Commercial Insurance Carrier for the Granite State Paid Family and Medical Leave Plan

PROPRIETARY & CONFIDENTIAL NEW HAMPSHIRE DEPARTMENT OF ADMINISTRATIVE SERVICES DIVISION OF PROCUREMENT AND SUPPORT SERVICES REQUEST FOR PROPOSAL FOR COMMERCIAL INSURANCE CARRIER FOR THE GRANITE STATE PAID FAMILY AND MEDICAL LEAVE PLAN RFP # 2571-22 DUE DATE: May 9, 2022 at 10:00 AM (EST) PROPRIETARY & CONFIDENTIAL Page 2 of 54 Table of Contents SECTION I: INTRODUCTION .................................................................................................................................. 3 SECTION II: BIDDING INSTRUCTIONS AND CONDITIONS .................................................................................... 6 SECTION III: SCOPE OF SERVICES AND CONTRACT TERMS .............................................................................. 11 SECTION IV: FINANCIAL SECTION ..................................................................................................................... 15 SECTION V: QUESTIONNAIRE

............................................................................................................................. 18 SECTION VI: TERMS AND CONDITIONS RELATED TO THE RFP PROCESS ............................................................ 30 SECTION VII: CONTRACT TERMS ........................................................................................................................ 32 APPENDIX A: HB2 BILL TEXT AS ENACTED .......................................................................................................... 34 APPENDIX B: FORM P-37 AGREEMENT .............................................................................................................. 40 APPENDIX C: TRANSMITTAL LETTER .................................................................................................................... 45 APPENDIX D: STATE EMPLOYER CENSUS AND FMLA USAGE ............................................................................. 46 APPENDIX E: BIDDER TOTAL PROJECTED COST FACTORS ................................................................................. 47 APPENDIX F: NHID FAMILY AND MEDICAL LEAVE INSURANCE (FMLI) RULES (INS 8000) ................................ 48 APPENDIX G: STATE OF NH DEMOGRAPHIC DATA ........................................................................................... 49 APPENDIX H: TECHNICAL CAPABILITIES ............................................................................................................ 50 APPENDIX I: BIDDER EXHIBIT CHECKLIST ........................................................................................................... 51 APPENDIX J: NON-DISCLOSURE AGREEMENT ................................................................................................... 52 PROPRIETARY & CONFIDENTIAL Page 3 of 54 REQUEST FOR PROPOSAL FOR COMMERCIAL INSURANCE CARRIER FOR THE GRANITE STATE PAID FAMILY AND MEDICAL LEAVE PLAN SECTION I: INTRODUCTION A. Objective The State of New Hampshire (NH) seeks a commercial insurance carrier to fully insure and administer the Granite State Paid Family and Medical Leave (PFML) Plan (the Plan). The winning carrier shall provide coverage to all three participant groups: the State as an Employer, Private and Other Public Employers and the Individual Group (as further described below) in compliance with the provisions of HB2 (Chapter 91, Laws of 2021) and its referenced RSAs (Appendix A), and all other applicable federal and state laws and Department of Administrative Services (DAS), NH Employment Security (NHES) and NH Insurance Department (NHID) rules. The winning carrier shall also administer the PFML Premium Fund associated with the PFML Plan. The winning carrier is not required to respond to the corresponding RFP issued for a marketing and outreach contractor but is permitted to do so. The marketing and outreach RFP will be posted and can be accessed at https://apps.das.nh.gov/bidscontracts/bids.aspx. B. Background Included in the Fiscal Year (FY) 22/23 NH State budget was a provision in the Budget Trailer Bill, HB2, to require the State to implement a voluntary paid family and medical leave plan. The Plan is the first of its kind affording an alternative to a mandatory program by providing voluntary access to an attractive and affordable benefit for all employees working in NH and a business enterprise tax (BET) credit equal to 50% of the premium paid by sponsoring employers. The Plan provides participating NH workers with 60% of their average weekly wage for up to six (6) weeks per year for specified leaves of absence from the workplace. The Plan is intended to emulate the federal Family and Medical Leave Act (FMLA) in many aspects, as further described in Section III. Subject to terms negotiated between Private and Other Public Employers and the winning carrier, the Plan is intended to provide wage replacement insurance to assist NH workers who do not have other comparable benefits when they need to take leave. As outlined in the law (Appendix A), the Plan defines three eligible groups: 1) State Employer: The State is required to purchase PFML insurance for its employees through the winning commercial carrier which shall serve as the Plan’s base risk pool, excluding coverage for an employee’s own serious health condition. The premium for the State shall be expressed as a percentage of wages. 2) Private and Other Public Employers: Private and Other Public Employers may voluntarily opt into the Plan and contract directly, either through in house staff or through agents, brokers, and/or consultants with the commercial carrier for advantageously priced PFML coverage that can be customized to the extent it is permitted by the law and insurance rules. The premium for employers shall be derived from the State Rate through the application of rating factors that are actuarially justified. 3) Individuals: Individuals working for employers who do not participate in the Plan may voluntarily opt into the Plan indirectly through a group purchasing pool. Premium from individuals in this group shall not exceed $5 per subscriber per week. The three groups are to be underwritten as one pool wherein the group rates are required to be submitted with the response to the RFP; thereafter, the winning carrier shall be required to file the applicable policies, certificates, and forms with NHID. That filing submission shall be comprised of (1) policies and certificates issued to the State Employer group, (2) policies and certificates issued to the Individual group, and (3) policies and certificates for the Private and Other Public Employers group. To administer the Plan, the winning carrier will collect premium directly from the State as an Employer, through payroll deduction for Private and Other Public Employers with greater than 50 employees, and through the PFML Premium Fund (which the winning carrier will administer on behalf of NHES) for the https://apps.das.nh.gov/bidscontracts/bids.aspx PROPRIETARY & CONFIDENTIAL Page 4 of 54 Individual Group and Private and Other Public Employers with fewer than 50 employees that do not choose to make payments through payroll deduction. The State will also establish the PFML Premium Stabilization Trust Fund, which will be administered by NHES. Taxes imposed on the premium written by the winning carrier in connection with the Plan, as well as gifts, grants, and donations to the Plan, shall be deposited into the PFML Premium Stabilization Trust Fund. The PFML Premium Stabilization Trust Fund shall act as a limited reserve to the extent premium stabilization funds are available and authorized, to be used exclusively for assuring that premium made by participants in the purchasing pool remain stable from year to year and do not exceed $5 per subscriber per week. Both DAS and NHES are required to produce summary reports on the Plan on an annual basis to be delivered to the Governor, the Senate President and the Speaker of the House of Representatives and make them available to the public. The specifications for the summary report for DAS and NHES are in the law. DAS and NHES will require the winning carrier to supply the necessary reports and underlying data. The law established a PFML Advisory Board that shall meet periodically and aid the DAS commissioner in formulating policies and discussing problems related to the implementation and administration of the Plan in an impartial and non-political manner. The winning carrier will prepare for and participate in such meetings as applicable and as directed by the State. It is the intention of the law to increase the number of employees in the state who receive PFML wage replacement benefits. To ensure that employers who might benefit from sponsoring PFML coverage for their employees and individuals who may be eligible to receive PFML coverage are aware of the Plan, DAS and NHES are releasing an RFP for the development and implementation of an outreach and marketing strategy and program. The program shall include all the necessary information for employers to offer, or for employees to obtain, PFML coverage. The winning carrier is encouraged to PROPRIETARY & CONFIDENTIAL Page 5 of 54 market the Plan in collaboration with DAS, NHES and the winning contractor of the outreach and marketing RFP, if different from the winning carrier. The law specifies that PFML coverage will be available for purchase by all three covered groups by January 1, 2023. C. Terminology 1. Birth and bonding aligns with the FMLA to include the birth of a child and to bond with the newborn child within one year of birth; and the placement with the employee of a child for adoption or foster care and to bond with the newly placed child within one year of placement. 2. Care for a family member aligns with the FMLA to include care for the employee’s spouse, son, daughter, or parent who has a serious health condition, including incapacity due to pregnancy and for prenatal care. 3. Child has the same meaning as "son or daughter" under the FMLA (i.e., a biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis, who is either under 18 years of age, or who is 18 years of age or older and incapable of self-care because of a mental or physical disability at the time that FMLA leave is to commence). 4. Employee means a person performing services for any employer with a physical location in NH in exchange for wages under any contract of hire written or oral, express or implied. 5. Employer means any individual or type of organization located in NH, which has in its employ one or more individuals performing services for it within the State. 6. Equivalent Benefit means at least the same benefit level (60%) and number of weeks (6) of family and medical leave. 7. Family member means a child; a parent; or the child's spouse or domestic partner; a biological, adoptive, foster or step grandparent; a spouse or domestic partner. 8. Individual Group is comprised of individuals who work for employers who do not offer either PFML coverage under the Plan as authorized by RSA 21-I:96 through RSA 21-I:108 or a PFML benefit that is at least equivalent to such coverage under the Plan, and who voluntarily opt to purchase coverage through the Plan. 9. Intermittent/Reduced Schedule recognizes that benefits shall be available in increments of at least four hours on any one day on an intermittent and continuous basis. 10. Own Serious Health Condition aligns with the FMLA to cover a serious health condition that makes the employee unable to perform the essential functions of his or her job, including incapacity due to pregnancy and for prenatal medical care. This type of coverage is only available if the employee’s employer does not offer short-term disability coverage. 11. Parent means a biological, adoptive, foster, or stepparent, or legal guardian as defined in “family member”. 12. Permanent State Employee means any full-time employee who has completed their 12-month probationary period with any branch of the State government, including any person who has been or will be employed on a temporary basis for a period of not less than six (6) months in a 12-month period. 13. Private Employer means any entity located in NH and which falls outside the definition of State Employer and Public Employer. 14. Public Employer means any political subdivision of the State, any quasi-public corporation, the state community college system and the state university system. 15. Qualifying Exigency and Military Caregiver aligns with the FMLA to include any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a military member on covered active duty or call to covered active duty status or caring for a covered service-member with a serious injury or illness if the eligible employee is the service-member's spouse, child, parent, or next of kin. 16. Serious health condition means any illness covered by the FMLA including treatment for addiction as prescribed by a treating clinician, consistent with American Society of Addiction Medicine criteria, as well as treatment for a mental health condition, consistent with American Psychiatric Association criteria. 17. Spouse means an individual who is legally married to the employee. 18. State Employer means the State of NH, including the executive, judicial and legislative branches. PROPRIETARY & CONFIDENTIAL Page 6 of 54 19. Wages means every form of remuneration for personal services paid to the employee by the employer, including salaries, commissions, tips and bonuses. D. Contract Period The term of the contract shall commence upon approval of the Governor and Executive Council through December 31, 2027, a period of approximately five (5) years. The contract may be extended for up to two (2) years under the same terms, conditions, and pricing structure upon the mutual agreement between the winning carrier and the State with the approval of the Governor and Executive Council. No payments under the contract shall take place before January 1, 2023. SECTION II: BIDDING INSTRUCTIONS AND CONDITIONS A. Proposal Submission Requirements, Deadline, and Location Instructions Chapter ADM 600 Procurement and Property Rules Apply to and are made a Part Hereof In accordance with http://www.gencourt.state.nh.us/rules/state_agencies/adm600.html proposals submitted in response to this RFP must be received by the Division of Procurement and Support Services (DPSS), Bureau of Purchase and Property no later than the time and date specified in the Timeline section herein. Proposals must be submitted as follows. o One (1) electronic submission of the complete proposal with pricing as a separate document via email NH.Purchasing@DAS.NH.Gov And o One (1) hard copy submission of the complete proposal with pricing and six (6) copies with no pricing via U.S. Mail or delivery service (see Section VI. Public Disclosure regarding redacted copies) Hard copy proposals must be addressed to: RFP#2571-22, Commercial Insurance Carrier for the Granite State Paid Family and Medical Leave Plan Andrew Bennett NH Bureau of Purchase & Property 25 Capitol Street - Room 102 Concord NH 03301 Email responses must be labeled with the following information: State of New Hampshire RFP# 2571-22 Due Date: May 9, 2022 @ 10:00 AM (EST) Commercial Insurance Carrier for the Granite State Paid Family and Medical Leave Plan Late submissions will not be accepted and will be returned to the Bidders unopened. Delivery of the proposals shall be at the Bidder’s expense. The time of receipt shall be determined by when a proposal has been officially documented by the Bureau of Purchase and Property, in accordance with its established policies, as having been received at the location designated above. The State accepts no responsibility for mislabeled mail or mail that is not delivered or is undeliverable for any reason. Any damage that may occur due to shipping shall be the Bidder’s responsibility. In case of a discrepancy between the electronic and paper submissions, the electronic version will take precedence. http://www.gencourt.state.nh.us/rules/state_agencies/adm600.html mailto:NH.Purchasing@DAS.NH.Gov