Renewals must be submitted to the CITY 180 Agree Renewals: days prior to the contract renewal date. Disagree Contract Termination: Respondent’s contract termination provision may not require more than a 180-day notice and can Agree occur only at renewal. CITY can terminate coverage with a Disagree 30-day notice. Designated Service Unit: Respondents must agree to provide a designated claim and customer service unit for CITY as a whole. While designated to the CITY, the unit does not need Agree to be a service unit; the unit employees may work Disagree “dedicated” on other clients. The service unit must have bilingual (Spanish-speaking) capabilities. Respondents must agree to Designated Eligibility Specialist: provide a designated eligibility specialist for the CITY as a Agree whole. While designated as a CITY unit, the employee(s) Disagree may work on other clients. Toll-Free 800 Number: Respondents must agree to provide Agree a separate toll-free 800 number for each CITY agency. Disagree Offshore Operations: Respondents must that all Agree customer service operations requiring verbal communication Disagree will be performed in the (i.e., will not be provided offshore). HIPAA and PPACA Compliance: Respondents must be in compliance with all HIPAA and PPACA requirements and be Agree able to conduct all applicable employer/plan sponsor and Disagree provider transactions consistent with those requirements. Respondents must agree to accommodate Administration: existing administration provisions of each CITY agency. Any Agree modifications needed to accommodate CITY data will be Disagree done at the vendor’s own expense. Participating Entities: The Participating Entities currently Agree administers eligibility, premium/contribution collection and Disagree payment. Data is transmitted via fax using HIPAA standards. Net of Commissions: All fees and premiums should be net of commissions. Commissions or service fees are not to be Disagree paid to any organization. Performance Guarantees: Respondents must agree to offer a Performance Guarantee on all lines of coverage. Desired performance criteria can be found in Appendix K. Detailed Disagree measurement criteria will be negotiated upon award of contract. Communications Requirements: Respondents must comply Agree with funding the communications requirements outlined Disagree below in bullets 20 26. – Summary Plan Descriptions (SPDs): Each vendor is Agree responsible for writing SPDs. Hard copy SPDs are to be Disagree
Renewals: Renewals must be submitted to the CITY 180 days prior to the contract renewal date. Agree Disagree Contract Termination: Respondent’s contract termination provision may not require more than a 180-day notice and can occur only at renewal. CITY can terminate coverage with a 30-day notice. Agree Disagree Designated Service Unit: Respondents must agree to provide a designated claim and customer service unit for CITY as a whole. While designated to the CITY, the unit does not need to be a “dedicated” service unit; the unit employees may work on other clients. The service unit must have bilingual (Spanish-speaking) capabilities. Agree Disagree Designated Eligibility Specialist: Respondents must agree to provide a designated eligibility specialist for the CITY as a whole. While designated as a CITY unit, the employee(s) may work on other clients. Agree Disagree Toll-Free 800 Number: Respondents must agree to provide a separate toll-free 800 number for each CITY agency. Agree Disagree Offshore Operations: Respondents must that all customer service operations requiring verbal communication will be performed in the (i.e., will not be provided offshore). Agree Disagree HIPAA and PPACA Compliance: Respondents must be in compliance with all HIPAA and PPACA requirements and be able to conduct all applicable employer/plan sponsor and provider transactions consistent with those requirements. Agree Disagree Administration: Respondents must agree to accommodate existing administration provisions of each CITY agency. Any modifications needed to accommodate CITY data will be done at the vendor’s own expense. Agree Disagree Participating Entities: The Participating Entities currently administers eligibility, premium/contribution collection and payment. Data is transmitted via fax using HIPAA standards. Agree Disagree Net of Commissions: All fees and premiums should be net of commissions. Commissions or service fees are not to be paid to any organization. Disagree Performance Guarantees: Respondents must agree to offer a Performance Guarantee on all lines of coverage. Desired performance criteria can be found in Appendix K. Detailed measurement criteria will be negotiated upon award of contract. Disagree Communications Requirements: Respondents must comply with funding the communications requirements outlined below in bullets 20 – 26. Agree Disagree Summary Plan Descriptions (SPDs): Each vendor is responsible for writing SPDs. Hard copy SPDs are to be Agree Disagree
Appendix%20G%20Questionnaire.docx