Group Medical Coverage for PPO Plan Only

269261 Group Medical Coverage for PPO Plan Only Scott Ferguson scott.ferguson@nashville.gov Jeremy Frye jeremy.frye@nashville.gov CIGNA Health & Life Insurance Co Paul Huffman 730 Cool Springs Blvd., Suite 500 Franklin TN 37067 ✔ ✔ Evaluation Criteria Aetna Life Insurance Company Blue Cross Blue Shield of TN Cigna Health & Life Insurance Co United Healthcare Services PPO Plan Licensing Requirements Yes Yes Yes Yes Background Check Acceptance Yes Yes Yes Yes Solicitation Acceptance Yes Yes Yes Yes Contract Acceptance Yes, with exceptions Yes, with exceptions Yes, with exceptions Yes, with exceptions ISA Questionnaire Completed and Terms Accepted Yes Yes Yes Yes PPO Experience, Account Management and Account Administration and Member Services (30 Points) 24.72 21.20 30.00 29.12 PPO Provider Network Access, Disruption and Discount Guarantees (19 Points) 14.24

16.62 19.00 11.86 PPO Pharmacy (9 Points) 6.35 7.94 7.94 9.00 PPO Tools, Communications, Health Management and Reporting Guarantees (7 Points) 3.92 3.04 7.00 4.36 Diversity Survey (5 Points) 5.00 4.50 4.00 5.00 Pricing (30 Points) 29.58 30.00 29.88 29.97 Totals 83.81 83.30 97.82 89.31 Weaknesses: Q#3 Firm did not describe in detail how they will ensure adequate staff to service Metro. Q#6 Firm did not outline specific proactive measures and define "data driven analytics". Q#10 Firm failed to meet the Requirement to allow Metro HR to have direct access to their system to make real time eligibility updates. Q#11 Firm failed to meet requested specific schedule of 8:00am to 6:00pm Central Time. Q#13 Firm failed to confirm requirement of 7 10 business days to deliver ID Cards. Q#16 Firm failed to outline the continuous routine in service training. Q#24 Firm agreed to provide only "select" legislative changes as opposed to Metro's request for "any" and did not provide an explanation for their timing and process for these types of notifications. Q#26 Firm failed to provide detailed description of 3rd party appeals process. Strengths: Firm's response addressed everything requested in the RFP except for the weakness noted below. Weaknesses: Q#44 Firm's savings guarantee excludes pensioners. Weaknesses: No weaknesses were noted. PPO Pharmacy Strengths: Firm's response addressed everything requested in the RFP except for the weakness noted below. Firm's response to the following question was a strength: Q#62 No member disruption. PPO Provider Network Access, Disruption and Discount Guarantees Diversity Survey Strengths: Overall strong plan highlighted key diversity, equity, and inclusion practices. PPO Tools, Communications, Health Management and Reporting Guarantees PPO Tools, Communications, Health Management and Reporting Guarantees Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Weaknesses: Q#73 Firm does not offer a full spectrum of digital and virtual resources. Q#76.1 Firm did not answer. Blue Cross Blue Shield of TN Diversity Survey Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Firm's response to the following question was a strength: Q#28 B 24/7 Customer service with the exception of holidays. Weaknesses: Q#50 Firm's response time is five (5) times longer than all other bidders. Weaknesses: No weaknesses were noted. PPO Experience, Account Management and Account Administration and Member Services RFQ# 29261 Group Medical Coverage for PPO Plan Only Strengths & Weaknesses Aetna Life Insurance Company Strengths: Overall strong plan highlighted key diversity, equity, and inclusion practices. PPO Experience, Account Management and Account Administration and Member Services PPO Provider Network Access, Disruption and Discount Guarantees Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Weaknesses: Q#3 Firm did not describe in detail how they will ensure adequate staff to service Metro. Q#24 Firm did not provide an explanation for their timing and process for these types of notifications. Q#28E Firm failed to provide the average hold time of a member in 2021. Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Weaknesses: Q#39B Firm did not provide a specific response of "Yes" or "No". Q#42 Firm did not provide a discount guarantee for each year of the agreement. PPO Pharmacy Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Weaknesses: Q#49 Firm did not describe their strategies for any category. Q#65 Firm did not confirm. Q#68 Firm will not agree to provide a copy of MAC list. Strengths: Firm's response addressed everything requested in the RFP except for the weakness noted below. Weaknesses: Q#73 Firm does not offer virtual resources giving members access to speak directly with therapists/counselors/etc. Page 1 of 2 Weaknesses: No weaknesses were noted. Cigna Health & Life Insurance Co Strengths: Overall strong diversity, equity, and inclusion practices. Weaknesses: Lacked individual goals. United Healthcare Services Strengths: Firm's response addressed everything requested in the RFP. Firm's response to the following questions were strengths: Q#3 Firm has a Smart Support program which includes specialized teams of designated individuals with government and education experience. Q#21 Firm made it clear that they take the added step of automatically reprocessing RAP claims. Q#28B Customer service representatives are available 24/7/365 days. Weaknesses: No weaknesses were noted. Strengths: Firm's response addressed everything requested in the RFP. PPO Experience, Account Management and Account Administration and Member Services PPO Provider Network Access, Disruption and Discount Guarantees Weaknesses: No weaknesses were noted. PPO Pharmacy Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Firm's response to the following questions were strengths: Q#61 Members would have less disruption during the year since Firm only makes formulary changes twice a year. Q#71 Firm will not charge for the files. Weaknesses: Q#57F CVS is excluded from Firm's 90 day retail network. Q#58 There will be disruption for members currently getting 90 day refills at CVS. PPO Tools, Communications, Health Management and Reporting Guarantees Strengths: Firm's response addressed everything requested in the RFP. Firm's response to the following questions were strengths: Q#73 Firm has a wealth of mental health and behavioral health resources including live interactions with a coach/therapist who also has capabilities to recognize an urgent immediate crisis and has the ability to escalate care. Q#74 Firm offers the Easy Choice tool to allow employees to compare plan options and cost. Q#76.1 Firm offers the One Guide service with access to a personal guide that engages them in programs. Weaknesses: No weaknesses were noted. Diversity Survey Strengths: Firm's response addressed everything requested in the RFP. Firm's response to the following questions were strengths: Q#29 Firm offers members a healthcare cost estimator/calculator tool. Q#37 Firm offered an additional customer delight guarantee of of $4 million dollars. Weaknesses: No weaknesses were noted. PPO Experience, Account Management and Account Administration and Member Services Strengths: Firm's response addressed everything requested in the RFP except for the weaknesses noted below. Weaknesses: Q#39C Firm did not outline how members will be notified if a provider is elliminated from the network. Q#41 Firm changed the geo access parameters requested by the RFP. Q#42 Firm did not provide a discount guarantee for each year of the agreement. PPO Pharmacy Strengths: Firm's response addressed everything requested in the RFP. Firm's response to the following questions were strengths: Q#61 Members would have less disruption during the year since Firm only makes formulary changes twice a year. Q#71 Firm will not charge for the files. PPO Provider Network Access, Disruption and Discount Guarantees Strengths: Strong overall diversity, equity, and inclusion practices. Weaknesses: No weaknesses were noted. Strengths: Firm's response addressed everything requested in the RFP. Weaknesses: No weaknesses were noted. Diversity Survey PPO Tools, Communications, Health Management and Reporting Guarantees Page 2 of 2 Solicitation Title & Number RFP Cost Points Group Medical Coverage for PPO Plan Only; RFQ# 269261 30 Offeror's Name Total Bid Amount SBE/SDV Participation Amount RFP Cost Points Aetna Life Insurance Company $622,223,000.00 $0.00 29.58 BLUE CROSS BLUE SHIELD OF TN $613,551,000.00 $0.00 30.00 Cigna Health & Life Insurance Co $615,952,000.00 $0.00 29.88 United Heathcare Services $614,145,000.00 $0.00 29.97 1 Ferguson, Scott (Finance) From: Frye, Jeremy (Finance) Sent: Monday, December 19, 2022 9:34 AM To: Ferguson, Scott (Finance) Subject: 269261 Group Medical PPO Diversity Scores Final Assessment Attachments: 269261 Cigna Group Medical PPO.pdf; 269261 UMR Group Medical PPO.pdf; 269261 BCBS Group Medical PPO.pdf; 269261 Athena Group Medical PPO.pdf Scott, Please accept this as my final assessment for the referenced RFQ. All respondents provided diversity practices see attachments for scores and comments. Jeremy R. Frye Contract Administrator Department of Finance Office of Minority and Women Business Assistance (BAO) Metropolitan Nashville Davidson County Government 730 2nd Avenue South, 1st Floor; PO Box 196300 Nashville, TN 37219-6300 (p) 615-862-6638 (f) 615-862-6175