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Health and Welfare Consultant RFP Bidders’ Conference November 16, 2011

Health and Welfare Consultant RFP Bidders’ Conference November 16, 2011. LACERS Health Benefits Administration Division. Alex Rabrenovich, Division Manager Mimi Lin, Assistant Division Manager Anthony Torres, Section Manager James Aceron, Health Contracts Administrator

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Health and Welfare Consultant RFP Bidders’ Conference November 16, 2011

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  1. Health and Welfare Consultant RFP Bidders’ ConferenceNovember 16, 2011

  2. LACERS Health Benefits Administration Division • Alex Rabrenovich, Division Manager • Mimi Lin, Assistant Division Manager • Anthony Torres, Section Manager • James Aceron, Health Contracts Administrator • Pat Badger-Alston, Health Member Services • Dan Goto, RFP Administrator • Theresa Stamus, Sr. Asst. City Attorney

  3. Background • LACERS Health and Welfare Program • Health Plans • Health Benefits • Membership • 17,000 + retired members • 27,000 + active members

  4. LACERS Health Goals • Implementation of Strategic Initiatives • Long-term sustainability of our health benefits program • Manage the rise in premium costs • Increase participation in disease management/wellness programs • Communicate useful information to our members • Partner with carriers to achieve desirable results • Develop transparency in carrier rate calculations

  5. Current Environment • City of LA 2012 projected $400 million general fund shortfall • Retiree pension reform • Changes for employee retirement contributions

  6. Current Environment • LACERS Health care cost trends • Premiums expected to exceed $100 million by 2012 • Health care reform • Impact on future costs and program benefits • Medicare Sustainability • Impact on future costs and plan offerings

  7. Current Environment Health Care Reform • Patient Protection and Affordability Care Act of 2010 (PPACA); and • Health Care and Education Reconciliation Act of 2010 (HCERA). 

  8. Consultant Traits • Reliable • Responsive • Available • Engaged • Creative • Motivated • Positive • Flexible

  9. LACERS • Board of Administration • 7 Members – Five year terms • 4 appointed by Mayor • 2 elected by active members • 1 elected by retired members • General Manager, Tom Moutes • Assistant General Managers, Li Hsi and Lita Payne

  10. LACERS Benefits • Medical and Dental Subsidies • Medical can be applied to: • dependents, surviving spouse, domestic partner • Dental available to retiree only • Medical Premium Reimbursement Program (MPRP) • LACERS Medicare Requirement • Medicare Part B Reimbursement

  11. RFP Component: Carve-Out LACERS may carve-out the Strategic Planning component of its Scope of Services and award a separate three-year contract. Proposers may submit separate bids as outlined in Section III (Scope of Services) of RFP for: • All services except Strategic Planning • Strategic Planning Only (carve-out bid) • All services including Strategic Planning

  12. LACERS 2012 Health Plans • Medical Carriers • Anthem Blue Cross HMO, PPO, and LPPO • Kaiser Permanente HMO and Kaiser Senior Advantage • SCAN • UnitedHealthcare of CA, NV, and AZ • Dental Carriers • MetLife PPO • SafeGuard HMO • Vision Carrier • Vision Service Plan (included for all plans except Kaiser)

  13. Health Plan Enrollment Stats • Over 18,138 covered lives • Approximately 13,043 retirees • Approximately 5,095 dependents • Under age 65 • Approximately 6,490 • 65 + with Medicare Part B • Approximately 1,132 • 65 + with Medicare Parts A and B • Approximately 10,516

  14. Health Plan Enrollment Stats • Anthem Blue Cross- 5,556 • Kaiser Permanente- 11,187 • SCAN- 349 • UnitedHealthcare- 1046 • MetLife- 13,749 • SafeGuard- 4,573 • Vision Service Plan- 6,951

  15. Health Care Cost History 2010 2011 2012 Maximum Monthly Health Subsidy $1123.00 $1190.00 $1190.00 Percent Increase 0.27% 5.97% 0.00% Aggregate Medical Premium Increase 4.5% 6.2% 0.2% 10 year average premium increase = 7.6 %

  16. RFP Overview • Services • Consultation and Advisory Services • Health Plan Bid Renewal Process • Strategic Planning • Program Evaluation and Development • Legislation and Regulatory Analysis • Communications • Special Projects

  17. RFP Overview • General Responsibilities and Conditions • RFP TimeLine • Release RFP October 26, 2011 • Bidder’s Conference November 16, 2011 • Proposal Deadline December 5, 2011 • Finalist Interviews December 2011-January 2012 • Selection of Consultant January 2012 • Contract Negotiations January 2012 • Contract Effective Date March 15, 2012

  18. RFP Overview • Qualifications • City of L.A. Standard Provisions • Proposal Requirements • Questionnaire

  19. RFP Overview • Fee Structure • Two Proposals • Fixed Fee – maximum cost per category of service • Monthly Retainer – monthly cost to perform any of the listed services during a three-year contract • Includes direct and indirect costs

  20. Contract Guidelines General Conditions and Compliance Documents

  21. RFP Administration • Dan Goto - RFP Administrator • Phone – (213) 473-7209 • FAX – (231) 473-7222 • E-Mail – daniel.goto@lacity.org

  22. RFP Administrator As RFP Administrator, I am responsible for: • The Administrative Process associated with the RFP • All Communications related to the RFP

  23. Marketing Cessation Policy Proposing firms are prohibited from communicating with LACERS Board members and staff concerning this RFP except with the designated RFP administrator and at meetings scheduled by the RFP administrator. • Violation of this policy will result in automatic disqualification of the firm involved.

  24. RFP Questions and Answers • Deadline for Questions and Answers – Today, November 16, 2011 at 3:00 P.M. • Questions pertaining to the RFP must be submitted in writing and may be mailed, e-mailed or faxed to the administrator.

  25. RFP Questions and Answers • All questions and addenda that arise from this RFP will be posted on the LACERS Website. It is the responsibility of the proposer to monitor the website for any updates to the RFP’s questions and addenda.

  26. RFP Submittal • Deadline for Submission – • December 5, 2011at 3:00 P.M. • No Exceptions. Late responses will not be considered.

  27. RFP Submittal • Proposal Is Complete • Well organized and easy to read • LACERS may deem a proposer non-responsive if the proposer fails to provide all required documents and copies.

  28. RFP Submittal • If the proposer submits alternatives and/or substitutions to the terms and conditions, LACERS reserves the right to determine if the alternatives/substitutions are acceptable. • All proposers are to document their alternative or substitution in the cover letter with justification.

  29. RFP Submittal There will be two levels of review. • #1 The administrative review determines the responsiveness to proposal requirements and mandatory document submissions. • All proposers must pass the administrative review to go to the next level of review. • #2 The review of proposal plan, costs and qualifications.

  30. Acceptance of Terms & Conditions Submission of a response to this RFP/RFQ/RFI (“RFP”) shall constitute acknowledgment and acceptance of the standard terms and conditions.

  31. Right to Withdraw • A proposer may withdraw its response, in writing, prior to the final due date and time. After withdrawing a previously submitted proposal, the proposer may submit another proposal at any time prior to the specified submission deadline. • LACERS reserves the right to withdraw this RFP or reject all proposals at any time without prior notice and retains the right to reject any and all proposals.

  32. Verification of Information LACERS reserves the right to verify the information in the response. If a firm knowingly and willfully submits false information or other data, the City reserves the right to reject that response. If a contract was awarded as a result of false statements or other data submitted in response to this RFP, LACERS reserves the right to terminate that contract.

  33. Contractor History of Responsibility A firm will not be recommended for a contract award, regardless of the merits of the response submitted, if it has a history of contract noncompliance with LACERS or any other entity or poor past or current performance with LACERS or any other entity.

  34. Proposer Qualifications LACERS may make investigations as necessary to determine the ability of the proposer to provide required services and comply with the requirements of the RFP.

  35. Public Records Act • All responses to this RFP are subject to public disclosure pursuant to the California Public Records Act • The Act provides generally that all records relating to a public agency’s business are open to public inspection and copying, unless specifically exempted under one of several exemptions set forth in the Act.

  36. Public Records Act • Any proposed contract awards brought before the Board of Administration will appear on a publicly posted agenda for a public meeting of said Board. • If the proposer considers any portion of the proposal is exempt from public disclosure under the Act, such protion may be marked “CONFIDENTIAL.” • LACERS will consider denying public disclosure of any portions so designated.

  37. Public Records Act • The submittal of a response with portions marked “CONFIDENTIAL” shall constitute a request for LACERS to consider the material confidential. • LACERS is not liable for any claim for damages if LACERS determines that the material is not exempt from disclosure, notwithstanding the request to consider the material confidential, and will be disclosed under the laws described above.

  38. Confidentiality & Non-Disclosure of Member Information Any proposer awarded a contract pursuant to this RFP must agree that: • All information provided by LACERS regarding its members and beneficiaries shall remain confidential and private.

  39. Contract Guidelines DEMONSTRATION OF COMPLIANCE REQUIRED WITH PROPOSAL

  40. RFP Warranty Proposers must complete this warranty/affidavit (Attachment 3) which includes a statement of non-collusion and identifies persons authorized to bind the firm in contracts.

  41. Non-Discrimination, Equal Employment Practices and Affirmative Action Certification The proposer must sign and submit with their proposal a Nondiscrimination, Equal Employment Practices and Affirmative Action Certification Declaration, Composition of Total Workforce Report (Attachment 4), or a signed version of proposer’s own affirmative action plan which meets all the requirements of the City’s Affirmative Action Plan. If the proposer elects to submit its own plan, it must be submitted to the Office of Contract Compliance (213) 847-2631 for approval.

  42. Municipal Lobbying Ordinance Each proposer is required to read the Los Angeles Municipal Lobbying Ordinance (Los Angeles Municipal Code § 48.02) found on the web at: http://ethics.lacity.org/pdf/laws/law_mlo.pdf. If proposers qualify as a lobbying entity please complete and return the Bidder Certification CEC Form 50 (Attachment 5) with your proposal.

  43. Campaign Contributions and Campaign-Related Activities • Proposers may not make campaign contributions to and/or engage in in fundraising for certain elected officials or candidates for elected City office from the time they submit the response until either the contract is approved or, for successful bidders, 12 months after the contract is signed. • Bidders are required to complete and submit CEC Form 55. • City Ethics Commission at (213) 978-1960 or ethics.lacity.org.

  44. Business Inclusion Program • LACERS strongly encourages all bid respondents to make an effort to include members of Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Other Business Enterprise (OBE), Small Business Enterprise (SBE), Emerging Business Enterprise (EBE), and Disabled Veterans-Business Enterprise (DVBE) groups in any subcontracting work to be performed if awarded the contract. • Bidders must submit with their proposal the MBE/WBE/ OBE Subcontractor Information Form (Attachment 7).

  45. Contract Guidelines COMPLIANCE REQUIREMENTS IF AWARDED A CONTRACT

  46. Standard Provisions for City Contracts (Rev. 03/09) If awarded a contract, the City of Los Angeles requires its contractors to adhere to the Standard Provisions for City Contracts (Rev. 03/09). A copy of the Standard Provisions for City Contracts (Rev. 03/09) is found on the web at: http://www.lacers.org/aboutlacers/request-for-proposals/index.html

  47. Bonding, Insurance and Indemnification • If awarded a contract, the respondent will furnish the City evidence of insurance coverage with minimum limits prescribed by LACERS. • Proof of insurance must be submitted in accordance with requirements of the City Administrative Office Insurance and Bonds Section prior to contract execution. For more information, visit the City Risk Manager’s website at: http://www.cao.lacity.org/risk/

  48. Los Angeles Business Tax Registration All contractors of the City of Los Angeles are required to register their business with the City of Los Angeles Office of Finance and are subject to Los Angeles City Business Tax. For information, visit the Office of Finance website at: http://www.lacity.org/finance/

  49. Questions • Questions and Answers • Please submit any questions in writing. • Questions and Answers will be posted on the LACERS website. • LACERS Web Site – http://www.lacers.org/AboutLACERS/RFPs/20121124Healthandwelfareconsultant/index.ht.

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