Vendor Conference:    Eligibility Support Services     RFP #529-08-0135   August 14, 2008
Welcome and Introductions  Steve R. Bailey
ESS RFP Vendor Conference <ul><li>Welcome </li></ul><ul><li>Introductions </li></ul><ul><ul><li>Steve R. Bailey, Manager, ...
HHSC Procurement Roles <ul><li>ECPS - Responsible for procurement activity </li></ul><ul><li>HUB - Responsible for HUB act...
Vendor Conference Overview <ul><ul><li>Procurement Activities </li></ul></ul><ul><ul><li>HUB Items </li></ul></ul><ul><ul>...
Procurement Activities <ul><ul><li>Questions & Answers  </li></ul></ul><ul><ul><li>Sole Point of Contact  </li></ul></ul><...
<ul><li>HUB Subcontracting Plan (HSP) Requirements  </li></ul><ul><li>Sherice Williams-Patty </li></ul>
HSP Agenda Topics <ul><li>RFP Section 4.0 Historically Underutilized Business  </li></ul><ul><ul><li>Participation Require...
If HSP is inadequate, response will be rejected
Section 1:  Company  Information HUB GOALS Section 2: Subcontracting Intentions:  If Yes: Enter subcontracting opportuniti...
One page for each area subcontracted (listed in Section 2) HSP Information Page
Section 3: List Line # and Subcontracting Opportunity
Section 4: Protégé performing the work  Section 5:  Professional Services  Category
HSP Information Page Section 6(a):  Good Faith Efforts to find/include Texas Certified HUB Vendors
Section 6(b): Contact HUB Trade Organization HSP Information Page
Section 6(c): Written Notification Requirements HSP Information Page
Section 7: List 3 HUBs Contacted for this Subcontracting  Opportunity HSP Information Page Section 8: Reason why HUB was n...
Section 8: List Subs Selected (HUBs & Non-HUBs) for this Subcontracting Opportunity HSP Information Page
Section 9: Self Performance Explanation Section 10:  Signature Affirms that True and Correct Information is Provided
<ul><li>Required with  </li></ul><ul><li>ALL  Pay Requests </li></ul><ul><li>List  ALL  Sub payments  </li></ul><ul><li>(H...
Administrative Services Development HUB Program Office <ul><li>Robert L. Hall, C.P.M. </li></ul><ul><li>Director of Admini...
<ul><li>HHSC Project Philosophy </li></ul><ul><li>Anne Heiligenstein </li></ul>
HHSC Project Philosophy <ul><li>HHSC’s fundamental commitment is to contract for results, including: </li></ul><ul><ul><li...
HHSC Mission <ul><li>HHSC’s mission in this procurement is to: </li></ul><ul><ul><li>Procure services that will assist in ...
Mission Objectives <ul><li>The mission objectives are to implement an eligibility process that: </li></ul><ul><li>offers m...
Project Results <ul><li>As a result of the procurement, the Vendor will: </li></ul><ul><li>maximize efficiency and reduce ...
<ul><li>Scope of Work </li></ul><ul><li>Shaun Barker </li></ul>
Eligibility Support Services RFP - Scope of Work <ul><li>Call Center Operations </li></ul><ul><li>Inquiry Management </li>...
Scope of Work: State Responsibilities <ul><li>Under the Eligibility Support Services RFP the State will: </li></ul><ul><li...
State Technology <ul><li>HHSC’s technology will support the eligibility determination process  </li></ul><ul><li>Vendor st...
State Technology <ul><li>Accepting client applications via call center </li></ul><ul><ul><li>Clients may apply for benefit...
<ul><li>CHIP Eligibility Determination </li></ul><ul><li>Elisa J. Garza </li></ul>
CHIP Eligibility Determination <ul><li>Vendor Responsibilities </li></ul><ul><li>Use HHSC technologies to determine eligib...
CHIP Eligibility Determination <ul><li>CHIP-only Application Processing </li></ul><ul><li>Use HHSC technologies to: </li><...
CHIP Eligibility Determination <ul><li>CHIP-plus Application Processing </li></ul><ul><li>Use HHSC Technologies to: </li><...
<ul><li>Transition and Operations </li></ul><ul><li>Leslie DeHay </li></ul>
Transition Phase <ul><li>The primary objectives of the Transition Phase are to:  </li></ul><ul><ul><li>Ensure a smooth tra...
<ul><li>Facilities and Assets </li></ul>
Customer Care Centers Customer Care Center  & Processing Center Locations
<ul><li>Four Customer Care Center facilities: </li></ul>Customer Care Centers – Assets and Technology RFP Vendor Furniture...
Midland Customer Care Center <ul><li>Document Processing Center (DPS Vendor) Staff </li></ul><ul><li>Image Assembly Staff ...
Athens Customer Care Center <ul><li>ES and CHIP Call Center for Client Access Staff </li></ul><ul><li>HHSC Texas Works and...
San Antonio Processing Center <ul><li>Image Assembly Staff </li></ul><ul><li>Application Support Staff </li></ul><ul><li>H...
Austin Customer Care Center <ul><li>CHIP Operations Staff </li></ul><ul><li>Enrollment Broker Operations Staff </li></ul><...
<ul><li>Financial Approach  </li></ul><ul><li>Larry Fisher </li></ul>
Financial Approach <ul><li>The State has chosen to utilize a FIXED PRICE APPROACH to the administrative services.  </li></...
Financial Approach <ul><li>The Vendor must m aintain, document, and submit operations cost data in accordance with HHSC re...
Financial Approach <ul><li>The Vendor must provide monthly financial statements, including, but not limited to an income s...
Financial Approach <ul><li>The State anticipates that no more than 50% of the administrative fees for the Eligibility Supp...
Financial Approach <ul><li>Separate fixed and variable administrative fees will be proposed for the first 12 –month operat...
Financial Approach <ul><li>The CHIP Services component includes variable administrative fees based on the following activi...
Financial Approach <ul><li>Ownership of all nonexpendable capital items  FUNDED  by the contract will pass to the State at...
Financial Approach <ul><li>Administrative fees paid to the Vendor during each Operational Contract Year will consist of:  ...
Financial Approach <ul><li>The total maximum cost of the Services and Deliverables supplied by the Vendor to HHSC during e...
<ul><li>Pricing Overview </li></ul>
Pricing Overview <ul><li>Forms substantially similar to those described in the RFP must provide the component costs of the...
Pricing Overview <ul><li>The potential Vendor must structure its pricing quotation to allow HHSC a method to map the propo...
Pricing Overview <ul><li>The State is requesting each prospective Vendor to identify the “Key Milestones” the Vendor belie...
Pricing Overview <ul><li>The potential Vendor’s operational cost proposal sheets (Appendix A-2) for the ESS  and CHIP oper...
Pricing Overview <ul><li>Instructions for completing each schedule are included in the RFP.  </li></ul><ul><li>In addition...
Pricing Overview <ul><li>Costs for administrative services provided by the Vendor for the Eligibility Support Services com...
Pricing Overview <ul><li>Price Summary Sheet 1 shows the fixed administrative fees for the transitional period by Key Mile...
Pricing Overview <ul><li>Price Summary Sheet 4 shows the variable administrative fees for the CHIP Services component for ...
Pricing Overview <ul><li>The maximum fees associated with additional non-recurring and/or periodic activities to be perfor...
Pricing Overview <ul><li>The cost proposal should include any business, economic, legal, programmatic, or practical assump...
<ul><li>Legal Considerations </li></ul><ul><li>C. J. Brandt </li></ul>
Legal Considerations <ul><li>Elements of the Contract: </li></ul><ul><li>Offer and Acceptance </li></ul><ul><ul><ul><li>HH...
Legal Considerations <ul><li>Elements of the Contract,  continued : </li></ul><ul><ul><li>RFP </li></ul></ul><ul><ul><li>P...
Legal Considerations <ul><li>Contract Remedies: </li></ul><ul><ul><li>Legal Remedies </li></ul></ul><ul><ul><ul><li>Damage...
Legal Considerations <ul><li>Contract Remedies,  continued : </li></ul><ul><ul><li>Damages </li></ul></ul><ul><ul><ul><li>...
Legal Considerations <ul><li>Conflicts of Interest </li></ul><ul><ul><li>Revolving Door </li></ul></ul><ul><ul><li>Organiz...
<ul><li>Questions and Answers  </li></ul>
<ul><li>End of Presentation </li></ul>
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Vendor Conference PowerPoint Presentation

  1. 1. Vendor Conference: Eligibility Support Services RFP #529-08-0135 August 14, 2008
  2. 2. Welcome and Introductions Steve R. Bailey
  3. 3. ESS RFP Vendor Conference <ul><li>Welcome </li></ul><ul><li>Introductions </li></ul><ul><ul><li>Steve R. Bailey, Manager, Enterprise Contract and Procurement Services (ECPS) </li></ul></ul><ul><ul><li>Sherice Williams-Patty, HUB Coordinator, HHSC Administrative Services Development </li></ul></ul><ul><ul><li>Anne Heiligenstein , Deputy Executive Commissioner HHSC Office of Social Services </li></ul></ul><ul><ul><li>C.J. Brandt, Office of Chief Counsel </li></ul></ul><ul><li>Housekeeping Items </li></ul>
  4. 4. HHSC Procurement Roles <ul><li>ECPS - Responsible for procurement activity </li></ul><ul><li>HUB - Responsible for HUB activity </li></ul><ul><li>Program - Responsible for project scope, requirements, performance, results, contract management/monitoring </li></ul><ul><li>Legal - Questions/answers and legal activity </li></ul>
  5. 5. Vendor Conference Overview <ul><ul><li>Procurement Activities </li></ul></ul><ul><ul><li>HUB Items </li></ul></ul><ul><ul><li>RFP Overview </li></ul></ul><ul><ul><li>Questions Submittal </li></ul></ul><ul><ul><li>Break </li></ul></ul><ul><ul><li>Preliminary Responses to Questions </li></ul></ul><ul><ul><li>Closing Comments </li></ul></ul>
  6. 6. Procurement Activities <ul><ul><li>Questions & Answers </li></ul></ul><ul><ul><li>Sole Point of Contact </li></ul></ul><ul><ul><li>Procurement Timeline </li></ul></ul><ul><ul><li>Accessing Information & Updates </li></ul></ul><ul><ul><li>Submission Requirements </li></ul></ul><ul><ul><li>Screening & Evaluation </li></ul></ul><ul><ul><li>Award & Releasing Information </li></ul></ul>
  7. 7. <ul><li>HUB Subcontracting Plan (HSP) Requirements </li></ul><ul><li>Sherice Williams-Patty </li></ul>
  8. 8. HSP Agenda Topics <ul><li>RFP Section 4.0 Historically Underutilized Business </li></ul><ul><ul><li>Participation Requirements </li></ul></ul><ul><li>HUB Subcontracting Plan for the RFP is required </li></ul><ul><li>Self Performance HSP </li></ul><ul><li>HSP Prime Contractor Progress Assessment Report </li></ul>
  9. 9. If HSP is inadequate, response will be rejected
  10. 10. Section 1: Company Information HUB GOALS Section 2: Subcontracting Intentions: If Yes: Enter subcontracting opportunities If No: skip to Sections 9 and 10
  11. 11. One page for each area subcontracted (listed in Section 2) HSP Information Page
  12. 12. Section 3: List Line # and Subcontracting Opportunity
  13. 13. Section 4: Protégé performing the work Section 5: Professional Services Category
  14. 14. HSP Information Page Section 6(a): Good Faith Efforts to find/include Texas Certified HUB Vendors
  15. 15. Section 6(b): Contact HUB Trade Organization HSP Information Page
  16. 16. Section 6(c): Written Notification Requirements HSP Information Page
  17. 17. Section 7: List 3 HUBs Contacted for this Subcontracting Opportunity HSP Information Page Section 8: Reason why HUB was not selected for this Subcontracting Opportunity
  18. 18. Section 8: List Subs Selected (HUBs & Non-HUBs) for this Subcontracting Opportunity HSP Information Page
  19. 19. Section 9: Self Performance Explanation Section 10: Signature Affirms that True and Correct Information is Provided
  20. 20. <ul><li>Required with </li></ul><ul><li>ALL Pay Requests </li></ul><ul><li>List ALL Sub payments </li></ul><ul><li>(HUBs & Non-HUBs) </li></ul>HSP Prime Contractor Progress Assessment Report ATTACHMENT “E”
  21. 21. Administrative Services Development HUB Program Office <ul><li>Robert L. Hall, C.P.M. </li></ul><ul><li>Director of Administrative Services Development </li></ul><ul><li>- (512) 424-6596 </li></ul><ul><li>- [email_address] </li></ul><ul><li>Carlos A. Balderas </li></ul><ul><li>ASD HUB Administrator </li></ul><ul><li>- (512) 424-6896 </li></ul><ul><li>- [email_address] </li></ul><ul><li>Sherice Williams-Patty </li></ul><ul><li>ASD HUB Administrator </li></ul><ul><li>- (512) 424-6903 </li></ul><ul><li>- [email_address] </li></ul><ul><li>Segundo Sanchez </li></ul><ul><li>ASD Procurement/HUB Team Lead </li></ul><ul><li>- (512) 424-6896 </li></ul><ul><li>- [email_address] </li></ul>
  22. 22. <ul><li>HHSC Project Philosophy </li></ul><ul><li>Anne Heiligenstein </li></ul>
  23. 23. HHSC Project Philosophy <ul><li>HHSC’s fundamental commitment is to contract for results, including: </li></ul><ul><ul><li>defined, measurable, and beneficial outcomes </li></ul></ul><ul><ul><li>best value </li></ul></ul><ul><ul><li>strong accountability </li></ul></ul><ul><ul><li>cooperative relationship with the State </li></ul></ul><ul><ul><li>quality approach to client services </li></ul></ul>
  24. 24. HHSC Mission <ul><li>HHSC’s mission in this procurement is to: </li></ul><ul><ul><li>Procure services that will assist in modernizing the eligibility system and improve Texans’ access to HHSC programs and </li></ul></ul><ul><ul><li>achieve the highest levels of quality, accuracy, and efficiency in the delivery of eligibility services </li></ul></ul>
  25. 25. Mission Objectives <ul><li>The mission objectives are to implement an eligibility process that: </li></ul><ul><li>offers multiple access channels </li></ul><ul><li>allows a vendor to support eligibility determination by skilled workers </li></ul><ul><li>allows vendors to perform eligibility determination for CHIP-only applications and renewals </li></ul><ul><li>leverage state investments </li></ul><ul><li>uses technology resources available to the state </li></ul><ul><li>identify areas for continued performance improvement and cost effectiveness </li></ul>
  26. 26. Project Results <ul><li>As a result of the procurement, the Vendor will: </li></ul><ul><li>maximize efficiency and reduce costs in all functions to support eligibility determination for programs managed by HHSC </li></ul><ul><li>improve the quality of services for programs provided by HHSC </li></ul><ul><li>improve client access provided by HHSC </li></ul><ul><li>implement more efficient business processes allowing HHSC to reduce processing times for applications for program benefits and reduce staff workloads </li></ul><ul><li>identify areas for continued performance process improvement and cost effectiveness </li></ul>
  27. 27. <ul><li>Scope of Work </li></ul><ul><li>Shaun Barker </li></ul>
  28. 28. Eligibility Support Services RFP - Scope of Work <ul><li>Call Center Operations </li></ul><ul><li>Inquiry Management </li></ul><ul><li>Image Association </li></ul><ul><li>Data Collection and Other Case Actions </li></ul><ul><li>CHIP Eligibility Determination and Related Services </li></ul><ul><li>Complaint and Dispute Handling </li></ul><ul><li>Appeals, Requests for Reviews, and Fair Hearings </li></ul><ul><li>Call Monitoring and Case Data Accuracy </li></ul><ul><li>Training and Quality Management </li></ul>
  29. 29. Scope of Work: State Responsibilities <ul><li>Under the Eligibility Support Services RFP the State will: </li></ul><ul><li>Determine eligibility for all HHSC programs including eligibility for CHIP clients with associated cases </li></ul><ul><li>Assess missing Information and manage correspondence with client </li></ul><ul><li>Collect data for applications and redeterminations </li></ul><ul><li>Perform data broker look-ups – except for CHIP (vendor does data broker look ups for CHIP) </li></ul><ul><li>Certify and issue benefits </li></ul><ul><li>Process requests for appeals and hear appeals </li></ul><ul><li>Provide assistance in eligibility offices and centers </li></ul><ul><li>Perform CHIP reviews </li></ul><ul><li>Resolve complaints </li></ul><ul><li>Issue expedited benefits </li></ul><ul><li>Provide technologies and assets </li></ul>
  30. 30. State Technology <ul><li>HHSC’s technology will support the eligibility determination process </li></ul><ul><li>Vendor staff will use HHSC technology, including the State Portal to perform the functions under this RFP </li></ul><ul><li>The State Portal (STP) is used to access: </li></ul><ul><ul><li>Inquiry </li></ul></ul><ul><ul><li>Case comments entry </li></ul></ul><ul><ul><li>Scheduler </li></ul></ul><ul><ul><li>Application Registration </li></ul></ul><ul><ul><li>TLM task creation & routing to the state </li></ul></ul><ul><ul><li>Alerts processing </li></ul></ul><ul><ul><li>Image association (thru content manager) </li></ul></ul>
  31. 31. State Technology <ul><li>Accepting client applications via call center </li></ul><ul><ul><li>Clients may apply for benefits over the phone through the vendor Customer Care Center staff </li></ul></ul><ul><ul><li>Vendor staff will use the Self Service Portal available via the Internet at www.yourtexasbenefits.com to enter the applicant’s information for further processing </li></ul></ul>
  32. 32. <ul><li>CHIP Eligibility Determination </li></ul><ul><li>Elisa J. Garza </li></ul>
  33. 33. CHIP Eligibility Determination <ul><li>Vendor Responsibilities </li></ul><ul><li>Use HHSC technologies to determine eligibility for CHIP applications and renewals that do not include other HHSC benefit programs. (CHIP-only) </li></ul><ul><li>Obtain the necessary information to make an eligibility determination for Children’s Medical Assistance (CMA), and route to the HHSC. </li></ul><ul><li>Route applications to HHSC when other HHSC Programs are included. (CHIP-plus) </li></ul><ul><li>Identify and route CHIP Requests for Review (RFR) to HHSC staff. </li></ul>
  34. 34. CHIP Eligibility Determination <ul><li>CHIP-only Application Processing </li></ul><ul><li>Use HHSC technologies to: </li></ul><ul><li>Review all incoming applications </li></ul><ul><li>Perform inquiry and link the document to the appropriate application or case </li></ul><ul><li>Perform Third Party Verification inquiry and document the results </li></ul><ul><li>Send a letter to request any missing information </li></ul><ul><li>Determine eligibility for CHIP (CHIP,SKIP, and CHIP perinatal) programs, and notify the family of the outcome </li></ul><ul><li>Route the application and supporting documentation to a state worker if the family is potentially eligible for Medicaid </li></ul>
  35. 35. CHIP Eligibility Determination <ul><li>CHIP-plus Application Processing </li></ul><ul><li>Use HHSC Technologies to: </li></ul><ul><li>Review all incoming applications </li></ul><ul><li>Perform inquiry, link the document to the appropriate application or case, and create a case if unable to link </li></ul><ul><li>Create a task to route the application to HHSC staff </li></ul>
  36. 36. <ul><li>Transition and Operations </li></ul><ul><li>Leslie DeHay </li></ul>
  37. 37. Transition Phase <ul><li>The primary objectives of the Transition Phase are to: </li></ul><ul><ul><li>Ensure a smooth transition and implementation of business operations and systems </li></ul></ul><ul><ul><li>Perform readiness assessment thoroughly and timely for implementation </li></ul></ul><ul><ul><li>Establish strong Vendor accountability controls </li></ul></ul><ul><ul><li>Ensure cost effectiveness </li></ul></ul><ul><ul><li>Mitigate risk to clients and HHSC </li></ul></ul>
  38. 38. <ul><li>Facilities and Assets </li></ul>
  39. 39. Customer Care Centers Customer Care Center & Processing Center Locations
  40. 40. <ul><li>Four Customer Care Center facilities: </li></ul>Customer Care Centers – Assets and Technology RFP Vendor Furniture and Fixtures RFP Vendor Leasehold Improvements Facilities HHSC Desktop Telephone Equipment and Accessories - Non EB DIR Telephony and Network Hardware and Software Telephony Northrop Grumman Desktop PC - Application Developer Northrop Grumman Desktop PC - Non EB HHSC Applications Development Software HHSC Server Hardware and Software Technology Future Asset/ Equipment Area
  41. 41. Midland Customer Care Center <ul><li>Document Processing Center (DPS Vendor) Staff </li></ul><ul><li>Image Assembly Staff </li></ul><ul><li>ES and CHIP Call Center for Client Access Staff </li></ul><ul><li>HHSC Texas Works, MEPD, Women’s Health Program, and Call Escalation Staff </li></ul><ul><li>HHSC Vendor Operations Oversight Staff </li></ul><ul><li>Office of Family Services Quality Assurance Staff </li></ul>
  42. 42. Athens Customer Care Center <ul><li>ES and CHIP Call Center for Client Access Staff </li></ul><ul><li>HHSC Texas Works and MEPD Staff </li></ul><ul><li>HHSC Vendor Operations Oversight Staff </li></ul><ul><li>Office of Family Services Quality Assurance Staff </li></ul><ul><li>Document Processing Center DRC </li></ul>
  43. 43. San Antonio Processing Center <ul><li>Image Assembly Staff </li></ul><ul><li>Application Support Staff </li></ul><ul><li>HHSC Texas Works, MEPD, and Call Escalation Staff </li></ul><ul><li>HHSC Women’s Health Program Staff </li></ul><ul><li>HHSC Vendor Operations Oversight Staff </li></ul><ul><li>Office of Family Services Quality Assurance Staff </li></ul>
  44. 44. Austin Customer Care Center <ul><li>CHIP Operations Staff </li></ul><ul><li>Enrollment Broker Operations Staff </li></ul><ul><li>THSteps Operations Staff </li></ul><ul><li>HHSC Texas Works and MEPD Staff </li></ul><ul><li>HHSC CHIP and Managed Care Operations Oversight Staff </li></ul><ul><li>OFS Quality Assurance Staff </li></ul><ul><li>HHSC Vendor Operations Management Staff </li></ul><ul><li>HHSC IV&V Vendor Staff </li></ul><ul><li>DIR Systems Support Staff </li></ul>
  45. 45. <ul><li>Financial Approach </li></ul><ul><li>Larry Fisher </li></ul>
  46. 46. Financial Approach <ul><li>The State has chosen to utilize a FIXED PRICE APPROACH to the administrative services. </li></ul><ul><li>The Vendor must maintain separate financial records for each of the two components administered under the contract resulting from this RFP: </li></ul><ul><ul><ul><li>(1) Eligibility Support Services </li></ul></ul></ul><ul><li> (2) Children’s Health Insurance Program (CHIP) Services </li></ul>
  47. 47. Financial Approach <ul><li>The Vendor must m aintain, document, and submit operations cost data in accordance with HHSC requirements and federal manuals and directives. </li></ul><ul><li>Documentation must support and differentiate between component operational costs for services provided by the Vendor and include the reimbursable federal matching rates for each applicable program or sub-program. </li></ul>
  48. 48. Financial Approach <ul><li>The Vendor must provide monthly financial statements, including, but not limited to an income statement, depicting the Vendor’s operation under the resulting contract no later than the twentieth calendar day following the end of the previous month. </li></ul><ul><li>Costs for administrative services provided by the Vendor for the Eligibility Support Services components will be based on a fixed fee plus variable fee formulas. </li></ul><ul><li>The specific business components applicable for this RFP are: </li></ul><ul><li>(1) Eligibility Support Services </li></ul><ul><li> (2) Children’s Health Insurance Program (CHIP) Services </li></ul>
  49. 49. Financial Approach <ul><li>The State anticipates that no more than 50% of the administrative fees for the Eligibility Support Services / CHIP Services will be paid on a fixed fee basis and a minimum of 50% of the administrative fees for the Eligibility Support Services / CHIP Services will be paid utilizing variable fees. </li></ul><ul><li>Transition costs to meet the requirements of the RFP will be paid on a fixed fee basis. Transition costs in excess of the final fixed price amount(s) included in the contract resulting from this RFP will not be paid by the State. Separate transition costs will be proposed, negotiated, and paid for: </li></ul><ul><ul><li>Eligibility Support Services </li></ul></ul><ul><ul><li>CHIP Services </li></ul></ul>
  50. 50. Financial Approach <ul><li>Separate fixed and variable administrative fees will be proposed for the first 12 –month operational period of a resulting contract for each component type. For subsequent contract years (12-month operational periods), the fixed and variable administrative fees will be determined by the application of a fixed annual inflator proposed by a Vendor and subject to approval and acceptance by HHSC. </li></ul><ul><li>The Eligibility Support Services component includes variable administrative fees based on the following activities: </li></ul><ul><ul><li>Number of “Image Application Only” transactions completed and processed correctly” </li></ul></ul><ul><ul><li>Number of “TIERS Alerts” completed and processed correctly </li></ul></ul><ul><ul><li>Number of “ESS Changes” completed and processed correctly </li></ul></ul>
  51. 51. Financial Approach <ul><li>The CHIP Services component includes variable administrative fees based on the following activities: </li></ul><ul><ul><li>Number of “CHIP Applications” completed and processed correctly </li></ul></ul><ul><ul><li>Number of “CHIP Renewals” completed and processed correctly </li></ul></ul><ul><ul><li>Number of “CHIP Changes” completed and processed correctly </li></ul></ul><ul><li>The Eligibility Support Services / CHIP Services variable payments will be based on the number of activities listed above that are appropriate for the respective components and are completed and processed correctly. Any activity or multiple activities that must be reprocessed due to Vendor error(s) will not be considered an appropriate activity or activities for payment of additional variable payment(s). </li></ul>
  52. 52. Financial Approach <ul><li>Ownership of all nonexpendable capital items FUNDED by the contract will pass to the State at the expiration of the contract. </li></ul><ul><li>Actual expenditures for Pass-Through Items made on the State’s behalf will be paid without allocation of any indirect charges (general & administrative expenses, overhead, etc.) or profit. </li></ul><ul><li>Expenditures designated as Pass-Through Items are listed in Section 2.2.10.8.2 of the RFP. </li></ul>
  53. 53. Financial Approach <ul><li>Administrative fees paid to the Vendor during each Operational Contract Year will consist of: </li></ul><ul><ul><li>Fixed Administrative Fees </li></ul></ul><ul><ul><li>Variable Administrative Fees </li></ul></ul><ul><ul><li>Administrative Fees for the Additional Periodic Activities </li></ul></ul><ul><ul><li>Administrative Fees for Additional Recurring Activities </li></ul></ul><ul><li>The sum of the four Fee components will be referred to as the “Fee Ceiling” . </li></ul>
  54. 54. Financial Approach <ul><li>The total maximum cost of the Services and Deliverables supplied by the Vendor to HHSC during each Operational Contract Year will not exceed the lesser of </li></ul><ul><ul><li>(a) the Vendor’s Fees (Fee Ceiling) or </li></ul></ul><ul><ul><li>(b) the sum of the Allowable Costs incurred by the Vendor plus the allowable administrative service fee during the subject Operational Contract Year. </li></ul></ul>
  55. 55. <ul><li>Pricing Overview </li></ul>
  56. 56. Pricing Overview <ul><li>Forms substantially similar to those described in the RFP must provide the component costs of the Firm Fixed Prices quoted for providing the services and deliverables set forth in the RFP. </li></ul><ul><ul><li>Attachment A, Appendix A-1 contains Transitional Pricing Schedules </li></ul></ul><ul><ul><li>Attachment A, Appendix A-2 contains Operational Pricing Schedules </li></ul></ul><ul><ul><li>Attachment A, Appendix A-3 contains the formal Price Summary Sheets </li></ul></ul>
  57. 57. Pricing Overview <ul><li>The potential Vendor must structure its pricing quotation to allow HHSC a method to map the proposed costs for the cost proposal submitted back to the Vendor’s Detailed Work Plan for the initial term of the Contract. </li></ul><ul><li>Transition Pricing Schedules: </li></ul><ul><li>The potential Vendor’s transitional cost proposal sheets for the Eligibility Support Services Component and the CHIP Services Component must identify the proposed “Key Milestones” the Vendor will accomplish during the Transitional period (Appendix A-1). </li></ul>
  58. 58. Pricing Overview <ul><li>The State is requesting each prospective Vendor to identify the “Key Milestones” the Vendor believes would be pertinent and appropriate as a Key Milestone during the Transition period. </li></ul><ul><li>The State reserves the option to add, delete and/or modify Key Milestones included in the Vendor’s transitional cost proposal sheets. </li></ul>
  59. 59. Pricing Overview <ul><li>The potential Vendor’s operational cost proposal sheets (Appendix A-2) for the ESS and CHIP operational components must be delineated by the primary business functions (functional areas) documented in the RFP. </li></ul>
  60. 60. Pricing Overview <ul><li>Instructions for completing each schedule are included in the RFP. </li></ul><ul><li>In addition to paper copies of the Vendor’s Cost Proposal and Price Summary sheets, Vendors must submit electronic versions in an MS Excel format. </li></ul><ul><li>The State will be providing prospective Vendors with an electronic version of the required Cost Proposal and Price Summary sheets in an MS Excel format on September 3, 2008. The file will be posted in the procurement library. </li></ul>
  61. 61. Pricing Overview <ul><li>Costs for administrative services provided by the Vendor for the Eligibility Support Services components will be based on a fixed fee plus variable fee formulas. </li></ul><ul><li>The specific business components applicable for this RFP are: </li></ul><ul><ul><li>Eligibility Support Services </li></ul></ul><ul><ul><li>Children’s Health Insurance Program (CHIP) Services </li></ul></ul>
  62. 62. Pricing Overview <ul><li>Price Summary Sheet 1 shows the fixed administrative fees for the transitional period by Key Milestone applicable for each component. </li></ul><ul><li>Price Summary Sheet 2 shows the fixed administrative fees for the first 12 months of the operational period for each component and the fixed annual inflator proposed by the Vendor. </li></ul><ul><li>Price Summary Sheet 3 shows the variable administrative fees for the ESS component for the first 12 month operational period (Operational Contract Year 1), by the specific types of variable activities requested by the State and the fixed annual inflator proposed by the Vendor. </li></ul>
  63. 63. Pricing Overview <ul><li>Price Summary Sheet 4 shows the variable administrative fees for the CHIP Services component for the first 12 month operational period (Operational Contract Year 1), by the specific types of variable activities requested by the State and the fixed annual inflator proposed by the Vendor. </li></ul><ul><li>Price Summary Sheet 5 shows the all-inclusive hourly labor rates and the proposed fixed annual inflator used to show costs associated with additional non-recurring and/or periodic activities to be performed by the Vendor by different types of service categories. </li></ul>
  64. 64. Pricing Overview <ul><li>The maximum fees associated with additional non-recurring and/or periodic activities to be performed by the Vendor will be based on explicit fixed prices proposed for Vendor inputs and the actual number of hours worked on the specific modification by the Vendor’s staff and/or the staff of a Vendor’s subcontractor. </li></ul>
  65. 65. Pricing Overview <ul><li>The cost proposal should include any business, economic, legal, programmatic, or practical assumptions that underlie the Cost Proposal. HHSC reserves the right to accept or reject any assumptions. </li></ul>
  66. 66. <ul><li>Legal Considerations </li></ul><ul><li>C. J. Brandt </li></ul>
  67. 67. Legal Considerations <ul><li>Elements of the Contract: </li></ul><ul><li>Offer and Acceptance </li></ul><ul><ul><ul><li>HHSC may accept proposal without negotiating </li></ul></ul></ul>
  68. 68. Legal Considerations <ul><li>Elements of the Contract, continued : </li></ul><ul><ul><li>RFP </li></ul></ul><ul><ul><li>Proposal </li></ul></ul><ul><ul><li>Any Required Documents </li></ul></ul><ul><ul><li>Any Negotiated Terms </li></ul></ul>
  69. 69. Legal Considerations <ul><li>Contract Remedies: </li></ul><ul><ul><li>Legal Remedies </li></ul></ul><ul><ul><ul><li>Damages </li></ul></ul></ul><ul><ul><li>Equitable Remedies </li></ul></ul><ul><ul><ul><li>Injunctive Relief </li></ul></ul></ul>
  70. 70. Legal Considerations <ul><li>Contract Remedies, continued : </li></ul><ul><ul><li>Damages </li></ul></ul><ul><ul><ul><li>Actual, Direct, Indirect, Consequential, etc. </li></ul></ul></ul><ul><ul><ul><ul><li>Liquidated Damages </li></ul></ul></ul></ul>
  71. 71. Legal Considerations <ul><li>Conflicts of Interest </li></ul><ul><ul><li>Revolving Door </li></ul></ul><ul><ul><li>Organizational Conflicts </li></ul></ul>
  72. 72. <ul><li>Questions and Answers </li></ul>
  73. 73. <ul><li>End of Presentation </li></ul>

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