Time over which standard is measured: Quarter Telephone Call Abandonment Rate Abandonment Rate of 3% or less Self Reported Frequency of report: Quarterly $500 per percentage point over 5% per reporting period. Contractor attendance at State-sponsored annual Open Enrollment meetings and orientation meetings Attendance by plan representative(s) trained on State of Maryland plan benefits at 100% of meetings scheduled by the State, for 100% of the meeting’s duration. Representative must arrive early enough to have their table set up prior to meeting start time. Display must be organized and include appropriate covering of table. Representative must have detailed plan knowledge, interact with members, and exhibit professional appearance and behavior. Sign-in sheets at Open Enrollment meetings Frequency of report: Annually $500 per scheduled meeting not attended. Claims processing time Upon receipt of all required documentation, 95% claims processed accurately within five business days; 98% within 10 business days. Self Reported Frequency of report: Quarterly $500 per period in which standard is not met.
Complaint Resolution Time Plan will: acknowledge receipt of the written complaint to the State and Member within two business days of receipt of the complaint letter; and provide a written complaint response to the State and Member within 21 business days of receipt of the initial complaint letter Self Reported and State correspondence logs $250 for each late acknowledge- ment letter, and $250 for each late written complaint response. Provision of Draft Plan Documents of Coverage of Self-Insured plans and Summary Plan Description for the fully-insured plans Draft Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all required updates is provided to the State at least three months prior to the first day of the plan year. For example, if the plan year effective date is January 1st, the vendor must provide the State the draft by October 1st of the prior year. Receipt date as documented by vendor and confirmed by State $500 per day for the first three calendar days that the draft document is not received. $1,000 per calendar day for each day the draft document is not received for the fourth calendar day and beyond. Provision of Final Plan Documents Final Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all of the required edits and in Receipt date as documented by vendor and confirmed by State $500 per day for each calendar day the draft plan document is not received for the first 3 calendar days. $1000 per day
the format ready for posting to State intranet is returned to the State no later than 45 days before the start of the plan year within 30 calendar days of the carrier’s receipt of the State’s edits. for each day the draft plan document is not received for the fourth calendar day and beyond. Client Satisfaction Account management team survey results must achieve a score of “satisfied” Annual survey 1% of premiums 1 Subject to audit by State and/or contract auditors. ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) Willing to Comply PG Performance Indicator Standard/Goal Reporting Measurement1 Liquidated Damages Telephone Call Availability: Measurements must be or for only the service center handling the State account. 98% of telephone calls are answered by a live service representative (with knowledge of State of Maryland account) within 30 seconds. The representative must have knowledge of the State of Maryland and be able to address the member's issue/question. Time over which standard is measured: Quarter Quarterly Plan Performance Measurement Report Card (Report Card to be submitted by the Offeror). Frequency of report: Quarterly 0.10% of premiums for each percentage point, or fraction thereof, below. Telephone Call Abandonment Rate Abandonment Rate of 5% or less Self Reported Frequency of reports: Quarterly $500 per percentage point over 5% per reporting period.
Vendor attendance at State-sponsored annual Open Enrollment and orientation meetings Attendance by plan representative(s) trained on State of Maryland plan benefits at 100% of meetings scheduled by the State, for 100% of the meeting’s duration. Representative must arrive early enough to have their table set up prior to meeting start time. Display must be organized and include appropriate covering of table. Representative must have detailed plan knowledge, interact with members, and exhibit professional appearance and behavior. Sign-in sheets at Open Enrollment meetings Frequency of report: Annually $500 per scheduled meeting not attended. Claims processing time Upon receipt of all required documentation, 98% claims processed accurately within five business days; 100% within 10 business days. Self Reported Frequency of report: Quarterly $500 per period in which standard is not met. Complaint Resolution Time Plan will: acknowledge receipt of the written complaint to the State and Member within two business days of receipt of the complaint letter; and provide a written complaint response to the Self reported and State correspondence logs $250 for each late letter, and, $250 for each late written complaint response.
State and Member within 21 business days of receipt of the initial complaint letter. Provision of Draft Plan Documents Certificate/ Evidence of Coverage for Self-Insured plans and Summary Plan Description for the fully-insured plans Draft Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all required updates is provided to the State at least three months prior to the first day of the plan year. For example if the plan year effective date January 1st, the vendor must provide the State the draft by October 1st of the prior year. Receipt date as documented by vendor and confirmed by State $500 per day for the first three calendar days that the draft document is not received. $1,000 per calendar day for each day the draft document is not received for the fourth calendar day and beyond Provision of Final Plan Documents Final Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all of the required edits and in the format ready for posting to State intranet is returned to the State no later than 45 days before the start of the plan year within 30 calendar days of the carrier’s receipt of the State’s edits. Receipt date as documented by vendor and confirmed by State $500 per day for each calendar day the draft plan document is not received for the first 3 calendar days. $1,000 per day for each day the draft plan document is not received for the fourth calendar day and beyond. Client Satisfaction Account management team survey results Annual survey 1% of premiums