Rfp for Preparing a Client Company Budget

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Rfp for Preparing a Client Company Budget Powered By Docstoc
					              Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
              Single Location: FI PPO

              To Vendor: Use Column Q to provide a brief explanation.
              However if the length of the explanation is greater than 400
              characters, you must use the "Explanation" worksheet to
              provide your detail explanation.

              MEDICAL RFP 2009                                               Answer Format     Response   Explanation

I.            GENERAL PLAN INFORMATION                                       Answer Format     Response   Explanation
      1.      PPO Plan Name                                                       text
      2.      Street Address                                                      text
      3.      City                                                                text
      4.      State                                                               text
      5.      Zip                                                                 text
      6.      Web Address                                                         text
      7.      PPO Operational Date                                           Month Day, Year
      8.      Corporate Tax Status                                                text
      9.      PPO Ownership/Controlling Interest                                  text
     10.      NCQA Accreditation Status                                           text
     11.      JCAHO Accreditation                                                 text
     12.      URAC Accreditation
            a. Health Plan                                                        text
           b. Health Network                                                      text
            c. Health Utilization Management                                      text
     13.    PPO Commercial Group Membership                                    number, 0
            If the PPO's rating has changed within the
            past 12 months for any of the rating agencies,
            indicate new rating and the date received in
     14.
            the appropriate box. If the rating has not
            changed, put "Not Changed" in the Rating
            cell.
         a. A.M. Best: Rating Status                                         drop down box
                 Financial Rating (if rated)                                      text
                 Date (if rated; if not rated, leave response cell
                                                                             Month Day, Year
                 blank)
           b. Standard & Poor's: Rating Status                               drop down box
                 Financial Rating (if rated)                                      text
                 Date (if rated; if not rated, leave response cell
                                                                             Month Day, Year
                 blank)
            c. Fitch: Rating Status                                          drop down box
                 Financial Rating (if rated)                                      text
                 Date (if rated; if not rated, leave response cell
                                                                             Month Day, Year
                 blank)
           d. Moody's: Rating Status                                         drop down box
                 Financial Rating (if rated)                                      text
                 Date (if rated; if not rated, leave response cell
                                                                             Month Day, Year
                 blank)


              Contacts                                                       Answer Format     Response   Explanation
              Please indicate the vendor contact, should
              there be any questions concerning submitted
              responses.
     15.      Primary Contact
            a. Name                                                               text
           b. Title                                                               text
            c. Address                                                            text

           474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                            1                Aon Consulting
               Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
               Single Location: FI PPO

               To Vendor: Use Column Q to provide a brief explanation.
               However if the length of the explanation is greater than 400
               characters, you must use the "Explanation" worksheet to
               provide your detail explanation.

               MEDICAL RFP 2009                                               Answer Format   Response   Explanation

            d. City                                                               text
             e. State                                                             text
             f. Zip                                                               text
            g. Phone Number                                                       text
            h. Fax Number                                                         text
             i. E-mail Address                                                    text
      16.      Secondary Contact
             a. Name                                                              text
            b. Title                                                              text
             c. Address                                                           text
            d. City                                                               text
             e. State                                                             text
             f. Zip                                                               text
            g. Phone Number                                                       text
            h. Fax Number                                                         text
             i. E-mail Address                                                    text


II.            PLAN DESIGN/FINANCIAL INFORMATION                              Answer Format   Response   Explanation
               Adhere to the proposed plan design shown in
               the worksheet(s), "Plan Design" in preparing
               the quote.
               The proposal is issued in accordance with the
               specifications, assumptions and information
               included in this Request for Proposal, the
       1.      accompanying worksheets and standard services                  drop down box
               addressed in the Request for Information
               previously submitted. If "No", indicate deviations
               in "Explanation" column and/or worksheet.


               Plan Design                                                    Answer Format   Response   Explanation
               Review and detail deviations from the proposed
       2.      plan(s) design shown in the worksheet(s), "Plan                drop down box
               Design."
               For fully-insured coverages, include a detailed
               description of the proposed plan(s) design,
       3.      including any riders, if quoted. Name the file:                drop down box
               [Your Organization's
               Name]_ProposedPlanDescription.
               Include a concise description of how this health
               plan covers transitional conditions, such as
               pregnancy, chemotherapy, etc., if a new member
       4.                                                                     drop down box
               is receiving treatment from a non-participating
               provider. Name the file: [Your Organization's
               Name]_TransitionalCare.
               For those employees outside of your service
               area, provide a proposed out-of-area plan design.
       5.                                                                     drop down box
               Name the file: [Your Organization's
               Name]_OutofArea_ Plan.




            474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                           2               Aon Consulting
         Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
         Single Location: FI PPO

         To Vendor: Use Column Q to provide a brief explanation.
         However if the length of the explanation is greater than 400
         characters, you must use the "Explanation" worksheet to
         provide your detail explanation.

         MEDICAL RFP 2009                                               Answer Format   Response   Explanation

         Financial - Underwriting
         Requirements/Premium Quotation
       For the fully-insured coverages requested, do you
 6.    have minimum participation requirements in                       drop down box
       order to underwrite this particular group?
       If "Yes", what is the minimum number or
    a. percentage of employees required to enroll in                      percent, 1
       order to underwrite the group?
       Does this figure include those employees waiving
    b.                                                                  drop down box
       coverage?
       For the fully-insured coverages requested, are
       there underwriting requirements for this initial
 7.                                                                     drop down box
       group of plan participants? If so, please provide
       the requirements below:
       Underwriting reason #1 (e.g., minimum employer
    a.                                                                       text
       contributions)
      b. Underwriting reason #2 (e.g., medical evidence)                     text

       c. Underwriting reason #3 (please specify)                            text
          For the fully-insured coverages requested, is The
          Client required to place other lines of coverage
          (i.e. minimum basic life, etc.) in order to secure
 8.                                                                     drop down box
          the medical coverage requested. If "Yes",
          indicate specifics in "Explanation" column
          and/or worksheet.
          For fully-insured quotes, provide your financial
 9.                                                                     drop down box
          quotation in the worksheet(s), "FQuote."
          If you were requested to provide guaranteed
          rates or rate caps beyond the first contract
10.                                                                     drop down box
          period, have you included the rates or caps in the
          financial quotation?
          If you were provided with a Risk Evaluation Form,
11.       did you reflect the medical information included              drop down box
          on the form in your quote?
         For fully-insured quotes, select the rating
12.
         method used to develop the proposed rates:

       a. PPO Quotes                                                    drop down box
         For fully-insured quotes, select the rating
13.      method which will be used in subsequent
         renewals:
       a. PPO Quotes                                                    drop down box
         Describe the terms and conditions under which
         you have the right to modify the rates or
14.      administrative agreement and/or its fees. If you                    text
         need more space, please use the "Explanation"
         column and/or worksheet.
         The quoted rates/fees include
15.      commissions/compensation requested in the                      drop down box
         Introduction Section of this RFP.
         The quoted rates will be reduced if your PPO is
16.                                                                     drop down box
         the only PPO offered in this market.


         Financial - Renewal Services                                   Answer Format   Response   Explanation

      474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                            3              Aon Consulting
                Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
                Single Location: FI PPO

                To Vendor: Use Column Q to provide a brief explanation.
                However if the length of the explanation is greater than 400
                characters, you must use the "Explanation" worksheet to
                provide your detail explanation.

                MEDICAL RFP 2009                                               Answer Format   Response   Explanation

                For the funding arrangement requested in this
                RFP, please indicate your willingness to
                comply with the following renewal
                requirements and services:
                For fully-insured coverages requested, renewal
                underwriting of rates is to be completed annually
       17.      with any adjustments effective on the contract                 drop down box
                anniversary date, unless an alternate date is
                mutually agreed to in advance by The Client.

                For fully-insured coverages requested, renewal
                rates (to be accompanied with an experience
       18.                                                                     drop down box
                summary report) are to be provided at least 180
                days in advance of the contract anniversary date.

                Renewal rates/administrative fees shall be
                guaranteed for a minimum of 12 months from the
       19.      contract anniversary date, unless an alternate                 drop down box
                date is mutually agreed to in advance by The
                Client.


III.            MEDICAL DELIVERY SYSTEM                                        Answer Format   Response   Explanation
                Please attach a copy of the provider
                directory(ies) for all locations for which you are
        1.                                                                     drop down box
                quoting. Name the file: [Your Organization's
                Name]_ProviderDirectories.
                List participating Acute Care Hospitals for the
        2.      geographic locations as shown in the                           drop down box
                worksheet(s), "Hosp".
                Provide the number of participating physicians by
        3.      specialty for the geographic locations shown in                drop down box
                the worksheet(s), "Doc".


                Employees' Access to Providers                                 Answer Format   Response   Explanation
                Using the census data provided, prepare a list to
                indicate which employees reside within and
        4.      outside of your service area. Name the file:                   drop down box
                [Your Organization's
                Name]_ServiceAreaSummary.


IV.             ADMINISTRATIVE AND OPERATIONAL ISSUES                          Answer Format   Response   Explanation
                Implementation Services
                Prepare a detailed schedule and time frame to
                implement this program by the effective date.
                Please indicate the implementation
        1.                                                                     drop down box
                responsibilities of your organization, The Client
                and Aon. Name the file: [Your Organization's
                Name]_Implementation.
                Design, submit for The Client's approval, and
        2.      print forms with The Client's logo for claims                  drop down box
                submission, where required.
                If requested, provide network service area zip
        3.      codes and electronic directories for The Client's              drop down box
                voice enrollment system.


             474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                          4                Aon Consulting
         Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
         Single Location: FI PPO

         To Vendor: Use Column Q to provide a brief explanation.
         However if the length of the explanation is greater than 400
         characters, you must use the "Explanation" worksheet to
         provide your detail explanation.

         MEDICAL RFP 2009                                               Answer Format   Response   Explanation

         Load, audit and insure clean eligibility data at
 4.                                                                     drop down box
         least 5 days prior to program effective date.
         Send plan representatives to the worksite to
 5.      conduct new member orientations for groups                     drop down box
         having 25+ employees at no additional charge.


         Other Services                                                 Answer Format   Response   Explanation
         List the location(s) of your service centers that
         would be servicing The Client's employees and
         the corresponding geographic areas/regions
 6.
         covered by the respective location. Use the
         "Explanation" column and/or worksheet if you
         need more space.
       a. Service Center 1
            Location 1                                                      text
            Geographic Region(s) Covered 1                                  text
      b. Service Center 2
            Location 2                                                      text
            Geographic Region(s) Covered 2                                  text
       c. Service Center 3
            Location 3                                                      text
         Geographic Region(s) Covered 3                                     text
       Indicate which conversion plans are offered
 7.    post-COBRA coverage; if offered, indicate the
       name of insuring entity.
    a. HMO
            Offered/Not Offered?                                        drop down box
            Name of Insuring Entity                                         text
      b. POS
            Offered/Not Offered?                                        drop down box
            Name of Insuring Entity                                         text
       c. PPO
            Offered/Not Offered?                                        drop down box
            Name of Insuring Entity                                         text
         Attach a description of premium or administrative
         fee billing procedures. Include information on the
         timing of billing, billing-payment reconciliations
 8.                                                                     drop down box
         and ability to provide for client self-billing. Name
         the file: [Your Organization's
         Name]_PremiumBilling.
         The plan will contain the birthday rule and will
 9.      have group to group coordination of benefits                   drop down box
         provision.
         To the extent permitted under state law, no fault
         auto insurance, governmental plans coordination
10.                                                                     drop down box
         and negligent third party subrogation will be
         administered.




      474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                           5               Aon Consulting
               Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
               Single Location: FI PPO

              To Vendor: Use Column Q to provide a brief explanation.
              However if the length of the explanation is greater than 400
              characters, you must use the "Explanation" worksheet to
              provide your detail explanation.

              MEDICAL RFP 2009                                               Answer Format   Response   Explanation

               Please attach a copy of a plan experience report
               that would be provided to The Client at the end of
     11.                                                                     drop down box
               the first year. Name the file: [Your
               Organization's Name]_MgmtRptgPkg.
     12.       The health plan will pay for printing costs for:

            a. ID Cards                                                      drop down box
           b. Booklets                                                       drop down box
            c. Certificates                                                  drop down box
           d. SPDs                                                           drop down box


V.            LEGAL/CONTRACTUAL CONSIDERATIONS                               Answer Format   Response   Explanation
               Vendor has complied with all state insurance
               department filing requirements for all
      1.                                                                     drop down box
               plans/products being offered in this quote in each
               state in which the Client has employees.
              Comment : Be sure to review the census file submitted with
              this RFP.
               If the answer to the preceding question is "no",
               for all plans/products quoted in this RFP for
               which the required state insurance department
            a.                                                                   text
               filing requirements have not been met, please
               specify the applicable plan/product and
               corresponding state
      2.       Vendor is bonded.                                             drop down box
               Vendor maintains a fidelity bond as required by
      3.                                                                     drop down box
               ERISA.
               Vendor maintains professional liability insurance
      4.       that exceeds $5 million per claim and $20 million             drop down box
               aggregate.
            a. If not, please explain amount of coverage.                        text
      5.       Liability insurance covers:
            a. Medical management decisions.                                 drop down box

           b. Professional malpractice                                       drop down box

            c. Provider contracting                                          drop down box
               Please describe any judgment or settlement
               during the past three years or pending litigation
      6.                                                                         text
               that could result in judgments or settlements in
               excess of $100,000.
               The vendor maintains executed contracts with all
      7.                                                                     drop down box
               providers participating in the network.
               The vendor provider contracts do not provide for
               any type of remuneration to your organization,
      8.                                                                     drop down box
               such as commission, finder's fee, rebate, or other
               financial benefit.
               Your organization is not a creditor of any provider
      9.                                                                     drop down box
               in the network.
               For this proposal, confirm that the risk is held
     10.       entirely by your organization. (Applicable to fully-          drop down box
               insured coverages.)



           474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                           6               Aon Consulting
            Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
            Single Location: FI PPO

            To Vendor: Use Column Q to provide a brief explanation.
            However if the length of the explanation is greater than 400
            characters, you must use the "Explanation" worksheet to
            provide your detail explanation.

            MEDICAL RFP 2009                                               Answer Format     Response   Explanation

         If it is not, indicate the percentage of the risk
       a.                                                                  % of risk ceded
         passed on to other firms.
         Provide treaty details of any ceded risk. If you
      b. need more space, please use the "Explanation"                          text
         column and/or Worksheet.

            Vendor agrees to prepare and file all legal
            documents necessary to implement and maintain
11.                                                                        drop down box
            the plan, including policies, amendments,
            contracts, and required state filings.
            Vendor agrees to provide necessary legal
12.         defense in the event of litigation, including all              drop down box
            costs inuring thereto.
            Vendor agrees to indemnify and hold The Client
            harmless for Vendor’s negligence or for Vendor’s
            failure to perform under the Agreement. The
13.                                                                        drop down box
            Client shall not provide any indemnity in favor of
            the Vendor. Vendor agrees to language
            contained in worksheet "Hold Harmless".



            Contractual                                                    Answer Format     Response   Explanation
            October 01, 2009 is to be the contract effective
14.                                                                        drop down box
            date.
            The contract will be issued in Hawaii unless you
15.         obtain permission from Aon Consulting to use an                drop down box
            alternative situs.

16.         July 1 will be the first contract anniversary date.            drop down box

            The vendor agrees not to appoint any agent,
            general agent, or broker, nor authorize payment
17.                                                                        drop down box
            of any kind to a party not approved in writing by
            The Client.
            We understand that terminology and contract
            provisions may vary among the involved vendors.
18.         We will permit such alternative language                       drop down box
            provided benefit payment levels are not adversely
            impacted.
            The vendor shall cause The Client and its welfare
            program to be the named insured thereunder.
19.         The vendor shall provide proof of such insurance               drop down box
            to The Client at or prior to the execution of the
            contract.
            There will be no restrictions or benefit limitations
            for pre-existing conditions applied to any
20.                                                                        drop down box
            members enrolled in the plan/program at any
            time.




      474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                               7                Aon Consulting
         Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
         Single Location: FI PPO

         To Vendor: Use Column Q to provide a brief explanation.
         However if the length of the explanation is greater than 400
         characters, you must use the "Explanation" worksheet to
         provide your detail explanation.

         MEDICAL RFP 2009                                               Answer Format   Response   Explanation

         No Loss/No Gain Provision: The insurer must
         provide coverage on a discontinuance and
         replacement basis (sometimes referred to as a
         "no loss/no gain" basis) for eligible employees
21.                                                                     drop down box
         (and dependents) participating in the current
         plans on the effective date and to unconditionally
         provide continuous coverage to all participants
         enrolled on the program effective date.

         Waiver of Actively at Work Provisions: Any
         participants not actively at work due to
22.                                                                     drop down box
         disablement on the program effective date will be
         covered.
         No statement of health or medical evidence will
23.      be imposed upon the [initial group of covered                  drop down box
         participants].
         Any disabled employees (or enrolled dependents)
         or other leave-of-absence employees who are
         inadvertently not disclosed in these specifications
24.      or who later are identified as eligible for benefits           drop down box
         with the incumbent vendor will become the
         liability of the vendor selected through this
         marketing.



         Future Contract Termination                                    Answer Format   Response   Explanation
         The vendor selected during this proposal process
         will be responsible for incurred claims up to the
         termination date of the contract, regardless of
         paid date, in the event the contract awarded
25.      during this marketing is subsequently terminated. drop down box
         The replacement vendor will have the
         responsibility pay claims incurred after the
         termination date of the contact.(Applicable to fully-
         insured coverages)
         The vendor selected during this proposal process
         will be responsible to maintain coverage for
         persons who are hospital-confined on the date
         the agreement terminates until the individual is
26.                                                            drop down box
         discharged, regardless of paid date, in the event
         the contract awarded during this marketing is
         subsequently terminated. (Applicable to fully-
         insured coverages)


         Compliance, General                                            Answer Format   Response   Explanation
         Vendor agrees that it will honor repayment
         demands or requests for reimbursement that are
27.                                                                     drop down box
         made within the 3-year period for Medicare to
         recover improper payments.
         The vendor agrees to comply with the
         Department of Labor's final claims procedure
28.      regulations, including the appropriate timeframes              drop down box
         for adjudicating claims and notice of appeal
         decisions.




      474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                          8                Aon Consulting
         Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
         Single Location: FI PPO

         To Vendor: Use Column Q to provide a brief explanation.
         However if the length of the explanation is greater than 400
         characters, you must use the "Explanation" worksheet to
         provide your detail explanation.

         MEDICAL RFP 2009                                               Answer Format   Response   Explanation

         Vendor will provide participants with annual
29.      notice that the plan provides for coverage for                 drop down box
         breast reconstruction following mastectomy.

         Compliance, HIPAA                                              Answer Format   Response   Explanation
         You maintain a dedicated individual or staff
30.                                                                     drop down box
         responsible for resolving HIPAA issues.
         Vendor certifies that it will comply with the
31.      interim final rules on nondiscrimination in the
         group health market, including:
         Coverage for self-inflicted injuries for persons
      a. who suffer from medical conditions (such as                    drop down box
         depression)
         Coverage for persons who are hospital-confined
      b. or not actively at work when coverage would                    drop down box
         otherwise take effect.

         Vendor certifies that it reports to the national
         Healthcare Integrity and Protection Databank
         (HIPDB) as required and, as may be necessary,
32.                                                                     drop down box
         submits inquiries to the HIPDB to determine
         whether any final adverse legal actions have
         been taken against its member providers.

         Vendor certifies that, if it conducts Standard
         Transactions, it is in full compliance with HIPAA's
33.                                                                     drop down box
         administrative simplification standards relating to
         electronic data interchange (EDI).
         Vendor will not require that enrollment and
34.      eligibility information electronically transmitted by          drop down box
         Client to Vendor comply with EDI.


         Compliance, Privacy and Confidentiality                        Answer Format   Response   Explanation
35.      The vendor agrees to make internal practices,
         books, and records relating to the use and
         disclosure of PHI received from, or created or
         received by organization available to the
         Secretary of the Department of Health and                      drop down box
         Human Services for purposes of the Secretary of
         the Department of Health and Human Services
         determining organization’s compliance with the
         privacy rules.
36.      The vendor adopts and implements written
         confidentiality policies and procedures in
         accordance with applicable law to ensure the                   drop down box
         confidentiality of member information used for
         any purpose.
37.      The vendor will not use or further disclose
         protected health information (PHI) other than as
                                                                        drop down box
         permitted or required by the Business Associate
         Agreement or as required by law.
38.      The vendor agrees to use appropriate safeguards
         to prevent the unauthorized use or disclosure of
         the PHI. Vendor agrees to report to the plan                   drop down box
         sponsor any unauthorized use or disclosure of
         the PHI.


      474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                          9                Aon Consulting
               Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
               Single Location: FI PPO

               To Vendor: Use Column Q to provide a brief explanation.
               However if the length of the explanation is greater than 400
               characters, you must use the "Explanation" worksheet to
               provide your detail explanation.

               MEDICAL RFP 2009                                               Answer Format   Response   Explanation

      39.      The vendor agrees to mitigate, to the extent
               practicable, any harmful effect that is known to
               vendor of a use or disclosure of PHI by vendor in              drop down box
               violation of the requirements of the federal
               privacy rule.
      40.      The vendor agrees to ensure that any agent,
               including a subcontractor, to whom it provides
               PHI received from, or created or received by the
                                                                              drop down box
               vendor agrees to the same restrictions and
               conditions that apply to vendor with respect to
               such information.
      41.      The vendor agrees to provide access to PHI in a
               "designated record set" in order to meet the                   drop down box
               requirements under 45 CFR §164.524.
      42.      The vendor agrees to make any amendment(s) to
               PHI in a "designated record set" pursuant to 45                drop down box
               CFR §164.526.
      43.      The vendor agrees to document such disclosures
               of PHI and information related to such
               disclosures as would be required to respond to a
                                                                              drop down box
               request by an individual for an accounting of
               disclosures of PHI in accordance with 45 CFR
               §164.528.
      44.      The vendor agrees to (i) implement
               administrative, physical, and technical
               safeguards that reasonably and appropriately
               protect the confidentiality, integrity, and
               availability of the electronic PHI that it creates,
               receives, maintains, or transmits, (ii) report to the
               plan sponsor any security incident (within the
                                                                              drop down box
               meaning of 45 CFR § 164.304) of which vendor
               becomes aware, and (iii) ensure that any vendor
               employee or agent, including any subcontractor
               to whom it provides PHI received from, or created
               or received by the vendor agrees to implement
               reasonable and appropriate safeguards to protect
               such PHI.


               Officer                                                        Answer Format   Response   Explanation
      45.      Vendor's completed proposal contains the form
               (included in the worksheet, "Officer"), signed by
               a company officer, attesting to compliance with                drop down box
               RFP specifications and the accuracy of all
               responses.


VI.            OTHER INFORMATION                                              Answer Format   Response   Explanation
               Please provide the following information in
               electronic format and name the file as
               specified:
               A copy of your most recent audited financial
       1.      statement. Name the file: [Your Organisation                   drop down box
               Name]_Audited Financial Statement.
               A description of the health plan's conversion
       2.      plan(s) and associated costs. Name the file:                   drop down box
               [Your Organisation Name]_Conversion Services.



            474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                          10               Aon Consulting
        Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
        Single Location: FI PPO

        To Vendor: Use Column Q to provide a brief explanation.
        However if the length of the explanation is greater than 400
        characters, you must use the "Explanation" worksheet to
        provide your detail explanation.

        MEDICAL RFP 2009                                               Answer Format   Response   Explanation

        A copy of the health plan's appeal and grievance
        policies, if not specified in the Suggested
3.                                                                     drop down box
        Employer Contract. Name the file: [Your
        Organisation Name] _Appeal_Grievance Policies.

        Current marketing materials that would be of
        assistance to Aon Consulting and The Client in
4.                                                                     drop down box
        evaluating your program. Name the file: [Your
        Organisation Name]_MarketingMaterials.

        Sample ID Card and description of elements that
5.      may be customized. Name the file: [Your                        drop down box
        Organisation Name]_IDCard.
      Current member enrollment materials that the
      health plan feels would be of assistance to Aon
6.    Consulting in evaluating your program. Name                      drop down box
      the file: [Your Organisation
      Name]_EnrollmentMaterials.
      Please provide three of your employer client
      references of similar size in the network
7.
      locations that will be serving most of The
      Client's employees.
   a. Reference #1
           Company Name                                                    text
           Contact Person                                                  text
           Title                                                           text
           Phone Number                                                    text
           Fax Number                                                      text
           E-mail Address                                                  text
           Network Name                                                    text
           PPO Members Enrolled                                          number, 0
     b. Reference #2
           Company Name                                                    text
           Contact Person                                                  text
           Title                                                           text
           Phone Number                                                    text
           Fax Number                                                      text
           E-mail Address                                                  text
           Network Name                                                    text
           PPO Members Enrolled                                          number, 0
      c. Reference #3
           Company Name                                                    text
           Contact Person                                                  text
           Title                                                           text
           Phone Number                                                    text
           Fax Number                                                      text
           E-mail Address                                                  text
           Network Name                                                    text
           PPO Members Enrolled                                          number, 0

     474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                           11              Aon Consulting
   Request for Proposal (RFP) for Hawaii Employer-Union Health Benefits Trust Fund
   Single Location: FI PPO

   To Vendor: Use Column Q to provide a brief explanation.
   However if the length of the explanation is greater than 400
   characters, you must use the "Explanation" worksheet to
   provide your detail explanation.

   MEDICAL RFP 2009                                               Answer Format   Response   Explanation




474a5842-cb8c-4741-a35e-9e523aa4ab76.xls 7/25/2011                          12               Aon Consulting

				
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Description: Rfp for Preparing a Client Company Budget document sample