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["Question/Info Request","Answered Vendor Date","Answer"]
["City of Canton contact name & phone number","2022-07-19","please direct questions via the bid site, do not contact directly"]
["Broker/consultant name","2022-07-19","Huntington Insurance, Bill McCarron"]
["Number of total lives (employees & dependents)","2022-07-19","employee count provided: total members 1872"]
["Annual script count","2022-07-19","please refer to the reporting which is a rolling 12 months"]
["Annual spend","2022-07-19","please rerer to the reporting which is a rolling 12 months "]
["Number of participating members in HDHP","2022-07-19","no HDHP currently"]
["We are reviewing the released RFP on the vision line and wondering if you can share the vision plan summary and rates?","2022-07-19","SPD is provided in the attachment.  We are a self funded health plan."]
[" Also, do you have vision specific claims data and enrollment?","2022-08-03","There was a vision census provided around 7/20 and vision claims experience provided aroudn 7/14.  (not sure when it was posted) "]
["We are in need of a census with the following: Date of Birth, Gender, Employee Zip code, Plan tier","2022-07-19","Please see addendum documents"]
["1. Why are the programs out to bid?","2022-07-19","The City would like to evaluate the marketplace for creative ideas and new opportunities"]
["2. When was the last time the programs were out to bid?","2022-07-19",2017]
["3. How will proposals be scored, including weightings and scoring criteria?","2022-07-19","Based on the factors in the proposal guidelines"]
["4. Who will be scoring proposals?","2022-07-19","A team composed from the City of Canton"]
["5. What is the decision-making and approval process?","2022-07-19","All prospect will be vetted and finalist will present to the appropriate team"]
["6. Is an insurance committee involved in any aspect of the RFP process?  If so, who is on the committee (in terms of role, representation, etc.)?","2022-07-19","There is no committee, but a team of stakeholders from the City"]
["7. Please provide details related to the statement near the bottom of page 11 that reads “Please note that our plan has a requirement for review of certain outpatient procedures.”  What are the specific requirements?","2022-07-19","Precertification is required for some procedures"]
["8. The RFP is requesting recommendations for a new plan design for dental and vision. Please explain what you are looking for and what has been considered in the past.","2022-07-19","There have been no changes for a long time; looking for innovative and more modern designs"]
["9. Has the City of Canton considered proposals from any consortium arrangements in the past?  If so, why were they rejected? Do those reasons/considerations remain?","2022-07-19","The City is part of a consortium for stoploss."]
["10. What is the annual wellness grant in today’s contract?  Has that amount changed in the last 3 years? If so, what were the prior amounts?","2022-07-19","No wellness grants currently"]
["11. What other allowances, grants or budgets are included in today’s contract?","2022-07-19","None currently"]
["There are multiple references in the Health RFP instructions that state a Proposal Form/Signature page needs to be completed in Section 9. There is no Section 9 in the RFP; it concludes at Section 8. I assume this is a typographical error that was carried over from the PBM RFP that has 9 Sections. Is someone able to confirm? I do not want to miss a form for completion. Thank you.","2022-07-19","This was a typographical error.   There are only 8 sections in the Health RFP.  We apologize for the confusion."]
["Please provide Census with dental and vision tier elections","2022-07-19","Please see addendum documents"]
["Please provide Experience for dental and vision","2022-07-19","Requested, to be issued in future addendum."]
["Please provide Certificates/Summary of Benefits for dental and vision","2022-07-19","Included as part of Addendum 1"]
["Complete employee and dependent census","2022-07-19","Please see addendum documents"]
["Rebates obtained in the last 12-18 months","2022-07-19","The request in the RFP is for 100% of rebate remittance to the City of Canton."]
["Stop Loss fees for just the Rx side","2022-07-19","stoploss is combined for medical and rx"]
["Is the Optum formulary open or preferred?","2022-07-19","open"]
["Is there an excel fee /spreadsheet template exhibit for Pharmacy that should also be filled out, like the medical fee spreadsheet?","2022-07-29","No, there is not a prescription pricing template required."]
["The RFP states there are 953 employees. The census provided yesterday lists 620 employees. Can you please verify that the census with 620 employees is correct?","2022-08-03","There are 2 separate census from each current carrier.  Total headcount is approx. 950 employees"]
["The employee and dependent(s) part of the census does not clearly delineate if the employee has just one child, or more than one child. Can you provide information on what employee has one child compared to having more than one?","2022-08-03","Please use data provided"]
["From the note in the RFP “Coverage is offered either on a single, single + 1, or family plan”. Can you please confirm for this 3-tier format that you want our proposal to show the employee and spouse, and employee with one child, in that “single +1” tier ? (the census breaks down like a typical 4-tier scenario and we want to make sure we quote this in the correct format for this proposal).","2022-08-03","Yes.  Employee + 1 is either employee and spouse or/ and employee with one child."]
["The SBC states “Specialty drugs must be obtained from AultCare’s Preferred Specialty Pharmacies”  - is this alluding to a hospital based in-house pharmacy in one of the Aultman hospitals, or just the network of Specialty Pharmacies within AultCare’s network?","2022-08-03","Aultcare appointed Specialty Pharmacies."]
["Can you provide the actual amount of the rebates dollars the City of Canton received in the last 12 months?","2022-08-03","We are not sharing at this time, but are requesting 100% rebate returned"]
["Can you provide the actual amount of stop loss fees that the City of Canton paid for Rx in the last 12 months?","2022-08-03","There is not stop loss fees associated with the plan currently.  "]
["Do they have retirees? If so, how many?","2022-07-29","No, Retirees are not covered"]
["With respect to Carrier Responses question #49 - “Vendor agrees that all ancillary supplies (e.g., needles, syringes, tubing, etc.) required for self-administering specialty products will be provided to members at no additional cost.”   Question: Does the City of Canton currently cover any of these items at $0 copay, if so, which ones?","2022-07-29","No, the supplies with a prescription fall under the appropriate benefit tier, but supplies to administer the product are included  in the prescription."]
["Please confirm the total number of enrolled employees and the breakdown of those enrolled in the UMR program and those that are enrolled in the Aultcare program.  Specifically under “General Information” under “Size of account:  Approximately 953 employees on the health plan; 15 opt-outs”.","2022-08-03","There are 2 separate census from each current carrier.  Total headcount is approx. 885 employees"]
["The attachments include a census with approximately 689 enrolled under UMR and 620 enrolled in Aultcare.  This adds up to about 1309 enrolled employees.","2022-08-03","The UMR census includes the dependents as identified"]
["Please clarify the number enrolled in each plan and the total number of enrolled employees.","2022-08-04","Approx 265 Employees with UMR and 620 in AultCare"]
["Is it possible to obtain a full summary booklet/cert for the medical plan?","2022-07-29","Yes, please see Addendum"]
["1. Will claims data and enrollment by month for last 24 months for dental be provided? ","2022-08-03","Dental expereince was provided."]
["2. Please confirm the UCR % for out of network dental claims.","2022-08-04","Non-Network Dental claims are paid from the 90% MDR fee schedule."]
[" 3. Can we deviate from the $100 deductible on orthodontics? The addendum stated they are looking for a more updated plan design. ","2022-08-03","The COC is open to other alternative paln designs but would like to see a match of current benefits as well."]
["4. Can you provide the dental admin fee and FIE rates for dental? ","2022-08-03","Not being provided with the RFP, be as competitive as possible."]
["5. Will you require GEO Access and Disruption reporting for dental and vision? If so, please provide the appropriate documents.","2022-08-03","GEO Access and Disruption reporting for dental and vision is not required at this time.  Maybe considered at a later date. "]
["On behalf of Anthem, I just wanted to inform you we will be declining to quote the Prescription Plan Administration for City of Canton.","2022-08-03","Acknowledged "]
["Can you please clarify the below question?  We are questioning if you mean pricing guarantees or the AWP. \"All PBMs must guarantee at least one hundred twenty (120) day written notice in advance of any rate change.\"","2022-08-03","This is for administration."]
["1. Can you please explain how the layered MOOPs in the plan (integrated MOOPs moving to Rx only MOOPs) are being managed?","2022-08-03","A file feed of prescription data is being provided to the administrator to manage the MOOP"]
["2. Can patients fill their specialty drugs at retail?","2022-08-03","Currently they are required to fill at a specialty pharmacy"]
["3. Can you provide a list of the specialty drugs covered under the plan? Can we use our own specialty formulary, or do you need vendors to match the current formulary?","2022-08-03","They have an open formulary today.  You can offer your own formulary."]
["4. Which pharmacies are included in AultCare’s Preferred Specialty Pharmacies Network?","2022-08-04","Preferred Specialty Pharmacies are Optum Specialty Pharmacy and Gentry Health Services Specialty Pharmacy."]
["5. Are you currently enrolled in a copay assistance program? If so, is it handled by the PBM? Any detail you can provide on how this program is administered?","2022-08-03","They are not currently enrolled in a copay assistant program."]
["6. Can you explain the significant volume of claims reversals we have observed in the claim file?","2022-08-03","They are reversals of claims.  Please exclude for repricing."]
["7. What clinical programs do you currently have in place? Can Benecard utilize our own Clinical programs to administer this plan?","2022-08-03","Step therapy is in place.  This is a union group, so program options must be scrutinized."]
["Exhibit A – Rx Utilization – Can you please confirm if the intention is to provide a Rx disruption and/or repricing analysis? If so, the file does not contain formulary status or tier. There is column S included that indicates “FormularyIndc”. The codes included are 0, 1 & 9. Please confirm what this column represents or if column S reflects the formulary status or tier. If this does not reflect formulary status or tier can you please provide a new file that includes formulary status or tier if we should proceed with a disruption and/or repricing?","2022-08-03","This is for repricing."]
["PBM RFP General question – When answering customer service questions, are we OK to provide contacts for both MHS and ESI for the PBM piece?","2022-08-03","Yes."]
["PBM RFP Formatting question – Page 20 of RFP, Section 6 Required Carrier Responses. The numbering is missing numbers 68 and 69 for the questions. Are there missing questions from the RFP? Does the broker want us to answer the RFP using the numbering provided (…65, 66, 67, 70, 71…)?","2022-08-03","Yes."]
["PBM RFP Attachment question – Page 9 of RFP, SOC report (Number 15). Do we include with our RFP submission or after the business is awarded? The instruction states “The successful proposer…,” which indicates that it would be the firm that received the bid that needs to furnish this report.","2022-08-03","Vendor can provide SOC report once named a finalist. "]
["PBM RFP Attachment question – Page 8 of RFP, Terms & Conditions Page. On Section 9 – Proposal Form, there is a paragraph that reads: “Proposer further agrees that the signing of this Proposal Form represents its acceptance of the terms and conditions set forth within said Request for Proposal.” In Section 3 – Instructions (page 8, number 5), it reads: “Each respondent MUST complete the Proposal Form/Signature page in Section 9 of This RFP, as well as the Terms & Conditions page.” Does the item on the Proposal Form equal the “Terms & Conditions page”? There is no solo “Terms & Conditions” signing page.","2022-08-04","This was a typographical error.   There are only 8 sections in the Health RFP.  We apologize for the confusion."]
["PBM RFP Attachment question – Page 8 of RFP, Sample copy of the ASO Agreement. Does this mean an executable version of our contract for City of Canton, or just a sample agreement? The article “the” is prompting the question, do they mean the agreement we’re making specifically for City of Canton? Is a PBM ASO Agreement the same as a Medical ASO Agreement? Both the Med/Dental/Vision and PBM RFPs ask for a “sample copy of the ASO agreement.”","2022-08-03","You should provide samples for ASO for PBM."]
["Please confirm that your current vision plan is through VSP. Can you please provide a VSP benefit highlight sheet for this plan? The cert book does not provide any information about non-network benefits.","2022-08-03","VSP is not in force currently."]
["A Non-Disclosure Agreement will be required for signature to release Medical and/or Rx Disruption results. How should this be provided for signature?","2022-08-03","Provide prior to submission"]
["Medical, Dental, Vision RFP Attachment question – Page 8 of RFP, Terms & Conditions Page. On Section 8/9 (see above question) – Proposal Form, there is a paragraph that reads: “Proposer further agrees that the signing of this Proposal Form represents its acceptance of the terms and conditions set forth within said Request for Proposal.” In Section 3 – Instructions (page 8, number 5), it reads: “Each respondent MUST complete the Proposal Form/Signature page in Section 8/9 of This RFP, as well as the Terms & Conditions page.” Does the item on the Proposal Form equal the “Terms & Conditions page”? There is no solo “Terms & Conditions” signing page.","2022-08-04","This was a typographical error.   There are only 8 sections in the Health RFP.  We apologize for the confusion."]
["Medical, Dental, Vision RFP Formatting question – Page 21, Section 8 Proposal Form. In the instructions (Section 3, number 5) it says the Proposal Form is Section 9. Is this a typo? How would the broker like to amend this? Do we call it Section 9 as the instructions indicate or do we leave it as Section 8 as in the RFP?","2022-08-03","We will match up as necessary"]
["Medical, Dental, Vision RFP Formatting question – Page 15, Section 7 Proposal Questions, Networks, Medical. In the Medical questions section, the questions on page 14 are numbered 1 through 7. On page 15, under the heading “Medical cont.,” the count begins anew and are numbered 1 through 11. In the question sections for “Financial & Reporting” and “Service & Reporting,” numbers are continued without restarting when a page break occurs. Do we maintain the RFP numbering as is?","2022-08-03","Yes"]
["Medical, Dental, Vision RFP Formatting question – Page 13, Section 7 Proposal Questions. In the instructions for Section 7 at the top of the page it reads: “Please provide your responses on a separate sheet for all questions in Section 8…” Is that a typo? Section 8 in the Medical, Dental and Vision RFP is the Proposal Form.","2022-08-03","Yes, please submit separately for section 7"]
["Please provide a breakdown of your administration costs billed on behalf of AultCare and UMR.","2022-08-03","Not providing at this time."]
["Section 6 - “52. Vendor agrees to provide administrative support for the City of Canton Medicare Part D drug program, including, but not limited to: eligibility maintenance and reconciliation, quarterly drug cost reporting and submission to CMS, annual drug cost reconciliation, preparing and distributing letters of creditable coverage, and ensuring compliance with all CMS and Retiree Drug Subsidy (RDS) requirements. Vendor will fully disclose to COC and CMS in the Part D subsidy billing package all rebates, including those you retain as a formulary management fee, as required by CMS guidance. Vendor also agrees to allow the City of Canton or its designee to audit the Vendor’s administration of the Medicare Part D drug program, including the reconciliation process without additional charges to the City of Canton.” Please clarify if you are requesting us to administer Part D or if this is referencing about RDS and creditable coverage which is not Part D.","2022-08-03","Referencing RDS and creditable coverage."]
["Are you able to provide the current admin fee through AultCare/VSP? It has not been provided at this time and I want to ensure we have a competitive offering.","2022-08-03","We are not providing the pricing be a competitive as possible."]
["I am unable to match the current plan design exactly, but we will be able to offer plan enhancements – Will these plan design differences rule us out of being considered?","2022-08-03","Canton has union so benefits must be duplicated"]
["Can you provide clarity on the attached Exhibit E? I am not seeing any information that is needed completion by the vision carriers so I wanted to confirm I don’t miss anything for submission.","2022-08-03","This is not needed for Vision."]
["Are there any issues or complaints with the current vision provider/plan?","2022-08-03","Evaluating programs with RFP."]
["If yes, what are they?","2022-08-03","N/A"]
["What will it take to move vision carriers?","2022-08-03","Please review RFP for core focus."]