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["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Arlington County Government hereinafter referred to as \"County\""]
["Arlington County Government offers Cigna and Kaiser plan options to their eligible population.  This RFP is a request a proposal option for the Cigna self-funded medical plans.  A Kaiser plan proposal will not be requested at this time.  The Cigna plans include two in-network only plans and one HDHP option.  Their Cigna medical plans also include a vision plan benefit that will need to be included as a part of the proposal."]
[]
[]
[]
[]
["Medical Technical Instructions"]
[]
["Arlington County Government is seeking proposals from qualified organizations to provide administration of the current medical programs for their active employees, retirees under 65, and COBRA participants effective July 1, 2021. This proposal request does not include any Medicare retirees."]
[]
["Important: As a reminder, please provide complete responses in your RFP submission as there will be no requests for clarification and your responses will be scored according to how you reply to each question and on requested materials provided."]
[]
["Worksheet Files:  Worksheet(s) to enter your proposal are contained within this Excel file.  Generally, the types of information that you will be entering into this file are plan design deviations, geo-access etc.  You are expected to provide the requested information by completing this workbook.  In addition, this file may also contain reference information (rate history, enrollment data, etc.) that will assist you in putting together your quote."]
[]
["Electronic File Attachments:  Any attachments that you are being asked to provide about your organization must also be submitted electronically and are listed in Part 3 below. Hard copy attachments will not be accepted.  An explanation of each attachment that you are required to provide appears in the Questionnaire; please be sure to follow the naming conventions that are provided for each attachment."]
[]
["In order to help you organize your proposal and ensure that it is complete, please review the following list to ensure that you have provided each required item. "]
[]
["Questionnaire File (s):"]
["Information",null,"Name of Worksheet"]
["Introduction",null,"Intro"]
["Clinic Background",null,"Clinic Background"]
["Clinic Questionnaire",null,"Clinic Questionnaire"]
["Clinic Explanation, if necessary",null,"Clinic Explanation"]
["Medical Questionnaire                                                                             ",null,"Med. Questionnaire"]
["Medical Questionnaire Explanations, if necessary                                                    ",null,"Med Ques_Explanation"]
["Wellness Questionnaire",null,"Wellness Questionnaire"]
["Wellness Questionnaire Explanations, if necessary",null,"Wellness Ques_Explanation"]
["HSA Questionnaire",null,"HSA Questionnaire"]
["HSA Explanations, if necessary",null,"HSA Explanation"]
[]
["Part 2. Worksheet File:"]
["Information",null,"Name of Worksheet"]
["Arlington County Government Plan design - OAPIN Copay Plan",null,"OAPIN Copay Plan Design"]
["Arlington County Government Plan design - OAPIN Coinsurance Plan",null,"OAPIN Coinsurance Plan Design"]
["Arlington County Government Plan design - OAP HDHP Plan",null,"OAP HDHP Plan Design"]
["Arlington County Government Plan design - Vision Plan",null,"Vision Plan"]
["Geo- Access Instructions",null,"Active & PreMedicare GeoAccess"]
["Provider Disruption - Layout",null,"Provider Disruption"]
["Plan Documents",null,"See Plan Documents Worksheet"]
[]
["Part 3. Electronic File Attachments to be included in the RFP"]
["Listing of Required Attachments"]
["Provider Disruption","M-1 [Your Organization's Name]_Provider Disruption"]
["Geo Access","M-2 [Your Organization's Name]_Geo Access Med."]
["Sample Reporting Package","M-3 [Your Organization's Name] Sample Reporting Package"]
["Transition of Care","M-4 [Your Organization's Name]_Transition of Care"]

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["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
[]
["Description"]
["Arlington has an established onsite clinic.  The Clinic provides certain low acuity, urgent and episodic health care, prescription services, laboratory services, personalized coaching, limited immunizations, and primary care referrals for the benefit of County eligible employees."]
["Population Eligible for Selected Services"]
["All Full and Part time members, working at least 10 hours a week, whom are plan eligible are eligible to use the clinic regardless of their selections."]
["Health Center Details"]
["Hours of Operation",{"$nulls":3},"Recognized Holidays",null,null,"Current Staffing Model"]
[]
["Mon","Closed",null,null,"New Year's Day","Thanksgiving",null,"APN - 32 Hours a week"]
["Tue","8:30-4:30",null,null,"Martin Luther King Day","Day after Thanksgiving",null,"CMA - 32 Hours a week"]
["Wed","8:30-4:30",null,null,"Memorial Day","Christmas Day"]
["Thu","8:30-4:30",null,null,"Independence Day","Day After Christmas"]
["Fri","8:30-4:30",null,null,"Labor Day"]
["Sat","Closed"]
["Sun","Closed"]
[]
[]
["Current Site Information"]
["Description",{"$nulls":3},"Annual #"]
["Primary Care Visits",{"$nulls":3},337]
["Work Related Visits ",{"$nulls":3}," 0"]
["Preventative Visits*",{"$nulls":3}," 19"]
["Wellness/Health Coaching Visits*",{"$nulls":3}," 2"]
["Flu Shots",{"$nulls":3}," 406"]
["Biometric Screenings",{"$nulls":3}," 0"]
["Travel Medicine Visits",{"$nulls":3}," 5"]
["Allergy Shots",{"$nulls":3}," 431"]
["Other (specify) ",{"$nulls":3},145]
["Lab Draws"]
["Immunization Administration (non flu)",{"$nulls":3},111]

{"sheet":"Clinic Questionnaire","index":2,"n_rows":149,"n_cols":5,"rows_kept":149,"merged":[[0,0,0,16],[1,0,1,4],[3,0,3,4],[4,0,4,3],[33,5,35,5],[36,5,40,5],[100,5,102,5],[116,6,116,12]]}
["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["To Offeror:  Use Column E to provide a brief explanation, if necessary.  If the length of the explanation is greater than 400 characters, you must use the \"Clinic Explanation\" worksheet to provide your detail explanation."]
["Clinic Questionnaire"]
["I.  REQUIREMENTS"]
[null,null,"ORGANIZATION INFORMATION ","Response","Explanation"]
[null,{"v":1,"d":"1."},"Please confirm you ability to manage and operate an onsite health clinic."]
[null,{"v":2,"d":"2."},"Please include a list of subcontractors that will be used for any function of the services provided or that will manage the onsite health clinic operations. In your response please include the following information:\n  * Year Established/Incorporated\n  * NAIC Code\n  * Specify services to be provided"]
[null,{"v":3,"d":"3."},"Length of time providing comprehensive primary care in health clinics."]
[null,{"v":4,"d":"4."},"Provide your total number of clinics providing primary and/or urgent care services in the U.S."]
[null,null,"CONTRACTUAL/COMPLIANCE"]
[null,null,"Contractual","Response","Explanation"]
[null,{"v":5,"d":"5."},"Vendor agrees to release staffing, providers or any other entities from any restrictive contract terms that would prevent them from transferring to any other clinic operating vendor. There will be no fees or chargebacks to Arlington or the formentioned group. (i.e. all staffing will be released from non-compete clauses without buyouts)"]
[null,null,"Compliance, General","Response","Explanation"]
[null,{"v":6,"d":"6."},"Vendor will meet all applicable standards of care, satisfy state and federal health care laws applicable to health clinic operations (and lab, pharmacy, and any other supplementary service), and will comply with all health care regulatory requirements.  Vendor will ensure that all providers are duly licensed under applicable state licensing law, will ensure that all providers are appropriately qualified and maintain appropriate credentials, and will comply with state and federal law applicable to medical record maintenance and custody."]
["II.  CLINICAL SERVICES"]
[null,null,"SCOPE OF SERVICES"]
[null,{"v":1,"d":"1."},"Primary Care/Preventive Health\nConfirm ability to provide below services; note any deviations","Response","Explanation"]
[null,"a.","Routine Physical/Well Check to include assessment of: blood pressure, blood sugar labs, cholesterol and comprehensive lipid panel labs, body mass index and body composition, alcohol use, emotional health, exercise, nutrition and tobacco use."]
[null,"b.","Wellness Counseling"]
[null,"c.","Adult Immunizations"]
[null,null,"  - Hepatitis A Vaccine and Antibody"]
[null,null,"  - Hepatitis B Vaccine"]
[null,null,"  - Influenza"]
[null,null,"  - Tetanus"]
[null,null,"  - Pneumococcal"]
[null,null,"  - Polio (IPV)"]
[null,null,"  - Dtap/Tdap"]
[null,null,"  - Varicella"]
[null,null,"  - Meningococcal"]
[null,null,"  - Shingles"]
[null,null,"  - Gardasil (HPV)"]
[null,"d.","Allergy Injections"]
[null,null," - Receipt of serum in controlled conditions directly from the manufacturer or from another provider"]
[null,null," - Administration of vaccine and post-vaccination monitoring"]
[null,"e.","Referrals"]
[null,null,"  - Primary Care Physician"]
[null,null,"  - Specialist"]
[null,null,"  - Disease management or other programs offered by County Health Plan"]
[null,null,"  - County wellness staff"]
[null,{"v":2,"d":"2."},"Chronic Condition Monitoring\nConfirm ability to treat below conditions; note any deviations","Response","Explanation"]
[null,"a.","Weight management"]
[null,"b.","Cardiovascular Disease"]
[null,"c.","Diabetes"]
[null,"d.","Hyperlipidemia"]
[null,"e.","Hypertension"]
[null,"f.","Asthma and other chronic respiratory diseases"]
[null,"g.","Allergies"]
[null,"h.","Arthritis"]
[null,"i.","GERD"]
[null,"j.","Depression screening and appropriate referrals"]
[null,"k.","Stable hyper- or hypothyroidism "]
[null,"l.","Medication adherence"]
[null,{"$f":"B42+1","v":{"v":3,"d":"3."}},"Acute/Episodic Treatment\nConfirm below injuries/illnesses will be treated; note any deviations","Response","Explanation"]
[null,"a.","Minor to Moderate burns"]
[null,"b.","Colds"]
[null,"c.","Sore Throat"]
[null,"d.","Sinus Infections"]
[null,"e.","Flu and other viruses"]
[null,"f.","Minor sprains and strains"]
[null,"g.","Minor lacerations"]
[null,"h.","Headaches/migraines"]
[null,"i.","Dizziness"]
[null,"j.","Gastroenteritis"]
[null,"k.","Skin Rashes"]
[null,"l.","Respiratory issues, including cough, bronchitis, pneumonia, asthma"]
[null,{"v":4,"d":"4."},"Biometric Screening\nConfirm below capabilities; note any deviations","Response","Explanation"]
[null,null,"Provide scheduled screening events that may include:  height, weight, BMI, body composition, blood pressure, total cholesterol, HDL, LDL, coronary risk ratio, blood glucose"]
[null,{"v":5,"d":"5."},"Laboratory Services\nConfirm below samples can be collected on-site; note any deviations","Response","Explanation"]
[null,"a.","  Urinary tract infection"]
[null,"b.","  Hematuria"]
[null,"c.","  Electrolyte balance"]
[null,"d.","  Renal function"]
[null,null,"Lipid panel/Cholesterol screening"]
[null,"e.","  LDL"]
[null,"f.","  HDL"]
[null,"g.","  VLDL"]
[null,"h.","  HDL to LDL Ratio"]
[null,"i.","  Triglycerides"]
[null,"j.","Pregnancy Testing (blood/urine)"]
[null,"k.","Medication level monitoring"]
[null,null,"CBC complete blood count"]
[null,"l.","  Hemoglobin"]
[null,"m.","  RBC"]
[null,"n.","  WBC"]
[null,"o.","  Hematocrit"]
[null,"p.","  Platelets"]
[null,null,"Complete Metabolic panel (blood chemistry)"]
[null,"q.","  Liver Function\n"]
[null,"r.","  Electrolyte - BMP"]
[null,"s.","Glucose / Hemoglobin A1c"]
[null,"t.","TSH"]
[null,null,"CLIA Waived Services\n"]
[null,"u.","  Rapid strep test"]
[null,"v.","  Rapid flu test (A&B)"]
[null,"w.","  Rapid RSV Test"]
[null,"x.","  Rapid pregnancy test"]
[null,"y.","  Rapid glucose test"]
[null,"z.","  Monospot"]
[null,{"v":6,"d":"6."},"Prescription Services\nConfirm ability to provide below services; note any deviations","Response","Explanation"]
[null,"a.","Written prescriptions by Nurse Practitioner"]
[null,"b.","Ability to add prescriptions from other providers to patient record"]
["III. OPERATIONS"]
[null,null,"GENERAL\nProvide or confirm the request information; note any deviations","Response","Explanation"]
[null,{"v":1,"d":"1."},"Describe your operational standards and commitment to ensuring adherence to those standards?"]
[null,{"v":2,"d":"2."},"Ability to operate the clinic four days/week for eight hours/day, with possible addition of a fifth day"]
[null,{"v":3,"d":"3."},"Confirm ability to offer both in-person and virtual visits"]
[null,{"v":4,"d":"4."},"Support the County's effort to market clinic services and encourage engagement with County employees"]
[null,{"v":5,"d":"5."},"Confirm lab vendor used is an in-network provider with the health plan"]
[null,{"v":6,"d":"6."},"Confirm you have processes and procedures in place to ensure adherence to applicable laws around medical waste removal, chemical storage and other relevant activities."]
[null,null,"Integration"]
[null,{"v":7,"d":"7."},"Integration with claims system so clinic data can be integrated into overall health plan analytics"]
[null,{"v":8,"d":"8."},"Ability to implement a reasonable first dollar charge for employees in HSA plan"]
[null,null,"Electronic Medical Record","Response","Explanation"]
[null,{"v":9,"d":"9."},"Provide the name of the Electronic Medical Record (EMR) that you will use in the health clinic. Is it internally hosted or externally hosted?"]
[null,{"v":10,"d":"10."},"Confirm you have routinely scheduled internal and external security audits process and that you are willing to provide your full audit reports to Arlington or their designated partner for review."]
[null,{"v":11,"d":"11."},"Describe how your EMR is able to electronically communicate with other providers in the community and health systems."]
[null,{"v":12,"d":"12."},"Describe how staff are trained on use of the EMR"]
[null,{"v":13,"d":"13."},"Who do the medical records belong to?  Vendor? Employee?"]
[null,null,"On-line Patient Portal","Response","Explanation"]
[null,{"v":14,"d":"14."},"Confirm the availability of an on-line patient portal"]
[null,{"v":15,"d":"15."},"Confirm the portal offers the following functionality:"]
[null,"a.","Use of the portal is \"opt-in\""]
[null,"b.","Self-scheduling appointments (on-site or virtual)"]
[null,"c.","Ability to view lab results"]
[null,"d.","Ability to view electronic medical record"]
[null,"e.","Ability to email questions to staff"]
[null,null,"Clinic Staffing","Response","Explanation"]
[null,{"v":16,"d":"16."},"Clinical and administrative staff are employed by or are independent contractors of your organization, affiliates, or parent company."]
[null,{"v":17,"d":"17."},"Provide the following staff:"]
[null,"a.","- Advanced Practice Registered Nurse with current Virginia license or the ability to obtain one (clinical services)"]
[null,"b.","- Certified Medical Assistant (clinical and administrative services)"]
[null,{"v":18,"d":"18."},"Independently contract with physician to supervise clinic staff"]
[null,{"v":19,"d":"19."},"Provide back-up per diem staffing for planned absences of regular staff at no additional cost to the County"]
[null,{"v":20,"d":"20."},"Provide County opportunity to meet and provide feedback regarding staff under consideration for placement at clinic"]
[null,{"v":21,"d":"21."},"In the event of a vendor change, consideration of hiring current clinic staff"]
["IV.  REPORTING"]
[null,null,"Vendor Transition","Response","Explanation"]
[null,{"v":1,"d":"1."},"Describe the transition process for medical records from current vendor"]
[null,{"v":2,"d":"2."},"Confirm your willingness to provide employees with a copy of their medical records should the vendor change in the future"]
[null,null,"GENERAL REPORTING"]
[null,{"v":3,"d":"3."},"Confirm ability to provide monthly, quarterly and annual reporting for the following:"]
[null,"a.","   Clinical"]
[null,"b.","   Operations"]
[null,"c.","   Medical Cost Savings and ROI"]
[null,"d.","   Referrals"]
[null,{"v":4,"d":"4."},"Confirm ability to provide ad hoc reporting"]
[null,{"v":5,"d":"5."},"Are there additional charges for ad hoc reports?"]

{"sheet":"Clinic Explanation","index":3,"n_rows":8,"n_cols":2,"rows_kept":8,"merged":[[0,0,0,11],[1,0,1,4],[3,0,4,1]]}
["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response exceeds 400 characters."]
[]
[]
["State the number of questions you addressed with further explanation:  "]
["Section/ Question #","Explanation"]

{"sheet":"Med Questionnaire","index":4,"n_rows":533,"n_cols":8,"rows_kept":533,"merged":[[0,0,0,11],[1,0,1,4],[4,3,4,7],[58,3,58,7],[166,3,166,6]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Technical Questionnaire"]
[null,"",""]
[{"$nulls":3},"To Offeror:  Use Column H to provide a brief explanation. However if the length of the explanation is greater than 400 characters, you must use the \"Explanation\" worksheet to provide your detail explanation."]
[]
[{"$nulls":3},"MEDICAL RFP "]
[]
["I.","","","GENERAL PLAN INFORMATION","Answer Format","Format Type","Response","Explanation"]
[null,"1.","","Please confirm the proposed network for each of the current plan designs."]
[null,"","a.","CIGNA (OAPIN) Copay Plan\n( Active/Pre-Medicare Retirees)","Text","Text"]
[null,"","b.","CIGNA (OAPIN) Coinsurance Plan\n( Active/Pre-Medicare Retirees)","Text","Text"]
[null,null,"c.","CIGNA (OAP) HDHP HSA\n( Active/Pre-Medicare Retirees) ","Text","Text"]
[null,"2.",null,"Network Model Type(s)","Text","Text"]
[]
["II.",null,null,"Network Access/Medical Network Management","Answer Format","Format Type","Response","Explanation"]
[null,"1.",null,"Provider Disruption:  You need to request from Aon's NAPD team: hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  Confirm you have followed the process and provided the requested data for the County.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"2.",null,"GeoAccess:  You need to request from our NAPD team: hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  Confirm you have followed the process and provided the requested data for the County.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"3.",null,"Confirm that your firm will maintain at least 95% of current network provider choice and geo-access standards in each plan year of the contract.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"4.",null,"Confirm that any provider termination or network reductions for any network service area with 2% or more terminations by specialty group will be reported in advance to the County with at least 60 days’ notice","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"5.",null,"Does your organization notify the County and/or participants if a network physician terminates his/her contract during the plan year? ","Drop down box","Yes, No, See Explanation"]
[null,null,"a.","When and how are the members notified? ","Text","Text"]
[null,null,"b.","What happens to patients that are receiving ongoing treatment with network physicians who terminate their contract?","Text","Text"]
[null,"6.",null,"Confirm that, if requested, your organization is willing and able to add medical providers to its medical networks.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"7.",null,"What is the average length in time to add a medical provider to your organization's medical network? (30-60 days?)","Text","Text"]
[null,"8.",null,"Confirm that Detailed disruption information about significant changes to network access will be provided to the County at least 60 days in advance and to participants at County's request.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"9.",null,"What network management services will be delivered by a subcontractor, wholly owned subsidiary or other outside organization? (Include any leased network arrangements.)","Text","Text"]
[null,null,"a.","If you use leased networks to service this account, are the leased discounts loaded into your claims system?","Drop down box","Yes, No, See Explanation"]
[null,"10.",null,"What is your network's physician to patient ratio?","Text","Text"]
[null,"11.",null,"How often are provider directories updated online?","Text","Text"]
[null,"12.",null,"Do you offer a 24/7 Nurseline?  ","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Credentialing and Recredentialing","Answer Format","Format Type","Response","Explanation"]
[null,"13.",null,"Is your firm's doctor credentialing program certified by NCQA?","drop down box","Yes, No, See Explanation"]
[null,"14.",null,"At the time of credentialing, your firm verifies at least the following information from primary sources:"]
[null,null,"a.","A current, valid license to practice as a physician or independent behavioral healthcare practitioner at the highest level certified or approved by the state.","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Clinical privileges in good standing at the institution designated by the behavioral healthcare practitioner as the primary admitting facility, as applicable.","drop down box","Yes, No, See Explanation"]
[null,null,"c.","A valid DEA or CDS certificate, as applicable.","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Graduation from an accredited professional school and/or highest training program applicable to the academic degree, discipline, and licensure of the practitioner.","drop down box","Yes, No, See Explanation"]
[null,null,"e.","Board certification if the practitioner states that he/she is board-certified on the application.","drop down box","Yes, No, See Explanation"]
[null,null,"f.","Work history for the past ten years.","drop down box","Yes, No, See Explanation"]
[null,null,"g.","Current, adequate malpractice insurance according to the firm's policy.","drop down box","Yes, No, See Explanation"]
[null,null,"h.","History of professional liability claims which resulted in settlements or judgments paid by or on behalf of the practitioner.","drop down box","Yes, No, See Explanation"]
[null,null,"i.","Query all entities where practitioners have held privileges.","drop down box","Yes, No, See Explanation"]
[null,null,"j.","Ever had placement issues post discharge","drop down box","Yes, No, See Explanation"]
[null,null,"k.","Ever had transfer acceptance issues intra or post discharge","drop down box","Yes, No, See Explanation"]
[null,"15.",null,"Confirm that your firm formally recredentials its practitioners at least every two years, during which it verifies at least the following information from primary sources:","drop down box","Yes, No, See Explanation"]
[null,null,"a.","A valid state license to practice","drop down box","Yes, No, See Explanation"]
[null,null,"b.","The status of clinical privileges at the institution designated by the practitioner as the primary admitting facility as applicable","drop down box","Yes, No, See Explanation"]
[null,null,"c.","A valid DEA or CDS certificate, as applicable (a copy is sufficient)","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Board certification (only if the practitioner was due to be recertified)","drop down box","Yes, No, See Explanation"]
[null,null,"e.","Current, adequate malpractice insurance according to the firm's policy","drop down box","Yes, No, See Explanation"]
[null,"16.",null,"As part of the credentialing and re-credentialing process for contracted providers, do you query the  Healthcare Integrity and Protection Data Bank (HIPDB);  If the HIPDB suggests current or past sanctions or exclusion from participation in Federal and/or State health care programs, what actions do you take in the case of (a) a prospective provider seeking to contract with you and (b) an already contracted provider?","text","Text"]
[]
[{"$nulls":3},"High Performance Network","Answer Format","Format Type","Response","Explanation"]
[null,"17.",null,"Does your organization offer high-performance networks?","Drop down box","Yes, No, See Explanation"]
[null,"18.",null,"What percentage of your standard network is included in your HPN?","Text","Text"]
[null,"19.",null,"What are your current arrangements and incentives for directing members to ACOs and Patient Centered Medical Homes?","Text","Text"]
[]
["III.",null,null,"Qualifications of Offeror and Ability to Administer Current Plan Designs, Audit & Systems, Reporting Capabilities & Reporting"]
[]
[{"$nulls":3},"PLAN DESIGN","Answer Format","Format Type","Response","Explanation"]
[null,"",null,"Adhere to the current plan design in preparing the quote."]
[null,"1.",null,"The County is requesting that Offerors duplicate the current plan designs offerings.  Please indicate  (yes/no) if your organization is quoting on a specific plan. If the plan you are quoting matches current in every way, indicate \"NO DEVIATIONS\" in your response. Please list any deviations in the plan design workbook tabs. Note that bidders may elect to quote one or more of the following plans:"]
[{"$nulls":3},"Please see the detailed SPD's located within the RFP"]
[null,null,"a.","CIGNA (OAPIN) Copay Plan\n( Active/Pre-Medicare Retirees)","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","CIGNA (OAPIN) Coinsurance Plan\n( Active/Pre-Medicare Retirees)","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","CIGNA (OAP) HDHP HSA\n( Active/Pre-Medicare Retirees) ","Drop down box","Yes, No, See Explanation"]
[null,"2.",null,"Medical Services Offeror is able provide medical and prescription drug coverage and customer service to participants in the continental United States, Alaska, Hawaii, Puerto Rico and the US Virgin Islands","Drop down box","Yes, No, See Explanation"]
[null,"3.",null,"Include a concise description of how your organization covers transition of care conditions, such as pregnancy, chemotherapy, case management, scheduled surgeries, chronic illnesses, terminal illnesses, behavioral health illnesses, etc., if a new member is receiving treatment from a non-participating provider as of June 30, 2021. Please specify if it varies by state or is consistent across the entire plan. Name the file:  \"M-4 [Your Organization's Name]_Transition of Care.\"","Drop down box","Included, Not Included, See Explanation"]
[null,"4.",null,"Please describe the process for the County to grant an exception to the plan design","Text","Text"]
[null,"5.",null,"The County medical plans include a vision benefit.  Please confirm that your proposed plan(s) includes this benefit","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"6.",null,"Confirm that out-of-network claims will be capped at the 80th percentile of R&C","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[{"$nulls":3},"Offeror Capabilities","Answer Format","Format Type","Response","Explanation"]
[null,"7.",null,"How does your organization make changes to correct problems as a result of a quality improvement review, such as an audit, etc.?","Text","Text"]
[null,"8.",null,"All claim records and eligibility data used by the Offeror in its role as claim administrator shall remain the property of the County as Plan Sponsor and Plan Administrator.","Drop down box","Agree, Disagree, See Explanation"]
[null,"9.",null,"Offeror agrees to perform annual verification of disabled/handicapped status of overage (>26 years) child dependents annually at no cost to the County","Drop down box","Agree, Disagree, See Explanation"]
[null,"10.",null,"Offeror agrees to provide electronic copies of plan materials, including SBCs, SPDs, Certificates of Coverage, and other plan materials.  ","Drop down box","Agree, Disagree, See Explanation"]
[null,"11.",null,"Offeror confirms the capability for providing the County with a link to the Offeror's website to obtain plan information, including Certificates of Coverage, SBCs, and benefit summaries.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"12.",null,"Indicate whether the following functions are centralized or decentralized and provide the location where the functions will be performed in the Explanation column."]
[null,null,"a.","Claims Administration","Drop down box","Centralized, Decentralized"]
[null,null,"b.","Member Services","Drop down box","Centralized, Decentralized"]
[null,null,"c.","Network Management","Drop down box","Centralized, Decentralized"]
[null,null,"d.","Disease Management","Drop down box","Centralized, Decentralized"]
[null,null,"e.","Utilization Review","Drop down box","Centralized, Decentralized"]
[null,null,"f.","Underwriting Services","Drop down box","Centralized, Decentralized"]
[null,null,"g.","Eligibility Services","Drop down box","Centralized, Decentralized"]
[{"$nulls":3},"Audits and Systems - Medical","Answer Format","Format Type","Response","Explanation"]
[null,"13.",null,"The County reserves the right to conduct audits.  Any third party auditor engaged by the County shall execute a confidentiality agreement in a form mutually agreed upon prior to conducting any audit ensuring that all information reviewed during such audit and all details will be treated as confidential and will not be revealed in any manner or form by or to any third party.\nConfirm you agree with each of the following:"]
[null,null,"a.","An independent consultant, on behalf of the County, will conduct a quality review of the medical plan designs, including pharmacy to be loaded in the claims system(s) prior to implementation (or as soon thereafter as reasonably possible). As the selected Offeror, your organization agrees to pay the cost of this review (up to $60,000).  Your organization will provide all necessary support to enable the independent consultant, on behalf of the County, to review claims in a test environment that mirrors the plan information present in the \"live\" claims processing system. If this review cannot be supported remotely and requires an on-site review, your organization will be responsible for travel costs up to $5,000.  All costs associated with this review shall not be included in the County's retention fee. ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","An independent consultant, on behalf of the County, will conduct a medical clinical audit, pharmacy audit and a claims audit, one of each every two years.  As the selected Offeror or administrator, your organization agrees to pay the cost of these audits (up to $65,000 each). Your organization will provide all necessary support to enable the independent consultant, on behalf of the County, to review the claims data. If this review cannot be supported remotely and requires an on-site review, your organization will be responsible for travel costs up to $5,000 (in addition to the $65,000).  All costs associated with this review shall not be included in the County's retention fee. ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"c.","Right to audit at no charge except as a direct pass-through of any data retrieval fees, which may be required if data requested has already been stored.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"d.","Right to audit post termination, up to two years following termination of the business relationship with prior written notification. The   County will not be held responsible for time or miscellaneous costs incurred by the health plan in association with audit including, but not limited to, the costs associated with providing audit reports, systems access, or space.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"e.","Right to audit more than once per year if the audits are different in scope or for different services.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"f.","Right to independently audit or evaluate clinical disease management and case management programs through the use of a qualified third party auditor.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"g.","Right to perform additional audits during the year of similar scope if requested as a follow-up to ensure significant/material errors found in an audit have been corrected and are not recurring or if additional information becomes available to warrant further investigation.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"h.","If your organization fails an audit, your organization will fund a re-audit at its own expense.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"i.","Your organization agrees to provide reasonable cooperation with requests for information, which includes but is not limited to the timing of the audit, deliverables, data/information requests and Offeror response time to questions during and after the process.  Offeror will also provide a response to all “findings” it receives within 30 days, or at a later date if mutually determined to be more reasonable based on the number and type of findings.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"j.","Your organization agrees to pay the Plan 100% of any overpayments made by the Plan as determined from an audit by a organization that the Plan chooses, and no later than 30 days after both parties have agreed to the recoveries, subject to a compounding interest penalty of 1% per month. ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"k.","As a result of an audit, the County can set a time limit for pursuing underpayments/overpayments to/from its members.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"l.","Your organization will allow County, or any other party selected by County (e.g. State Auditor General or County's independent auditors), to audit claims at any time, including, but not limited to, medical claim financial payments and clinical services.  This would be in addition to any annual claims audit that County performs through contract with a organization for independent auditing services.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"m.","Your organization will reimburse County for payments not authorized under the plan.  If not, explain why your organization is unwilling to agree to this request.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"n.","Your organization is held accountable for the integrity of the financial transactions.","Drop down box","Agree, Disagree, See Explanation"]
[null,"14.",null,"Confirm there would be no limit to the number of claims/discrepancies reviewed by the County’s auditor and vendor.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"15.",null,"Each and every payment by Client to the vendor, whether representing fees, claims or otherwise, would be subject to audit and reconciliation and no such payment made by Client would constitute a waiver of its right to audit or reconcile. ","Drop down box","Agree, Disagree, See Explanation"]
[null,"16.",null,"If the audit identifies confirmed errors, you will provide service warranty reports to auditor for every confirmed error.","Drop down box","Agree, Disagree, See Explanation"]
[null,"17.",null,"You will review the service warranty with auditor and the County for final approval. Any claim errors identified in an audit, should include details of the error, how it was corrected and provide quantification of the overall impact of the error.","Drop down box","Agree, Disagree, See Explanation"]
[null,"18.",null,"Issues identified in an external audit will not be used to offset amounts due back to the County or to members.","Drop down box","Agree, Disagree, See Explanation"]
[null,"19.",null,"If you require the County to change claim platforms, you will allow the County to conduct a pre-migration readiness assessment and claim audit in order to test that the set up and benefits will be processed correctly.  The cost of the migration audit will be paid for by your organization.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Audit and Systems - Pharmacy","Answer Format","Format Type","Response","Explanation"]
[null,"20.",null,"The County retains the right to audit such information as reasonably required to determine that your firm is complying with the Agreement, which includes but is not limited to: 100% of pharmacy claims data, with all NCPDP fields from the most current version and release; data management; participating pharmacy contracts with PBM (transparent pricing models only); pharmaceutical manufacturer; Mail Order and Specialty Pharmacy contracts to the extent they exist with other vendor(s); approved and denied utilization management reviews; clinical program outcomes; appeals;  and information related to the reporting and measurement of performance guarantees. ","Drop down box","Agree, Disagree, See Explanation"]
[null,"21.",null,"The County shall not be liable for underpayments made as result of PBM error and discovered through the audit.  ","Drop down box","Agree, Disagree, See Explanation"]
[null,"22.",null,"100% of any agreed to adjustments, payments and/or reimbursements determined to be necessary as a result of any examination or audit shall be paid by you within 30 calendar days after both parties agree with the amounts to be reconciled, as applicable, and have executed an appropriate release document closing the audit period, which can include electronic acknowledgement.","Drop down box","Agree, Disagree, See Explanation"]
[null,"23.",null,"The County, through a mutually agreeable independent third party retained by The County, may conduct an annual Manufacturer Payments audit for the prior two contract years. Such audit shall be limited to a review of no less than ten (10) pharmaceutical company contracts directly related to The County's Manufacturer Payments as selected by The County.  Such review of pharmaceutical company contracts may include formulary and Manufacturer Payment provisions and shall be limited to information necessary for validating the accuracy of the Manufacturer Payment amounts remitted to The County by your firm. ","Drop down box","Agree, Disagree, See Explanation"]
[null,"24.",null,"The right to audit Manufacturer Payments extends to any and all agreements with pharmaceutical manufacturers based on the definition of Manufacturer Payments. This includes but is not limited to Rebate agreements and other types of agreements that may require the County to enroll in certain programs in order to be eligible to receive Manufacturer Payments. ","Drop down box","Agree, Disagree, See Explanation"]
[null,"25.",null,"You agree to share 100% of all audit recoveries (retail, mail, and specialty) with the County on a quarterly basis within 30 calendar days from the close of the contract quarter.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Reporting Capabilities","Answer Format","Format Type","Response","Explanation"]
[{"$nulls":3},"Please indicate your willingness to provide reports to the County to comply with  the following reporting requirements. Each report must reflect claims and enrollment (enrollees as well as members) by lines of coverage split between employees, COBRA participants and Pre-Medicare Retirees, plus a total for all activity)\n\nPre- Medicare retirees must be spilt into additional sub-groups, including groups that consist only of dependents (e.g. of Medicare-enrolled retirees; of Line of Duty retirees)"]
[null,"26.",null,"Offeror agrees to provide monthly paid claims and enrollment reports by group and plan type to the County as part of your standard reporting package. Costs for standard reports should be included in the quote provided. If you disagree, please explain","Drop down box","Agree, Disagree, See Explanation"]
[null,"27.",null,"Offeror agrees to meet with the County on a semi-annual basis (at minimum) to review claim experience, plan progress, service-related issues, etc. Review will include an Executive Summary and plan recommendations based on County utilization. If you disagree, please explain.","Drop down box","Agree, Disagree, See Explanation"]
[null,"28.",null,"Do you provide online access to reporting tools for the County and any authorized vendors (e.g. actuarial consultants)?","Drop down box","Yes, No, See Explanation"]
[null,"29.",null,"If the relationship is terminated, do you have the ability to provide the County with a detailed report of each participant, with a major in-process condition, to assist in transitioning these participants to another health plan?","Drop down box","Yes, No, See Explanation"]
[null,"30.",null,"List the key drivers that you track to assess improved outcomes and lower costs.","Text","Text"]
[null,"31.",null,"Do you provide ACA reporting and filing?  If yes, please describe your full capabilities and any associated pricing.","Drop down box","Yes, No, See Explanation"]
[null,"32.",null,"Can you provide ad hoc reports at no additional cost?  If so, provide average turnaround time. ","Drop down box","Yes, No, See Explanation"]
[null,"33.",null,"Please provide an electronic copy of each report within the standard reporting package (use sample data). Name the file: \"M-3 [Your Organization's Name] Sample Reporting Package.\"","Drop down box","Provided, Not Provided, See Explanation"]
[{"$nulls":3},"Monthly Reports","Answer Format","Format Type","Response","Explanation"]
[null,"34.",null,"Monthly reporting will contain the following information:"]
[null,null,"a.","Paid Claims by Plan and applicable division","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Capitation (if applicable)","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Administrative/Network Fees (if applicable)","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Claims exceeding $50,000 with diagnosis","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Monthly enrollment counts by Plan and applicable division","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Electronic eligibility listing","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Runout and reserves","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Claims paid by $ amount increments","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Reconciliation of claims drafts to paid claims","Drop down box","Yes, No, See Explanation"]
[null,"35.",null,"General claim utilization reports provided semi-annually or as needed by major line of coverage identifying: "]
[null,null,"a.","Claims submitted","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Claims eligible","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Deductible and coinsurance application","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Payment reductions due to network negotiated rates","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","R&C cutbacks and savings","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Coordination of Benefit savings","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Ineligible expenses","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Age-out report for dependent children 3 months before turning age 26","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Report and track >26 disabled/handicap dependent status","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Net benefits paid by Plan","Drop down box","Yes, No, See Explanation"]
[null,"36.",null,"Claim utilization report will show separate experience for:"]
[null,null,"a.","Employees","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Dependents","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Under 65 Retirees and Under 65 Dependent of Medicare Retirees","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","COBRA Participants","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Electronic format of claims data (csv or excel)","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Employee contested claims separated by denial reason.","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Claim lag report.","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Network savings reports for each plan and network offered.","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Most-utilized hospitals and physicians reports.","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","ALOS","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Days/1,000","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Emergency Room and Urgent Care Visits","Drop down box","Yes, No, See Explanation"]
[null,null,"m.","Office Visits","Drop down box","Yes, No, See Explanation"]
[null,null,"n.","Trends","Drop down box","Yes, No, See Explanation"]
[null,null,"o.","Utilization of High Performance Networks, ACOs, and PCMH","Drop down box","Yes, No, See Explanation"]
[null,"37.",null,"Will all utilization reporting be accessible online by the County or Consultant?","Drop down box","Yes, No, See Explanation"]
[null,"38.",null,"Year-end financial accounting report for the program will be provided within 45 days of the contract anniversary date for no additional charge","Drop down box","Yes, No, See Explanation"]
[]
[null,"",null,"Member Services and Claims Administration (includes Customer Service, Website Capabilities,  Communication and Open Enrollment Support)"]
["IV.",null,null,"Customer Service Center","Answer Format","Format Type","Response","Explanation"]
[null,"1.",null,"Please provide the location (city/state) of each of the following functions as they would relate to the County account."]
[null,null,"a.","Customer Service Center","Text","Text"]
[null,null,"b.","Claims Processing Center","Text","Text"]
[null,"2.",null,"Please specify the hours of operation for each of the following."]
[null,null,"a.","Customer Service Center","Text","Text"]
[null,null,"b.","Claims Processing Center","Text","Text"]
[null,"3.",null,"How are after-hour phone calls handled?","Text","Text"]
[null,"4.",null,"There is a single toll-free customer service number for addressing claims payment, member service and any appeals","Drop down box","Yes, No, See Explanation"]
[null,"5.",null,"Briefly describe the customer service team that would be responsible the County account including how many staff members are assigned and how you ensure the County members are routed directly to the designated team","Text","Text"]
[null,null,"a.","Provide the hours when a member can speak directly to a customer service representative","Text","Text"]
[null,"6.",null,"Please answer the following questions as they relate to Customer Services."]
[null,null,"a.","Can customer service representatives access information related to a specific claim online?","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Do customer service representatives also process claims?","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Do customer service representatives have the ability to update eligibility?","Drop down box","Yes, No, See Explanation"]
[null,"7.",null,"Provide the following statistics for the customer service center that will handle the County account based on the most current the 2019 plan year reporting period. We are requesting actual results for the proposed customer service center; therefore, standards should not be provided."]
[null,null,"a.","Indicate Current Reporting Period","Text","Text"]
[null,null,"b.","Average customer service telephone response time (seconds) ","Text, time","Text, time"]
[null,null,"c.","Call abandonment rate (%) ","Text, %","Text, %"]
[null,null,"d.","Percentage of incoming calls that are recorded","Text, %","Text, %"]
[null,null,"e.","Length of hold time ","Text, time","Text, time"]
[null,null,"f.","First call resolution percentage ","Text, %","Text, %"]
[null,"8.",null,"What percent of calls are mandated to be documented in your organization's system?","Text, %","Text, %"]
[null,"9.",null,"Indicate your process for documenting member calls."]
[null,null,"a.","Representatives cannot close the calls unless the event is documented.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","Representatives document calls using standard system generated reason codes.","Drop down box","Agree, Disagree, See Explanation"]
[null,"10.",null,"Please answer the following questions as they relate to Claims Processing based on 2019 plan year reporting period (we are requesting actual results)"]
[null,null,"a.","Indicate Current Reporting Period","Text","Text"]
[null,null,"b.","Claim payment accuracy (number of correct payments divided by number of payments) ","Text, %","Text, %"]
[null,null,"c.","% of claims auto-adjudicated"]
[null,null,"d.","Claim processing accuracy (number of claims processed with 100 percent accuracy divided by number of claims) ","Text, %","Text, %"]
[null,null,"e.","Financial accuracy (dollars paid correctly divided by total dollars paid) ","Text, %","Text, %"]
[null,null,"f.","Average turnaround time:\n   i) x% in 10 business days (14 calendar days);\n   ii) x% in 20 business days (30 calendar days)","Text, %","Text, %"]
[null,null,"g.","Non-Medicare COB savings as a percentage of paid claims ","Text, %","Text, %"]
[null,null,"h.","Average number of days claims are pended ","Text, number","Text, number"]
[null,"11.",null,"What other services are made available through telephonic interface (i.e., IVR)?","Text ","Text"]
[null,"12.",null,"How are member inquiries logged and tracked?","Text ","Text"]
[null,"13.",null,"How are out of state and out of country emergencies handled?","Text","Text"]
[null,"14.",null,"Can you comply with primary and secondary payer requirements for Medicare?","Drop down box","Yes, No, See Explanation"]
[null,"15.",null,"Please briefly describe your multi-lingual capabilities in the call center","Text","Text"]
[{"$nulls":3},"Website Capabilities","Answer Format","Format Type","Response","Explanation"]
[null,"16.",null,"Please identify which of the following services are currently available to members on your website."]
[null,null,"a.","Review claim history and EOBs","Drop down box","Available, Not Available, See Explanation"]
[null,null,"b.","Check benefit status (deductibles met, amount of benefit remaining, etc.)","Drop down box","Available, Not Available, See Explanation"]
[null,null,"c.","Request additional or replacement ID cards.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"d.","Print ID cards directly from site.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"e.","Access historical health data.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"f.","Access educational information","Drop down box","Available, Not Available, See Explanation"]
[null,null,"g.","Take a health risk assessment.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"h.","Provider directories (standard).","Drop down box","Available, Not Available, See Explanation"]
[null,null,"i.","Pharmacy directories and drug formularies","Drop down box","Available, Not Available, See Explanation"]
[null,null,"j.","Provider quality information.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"k.","Provider cost information for medical and prescription drugs.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"l.","Web chat feature","Drop down box","Available, Not Available, See Explanation"]
[null,null,"m.","Send an email to member services","Drop down box","Available, Not Available, See Explanation"]
[null,null,"n.","Provider selection where users enter search criteria.","Drop down box","Available, Not Available, See Explanation"]
[null,null,"o.","Prior Authorization","Drop down box","Available, Not Available, See Explanation"]
[null,null,"p.","Treatment cost estimator","Drop down box","Available, Not Available, See Explanation"]
[null,null,"q.","Review prescription drug cost and compare retail drug cost versus mail order drug cost","Drop down box","Available, Not Available, See Explanation"]
[null,null,"r.","Plan design information","Drop down box","Available, Not Available, See Explanation"]
[null,null,"s.","Wellness resources","Drop down box","Available, Not Available, See Explanation"]
[null,null,"t.","Download printable versions of claim and reimbursement forms","Drop down box","Available, Not Available, See Explanation"]
[null,null,"u.","Submit appeals","Drop down box","Available, Not Available, See Explanation"]
[null,null,"v.","Prescription mail order service refill/order tracking","Drop down box","Available, Not Available, See Explanation"]
[null,"17.",null,"Do you currently provide versions of your member site in multiple languages that offer the same functionality as the English version?","Drop down box","Available, Not Available, See Explanation"]
[null,"18.",null,"Please specify the tools available to the County via the employer portal of your company's website.","Answer Format","Format Type","Response","Explanation"]
[null,null,"a.","Real-time secure access to financial information for the County.","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Receive standard reports, including claims experience, utilization data, eligibility, billing and claims history","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Real-time on-line eligibility maintenance","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Access to claims data.","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Create customized reports","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Access to member-specific coverage and claim information","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Correspond with account management and customer service for problem resolution","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Account level delegate rights.","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Eligibility verification.","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Access plan details","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Access health topics and medical information","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Request ID cards.","Drop down box","Yes, No, See Explanation"]
[null,"19.",null,"Please describe the training you will provide to the County staff as it related to using the features provided on the employer website portal","text","text"]
[{"$nulls":3},"Mobile Application Capabilities","Answer Format","Format Type","Response","Explanation"]
[null,"20.",null,"Does your company offer a mobile device application? If so, does it include the following?","Drop down box","Yes, No, See Explanation"]
[null,null,"a.","Text messaging","Drop down box","Available, Not Available, See Explanation"]
[null,null,"b.","Appointment reminders","Drop down box","Available, Not Available, See Explanation"]
[null,null,"c.","Ability to download forms (claim, prior authorization, etc.)","Drop down box","Available, Not Available, See Explanation"]
[null,null,"d.","Ability to request additional or replacement ID cards","Drop down box","Available, Not Available, See Explanation"]
[null,null,"e.","Access to claims data","Drop down box","Available, Not Available, See Explanation"]
[null,null,"f.","Ability to track deductibles, out of pockets, and any other maximums","Drop down box","Available, Not Available, See Explanation"]
[null,null,"g.","Ability to obtain provider cost information","Drop down box","Available, Not Available, See Explanation"]
[null,null,"h.","Ability to obtain provider quality information","Drop down box","Available, Not Available, See Explanation"]
[null,null,"i.","Ability to view Explanations of Benefits","Drop down box","Available, Not Available, See Explanation"]
[null,null,"j.","Ability to run reports to analyze healthcare spending","Drop down box","Available, Not Available, See Explanation"]
[null,null,"k.","Access historical health data","Drop down box","Available, Not Available, See Explanation"]
[null,null,"l.","Is customer service available through the mobile app","Drop down box","Yes, No, See Explanation"]
[null,null,"m.","Is there an option for an online chat through the app","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Communications","Answer Format","Format Type","Response","Explanation"]
[null,"21.",null,"Please confirm Offeror is willing to draft the Certificates of Coverage and SBCs accurately and in compliance with ACA and provide to the County by specified date in advance of Open Enrollment.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"22.",null,"Briefly describe the types of standard communication materials available and whether there are charges for those materials.","Text","Text"]
[null,"23.",null,"Can the County's own \"branding\" be added to communication materials? If so, is there an additional cost? Please explain in the Explanation column.","Drop down box","Yes, No, See Explanation"]
[null,"24.",null,"List languages other than English in which communication materials are available.  If applicable, detail additional costs.","Text","Text"]
[null,"25.",null,"Upon request by the County, you will produce and send ID cards for receipt by plan members on or before June 15 prior to the start of each plan year at no additional cost.","Drop down box","Agree, Disagree, See Explanation"]
[null,"26.",null,"You will produce and send ID cards for distribution to members within 5 business days or less of receipt of clean eligibility and enrollment files at no additional cost. One ID Card must be sent per individual member and two (2) ID Cards per family.","Drop down box","Agree, Disagree, See Explanation"]
[null,"27.",null,"Briefly describe any innovative communication materials that you offer which differentiate you from your competitors (e.g. video clips, etc.).","Text","Text"]
[null,"28.",null,"Offeror will provide participants with annual notice that the plan provides for coverage for breast reconstruction following mastectomy.","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Open Enrollment Support","Answer Format","Format Type","Response","Explanation"]
[null,"29.",null,"Please confirm that identification cards (ID cards) are issued to new participants within five (5) business days of receipt of clean data and five (5) days prior to July 1 for the 2021/2022 plan year.","Drop down box","Yes, No, See Explanation"]
[null,"30.",null,"Please confirm that you are willing to assist the County with the preparation and attendance at benefit fairs and all other events as requested during their scheduled open enrollment, at no additional cost.","Drop down box","Yes, No, See Explanation"]
[null,"31.",null,"Please describe the training you will provide to the County staff as it related to using the features provided on the employer website portal","Text","Text"]
[null,"32.",null,"If related to Offeror's errors or Offeror's initiated changes, your organization will be responsible for the cost to reproduce ID cards (including priority shipping).","Drop down box","Yes, No, See Explanation"]
[]
["V.","",null,"Clinical and Quality Care Programs/Behavioral Health Capabilities/Telemedicine Capabilities"]
[]
[{"$nulls":3},"Medical/Pharmacy Utilization Management","Answer Format","Format Type","Response","Explanation"]
[null,"1.",null,"What criteria do you use for determining medical necessity? Do these criteria vary by region?","Text","Text"]
[null,"2.",null,"Describe in detail your appeals process, including availability of peer-to-peer consultation","Text","Text"]
[null,"3.",null,"Gaps in Care  "]
[null,null,"a.","How do you identify Gaps in Care?","Text","Text"]
[null,null,"b.","Describe member messaging and follow-up","Text","Text"]
[null,null,"c.","Provide your organization's Book of Business actual results/outcomes in addressing Gaps in Care","Text","Provided, Not Provided, See Explanation"]
[null,"4.",null,"Provide a BRIEF description of the services listed below. "]
[null,null,"a.","Preadmission verification/concurrent review/discharge planning.","Text","Text"]
[null,null,"b.","Case management.","Text","Text"]
[null,null,"c.","Outpatient surgical review.","Text","Text"]
[null,null,"d.","Inpatient mental health/substance abuse review.","Text","Text"]
[null,null,"e.","Other.","Text","Text"]
[null,"5.",null,"Does your UR/UM offer the following reviews?"]
[null,null,"a.","Outpatient surgical review.","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Inpatient mental health and substance abuse review.","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Return to work assessment.","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Outpatient Mental health.","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Outpatient Substance abuse","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Physical therapy.","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Occupational therapy.","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Home health care.","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Other - please specify.","Text","Text"]
[null,"6.",null,"Indicate which of the following services your UM Program provides:"]
[null,null,"a.","Needs assessment.","Drop down box","Provides, Does Not Provide, See Explanation"]
[null,null,"b.","Care planning for medical services.","Drop down box","Provides, Does Not Provide, See Explanation"]
[null,null,"c.","Facilitation of coordination services.","Drop down box","Provides, Does Not Provide, See Explanation"]
[null,null,"d.","Discharge planning.","Drop down box","Provides, Does Not Provide, See Explanation"]
[null,null,"e.","Follow-up to monitor services and the patient.","Drop down box","Provides, Does Not Provide, See Explanation"]
[null,null,"f.","Other (please specify).","Text","Text"]
[null,"7.","","How are utilization management activities, outcomes, and results communicated to the County?","Text","Text"]
[null,"8.",null,"What programs does Offeror have in place to emphasize appropriate utilization by the County members? Specifically, what programs does Offeror have to address inappropriate use of the emergency room and educate the County  members on the most appropriate utilization settings?","Text","Text"]
[null,"9.",null,"What tools and methods are used to prevent hospital emergency room usage and hospital readmissions?","Text","Text"]
[null,"10.",null,"Your organization has the capability to integrate medical and prescription drug claims data to enhance:"]
[null,null,"a.","Concurrent drug utilization reviews (i.e., drug-disease interactions)","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Therapeutic management initiatives (i.e., prior authorization programs)","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Compliance programs","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Gaps in (Omissions in) care","Drop down box","Yes, No, See Explanation"]
[null,"11.",null,"How often are your organization's clinical programs reviewed to ensure they remain up-to-date?","Text","Text"]
[{"$nulls":3},"Case Management","Answer Format","Format Type","Response","Explanation"]
[null,"12.",null,"Please describe the criteria for employment, and the background of, case managers and coaches.","Text","Text"]
[null,"13.",null,"Please provide the average caseload for the case managers that would be servicing the County members, expressed as \"x cases/mgr\".","Text","Text"]
[null,"14.",null,"Indicate which of the following triggers are used to identify potential case management cases:"]
[null,null,"a.","Utilization (e.g. multiple admissions, readmissions, length of stay)","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Diagnosis","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Procedure (e.g. transplants, hemodialysis, etc.)","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Alternate level of care (e.g. rehab, LTAC, SNF)","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","High-cost services (inpatient/outpatient)","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","High-cost threshold > $50,000 incurred on a rolling 12 months (if threshold is different, please indicate).","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Situational triggers (e.g. caregiver, psychosocial factors)","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Predictive technology","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Other","Text","Text"]
[null,"15.",null,"Case management referrals are accepted from:"]
[null,null,"a.","Nurse advice/health information line","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Disease Management","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Discharge Planner","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Utilization management staff","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Member self-referral","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Practitioner referral","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Medical Director","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Outreach staff","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Other","Text","Text"]
[null,"16.",null,"On average during the previous 12 months, what percent of members were for high-risk outreach?  ","Percent","Percent"]
[null,"17.",null,"On average during the previous 12 months, what percent of members were referred to complex case management? ","Percent","Percent"]
[null,"18.",null,"What percentage of each refuse assistance?","Percent","Percent"]
[null,"19.",null,"Please indicate which of the following case management programs are included at no additional charge in the plan design quoted for the County."]
[null,null,"a.","Asthma case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"b.","Back case programs/discounts.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"c.","Cancer case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"d.","Chronic case programs.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"e.","Congestive heart failure case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"f.","Diabetes case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"g.","Depression.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"h.","Substance abuse","Drop down box","Included, Not Included, See Explanation"]
[null,null,"i.","Family planning program","Drop down box","Included, Not Included, See Explanation"]
[null,null,"j.","Heart disease case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"k.","Hypertension case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"l.","Low back pain/injury case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"m.","Lung conditions (except asthma) case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"n.","Muscle or joint problems case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"o.","Neonatal intensive case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"p.","Patient management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"q.","Prenatal case management.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"r.","Rheumatoid arthritis.","Drop down box","Included, Not Included, See Explanation"]
[null,null,"s.","Complex Comorbidities","Drop down box","Included, Not Included, See Explanation"]
[null,null,"t.","Catastrophic injuries","Drop down box","Included, Not Included, See Explanation"]
[null,null,"u.","End of Life","Drop down box","Included, Not Included, See Explanation"]
[{"$nulls":3},"Disease Management","Answer Format","Format Type","Response","Explanation"]
[null,"20.",null,"Please confirm Offeror is able to administer a Diabetes Prevention Program (DPP). ","Drop down box","Yes, No, See Explanation"]
[null,"21.",null,"Please describe how Offeror handles the integration of disease management and behavioral health.","Text","Text"]
[null,"22.",null,"List health plan program accreditation status: NCQA Disease Management Program Accreditation, NCQA Disease Management Program Certification, &/or URAC Disease Management Program Accreditation.","Text","Text"]
[null,"23.",null,"List the conditions managed in your disease management program "]
[null,null,"a.","Asthma","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"b.","Cancer","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"c.","COPD","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"d.","Congestive Heart Failure (CHF)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"e.","Coronary Artery Disease (CAD)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"f.","Depression","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"g.","Diabetes","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"h.","End Stage Renal Disease (ESRD)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"i.","Gastro Esophageal Reflux Disorder (GERD)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"j.","Hepatitis","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"k.","Hyperlipidemia","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"l.","Hypertension","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"m.","Low Back Pain","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"n.","Metabolic Syndrome","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"o.","Osteoporosis","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"p.","Pain Management","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"q.","Peptic Ulcer Disease (PUD)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"r.","Peripheral Artery Disease (PAD)","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"s.","Mental health ","Drop down box","Managed, Not Managed, See Explanation"]
[null,null,"t.","Substance abuse","Drop down box","Managed, Not Managed, See Explanation"]
[null,"24.",null,"What are your hours of operation and days of operation for member outreach and in-bound calls?","Text","Text"]
[null,"25.",null,"Is your organization's Disease Management enrollment model opt-in or opt-out?","Drop down box","Opt-in, Opt-out, See Explanation"]
[null,"26.",null,"Define active participation/engagement in your program (opt-in versus opt-out). Please be specific (e.g. individuals with identified condition vs receiving ongoing telephonic nurse interventions).","Text","Text"]
[null,"27.",null,"Offeror is asked to identify the current mix of disease case managers below."]
[null,null,"a.","Registered Nurses (RN) : Percent of Case Managers.","Percent","Percent"]
[null,null,"b.","Licensed Practical Nurses (LPN) : Percent of Case Managers.","Percent","Percent"]
[null,null,"c.","Dieticians: Percent of Case Managers .","Percent","Percent"]
[null,null,"d.","Mental Health Practitioners: Percent of Case Managers. ","Percent","Percent"]
[null,null,"e.","Dieticians: Percent of Case Managers ","Percent","Percent"]
[null,null,"f.","Mental Health Practitioners: Percent of Case Managers. ","Percent","Percent"]
[null,null,"g.","Social Workers : Percent of Case Managers.","Percent","Percent"]
[null,null,"h.","Physicians : Percent of Case Managers.","Percent","Percent"]
[null,null,"i.","Other : Percent of Case Managers.","Percent","Percent"]
[null,"28.",null,"Outline your protocol for reaching out to potential program participants.  (e.g. How many times do you call someone to enroll in the program if you are unable to reach them?)","Text","Text"]
[null,"29.",null,"How do you define graduation from a disease management program?","Text","Text"]
[null,"30.",null,"Describe Offeror methodologies for calculating and reporting cost savings related to disease management.  ","Text","Text"]
[null,"31.",null,"Indicate the electronic avenues used/available to communicate with participants (e.g. email, Text messaging, secure chat capability with nurse coach, other).","Text","Text"]
[null,"32.",null,"Do you notify and communicate/engage with the PCP/treating physician for a patient enrolled in a disease management or wellness program? ","Drop down box","Yes, No, See Explanation"]
[null,"33.",null,"Is a welcome letter sent to each identified participant in your Disease Management program?","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Managed Behavioral Health Capabilities","Answer Format","Format Type","Response","Explanation"]
[null,"34.",null,"Is the Managed Behavioral Health network owned or leased by your company?","Drop down box","Owned, Leased, See Explanation"]
[null,"35.",null,"Confirm that there is a behavioral health triage system in place, operational 24-hours/7-days a week and staffed by behavioral health professionals with at least a master's degree, to direct members to appropriate levels of mental health or substance abuse care.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"36.",null,"Urgent problem visits are available within 24-hours","Drop down box","Yes, No, See Explanation"]
[null,"37.",null,"Are virtual appointments an option with your company's behavioral health providers?","Drop down box","Yes, No, See Explanation"]
[null,"38.",null,"Confirm that health plan members have access to a range of alternative behavioral health services; including, residential treatment, partial hospitalization, halfway houses, intensive outpatient care, and home therapy.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"39.",null,"Confirm the network has a multidisciplinary mixture of board-certified psychiatrists, independently licensed doctoral psychologists, and master's-level clinicians.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"40.",null,"Confirm the network has a multidisciplinary mixture of board-certified psychiatrists, independently licensed doctoral psychologists, and master's-level clinicians that are:"]
[null,null,"a.","Pediatric specific","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,null,"b.","Adolescent/teenager specific","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,null,"c.","First responder specific","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"41.",null,"Confirm your company has established standards for the timeliness of routine and urgent care, behavioral healthcare appointments, and access to after-hours care.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"42.",null,"For outpatient care, is the review of the clinical assessment always, sometimes or never done by the same person?","Drop down box","Always, Sometimes, Never, See Explanation"]
[null,"43.",null,"Confirm your company has protocols in place to handle emergency calls.  Please provide your procedures in the \"Explanation\" worksheet.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"44.",null,"Confirm your company updates primary care physicians (PCPs) on diagnosis, treatment, and referral of behavioral healthcare disorders commonly seen in primary care.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"45.",null,"Confirm your company will coordinate with the PCPs when there is a mixed diagnosis. (i.e., medical component and behavioral health component).","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"46.",null,"Offeror establishes standards for the number and geographic distribution of behavioral healthcare practitioners; including, psychiatrists, psychologist, clinical social workers, psychiatric nurses, and other behavioral healthcare specialists.","Drop down box","Yes, No, See Explanation"]
[null,"47.",null,"Describe your company's process for network sufficiency review","Text","Text"]
[null,"48.",null,"What methods does your company employ to oversee and ensure appropriateness of treatment (utilization and duration)?","Text","Text"]
[null,"49.",null,"Describe how your company is addressing the burgeoning use of “luxury” behavioral health treatment facilities, which are out of area and/or out of network. ","Text","Text"]
[null,"50.",null,"Describe in detail the information required for processing a provider treatment plan.","Text","Text"]
[null,"51.",null,"Describe in detail the process for approving treatment plans. ","Text","Text"]
[null,"52.",null,"What is your standard turn-around time for approving or disapproving a provider treatment plan? ","Text","Text"]
[null,"53.",null,"How do your actual results compare to your standard turn-around time over the past 12 months?","Text","Text"]
[null,"54.",null," Describe in detail your pre-admission and continued hospital stay certification process for inpatient care, including the nature and timing of the contact with the provider(s) and the patient.","Text","Text"]
[null,"55.",null,"How are the specifications of approved treatment formally communicated to the provider, the treatment facility and to the patient?","Text","Text"]
[null,"56.",null,"During what hours of the day are pre-admission and continued hospital stay certification services provided?","Text","Text"]
[null,"57.",null,"How is an emergency inpatient admission defined and how is it certified (during regular hours and during weekends or after hours)?  Please include any differences between certifying an admission to in-network and out-of-network facilities.","Text","Text"]
[null,"58.",null,"Describe in detail your appeals process, including availability of peer-to-peer consultation","Text","Text"]
[null,"59.",null,"What are the standard number of inpatient days and number of outpatient treatment sessions that are approved for a patient's initial treatment in the following conditions?"]
[null,null,"a.","Drug/ Alcohol standard # inpatient days","Number","Number"]
[null,null,"b.","Mental Health standard # inpatient days","Number","Number"]
[null,null,"c.","Drug/ Alcohol standard # outpatient treatment sessions","Number","Number"]
[null,null,"d.","Mental Health standard # outpatient treatment sessions","Number","Number"]
[null,"60.",null,"Describe what follow-up action is taken by your company when patients drop out of treatment against medical advice.","Text","Text"]
[null,"61.",null,"Describe in detail the after-care monitoring services you provide, including the frequency to follow up, the criteria for determining when to contact the patient or family directly (rather than contacting the after-care provider for information), criteria for intervention, and the amount of contact with the  County's EAP.","Text","Text"]
[null,"62.",null,"Describe the criteria used to determine if the intensive treatments are successful, and the criteria used to assess a patient's progress or outcome.","Text","Text"]
[null,"63.",null,"Provide the approval and non-approval treatment rates for inpatient and outpatient for calendar year 2018 and 2019.","Text","Text"]
[null,"64.",null,"Confirm that your Administrative Services fee include MHSA administration.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[{"$nulls":3},"Telemedicine","Answer Format","Format Type","Response","Explanation"]
[null,"65.",null,"Please complete the following questions on your company's practices and capabilities in the Telemedicine market. Provide responses specific to your health plan's utilization and experience with telemedicine services and engagement (i.e. do NOT refer to the telemedicine book of business specifics)."]
[null,null,"a.","Does your firm offer a telemedicine program?","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","if yes, who provides this service?  Is it outsourced?  if outsourced, to whom?","Text","Text"]
[null,null,"c.","Number of members with access to Telemedicine","Number","Number"]
[null,null,"d.","Number of consult visits via phone in calendar year 2019","Number","Number"]
[null,null,"e.","Number of consult visits via video in calendar 2019","Number","Number"]
[null,null,"f.","Number of prescriptions issued in calendar year 2019","Number","Number"]
[null,null,"g.","How does the member access the telemedicine program?","Text","Text"]
[null,"66.",null,"What percent of telemedicine consultations result in: a) Resolution, b) visit to the Emergency Room, c) visit to other health care provider.","Number","Number"]
[{"$nulls":3},"Design and Reporting"]
[null,"67.",null,"What flexibility in plan design options are available (e.g.. Copayments)?","Text","Text"]
[null,"68.",null,"Does the Offeror provide the following practitioners through telemedicine visits"]
[null,null,"a.","General Medical (PCP)","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Pediatrics","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Mental Health","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Physical therapy.","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Dermatology","Drop down box","Yes, No, See Explanation"]
[null,"69.",null,"Does the Offeror's monthly telemedicine reporting include the following?"]
[null,null,"a.","Number of registrations","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Number of unique members","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Number of general medical visits","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Number of behavioral health visits","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Number of dermatology health visits","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Top diagnoses","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Utilization by gender","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Utilization by age group","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Number or prescriptions prescribed","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Top prescriptions written","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Day of the week used","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Time of day used","Drop down box","Yes, No, See Explanation"]
[null,null,"m.","Average response time between visit request and physician engagement","Drop down box","Yes, No, See Explanation"]
[null,null,"n.","Claims savings by episode","Drop down box","Yes, No, See Explanation"]
[null,null,"o.","Total net claims savings","Drop down box","Yes, No, See Explanation"]
[null,null,"p.","Where members would have gone if telemedicine not available","Drop down box","Yes, No, See Explanation"]
[null,null,"q.","Member overall satisfaction","Drop down box","Yes, No, See Explanation"]
[null,"70.",null,"What telemedicine communication tools and resources are available to the County and what telemedicine educational materials are available to the County employees at no additional cost? ","Text","Text"]
[null,"71.",null,"How is a telemedicine visit reported to a member's primary care physician?","Text","Text"]
[null,"72.",null,"Does your firm track satisfaction rates for your telemedicine services? If yes, provide latest results showing percent of members satisfied or highly satisfied.","Drop down box","Yes, No, See Explanation"]
[null,"73.",null,"Detail the presence of any spread pricing that you or your telemedicine vendor may retain for all telehealth consultations in addition to any fees you may charge for the service.  Please confirm whether this service is included in the Administration Fee.","Text","Text"]
[null,"74.",null,"Please confirm you can provide both direct pay (employee pays) and plan sponsored (run through the medical plan).","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"75.",null,"Please confirm a guaranteed wait time is offered.","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[]
["VI.",null,null,"Performance Guarantees","Answer Format","Format Type","Response","Explanation"]
[{"$nulls":3},"The County is willing to negotiate performance standards on financial and service performance results with the selected Offeror to encourage the Offeror to provide superior performance.  Failure to meet the performance guarantee(s) would result in a financial penalty.  The guarantees (with the exception of the implementation guarantees) are expected to occur each year, for the life of the contract.  Please indicate your concurrence below."]
[null,"1.",null,"Confirm your willingness to put 20% of ASO fee at risk each year on Account Management, Customer Service, Claim administration, and Pharmacy (excludes implementation)","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"2.",null,"You agree to provide quarterly reports to validate compliance with the service and performance guarantees.  Reports will be provided automatically without a written request requirement.","Drop down box","Agree, Disagree, See Explanation"]
[null,"3.",null,"You agree to allow the County the flexibility to allocate in writing the total amount at risk among the various performance categories at least 90 days prior to the start of each contract year.","Drop down box","Agree, Disagree, See Explanation"]
[null,"4.",null,"You agree that the guarantees will be measured and reconciled on a quarterly basis within 45 days from the close of the quarter, with the exception of annual guarantees which will be measured and reconciled within 45 days from the close of the year.  All performance guarantees will be audited on a scheduled basis.  The review of the performance guarantees will be done in person.","Drop down box","Agree, Disagree, See Explanation"]
[null,"5.",null,"You agree that penalties will automatically be paid annually within 75 days of the close of the measurement period without any written request requirement.","Drop down box","Agree, Disagree, See Explanation"]
[null,"6.",null,"You agree that all performance guarantees must be measured and reported on the County plans' specific data, not book of business.","Drop down box","Agree, Disagree, See Explanation"]
[null,"7.",null,"You agree that all back-up documentation will be provided upon request for each of the agreed upon guarantees","Drop down box","Agree, Disagree, See Explanation"]
[null,"8.",null,"Should you require the County to migrate adjudication platforms or service facilities, you will guarantee that the County will be satisfied with the migration. Satisfaction will be measured as \"satisfied\" or \"not satisfied\". This will be a separate, stand-alone performance guarantee. The amount at risk will be equal to 30% of the combined total amount at risk for all other ongoing performance guarantees.","Drop down box","Agree, Disagree, See Explanation"]
[null,"9.",null,"You will agree to pay any performance guarantees regardless of the status of an executed contract or subsequent amendments.","Drop down box","Agree, Disagree, See Explanation"]
[null,"10.",null,"You will measure, report and pay implementation guarantees within 120 calendar days after implementation.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Account Management","Format Type","Format Type","Response","Explanation"]
[null,"11.",null,"County Satisfaction Survey - Account Management Satisfaction - At least a 4.0 on a scale of 1 to 5 (with 5 being the best) on an annually satisfaction survey.\n\nDesignated members of the County's staff will complete an annual report card to evaluate Offeror account team, or the overall service performance. Guarantee will be measured using a mutually agreed upon survey tool. Scorings can be pass/fail or based on a rating such as: \n\n5 = Outstanding\n4 = Commendable\n3 = Satisfactory\n2 = Needs improvement\n1 = Unacceptable\n\nOfferor shall be responsible for survey design, data collection, analysis and all costs associated with conducting the surveys. The account team is typically scored on:  \n\nTechnical knowledge\nAccessibility and Responsiveness\nInterpersonal Skills\nCommunication Skills\nOverall Performance                     ","Drop down box","Agree, Disagree, See Explanation"]
[]
[{"$nulls":3},"Member Services","Answer Format","Format Type","Response","Explanation"]
[null,"12.",null,"Member services will include the following potential metrics"]
[null,null,"a.","99% of telephone calls to member services will be answered within 15 seconds; 100% within an average of 30 seconds.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","Average abandonment rate will not exceed 2%.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"c.","First Call Resolution - 92% of inquiries will be resolved during first call","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"d.","95% of telephone calls will be resolved within 5 business days.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Claims Administration","Answer Format","Format Type","Response","Explanation"]
[null,"13.",null,"Claims administration will include the following potential metrics"]
[null,null,"a.","Claims payment financial accuracy for the County's plans will be at least 99.5%.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","Claims payment procedural accuracy for the County's plans will be at least 98.5%.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"c.","95% of claims will be processed within 10 business days; 99% of claims will be processed within 30 business days and 100% within 45 business days.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"d.","95% of adjusted claims will be turned around within 5 business days.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Pharmacy Management","Answer Format","Format Type","Response","Explanation"]
[null,"14.",null,"Pharmacy will include the following potential metrics"]
[null,null,"a.","Claims Processing Accuracy (Retail, Mail, and Specialty) -  >99.9% Retail >99.99% Mail >99.99% Specialty \n","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","Mail Order Turnaround Time for Prescription Drugs Requiring No Intervention (Non-Protocol or Clean Rxs) - 100% shipped within 2 business days (not an average). ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"c.","Mail Order Turnaround Time for Prescription Drugs Requiring Administrative/Clinical Intervention (Protocol Rxs) - 100% of prescriptions requiring administrative/clinical intervention will be shipped within 4 business days (not an average). ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"d.","Prior Approvals - You will promptly review and respond to requests for prior approval for specific drugs following receipt of all required information, but in any case will respond in no more than 2 business days (no average) once all clinical information is received.","Drop down box","Agree, Disagree, See Explanation"]
[{"$nulls":3},"Implementation","Answer Format","Format Type","Response","Explanation"]
[null,"15.",null,"Program will be operational by agreed upon date, to the satisfaction of the County.  This includes the steps below.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"a.","Implementation Tasks - Those tasks with deliverable dates, necessary to satisfactorily install the program by the effective date, will be clearly defined no later than 210 days prior to the effective date.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"b.","Production and distribution of ID cards prior to effective date","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"c.","Eligibility Loading- Initial implementation electronic eligibility files will be loaded ","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"d.","Meet or exceed the County's subjective assessment of satisfaction with program implementation.","Drop down box","Agree, Disagree, See Explanation"]
[null,null,"e.","Plan Designs Loaded - The claim system and benefit reference tool utilized by service and claims representatives will be accurately updated on the effective date of the plan","Drop down box","Agree, Disagree, See Explanation"]
[null,"16.",null,"Specify the Amount at Risk for Implementation","Dollar","Dollar"]
[null,"17.",null,"Pre-Implementation Audit - You will guarantee that the pre-implementation audit will be completed, including follow up test claims, at least 15 days prior to the effective date as long as the  County has signed off on the benefit set-up at least 75 calendar days prior to the effective date. ","Drop down box","Agree, Disagree, See Explanation"]

{"sheet":"Wellness Questionniare","index":5,"n_rows":336,"n_cols":19,"rows_kept":336,"hidden":true}
[{"$nulls":10},{"$f":"'Med Ques_Explanation'!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[{"$nulls":10},"RFP No. 719-13 Medical Plan"]
[{"$nulls":10},"Wellness Questionnaire"]
[]
[{"$nulls":10},"To Offeror:  Use Column Q to provide a brief explanation. However if the length of the explanation is greater than 400 characters, you must use the \"Explanation\" worksheet to provide your detail explanation."]
[]
[]
[]
[{"$nulls":10},"Wellness Questionnaire",null,"Answer Format",null,"Format Type","Response","Explanation"]
[]
[{"$nulls":10},""]
[{"$nulls":7},"I.",null,null,"ORGANIZATIONAL INFORMATION",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"1.",null,"The County may consider carving out the wellness program in the future. Do you offer wellness services on a carve-out basis?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"2.",null,"If so, would you agree to provide all necessary data, reporting and integration required of the Offeror selected by the County?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"3.",null,"List the total number of self-insured employer clients and the corresponding total number of eligible employees for whom your organization was providing comprehensive wellness services as of 1/1/2020. "]
[{"$nulls":9},"a.","Total number of self-insured employer clients","Number, 0","number, 0","respNumNewAcct1","Number, 0"]
[{"$nulls":9},"b.","Total number of eligible employees","Number, 0","number, 0","respTotEligEmp1","Number, 0",{"$nulls":3},"md rfp has a worksheet (financial)"]
[{"$nulls":8},"4.",null,"Does your organization currently provide wellness services for any other local government or public school system clients?  If yes, provide the names of those local governments or public school systems for whom you currently provide these services.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"5.",null,"Does your organization currently provide wellness services for any clients where some eligible employees are not enrolled in medical coverage or are enrolled in a health plan other than yours?  ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"6.",null,"If yes, briefly describe any wellness services that are not available to eligible employees not enrolled in your health plan.  Also describe any services that are available but may be modified for non-enrolled employees.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"7.",null,"Does your organization currently provide onsite clinic services (such as onsite medical or dental services, onsite pharmacy, onsite physical therapy, etc.) for any of your self-insured clients?  If yes, describe the types of onsite clinic services that you provide.  ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"8.",null,"What is the minimum lead-time needed to work with the County to provide a comprehensive wellness program that is fully integrated with the current in house programs?  ","Listbox: 1 month; 2 months; 3 months; 4 months; 6 months; Other - See \"Explanation\" Worksheet","drop down box","respMinLeadTimeImpleDMProg","Listbox, ListMinLeadTime"]
[{"$nulls":8},"","","Account Management"]
[{"$nulls":8},"9.",null,"",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"","a.","Describe the responsibilities of the wellness consultant.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"","b.","What is the average number of clients that the wellness consultant works with?",null,"number, 0","respExpandWebInfoTech","Number, 0"]
[{"$nulls":8},"","c.","Will the wellness consultant be local and available to meet with the County onsite as needed regarding the program?  If yes, what is the frequency that the wellness consultant will meet with the County?",null,"text","respSecFax","Text"]
[{"$nulls":9},"d.","Will the wellness consultant be available to attend and provide support during onsite events/initiatives if needed?",null,"text","respSecFax","Text"]
[{"$nulls":10},"Subcontractor Information"]
[{"$nulls":8},"10.",null,"Are any of your wellness services subcontracted?",null,"drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":8},"11.",null,"If yes, list the outsourced service(s) and the name of the corresponding outsourced partner (includes all services - e.g. communications, biometrics, coaching, online programs and information, etc.):"]
[{"$nulls":8},"",null,"","Text"]
[{"$nulls":8},"","a.","Outsourced service #1","Text","text","respOutsourceServ1","Text"]
[{"$nulls":8},"",null,"Outsource partner ","Text","text","respOutsourcePart1","Text"]
[{"$nulls":10},"Length of time providing outsourced services",null,"text","respOutsourceServ2","Text"]
[{"$nulls":8},"","b.","Outsourced service #2","Text","text","respOutsourceServ2","Text"]
[{"$nulls":8},"",null,"Outsource partner ","Text","text","respOutsourcePart2","Text"]
[{"$nulls":10},"Length of time providing outsourced services",null,"text","respOutsourceServ2","Text"]
[{"$nulls":8},"","c.","Outsourced service #3","Text","text","respOutsourceServ3","Text"]
[{"$nulls":8},"",null,"Outsource partner ","Text","text","respOutsourcePart3","Text"]
[{"$nulls":10},"Length of time providing outsourced services",null,"text","respOutsourceServ2","Text"]
[{"$nulls":8},"","d.","Outsourced service #4","Text","text","respOutsourceServ4","Text"]
[{"$nulls":8},"",null,"Outsource partner ","ListHoursofOperation: 12:00 AM - 11:30 PM; 24 hours/7 days; No Saturday Hours; No Sunday Hours; No Weekend Hours; See \"Explanation\" worksheet","text","respOutsourcePart4","Text"]
[{"$nulls":10},"Length of time providing outsourced services",null,"text","respOutsourceServ2","Text"]
[{"$nulls":10},"Communications"]
[{"$nulls":8},"12.",null,"Briefly describe the types of standard communication materials available and whether any related charges for those materials.","ListProvidedNAExplain: Provided; Not Provided; Not Applicable; Not Provided - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAttSampCommMat","Text"]
[{"$nulls":10},"Is your organization able to provide editable communications materials to the County, that may be modified for use regardless of health plan enrollment?  If yes, describe how these materials will be provided (format and medium).",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":8},"13.",null,"Are the following customizations to standard communications available?  If yes, indicate in the explanation column if there is an additional fee for the customization.  "]
[{"$nulls":9},"a.","County/Health Smart program \"branding\" may be added to standard communication materials. ",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","County/Health Smart program \"branding\" may be added to health portal.",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","County/Health Smart program \"branding\" may be added to the health assessment.",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Customization of standard text in member letters and other paper based communications.",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Customization of standard content in electronic member communications.",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Removal (or minimization) of health plan name and logos from communications materials, health portal and health assessment to support use with non-health plan enrolled members.",null,"drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","List languages other than English in which communication materials are readily available.  If applicable, detail additional costs.","ListProvidedNAExplain: Provided; Not Provided; Not Applicable; Not Provided - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respWebTechDelPrg","Listbox,ListYNNAExplain"]
[]
[{"$nulls":7},"II.",null,null,"HEALTH ASSESSMENT & BIOMETRICS","ListAttachedNAExplain: Attached; Not Attached; Not Applicable; Not Attached - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":9},"","Health Assessment (HA)","ListAttachedNAExplain: Attached; Not Attached; Not Applicable; Not Attached - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet"]
[{"$nulls":8},"1.",null,"HA Validation"]
[{"$nulls":9},"a.","Has your HA tool been validated internally?",null,"drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Briefly describe the validation process.",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"c.","Has your HA tool been validated externally?",null,"drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Briefly describe the validation process.",null,"text","respLangAvailPlan","Text"]
[{"$nulls":8},"2.",null,"How long has your organization been providing this HA?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":7},"","3.",null,"Is your HA available in languages other than English?  ","Text","drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","If \"yes\", specify which languages are currently available or planned and any additional costs incurred for having access to non-English versions.","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respLangAvailPlan","Text"]
[{"$nulls":8},"4.",null,"Is the HA available in the following formats?"]
[{"$nulls":9},"a.","Online",null,"drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Paper",null,"drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Telephonic",null,"drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":8},"5.",null,"What is the reading level (grade level) of the HA? ",null,"text","respCustOptHRAQuest","Text"]
[{"$nulls":8},"6.",null,"How long on average does it take for a participant to complete the HA? ",null,"text","respCustOptHRAQuest","Text"]
[{"$nulls":8},"7.",null,"Is there a time limit to complete?  Can participants complete the HA over multiple sessions?",null,"text","respCustOptHRAQuest","Text"]
[{"$nulls":8},"8.",null,"Are \"readiness to change\" questions included in the questionnaire and used to tailor feedback in the individual reports back to members?","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respReadChangeQuest","Listbox,ListYNNAExplain"]
[{"$nulls":8},"9.",null,"Are \"productivity\" questions included in the questionnaire?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","Do the questions specifically address self-reported absenteeism?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Do the questions specifically address self-reported presenteeism?  ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"10.",null,"Is a health score communicated to the individual completing the HA? ","Text","drop down box","respPartInterestQuestInc","Listbox,ListYNNAExplain"]
[{"$nulls":8},"11.",null,"Briefly describe one or two key features that differentiate your HA from your competitors.",null,"text","respCustOptHRAQuest","Text"]
[{"$nulls":8},"12.",null,"Does your HA integrate game theory and game mechanics to engage members?  If yes, briefly describe how these tools are integrated in the HA.",null,"drop down box","respPartInterestQuestInc","Listbox,ListYNNAExplain"]
[{"$nulls":8},"13.",null,"Is the County able to customize the HA by adding and/or deleting specific questions?  In the explanation column, briefly describe how deletion of questions may impact validation/scoring.",null,"drop down box","respPartInterestQuestInc","Listbox,ListYNNAExplain"]
[{"$nulls":8},"14.",null,"Can HA triggers for identification of individuals for health coaching outreach be modified/customized? ",null,"drop down box","respHealthStatAuto","Listbox,ListYNNAExplain"]
[{"$nulls":8},"15.",null,"Are HA results used to prioritize program offerings and provide ongoing targeted health information to members after initial results are provided (i.e. throughout program year)?  Please describe.",null,"drop down box","respHealthStatAuto","Listbox,ListYNNAExplain"]
[{"$nulls":8},"16.",null,"Does HA comply with GINA? (i.e., health history is voluntary and participants qualify for incentives by completing the portion that does not call for family medical history)",null,"drop down box","respHealthStatAuto","Listbox,ListYNNAExplain"]
[{"$nulls":8},"17.",null,"If the County should decide to utilize a third party HA, can the health plan HA be \"turned off\" to avoid confusing members?",null,"drop down box","respHealthStatAuto","Listbox,ListYNNAExplain"]
[{"$nulls":9},"","Biometric Screenings","ListAttachedNAExplain: Attached; Not Attached; Not Applicable; Not Attached - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet"]
[{"$nulls":7},"","18.",null,"Do you have the capability to do onsite biometric screenings either internally or through a vendor partner?","Text","drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","If so, what is the minimum number of participants needed per location?",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"b.","Do you deliver results immediately to participants?  ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Are results explained by a counselor/nurse present at the screenings?  ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":7},"","19.",null,"Would you accept biometric information directly from physicians of participants? If so, describe how this would be done.","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":7},"","20.",null,"Do you provide \"at home\" biometric data collection kits?","Text","drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"21",null,"Do you have arrangements with area labs to conduct biometric screenings for members that cannot attend an onsite screening? ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","List names of laboratory partners, if applicable. ",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"b.","Are you able to accept screening results from the HealthSmart Wellness Clinic?  If yes, how would the information need to be provided and are there additional fees to accept this data?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"22.",null,"Are you able to provide the following specific biometric screening approaches?"]
[{"$nulls":7},"",null,"a.","Fingerstick","Text","drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Venipuncture",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Fasting",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Non-fasting",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":7},"","23.",null,"Indicate the specific health elements (blood pressure, blood glucose, BMI, etc.) recommended in your proposed biometric screenings. ","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respLangAvailPlan","Text"]
[{"$nulls":8},"24.",null,"Describe any other tests that you can provide at an onsite screening (e.g. Cotinine, step test, etc.)",null,"text","respLangAvailPlan","Text"]
[{"$nulls":7},"","25.",null,"Can you auto-populate the HA with results from:","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet"]
[{"$nulls":9},"a.","Onsite biometric screening event",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","At home biometric screening tests",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","At lab biometric screenings",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","At physician's office/provider form",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","HealthSmart Wellness Clinic ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"26.",null,"What is your timeframe for loading results from:","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet"]
[{"$nulls":9},"a.","Onsite biometric screening event",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"b.","At home biometric screening tests",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"c.","At lab biometric screenings",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"d.","At physician's office/provider form",null,"text","respLangAvailPlan","Text"]
[{"$nulls":9},"e.","HealthSmart Wellness Clinic ",null,"text","respLangAvailPlan","Text"]
[{"$nulls":8},"27.",null,"Can you lock the electronically populated biometric values so that they cannot be manually overwritten?","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"28.",null,"Do you have an online scheduling tool that member's may use to schedule onsite biometric screenings?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":7},"",null,"a.","Is the online tool customizable?  If yes, briefly describe available customizations in the explanation column.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":7},"","","b.","Does the tool include backdoor access for the County to monitor activity and report back to wellness champions or other support staff if needed? ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[]
[{"$nulls":7},"III.","",null,"HEALTH PORTAL/WEB-BASED INTERACTIVE TOOLS",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"1.",null,"Indicate if the following programs, categories of information and tools are available on your portal.  Indicate in the explanation column if additional fees apply."]
[{"$nulls":9},"a.","Health and Condition Information?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Medication information (including prescription medications, herbals and OTC medication)?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Health trackers (e.g. weight, blood pressure, steps, diet, etc.)?  Briefly describe in the explanation column.",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Health newsfeed (updated daily)?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Online newsletter (updated at least monthly)?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"f.","Customizable client bulletin board?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"g.","Health tips, information or reminders via portal messaging?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"h.","Health tips, information or reminders via text messaging?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"i.","Personalized content based on member interest?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"j.","Personalized content based on HRQ and screening results?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"k.","Ergonomics / workplace safety?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"l.","Smart phone access to portal?  If yes indicate in the explanation column which smart phone(s) your portal is able to interface with and what portal features are available via smart phone access.",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"m.","Describe any other smart phone apps available (beyond portal access).",null,"text",null,"Text"]
[{"$nulls":9},"n.","Ability to download data from smart phone apps or other biometric devices?  If yes, indicate in the explanation column what devices your portal is currently able to interface with.  ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"o.","Online interaction between members (e.g. live chat, discussion boards, challenges, etc. hosted by the wellness portal - NOT via public social media sites such as Facebook or Twitter)",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"p.","Portable personal health record (PHR)?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"2.","","Is a log on and password required for access to web-based tools?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","Is access to the web-based tools via a single sign on?  (i.e. no need to register/log-in to access tools promoted on the site).",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"3.","","Briefly describe how you keep participants engaged in web-based programs.  How do you increase utilization?",null,"text",null,"Text"]
[{"$nulls":8},"4.",null,"Briefly describe how game theory and game mechanics are integrated into the portal to improve engagement.",null,"text",null,"Text"]
[{"$nulls":8},"5.",null,"Does your web-based interactive programming incorporate readiness to change theory?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"4.","","Describe how your web-based interactive programming is personalized for the client and/or participant.",null,"text",null,"Text"]
[{"$nulls":8},"6.",null,"Are the following portal customizations available?  Indicate in the explanation column if there are additional fees for customization."]
[{"$nulls":8},"6.",null,"Does your portal offer a member \"Personal Health Record\" (PHR).",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","If yes, is the PHR portable?",null,"text",null,"Text"]
[{"$nulls":9},"a.","County/Health Smart program branding?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Links from the County intranet site or other vendor partner portals to the wellness program?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Links from wellness portal to other County program or Offeror portals?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Customization of portal text?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Customizable bulletin board for County specific events/information?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"f.","Ability to push targeted communications based on demographics or business specifics such as segment, division, etc.",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"7.",null,"Briefly discuss how you handle both scheduled and unscheduled system maintenance issues.",null,"text",null,"Text"]
[{"$nulls":8},"8.",null,"Briefly describe any plans to expand web-based information technology that will be effective within the next 12 months. ",null,"text","respWebAddUseIDPW","Text"]
[{"$nulls":8},"9.",null,"Can your portal be linked to CSC's intranet or other vendor partner portals?  ",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","Can links chosen by the Client be included on your portal (e.g. for access to a health plan or another organization's portal)?",null,"drop down box","respHRAToolAvailOtherLang","Listbox,ListYNNAExplain"]
[{"$nulls":8},"9.",null,"Please provide demo log-in information such as user ID and password needed to access your web site (sufficient to experience the web site as the County participants would).  Provide 6 guest log-ins.",null,"text",null,"Text"]
[]
[{"$nulls":7},"IV.","","","LIFESTYLE BEHAVIOR CHANGE PROGRAMS","ListCompletedNAExplain: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":7},"","1.","","Do you offer online coaching programs including but not limited to the following?  If yes, specify in the explanation column whether the module is a one-time session or if the module requires multiple sessions for completion.  "]
[{"$nulls":9},"a.","Nutrition Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Stress Management ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Tobacco Cessation",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Weight Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Exercise Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"f.","Sleep Disorders",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"g.","Cholesterol",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"h.","Blood pressure",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"i.","Glucose/Pre-diabetes",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"j.","Family Oriented Programs (if yes, please list available programs in Explanation column)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"k.","Child Specific Programs (if yes, please list available programs in Explanation column)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"l.","Ergonomics / workplace safety",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"m.","Other Programs - specify",null,"text","respOutsourcePart4","Text"]
[{"$nulls":8},"2.",null,"Do you have the capability to develop or customize a program for mental health issues to meet Client specific needs?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","If yes, describe your experience and capabilities including the types of interventions (e.g. onsite screening, coaching) available. ",null,"text","respOutsourcePart4","Text"]
[{"$nulls":7},"","2.","","Do you offer telephonic coaching programs including but not limited to the following?  If yes, specify in the explanation column the average number of calls/sessions for each program and the timing of the calls (e.g. weekly, monthly, etc.)."]
[{"$nulls":9},"a.","Nutrition Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Stress Management ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Tobacco Cessation",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Weight Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Exercise Management",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"f.","Sleep Disorders",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"g.","Cholesterol",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"h.","Blood pressure",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"i.","Glucose/Pre-diabetes",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"j.","Family Oriented Programs (if yes, please list available programs in Explanation column)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"k.","Child Specific Programs (if yes, please list available programs in Explanation column)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"l.","Ergonomics / workplace safety",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"m.","Other Programs - specify",null,"text","respOutsourcePart4","Text"]
[{"$nulls":8},"3.",null,"Briefly describe your identification/risk stratification approach below."]
[{"$nulls":9},"a.","Does the program use self-reported HA data to identify the member's overall level of risk?  If yes, specify in the explanation column what risk factors are used to identify/risk stratify members.  ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Does the program use validated biometric data to identify the member's overall level of risk?  If yes, specify in the explanation column which values are used to identify/risk stratify members.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Does the program use medical and/or Rx claims to identify members at risk?  If yes, specify in the explanation column what risks are identified via claims and used in the identification/risk stratification process. ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Are members able to self-refer to telephonic coaching programs regardless of risk?  If no, briefly explain the program rationale in the explanation column.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"4.",null,"Are members invited to participate in specific coaching programs (i.e. online versus telephonic) based on their level of risk and readiness to change?  If yes, briefly explain the approach in the explanation column and the average % of HA participants targeted for each approach.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"5.",null,"The County currently employs health coaches on staff.  Would your organization be willing to integrate with the County staff by providing some or all of the operational support for the coaches (identification, system access for documentation, tracking and reporting, fulfillment of educational materials, etc.)?  If yes, briefly describe how you would support the onsite health coaches.  List any additional fees that would apply.",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","Do you currently partner with any clients who provide their own onsite coaching?  Briefly describe how you support the coaches.",null,"text","respOutsourcePart4","Listbox,ListYNNAExplain"]
[{"$nulls":8},"6.",null,"Can you sponsor/administer \"Wellness challenges\" periodically throughout the year? (e.g. team or individual based walking challenge, \"biggest loser\", etc.)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"a.","If so, briefly describe the Wellness challenges that are currently available.",null,"text","respOutsourcePart4","Text"]
[{"$nulls":8},"7.",null,"Are the challenges available online and in paper format?",null,"text","respOutsourcePart6","Text"]
[{"$nulls":8},"8.",null,"Does the County have the ability to create their own challenges and use the wellness portal to support the program (communication, tracking, reporting, etc.)?  If yes, describe any additional fees that may apply.",null,"text","respOutsourcePart5","Text"]
[{"$nulls":8},"9.",null,"Indicate other wellness/lifestyle behavior change coaching program delivery methods available (briefly describe using the explanation column):"]
[{"$nulls":9},"a.","Secure email communications",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Text messages",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Online live chat with a coach",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Video materials",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","Audio materials",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"f.","Promotional awareness campaigns",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"g.","Smartphone apps",null,"drop down box",null,"Listbox,ListYNNAExplain"]
[{"$nulls":9},"h.","Other - please specify",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"10.",null,"Briefly describe how you increase utilization and keep participants engaged in wellness/lifestyle behavior change programs.  ",null,"text","respOutsourcePart4","Text"]
[{"$nulls":8},"11.",null,"What do you consider successful completion in your wellness program?"]
[{"$nulls":9},"a.","Online program",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":9},"b.","Telephonic coaching",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"12.",null,"Will you provide a primary health coach model for telephonic coaching?  (i.e. The same coach works with participants throughout the duration of the program.)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"13.",null,"Do the coaches use a \"whole person\" approach where they manage multiple risks regardless of the program the member originally enrolled in?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"14.",null,"Briefly describe your health coaches' qualifications and training.",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":10},"Does your program utilize \"enrollment\" staff to initially reach out and engage members in coaching?  ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"15.",null,"If yes, briefly describe your enrollment staff's qualifications and training.",null,"text","respDiseaseState1","Text"]
[{"$nulls":8},"16.",null,"Do your health coaches accept in-bound calls and place out-bound calls? ","Percentage","drop down box","respAccInOutBoundCalls","Listbox,ListInOutBound"]
[{"$nulls":8},"17.",null,"What are your hours of operation and days of operation for member outreach and in-bound calls? Be sure to specify time zones.",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"18.",null,"How many times do you attempt to call someone to enroll in the program if you are unable to reach them?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":9},"a.","How many letters do you send out if you are unable to make phone contact with the member?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"19.",null,"What do you do with individuals who decline the program?  Are these members flagged for outreach again later in the program?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"20.",null,"What do you do if the phone number is not correct? Briefly describe your process for acquiring updated phone numbers including use of external agencies to find phone numbers (include name search tool/company used).",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":9},"a.","What follow-up do you provide to the County?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":9},"b.","What is your rate of obtaining correct phone numbers for those whose number is not correct?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"21.",null,"What % of HA/Biometric screening participants are targeted for telephonic coaching?  Online programs?",null,"text","respHRAToolOrgOff","Text"]
[{"$nulls":8},"22.",null,"Does the County have the flexibility to limit or expand the number of individuals targeted for online and telephonic coaching intervention?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"23.",null,"Does the County have the flexibility to alter the stratification criteria to target specific risks (such as tobacco or BMI)?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":8},"24.",null,"Is your organization able to provide onsite health education and coaching resources (i.e. nutritionist, diabetes educator, etc.) one day a week (based on the County's discretion) including but not limited to the following:  "]
[{"$nulls":9},"a.","Health screening (e.g. dermatologist for skin screening)",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"b.","Face to face coaching ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"c.","Health education presentations for employees ",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"d.","Education and enrollment related to wellness program resources",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[{"$nulls":9},"e.","If yes, describe any fees related to these services",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[]
[]
[{"$nulls":7},"V.",null,null,"INCENTIVE MANAGEMENT","ListCompletedNAExplain: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","Answer Format",null,"Format Type","Response","Response"]
[{"$nulls":7},"","1.",null,"Can you administer (track and report on) incentives for the following:"]
[{"$nulls":9},"a.","Non-health plan enrollees?",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Completion of HA",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Completion of biometric screenings",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Participation in or completion of  telephonic health coaching programs",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"e.","Participation in or completion of online Lifestyle Behavior Change programs",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"f.","Participation in or completion of onsite health coaching programs",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"g.","Meeting or making progress toward a health goal defined by the member or coach",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"h.","Meeting a defined health standard defined by the County (e.g. BMI, cholesterol, blood pressure, glucose, etc.)",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"j.","Progress toward meeting a health standard (e.g. loss of 5% of body weight)",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"k.","Participation in programs offered by the County or the County's other vendors or at the local onsite level (if participation reports are provided)",null,"drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":8},"2.",null,"Do any of these incentives require an additional fee?  If yes describe the fee.",null,"text","respWebAddUseIDPW","Text"]
[{"$nulls":8},"3.",null,"Are you able and willing to report information on active program participants to the County and the claims payer (including other than your own organization) that permits administration of the following:","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet"]
[{"$nulls":7},"",null,"a.","Reduced premium contribution","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet","drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Lower prescription drug co-payments","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet","drop down box","respLowPrescriptDrugCopay","Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Different co-payments/co-insurance for medical services.",null,"drop down box","respDiffCopayCoinMedServ","Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Different HSA contributions",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":8},"4.",null,"Are there additional fees for providing incentive reports?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":8},"5.",null,"Do you offer a points based tracking tool via your website?  ",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"a.","Does the tool have the flexibility to accept and track both self-reported activity and/or validated activities/data based on the County's  preference?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Can the tool be customized to support the County's incentive strategy?  If yes, briefly describe available customizations.",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Are there additional fees for the points based incentive tracking tool?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Are there additional fees to customize the tool?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":8},"7.",null,"Is your company able to provide incentive fulfillment for the following?  If you partner with a third party to provide incentive fulfillment, indicate the name of your partner in the explanation column."]
[{"$nulls":9},"a.","Health related merchandise (such as pedometers, resistance bands or fitness equipment)?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Other merchandise?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Gift Cards?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Online shopping mall?",null,"drop down box",null,"Listbox, ListYNNAExplain"]
[{"$nulls":8},"8.",null,"Briefly describe the incentive options your company has found to yield the greatest results in terms of increased participation and improved outcomes.",null,"text","respWebAddUseIDPW","Text"]
[]
[{"$nulls":7},"VI.","",null,"VENDOR INTEGRATION",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"2.",null,"Indicate below how the organization will collaborate to provide integrated delivery of the programs with the County, their onsite clinic and their other health care initiatives or vendors."]
[{"$nulls":10},"The County has an onsite clinic open from 8 – 5 three days a week (Monday, Wednesday and Friday). The vendor agrees to provide an onsite rep 1 day a week to handle employee education and claims issues for medical",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"a.","Warm transfer to onsite clinic and other vendors",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"b.","Accept inbound warm transfers",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"c.","Send referrals to the onsite clinic and other vendors via fax or secure email with member consent.",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"d.","Accept inbound referrals via fax or secure email and provide outreach to members based on the referral.",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":10},"Provide a list to the County's onsite clinic of high risk members to allow for coaching and referral if the member is seen in the onsite clinic.",null,"text","respWebAddUseIDPW","Text"]
[{"$nulls":10},"Collaborate with the County onsite health coaches to identify and outreach to specific groups of members (based on specific risk criteria identified by County).",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"e.","Develop a hierarchy for program outreach with the County, the County's  onsite clinic and other health management programs such as case management and condition management, regardless of which health plan the member is enrolled in.",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"f.","Provide participation reports to the County's other vendors to support the integrated program.",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":9},"g.","Participate in monthly calls to discuss program administration and member cases?",null,"drop down box","respGlucoDiabetic","Listbox, ListYNNANoExplain"]
[{"$nulls":8},"3.",null,"Track and report inbound and outbound referral activity and disposition?",null,"drop down box","respMgmtReportOutline","Listbox,ListYNNAExplain"]
[]
[{"$nulls":7},"VII.",null,null,"REPORTING","Listbox: Willing; Not Willing; Not Applicable; Not Willing - See \"Explanation\" Worksheet","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"1.",null,"",null,"drop down box","respAttSampleReports","Listbox, ListAttachedNAExplain"]
[{"$nulls":8},"2.",null,"Do the standard reports include the following:"]
[{"$nulls":9},"a.","Activity and participation results for all program components including HA, biometric screening, coaching programs, online tools/program/portal activity, challenges, onsite programs.",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Population health risks by risk level (based on HA and biometric screening results)",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Population health risks by individual risk factor (based on HA and biometric screening results)",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Readiness to change",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"e.","Self-reported productivity results",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"f.","Year over year shifts in risk levels and readiness to change.",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"g,","Goals met",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"h.","Member satisfaction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"i.","Are reports exportable to Excel, text, or csv file format to allow the County to manipulate the data?",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":8},"3.",null,"For each report included in the sample reporting package provided, indicate the name of the report, describe the information reported and the frequency of the issuance of the report.  Up to 5 reports can be described below; if you need more space, use the \"Explanation\" column and/or worksheet. Indicate the question answered.","Text"]
[{"$nulls":8},"","a.","Standard Report #1:  Report Name","Text","text","respStandRepName1","Text"]
[{"$nulls":7},"","",null,"Standard Report #1:  Description","Listbox: Per Occurrence; Weekly; Monthly; Quarterly; Annually","text","respStandRepDescript1","Text"]
[{"$nulls":7},"","",null,"Standard Report #1:  Frequency","Text","drop down box","respStandRepFreq1","Listbox, ListStandReportFreq"]
[{"$nulls":7},"","",null,"Standard Report #1:  Format/File Type","Text","drop down box","respStandRepFormFileType3","Listbox, ListStandReportFileType"]
[{"$nulls":7},"",null,"b.","Standard Report #2:  Report Name","Text","text","respStandRepName2","Text"]
[{"$nulls":7},"","",null,"Standard Report #2:  Description","Listbox: Per Occurrence; Weekly; Monthly; Quarterly; Annually","text","respStandRepDescript2","Text"]
[{"$nulls":7},"","",null,"Standard Report #2:  Frequency","Text","drop down box","respStandRepFreq2","Listbox, ListStandReportFreq"]
[{"$nulls":7},"","",null,"Standard Report #2:  Format/File Type","Text","drop down box","respStandRepFormFileType3","Listbox, ListStandReportFileType"]
[{"$nulls":7},"",null,"c.","Standard Report #3:  Report Name","Text","text","respStandRepName3","Text"]
[{"$nulls":7},"","",null,"Standard Report #3:  Description","Listbox: Per Occurrence; Weekly; Monthly; Quarterly; Annually","text","respStandRepDescript3","Text"]
[{"$nulls":7},"","",null,"Standard Report #3:  Frequency","Text","drop down box","respStandRepFreq3","Listbox, ListStandReportFreq"]
[{"$nulls":7},"","",null,"Standard Report #3:  Format/File Type","Text","drop down box","respStandRepFormFileType3","Listbox, ListStandReportFileType"]
[{"$nulls":9},"d.","Standard Report #4:  Report Name","Text","text","respStandRepName4","Text"]
[{"$nulls":7},"","",null,"Standard Report #4:  Description","Listbox: Per Occurrence; Weekly; Monthly; Quarterly; Annually","text","respStandRepDescript4","Text"]
[{"$nulls":7},"","",null,"Standard Report #4:  Frequency","Text","drop down box","respStandRepFreq4","Listbox, ListStandReportFreq"]
[{"$nulls":7},"","",null,"Standard Report #4:  Format/File Type",null,"drop down box","respStandRepFormFileType3","Listbox, ListStandReportFileType"]
[{"$nulls":7},"",null,"e.","Standard Report #5:  Report Name","Text","text","respStandRepName4","Text"]
[{"$nulls":10},"Standard Report #5:  Description","Listbox: Per Occurrence; Weekly; Monthly; Quarterly; Annually","text","respStandRepDescript4","Text"]
[{"$nulls":10},"Standard Report #5:  Frequency","Text","drop down box","respStandRepFreq4","Listbox, ListStandReportFreq"]
[{"$nulls":7},"",null,null,"Standard Report #5:  Format/File Type",null,"drop down box","respStandRepFormFileType3","Listbox, ListStandReportFileType"]
[{"$nulls":8},"4.",null,"Will the County's specific results be compared to:"]
[{"$nulls":9},"a.","National averages (as appropriate)",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Your book of business results",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","The County's Industry - local government",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","5.",null,"The County may require reporting at a business unit level, and perhaps at a sub-unit level.  Indicate how many reporting segments are included in your pricing.  ","Text","drop down box","respBloodPressMontHyper","Text"]
[]
[{"$nulls":7},"VIII.",null,null,"ROI AND PERFORMANCE GUARANTEES","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","Answer Format","Field Names","Format Type","Response","Explanation"]
[]
[{"$nulls":8},"1.",null,"Indicate the total percentage of programs fees that you are willing to place at risk for performance guarantees.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","text","respStandRepName1","Text"]
[{"$nulls":8},"2.","","Indicate which of the following metrics you include in your performance guarantees.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet"]
[{"$nulls":9},"a.","Implementation satisfaction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"b.","Operations (ASA, abandonment rate, website uptime, etc.)",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"c.","Participation",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"d.","Population level risk reduction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"e.","Individual risk reduction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"f.","Member satisfaction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":9},"g.","Client satisfaction",null,"drop down box","respBloodPressMontHyper","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","4.",null,"Briefly describe any return on investment (ROI) guarantees. Describe how ROI will be calculated.  ",null,"text","respStandRepName1","Text"]
[{"$nulls":8},"6.",null,"ACG reserves the right to audit the performance of the wellness program at least once annually.","Listbox: Agree; Do Not Agree; Not Applicable; Do Not Agree - See \"Explanation\" Worksheet","drop down box","respAudClinPerform","Listbox, ListAgreeNAExplain"]
[{"$nulls":8},"7.",null,"Confirm that all performance guarantees will be measured on a client-specific basis rather than your book of business (BOB). ","Listbox,ListYNNoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box",null,"Listbox, ListYNNoExplain"]

{"sheet":"Med Ques_Explanation","index":6,"n_rows":9,"n_cols":2,"rows_kept":9,"merged":[[1,0,1,4],[4,0,5,1]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Questionnaire Explanation"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response "]
[]
[]
[]
["Section/ Question #","Explanation"]

{"sheet":"Wellness Questionnaire","index":7,"n_rows":238,"n_cols":8,"rows_kept":238,"merged":[[0,0,0,11],[1,0,1,4],[4,3,4,7],[6,3,6,7],[8,3,8,7],[154,9,156,14]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Wellness Questionnaire"]
[null,"",""]
[{"$nulls":3},"To Offeror:  Use Column H to provide a brief explanation, if necessary. However if the length of the explanation is greater than 400 characters, you must use the \"Wellness Ques_Explanation\" worksheet to provide your detail explanation."]
[]
[{"$nulls":3},"MEDICAL RFP "]
[]
["I.","",null,"Wellness Program Abilities/Capabilities"]
[]
[{"$nulls":3},"Wellness Program Design/Products and Services","Answer Format","Format Type","Response","Explanation"]
[null,"1.",null,"Offeror agrees to a MINIMUM of $50,000 annual Offeror funding to support the County directed wellness initiatives.","Drop down box","Yes, No, See Explanation"]
[null,"2.",null,"Does your proposed Wellness Program offer the following Products/Services? (indicate Yes or No)"]
[null,null,"a.","Health Coaching","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Onsite biometric screenings","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Dedicated onsite wellness professional","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Diabetes Management","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Onsite clinical immunizations","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Nutrition education","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Weight management","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Obesity management","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Smoking cessation","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Stress management / stress reduction","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Onsite fitness center management","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Nearsite fitness center partnerships (e.g. YMCA)","Drop down box","Yes, No, See Explanation"]
[null,null,"m.","Tracking from other gym attendance online?","Drop down box","Yes, No, See Explanation"]
[null,null,"n.","Personal training / wellness & fitness coaching","Drop down box","Yes, No, See Explanation"]
[null,null,"o.","Onsite group exercise classes","Drop down box","Yes, No, See Explanation"]
[null,null,"p.","Ergonomics / back care / injury prevention","Drop down box","Yes, No, See Explanation"]
[null,null,"q.","Expectant parents / prenatal care","Drop down box","Yes, No, See Explanation"]
[null,null,"r.","Fitness tracking devices","Drop down box","Yes, No, See Explanation"]
[null,null,"s.","Activity tracking devices downloadable via mobile applications","Drop down box","Yes, No, See Explanation"]
[null,null,"t.","Self-Care initiatives / consumerism - online programs","Drop down box","Yes, No, See Explanation"]
[null,null,"u.","Partnership with retailer(s) for healthy food or other healthy products initiatives","Drop down box","Yes, No, See Explanation"]
[null,null,"v.","Lunch & learn programs","Drop down box","Yes, No, See Explanation"]
[null,null,"w.","Coordination with community / local health programs","Drop down box","Yes, No, See Explanation"]
[null,null,"x.","Information on the County sponsored recreation leagues","Drop down box","Yes, No, See Explanation"]
[null,null,"y.","Incentive management and fulfillment ","Drop down box","Yes, No, See Explanation"]
[null,null,"z.","Promotional awareness campaigns","Drop down box","Yes, No, See Explanation"]
[null,null,"aa.","Reminder letters for routine screenings","Drop down box","Yes, No, See Explanation"]
[null,"3.",null,"Indicate your agreement to attend onsite Wellness Events and Health Fairs","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Wellness Reporting","Answer Format","Format Type","Response","Explanation"]
[null,"4.",null,"Indicate if the standard reports include the following:"]
[null,null,"a.","Activity and participation results for all program components including HRA, biometric screening, coaching programs, online tools/program/portal activity, challenges, onsite programs","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Population health risks by risk level (based on HRA and biometric screening results)","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Population health risks by individual risk factor (based on HRA and biometric screening results)","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Readiness to change","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Self-reported productivity results","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Year over year shifts in risk levels and readiness to change.","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Goals met","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Evidence based medicine compliance","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Member Satisfaction","Drop down box","Yes, No, See Explanation"]
[null,"5.",null,"Is the County's data compared to a standard?  If so, please explain (e.g., book of business, industry, national averages)","Drop down box","Yes, No, See Explanation"]
[null,"6.",null,"Are reports exportable to Excel, text, or csv file format to allow the County to manipulate the data?","Drop down box","Yes, No, See Explanation"]
[null,"7.",null,"Can these reports be customized to further meet the County needs?","Drop down box","Yes, No, See Explanation"]
[null,null,"a.","Indicate yes/no if there is additional cost for customized reports. Provide additional cost detail in the Explanations section.","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Onsite biometric screenings","Answer Format","Format Type","Response","Explanation"]
[null,"8.",null,"Do you have the capability to do onsite biometric screenings?","Drop down box","Yes, No, See Explanation"]
[null,"9.",null,"If so, what is the minimum number of participants needed per location?","Number","Number"]
[null,"10.",null,"Are results explained by a health coach present at the screenings?  Please explain.","Drop down box","Yes, No, See Explanation"]
[null,"11.",null,"Would you accept biometric information directly from physicians of participants?","Drop down box","Yes, No, See Explanation"]
[null,"12.",null,"Would you accept biometric information directly from a laboratory vendor?","Drop down box","Yes, No, See Explanation"]
[null,"13.",null,"Are you able to accept screening results from the HealthSmart Wellness Clinic?","Drop down box","Yes, No, See Explanation"]
[null,"14.",null,"Do you have arrangements with area labs to conduct biometric screenings?  If onsite is not an option, can members go to these labs to have screenings done at no cost?  List names of laboratory partners.","Drop down box","Yes, No, See Explanation"]
[null,"15.",null,"Indicate the specific health elements (blood pressure, total cholesterol and cholesterol ration, blood glucose, BMI, etc.) recommended in your proposed biometric screenings. ","Text","Text"]
[null,"16.",null,"Indicate procedure(s) used (finger prick, venipuncture, other) and whether or not each procedure is fasting or non-fasting. ","Text","Text"]
[null,"17.",null,"Do you have an online scheduling tool that member's may use to schedule onsite biometric screenings?","Drop down box","Yes, No, See Explanation"]
[null,"18.",null,"Is the online tool customizable?  If yes, briefly describe available customizations in the explanation column.","Drop down box","Yes, No, See Explanation"]
[null,"19.",null,"Indicate procedure(s) used (finger prick, venipuncture, other) and whether or not each procedure is fasting or non-fasting. ","Text","Text"]
[{"$nulls":3},"Lifestyle Behavioral Change Programs","Answer Format","Format Type","Response","Explanation"]
[null,"20.",null,"Do you offer online programs for the following topics? If yes, specify in the explanation column whether the module is a one-time session or if the module requires multiple sessions for completion."]
[null,null,"a.","Nutrition management","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Stress management","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Tobacco cessation","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Weight management","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Exercise management","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Sleep disorders","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Cholesterol","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Blood pressure","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Glucose / pre-diabetes","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Mental Health / Depression","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Musculoskeletal / Back Pain / Joint Pain","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Mindfulness","Drop down box","Yes, No, See Explanation"]
[null,null,"m.","Family Oriented Programs (if yes, please list available programs in Explanation column)","Drop down box","Yes, No, See Explanation"]
[null,null,"n.","Ergonomics / injury prevention","Drop down box","Yes, No, See Explanation"]
[null,null,"o.","Other programs - specify","Text","Text"]
[null,"21.",null,"Do you offer telephonic coaching programs for the following programs? If yes, specify in the explanation column the average number of calls/sessions for each program and the timing of the calls"]
[null,null,"a.","Nutrition management","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Stress management","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Tobacco cessation","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","Weight management","Drop down box","Yes, No, See Explanation"]
[null,null,"e.","Exercise management","Drop down box","Yes, No, See Explanation"]
[null,null,"f.","Sleep disorders","Drop down box","Yes, No, See Explanation"]
[null,null,"g.","Cholesterol","Drop down box","Yes, No, See Explanation"]
[null,null,"h.","Blood pressure","Drop down box","Yes, No, See Explanation"]
[null,null,"i.","Glucose / pre-diabetes","Drop down box","Yes, No, See Explanation"]
[null,null,"j.","Mental Health / Depression","Drop down box","Yes, No, See Explanation"]
[null,null,"k.","Musculoskeletal / Back Pain / Joint Pain","Drop down box","Yes, No, See Explanation"]
[null,null,"l.","Other programs - specify","Text","Text"]
[null,"22.",null,"Are members able to self-refer to telephonic coaching programs regardless of risk?  If no, briefly explain the program rationale in the explanation column.","Drop down box","Yes, No, See Explanation"]
[null,"23.",null,"Are members invited to participate in specific coaching programs (i.e. online versus telephonic) based on their level of risk and readiness to change?  If yes, briefly explain the approach in the explanation column and the average % of HRA participants targeted for each approach.","Drop down box","Yes, No, See Explanation"]
[null,"24.",null,"Do your health coaches accept in-bound calls and place out-bound calls?","Drop down box","In-bound, Out-bound, Both, See Explanation"]
[null,"25.",null,"How many times do you attempt to contact someone to enroll in the program if you are unable to reach them?","Text","Text"]
[null,"26.",null,"What do you do with individuals who decline the program?  Are these members flagged for outreach again later in the program?","Drop down box","In-bound, Out-bound, Both, See Explanation"]
[null,"27.",null,"Indicate coaching program delivery methods available (briefly describe using the explanation column):"]
[null,null,"a.","Email communications","Drop down box","Available, Not Available, See Explanation"]
[null,null,"b.","Text messages","Drop down box","Available, Not Available, See Explanation"]
[null,null,"c.","Online live chat with a coach","Drop down box","Available, Not Available, See Explanation"]
[null,null,"d.","Video materials","Drop down box","Available, Not Available, See Explanation"]
[null,null,"e.","Audio materials","Drop down box","Available, Not Available, See Explanation"]
[null,null,"f.","Promotional awareness campaigns","Drop down box","Available, Not Available, See Explanation"]
[null,null,"g.","Smartphone apps","Drop down box","Available, Not Available, See Explanation"]
[null,null,"h.","Other - please specify","Text","Text"]
[null,"28.",null,"Briefly describe how you increase utilization and keep participants engaged in wellness/lifestyle behavior change programs.  ","Text","Text"]
[null,"29.",null,"What do you consider successful completion of a coaching program?","Text","Text"]
[null,"30.",null,"Briefly describe your health coaches' qualifications and training.","Text","Text"]
[null,"31.",null,"Does your company have the capability and experience to provide onsite health seminars/fairs and health related education programs?","Drop down box","Yes, No, See Explanation"]
[null,"32.",null,"Can you sponsor/administer \"wellness challenges\" periodically throughout the year?","Drop down box","Yes, No, See Explanation"]
[null,null,"a.","If so, briefly describe the wellness challenges that you have sponsored/administered.","Text","Text"]
[null,"33.",null,"Can you send email reminders to participants who have started but not completed program activities or online wellness courses?","Drop down box","Yes, No, See Explanation"]
[null,"34.",null,"Can you push out individually tailored programs to those individuals identified with high risk behaviors in the HRA?","Drop down box","Yes, No, See Explanation"]
[null,"35.",null,"Will you provide a primary health coach model? (The same coach works with participants throughout the duration of the program).","Drop down box","Yes, No, See Explanation"]
[null,"36.",null,"Do the coaches use a \"whole person\" approach where they manage multiple risks regardless of the program the member originally enrolled in?","Drop down box","Yes, No, See Explanation"]
[null,"37.",null,"Is your organization able to provide onsite health education and coaching resources (i.e. nutritionist, diabetes educator, etc.) one day a week (based on the County's discretion) including but not limited to the following:  "]
[null,null,"a.","Health Screening (e.g., dermatologist for skin screening)","Drop down box","Yes, No, See Explanation"]
[null,null,"b.","Face to face coaching","Drop down box","Yes, No, See Explanation"]
[null,null,"c.","Health education presentations","Drop down box","Yes, No, See Explanation"]
[null,null,"d.","If yes, describe any fees related to these services","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Health Risk Assessment (HRA)","Answer Format","Format Type","Response","Explanation"]
[null,"38.",null,"HRA Validation"]
[null,null,"a.","Has your HRA tool been validated internally?","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Briefly describe the validation process.","text","Text"]
[null,null,"c.","Has your HRA tool been validated externally?","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Briefly describe the validation process.","text","Text"]
[null,null,"e.","How long has your organization been providing this HRA?","text","Text"]
[null,"39.",null,"Finalists will be asked to provide a copy of the HRA you propose to use, and, if applicable, citations of any peer reviewed publications. Confirm that you will provide the necessary information if/when requested","Drop down box","Confirmed, Not Confirmed, See Explanation"]
[null,"40.",null,"How is the HRA administered (online, paper, telephone)?","Drop down box","Online, Paper, Telephone, All, See Explanation"]
[null,"41.",null,"What is the reading level (grade level) of the HRA?","Text","Text"]
[null,"42.",null,"How long on average does it take for a participant to complete the HRA?","Text","Text"]
[null,"43.",null,"Is your HRA available in languages other than English?  Please provide available languages","Drop down box","Yes, No, See Explanation"]
[null,"44.",null,"Is there a time limit to complete? Can participants complete the HRA over multiple sessions?","Text","Text"]
[null,"45.",null,"Are \"readiness to change\" questions included in the questionnaire?","Drop down box","Yes, No, See Explanation"]
[null,null,"a.","If \"yes\", are the \"readiness to change\" responses used to tailor the feedback in the individual reports to members?","Drop down box","Yes, No, See Explanation, Not Applicable"]
[null,null,"b.","If \"yes\", will the management reports outline \"readiness to change\" shifts as part of the data reported to the County?","Drop down box","Yes, No, See Explanation, Not Applicable"]
[null,"46.",null,"Are \"productivity\" questions included in the questionnaire?","Drop down box","Yes, No, See Explanation"]
[null,"47.",null,"Do the questions specifically address self-reported absenteeism?","Drop down box","Yes, No, See Explanation"]
[null,"48.","a.","If yes, will the management reports outline productivity shifts as part of the data reported to the County?","Drop down box","Yes, No, See Explanation, Not Applicable"]
[null,"49.",null,"Do the questions specifically address self-reported presenteeism?","Drop down box","Yes, No, See Explanation"]
[null,"50.",null,"Does your HRA integrate game theory and game mechanics to engage members?  If yes, briefly describe how these tools are integrated in the HRA.","Drop down box","Yes, No, See Explanation"]
[null,"51.",null,"Is the County able to customize the HRA by adding and/or deleting specific questions?  In the explanation column, briefly describe how deletion of questions may impact validation/scoring.","Drop down box","Yes, No, See Explanation"]
[null,"52.",null,"Does HRA comply with GINA? (i.e., health history is voluntary and participants qualify for incentives by completing the portion that does not call for family medical history)","Drop down box","Yes, No, See Explanation"]
[null,"53.",null,"Is the health score communicated to the individual completing the HRA?","Drop down box","Yes, No, See Explanation"]
[null,"54.",null,"Does the HRA provide the opportunity for members to model the impact of changes on health risk (For example, \"Losing 20lbs will do what to my health risk score?\")","Drop down box","Yes, No, See Explanation"]
[null,"55.",null,"Can the County's own branding be added to the HRA?","Drop down box","Yes, No, See Explanation"]
[null,"56.",null,"Are HRA results used to prioritize program offerings and provide ongoing targeted health information to members after initial results are provided?","Drop down box","Yes, No, See Explanation"]
[{"$nulls":3},"Program Integration","Answer Format","Format Type","Response","Explanation"]
[null,"57.",null,"Do you currently accept laboratory data/values directly from laboratory vendors for your programs? If so, please list laboratory vendors that you currently accept data from and/or have a relationship/partnership with.","Drop down box","Yes, No, See Explanation"]
[null,"58.",null,"Can your wellness program be offered to employees who do not participate in the medical program at no additional cost?","Drop down box","Yes, No, See Explanation"]
[]
[null,"",null,"HEALTH PORTAL/WEB-BASED INTERACTIVE TOOLS","Answer Format","Format Type","Response","Explanation"]
[null,"59.",null,"Do you have an dedicated wellness portal for members?","drop down box","Yes, No, See Explanation"]
[null,"60.",null,"Indicate if the following categories of information and tools are available on your portal.  Indicate in the explanation column if additional fees apply."]
[null,null,"a.","Health and Condition Information?","drop down box","Available, Not Available, See Explanation"]
[null,null,"b.","Medication information (including prescription medications, herbals and OTC medication)?","drop down box","Available, Not Available, See Explanation"]
[null,null,"c.","Health trackers (e.g. weight, blood pressure, steps, diet, etc.)?  Briefly describe in the explanation column.","drop down box","Available, Not Available, See Explanation"]
[null,null,"d.","Health newsfeed (updated daily)?","drop down box","Available, Not Available, See Explanation"]
[null,null,"e.","Online newsletter (updated at least monthly)?","drop down box","Available, Not Available, See Explanation"]
[null,null,"f.","Customizable client bulletin board?","drop down box","Available, Not Available, See Explanation"]
[null,null,"g.","Health tips, information or reminders via portal messaging?","drop down box","Available, Not Available, See Explanation"]
[null,null,"h.","Health tips, information or reminders via text messaging?","drop down box","Available, Not Available, See Explanation"]
[null,null,"i.","Personalized content based on member interest?","drop down box","Available, Not Available, See Explanation"]
[null,null,"j.","Personalized content based on HRQ and screening results?","drop down box","Available, Not Available, See Explanation"]
[null,null,"k.","Ergonomics / workplace safety?","drop down box","Available, Not Available, See Explanation"]
[null,null,"l.","Indicate if your portal is optimized for viewing on mobile devices.","drop down box","Available, Not Available, See Explanation"]
[null,null,"m.","Describe any other smart phone apps available (beyond portal access).","text","Text"]
[null,null,"n.","Ability to sync data from smart phone apps or other biometric devices?  If yes, indicate in the explanation column what devices your portal is currently able to interface with.  ","drop down box","Yes, No, See Explanation"]
[null,null,"o.","Online interaction between members (e.g. discussion boards, challenges, etc.) hosted on the wellness portal","drop down box","Available, Not Available, See Explanation"]
[null,null,"p.","Portable personal health record (PHR)?","drop down box","Available, Not Available, See Explanation"]
[null,"61.","","Is a log on and password required for access to web-based tools?","drop down box","Yes, No, See Explanation"]
[null,null,"a.","Is access to the web-based tools via a single sign on?  (i.e. no need to register/log-in to access tools promoted on the site).","drop down box","Yes, No, See Explanation"]
[null,"62.","","Briefly describe how you keep participants engaged in web-based programs.  How do you increase utilization?","text","Text"]
[null,"63.",null,"Briefly describe how game theory and game mechanics are integrated into the portal to improve engagement.","text","Text"]
[null,"64.",null,"Does your web-based interactive programming incorporate readiness to change theory?","drop down box","Yes, No, See Explanation"]
[null,"65.","","Describe how your web-based interactive programming is personalized for the client and/or participant.","text","Text"]
[null,"66.",null,"Does your portal offer a member \"Personal Health Record\" (PHR).","drop down box","Yes, No, See Explanation"]
[null,"67.",null,"Are the following portal customizations available?  Indicate in the explanation column if there are additional fees for customization."]
[null,null,"a.","If yes, is the PHR portable?","drop down box","Yes, No, See Explanation"]
[null,null,"b.","County program branding?","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Links from the County intranet site or other vendor partner portals to the wellness portal?","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Links from wellness portal to other County program or vendor portals?","drop down box","Yes, No, See Explanation"]
[null,null,"e.","Customization of portal text?","drop down box","Yes, No, See Explanation"]
[null,null,"f.","Customizable bulletin board for County specific events/information?","drop down box","Yes, No, See Explanation"]
[null,null,"g.","Ability to push targeted communications based on demographics or business specifics such as segment, division, etc.","drop down box","Yes, No, See Explanation"]
[null,"68.",null,"Briefly discuss how you handle both scheduled and unscheduled system maintenance issues.","text","Text"]
[null,"69.",null,"Briefly describe any plans to expand web-based information technology that will be effective within the next 12 months. ","text","Text"]
[null,"70.",null,"Can your portal be linked to the County's intranet or other vendor partner portals?  ","drop down box","Yes, No, See Explanation"]
[null,null,"a.","Can links chosen by the Client be included on your portal (e.g. for access to a health plan or another organization's portal)?","drop down box","Yes, No, See Explanation"]
[null,"71.",null,"Please provide demo log-in information such as user ID and password needed to access your web site (sufficient to experience the web site as the County participants would).","text","Text"]
[]
[{"$nulls":3},"INCENTIVE MANAGEMENT","Answer Format","Format Type","Response","Response"]
[null,"72.",null,"Can you administer (track and report on) incentives for the following:"]
[null,null,"a.","Non-health plan enrollees?","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Completion of HRA","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Completion of biometric screenings","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Participation in or completion of  telephonic health coaching programs","drop down box","Yes, No, See Explanation"]
[null,null,"e.","Participation in or completion of online Lifestyle Behavior Change programs","drop down box","Yes, No, See Explanation"]
[null,null,"f.","Participation in or completion of onsite health coaching programs","drop down box","Yes, No, See Explanation"]
[null,null,"g.","Meeting or making progress toward a health goal defined by the member or coach","drop down box","Yes, No, See Explanation"]
[null,null,"h.","Meeting a defined health standard defined by the County (e.g. BMI, cholesterol, blood pressure, glucose, etc.)","drop down box","Yes, No, See Explanation"]
[null,null,"j.","Progress toward meeting a health standard (e.g. loss of 5% of body weight)","drop down box","Yes, No, See Explanation"]
[null,null,"k.","Participation in programs offered by the County or the County's other vendors or at the local onsite level (if participation reports are provided)","drop down box","Yes, No, See Explanation"]
[null,"73.",null,"Do any of these incentives require an additional fee?  If yes describe the fee.","drop down box","Yes, No, See Explanation"]
[null,"74.",null,"Are you able and willing to report information on active program participants to the County that permits administration of the following:"]
[null,null,"a.","Reduced premium contribution","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Lower prescription drug co-payments","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Different co-payments/co-insurance for medical services.","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Different HSA contributions","drop down box","Yes, No, See Explanation"]
[null,"75.",null,"Are there additional fees for providing incentive reports?","drop down box","Yes, No, See Explanation"]
[null,"76.",null,"Do you offer a points based tracking tool via your website?  ","drop down box","Yes, No, See Explanation"]
[null,null,"a.","Does the tool have the flexibility to accept and track both self-reported activity and/or validated activities/data based on the County's  preference?","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Can the tool be customized to support the County's incentive strategy?  If yes, briefly describe available customizations.","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Are there additional fees for the points based incentive tracking tool?","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Are there additional fees to customize the tool?","drop down box","Yes, No, See Explanation"]
[null,"77.",null,"Is your company able to provide incentive fulfillment for the following?  If you partner with a third party to provide incentive fulfillment, indicate the name of your partner in the explanation column."]
[null,null,"a.","Health related merchandise (such as resistance bands or fitness equipment)?","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Other merchandise?","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Gift Cards?","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Online shopping mall?","drop down box","Yes, No, See Explanation"]
[null,"78.",null,"Briefly describe the incentive options your company has found to yield the greatest results in terms of increased participation and improved outcomes.","text","Text"]
[]
[null,"",null,"VENDOR INTEGRATION","Answer Format","Format Type","Response","Explanation"]
[null,"79.",null,"Indicate below how your organization will collaborate to provide integrated delivery of the programs with the County, their onsite clinic and their other health care initiatives or vendors."]
[null,null,"a.","Warm transfer to onsite clinic and other vendors","drop down box","Yes, No, See Explanation"]
[null,null,"b.","Accept inbound warm transfers","drop down box","Yes, No, See Explanation"]
[null,null,"c.","Send referrals to the onsite clinic and other vendors via fax or secure email with member consent.","drop down box","Yes, No, See Explanation"]
[null,null,"d.","Accept inbound referrals via fax or secure email and provide outreach to members based on the referral.","drop down box","Yes, No, See Explanation"]
[null,null,"e.","Develop a hierarchy for program outreach with the County, the County's  onsite clinic and other health management programs such as case management and condition management, regardless of which health plan the member is enrolled in.","drop down box","Yes, No, See Explanation"]
[null,null,"f.","Provide participation reports to the County's other vendors to support the integrated program.","drop down box","Yes, No, See Explanation"]

{"sheet":"Wellness Ques_Explanation","index":8,"n_rows":9,"n_cols":2,"rows_kept":9,"merged":[[1,0,1,4]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Wellness Questionnaire Explanation"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response "]
["was given.  Explanations must be numbered to correspond to the question to which they pertain and they must be brief."]
[]
[]
["Section/ Question #","Explanation"]

{"sheet":"HSA Questionnaire","index":9,"n_rows":59,"n_cols":6,"rows_kept":59,"merged":[[0,0,0,5],[1,0,1,4],[4,3,4,5]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["HSA Questionnaire"]
[]
[{"$nulls":3},"To Offeror:  Use Column F to provide a brief explanation, if necessary. However if the length of the explanation is greater than 400 characters, you must use the \"HSA Explanation\" worksheet to provide your detail explanation."]
[null,""]
["I.","","","GENERAL PLAN INFORMATION","Response","Explanation"]
[null,"1.",null,"How many years has your organization been providing Health Savings Account (HSA) services?"]
[null,"2.",null,"If your organization does not provide HSA services, please provide the name of the organization with whom you subcontract, in the \"Explanation\" column, and provide the number of years that organization has been providing HSA services."]
[null,"3.",null,"How many clients does your organization have who utilize HSA services?"]
[null,"4.",null,"What is your organization's (or your subcontractor's organization) total number of HSA accountholders."]
[null,"5.",null,"What is the percentage of HSA account holders who invest?"]
[null,"6.",null,"What is the minimum threshold to invest?"]
[null,"7.",null,"What is the number of investment options? Please a brief description on the HSA Explanation Tab"]
[null,"8.",null,"What is the current interest rate for cash accounts?"]
[null,"9.",null,"Does the HSA owner have the ability to limit the distribution?"]
[null,"10.",null,"What are the total HSA assets under management?"]
[null,"11.",null,"Will there be a dedicated toll-free number exclusively for the County participants?"]
[null,null,"a.","If so, is it included in the fee?"]
[null,"12.",null,"Who is responsible for answering employee questions regarding claims or HSA program details - the health plan or the HSA administrator?"]
[null,"13.",null,"Will the HSA Customer Services Representatives provide warm transfers to callers who need to speak to a representative from their health plan or PBM?"]
[null,"14.",null,"Does Customer Service Representatives offer multi-lingual options"]
[null,"15.",null,"Do you provide the following, at a minimum, electronically? "]
[null,null,"a.","Customized Enrollment Communication Materials"]
[null,null,"b.","In-Person Open Enrollment Meeting Support"]
[null,null,"c.","Customized Welcome Packet Materials"]
[null,null,"d.","Ongoing Educational Materials"]
[null,null,"e.","Are multi-lingual communication materials available? Please provide language options"]
[null,"16.",null,"Do you allow an employer to customize text incorporated on the landing page, including the logo?"]
[null,"17.",null,"Is a mobile application available for HSA services?"]
[null,null,"a.","If so, please describe your mobile access capabilities."]
[null,"18.",null,"Can your organization's HSA integrate with the following third party administrative vendors"]
[null,null,"a.","Payroll"]
[null,null,"b.","Medical/Prescription "]
[null,null,"c.","Dental"]
[null,null,"d.","Vision"]
[null,"19.",null,"Does your organization's on-line capabilities offer the following to manage HSA plans?"]
[null,null,"a.","Check balance"]
[null,null,"b.","Confirm/update personal information"]
[null,null,"c.","Pay medical expenses online"]
[null,null,"d.","Review a list of eligible expenses"]
[null,null,"e.","Use tools and calculators"]
[null,null,"f.","Get answers to common questions"]
[null,null,"g.","Order additional debit cards"]
[null,null,"h.","Make a one-time or recurring contribution (current or prior year)"]
[null,null,"i.","Select automatic transfers to investments"]
[null,null,"j.","View online tax documents and monthly statements"]
[null,"20.",null,"Is an HSA debit card or checkbook offered that allows members to pay for medical expenses directly from their account? "]
[null,"21.",null,"Will the HSA administrator accept rollovers from other HSAs? "]
[null,"22.",null,"Please confirm that your organization can accept post-tax contributions to HSAs. "]
[null,"23.",null,"Please confirm that your organization can provide tax reporting statements, including 1099-SA and Form 5498-SA. "]
[null,"24.",null,"Who is your HSA bank partner and can other banks be used?"]
[null,"25.",null,"Do you have an \"HSA On-demand\" feature that allows members to utilize dollars (i.e. borrow from future balance) on day one?"]
[null,"26.",null,"Can HSA account be opened on behalf of the customer?"]
[null,"27.",null,"Track and pay medical/health claims online?"]
[null,"28.",null,"If applicable, can member view current accounts  and HSA accounts on one platform?"]
[null,"29.",null,"Are new file interface connections required?"]
[null,"30.",null,"What kind of reporting access will be available to the County?"]
[null,"31.",null,"Is HSA administrator carrier neutral?"]

{"sheet":"HSA Explanation","index":10,"n_rows":8,"n_cols":2,"rows_kept":8,"merged":[[0,0,0,2],[1,0,1,4],[4,0,4,1]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["HSA Explanation"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response was given.  Explanations must be numbered to correspond to the question to which they pertain and they must be brief."]
[]
[]
["Section/ Question #","Explanation"]

{"sheet":"OAPIN Copay Plan Design","index":11,"n_rows":27,"n_cols":4,"rows_kept":27,"merged":[[1,0,1,4],[4,0,4,2],[6,0,8,0],[22,0,23,0],[26,0,26,2]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["Arlington County Government Plan Design "]
["Indicate the plan deviation within the column named \"Plan Deviations\". Also indicate if the plan design deviation is an enhancement or reduction by indicating (+/-)"]
[null,null,"If there are no deviations, please state \"no deviations\" below"]
["Benefit Service","CIGNA - Copay Plan"]
[null,"Inforce Plan","Plan Deviations","\"+\" or \"-\""]
[null,"In-Network"]
["PCP","$30/visit"]
["Specialist","$60/visit"]
["Referral required for Specialist","No"]
["Annual Deductible",{"v":0,"d":"$0"}]
["Annual Out of Pocket","$6,600 Ind.\n$13,200 Fam."]
["Preventive Care",{"v":0,"d":"$0"}]
["Inpatient Care (per admission)",{"v":500,"d":"$500"}]
["Urgent Care",{"v":75,"d":"$75"}]
["Emergency Room",{"v":200,"d":"$200"}]
["Mental Health – Inpatient",{"v":500,"d":"$500"}]
["Mental Health – Outpatient",{"v":60,"d":"$60"}]
["Specialty Imaging (MRI, CT Scan)","$100/test"]
["Physical Therapy","$45/visit"]
["Occupational, Cognitive & Speech Therapy","$30 PCP/$60 Spec."]
[null,"52 visit/yr limit for all therapies combined"]
["Acupuncture","$30 PCP/$60 Spec."]
[null,"20 visits/yr"]
["Based on your review of the SPDs and other plan documentation, please list any other deviations not already noted above. \nIf there are any deviations, please list the benefit service in Column A and the deviation(s) in column C through D."]

{"sheet":"OAPIN Coinsurance Plan Design","index":12,"n_rows":27,"n_cols":4,"rows_kept":27,"merged":[[1,0,1,4],[4,0,4,2],[26,0,26,3]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["Arlington County Government Plan Design "]
["Indicate the plan deviation within the column named \"Plan Deviations\". Also indicate if the plan design deviation is an enhancement or reduction by indicating (+/-)"]
[null,null,"If there are no deviations, please state \"no deviations\" below"]
[null,"CIGNA  - Coinsurance Plan"]
[null,"Inforce Plan","Plan Deviations","\"+\" or \"-\""]
[null,"In-Network"]
["PCP","10% coinsurance"]
["Specialist","10% coinsurance"]
["Referral required for Specialist","No"]
["Annual Deductible",{"v":0,"d":"$0"}]
["Annual Out of Pocket","$2,000 Ind. \n$5,000 Fam."]
["Preventive Care",{"v":0,"d":"$0"}]
["Inpatient Care (per admission)","10% coinsurance"]
["Urgent Care","10% coinsurance"]
["Emergency Room","10% coinsurance"]
["Mental Health – Inpatient","10% coinsurance"]
["Mental Health – Outpatient","10% coinsurance"]
["Specialty Imaging (MRI, CT Scan)","10% coinsurance"]
["Physical Therapy","10% coinsurance"]
["Occupational, Cognitive & Speech","10% coinsurance"]
["Therapy","52 visit/yr limit for all therapies combined"]
["Acupuncture","10% coinsurance"]
[null,"20 visits/yr"]
["Based on your review of the SPDs and other plan documentation, please list any other deviations not already noted above. \nIf there are any deviations, please list the benefit service in Column A and the deviation(s) in column C throuhg D."]

{"sheet":"OAP HDHP Plan Design","index":13,"n_rows":27,"n_cols":7,"rows_kept":27,"merged":[[1,0,1,5],[4,0,4,8],[5,1,5,2],[5,3,5,5],[6,1,6,2],[6,3,6,5],[7,1,7,2],[21,1,22,1],[21,2,22,2],[23,1,23,2],[25,1,25,2],[26,0,26,6]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["Arlington County Government Plan Design "]
["Indicate the plan deviation within the columns named \"Plan Deviations\". Also indicate if the plan design deviation is an enhancement or reduction by indicating (+/-)"]
[null,"Annual County HSA Contribution - $700 Ind./$1,400 Fam.",null,"If there are no deviations, please state \"no deviations\" below"]
[null,"Cigna POS HDHP",null,"Plan Deviations"]
[null,"Inforce Plan"]
[null,"In Network","Out of Network","In Network","\"+\" or \"-\"","Out of Network","\"+\" or \"-\""]
["PCP","10% after deductible","30% after deductible"]
["Specialist","10% after deductible","30% after deductible"]
["Referral required for Specialist","No","No"]
["Annual Deductible","$1,400 Ind.\n$2,800 Fam.","$2,800 Ind.\n$5,600 Fam."]
["Annual Out of Pocket","$5,000 Ind.\n$10,000 Fam.","$10,000 Ind\n$20,000 Fam."]
["Preventive Care","0%, No Deductible","30% after deductible"]
["Inpatient Care (per admission)","10% after deductible","30% after deductible"]
["Urgent Care","10% after deductible","10% after deductible"]
["Emergency Room","10% after deductible","10% after deductible"]
["Mental Health – Inpatient","10% after deductible","30% after deductible"]
["Mental Health – Outpatient","10% after deductible","30% after deductible"]
["Specialty Imaging (MRI, CT Scan)","10% after deductible","30% after deductible"]
["Physical Therapy","10% after deductible","30% after deductible"]
["Occupational, Cognitive & Speech Therapy"]
[null,"52 visits/yr limit for all therapies combined"]
["Acupuncture","10% after deductible","30% after deductible"]
[null,"20 visits/yr"]
["Based on your review of the SPDs and other plan documentation, please list any other deviations not already noted above. \nIf there are any deviations, please list the benefit service in Column A and the deviation in columns D through G"]

{"sheet":"Questions not used","index":14,"n_rows":450,"n_cols":19,"rows_kept":450,"hidden":true}
[]
[]
[]
[{"$nulls":8},"14.",null,"Use of a specific bank is required for self-insured coverages.  ","List Box:  Yes, No","drop down box","respSpecificBank","Listbox,ListYesNo"]
[{"$nulls":8},"15.",null,"If yes, indicate bank name.","Text","text","respBankName","Text"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"20.",null,"Offeror accepts that the County will not wire funds, pre-fund (imprest) the account, or allow a Offeror direct access to debit from the County account.  ",null,"drop down box","respQuoteRates","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"16.","","","List Box: Yes, No","drop down box","respQuoteRates","Listbox,ListYesNo"]
[{"$nulls":8},"21.","","The County will be reimbursed for 100% of claims paid in error, regardless of whether vendor recoups the amount paid in error","List Box: Yes, No","drop down box","respReducePlanType","Listbox,ListYesNo"]
[{"$nulls":8},"","","Unpaid Checks Administration",null,"percent, 1","respRiskPercentage","Percent,1"]
[{"$nulls":8},"20.","","If not, indicate the percentage of the risk passed on to other firms. ",null,"text","respTreatyRisk","Text",null,null,"$ amount?"]
[{"$nulls":8},"","","Provide treaty details of any ceded risk in the text box:",null,"text","respTreatyRisk","Text"]
[{"$nulls":8},"","","For the self-insured coverages requested, the claim amount paid will be the negotiated amount. In other words, County/APS will pay actual negotiated amount; none of the savings will be retained by your organization or shared with any other organization.","List Box: Yes, No","drop down box","respNegotiateAmount","Listbox,ListYesNo"]
[{"$nulls":8},"","","For the self-insured coverages requested, the claim amount paid will be the negotiated amount. In other words, County/APS will pay actual negotiated amount; none of the savings will be retained by your organization or shared with any other organization.","List Box: Yes, No","drop down box","respNegotiateAmount","Listbox,ListYesNo"]
[{"$nulls":8},"","","Aon Compensation","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"22.",null,"For each line of coverage for which you are quoting, indicate the commission percentage included in your rates:"]
[{"$nulls":8},"","","[Product line #1]","Percentage","percent, 2","respProductLine1","Percent,2"]
[{"$nulls":8},"","","[Product line #2]","Percentage","percent, 2","respProductLine2","Percent,2"]
[null,{"$f":"OR(fmSFullHMO,fmSFullPPO,fmSFullPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","[Product line #3]","Percentage","percent, 2","respProductLine3","Percent,2"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"17.",null,"[Product line #4]","Percentage","percent, 2","respProductLine4","Percent,2"]
[null,{"$f":"OR(fmSFullHMO,fmSFullPPO,fmSFullPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"18.",null,"Detail the methodology for the calculation of commission payments by your organization.","Text","text","respMethodology","Text"]
[{"$nulls":8},"19.",""]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"20.",null,"Financial - Renewal Services","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"21.",null,"For the funding arrangement requested in this RFP, please indicate your willingness to comply with the following renewal requirements and services:"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"22.",null,"For fully-insured coverages requested, renewal underwriting of rates is to be completed annually with any adjustments effective on the contract anniversary date, unless an alternate date is mutually agreed to in advance by County/APS.","List Box: Yes, No","drop down box","respUnderwritingRates","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"23.","","APS --For self-insured coverages requested, notification of renewal fees (to be accompanied by a detailed breakdown of all administrative expense components) is to be provided at least 180 days in advance of the contract anniversary date to a designated Agency representative.","List Box: Yes, No","drop down box","respNotifyRenewFee","Listbox,ListYesNo"]
[null,{"$f":"NOT(fmFullOnlY)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"24.","","County- --For self-insured coverages requested, notification of renewal fees (to be accompanied by a detailed breakdown of all administrative expense components) will be provided in September/October previous to plan year start of July the following year","List Box: Yes, No","drop down box","respRenewalRates","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"31.","","","List Box: Yes, No","drop down box","respRenewalRatesAdminFee","Listbox,ListYesNo"]
[null,{"$f":"NOT(fmFullOnlY)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"32.",null,"Vendor will provide routine underwriting- and actuarial-related contract services.","List Box: Yes, No","drop down box","respVendorServices","Listbox,ListYesNo"]
[{"$nulls":8},"33.",null,"The vendor will provide a complete description of the methodology inherent in the renewal work up and any changes in the fees/rates.","List Box: Yes, No","drop down box","respRenewWorkUp","Listbox,ListYesNo"]
[{"$nulls":8},"","","The vendor will provide a definition of all terms and an itemization of all assumptions used including projected claims, trend factors and the formula involved, plus a complete explanation of the logic inherent in the final renewal rate/fee package.","List Box: Yes, No","drop down box","respItemization","Listbox,ListYesNo"]
[null,{"$f":"fmattProviderDir","v":{"$error":"#NAME?"}},false,{"$nulls":4},"III.","","","The vendor will provide estimated or actual identification of expenses, including the change in IBNR, pool charges (if appropriate), claim administration expenses, other expenses (such as, number of transactions/EOBs), and a detailed allocation of your administrative cost projections.","List Box: Yes, No","drop down box","respEstimateActualExpenses","Listbox,ListYesNo"]
[{"$nulls":8},"1.","","For self-insured coverages requested, the vendor will provide Administrative Services Only (ASO) fee and rate justification.","List Box: Yes, No","drop down box","respASO","Listbox,ListYesNo"]
[{"$nulls":8},"2.",null,"The vendor will provide a comparison of old and new rates and factors.","List Box: Yes, No","drop down box","respCompareRate","Listbox,ListYesNo"]
[{"$nulls":8},"3.","","For self-insured coverages requested, the vendor will provide pseudo premium rates, claim projections and estimated incurred but unpaid (IBNR and O&U) claim reserves.","List Box: Yes, No","drop down box","respPsuedoRates","Listbox,ListYesNo"]
[{"$nulls":8},"",""]
[null,{"$f":"fmGeoAccess","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","MEDICAL DELIVERY SYSTEM","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"fmServiceArea","v":{"$error":"#NAME?"}},false,{"$nulls":5},"1.","","","List Box: Attached, Not Attached","drop down box","respProvideDirect","Listbox,ListAttached"]
[{"$nulls":8},"2.",null,"","List Box: Attached, Not Attached","drop down box","respNetCareHospitals2","Listbox,ListAttached"]
[{"$nulls":8},"3.","","","List Box: Completed, Not Completed","drop down box","respNetCareHospitals3","Listbox,ListCompleted"]
[null,{"$f":"fmGeoAccess","v":{"$error":"#NAME?"}},false,{"$nulls":5},"6.",""]
[null,{"$f":"AND(OR(fmSSIHMO,fmSSIPPO,fmSSIPOS,fmMSIHMO,fmMSIPPO,fmMSIPOS,fmMFullHMO,fmMFullPOS,fmMFullPPO),OR(fmPhyReimburse,fmHospitalSav,fmPayType))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"4.","","Employees' Access to Providers","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"fmMgmtReportInclude","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","","List Box: Yes, No","drop down box","respGeoAccess","Listbox,ListYesNo"]
[null,{"$f":"fmMgmtReportInclude","v":{"$error":"#NAME?"}},false,{"$nulls":4},"IV.","","","","Listbox: Attached, Not Attached","drop down box","respCensusData","Listbox,ListAttached"]
[null,{"$f":"fmMgmtReportInclude","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","",null,"drop down box","respGeoAccess","Listbox,ListYesNo"]
[null,{"$f":"AND(fmMultiple,fmPerformStandInclude)","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"1.","","Please confirm that \"the center of zipcode\" geo-mapping method  was used:",null,"drop down box","respGeoAccess","Listbox,ListYesNo"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"2.","","Please note the geo-mapping method used:","Listbox: ListGeo","drop down box","respGeoMapping","Listbox,ListGeo"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"3.",""]
[null,{"$f":"OR(fmPOS,fmPPO)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"1."]
[{"$nulls":8},"2.",null,"ADMINISTRATIVE AND OPERATIONAL ISSUES","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":9},"a.",null,"List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation",null,"Note: note sure what voice and/or online enrollment system"]
[{"$nulls":4},14,{"$nulls":3},"","b."]
[{"$nulls":8},"","c.","Implementation Services"]
[{"$nulls":9},"d.","","List Box: Attached, Not Attached","drop down box","respImplementSchedule","Listbox,ListAttached"]
[{"$nulls":8},"","","Indicate your willingness to provide the following services, if required:"]
[{"$nulls":8},"","","Design, submit for the County and APS approval, and print forms with County/APS's logo for claims submission, where required.","List Box: Yes, No","drop down box","respDesignSubmitCounty/APSApproval","Listbox,ListYesNo"]
[{"$nulls":8},"","","Provide network service area zip codes and electronic directories for the County and APS voice and/or online enrollment system.","List Box: Yes, No","drop down box","respNetworkServiceAreaZip","Listbox,ListYesNo"]
[{"$nulls":8},"","","Load, audit and insure clean eligibility data at least 5 days prior to program effective date.","List Box: Yes, No","drop down box","respLoadAuditInsure","Listbox,ListYesNo"]
[{"$nulls":8},"","","Send plan representatives to the worksite to conduct new member orientations for locations having 25+ employees at no additional charge.","List Box: Yes, No","drop down box","respOrientations","Listbox,ListYesNo"]
[{"$nulls":8},"3.","","To Consultant:  Aon Consulting has entered into an arrangement with selected carriers to provide a standard set of pre-implementation services for County/APSs with up to 3 plans.  Note that there are two variables that you need to determine and enter into the question on row 290 below.  Variable 1 is the cost of the review.  Variable 2 is a cap on travel expenses, should it be necessary to do an on-site review.  For Variable #1, Cost of the Review, see the chart below; please select the appropriate cost (based on # of employees and # of plans) and insert that amount in the question that follows to reflect the appropriate pricing structure for your particular County/APS.   You insert the cost into the area marked with the bracketed text $[Variable #1].  For Variable #2, Cap on Travel Costs, please determine a reasonable amount of expenses and insert that in the bracketed text $[Variable #2].  If you do not want to include this in your RFP, hide the row 289.  "]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMFullPPO,fmMSIPPO,fmSSIPPO,fmMFullPOS,fmMSIPOS,fmSSIPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"a.","# of Ees",null,"# Plans",null,"Cost"]
[null,{"$f":"fmPerformStandInclude","v":{"$error":"#NAME?"}},false,{"$nulls":5},"4.","","200 to 999",null,3,null,{"v":15000,"d":"$15,000"}]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"3.",null,"1,000 to 4,999",null,3,null,{"v":25000,"d":"$25,000"}]
[null,{"$error":"#NAME?"},false," ",{"$nulls":4},"4.","","5,000 +",null,3,null,{"v":50000,"d":"$50,000"}]
[null,{"$error":"#NAME?"},false," ",{"$nulls":4},"5.","","Indicate your willingness to provide the following pre-implementation services:",{"$nulls":7},"Note: will we build in a credit for this "]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"6.","","[Aon Consulting, Inc., on behalf of The County/APS, will conduct a quality review of the plan design to be loaded in the claims system(s) prior to implementation (or as soon thereafter as reasonably possible). As the selected carrier or administrator, you agree to pay the cost of this review, up to $[Variable #1].  You will provide all necessary support to enable Aon Consulting, Inc., on behalf of The County/APS, to review claims in a test environment that mirrors the plan information present in the \"live\" claims processing system. If this review cannot be supported remotely and requires an on-site review, you will be responsible for travel costs up to $[Variable #2].  All costs associated with this review shall not be included in The County/APS retention fee.] ","List Box: Yes, No","drop down box","respQualityReview","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"7.","","For each of the following, provide a \"yes\" answer if you agree to each provisions without condition.  Answer \"no\" if you do not agree, of if there are stipulations.  List any stipulations and/or conditions in the Explanation column.",{"$nulls":7},"Note: pgs "]
[{"$nulls":8},"8.","","Be able to implement plan in 90 days and meet deadlines set forth in an agreed upon implementation schedule.","List Box: Yes, No","drop down box","respDeadlinesImplementationSchedule","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false,{"$nulls":7},"Production and distribution of current up-to-date provider directories to  the County and APS offices prior to the enrollment period. ","List Box: Yes, No","drop down box","respProductionDistribution","Listbox,ListYesNo"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMFullPPO,fmMSIPPO,fmSSIPPO,fmMFullPOS,fmMSIPOS,fmSSIPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","Production and distribution of ID cards prior to effective date with accuracy equal to data provided by the County and APS.","List Box: Yes, No","drop down box","respProductionDistributionCards","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false,{"$nulls":6},"","Appropriate members of account team to perform a service and operational audit for County/APS within the first three months of the program. ","List Box: Yes, No","drop down box","respServiceOperationalAudit","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"9.",null,"Provide the County and APS with a benefits and financial contract 90 days prior to the effective date.","List Box: Yes, No","drop down box","respBenefitsFinancialContract","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false," ",{"$nulls":4},"10.","","Meet or exceed the County and APS subjective assessment of satisfaction with program implementation.","List Box: Yes, No","drop down box","respSatProgImp","Listbox,ListYesNo"]
[null,{"$error":"#NAME?"},false," ",{"$nulls":4},"11.",""]
[{"$nulls":8},"40."]
[{"$nulls":8},"41.",null,"Health Care Reform/ACA Support",null,"Answer Format",null,"Format Type","Response","Explanation"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIPPO,fmMFullPPO,fmMSIPOS,fmMFullPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"","","Confirm that offeror will provide full support related to Health Care Reform/ ACA to ensure the County and APS remains compliant and has the most up to date information available.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","drop down box","respCaseClose","Listbox, ListCompletedNAExplain"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIPPO,fmMFullPPO,fmMSIPOS,fmMFullPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"","","Will you agree to provide communication materials to members and to County and APS staff to ensure compliance with ACA?","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","drop down box","respCaseClose","Listbox, ListCompletedNAExplain"]
[{"$nulls":8},"42.","","Briefly describe the support and materials you will provide relative to HCR/ACA.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","text","respAddChargeCustReport","Text"]
[{"$nulls":7},"","43.","","Will you agree to provide information on Exchanges, including availability, benefits and pricing as applicable?","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","drop down box","respCaseClose","Listbox, ListCompletedNAExplain"]
[{"$nulls":7},"","","a.","Briefly describe the support and materials you will provide relative to Exchanges.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","text","respAddChargeCustReport","Text"]
[{"$nulls":7},"","","b."]
[{"$nulls":7},"","","c.","Network Maintenance","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIPPO,fmMFullPPO,fmMSIPOS,fmMFullPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":4},"","","d.","Maintenance of satisfactory number of providers (hospitals  and physicians) in all implemented locations.","List Box: Yes, No","drop down box","respNumberProviders","Listbox,ListYesNo"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIPPO,fmMFullPPO,fmMSIPOS,fmMFullPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"44.","","Provider Directories:"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIPPO,fmMFullPPO,fmMSIPOS,fmMFullPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"45.","","Are updated at least every six months","Listbox: Yes; No","drop down box","respPrintUpdateSixMonth","Listbox, ListYNNAExplain"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"46.","","Have special notations for provider no longer accepting new patients","Listbox: Yes; No","drop down box","respSpecNotat","Listbox, ListYNNAExplain"]
[null,{"$f":"AND(fmMultiple,fmPerformStandInclude)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","Provide a toll free number for continuous updates and updated provider directories","Listbox: Yes; No","drop down box","respContUpdateProvDir","Listbox, ListYNNAExplain"]
[null,{"$f":"AND(fmMultiple,fmPerformStandInclude)","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"","","Are available via the Internet","Listbox: Yes; No","drop down box","respAvailViaInternet","Listbox, ListYNNAExplain"]
[{"$nulls":8},"47.","","Indicate the frequency at which internet provider directory information is updated (i.e. daily, weekly)","List Box: Yes, No","text","respModifyRatesAdminFee","Text"]
[null,{"$f":"fmMgmtReportInclude","v":{"$error":"#NAME?"}},false,{"$nulls":5},"48.",null,"Actively pursue physicians nominated by the County and APS employees to participate in network.","List Box: Yes, No","drop down box","respPursuePhysicians","Listbox,ListYesNo"]
[{"$nulls":8},"49.","","Briefly describe how you are improving quality among network providers.","List Box: Yes, No","text","respModifyRatesAdminFee","Text"]
[{"$nulls":8},"50."]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"51.",null,"Data Management","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"52.","","","List Box: Yes, No","drop down box","respProductionReportsData","Listbox,ListYesNo"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"","","",null,"drop down box","respProductionReportsData","Listbox,ListYesNo"]
[{"$nulls":8},"50.","","Can the offeror meet the County's and APS file layouts and specifications.  See attached zip file with specifications:  Medical County/APS File Specs.zip","List Box: Attached, Not Attached","drop down box","respMgmtUtilReport","Listbox,ListAttached"]
[{"$nulls":8},"","","Offeror can administer eligibility requirements.",null,"drop down box","respProductionReportsData","Listbox,ListYesNo"]
[{"$nulls":8},"","","The claims system maintains on-line eligibility files that are updated at least weekly.",null,"drop down box","respProductionReportsData","Listbox,ListYesNo"]
[{"$nulls":8},"53.",null,"A real-time, management information system is available, which supports the County's and APS requirements for database maintenance and management reporting ( i.e. The County and APS  have electronic access to the system to make changes name, correct DOB, modify enrollment, view claims, verify dependent coverage etc.","List Box: Yes, No","drop down box","respAnalyzeDataMeet","Listbox,ListYesNo"]
[{"$nulls":8},"","a.","Do you agree to provide all necessary data, reporting and integration required by the DM and/or Data Aggregation program/s vendor selected by the County/APS?","List Box: Yes, No","drop down box","respAnalyzeDataMeet","Listbox,ListYesNo"]
[{"$nulls":4},14,{"$nulls":3},"","","Will you agree to performance standards that specifically address successful integration with the carved out DM program?","List Box: Yes, No","drop down box","respAnalyzeDataMeet","Listbox,ListYesNo"]
[{"$nulls":8},"",""]
[{"$nulls":8},"","b.","Other Services","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"","","List the location(s) of your service centers that would be servicing the County's and APS  employees and the corresponding geographic areas/regions covered by the respective location.  Use the \"Explanation\" column and/or worksheet if you need more space."]
[{"$nulls":8},"","","Service Center 1"]
[{"$nulls":9},"c.","Location 1","Text","text","respServiceCenterLocate1","Text"]
[{"$nulls":8},"","","Geographic Region(s) Covered 1","Text","text","respServiceCenterRegion1","Text"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","Service Center 2"]
[null,{"$error":"#NAME?"},false,{"$nulls":6},"d.","Location 2","Text","text","respServiceCenterLocate2","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","","Geographic Region(s) Covered 2","Text","text","respServiceCenterRegion2","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","","Service Center 3"]
[null,{"$error":"#NAME?"},false,{"$nulls":6},"e.","Location 3","Text","text","respServiceCenterLocate3","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","","Geographic Region(s) Covered 3","Text","text","respServiceCenterRegion3","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","","Service Center 4"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","f.","Location 4","Text","text","respServiceCenterLocate4","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":5},"","","Geographic Region(s) Covered 4","Text","text","respServiceCenterRegion4","Text"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra1)=\"\",fmCobra1=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"","","Service Center 5"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra1)=\"\",fmCobra1=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"5.","","Location 5","Text","text","respServiceCenterLocate5","Text"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra1)=\"\",fmCobra1=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"a.","Geographic Region(s) Covered 5","Text","text","respServiceCenterRegion5","Text"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra1)=\"\",fmCobra1=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"","Service Center 6"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra2)=\"\",fmCobra2=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"","Location 6","Text","text","respServiceCenterLocate6","Text"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra2)=\"\",fmCobra2=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"b.","Geographic Region(s) Covered 6","Text","text","respServiceCenterRegion6","Text"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra2)=\"\",fmCobra2=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","Indicate whether the following additional services are provided and the associated costs."]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra3)=\"\",fmCobra3=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","",{"$f":"\"COBRA: \" & flowCobra1","v":{"$error":"#NAME?"}}]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra3)=\"\",fmCobra3=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"c.","Service Provided?","List Box: Yes, No","drop down box","respCobraService1","Listbox,ListYesNo"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra3)=\"\",fmCobra3=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":7},"Associated Cost","Dollar","dollar, 2","respAssocCost1","Dollar,2"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra4)=\"\",fmCobra4=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","",{"$f":"\"COBRA: \" & flowCobra2","v":{"$error":"#NAME?"}}]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra4)=\"\",fmCobra4=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},{"$nulls":6},"","d.","Service Provided?","List Box: Yes, No","drop down box","respCobraService2","Listbox,ListYesNo"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra4)=\"\",fmCobra4=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},{"$nulls":6},"","","Associated Cost","Dollar","dollar, 2","respAssocCost2","Dollar,2"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra5)=\"\",fmCobra5=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","",{"$f":"\"FSA Administration: \" & flowCobra3","v":{"$error":"#NAME?"}}]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra5)=\"\",fmCobra5=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","e.","Service Provided?","List Box: Yes, No","drop down box","respCobraService3","Listbox,ListYesNo"]
[null,{"$f":"AND(fmCobra,IF(OR(TRIM(fmCobra5)=\"\",fmCobra5=\"0\"),FALSE,TRUE))","v":{"$error":"#NAME?"}},{"$nulls":8},"Associated Cost","Dollar","dollar, 2","respAssocCost3","Dollar,2"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","",{"$f":"\"HIPAA Administration: \" & flowCobra4","v":{"$error":"#NAME?"}}]
[null,{"$f":"fmAttPremiumBillDescrip","v":{"$error":"#NAME?"}},false,{"$nulls":5},"54.",null,"Service Provided?","List Box: Yes, No","drop down box","respCobraService4","Listbox,ListYesNo"]
[{"$nulls":8},"55.","","Associated Cost","Dollar","dollar, 2","respAssocCost4","Dollar,2"]
[{"$nulls":8},"6.",null,{"$f":"\"Other: \" & flowCobra5","v":{"$error":"#NAME?"}}]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},{"$nulls":6},"7.","","Service Provided?","List Box: Yes, No","drop down box","respCobraService5","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"8.","","Associated Cost","Dollar","dollar, 2","respAssocCost5","Dollar,2"]
[null,{"$f":"fmMgmtReportNotInclude","v":{"$error":"#NAME?"}},false,{"$nulls":5},"9.",null,"The County and APS reserves the right to accept or decline the designated service centers.","List Box: Yes, No","drop down box","respDesignatedServiceCenters","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIPPO,fmMFullPPO)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"14.","","Attach a description of premium or administrative fee billing procedures.  Include information on the timing of billing, billing-payment reconciliations and ability to provide for County/APS self-billing.  Name the file:  [Your Organization's Name]_ M-4  PremiumBilling.","List Box: Attached, Not Attached","drop down box","respPremBillProcess","Listbox,ListAttached"]
[null,{"$f":"OR(fmMSIPPO,fmMFullPPO)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"56.","","The plan will contain the birthday rule and will have group to group coordination of benefits provision. ","List Box: Yes, No","drop down box","respBirthRule","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIPPO,fmMFullPPO)","v":{"$error":"#NAME?"}},false,{"$nulls":6},"a.","To the extent permitted under state law, no fault auto insurance, governmental plans coordination and negligent third party subrogation will be administered.","List Box: Yes, No","drop down box","respNegSubContract","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIPPO,fmMFullPPO)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","b.","All claim records and eligibility data used by the carrier in its role as claim administrator shall remain the property of The County/APS as Plan Sponsor and Plan Administrator under ERISA.","List Box: Yes, No","drop down box","respClaimRecordsEligibilityData","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIPPO,fmMFullPPO)","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"","c.","Vendor agrees to monitor federal and state legislation affecting the delivery of medical benefits under the plan and to report to The County/APS on those issues in a timely fashion prior to the effective date of any mandated plan changes.","List Box: Yes, No","drop down box","respFederalStateLegislation","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIPOS,fmMFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"57.","","Please attach a copy of a plan experience report that would be provided to County/APS at the end of the first year.  Name the file:  [Your Organization's Name]_ C-8 ExpRptgPkg.","List Box: Attached, Not Attached","drop down box","respMgmtReportPackage","Listbox,ListAttached"]
[null,{"$f":"fmAdminOpSrvcDFPM","v":{"$error":"#NAME?"}},false,{"$nulls":5},"58.","","For PPO and POS plan(s), are participants required to submit claim forms and bills:"]
[null,{"$f":"fmAdminOpSrvcAPTOPM","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"59.",""," In-Network","List Box: Yes, No, N/A","drop down box","respPPOSubmitInNet","Listbox,ListYesNoNA"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":5},"18.","a.","Out-of-Network","List Box: Yes, No, N/A","drop down box","respPPOSumbitOutNet","Listbox,ListYesNoNA"]
[{"$nulls":8},"60.","","Out-of-Area","List Box: Yes, No, N/A","drop down box","respPPOSubmitOutArea","Listbox,ListYesNoNA"]
[{"$nulls":8},"61.",null,"At what R&C percentile will out-of-network PPO claims be paid?","Percentage","percent, 1","respPPOPercentRCOutNet","Percent,1"]
[{"$nulls":4},14,{"$nulls":3},"62.","","At what R&C percentile will out-of-network POS claims to be paid?","Percentage","percent, 1","respPOSPercentRCOutNet","Percent,1"]
[{"$nulls":8},"","a.","Can you pay at various R&C percentiles at the direction of the County and APS?","List Box: Yes - See \"Explanation\", No, N/A","drop down box","respDeductibles","Listbox,ListYesExplain"]
[{"$nulls":4},14,{"$nulls":3},"","b.",{"$f":"xfmAdminOpSrvcAPTOPMRspn","v":{"$error":"#NAME?"}},"List Box: Yes - See \"Explanation\", No, N/A","drop down box","respAmountOutOfPocketMax","Listbox,ListYesExplain"]
[{"$nulls":8},"","c.","When customized printing is required, the health plan must present a proof to the County and APS for approval. ","List Box: Yes, No","drop down box","respCustomizedPrintingRequired","Listbox,ListYesNo"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":6},"c.","Plan will provide educational materials in a variety of formats (e.g., print, webinar, video) for open enrollment and other needs",null,"drop down box","respCustomizedPrintingRequired","Listbox,ListYesNo"]
[{"$nulls":8},"63.","","The health plan will pay for printing costs for:"]
[{"$nulls":10},"ID Cards","List Box: Yes, No","drop down box","respIDCards","Listbox,ListYesNo"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":7},"Certificates","List Box: Yes, No","drop down box","respCertificates","Listbox,ListYesNo"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":5},"64.","a.","SPDs","List Box: Yes, No","drop down box","respSPDs","Listbox,ListYesNo",{"$nulls":3},"note: will this apply"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,{"$nulls":6},"b.","Open Enrollment Materials",null,"drop down box","respSPDs","Listbox,ListYesNo"]
[null,{"$f":"fmMultiple","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"65.","","The health plan can provide SPDs in an electronic format.","List Box: Yes, No","drop down box","respSPDFormat","Listbox,ListYesNo"]
[{"$nulls":8},"66.",null,"Plan summaries are available in Spanish.",null,"drop down box","respCustTeleNum","Listbox, ListYNNAExplain"]
[{"$nulls":8},"67.",null,"Educational programs are available in Spanish.",null,"drop down box","respCustTeleNum","Listbox, ListYNNAExplain",{"$nulls":3},"note: does hmo need referral"]
[{"$nulls":9},"a.","The health plan will produce complete SBCs in an electronic format for no additional charge.","List Box: Yes, No","drop down box","respSPDFormat","Listbox,ListYesNo"]
[{"$nulls":8},"","","The health plan will incorporate prescription drug data from the County and APS, should they decide to carve-out the pharmacy program, into the medical plan SBC (produced by your organization) for no additional charge.","List Box: Yes, No","drop down box","respSPDFormat","Listbox,ListYesNo"]
[{"$nulls":7},"","68.","","The health plan agrees that no external communications material that mentions the County's or APS benefit plans may be circulated without written approval from them.. ","List Box: Yes, No","drop down box","respExternalCommunicationMaterial","Listbox,ListYesNo"]
[{"$nulls":8},"69.","","The County and APS (or its representative(s)) reserves the right to audit claims (and/or capitation payments, if applicable) upon reasonable advance notice.","List Box: Yes, No","drop down box","respAuditClaims","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","a.","Indicate your capabilities regarding electronic referrals for all plans requiring physician referral:"]
[{"$nulls":8},"70.",null,"The offeror currently has an electronic referral process.","List Box: Yes, No","drop down box","respDesignSubmitCounty/APSApproval","Listbox,ListYesNo"]
[{"$nulls":7},"","71.","","If no, when will this capability be available","List Box: Yes, No","text","respModifyRatesAdminFee","Text"]
[{"$nulls":7},"","6.","","Offeror can meet COB requirements.","Listbox: Willing; Not Willing","drop down box","respVenCOBReq","Listbox, ListWillingNAExplain"]
[{"$nulls":7},"","72.","","Offeror can handle claims reimbursements through ACH transfers.",null,"drop down box","respDesignSubmitCounty/APSApproval","Listbox,ListYesNo"]
[{"$nulls":7},"","11.","","If no, identify specific banking requirements for claims payment","List Box: Yes, No","text","respModifyRatesAdminFee","Text"]
[{"$nulls":7},"","73.","","All claim records and eligibility data used by the carrier in its role as claim administrator shall remain the property of the County and APS as Plan Sponsor and Plan Administrator.","List Box: Yes, No","drop down box","respClaimRecordsEligibilityData","Listbox,ListYesNo"]
[{"$nulls":7},"","74.","","Each of your networks serving the County and  APS members is supported by a computerized, on-line direct access claims processing system containing plan/claim information storage and retrieval.","Listbox: Yes; No","drop down box","respNetServClmProcSys","Listbox, ListYNNAExplain"]
[{"$nulls":8},"75.",null,"","Listbox: Yes; No","drop down box","respSysReqNoManOper","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","76.","","Are all of your internal systems integrated (e.g., claims payment, medical and behavioral health eligiblity, and customer service)?","Listbox: Yes; No","drop down box","respClmSysMainOnline","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","77.",null,"The claims system maintains on-line eligibility files that are updated at least weekly.","Listbox: Yes; No","drop down box","respClmSysMainOnline","Listbox, ListYNNAExplain"]
[{"$nulls":8},"79.","","The claims system maintains dependent eligibility files.","Listbox: Yes; No","drop down box","respClmSysMainDep","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","80.","","Confirm the County and APS may add employee eligiblity online for emergencies and new participants.  Confirm these changes would not be overwritten by the next file feed..  ","Listbox: Yes; No","drop down box","respCOBDataUpdateAnn","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","78.","a.","How are retroactive terminations handled and what is your process for collecting and crediting any claims that were paid after termination?","List Box: Yes, No","text","respModifyRatesAdminFee","Text"]
[{"$nulls":7},"",null,"b.","The claims system automatically screens for duplicate bills.","Listbox: Yes; No","drop down box","respClmSysDupBill","Listbox, ListYNNAExplain"]
[null,{"$f":"AND(fmMeasurePerformance,IF(OR(TRIM(fmAdminOpRqtMsrmntMonth1)<>\"\",TRIM(fmAdminOpRqtMsrmntYear1)<>\"\"),TRUE,FALSE))","v":{"$error":"#NAME?"}},false,{"$nulls":7},"What is your contingency plan in the event that the proposed customer service center is off-line/down?",null,"text","respClmOffPropProc","Text"]
[null,{"$error":"#NAME?"},false,{"$nulls":7},"You agree to provide full claim fiduciary services","List Box: Yes, No - See Explanation","drop down box","respPropIssue","Listbox,ListYesNoSeeExplain",{"$nulls":3},"note: any update "]
[null,{"$error":"#NAME?"},{"$nulls":6},"79.","","Describe the appeals process flow in detail, explaining what is included in the fiduciary services.","Text","text","respOutAreaEmerg","Text"]
[null,{"$error":"#NAME?"},{"$nulls":7},"a.","What is the process of handling uncashed (outstanding) checks?",null,"text","respClmOffPropProc","Text"]
[null,{"$error":"#NAME?"},{"$nulls":6},"","","The above described service is at no additional cost.",null,"drop down box","respCOBDataUpdateAnn","Listbox, ListYNNAExplain"]
[null,{"$error":"#NAME?"},{"$nulls":6},"",""]
[{"$nulls":7},"","",null,"At least 90% of telephone calls to member services were answered within 20 seconds.","List Box: Met, Not Met","drop down box","respFinDollarAccuracy4","Listbox,ListMetNotMet"]
[{"$nulls":7},"",null,"b."]
[{"$nulls":7},"","",null,"Subcontracted Services",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":7},"",null,"c.","Indicate if you: (1) changed any of your subcontracted service providers in the last 12 months; (2) are planning any changes in your subcontracted arrangements during the upcoming 12 months; (3) N/A - Services not changed or planned to change; or (4) N/A - Service Not Subcontracted. For services where subcontractor was either changed or planned to be changed, please provide the name of the new service provider in the space provided below."]
[{"$nulls":7},"","",null,"Customer service","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"d.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Retiree Direct Billing and Supplement Administration","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"e.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Large Case Management","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"f.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Utilization Management","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"g.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Provider quality data ","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"h.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"24/7 nurse-line","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"i.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Organ Transplant Networks","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"j.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Coordination of Benefits","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"k.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":7},"","",null,"Behavioral Health Network and Intake Services","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"",null,"l.","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmPenaltyMeet,fmPenaltyFee))","v":{"$error":"#NAME?"}},false,{"$nulls":4},"","",null,"Claims Administration","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":8},"","","Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":8},"","","Provider Credentialing","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":7},"VI.","",null,"Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":8},"","c.","Other","ListSubcontractServ: Changed/Last 12; Planned/Next 12; N/A - No Changes; N/A - Not Subcontracted","drop down box","respPlanMergAcq","Listbox,ListSubcontractServ"]
[{"$nulls":8},"1.",null,"Name of new subcontracted service provider","Text","text","respPlanMergAcq","Text"]
[{"$nulls":8},"2."]
[{"$nulls":7},"","","a."]
[{"$nulls":7},"","","b.","HEALTH MANAGEMENT/ WELLNESS SERVICES INFORMATION",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":9},"c.","","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","drop down box","respCaseClose","Listbox, ListCompletedNAExplain"]
[{"$nulls":9},"d.","Vendor agrees to provide County/APS an annual allowance for additional Health Management and/or Wellness programs that are not already included in the medical plan administration fee.","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":9},"e.","If you answered yes to the above question, provide the dollar amount of the allowance FOR EACH ENTITY, confirm that it is an annual allowance, and describe any limitations on how the County/APS may use it.","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet"]
[{"$nulls":8},"3.",null,"County Annual Allowance",null,"text","respAddChargeCustReport","Text"]
[{"$nulls":8},"4.",null,"APS  Annual Allowance",null,"text","respAddChargeCustReport","Text"]
["Yes- included in admin fee",{"$nulls":3},"check listbox function",null,null,"","5.",null,"County/APS Annual Allowance",null,"text","respAddChargeCustReport","Text"]
["Yes- for an extra charge",{"$nulls":7},"","a.","County/APS Annual Allowance",null,"text","respAddChargeCustReport","Text"]
["Not available",{"$nulls":6},"",null,"b.","County/APS Annual Allowance",null,"text","respAddChargeCustReport","Text"]
[{"$nulls":7},"",null,"c.","What health risk assessment does your Wellness program use? ",null,"text","respAddChargeCustReport","Text"]
[{"$nulls":7},"",null,"d.","Vendor agrees to meet with County/APS to discuss Health Management and/or Wellness program performance and outcomes semi-annually.","Listbox: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"",null,"e.","For each of the following services, indicate whether the service is included in your quoted administration fee (or insured rates).  If available for an additional charge, indicate in Explain, and provide cost in financial quote worksheet).  Indicate \"N\" if service is not available."]
[{"$nulls":7},"",null,"f.","Pre-notification services (pre-certification, concurrent review, outpatient/alternate care review, discharge planning, case management identification)","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","g.","Large case management","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"",null,"h.","Utilization review","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","i.","Disease management","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","j.","Maternity management","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","k.","24 hour nurseline/triage","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","l.","Health and Wellness Portal",null,"drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","m.","Online Wellness Programs","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":10},"Telephonic Wellness/Lifestyle Coaching",null,"drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","","","Health Risk Assessments",null,"drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[{"$nulls":8},"6.",null,"Onsite Biometric Screenings",null,"drop down box","respAnyServSubCont","Listbox, ListYNNAExplain"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMFullPPO,fmMSIPPO,fmSSIPPO,fmMFullPOS,fmMSIPOS,fmSSIPOS))","v":{"$error":"#NAME?"}},false," ",{"$nulls":4},"7.",null,"3-5 one hour health presentation annually",null,"text","respAddChargeCustReport","Text"]
[{"$nulls":8},"8.","","Other (please explain)",null,"text","respAddChargeCustReport","Text"]
[{"$nulls":8},"",""]
[null,{"$f":"OR(fmAttSuggestEmployerContract,fmAttAnnRpt,fmAdtFnclStmt,fmCnvrsnSrvc,fmAttAppealGrievance,fmAttMarketing,fmAttIDCard,fmAttMemberEnroll)","v":{"$error":"#NAME?"}},false,{"$nulls":4},"VI.","","","Evidence Based Plans",null,"Answer Format",null,"Format Type","Response","Explanation"]
[null,{"$f":"fmAttSuggestEmployerContract","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","Describe your capabilities to track and report member compliance with evidence based care guidelines around preventive screenings and chronic condition management.","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","text","respAddChargeCustReport","Text"]
[null,{"$f":"fmAttAnnRpt","v":{"$error":"#NAME?"}},false,{"$nulls":5},"1.","","Are you able to provide different benefit levels based on compliance and non-compliance (i.e. value based plan designs where members who are compliant may pay no or reduced co-pay)?","Listbox: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet","drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"2.","","Do you provide reminders to members and/or providers for identified gaps in evidence based guideline compliance?\n",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"3.",""]
[{"$nulls":8},"4.","","Behavioral Health Capabilities","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"5.","","Please provide the following information in electronic format and name the file as specified:"]
[{"$nulls":8},"6.","","There is a behavioral health triage system in place, operational 24-hours/7-days a week and staffed by behavioral health professionals with at least a master’s degree, to direct members to appropriate levels of mental health or substance abuse care.","List Box: Attached, Not Attached","drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"7.","","Urgent problem visits are available within 24-hours.","List Box: Attached, Not Attached","drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"8.","","Health plan members have access to a range of alternative behavioral health services; including, residential treatment, partial hospitalization, halfway houses, intensive outpatient care, and home therapy.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"9.","","The network has a multidisciplinary mixture of board-certified psychiatrists, independently licensed doctoral psychologists, and master’s-level clinicians.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"10.","","Offeror establishes standards for the number and geographic distribution of behavioral healthcare practitioners; including, psychiatrists, psychologists, clinical social workers, psychiatric nurses, and other behavioral healthcare specialists.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"11.",null,"Offeror has established standards for timeliness of routine and urgent care, behavioral healthcare appointments, and access to after-hours care",null,"drop down box","respProvideCoverage","Listbox,ListYesNo",{"$nulls":3},"where is VII"]
[{"$nulls":8},"","","Offeror monitors responsiveness of member services or appointment telephone lines.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo",{"$nulls":3},"hid - VIII - Medicare Supplemental plans.  Delete?"]
[{"$nulls":7},"","",null,"To make UM decisions, Offeror uses written utilization review criteria for determination of clinical appropriateness.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":7},"","",null,"",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":7},"VIII.","","","Written policies and procedures address the types of practitioners accepted to participate in the network; including, psychiatrists and/or physicians who are certified in addiction medicine, doctoral and/or master's level psychologists who are state-certified or state-licensed, master's level clinical social workers who are state-certified or state-licensed, and master's level clinical nurse specialists who are nationally- and/or state-licensed to practice independently.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":7},"","","","The County and APS have an in-house EAP program.  The Offeror must be willing to coordinate treatment with County and APS EAP staff.",null,"drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":7},"","1.",""]
[{"$nulls":7},"","2.",""]
[{"$nulls":7},"","3.","","Medicare Supplemental Plans"]
[{"$nulls":7},"","4.","","Administrative Capabilities"]
[{"$nulls":7},"","5.","","This section asks offerors to describe their member services, results and management process, as well as their administrative/systems capabilities. "]
[{"$nulls":7},"","1.","","","Listbox: Willing; Not Willing","drop down box","respAccomDepColl","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","2.","","Affirm that you can provide the reports described in Section 4.0 of the RFP.","Listbox: Willing; Not Willing","drop down box","respAccomDepColl","Listbox, ListYNNAExplain"]
[{"$nulls":7},"","3.","","Include a complete list of the standard reports you can provide to the County/APS to demonstrate you are meeting the Standards of Performance as described in Section 3.0.  [Your Organization's Name]_Exhibit 2","Listbox: Willing; Not Willing","drop down box","respAttMarkMat","Listbox, ListAttachedNAExplain"]
[{"$nulls":7},"","4.","","","Listbox: Willing; Not Willing","drop down box","respAccomDepColl","Listbox, ListYNNAExplain"]
[{"$nulls":8},"4.","","","Listbox: Willing; Not Willing","drop down box","respAccomDepColl","Listbox, ListYNNAExplain"]
[{"$nulls":8},"5.",null,"Confirm that you can you offer direct billing services","Listbox: Willing; Not Willing","drop down box","respAccomDepColl","Listbox, ListYNNAExplain"]
[{"$nulls":8},"","","If you answered Yes to the question above, briefly describe your direct billing capabilities.","Listbox: Willing; Not Willing","text","respOutAreaEmerg","Text"]
[{"$nulls":8},"","","How you will administer the billing for retirees who qualify for the low income subsidy?","Listbox: Willing; Not Willing","text","respOutAreaEmerg","Text"]
[{"$nulls":8},"6.","","Briefly describe your ongoing enrollment procedures.  Do you recommend a specific process for new retirees who “age in” to the Medicare program?","Listbox: Willing; Not Willing","text","respOutAreaEmerg","Text"]
[{"$nulls":8},"","","","List Box: Completed, Not Completed","drop down box","respReviewDeviations1","Listbox,ListCompleted"]
[{"$nulls":8},"","","Confirm you are quoting administrative services that will integrate with Medicare following the Standard Coordination/Supplemental coordination of benefits platform to match current",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"",""]
[{"$nulls":8},"","","Medicare Advantage, Medi-Gap and/or other Fully Insured Medicare Carve-out Retiree Plans","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":8},"","","County/APS does not currently offer an Insured Carve-out plan.  However, they may consider providing retirees with a Medi-Gap or MA type Medical/Rx plan in the future.  Indicate whether you have the ability to offer a comprehensive Medicare Advantage and/or Carve-out type plan.","List Box: Completed, Not Completed","drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"","","Are you proposing a Medicare Advantage PPO Plan?",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"","","If yes, can you offer a single set of rates regardless of where retirees reside?",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"","","Are you proposing a MediGap or other Medicare Plan?",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"7.","","If yes, can you offer a single set of rates regardless of where retirees reside?",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"8.","","Are there minimum contribution requirements? If so, provide details.",null,"text","respOutAreaEmerg","Text"]
[{"$nulls":8},"9.","","Briefly describe your ongoing enrollment procedures.  Do you recommend a specific process for new retirees who “age in” to the Medicare program?",null,"text","respOutAreaEmerg","Text"]
[{"$nulls":7},"","10.",null,"Vendor has experience coordinating with Medicare",null,"drop down box","respAccEligInfoElect","Listbox, ListYNNAExplain"]
[{"$nulls":8},"11.",null,"Provide information on whether the coordination process is streamlined for the member and specifically indicate the retiree's responsibility in the process.",null,"text","respOutAreaEmerg","Text"]
[{"$nulls":7},"","12.",null,"","List Box: Attached, Not Attached","text","respOutAreaEmerg","Text"]
[{"$nulls":9},"a.","Provide plan design information on the plans you offer that include medical and prescription drug.  County/APS would most likely consider plans that provided a benefit level similar to the current plans offered to retirees.  Please limit the plan designs you provide to three (3) that you feel most closely represent a high level of benefits and include prescription drug.  Provide this information as a separate attachment labeled: [Your organization's name]_ C-6 MA Insured Retiree Plan designs.","List Box: Attached, Not Attached","drop down box","respConciseDescp","Listbox,ListAttached"]
[{"$nulls":9},"b.","","List Box: Attached, Not Attached","drop down box","respConciseDescp","Listbox,ListAttached"]
[{"$nulls":7},"",null,"c.","Discuss how members will be able to locate providers accepting your insured program","ListCompletedNAExplain: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respOutAreaEmerg","Text"]
[{"$nulls":7},"","13.",null,"Provide information on the history of the plans you offer.  Include when plans first became available and any changes in plan offerings since inception.  Also include information on previous plans offered that have since terminated.","ListCompletedNAExplain: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respOutAreaEmerg","Text"]
[{"$nulls":9},"a.","Provide enrollment history for the plan you are quoting for the following calendar years:","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAvgDropRatePrgPart","Listbox,ListYNYesExplain"]
[{"$nulls":9},"b.",2011,null,"text","respOutAreaEmerg","Text"]
[{"$nulls":7},"",null,"c.",2012,null,"text","respOutAreaEmerg","Text"]
[{"$nulls":7},"","14.",null,"2013 (current enrolled)","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respOutAreaEmerg","Text"]
[{"$nulls":8},"","","Provide rate increase history for the plan you are quoting for the following calendar years:","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","drop down box","respAvgDropRatePrgPart","Listbox,ListYNYesExplain",{"$nulls":3},"unhid - IX  Legal/Contractual considerations"]
[{"$nulls":7},"IX.","","",2011,null,"percent, 1","respPercentFeeRisk1","Percent,1",{"$nulls":3},"note: update County/APS"]
[{"$nulls":8},"1.","",2012,null,"percent, 1","respPercentFeeRisk2","Percent,1"]
[{"$nulls":8},"","","2013 (current enrolled)","ListYNNAExplain: Yes; No; Not Applicable; No - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","percent, 1","respPercentFeeRisk3","Percent,1"]
[{"$nulls":8},"","a.","In 200 words or less, please convey your intentions to continue to offer these insured products.  Please describe how they fit into your organization’s strategic plan.","ListCompletedNAExplain: Completed; Not Completed; Not Applicable; Not Completed - See \"Explanation\" Worksheet; Not Applicable - See \"Explanation\" Worksheet; See \"Explanation\" Worksheet","text","respOutAreaEmerg","Text",{"$nulls":3},"note: update County/APS "]
[{"$nulls":4},14,{"$nulls":3},"",""]
[{"$nulls":8},"2.","","LEGAL/CONTRACTUAL CONSIDERATIONS","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":4},1,{"$nulls":3},"3.",null,"Please confirm that your organization has complied with all state insurance department filing requirements for all plans/products being offered in this quote in each state in which County/APS has employees.","List Box: Yes, No","drop down box","respAnalyzeDataMeet","Listbox,ListYesNo"]
[{"$nulls":4},7,{"$nulls":4},"",""]
[{"$nulls":4},14,{"$nulls":4},"","","Text","text","respReference1g","Text",{"$nulls":3},"note: are they on a CY PY"]
[{"$nulls":9},"","We understand that terminology and contract provisions may vary from vendor to vendor.  We will permit such alternative language provided they are reviewed and approved by County/APS."]
[{"$nulls":4},1,{"$nulls":3},"4.",null,"","List Box: Yes, No","drop down box","respContractIssued","Listbox,ListYesNo"]
[{"$nulls":4},7,{"$nulls":4},"","County"]
[{"$nulls":4},14,{"$nulls":4},"","July 1, 2021 will be the contract effective date.","List Box: Yes, No","drop down box","respEffectiveDate","Listbox,ListYesNo",{"$nulls":3},"Note; update PY"]
[{"$nulls":4},14,{"$nulls":4},"","July 1 is the anniversary date.","List Box: Yes, No","drop down box","respAnnDate","Listbox,ListYesNo",{"$nulls":3},"where is?"]
[null,{"$f":"OR(fmSFullHMO,fmSFullPPO,fmSFullPOS,fmMFullHMO,fmMFullPPO,fmMFullPOS)","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"5.","","","List Box: Yes, No","drop down box","respERISA","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,null,14,{"$nulls":3},"6.","","APS"]
[{"$nulls":8},"7.","","July 1, 2021 will be the contract effective date.","List Box: Yes, No","drop down box","respEffectiveDate","Listbox,ListYesNo",{"$nulls":3},"review"]
[{"$nulls":8},"8.",null,"July 1 is the anniversary date.","List Box: Yes, No","drop down box","respAnnDate","Listbox,ListYesNo"]
[{"$nulls":8},"9.","","","List Box: Yes, No","drop down box","respERISA","Listbox,ListYesNo"]
[{"$nulls":8},"10.","","Vendor agrees to the mandatory Procurement language of each Agency as provided in accompanying RFP Procurement documents.  Vendor understands that failure to agree to mandatory provisions will result in vendor's proposal not being considered.","List Box: Yes, No","drop down box","respERISA","Listbox,ListYesNo"]
[null,{"$f":"NOT(fmSIOnly)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"11.","","County/APS reserves the right to terminate its contract on any monthly adminstrative fee due date, provided such notification is given at least 30 days in advance","List Box: Yes, No","drop down box","respTerminateContract","Listbox,ListYesNo",{"$nulls":3},"note: keep?"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"12.","",{"$f":"\"For self-insured coverages, County/APS reserves the right to terminate its contract at any time provided such notification is given at least 30 days in advance.\"","v":"For self-insured coverages, County/APS reserves the right to terminate its contract at any time provided such notification is given at least 30 days in advance."},"List Box: Yes, No","drop down box","respTerminateContract","Listbox,ListYesNo"]
[{"$nulls":8},"13.","","Vendor agrees to provide SSAE 16 reports to County/APS annually, as performed, or as requested by County/APS auditors?",null,"drop down box","respTerminateContract","Listbox,ListYesNo",{"$nulls":3},"Note: ?"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"14.","","There will be no restrictions or benefit limitations for pre-existing conditions applied to any employees or their dependents under the plan.","List Box: Yes, No","drop down box","respNoRestrict","Listbox,ListYesNo"]
[{"$nulls":8},"15.","","Health plan must unconditionally agree to provide coverage to all present participants (employees and eligible dependents) enrolled on the program effective date.","List Box: Yes, No","drop down box","respProvideCoverage","Listbox,ListYesNo"]
[{"$nulls":8},"16.","","Employees who are not actively at work due to disablement on the program effective date will be covered. ","List Box: Yes, No","drop down box","respDisablement","Listbox,ListYesNo"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"18.","","The vendor must agree to transfer to the County and to APS, within 30 days of notice of termination, all required data and records necessary to administer the plans subject to state and federal confidentiality considerations.  The transfer may be made electronically, in a file format to be determined based on the mutual agreement between the County/APS and the provider of services.","List Box: Yes, No","drop down box","respTransfer","Listbox,ListYesNo",{"$nulls":3},"note: update County/APS"]
[{"$nulls":8},"19.","","The County/APS will neither recognize the appointment of any agent, general agent or broker by a respondent to these bid specifications nor authorize any payment or remuneration of any kind by a health plan to a party not approved in writing by the County/APS.","List Box: Yes, No","drop down box","respAppointment","Listbox,ListYesNo"]
[{"$nulls":8},"20.","","If requested, the health plan agrees to assume claim fiduciary responsibilities including appeals and defense of \"utilization review\" decisions.","List Box: Yes, No","drop down box","respClaimFiduciaryResponsibilites","Listbox,ListYesNo"]
[{"$nulls":8},"","a.","Vendor agrees to provide necessary legal defense in the event of litigation.","List Box: Yes, No","drop down box","respLitigation","Listbox,ListYesNo"]
[{"$nulls":8},"","","Vendor agrees to cover all costs associated with legal defense in the event of litigation.","List Box: Yes, No","drop down box","respCoverCostLit","Listbox,ListYesNo"]
[{"$nulls":8},"","","Vendor agrees to prepare and file all legal documents necessary to implement and maintain the plan, including policies, amendments, contracts, required state filings, and development of booklet/certificate formats.","List Box: Yes, No","drop down box","respPrepareFileLegalDocuments","Listbox,ListYesNo"]
[{"$nulls":8},"","b.","Vendor agrees to monitor federal and state legislation affecting the delivery of medical benefits under the plan and to report to County/APS on those issues in a timely fashion prior to the effective date of any mandated plan changes.","List Box: Yes, No","drop down box","respFederalStateLegislation","Listbox,ListYesNo"]
[{"$nulls":8},"","","Indicate which conversion plans are offered post-COBRA coverage; if offered, indicate the name of insuring entity."]
[{"$nulls":8},"","","HMO"]
[{"$nulls":8},"","c.","Offered/Not Offered?","List Box: Offered, Not Offered","drop down box","respOfferNotOffer1","Listbox,ListNameInsureEntity"]
[{"$nulls":8},"","","Name of Insuring Entity","Text","text","respEntity1","Text"]
[{"$nulls":8},"","","POS"]
[{"$nulls":8},"","d.","Offered/Not Offered?","List Box: Offered, Not Offered","drop down box","respOfferNotOffer2","Listbox,ListNameInsureEntity",{"$nulls":3},"Note: keep all"]
[{"$nulls":8},"","","Name of Insuring Entity","Text","text","respEntity2","Text"]
[{"$nulls":8},"","","PPO"]
[{"$nulls":8},"","e.","Offered/Not Offered?","List Box: Offered, Not Offered","drop down box","respOfferNotOffer3","Listbox,ListNameInsureEntity"]
[{"$nulls":8},"","","Name of Insuring Entity","Text","text","respEntity3","Text"]
[{"$nulls":8},"","","Indemnity"]
[{"$nulls":8},"21.","","Offered/Not Offered?","List Box: Offered, Not Offered","drop down box","respOfferNotOffer3","Listbox,ListNameInsureEntity"]
[{"$nulls":8},"22.","","Name of Insuring Entity","Text","text","respEntity3","Text",{"$nulls":3},"note: same date?"]
[{"$nulls":8},"23.","","EPO"]
[{"$nulls":9},"a.","Offered/Not Offered?","List Box: Offered, Not Offered","drop down box","respOfferNotOffer3","Listbox,ListNameInsureEntity"]
[{"$nulls":9},"b.","Name of Insuring Entity","Text","text","respEntity3","Text"]
[null,{"$f":"AND(fmPerformStandInclude,OR(fmMSIHMO,fmMSIPPO,fmMSIPOS))","v":{"$error":"#NAME?"}},false,{"$nulls":6},"c.","","List Box: Yes, No","drop down box","respHoldHarm","Listbox,ListYesNo"]
[{"$nulls":8},"","","","List Box: Yes, No","drop down box","respNetRelatedLitig","Listbox,ListYesNo",{"$nulls":3},"duplicate?"]
[{"$nulls":7},"V.","","","Effective for claims filed on or after 7/1/2014, Vendor certifies that it will comply with the Department of Labor's final claims procedure regulations, including:"]
[{"$nulls":3}," ",{"$nulls":4},"1.","","The notice requirements for improper and incomplete claims","List Box: Yes, No","drop down box","respReqImpInc","Listbox,ListYesNo",{"$nulls":3},"?"]
[{"$nulls":3}," ",{"$nulls":4},"","","The appropriate timeframes for adjudicating urgent, pre-service and post-service claims","List Box: Yes, No","drop down box","respAdjUrgent","Listbox,ListYesNo"]
[{"$nulls":9},"a.","The appropriate timeframes for notice of appeal decisions.","List Box: Yes, No","drop down box","respNoticeAppDec","Listbox,ListYesNo"]
[{"$nulls":8},"2.",""]
[{"$nulls":8},"3.","","LEGAL/CONTRACTUAL CONSIDERATIONS","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[{"$nulls":3}," ",{"$nulls":4},"4.","","We understand that terminology and contract provisions may vary from vendor to vendor.  We will permit such alternative language provided they are reviewed and approved by County/APS.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respAnalyzeDataMeet","Listbox,ListYNNANoExplain"]
[{"$nulls":3}," ",{"$nulls":4},"","a.",""]
[{"$nulls":8},"5.","","","Text","text","respReference1g","Text"]
[{"$nulls":9},"a.","Vendor is bonded.",null,"drop down box","respVendorBond","Listbox,ListYesExempt"]
[{"$nulls":9},"b.","Vendor maintains a fidelity bond as required by ERISA.",null,"drop down box","respFidelity","Listbox,ListYesExempt"]
[{"$nulls":9},"c.","Vendor maintains professional liability insurance that exceeds $5 million per claim and $20 million aggregate. ","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respMaintCmpGenLia","Listbox,ListYNNANoExplain"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"6.","","If not, please explain amount of coverage.","Text","text","respCoverage","Text",{"$nulls":3},"it will be self funded"]
[{"$nulls":8},"7.","","Liability insurance covers:",null,null,"respLiabilityInsur"]
[{"$nulls":8},"8.","","Medical management decisions.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respMedicalManage","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"9.","","Professional malpractice","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respMalpractice","Listbox,ListYNNANoExplain"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"10.","","Provider contracting","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respProvider","Listbox,ListYNNANoExplain",{"$nulls":3},"n/a?"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"11.","","Please describe any judgment or settlement during the past three years or pending litigation that could result in judgments or settlements in excess of $100,000.","Text","text","respLitigat1","Text"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":6},"a.","If self-funded option is offered, vendor will act as plan fiduciary, if requested.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respClaimFiduciaryResponsibilites","Listbox,ListYNNANoExplain"]
[{"$nulls":9},"b.","The vendor maintains executed contracts with all providers participating in the network.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respVendorNet","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"12.","","The vendor provider contracts do not provide for any type of remuneration to your organization, such as commission, finder's fee, rebate, or other financial benefit.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respRemuneration","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"13.","","Your organization is not a creditor of any provider in the network.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respCredit","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","Provide treaty details of any ceded risk. If you need more space, please use the \"Explanation\" column and/or Worksheet. ","Text","text","respTreatyRisk","Text",{"$nulls":3},"start here"]
[{"$nulls":8},"15.","","Vendor agrees to prepare and file all legal documents necessary to implement and maintain the plan, including policies, amendments, contracts, and required state filings.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respPrepareFileLegalDocuments","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"16.","","Vendor agrees to provide necessary legal defense in the event of litigation, including all costs inuring thereto.","Listbox,ListYesNo: Yes; No; No - See \"Explanation\"; N/A","drop down box","respLitigation","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"17.","","Vendor agrees to indemnify and hold The County/APS harmless for Vendor’s negligence or for Vendor’s failure to perform under the Agreement.  The County/APS shall not provide any indemnity in favor of the Vendor.  Vendor agrees to language contained in worksheet \"Hold Harmless\".","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respHoldHarm","Listbox,ListYNNANoExplain",{"$nulls":3},"duplicate"]
[{"$nulls":8},"18.","",{"$nulls":8},"duplicate"]
[{"$nulls":8},"19.",null,"Contractual",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"20.",null,{"$f":"TEXT(fmPrgEffDate,\"mmmm dd, yyyy\")&\" is to be the contract effective date.\"","v":{"$error":"#NAME?"}},"Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respEffectiveDate","Listbox,ListYNNANoExplain",{"$nulls":3},"duplicate"]
[{"$nulls":8},"21.",null,{"$f":"\"The contract will be issued in \"& fCounty/APSontractSitus &\" unless you obtain permission from Aon Consulting to use an alternative situs.\"","v":{"$error":"#NAME?"}},"Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respContractIssued","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"22.",null,{"$f":"tPlanYearEffMonth & \" \" & fmPlanYearEffDay& \" will be the first contract anniversary date.\"","v":{"$error":"#NAME?"}},"Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respAnnDate","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"23.",null,"The vendor agrees not to appoint any agent, general agent, or broker, nor authorize payment of any kind to a party not approved in writing by The County/APS.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respAppointment","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"24.",null,"We understand that terminology and contract provisions may vary among the involved vendors. We will permit such alternative language provided benefit payment levels are not adversely impacted.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respTerminology","Listbox,ListYNNANoExplain"]
[null,{"$f":"fmAttSuggestEmployerContract","v":{"$error":"#NAME?"}},false,{"$nulls":5},"25.",null,"The vendor shall cause The County/APS and its welfare program to be the named insured thereunder.  The vendor shall provide proof of such insurance to The County/APS at or prior to the execution of the contract. ","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respWelfareProgram","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"26.",null,"There will be no restrictions or benefit limitations for pre-existing conditions applied to any members enrolled in the plan/program at any time. ","Listbox,ListYesNo: Yes; No; No - See \"Explanation\"; N/A","drop down box","respNoRestrict","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respProvideCoverage","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respDisablement","Listbox,ListYNNANoExplain"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"","","No statement of health or medical evidence will be imposed upon the [initial group of covered participants].","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respMedEvidence","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"27.",null,"Any disabled employees (or enrolled dependents) or other leave-of-absence employees who are inadvertently not disclosed in these specifications or who later are identified as eligible for  benefits with the incumbent vendor will become the liability of the vendor selected through this marketing.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respDisabledEmploy","Listbox,ListYNNANoExplain",{"$nulls":3},"apply to SI"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"28.",null,"Please include a copy of a sample employer contract that includes all exclusions and limitations that the vendor expects will apply to \"&fCounty/APSlientName & \".  Name the file:  [Your Organization Name]_Sample Employer Contract.","Listbox, ListProvideNA:Provided, Not Provided,N/A, Not Provided - See \"Explanation\"","drop down box","respSugEmpContrtact","Listbox, ListProvideNA ",{"$nulls":3},"remove?"]
[null,{"$f":"OR(fmMSIHMO,fmMSIPPO,fmMSIPOS,fmSSIHMO,fmSSIPPO,fmSSIPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"29.",{"$nulls":9},"duplicate"]
[{"$nulls":8},"30.",""]
[{"$nulls":8},"","","Future Contract Termination",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"31.",null,{"$f":"\"The County/APS shall have the right, in its sole and absolute discretion and without the payment of any penalty, to terminate the contract in whole or in part at any time during the term thereof upon \" & fmTermNotifyDate & \" days prior written notice to vendor.\"","v":{"$error":"#NAME?"}},"Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respTermContract","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","",{"$f":"\"The vendor selected during this proposal process must agree to transfer to \"& fCounty/APSlientName & \", \" & \"within \" & fmTermNotifyDate &\" days of notice of termination, all required data and records necessary to administer the plan(s)/program(s),\" & \" subject to state and federal confidentiality considerations.  The transfer may be made electronically, \" & \"in a file format to be determined based on the mutual agreement between \"& fCounty/APSlientName & \" and the vendor.\"","v":{"$error":"#NAME?"}},"Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respTransfer","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"",null,"Compliance, General",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"34.","","Vendor agrees that it will honor repayment demands or requests for reimbursement that are made within the 3-year period for Medicare to recover improper payments. ","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respReimbursement","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"35.","","The vendor agrees to comply with the Department of Labor's final claims procedure regulations, including the appropriate timeframes for adjudicating claims and notice of appeal decisions.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respComply","Listbox,ListYNNANoExplain"]
[{"$nulls":9},"a.","Vendor will provide participants with annual notice that the plan provides for coverage for breast reconstruction following mastectomy.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respVenProAnnNotice","Listbox,ListYNNANoExplain"]
[{"$nulls":9},"b.",{"$nulls":8},"?"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"36.","","Compliance, HIPAA","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"37.",null,"You maintain a dedicated individual or staff responsible for resolving HIPAA issues.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respHIPAA","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"38.","","Vendor certifies that it will comply with the interim final rules on nondiscrimination in the group health market, including:"]
[{"$nulls":8},"39.","","Coverage for self-inflicted injuries for persons who suffer from medical conditions (such as depression)","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respCovSelfInjury","Listbox,ListYNNANoExplain"]
[null,{"$f":"OR(fmMFullHMO,fmMFullPPO,fmMFullPOS,fmSFullHMO,fmSFullPPO,fmSFullPOS)","v":{"$error":"#NAME?"}},false,{"$nulls":5},"40.","","Coverage for persons who are hospital-confined or not actively at work when coverage would otherwise take effect.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respCovHospConfine","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","Vendor certifies that it reports to the national Healthcare Integrity and Protection Databank (HIPDB) as required and, as may be necessary, submits inquiries to the HIPDB to determine whether any final adverse legal actions have been taken against its member providers.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respVenCertReport","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","Vendor certifies that, if it conducts Standard Transactions, it is in full compliance with HIPAA's administrative simplification standards relating to electronic data interchange (EDI).","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respVenNecSysCap","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"41.",null,"Vendor will not require that enrollment and eligibility information electronically transmitted by County/APS to Vendor comply with EDI.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respVenReqPro","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"42.",null,"Vendor certifies that it is in full compliance with HIPAA's regulations protecting the privacy of individually identifiable health information.","List Box: Yes, No","drop down box","respVenNotReqEnroll","Listbox,ListYesNo"]
[{"$nulls":8},"43.","","Vendor agrees to provide the Consultant/Broker access to protected health information under the employer's health plan if the Consultant/Broker executes a Business Associate Agreement with the health plan.","List Box: Yes, No","drop down box","respVenRegProtectPriv","Listbox,ListYesNo"]
[{"$nulls":4},1,null,null,"","44.",""]
[{"$nulls":4},14,{"$nulls":3},"45.","","Compliance, Privacy and Confidentiality",null,"Answer Format",null,"Format Type","Response","Explanation"]
[{"$nulls":8},"46.",null,"The vendor agrees to make internal practices, books, and records relating to the use and disclosure of PHI received from, or created or received by organization  available to the Secretary of the Department of Health and Human Services for purposes of the Secretary of the Department of Health and Human Services determining organization’s compliance with the privacy rules.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"47.","","The vendor adopts and implements written confidentiality policies and procedures in accordance with applicable law to ensure the confidentiality of member information used for any purpose.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"48.","","The vendor will not use or further disclose protected health information (PHI) other than as permitted or required by the Business Associate Agreement or as required by law.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"49.","","The vendor agrees to use appropriate safeguards to prevent the unauthorized use or disclosure of the PHI.  Vendor agrees to report to the plan sponsor any unauthorized use or disclosure of the PHI.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"50.","","The vendor agrees to mitigate, to the extent practicable, any harmful effect that is known to vendor of a use or disclosure of PHI by vendor in violation of the requirements of the federal privacy rule.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"51.",null,"The vendor agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received from, or created or received by the vendor agrees to the same restrictions and conditions that apply to vendor with respect to such information.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"52.",null,"The vendor agrees to provide access to PHI in a \"designated record set\" in order to meet the requirements under 45 CFR §164.524.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":10},"The vendor agrees to make any amendment(s) to PHI in a \"designated record set\" pursuant to 45 CFR §164.526.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"",null,"The vendor agrees to document such disclosures of PHI and information related to such disclosures as would be required to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 CFR §164.528.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"53.",null,"The vendor agrees to (i) implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic PHI that it creates, receives, maintains, or transmits, (ii) report to the plan sponsor any security incident (within the meaning of 45 CFR § 164.304) of which vendor becomes aware, and (iii) ensure that any vendor employee or agent, including any subcontractor to whom it provides PHI received from, or created or received by the vendor agrees to implement reasonable and appropriate safeguards to protect such PHI.","Listbox,ListYNNANoExplain: Yes; No; No - See \"Explanation\"; N/A","drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[{"$nulls":8},"","","PHI is owned by the County or APS for self-insured plans.",null,"drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[null,{"$f":"OR(fmAttSuggestEmployerContract,fmAttAnnRpt,fmAdtFnclStmt,fmCnvrsnSrvc,fmAttAppealGrievance,fmAttMarketing,fmAttIDCard,fmAttMemberEnroll)","v":{"$error":"#NAME?"}},false,{"$nulls":4},"X.",null,"","County or APS have access to PHI upon request.",null,"drop down box","respIncentiveWS","Listbox,ListYNNANoExplain"]
[null,{"$f":"fmAttSuggestEmployerContract","v":{"$error":"#NAME?"}},false]
[null,{"$f":"fmAttAppealGrievance","v":{"$error":"#NAME?"}},false,{"$nulls":5},"4.",null,"OTHER INFORMATION","List/Expected Response","Answer Format","Field Names","Format Type","Response","Explanation"]
[null,{"$f":"fmAttMarketing","v":{"$error":"#NAME?"}},false,null,14,null,null,"","5.","","Please provide the following information in electronic format and name the file as specified:"]
[null,{"$f":"fmAttIDCard","v":{"$error":"#NAME?"}},false,{"$nulls":5},"6.",null,"A copy of a Suggested Employer Contract with a statement that the sample includes all exclusions and limitations that will apply to a policy issued to County/APS.  Name the file:  [Your Organization's Name]_C-8 Suggested Employer Contract.","List Box: Attached, Not Attached","drop down box","respSugEmpContrtact","Listbox,ListAttached"]
[null,{"$f":"fmAttMemberEnroll","v":{"$error":"#NAME?"}},false,{"$nulls":5},"7.",null,"","List Box: Attached, Not Attached","drop down box","respAnnReport","Listbox,ListAttached"]
[{"$nulls":8},"8.","","","List Box: Attached, Not Attached","drop down box","respAuditFinState","Listbox,ListAttached"]
[{"$nulls":8},"","","","List Box: Attached, Not Attached","drop down box","respConverServices","Listbox,ListAttached"]
[{"$nulls":8},"","","","List Box: Attached, Not Attached","drop down box","respAppealGrievance","Listbox,ListAttached"]
[{"$nulls":8},"","","Current marketing materials that would be of assistance to County/APS in evaluating your program.  Name the file:  [Your Organization's Name]_C-21 MarketingMaterials.","List Box: Attached, Not Attached","drop down box","respMktgMaterials","Listbox,ListAttached"]
[{"$nulls":8},"","","","List Box: Attached, Not Attached","drop down box","respIDCard","Listbox,ListAttached"]
[{"$nulls":8},"","","","List Box: Attached, Not Attached","drop down box","respMemEnrollMaterials","Listbox,ListAttached"]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]
[{"$nulls":8},"",""]

{"sheet":"Wellness Explanation","index":15,"n_rows":9,"n_cols":2,"rows_kept":9,"hidden":true}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 719-13 Medical Plan"]
["Wellness Explanation"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response "]
["was given.  Explanations must be numbered to correspond to the question to which they pertain and they must be brief."]
[]
[]
["Section/ Question #","Explanation"]

{"sheet":"Vision Plan","index":16,"n_rows":24,"n_cols":7,"rows_kept":24,"merged":[[1,0,1,6],[4,0,4,3],[6,0,6,6],[7,1,7,2],[7,3,7,6],[8,1,8,2],[8,3,8,6],[14,0,14,6],[23,0,23,1]]}
[{"$f":"Introduction!A1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
[]
["Arlington County Government Plan Design "]
["Indicate the plan deviation within the columns named \"Plan Deviations\". Also indicate if the plan design deviation is an enhancement or reduction by indicating (+/-)"]
[]
["This vision benefit is a stand alone plan.  Those enrolled in Medical are automatically covered for Vision.   If there are no deviations please state \"no deviations\" below"]
[null,"CIGNA - Vision Plan",null,"Plan Deviations"]
[null,"Inforce Plan"]
[null,"In-Network","Out-of-Network","In-Network","\"+\" or \"-\"","Out-of-Network","\"+\" or \"-\""]
["Eye Exam (once per calendar year)",{"v":10,"d":"$10"},"up to $45"]
["Lenses Allowance (once every calendar year)","Single: 100% up to $20\nLined Bifocal: 100% up to $30\nLined Trifocal: 100% up to $40\nLenticular: 100% up to $75","Single: up to $20\nLined Bifocal: up to $30\nLined Trifocal: up to $40\nLenticular: up to $75"]
["Contact Lens Allowance (one pair per calendar year)","Elective: 100% up to $75","Elective: up to $75"]
["Retail Frame Allowance (one pair per calendar year)","100% up to $30","up to $30"]
["Based on your review of the SPDs and other plan documentation, please list any other deviations not already noted above. \nIf there are any deviations, please list the benefit service in Column A and the deviation(s) in columns D  through G"]
{"$rows_empty":8}
["*Refer to plan summary or plan document for related details."]

{"sheet":"Active & PreMedicare GEOAccess","index":17,"n_rows":5,"n_cols":1,"rows_kept":5,"merged":[[0,0,0,10],[1,0,1,5],[4,0,4,9]]}
["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Geo Access Instructions"]
[]
["To obtain the Geo Access instructions, you will need to request from Aon's NAPD team at hnapdmbx@aon.com. Please follow the workflow requested in the e-mail reply from the NAPD team.  "]

{"sheet":"Provider Disruption","index":18,"n_rows":5,"n_cols":1,"rows_kept":5,"merged":[[1,0,1,5],[4,0,4,9]]}
["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Provider Disruption"]
[]
["To obtain ACG's current utilized providers, you will need to request from Aon's NAPD team at hnapdmbx@aon.com. Please follow the workflow requested in the e-mail reply from the NAPD team.  "]

{"sheet":"Plan Documents","index":19,"n_rows":6,"n_cols":1,"rows_kept":6,"merged":[[1,0,1,5],[2,0,2,5]]}
["Request for Medical Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Medical Plan"]
["Plan Documents"]
[]
[]
["See Attachment I"]