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Questionnaire for Retired Employee Medical Policy for Company Point of View

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					    HARRIS COUNTY
 REQUEST FOR PROPOSAL                                                 Job No.: 05/0209
                                                                Date Due: JULY 11, 2005
       Cover Sheet                                                    DUE NO LATER THAN 2:00 P.M.
                                                                     LOCAL TIME IN HOUSTON, TEXAS
                                                                Proposals received later than the date
                                                                and time above will not be considered.


 PROPOSAL FOR: Dental DHMO and DPPO, Basic Life and AD&D, Voluntary Life and
 Voluntary AD&D, Vision and Flexible Spending Account Coverages for the Harris County
 Hospital District


                                           OFFERORS NOTE!!
Carefully read all instructions, requirements and          Please return proposal in an appropriately sized
specifications.  Fill out all forms properly and           envelope or box. PACKAGE MUST SHOW THE JOB
completely. Submit your proposal with all appropriate      NUMBER, DESCRIPTION AND BE MARKED
supplements and/or samples.                                "SEALED PROPOSAL".

                                     RETURN PROPOSAL TO:
                             HARRIS COUNTY PURCHASING AGENT
                               1001 PRESTON AVENUE, SUITE 670
                                     HOUSTON, TEXAS 77002

For additional information, contact Vivian Groce @ 713-755-2606 or vivian_groce@co.harris.tx.us

You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or written
in ink.
                                  Total Amount of Proposal $

Company Name:

Company Address:

City, State, Zip Code:

Taxpayer Identification Number (T.I.N.):

Telephone No.:                FAX No.:                     E-mail:

Print Name:

Signature:



Revised 12/04




                                                                                                  Page 1 of 30
                                                     TABLE OF CONTENTS

Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT
APPLICABLE to this bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If any
portion of the package is missing, notify the Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the following
before you return your bid packet.
__X__ 1.             Cover Sheet
                     Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear on this
                     page.

__X__ 2.          Table of Contents
                  This page is the Table of Contents.

__X__ 3.          General Requirements
                  You should be familiar with all of the General Requirements.

__X__ 4.          Special Requirements/Instructions
                  This section provides information you must know in order to make an offer properly.

__X__ 5.          Specifications
                  This section contains the detailed description of the product/service sought by the County.

__X__ 6.          Pricing/Delivery Information
                  This form is used to solicit exact pricing of goods/services and delivery costs.

__X__ 7.          Attachments
                  __X__ a.           Residence Certification/Tax Form
                                     Be sure to complete this form and return with packet.

                  _____    b.        Bid Guaranty & Performance Bond Information & Requirements
                                     This form applies only to certain bids/proposals. All public work contracts over $25,000 require a
                                     Payment Bond and over $100,000 must also have a Performance Bond, in a form approved by the
                                     County. Please read carefully and fill out completely.

                  _____    c.        Bid Check Return Authorization Form
                                     This form applies only to certain bids/proposals. Please read carefully and fill out completely.

                  _____    d.        Vehicle Delivery Instructions
                                     Included only when purchasing vehicles.

                  __X__ e.           Minimum Insurance Requirements
                                     (Included in specific requirements when applicable (does not supersede ―Hold Harmless‖ section of
                                     General Requirements).

                  _____    f.        Worker’s Compensation Insurance Coverage Rule 110.110
                                     This requirement is applicable for a building or construction contract.

                  _____    g.        Financial Statement
                                     When this information is required, you must use this form.

                  _____    h.        Reference Sheet
                                     When this information is required, you must use this sheet.

                  __X__ i.           Other
                                     Exhibits
Revised 03/04




                                                                                                                           Page 2 of 30
                                                 GENERAL REQUIREMENTS FOR PROPOSALS

READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE RESPONSIBLE FOR FULFILLING ALL
REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU UNDERSTAND THEM.

General Requirements apply to all advertised requests for proposals; however, these may be superseded, whole or in part, by the SPECIAL
REQUIREMENTS/INSTRUCTIONS OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be sure your proposal package is
complete.

ADDENDA
When specifications are revised, the Harris County Purchasing Agent will issue an addendum addressing the nature of the change. Offerors must sign it
and include it in the returned proposal package.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris County Commissioners Court.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with the laws of the State of Texas, to
waive any formality or irregularity, to make awards to more than one offeror, to reject any or all proposals. In the event the lowest dollar offeror meeting
specifications is not awarded a contract, the offeror may appear before the Commissioners Court, Hospital District Board of Managers, Community
Supervision & Corrections Department Board, the Juvenile Board or other applicable governing body and present evidence concerning his responsibility
after officially notifying the Office of the Purchasing Agent of his intent to appear.

BONDS
If this proposal requires submission of proposal guarantee and performance bond, there will be a separate page explaining those requirements. Offers
submitted without the required proposal bond or Cashier's Check are not acceptable.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the Harris County Commissioners
Court must sign the contract before it becomes binding on Harris County or the offeror. Department heads are NOT authorized to sign agreements for
Harris County. Binding agreements shall remain in effect until all products and/or services covered by this purchase have been satisfactorily delivered and
accepted.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are limited to those stated by the
offeror in the original proposal.

DIGITAL FORMAT
If offeror obtained the proposal specifications in digital format in order to prepare a response, the proposal must be submitted in hard copy
according to the instructions contained in this proposal package. If, in its proposal response, offeror makes any changes whatsoever to the County's
published proposal specifications, the County's proposal specifications as published shall control. Furthermore, if an alteration of any kind to the
County's published proposal specifications is only discovered after the contract is executed and is or is not being performed, the contract is subject to
immediate cancellation.

DISQUALIFICATION OF OFFEROR
Upon signing this proposal document, an offeror offering to sell supplies, materials, services, or equipment to Harris County certifies that the offeror
has not violated the antitrust laws of this state codified in §15.01, et seq., Business & Commerce Code, or the federal antitrust laws, and has not
communicated directly or indirectly the offer made to any competitor or any other person engaged in such line of business. Any or all proposals may
be rejected if the County believes that collusion exists among the offerors. Proposals in which the prices are obviously unbalanced may be rejected.
If multiple proposals are submitted by an offeror and after the proposals are opened, one of the proposals is withdrawn, the result will be that all of
the proposals submitted by that offeror will be withdrawn; however, nothing herein prohibits a vendor from submitting multiple offers for different
products or services.

E-MAIL ADDRESSES CONSENT
Vendor affirmatively consents to the disclosure of its e-mail addresses that are provided to Harris County, the Harris County Flood Control District,
the Harris County Hospital District including its HMO, the Harris County Appraisal District, or any agency of Harris County. This consent is
intended to comply with the requirements of the Texas Public Information Act, Tex. Gov’t Code Ann. §522.137, as amended, and shall survive
termination of this agreement. This consent shall apply to e-mail addresses provided by Vendor, its employees, officers, and agents acting on
Vendor’s behalf and shall apply to any e-mail address provided in any form for any reason whether related to this bid/proposal or otherwise.

EVALUATION
Evaluation shall be used as a determinant as to which proposed items or services are the most efficient and/or most economical for the County. It shall be
based on all factors which have a bearing on price and performance of the items in the user environment. All proposals are subject to negotiations by the
Purchasing Agent and other appropriate departments, with recommendation to the appropriate governing body. Compliance with all

Revised 01/05


                                                                                                                                        Page 3 of 30
requirements, delivery and needs of the using department are considerations in evaluating proposals. Pricing is NOT the only criteria for making a
recommendation. A preliminary evaluation by Harris County will be held and appropriate proposals will be subjected to the negotiating process. Upon
completion of the negotiations, Harris County will make an award. All proposals that have been submitted shall be available and open for public
inspection after the contract is awarded except for trade secrets or confidential information contained in the proposals and identified as such.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the specifications), or any contract continuing as a result of an extension option, must
include fiscal funding out. If, for any reason, funds are not appropriated to continue the lease or contract, said lease or contract shall become null and void
on the last day of the current appropriation of funds. After expiration of the lease, leased equipment shall be removed by the contractor from the using
department without penalty of any kind or form to Harris County. All charges and physical activity related to delivery, installation, removal and
redelivery shall be the responsibility of the offeror.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the specifications shall govern. In the event of
any conflict of interpretation of any part of this overall document, Harris County's interpretation shall govern.

GOVERNING LAW
This request for proposals is governed by the competitive bidding requirements of the County Purchasing Act, Texas Local Government Code, §262.021
et seq., as amended. Offerors shall comply with all applicable federal, state and local laws and regulations. Offeror is further advised that these
requirements shall be fully governed by the laws of the State of Texas and that Harris County may request and rely on advice, decisions and opinions of
the Attorney General of Texas and the County Attorney concerning any portion of these requirements.

GRANT FUNDING
Any contract entered into by the County that is to be paid from grant funds shall be limited to payment from the grant funding and the
vendor/provider understands that the County has not set aside any County funds for the payment of obligations under a grant contract. If grant
funding should become unavailable at any time for the continuation of services paid for by the grant, and further funding cannot be obtained for the
contract, then the sole recourse of the provider shall be to terminate any further services under the contract and the contract shall be null and void.

HIPAA COMPLIANCE
Offeror agrees to comply with the Standards for Privacy of Individually Identifiable Health Information of the Health Insurance Portability and
Accountability Act of 1996, PL 104-191, 45 CFR Parts 160-164, as amended, and the Texas Medical Records Privacy Act, Texas Health and Safety
Code Chapter 181, as amended, collectively referred to as "HIPAA", to the extent that the Offeror uses, discloses or has access to protected health
information as defined by HIPAA. Offeror may be required to enter a Business Associate Agreement pursuant to HIPAA.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury, death and/or property damage
resulting directly or indirectly from contractor's performance. Contractor shall procure and maintain, with respect to the subject matter of this proposal,
appropriate insurance coverage including, as a minimum, public liability and property damage with adequate limits to cover contractor's liability as may
arise directly or indirectly from work performed under terms of this proposal. Certification of such coverage must be provided to the County upon request.

INSPECTIONS & TESTING
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and requirements and needs of the using
department. If an offeror cannot furnish a sample of a bid item, where applicable, for review, or fails to satisfactorily show an ability to perform, the
County can reject the bid as inadequate.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice on each purchase order or purchase release after each delivery, indicating the purchase order number.
Invoices must be itemized. Any invoice which cannot be verified by the contract price and/or is otherwise incorrect, will be returned to the offeror
for correction. Under term contracts, when multiple deliveries and/or services are required, the offeror may invoice following each delivery and the
County will pay on invoice. Contracts providing for a monthly charge will be billed and paid on a monthly basis only. Prior to any and all payments
made for goods and/or services provided under this contract, the offeror should provide his Taxpayer Identification Number or social security
number as applicable. This information must be on file with the Harris County Auditor’s office. Failure to provide this information may result in a
delay in payment and/or back-up withholding as required by the Internal Revenue Service.

MAINTENANCE
Maintenance required for equipment proposed should be available in Harris County by a manufacturer-authorized maintenance facility. Costs for this
service shall be shown on the Pricing/Delivery Information. If Harris County opts to include maintenance, it shall be so stated in the purchase order and
said cost will be included. Service will commence only upon expiration of applicable warranties and should be priced accordingly.

MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", an offeror must provide to the County with each
delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the offeror to furnish this documentation
will be cause to reject any bid applying thereto.

Revised 01/05
NEW MILLENIUM COMPLIANCE
All products and/or services furnished as part of this contract must be compliant for the present year and forward. This applies to all computers
including hardware and software as well as all other commodities with date sensitive embedded chips.

                                                                                                                                          Page 4 of 30
POTENTIAL CONFLICTS OF INTEREST
An outside consultant or contractor is prohibited from submitting a proposal for services on a Harris County project of which the consultant or
contractor was a designer or other previous contributor, or was an affiliate, subsidiary, joint venturer or was in any other manner associated by
ownership to any party that was a designer or other previous contributor. If such a consultant or contractor submits a prohibited proposal, that
proposal shall be disqualified on the basis of conflict of interest, no matter when the conflict is discovered by Harris County.

PRICING
Prices for all goods and/or services shall be negotiated to a firm amount for the duration of this contract or as agreed to in terms of time frame. All prices
must be written in ink or typewritten. Where unit pricing and extended pricing differ, unit pricing prevails.

PROPOSAL COMPLETION
Fill out and return to Purchasing, ONE (1) complete proposal form in an appropriately sized envelope or box. PACKAGE MUST SHOW THE JOB
NUMBER, DESCRIPTION AND BE MARKED “SEALED PROPOSAL.” An authorized company representative should sign the Proposal Cover
Sheet. Completion of these forms is intended to verify that the offeror has submitted the proposal, is familiar with its contents and has submitted the
material in accordance with all requirements.

PROPOSAL RETURNS
Offerors must return all completed proposals to the office of the Harris County Purchasing Agent reception desk at 1001 Preston Avenue, Suite 670,
Houston, Texas before 2:00 P.M. LOCAL TIME IN HOUSTON, TEXAS on the date specified. Late proposals will not be accepted.

PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by an authorized agent of the Harris
County Purchasing Agent. The fastest, most reasonable delivery time shall be indicated by the offeror in the proper place on the proposal document. Any
special information concerning delivery should also be included, on a separate sheet, if necessary. All items shall be shipped F.O.B. INSIDE
DELIVERY unless otherwise stated in the specifications. This shall be understood to include bringing merchandise to the appropriate room or place
designated by the using department. Every tender or delivery of goods must fully comply with all provisions of these requirements and the specifications
including time, delivery and quality. Nonconformance shall constitute a breach which must be rectified prior to expiration of the time for performance.
Failure to rectify within the performance period will be considered cause to reject future deliveries and cancellation of the contract by Harris County
without prejudice to other remedies provided by law. Where delivery times are critical, Harris County reserves the right to award accordingly.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to products made of recycled materials if
the products meet applicable specifications as to quantity and quality. Harris County will be the sole judge in determining product preference application.

SCANNED OR RE-TYPED RESPONSE
If in its response, offeror either electronically scans, re-types, or in some way reproduces the County's published proposal package, then in the event of any
conflict between the terms and provisions of the County's published proposal package, or any portion thereof, and the terms and provisions of the
response made by offeror, the County's proposal package as published shall control. Furthermore, if an alteration of any kind to the County's published
proposal package is only discovered after the contract is executed and is or is not being performed, the contract is subject to immediate cancellation.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be held invalid, such holding shall
not affect the remaining portions of these requirements and the specifications and it is hereby declared that such remaining portions would have been
included in these requirements and the specifications as though the invalid portion had been omitted.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description concerning any point, shall be regarded as
meaning that only the best commercial practice is to prevail and that only material and workmanship of the finest quality are to be used. All
interpretations of specifications shall be made on the basis of this statement. The items furnished under this contract shall be new, unused of the latest
product in production to commercial trade and shall be of the highest quality as to materials used and workmanship. Manufacturer furnishing these items
shall be experienced in design and construction of such items and shall be an established supplier of the item proposed.

SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned proposal package. Literature, brochures, data sheets, specification
information, completed forms requested as part of the proposal package and any other facts which may affect the evaluation and subsequent contract
award should be included. Materials such as legal documents and contractual agreements, which the offeror wishes to include as a condition of the
proposal, must also be in the returned proposal package. Failure to include all necessary and proper supplemental materials may be cause to reject the
entire proposal.
Revised 04/04




                                                                                                                                         Page 5 of 30
TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris County claims exemption from all
sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited Sales Tax Exemption Certificates will be furnished upon written
request to the Harris County Purchasing Agent.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

TERMINATION
Harris County reserves the right to terminate the contract for default if Seller breaches any of the terms therein, including warranties of offeror or if the
offeror becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies which Harris
County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper goods and/or services within the proper
amount of time, and/or to properly perform any and all services required to Harris County's satisfaction and/or to meet all other obligations and
requirements. Harris County may terminate the contract without cause upon thirty (30) days written notice.

TESTING
Harris County reserves the right to test equipment, supplies, material and goods proposed for quality, compliance with specifications and ability to meet
the needs of the user. Demonstration units must be available for review. Should the goods or services fail to meet requirements and/or be unavailable for
evaluation, the offer is subject to rejection.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession of the goods at the point or
points of delivery. Receiving times may vary with the using department. Generally, deliveries may be made between 8:30 a.m. and 4:00 p.m., Monday
through Friday. Offerors are advised to consult the using department for instructions. The place of delivery shall be shown under the "Special
Requirements/Instructions" section of this proposal and/or on the Purchase Order as a "Deliver To:" address.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris County as an indirect party to any suit
arising out of personal or property damages resulting from offeror's performance under this agreement.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the proposal. Offerors may not limit or exclude any
implied warranties. Offeror warrants that product sold to the County shall conform to the standards established by the U.S. Department of Labor under
the Occupational Safety and Health Act of 1970. In the event product does not conform to OSHA Standards, where applicable, Harris County may return
the product for correction or replacement at the offeror's expense. If offeror fails to make the appropriate correction within a reasonable time, Harris
County may correct at the offeror's expense.



                                                              VENDORS OWING TAXES
Pursuant to TX Local Government Code 262.0276, the Hospital District Board of Managers has adopted a policy which requires that vendors’ taxes
be current as of the date bids/proposals are due. Bidders/proposers with delinquent taxes on the due date will not be eligible for award. Whether or
not a vendor’s taxes are delinquent will be determined by an independent review of the Tax Office records. Vendors who believe a delinquency is
reflected in error must contact the Tax Office to correct any errors or discrepancies prior to submitting their bid in order to ensure that their bid will
be considered. Tax records are available online at the Tax Office website—www.hctax.net. Prior to submitting a bid, vendors are encouraged to visit
the Tax Office website, set up a portfolio of their accounts and make their own initial determination of the status of their tax accounts. This policy is
effective for all bids due on or after July 1, 2004.




Revised 06/04




                                                                                                                                         Page 6 of 30
                               SPECIAL REQUIREMENTS/INSTRUCTIONS

The following requirements and specifications supersede General Requirements where applicable. The terms
"Harris County" or "HCHD" are understood to include the Harris County Hospital District (District).

VENDOR INSTRUCTIONS
Responses to this Request for Proposal (RFP) shall be formatted as follows:
All proposals must be typed on standard 8-1/2" X 11" paper, indexed and placed in a 2 or 3-ring binder. Proposal
should be organized in the following order for consistency and easy screening:

Section I:      Table of Contents
Section II:     RFP Cover Sheet, Transmittal Letter, and Residence Certification - The transmittal letter
should include company name and address; name, title, telephone and fax number of person(s) to be contacted for
clarifications or additional information regarding proposal; name, title, telephone and fax number of person
authorized to contractually obligate your company with proposal and any future negotiations; and a brief summary
explaining how all requirements of this RFP will be met and proposer’s ability to meet the needs and requirements
of the RFP.
Section III: Proposed Services
Section IV: Pricing Information
Section V:      Questionnaire - Respondents must answer the questionnaires and submit requested reports/
questionnaires via paper as well as on a CD or Diskette. Include all questionnaires and attachments with your
RFP response. Please do not change the format of the attachment questionnaires. If you have additional
information, please add the information at the end of each spreadsheet. Your adherence to this request is
appreciated. Failure to submit all requested data in the requested formats may prevent consideration of your
proposal.
Section VI: References
Section VII: Agreement(s) – Include all Agreements or Contract(s) associated with response.
Section VIII: Special Requirements – Minimum Proposer Requirements, Certificate(s) of Insurance,
exceptions to any of the requirements in this RFP, appropriate company brochures, etc. may be included.

Proposer should include ONE (1) ORIGINAL (CLEARLY MARKED “ORIGINAL”) and FIVE (5) COPIES
(CLEARLY MARKED “COPY”) of the response sealed in an envelope or package for delivery to the Harris
County Purchasing Agent per the instructions in the General Requirements (see Proposal Completion and Proposal
Returns). Please include your CD or Diskette with each copy. All documents included in the proposal and the
outside of the envelope or package must be marked with the vendor's name and the job number that corresponds to
this RFP.
Harris County will not be liable for any costs incurred by the vendor in preparing a response to this RFP. Vendors
submit proposals at their own risk and expense. Harris County makes no guarantee that any services will be
purchased as a result of this RFP, and reserves the right to reject any and all proposals. All proposals and
accompanying documentation will become the property of Harris County. All proposals are open to negotiation.

While Harris County appreciates a brief, straightforward, concise reply, the proposer must fully understand that the
evaluation is based on the information provided. Accuracy and completeness are essential. Omissions, ambiguous
and equivocal statements may be construed against the proposer. The proposal response may be incorporated into
any contract which results from this RFP, and vendors are cautioned not to make claims or statements it is not
prepared to commit to contractually. Failure of the vendor to meet such claims will result in a requirement that the
vendor provide resources necessary to meet submitted claims.

                      SPECIAL REQUIREMENTS/INSTRUCTIONS – CONTINUED

                                                                                                     Page 7 of 30
All documents will be held by the County and are NOT subject to public view until an award is made. Under the
Request for Proposal process, sealed offers will be received and opened in the Office of the Harris County
Purchasing Agent. At and after opening, proposals will NOT be part of the public record and subject to disclosure,
but will be kept confidential until time of award and execution of an agreement. When an award is
made and execution of an agreement, proposals are subject to review under the ―Public Information Act‖. To the
extent permitted by law, vendors may request in writing non-disclosure of confidential data. Such data shall
accompany the proposal, be readily separable from the proposal, and shall be CLEARLY MARKED
―CONFIDENTIAL‖.

All correspondence relating to this RFP, from advertisement to award shall be sent to the Harris County Purchasing
Department. All presentations and/or meetings between Harris County Hospital District and the vendor relating to
this RFP shall be coordinated by the Harris County Purchasing Department.

EVALUATION PROCESS
All proposals will be examined by an evaluation committee consisting of various Harris County Hospital District
personnel and Harris County Purchasing.

Proposals that do not conform to the instructions or which do not address all the services as specified may be
eliminated from consideration. However, Harris County, reserves the right to accept such a proposal if it is
determined to be in the best interest of the District.

Harris County may initiate discussions with selected vendors; however, discussions may not be initiated by
vendors. Harris County expects to conduct discussions with vendor’s representatives authorized to contractually
obligate the vendor with an offer. Vendors shall not contact any Harris County Hospital District personnel
regarding this RFP during the RFP process without the express permission from the Office of the Harris County
Purchasing Agent. Harris County Purchasing may disqualify any vendor who has made site visits, contacted
District personnel or distributed any literature without authorization from the Purchasing Department.

Selected vendors may be expected to make a presentation(s) to an evaluation committee. Presentations may
result in negotiating sessions with one or more vendors. Harris County expects to conduct negotiations with
vendor’s representatives authorized to contractually obligate the vendor with an offer. If vendor is unable to
agree to contract terms and conditions, Harris County reserves the right to terminate contract negotiations with
any vendor and continue negotiations with other vendors.

EVALUATION CRITERIA
The award of the contract shall be made to the responsible vendor whose proposal is determined to be the best
evaluated offer resulting from negotiations, taking into consideration the following and other factors set forth in
the RFP. It is anticipated that these items are listed in order of relative importance.
o      Proposed services
o      Completed questionnaire and agreement of all terms and conditions
o      Demonstrated ability to provide the required services
o      Proposer’s Qualifications
o      Experience with clients of similar size and structure to the Hospital District
o      References
o      Cost – Premiums and rate guarantees for future renewals
o      Compliance with instructions and specifications
o      Financial Stability

                     SPECIAL REQUIREMENTS/INSTRUCTIONS – CONTINUED

                                                                                                    Page 8 of 30
AWARD
The Hospital District reserves the right to award to multiple firms if, in its judgment, no single respondent is
capable of meeting all its needs.

No award can be made until approved by Hospital District Board of Managers. This RFP in no manner obligates
Harris County or any of its agencies to the eventual purchase of any service described, implied or which may be
proposed. Progress toward this end is solely at the discretion of Harris County and may be terminated at any time
prior to execution of an agreement. Submission of a proposal implies the vendor's acceptance of the evaluation
criteria and vendor recognition that subjective judgments must be made by the evaluating committee.

LEGAL DOCUMENTS
Proposer should submit any agreements which may be required by its organization to enter into a contract with
the Harris County Hospital District. These agreements are subject to review and amendment by the Harris
County Attorney's Office, and approval by the Harris County Hospital District.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice indicating the purchase order number. Invoices must be itemized.
Any invoice which cannot be verified by the contract price and/or is otherwise incorrect, will be returned to the
offeror for correction. The offeror may invoice following each delivery and the Hospital District will pay on
invoice. Prior to any and all payments made for goods and/or services provided under this contract, the offeror
should provide its Taxpayer Identification Number or social security number as applicable. This information
must be on file with the Harris County Hospital District Accounts Payable Department. Failure to provide this
information may result in a delay in payment and/or back-up withholding as required by the Internal Revenue
Service.




                                                                                                  Page 9 of 30
                                               SPECIFICATIONS

  Dental DHMO and DPPO, Basic Life and AD&D, Voluntary Life and Voluntary AD&D, Vision and
           Flexible Spending Account Coverages for the Harris County Hospital District


SCOPE
Harris County is are seeking proposals for Dental DHMO, Dental PPO, Life, AD&D, Voluntary Life, Voluntary
AD&D, Vision and Flexible Spending Account services for the Harris County Hospital District. The Hospital
Districts Benefit Plan Year begins March 1 and open enrollment will begin in January 2006 for all plans with
the exception of the Flexible Benefits Plan, which will begin January 1, 2006. The Hospital District has a long
term relationship with the current vendors with either 3+ or 5+ year agreements.

Vendors are encouraged to review this entire Request for Proposal including Exhibits upon receipt. Questions
that are answered in the RFP or the Exhibits will be referred back to the appropriate Exhibits. All questions
must be emailed to vivian_groce@co.harris.tx.us by June 30, 2005 by 3:00 p.m. Responses to questions will be
addressed in an Addendum to this RFP.

RENEWAL OPTION
Harris County may consider four (4) one-year renewal options, renewable one year at a time, based upon the same
terms, conditions and pricing as the original year. Renewal is subject to approval by the Harris County Hospital
District Board of Managers. Once the renewal option is exhausted, the contract must be rebid. If a bidder does not
wish to consider a renewal, write "N.A." in the space for the year indicated on Pricing in Exhibits 4, 14, 20 and 21.

Harris County retains the option to rebid at any time if in its best interest and is not automatically bound to
renewal or rebid.

BACKGROUND
Harris County Hospital District (Hospital District) provides access to cost-effective, quality health care
delivered in a compassionate manner to all residents of Harris County regardless of their ability to pay. HCHD
currently consists of 3 hospitals, 2 specialty centers and numerous community health centers and school based
clinics. All vendors are encouraged to visit the Hospital District website at: hchdonline.com.

The Hospital District, a tax-supported healthcare delivery system headquartered in Houston, Texas, is comprised
of three hospitals; Ben Taub General Hospital, Lyndon B. Johnson General Hospital and Quentin Mease
Hospital and numerous neighborhood clinics.          The Hospital District has approximately 5,311 full-time
employees, 1,051 registry status employees, and 58 part-time employees.

The Hospital District has provided a self-funded medical insurance program with Aetna Insurance Company as
the third party administrator since March 1, 2004. From March 1, 2000, to present, the Hospital District
provides employees, eligible dependents and retirees Vision Insurance and Dental Indemnity through Spectera
Insurance Company, and Dental DHMO coverage through National Pacific Dental (DHMO). HCHD provides
Basic Life and AD&D for employees through Highmark Life. The Voluntary Life and Voluntary AD&D plans
are also provided for employees and dependents through Highmark Life. The vision, dental and Life/AD&D
coverages will end February 28, 2006. The Hospital Districts Benefit Plan Year begins March 1 and open
enrollment will begin in January 2006 for all plans with the exception of the Flexible Benefits Plan, which will
begin January 1, 2006.




                                                                                                     Page 10 of 30
                              SPECIFICATIONS - CONTINUED

GENERAL INFORMATION:

EMPLOYER:                      Harris County Hospital District (Hospital District)

ADDRESS:                       2525 Holly Hall
                               Houston, TX 77054

LOCATION OF EMPLOYEES:         Harris County, Texas and surrounding areas
INDUSTRY:                      Public Hospital Entity

COVERAGES TO BE QUOTED:        Dental DHMO and Dental PPO, Basic Life & AD&D,
                               Voluntary Life & Voluntary AD&D and Vision.
                               Voluntary Life and Voluntary AD&D should be quoted
                               on independent of Basic Life/AD&D.
CURRENT COVERAGES /            National Pacific Dental/Highmark Life/Spectera
CARRIER(S):

PROPOSED EFFECTIVE DATE:       March 1, 2006

CURRENT PLAN BENEFITS:         See Exhibits:
                               Dental: 4, 5, 8, 9, 12
                               Life/AD&D: 14, 16
                               Vision: 18, 20
                               Flex: 21

RENEWAL INCREASE /             The Hospital District requires 60 days notice of
TERMINATION / RATE INCREASE    termination and 120 days notice of any renewal
NOTICES:                       increase. If proposer is unable to provide 120 days
                               notice of renewal increase, such increase is expected
                               within at least 90 days of renewal date.

                               If the Hospital District is required to provide a
                               termination notice to the vendor, such notice will not
                               exceed 30 days.

                               It is required that changes in cost/renewal shall not be
                               more than on an annual basis. If changes in benefits or
                               material changes in census of more than 25%
                               characteristics of the group, client will require no less
                               than 60 days notice of such change in cost.

PROPOSED PLAN OF BENEFITS:     See Exhibits:
                               Dental: 4, 6
                               Life/AD&D: 14
                               Vision: 20
                               Flex: 21



                                                                                           Page 11 of 30
                             SPECIFICATIONS – CONTINUED


CLAIMS / PREMIUM HISTORY:     See Exhibits:
                              Dental: 4, 13
                              Life/AD&D: 14, 15
                              Vision: 17, 19

EMPLOYEE & RETIREE CENSUS:    See Exhibits: 1, 2

ELIGIBILITY:                  Dental Plans - Active Employees/Dependents and
                              Retirees/Dependents
                              Basic Life/AD&D Plans – Active Employees Only
                              Voluntary Life – Active Employees/Dependents
                              Voluntary AD&D - Active Employees/Dependents
                              Vision Plan – Active Employees/Dependents and
                              Retirees/Dependents

                              Active Employee – 90 days after date of hire

WAITING PERIOD:               Quotes should assume all waiting periods are waived for
                              the initial group.

ENROLLMENT:                   Either passive enrollment or open enrollment is assumed
                              for each plan year.

CURRENT AND PROPOSED          Fully Insured
FUNDING:

CURRENT RATES AND EMPLOYER    See Exhibits:
CONTRIBUTIONS:                Dental: 4, 5
                              Life/AD&D: 14
                              Vision: 17
                              Basic Life/AD&D – Employer Paid
                              Voluntary Life/Voluntary AD&D – Employee Paid
                              Dental Plans – Employer & Employee Paid
                              Vision Plan – Employer & Employee Paid

WAITING PERIOD FOR NEW        Active Employee – 90 days after date of hire
HIRES:

COMMISSIONS:                  All responses should be net of commissions. There are
                              to be no commissions paid on these coverages. Please
                              confirm in your response that all rates are net of
                              commissions, over-rides, bonuses, etc. Please confirm
                              that there are no types of payments of any type to any
                              agent, person or entity as relates to your quote.


                             SPECIFICATIONS – CONTINUED

                                                                                        Page 12 of 30
NO LOSS, NO GAIN:                       Coverage should be written on a no loss, no gain basis.
                                        Confirm in your proposal that no current covered
                                        participant will lose coverage and that the actively-at-
                                        work requirement will be waived.

                                        Please also confirm in your proposal you will cover any
                                        employee(s) who are currently disabled but do not meet
                                        waiver of premium under current carrier.

DEVIATIONS:                             Please specify all deviations in writing. Any deviation to
                                        the current plan designs/contracts that are not disclosed
                                        will be assumed to be the same as the current plans.

FLEXIBLE SPENDING ACCOUNTS (FSA):
The Hospital District currently administers the medical reimbursement and dependent care reimbursement
accounts through its Payroll Department. Current enrollment in the medical reimbursement account is 488 and
the dependent dare reimbursement account: 92

The service provider will be responsible for administering medical reimbursement accounts and dependent care
reimbursement accounts, in accordance with IRC Section 125 and related regulations. In addition, the Hospital
District will consider a proposal to include a qualified transportation reimbursement account.

The Hospital District will make payroll deductions for the amounts allocated by the employee for the flexible
spending accounts. There are 26 total deductions made in a year for employees paid biweekly and 12 total
deductions made in a year for those employees paid monthly. Accumulation of pre-tax dollars is on a calendar year
(March - February) basis.

INTERFACES:

Dental and Vision - Participants will be loaded into vendor’s database via PeopleSoft Interface. A full data file
will be provided to the dental and vision vendor(s) so that the vendor(s) can upload data into their system(s).
The interface will include all active and retired employees and dependents that are enrolled in the dental or
vision plans. When an employee’s coverage is terminated, the termination date will be populated for both the
employee and all dependents. See PeopleSoft Interface – Exhibit 22.

Life/AD&D - A full data file will be provided to the life & AD & D vendors so that the vendor can upload data
into their system via PeopleSoft Interface, if eligibility is required by vendor. The interface will include all
active employees that are enrolled in the life, supplemental life, and AD &D plans. When an employee’s
coverage is terminated, the termination date will be populated for both the employee and all dependents. See
PeopleSoft Interface – Exhibit 23. Please advise if you prefer an annual census, updates via monthly billing
statement or monthly eligibility via PeopleSoft Interface.

FSA - FSA contributions by participant/account type will be loaded into vendor’s database via PeopleSoft
Interface. A full data file will be provided to the FSA vendor so that the vendor can upload data into their
system. The interface will include all active employees that are enrolled in the health care or dependent care
FSA plans. When an employee’s coverage is terminated, the termination date will be populated for the
employee. See PeopleSoft Interface – Exhibit 24.



                                                                                                  Page 13 of 30
                                      SPECIFICATIONS – CONTINUED

Encryption:
The extracted detail interface data that will be sent to vendors is extremely sensitive and must be protected.
Vendor must accept and process flat file by position with the PGP encryption method.

File Transfer Method:
Vendor must support the File Transfer Protocol via an FTP server, and the Hospital District must be able to
login to the FTP server.

File Transfer Frequency:
The Hospital District must be allowed to transfer files on whatever frequency is needed (i.e. daily, weekly, bi-
weekly, monthly).

ACCESS TO RECORDS
The Hospital District shall be given reasonable rights to perform audits by the Hospital District own personnel
and/or an outside firm of consultants/auditors, in order to investigate the Hospital District claims and services, and
to evaluate performance of the company. The company shall agree to provide full cooperation and access to files,
claims data, etc., and shall not purge any information that would hinder the task of auditing. Performance of these
functions shall be carried out at the Hospital District convenience and with advance notification.

CLAIMS AND CUSTOMER SERVICE
The service provider will provide prompt customer service and thorough and responsive processing of all claims
submitted by the plan participants. The Hospital District reserves the right for representatives to visit and review
the provider's claims processing operations during normal business hours.

The services provider will keep records on complaints and concerns expressed by participants, and non-
confidential records should be made available for the Hospital District representatives to review. Written notice
will be provided following receipt of a claim submitted by a participant, as to the disposition of the claim. In case
of delay, an explanation of the reason for the delay will be provided. If a claim is disputed, fair resolution and
written notice of the reason for the denial and appeal process procedures will be provided to the participant.

In case of denial of a claim for payment for any reason, the claimant will be notified in writing in a clear, concise
and easy-to-understand manner giving the reason for denial. If there is an appeal process involved, the claimant
will be provided full information relating to the procedures and steps to follow.

The provider will defend, at the provider’s cost and expense, any and all claims and actions, which are filed for
failure to pay covered benefits under the plan offered.

COMMUNICATION
The service provider will commit to a high level of communication so participants can have an understanding of
the plan’s design and value of the benefits being offered. The service provider should provide high quality
communication to employees by conducting meetings and by providing written and visual materials in a
simplified, easy-to-understand manner. Communications should be provided in English, Spanish and/or other
languages as required.




                                                                                                     Page 14 of 30
                                    PRICING/DELIVERY INFORMATION


Offerors must use the pricing forms included in the Exhibits 4, 14, 20, 21; duplicate forms as necessary to quote
various options. Plan design options and funding alternatives are described in the Specifications.

Indicate plan(s) and service(s) quoted:

PLAN/SERVICE                                   YES     NO

Dental Plan                                    ____    ____
Vision Plan                                    ____    ____
Basic Life Insurance and AD&D                  ____    ____
Voluntary Life Insurance and AD&D              ____    ____
Flexible Spending Accounts                     ____    ____

Multi-Year Rate Guarantees
The Hospital District may wish to renew each contract annually for four (4) years. Offerors may duplicate the
Pricing Sheets to indicate renewal rate/pricing for renewal years. If any change to initial year pricing is requested,
offeror must include the methodology that will be used to determine the actual adjustment. Once proposed and
accepted by the Hospital District, exercise of any renewal pricing option is solely at the discretion of the Hospital
District.




                                                                                                     Page 15 of 30
                                                                                                               Attachment a
                                                                                                             Job No. 05/0209

                                            RESIDENCE CERTIFICATION/TAX FORM

Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence
Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of
governmental contracts; pertinent provisions of §2252.001 are stated below:

          (3)      "Nonresident bidder" refers to a person who is not a resident.

          (4)      "Resident bidder" refers to a person whose principal place of business is in this state, including a
                   contractor whose ultimate parent company or majority owner has its principal place of business in
                   this state.

          I certify that          is a Resident Bidder of Texas as defined in
                     [Company Name]
          Government Code §2252.001.

          I certify that          is a Nonresident Bidder as defined in
                           [Company Name]
          Government Code §2252.001 and our principal place of business is              .
                                                                                [City and State]



Taxpayer Identification Number (T. I. N.):

Company Name submitting Bid/Proposal:

Mailing Address:

If you are an individual, list the names and addresses of any partnership of which you are a general partner:



PROPERTY: List all taxable property owned by you or above partnerships in Harris County.

Harris County Tax Acct. No.*                     Property address or location**




 * This is the property account identification number assigned by the Harris County Appraisal District.
** For real property, specify the property address or legal description. For business personal property, specify the
   address where the property is located. For example, office equipment will normally be at your office, but inventory
   may be stored at a warehouse or other location.
Revised 12/04




                                                                                                              Page 16 of 30
                                                                                                      Attachment e


                             Minimum Insurance Requirements

•     The contractor shall, at all times during the term of this contract, maintain insurance coverage with not less
      than the type and requirements shown below. Such insurance is to be provided at the sole cost of the
      contractor. These requirements do not establish limits of the contractor's liability.

•     All policies of insurance shall waive all rights of subrogation against the County, its officers, employees
      and agents.

•     Upon request, certified copies of original insurance policies shall be furnished to Harris County.

•     The County reserves the right to require additional insurance should it be deemed necessary.

A.    Workers' Compensation (with Waiver of subrogation to Harris County) Employer's Liability, including all
      states, U.S. Longshoremen, Harbor Workers and other endorsements, if applicable to the Project.

      Statutory, and Bodily Injury by Accident: $100,000 each employee. Bodily Injury by Disease: $500,000
      policy limit $100,000 each employee.


B.    Commercial General Liability Occurrence Form including, but not limited to, Premises and Operations,
      Products Liability Broad Form Property Damage, Contractual Liability, Personal and Advertising Injury
      Liability and where the exposure exists, coverage for watercraft, blasting collapse, and explosions,
      blowout, cratering and underground damage.

      $300,000 each occurrence Limit Bodily Injury and Property Damage Combined $300,000 Products-
      Completed Operations Aggregate Limit $500,000 Per Job Aggregate $300,000 Personal and Advertising
      Injury Limit. Harris County shall be named as "additional insured" on commercial general liability policy.


C.    Automobile Liability Coverage:

      $300,000 Combined Liability Limits. Bodily Injury and Property Damage Combined. Harris County shall
      be named as "additional insured" on automobile policy.


Revised 12/00




                                                                                                    Page 17 of 30
                                              QUESTIONNAIRE


GENERAL INFORMATION

1. Provide background information and a brief description of your organization. Include any pertinent
   information relative to the size and organizational structure of your company. Provide an organizational
   chart including the service team assigned to this account, with resumes.

2. What is the turnaround time for ID cards? Describe lead time required to send out ID cards, employee
   communications materials, provider network directories, production of ID cards, and eligibility input.

3. How many accounts are handled in your office? What is the average size of account handled in your office?
   How many accounts will team leader for this client handle in addition to this client? What is your target
   market?

4. Will you provide a high level claims/customer service representative to be dedicated to the client’s employee
   benefits department contacts for claims questions? Will this person have a backup? Please provide the
   name and experience level of this dedicated representative.

5. Please provide any and all fees not disclosed in your administrative fee / quote. Examples: printing of
   booklets / directories, plan document development, amendment development, etc.

6. Client requires that copies of all contracts, plan document drafts, first month’s billing, and an eligibility
   audit report be delivered to client and also to Palmer & Cay no later than 30 days of the effective date of
   coverage. Please confirm that your company will comply with this request.

7. Performance Guarantees – please disclose what type of performance guarantee and financial penalties are
   available for this client for not only delivery of items requested above, but a guarantee of achieving an
   Implementation on a timely basis, ongoing claims / customer service administration, management of
   account, etc.

8. Please identify all subcontractors (including consultants, advisors, network managers, and suppliers) to be
   used and describe specific responsibilities, qualifications, and background experience of all key personnel.
   Include financial stability for each major subcontractor, consultant, or advisor.

9. Please provide pertinent financial data that demonstrates your organization’s ability to successfully perform
   this contract. Include a copy of the three (3) most recent annual reports and financial statements for each
   quarter since the last annual report to date. Please provide your most recent ratings (include the date of the
   rating) by each of the following:

        a. Weiss:
        b. Duff & Phelps:
        c. Standard & Poors:
        d. Moody’s:
        e. A.M. Best:




                                                                                                 Page 18 of 30
                                         QUESTIONNAIRE - CONTINUED


10. Report any restraining or disciplinary action taken against you by any regulatory body within the last 3 years
    and the outcome of any such actions.


11. Provide references for groups of similar size, industry and location. Specifically, three active and three
    terminated accounts (other than mergers), within the last five years. Please provide group name, contact
    person, telephone number, effective date, and termination date.

12. Either monthly or quarterly meetings with client and consultant are a requirement for you to be awarded this
    business. Please confirm your willingness to participate in these meetings.

13. Multi-year rate guarantees are strongly encouraged. Current vendors have one year contracts with renewal
    options for four additional years. Please indicate below how long the proposed premium rates will remain
    in effect:

    Dental DHMO
    Dental DPPO
    Vision
    Basic Life/AD&D
    Voluntary Life w/dependents
    Voluntary AD&D w/dependents
    Flexible Spending Accounts

14. Specify any minimum enrollment requirements for voluntary coverages:

    Voluntary Life
    Voluntary AD&D

15. Please provide a detailed description of your internet capabilities. What is available to employees on your
    website? What is available to employers?

16. Please confirm that you can support an online enrollment with a third party enrollment vendor.

17. If selected to provide coverage, please confirm that you will provide a Summary Plan Description within 30
    days of the effective date.

18. Please describe in detail how renewal rates will be calculated. Please provide the retention percentage as a
    percent of overall premium that you have utilized in generating fully insured rates. Please identify if this
    percentage will change in underwriting the first renewal.




                                                                                                     Page 19 of 30
                                      QUESTIONNAIRE – CONTINUED


19. Confirm that all renewal information will be communicated no later than 120 days prior to the plan anniversary
    date.

20. Also accompanying your proposal should be your Proposed Implementation Timetable. Your timetable
    should assume March 1, 2006 as the program effective date, January 1, 2006 for FSA.

Please be advised that quoted rates will be final regardless of actual plan enrollment.


FINANCIAL INFORMATION

RATES

Rates should be reflective of existing tier structure unless other tiers are requested.

ADMINISTRATIVE COSTS

1. Specify your first year contract rates and any additional renewal options up to four additional years. Be sure
   to include any rate increases or rate caps for your additional periods (if any). Preferred contract periods are a
   one year contract with four renewal options.


ADMINISTRATION

2. What is the location of the claims office that will be processing claims and providing general administration
   for this account? If more than one location, please identify all locations where claims will be processed.


3. What is the location of any local service and office assistance that would be available for group
   administrators and/or employees?


4. What will be the days and hours of operation for the customer service unit(s)? Would you be willing to
   offer extended hours, if necessary? Is there a toll-free number? Do the customer service representatives
   have the authority to resolve problems immediately? What percentages of problems are resolved during the
   initial call?


5. How long does a participant have to submit a claim from date of service?

6. Please furnish a copy of the payment explanation form and claim form that would be used by the claimant. Also
   furnish language used for denied claims.

7. How are claim disputes and denials handled? Please describe your appeal process. What is your turnaround time
   for response to claim disputes?

                                         QUESTIONNAIRE – CONTINUED
                                                                                                    Page 20 of 30
8. Assume a Texas situs.

9. The actively-at-work provision and any pre-existing condition limitation provisions will be waived for all
   eligible employees on the effective date of March 1, 2006.

10. Please confirm that quoted rates include costs associated with enrollment, initial ID card production, attendance
    at meetings, claims processing, loading of eligibility data, management reporting and any other service not
    expressly detailed as a separate cost in your proposal.

REPORTING

11. Please provide a sample of your standard management reports for Dental DHMO and Dental PPO, Life,
    AD&D, Voluntary Life, Voluntary AD&D, Vision and Flexible Spending Account coverages along with
    samples of claims data reports. Claims reports by type, participation reports by tier level are requested on a
    monthly basis, quarterly at a minimum. Please advise frequency of reporting. Below is a list of required
    reports to be provided on a monthly basis:

          Premium and Claims (report should include employee participation by tier and plan) and claims by
           month for each line of coverage.

12. Please provide a sample of your Premium vs. Claims reports.

DENTAL DHMO AND DPPO

1. Please quote the current dental plan designs in the attached worksheets.           Please quote the alternate
   Indemnity plan designs in the attached worksheets, Option 1 and Option 2. Please quote a DHMO plan that
   is close to the current plan design and please quote one or two alternate options.

2. Please use existing rate/tier structure in attached worksheet.

3. Census information has been provided in attached worksheet. Please provide a Geo Access Report utilizing
   2 providers within 20 miles.

4. Please review the attached reports by plan of the top 100 dentist utilized by the plan participants. Please
   note if they are in or out of your network by plan (DHMO/DPPO) and provider.

5. The current Dental Indemnity Plan is a ―blind‖ DPPO. Please quote the Indemnity plan as a ―blind‖ DPPO
   with in and out of network benefits at the same levels.




                                                                                                     Page 21 of 30
                                     QUESTIONNAIRE – CONTINUED


DENTAL QUESTIONNAIRE


Please answer the following questions and return with your quote:

1. Is the dental plan offered ―closed‖ or ―open?‖ If closed, please provide a list of all services that are NOT
   covered, or please confirm that ONLY the listed services are covered and no other services would be
   covered. If services are not covered in your schedule, please explain how non-specified dental procedures
   are administered (reduced rates, discount amount, etc.).
   Please respond for both DHMO and DPPO.

2. Does your quote have the following services in one category? Does your quote split any services? Please
   explain how these services are handled.

       Endodontics/Root Canals

       Periodontics and Periodontal Maintenance

       Oral Surgery

3. How is your R & C based? What percentile do you use?

4. Does your quote include Asymptomatic or Naturally Functioning Tooth limitations?

5. Does your quote subject Orthodontia to a severity index?

6. DPPO/Indemnity – please advise how benefits are paid if they are not in-network. Are they reimbursed at R
   & C or are they reimbursed at the in-network rate only? Do you have a maximum allowable fee payment
   schedule for the DHMO? The DPPO? Please submit with your RFP response.

7. Please confirm any waiting periods. Open enrollment is usually in January of each year for a March 1
   renewal date. How do you handle employee who do not sign up in the current year and enroll in subsequent
   years?

8. Please confirm there will be no waiting periods for the existing Dental plan participants.

9. Please provide a disruption analysis of your network providers for both the DHMO and the DPPO plans.
   We have provided a list of the current top 100 providers for both plans in the Attachments section of this
   RFP. Please indicate if each provider is in your network or not.

10. Please advise how many of the dental providers in the DHMO network are closed for new patients. How
    many are open for new patients? Please provide the same information for your DPPO network.




                                                                                                Page 22 of 30
                                     QUESTIONNAIRE – CONTINUED

11. What is the average turnaround time, from date of receipt for the following:

    Claims
    ID Cards
    Dental       Pre-Treatment
    Review

12. A census of employee and home zip codes is included with this RFP. We are requesting a network match
    based upon this census for both the DHMO and the DPPO plans. We understand that each carrier has its own
    standard criteria for determining network match, however, we require that all carriers use the same criteria so
    that we can make valid comparisons with respect to provider access. The criteria will be:

     Access to two providers within fifteen miles of the employee's ZIP Code. The mileage radius for
     determining an employee "match" cannot exceed ten miles. Please provide number of employees
     within the match, # employees matched, % matched and # employees not matched.

13. Please provide a comprehensive allocation of services for the DHMO plan for your quote for comparison
    purposes. The current plan design and co-payments are attached. Please quote a plan as close to the current
    plan as possible. Please submit two alternate plans. Please provide rates in the attached worksheet: Dental
    RFP – Rates & Plan Design.xls. Please submit copies of your alternate plans to include benefits and co-
    payments. Please advise if there are any waiting period stipulations.

14. Please provide a comprehensive allocation of services below for your quote for comparison purposes. If any
    benefit is in a different class, please note the class under your proposed dental plan schedule. Please
    complete the attached Dental Spreadsheet for the current plan design and Option 1 and Option 2 if quoted.
    An excel spreadsheet is attached in the ―ATTACHMENTS‖ section of this RFP. Worksheet name is:
    Dental RFP – Rates & Plan Design.xls.

   CURRENT RATES                      DHMO           INDEMNITY
   Employee Only                      $ 8.59         $29.22
   Employee/Spouse                    $ 8.54         $47.08
   Employee/Child(ren)                $ 8.54         $47.08
   Employee/Family                    $26.24         $83.12

PLEASE COMPLETE THE TABLES IN THE ATTACHMENTS SECTION OF THIS DOCUMENT
FOR YOUR CURRENT AND PROPOSED PLANS FOR BOTH DHMO AND DPPO PLANS.
ADDITIONALLY, PLEASE PROVIDE SAMPLES OF YOUR PATIENT CHARGE SCHEDULE FOR
EACH DHMO PLAN QUOTED.




                                                                                                   Page 23 of 30
                                     QUESTIONNAIRE – CONTINUED


BASIC LIFE/AD&D AND VOLUNTARY LIFE/VOLUNTARY AD&D
1. What is your approximate turnaround time for approval on Evidence of Insurability applications for
   Voluntary Life? At what level of coverage is EOI required?

2. Do your rates include waiver of premium?

3. Will basic coverage automatically be increased based on salary increase without medical underwriting? At
   what frequency (salary increase date or plan year date)?

4. Will your contract include any of the following provisions (include complete details/costs)?

       Living benefits
       Death benefit proceeds interest-bearing draft bank account
       Financial counseling services to employees receiving ―Living Benefits‖ and/or beneficiaries

5. Will you grandfather current coverage levels?

6. How will waiver of premium reserves be established?

7. Describe the conversion and portability features of your contract and indicate the charges, if any, to the
   group plan for these options. Do you use a dual application process?

8. Provide quotes on current plan designs and proposed plan designs in attached worksheets. Please note any
   differences in plan designs. Current Plans offered are:

        Basic Life/AD&D (employer paid)
        Voluntary Life Employee/ Dependent coverages (employee paid)
        Voluntary AD&D Employee/Dependent (employee paid)

9. Quotes should be provided on a fully insured basis for Basic Life/AD&D.

10. Quotes should be provided for voluntary coverage of Voluntary Life, Voluntary AD&D and Dependent
    Life/AD&D.

11. Benefits are only available to full time employees who meet the eligibility requirements.

12. Basic Life/AD&D coverages should have a guarantee issue that is independent of the Voluntary Life and
    Voluntary AD&D coverages.

13. Voluntary Life (with dependent coverage) and Voluntary AD&D (with dependent coverage) coverages
    should be quoted independent of each other. Please quote guarantee issue coverage as high as possible
    ($250,000+) for each benefit. The guarantee issue for the Voluntary plans should not be tied to the Basic
    Life/AD&D plans.

PLEASE COMPLETE THE TABLES IN THE ATTACHMENTS SECTION OF THIS DOCUMENT
FOR YOUR CURRENT AND PROPOSED PLANS FOR ALL LIFE, AD&D, VOLUNTARY LIFE AND
VOLUNTARY AD&D PLANS.

                                                                                                   Page 24 of 30
                                      QUESTIONNAIRE – CONTINUED


VISION PLAN QUESTIONNAIRE

PLEASE ENSURE ALL REQUESTED ITEMS ARE SUBMITTED WITH YOUR RFP:
                  Confirmation of Plan Design
                  Completed Network Match
                  Completed Rate Quotations
                  Separate list of all deviations (if applicable)
In addition to the master questionnaire please answer the following questions:

1. What is your current trend?

2. What was your average member out-of-pocket cost (excluding copays) in 2004?

3. To the extent that you are unable to comply with the proposed plan designs exactly, please provide a list, by
   benefit that includes our requested plan design and your alternative proposed plan design.

4. Will all participants receive ID cards? If not, how do providers confirm eligibility?

5. Do you have online eligibility capabilities? Please describe. What are the charges associated with online
   eligibility?

6. Confirm that you will provide all initial and ongoing administrative materials at no charge (directories, claim
   forms, etc.).

7. Please describe the information on your website which supports enrollment.

8. Please describe your network in detail. Are national retails stores in your network? If so, how many? (please
   provide a listing of your retailers) Does your network include individual providers? If so, how many? If you
   offer a combination of both retail stores and individual providers, what is the percentage make-up of each?


9. A census of employee and home zip codes is included with this RFP. We are requesting a network match
   based upon this census for the Vision plan. We understand that each carrier has its own standard criteria for
   determining network match, however, we require that all carriers use the same criteria so that we can make
   valid comparisons with respect to provider access. The criteria will be:

   Access to two providers within fifteen miles of the employee's ZIP Code. The mileage radius for
   determining an employee "match" cannot exceed ten miles. Please provide number of employees
   within the match, # employees matched, % matched and # employees not matched.

10. Do you own your own laboratory? If so, where is it located and what types of operations are handled within
    the laboratory?
                                  QUESTIONNAIRE – CONTINUED


                                                                                                   Page 25 of 30
11. Can any segment of your providers offer one hour or same-day eyeglass turnaround?

12. Do you have the capability to provide mail order contact lenses? Please describe your mail order program.
    What is the average amount of time it takes for employees to receive an order of contact lenses? Are there any
    additional costs for this program?

13. Do you offer a network or benefits for corrective eye surgery (e.g., LASIK)? Please describe.

14. Do you offer discounts for cosmetic lens options?

15. What lens options are covered in full for eyeglasses? For non-covered lens options what type of discounts do
    members receive?


Please provide a quotation based upon the following plan designs:
 Current Vision Plan - Plan Summary

Type of Plan: (Standard, Exam Core, Voluntary Materials, Discount, etc.)

Copay Levels: $40 Eye Exam/$35 Materials (out of network)
Benefit Frequency: Eye exam every 12-months, Lenses every 12-months, Frames every 12-months (in-
network) every 24 months (out-of-network), Contact lenses every 12-months.

Type of Employee Participation: (Voluntary, Employee / Employer Paid)
Employer Contribution: 100% - EE Only; ES, EC, EF – 50%
Type of Funding: Fully Insured


Notes: Please review the attached benefit designs which are an exact match of HCHD’s current plan with
Spectera vision. They would like to have benefits equal to or better than their current plan. You may quote
alternate plan designs. Please provide descriptions of the proposed design in the attached questionnaire, along
with proposed rates. Please provide a copy of your benefits summary for any proposed plan design.


PLEASE COMPLETE THE TABLES IN THE ATTACHMENTS SECTION OF THIS DOCUMENT
FOR YOUR CURRENT AND PROPOSED VISION PLANS. PLEASE PROVIDE COPIES OF YOUR
PROPOSED PLAN DESIGNS.




                                     QUESTIONNAIRE - CONTINUED



                                                                                                    Page 26 of 30
FLEXIBLE SPENDING ACCOUNT PLAN QUESTIONNAIRE

General Company Information

1. Provide the following information about your company:
   a. Legal name of the responding organization
   b. Address, telephone/fax number of the corporate headquarters
   c. Address, telephone/fax number of the company office nearest to Houston/Harris County
   d. Brief history of the company, including such items as date of establishment, number of years in business
      providing third party administration services for flexible spending accounts.

2. Explain why your company’s services best meets the requirements of the Hospital District. Describe any
   additional features, aspects, or advantages of your services not covered elsewhere in the proposal.

3. What makes your company different from other vendors in providing third party administration services for
   flexible spending accounts?

4. What do you consider to be your overall company strength(s)?

Company Experience

5. How many accounts does your company manage?
   Total:           _______________
   Hospital Only:   _______________

6. Explain your organization's experience and diversity of resources that qualifies it for consideration for third
   party administration services for flexible spending accounts.

Services

7. How many individual accounts may be maintained on your current data processing system, and how many
   individual accounts do you currently have on your system?

8. How are contributions posted to individual accounts?

9. How are contribution adjustments handled?

10. What documentation is required for claims processing?

11. What is the minimum claim payment?

12. Does the system automatically pend claims which cannot be paid due to insufficient funds (Dependent Care
    Account)?

13. How are payment checks issued and from where are they mailed?

                                       QUESTIONNAIRE - CONTINUED

14. How are claim denials processed?

                                                                                                  Page 27 of 30
15. How often are account statements issued?

16. How long can accounts remain open for claims submission after the end of the plan year?

17. How are participant inquiries regarding available account balance and claims in process handled?

18. Where will claims be paid?

19. Can you provide participants with account balance reports and annual accounting statements within 30 days of
    the end of the plan year?

20. Would the Hospital District have a dedicated unit to manage the accounts? How would you staff for the
    addition of the Hospital District accounts?

21. How long have you been paying spending account claims?

22. What is your turnaround time on claims submitted for payment? Are claims die to be received by mail only or
    are fax copies sufficient for payment of a claim?

23. Do you offer direct deposit to the member for claims submitted for payment?

24. Will member deposits be in an interest bearing account? If so, how will the interest be accounted for?

25. Describe your Interactive Voice Response (IVR) and Internet customer service capabilities.

INTERFACES QUESTIONNAIRE

Interfaces:
1. Can your company conform to the Hospital District PeopleSoft Interface requirements? If not, please
provide your standard interface requirements for the Hospital Districts review.
2. Please advise if you are able to accept eligibility data by diskette, tape, hard copy or on-line? What is your
preferred medium?
3. Are there additional fees required for system interfaces? If so, please detail.

Encryption:
1. Can your company accept and process flat file by position with the PGP encryption method?

File Transfer Method:
1. Will your company support the File Transfer Protocol via an FTP server?
2. Will HCHD be able to login to the FTP server?

File Transfer Frequency:
Will HCHD be allowed to transfer files on whatever frequency is needed (i.e. daily, weekly, bi-weekly,
monthly)?


                                                  EXHIBITS

PLEASE REQUEST EXHIBITS BY EMAIL TO vivian_groce@co.harris.tx.us. PLEASE READ AND
REVIEW ALL EXHIBITS PRIOR TO SUBMITTING QUESTIONS.

                                                                                                    Page 28 of 30
PLEASE RESPOND TO ALL QUESTIONNAIRES IN THE EXHIBITS VIA HARD COPY IN YOUR
RFP RESPONSE AND SAVE TO A DISK OR CD AND SUBMIT AS PART OF YOUR RFP
RESPONSE. EXCEL FILE FORMAT IS PREFERRED AS VIA THE QUESTIONNAIRES.

EXHIBIT 1:         CENSUS – INCLUDES CENSUS FOR ALL LINES OF COVERAGE

EXHIBIT 2:         RETIREE DENTAL AND VISION CENSUS
                   (INCLUDES KEY TO CENSUS DATA) HCHDretireecensus.xls
                   RETIREE CENSUS KEY   HCHDretireecensusKEY.pdf

EXHIBIT 3:         DISCLOSURE OF EMPLOYEES NOT ACTIVE AT WORK
                   (If required at this point, please advise. Information not currently available.)

DENTAL EXHIBITS

Exhibit 4:          DENTAL CURRENT AND PROPOSED PLAN DESIGNS
(Complete current and proposed plan design worksheets) Dental RFP – Rates & DPPOPlanDesign.xls

                   DENTAL RATES & CONTRIBUTIONS
                   Dental RFP – Rates & DPPOPlanDesign.xls

EXHIBIT 5:        CURRENT DHMO PLAN DESIGN
              DHMOcurrentplandesign.pdf

EXHBIT 6:          PROPOSED DHMO PLAN DESIGN
                   DHMOproposedplandesign.pdf

EXHIBIT 7     :    DENTAL EMPLOYEE PARTICIPATION BY MONTH
                   Dental Participation by Month - DHMO & Indemnity.xls

EXHIBIT 8:         DENTAL DHMO SCHEDULE OF BENEFITS
                   DentalDHMOscheduleofbenefits.pdf

EXHIBIT 9:         DENTAL DPPO SCHEDULE OF BENEFITS
                   DentalDPPOscheduleofbenefits.pdf

EXHIBIT 10:        DENTAL DHMO TOP 100 CURRENT PROVIDERS
                   (Disruption reports to be completed)
                   Dental Top DHMO Doctors.xls

EXHIBIT 11: DENTAL DPPO TOP 100 CURRENT PROVIDERS
                (Disruption reports to be completed)
                Dental Top Indemnity Doctors.xls

EXHIBIT 12: DENTAL INDEMNITY CERTIFICATE
                Dental Indemnity COC.pdf

EXHIBIT 13: DENTAL UTILIZATION – EXPERIENCE
                Dental Utilization Report (DHMO & Indemnity).xls

                                                                                                 Page 29 of 30
LIFE/AD&D ATTACHMENTS

Exhibit 14:   LIFE/AD&D QUESTIONNAIRES (6 worksheets to be completed)
              Life.ADD Questionnaire.xls

              LIFE.AD&D RATE HISTORY (Basic and Supplemental)
              Life.ADD Questionnaire.xls

EXHIBIT 15: LIFE.AD&D PREMIUM VS. CLAIMS (Basic and Supplemental)
     Life.ADD.Experience & Claim History (912787).xls

EXHIBIT 16: LIFE.AD&D CERTIFICATES (Basic and Supplemental)
            912787l__revised_policy cert_5_24_4_.pdf
                         Amendment No. 1 (Amendment1.pdf)
                         Amendment No. 2 (Amendment2.pdf)
                         Amendment No. 3 (Amendment3.pdf)
                         Amendment No. 4 (Amendment4.pdf)

VISION ATTACHMENTS

EXHIBIT 17: VISION RATE & CONTRIBUTIONS HISTORY
                  Vision RFP - Rates & Contributions.xls

EXHIBIT 18: VISION CURRENT BENEFITS
                  2004-Trifold (HCHD Spectera Benefit Summary).pdf

EXHIBIT 19: VISION COST OF SERVICES
                  HCHD 9-2004 (Spectera Cost of Services Report).pdf

EXHIBIT 20: VISION CURRENT AND PROPOSED PLAN DESIGNS INCLUDES PROPOSED RATES
            (Complete current and proposed plan design worksheets and proposed rates)
            VisionCurrentandProposedPlanDesigns.xls

EXHIBIT 21: FLEXIBLE SPENDING ACCOUNTS
                 HCHD Flexible Spending Accounts RFP Response.xls

EXHIBIT 22: DENTAL AND VISION BENEFITS PARTICIPANT INTERFACE TO VENDOR

EXHIBIT 23: LIFE & AD&D BENEFITS PARTICIPANT INTERFACE TO VENDOR

EXHIBIT 24: FSA BENEFITS PARTICIPANT INTERFACE TO VENDOR




                                                                            Page 30 of 30

				
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