sRFP-18-003 - Group Health & Benefits Carrier

Request for Proposal
(RFP)
 
for
 
 
Group Health & Benefits Carrier
 
 The Safe Workplace Associations
 
 
 
sRFP-18-003
 
 
 
Submitted by:
 Full Organization Legal Name:
RFP Contact Person and Title:
Street Address:
City, Province, Postal Code:
Phone Number:     
E-mail Address for RFP Contact Person:
 
 
 
I.          TABLE OF CONTENTS
II...... INTRODUCTION.. 5
IV.... PROPONENT QUALIFICATIONS AND BUSINESS REQUIREMENTS.. 7
A.  Project 7
B.  Scope of Services. 7
C. Administrative Provisions. 8
D. Guidelines for Proponent’s Submission. 10
E.  Respondent Questions. 10
F.  Experience & Qualifications. 18
G. Evaluation of Proposals. 18
H. The Associations Confidentiality. 21
I.    Sub-contracting or Substitution. 21
J.  Costs and Expenses. 21
K.  Review Representative. 21
L.  Additional Information. 22
M. Other Considerations. 22
N. Notification to Other Proponents of Outcome of RFP Process. 22
O. Debriefing. 22
P.  Selection of Proponent 22
Q. Conflict of Interest 22
V. ... RFP TERMS.. 23
A.  Information Gathering Process. 23
B.  Cost of RFP Response. 23
C. Use of the Associations Names or Logos. 23
D. Explanation of Information Evaluation or Decision Making. 23
E.  Restriction on the Associations Contacts. 23
F.  Confidentiality of Proponent’s Information. 23
G. Data Validity. 23
H. Errors and Omissions. 24
I.    Indemnification. 24
J.  Conflict of Interest 24
K.  Right to Termination. 24
APPENDIX A - GENERAL PROPONENT INFORMATION.. 25
APPENDIX B - TAX COMPLIANCE DECLARATION.. 27
APPENDIX C - CONFLICT OF INTEREST DECLARATION.. 28
APPENDIX D - RESPONDENT ACKNOWLEDGEMENT FORM.. 29
APPENDIX E – EP3 STATEMENT.. 30
 

 
II.         RFP CHECKLIST
 
The Associations recommend that Proponents use the following checklist when completing the RFP to help ensure that all the key components to their organization’s proposal are submitted on time.  Documents must be delivered to the Project Representative by the dates and times set out below. 
 
Courier or Deliver By:
October 26, 2018        @ 2:00 pm EST  
 
Group Health & Benefits Carrier
 
TO:
The Associations - sRFP- 18-003  - Project Representative:    Alan Hansen 
5110 Creekbank Road, Suite 400
Mississauga ON L4W 0A1
 
Include all RFP materials, in one (1) package.
The package should contain:
 
☐   One (1) envelope prominently marked “Original” signed by an authorized representative and containing
☐   One (1) printed original and 1 CD or USB of all documents and exhibits in response to the RFP
 
☐   One (1) envelope marked “Copies” and containing
☐   Five (5) copies of all documents and exhibits in response to the RFP and
☒   Five (5) CD’s or USB’s containing all documents and exhibits in response to the RFP in Microsoft Word and Microsoft Excel where required.
 
Read all questions in Section IV. E carefully and provide answers in the format provided.  If additional space is required, please indicate clearly and attach additional pages at the end of this proposal.
 
Please ensure these additional documents are downloaded from Merx and that Appendix G “Rate History-Quoted Rates” and Appendix F “Quotation Requirements”, is completed and submitted:
 

• Appendix F “Quotation Requirements” (This Appendix must be completed and submitted).

• Appendix G “Rate History - Quoted Rates” (spreadsheet with your volumes and quoted rates compared to the current rate, populate cells highlighted in yellow. This Appendix must be completed and submitted).

• Appendix H “Plan Design Designs, Experience”

• Appendix I “Census”

 
Proposals are to be prominently marked with the RFP title and number (see RFP cover), with the full legal name and return address of the proponent, and with the Proposal Submission Deadline date and time.
 
Proposals submitted in any other manner may be disqualified.
 
In the event of a conflict or inconsistency between the hardcopy and the electronic copy of the proposal, the hardcopy of the proposal shall prevail.
 
 

   

1. Background

 
The Safe Workplace Associations (“Associations”) are comprised of the following five organizations and will be referred to interchangeably as such throughout this RFP:
Centre for Health & Safety Innovation (CHSI) is a focal point for innovation and applied learning. With its close proximity to airports, highways, and hotels, CHSI is the perfect location to host training programs, strategy sessions, board meetings or receptions.  Since opening in 2006, CHSI has provided unparalleled services to clients within the Ontario Prevention System, as well as to a diverse group of local and corporate businesses.
Infrastructure Health & Safety Association (IHSA) is a high risk activity educator providing unique, customized training programs in the fields of Construction, Transportation and the Electrical and Utility Sectors.  IHSA’s programs, products and services are shaped by subject matter expertise, sector partnership and evidence based practices.  Our goal is to build strong partnerships with our clients and deliver innovation, customized programs that support their implementation of prevention solutions and provide continuous improvement to their health and safety performance.
Public Services Health &Safety Association (PSHSA) serves Ontario’s Public and Broader Public Sector employers and workers, providing training, consulting and resources to reduce workplace risks and prevent occupational injuries and illnesses. We serve more than 10,000 organizations and over 1.6 million workers across the province’s education and culture, community and healthcare, municipal and provincial government and emergency services sectors.  Located across Ontario, our regional teams bring together sector-specific experience with expertise in common workplace issues to provide clients proven prevention training, consulting and resources based on best practices and ongoing research.
 
Workplace Safety North (WSN) is an independent not-for-profit health and safety organization. Our members are companies in Ontario's mining, forestry, paper, printing and converting sectors. We also provide health and safety services to businesses in all sectors across Northern Ontario. 
Workplace Safety & Prevention Services (WSPS) is a leader in providing impactful risk management solutions that drive lasting business success for our customers.  WSPS offers unparalleled health & safety expertise, insight and solutions for creating healthy work environments where employees thrive and businesses prosper. WSPS is primarily focused on the agricultural, industrial/manufacturing and service sectors.
CHSI Office Location:                    PSHSA Office Locations:                         WSN Office Location:
5110 Creekbank Road                    4950 Yonge Street, Suite 1800                   690 McKeown Avenue
Mississauga ON L4W 0A1              Toronto ON M2N 6K1                                  North Bay ON P1B 9P1


IHSA Office Locations:
Mississauga                                   Mississauga                                              Etobicoke
5110 Creekbank Road, Suite 400    5345 Creekbank Road                              21 Voyager Court South
Mississauga ON L4W 0A1               Mississauga ON L4W 5L5                          Etobicoke ON M9W 5M7
 
Workplace Safety & Prevention Services Office Locations:
Head Office                                          Regional Office--Ottawa                       
Centre for Health & Safety Innovation     Carleton Technology & Training Centre  
5110 Creekbank Road, Suite 300           Suite 3100, Carleton University             
Mississauga ON L4W 0A1                      1125 Colonel By Drive                          
Ottawa ON K1S 5R1                             
 
This RFP has been prepared to assist prospective vendors in responding to the Associations requirements for a Group Health & Benefits Carrier.
 
 

1. Accessibility for Ontarians with Disabilities (AODA)

The selected Proponent shall comply with the requirements for all relevant accessibility standards established by regulation under the Accessibility for Ontarians with Disabilities Act, 2005 and the Integrated Accessibility Standards Regulation (IASR).
 
The Associations are committed to eliminating barriers and improving accessibility for persons with disabilities to afford equal opportunities and the provision of integrated programs and services where possible, in manner that respects dignity and independence.
 
We are committed to incorporating accessibility design, criteria and features when procuring or acquiring
goods, services or facilities upon request, except where it is not practicable to do so.

1. Definitions   

1. The Associations - wherever used shall mean the five organizations represented in this RFP: CHSI, IHSA, PSHSA, WPN and WSPS

1. RFP - wherever used shall mean this Request for Proposal.

1. Proponent - wherever used shall mean RFP recipient/participant.

1. Offer/Offer of Service/Proposal - wherever used shall mean a Proponent’s written response to this RFP.

1. Consultant wherever used shall mean a provider of consulting services.

1. BPS – Broader Public Sector.  As of April 2, 2012 all Health & Safety Associations are required to follow the Broader Public Sector Procurement Directive.

  A.Project
 
There are currently 578 active and 330 retired members, plus 24 survivors, covered by the benefits program.   Each individual Association has its own plan design and provisions.  Individual experience by Association has been provided; however the group is currently rated on a combined basis.
 
The Associations have formed a Health and Safety Governance Committee to work in an advisory capacity to enhance the value of their Group Benefits Program, health initiatives and related products and services, with the purpose of ensuring comprehensive health and benefits programs with good value to all members.  The Committee will provide thought leadership and will explore proven practices around health, wellness and benefits programs, as well as ensure consistent practices are applied and evaluated across the sector to better support the Associations and its employees.
 
The current carrier has carried the insurance for 11 years under one policy, with separate divisions for each Association group.
 
The current renewal date is April 1st, 2019.  The Associations would like to maintain the current April 1st renewal effective date to coincide with their financial years.
B.Scope of Services
 
 Market Review
 
Your company is being invited to submit a proposal to provide employee benefits for the Associations.
The group benefits to be reviewed in this market study include:
             BenefitFunding Arrangement
Basic Employee LifeExperience-Rated, Non-Refund
Dependent  LifeExperience-Rated with BL, Non-Refund
Optional LifeFully Pooled
Long Term DisabilityExperience-Rated, Non-Refund
Short Term DisabilityExperience-Rated, Non-Refund
Extended Health CareExperience-Rated, Non-Refund
Dental CareExperience-Rated, Non-Refund
Employee & Family Assistance (EFAP)Experience-Rated, Non-Refund
Health Care Spending Account (IHSA)ASO Billed in Arrears
 
All benefits are to remain as per these current funding arrangements.  Please submit Appendix F - Quotation Requirements, with your proposal.
 
The purpose of the market study is to review the Canadian marketplace to find a suitable carrier for the Associations Basic, Optional and Dependent Life, Short Term Disability, Long Term Disability, EFAP, Health and Dental benefit programs, from both a cost and service perspective.  The preference is to have one carrier for all benefits; however, please note if you would be willing to underwrite Life, STD and LTD only and/or Health and Dental only; and whether this would impact the quoted rates and/or expenses.
The following are criteria that will serve as the basis for decision-making:

1. Competitive rates and the length of time the quoted premium rates will be guaranteed;

1. Cost containment strategies;

1. Ability to match current plan designs and provisions (noting various Union, Retiree & Survivor classes);

1. Superior account service capabilities;

1. Scope and quality of claims services;

1. Potential to establish a long-term partnership with the Associations;

1. Proven expertise with clients of similar size and complexity

 
In your response, we require that you:

• Complete and return all the documents, attachments and appendices including the appendices attached with the RFP on Merx. Do not include any additional information, only these completed documents should be returned.

• Confirm your ability to match the current plan designs and underwriting arrangements.

• List any and all deviations in your response.

 
            Term of Service
The successful Proponent may be the Service Provider for a period of 48 months provided the Proponent has performed to the satisfaction of the Associations.
 
At the sole discretion of the Associations, the Service Provider status may be extended for one additional 12 month period, pending successful evaluations.
C.Administrative Provisions
The chart below summarizes the structure of this plan.  Each agency is considered a separate billing division of the master contract:DivisionDivision Name
   001Infrastructure Health and Safety Association (IHSA)
   003Workplace Safety North (WSN)
   004Workplace Safety & Prevention Services (WSPS)
   010Public Services Health & Safety Association (PSHSA)
   013Centre For Health & Safety Innovation (CHSI)


  Definition of Classes/Plans:DivClassPlanPlan Name
001001011IHSA - Active Non-Bargaining
001002018IHSA - Bargaining Unit Employees
001002184IHSA - Bargaining Unit Survivors
001003012IHSA - Retirees Non-Bargaining
001003019IHSA - Bargaining Unit Retirees
001003020IHSA - Bargaining Unit Retirees (eff. June 21, 2018)
001004013CSAO - Retirees
001004014CSAO - Survivors
001004015CSAO - Retirees 2002 (closed class)
001004016CSAO - Survivors 2002 (closed class)
001004023EUSA - Retirees
001004024EUSA - Survivors
001004073TSAO - Retirees
001004074TSAO - Survivors
003300031Workplace Safety North (WSN) - Active
003300034Workplace Safety North (WSN) - Survivors
003300037WSN Excluded
003301036WSN - Retirees on or after October 26, 2010
003301038WSN - Retirees on or after July 1, 2018
003302033MASHA - Retirees
003302035MASHA - Retirees With Drugs Only
003302052OFSWA - LTD Retirees
003302053OFSWA - Retirees
003302063PPSHA - Retirees
004400041WSPS - Active
004400044WSPS - Survivors
004401043WSPS - Early Retirees, Retirees
010100111PSHSA - Active
010100115PSHSA Contract Employees
010101083PSHSA - Retirees
013130131CHSI - Active
 
The provisions for the current plan are based on the following:Required renewal notice period90 days
AdministrationRegular Billing and Administration with the Associations using the online insurance company internet system to process enrolments and changes
Waiting periodVaries by association/class 
EligibilityActively working a minimum of 20 hours per week
Coverage for retirees & survivors as outlined in the plan design
Cost SharingAll benefits are 100% employer paid with the exception of Optional Life (Optional Life is 100% Employee paid by all members of the Associations) and:
     For WSPS Retirees, new cost- share introduced:
New 2017 retirees pay 10% of post-retirement premium, with members who Retire each subsequent year having the co-pay increase by an additional 10% to 2021, with members retiring in 2021 paying 50%.
     For WSN Retiree classes:
Retirees on or after Jan 2018 (class 038) pay 50% of premium to a max of $250/month.  
All benefits are to remain as per their current funding arrangements (as per Section IV B “Scope of Services”). Please submit the downloaded Appendix F - Quotation Requirements, with your proposal.
D.Guidelines for Proponent’s Submission
The preferred format for the Proponent’s “Offer of Service” or response to this RFP is as follows:
 

• Project Understanding.  In narrative form, provide a summary of your understanding of the assignment, the major tasks to be completed, and the skills required to do the project. Each Proponent is to include in its proposal a description of how the Proponent will provide the services which must include a project work plan that specifies milestones, methodology and approach, project main contacts and the process for managing and resolving any issues.

• Experience and Qualifications.  Provide a detailed explanation of your firm’s experience and qualifications, and the qualifications of the individuals you are proposing to undertake the project. See Section F below.

• Project Costs and Schedule. Provide a complete listing of pricing/costs, including staff, expenses and any contingencies; together with an outline of the project plan and schedule. Please provide detailed pricing on all aspects of this project and indicate milestones.

           
Include:
1.  Any out-of-pocket expenses should be clearly stated.
2.  Any assumptions incorporated in the proposal.
3.  Value-added services offered free of charge.
4.  Other services available from the Proponent and any other information that may support the  
     Proposal.
E.Respondent Questions
Complete all questions where applicable.  If a section does not apply to your proposal, please clearly indicate “Not Applicable”.
 
General Information and Administration
General Carrier Information

1. The Association wishes to work in partnership with a provider that is available, proactive and client-oriented.  In your opinion, what differentiates your company from other insurance companies in this regard?  Provide one differentiating factor only.

1. Please confirm the proposed account management team (Account Executive, Service Representatives etc.).  Please describe how the account management team will work with the Association on an ongoing basis and points of contact for the Associations Human Resources on a day-to-day basis.

1. Please confirm what period your company is willing to extend benefits during a layoff or severance for without prior written authorization (e.g., up to 6 months).

1. Please confirm you are able to meet an April 1, 2019 implementation date, and include a proposed implementation project plan identifying roles and responsibilities.  Please confirm that you would be willing to maintain an April 1st renewal effective date and consider this in your quoted rate and expenses/TLR guarantees.

1. Please confirm that the plan provisions as described in Appendix H can be duplicated for the benefits program.  Please outline all plan and underwriting deviations by benefit and any associated costs, where applicable.

1. Quoted rates will not be subject to recalculation on the effective date unless there is a substantial difference between the enrolment and the original data submitted.   Please confirm.

1. Please confirm that all quoted rates include 1.9% commission.

 

1. Please confirm that the guidelines of the Canadian Life and Health Insurance Association (CLHIA) with respect to termination and transfer of group insurance coverage will apply, and no employee will lose any coverage as a result of a change in carriers; specifically a continuation of health and/or dental coverage for any employees not actively at work (this includes employees on workers compensation, disability, and maternity/parental leave) at the date of plan transfer will be accepted on a premium paying basis.

 

1. Please confirm that each of the following minimum requirements is met by marking an “X” in the respective box:

 YesNo
Your organization’s industry rating is currently in good standing and in future trending (on Moody’s, S&P, Dominion Bond etc.)☐☐
The current benefit and funding provisions are duplicated without any deviation☐☐
Are you currently (or at any time in the past two years has your company been) on Assuris or government authorities’ “watch list”?☐☐
 

1. Please identify any marketing discounts applied to the rates, and the value (%) of these discounts. In addition, confirm if your organization will recoup these marketing discounts after the rate guarantees expire, and the proposed methodology (if applicable). Please provide manual rates in Appendix F.

1. Please confirm any value added services or products provided within your quoted fees/rates. Specifically, please identify cost management measures that have been provided within both non-union and collectively bargained groups that do not alter the plan design but generate savings through delivery.

1. Please advise how you would handle drugs that were previously approved via prior authorization

 

1. Would you be willing to provide an Open Enrollment with no medical evidence required for Optional Life?

 

1. Describe how your company adds or removes drugs from the existing plan formulary.

 

1. Please indicate that all lines of benefits have been quoted on?

       Yes              No
        ☐               ☐
Administration
The current plan provisions are available in Appendix H.
 Description
Effective dateApril 1, 2019
Renewal notice periodRenewal required minimum 90 days prior to renewal date
AdministrationRegular Billed and Administered with the Association using online insurance company internet system to process enrolments and  changes
 

1. Please provide a detailed outline of your implementation team and the implementation project plan including roles and responsibilities and estimated timeline(s) of each major milestone. Please include in your outline:

1. Any additional charges that would be applied

1. In order to facilitate the April 1, 2019 effective date, please confirm the process to load employee data.  Include in your response whether the process will be on-line or paper based and any communication support you can provide.

Include in your response the resources that would be available to assist in the transition such as completion of enrolments (not all employees have laptops or access to computers), communications persons for all employee announcements/information booklets, IT for system interfaces etc.  If there are costs associated with these resources, please detail.  

1. Please describe the on-line services available for administrators. Advise if client plan administrators can do the following online:

1. add plan members and input enrolment eligibility information, including salary and benefit options

1. change plan member information to reflect changes to benefit, employment status, or personal information

1. terminate plan members, with effective date for coverage cessation and/or last day of work

1. view and print member statements

1. print or view billing statements and administration reports

1. download employee data for management information and reporting

1. download administration forms

 
Quotation Requirements
               Current Arrangements
 Using Appendices F and G, please outline the following;

• Rates and their applicable guarantee period, by benefit, for the current funding arrangements

• Health Pool Charge & Total Loss Ratio expense guarantee period for STD, EHC and Dental

• Administrative expense charges for HCSA

• Manual rates by benefit; 

• Incurred But Not Reported (IBNR) claims reserve factors and formulae for all benefits.

 
Service Capabilities
Experience and Customer Service

1. Please provide your target market and reflect on your expertise with groups of similar size and complexity, with both union and non-union components.

 

1. Please confirm your ability to partner with the Associations in supporting and incorporating any potential upcoming plan design changes and/or cost containment measures.

1. Please outline your willingness to provide support to the Associations with regard to union negotiations, administrator training, employee presentations, etc.

 

1. How are incoming calls logged and what are your service standards for responding to employee and/or administrator questions? Please provide Call Centre statistics for the most recent available 12-month period as per the chart below.

 
      Number of calls answered ending for the most recent available 12-month period:             
 Service Standard# of Calls Meeting Service Standard% of Calls Meeting Service Standard
1st Call Resolution   
Abandonment Rate                                                                                             
Average Wait Time                                                                                             
Service Standard                                                                                               

1. What type of information is available on the plan member website / mobile application (i.e., booklets, find a practitioner, claims history, health information, drug lookup, drug card, claims submission, etc.)?

 

1. Please provide further information regarding your companies’ upcoming innovations and or initiatives.

 
Claims Management and Service Capabilities

1. Please confirm statistics on claim adjudication for the most recent available 12-month period as per chart below:

BenefitAverage
Turnaround
(Days)% Paid Within Average
Turnaround TimeLocation Where
Claims Are Paid
Life                                                                  
LTD – Routine Claim                                                                  
STD                                                                  
Health                                                                  
Drugs

• Pay Direct
• Reimbursement

                                                                  
Hospital                                                                  
Out-of-Country                                                                  
Dental

• Routine
• Predetermination

                                                                    

1. Please confirm your capabilities with respect to on-line submission of health and/or dental and/or health care spending account claims via the Internet and/or mobile application:             

BenefitYesNoSubmitted Electronically by Employee or Provider?Mobile Application?
 
    
 Paramedicals                                                                        
 Vision                                                                        
 Other Health Services                                                                        
 Dental                                                                        
 HCSA (Health Care Spending Account)                                                                        







  Please confirm what mobile devices (Apple, Android, Blackberry, etc.) are supported by your claims submission application.
 

1. What type of information is available on the plan member website / mobile device (e.g., booklets, practitioner locator, claims history, health information, drug lookup, drug card, claims submission, etc.)?  Advise if plan members can do the following online:

1. Print personalized claim forms

1. View/print status or details of paid claims

1. Print claim forms for coordination of benefits

1. Check to see when they are eligible for their next payment for eyeglasses/contacts or their next dental recall exam

1. Print drug cards

1. Print travel cards

1. Drug look-up

1. Lowest cost pharmacy locator

1. List what other information is available to plan members

 
Claims Reporting
Please confirm your claims reporting capabilities, including a brief summary of the reports available, as well as any associated costs for these reports. Include information on the availability of accessing claims information on-line.  Please describe what would be considered custom reports and timelines for such requests.  Please confirm that you are able to provide required reports by division and/or class, where required.  
 
Disability and Absence Management
Disability Reporting

1. Please describe what reports are available for the Associations to track claims status and claims trends for their group programs. Please provide sample claims reports for review. In addition confirm:

1. if these reports are available electronically, or paper based only;

1. if reports are available via self-serve portal, or are the Associations required to schedule report delivery;

1. how often the Associations can expect to receive reports.

1. Please provide statistics on your block of business for the following:

1. Average turnaround time for review of claim information and decision

1. Average duration of claim

1. Average number of hours of rehabilitation support per case

1. Rate of repeat claims for the most recent available 12-month period

1. Rate of declined claims for the most recent available 12-month period

Disability Management

1. Confirm whether the same team of case managers and supervisors manages your STD and LTD claims.

 

1. What are your target caseloads for STD and LTD respectively?  How are caseloads monitored and managed to ensure high quality case management and customer service?

 

1. Describe how your organization will support the claims transition from Short Term Disability to the Long Term Disability program.

 

1. What is your strategy for obtaining timely medical information?

 

1. What case management tools are utilized to support better outcomes in disability management? What outcomes or results have you achieved? Please clearly identify what is value-add versus fee-for-service.

 

1. Please describe how your organization adjudicates and manages STD and LTD claims related to mental disorders. If you have specific processes or case interventions, please comment on the impact or outcomes when these processes or interventions are implemented.

 

1. What case management review process occurs in preparation for the change in definition of disability?

 

1. What are the distinct differences in managing permanent vs. active LTD claims?

 
Employee and Family Assistance Program (“EFAP”)
Experience and Customer Service
Provide a brief synopsis of your organization’s background and areas of expertise in providing EFAP services including the number of years your organization has been in this field.

1. Describe separately your telephone and web-based access and intake system for weekdays, evenings and weekend/holidays.

1. What is the role and qualifications of the person who answers the initial call?  Do they go through any specialized internal training?

1. Can your organization’s access system provide 24-hour telephone crisis counseling, emergency triage, and schedule routine appointments?  How is this accomplished?

1. What is the average response time the Association’s staff can expect to have access to face-to-face counseling?

1. Please provide a listing of workshops that will help the Association prevent or mitigate behavioral and organizational health issues.

1. What modalities of counseling do you offer?

1. Please confirm you can provide quarterly EFAP statistics by division.

 
EFAP Pricing

1. Please complete core service pricing assuming a standard utilization rate of 18%.   Please confirm what core services are included in your pricing; provide a quote based on both a reconcilable and non-reconcilable (monthly fixed fee) pricing basis.

 

1. Please clearly indicate any additional charges for promotional services/materials.

 

1. What optional services are available?  Please provide detailed pricing of these optional services.

F.Experience & Qualifications
Include any additional information that will support your proposal.
 

1. Corporate Viability

Provide latest year-end financial statement(s) and relevant corporate policies/certificates (i.e., health and safety, social responsibility, environmental, ISO, NQI, etc.)  Provide permission for the Associations to use documents to verify corporate viability.
 

1. Previous Experience

Provide an outline of your firm’s previous experience working on projects of this nature.
 
Where relevant, describe Proponent’s relationship with other companies with whom Proponent may partner to service the Associations needs and requirements as described in this RFP.
 
                  Each Proponent must provide as part of its proposal a summary outlining:

• Company history including information regarding recently formed partnerships or strategic alliances  

      with other companies that may be beneficial to the Associations for the purposes of the services
      requested in this RFP.

• Personnel working on the project with qualifications and experience.

• Experience in related projects.

 

1. Vendor Health & Safety Program

Provide relevant corporate policies/certificates regarding health and safety program, policies and records.

1. Accessibility Criteria (as required)

Provide details on how your firm meets AODA requirements specifically in regards to technology.
 
G.Evaluation of Proposals
            The Evaluation Team reviews submissions and will identify and select the Proponent who can provide the required services in an effective manner at the most effective cost consistent with project objectives.  Neither the lowest price Proposal nor any Proposal will necessarily be accepted.
 
Stage I – Mandatory Requirements
Stage I will consist of a review to determine which Proposals comply with all the mandatory requirements.  Proposals which do not comply with all the mandatory requirements may be disqualified and not evaluated further.
 
Other than inserting the information requested on the mandatory submission forms set out in this RFP, a Proponent may not make any changes to any of the forms.  Any Proposal containing such changes, whether on the face of the form or elsewhere in the Proposal, may be disqualified.
      
The Proponent, by submitting a Proposal, warrants that to its best knowledge and belief no actual or potential conflict of interest exists with the submission of the Proposal or performance of the contemplated contract other than those disclosed under General Proponent Information.  Where the Associations discover a Proponent’s failure to disclose all actual or potential Conflicts of Interest, the Associations may disqualify the Proponent or terminate any contract awarded to that Proponent pursuant to this procurement process.

A Proposal that includes conditions, options, variations or contingent statements that are contrary to or inconsistent with the terms set out in the RFP may be disqualified.
 
 
 
 
Each proposal must include the following completed documents located as Appendices:
           Mandatory Documents to be Completed and Submitted
Appendix   AGeneral Proponent Information
Appendix   BTax Compliance Declaration
Appendix   CConflict of Interest Declaration
Appendix   DRespondent Acknowledgement Form
Appendix   FQuotation Requirements (attached on Merx)
Appendix   GRate History—Quoted Rates (attached on Merx)
 
Please provide/confirm the following:

1. That all quoted rates include commission of 1.9% of annualized premiums.     Yes  ☐   No  ☐

1. Specifically confirm any deviations and/or limitations from the current plan design.

 
            Disabled Lives and Waiver of Premium and Experience History  
                                                                                                                                          
            The current experience history, the reserve information, as well as the current plan designs are             attached in Appendix H.
      
Stage II – Rated Criteria
Stage II will consist of a scoring by the Evaluation Team of each qualified Proposal on the basis of the rated criteria.  A minimum score of 75% is required in order for a Proponent to qualify for Stage III – Pricing Scoring.
 
The Associations will not necessarily accept the lowest priced proposal or any proposal.  While price is an important element in the selection process, Proponents should recognize that there are other criteria in this RFP that the Associations will consider in evaluating proposals.
 
The Evaluation Team will base its selection decisions on responses received and the best outcome for the Associations.  Each response will be carefully evaluated and scored by the Evaluation Team.
 
Each response will be scored in accordance with the relative importance weighting indicated in the table below.  It is suggested Proponents address these criteria in sufficient depth in their responses. #Rated CriteriaWeighting (Points)
1.Proponent’s History & Executive Summary:
• Please provide a brief company history, financial stability and executive 
    Summary.
• Please detail the experience of the proposed Account Management Team.
• Ability to meet an April 1, 2019 implementation date.  Provide a high level Project plan (including timelines) identifying roles and responsibilities.
• Ability to match current plan designs and provisions.15
 
2.Proponent’s Scope and Quality of Services:
• Scope & Quality of Administrative Services.
• Scope & Quality of Claims Payment and Reporting Services.
• Employee and Family Assistance Program Services offered.
• Proponent’s innovation & technology.25
 
3.Proponent’s Disability Management:
• Proactive disability management, innovations and service offerings
• Early Intervention.10
 
 Total Points50
 
Financial stability will be evaluated on the information supplied in the response. This may include but is not limited to the years in operation, financial information including audited statements and other proof such as bank letter, bond or other information that will support the response.
 
Points will be awarded based on the degree to which the material provided demonstrates a Proponent’s capability to perform and successfully carry out the work described.  
 
Stage III – Pricing Scoring
Upon successful completion of Stage II, qualified proponents achieving a score of 75% or more will have their pricing scored.  The Evaluation Team will evaluate pricing after the evaluation of mandatory requirements and rated requirements are completed.
  PricingWeighting (Points)
1Proponent’s Competitive Net Costs:
• Please provide quoted rates and volumes as indicated in Section F, identifying any marketing discounts.
•  Please include additional requirements such as pool charge, guarantee periods, manual rates and target loss ratios, as outlined in Section F.50
 
 
Pricing for each qualified Proponent will be scored based on a relative pricing formula, using the rates set out in the Proposal.
 
Each Proponent will receive a percentage of the total possible points allocated to price by dividing that Proponent’s price into the lowest bid price.  For example, if the lowest bid price is $120.00, a Proponent that bids $120.00 receives 100% of the possible points (120/120 = 100%), a Proponent that bids $150.00 receives 80% of the possible points (120/150 = 80%), and a Proponent that bids $240.00 receives 50% of the possible points (120/240 = 50%).
 
Cumulative Score
At the conclusion of Stage III, all scores for qualified Proponents from Stage II and III will be added and, subject to satisfactory reference checks, the highest scoring Proponents will be selected for Stage IV--Finalist Presentation.
 
Stage IV--Finalist Presentation.
Invitations will be sent out to the short-listed Proponents to advance to Stage IV to make their presentations to the Evaluation Team and will be contacted to be interviewed during the week of December 3, 2018.
Upon completion of all presentations, the Evaluation Team will make their final decision.  All Stage IV Finalists will be notified of the final decision. 
 
 
Negotiations
The Associations may, in its sole discretion, enter into negotiations with one or more Proponents.  The Associations reserves the right to negotiate with more than one proponent concurrently or consecutively, and to add to, expand, reduce, or modify the scope of this RFP.  If the Associations and the Proponents selected for negotiation are unable to negotiate an agreement, the Associations may begin or continue negotiations with any other Proponent, at any time.  Negotiations may take place with selected Proponents without the obligation to re-call proposals or provide an opportunity for other Proponents to quote on the same changes.  No Proponent shall have any rights against the Associations arising from such negotiation. 
 
H.The Associations Confidentiality
All information contained in this RFP, and all information and material obtained during the course of the RFP process is confidential and remains the property of the Associations. The Proponent must agree to sign a confidentiality agreement. The outputs of the project will remain the property of the Associations.  
I.Sub-contracting or Substitution
No sub-contracting or substitution on the part of the Proponent will be accepted without explicit agreement from the Associations. 
J.Costs and Expenses
The Proponent shall bear all costs associated with or incurred in the preparation and presentation of its proposal including, if applicable, costs incurred for interviews or demonstrations.
 
When providing complete pricing/costs, a Proponent must be aware of and affirm the following:
 
On June 17, 2009, the Ontario government established new standards relating to the procurement of consulting services and management of consulting contracts for all government agencies, including the Ministry of Labour and the Associations. As a result, the Associations will not pay for any hospitality, incidental and food expenses, including, but not limited to: meals, beverages, gratuities, personal telephone calls, etc.
 
The Associations will not be responsible for any travel expenses.
 
Describe any requirements specific to this RFP concerning cost or cost containment or phases that the Proponent must be aware of.

• Include information on any the Associations invoice payable or interest payment policy.

• Deposits are to be discouraged and only if required (by industry or service sector), will not exceed 20% of the total project/item cost.

 
The fees quoted for services or goods shall not include applicable taxes (i.e. HST, GST, PST, VAT …).
 
All fees for services shall be quoted in Canadian Funds.
K.Review Representative
All contact and questions with regard to this RFP must be made through the Associations Project Representative selected for this initiative, by e-mail.  For the purposes of this RFP, the Associations Project Representative is:
 
Name:               Alan Hansen
E-mail:              ahansen@ihsa.ca
 
Important Dates:

• Submit questions regarding this RFP and intent to submit a response, up to and including October 10th, 2018 by 2:00 pm EST.

• All responses to Provider questions will be posted by October 16th, 2018.

• Submit the completed RFP with required documents by October 26th, 2018 by 2:00 pm EST.

• Confirm availability for possible finalist presentations the week of December 3rd, 2018.

 
           All questions received and their responses will be provided to all Proponents. The Associations reserve the
           right to not answer a Proponent’s question.  The reasons for this might be:
1.       The information requested is not needed for the preparation of a submission, or
2.       The answer to the question posed can be found in the RFP, or
3.       The answer to the question posed is the purpose of the RFP.
 
The Associations will not provide answers to questions in any form or electronic format by direct reply in order that the fairness of the procurement process is maintained.
 
Unless otherwise notified, the time required by the Associations to answer questions will not change the deadline specified for submission of a Proposal.
L.Additional Information
The Associations may request additional data, discussions, presentations or on-site visits in support of a response to this RFP, all without obligation to provide other RFP recipients with similar information or notice of such communication.  The Associations reserves the rights to implement the appropriate due diligence processes to organize or clarify any information provided, or to collect more evidence of managerial, financial and technical abilities, including but not limited to meetings and visits with current customers served by the Proponent.
 
•    The deadline for submission of an Offer is October 26 @ 2:00 pm EST.
•    The successful proponent will do everything possible to exceed delivery expectations.
M.Other Considerations
Circumstances may arise in which additional billable work or service(s) may be required by the Associations that cannot be currently determined for this RFP.  Proponents will provide in their responses their lowest hourly or unit pricing and/or highest discount structure that will be extended to the Associations if additional work/services outside the scope of this RFP is approved by the Associations. This pricing may be used as further consideration by the Associations during the Evaluation of Offer stage.
 
When replying to this RFP, a Proponent should consider its response as an investment and cornerstone of the potential for additional engagements.
N.Notification to Other Proponents of Outcome of RFP Process
Once the successful Proponent and the Associations execute a contract, the other Proponents that submitted Proposals will be notified in writing of the outcome of the RFP process.
O.Debriefing
Proponents may request a debriefing after receipt of a notification of award.  All requests must be in writing to the Project Representative and must be made within sixty (60) days of notification of award.  The intent of the debriefing information session is to aid the Proponent in presenting a better proposal in subsequent procurement opportunities.  Any debriefing provided is not for the purpose of providing an opportunity to challenge the procurement process.
P.Selection of Proponent
The Evaluation Team anticipates that a Proponent will be selected within sixty (60) days of the Proposal Submission Deadline.  Notice of the selection to the successful Proponent will be in writing.
Q.Conflict of Interest
Proponents that respond to this RFP must identify any real or perceived situations where a conflict of interest, past, current or future exists.  All instances are to be declared in Appendix C. 
   
By submitting a proposal, the Proponent agrees the following terms and conditions shall apply:
 
A.Information Gathering Process
This RFP is being issued for information gathering purposes only. The Associations shall not be bound or obligated in any manner as a result of issuing this RFP to enter into contract negotiations, or to conclude a contract. Without limiting the generality of the foregoing, the Associations expressly reserves the right, at its sole discretion, (i) to initiate any form of procurement process including without limitation direct negotiations with any proponent regardless of whether such proponent responded to this RFP; or (ii) to elect not to procure the good or service that is the subject of this RFP.
 
B.Cost of RFP Response
All work undertaken by any Proponent in preparation of its Proposal is performed on a speculative basis.  the Associations accepts no responsibility for costs of proposal preparation, benchmarking, piloting, interviews, meetings, or other activities related to proposal preparation or any contract negotiations.  All Proposals submitted will be regarded as the personal property of the Associations and will not be returned.
 
C.Use of the Associations Names or Logos
A proponent shall not use the Associations names or logos or associated names or logos or make reference to this RFP in any advertising copy or other promotional materials or messages without the Associations’ prior written consent.
 
D.Explanation of Information Evaluation or Decision Making
The Association is not bound to explain how any Proposal was evaluated nor is the Association bound to explain any decision it makes based upon the subject matter of a Proponent’s Proposal or any part of this RFP process.
 
E.Restriction on the Associations Contacts
All contacts, written and oral, concerning this RFP, in any respect, should be made solely through the Association’s Representative named in this RFP.  Discussion of this RFP with any other parties within the Association may result in a Proponent’s Proposal not being considered.
 
F.Confidentiality of Proponent’s Information
Information provided by a Proponent and all or a portion of the Proposal itself, even if identified as being confidential, may be used, reproduced, and disclosed by the Association and, on a confidential basis, to third parties retained by the Association in connection with the subject matter of this RFP, including without limitation, for the purposes of evaluating the information.
 
Information provided by a Proponent is subject to disclosure in accordance with the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. F.31, as amended.  Each Proponent is requested to identify in its Proposal any information it wishes the Associations to keep confidential.  Proponents are advised that the information provided by a Proponent and all or a portion of the Proposal itself, may be disclosed by the Association to third parties where an order by the Information and Privacy Commissioner or a court requires the Associations to do so.
 
G.Data Validity
All data and information included in this RFP have been extracted from sources which the Association considers to be reliable.  However, the Association makes no warranties and accepts no responsibility for inaccurate data contained herein. 
 
H.Errors and Omissions
The Association shall not be held liable for any errors or omissions in any part of this RFP.  While the Association has used considerable effort to ensure an accurate representation of information in this RFP, the information contained in the RFP is supplied solely as a guideline for potential Proponents.  This information is not necessarily comprehensive or exhaustive.  Nothing in the RFP is intended to relieve a Proponent from forming its own opinions and conclusions with respect to the matters addressed in the RFP.
 
I.Indemnification
The Proponent shall indemnify and hold harmless the Association, it’s officers, board members, partners, agents and employees from and against all actions, claims, demands, losses, costs, damages, suits or proceedings whatsoever which may be brought against or made upon the Association and against all loss, liability, judgments, claims, suits, demands or expenses which the Association may sustain, suffer or be put to resulting from or arising out of the Proponent’s failure to exercise reasonable care, skill or diligence or omissions in the performance or rendering of any work or service required hereunder to be performed or rendered by the Proponent, it’s agents, officials and employees.
 
J.Conflict of Interest
Proponents that respond to this RFP must identify any real or perceived situations where a conflict of interest, past, current or future exists.  All instances are to be declared in Appendix C.
 
K.Right to Termination
The Association may, in its sole discretion, cancel this RFP or revise the scope of this RFP at any time.
 

   
Contact Information 
Please provide the following information:                                                                                             
(Name one person to be the contact for this RFP response and for any clarifications that might be necessary)
 
Full Organization Legal Name:  Click here to enter text.
Street Address:
 Click here to enter text.
City, Province/State:     
 Click here to enter text.
Postal Code:    
 Click here to enter text.
Phone Number:Click here to enter text.
Fax Number:    Click here to enter text.
Organization Website (if one exists):     Click here to enter text.
Organization Ownership
(specify private or public company):Click here to enter text.
Parent Organization Name (if any):Click here to enter text.
RFP Contact Person and Title:  Click here to enter text.
E-mail Address for RFP Contact Person:
 Click here to enter text.
           
Occupational Health & Safety  

 
References – Current Clients
 
 
Please provide two references including contact names, phone numbers and email addresses of new clients (within the last 3 years) who work with the Account Manager and Service Representative(s) appointed to the Associations.
 Company NameClick here to enter text.
Contact NameClick here to enter text.
Contact Phone NumberClick here to enter text.
LocationClick here to enter text.
 
 Company NameClick here to enter text.
Contact NameClick here to enter text.
Contact Phone NumberClick here to enter text.
LocationClick here to enter text.
 
Please provide one reference from a long term client (10 plus years) of similar size to our client to determine if the same level of service has been maintained.
 Company NameClick here to enter text.
Contact NameClick here to enter text.
Contact Phone NumberClick here to enter text.
LocationClick here to enter text.
 
Please also provide a reference from one terminated client within the last year.
 Company NameClick here to enter text.
Contact NameClick here to enter text.
Contact Phone NumberClick here to enter text.
LocationClick here to enter text.
 

   
The Ontario Government expects all suppliers to pay their provincial taxes on a timely basis. In this regard, Proponents are advised that any contract with the Ontario Government will require a declaration from the successful Proponent that the Proponent's provincial taxes are in good standing.
 
In order to be considered for a contract award, the Proponent must submit the following tax compliance status statement and the following consent to disclosure:
 
Declaration
 
I/VE hereby certify that Click here to enter text.  At the time of submitting its proposal,
                                    (legal name of Proponent)
 
is in full compliance with all tax statutes administered by the Ministry of Revenue for Ontario and that, in particular, all returns required to be filed under all provincial tax statutes have been filed and all taxes due and payable under those statutes have been paid or satisfactory arrangements for their payment have been made and maintained.
 
Consent to Disclosure
I/We consent to the Ministry of Revenue releasing the taxpayer information described in this Declaration to the Ministry issuing the RFP as necessary for the purpose of verifying that I/we am/are in full compliance with all statutes administered by the Ministry of Revenue.
 
 
Dated at this   Date                         day of                        Date
 
 
 
 

An authorized signing officer)
 
 
 
 

(Print Name)
 
 
 
 

(Title)
 
 
 
 

(Phone Number)                                                             (Fax Number)
 
 
 

   
The PROPONENT and its Affiliates declare that it does not now have and agrees not to have any public or private interest, and shall not acquire directly or indirectly any such interest in connection with the work defined in this RFP, that would conflict or appear to conflict in any manner with the performance of the SERVICES under this RFP or subsequent contract. “Affiliate” means a corporate entity linked to the PROPONENT through common ownership. The PROPONENT and its Affiliates agree not to provide any services to any entity that may have an adversarial interest in a project for which it has provided services to the Associations. The PROPONENT and its Affiliates agree to disclose to the Associations all other interests that the PROPONENT has or contemplate having during each phase of the project. In all situations, the Associations will decide if a conflict of interest exists. If the Associations conclude that a conflict of interest exists, it will inform the PROPONENT and its Affiliates. If the PROPONENT and its Affiliates choose to retain the interest constituting the conflict, the Associations may terminate the Contract for cause in accordance the provisions stated in the Contract.
 
 
 
 
 
 
______________________________________              ______________________________________
PROPONENT ORGANIZATION                                      PROPONENT REPRESENTATIVE        
I have the authority to bind the organization.                                                                              
 
 
 
 
______________________________________
DATE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

    
sRFP-18-003
Group Health & Benefits Carrier   
(Please complete the following information)
 
Respondent’s Registered Legal Business Name:
Mailing Address:                     Click here to enter text.
 
Name of Contact Person:        Click here to enter text.                    Title:                   Click here to enter text.
 
Contact Person Tel.#:              Click here to enter text.                    Facsimile Tel.#:  Click here to enter text.
 
E-mail Address:                       Click here to enter text.
 
The respondent hereby acknowledges
(i)         that the information it is providing is, to the best of its knowledge, complete and accurate;
(ii)         that the information it is providing, and all or a portion of the Proposal itself, even if identified as being confidential, may be used, reproduced, and disclosed by the Associations on a confidential basis to third parties retained by the Associations in connection with the subject matter of this RFP, including without limitation, for the purposes of evaluating the information;
(iii)        that the information it is providing is subject to disclosure in accordance with the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. F.31, as amended, that notwithstanding that the respondent has identified in its proposal any information it wishes the Associations to keep confidential, the information provided by a Proponent and all or a portion of the Proposal itself, may be disclosed by the Associations to third parties where an order by the Information and Privacy Commissioner or a court requires the Associations to do so.
(iv)        that the Associations shall not be liable for any costs incurred by the respondent in the preparation of its proposal;
(v)        that all materials submitted to the Associations by the respondent shall become the personal property of the Associations and shall not be returned; 
(vi)        that, as elaborated upon in paragraph A, “Information Gathering Process” of Section V.A,  this RFP is for information gathering purposes only and does not create any legal obligations or restrict the Associations rights regarding the procurement of any good or service.
(vii)       that a benefit has not been conferred of any kind on anyone employed by or connected with the Associations, for the purpose of influencing the outcome of procurement.
 
Signature of Witness:                                                                Signature of Respondent representative:
 
 
_________________________________________                      _________________________________________
     (I have authority to bind the Respondent)
Name of Witness:                                                                                              (corporate seal)
 
                                                                                                Name:
_________________________________________
Title:
Date: