RFP 2026-020 Health & Welfare Benefits Consulting

Administered by University of Maine System

Office of Strategic Procurement

Request for Proposal (RFP)

SUBMISSION FORM PACKAGE

HEALTH & WELFARE BENEFITS CONSULTING

RFP #2026-020

Issued Date: April 2, 2026

Response Deadline Date/Time: April 22, 2026 11:59 p.m. EST

Response Submission Information:

Submitted electronically to UMSResponses@maine.edu

Email Subject Line - RC: Health & Welfare Benefits Consulting - RFP#2026-020

Response Contact Information:

Email: UMSResponses@maine.edu

INSTRUCTIONS

Response Format Instructions

This section contains instructions for Respondents to use in preparing their response. The Respondent's submission must follow the outline used below, including the numbering of section and sub-section headings. Failure to use the outline specified in this section or to respond to all questions and instructions throughout this document may result in the response being disqualified as non-responsive or receiving a reduced score.

The University and its evaluation team for this document have sole discretion to determine whether a variance from the document specifications should result in either disqualification or reduction in scoring of a response.

Re-phrasing of the content provided in this document will, at best, be considered minimally responsive. The University seeks detailed yet succinct responses that demonstrate the Respondent's experience and ability to perform the requirements specified throughout this document.

Section 1 - Response Cover Page

Label this response - Section 1 - UMS Response Cover Page

Insert Appendix A - University of Maine System Response Cover Page

Insert Appendix B - Debarment, Performance and Non-Collusion Certification

Section 2 - Cost Response

Label this response - Section 2 - Cost Evaluation

Insert Appendix C - Required Cost Evaluation Exhibits

Section 3 - Master Agreement

Label this response - Section 3 - Master Agreement

Insert Appendix D1 - Master Agreement

Section 4 - Response to Questions

Label this response - Section 4 - Response to Evaluation Questions & Related Information

Insert Appendix E - Minimum Eligibility Requirements

Insert Appendix F - Evaluation Question(s) - Organization, Qualifications, Experience and References

Insert Appendix G - Solution Requirements Narrative Questions

Insert Appendix H - Solution Requirements Matrix

SECTION 1

Appendix A - University of Maine System Response Cover Page

RFP # 2026-020

Health & Welfare Benefits Consulting

This pricing structure contained herein will remain firm for a period of 90 days from the date and time of the quote deadline date.

Consultant will not receive financial compensation from external vendors unless specifically agreed.

No personnel currently employed by the University or any other University agency participated, either directly or indirectly, in any activities relating to the preparation of the Respondent's response.

No attempt has been made or will be made by the Respondent to induce any other person or firm to submit or not to submit a response.

The undersigned is authorized to enter into contractual obligations on behalf of the above-named organization.

By submitting a response to a Request for Proposal, bid or other offer to do business with the University your entity understands and agrees that:

The Agreement provisions in Section 1.2.1.2 of this document will not be modified and are thereby incorporated into any agreement entered into between University and your entity; that such terms and condition shall control in the event of any conflict with such agreement; and that your entity will not propose or demand any contrary terms;

The above Agreement provisions in Section 1.2.1.2 of this document will govern the interpretation of such agreement notwithstanding the expression of any other term and/or condition to the contrary;

Your entity agrees that the resulting Agreement will be the entire agreement between the University (including University's employees and other End Users) and Respondent and in the event that the Respondent requires terms of use agreements or other agreements, policies or understanding, whether on an order form, invoice, website, electronic, click-through, verbal or in writing, with University's employees or other End Users, such agreements shall be null, void and without effect, and the terms of the Agreement shall apply.

Your entity will identify at the time of submission which, if any, portion or your submitted materials are entitled to ''trade secret" exemption from disclosure under Maine's Freedom of Access Act; that failure to so identify will authorize UMS to conclude that no portions are so exempt; and that your entity will defend, indemnify and hold harmless UMS in any and all legal actions that seek to compel UMS to disclose under Maine's Freedom of Access Act some or all of your submitted materials and/or contract, if any, executed between UMS and your entity.

To the best of my knowledge all information provided in the enclosed response, both programmatic and financial, is complete and accurate at the time of submission.

Date: ______________________________________

__________________________________________ ______________________________________

Name and Title (Printed) Authorized Signature

Appendix B - Debarment, Performance and Non-Collusion Certification

University of Maine System

DEBARMENT, PERFORMANCE and NON-COLLUSION CERTIFICATION

RFP # 2026-020

Health & Welfare Benefits Consulting

By signing this document, I certify to the best of my knowledge and belief that the aforementioned organization, its principals and any subcontractors named in this proposal:

Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from bidding or working on contracts issued by any governmental agency.

Have not within three years of submitting the proposal for this contract been convicted of or had a civil judgment rendered against them for:

Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state or local government transaction or contract.

Violating Federal or State antitrust statutes or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and

Have not within a three (3) year period preceding this proposal had one or more federal, state or local government transactions terminated for cause or default.

Have not entered into a prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and this proposal is in all respects fair and without collusion or fraud. The above mentioned entities understand and agree that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards.

Failure to provide this certification may result in the disqualification of the Respondent's proposal, at the University's discretion.

Date: ______________________________________

__________________________________________ ______________________________________

Name and Title (Printed) Authorized Signature

SECTION 2

Appendix C - Required Cost Evaluation Exhibits

University of Maine System

COST EVALUATION

RFP # 2026-020

Health & Welfare Benefits Consulting

GENERAL INSTRUCTIONS:

The Respondent must submit a cost response that covers the entire period of the Agreement, including any optional renewal periods.

The cost response shall include the costs necessary for the Respondent to fully comply with the Agreement terms and conditions and requirements. Note regarding total cost of ownership: This "cost" will encompass the entire solution pricing along with all services offered as part of the solution.

Failure to provide the requested information and to follow the required cost response format provided in Appendix C may result in the exclusion of the Response from consideration, at the discretion of the University. You can add rows and columns required to insert additional information. If a particular cost table is not required as part of your response, simply leave it blank.

No costs related to the preparation of the Response for this document or to the negotiation of the Agreement with the University may be included in the Response. Only costs to be incurred after the Agreement effective date that are specifically related to the implementation or operation of contracted services may be included.

Identify all costs by year, to be charged for performing the services necessary to accomplish the objectives of this document.

Pricing will be guaranteed by the Respondent for the term of the Agreement.

The University will NOT seek a best and final offer (BAFO) from any Respondent in this procurement process. All Respondents are expected to provide their best value pricing with the submission of their response. Respondents will NOT be given another opportunity to modify pricing once submitted.

Consortium Purchasing Capability: We encourage Respondents to evaluate and utilize consortium purchasing opportunities through organizations such as:

E&I Cooperative Services

Massachusetts Higher Education Consortium (MHEC)

NASPO ValuePoint

Other relevant higher education or public sector cooperatives

INSTRUCTIONS FOR - Exhibit 1 (Table 1) - Core Services and Ad Hoc Services Cost Proposal

CONSULTANT CORE SERVICES

The following list of consultant core services is required by the University.

Respondent submissions that do not provide the full list of consultant core services will be immediately disqualified from further consideration, or further review of the submission.

Assist the University of Maine System in compliance with laws and regulations related to employee benefits. Researching, alerting and advising of any new developments in state and federal law and employee benefit programs on an ongoing basis.

Work with UMS on strategic planning regarding all health and welfare coverage. Advise and assist in keeping its plans both competitive with other best-in-class peer plans while controlling and reducing costs.

Provide strategic guidance on pharmacy benefit management, including formulary design, specialty drug cost management, PBM contract terms, and rebate transparency. Advise UMS on emerging drug pricing legislation and recommend strategies to manage pharmaceutical cost trend across all covered populations.

Competitive bidding: assume at least 1 competitive bidding annually. Note that in some years there may be more than one, other years there may be none. However, we will not be contractually limited as part of this consulting arrangement. Proposal should describe any impact of multiple bidding processes on service and fees. Bidding process must be in compliance with UMS procurement standards. Support for competitive bidding to include:

Prepare bid specifications and solicit proposals from insurance markets which specialize in group insurance plans including self-funded arrangements, as needed.

Evaluate bids and bidders, claim payment procedures, customer service, network, reserve establishment policies, financial soundness and prepare summary of analysis.

Work with UMS staff/committee to interview finalist bidders and conduct reference checks.

Assist UMS staff/committee in identifying and recommending the most cost-beneficial package from among the various bidders.

Assist the HR/Benefits Office with all negotiations with providers on all issues including those related to premiums, benefit levels, plan design, and special terms and conditions.

Assist UMS in maintaining compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA), including ongoing review of non-quantitative treatment limitations (NQTLs), comparative analysis documentation, and response to any related regulatory inquiries or audits by the Department of Labor or other oversight agencies.

Assist the HR/Benefits Office in administering all group insurance plans, such as:

Respond to questions from and provide information to the benefits department staff and provide other consulting services related to the plans during the year.

Review vendor contracts, Summary Plan Descriptions/booklets and other materials for accuracy and completeness. Work with outside legal counsel and in-house counsel to review contracts and finalize documents.

Assist with COBRA, HIPAA, audits, ACA, training and questions as needed.

Assist with resolution of difficult and/or unusual claims problems that have been escalated through the appeals process.

Support UMS in developing and maintaining year-round employee benefits communications, including benefits literacy materials, life event communications, and targeted messaging for distinct employee populations. Review and advise on the accessibility and clarity of all benefits-related communications, including open enrollment and mid-year materials.

Support UMS work with Employee Health Plan Task Force (EHPTF) comprised of university administration and bargaining unit representatives. This group makes recommendations regarding the health plan based on information provided by the consultant, carrier, and other subject matter experts. This support typically includes responsibilities such as:

Prepare agenda and technical content for monthly Task Force meetings approximately every other month typically via Zoom and once a year (5-6 hours) in Bangor, Maine.

Participate in monthly prep sessions (with facilitator) and/or participate in subcommittee meetings (bi-monthly) via conference call.

Support of UMS wellness incentive program as appropriate, working with wellness provider and UMS staff including Unions, HR, and Finance staff:

Provide expertise, advice and support to UMS wellness staff and vendor with development and management of wellness programs and health management initiatives.

Review draft documents and communications,

Work with health plan vendor to project cost impact of proposed incentives and plan changes.

Support the long-term sustainability of our active and retiree benefit programs. Consultant will provide strategic guidance, expertise and liaison with HR, Finance, Unions, and other groups and task forces to recommend and provide solutions to mitigate risk and manage Healthcare cost trend.

Support university's health care vendor in creative contracting solutions with Maine healthcare system. This may involve participation (in person or by phone) in meetings with health systems, their actuaries and other large Maine employers looking to develop ACO and other creative contracting solutions.

Reporting and data analysis:

Consultant is expected to:

Be fully versed in data warehouse reporting and able to generate meaningful reports.

Prepare a formal annual benchmarking report comparing UMS benefit plans to higher education peers, the State of Maine, and relevant industry standards. Reports shall draw on recognized data sources such as NACUBO, Mercer, SHRM, or comparable benchmarking surveys, and shall include recommendations based on findings.

Collect data from vendors in support of required reporting such as the UMS Annual Financial Report following GASB, actuarial, and other appropriate standards.

Utilize advanced data analytics and predictive modeling tools to support cost trend analysis, utilization forecasting, and population health management. Provide UMS with actionable insights derived from plan data to support strategic decision-making and long-term cost containment efforts.

Review claims experience (including large claim management), claim service, and claim administration.

Monitor and measure performance and service guarantees for all vendors.

Prepare monthly reporting package of actual vs budgeted health plan costs for self-insured medical plan.

Advise UMS on its fiduciary responsibilities as a plan sponsor, including plan document maintenance, summary plan description accuracy, and readiness for IRS or Department of Labor audits. Work with outside legal counsel and in-house attorneys to ensure ongoing compliance with applicable federal and state requirements.

Disclose in writing any compensation arrangements, contingent commissions, or other financial relationships with carriers or vendors included in any competitive bidding process. Such disclosures shall be provided prior to the initiation of each bidding process and updated as circumstances change, in accordance with UMS procurement standards.

Periodic vendor meetings:

Monthly meetings with health plan providers (currently Anthem), generally held via Zoom

Quarterly meetings with wellness vendors, generally held in Portland or Bangor, Maine

Annual meetings with Dental/Vision, Life/Disability and EAP vendors, generally held in Portland or Bangor, Maine

Open enrollment: provide support of active, COBRA and retiree packages and mailings with outsource partners; work with internal communication staff and assist with drafting and reviewing open enrollment materials, with coordinating webinar and rate pages.

TABLE A: CONSULTANT CORE SERVICES

The Respondent is to provide all the associated lifecycle costs for your proposed service.

ENTIRE PERIOD OF PERFORMANCE - CONSULTANT CORE SERVICES

TABLE B: AD HOC SERVICES

SECTION 3

Appendix D1 - Evaluation Question(s) - Master Agreement

This portion of the RFP contains special terms and conditions which will govern the resulting agreement, many of which are stated in RFP Section 1.2, with more detail in RFP Appendix D. Please indicate your acceptance for each special term by "X' in the Agree or Disagree column.

Should you take exception to any of these special terms and conditions you are required to note your exception directly below each of the respective terms in question. It should be noted that any exceptions may result in the disqualification of your proposal, lack of providing the required response or indicating terms will be negotiated post award will result in a zero (0) score for the Master Agreement evaluation criteria in RFP Section 2.1.1.

SECTION 4

Appendix E - Minimum Eligibility Requirements

Respondent's Organization Name: ________________________________________________

INSTRUCTIONS: Respondents shall ensure that all information required herein is submitted with the response. All information provided should be verified by documentation requested by the University. Failure to provide all information, inaccuracy or misstatement may be sufficient cause for rejection of the response or rescission of an award. Respondents are encouraged to provide any additional information describing operational abilities.

Minimum Eligibility Requirement Question(s)

All benefit consulting firms submitting a proposal must meet the following minimum qualifications. Respondents that do not meet these qualifications will be disqualified. Please provide supporting documentation to demonstrate you meet the minimum qualifications. Failing to provide evidence will result in disqualification.

Licensed to do business in Maine and other states as appropriate.

To demonstrate compliance with this eligibility requirement, respondents must provide the following documentation:

Proof of Authorization to Conduct Business in Maine

A current Certificate of Good Standing, Certificate of Authority, or similar documentation issued by the Maine Secretary of State.

Documentation of Licensure in Other States (If Applicable)

A list of states where the vendor is licensed to operate, with copies of corresponding registration or licensing documents.

Statement of Compliance

A signed statement confirming the vendor will maintain all required business licenses throughout the contract term.

Have the expertise, licenses and resources to provide Employee Benefit Advisor services for the University of Maine System's current and future operations with specific experience with self-insured plans.

Professional Expertise and Qualifications

Provide documentation showing:

A description of the firm's qualifications and areas of specialty related to health & welfare benefits consulting.

A summary of the firm's experience advising large, complex organizations, preferably higher education systems or multi-entity employee, on benefits strategy, compliance, vendor management, and long-term plan performance.

Demonstrated Experience With Self-Insured Health Plans

To demonstrate capability in managing self-insured plan environments, respondents must provide:

At least two examples (or case summaries) demonstrating successful support of self-funded medical or welfare benefit plans.

Statement of Capability for Future Needs

Because UMS operations may evolve over time, respondents must provide:

A statement of the firm's ability to scale services as UMS expands or changes its benefits plans, self-insured strategy, or vendor partnerships.

Examples demonstrating adaptability and proven long-term client support.

Consistently maintain and allocate sufficient staffing resources to provide timely service for UMS Employee Benefit Advisor service needs.

Account Team Structure & Assigned Personnel

Provide an organizational chart and identify the specific team members who will support UMS, including their roles and time commitments.

Staff Qualifications & Relevant Experience

Submit brief bios or resumes demonstrating that assigned staff have appropriate credentials and experience supporting self-insured employee benefit programs.

Staffing Capacity & Service Delivery Approach

Describe how the firm allocates resources, manages workloads, and ensures sufficient coverage to meet ongoing and peak-period service needs.

Maintain staff that are qualified and available to provide specialized technical expertise in various disciplines as necessary.

Summary of Specialized Technical Expertise

A brief description of the specialized technical disciplines available within the firm (e.g., actuarial services, pharmacy benefit analysis, compliance, data analytics, stop-loss consulting, wellness strategy).

Qualifications of Specialized Personnel

Short bios or resumes demonstrating relevant certifications, credentials, and experience (e.g., actuaries, pharmacists, compliance attorneys, data analysts).

Availability and Resource Commitment

A statement confirming the availability of these specialists to support UMS as needed, including how the firm ensures access during high-demand periods.

Experience working with public employers and Non-ERISA plans

Summary of Public Employer Experience

A brief description of the firm's experience serving public-sector employers (e.g., state agencies, municipalities, higher education systems), including scope of services and years of involvement.

Non-ERISA Plan Expertise

Examples demonstrating the firm's knowledge of and experience with Non-ERISA health & welfare plans, including plan design, compliance considerations, and administrative requirements unique to governmental and public institutions.

Representative Client List or Case Summaries

A list of public-sector clients supported within the last 5-7 years, or 2-3 short case summaries illustrating successful advisory services for public employers or Non-ERISA plan sponsors.

Execute and adhere to RFP Appendix A and Appendix B which discloses any direct or indirect compensation to you and/or your firm from any third-party vendors and/or insurance companies as they relate to UMS's insurance plans and benefit offerings.

Appendix F - Evaluation Question(s) - Organization, Qualifications, Experience and References

Respondent's Organization Name: ________________________________________________

INSTRUCTIONS: Respondents shall ensure that all information required herein is submitted with the response. All information provided should be verified by documentation requested by the University. Failure to provide all information, inaccuracy or misstatement may be sufficient cause for rejection of the response or rescission of an award. Respondents are encouraged to provide any additional information describing operational abilities.

Evaluation Question(s)

Provide a statement describing your company to include name, number of employees, locations, number of years in business, number of years offering/supporting the proposed solutions, and any and all acquisitions or mergers in the last five years. Describe the company's ownership structure.

Include a description of your company's organizational structure.

What resources are available on a national and local level?

Organization Location and Licensure

Location of the office from which the primary consulting services will originate.

Do you have a Maine based office?

Indicate the location from which the contract will be managed.

Attach documentation of any applicable Maine licensure requirements (or any specific credentials required) to conduct this engagement.

How many employers do you service?

Of these employers, how many are state government or large municipal (10,000+ employees), or higher education clients?

How many employers in the State of Maine do you service?

Describe the size and complexity of your State of Maine clients including largest and smallest?

Name two health consulting relationships encompassing a similar number of covered active and retiree lives as the University's for which you are currently performing consulting duties.

Provide an overview of your company's account management organization, including number and role of each staff member. Also include an organizational chart specific to the office/team that would service this account.

Describe their experience with employee benefits consulting.

Do you have the ability to provide health program actuarial services? Is your actuary part of the core consulting team?

Do you have clinical expertise on staff? If yes, please describe.

Are any of your consulting or support functions performed off shore? If so, describe.

Describe your company's disaster recovery and contingency plans. Have you ever tested or implemented these plans?

Provide two organizations of similar employee/retiree sizes with whom your firm has lost a relationship during the past 36 months. Please provide a name and telephone number of a contact with these organizations.

Attach a list of all current litigation in which the Respondent is named and a list of all cases that have closed within the past five (5) years in which Respondent paid the claimant either as part of a settlement or by decree. For each, list the entity suing, the complaint, the accusation, amount, and outcome. If there has been no such litigation, write "none" on submitted attachment.

If subcontractors are to be used, provide a list that specifies the name, address, phone number, contact person, and a brief description of the subcontractors' organizational capacity and qualifications, and how you intend to use the subcontractors.

Provide a statement that explains why your company would be most qualified to provide products and services to the University of Maine System. Describe what differentiates you from your competitors. Respondent must demonstrate that they are a recognized leader in the services and/or products covered in this document.

List the industries and/or professional associations in which your firm is an active member.

Describe your firm's culture and approach to providing high performance benefits while supporting cost management to current clients and their members.

Provide examples of how your firm has supported clients in transforming employee benefits and adopting high performance, high value strategies and partnerships.

Describe your company's experience providing benefit consulting services in a unionized environment.

Include the number of unionized clients your company provides services to.

Include whether those clients are in higher education.

Include examples of which employee unions (e.g. SEIU, AFSCME, UAW, etc.) were involved in your previous experience providing consulting services.

Financial Stability

No financial statements are required to be submitted with your responses; however, prior to an award the University may request your audited financial statements, credit reports and letters from your bank and suppliers.

Organization Reference Form

Respondent's Organization Name: ______________________________________________

INSTRUCTIONS: Provide a minimum of three (3) current professional references who may be contacted for verification of the Respondent's professional qualifications to meet the requirements set forth herein. We strongly prefer references from higher education institutions similar in size and requirements to the University of Maine System.

We request that the references include one long-standing customer (minimum of 3-year engagement) and one new customer (one who has been engaged with Respondent for less than one year).

Please provide your full scope of services for each reference listed below.

Appendix G - Evaluation Question(s) - Solution Requirements Narrative Questions

Respondent's Organization Name: ______________________________________________

All responses to the questions will reflect what is offered as part of the Respondent's proposed solution. Respondents MUST indicate if the product or service requires modification, additional products or services, or if any other accommodation would be necessary to meet the requirement.

Evaluation Question(s) - Solution Requirement Questions

Advisor Background & Experience

Describe your background as a Consultant and Benefits Advisor, including relevant experience with higher education or similar clients.

What attributes and assets would make you a valuable strategic partner to the University?

List any industry awards, recognitions, and certifications your company has earned.

Would you be acting as a fiduciary on all services provided to the University of Maine System? If no, please explain.

Strategic Planning & Experience

Describe the strategic support that you provide to other clients and can provide to UMS management team.

Describe your approach to employee benefits strategic planning and how it reduces costs while enhancing benefits; include specific examples.

Provide your standard project plan covering selection, underwriting, and implementation phases of transparent, high-value health plans.

How do you analyze current plan design, claims (including pharmacy), and data to develop cost-control strategies, funding, and purchasing options?

What primary challenges and opportunities do you see for self-insured plan sponsors like the University in the next 1-5 years?

Provide examples of benefit design strategies (direct contracting, tiering, incentives, wellness programs, etc.) that you've developed that improved performance and ROI.

Share your experience with pharmacy benefit and pass-through arrangements, ACO risk arrangements, and underwriting principles for renewal negotiations.

Communication

Describe your approach to employee and retiree benefit communications, including types of media. This should include open enrollment materials as well as support for educational sessions. Provide examples.

Do you have a dedicated benefits communications consultant on staff? If not, how do you resource this?

Legal & Compliance

Describe your organization's legal resources and how you update clients on federal and state benefits-related legislation.

Do you have in-house legal counsel? If so, outline your counsel's expertise in public sector/non-ERISA benefits issues. If subcontracted, describe the relationship and qualifications.

Clients & References

Provide client breakdown by funding type (fully insured, level-funded, self-funded), size, entity sector, and geography (Maine vs. non-Maine).

Share recent cost trends across your book of business (annual premium increases, PMPM costs, pharmacy cost trends).

Describe your tools and methodologies for identifying cost-saving opportunities and provide three innovative, cost-reducing solutions you've implemented for clients.

Describe your process for monitoring performance guarantees, reviewing savings initiatives, and ensuring client satisfaction.

Advisor Team & Qualifications

Provide an overview of the proposed team for the University, including roles, responsibilities, and qualifications.

Describe the software, tools, and training used to support client management.

Services & Support

Describe your account support services (enrollment coordination, member communications, compliance consulting, actuarial/clinical expertise, auditing).

Provide two scenarios showing how you monitored claims and adjusted strategies for clients.

Provide two examples of how you have supported plan members (e.g., resolving bills, lowering costs, or finding high-value providers).

Describe your capabilities in technology-enabled employee services, analytics, auditing, and handling high-cost claims.

How do you evaluate and monitor vendor/point solution performance while minimizing disruption?

Health Plan Strategy

Provide examples of balancing affordability, quality, and disruption when implementing strategies.

How do you serve as fiduciary/steward of client health plan dollars?

Describe your RFP approach for TPA evaluation and contracting, including repricing methodology. Are you willing to use third-party RFP templates?

Describe your approach to wellness program recommendations and ROI evaluation.

Pharmacy (Rx)

What percentage of your clients carve out pharmacy? What percentage have transparent contracts (non-CVS/Optum/ESI).

Do you have partnerships with PBMs or work with external Rx consultants? Describe the process and provide examples of PBM terms you've negotiated out of contracts.

Regarding transparent PBM relationships, what support do you provide including auditing guidance/strategic directions.

Provide recent pharmacy cost trends in your book of business (including specialty pharmacy and carve-outs).

Describe how you negotiate and monitor lowest-net-cost formularies.

Compensation & Transparency

Describe your compensation model (fees, commissions, revenue sharing). Include all services covered in your cost proposal and any additional optional services with pricing.

Will you commit to disclosing all compensation from all sources tied to the University's benefits, even if not legally required?

Do you or your affiliates have financial ties to vendors/solutions you recommend? If so, describe how you ensure impartiality.

What is your philosophy on transparency and willingness to commit contractually to acting solely in the plan's interest?

Additional Information

Please describe the distinguishing characteristics, capabilities, and approaches that set your firm apart from other respondents. In your response, provide a detailed explanation of the specific qualifications, experience, and value-added services that uniquely position your firm to perform this engagement successfully and to advance the University's objectives.

Please provide any additional information or materials relevant to this RFP.

Appendix H - Solution Requirements Matrix

All responses to the questions will reflect what is offered as part of the Respondent's proposed solution. Respondents MUST indicate if the solution offered meets the requirement stated by entering "Yes", "No" or "Partial".

YES - This response indicates the Respondents' solution includes the requirement.

PARTIAL - This response indicates the Respondents' solution meets the requirement partially.

NO - This response indicates the Respondents' solution does NOT include the business functionality noted in the requirement.

If you answer "Partial" or "No" please provide the clarification in the Explanation column for what can be done to meet the requirement.

Your submission of this form must include an MS Excel Version of this document for ease of evaluation. For a copy of the excel version of Appendix H contact the Proposal Contact identified on the cover page of this document.