RAPID CITY AREA SCHOOL DISTRICT - RFP
VENDOR QUESTIONS AND ANSWERS
February 9, 2009
1. Can you provide the current (8/08 - present) Delta Dental rates and previous (9/07-7/30/08) Delta Dental rates?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
2. Can you provide information on any dental plan design changes from 2007 – 2009? If so, what were they and when were they implemented?
The only plan design change during that time was the addition of the Smile Smart for Your Health Enhanced Benefits Program. This program was added 9/1/08. This program provides enrollees with enhanced preventive dental benefits for certain oral and medical conditions that may affect their overall health. Information on the Smile Smart program can be found on the DDSD website:
http://www.deltadentalsd.com/webpage
3. What level of R&C is Delta Dental of South Dakota reimbursing non-network providers? Is it the 51st percentile?
Delta Dental of South Dakota does reimburse non-network providers at the 51st percentile. For 2008, 98.9% of Rapid City School District claim payments were made to a network provider.
4. Should we include commissions in our quote?
No commissions are payable to Gallagher. Local agents can submit proposals with commissions; however, they must be fully disclosed including all overrides, contingencies and service fees. If a carrier responds directly to Gallagher Benefit Services, there will be no commissions.
5. Why is the District out to bid this year? Are they having any service issues with any of their current vendors?
The District felt that it was in its best interest to periodically bid its programs.
6. How long has the District been with their current TPA?
The School District has been with their current TPA since September 1, 1993.
7. Are the benefits union bargained?
Benefits are not bargained. There is an Insurance Committee that consists of two (2) members from each bargaining group. They act in an advisory capacity only.
8. It’s fairly rare to see a large employer move from self-funding back to being fully insured. Why are they considering this? How likely is it that they will move to being fully insured?
The District intends to seriously consider all reasonable financial arrangements.
9. Page 16 of the RFP outlines some fully insured plan modifications the District is considering. Should we provide pricing for these modifications in our self-funded proposal as well?
Yes, the same plan modifications (outlined on page 16 of the RFP, under B. Fully Insured Medical PPO/Rx Plan) should be considered in a self-funded situation as well as in a fully insured situation. Vendors quoting on a self-funded basis should provide the price impact, if any, to the ISL/ASL premiums, aggregate attachment factor and expected claims associated with the plan modifications. The stop loss worksheet in EXHIBT 11 has been updated to reflect the plan modifications. The revised exhibit is posted on the website: EXHIBIT 11 REVISED – Proposed Costs - Medical.
10. Does the District’s current UR vendor also provide disease management services?
No, the current vendor does not provide disease management at this time.
11. Will Gallagher be sending out information on the District’s rate history - including current administration fees, PPO access fees, PBM fees, UR/DM fees, stop loss rates and aggregate factors? This information is critical from an underwriting perspective.
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
12. Would it be permissible for us to quote a Supplemental Life plan? With a low amount of Basic Life coverage, there may be keen interest in a Supplemental Life plan. We are fully prepared to take the lead role and costs in helping to drive a healthy participation in this virgin coverage.
No; the School District is not interested in Supplemental/Voluntary Life quotes.
13. Basic Life/AD&D. Thank you for the three years of paid claims, premium, and Waiver of Premium claims. Might it be possible to receive the same for 9/1/04-9/1/05 and 9/1/03-9/1/04?
Paid premiums have changed very little from year to year. The additional requested information is provided below:
Basic Life/AD&D / 9/1/03 – 8/31/04 / 9/1/04 – 8/31/05Claims / 1 Life / 1 AD&D / 3 Life / 1 Dependent
Benefit / $20,000 / $31,000
Premium / $39,761 (total) / $39,618 (total)
There are no waiver claims.
14. The rate in the booklet indicates $.13/$.03. The book is from 1992. Has this been the rate since 1992? If not, might you be able to provide an updated (last 5 years) of rate history for Basic Life/AD&D and Dependent Life?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
NOTE: The Basic Life/AD&D rates have not changed in the past twelve (12) years.
15. There is a General Questionnaire included in the RFP. Usually, I complete a questionnaire for Life, specifically. I would just like to make sure I am doing all that you want. Please indicate if the completion of a Life Questionnaire will be appreciated.
All questionnaires relevant to the coverages for which you are providing a quote should be answered completely. You can indicate “N/A” on the questionnaires related to those coverages which are not applicable to your proposal. The General Questionnaire should be answered by all vendors providing a proposal.
16. Life Insurance Questions
a) The Schedule of Insurance includes the following notation: "Retiree coverage terminates upon qualification for Medicare due to age." That seems to tie in with what I see on the census file. PLEASE CONFIRM.
Confirmed. Retiree coverage terminates upon eligibility for Medicare.
b) What are the current rates for Life, Dependent Life and AD&D?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
c) Is there a separate rate for retirees? If not, would the client be interested in establishing a separate rate for active and retirees?
No, there is not a separate rate for retirees. The School District is not interested in a separate rate for retirees.
d) What are the renewal rates for Life, Dependent Life and AD&D?
Renewal rates will not be provided.
17. What are the late entrant rules for the dental plan?
The District does not have annual open enrollment. Employees are only eligible to enroll at hire or with an approved family status change. Therefore, there are no late entrants to the dental plan other than those that come on due to status change. They are not subject to any additional condition as a late entrant.
18. It sounds like you are marketing the administration piece as well. Do you want us to assume First Administrators as the TPA and Select First as the network for now? We can always change our quote if the TPA and network changes.
Only bundled proposals will be accepted for the medical coverage. You will need to partner with a TPA and network (not necessarily First Administrators / Select First). The life and dental coverages can be quoted on a stand-alone basis.
19. We will offer a stop loss quote with and without our disease management programs and include an explanation of all programs.
Only bundled proposals will be accepted for the medical coverage. You will need to partner with a TPA and network (not necessarily First Administrators / Select First). Disease management can be quoted on an unbundled basis.
20. Does this school district offer voluntary life? We can probably get a little more aggressive on the basic life/AD&D, if we had the voluntary life.
No. Refer to item 12 above.
21. We have not evaluated SelectFirst's network. Do you have a report that you can send me that shows reported claims versus paid claims so we know what kind of network discount we can apply? This would help greatly!
The current network discount information will not be provided.
22. Do you have the current spec rates, aggregate factor and aggregate premium?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
23. Basic Life/AD&D. Can you please verify the rate history for the group? The only rates provided were the initial 1992 rates with Pioneer Mutual Life Insurance Company of $.13/.03 Life/AD&D and $.40/Dependent Unit.
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
24. Basic Life/AD&D. Is any experience available prior to 2005 since they have been with the current carrier since 1992?
Refer to item 13 above.
25. Basic Life/AD&D. Is it possible to get any additional experience dating for Oct., Nov. and Dec. of 2008? We received experience through Sept. 2008 but nothing after that. Please let us know if this information is available.
There were two (2) dependent claims for a total benefit of $3,000.
26. What is the current network savings number for the last year, based upon the networks in place?
The current network discount information will not be provided.
27. On the Exhibit 5-Medical-Network Analysis Profesional.xls worksheet, I don’t know what they want in the “Average Medicare (Par) Allowable” column?
For each of the procedures listed, we are looking for each vendor to provide the amount Medicare would allow.
28. Dental. Can we get rates that coincide with the 2006, 2007 and 2008 experience? Also, are renewal rates available as yet?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site. Renewal rates will not be provided.
29. Dental. Can you explain a "blind PPO"?
A “blind PPO” is a passive PPO (i.e., no benefit differential between in- and out-of-network benefit provisions – deductibles, coinsurance, maximums).
30. Dental. Can you provide the following additional information:
a) Experience for the past 24 months?
The dental experience for the period of 9/06 – 12/08 was posted to the website as part of the original RFP posting. Refer to APPENDIX G of the website.
b) ASO fee history?
The dental plan is currently fully insured.
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
31. Dental. The experience is showing claims and lives can we get monthly premium?
Delta Dental of South Dakota provided additional information, to include premiums along with the other data originally requested. In addition, they expanded the time period to include all of calendar years 2006, 2007 and 2008. The School District’s claims typically run higher in the summer and lower in the fall. The updated exhibit should provide a better picture on the relationship between their premiums and claims on a month by month basis over the past three years.
Refer to the RFP website: APPENDIX G REVISED – Dental Experience. This appendix has been posted to the site.
32. Basic Life/AD&D. Can you provide the following additional information:
a) Experience for the past 5 years (including premium and claims)?
· For the period of 9/1/03 – 9/1/05, refer to item 13 above.
· The Life/AD&D experience for the period of 9/1/05 – 9/1/08 was posted to the website as part of the original RFP posting. Refer to APPENDIX H of the website.
· For the period of 9/1/08 – 12/31/08, refer to item 25 above.
b) Rate history?
Refer to the RFP website: APPENDIX I – Rate History. This appendix has been posted to the site.
c) Volumes?
Life volume data is not available. Approximate life volumes can be determined using paid premium and unit rate data provided.
d) Waiver claims? Any current waivers?
Refer to item 13 above and item 44 below. There are no current waiver claims, nor have there been any in the past.
33. Under the performance guarantees section (page 24), it asks for telephone response times for the payer’s customer service dept. as well as for an on-site service rep. Does Rapid City currently have an onsite service rep and if so, is this an employee of Rapid City or the current administrator?
The School District does not have an on-site service representative.
Therefore, the language on page 24 of the RFP – Performance Guarantee related to “Telephone Response Time” – should read as follows:
Telephone response time / Average speed of answer within 30 seconds or less / The amount of time that elapses between the time a call is received into the phone system to the time answered by a representative (live voice answer). / Quarterly, with monthly reporting to client of client-specific results. / 1% of quarterly fee34. On the network questionnaire, it asks if we will accept the client’s current enrollment forms. Does Rapid City hold open enrollment each year, or do they anticipate sending the current enrollment to the potential new vendor? If so, is it available electronically?
Refer to item 17 above. Initial enrollment can be provided electronically for any new vendor/carrier.
35. Does Rapid City desire support from vendors for enrollment meetings? If so, can you clarify the type of support needed, number of meetings, locations, etc.?
No enrollment meetings are anticipated. Per item #17 above, there is no open enrollment.