PUBLIC NOTICE
SOQ  23-011
 
Self-Funded Group Medical Plan
 
The Parish of Jefferson, authorized by Resolution No. 141904  is hereby soliciting Statements of Qualification (SOQ) from qualified organizations interested in providing proposals for a Self-Funded Group Medical Plan to include a Third-Party Administration (TPA) or Administration Services Only (ASO), Preferred Provider Network, Specific and Aggregate Stop Loss Insurance (Medical and RX), Catastrophic Case Management Services and Pharmacy Benefits Manager (PBM) beginning January 1, 2024, and to provide for related matters (Parishwide).
 
Deadline for Submissions: 3:30 p.m. , June 9, 2023
 
Introduction
Jefferson Parish Government consists of approximately thirty departments providing services for the citizens of Jefferson Parish.  Services provided include, but are not limited to, water, sewage, drainage, streets, fire and supporting departments.  Included in the employee benefits plans are employees of the 24th Judicial District Court, Juvenile Court, First and Second Parish Courts, the District Attorney’s Office, the Coroner’s Office, the Justices of the Peace and the Constables Offices. There are approximately 3,000 benefits eligible employees and approximately 1,100 retirees. 
 
Proposed plan designs should include a dual option group medical plan including pharmacy benefits.  Copay type plans are preferred with plan deductibles no greater than a $500 individual deductible for plan 1 and a $1,500 individual deductible for the plan 2. 
 
Proposed plans will provide coverage for:
 
Active employees and their eligible dependents
Non-Medicare eligible retirees and their eligible dependents 
Proposals should include an employee wellness program, COBRA Administration, and an employee assistance program (EAP).
 
Proposed provider networks should provide in-network coverage for employees and retirees who reside in and out of the State of Louisiana.
 
Clesi Burns, LLC is the appointed consultant. TPA/ASOs should submit proposal responses directly on a net of commission basis. Zero (0%) commission level.
 
Upon request to Patrick Burns with Clesi Burns at [email protected], Jefferson Parish will provide a census and claims data from the current fully-insured insurance carrier.
 
Minimum Qualifications
The following are mandatory requirements for all proposers that cannot be delegated to another entity and must be met by the actual entity submitting the proposal.  Failure to meet any of these requirements at the time of the submission deadline will result in the disqualification of a proposal:
 
Proposer must be licensed in Louisiana and in other states once it is known that a beneficiary has moved to or received services in that state.  The proposer should also indicate in their response how they are in compliance and have a working knowledge and understanding of the claim’s payment laws and other health insurance laws of the states where a Jefferson Parish employee, retiree or dependent may receive treatment.  For example, state whether or not you have a compliance officer, list those states you are currently licensed in, and explain who is responsible for overseeing compliance. 
Proposer must have at least five (5) years of experience in providing the type of plans and services requested in this SOQ; specifically, a self-funded plan with reinsurance coverage. 
Proposer must offer the type of plans and services as described in this SOQ to at least three (3) similar employer groups with at least 3,000 total members. References must be provided. 
Proposer must provide these types of service to at least 50,000 members.Evaluation Criteria
Rates/Financial proposals – 30 Points Maximum
Demonstrated experience providing quality medical and pharmacy plan benefits administration for large groups (3000+ members) – 20 Points Maximum
Company and reinsurance carrier’s financial strength (A.M. Best or Standard & Poor’s ratings if rated and/or company’s audited financials) – 10 Points Maximum
Demonstrated ability to provide an employee wellness program, COBRA administration, and employee assistance program (EAP) – 20 Points Maximum
Provider Network (Include provider directory and GEO Access report) – 20 Points Maximum 
 
An initial inquiry period is set for all interested proposers to perform a detailed review of the SOQ documents. Without exception, all questions MUST be in writing and received by 3:30 p.m., June 2, 2023.  All questions and answers will be shared with all prospective proposers.
The person or firm submitting a Statement of Qualification (General Professional Services Questionnaire) must identify all subcontractors who will assist in providing professional services for the project, in the professional services questionnaire.  Each subcontractor shall be required to submit a General Professional Services Questionnaire and all documents and information included in the questionnaire.  (Refer to Jefferson Parish Code Ordinance, Section 2-928)
 
All persons or firms (including subcontractors) must submit a Statement of Qualifications (General Professional Services Questionnaire) by the deadline. The latest professional services questionnaire may be obtained by contacting the Purchasing Department at (504) 364-2678 or via the Jefferson Parish website at www.jeffparish.net.  This questionnaire can be accessed by hovering over “Business and Development” on the website and clicking on the Professional Services Questionnaires option under “Doing Business in Jefferson Parish”.
 
Submissions will only be accepted electronically via Jefferson Parish’s e-Procurement site, Central Bidding at www.centralauctionhouse.com or www.jeffparishbids.net.  Registration is required and free for Jefferson Parish vendors by accessing the following link: www.centralauctionhouse.com/registration.php.
 
No submittals will be accepted after the deadline.
 
Affidavits are not required to be submitted with the Statement of Qualifications, but shall be submitted prior to contract approval.
 
Disputes/protests relating to the decisions by the evaluation committee or by the Jefferson Parish Council shall be brought before the 24th Judicial Court.
 
ADV: The New Orleans Advocate:  May 10, 2023