Request For Information Template
Ohio Public Employees Retirement SystemRequest for InformationFor:Retiree Medical Account AdministrationDate: February 19, 2019277 East Town Street, Columbus, Ohio 432151-800-222-7377
OHIO PUBLIC EMPLOYEES RETIREMENT SYSTEMRequest for InformationFor: Retiree Medical Account AdministrationTable of ContentsA.Project ScopePage 2B.Background- Retirement Board- Financial Information- Program OverviewPage 2Page 2Page 3Page 3C.Response Content- Cover Letter- Questionnaire- Additional InformationPage 5Page 5Page 6Page 8D.-Instructions for Submitting Responses1Page 9
OHIO PUBLIC EMPLOYEES RETIREMENT SYSTEMRequest for InformationFor: Retiree Medical Account AdministrationA. PROJECT SCOPEThe Ohio Public Employees Retirement System (OPERS) is requesting information regarding the current optionsavailable for support in administering our Retiree Medical Account (RMA) program. OPERS is seekinginformation from Vendors that can perform the following services for Suffix 10, 20, 40, and 11 accounts (seesections below for definitions).oPerform record keeping and administrative services (i.e., apply contributions, track vesting schedules,apply interest, maintain account balances, etc.)oAdjudicate claims and issue timely reimbursements to OPERS’ participants for qualified medicalexpenses as defined by IRS Code Section 213oProvide accurate and timely reporting of submitted reimbursement claimsoProvide superior customer service to OPERS employees and participantsoAdminister the RMA plan design as outlined in OPERS Retiree Medical Account plan document and inthe OPERS Wellness Retiree Medical Account plan documentoProvide clear and concise communication materials to OPERS participantsoReceive eligibility / data files from OPERS and OPERS’ vendorsOPERS is exploring the feasibility to administer this program one of two ways: 100% outsourced solution inwhich a vendor could perform all record keeping and claims processing functions or a partially outsourcedsolution in which OPERS would retain the record keeping functions and the vendor would perform the claimsprocessing functions.OPERS encourages vendors that can only perform claims processing functions to still respond to this Requestfor Information.For more information about Retiree Medical Accounts, visit www.opers.org.B. BACKGROUND1. Retirement BoardIn 1935, OPERS began a tradition of providing excellent retirement benefits for public employees. Withapproximately 101.4 billion in net assets, the System offers retirement, disability, and survivor benefitprograms for public employees throughout the state who are not covered by another state or local retirementsystem. OPERS serves more than 1,116,000 members of approximately 3,700 public employers and over210,000 retirees and surviving beneficiaries who receive monthly benefits.2
2. Financial InformationThe most recent OPERS Comprehensive Annual Financial Report is available on the OPERS website atwww.opers.org.3. Program OverviewOPERS sponsors a retiree medical account program that includes medical expense reimbursement accounts forparticipants in the Member Directed and Combined pension plans and in the Wellness plan. Participants useavailable balances in their RMA accounts for reimbursement of qualified medical expenses according to therequirements of the Retiree Medical Account plan document and the Wellness Retiree Medical Account plandocument.DefinitionsThe following definitions are provided to assist in understanding this RFI.oSuffix 10 – Applies to Member-Directed accounts that are in contributing status, meaning that thecontributing participant is still employed in an OPERS-covered position and is contributing to their MemberDirected investment account; OR the participant is no longer employed in an OPERS-covered position, buthas not officially retired or refunded and has not received a distribution from their Member-Directedinvestment account. Participants have a portion of their employer’s contributions deposited into their RMAthat then can be used later for reimbursement of qualified medical expenses.There are approximately 16,000 Suffix 10 accounts.oSuffix 11 - Applies to Wellness RMA Participants.There are approximately 500 participants with a Suffix 11 account.oSuffix 20 – Applies to Member-Directed accounts that are in distribution status. The participant has stoppedcontributing to their Member-Directed RMA and has retired or refunded, which means that the participantcan now seek reimbursement from the RMA for qualified medical expenses.There are approximately 6,700 participants with a Suffix 20 account.oSuffix 40 – Applies to Member-Directed accounts for which the participant has died; an eligible dependentmay use the remaining balance in the RMA for reimbursement of qualified medical expenses.There are approximately 100 participants with a Suffix 40 account.The RMA serves as a funding vehicle in which participants can accumulate a balance from contributions intotheir accounts. Upon termination from an OPERS-covered position or retirement and distribution from OPERS,participants can use the available balance to seek reimbursement for any qualified medical expenses they mayincur.oParticipants with Member-Directed RMAs (Living)OPERS offers three retirement plans: a defined benefit plan (i.e., a traditional pension plan), a definedcontribution plan, and a combined plan. The Member-Directed Plan is OPERS’ defined contribution plan.Participants actively employed in an OPERS-covered position who elect this plan participate in theMember-Directed RMA and vest in their account balances over a period of five (5) years if the accountwas established prior to July 1, 2015. If the account was established on or after July 1, 2015, theaccount balance is vested over fifteen (15) years with a 10% vesting beginning the sixth year (10% eachyear beginning year 6 and running through year 15).3
During a public employee’s active employment, funds will accumulate in a Suffix 10 account, and cannotbe accessed by the active employee. Upon leaving an OPERS-covered position and taking a distribution(either upon retirement or refund), the vested portion of the Suffix 10 balance is transitioned to a Suffix20 account the participant can then use the balance of for reimbursement of qualified medicalexpenses.oParticipants with Member-Directed RMAs (Deceased)Upon the participant’s death, the balance within the Suffix 10 or Suffix 20 account will be transitionedinto a Suffix 40 account that the participant’s eligible dependents may use the available balance of forreimbursement of qualified medical expenses.oParticipants with Wellness RMAsParticipants in the Defined Benefit and Combined plans received contributions to wellness RMA accountsfor wellness incentives earned during their participation in the OPERS’ wellness program or for unusedpremium allowances associated with a prior OPERS health plan that has since been terminated. TheWellness RMA balance is available in a Suffix 11 account for reimbursement of qualified medical expenses.In summary, the current population breakdown for the RMA program is included below. Please note that thispopulation may grow in the future.Suffix 10 Accounts16,000Suffix 20 Accounts6,700Suffix 40 Accounts100Suffix 11 Accounts500TOTAL23,300InterestA 4% fixed annual interest rate is applied to Suffix 10, 20 and 40 accounts only if the OPERS Health Care fund hasa positive investment return during the current calendar year. If the OPERS Health Care fund does not have apositive return, no interest is applied.Suffix 10 AccountsInterest is posted as of the last business day of the last month of the year, with no proration for partial months.An account must have a balance at the end of the year to earn interest for the following year. Example: TheHealth Care Fund had a positive investment return for 2019. On 12/31/2019, the RMA Participant had anaccount balance of 1,200. On 12/31/2020, the interest is calculated and posted to the participant's totalaccount balance.In addition, when an account is transferred to suffix 20, the proper vesting schedule and partial interest isapplied as described above. The partial interest is what was was what earned on the vested balance betweenJanuary and the transition date.Suffix 20 and 40 AccountsInterest is posted as of the last day of the month, with no proration for partial months. Claims are processedprior to the allocation of interest. An account must have a balance at the end of the month to earn interest forthe month. Example: The Health Care Fund had a positive investment return for 2019. On 12/31/2019, the RMA4
Participant had an account balance of 1,200. Each month during 2020, 1/12th of interest will be posted to theaccount if there is a positive balance on the last day of the month after all claims were processed.ForfeitureUpon termination from an OPERS-covered position and distribution from OPERS, a MD-RMA participants willforfeit their Employer Contribution Account.Upon death, the following forfeiture policy should be applied for MD-RMA and Wellness RMA participants.o Date of death March 24, 2015 and after:- The account will forfeit in total when there have been no claims submitted against theaccount for 24 consecutive months.- The 24-month period resets with each claim reimbursement.- If the account forfeits, the participant’s eligible dependents and/or estate does not have theright to reinstate the account balance.oDate of death March 23, 2015 and prior:- The account will forfeit in total when there have been no claims submitted against theaccount for 12 consecutive months.- The 12-month period resets with each claim reimbursement.- If the account forfeits, the participant’s eligible dependents and/or estate has a right torequest for the account to be reinstated.C. RESPONSE CONTENTThe written response should include the following information. For ease of review each request should beaddressed in a separate section preceded by an index tab to identify the appropriate Request for Information(RFI) section. The response should be formatted on consecutively numbered pages and include a table ofcontents.Although not required, OPERS prefers that submissions be printed two-sided to reduce the volume of materialsused to produce the responses.1. Cover LetterThe respondent should include a cover letter, in the form of a standard business letter, and must be signedby an authorized individual. It should include:1.1 A statement regarding your organization’s legal structure (e.g. an Ohio corporation), Federal taxidentification number, and principal place of business.1.2 Your organization’s primary contact on this RFI who has authority to answer questions regarding theresponse:a. Organization’s Nameb. Contact’s Namec. Contact’s Titled. Contact’s Addresse. Contact’s Phone numberf.Contact’s e-mail address5
2. QuestionnaireOPERS is requesting that responses to the questions in sections 2.2 – 2.5 reflect your experience specific toadministering retiree medical accounts. Please provide the following information:2.1 Company Informationa. Your organization’s domestic office locations.b. Your organization’s hierarchical structure, including subsidiary and affiliated companies, and jointventure relationships.c. The name and title for each of your C-suite officers, including at a minimum, the chief executiveofficer, the chief operations officer and the chief information technology officer (or theequivalent for each of these positions) and the number of years each individual has served in thatposition with your firm.d. The number of clients and individual lives represented within your organization’s reimbursementaccount product line.e. How long your firm has been administering reimbursement accounts.2.2 Claims Processing / Reimbursementa. Describe how your organization processes claims. Within your response, please indicate (anddefine) if multiple teams are involved and the approximate time frame in which a participantreceives a reimbursement upon submitting a claim.b. Describe the different methods participants can use to submit reimbursement claims to yourorganization.c. OPERS retirees receive their retirement benefit via direct deposit into their bank account. Is yoursystem configured so that reimbursement claims can be sent via direct deposit or EFT to theparticipant’s designated bank account?2.3 Record Keepinga. Is your organization able to apply contributions to the individual RMAs (Suffix 10 accounts) asoutlined in section (B)(3)? If yes, please describe what type of process is implemented to ensurethat the contributions are applied correctly.i.If your organization can’t apply contributions, would you be able to ingest a filefrom OPERS that provides participant-level contributions that you would apply tothe participant’s RMA?b. Is your organization able to apply the vesting schedule to the individual RMAs (Suffix 10accounts) as outlined in section (B)(3)? If yes, please describe what type of process isimplemented to ensure that the schedule is applied correctly.i.If your organization can’t apply the schedule, would you be able to ingest a file fromOPERS that provides participant-level vesting information that you would apply tothe participant’s RMA?6
c. Is your organization able to apply interest to the individual RMAs as outlined in section (B)(3)? Ifyes, please describe what type of process is implemented to ensure that the interest is appliedcorrectly.i.If your organization can’t apply interest, would you be able to ingest a file fromOPERS that provides participant-level interest adjustments that you would apply tothe participant’s RMA?d. Describe the process your organization uses to maintain accurate RMA balances.e. Is your organization able to produce reports by transaction type (i.e. contribution, interest,reimbursements, forfeitures) for the following time n-to-Datef.Is your organization able to roll individual RMA balances from one plan year into the followingplan year?g. Is your organization able to assess a monthly administrative fee against RMA balances?h. Are transactions created when overpayments occur? If yes, how are the receivables created andclosed?i.Describe your organization’s overpayment collection method. Please include information on anycommunications that the participant may receive about collecting the overpayment.j.Is your organization able to apply a forfeiture policy like OPERS’ policy described in this RFI? Ifyes, please describe what type of process would be implemented to ensure that the policy isapplied correctly.k. If participants return to work in an OPERS-covered position, would your organization be able tosuspend reimbursements from being issued from their RMAs (during their active period ofemployment in the OPERS-coveredposition) upon re-employment notification from OPERS andresume reimbursements upon notice of termination of re-employment?l.Are any of your record keeping functions facilitated off-shore? If yes, please indicate/describewhich functions.m. Is your organization able to ingest a file inclusive of contribution, vesting, and/or interest data viathe following cadence?i.Two times per monthii.Weeklyiii.Dailyn. Does your organization provide the following types of communications to RMA participants?i.Account Statementsii.Forfeiture Noticesiii.Please indicate any additional communications that are provided7
2.4 Participant Customer Service / Communicationsa. Are any of your customer service functions facilitated off-shore? If yes, please indicate/describewhich functions.b. Does your organization’s customer service team have access to the participant’s account toprovide information on balances, pending claims, etc.?c. Does your organization provide the following types of communications to RMA participants?i.Claim Formsii.Please indicate any additional communications that are providedd. Does your organization provide the opportunity for participants to set up an online account? Ifso, what type of information would they be able to access?e. Describe your escalation process if a participant or client raises serious performance deficiencies.2.5 Plan Sponsor Supporta. Does your organization provide a plan sponsor portal through which a plan sponsor could viewthe same transactional information that participants can see through their online account?b. Do you provide your clients with a dedicated, toll-free phone number?c. Are any of your client service functions facilitated off-shore? If yes, please indicate/describewhich functions.d. Describe what type of reporting a plan sponsor receives on how accounts areadministered/maintained. Within your response, please include brief definition and cadence ofwhen the report would be received.e. Describe your organization’s quality control processes that are applied before providing yourclients with data / reporting.f.3.Is your organization able to ingest a file inclusive of eligibility data via the following cadence?i.Two times per monthii.Weeklyiii.DailyAdditional Information3.1 Respondent acknowledges that OPERS is subject to the Ohio Public Records Act, and the documentssubmitted pursuant to this RFI may be subject to a public records request. Accordingly, respondentmust identify any material or documents that are confidential and clearly mark those items ordocuments at the time of submittal. If a request for records is made that includes informationrespondent has identified as confidential, OPERS will make reasonable efforts to contact respondentin sufficient time to allow respondent to take appropriate legal steps to protect the confidentialinformation from disclosure. If as a result of the position taken by respondent regarding theconfidentiality of the information OPERS is assessed any damages or fees, respondent shall indemnifyOPERS for such damages or fees. If no documents or materials are identified and marked byrespondent as confidential, respondent will be deemed to have consented to the release of the8
document or material, and to have waived any cause of action against OPERS resulting from therelease of the documents or materials.3.2 The respondent should provide any other information it believes relevant to this RFI.D. INSTRUCTIONS FOR SUBMITTING RESPONSESPlease submit five (5) hard copies of your written responses to the following address by noon (12:00 PM EST),March 5, 2019.Ohio Public Employees Retirement SystemAttn: Nicole Parsell, Procurement Agent277 East Town StreetColumbus, Ohio 43215Please also submit two (2) electronic copies of your written responses (including one (1) redacted copy for publicrecords requests) to nparsell@opers.org.There is no expressed or implied obligation for OPERS to reimburse responding firms for any expenses incurredin preparing responses to this request.This RFI is not a contract, a promise to enter into a contract, or meant to serve as a contract; it seeks informationonly.All documents and materials submitted in response to this RFI will become the property of OPERS and will notbe returned to responding firms.Questions about this RFI should be emailed to Nicole Parsell at nparsell@opers.org. The question and answerperiod will be from February 19th – 27th.This RFI is issued on February 19, 2019.9
Request for Information For: Retiree Medical Account Administration Date: February 19, 2019 277 East Town Street, Columbus, Ohio 43215 1-800-222-7377 . 1 OHIO PUBLIC EMPLOYEES RETIREMENT SYSTEM Request for Information
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