H&W RFP: Scope of Services
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PG&E
December 20, 2013
H&W RFP: Scope of Services
Copyright © 2013, herronpalmer, LLC
No part of this document may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval devices or systems, without prior written permission from herronpalmer, LLC. This document contains PG&E confidential information and such confidential information may not be used, reproduced, or disclosed outside of PG&E without prior written authorization by PG&E.
Table of Contents
Scope of Services Instructions
Overview: This document describes the various responsibilities and owners of these tasks. The Service Providers are required to review these responsibilities and owners assigned to these responsibilities. Sections included in the Scope of Services tables below:
Proprietary and Confidential | herronpalmer Owner: The responsibilities for each section have been abbreviated in the "Owner" Column. If you have updates to the assigned owners, please make changes by selecting the item from the drop-down list. Please highlight your proposed change:
"C" = Internal PG&E responsibilities
"SP" = Outsourcing Service Provider responsibilities
"T" = Third Party (not PG&E or Service Provider)
Responsibilities: If you have changes to the Responsibilities, please make the proposed changes in the Comments column.
Included in Scope of Services: Please indicate whether the specific function is included in your service offering to PG&E and is a function/capability:
“I” = currently in place with other clients today
“X” = included, but not in place for other clients today; or
“U” = the function is not available or on your product development road map
Cost: Indicate if there is an additional cost (costs that are not included in the fee quote) to provide the function. Note: We assume that any item marked as ‘I’ with no additional fee will be in your service offering. Stating that more information is required to provide a fee quote is not an acceptable response. You should gather any additional required information during the RFP question/answer process.
Third-Party Supplier: Indicate the supplier of this function if not performed internally. Wholly-owned subsidiaries should not be considered third-parties.
Comments: Please provide any additional information or clarifications. Please do not change the format of this document.
I. Services for Health and Welfare Plans
Owner Include Responsibilities Cost Third Party Item C SP T I X U 1 1. Plans and Populations
2 C Plan design
3 C Plan fiduciary (e.g., final appeals, compliance)
4 C Vendor management
Eligibility, enrollment, life-event changes, 5 SP reporting and participant support for the following plans:
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 6 . Medical Plan – Network Access Plan (NAP) SP
7 . Medical Plan – Comprehensive Access Plan SP (CAP) 8 SP . Medical Plan – Health Account Plan (HAP)
9 SP . Medical Plan – HMO’s
10 . Medical Plan – Exclusive Provider SP Organization (EPO) 11 SP . Medical Plan – Medicare Advantage
12 SP . Medicare Supplemental Plan (MSP)
13 SP . Retiree Optional Plan (ROP)
14 SP . Vision Choice Plan
15 SP . Dental – w/Implants
16 SP . FSA Healthcare
17 SP . FSA Dependent care
18 SP . HRA
19 SP . Basic and Supplemental Life Insurance
20 SP . Spouse/Domestic Partner Life
21 SP . Life (Children)
22 SP . Retiree Life
23 SP . Basic and supplemental AD&D
24 SP . Executive and Board of Director AD&D
25 SP . LTD – 66-2/3% of Pay
26 SP . Business Travel Insurance (BTI)
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 27 SP . Employee Assistance Program (EAP)
28 SP . STD – 66-2/3% of Pay
29 SP . Work Life Benefits
30 SP . Vacation Buy Plan
31 SP . Commuter transit program
32 SP . Health Club reimbursement accounts
Services are applicable to the following employee populations: actives, part time, inactives, 33 SP probationary, retirees, severance disabled, on strike, dependents, survivors, and domestic partners, as applicable given plan rules 34 Support dependent eligibility requirements by SP state 35 SP Administration of COBRA plans
36 Administration of spending accounts (FSA and SP HRA) 37 SP Administration of Direct Billing
38 T Claims adjudication and payment
39 2. Core Participant Events/Activities
40 C Send employee data via HR/payroll feed
41 Provide updates to plan and eligibility rules on an C annual basis 42 SP Load employee data
Identify and process all required participant events 43 in accordance with plan documents and applicable SP legislation. This includes, but is not limited to the following events: 44 SP . New hire
45 SP . Rehire (reinstate benefits)
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 46 . Family status change (gain/lose SP dependent) 47 SP . Dependent eligibility/employment changes
48 SP . Job status change
49 SP . Change of residence
50 SP . Leave of absence
51 SP . Termination
52 SP . Transfers
53 SP . Disability
54 SP . Death
55 SP . Retirement
56 SP . Medicare eligible
Determine all eligibility, including: . Eligibility for split family coverage. 57 . SP Eligibility for married spouses, domestic partners and same sex partners both working at PG&E . Rehired retirees (non-contractors) 58 Address and support administration of state tax SP laws associated with domestic partners Determine benefit plan option availability and 59 SP calculate prices and/or credits (including part time employees) 60 SP Produce and distribute enrollment kits
61 Provide information to pre-retirees on their retiree SP medical options and process for enrollment Process time-based events including turning age 62 SP T 65, dependent aging out and age band changes, based on plan rules 63 Accept dependent information online or via Service SP Center
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U Provide PG&E a file with dependent information 64 sufficient to conduct a dependent audit twice per SP year; service provider updates records based on audit results 65 Accept and retain beneficiary designation online SP T and in paper form 66 Support use of paper affidavits as accepted SP certification for domestic partner status Collect required supporting documentation, if 67 SP required (e.g., student identification, marriage license, birth certificates) 68 Accept and process participant and dependent SP enrollment elections 69 Assign default coverage to participants who do not SP enroll by enrollment deadline 70 SP Produce and distribute confirmation statements
Produce and mail HIPAA Certificates of Group 71 SP Health Coverage, as necessary for participants, spouses, or dependents losing coverage 72 Send eligibility/premium data to third parties, as SP necessary 73 Accept data from Service Provider via periodic T carrier interface file 74 Recognize progression of transactions/data sent SP with similar effective dates Recognize employee data effective dates for 75 SP multiple transactions sent on same feed (start and end dates vs effective dates only) 76 Send enrollment reminders to new hires not SP making H&W benefit elections 77 Provide full retirement counseling services, SP including integration with other service providers 78 Provide full survivor support counseling services, SP including integration with other service providers 79 SP Maintain and administer special agreements
80 3. H&W Deduction Processing
81 Transmit payroll instructions to active payrolls SP including arrears processing) 82 Transmit payroll instructions to retiree payrolls SP (including arrears processing) Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 83 Apply H&W deductions for active employees to C payroll 84 Accept retiree payroll instructions via periodic C T payroll instructions file Reconcile payroll instructions vs. results and 85 SP calculate and transmit retroactive or adjustment deduction amounts 86 C Reconcile active payroll deductions
87 C T Reconcile retiree payroll deductions
88 4. Eligibility and Premium Reporting
89 SP Transmit eligibility to carriers weekly
90 Advocate for participant and own resolution of SP participant eligibility and claim issues 91 Process and confirm emergency enrollments, if SP necessary, with carriers 92 Accept data from Service Provider via periodic T carrier interface file 93 Produce monthly premium reports for health plans SP in standard format and send to client 94 C Pay carriers per Service Provider’s instruction
95 Pay carriers directly (optional service per provider SP reporting if required by PG&E) 96 Reconcile monthly premium reports with carriers SP via feedback file 97 Reconcile monthly premium reports with Service T Provider 98 Conduct a full file review and audit of eligibility SP each quarter with carriers 99 5. COBRA-Rights Notification
10 Identify COBRA-eligible participants due to 0 SP employment or family status changes
10 Provide initial COBRA-rights notification to 1 SP participant, covered spouse and dependents
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 10 2 6. COBRA Administration
10 Calculate COBRA rates based on client-provided 3 C plan costs
10 Send COBRA coverage continuation notices to 4 SP qualified beneficiaries who experience a qualifying event and to participant and family 10 Process and maintain COBRA elections for each 5 SP qualified beneficiary; monitor enrollment window
10 6 SP Process COBRA annual enrollment
10 7 SP Create and distribute enrollment material
10 8 SP Process COBRA coverage changes
10 Track COBRA coverage periods (including multiple 9 SP qualifying events)
11 0 SP Process COBRA coverage terminations
11 1 SP Notify carriers of enrollment changes
11 Perform COBRA direct billing, payment collections 2 SP and refunds
11 Provide notice of unavailability of continuation 3 SP coverage
11 Provide notice of early termination of continuation 4 SP coverage
11 Receive feed file from Provant for incentives to set 5 SP up seed HRA account
11 6 SP Send eligibility file to Provant
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 11 7 T Perform COBRA claims processing (carriers)
11 7. Qualified Medical Child Support Order 8 (QMCSO)
11 Design model language for qualification 9 C determination and provide to Service Provider
12 Respond to requests for Agency-requested benefits 0 SP information
12 1 SP Qualification of new orders
12 Generate required COBRA notifications to 2 SP alternative recipient and custodial parents
Set-up and maintenance of coverage for 12 dependents entitled to benefits under a QMCSO 3 SP including support of enrollment changes and notification to carriers and other parties, as necessary Communicate enrollment and plan information to 12 Custodial Parent or Designated Representative 4 SP through child welfare agency; maintain address of custodial parent 12 Conduct final review of qualifications outside 5 C model language
12 6 T Claims adjudication and payment
12 7 8. Appeals
12 Upon participant request, describe the appeals 8 SP process and secure appropriate HIPPA release forms (if applicable) 12 Acknowledge receipt of initial written appeals and 9 SP respond to initial written appeals if required
13 As needed, provide PG&E with background 0 SP information and documentation for final decisions within one business day of receipt of final appeal Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 13 1 C Respond to final appeals
13 2 T Respond to all claims appeals
13 Responsible for final decisions for all claims 3 T appeals
13 4 9. Imputed Income
Apply imputed income rules and calculate imputed 13 income for employee/retiree life insurance, 5 SP spouse/child insurance and domestic partner coverage 13 Send imputed income amounts to PG&E for active 6 SP employees
13 Send imputed income amounts to pension payroll 7 SP provider (PG&E) for retirees in payment status
13 Process imputed income on year-end tax 8 C statements
13 10. Flexible Spending Account (FSA) and Health 9 Reimbursement Account (HRA) Administration 14 Accept elections from participants in annual 0 SP amounts and convey to PG&E the deduction amounts per pay period 14 Accept and track contribution balance files from 1 SP PG&E payroll
14 Convert annual election to pay period deduction 2 SP amount
14 3 SP Provide participants with FSA debit cards
14 4 C Apply FSA deductions to payroll
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 14 5 C Deposit contribution in FSA trust
14 Execute quarterly data reconciliation of expected 6 SP to actual employee deductions
14 Complete annual full file reconciliation of elected 7 SP employee deductions per FSA provider and PG&E data base 14 Accept FSA claims (via FSA debit card, online 8 SP submission, or paper form submission) for reimbursement to employees 14 9 SP Process, adjudicate and pay FSA claims daily
15 0 SP Provide annual participant statements
15 1 SP Provide monthly reports to PG&E
15 2 C Reconcile FSA records to trust
15 3 SP Reconcile checks processed to claims
15 Provide annual forfeitures, imputed income and 4 SP reconciliation reports to PG&E
15 5 C Coordinate forfeiture process
15 Provide FSA provider (Kaiser) with seeder file of 6 SP new participant elections post AE
15 Receive a seeder file for the HRA eligible 7 SP participants
15 Provide PG&E reporting related to HRA claims 8 SP processed
15 Convert HRA account from active to retiree 9 SP account upon retirement or moving to LTD
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 16 Reconcile HRA claims processed with PG&E 0 SP funding
16 Process account transfers during mid year and 1 SP Annual Enrollment for HRA accounts
16 11. Primary Care Provider (PCP) Collection – 2 Currently not applicable to PG&E (for future reference only) 16 Identify which plans require a PCP and provide 3 C plan network information
16 Notify the participant during the initial election 4 SP process if PCP designation is required for the plan
16 Collect PCP information online or via Service 5 SP Center
16 Transmit PCP enrollments from participants to 6 SP carriers (upon initial enrollments)
16 Pass plan network and PCP information received 7 SP from client to the provider directory vendor
12. Retiree Medical Savings Account (RMSA), 16 Retiree Medical Employer Contribution 8 (RMEC) Administration, Retiree Premium Offset Account (RPOA) 16 Determine initial eligibility at retirement and 9 T calculate initial RMSA balance for retiree and spouse 17 Manage list of employees (14) with election choice 0 C between RMSA and RMEC (PG&E married couples) including modeling and counseling 17 Send RMSA eligibility file to DB provider based on 1 SP an agreed upon frequency
17 Identify when participant RMSA fully depleted and 2 SP send file to DB provider with notification
17 Maintain separate account balances for participant, 3 SP spouse or eligible surviving dependents
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 17 Receive input or file from PG&E or 3rd party 4 SP provider with initial RMSA balance for retiree and spouse Calculate and maintain monthly RMSA balance in 17 accordance with documented requirements 5 SP attached in appendix including retroactive adjustments as required 17 Update RMSA balance monthly to reflect draw 6 SP down and annual interest update
17 Adjust retiree medical premiums based on 7 SP available draw down – provide breakdown of RMSA 17 Apply transactional activity and retroactive 8 SP adjustments to create correct medical expense and provide updates to pension payroll provider 17 Differentiate between pre-Medicare and post- 9 SP Medicare draw down
18 Provide participant access to RMSA balance via 0 SP Web
18 Provide itemized RMSA balance on Web with 1 SP breakdown of beginning balance, draw down, interest and ending balance 18 Provide 3rd party vendor with updated retiree and 2 SP spouse balance at year end
18 Remove RMSA from surviving spouse after 3 SP Medicare
18 Provide RMSA account balance on enrollment 4 SP worksheet with standard Annual & mid-year Enrollment material 18 Provide RMSA adjusted premium amount on 5 SP enrollment worksheet with standard Annual & mid-year enrollment material 18 Build RMEC calculator and calculate RMEC offset to 6 SP monthly premium
18 Maintain RPOA 50% and/or 25% account balance 7 SP
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 18 Apply RPOA offset to Retiree Medical premium for 8 SP grandfathered group
18 Transfer RPOA benefit to survivor upon death of 9 SP Retiree
19 Manage Retirees turning on and off RPOA election 0 SP
19 1 13. Inactive Billing and Collections
19 Initiate monthly billing process for “direct-bill” 2 SP participants (including employees in arrears)
19 Process accounts receivable 3 SP
19 Maintain individual participant accounts 4 SP
19 Terminate coverage due to non-payment of 5 SP premiums after grace period
19 Generate off-cycle invoices for new/changed 6 SP deductions that occur after the monthly process is completed 19 Accommodate ACH payment at participant request 7 SP
19 Process refunds on a monthly basis 8 SP
19 Provide answers to inquiries regarding invoice 9 SP mailings, payment receipt and termination for non- payment via Web and through Service Center 20 Provide summary and detailed transaction reports 0 SP monthly to PG&E
20 1 14. Medicare Part D Eligibility (All Strategies)
20 Provide disclosure notice of creditable/non- 2 SP creditable coverage, including creditable coverage history for: Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 20 3 SP . Initial enrollment in Medicare Part D
20 4 SP . Ongoing enrollment in employer plan
20 5 SP . Annual enrollment for Medicare Part D
20 6 SP . Upon request
20 Track Medicare-eligible participants and provide 7 SP counts to PG&E annually
20 Submit creditable status of prescription drug 8 C plan(s) to Centers for Medicare and Medicaid Services (CMS) annually via website 20 9 SP Provide annual enrollment support each fall
21 Participant counts provided annually to PG&E 0 SP within first 60 days of plan year
21 15. Medicare and Medicare Part D Subsidy 1 Support
21 Verify participants eligible for Medicare and 2 C SP Medicare Part D subsidy and provide to Service Provider 21 Administer Pre ’94 Retiree credit with Medicare 3 SP ($40 credit for participant and spouse)
21 Under Age 65 PG&E Medicare Part B credit offsets 4 SP to Retiree Medical Premiums
21 Age 65 and over 65 PG&E Medicare Part B credit 5 SP offsets to Retiree Medical Premiums ($15/$30 per ppt based on plan) 21 6 SP Coordination of Medicare plans end status
21 7 SP Administer Medicare data match questionnaire
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 21 Track and report ESRD Medicare eligibility for 8 SP active employees
21 Track Medicare Part D enrollment for participants 9 SP and dependents
22 0 SP Provide census data extract for initial census
22 Adjust participant coverage if Medicare Part D 1 SP enrollment
22 Notify participants of impact of Medicare Part D 2 SP enrollment
22 Provide monthly changes-only eligibility reporting 3 SP to CMS
22 Reconcile eligibility data with CMS based on 4 SP response codes received
22 Provide electronic reporting of subsidy periods 5 SP and eligibility to third-party providers
22 6 SP Provide census data to actuary for attestation
22 Provide duplicate CMS response file to third-party 7 SP provider for each health plan’s participants
22 Support Voluntary Data Sharing Agreement 8 SP (VDSA) as alternative reporting method for RDS
22 Follow up and research with Medicare related 9 SP Medicare Secondary Payer claims
23 Administer Medicare in compliance with applicable 0 SP federal regulations
23 Confirm with employee enrollment in Medicare 1 SP plan upon eligibility or if not in correct plan, verify Medicare status and enrolled in Medicare plan 23 Ensure appropriate identifiers on Medicare 2 SP records to ensure proper payment from Medicare
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 23 Administer Medicare credit for under 65 and over 3 SP 65 retirees ($15 credit) and LTD to offset retiree premiums 23 Actuary to provide actuarial attestation for CMS 4 T subsidy
23 Third-party providers (PBMs, health plans) to 5 T update records for subsidy periods and eligibility
23 Provide cost data to PG&E to initiate subsidy 6 T payment
23 Support CMS EGWP eligibility, enrollment and 7 SP disenrollment requirements
23 8 C Submit request for subsidy payment
23 9 16. ZIP Code Maintenance
24 Provide updates of standard service areas to 0 T Service Provider electronically
24 1 SP Maintain standard service areas
24 Apply annual updates from third-party 2 SP administrators (standard format)
24 Apply annual updates of ZIP codes from Postal 3 SP Service
24 Notify PG&E of split ZIP codes and effect on service 4 SP areas and enrolled participants
24 Separately maintain foreign postal (zip code) 5 SP (Anthem CAP plan)
24 Maintain grandfathered participants outside of zip 6 SP code area still eligible for current plans
24 7 17. Annual Enrollment
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 24 Facilitate an annual kick-off meeting and periodic 8 SP status calls for annual enrollment planning and management 24 Maintain duplicate copy of production 9 SP environment to test all AE changes and new processes at least 3 months prior to AE window 25 SP Provide test cases and expected results for AE 0 changes and regression testing of AE function
25 SP 1 Complete testing of AE process with PG&E
25 2 C Notify Service Provider of plan design changes
25 3 C Notify Service Provider of carrier changes
25 4 T Determine rates for new plan year
25 Provide service area ZIP code tables for new plan 5 T year
25 Update and test zip codes and rates for new plan 6 SP year
25 Update all systems (Website, Service Center, etc.) 7 SP and systematic communications
25 8 SP Calculate eligibility – active, COBRA, and retirees
25 Design, produce, and distribute enrollment 9 SP materials
26 0 SP Perform dual-year processing
26 Process current year status changes (during AE) 1 SP and apply to new enrollment period based on plan rules 26 Process current year address changes (during AE) 2 SP and apply to new enrollment period based on plan rules Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 26 3 SP Update new year base pay
26 Accept and process participant and dependent 4 SP enrollment and PCP elections
26 Provide for participant confirmation of dependent 5 SP and student status online and via Service Center
26 Collect required supporting documentation for life 6 SP event, if required (e.g., student identification, marriage certification ) 26 7 SP Assign default coverage
26 8 SP Process EOI
26 9 SP Apply new year deductions to active payroll
27 0 SP Produce and distribute confirmation statements
27 1 SP Produce eligibility and premium reports
27 Produce annual enrollment reports including a 2 SP daily summary of annual enrollment statistics during the enrollment period 27 Track multiple plan years concurrently with 3 SP elections based on effective-date processing
Send annual enrollment files to carriers, and 27 manage ongoing eligibility update files during 4 SP December, to ensure accurate ID cards are received by January 1 27 Manage process of sending required cards to 5 SP participants and coordinate timely delivery with carriers 27 Manage retirees who opt out of and back in to 6 SP Medical plans (vs. surviving spouses who cannot opt back in)
Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 27 Apply new year retiree medical deductions to 7 C T pension payroll
27 8 C T Apply new year eligibility and reconcile premium
27 9 18. Evidence of Insurability (EOI) Identify elections requiring evidence of insurability 28 (EOI), notify participant and provide form (via 0 SP Service Center and online) for participant to complete 28 Maintain interim coverage, if applicable, pending 1 SP approval from carrier
28 Review and address pending EOI requests on a 2 SP weekly basis
28 Make approval/denial decision for EOI based on 3 T participant-provided information
28 Provide single sign on capability from the provider 4 SP Web site to other service provider (ex: MetLife) for Evidence of Insurability data input
Proprietary and Confidential | herronpalmer II. Service Center
Owner Included Item Responsibilities Cost Third Party C SP T I X U 28 1. Contact Handling 5
28 6 SP Provide PG&E-specific U.S. toll-free number
28 7 SP Provide international telephone number
28 8 SP Provide call-routing system (Call Prompter)
28 Provide U.S.-based Customer Service 9 SP Representatives (CSRs)
29 0 SP Provide email inquiry capability
29 1 SP Provide online chat capability
29 Semi-dedicated CSR team, co-located with PG&E’s 2 SP administration service team
29 3 2. Service Center Hours
29 Provide Automated Call Router: 7 days per week, 4 SP 24 hours per day, except for scheduled maintenance 29 Provide Representatives: 7:30 a.m. – 5:00 p.m. 5 SP Pacific Standard Time (PST), every day the New York Stock Exchange is open 29 Provide extended hours during OE or related to 6 SP other significant Corporate action – if required
29 7 3. Representative-Assisted Services – H&W
29 8 SP Tier I and II Inquiries:
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 29 9 SP . Plan provisions and information
30 0 SP . Participant and dependent information
30 1 SP . Administrative rules
30 . Processing mechanics (i.e., Internet, forms, 2 SP enrollment process, etc.)
30 3 SP . Data accuracy inquiries
30 4 SP . Current coverage and deductions
30 5 SP . Claim filing procedures
30 6 SP . Other general inquiries (i.e., appeals)
30 7 C . Escalated Issues
30 8 SP Transactions:
30 9 SP . Annual enrollment functions
31 0 SP . Life event changes
31 1 SP . Newly eligible enrollments
31 2 SP . Change in family status events
31 3 SP . Change in job status events
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 31 4 SP . Disability or death events
31 5 SP . Dependent data maintenance
31 6 SP . Confirmations
31 7 SP . QMCSOs
31 8 SP . Power of Attorney
31 . Survivor Support and coordination with 9 SP other service providers
32 . Inactive participant data maintenance (e.g., 0 SP address change)
32 1 SP . Request forms and kits
32 . Request hardcopy of all legally required 2 SP plan disclosure information
32 SP 3 . Password maintenance/assistance
32 SP . Assist participants with using self-service 4 tools – walk through with participants if needed 32 5 4. Retirement Coordination Support
Coordinate contact for retirees with DB provider 32 to ensure all steps associated with the event are 6 SP processed including retiree medical modeling and RMSA/RMEC administration. 32 Support third party vendors/carriers as needed to 7 SP carry out their responsibilities with the retirement processing
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 32 Coordinate Retiree Medical elections with DB 8 SP service provider
32 Coordinate Retiree questions with PG&E 9 SP Retirement Payroll team
33 0 5. Call Monitoring
33 Quality monitoring and evaluation of customer 1 SP service representatives
33 Monthly report of quality monitoring and 2 SP evaluation results
33 Provide PG&E with individual call recordings and 3 SP quality-monitoring results
33 Support PG&E participation in call monitoring (if 4 SP requested) and a quarterly audit by PG&E of unscreened call recordings 33 5 C Review quality-monitoring results
33 6 6. Call Tracking
33 7 SP Record all incoming and outgoing participant calls
33 Provide client specific report on call activity by 8 SP service area and key issue
33 Provide electronic notes in administration system 9 SP or case management system for each call to Service Center that requires follow-up 34 Provide copies of recorded calls to PG&E upon 0 SP request
34 1 7. Case Management
34 2 SP Provide automated case tracking system
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 34 Establish electronic case for each escalated 3 SP call/issue
34 Provide automatic reminder of workload for 4 SP customer service representatives
34 5 SP Provide automated workflow routing
34 6 SP Provide automatic reminder of call-backs
34 Monitor and report compliance with required 7 SP callbacks
34 Provide method for customer service supervisor to 8 SP view outstanding cases and redirect workload if appropriate Provide specialized tools or systems for the 34 monitoring and processing of benefit 9 SP administration related events (life events, retirement events, status changes, etc.) 35 Provide supervisory functionality (case load 0 SP management, case transfer, etc.)
35 Monitor and age the number of open or pended 1 SP cases by category and provide reporting to PG&E
35 Monitor and age the number of closed cases by 2 SP category and provide reporting to PG&E
35 Ensure the case management and workflow tools 3 SP are integrated with all benefit areas
35 4 SP Track all cases until resolved and closed
35 Provide PG&E access to case management tool and 5 SP the ability to update with activity performed to support case activity 35 Perform historical data research (prior service 6 C provider or pre-outsourcing)
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 35 7 8. Knowledge Management Tool
35 Employ a knowledge-management tool that 8 SP provides eligibility based plan rules to support customer service center representatives 35 Ensure all knowledge sources are exhausted prior 9 SP to call escalation to PG&E
36 0 9. Referrals
36 1 SP Provide third-party contact information
36 2 SP Perform direct “warm” transfers to third-party
36 Receive and resolve referred calls/ participant 3 T issues
36 4 10. Special Services
36 Provide industry-standard relay service for 5 SP hearing-impaired customers
36 6 11. Advocacy
36 Advocate for participant and own resolution of 7 SP participant eligibility issues
36 Advocate for participant and own resolution of 8 SP participant claim issues
36 9 12. Supported Languages
37 Call routing script is available in English and 0 SP Spanish
37 1 SP CSRs provide support in English and Spanish
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 37 Provide multilingual conferencing services, as 2 SP necessary
Proprietary and Confidential | herronpalmer III. Internet Services
Owner Included Item Responsibilities Cost Third Party C SP T I X U 37 1. Availability 3
37 7 days per week, 24 hours per day, except for 4 SP scheduled maintenance
37 5 2. Supported Languages
37 6 SP Internet site is presented in English
37 7 3. General
Provide Website compliant with either the Federal 37 Government's Section 508 Guidelines or the World 8 SP Wide Web Consortium's Web Content Accessibility Guidelines 1.0 (WCAG 1.0) for accessibility to users with disabilities 37 9 SP Password maintenance
38 0 SP Online printable transaction confirmations
38 Acquire and maintain domain name 1 SP http://mypgebenefits.com/
38 2 SP Host interactive SPDs
38 3 SP Develop and maintain interactive SPDs
38 Provide benefits landing page that provides high 4 SP level view of each benefit area and links to appropriate third-party Websites 38 Link to other 3rd party Web sites (e.g., carriers) via 5 SP single sign-on
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 38 Link from PG&E H.R. Intranet to provider via single 6 SP sign-on
38 Provide ability to deliver client specific, ad-hoc 7 SP messages/communications via the Website
Provide plan participants with the option to store 38 more than one e-mail address on the Web site, 8 SP along with the ability to elect which address is to be used for e-mail communications. 38 Website access via hand-held devices (i.e., smart 9 SP phones, tablets)
39 Support targeted information based on individual 0 SP participant authentication, employee type and status 39 Same authentication for Participant Web and Plan 1 SP Sponsor Web for authorized individual users
39 2 SP Support user ID other than SSN
39 3 4. Inquiries:
Plan provisions and information (SPDs, forms, plan 39 documents, guides, etc.) based on each 4 SP participant’s specific eligibility – participants will only see documents and plan rules for which they are eligible 39 5 SP Participant information (demographic data)
39 6 SP Current coverage and deductions
39 7 SP Claim filing procedures
39 8 SP Direct billing payment status
39 9 5. Transactions:
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 40 0 SP Annual enrollment functions
40 1 SP Life events
40 2 SP Newly eligible enrollments
40 3 SP Change in family status events
40 4 SP Dependent data maintenance
40 Decision support and modeling services, including, 5 SP FSA calculator, plan and cost compare tools, claims projections, etc. 40 6 SP Confirmations
40 Inactive participant data maintenance (e.g., 7 SP address change, contact information)
40 8 SP Initiate H&W retirement event
40 9 SP Print forms, kits, SPDs, plan documents, etc.
41 Track participant sessions, web pages viewed, and 0 SP actions taken
41 1 SP Beneficiary designation and updates
41 Accept e-mail requests for forms and general plan 2 SP information
41 6. Internet Services – Retirement 3 Coordination
41 4 SP Provide estimated retiree H&W benefit costs
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 41 5 SP Provide RMSA/RPOA balance information
41 6 7. Internet Services – Plan Sponsor
41 Provide key performance measures (SLAs) and 7 SP plan activity reports (e.g., dashboards)
41 Provide standard reports including annual 8 SP enrollment results
41 9 SP PG&E access to imaging, cases and recorded calls
42 0 SP Access to transaction history online
42 Ad hoc reports: Provide client-defined reports 1 SP from standard data
42 Document sharing: Provide consolidated project 2 SP database so Service Provider and PG&E can share info, document decisions and develop project plans 42 3 SP Special events: Online events and Webinars
42 Updates: Provide updates on impact of legislative 4 SP changes on service delivery and administration
42 5 SP Allow for PG&E customized messaging
Proprietary and Confidential | herronpalmer IV. Communications
Owner Included Item Responsibilities Cost Third Party C SP T I X U 42 1. Communications Strategy 6
42 Facilitate communications requirements/strategy 7 SP planning meeting with PG&E on annual basis
42 Participate in communications 8 C requirements/strategy planning meeting with Service Provider 42 9 2. Communications Delivery Methods
43 Primary distribution method is electronic for 0 SP active non-union represented employees and paper for union employees and retirees 43 Enrollment election method is either internet or 1 SP call center at the participant’s choice
Allow participants to make elections on how they 43 prefer to receive communications (i.e., via paper or 2 SP electronically) and store information in accordance with DOL guidelines 43 3 SP Deliver targeted messaging through web site
43 Deliver targeted e-mail/e-card and postcard 4 SP messages to participants
43 3. Communications Materials – Launch & 5 Ongoing
43 Design, produce and distribute pre-launch 6 SP notification and introduction and/or promotion materials 43 Design, produce and distribute quarterly benefits 7 SP newsletter
43 Design, produce and distribute all H&W 8 SP administration related correspondence
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 43 9 C Review and approve content
44 Design, produce and distribute active H&W and 0 SP retiree related materials
44 Design, produce and distribute new hire 1 SP enrollment kits
44 2 4. Annual Enrollment Materials
44 Review and approve content of annual enrollment 3 C communication materials
44 Develop annual enrollment communications 4 SP strategy document
Produce all required annual enrollment communications including: standard enrollment guides (with enrollment worksheet), plan highlights, SBCs (or other required notices), 44 personal fact sheets, confirmation statements, 5 SP PG&E approved correspondence for service provider errors, AE envelopes, posters, postcards, electronic notices/announcements, HIPAA Privacy and Special Enrollment Notices and Women’s Health and Cancer Rights Act Notices 44 Coordinate fulfillment and distribution of annual 6 SP enrollment kits
44 7 5. Materials Management
44 Provide electronic documents to Service Provider 8 C (e.g., SPDs, SMMs, newsletters)
44 Print-on-demand function for PG&E and carrier- 9 SP provided electronic documents
45 Manage inventory of preprinted materials and 0 SP print additional inventory as needed
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 45 1 6. Fulfillment
45 Assemble all materials and distribute to 2 SP participants
45 Provide process controls/audit trail of fulfillment 3 SP process
45 4 7. Returned Mail
45 If active employee, contact participant for new 5 C address
45 6 SP Check database for updated address
45 If address has been updated, send returned mail to 7 SP new address
45 If address has not been updated, set bad-address 8 SP flag on system
45 9 SP If active employee, notify PG&E of bad address
46 If inactive participant, manage lost-participant 0 SP search
46 Utilize credit or government agency database to 1 SP facilitate lost-participant search
Proprietary and Confidential | herronpalmer V. Data Reports and Interfaces
Owner Included Item Responsibilities Cost Third Party C SP T I X U 46 1. Data Sources – General 2
Maintain basic employment and indicative data 46 (“source” of this data) for active employees and all 3 C participants that are maintained on the PG&E HR system 46 Provide participant data changes on HR/payroll 4 C interface
46 Support reconciliation of data being sent to Service 5 C Provider
46 Support resolution of data errors identified during 6 C loads
46 Load client-provided data and perform standard 7 SP and plan-specific edits and corrections
46 Perform weekly data reconciliation process for 8 SP indicative data among systems if needed
Maintain basic indicative data (“source” of this 46 data) for all participants including those not 9 SP maintained on the PG&E HR system (e.g., retirees, term vested, survivors, dependents, beneficiaries, QDRO alternate payees) 47 Maintain complete historical data changes on all 0 SP data elements (“source” of this data)
47 If separate systems are used, maintain integrated 1 SP data for correct determination of eligibility and benefits across all H&W benefits 47 Research historical data issues and provide 2 C updates when appropriate
47 Real time front end edits on batch processing and 3 SP data input to administrative system
47 4 SP Log all online transactions and data changes
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 47 Audit trails of all changes to system tables and data 5 SP elements
47 Trace data changes to date updated and user or 6 SP source of transaction or change
47 Date and time stamp all transactions and data 7 SP changes
47 8 2. Data Sources – H&W
47 Maintain eligibility and enrollment data for all 9 SP participants
48 Accept data transmission/scan from DB provider 0 SP for Retiree Medical election
48 1 T Carriers maintain coverage data for all participants
48 2 3. Beneficiary Data Maintenance
48 Accept beneficiary elections online and in paper 3 SP form
48 Retain imaged beneficiary election forms, as 4 SP required
48 Accept and maintain online beneficiary 5 SP information
48 Conduct annual beneficiary re-solicitation for 6 SP participants with missing beneficiary information
48 Conduct beneficiary re-solicitation for all 7 SP participants every three years
48 8 4. File Transmission Methods
48 Electronic file transmission with exception 9 C SP T processing handled manually as needed
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 49 0 SP Files sent are ASC X12 compliant
49 1 5. H&W Interfaces
49 Produce and send changes-only indicative data 2 C files to Service Provider
49 Load weekly participant data into administration 3 SP system
Maintain employment and indicative data for 49 eligibility/elections per PG&E’s plan rules 4 SP including plan rates, split-family rules, company couple rules, waiting periods, etc. 49 Produce and send file of H&W deductions for 5 SP active participants to PG&E
49 Support provision of retroactive start dates as well 6 SP as pre- and post-tax deduction amounts
49 Produce a full file of deductions to send after 7 SP annual enrollment
49 8 SP Send imputed income file to PG&E as required
49 Send imputed income amounts for retirees and 9 SP severed employees on annual file
50 0 C Load deduction data into payroll system
50 Send FSA deductions and data to Kaiser FSA 1 SP administrator on a pay-cycle basis
50 Perform data validation and reconciliation on all 2 SP T incoming data interfaces (carriers)
50 Produce and send file of H&W deductions for 3 SP retirees to the pension payroll provider
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 50 4 C Load deduction data into pension payroll system
50 Provide H&W information to actuary for 5 SP determination of new rates
50 Provide H&W information to other service 6 SP providers (i.e., H&W consultant, data warehouse)
50 Perform data validation and reconciliation on all 7 SP incoming data interfaces (H&W service provider)
50 Accept multiple events per participant in single 8 SP transmission
50 Perform full file data reconciliation to carriers on 9 SP quarterly basis
51 Produce and send monthly changes-only eligibility 0 SP reporting to CMS
51 Produce and send Medicare Part D enrollment and 1 SP subsidy effective dates to third-party providers
51 Provide census data for ASC 715 report (formerly 2 SP FAS 106) for actuary
51 Create ASC 715 report (formerly FAS 106) report 3 T for presentation to PG&E
51 4 6. Carrier Interfaces
51 Produce/send weekly eligibility files/reports to all 5 SP carriers via secure connectivity
51 Receive files from carriers (i.e., MetLife, 6 SP Commuter) to report enrollment information
51 Send and receive file to Absence and Disability plan 7 SP administrator to feed eligibility, update status changes and set up direct bill
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 51 Accept and report multiple events per participant 8 SP as needed on the same transmission feed and/or for same effective date of transaction Send annual enrollment files to carriers, and 51 manage ongoing eligibility update files during 9 SP December, to ensure accurate ID cards are received by January 1 52 Include Medicare Part D subsidy indicators on 0 SP eligibility files
52 1 T Receive enrollment data from Service Provider
52 Request confirmation - and document receipt of 2 SP the confirmation - from each carrier for every file transmitted 52 Research discrepancies from carriers and notify 3 SP PG&E of continuing discrepancies
52 4 T Research discrepancies from Service Provider
52 5 T Notify PG&E of continuing discrepancies
52 6 SP Perform data validation and reconciliation
52 Complete quarterly full file reconciliation of 7 SP provider and carrier databases
52 8 SP Accept 401(h) reporting
52 9 7. Controls and Audit Trail
53 On-line processing fully supported by 0 SP comprehensive edit and validation routines
53 Batch-processing capabilities fully supported by 1 SP comprehensive edit and validation routines
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 53 Provide complete audit trails for changes made to 2 SP system control tables and user data
53 All system tables have a Date Last Updated field 3 SP and User ID for individual making the change
53 Provide ability to trace transactions to a particular 4 SP user and/or point-of-origin
53 5 SP Date and time stamp all transactions
53 Identify effective date of all transaction – whether 6 SP past (retroactive) or future
53 7 SP Research discrepancies from Service Provider
53 8 SP Notify PG&E of continuing discrepancies
53 9 SP Perform data validation and reconciliation
54 0 8. Plan Sponsor Reports
54 Detailed monthly reporting including, but not 1 SP limited to, plan administration, service performance and quality statistics. 54 Provide weekly report of participant deaths to 2 SP PG&E
54 Monthly review of reports with notification to 3 C Service Provider of any errors or issues
54 Generate address report for PG&E up to four times 4 SP per year upon request
54 5 9. Ad Hoc Reports
54 Provide online ad hoc report generation 6 SP capabilities that include:
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 54 7 SP . Drill down capabilities
54 8 SP . Support of “if/then” logic
54 . Ability to generate reports using both 9 SP calculated and stored values
55 0 SP . Any selected point-in-time or data ranges
55 . Trend reports showing changes over 1 SP various time periods
55 . Allow all reports generated to be printed, 2 SP viewed online, or exported (Excel, Access, ASCII, and PDF formats) 55 . Allow users to save reports in general or 3 SP private libraries
55 4 SP Provide training on report tools
55 Produce ad hoc reports utilizing tools provided by 5 C Service Provider
55 Provide specifications for ad hoc report that cannot 6 C be developed from online ad hoc reporting tools
55 Provide “ad hoc” reports that client cannot 7 SP generate from online tools
55 8 SP Ability to save queries for others to access and use
Proprietary and Confidential | herronpalmer VI. Compliance
Owner Included Item Responsibilities Cost Third Party C SP T I X U 55 1. Form 5500 Services 9
56 Collect and organize required information and data 0 SP to complete Form 5500 filings
56 Provide participant counts for 5500 filing (raw 1 SP data only)
56 Provide required data to Outsourcing Service 2 T provider (e.g., schedule A)
56 Develop signature-ready 5500 and associated 3 SP Schedules
56 4 C Sign and submit Form 5500s
56 5 2. Summary Annual Report Production
56 6 SP Provide necessary participant information
56 7 SP Produce SAR content
56 8 SP Distribute SARs to all plan participants
56 9 3. IRS Limits – H&W
57 0 SP Monitor Spending Account Deferral limits
57 Process IRS forms for Qualified Dependents 1 SP (domestic partners)
57 Edit contributions to ensure compliance with 2 SP limits; reject contributions beyond limits
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 57 Transmit payroll instructions to change/stop 3 SP deductions
57 4 4. Limits and Testing – H&W
57 Perform H&W Section 79 testing and provide 5 SP report of results with recommendations annually
57 Perform H&W Section 125 testing and provide 6 SP report of results with recommendations annually
57 Perform H&W Section 129 testing (daycare FSA) 7 SP with average benefits text twice per year; provide report of results with recommendations 57 Run the Section 105(h) tests annually or provide 8 SP an extract with Pass/Fail results
57 Identify alternative corrective actions in cases of 9 SP test failure
58 0 C Review test results
58 1 C Approve recommended corrective action
58 Perform necessary actions to correct upon client 2 SP approval
58 3 5. Other Compliance Services
58 Administer programs in compliance with all 4 SP benefits impacting Federal and State Legislation
58 Provide all legally required reporting and 5 SP disclosure materials to participants
58 6 C Update plan documents and SPDs
58 Store and make available plan documents and 7 SP SPD’s to participants
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 58 8 SP Perform SPD review upon request
Flag employee/participant records and respond to 58 court orders, ERISA claims or other agency 9 SP requests in accordance with plan documents and client direction 59 Complete eligibility report for employees not 0 SP covered by PG&E plans and calculate payment due for San Francisco Health Care ordinance. 59 1 6. Legislative Changes
59 Monitor legislative changes affecting 2 SP administration
59 Notify PG&E of changes and solicit PG&E input 3 SP where applicable
59 Where appropriate, provide direction of how to 4 C change administrative practices as a result of the legislative change 59 Update information systems and technology to 5 SP reflect changes within legislation
59 Update procedures to reflect annual changes 6 SP within existing legislation
59 7. Patient Protection and Affordable Care Act 7 (PPACA)
59 Provide annual file of value of health insurance 8 SP coverage to payroll at end of each calendar year
59 Disclose value of health insurance coverage on 9 C employee’s Form W-2
60 Calculate cost of employer-sponsored health 0 SP coverage and provide data to payroll to support Form W-2 reporting 60 Hosting on Web and distribution of Summary of 1 SP Benefit and Coverage statements
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 60 Creation and distribution of Notice of Health 2 SP Insurance Marketplace Coverage Options
60 Updates to Health Care Flexible Spending Account 3 SP contribution limit
60 Calculation of headcount related to Patient- 4 SP Centered Outcomes Research Institute and Transitional Reinsurance Program fees Employer Mandate: Administration of 60 “measurement and stability period” safe harbor 5 SP (hours tracking and determination of full-time employee status and coverage eligibility periods as defined by the regulations) 60 Provide data to support shared responsibility 6 SP reporting requirements resulting from ACA
60 7 8. Defense of Marriage Act (DOMA)
60 8 SP Update plans to comply with DOMA
60 Update procedures and administer plans to comply 9 SP with DOMA (e.g., imputed income based on state requirements) 61 0 9. Tax Compliance
61 Maintain federal, state, and local tax tables on 1 T system
61 2 T Prepare and send quarterly and annual tax reports
Proprietary and Confidential | herronpalmer VII. Implementation
Owner Included Item Responsibilities Cost Third Party C SP T I X U 61 1. Implementation 3
61 4 SP Perform project management
61 5 C Perform internal project management
61 6 C Provide required conversion data
61 Provide data requirements, data layouts and data 7 SP usage documentation
61 8 SP Load, edit, and validate conversion data
Provide plan administration requirements related 61 to all eligibility, plan provisions, communication, 9 SP reporting, interface and recordkeeping requirements 62 Provide administrative system capable of 0 SP performing all plan functions describe in above scope of services document 62 Develop and perform unit, systems, integration, 1 SP and client acceptance testing
62 Participate in client acceptance test planning, 2 C review and approval
62 3 C Participate in CSR cultural training
62 Prior Record-keeper completes events (including 4 C T COBRA events), QDROs, QMCSOs, and Cases/Appeals in progress prior to implementation Prior Record-keeper responsible for complete 62 billing cycle, including refunds and collections, for 5 C T last cycle run prior to transition
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 62 6 2. Implementation Staffing and Resources
Provide additional customer service staffing for the 62 first six months after the go live date for each 7 SP service (assume increased call volume with transition) 62 Assign a PMP certified implementation project 8 SP manager who will:
. Have prior implementation project 62 management experience at Service 9 SP Provider for organizations similar in size and complexity 63 0 SP . Have industry specific and Service Provider system specific expertise 63 . Serve as a single point of contact for PG&E 1 SP for the duration of the implementation project 63 2 SP . Dedicate 100% of his/her time for the duration of the implementation project . Assign lead conversion managers for each 63 delivered service who are familiar with the 3 SP functional as well as system requirements of the conversion . Manage and coordinate the efforts of all 63 internal Service Provider support staff, 4 SP SMEs, and Service Provider sub- contractors throughout each phase of the implementation project 63 . Ensure cross-functional coordination of 5 SP PG&E implementation activities – including user acceptance testing . Oversee cross-functional scheduling of 63 PG&E assigned deliverables (i.e., not 6 SP scheduling review deadlines the same day PG&E is in a full-day meeting with Service Provider) 63 7 SP . Be responsible for transitioning from implementation to ongoing
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 63 8 SP Assign implementation support staff who will: 63 . Have prior implementation experience at 9 SP Service Provider for organizations similar in size and complexity 64 . Be identified as resources with assigned 0 SP responsibilities on the implementation project plan . Be available to dedicate the appropriate 64 amount of time in order to complete the 1 SP primary functions assigned to them at each identified phase of the implementation project plan 64 2 SP Assign a senior executive who will: 64 3 SP . Serve as a client advocate throughout the duration of the implementation project 64 4 SP . Expedite the resolution of escalated issues . Ensure that additional Service Provider 64 resources, SMEs and sub-contractors are 5 SP available and assigned on an as-needed basis 64 Ensure service provider staffing works hours in 6 accordance with PG&E resources (onshore and offshore)
64 3. Project Management Responsibilities and 7 Tools
64 Provide comprehensive project management 8 SP services required for the successful implementation for your proposed solution 64 9 SP Perform full oversight of third-party relationships and subcontractors 65 0 SP Create and maintain detailed implementation plans that: 65 . Have been specifically modified for PG&E 1 SP and accurately represents the full scope of work Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 65 2 SP . Incorporate milestones from all provided services 65 3 SP . Incorporate unit and client acceptance testing 65 4 SP . Incorporate coordination with third-party organizations and subcontractors 65 5 SP . Are updated weekly 65 6 SP . Accurately reflect begin and end dates for each task 65 7 SP . Name specific assigned Service Provider resources 65 . Clearly outline PG&E tasks – including each 8 SP round of review for requirements and similar documents 65 9 SP . Identify late or “at risk” down-stream tasks (critical path) 66 0 SP Incorporate mutually agreed upon changes into the project plan as needed Post all critical implementation documents online 66 in project management website (business 1 SP requirements, issues logs, project schedules, meeting minutes, etc.) 66 2 SP Schedule, organize, and facilitate project kick-off meeting 66 3 SP Participate in and facilitate project Steering Committee meetings/process Conduct and lead all business requirements 66 gathering and other required sessions with PG&E 4 SP (and their current Service Providers) to analyze and document business requirements 66 5 SP Conduct and lead business requirements gathering sessions with third-party Service Providers
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U Provide comprehensive requirements 66 documentation that includes all functional 6 SP requirements, deduction types, file interfaces, and customizations, definitions, and processes Manage requirements documentation changes 66 using a formal version control process. Ensure that 7 SP all documentation and administration manuals are kept current 66 8 SP Conduct weekly project status meetings Prepare weekly status reports including summary 66 of progress relative to Project Plan, issue status, 9 SP project risks, and a list of the key PG&E deliverables for the next two weeks with due dates 67 0 SP Conduct status reviews/decision points (go/no go) sessions at end of each implementation phase 67 1 SP Manage all vendor and third party relationships within proposed solution 67 2 SP Maintain issues/risk log to record, track, and close issues (including final resolution) 67 3 SP Maintain documentation on interim and manual solutions 67 4 SP Manage risk areas – create mitigation strategy for any identified risks Develop a mutually agreed upon and documented 67 process that includes appropriate contact 5 SP information and procedures for issue escalation and resolution 67 Respond to Change Control requests prior to 6 SP commencement of work and in accordance with mutually agreed upon Change Control procedures Develop Operational transition plan (migration of 67 work from current process to new delivery model) 7 SP including systems, data sources, testing, work in progress, blackout periods, data load timelines, etc. 67 Develop Go Live checklist (includes all operational 8 SP transition, data migration, customer service center related processes, systems readiness, etc.)
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U Create a transition plan from PG&E and other 67 Service Provider outlining all key hand-off dates, 9 SP communications, and risks mitigation plans (for approval by the Service Provider and PG&E) 68 Develop project plan for any residual/re– 0 SP prioritized/post go-live tasks – includes all issues identified that were not resolved prior to go-live 68 1 4. Change Management
68 2 SP Identify any required training and associated completion dates 68 3 C SP Develop service rollout communications plan 68 Develop and distribute rollout communications – 4 C SP introducing new services, new website, customer service center, Service Provider tool use, etc. 68 5 SP Integrate Change Management Plan activities into overall project plan 68 6 5. Interface Development
68 7 SP Lead interface and report development, including coordinating with third party vendors as needed 68 Develop standard and custom interfaces and 8 SP reports defined and approved during requirements definition Lead discussions for development of HRIS and 68 Payroll interfaces – including setting agendas, 9 SP facilitating meetings, documenting open items, and documenting the resulting layouts 69 0 SP Perform three rounds of testing for each interface between Service Provider and PG&E 69 1 SP Perform a full-cycle integration test of all files between PG&E and Service Provider 69 2 SP Develop any interfaces necessary between Service Provider and third party vendor systems
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 69 Provide production representative test data in 3 SP format required for unit testing, as defined in approved specification 69 4 6. Implementation Testing
Present a comprehensive testing strategy/planning 69 document to define and explain testing approach, 5 SP resource requirements, and roles and responsibilities 69 6 SP Document internal test plans and share plans test results with PG&E Provide testing software that supports and maintains: Test scenarios 69 Test scripts 7 SP Test results Monitors outstanding trackers/fixes/bugs Records and tracks completion of fixes/bugs Monitors regression and retest scenarios 69 8 SP Develop a comprehensive test plan that includes: . Test case scenarios for all services, plan 69 provisions, and populations being 9 SP implemented – including third party systems . Identify real employees/participants 70 associated with each test case scenario 0 SP (minimal Service Provider created test participants) 70 1 SP . PG&E-specific scenarios for each customization 70 2 SP . Detailed test scripts with step-by-step instructions 70 3 SP . Interface testing requirements (to/from all parties)
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 70 4 SP . Call scenario scripts for testing customer service center representative 70 . Employee populations that match the 5 SP criteria associated with each test case scenario . A realistic testing schedule timeline that 70 identifies due dates, completion dates, 6 SP resource requirements, and roles & responsibilities Allow PG&E to review/test and approve all 70 calculations, transaction processing, delivery tools, 7 SP and correspondence during implementation, and then during ongoing operations when changes are made 70 8 SP Capture key changes between PG&E’s current and future state 70 9 SP Provide PG&E and effected vendors user acceptance testing (UAT) timeframe that includes: . A schedule of UAT related activities that 71 clearly identify each scope area, 0 SP planning/test case creation, testing periods, PG&E resources, issue resolution periods, and sign-off dates 71 . Full testing of all functionality that will be 1 SP approved by Service Provider and deemed “production ready” prior to PG&E UAT . Comprehensive PG&E UAT scope - 71 conversion results, interfaces, 2 SP communications, IVR, all website content, transaction processing, and customer service center 71 . Assisting PG&E in identifying 3 SP employees/participants for each test scenario 71 . Allowing PG&E to create test call scenarios 4 SP and participate in center representative testing prior to them taking live calls 71 . Including test conditions for all valid 5 SP scenarios that may cause variability or personalization within the systems
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 71 6 SP . Providing test scripts to PG&E and support PG&E in completion of test scripts . Providing PG&E with access to systems, 71 tools, and resources required to review, 7 SP test and approve all identified test case scenarios 71 8 SP . Capturing all PG&E UAT issues 71 . Maintaining log of resolved PG&E UAT 9 SP issues and those issues deferred by Service Provider 72 0 SP . Conducting daily testing status meeting 72 . Identifying resolution dates for all issues 1 SP identified during UAT that could not safely be resolved prior to “go-live” . A period of true fully-integrated “user 72 experience” testing (i.e., allow client to 2 SP initiate transaction on web, receive print communications, and see results on interfaces) 72 3 . Provide test environment for parallel testing period of 2-3 weeks (if requested) 72 . Allowing PG&E to perform user acceptance 4 SP testing remotely (i.e., from PG&E’s offices) in a manner acceptable to PG&E Present conversion strategy document to define and explain conversion approach including current 72 and historical data mapping, conversion file 5 SP creation and validation, timing of data loads, migration of any work in progress, and roles and responsibilities 72 Maintain separate testing and production system 6 SP environments and refresh as needed for each testing cycle 72 Conduct interface and report testing process, 7 SP including coordinating with third party vendors as needed
Proprietary and Confidential | herronpalmer VIII. Governance
Owner Included Item Responsibilities Cost Third Party C SP T I X U 72 1. Governance 8
72 Assign an Executive Sponsor responsible for 9 SP overseeing the PG&E account
73 Assign a relationship manager responsible for the 0 SP overall relationship between provider and PG&E
73 Assign a single point of contact dedicated to PG&E 1 SP responsible for day-to-day management and support 73 2 SP Designate contacts for other supporting vendors
73 Ensure Executive Sponsor participates in all 3 SP quarterly service reviews and key annual planning meetings 73 Annually establish targeted initiatives for cost 4 SP reductions and process improvements with PG&E
73 Annually review and revise performance standard 5 SP metrics and categories
73 Annually conduct satisfaction surveys of key PG&E 6 SP staff – show PG&E results versus remainder of client base 73 Commit to participate in quarterly steering 7 SP committee meetings at PG&E (no travel cost charged to PG&E) Develop quarterly management report summarizing monthly metrics, customer service 73 center usage, operational trends, the quarter’s 8 SP events, accomplishments, issues, upcoming objectives and events (next 90 days), results of performance measurements, and related service level agreements 73 Develop quarterly performance standards and 9 SP metrics report that include an action plan for any missed metrics
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U Conduct employee/customer satisfaction surveys 74 for users of the internet and service centers using 0 SP statistically valid sampling and a proven solicitation method SP Provide legislative and education support that 74 specifically addresses how issues would affect 1 PG&E in light of PG&E’s plan provisions and operational processes 74 SP Provide options and recommendations for PG&E to 2 consider for compliance with legislative changes
Continually provide general information on benefit 74 issues, trends in the industry, legislative changes 3 SP (and impact on administration), and benefit design issues 74 4 SP Conduct weekly status calls with PG&E
74 Formally document all change requests (including 5 SP changes that do not impact fees) prior to the start of any work Provide change analysis and any associated fees 74 within 15 business days of request – including 6 SP timeline for completing change – for all change orders Develop a mutually agreed upon and documented 74 process that includes appropriate contact 7 SP information and procedures for issue escalation and resolution 74 Perform root cause analysis on all issues with 8 SP potential to impact multiple participants
74 Notify PG&E Benefits staff for all system changes 9 SP prior to introducing them to the production environment
Proprietary and Confidential | herronpalmer IX. Miscellaneous
Owner Included Item Responsibilities Cost Third Party C SP T I X U 75 1. Plan Audit 0
75 Communicate audit schedule and scope to Service 1 C Provider
75 2 C Manage overall audit process
75 Produce discrimination reports and participant 3 SP counts for Form 5500 annually
75 Provide requested pre-existing materials to 4 SP auditors
75 Provide onsite support for 40 hours for H&W per 5 SP year
75 6 T Perform plan audit
75 7 2. Service Audit
75 8 C Manage overall audit process
75 9 SP Provide requested materials to auditors
76 Provide required support for on-site auditors on 0 SP annual basis
76 Provide semi-annual SSAE No. 16 and ISAE No. 1 SP 3402 audit results to PG&E
76 2 3. Documentation
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 76 Maintain administrative processes manual and 3 SP update at a minimum annually
76 4 SP Maintain requirements documentation
76 Capture plan and administrative changes in 5 SP electronic format
76 Retain history of changes to process manual with 6 SP ability to redline recent activity for client sign off
76 7 4. Records Retention
76 Retain records online for immediate access for 36 8 SP months (excluding non-vested terms)
76 Retain all records older than 36 months in archive 9 SP including transition from PG&E or prior record keeper(s) for no less than 7 years 77 Store and retrieve all paper records via an online 0 SP record management system
77 5. Beneficiary Validation and Survivor 1 Services
Provide a single point of contact, specially trained 77 in bereavement and loss, for survivors throughout 2 SP the death event and ensure all steps associated with the event are processed across all benefits and payments are made on a timely basis 77 Provide integrated condolence letters for death 3 SP event
Perform beneficiary validation review upon 77 notification of a participant’s death to identify 4 SP beneficiary based on plan specific rules and federal regulatory requirements 77 Request appropriate documents to verify 5 SP participant’s death and authenticate beneficiaries
Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U Determine whether a restriction must be placed on 77 participant’s Plan account or benefit and whether 6 SP document is valid pursuant to Plan Sponsor’s Guidelines 77 Provide support to third party vendors as needed 7 SP to carry out their responsibilities (i.e., Anthem, Kaiser, etc.)
Proprietary and Confidential | herronpalmer