ITB 071I7000400



M E M O R A N D U M

TO: Kevin Dunn, Services Division Director

DTMB - Procurement

FROM: Lance Kingsbury, Buyer Specialist

DTMB - Procurement, Services Division

DATE: September 11, 2013

SUBJECT: Award Summary for RFP 071I3200068 – MPSERS Vision Benefit Plan for ORS

Background Information/General:

This request is for administration of post-employment Vision Benefit coverage for Members including Retirants, beneficiaries, COBRA participants, and their Dependents of the Michigan Public School Employees Retirement System (MPSERS), administered by DTMB, Office of Retirement Services (ORS). ORS administers the MPSERS Plan which provides post-employment health coverage to non-Medicare eligible and Medicare eligible retirants, beneficiaries, and their dependents enrolled in the health plan.  Health coverage is provided to eligible retired employees of local school districts, intermediate school districts, tax-supported community or junior colleges, and certain universities.  Approximately 155,000 of the 192,000 total MPSERS Retirants are enrolled in one of the health insurance coverage options offered by the Retirement System.  Total Members enrolled in one of the health insurance coverage options offered by the Retirement System is approximately 223,000.

Joint Evaluation Committee (JEC):

The JEC for this RFP consisted of the following individuals:

|Lance Kingsbury (Voting) |Steve Crippen (Voting) |

|Department of Technology, Management and Budget |Department of Technology, Management and Budget |

|Mark Howard (Voting) |Kerrie Vanden Bosch (Non-Voting) |

|Department of Technology, Management and Budget |Department of Technology, Management and Budget |

|Phil Stoddard (Non-Voting) | |

|Department of Technology, Management and Budget | |

Bidders:

The RFP was posted on the internet May 16, 2013, and was available for 28 days with a published due date of June 12, 2013. The following Bidders submitted proposals in response to this RFP:

|Bidder |City, State |MI Business |CRO |SDVOB |

|Blue Cross Blue Shield of Michigan |Detroit, MI |Yes |No |No |

|Davis Vision, Inc. |San Antonio, TX |Yes |No |No |

|EyeMed Vision Care, LLC |Mason, OH |Yes |No |No |

|Metropolitan Life Insurance Company |New York, NY |Yes |No |No |

|National Vision Administrators, L.L.C. |Clifton, NJ |Yes |No |No |

Evaluation Criteria:

Responses to this RFP were evaluated using a two-step process:

Step 1 – Evaluation of Technical Proposal

Step 2 – Evaluation of Price Proposal

The following charts represent the scoring of the particular factors:

| |Points Possible |

|1. |Work and Deliverable (Section 1.022, excluding 1.022D) |50 |

|2. |Provider Network (1.022D) |10 |

|3. |SLAs (1.022G) |5 |

|4. |Bidder Information (4.011) |5 |

|5. |Prior Experience (4.012) |20 |

|6. |Staffing (1.031 & 4.013) |10 |

|TOTAL: |100 |

Price Evaluation

(a) Only those proposals receiving a score of 80 points or more in the technical proposal evaluation will have their pricing evaluated to be considered for award.

(b) Evaluation of price proposals includes consideration for a Qualified Disabled Veteran Preference. 1984 PA 431, as amended, establishes a preference of up to 10% for businesses owned by qualified disabled veterans meeting the minimum point threshold for passing.

(c) The State reserves the right to consider economic impact on the State when evaluating proposal pricing. This includes, but is not limited to: job creation, job retention, tax revenue implications, and other economic considerations.

Evaluation Results for Technical Evaluation (100 points possible):

Blue Cross Blue Shield

The JEC determined that Blue Cross Blue Shield (BCBS), based on a score of 91, could meet the requirements of the RFP. This determination was accomplished by evaluating their responses to the evaluation criteria noted in the table above.

1. Statement of Work (Article 1) Score: 48 / 50

The JEC noted the following deficiencies:

• BCBS did not mention their procedure for recoveries.

• Enrollment files must be processed and member eligibility and/or enrollment update completed within one business day of notification; BCBS states this will be done in 48 hours.

• 100% of all accurate records that pass Contractor’s validation edits must be uploaded according to the Plan Sponsor’s schedule within one business day; BCBS states this will be done in 48 hours.

2. Provider Network (1.022D) Score: 7 / 10

The JEC noted the following deficiency:

• Disruption analysis and percentage of member access to a vision provider did not meet all requirements.*

3. Contractor Roles (1.031) / Staffing (4.013) Score: 9 / 10

The JEC noted the following deficiency:

• BCBS did not provide a resume for their underwriter.

4. SLAs (1.071) Score: 4 / 5

The JEC noted the following deficiencies:

• BCBS did not meet SLA #1.

• BCBS did not meet SLA #14.

5. Company Information (4.011) Score: 5 / 5

The JEC noted the following deficiencies:

• None.

6. Prior Experience (4.012) Score: 18 / 20

The JEC noted the following deficiencies:

• BCBS descriptions or their prior experiences lacked detail.

Total Score: 91 / 100

Davis Vison, Inc.

The JEC determined that Davis Vision, Inc. (DV), based on a score of 87, could meet the requirements of the RFP. This determination was accomplished by evaluating their responses to the evaluation criteria noted in the table above.

1. Statement of Work (Article 1) Score: 45 / 50

The JEC noted the following deficiencies:

• DV’s definition of First Call Resolution differs from the requirement.

• On a monthly basis, 95% of calls must be answered within 30 seconds or less; DV stated this measurement will be an aggregate across DV’s priority service level book of business.

• On a monthly basis, 85% of calls must have less than 30 seconds elapse between when a caller elects to speak to a customer service representative and when the call is connected to a customer service representative; DV stated this measurement will be an aggregate across DV’s priority service level book of business.

• The monthly call abandonment rate must not exceed 3% after being connected for at least 40 seconds; DV stated this measurement will be an aggregate across DV’s priority service level book of business.

• DV’s specifications of the Data Management Vendor claims as described in Attachment F differ.

2. Provider Network (1.022D) Score: 7 / 10

The JEC noted the following deficiency:

• Disruption analysis and percentage of member access to a vision provider did not meet all requirements.*

3. Contractor Roles (1.031) / Staffing (4.013) Score: 6 / 10

The JEC noted the following deficiencies:

• One out of the two back up SAMs lack experience.

• DV did not provide a resume for the other back up SAM.

• SAM resume provided lacked detail.

• DV did not provide a resume for the Client Administrator (assisting in Implementation).

4. SLAs (1.071) Score: 4 / 5

The JEC noted the following deficiencies:

• DV did not meet SLA #5.

• DV did not meet SLA #6.

• DV did not meet SLA #7.

5. Company Information (4.011) Score: 5 / 5

The JEC noted the following deficiencies:

• None.

6. Prior Experience (4.012) Score: 20 / 20

The JEC noted the following deficiencies:

• None.

Total Score: 87 / 100

EyeMed Vision Care, LLC

The JEC determined that EyeMed Vision Care, LLC (EyeMed), based on a score of 94, could meet the requirements of the RFP. This determination was accomplished by evaluating their responses to the evaluation criteria noted in the table above.

1. Statement of Work (Article 1) Score: 48 / 50

The JEC noted the following deficiencies:

• EyeMed did not provide independent ratings of financial strength.

• EyeMed did not mention their procedure for handling recoveries.

• Enrollment files must be processed and Member eligibility and/or enrollment update completed within one business day of notification from the Plan Sponsor; EyeMed’s standard is to load all files within two business days.

• 100% of all accurate records that pass Contractor’s validation edits must be uploaded according to the Plan Sponsor’s schedule within one business day; EyeMed’s standard is to load all files within two business days.

2. Provider Network (1.022D) Score: 9 / 10

The JEC noted the following deficiency:

• Disruption analysis and percentage of member access to a vision provider did not meet all requirements.*

3. Contractor Roles (1.031) / Staffing (4.013) Score: 8 / 10

The JEC noted the following deficiencies:

• EyeMed’s resumes had no dates of employement.

• EyeMed did not provide an Optometrist or Ophthalmologist.

4. SLAs (1.071) Score: 3 / 5

The JEC noted the following deficiencies:

• EyeMed did not meet SLA #1.

• EyeMed did not meet SLA #2.

• EyeMed did not meet SLA #4.

• EyeMed did not meet SLA #14.

5. Company Information (4.011) Score: 5 / 5

The JEC noted the following deficiencies:

• None.

6. Prior Experience (4.012) Score: 20 / 20

The JEC noted the following deficiencies:

• None.

Total Score: 93 / 100

Metropolitan Life Insurance Company

The JEC determined that Metropolitan Life Insurance Company (Met), based on a score of 64, could not meet the requirements of the RFP. This determination was accomplished by evaluating their responses to the evaluation criteria noted in the table above.

1. Statement of Work (Article 1) Score: 30 / 50

The JEC noted the following deficiencies:

• Met could not administer the plan in accordance with the Plan Design.

• Met offered an “enhanced custom plan” as opposed to the Plan Design that must be provided as shown in the RFP Attachment C.

• Met did not confirm they can administer claims in conformity with the Plan Design as described in the RFP.

• Met is not willing to transfer claim data elements involved in the processing or payment of claims to the Data Management Vendor.

• Met is not willing to transfer additional claim data elements, if requested by the Plan Sponsor, to the Data Management Vendor.

• Met did not mention their procedure for handling recoveries.

• Met does not provide a dedicated telephone number (page 7).

• Met did not address about a written compliant if a member’s telephonic issue is not resolved immediately; nor did Met confirm they would follow up with a written response within five days for those issues not resolved immediately.

• Met is offering an insured arrangement, therefore, they cannot provide pass-through pricing to the Plan Sponsor for a self-funded arrangement.

• Met does not provide an Explanation of Benefits (EOB) to the members for in-network service. An EOB is required for both in and out of network service/claims.

• Met does not meet the following requirement: “must not sell email addresses or demographic information of members and can only disclose email addresses or demographic information to partners with the approval of the member.”

• Met did not indicate how frequently they send satisfaction surveys to members.

• Met did not confirm customization of surveys or provide the top five categories of complaints for 2010, 2011, and 2012, or include an action plan to improve these areas.

• Enrollment files must be processed and Member eligibility and/or enrollment update completed within one Business Day of notification from the Plan Sponsor. Met’s standard is two business days.

• 100% of all accurate records that pass Contractor’s validation edits must be uploaded according to the Plan Sponsor’s schedule within one Business Day. Met’s standard is load 95% of the files within two business days.

• The process for testing system changes lacked detail.

2. Provider Network (1.022D) Score: 6 / 10

The JEC noted the following deficiency:

• Disruption analysis and percentage of member access to a vision provider did not meet all requirements.*

3. Contractor Roles (1.031) / Staffing (4.013) Score: 5 / 10

The JEC noted the following deficiencies:

• Met did not provide a SAM back up.

• Met did not provide resumes for key personnel; only bios, which lacked detail.

• Met did not provide an enrollment or customer service specialist(s).

• Met did not provide an Optometrist or Ophthalmologist.

• Met does not allow the State pre-approval of subcontractors.

4. SLAs (1.071) Score: 3 / 5

The JEC noted the following deficiencies:

• Met did not meet SLA #1.

• Met did not meet SLA #2.

• Met did not meet SLA #10.

• Met did not meet SLA #14.

5. Company Information (4.011) Score: 5 / 5

The JEC noted the following deficiencies:

• None.

6. Prior Experience (4.012) Score: 14 / 20

The JEC noted the following deficiencies:

• Project descriptions lacked detail.

• References provided are not the same size (and one not the same scope) of the services requested in the RFP.

• One reference provided is of themselves.

Total Score: 63 / 100

National Vision Administration, L.L.C.

The JEC determined that National Vision Administrators, L.L.C. (NVA), based on a score of 91, could meet the requirements of the RFP. This determination was accomplished by evaluating their responses to the evaluation criteria noted in the table above.

1. Statement of Work (Article 1) Score: 48 / 50

The JEC noted the following deficiencies:

• NVA did not provide financial strength (A.M. Best Rating).

• NVA did not provide any information on resolving an issue if they were to receive a written inquiry.

• NVA’s process for testing system changes was vague and lacked detail.

2. Provider Network (1.022D) Score: 8 / 10

The JEC noted the following deficiency:

• Disruption analysis and percentage of member access to a vision provider did not meet all requirements.*

3. Contractor Roles (1.031) / Staffing (4.013) Score: 8 / 10

The JEC noted the following deficiency:

• NVA did not provide an Implementation Manager/Lead.

4. SLAs (1.071) Score: 5 / 5

The JEC noted the following deficiencies:

• None

5. Company Information (4.011) Score: 5 / 5

The JEC noted the following deficiencies:

• None.

6. Prior Experience (4.012) Score: 17 / 20

The JEC noted the following deficiencies:

• NVA did not provide any membership numbers/costs of any experiences.

• NVA’s project descriptions lacked detail.

Total Score: 91 / 100

*Refer to the Provider Network Tables in the attached ORS Vision Analysis sheet

JEC Scoring Summary for Technical Proposal:

| |Poi|BCBS |DV |EyeMed |Met |

| |nts| | | | |

|Admin fees listed are Per Contract Per Year - Admin fees are multiplied by contract counts provided by ORS. | |NVA – Fully Insured |$21,351,964.26 |$7,117,321.42 |$42.05 |

|Total amounts are the three year cumulative amounts. | | | | | |

| | |EyeMed – Fully |$22,594,457.08 |$7,531,485.69 |$44.97 |

| | |Insured | | | |

| | |Self-Funded assumes 100% in-network for claims |

| | |Amounts listed are three year cumulative totals | |

| |Premiums for Fully Insured | | | |

| |BCB|Davis Vision |EyeMed |NVA | |

| |SM | | | | |

|Premiums listed are Per Contract Per Year - Premiums are multiplied by contract counts provided by ORS. Total | |EyeMed |$19,118,709.90 |$19,110,382.36* |$19,110,382.36* |

|amounts are the three year cumulative amounts. | | | | | |

| | |* Current vendor, no disruption - actual claims data used | |

| |

| |Network Access | | |Network Size |

| |BCBSM |NVA |Davis Vision |EyeMed | |

Chain Locations:

BCBSM – VSP: Costco, Vision Works, Wisconsin Vision & Rx Optical, SVS Vision, Henry Ford Optimeyes

Davis Vision: Meijer, Rx Optical, See Optical, Henry Ford Optimeyes, EyeMart Express, America’s Best, SVS Vision, Wal-Mart

EyeMed: LensCrafters, Pearle Vision, Target Optical, JCPenney Optical

NVA: America’s Best, Dr. Bitzer’s Vision World, Sam’s Optical, EyeDRx, Hour Eyes, Binyon’s, Eye Master’s, Sterling VisionCare, National, Standard Optical, Wal-Mart

Frames:

BCBSM – VSP: Blue Vision does not limit what glasses are covered.  A member can choose any frame that falls within their frame allowance.

Davis Vision: Davis Vision covers all frame brands on the market today.

EyeMed: All brands of frames at every provider location.

NVA: Members may select any frame including designer collections at any in-network eye care professional and use their frame allowance towards the purchase.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download