H&W RFP: Scope of Services

H&W RFP: Scope of Services

<p>PG&E</p><p>December 20, 2013</p><p>H&W RFP: Scope of Services</p><p>Copyright © 2013, herronpalmer, LLC</p><p>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.</p><p>Table of Contents </p><p>Scope of Services Instructions</p><p>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:</p><p>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:</p><p> "C" = Internal PG&E responsibilities</p><p> "SP" = Outsourcing Service Provider responsibilities</p><p> "T" = Third Party (not PG&E or Service Provider)</p><p>Responsibilities: If you have changes to the Responsibilities, please make the proposed changes in the Comments column.</p><p>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:</p><p> “I” = currently in place with other clients today</p><p> “X” = included, but not in place for other clients today; or</p><p> “U” = the function is not available or on your product development road map</p><p>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.</p><p>Third-Party Supplier: Indicate the supplier of this function if not performed internally. Wholly-owned subsidiaries should not be considered third-parties.</p><p>Comments: Please provide any additional information or clarifications. Please do not change the format of this document.</p><p>I. Services for Health and Welfare Plans</p><p>Owner Include Responsibilities Cost Third Party Item C SP T I X U 1 1. Plans and Populations</p><p>2 C Plan design</p><p>3 C Plan fiduciary (e.g., final appeals, compliance)</p><p>4 C Vendor management</p><p>Eligibility, enrollment, life-event changes, 5 SP reporting and participant support for the following plans:</p><p>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</p><p>7 . Medical Plan – Comprehensive Access Plan SP (CAP) 8 SP . Medical Plan – Health Account Plan (HAP)</p><p>9 SP . Medical Plan – HMO’s</p><p>10 . Medical Plan – Exclusive Provider SP Organization (EPO) 11 SP . Medical Plan – Medicare Advantage</p><p>12 SP . Medicare Supplemental Plan (MSP)</p><p>13 SP . Retiree Optional Plan (ROP)</p><p>14 SP . Vision Choice Plan</p><p>15 SP . Dental – w/Implants </p><p>16 SP . FSA Healthcare </p><p>17 SP . FSA Dependent care</p><p>18 SP . HRA</p><p>19 SP . Basic and Supplemental Life Insurance</p><p>20 SP . Spouse/Domestic Partner Life</p><p>21 SP . Life (Children)</p><p>22 SP . Retiree Life</p><p>23 SP . Basic and supplemental AD&D</p><p>24 SP . Executive and Board of Director AD&D</p><p>25 SP . LTD – 66-2/3% of Pay</p><p>26 SP . Business Travel Insurance (BTI)</p><p>Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 27 SP . Employee Assistance Program (EAP)</p><p>28 SP . STD – 66-2/3% of Pay</p><p>29 SP . Work Life Benefits</p><p>30 SP . Vacation Buy Plan</p><p>31 SP . Commuter transit program</p><p>32 SP . Health Club reimbursement accounts</p><p>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</p><p>36 Administration of spending accounts (FSA and SP HRA) 37 SP Administration of Direct Billing</p><p>38 T Claims adjudication and payment</p><p>39 2. Core Participant Events/Activities</p><p>40 C Send employee data via HR/payroll feed</p><p>41 Provide updates to plan and eligibility rules on an C annual basis 42 SP Load employee data</p><p>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</p><p>45 SP . Rehire (reinstate benefits)</p><p>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</p><p>48 SP . Job status change</p><p>49 SP . Change of residence</p><p>50 SP . Leave of absence</p><p>51 SP . Termination</p><p>52 SP . Transfers</p><p>53 SP . Disability</p><p>54 SP . Death</p><p>55 SP . Retirement</p><p>56 SP . Medicare eligible</p><p>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</p><p>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</p><p>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</p><p>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 </p><p>80 3. H&W Deduction Processing</p><p>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</p><p>87 C T Reconcile retiree payroll deductions</p><p>88 4. Eligibility and Premium Reporting</p><p>89 SP Transmit eligibility to carriers weekly </p><p>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 </p><p>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</p><p>10 Identify COBRA-eligible participants due to 0 SP employment or family status changes</p><p>10 Provide initial COBRA-rights notification to 1 SP participant, covered spouse and dependents</p><p>Proprietary and Confidential | herronpalmer Owner Include Responsibilities Cost Third Party Item C SP T I X U 10 2 6. COBRA Administration </p><p>10 Calculate COBRA rates based on client-provided 3 C plan costs</p><p>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</p><p>10 6 SP Process COBRA annual enrollment</p><p>10 7 SP Create and distribute enrollment material</p><p>10 8 SP Process COBRA coverage changes</p><p>10 Track COBRA coverage periods (including multiple 9 SP qualifying events)</p><p>11 0 SP Process COBRA coverage terminations</p><p>11 1 SP Notify carriers of enrollment changes</p><p>11 Perform COBRA direct billing, payment collections 2 SP and refunds</p><p>11 Provide notice of unavailability of continuation 3 SP coverage</p><p>11 Provide notice of early termination of continuation 4 SP coverage</p><p>11 Receive feed file from Provant for incentives to set 5 SP up seed HRA account</p><p>11 6 SP Send eligibility file to Provant</p><p>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)</p><p>11 7. Qualified Medical Child Support Order 8 (QMCSO)</p><p>11 Design model language for qualification 9 C determination and provide to Service Provider</p><p>12 Respond to requests for Agency-requested benefits 0 SP information</p><p>12 1 SP Qualification of new orders </p><p>12 Generate required COBRA notifications to 2 SP alternative recipient and custodial parents</p><p>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</p><p>12 6 T Claims adjudication and payment</p><p>12 7 8. Appeals</p><p>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</p><p>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</p><p>13 2 T Respond to all claims appeals</p><p>13 Responsible for final decisions for all claims 3 T appeals</p><p>13 4 9. Imputed Income</p><p>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</p><p>13 Send imputed income amounts to pension payroll 7 SP provider (PG&E) for retirees in payment status</p><p>13 Process imputed income on year-end tax 8 C statements</p><p>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</p><p>14 Convert annual election to pay period deduction 2 SP amount</p><p>14 3 SP Provide participants with FSA debit cards</p><p>14 4 C Apply FSA deductions to payroll</p><p>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</p><p>14 Execute quarterly data reconciliation of expected 6 SP to actual employee deductions</p><p>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</p><p>15 0 SP Provide annual participant statements</p><p>15 1 SP Provide monthly reports to PG&E</p><p>15 2 C Reconcile FSA records to trust</p><p>15 3 SP Reconcile checks processed to claims</p><p>15 Provide annual forfeitures, imputed income and 4 SP reconciliation reports to PG&E</p><p>15 5 C Coordinate forfeiture process</p><p>15 Provide FSA provider (Kaiser) with seeder file of 6 SP new participant elections post AE</p><p>15 Receive a seeder file for the HRA eligible 7 SP participants</p><p>15 Provide PG&E reporting related to HRA claims 8 SP processed</p><p>15 Convert HRA account from active to retiree 9 SP account upon retirement or moving to LTD</p><p>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</p><p>16 Process account transfers during mid year and 1 SP Annual Enrollment for HRA accounts</p><p>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</p><p>16 Notify the participant during the initial election 4 SP process if PCP designation is required for the plan</p><p>16 Collect PCP information online or via Service 5 SP Center</p><p>16 Transmit PCP enrollments from participants to 6 SP carriers (upon initial enrollments)</p><p>16 Pass plan network and PCP information received 7 SP from client to the provider directory vendor</p><p>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</p><p>17 Identify when participant RMSA fully depleted and 2 SP send file to DB provider with notification</p><p>17 Maintain separate account balances for participant, 3 SP spouse or eligible surviving dependents</p><p>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</p><p>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</p><p>18 Provide participant access to RMSA balance via 0 SP Web</p><p>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</p><p>18 Remove RMSA from surviving spouse after 3 SP Medicare </p><p>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 </p><p>18 Maintain RPOA 50% and/or 25% account balance 7 SP</p><p>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</p><p>18 Transfer RPOA benefit to survivor upon death of 9 SP Retiree</p><p>19 Manage Retirees turning on and off RPOA election 0 SP</p><p>19 1 13. Inactive Billing and Collections</p><p>19 Initiate monthly billing process for “direct-bill” 2 SP participants (including employees in arrears)</p><p>19 Process accounts receivable 3 SP</p><p>19 Maintain individual participant accounts 4 SP</p><p>19 Terminate coverage due to non-payment of 5 SP premiums after grace period</p><p>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</p><p>19 Process refunds on a monthly basis 8 SP</p><p>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</p><p>20 1 14. Medicare Part D Eligibility (All Strategies)</p><p>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</p><p>20 4 SP . Ongoing enrollment in employer plan</p><p>20 5 SP . Annual enrollment for Medicare Part D</p><p>20 6 SP . Upon request</p><p>20 Track Medicare-eligible participants and provide 7 SP counts to PG&E annually</p><p>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</p><p>21 Participant counts provided annually to PG&E 0 SP within first 60 days of plan year</p><p>21 15. Medicare and Medicare Part D Subsidy 1 Support</p><p>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)</p><p>21 Under Age 65 PG&E Medicare Part B credit offsets 4 SP to Retiree Medical Premiums </p><p>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</p><p>21 7 SP Administer Medicare data match questionnaire</p><p>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</p><p>21 Track Medicare Part D enrollment for participants 9 SP and dependents</p><p>22 0 SP Provide census data extract for initial census</p><p>22 Adjust participant coverage if Medicare Part D 1 SP enrollment</p><p>22 Notify participants of impact of Medicare Part D 2 SP enrollment</p><p>22 Provide monthly changes-only eligibility reporting 3 SP to CMS</p><p>22 Reconcile eligibility data with CMS based on 4 SP response codes received</p><p>22 Provide electronic reporting of subsidy periods 5 SP and eligibility to third-party providers</p><p>22 6 SP Provide census data to actuary for attestation</p><p>22 Provide duplicate CMS response file to third-party 7 SP provider for each health plan’s participants</p><p>22 Support Voluntary Data Sharing Agreement 8 SP (VDSA) as alternative reporting method for RDS</p><p>22 Follow up and research with Medicare related 9 SP Medicare Secondary Payer claims </p><p>23 Administer Medicare in compliance with applicable 0 SP federal regulations </p><p>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</p><p>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</p><p>23 Third-party providers (PBMs, health plans) to 5 T update records for subsidy periods and eligibility</p><p>23 Provide cost data to PG&E to initiate subsidy 6 T payment</p><p>23 Support CMS EGWP eligibility, enrollment and 7 SP disenrollment requirements</p><p>23 8 C Submit request for subsidy payment</p><p>23 9 16. ZIP Code Maintenance</p><p>24 Provide updates of standard service areas to 0 T Service Provider electronically</p><p>24 1 SP Maintain standard service areas</p><p>24 Apply annual updates from third-party 2 SP administrators (standard format)</p><p>24 Apply annual updates of ZIP codes from Postal 3 SP Service</p><p>24 Notify PG&E of split ZIP codes and effect on service 4 SP areas and enrolled participants</p><p>24 Separately maintain foreign postal (zip code) 5 SP (Anthem CAP plan)</p><p>24 Maintain grandfathered participants outside of zip 6 SP code area still eligible for current plans</p><p>24 7 17. Annual Enrollment</p><p>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</p><p>25 SP 1 Complete testing of AE process with PG&E</p><p>25 2 C Notify Service Provider of plan design changes</p><p>25 3 C Notify Service Provider of carrier changes</p><p>25 4 T Determine rates for new plan year</p><p>25 Provide service area ZIP code tables for new plan 5 T year</p><p>25 Update and test zip codes and rates for new plan 6 SP year</p><p>25 Update all systems (Website, Service Center, etc.) 7 SP and systematic communications</p><p>25 8 SP Calculate eligibility – active, COBRA, and retirees</p><p>25 Design, produce, and distribute enrollment 9 SP materials</p><p>26 0 SP Perform dual-year processing </p><p>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</p><p>26 Accept and process participant and dependent 4 SP enrollment and PCP elections</p><p>26 Provide for participant confirmation of dependent 5 SP and student status online and via Service Center</p><p>26 Collect required supporting documentation for life 6 SP event, if required (e.g., student identification, marriage certification ) 26 7 SP Assign default coverage</p><p>26 8 SP Process EOI</p><p>26 9 SP Apply new year deductions to active payroll</p><p>27 0 SP Produce and distribute confirmation statements</p><p>27 1 SP Produce eligibility and premium reports</p><p>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</p><p>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)</p><p>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</p><p>27 8 C T Apply new year eligibility and reconcile premium</p><p>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</p><p>28 Review and address pending EOI requests on a 2 SP weekly basis </p><p>28 Make approval/denial decision for EOI based on 3 T participant-provided information</p><p>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</p><p>Proprietary and Confidential | herronpalmer II. Service Center</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 28 1. Contact Handling 5</p><p>28 6 SP Provide PG&E-specific U.S. toll-free number</p><p>28 7 SP Provide international telephone number</p><p>28 8 SP Provide call-routing system (Call Prompter)</p><p>28 Provide U.S.-based Customer Service 9 SP Representatives (CSRs)</p><p>29 0 SP Provide email inquiry capability</p><p>29 1 SP Provide online chat capability</p><p>29 Semi-dedicated CSR team, co-located with PG&E’s 2 SP administration service team </p><p>29 3 2. Service Center Hours</p><p>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</p><p>29 7 3. Representative-Assisted Services – H&W</p><p>29 8 SP Tier I and II Inquiries:</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 29 9 SP . Plan provisions and information</p><p>30 0 SP . Participant and dependent information</p><p>30 1 SP . Administrative rules</p><p>30 . Processing mechanics (i.e., Internet, forms, 2 SP enrollment process, etc.)</p><p>30 3 SP . Data accuracy inquiries</p><p>30 4 SP . Current coverage and deductions</p><p>30 5 SP . Claim filing procedures</p><p>30 6 SP . Other general inquiries (i.e., appeals)</p><p>30 7 C . Escalated Issues</p><p>30 8 SP Transactions:</p><p>30 9 SP . Annual enrollment functions</p><p>31 0 SP . Life event changes</p><p>31 1 SP . Newly eligible enrollments</p><p>31 2 SP . Change in family status events</p><p>31 3 SP . Change in job status events</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 31 4 SP . Disability or death events</p><p>31 5 SP . Dependent data maintenance</p><p>31 6 SP . Confirmations</p><p>31 7 SP . QMCSOs</p><p>31 8 SP . Power of Attorney</p><p>31 . Survivor Support and coordination with 9 SP other service providers</p><p>32 . Inactive participant data maintenance (e.g., 0 SP address change)</p><p>32 1 SP . Request forms and kits</p><p>32 . Request hardcopy of all legally required 2 SP plan disclosure information</p><p>32 SP 3 . Password maintenance/assistance</p><p>32 SP . Assist participants with using self-service 4 tools – walk through with participants if needed 32 5 4. Retirement Coordination Support</p><p>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</p><p>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</p><p>32 Coordinate Retiree questions with PG&E 9 SP Retirement Payroll team</p><p>33 0 5. Call Monitoring</p><p>33 Quality monitoring and evaluation of customer 1 SP service representatives</p><p>33 Monthly report of quality monitoring and 2 SP evaluation results</p><p>33 Provide PG&E with individual call recordings and 3 SP quality-monitoring results</p><p>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</p><p>33 6 6. Call Tracking</p><p>33 7 SP Record all incoming and outgoing participant calls</p><p>33 Provide client specific report on call activity by 8 SP service area and key issue</p><p>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</p><p>34 1 7. Case Management</p><p>34 2 SP Provide automated case tracking system</p><p>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</p><p>34 Provide automatic reminder of workload for 4 SP customer service representatives</p><p>34 5 SP Provide automated workflow routing</p><p>34 6 SP Provide automatic reminder of call-backs</p><p>34 Monitor and report compliance with required 7 SP callbacks</p><p>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.)</p><p>35 Monitor and age the number of open or pended 1 SP cases by category and provide reporting to PG&E</p><p>35 Monitor and age the number of closed cases by 2 SP category and provide reporting to PG&E</p><p>35 Ensure the case management and workflow tools 3 SP are integrated with all benefit areas</p><p>35 4 SP Track all cases until resolved and closed</p><p>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)</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 35 7 8. Knowledge Management Tool</p><p>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</p><p>36 0 9. Referrals</p><p>36 1 SP Provide third-party contact information</p><p>36 2 SP Perform direct “warm” transfers to third-party</p><p>36 Receive and resolve referred calls/ participant 3 T issues</p><p>36 4 10. Special Services</p><p>36 Provide industry-standard relay service for 5 SP hearing-impaired customers</p><p>36 6 11. Advocacy </p><p>36 Advocate for participant and own resolution of 7 SP participant eligibility issues</p><p>36 Advocate for participant and own resolution of 8 SP participant claim issues</p><p>36 9 12. Supported Languages</p><p>37 Call routing script is available in English and 0 SP Spanish</p><p>37 1 SP CSRs provide support in English and Spanish</p><p>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</p><p>Proprietary and Confidential | herronpalmer III. Internet Services</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 37 1. Availability 3</p><p>37 7 days per week, 24 hours per day, except for 4 SP scheduled maintenance</p><p>37 5 2. Supported Languages</p><p>37 6 SP Internet site is presented in English</p><p>37 7 3. General</p><p>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</p><p>38 0 SP Online printable transaction confirmations</p><p>38 Acquire and maintain domain name 1 SP http://mypgebenefits.com/</p><p>38 2 SP Host interactive SPDs</p><p>38 3 SP Develop and maintain interactive SPDs</p><p>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</p><p>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</p><p>38 Provide ability to deliver client specific, ad-hoc 7 SP messages/communications via the Website</p><p>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)</p><p>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</p><p>39 2 SP Support user ID other than SSN</p><p>39 3 4. Inquiries:</p><p>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)</p><p>39 6 SP Current coverage and deductions</p><p>39 7 SP Claim filing procedures</p><p>39 8 SP Direct billing payment status</p><p>39 9 5. Transactions:</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 40 0 SP Annual enrollment functions</p><p>40 1 SP Life events</p><p>40 2 SP Newly eligible enrollments</p><p>40 3 SP Change in family status events</p><p>40 4 SP Dependent data maintenance</p><p>40 Decision support and modeling services, including, 5 SP FSA calculator, plan and cost compare tools, claims projections, etc. 40 6 SP Confirmations</p><p>40 Inactive participant data maintenance (e.g., 7 SP address change, contact information)</p><p>40 8 SP Initiate H&W retirement event</p><p>40 9 SP Print forms, kits, SPDs, plan documents, etc.</p><p>41 Track participant sessions, web pages viewed, and 0 SP actions taken</p><p>41 1 SP Beneficiary designation and updates</p><p>41 Accept e-mail requests for forms and general plan 2 SP information</p><p>41 6. Internet Services – Retirement 3 Coordination</p><p>41 4 SP Provide estimated retiree H&W benefit costs</p><p>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</p><p>41 6 7. Internet Services – Plan Sponsor</p><p>41 Provide key performance measures (SLAs) and 7 SP plan activity reports (e.g., dashboards)</p><p>41 Provide standard reports including annual 8 SP enrollment results</p><p>41 9 SP PG&E access to imaging, cases and recorded calls</p><p>42 0 SP Access to transaction history online</p><p>42 Ad hoc reports: Provide client-defined reports 1 SP from standard data</p><p>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</p><p>42 Updates: Provide updates on impact of legislative 4 SP changes on service delivery and administration</p><p>42 5 SP Allow for PG&E customized messaging</p><p>Proprietary and Confidential | herronpalmer IV. Communications</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 42 1. Communications Strategy 6</p><p>42 Facilitate communications requirements/strategy 7 SP planning meeting with PG&E on annual basis</p><p>42 Participate in communications 8 C requirements/strategy planning meeting with Service Provider 42 9 2. Communications Delivery Methods</p><p>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</p><p>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 </p><p>43 Deliver targeted e-mail/e-card and postcard 4 SP messages to participants</p><p>43 3. Communications Materials – Launch & 5 Ongoing</p><p>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</p><p>43 Design, produce and distribute all H&W 8 SP administration related correspondence</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 43 9 C Review and approve content </p><p>44 Design, produce and distribute active H&W and 0 SP retiree related materials</p><p>44 Design, produce and distribute new hire 1 SP enrollment kits</p><p>44 2 4. Annual Enrollment Materials</p><p>44 Review and approve content of annual enrollment 3 C communication materials</p><p>44 Develop annual enrollment communications 4 SP strategy document</p><p>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</p><p>44 7 5. Materials Management</p><p>44 Provide electronic documents to Service Provider 8 C (e.g., SPDs, SMMs, newsletters)</p><p>44 Print-on-demand function for PG&E and carrier- 9 SP provided electronic documents</p><p>45 Manage inventory of preprinted materials and 0 SP print additional inventory as needed</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 45 1 6. Fulfillment</p><p>45 Assemble all materials and distribute to 2 SP participants</p><p>45 Provide process controls/audit trail of fulfillment 3 SP process</p><p>45 4 7. Returned Mail</p><p>45 If active employee, contact participant for new 5 C address</p><p>45 6 SP Check database for updated address</p><p>45 If address has been updated, send returned mail to 7 SP new address</p><p>45 If address has not been updated, set bad-address 8 SP flag on system</p><p>45 9 SP If active employee, notify PG&E of bad address</p><p>46 If inactive participant, manage lost-participant 0 SP search</p><p>46 Utilize credit or government agency database to 1 SP facilitate lost-participant search</p><p>Proprietary and Confidential | herronpalmer V. Data Reports and Interfaces</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 46 1. Data Sources – General 2</p><p>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</p><p>46 Support reconciliation of data being sent to Service 5 C Provider</p><p>46 Support resolution of data errors identified during 6 C loads</p><p>46 Load client-provided data and perform standard 7 SP and plan-specific edits and corrections</p><p>46 Perform weekly data reconciliation process for 8 SP indicative data among systems if needed</p><p>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)</p><p>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</p><p>47 Real time front end edits on batch processing and 3 SP data input to administrative system</p><p>47 4 SP Log all online transactions and data changes</p><p>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</p><p>47 Trace data changes to date updated and user or 6 SP source of transaction or change</p><p>47 Date and time stamp all transactions and data 7 SP changes</p><p>47 8 2. Data Sources – H&W</p><p>47 Maintain eligibility and enrollment data for all 9 SP participants</p><p>48 Accept data transmission/scan from DB provider 0 SP for Retiree Medical election</p><p>48 1 T Carriers maintain coverage data for all participants</p><p>48 2 3. Beneficiary Data Maintenance</p><p>48 Accept beneficiary elections online and in paper 3 SP form</p><p>48 Retain imaged beneficiary election forms, as 4 SP required</p><p>48 Accept and maintain online beneficiary 5 SP information</p><p>48 Conduct annual beneficiary re-solicitation for 6 SP participants with missing beneficiary information</p><p>48 Conduct beneficiary re-solicitation for all 7 SP participants every three years</p><p>48 8 4. File Transmission Methods</p><p>48 Electronic file transmission with exception 9 C SP T processing handled manually as needed</p><p>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</p><p>49 1 5. H&W Interfaces</p><p>49 Produce and send changes-only indicative data 2 C files to Service Provider </p><p>49 Load weekly participant data into administration 3 SP system</p><p>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</p><p>49 Support provision of retroactive start dates as well 6 SP as pre- and post-tax deduction amounts</p><p>49 Produce a full file of deductions to send after 7 SP annual enrollment</p><p>49 8 SP Send imputed income file to PG&E as required </p><p>49 Send imputed income amounts for retirees and 9 SP severed employees on annual file</p><p>50 0 C Load deduction data into payroll system</p><p>50 Send FSA deductions and data to Kaiser FSA 1 SP administrator on a pay-cycle basis </p><p>50 Perform data validation and reconciliation on all 2 SP T incoming data interfaces (carriers)</p><p>50 Produce and send file of H&W deductions for 3 SP retirees to the pension payroll provider</p><p>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</p><p>50 Provide H&W information to actuary for 5 SP determination of new rates</p><p>50 Provide H&W information to other service 6 SP providers (i.e., H&W consultant, data warehouse)</p><p>50 Perform data validation and reconciliation on all 7 SP incoming data interfaces (H&W service provider)</p><p>50 Accept multiple events per participant in single 8 SP transmission</p><p>50 Perform full file data reconciliation to carriers on 9 SP quarterly basis</p><p>51 Produce and send monthly changes-only eligibility 0 SP reporting to CMS</p><p>51 Produce and send Medicare Part D enrollment and 1 SP subsidy effective dates to third-party providers</p><p>51 Provide census data for ASC 715 report (formerly 2 SP FAS 106) for actuary</p><p>51 Create ASC 715 report (formerly FAS 106) report 3 T for presentation to PG&E</p><p>51 4 6. Carrier Interfaces</p><p>51 Produce/send weekly eligibility files/reports to all 5 SP carriers via secure connectivity</p><p>51 Receive files from carriers (i.e., MetLife, 6 SP Commuter) to report enrollment information</p><p>51 Send and receive file to Absence and Disability plan 7 SP administrator to feed eligibility, update status changes and set up direct bill</p><p>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</p><p>52 1 T Receive enrollment data from Service Provider</p><p>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</p><p>52 4 T Research discrepancies from Service Provider</p><p>52 5 T Notify PG&E of continuing discrepancies</p><p>52 6 SP Perform data validation and reconciliation</p><p>52 Complete quarterly full file reconciliation of 7 SP provider and carrier databases</p><p>52 8 SP Accept 401(h) reporting</p><p>52 9 7. Controls and Audit Trail</p><p>53 On-line processing fully supported by 0 SP comprehensive edit and validation routines</p><p>53 Batch-processing capabilities fully supported by 1 SP comprehensive edit and validation routines</p><p>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</p><p>53 All system tables have a Date Last Updated field 3 SP and User ID for individual making the change</p><p>53 Provide ability to trace transactions to a particular 4 SP user and/or point-of-origin</p><p>53 5 SP Date and time stamp all transactions</p><p>53 Identify effective date of all transaction – whether 6 SP past (retroactive) or future</p><p>53 7 SP Research discrepancies from Service Provider</p><p>53 8 SP Notify PG&E of continuing discrepancies</p><p>53 9 SP Perform data validation and reconciliation</p><p>54 0 8. Plan Sponsor Reports</p><p>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</p><p>54 Monthly review of reports with notification to 3 C Service Provider of any errors or issues</p><p>54 Generate address report for PG&E up to four times 4 SP per year upon request</p><p>54 5 9. Ad Hoc Reports</p><p>54 Provide online ad hoc report generation 6 SP capabilities that include:</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 54 7 SP . Drill down capabilities</p><p>54 8 SP . Support of “if/then” logic</p><p>54 . Ability to generate reports using both 9 SP calculated and stored values</p><p>55 0 SP . Any selected point-in-time or data ranges</p><p>55 . Trend reports showing changes over 1 SP various time periods</p><p>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</p><p>55 4 SP Provide training on report tools</p><p>55 Produce ad hoc reports utilizing tools provided by 5 C Service Provider</p><p>55 Provide specifications for ad hoc report that cannot 6 C be developed from online ad hoc reporting tools</p><p>55 Provide “ad hoc” reports that client cannot 7 SP generate from online tools</p><p>55 8 SP Ability to save queries for others to access and use</p><p>Proprietary and Confidential | herronpalmer VI. Compliance</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 55 1. Form 5500 Services 9</p><p>56 Collect and organize required information and data 0 SP to complete Form 5500 filings</p><p>56 Provide participant counts for 5500 filing (raw 1 SP data only)</p><p>56 Provide required data to Outsourcing Service 2 T provider (e.g., schedule A)</p><p>56 Develop signature-ready 5500 and associated 3 SP Schedules</p><p>56 4 C Sign and submit Form 5500s</p><p>56 5 2. Summary Annual Report Production</p><p>56 6 SP Provide necessary participant information</p><p>56 7 SP Produce SAR content</p><p>56 8 SP Distribute SARs to all plan participants</p><p>56 9 3. IRS Limits – H&W</p><p>57 0 SP Monitor Spending Account Deferral limits</p><p>57 Process IRS forms for Qualified Dependents 1 SP (domestic partners)</p><p>57 Edit contributions to ensure compliance with 2 SP limits; reject contributions beyond limits</p><p>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</p><p>57 4 4. Limits and Testing – H&W</p><p>57 Perform H&W Section 79 testing and provide 5 SP report of results with recommendations annually</p><p>57 Perform H&W Section 125 testing and provide 6 SP report of results with recommendations annually</p><p>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</p><p>57 Identify alternative corrective actions in cases of 9 SP test failure</p><p>58 0 C Review test results</p><p>58 1 C Approve recommended corrective action</p><p>58 Perform necessary actions to correct upon client 2 SP approval</p><p>58 3 5. Other Compliance Services</p><p>58 Administer programs in compliance with all 4 SP benefits impacting Federal and State Legislation</p><p>58 Provide all legally required reporting and 5 SP disclosure materials to participants</p><p>58 6 C Update plan documents and SPDs</p><p>58 Store and make available plan documents and 7 SP SPD’s to participants</p><p>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</p><p>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</p><p>59 Monitor legislative changes affecting 2 SP administration</p><p>59 Notify PG&E of changes and solicit PG&E input 3 SP where applicable</p><p>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</p><p>59 Update procedures to reflect annual changes 6 SP within existing legislation</p><p>59 7. Patient Protection and Affordable Care Act 7 (PPACA)</p><p>59 Provide annual file of value of health insurance 8 SP coverage to payroll at end of each calendar year</p><p>59 Disclose value of health insurance coverage on 9 C employee’s Form W-2</p><p>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</p><p>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</p><p>60 Updates to Health Care Flexible Spending Account 3 SP contribution limit</p><p>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</p><p>60 7 8. Defense of Marriage Act (DOMA)</p><p>60 8 SP Update plans to comply with DOMA</p><p>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</p><p>61 Maintain federal, state, and local tax tables on 1 T system</p><p>61 2 T Prepare and send quarterly and annual tax reports</p><p>Proprietary and Confidential | herronpalmer VII. Implementation</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 61 1. Implementation 3</p><p>61 4 SP Perform project management</p><p>61 5 C Perform internal project management</p><p>61 6 C Provide required conversion data</p><p>61 Provide data requirements, data layouts and data 7 SP usage documentation</p><p>61 8 SP Load, edit, and validate conversion data</p><p>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</p><p>62 Participate in client acceptance test planning, 2 C review and approval</p><p>62 3 C Participate in CSR cultural training</p><p>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</p><p>Proprietary and Confidential | herronpalmer Owner Included Item Responsibilities Cost Third Party C SP T I X U 62 6 2. Implementation Staffing and Resources</p><p>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:</p><p>. 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</p><p>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)</p><p>64 3. Project Management Responsibilities and 7 Tools</p><p>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</p><p>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.)</p><p>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</p><p>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</p><p>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</p><p>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</p><p>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)</p><p>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</p><p>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</p><p>Proprietary and Confidential | herronpalmer VIII. Governance</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 72 1. Governance 8</p><p>72 Assign an Executive Sponsor responsible for 9 SP overseeing the PG&E account</p><p>73 Assign a relationship manager responsible for the 0 SP overall relationship between provider and PG&E</p><p>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</p><p>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</p><p>73 Annually review and revise performance standard 5 SP metrics and categories </p><p>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</p><p>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 </p><p>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</p><p>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</p><p>74 Notify PG&E Benefits staff for all system changes 9 SP prior to introducing them to the production environment</p><p>Proprietary and Confidential | herronpalmer IX. Miscellaneous</p><p>Owner Included Item Responsibilities Cost Third Party C SP T I X U 75 1. Plan Audit 0</p><p>75 Communicate audit schedule and scope to Service 1 C Provider</p><p>75 2 C Manage overall audit process</p><p>75 Produce discrimination reports and participant 3 SP counts for Form 5500 annually</p><p>75 Provide requested pre-existing materials to 4 SP auditors</p><p>75 Provide onsite support for 40 hours for H&W per 5 SP year</p><p>75 6 T Perform plan audit</p><p>75 7 2. Service Audit</p><p>75 8 C Manage overall audit process</p><p>75 9 SP Provide requested materials to auditors</p><p>76 Provide required support for on-site auditors on 0 SP annual basis</p><p>76 Provide semi-annual SSAE No. 16 and ISAE No. 1 SP 3402 audit results to PG&E</p><p>76 2 3. Documentation</p><p>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</p><p>76 4 SP Maintain requirements documentation</p><p>76 Capture plan and administrative changes in 5 SP electronic format</p><p>76 Retain history of changes to process manual with 6 SP ability to redline recent activity for client sign off </p><p>76 7 4. Records Retention</p><p>76 Retain records online for immediate access for 36 8 SP months (excluding non-vested terms)</p><p>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</p><p>77 5. Beneficiary Validation and Survivor 1 Services</p><p>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</p><p>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</p><p>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.)</p><p>Proprietary and Confidential | herronpalmer </p>

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