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NOTICE September 6, 2019 City of Cleveland Healthcare Request for Proposals If you are receiving the enclosed RFP for the CITY OF CLEVELAND, please visit: http://www.clevelandohio.gov/CityofCleveland/Home/Government/City Agencies/Finance/RFP You will be directed to the full RFP including census, claims experience and required City forms. Thank you. REQUEST FOR PROPOSALS For CITY OF CLEVELAND CITY OF CLEVELAND 601 Lakeside Avenue Cleveland, Ohio 44114 Release Date: September 6, 2019 RFP Question Submission: September 23, 2019 Response to Questions from Fedeli: September 25, 2019 Proposals Due to The City: October 8, 2019 Plan Effective Date: April 1, 2020 CITY OF CLEVELAND - RFP TABLE OF CONTENTS SECTION I. GENERAL INFORMATION . Request for Proposal Notice . Proposal Evaluation Criteria . Conditions and Stipulations II. CITY INFORMATION . Request for Medical Benefits . Contributions and Plan Information III. PROPOSAL FORMS . Quote Criteria Proposed - Summary of Requested Information IV. QUESTIONNAIRES . Medical . Performance Guarantees . Prescription . Dental . Vision . Worksite . Life IV. APPENDICES . Summary of Benefits – Current Plan(s) . Employee Census . Claim History / Health History Forms . Pharmacy Repricing Report City of Cleveland – RFP Effective Date: April 1, 2020 Page 2 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. SECTION I – GENERAL INFORMATION Request for Proposal Notice Proposal Evaluation Criteria Conditions & Stipulations City of Cleveland – RFP Effective Date: April 1, 2020 Page 3 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. REQUEST FOR PROPOSAL NOTICE Notice is hereby given that the CITY will accept Proposals for the following specified group insurance benefits until: October 8, 2019 Coverage Desired: Medical, Prescription Drugs, Dental, Vision, Life & AD&D, Voluntary Life & AD&D, Dependent Life, Worksite Benefits All Proposals shall be clearly identified as ‘Insurance Proposal for the CITY OF CLEVELAND’. Copies of your proposal (One (1) original; One (1) duplicate; One (1) electronic, shall be delivered to the CITY no later than October 8, 2019, at the following address: CITY OF CLEVELAND Attn: Rob Ryan 601 Lakeside Avenue Room 121 Cleveland, Ohio 44114 Proposals will be evaluated, and the successful vendor(s) may be asked to participate in finalist meetings. The CITY reserves the right to reject any or all proposals, waive formalities and to select the vendor and benefit options that best meet the needs of the CITY and its employees. Bidders are encouraged to include best pricing with their submission as there is no guarantee of a request for price revisions. Inquiries, clarification, or requests for additional information should be directed in writing to the following CITY contact: Kim Stika Client Executive The Fedeli Group [email protected] City of Cleveland – RFP Effective Date: April 1, 2020 Page 4 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. GENERAL INFORMATION Name of Account: CITY of CLEVELAND, OHIO 601 Lakeside Avenue Cleveland, OH 44114 Size of Account: Approximately 6,400 participating employees. Approximately 7,200 employees eligible for coverage. Coverage’s Desired: Medical, Prescription, Dental, Vision, Life/AD&D, Voluntary Life/AD&D, Dependent Life, Worksite Benefits Current Funding: Self-Insured – Medical/Prescription Drugs (Anthem - $350,000 Specific Deductible) (MMO - $300,000 Specific Deductible) Fully-Insured: Dental Vision Life Insurance Worksite Benefits Funding Desired: Self-Insured: Medical Prescription Drug Fully-Insured: Dental Vision Life Insurance Worksite Benefits Current Vendor: Medical – Anthem/Medical Mutual Prescription – CVS Health (Health Action Council) Dental - CIGNA Vision – EyeMed Life Insurance – MetLife Worksite - Trustmark Eligibility: First of the month following date of hire City of Cleveland – RFP Effective Date: April 1, 2020 Page 5 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. GENERAL INFORMATION (continued) Employee Contribution (per month): MEDICAL/RX Medical Mutual $750 Deductible $65.66 Single / $155.12 Family** $83.16 Single / $199.42 Family (Non-Wellness Rate) Anthem $750 Deductible $83.56 Single / $193.62 Family** $105.84 Single / $248.94 Family (Non-Wellness Rate) Prescription $15.50 Single / $33.30 Family (CVS)** $19.64 Single / $42.82 Family (CVS - Non-Wellness Rate) DENTAL CIGNA Option I - PPO $3.70 Single / $9.48 Family Option II - DHMO $2.82 Single / $7.22 Family LIFE & AD&D/Vol LIFE & AD&D MetLife Please see attached schedules and rates VISION* EyeMed $0.84 (EyeMed Composite) *Please note: AFSCME Local 100 members do not participate in the EyeMed Vision plan **Rates displayed are the “Wellness” rates and represent a 4% discount off the full employee contribution amounts City of Cleveland – RFP Effective Date: April 1, 2020 Page 6 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. GENERAL INFORMATION (continued) NOTE: School Guards have a separate plan design but may buy-up to either the $750 Deductible Medical Mutual or Anthem plan. Medical Mutual $1,000 Deductible $10.50 Single / $26.26 Family Buy up to: Medical Mutual $750 Deductible $159.29 Single/$267.22 Family Anthem $750 Deductible $278.64 Single/Family-Not Available CIGNA (Dental) $5.26 Single/$15.76 Family MetLife (Life & AD&D/Vol Life & AD&D) Employee pays $2.82 per month For $15,000 Basic Life Rate Guarantee Period: The CITY will entertain a multi-year administrative fee guarantee or a one-year fee with a subsequent cap. Other options will be considered. The CITY will entertain a multi-year stop loss offer. Effective Date: April 1, 2020 Commissions: Net of Broker / Consultant Commission City of Cleveland – RFP Effective Date: April 1, 2020 Page 7 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. PROPOSAL EVALUATION CRITERIA The CITY will evaluate and select proposals based on the needs of the CITY and its members. The CITY is not obligated to award the contract based on cost alone. The following criteria will be used in evaluating each of the responses: 1. Compliance with specifications. 2. Ability to provide administrative support and member services to the CITY and its covered employees and dependents. 3. Compliance with applicable State and Federal laws and regulations. 4. Financial strength of insurance company or managed care organization. 5. Financial rating (if applicable). 6. Retention costs, administration fees and renewal underwriting procedures. 7. Rate guarantees. 8. Completion of the Rate and Benefit Proposal Forms and Questionnaires. 9. Size and location of the Medical Plan Provider Network (or Networks). 10. Nature of medical provider contracts, including discounts and other cost containment methods. 11. Ability to provide the CITY with the reports requested in the proposal. 12. Ability to provide AdHoc reports as requested. 13. Ability to administer claims processing in a seamless and efficient manner. 14. Effectiveness of the drug formulary. 15. Ability to meet the quality of care standards under the National Committee for Quality Assurance (NCQA). Is this still the standard? 16. The ability of the CITY to customize a benefit program that will meet the needs of its employees and labor contracts. 17. Other criteria identified by the CITY as important in evaluation of submitted proposals. City of Cleveland – RFP Effective Date: April 1, 2020 Page 8 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. PROPOSAL EVALUATION CRITERIA (continued) 18. The amount of Wellness dollars provided. 19. The amount of clinical data warehouse feed credits offered. 20. Willingness to offset pharmacy data integration fees. 21. Effectiveness of member engagement, onsite wellness resources, and clinical management programs. City of Cleveland – RFP Effective Date: April 1, 2020 Page 9 The CITY reserves the right to modify the scope of services at any time before execution of a contract to add, delete, or otherwise amend any item(s), as it deems necessary, in its sole judgment, and in the best interest of the CITY. CONDITIONS AND STIPULATIONS You are invited to submit your proposal for the administration of the indicated benefit plans based on the information contained in this Request for Proposal. Unless a specific note is made to the contrary, we will assume that your proposal conforms to the CITY’s specifications. You are invited to ask questions during the proposal process and to seek additional information, if needed. We want this to be an interactive process and will make every effort to provide sufficient data for your response. Telephone calls and meeting requests (regarding the RFP) will not be permitted. All correspondence must be submitted in the form of a question and sent to the following dedicated email address: [email protected].

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