Loading...
HomeMy WebLinkAboutCOD-038-10Gja"I~C1~011 REPORT CORPORATE SERVICES DEPARTMENT Meeting: GENERAL PURPOSE AND ADMINISTRATION Date: July 5, 2010 Report: COD-038-10 Resolution#: ~PN-'y~4'~0 File#: NIA By-law#: N/A Subject: Great West Life Benefit Renewal 2010 - 2011 RECOMMENDATIONS: It is respectfully recommended that the General Purpose and Administration Committee recommend to Council the following: THAT Report COD-038-10 be received; 2. THAT Great West Life be advised of the Municipality's disappointment with the financial impact imposed on the Municipality with the 45.8 percent increase in the renewal of the benefit program for the 2010 to 2011 premium year; 3. THAT Council authorize over expenditure of the 2010 budget accounts to accommodate the Great West Life premium increase for the balance of 2010; and 4. THAT the 2011 budget be prepared as appropriate, reflecting the Great West Life premium increases. Submitted MM/gj (d~1e Marano, H.B.Sc., C.M.O., Director of Corporate Services/ Human Resources d' - _"""-" ~ ~~ Reviewed by: Franklin Wu Chief Administrative Officer CORPORATION OF THE MUNICIPALITY OF CLARINGTON 40 TEMPERANCE STREET, BOWMANVILLE, ONTARIO L1C 3A6 T (905)623-3379 F (905)623-0830 REPORT NO.: COD-038-10 PAGE 2 BACKGROUND AND COMMENT 1.0 History 1.0 The employee group benefit program underwent a market review and competition in 2008 with the assistance of Buffett Taylor Employee Benefits Consulting to review the results of the RFP. Eighteen benefit providers picked up the bid document, however out of the 7 companies who decided to bid, only 4 were able to bid on all benefits for a complete quote. Great West Life Assurance Company was the successful bidder and was awarded the contract through report COD-064-08 (Attachment #1 ). There was an estimated savings in the renewal premiums of approximately $300,000 with the Great West Life bid. 1.1 The Great West Life proposal committed to some guarantees on the rates following the renewal: 27 months LTD and Life Insurance 15 months Health & Dental 12 months other quotes and charges 1.2 The renewal for LTD and Life does not show an increase as promised, and the guaranteed rate commitment of 15 months expired about April 155, 2010. 1.3 Great West Life award included a term of four years, with an option to review for possible renewal pending satisfactory service and terms. The first term was effective from February 15`, 2009, therefore the final year term should run from February 1, 2012 to March 15c 2013. 2.0 The 2010 Budget Preparation 2.1 In September 2009 for preparation of the 2010 budget, staff requested confirmation from Great West Life of an estimated potential increase for the 2010 renewal. An a-mail response from the Account Manager the following comment: "If you need to provide your finance department with an estimate and what I provided is unacceptable, please use your number. If 12 percent is the highest increase you would accept then it is a realistic estimate, just not one that I can put forward at this time." The budget was prepared based on this assurance of the12% premium increase being a reasonable estimate and the implied commitment of Great West Life. REPORT NO.: COD-038-10 PAGE 3 The Account Manager who had provided excellent customer service throughout the term, left GWL to join another firm just prior to a scheduled meeting to discuss the anticipated 2010 - 2011 renewal . 2.2 The 2010 budget impact affects part of the year since Great West Life did agree to defer the implementation of the increase to start July 15` 2010. The estimated 2010 impact is $378,435. 3.0 First Renewal Term 2010 - 2011 3.1 GWL issued a renewal notice dated April 15S 2010 indicating an overall impact of 45.8% on the premium cost for benefits other than Life and LTD which are guaranteed until the next renewal term. The policy was scheduled to renew with GWL effective May 1, 2010, however with the delays in the process due to the change in GWL staff and repeated concerns expressed by the Municipality on the renewal impact, the renewal date was deferred to June 1, 2010. 3.2 Staff met with key representatives from Great West Life on two occasions to review the proposed impact for the renewal. At the initial meeting, Staff expressed incredulity at the proposed 45.8 % increase and requested an in depth review of each component of the premium expense to validate the numbers presented. GWL returned to review their findings, advising that their numbers were accurate and the company was losing a significant amount of money on the claims paid out versus the premiums paid. On June 11"' a written notice was received confirming that GLW were not prepared to phase or amend the 45.8 increase for the renewal. The result is a financial impact of an additional $63,073 per month, totaling $756,870 over twelve months, if there is no increase in premiums on the renewal for June 1, 2011, however based on GWL current approach it is likely that there may be some increase in the 2011 to 2012 renewal. 3.3 Staff consulted the benefit consultant company that assisted in the analysis of the bid and award, who confirmed that the amount of increase appeared to be significantly larger than what would be expected, but without the details of the claims information they were not able to be specific in their comment. They did note that if the claims had deteriorated since the market analysis, the Municipality may have been in the same cost position had it remained with the prior carrier. REPORT NO.: COD-038-10 4.0 Conclusion PAGE 4 4.1 While there is no doubt the Municipality's prior year claims include a number of significantly large use of drug and health benefit, and any business enterprise is not expected to subsidize premiums, it is disappointing that Great West Life would not phase in the drastic premium increase. 4.2 It is recommended that the Municipality complete the contractual term to 2013, and review the market conditions in the 3ro year for possible competition at the conclusion of the contract. 4.3 The Budget 2011 will be prepared representing the full impact of the premium increase, plus any anticipated renewal impact for June 1, 2011 to May 31, 2012. Attachments: Attachment 1 -Report COD-064-08 ~~Ji11C uJ~ ATTACHMENT #1 Leading the W"oy~~ • REPORT CORPORATE SERVICES DEPARTMENT Meeting: GENERAL PURPOSE AND ADMINISTRATION COMMITTEE Date: October 20, 2008 Report #: COD-064-08 File # By-law # Subject: RFP2008-5 -PROVISION OF EMPLOYEE GROUP BENEFITS Recommendations: It is respectfully recommended that the General Purpose and Administration Committee recommend to Council the following: 1. THAT Report COD-064-OS be received; 2. THAT the presentation provided by Buffett Taylor Employee Consulting be received for information; • 3. THAT Great West Life Assurance Company be awarded the contract for the provision of Employee and Dependent Life, Long Term Disability, Health and Dental coverage for a minimum four year term with a review at the conclusion for a possible renewal of a further term pending satisfactory service and acceptable terms; 4. THAT Chubb Insurance Company of Canada be awarded the contract for the provision of Accidental Death and Dismemberment coverage for a minimum four year term. With a review at the conclusion for a possible renewal of a further term pending satisfactory service and acceptable terms; 5. THAT staff be authorized to proceed with negotiations of a final agreement with Great West Life Assurance Company and Chubb Insurance Company on behalf of the Municipality; 6. THAT the attached By-laws marked Schedule "A" and "B" authorizing the Mayor and Clerk to execute agreements with the Great West Life Assurance Company and Chubb Insurance Company of Canada be forwarded to Council for approval; and 7. THAT the Director of Corporate Services be authorized to approve administrative policies/ agreem as required. Submitted by: Reviewed by: ~ / ~-'c---~~~ Chief Administrative Officer MMLIOBV,m CORPORATION OF THE MUNICIPALITY OF CLARINGTON 40 TEMPERANCE STREET, BOWMANVILLE, ONTARIO L1C 3A6 T (905)623-3379 F (905)623-4169 REPORT NO.: COD-064-08 PAGE 2 • 1. BACKGROUND AND COMMENT 1.1. Request for Proposal RFP2008-5 -Provision of Employee Benefits was issued inviting responses from qualified and experienced benefits insurers with the assistance of Buffett Taylor Employee Benefits Consulting. The recommended term of the agreement is for a period of four (4) years after which a review, utilizing, as appropriate an independent consultant, with a view to continuation or re-marketing the program. 1.2. The proposal for benefits coverage included all employee benefits, employee and dependent life insurance, long term disability (LTD), extended health and dental (EH&D), accidental death and dismemberment (AD&D) and deluxe travel insurance. Coverage was intended to cover all levels of municipal staffing, including approximately 290 employees, LTD claimants and retirees. In addition, it was an opportunity to explore the benefits of amalgamating all benefits under one provider, whereas we are currently covered by three • providers, Sun Life Financial for LTD., Manulife Financial for Health and Dental and RBC Insurance for Life Insurance. 1.3. A total of eighteen (18) benefit providers obtained the bid document and seven (7) submissions were received. All submissions were then reviewed by Municipality's evaluation team consisting of staff from Human Resources, Payroll, Purchasing and Buffett Taylor. A report prepared by Buffett Taylor summarizing the process, the rational for the selected providers and providing recommendations for award is attached as Schedule"B". As stipulated in the proposal document, proponents were evaluated based on the following criteria: 3.1. Company Profile and Experience including references and any conflicts of interest 1.3.2. Service Team including experience, quaycations/certifications and unique experience ® 1.3.3. Financial requirements including premiums, renewal methodology and rate guarantees REPORT NO.: COD-064-08 PAGE3 • 1.3.4. Responses to 48 point questionnaire. A copy of the questionnaire is attached as Schedule "D" 1.3.5. Transitional Services -timetable, implementation team, employee communications and information sessions and identified time savers. 1.4. Each benefits provider submitted comprehensive proposals addressing all issues contained in the bid document. However, after a review of all documents, the Desjardins Financial Security submission was rejected as it was non-compliant. Based on the evaluation committee's review and scoring of the submissions two firms, Manulife and Great West Life, stood out based on their overall scores. The evaluation team proceeded to interview representatives from each provider in order to finalize the selection process. 2. ANALYSIS 2.1. Based on the overall highest score the evaluation committee is recommending ® that Great West Life Assurance Company be awarded the contract for the provision of employee and dependent life, long term disability (LTD), extended health and dental (EH&D) and deluxe travel insurance. However, Great West Life was not competitive on the provision of accidental death and dismemberment coverage 2.2. After completing the interview and scoring process it was determined that Chubb Insurance Company of Canada was offering the best overall proposal for the provision of Accidental Death and Dismemberment coverage. Accordingly, the evaluation team is recommending Chubb as the provider for the AD&D coverage. 2.3. Details supporting the above noted recommendations are contained in the Market Survey Highlights and Recommendation report submitted by Buffett Taylor and attached as Schedule "C". 3. FINANCIAL IMPLICATIONS 3.1. Adoption of the foregoing recommendations will, at a minimum, result in a rate stabilization for all benefit premiums with a potential for a reduction in overall REPORT NO.: COD-064-08 PAGE 4 • costs to the Municipality, however, the exact amount is yet to be determined. The total benefit cost for 2007 was $1,850,258.02. 3.2. Notwithstanding the cost benefits, which includes cost guarantees ranging from 1 to 3 years as noted in the attached Buffett Taylor report, the selected firms are well suited to deliver long term, cost viable benefits while meeting the Municipality's service requirements. 3.3. Although the process did not result in a consolidation of all benefits it did reduce the number of providers from three to two and this will provide administrative benefits over the term of the agreements. 3.4. The funds required for the benefits coverage are provided in annual operating. budgets for each department. 4. CONCLUSION . 4.1. To award the contracts for the provision of Employee and Dependent Life ,Long Term Disability, Health and Dental coverage to Great West Life and the Accidental Death and Dismembermerit coverage to Chubb Insurance Company each for a four year term. At the conclusion, or throughout the term as deemed appropriate, a review will be undertaken, for consideration of renewal or market competition. 4.2. The transition to the new providers is an extensive undertaking. It is targeted to start February 1, 2009. Staff will be educated, and change over documentation will be undertaken beiween November 2008 and February 2009. Great West have assured the municipality that it is comfortable with conducting a smooth transition to the new plans. Attachments: 1 -Schedule "A", By-law ® 2 -Schedule "B", By-law 3 -Schedule "C" Buffett Taylor Employee Benefits Consulting Report (Market Survey) 4 -Schedule "D", RFP Questionnaire Schedule "A" THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON BY-LAW 2008- Being a By-law to authorize an agreement between the Corporation of the Municipality of Clarington and Great West Life Assurance Company, Ontario, for the Provision of Employee Group Benefits. THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON HEREBY ENACTS AS FOLLOWS: THAT the Mayor and Clerk are hereby authorized to execute, on behalf of the Corporation of the Municipality of Clarington and seal with the Corporation Seal, a contract between, Great West Life Assurance Company, Ontario, and said Corporation; and 2. THAT the contract attached hereto as Schedule "A" form part of this By-law. By-law read a first and second time this day of , 2008. By-law read a third time and finally passed this day of , 2008. Jim Abernethy, Mayor Patti L. Barrie, Municipal Clerk Schedule "B" THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON BY-LAW 2008- Being a By-law to authorize an agreement between the Corporation of the Municipality of Clarington and Chubb Insurance Company of Canada to for the Provision of Employee Group Benefits. THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON HEREBY ENACTS AS FOLLOWS: 1. THAT the Mayor and Clerk are hereby authorized to execute, on behalf of the Corporation of the Municipality of Clarington and seal with the Corporation Seal, a contract between, Chubb Insurance Company of Canada, and said Corporation; and 2. .THAT the contract attached hereto as Schedule "A" form part of this By-law. By-law read a first and second time this day of , 2008. By-law read a third time and finally passed this day of , 2008. Jim Abernethy, Mayor Patti L. Barrie, Municipal Clerk Schedule "C" BUFFETT TAYLOR Employee Benefits Consulting MUNICIPALITY OF CLARINGTON -- MARKET SURVEY ~~~ HIGHLIGHTS Et RECOMMENDATIONS Market Survev Overview Buffett Taylor was contracted by the Municipality of Clarington to survey the group insurance marketplace in order to test the competitiveness of the current providers. The main purpose of this market survey was to test the competitiveness of the current rates, underwriting methodologies, financial and administrative terms of the current insurance contracts. In addition, secondary objectives were: +! To consider amalgamating benefits under one provider, to provide stream-lining and efficiencies; * Obtain rate stability through extended rate guarantees; +le Analyze the service capabilities available in the marketplace, including online insurer systems for billing and administration; +- Ensure superior customer service; ~ Review current life and LTD non-evidence and overall maximums to ensure that maximums are adequate to reflect both the current and the long term changing needs of the municipality; . ~ Examine the value added services offered in the marketplace ~- Review industry standards and best practices with respect to benefits in order to enact positive changes to the existing plan, and +k Establish a long term relationship with the selected provider(s) In conjunction with Clarington's Purchasing Division, marketing specifications were released to the competitive marketplace on July t8, 2008. Upon being appointed to work on this project, Buffett Taylor met with Clarington to discuss the process and to develop an RFP package that included: ~ An exact duplication of Clarington's current plan design schedule and contractual provisions; • Employee demographic information for the purposes of insurer rate calculations; +- Historical claims experience and rate history; ~ Outline of the existing funding arrangements; 9~ Listing of open long term disability claimants and open premium waiver claims; and ~ A customized underwriting questionnaire to determine the advantage of alternate funding arrangements, plan designs and to determine the competitiveness of insurer's expense levels. e Relevant sections pertaining to Clarington's requirements for compliance with RFP submissions (including required Forms and formats for proposal). The municipality's current providers are: ~ Sun Life Financial -employee life, dependent life and long term disability ~ Manulife Financial -extended health and dental benefits ® ~ RBC Insurance -accidental death and dismemberment 1" ~;, i..~~ ~ry,.~ A„iih \h~l "~. ~ 4 .,..~ I 1 1Ah P'a,m. ~.,n I h4 A1~ ,.ii, WWV ,uf4.a;(:19or r'nm i'. i ,,i ~ J icc l a~; ~ ;,. ~. _ ~~. Employee Benefit Provision -Market Survey Municipality of Clarington October 9, 2008 Page 2 On an overall basis, we were very pleased with the response from the competitive marketplace. The marketplace showed a significant interest in partnering to underwrite Clarington's program. The following is a summary of the carriers who were asked to provide proposals. We have indicated their response to the market survey below. .. Ace Ina AD&D Declined AIG Commercial AD&D DID NOT RESPOND AIG L'rfe Life 8 LTD Declined Chubb Insurance ADBD Quoted Cooperator's Life & LTD Declined Desjardins All Benefits Quoted Empire Life All Benefits Declined Equitable Life All Benefits Declined Great West L'rfe All Benefits Quoted Green Shield Health & Dental Quoted Industrial Alliance All Benefits Declined Industrial Alliance Pack AD&D Quoted Manullfe Finandal (health & dental) All Benefits Quoted Medavie Blue Cross All Benefits Declined RBC lnsuiance (ADBD) Life, AD6D 8 LTD Declined SSQ Financial All Benefits Declined Standard Life All Berefits Declined Sun Life (life 8 LTDJ All Benefits Quoted In terms of the AD&D benefit, in addition to the two quotes received from Chubb and IAP, the following traditional insurance carriers - Manulrfe, Great West Lffe and Desjardins, also provided AD&D quotes. Process for Evaluation 8 Recommendation Based upon the following process: # Submissions reviewed by Clarington Purchasing Division to ensure that all RFP submission criteria was met; # An extensive review conducted by Buffett Taylor of all written submissions; # Rating and evaluation of submissions in conjunction with Clarington representatives, based on pre-determined criteria and score/weighting formula; # Finalist presentations /interviews with selected proponents; # Reference checks we recommend that the Municipality of Clarington transfer the Life, Long Term Disability, Health and Dental benefits to Great West Lffe with an effective date of February 1, 2009. .. C., I'."~I<, ,tiny ~~na ll hub, n-i.u ~.. IIAnIN I'L„~., i ~~~~.I'~b 1t.~l~.ci Nw,v hi l(rtllNVlor rom I.r.~ ~~, I>.' I~dI I~...~!:,~ ~".~.",~.,~ ,C„ Employee Benefit Provision -Market Survey Municipality of Clarington October 9, 2008 Page 3 . Although it is important to note that financial (price) aspects are generally a key element in the criteria and evaluation process, the importance of the technical and non-financial aspects of each quote was also given high consideration. Given that group benefit plans of this size are quite complex to administer and manage on an ongoing basis, the ability of Clarington to contract with providers that can meet existing and ongoing challenges with innovation and flexibility becomes. a core requirement. Simply put, group plans of this size cannot be moved on a frequent basis; therefore, it is essential that Clarington can develop a long term partnership with a provider that can demonstrate excellence in all aspects of product delivery. Again, the marketing provides the opportunity to ensure that carriers, based on the value of their proposal, are best suited to deliver a long term, cost viable benefits program, while meeting the Municipality's service requirements and expectations. Reasons for Recommendation • Great West Life's offering to Clarington allows for not only the streamlining of multiple benefits under a single carrier, but also: +R Great West Life offered extended guarantees on their pricing aspects as follows: o a 27 month guarantee on insured Life and Long Term Disability rates; o a 15 month guarantee on insured Health and Dental rates; o a 12 month guarantee on stop loss charges and pooling quotes for Health and Travel 1r a competitive pricing structure relative to current providers: o estimated current (pre-renewal) annualized costs for Life, Dependent Life, Long Term Disability, Health, Travel and Dental = $1,839,542 (excluding sales tax). Great West Life quote annualized = $1,546,053 (excluding sales tax). +~ a commitment to provide no deviation from curcent plan design parameters;. # a commitment to high levels of customer service; ~ a demonstrated ability to provide flexibility in meeting the insurance requirements of the municipality (e.g. willingness to offer higher maximums on I'rfe and disability benefits to ensure that all staff are fully insured under the base group plan without having to meet additional evidence of insurability requirements as required with the current provider, along with a provision to ensure ongoing full coverage within reasonable salary increase parameters); # highest levels of technology on both the plan member level site and employer administration site; • an inclusion of value added components and products at no additional cost to the municipality; ~ a demonstrated ability to effectively transition similar sized group plans using customized communication and employee sessions, along with a dedicated transition service team; • a clear timetable for transition of benefits, including a commitment to provide bookleUcontract drafts for review prior to the effective date of February 2009; Ir a clear and concise approach to disability management and the availability of ad-hoc services that Clarington may wish to utilize during the self-administered short term disability period. s a commitment to provide a disability "needs analysis" prior to plan implementation to ensure that the disability benefit transition is handled smoothly and is reflective of Clarington's needs Accidental Death 8 Dismemberment (ADBDI Benefit A combination of price and extended rate guarantee leads to the recommendation to award the ADBD benefit to Chubb Insurance effective February 1, 2009. This carrier has provided a competitive pricing structure coupled with a three year rate guarantee. L~II~. ~n~u.~i A.~il P.I~~.~h• ~~ „i, 11`. J\h Ph.~ni n °b~i 11.I-.r.e wevx hUf(e1lf.iyloi ronl I,i- ..I'ns' I,dl l,~rl~ _..-~~ Employee Benefit Provision -Market Survey Municipality of Clarington October 9, 2008 Page 4 schedule "C" • Chubb's offering includes enhancements to some of the ancillary benefits relative to the existing AD&D coverage. Overall Conclusion Based on comprehensive evaluation criteria, the favorable combination of price and technical product substantiate the recommendation that Great West Life be selected as the carrier for the Life, Long Term Disability, Health and Dental plans, and that Chubb Insurance be selected as the AD&D carrier. For more information on this report, please contact your Buffett Taylor service team: Joyce Persaud Account Manager (905) 666-1300 ext. 249 David Czuczman Practice Leader (905) 666-1300 ext. 233 I' ~II~ i tii _i ,. -n ~, AA1uh~ IryLnrv~ ~ ~~~ IALe r~,.~n. ,i-,~r.,, I'nu tld - -.vl~^,vww bu Retlt.~ylur cqm I-r. ,.e„!s~" L II ~ rcc I ~ i ~~ -. -i THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REQUEST FOR PROPOSAL FOR THE PROVISION OF EMPLOYEE GROUP BENEFITS -PROVIDER SERVICES • Schedule °D" Underwriting Questionnaire 1. Please confirm that your company operates in accordance with CLHIA guidelines and that no current insured members will suffer a loss of coverage as a result of a change in carder. 2. Please confirm that your quotation does not deviate from the Plan Design Outline, provided under Appendix #2. Otherwise, any deviation should be listed and explained in detail. Please do not refer to your standard proposal pages. 3. In the event that all benefits are not placed with one carrier, please advise which, if any, of the benefits you would be prepared to underwrite separately. 4. Please advise the date at which time the terms of your proposal is no longer binding. 5. Are you prepared to offer any rete and I or retention charge guarantees in excess of one year? If so, please specify by line of benefit. 6. Please confirm that your quoted rates will not be subject to recak:ulation on the effective date. 7. At minimum, please confine that your AD&D quote includes the following: A. Enhanced paralysis benefits B. Exposure and disappearance C. Repatriation benefit $10,000 D. Rehabilitation benefit $10,000 E. Conversion privilege F. Education benefit up to 5% of less of $5,000 per year G. Spousal retraining benefit $10,000 H. Family transport benefit $5,000 I. Day care benefit up to 3% or $3,000 per year to a $12,000 maximum J. Home and vehicle modification benefit $10,000 8. Please provide all details relating to your quoted AD&D benefit. 9. Please describe any enhancements to your basic AD&D above and beyond item #7 above, included in your quoted charge. 10. Regarding the life and LTD benefit, please describe your basis for establishing renewal rates, including: a. the formula used to determine the degree of credibility that is applied to the claims experience; and b. the fador(sj used to determine the reserves for Incurred But Not Reported (IBNR) reserves and disabled I'de reserves (DLR's) and waiver of premium reserves (WOP), as applicable. 11. If marketing discounts have been applied to the quoted premium rates for the non-refund benefits, please provide the level of these discounts. Please also confirm the period over which it is intended that these marketing discounts will be phased out 12. For the EHC and dental benefits, please confirm that EHC will be underwritten on the current basis: Insured, non-refund accounting including $10,000 stop loss applicable to drug, dental accident and private duty nursing. 13. Please detail your terminal provisions with respect to IBNR's 14. Confirm your float requirements on an ASO funded program. 15. Confirm booklet and amendment charges. ® 16. Your quoted rates should include a booklet allowance. Please confine the per booklet allowance available td Clarington. THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REQUEST FOR PROPOSAL FOR THE PROVISION OF EMPLOYEE GROUP BENEFITS -PROVIDER SERVICES • 17. Please confirm a 60 day premium grace period will apply for all coverage, dudng which time, premiums may be remitted without interest charges. 18. Please detail any wellness products /services which are available within your quoted EHC charges. Please include reference to online, in-person (seminar) services and products. 19. Please confirm you will agree to 'grandfather" all existing amounts of life, dependent life and AD&D insurance. 20. Please advise whether you are prepared to offer any amounts of optional life insurance, without evidence of insurability. If so, please advise of any specific requirements that may apply. 21. Please confirm the highest available basic life non-evidence maximum and the highest available overall maximum, within your quoted rate. 22. Due to the increasing cost of salades (as negotiated by collective bargaining or otherwise) and Clarington's desire to fully insure its employees at sufficient levels to cover their changing salaries, the current non-evidence and overall maximum are insufficient to meet the needs of the non-affiliated and Mayor /Council divisions. Claring[on is interested in obtaining the highest available overall maximum and eliminating the non-evidence maximum requirement. Please confirm your highest available overall maximum and associated rate adjustment. Note, Cladngton is wllllna to consider entering into a minimum 4 year agreement with the selected carrier, in exchange for this provision. 23. Please confirm your breakeven loss ratio for life, health and dental, and LTD benefits (inclusive of all fees with premium tax). 24. Please confine you will agree to "grandfather' all existing amounts of long term disability insurance. 25. Please confine the highest available LTD non-evidence maximum and the highest available overall maximum, within your quoted rate. 26. Similar to question #21 above, the current non-evidence and overall maximum are insufficient to meet the needs of the non-affiliated division. Cladngton is interested in obtaining the highest available overall maximum and eliminating the non-evidence maximum requirement. Please confine your highest available overall maximum and associated rate adjusbment. 27. Please confine. the availability of a dedicated disability service team. 28. Please describe your company's quality assurance and fraud prevention policies and processes. 29. Please confirm your company can continue to accommodate the cunent administration anangements (seif- administered, head office-billed). Please confirm your ability to electronically provide monthly premium statements in excel format. 30. Please advise from which of your offices this account would be serviced. 31. From what location(s) would claims be paid? Please specify by line of benefit. 32. What is your company's current average turnaround time far the payment of claims? Please specify by line of benefit.. 33. Please confine your company's ability to provide the following employee services. Our expectation is that the following services are included as part of your companies group benefits offering, however if separate charges apply, please confirm. s 1-800 claims and service call centre. Please confirm the hours of operation for your call centre. • Availably of interactive voice response (IVR) ® # Availability of online member services ~ Direct deposit THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REQUEST FOR PROPOSAL FOR THE PROVISION OF EMPLOYEE GROUP BENEFITS-PROVIDER SERVICES • • Online claims history review * Member electronic claims submission 34. Please describe the availability of your company's web-based administration system for employers. Please confirm employer system requirements. 35. Confirm availability/access to create request ad-hoc reports for all benefit lines as required (self-service online). 36. Confirm your company is able to maintain employee mailing addresses. 37. Please confirm that you will provide the following information on an annual basis, or as required, by employee group classification: a. for all benefits, including all pooled aspects of the EHC coverage, a summary of paid claims, and; b. for life benefits, a listing by certificate of all paid claims and waiver of premium claims, including the amount of waiver of premium reserves, by individual, and; c. for long term disability, a listing by certificate of paid claims, including the amount allocated as disabled life reserves, by individual, and d. for life and LTD, a comparison of the age banded distribution of volumes between the current and prior policy years, and; e. for EHC and dental benefits, detailed claims listings indicating the following information: 1. paid claims for employees, dependents and totals per certificate. 2. paid claims categorized by service type f. For EHC, completed detailed drug utilization reporting, including top 100 DINS by cost and number of scripts paid and top 25 disease state categories. 38. Please confirm that your company will provide quarterly reports, which illustrate paid premium and paid Gaims for each of the benefits provided. 39. Please provide details of your ability to provide meaningful ad-hoc claim management reporting, as maybe requested for bargaining purposes. Please include information on the ability to provide such reports and associated costs. 40. If the claims experience for the life and long term disability benefits is to be considered in the renewal rate setting, please confirm the quaredy claims experience will include a listing of the individuals for whom waiver of premium and LTD claims have been approved and which includes the waiver of premium and disabled life reserves that have been established for those claimants. 41. Please confirm your availability to meet with Clarington on a regular basis. 42. Please confirm you have provided a transition timetable as requested, based on a February 1, 2009 effective date. 43. Please confirm the availability of a dedicated Vansition team to ensure the successful transfer of all Benefits. 44. Please confirm your company is able to prepare and distribute all employee communications, as required by Clarington. 45. Please confirm your company is able to accommodate /provide employee information sessions at various locations, as required by Clarington. 46. Clarington is interested in time-saving and cost effective solutions to transitioning the benefits program. Please describe your requirements, in terms of transfer of employee data and claims data, which will assist Clarington in smoothly transitioning the benefits program to your company (i.e. trensfer of vision maximums and electronic employee data downlcad). • C THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REQUEST FOR PROPOSAL FOR THE PROVISION OF EMPLOYEE GROUP BENEFITS -PROVIDER SERVICES 47. Please confirm your commitment to deliver all documentation and training prior to the effective date of coverage. Please outline additional services that your firm can offer on an ad-hoc basis. These could include but not be limited to independent medical exams, adjudicatan of a short tens disability absence, etc.