R-13-12-19-G6 - 12/19/2013RESOLUTION NO. R -13-12-19-G6
WHEREAS, the City of Round Rock has previously entered into an Administrative Services
Agreement ("Agreement") with Aetna Life Insurance Company ("Aetna") for stop loss insurance, and
WHEREAS, the City Council desires to renew said Agreement with Aetna, Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the Council hereby authorizes renewal of the Administrative Services Agreement with
Aetna for insurance coverage for the guarantee period of January 1, 2014 through December 31, 2014
as set forth in the document package from Aetna attached as Exhibit "A."
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
open to the public as required by law at all times during which this Resolution and the subject matter
hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended
RESOLVED this 19th day of December, 2013.
ALAN MCGRAW, Mayor
City of Round Rock, Texas
ATTEST:
21044/+— I�cuk
SARA L. WHITE, City Clerk
0112.1304, 00288384/ss2
i
T OM
0 'r
0 O.
a 0)
E
0 00
U i
0
C 6
aZ
u
F o
o
EU
Q
Illustrative/Firm Stop Loss Quote
C p .5
oc
O y
g y ti
ti
_2 c
d 7 L 4
o 1 t v
E. P. 0 0
H b U
N O N a
>u0 E
' O y 0
V Y G
bD Yg- et
cov a p, 6
,a.0 d w
z •0 a
1226 • o..
. E 43
o0 . [ o.
.a 2
0yd0 0Nm
pU
co0 0/ V
u P.
E.uV
i
P. b = E
v F3w
o� -a F.
0 t. d o.
0 v `3 ao Q 0 o 0
v s
0= g 3 q u a 0
.E. a. O. C O .a .a w
N 0„0 N .0
d c rg 0 $ a> „S 2
F�o
a c0,i 66 P+
EXHIBIT
.."0
h O z
17
N o O i
O O
hoz
wUa •``
0
O v
ovo
MaoY98z.E ami
69
0 b N
O
0 :O o 0
o' 'v
o a o'•. z 0 E
C4 A
T•
b0
d u •C o
t410o E
0 .c y Q
431 E
m mE
w
0 N
vQ� 0 5 V) c•
04 O.
d a Q a aw
0 v C'a E o o
c c U 2 > E
se
a�'UU a4 4. c4
RAGE SPECIFICATIONS
ao_
h O
N W O
00 h M
h o 00 00
vrn
rn 00
69 en
N h49
V
00
69 69 Vf
O Ohen
00
e 'a0 .- c
on Ei O O N 01 COO O
CV 4. 00 fA COhN 001w 00 Vi
.,-;' Nei".-
69CA69
Stop Loss Renewal
111
O
p
0
r4
z
1.7
N
U
W
N
• 10 e M N • M
N OG o`M oo V V
Fn
rn
C.4 61 as
rn o3 N
M V
'0690,r`V)
69
N 0,
D`
069
NI
4t
X
0
ro
w
O
E
0
U
W
w
CS
0.0
OD
OD
q
a
1
• o.
u
C
• O
o u
i 0
0
4 'o
A N
▪ H
Gib a
▪ o
ms,
d �
-- o
E
ODw
DI
DI)tap
H ▪ rte-.
0
rnX8
E; u d
E b a
0 E
N
City of Round Rock
Table of Contents
Proposal Requirements
— Section 1— Page 1
— Section 11 — Pages 1-2
— Section 111 — Pages 1-12
— Section IV — Pages 1-11
Financial Exhibits and Assumptions
— Stop Loss Rate Exhibit — Page 1
— Stop Loss Quotation Caveats — Pages 1-2
Attachments
— Attachment A — Reference Sheet — Page 1
— Attachment B — Proposal Submittal Form and Execution of Proposal — Page 1_
— Attachment C—Addendum Acknowledgment Form — Page 1
Exhibits
— Exhibit A RFP No. 14-005 — Pages 1-9
— ALIC — TX License — Pages 1-2
We have provided our Samples & Brochures on CD-ROM.
EXHIBIT "A"
October 2013 www.aetna.com Page 1
City of Round Rock Proposal Requirements
Section I — General
The City of Round Rock, Texas herein after "City", is soliciting request for proposals to enter
into an agreement with a qualified Individual, Firm, or Corporation, (Respondent), to
provide stop Toss insurance, herein referred to as "Services". All pricing structures and rates
shall be negotiated and agreed in writing by both parties prior to execution.
The City is soliciting offers under the guidelines provided with authority through Texas Local
Government Code Chapter 252. All proposals must meet the requirements outlined in this
RFP to be considered for evaluation by the City.
1. BACKGROUND / HISTORY: The City operates within a self-insured medical
benefit program that provides benefits to its employees, dependents and
retirees. Aetna is the current third party administrator. The City currently offers
a single option PPO through Aetna's Aexcel network.
1.1 Purpose: The City of Round Rock, herein after "City", seeks proposals from
qualified vendors, hereafter referred to as "Respondent" to provide specific
and aggregate stop loss insurance for the coverage as detailed in "Exhibit A".
Confirmed.
1.2 Objective: The City seeks to provide stop loss insurance for the City of Round
Rock to be effective January 1, 2014.
Confirmed.
2. PLAN OVERVIEW: The following Scope/Plan Overview of Services provides additional
information and outlines specific requirements that must be met as part of the
Respondent's proposal. All Respondents are expected to have the ability to provide
the following:
2.1 Refer to Exhibit A -- "Plan Overview" outlined attached Excel spreadsheet
Confirmed.
October2013 www.aetna.com Page 1
City of Round Rock Proposal Requirements
Section 11 - Statement of Work
1. INTRODUCTION: This Request for proposals (RFP) describes information for the
Respondent to provide services which shall include, but are not limited to the
requirements contained herein. Services set forth that contain the words "must" or
"shall" are mandatory and shall be provided as specified with no alteration,
modification or exception unless an alteration, modification or exception would
enhance the services provided to the City. Any and all alterations, modifications or
exceptions to any requirement shall be dearly noted by the Respondent. Services set
forth that contain the words "may" or "can", allow Respondents to offer alternatives
to the manner in which the services are described in the RFP.
Confirmed.
2. AGREEMENT TERM: The term of the initial Agreement shall for insurance coverage for
the guarantee period of January 1, 2014 through December 31, 2014.
2.1 If the Respondent fails to perform its duties in a reasonable and competent
manner, the City shall give written notice to the Respondent of the deficiencies
and the Respondent shall have ninety (90) days to correct such deficiencies. If
the Respondent fails to correct the deficiencies within the thirty (30) day, the
City may terminate the agreement by giving the Respondent written notice of
termination and the reason for termination.
Confirmed.
2.2 If the Agreement is terminated, for any reason, the Respondent shall turn over
all records to the City within fifteen (15) working days after completion of
duties contained in the Agreement.
Aetna can agree to correct the deficiencies within a reasonable time period as stated
in our current MSA with the City.
October 2013 www.aetna.com Page 1
City of Round Rock Proposal Requirements
Section 11 - Statement of Work
3. RESPONDENT PROPOSAL: The City is seeking proposals from respondents to provide
stop loss insurance. The Respondent shall:
3.1 Refer to Exhibit A - "Proposal" outlined in attached Excel spreadsheet.
Confirmed.
4. PROGRAM REQUIREMENTS: The City is requesting, at a minimum, the following
based upon the criteria listed:
4.1 Refer to Exhibit A - "Submittal Requirements &Questions" outlined in attached
Excel spreadsheet.
Confirmed.
NOTE: RESPONDENT MUST COMPLETE AND SUBMIT "EXHBITA" WITH THEIR RFP RESPONSE.
October 2013 www.aetna.com Page 2
City of Round Rock Proposal Requirements
Section I11- Proposal Information
1. SCHEDULE OF EVENTS: It is the City's intention to comply with the following
solicitation timeline:
EVENT DATES
Release of RFP October 17, 2013
Deadline for Submission of Questions October 22, 2013, 5:OOpm, (CST)
Deadline for responses to all Questions/Addendums October 25, 2013,
5:OOpm, (CST)
Deadline for Submission of Proposal October 31, 3:OOpm, (CST)
Expected Contract Start Date February 2014
Confirmed. We are using a January 1, 2014 date as provided in Addendum #2.
NOTE: The City reserves the right to modify these dates. Notice of date change will be
posted to the City's website.
2. PROPOSAL REQUIREMENTS:
2.1. Submission:
2.1.1. Respondents shall submit one (1) evident signed "Original" and five (5) copies of the
proposal and one (1) electronic copy in "CD" format, including required attachments.
Pages should be numbered and contain an organized, paginated table of contents
corresponding to the section and pages of the proposal. The proposal must address all
requirements of this RFP regarding the proposed stop loss insurance, including the
requirements contained in Section II, Statement of Work attached as Exhibit A.
Confirmed.
2.1.2. Respondents to this RFP are responsible for all costs of Proposal preparation.
Confirmed.
October 2013 www.aetna.com Page 1
City of Round Rock Proposal Requirements
Section 111- Proposal Information
2.1.3. All proposals shall be received and time stamped at the City prior to October 31, 2013,
3:00 pm, Central Standard Time (CST) as specified in the Schedule of Events. Late
Proposal will not be considered under any circumstance and will be returned
unopened, if return address is provided.
Confirmed.
2.1.4. Proposal should be placed in a sealed, separate envelope/package and correctly
identified with the solicitation title, City of Round Rock RFP No. 14-005 —STOP LOSS
INSURANCE, submittal deadline/opening date and time and "DO NOT OPEN". If
submitting multiple responses, each response should be placed in a separate envelope
and correctly identified with the solicitation title, RFP number, submittal
deadline/opening date and time, and "DO NOT OPEN". It is the respondent's
responsibility to appropriately mark and deliver the Proposal to the City by the
specified date and time. The City will not bear liability for any costs incurred in the
preparation and submission of offers in response to this RFP.
Confirmed.
2.1.5. Receipt of all addenda (Addendum Acknowledgment Form Attachment C) to this RFP
should be acknowledged, signed and included in the proposal.
Confirmed.
October 2013 www.aetna.com Page 2
City of Round Rock Proposal Requirements
Section 111- Proposal Information
2.2. Content: Proposal submitted without this information may be rejected. The City
reserves the right, in its sole judgment and discretion, to waive minor technicalities
and errors in the best interest of the City. The Proposal Submittal, all Attachments,
and Execution of Proposal Form (Attachment B, Section III, Proposal Information,
Para. 2.2.6) shall be returned with the bid response. Failure to do so may result in
disqualification.
City of Round Rock Stop Loss Insurance RFP No. 14-005
Class 953 / Item 48 October 2013
2.2.1. Company Information:Proposal shall include the legal definition of the
Respondent's business organization (if a corporation), the state in which
incorporated, the types of business ventures in which the organization is involved,
and a chart of the organizational structure. lithe organization includes more than
one product division, the division responsible for the development and marketing of
the proposed products and services shall be identified and described in detail.
Proposal should include information regarding all of the respondent's facilities and
resources offered that shall contribute to the successful implementation of the
proposed program including, but not limited to the following:
2.2.1.1. Company description;
2.2.1.2. Ownership (if partnership, identify each partner);
2.2.1.3. Physical address (if partnership, include address of each partner);
2.2.1.4. Mailing address (if partnership, include address of each partner);
2.2.1.5. Other company locations;
2.2.1.6. Telephone and facsimile number;
2.2.1.7. E-mail address of company's primary contact;
2.2.1.8. Financial report, including latest annual report and latest
quarterly report; 2.2.1.9. All litigation that your company has been
involved in within the last three (3) years. If the firm has been in
existence less than three (3) years, identify litigation involving
owners and management.
Confirmed.
October 2013
www.aetna.com Page 3
City of Round Rock Proposal Requirements
Section 111- Proposal Information
2.2.2. Proposed Products/Services: The proposal shall include detailed information to
demonstrate how the Respondent shall provide each of the service requirements
specified in Section 11, Statement of Work. The proposal should provide separate
sections for each product/service provided and should be labeled with
corresponding numbers for the requirements set forth in Section 11, Statement of
Work attached as "Exhibit A".
2.2.2.1. Respondents shall describe in detail how they plan to meet the following
service, performance standards and timeline listed in Section II, Statement
of Work.
Confirmed.
2.2.3. Experience and Proposal: Pursuant with Section 11, Statement of Work outlined and
attached as "Exhibit A", the proposal shall describe services your organization has
provided that demonstrates your organization's capability to carry out the proposed
services. Include a narrative overview of the nature of the services provided, scope of
activities, and the organization for which the service was provided. Also, provide any
experience in providing similar services to public entities. Include resumes for all
personnel who shall be responsible for the management and day-to-day operations of
the products/services solicited in this RFP. Respondent shall provide the name(s) of
top management and key employees and each person's duties, including the
background and experience of these employees.
We will provide a list of day to day operations staff upon award of contract.
Resumes have been provided in the Samples and Brochures Section of this proposal
located on CD-ROM.
October 2013 www.aetna.com Page 4
City of Round Rock Proposal Requirements
Section III - Proposal Information
2.2.4. References: Provide the name, address, telephone number and E-mail address of at
least three (3) references from firms of comparable size that have utilized similar
service (Attachment A). Include description, contact names, position, company name,
e-mail address and telephone number for each reference listed. Any negative
responses received may be grounds for disqualification of the proposal.
Confirmed.
2.2.5. Proposal Submittal Form and Execution of Proposal: (Attachment B) - This form is to
be completed and return with the proposal. It is to be signed by an authorized agent
of your company. Failure to do so may result in disqualification of the Proposal.
Confirmed.
2.2.6. A(I inquiries shall be submitted in writing by October 22, 5:00 pm, (CST) to Mike
Schurwon, CPPB, CTPM by e-mail at: mschurwon@roundrocktexas.gov on the due
date noted. The City shall NOT be responsible for failure of electronic equipment or
operator error.
Confirmed.
October 2013 www.aetna.com Page 5
City of Round Rock Proposal Requirements
Section 111- Proposal Information
2.2.7. All inquiries that result in written addenda to the RFP will be posted to the City's
webpage and the Electronic State Business Daily, on the date specified in the
Schedule of Events, at the following:
http://roundrocktexas.gov/home/index.asp?page=462 http://esbd.cpa.state.tx.us/
Respondents shall acknowledge and return receipt of all addenda, Section III, Proposal
Information, Para. 2.2.6 (Attachment C). if respondent does not have Internet access,
copies may be obtained through the point of contact listed above (2.3.1). It shall be
the respondent's responsibility to periodically check the City's webpage for any
updated addenda information.
Confirmed.
2.2.8. Upon issuance of this RFP, besides written inquiries as described above, other
employees and representatives of the City will not answer questions or otherwise
discuss the contents of the RFP with any potential respondent or their
representatives. Failure to observe this restriction may result in disqualification of any
subsequent response. This restriction does not preclude discussions between affected
parties for the purpose of conducting business unrelated to this request for proposals.
Confirmed.
October 2013
www.aetna.com Page 6
City of Round Rock Proposal Requirements
Section 111- Proposal Information
2.3. Delivery of Proposal:
Signed and sealed proposal shall be submitted no later than October 31, 2013, 3:00
pm, (CST), to the City by one of the following methods:
U.S. Postal Service Overnight/Express Mail Hand Deliver
City of Round Rock City of Round Rock City of Round Rock
221 East Main Street 221 East Main Street City Hall — Reception Desk
Round Rock, TX 78664-5299 Round Rock, TX 78664-5299
221 East Main Street
Attention: Mike Schurwon Attention: Mike Schurwon Round Rock, TX 78664-5299
Purchaser Purchaser Attention: Mike Schurwon
Hours — 8:00 AM to 5:00 PM Purchaser
Monday - Friday
Hours — 8:00 AM to 5:00 PM
Monday - Friday
Confirmed.
2.4. Proposal Opening:
2.4.1. Proposals will be opened at the City of Round Rock, City Hall, 221 East Main Street,
Council Chambers, Round Rock, Texas 78664.
Confirmed.
2.4.2. Proposal will be received until the date and time established for receipt. Proposal shall
be opened in a manner that does not disclose the contents before an award. Only the
names of the respondents who submitted proposal will be made public.
Confirmed.
October 2013 www.aetna.com Page 7
City of Round Rock Proposal Requirements
Section I11- Proposal Information
2.4.3. Prices and terms will not be divulged until after award. The City considers all
information, documentation, and other related submission materials to be
confidential and/or proprietary before an award.
Confirmed.
2.4.4. Telephone and facsimile proposal are not accepted in response to this RFP. 2.4.5.
Responses cannot be altered or amended after opening.
Confirmed.
2.4.6. No response can be withdrawn after opening without written approval from the City
for an acceptable reason.
Confirmed.
2.4.7. The City will not be bound by any oral statement or offer made contrary to the written
specifications.
Confirmed.
2.4.8. All submitted proposal responses becomes the property of the City after the RFP
submittal deadline/opening date.
Confirmed.
October 2013 www.aetna.com Page 8
City of Round Rock Proposal Requirements
Section III - Proposal Information
2.4.9. Responses submitted shall constitute an offer for a period of ninety (90) days or until
selection is made by the City.
Confirmed.
3. PROPOSAL EVALUATION: The intent of the City is to award to one Respondent
whose proposal is considered to be the best value to the City. In determining best
value, the City may consider:
3.1 Evaluation Criteria: Refer to Exhibit A — "Evaluation Factors" outlined in attached Excel
spreadsheet.
Confirmed.
3.2. An evaluation committee will be established to evaluate the proposal. The committee
will include employees of the City and may include other impartial individuals who are
not City employees. The evaluation committee will determine if discussions and/or
Best and Final Offers are necessary. Award of a contract may be made without
discussions or Best and Final Offers, if in the best interest of the City. The evaluation
committee may determine that discussions are necessary to clarify or verify a written
proposal response. The City may, at its discretion, elect to have respondents provide
oral presentations of their proposal. A request for a Best and Final Offer is at the sole
discretion of the City and will be requested in writing. The evaluation committee will
evaluate the finalists and make a recommendation for award.
Confirmed.
October 2013 www.aetna.com Page 9
City of Round Rock Proposal Requirements
Section III - Proposal Information
3.3. The City reserves the right to reject any or all proposal submitted, or to award to the
respondent who in the City's opinion offers the best value to the City. The City also
reserves the right to cancel the RFP process and pursue alternate methods for
providing the requirements.
Confirmed.
3.4. The City reserves the right to conduct studies and other investigations as necessary to
evaluate any proposal.
Confirmed.
3.5. The City reserves the right to waive any minor technicality, irregularities or
informalities noted in the submission process. Submission of proposal confers no legal
rights upon any proposer.
Confirmed.
3.6. The City reserves the right to request further documentation or information and to
discuss a proposal response with any proposer in order to answer questions or to
clarify any aspects of the proposal.
Confirmed.
3.7. The City may develop a "short list" of qualified proposal, and may determine that the
proposer(s) should submit a Best and Final Offer (BAFO). Each "short listed" proposer
will be given a reasonable opportunity for discussion and revision of their Proposal.
Confirmed.
October 2013 www.aetna.com Page 10
City of Round Rock Proposal Requirements
Section III - Proposal Information
4. SELECTION AND AWARD PROCESS:
4.1. Proposal shall be scored by an evaluation committee, using the criteria shown in
Section III, Proposal Information, and Proposal Evaluation Para. 3.1. In the event an
Award does not occur, the process may continue until the City makes an Award or
terminates the process.
Confirmed.
4.2. A Proposal presented in response to this RFP is subject to negotiation concerning any
issue(s) deemed relevant by the City. The City reserves the right to negotiate any issue
with any party. Any contact by the Respondent with the City regarding this RFP, other
than those submitted in writing will result in disqualification of the proposal.
Confirmed.
4.3. Submission of proposal indicates the Respondent's acceptance of the evaluation
process and recognition that the City may make subjective judgments in evaluating
the Proposal to determine the best value for the City.
Confirmed.
4.4. An independent signed authorized contract will be sent to the successful proposer.
Execution of a City of Round Rock contract is required prior to processing any
payments to the awarded proposer.
Confirmed.
October 2013 www.aetna.com Page 11
City of Round Rock Proposal Requirements
Section 111- Proposal Information
5. POST AWARD MEETING: The City and the Respondent shall have a post award
meeting to discuss, but not be limited to the following:
5.1. Provide City contact(s) information for implementation of the Agreement. 5.2.
Identify specific milestones, goals and strategies to meet objectives
Confirmed.
October 2013 www.aetna.com Page 12
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
1. ABANDONMENT OR DEFAULT: A Respondent who abandons or defaults on work
which causes the City to purchase goods or services elsewhere may be charged the
difference in cost of goods, services or handling, if any, and may not be considered
in the re -advertisement of the goods or services and may not be considered in
future solicitations for the same type of work unless the scope of work is
significantly changed. If the respondent defaults on the contract, the City reserves
the right to cancel the contract without notice and either re -solicit or re -award the
contract to the next best responsive and responsible respondent. The defaulting
respondent shall not be considered in the re -solicitation and may not be
considered in future solicitations for the same type of work, unless the specification
or scope of work is significantly changed.
Aetna cannot agree to be liable for replacement costs as such costs are beyond the
control of Aetna.
2. CANCELLATION: The City reserves the right to cancel the Agreement for default of
all or any part of the undelivered portion of the order if the Respondent breaches any
of the terms hereof including warranties or becomes insolvent or commits acts of
bankruptcy. Such right of cancellation is an addition to and not in lieu of any
remedies, which the City may have in law or equity. Upon award, this contract may
be cancelled, without penalty, by either party by providing thirty (30) days written
notice to the other party. The City shall pay the respondent the contract price
prorated for acceptable service performed up to the date specified in the notice of
cancellation. Termination under this paragraph shall not relieve the respondent of
any obligation or liability that has occurred before cancellation. The respondent shall
refund any balance of unused prepaid funds to the City.
Confirmed.
October 2013 www.aetna.com Page 1
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
3. CONFIDENTIALITY OF CONTENT: All documents submitted in response to a
solicitation shall be subject to the Texas Public Information Act. Following an award,
responses are subject to release as public information unless the response or
specific parts of the response can be shown to be exempt from the Texas Public
Information Act. Pricing is not considered to be confidential under any
circumstances.
3.1. Information in a submittal that is legally protected as a trade secret or
otherwise confidential must be clearly indicated with stamped, bold red letters
stating "CONFIDENTIAL" on that section of the document. The City will not be
responsible for any public disclosure of confidential information if it is not clearly
marked as such.
Confirmed.
3.2. If a request is made under the Texas Public Information Act to inspect
information designated as confidential, the Respondent shall, upon request from
the City, furnish sufficient written reasons and information as to why the
information should be protected from disclosure. The matter will then be
presented to the Attorney General of Texas for final determination.
Confirmed.
4. PROPRIETARY OR CONFIDENTIAL INFORMATION: Responses may include
proprietary or confidential information. The City shall take reasonable precautions in
protecting such information provided that it is clearly identified as proprietary or
confidential on the page on which it appears.
Confirmed.
October 2013 www.aetna.com Page 2
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
5. DAMAGE CLAIMS: The Respondent shall be responsible for damage to the City's
equipment or property, the workplace and its contents by its work, negligence in
work, its personnel and equipment. The Respondent shall be responsible and liable
for the safety, injury and health of its working personnel while its employees are
performing service work. The respondent shall defend, indemnify, and hold harmless
the City, all of its officers and employees from and against all claims, actions, suits,
demands, proceedings costs, damages, and liabilities, arising out of, connected
with, or resulting from any acts or omission of respondent or any agent, employee,
sub -Respondent, or supplier of Respondent in the execution or performance of this
contract.
Your Indemnification language is generally acceptable. However, we wish to clarify the
following:
(1) Aetna can agree to indemnify the City on a comparative negligence theory, but we
are not prepared to indemnify the City for 100% of a loss if Aetna is only partially at
fault. As such the words "that portion of should be inserted before " all claims,
actions, suits, demands..." in the third sentence.
(2) Consistent with the last comment, a standard of care should be introduced so that
Aetna would only be liable for conduct deemed to be negligent. We are prepared to
discuss other formulations of the standard of care, but we do not believe it is
appropriate to omit the standard of care altogether in this paragraph.
(3) In the final language, we will be adding a sentence clarifying that Aetna will have the
right to control the defense of any such action.
(4) In the final language, we will also be adding a sentence requiring the party seeking
indemnification to provide the indemnifying party reasonable notice of any actual or
threatened action.
October 2013 www.aetna.com Page 3
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
6. INTERLOCAL COOPERATIVE CONTRACTING (PIGGYBACK): Other governmental
entities may be extended the opportunity to purchase off of the City's
Agreements, with the consent and agreement of the awarded Respondent(s) and
the City. Such consent and agreement shall be conclusively inferred from lack of
exception to this clause in a Respondent's submittal. However, all parties indicate
their understanding and hereby expressly agree that the City is not an agent of,
partner to, or representative of those outside agencies or entities and that the
City is not obligated or liable for any action or debts that may arise out of such
independently -negotiated "piggyback" procurements.
Aetna's fees/premiums quoted are unique to this agency and cannot be extended.
We would be pleased to work with other governmental entities to determine
whether these terms can be extended to them, but each case would need to be
individually underwritten.
7. RIGHT TO AUDIT:
7.1. The Respondent agrees that the representatives of the Office of the State
Auditor or other authorized representatives of the City shall have access to, and
the rights to audit, examine, or reproduce, and and all records of the Respondent
related to the performance under this Agreement. The Respondent shall retail all
such records for a period of three (3) years after final payment on this Agreement
or until all audit and litigation matters that the City has brought to the attention of
the Respondent are resolved, whichever is longer. The Respondent agrees to
refund to the City any overpayments disclosed by any such audit.
October 2013 www.aetna.com Page 4
City of Round Rock Proposal Requirements
Section W — General Terms and Conditions
7.2. Respondent understands that acceptance of funds under this contract acts as
acceptance of the authority of the City to conduct an audit or investigation in
connection with those funds. Respondent further agrees to cooperate fully with
the above parties in the conduct of the audit or investigation, including providing
all records requested. Respondent shall ensure that this clause concerning the
authority to audit funds received indirectly by sub -Respondents through the
respondent and the requirement to cooperate is included in any subcontract it
awards.
We welcome independent audits of relevant records and documentation by our
customers or their representatives, provided no audit interferes with our business
operations or the confidential interests of our company or another party. We have
assumed for the purpose of this contract that an "audit" is defined as performing a
review of claim transactions for the purpose of assessing the accuracy of benefit
determinations and shall be subject to mutual agreement as to nature, scope, format,
structure and cost. We work from established audit guidelines that are accepted in
this industry and we are confident we can meet your needs in this important area as
well.
8. TAX EXEMPTION: The City of Round Rock is exempt from all Federal excise, State,
and Local taxes unless otherwise stated in this document. The City claims
exemption from all States and/or use taxes under Texas Tax Code §151.309, as
amended. Texas Limited Sales Tax Exemptions Certificates will be furnished upon
request. Respondents shall not charge for said taxes. If billed, City will not remit
payment until invoice is corrected.
Confirmed.
October 2013 www.aetna.com Page 5
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
9. RESPONDENT RESPONSIBILITES:
9.1. The respondent shall comply with all federal, state and local laws, statutes,
ordinances, rules and regulations, and the orders and decrees of any court or
administrative bodies or tribunals in any matter affecting the performance of the
contract including, if applicable, workers' compensation laws, minimum and
maximum salary and wage statutes and regulations, and licensing laws and
regulations. When required, respondent shall furnish the City with satisfactory
proof of its compliance.
Confirmed.
9.2. The Respondent shall fully and timely provide all deliverables described in the
Solicitation, Contract/Purchase Order and in the Respondent's response in strict
accordance with the terms, covenants, and conditions of the Agreement and all
applicable Federal, State, and Local laws, rules and regulations.
Confirmed.
10. AWARD OF CONTRACT:
10.1. A response to a solicitation is an offer to contract with the City based on the
terms, conditions and specifications contained in the solicitation. Responses
do not become contracts unless it is accepted through an authorized signed
approved City Contract.
Confirmed.
October 2013 www.aetna.com Page 6
City of Round Rock Proposal Requirements
Section IV— General Terms and Conditions
10.2. This contract shall be conducted in accordance with Texas Local Government
Code Chapter 252. The contract shall consist of the RFP; any questions and
answers and/or addenda as a result of the submitted written questions; the
Successful Respondent's response; any City request for a Best and Final Offer;
any successful respondent's Best and Final offer; the Notice of Award; and any
subsequent written amendments agreed to by the City and the Respondent
(the "Contract Documents").
Confirmed.
10.3. Any contract resulting from this solicitation is subject to cancellation, without
penalty, either in whole or in part, if the funding is not appropriated by the City
of Round Rock. The contract for this procurement shall be governed,
construed and interpreted under the laws of the State of Texas.
Confirmed.
10.4. This contract is void if sold or assigned to another company without written
approval of the City. Written notification of changes to company name,
address, telephone number, etc. shall be provided to the City designated
Project Leader(s) and Contract Administrator as soon as possible, but not later
than thirty (30) days from the date of change.
Confirmed.
October 2013 www.aetna.com Page 7
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
11. SPECIFICATIONS: The services performed shall be in accordance with the
purchase specifications herein. The City shall decide the answers to all questions
that may arise as to the interpretation of the specifications and the quality, or
acceptability of work performed. The City shall decide the rate of progress of the
work and the acceptable fulfillment of the service on the part of the respondent.
Not applicable to the services we provide.
12. PATENTS OR COPYRIGHTS: The respondent agrees to protect the City and each
participating municipality from claims involving infringement of patent or
copyrights.
Confirmed.
October 2013 www.aetna.com Page 8
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
13. RESPONDENT ASSIGNMENTS: The successful respondent hereby assigns to
purchaser, any and all claims for overcharges associated with any contract resulting
from this RFP which arise under the antitrust laws of the State of Texas, Texas
Business and Commercial Code Ann. Sec. 15.01, et seq. (1967).
Confirmed.
14. DISPUTE RESOLUTION: If a dispute or claim arises under an Agreement, the parties
agree to resolve the dispute or claim by appropriate internal means. If the parties
cannot reach a mutually satisfactory resolution, any such dispute or claim will be
sought to be resolved with the help of a mutually selected mediator. If the parties
cannot agree on a mediator, City and Respondent shall each select a mediator and
the two mediators shall agree upon a third mediator. Any costs and fees, other
than attorney fees, associated with the mediation shall be shared equally by the
parties.
City and Respondent hereby expressly agree that no claims or disputes between the
parties arising out of or relating to the Agreement or a breach thereof shall be
decided by any arbitration proceeding, including without limitation, any
proceeding under the Federal Arbitration Act (9 USC Section 1-14) or any applicable
state arbitration statute.
Aetna reserves the right to pursue in court if necessary.
15. SUBSTITUTIONS: Substitutions are not permitted without the written approval of
the City.
Confirmed.
October 2013
www.aetna.com Page 9
City of Round Rock Proposal Requirements
Section IV—General Terms and Conditions
16. PUBLIC DISCLOSURE: No public disclosures or news releases pertaining to this RFP
shall be made without prior written approval of the City. The respondent shall
coordinate and obtain approval for the following activities, which include but are
not limited to: orientation sessions, sales calls, customer user seminars, and general
mailings to municipalities.
Confirmed.
17. PUBLIC INFORMATION ACT: Information, documentation, and other material in
connection with this solicitation or any resulting contract may be subject to public
disclosure pursuant to Chapter 552 of the Texas Government Code (the "Public
Information Act").
Confirmed.
18. ANTI -LOBBYING AFFIDAVIT: By executing the response to the RFP, the Respondent
agrees to the following terms and conditions of the RFP. From and after the
deadline for submission of the initial response, RFP No. 1.4-001, the Respondent,
its employees, officials, agents, and sub -Respondents shall not communicate or
attempt to communicate about this RFP and the entity's response with City
personnel, the evaluation committee members, and the other City officials
involved in making recommendations or decisions for award of contracts arising
from this RFP; provided, however, the entity, its employees, officials, agents, and
sub -Respondents shall be allowed to participate in the City sponsored evaluation
process, in the form authorized.
October 2013 www.aetna.com Page 10
City of Round Rock Proposal Requirements
Section IV — General Terms and Conditions
Further, the Respondent shall not, through indirect means of unpaid associates,
volunteers, or other persons, communicate or attempt to communicate about the
Respondent's response to any City personnel, the evaluation committee members,
or the other City officials involved in making recommendations or decisions for
award of contracts arising from this RFP. The Respondent understands and agrees
that violation of this requirement may result in rejection of its Proposal as a violation
of the terms and conditions of the procurement process.
Confirmed.
19. ADDITIONAL. TERMS AND CONDITIONS: In addition to the above General Terms and
Conditions listed in Section IV, the City's Definitions, Terms and Conditions shall be
enforced and part of the contract and can be obtained from the City's website at:
http://www.roundrocktexas.gov/home/index.asp?page=462
Confirmed.
October 2013 www.aetna.com Page 11
City of Round Rock Aetna Life Insurance Company
January 1, 2014 through December 31, 2014 Customer Number - 819919
Illustrative/Firm Stop Loss Quote
- This exhibit outlines your Firm renewal rates effective January 1, 2014.
- Pricing assumes plan enrollment of 774 employees. If actual enrollment varies by more than 10% in
total and/or the plan design changes we reserve the right to readjust the stop loss premium.
- In an environment where healthcare costs are increasing, maintaining the same deductible shifts more of the claim
cost to the stop loss provider.
To help reduce the effect of leveraging, it is recommended that a plan sponsor consider increasing their
Stop Loss deductible to keep pace with medical trend.
Please refer to the stop loss policy for detailed Stop Loss information.
Option 1 Option 2
1/1/2014 1/1/2014
STOP LOSS COVERAGE SPECIFICATIONS
Policy Period Length (months): 12 12
Number of Employees Covered Under Stop Loss: 774 774
Producer Compensation: 0.0% 0.0%
Terminal Liability Option:None None
Claims Paid Basis for Medical Coverages: Cleared Cleared
Claims Paid Basis for APM Rx coverage is on a cleared basis
INDIVIDUAL STOP LOSS COVERAGE SPECIFICATIONS
Individual Stop Loss Level: $200,000 $225,000
Contract Type: Paid Paid
Coinsurance %: 100% 100%
M/N Claims Apply to ISL (Aetna Administered only): Yes Yes
Rx Claims Applied to ISL (Aetna Administered only): Yes Yes
Individual Specific Stop Loss Limits (Lasering): No No
Individual Lifetime Stop Loss Payment Amount:Unlimited Unlimited
Reimbursement Method: Immediate Immediate
AGGREGATE STOP LOSS COVERAGE SPECIFICATIONS
Aggregate Stop Loss Percentage: 125% 125%
Contract Type: Paid Paid
Maximum Annual ASL Payment Amount: $1,000,000 $1,000,000
Reimbursement Method:
Prior Carrier Runoff Cap: $0 $0
Total Claims Applied to Aggregate Stop Loss: $5,877,190 $5,931,478
Benefits that apply to ASL -Medical: $4,293,907 $4,293,907
Benefits that apply to ASL -Drug: $1,583,283 $1,583,283
Lasering Adjustment: $0 $0
Pooling and Coinsurance Adjustment: $0 $54,288
FINANCIAL INFORMATION
Total Stop Loss Premium: $773,783 $661,491
Total Premium (PEPM) Composite Rate: $83.31 $71.22
Individual Stop Loss premium as % of Stop Loss Premium: 95.21% 94.34%
Stop Loss Aggregate Limit*: $7,346,529 $7,414,332
Stop Loss Aggregate Limit (PEPM) Composite Factor: $790.97 $798.27
ISL rate: $79.32 $67.19
ASL rate: $3.99 $4.03
*Minimum Stop Loss Aggregate Limit will be set using the first month enrollment x Stop Loss Aggregate Limit (PEPM)
Composite Factor x # of contract Months.
October 2013 www.aetna.com Page 1
City of Round Rock Aetna Life Insurance Company
January 1, 2014 through December 31, 2014 Customer Number - 819919
Illustrative/Firm Stop Loss Quote
- This exhibit outlines your Firm renewal rates effective January 1, 2014.
Pricing assumes plan enrollment of 774 employees. If actual enrollment varies by more than 10% in
total and/or the plan design changes we reserve the right to readjust the stop loss premium.
In an environment where healthcare costs are increasing, maintaining the same deductible shifts more of the claim
cost to the stop Toss provider.
- To help reduce the effect of leveraging, it is recommended that a plan sponsor consider increasing their
Stop Loss deductible to keep pace with medical trend.
Please refer to the stop loss policy for detailed Stop Loss information.
Option 1
1/1/2014
Premium rates are billed and Aggregate Factors are administered on a composite basis.
Option 2
1/1/2014
October 2013 www.aetna.com Page 2
City of Round Rock Financial Exhibits and Assumptions
Stop Loss Quotation Caveats
Contract/Policy Period: 12 months — 01/01/2014 to 12/31/2014
We are pleased to provide you with our proposal for Stop Loss insurance. This proposal
reflects certain assumptions and contains the following features:
Stop Loss Policy - We will provide you Stop Loss coverage with the features described in
your rate sheet.
Stop Loss coverage will be provided by Aetna Life Insurance Company.
Eligibility — Eligibility will apply to active, permanent full-time employees working in the
U.S., as well as to their dependents. It will also apply to COBRA continuees and those who
are entitled to extended benefits under the plan following termination. For Stop Loss,
eligibility applies to active, permanent full-time employees who are working at least twenty
hours per week on a regularly scheduled basis.
Pre and Post 65 retirees have been included in this quotation at the customer's request.
Paid - Claims paid within the policy year will count toward the accumulation of either of the
Stop Loss limits regardless of when they were incurred.
Preexisting Conditions Exclusion - the preexisting conditions rule has been waived for
existing participants and new entrants after the effective date.
Behavioral Health Benefits — BHB payable under any portion of the plan that are not
administered by Aetna are not covered by Stop Loss.
Individual Lifetime Stop Loss Payment Amount - The Individual Lifetime Stop Loss Payment
Amount will be capped to be no greater than the underlying lifetime medical plan
maximum, for a given Participant, minus the Individual Stop Loss Amount in effect for each
policy period.
Our Stop Loss policy has other features and conditions which are described in the attached
Stop Loss General Description document. The Stop Loss General Description document and
rate sheet are also part of this proposal. Please review them carefully and notify us
immediately if any of the features do not meet your expectations or if any of our
assumptions are incorrect. Changes in the features or assumptions may affect our Stop
Loss premiums.
October 2013 www.aetna.com Page 1
City of Round Rock Financial Exhibits and Assumptions
Stop Loss Quotation Caveats
We reserve the right to change our rates and/or factors at any time during the policy year,
effective on the date the change occurred, in the following circumstances:
• Plan design changes from the proposed benefits including but not limited to
changes required in response to recent health care reform legislation.
• Actual enrollment in any line of coverage changes from the assumed enrollment
outlined on the rate sheet by 15%.
Large Group Acquisition - In the event that a large group is acquired after the original
effective date and is covered under the Stop Loss policy, we reserve the right to underwrite
the individuals within this group based on current large claim data provided by the
customer. If this information is not forthcoming, we will apply the Actively -at -Work and
Dependent Non -Confinement underwriting rules to those in the new group on the effective
date of their coverage under Stop Loss.
We reserve the right to amend or withdraw our proposal to reflect the underwriting
impact of any additional information we obtain or in the event you are unable to
provide us any of the information we need to fully underwrite the risk.
October 2013 www.aetna.com Page 2
City of Round Rock Attachments
Attachment A - Reference Sheet
NOTE: RESPONDENTS SHALL COMPLETE AND RETURN THIS ATTACHMENT WITH THEIR
PROPOSAL. FAILURE TO DO SO MAY RESULT IN DISQUALIFICATION OF THE PROPOSAL.
Respondent (Company): Aetna Life Insurance Company
Name (Typed /printed): Maria S. Mendez
Telephone number: (682)518-8179 E-mail Address: mendezml@aetna.com
Provide the name, address, telephone number and E-mail address of at least three (3)
references from firms of comparable size that have utilized similar service. Include
description, contact names, position, company name, e-mail address and telephone
number for each reference listed. Any negative responses received may be grounds for
disqualification of the Proposal. City of Round Rock references are not applicable.
References may be checked prior to contract award.
Description of Services: Stop Loss and Medical
Name of Contact: Ammv Butler
Title of Contact: Benefits Specialist
Company Name: City of Edmund
E -Mail Address: Ammy.Butler@edmondok.com
Telephone #: 405-359-4557
Fax #:
Description of Services: Stop Loss, Medical, FSA, Rx, and Medicare
Name of Contact: Rhonda Simpson
Title of Contact: Director of Benefits
Company Name: Oklahoma City Community College
E -Mail Address: rsimpson@occc.edu
Telephone #: 405-682-7823
Fax #:
Description of Services: Medical, Rx, Stop Loss and Dental
Name of Contact: Robert Gallegos
Title of Contact: Risk Management Coordinator
Company Name: San Elizario Independent School District
E -Mail Address: regallego@seisd.net
Telephone #: 915-872-3900 ext 3503
Fax #:
October 2013
www.aetna.com
CONFIDENTIAL
Page 1
City of Round Rock Attachments
Attachment B - Proposal Submittal Form And Execution Of Proposal
NOTE: RESPONDENTS SHALL COMPLETE AND RETURN THIS ATTACHMENT WITH THEIR PROPOSAL.
FAILURE TO DO SD MAY RESULT IN DISQUALIFICATION OF THE PROPOSAL.
By signature hereon, the Respondent certifies that:
All statements and information prepared and submitted in the response to this RFP are current,
complete and accurate.
He/she has not given, offered to give, nor intends t� give at anytime hereafter, any economic
opportunity, future employment, gift, loan gratuity, special discount, trip, favor, or service to a City
employee in connection with the submitted response. Failure to sign the Execution of Proposal or
signing it with a false statement shall void the submitted offer or any resulting contracts.
Respondent represents and warrants that the individual signing this Execution of Proposal is
authorized to sign this document on behalf of the Respondent and to bind the Respondent under
any contract resulting from this request for proposals.
RESPONDENT (COMPANY)4etna Life Insurance Company
SIGNATURE (IN INK):
NAME (TYPED/PRINTED) Peter G. Trusz
TITLE: Sales Director for Public and Labor Sector DATE: 10/29/2013
STREET: 151 Farmington Avenue
CITY/STATE/ZIP: Hartford. CT 06156
TELEPHONE AND FAXSCMILE NO.: 860-273-0123 (phone) 860-273-3382 (fax)
E-MAIL ADDRESS: TruszPc aetna.com
FEDERAL TAX IDENTIFICATION NUMBER (FIN): 06-6033492
By submitting a response to this solicitation, the Respondent agrees that the City's standard
Definitions, Terms and Conditions, in effect at the time of release of the solicitation, shall govern
unless specifically provided otherwise in a separate agreement or on the face of a purchase order.
Said Definitions, Terms and Conditions are subject to change without notice. It is the sole
responsibility of respondents to stay apprised of changes. In addition to the above General Terms
and Conditions listed in Section IV, the City's Definitions, Terms and Conditions shall be enforced
and part of the contract and can be obtained from the City's website at:
http://www.roundrocktexas.gav/home/index.aspTpage=463.
October 2013 www.aetna.com Page 1
City of Round Rock Attachments
Attachment C - Addendum Acknowledgment Form
NOTE: IF ADDENDUMS HAVE BEEN ISSUED, RESPONDENTS SHALL COMPLETE AND
RETURN THIS ATTACHMENT WITH THEIR PROPOSAL. FAILURE TO DO SO MAY RESULT IN
DISQUALIFICATION OF THE PROPOSAL.
ADDENDA ACKNOWLEDGMENT: The undersigned acknowledges the receipt of
the following Ad da:
Addendum #: 1 � 1 , Dated: 10/22/2013
Addendum 41: 2 Dated: 10/29/2013
IP
Addendum #: Dated:
Addendum #: Ddted:
Addendum #: Dated:
Respondent (Company): Aetna Life Insurance Company
Signature (in ink):14
Name (Typed/printed): Peter G. Trusz
Title: Sales Director for Public and Labor Sector Date: 10/29/2013
October 2013 www.aetna.com Page 1
City of Round Rock
Exhibit A - Stop Loss RFP
Plan Overview
Plan Overview
Pian Effective Date
1/1/2014
Employer Census
Please refer to Addendum #1: To be posted to City website.
Current and Future Medical Plans
Please refer to Addendum #1 - To be posted to City website.
Experience, Enrollment and Rate Information
Please refer to Addendum #1 - To be posted to City website.
Current Plan Document
Please refer to Addendum #1 - To be posted to City website.
Current Medical/Rx Carrier
Aetna - Since 2006
Future Medical/Rx Carrier
Aetna -Aexcel Network; single plan offering - Effective 01/01/2014
Current Stop Loss Carrier
Aetna
Current Rates
Individual $67.85
Aggregate $ 4.92
Current Aggregate Factor
$964.73
Current Lasers
None
Current Plan Design
Individual Stop Loss Plan Design
Contract Type - Paid
Individual Deductible - $200,000
Coverages Included - Medical/Rx
Annual Maximum - Unlimited
Lifetime Maximum - Unlimited
Aggregate Stop Loss Plan Design
Contract Basis - Paid
Coverages Included - Medical/Rx
Aggregate Corridor - 125%
Requested Plan Design
Individual Stop Loss Plan Design
Contract Type -18/12 & 24/12
Individual Deductible - $200,000 - Match Current
Individual Deductible - $225,000 - Option 1
October 2013 www.aetna.com Page 1
Aggregate Stop Loss Plan Design
Contract Basis - Paid
Coverages Included - Medical/Rx
Aggregate Corridor - 125%
Graded Evaluation Factors
The following graded evaluation factors will be used to determine how well a
Respondent(s) meet(s) the desired performance.
Factor Points
Price 45
Individual Lasers 10
Proposal Responsiveness 5
Policy Exclusions 20
References/Prompt Pay/Customer Service 15
Public Entity Experience 5
Maximum Total points 100
October 2013
www.aetna.com Page 2
STATE OF TEXAS
STATE BOARD OF INSURANCE
Certificate N? 4895
THIS IS TO CERTIFY THAT
CERTIFICATE OF AUTHORITY
AETNA LIFE INSURANCE COMPANY
HARTFORD, CONNECTICUT
Company No.
kasocampliocbmitkxbbergamocackintxStatomixTexasoapplicablecikecastaxadakiltxbecelnocanibarizeckcimxtramc-
adXbileCbUISiEDESSIC/X
has been granted permission to file, have approved and to issue approved variable an-
nuity contracts in Texas in accordance with and subject to the law and administration
of the State and as provided in Order No. 28101 of the Commissioner of Iasurance of
the State Board of Insurance, State of Texas.
insantansemithismahaditainoofx7Rawalc This Certificate of Authority shall be in full force and effect until
it is revoked, canceled or suspended according to law.
IN TESTIMONY WHEREOF, witness my
hand and seal of office at Austin, Texas, this
..13th..day of acraher , A, D. 1911_
COMMISSI NER OF INSURANCE
STATE OF TEXAS
STATE BOARD OF INSURANCE
Certificate No 10 53
Company No.
02-OO400
CERTIFICATE OF AUTHORITY
/ETNA LIFE INSURANCE COMPANY
HARTFORD, CONNECTICUT
has complied with the laws of the State of Texas applicable thereto and is hereby authorized to trans-
act the business of
Life; Health and Accident
insurance within the State of Texas. This Certificate of Authority shall be in full force and effect until
it is revoked, canceled or suspended according to law.
11 n,..\\
IN TESTIMONY WHEREOF, witness my
hand and seal of office at Austin, Texas, this
9th ._. day of_- .._ . July ._ , A.
COMMISSIONER OF INSURANCE
ROUND ROCK MRS
PURPOSE KISIun rlIOSPwn
City of Round Rock
Agenda Item Summary
Agenda Number: G.6
Title: Consider a resolution approving the renewal of the Administrative Services
Agreement with Aetna for stop loss insurance coverage for the period of
January 1, 2014 through December 31, 2014.
Type: Resolution
Governing Body: City Council
Agenda Date: 12/19/2013
Dept Director: Valerie Francois, Human Resources Director
Cost: $633,627.00
Indexes: Self -Funded Health Insurance
Attachments: Resolution, Exhibit A
Department: Human Resources Department
Text of Legislative File 13-1019
We are recommending that the specific deductible (specific reinsurance) be maintained at
$200,000 while realizing approximately $47,000.00 in annual savings due to plan revisions
for 2014.
Cost: $633,627.00
Source of Funds: Self-funded health insurance
Approval
City of Round Rock Page 1 Printed on 12117/2013