Type of Service Customer Service Claims Processors Number of Full Time Employees Number of Part Time Employees Average Years of Experience Number of New Employees to be Hired (if any) 3. Work Volume 17 Group Term Life 2015 2016 2017 Provide your company’s total dollar volume of Life Insurance for the past three years. Provide the number of claims for benefits paid by your company for the past three years. Accidental Death and Dismemberment 2015 2016 2017 Provide your company’s dollar volume of AD&D Insurance for the past three years. Provide the number of claims for benefits paid by your company for the past three years. 4. Based on Total Claims in Calendar Year 2017 provide: Group Life Number of Claims % Dollar Accuracy % Error Frequency Valid Claims Ineligible Claims AD&D Number of Claims % Dollar Accuracy % Error Frequency Claims Ineligible Claims 5. What Percentage of Your Business would this Contract represent? Group Life Percentage Insured Dollar Volume AD&D Percentage Insured Dollar Volume IV. REFERENCES Please complete the following tables with the requested reference information. 1. Please provide three of your employer client references with a similar size enrolled population as defined in Section 5.3.2.H. If available, please provide at least one government client reference. Life Information Reference #1 Reference #2 Reference #3 Organization Name
Appendix 2.1-5: Compliance Checklist Representations made by the Offeror in this proposal become contractual obligations that must be met during the contract term. Instructions: Please complete each item with the requested information. in the response column with the words "Choose” contain a drop down list of options. Please select a response from those options as applicable. NOTE: All "No" responses must be addressed in "Appendix 2.1-2: Explanations and Deviations.” Compliance Checklist Contractor's Response Yes or No The Contractor(s) agrees to the Payment Terms for Both Services Categories as described in Section 2.5. The Contractor(s) agrees to the following Specifications for All Plans as described in Section 2.6 Section 2.6.1 Section 2.6.2 Section 2.6.3 Section 2.6.4 Section 2.6.5 Section 2.6.6 Section 2.6.7 Section 2.6.7.1 Section 2.6.7.2 Section 2.6.7.3 Section 2.6.8 Section 2.6.8.1 Section 2.6.8.2 Section 2.6.9 Section 2.6.10 Section 2.6.11 Section 2.6.12 Section 2.6.13 Section 2.6.14 The Contractor(s) agrees to the Implementation Schedule as defined in Section 2.7. The Contactor(s) agrees to the Report Requirements as defined in Section 2.8. The Contractor(s) agrees to the Annual Life Reports as defined in Section 2.8.1 Section 2.8.1.1 Section 2.8.1.2 Section 2.8.1.3 Section 2.8.1.4 Section 2.8.1.5 The Contractor(s) agrees to the Annual AD&D Reports as defined in Section 2.8.2 Section 2.8.2.1
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 over 35% 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 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 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.
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. $1000 per day for each day the 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 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 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 53% or less Self Reported Frequency of reports: Quarterly $500 per percentage over 53% 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.