Medical Plan Administration

Q (Terms and Conditions): How would you like us to capture modifications to procurement documents, including the Terms and Conditions? Would you like a list of exceptions/deviations or redlines applied?

A: Please provide redlines.

Q (No subject): 11. The Contract Certification Affidavit requires notary along with signature. Since the proposal is being submitted electronically, may the requirement for notary by waived?

A: WSSC Water will waive the notary requirement for electronic submission.

Q (No subject): 10. Are the pharmacy benefits, currently carved out to CVS/Caremark, included in the scope of this RFP?

A: No

Q (No subject): 9. Please clarify the Medicare status of the pre-65 Retirees on the various agency Retiree census files, as notation is not consistent.

A: For the M-NCPPC census: Columns F-G represent the Non-Medicare enrollment, and columns H-I represent the Medicare enrollment. If all members within a retiree's family unit are Non-Medicare, then their Non-Medicare election is shown in the Non-Medicare section, and Medicare will show as "N/A". If all members within a retiree's family are Medicare, then Non-Medicare will show as "N/A", and their Medicare election is shown in the Medicare section. If the members within a retiree's family unit are split between Non-Medicare and Medicare, then the election of the Non-Medicare members is shown in the Non-Medicare section, and the election of the Medicare members is shown in the Medicare section. WSSC census as labeled.

Q (No subject): 8. Please confirm the OON reimbursement rate for the medical plans with OON coverage.

A: 80% percentile of UCR

Q (No subject): 6. Would WSSC consider issuing an extension to the requested due date of April 20th given the complexity of the RFP? As an example, RFPs of this size are typically issued with a minimum of 30 calendar days from issue date to due date.

A: No; we are unable to extend the deadline at this time; please submit your proposal within the specified timeframe

Q (No subject): 5. Would alternatives to the current ASO Medicare Complement/Supplement plans be considered?

A: No

Q (No subject): 7. M-NCPPC’s Retiree census includes two ‘Medical Election’ columns with no key or legend provided to determine which column should be used. Please clarify how this census should be read for current enrollment.

A: As labeled, columns F-G represent the Non-Medicare enrollment, and columns H-I represent the Medicare enrollment. If all members within a retiree's family unit are Non-Medicare, then their Non-Medicare election is shown in the Non-Medicare section, and Medicare will show as "N/A". If all members within a retiree's family are Medicare, then Non-Medicare will show as "N/A", and their Medicare election is shown in the Medicare section. If the members within a retiree's family unit are split between Non-Medicare and Medicare, then the election of the Non-Medicare members is shown in the Non-Medicare section, and the election of the Medicare members is shown in the Medicare section.

Q (No subject): 4. WSSC Water and M-NCPPC 2027 Medical RFP Part 1 Technical Questionnaire, A6 – Plan Design tab directs proposers to enter all proposed plan deviations in column C beside current plan name. Does column C have a character limit and if so where should we note any additional plan deviations?

A: If you need additional space for plan deviations, you may use the "explanation" worksheet and note "plan Design deviations"

Q (No subject): 3. WSSC Water and M-NCPPC 2027 Medical RFP Part 1 Technical Questionnaire, A6 – Plan Design tab only provides space to note any deviations to the EPO and POS plans. Where should we note any deviations to the current Med Comp plans?

A: If you need additional space for plan deviations, you may use the "explanation" worksheet and note "plan Design deviations"

Q (No subject): 2. Please confirm if electronic signatures will be acceptable for the signature requirements.

A: Electronic signatures are acceptable for the signature requirements.

Q (No subject): 1. WSSC Water and M-NCPPC 2027 Medical RFP Part 1 Technical Questionnaire, A6 – Plan Design tab directs proposers to the website for each agency to obtain summaries of plan benefits. In reviewing the benefit information available on the various websites there are issues with the version of some EOC’s being from prior plan years and some EOC’s not posted at all, particularly for the Retiree plans. In order to confirm our benefits match current, or list deviations, we would need current (2026 plan year) carrier SPDs or EOCs that include the schedule of benefits for each agency and current plan.

A: Please see attached SPDs. SBCs were included in the RFP data materials. Note that M-NCPPC SPDs are in draft format but represent the plans accurately for purposes of plan design deviations.

Q (No subject): With necessary data still pending (full census file, claims data, and enrollment data) will an extension be granted?

A: All data was provided on 3/31 via email, which was sent directly to the contact who provided the intent to bid. Please advise Aon directly if you did not receive this information.

Q (No subject): For 295 Medicare Retirees for M-NCPPC population in scenario 1, line 20 says (Medicare excluded) under UHC EPO. Are the 295 lives to be included or excluded?

A: As noted on each fee quote worksheet: "Currently, Medicare Retirees are covered under the agency's self-insured medical plan; however, a Medicare Advantage RFP is also currently underway. It is to be determined if the Medicare Retirees will remain on the self-insured medical plan or move to a Medicare Advantage plan effective 1/1/2027. " There are separate sections below to provide quotes assuming the Medicare Retiree population is excluded or included with the self-insured medical carrier. Financial quotations are being requested for two scenarios: 1 - Excluding Medicare Retirees; 2 - including Medicare Retirees

Q (No subject): Can you please tell us if the 295 Medicare Retirees for M-NCPPC population, showing in the UHC EPO fee quote tab, are remaining in the EPO plan with the medical carrier (see line 14) of financial exhibit?

A: Financial quotations are being requested for two scenarios: 1 - Excluding Medicare Retirees; 2 - including Medicare Retirees

Q (Claim and Clinical Allowance): Can you please clarify the request for the claim and clinical allowance? Are you requesting we cover up to $65,000 for a clinical audit every two years and up to $65,000 every two years for a separate claims audit (up to $130,000 every two years in total)?

A: Please provide the maximum claim allowances you will offer in your proposal. This may be combined clinical/claims or separate. Ideally, both would be covered.

Q (Variable Copay Plan Capabilities Tab A4 Q. 41-44): Are you looking for a financial quote for a variable copay plan to be included in this RFP response? If so, how should we submit financials and proposed plan design?

A: No. We are asking for information on whether you offer this type of plan for potential future consideration.

Q (Medical Amendment 1): Can you please clarify what is changing in Amendment 1? It's been posted without a description.

A: To date, there is no official Amendment 1 for this solicitation. There may have been a notification from the Supplier Portal (Oracle) with an Amendment, which was published to update a link to OpenGov.