of the draft report.

3. Medium Effort: The bidder should provide a range of price estimates for work to provide a “medium effort” analysis. This may apply to a legislative bill that is considered to have an average level of complexity, with straightforward analytic questions. This may require, for example: i. Participating in 5-9 conference calls with faculty team and CHBRP lead analyst averaging 45 minutes each. ii. Monitoring and responding to two dozen to three dozen substantive emails. iii. Conducting a review of a survey on coverage sent to the major health insurance carriers in California iv. Conducting analysis of utilization of health care services affected by the legislative bill v. Developing a cost impact model based on data-driven assumptions coverage, unit cost and utilization data vi. Conducting 1-2 reviews of the report at different drafting points.

4. High Effort: The bidder should provide a range of price estimates for work to provide a “high effort” analysis. This may apply to a legislative bill that is considered to have a higher level of complexity, with more complex analytic questions, and a wider scope of affected health care services. This may require, for example: 10 a.i. Participating in 6-12 conference calls with faculty team and CHBRP lead analyst averaging 45 minutes each, a.ii. Monitoring and responding to three dozen substantive emails. a.iii. Conducting a review of a survey on coverage sent to the major health insurance carriers in California a.iv. Conducting analysis of utilization of health care services affected by the legislative bill a.v. Developing a cost impact model based on data-driven assumptions coverage, unit cost and utilization data a.vi. Conducting 2-3 reviews of the report at different drafting points.

 Pricing Assumptions

It is preferred that bidders propose fees on a “per analysis & per analysis complexity” basis rather than hourly rate. However, so that we may understand the underlying assumptions on which your rate is based, please include in your proposal any assumptions regarding the anticipated hours per analysis broken down by anticipated tasks and hourly rate and position title. UC expects to enter into a long term alliance with successful bidder. Please provide your company’s pricing based on the length of the contract terms (1 year, 2 years, and 3 years) as indicated in the pricing sheet attached to this RFP.

 Additional Earned Incentives and Discounts - Bidders should consider additional discounts which may reflect what is gained by utilizing efficient business operations, such as: 1. The University of California considers 30-day payment periods normal. Electronic Fund Transfers (EFT) for invoice payment 2. Volume Incentives (additional %-off or net-dollars-off discounts) based upon reaching specific, mutually agreed upon dollar volume usage levels. 3. Specify any other incentives that may be earned by the University of California such as a sign-on bonus. Please include in your company’s proposal how the Earned Incentives are paid along with frequency of payment. Provide sample or describe how Earned Incentive dollars are tracked and reported.

12. No Mandatory Use Bidder is advised that there is no mandatory use policy at the University of California for agreements. A winning bidder may still see some competition at any given UC location for any given service. However, by providing outstanding prices and service and the overall best total cost and quality to the University system wide, the winning bidder is expected to garner a very large percentage of the total available UC business.

13. Audit Requirements Any agreement resulting from this Request for Proposal shall be subject to examination and audit by the University of California, the State of California, or the University’s duly authorized third-party auditor for a period of three (3) years after final payment. The examination and audit shall be confined to those matters connected with the performance of the agreement, including but not limited to, the costs of administering the agreement.

14. Marketing References The successful bidder shall be prohibited from making any reference to the University of California, in any literature, promotional material, brochures, or sales presentations without the express written consent of the University of California Office of the President, Strategic Sourcing Department.

15. EVALUATION PROCESS

11 15.1 Bid Evaluation Methodology Bids will first be screened as to whether minimum qualifications are met. To be evaluated, the bid must be submitted on time, complete, and responsive to all questions or requests for information. All minimally-qualified bids will then be evaluated and scored on a standard University of California “cost per quality point” basis. The “cost per quality points” method begins with the assessment of “quality points,” a weighted sum of points given out of total points possible for each question/criterion. Weightings are assigned by the team before bids are received, and are specifically designed to recognize that some criteria are of greater relative importance than other criteria (for example, a response to how many ways a bidder may provide certain electronic payment solutions may be pre-assigned a lower relative weighting than the question regarding the specifications of the ergonomics evaluation and the reports generated). Each participant on the evaluation team gives one (1) “grade” (or assessment of total quality points) per bid response. At the conclusion of “Phase I,” bid prices are distributed to the team, including all elements (such as, per-item or per-occurrence charges, and other miscellaneous charges or discounts) that comprise the “total cost” of the bid as quoted. The total quoted cost will then be divided by the total quality points. A small group of finalists are then selected from the top scores and those companies are asked to participate in “Phase II” evaluations. “ Phase II” evaluations continue the grading and assessment process, but at an in-depth level. Usually Phase II will involve a face-to-face presentation, an open question-and-answer session and significant examination of company financial health, customer references, site visits and other criteria as specified in this RFP.5 The proposal which is assessed the lowest cost per quality points will be tendered a contract. Should that bidder refuse or decline to accept the contract, the award may be made successively to the bidder with the second lowest cost per quality point, or then to the third in the event of further declination. The University of California may waive irregularities in a proposal provided that, in the judgment of the University of California, such action will not negate fair competition and will permit proper comparative evaluation of bids submitted. The University of California's waiver of an immaterial deviation or defect shall in no way modify the Request for Proposal documents or excuse the Bidder from full compliance with the Request for Proposal specifications in the event the contract is awarded to that Bidder. In performing its review of the bid submittals, the University of California reserves the right to obtain and use in its evaluation any independently derived information, including but not limited to financial reports and secondary customer references.

16. EVALUATION CRITERIA

16.1 Phase I: Selection of Finalists The goal of “Phase I” is to select a small group of finalists. Bids are reviewed and “graded” by a team representing the University without regard to, or access to, bid pricing. The RFP Administrator holds all pricing until the team scores responses to all other requirements (“quality points”). The University will evaluate and score all responsive bids using the following factors, which will comprise the “quality points”:  General Capabilities

1. Company organization and strategic direction 2. Account management and program administration 3. Expertise of personnel and training requirements for employees 4. Implementation plan 5. Access to relevant and up-to-date health care pricing tools 6. Company financial health

5 Finalist presentations may take place at either University of California, Los Angeles or at UC OP Offices in Oakland, CA. 12  Service Quality and Commitments

1. Ability to provide service standards to meet UC requirements 2. Quality management and continuous improvement processes 3. Innovative approaches to securing data and market trends 4. Depth and Range of services provided

 Technical Qualifications and Information Management

1. Alignment of bidder's services with UC requirements 2. Ability to provide response and other special services as required 3. Ability to provide e-commerce solutions for billing and purchase orders 4. Ability to provide types and frequencies of reports to meet UC requirements

The University of California will then assess the total cost of the bid, including in the calculations:  TOTAL PRICE AS QUOTED ON BID PRICING MATRIX (see Price Quotes Per Project for bid pricing matrix).  Any additional costs, fees, charges, etc. as quoted for items within the scope of the bid  Additional discounts for items/services within the scope of the bid. 16.2 Phase II: Finalist Presentations, Reference Checks, and Selection Only the top finalists in scoring will move into Phase II. The University of California anticipates that three (3) bidding companies will be selected as finalists, but may consider fewer or more bidders as finalists, depending on the quality of bid responses and the overall number of responsive bids. In Phase II, the Bidder is requested to give an oral presentation concerning the Bidder’s services and ability to service the Agreement. Key Executive and Account personnel are expected to be physically in the room for the Finalist Presentation. The evaluation team will submit a guideline for Finalist Presentations when the Finalists are notified. Bidders should be prepared to deliver:  An overview presentation  A demonstration of a project similar to the work scope identified in this RFP.  A personal introduction to the key members of the prospective account management team Bidder experience is an important criterion in the selection process. Bidder shall provide a reference list of a minimum of three (3) customers who have used the same or similar health actuarial services as specified in this RFP. Such services must have been provided for a period of not less than one (1) year within the previous three (3) years. In addition, please provide (2) former client contracted references who are no longer doing business with your company. For those Bidders who have provided service to the University of California in the previous two (2) years, UC may decide to use internal data to evaluate Bidder performance in addition to the reference criteria. Providing or submitting incorrect or incomplete reference information may lead to Bidder's elimination from consideration for the Agreement. The decision to eliminate Bidder from consideration for the Agreement for poor reference checks, or for incorrect and/or incomplete reference information shall be at the sole discretion of the University of California and shall not be subject to appeal. The proposal offering the lowest cost per quality point will be recommended to receive a contract governing award of business. Any contract awarded pursuant to this RFP will incorporate the requirements and specifications contained in the RFP, as well as the contents of the bidder’s proposal as accepted by the University and will be in writing. Should the Bidder with the proposal offering lowest cost per quality point for any option refuse or fail to accept the tendered purchase contract, the award may be made successively to the bidder with the second lowest cost per quality point, or then to the third in the event of further failure to accept.

The University of California reserves the right to accept or reject any or all bids, make more than one award, 13 or no award, as the best interests of the University of California may appear. Any contract awarded pursuant to this RFP will incorporate the requirements and specifications contained in the RFP, as well the contents of the bidder’s proposal as accepted by the UC and will be in writing.

17. BIDDER CHECKLIST FOR RESPONSE

This section is provided in the interest of making it easier to submit a complete bid package. Please review all items (as noted below), in your bid packages prior to submission of your bid. On or before RFP Due Date (see time line above), please provide the following:  Original RFP – Two hardcopies and the other on a USB drive (See below for mailing instruction)  Include all files and attachments  Include all pricing, exactly matching the hard copy submission

Send as follows: Two original hardcopy and two USB drive (Word or PDF format, including pricing) to the RFP Administrator: Karen Rhee Commodity Manager, Strategic Sourcing Centers of Excellence University of California Office of the President 1111 Franklin Street, 10th Floor Oakland, CA 94607 510-587-6445 | [email protected]

File & email Naming Convention: All files, attachments, and the e-mail subject line need to start with your company name. For example – ABC Actuarial Firm RFP Response.doc XYZ Consulting Pricing Schedulce.xls

18. BID RESPONSE TO REQUEST FOR PROPOSAL

18.1 Instructions for General, Service and Technical Capabilities Questions  Answers should be provided in space that you create, immediately following the questions, in a document that begins with the Bid Cover Sheet.  Answers should be as brief as they can be, while also being full and complete.  Attachments may be necessary for some questions to further clarify or illustrate a response. In those cases, please use some widely accepted method (such as labeled divider tabs or page numbers) to make it easy for the evaluators to find the referenced attachment.  Hard Copy bid response documents, both the Original and the requested copies, must be submitted in binders and organized exactly as in this document. Please include a Table of Contents.

18.2 Bid Cover Sheet/Respondent Identification and Classification Provide a cover sheet for your response, which contains:

 The following text: Response to University of California REQUEST FOR PROPOSAL - CHBRP Actuarial Services RFP 2015.  Company name and address for primary U.S. location or headquarters;  Company contact’s name and title  Contact’s telephone number, fax number and email address (and mailing address if different from above) 14  Signature of a representative of your company who is duly authorized to enter into bids for contracts NOTE: Only the Original bid response, submitted to the RFP Administrator, should contain the original signature of your company’s representative. All additional copies should have copies of the Original bid response cover page.

18.3 General Capabilities Questions 1. Provide a copy of your company’s organization chart and describe your company’s business model (breadth and depth of services offered, even if outside the scope of this RFP).

ANSWER:

2. How long has your company been in business? Have your service offerings changed in the last 5 (five) years? If so, how? Does your organization have a Public Sector Practice, or area of concentration? If so, please describe.

ANSWER:

3. If awarded the business, how would the University account be managed from a workflow, quality management, and overall satisfaction perspective?

ANSWER:

4. Where is your company headquartered (actual street address)? If different, where is the regional office from which the University account would be managed? How many offices does your company have in California? Which offices (in-State and out-of-State) would be involved with the University?

ANSWER:

5. How often is customer feedback solicited on a formal and informal basis?

ANSWER:

6. Please list all of your employees who would service the University account (functional titles are OK, rather than names, i.e., “local sales representative” or “driver – San Diego”) and what % of their time would be dedicated to the University account. In addition, please provide resumes for each of the proposed employees and/or subcontractors.

ANSWER:

7. Describe your proposed Implementation Plan. How would you approach getting up to speed with CHBRP’s work, and transitioning into this role?

ANSWER:

8. Please describe the health actuarial pricing tools used by your firm/company?

ANSWER:

9. Please describe your outpatient prescription drug cost and/or any modeling resources used by your firm/company?

ANSWER:

10. Please describe the economic forecasting/ analytic tools used by your firm/company or subcontracting partner for the “other health insurance topics” CHBRP may be requested to analyze?

15 ANSWER:

11. Invoices are expected to be timely and accurate when submitted to the University, and must indicate at a minimum:

a. Sales tax as a separate line item b. Purchase Order (P.O.) Number or release number and the agreement number c. Any applicable discount d. Reference to original order and invoice number for all credit invoices issued

Please confirm your ability to meet the above minimum invoicing requirements.

ANSWER:

12. Describe your company’s invoicing payment terms and conditions, including capabilities (or limitations) for the following options:

a. Manual Process, individual invoices issued and remitted to UC OP’s Accounts Payable Office b. Monthly summary billing

ANSWER:

18.4 Summary Of Bidder’s Proposed Personnel/Management Approach The bidder must present a detailed description of its proposed approach to the management of the project. The bidder must identify the specific professionals who will work on UC OP’s project if their company is awarded the contract resulting from this RFP. The names and titles of the team proposed for assignment to the UC OP project shall be identified in full, with a description of the team leadership, interface and support functions, and reporting relationships. Describe any public sector experience of team members, and any experience analyzing legislation. The primary work assigned to each person should also be identified. 18.5 Subcontractors If the bidder intends to subcontract any part of its performance hereunder, the bidder must provide:  Name, address and telephone number of the subcontractor(s);  Specific tasks for each subcontractor;  Percentage of performance hours intended for each subcontract; and  Total percentage of subcontractor(s) performance hours.

18.6 Technical Approach The bidder’s technical approach must consist of the following subsections.  Understanding of the Project Requirements;  Proposed Development Approach;  Technical Considerations;  Detailed Project Work Plan; and  Deliverables and Due Dates.

16 ATTACHMENT #1

Proposer Inquiry Form

CHBRP Actuarial Services RFP 2015

Bidders should use this form to submit questions regarding the RFP. University will provide a complete list of questions received along with the University’s responses to all bidders who participate. Questions will be listed without reference to the source.

Name of Company: ______

Company Representative: ______

Question(s)

Note: Reproduce this form as necessary. email this form to: [email protected] by 8/21/15

17 ATTACHMENT #2

Cost Sheet for Actuarial Work

All respondents are required to complete this attachment. Please provide pricing for your hourly rate.

The guaranteed hourly rate:

Hourly Rates: Consulting Principal Actuary $______Consulting Principal Actuary $______Associates & Managers $______Actuarial Staff $______Support Staff $______

It is expressly agreed and understood that, prior to the performance of any services, UC and the Consulting Actuary may, in alternative to the hourly rates described above, determine a mutually agree upon fee for the services provided.

______Date Printed Name/Title

ATTACHMENT #3

Cost Sheet for Analytic Work

All respondents are required to complete this attachment. Please provide pricing for your hourly rate.

The guaranteed hourly rate:

Hourly Rates: Consulting Principal $______Associates & Managers $______Analytic Staff $______Support Staff $______

It is expressly agreed and understood that, prior to the performance of any services, UC and the Consulting Actuary and Analytic Consultants may, in alternative to the hourly rates described above, determine a mutually agree upon fee for the services provided.

______Date Printed Name/Title