The Board ofStark County

Commissioners

Request for Proposal

Specificationsfor

Stop-Loss Insurance Coverage

Effective January 1, 2017

TABLE OF CONTENTS

Invitation for Proposals

Section:

1. Quotation Information

2. General Information

3. Instructions

4. General Conditions

5. Rate History

6. Required Proposal Form

Supporting Documents

Claims Experience

Census Listing

Stop-Loss Policy Schedule

Health Plan Benefit Schedules

(both segments have same plan)

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INVITATION FOR PROPOSALS

Sealed proposals, in accordance with O.R.C. § 307.86(F) and Stark County’s specifications for stop-loss insurance for the Board of Stark County Commissioners self-funded health plan, will be received at the offices of the Board at the County Office Building, 110 Central Plaza South, Suite 240, Canton, Ohio 44702 until 2:00 pm local time on Monday, October 24, 2016 at which time they will be publicly opened and tabulated.

Proposals shall be submitted in a sealed envelope upon the forms furnished with the specifications, shall contain the full name of each person, agency or company submitting the proposal, and shall be signed by an official authorized to execute a contract. Proposal envelopes shall be marked: “STOP-LOSS FOR STARK COUNTY COMMISSIONERS HEALTH PLAN”

Copies of specifications are on file for review on and after October 3, 2016 from 8:30 AM to 4:30 PM, Monday through Friday, except holidays, at 110 Central Plaza South, Suite 240, Canton, Ohio 44702. Specifications may be picked up at the address shown above, OR may be requested by mail to the address shown above OR may be found on the Stark County Commissioners’ website, www.starkcountyohio.gov/commissioners under “latest news.”

Each proposal and all certificates shall be upon the forms furnished with the specifications, and shall be delivered to the offices of the Board at or prior to the date and hour specified for receiving proposals. The Board is not responsible for documents received after the proposal opening and such documents will be rejected.

Unless specifically excepted, all proposals shall be deemed to incorporate the County’s RFP specifications by reference.

In the case of corporations not chartered in Ohio, the proposal shall be accompanied by a current certificate of the Secretary of State, certifying that such corporation is authorized to do business in Ohio.

Each proposer must insure that all employees and applicants for employment are not discriminated against because of race, color, religion, sex, handicap or national origin.

Terms of payment shall be as provided in the specifications or as otherwise negotiated.

The Board of Stark County Commissioners reserves the right to reject any or all proposals, to waive any informalities or irregularities in the proposals received, and to accept any proposal or combination of proposals which is deemed most favorable to the County at the time and under the conditions stipulated.

BY ORDER OF THE BOARD OF STARK COUNTY COMMISSIONERS CANTON, OHIOCAROL HAYN, BENEFITS COORDINATOR

Publish in: Canton Repository

Publication dates: October 3, 2016October 10, 2016

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SECTION 1

QUOTATION INFORMATION

Specifications: Proposal specifications may be picked up at 110 Central Plaza South, Suite 240, Canton, Ohio 44702

OR may be requested by mail to the address shown above

OR may be found on the Stark County Commissioners’ website, www.starkcountyohio.gov /commissioners under “latest news.”

Companies or individuals requesting specifications will be considered Proposers of Record to whom notice of any addenda or additional information will be sent, and from whom proposals will be accepted. Companies or individuals obtaining specifications from the website should notify the Benefits Coordinator to be considered Proposers of Record.

Due date: Two (2) sealed copies of your proposal must be received no later than 2:00 p.m. local time on Monday, October 24, 2016 at the office of The Board of Stark County Commissioners, 110 Central Plaza South, Suite 240, Canton, Ohio 44702.

Send to: Proposals should be sent/delivered toCarol C. HaynHuman Resources DepartmentThe Board of Stark County Commissioners110 Central Plaza South, Suite 240Canton, Ohio 44702

Questions: Any questions and/or need of clarification should be directed toCarol Hayn, Benefits CoordinatorHuman Resources DepartmentStark County Commissioners OfficePhone: (330) 451-7179Confidential Fax: (330) 451-1641E-Mail: cchayn@starkcountyohio.gov

Format: Each proposal submitted shall quote the premium rates and aggregate claim factors for stop-loss coverage for a period not less than twelve (12) months, with renewal options, using the forms provided. Multi-year quotes are encouraged.

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Contract Period: Stark County desires a contract with the carrier for a three (3) year period. Rates may change annually; however, longer than 12 month rates are encouraged.

Deviations: All assumptions should be clearly stated. Any deviations from the specifications MUST be plainly identified and clearly defined in a Deviations section submitted with the proposal. Unless otherwise stated, the County will assume that the proposer intends for its proposal to be in strict accordance with the specifications stated in the Request for Proposal (RFP) document and will evaluate the proposal on that basis.

Errors/Omissions: Errors and/or omissions in a submitted proposal may result in the proposal being declared invalid.

Negotiation: Under this Request for Proposal, the County will contact and negotiate with proposers as it sees fit to obtain terms it deems most favorable, as provided under O.R.C. § 307.86(F).

Right to reject: The Board of Stark County Commissioners reserves the right to reject any and all proposals, to waive any informalities or irregularities in the proposals received, and to award the contract to the proposer whose proposal is deemed most favorable to Stark County.

Tax exemption: Stark County is exempt from payment of all federal and state taxes.

Special conditions: Special conditions included in the Request for Proposal documentshall take precedence over any general provisions hereinafter setforth.

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SECTION 2

GENERAL INFORMATION

Name of account: The Board of Stark County Commissioners (Stark County)110 Central Plaza South, Suite 240, Canton, Ohio 44702

Size of account: Approximately 1,470 employees on the health plan; 76 opt-outs

Business: County government, 9121-03

Coverage to be quoted: Specific and aggregate stop-loss insurance(See Instructions for quote requirements)

2012-2014 TPAs/networks: AultCare & HealthSmart/Ohio Health Choice for medical administrationCVS/Caremark for prescription drug program (retail & mail service)

2015-2017 TPAs/networks: AultCare & Mutual Health Services/SuperMed for medical administration

CVS/Caremark for prescription drug program (retail & mail service)

Eligibility: Prior to 7/1/2008: Minimum 20 hours per week; employees on plan as of 7/1/2008 grandfatheredAs of 7/1/2008: Minimum 32 hours per week (30 hours as of 1/1/2015); coverage effective first of month following date of hire (one calendar month waiting period added 1/1/2016)Elected officials and members of certain boards are eligibleNo retiree coverage

2015 contributions: Non-bargaining employees: 13% of funding ratesBargaining employees: Per collective bargaining agreements (10% - 13%)

Rate guarantee period: Minimum twelve (12) months (through 12/31/2017) Multiple year quotes are highly encouraged

Commissions: All quotations are to be provided without broker commission

Effective date: January 1, 2017

Background information: Stark County currently offers one PPO plan, with a choice of networks. The AultCare network includes Aultman hospital in Canton. Access to Cleveland Clinic is available with a referral and advance approval from AultCare. The MMO SuperMed network includes Mercy Medical Center in Canton. Access to Cleveland Clinic and University Hospitals is available without referral or advance approval.

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SECTION 3

INSTRUCTIONS & CONDITIONS

1. Stark County may accept or reject any or all proposals received.

2. Each carrier/MGU/TPA submitting a stop-loss proposal must furnish the following:

A. Sample copy of the stop-loss contractB. Best’s insurance rating of the stop-loss issuer

3. Each respondent must complete the Proposal Form/Signature page in Section 6 of this RFP.

4. Proposals shall be considered only if the respondent shows it is duly authorized to do business in this state by the State of Ohio Department of Insurance.

5. Proposals are requested on a stated rate which shall remain firm for the period of the contract.

6. Cancellation – the carrier/MGU/TPA shall indicate that the stop-loss contract shall not be cancelled until one hundred twenty (120) days written notice thereof is given to Stark County.

7. Cancellation – Stark County has the right to cancel any carrier/MGU/TPA with one hundred twenty (120) days written notice.

8. Rate Change – All carriers/MGUs/TPAs must guarantee at least ninety (90) days written notice in advance of any rate change.

9. It is the intent of Stark County that the award shall be for a three year period. However, the right is reserved to change carriers on any anniversary date.

10. The successful stop-loss carrier or MGU must be willing to accommodate the County’s administrative procedures, including but not limited to the following:

The County remits stop-loss premiums on a self-billed basis within 10 days of the first bi-weekly pay cycle of the month. Premium remittance dates will therefore vary according to the County’s payroll calendar.

Enrollment forms may or may not be available for submission with a specific stop-loss claim. Eligibility as determined by the County must be accepted by the carrier.

Before the contract is awarded, proposal finalists may be invited to meet with representatives of the Commissioners to establish the agreement to administer the plan according to County guidelines.

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11. Stop-loss quote requirements:

Cover medical and prescription claims under specific and aggregate 24/12 contract basis for specific and aggregate, which means:

claims incurred in 24 months, paid in 12 months example: for first contract year, claims incurred 1/1/2016–12/31/2017

and paid 1/1/2017–12/31/2017 No dollar run-in limits on specific or aggregate claims Specific to be quoted at $200,000 and $225,000 and $250,000 No maximum for specific stop-loss claims Cover claims paid per the County’s underlying benefit plan Cover claims paid by two TPAs (AultCare and Mutual Health Services)

12. Neither Stark County, nor any other entity involved in this project, assumes any liability for any costs incurred by the carrier/MGU/TPA in the preparation of their proposal nor during the proposal evaluation process.

13. In accordance with opinions from the Ohio Attorney General, the County cannot sign an Agreement or Contract containing blanket Indemnification or Hold Harmless provisions. (See 1999 Ohio Op. Atty. Gen. No. 99-049 and 2005 Ohio Op. Atty. Gen. No. 2005-007.)

14. As a self-funded public-sector employer-sponsored health plan, the County’s plan is subject to regulations from the Ohio Department of Insurance. Successful proposers must accept our plan accordingly.

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SECTION 4

GENERAL CONDITIONS

The statistical data and general information contained in the specifications are, to the best knowledge of

Stark County, complete and accurate. However, any such data and information released with the

specifications are representations and not warranties by Stark County. Each entity submitting a proposal

shall assume for itself the sole responsibility for reliance upon information included in the specifications

to meet its quoting and underwriting needs and for determination of the appropriate rating structure. Any

prospective proposer desiring clarification of any section, clause, or wording of the Request for Proposal

should direct such questions to the Stark County Benefits Coordinator in writing to the address on page 3,

or fax to (330) 451-1641 at least seven (7) days prior to bid due date. Failure to request interpretation or

question the intent or scope of this Request for Proposal, as provided, shall not be sufficient cause for

relief from any provision of a contract issued as the result of this Request for Proposal.

All proposals received in response to this Request for Proposal shall be considered as “open offers” from

the date of submission through December 31, 2016. During this period, the proposals received will be

analyzed and negotiations with finalists will be conducted.

The Board of Stark County Commissioners reserves the right to reject any or all proposals, to waive any

informalities or irregularities in the proposals received, and to accept any proposal which is deemed most

favorable to the County at the time and under the conditions stipulated.

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SECTION 5

STOP-LOSS RATING HISTORY

Specific & Aggregate cover Medical & Prescriptions

2014 2015 2016

Carrier AIC AIC US Fire

Specific Stop-Loss Contract Basis 24/12 24/12 24/12Retention $150,000 $150,000 $200,000

Single Rate $15.20 $20.50 $16.17Family Rate $39.60 $53.45 $45.81

Aggregate Stop-LossContract Basis 24/12 24/12 24/12

Single Rate $0.85 $0.90 $1.67Family Rate $2.05 $2.15 $1.67

Single Factor $597.80 $639.65 $682.49Family Factor $1,524.20 $1,630.90 $1,665.93

Average monthly employees 1,466 1,481 1,481 (thru 8/31)(includes COBRAs)

NOTES:

AIC = AultCare Insurance Company In 2014 and 2015, Aggregating Specific of $125,000 applied to claims paid by the non-AultCare

TPA only In 2016, the $125,000 Aggregating Specific applies to claims paid by both TPAs In 2014 contract year, two claimants had higher specifics: one at $200,000 and one at $500,000 In 2015 contract year, one claimant had higher specific of $300,000

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SECTION 6

PROPOSAL FORM

Stop-Loss Rating

TO: The Board of Stark County CommissionersStark County Administration Building110 Central Plaza South, Suite 240Canton, Ohio 44702

FROM: Name

Address

Telephone Number ( )

E-Mail Address ______________________________________________

Now comes the undersigned proposer, who after having carefully examined the Invitation, Specifications, Instructions, and all attachments to this package hereby agrees that it will furnish stop-loss coverage for the Stark County Commissioners Self-Funded Health Benefits Program as follows:

SPECIFIC STOP-LOSS YEAR 1 YEAR 2 YEAR 3__ 2017 2018 2019

$200,000 Specific

Single Rate Family Rate Contract Basis

$225,000 SpecificSingle Rate Family Rate Contract Basis

$250,000 SpecificSingle Rate Family Rate Contract Basis

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AGGREGATE STOP-LOSS YEAR 1 YEAR 2 YEAR 3__ 2017 2018 2019

$200,000 Specific

Single Rate Family Rate Single Factor Family Factor

Contract Basis

$225,000 SpecificSingle Rate Family Rate Single Factor Family Factor

Contract Basis

$250,000 SpecificSingle Rate Family Rate Single Factor Family Factor

Contract Basis

Proposer further agrees that the signing of this Proposal Form represents its acceptance of the terms and conditions set forth within said Request for Proposal.

Proposer states that its proposal is made without any understanding or agreement with or in conjunction with any other person, agency, company or other entity, unless expressly identified herein. Proposer further states that its proposal is fair in all respects and that same has been made without fraud or collusion.

Proposer further agrees that if its proposal is accepted, it shall issue a stop-loss policy, within 30 days of such award.

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Signature Clause

Where Proposer is a Corporation: Name of Corporation

President

Secretary

Where Proposer is a Partnership: (List All Partners) Name of Partnership

Where Proposer is an Individual: (List Firm Name and Style Thereof) Name of Firm

COUNTY OF:

STATE OF:

SWORN TO AND SUBSCRIBED TO, before me, a Notary Public, as knowing and voluntary act on this

day of , .

Notary Public

SEAL My Commission Expires:

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CONFLICT OF INTEREST

No member, officer, or employee of Stark County, shall participate in the selection, award, or in the administration of this contract if a conflict of interest would arise. A conflict of interest would occur when a financial or other interest is held by:

1. The employee, officer, or agent involved in making the award;2. Any member of his/her immediate family;3. His/Her partner;4. An organization which employs, or is about to employ any of the above.

The above described parties are prohibited from having an interest in or receiving any of the proceeds of this contract. If you have questions regarding the content of this section, please contact the Stark County Benefits Department at (330) 451-7179.

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