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Exchange Call Center RFP Questions & Answers Final Last Updated 10/24/2012

Connecticut Health Insurance Exchange Exchange Call Center RFP

QUESTIONS & ANSWERS

Memo: The document represents the final version of the submitted questions. No further questions will be

accepted by the Exchange. The RFP response deadline remains 5:00pm Eastern Standard Time on

November 5, 2012.

Question #

Date of Answer

RFP Section

#

RFP Page #

RFP Text / Reference Question Answer

1 10/17/2012 - - -

Do we have an idea of the call volume the call center

can expect to receive either on per month, or per year

basis?

The Exchange has no historical data on call arrival

patterns or the expected variation in volume of calls

over the month and over the year. The State expects the

Responder to have the necessary expertise to

properly anticipate load and staffing requirements for the

Exchange Call Center.

2 10/17/2012 - - -

Do we have an estimated call duration – amount of

time spent on each call for a call center representative?

Please refer to question #1.

3 10/17/2012 - - -

Do you need to have an existing service contract with the state in order to

participate in this proposal?

The Call Center vendors do not need to have existing

state contracts in order to be eligible for consideration as the Call Center outsourced

vendor.

4 10/17/2012 - - -

Will the Exchange be making contract terms and

conditions available for review? They were not

included in the RFP document?

Yes, a general contract terms and conditions

document will be posted on the CTHIX website as soon

as it is completed.

5 10/24/2012 General Evaluation Criteria

Will the advisory committee members be part of the

evaluation process? Can the Exchange please advise

who is participating in the evaluation?

The Exchange does not disclose the composition of the evaluation committee.


Question #

Date of Answer

RFP Section

#

RFP Page #


6 10/24/2012 General Evaluation Criteria

Has the Exchange established evaluation

criteria for the Call Center RFP?

The proposals will be reviewed using the following

scoring criteria:

Total Score = 100% · Organizational Capability

10% · Approach and

Methodology 15% · Level of Fit of the

Proposed Solution 35% · Project Timeline 10%

· Cost/Pricing Proposal 30%

7 10/24/2012 General Materials

Will the Exchange Call Center be responsible for creating materials in other

formats to comply with ADA requirements?

No.

8 10/24/2012 2.1.2 7

Services offered in this tier include answering questions

about the Exchange and health care reform, directing existing Medicaid consumers to DSS Benefits Center via

IVR prompts or a “warm transfer”, as well as routing

and resolving complaints and appeals to the appropriate State agencies such as the

Connecticut Insurance Department (CID) and Office of the Healthcare Advocate (OHA) via a “cold transfer”.

What is your preferred method of call transfer

assuming an automated environment?

Warm transfer.

9 10/24/2012 2.1.2 7

Consumer Support Components highlighted in red as one of the activities applicable to the Exchange

Call Center is insurance shopping tools.

Will these tools be accessible via the

Exchange Web Portal that is part of the SHOP RFP

and in which that vendor will be responsible for providing

or will the Call Center Exchange vendor need to

provide their own comparison shopping tools

for comparison and final cost calculation?

The Web Portal will include the tools necessary for the

Call Center Representatives to pre-screen the

consumers, determine their eligibility for MAGI Medicaid,

QHP, APTC, and enroll in QHP plans using the

comparison shopping tools to display the plans relevant to consumers. SHOP BPO

Vendor will have a separate Help Desk to provide

assistance to employees of small employers in plan

selection and enrollment.


Question #

Date of Answer

RFP Section

#

RFP Page #


10 10/24/2012 2.1.2 7 Tier 0 Website

Will the Exchange Call Center have full access to the exchange website in

order to complete eligibility and enrollment on behalf of consumers who are unable to complete processing on their own? How does the Exchange envision Call

Center agents accessing the Exchange and IE

System?

The Exchange Call Center staff will use the web portal

with configured access rights to enroll the

consumers into the QHP selected by consumer.

11 10/24/2012 2.1.2 7






What is the estimated percentage of calls that will need to be transferred to

State Agencies?

Please follow industry standards and benchmarks.

12 10/24/2012 2.1.2 7






Please confirm that the Call Center vendor is not

responsible for tracking calls once they have been transferred (warm or cold)

to an external entity.

The Call Center vendor is not responsible to track the transfers through resolution.

However the Call Center vendor is responsible for

tracking where the transfers are made, as well as

tracking and reporting on related metrics (e.g. number

of transfers to CID on consumer complaints

related to issuers/plans, etc.).


Question #

Date of Answer

RFP Section

#

RFP Page #


13 10/24/2012 2.1.2 8 Tier 2

Will the Tier 2 personnel be responsible for resolving

eligibility issues when clients apply on-line? For

example citizenship verification that needs the

consumer to show verification so that can be verified through SAVE and similar appeal issues? Can the Exchange please clarify

the Call Center vendor’s responsibilities for

supporting routing and resolving eligibility issues?

The Federal Hub will be integrated in the application.

If paper verifications are

required on exception basis, the Call Center Vendor will

inform the consumers on in-bound paper channel to submit the verification

document. The Call Center Vendor will be notified through a workflow on verification documents

received once these are available in the system. At this point, the Call Center vendor will follow up with

the consumer to pick up the enrollment process.

It is not expected that Call Center Vendor will access any additional electronic sources that are not built

into the system for the verification purposes.

14 10/24/2012 2.2.2 10

RFP states the Exchange Call Center will perform activities necessary to receive, log and

track incoming communications

Will the Exchange Call Center be responsible for setting up complete end to end mailroom operations

which includes scanning all incoming documents,

sending outgoing documents such as re-enrollment packets and

requesting required verifications, working return mail etc.? What does the

Exchange anticipate would be the volume for these

mailings?

Call Center Vendor is not responsible for processing paper and fax verification

documents. Details on scanning and processing

are currently being addressed and will be

shared with the selected vendor.

15 10/24/2012 2.2.2 10



Will the Exchange Call Center be responsible for

establishing a PO Box and Business Reply envelope account for consumers to send documents to the

Exchange for processing? What does the Exchange anticipate would be the

volume for these mailings?

Yes. The majority of communications are

expected to be handled through electronic means or

over the phone.


Question #

Date of Answer

RFP Section

#

RFP Page #


16 10/24/2012 2.2.2 10



Will there be outreach materials that the Call

Center is responsible for mailing like plan

comparison charts? What does the Exchange

anticipate would be the volume for these mailings?

No. Anything needed will be available on the website.

17 10/24/2012 2.2.2 10 Figure 3: Future Environment

How will the agents in the Call Center connect to the

HIX system: Internet or private connection?

Internet.


Will the HIX system deployed by the State have

the ability to be queried (using Web Services, for

instance) so that the IVR of the HIX Contact Center

contractor can provide more accurate information to the

callers?

Yes.


Will the HIX system deployed by the State have the ability to be queried in

real time (using Web Services, for instance) so that the agents in the HIX Contact Center can get

accurate information about the caller on a pop-up

screen when they take a call?

Yes.


Will the DSS ConneCT IVR remains client facing or will the Exchange be the only client facing IVR? If the ConneCT IVR remains

client facing how many calls will the Exchange IVR

receive from ConneCT?

These questions do not to apply to the scope of this

request.

21 10/24/2012 2.2.2 10 Figure 3: Future Environment Please provide technical

information about the configuration of the ESB.

It will be provided to the selected vendor once it

becomes available.


To support project planning and scheduling, what is the timing for availability of the

interfaces being supplied by the State’s System

Integrator?


becomes available.


Question #

Date of Answer

RFP Section

#

RFP Page #



Can the Exchange provide additional information on

the existing IVR, including software and capabilities to assist the Call Center better

in planning integration?

At a later date, a design session will be conducted

for selected vendors (finalists) before an award is

made.

24 10/24/2012 2.2.2 10 Figure 3, Future Environment

In Figure 3, do the colors depict agency or vendor

responsibilities? If so, can the Exchange please clarify whether the responsibilities of the HIX Exchange Call Center do include a web portal or shared rules?

Web portal and shared rules are responsibility of the Systems Integrator. Call Center vendor will utilize

Web Portal that relies on the shared rules to determine

the client eligibility.

25 10/24/2012 2.2.3 11 Table 1- Estimated exchange

user population

Only the low income children population (CHIP) states that the consumer

will apply through the Exchange portal or the exchange Call Center.

Should this statement apply to all populations?

Should the Exchange Call

Center be capable of sending paper applications

and accepting them to process eligibility?

Yes. They would need to direct individuals.

26 10/24/2012 2.2.3 13-Oct SHOP Exchange

Can the Exchange confirm that the Exchange Call

Center will not be expected to be the primary Call

Center for participants in the SHOP Exchange? If this

is not true, and this RFP should cover SHOP

Exchange Call Center activities, can the Exchange

please provide similar volumes and assumptions for the SHOP Exchange as

are found in the RFP Section 2.2.3, Volumetrics?

The SHOP BPO Vendor will provide a Help Desk to

assist employees of small employers.

27 10/24/2012 2.2.3 11 Table 1 and 2

Can the Exchange please confirm that the population

estimates are based on annual totals?



Question #

Date of Answer

RFP Section

#

RFP Page #


28 10/24/2012 2.2.4.2 13

Provide access to an up-to-date and integrated client

record across all programs at each touch point.

Can the Exchange please clarify the scope and responsibilities for the

“integrated client record”?

Will the integrated client record be maintained by the IE / Exchange vendor with access by the Call Center

vendor?

Or is the Call Center Vendor required to maintain the integrated client record as the “source of truth”? If so, will the Exchange and IE systems support real

time interfaces to allow for the maintenance of an

integrated record?

"Integrated client record" is a record maintained by the

call center vendor to provide data extracts or reports on clients who contacted the call center and the type of

request or services needed.

29 10/24/2012 2.2.4.4. 14 Capacity and Scalability

To help provide additional flexibility in a cost effective manner to quickly adjust to

call volumes, will the Exchange allow the use of

at home workers?

As part of the proposal, Call Center Vendor is expected to provide a staffing model that should include any off-

site locations and number of staff by location (4.4.3. Off-

site Services).

Include location of staff and which states at home

workers will reside. In home workers will be expected to follow all privacy laws and

abide by the terms and conditions the awarded

vendor agrees to with the Exchange.


Question #

Date of Answer

RFP Section

#

RFP Page #


30 10/24/2012 2.5.1 15

As such, our anticipated goal for Exchange Call Center

operations requires go-live by no later than September 1,

2013 in order for the Exchange Call Center to be tested, modified, promoted and fully integrated into the

eligibility determination process.

In order for bidders to accurately estimate staffing ramp up and training, does

the Exchange anticipate that the Exchange Call Center will actually be

taking consumer calls on September 1, 2013? Or, as stated in RFP Section 2.5.1,

is the time between September 1 and

September 30, 2013 used only for testing,

modifications, promotion and integration with

eligibility determination processes?

Yes. The Call Center should be operational by

September 1, 2013. The 1-800 number will be

advertised by the Exchange prior to that date, and a level

of consumer interest is expected prior to the open

enrollment date.

31 10/24/2012 2.6.2 16

The QA Vendor will also review Call Center Vendor

quality control procedures and processes to develop, track and report on SLA metrics.

Are SLAs in place for the other HIX components

which will affect Call Center performance (e.g. timely

resolution, system interfaces)?

Yes, SI has system performance metrics defined and will be held accountable for reaching these metrics. These will be shared with

the selected vendor.

32 10/24/2012 2.6.2 16

A QA Vendor will be working with the IEPMO to assist with the quality assurance reviews

of Exchange Call Center deliverables on behalf of the Exchange. The Call Center Vendor must fully cooperate

with the QA Vendor as it executes its responsibilities.

Will the QA Vendor be responsible for procuring

licenses to our Call Center solution?

If the Call Center Vendor

should include licenses for the QA Vendor, please

provide the number of users and type of access we

should account for.

QA Vendor will not require licenses for Call Center solution. It is however

expected that QA Vendor will review items such Call

Center Vendor Deliverables, call center scripts,

performance metrics, SLAs, consumer survey results.

33 10/24/2012 4.1.1 20 Minimum font size: 11 point

(except for footnotes, headers, or footers)

RFP indicates 11pt font as the minimum size for text. Is

it allowed to use smaller than 11pt font for tables, exhibits, and graphics?

Yes, as long as it is legible upon printing.

34 10/24/2012 4.1.1 20

The proposal created by the Responder should be formatted as follows:

• Requirements Traceability

Matrix should be submitted in MS Word format.

• Proposal should be submitted in either PDF or MS

Word format.

Appendix B, Requirements Traceability Matrix, is currently an MS Excel

document. Please confirm if it is acceptable for the

Prospective Responders to submit the Requirements Traceability Matrix in MS

Excel format instead of the MS Word format noted in

the RFP?

No. Please use Microsoft Excel for Requirements

Traceability Matrix submission.


Question #

Date of Answer

RFP Section

#

RFP Page #


35 10/24/2012 4.1.1 20

The Responder’s Exchange Call Center proposal should

consist of the following sections, in the order

listed below:

• Cover Letter • Table of Contents

• Executive Summary • Organizational Capability

• Approach and Methodology • Level of Fit of the Proposed

Solution • Project Timeline

• Scope Exclusions • Cost/Pricing Proposal

Is it the State’s expectations to receive Six (6) hard copy

binders that contain both the technical and cost

proposals as part of the RFP submission? Is it the

State’s expectation to receive ten (10) soft copies on CD-ROM that contains

documents for both the Technical and Cost

proposals on a single CD?

Yes. Please see answer to question 69.

36 10/24/2012 4.4.9 24

Provision of continuous operations of the (including the underlying systems for

which the Responder is responsible)

What is the expected RTO/RPO of the Call

Center?

The State's RTO/RPO is 48 hours.

37 10/24/2012 4.4.9 24 The Exchange’s involvement in developing a Future State

disaster recovery plan

Is there an overall DR Plan that the Call Center would

be integrated into?

The Call Center vendor would be dependent on the

State's recovery.

38 10/24/2012 4.8 25-26

The Responder will provide in the cost proposal a firm fixed

price for the development, certification, and deployment of all Exchange Call Center components, including IVR

system. The fixed price should be representative of the “stand up” cost of the proposed Exchange Call

Center solution.

In order for bidder’s to provide the most cost

effective proposal for the scope of work requested,

will the Exchange consider bidder’s proposals for

breaking up the firm fixed price for the “stand up” of the Call Center over a set number of milestones or deliverables during the

implementation?

Yes, as long as the total firm fixed price is clearly identified in the cost

proposal.


Question #

Date of Answer

RFP Section

#

RFP Page #


39 10/24/2012 Appendi

ces- General

30-38 Future State Business

Process Models

The Generic Exchange Blueprint Process Models’

legend uses color to differentiate business areas

(e.g. Financial Management, Plan

Management). However, there are only two colors represented in the flow

charts – process boxes are yellow and data storage

symbols are purple.

Does the color in the legend apply to these generic

blueprint models? Can the Exchange provide

additional guidance on what is Exchange vendor VS.

Call Center vendor responsibility within the

flow?

Call Center process models is a subset of the Exchange

process models that currently exist. Consumer

Assistance process models that are applicable to Call Center functionality are

depicted in yellow.

The flows are high level and do not include

responsibilities of the Vendor vs. the Exchange staff. The RFP provides sufficient level of detail

around the Call Center BPO vendor responsibilities.

40 10/24/2012 Appendi

x B Item 91

What is the role of the emergency helpdesk

support?

The role of the emergency helpdesk is similar to regular

Call Center role, with different hours of operation to account for unexpectedly

high consumer demand.

41 10/24/2012 Appendi

x B Item 146

What external locations will need to interface with the Call Center CRM system?

What is the anticipated number of users?

Exchange Tier 3 consumer support group will be

interaction with Call Center CRM system. Estimated number of licenses is 20.

42 10/24/2012 Appendi

x B Item 58

The system shall assist consumers through Interactive

Voice Response (IVR) technology. IVR should be customized for Exchange functionality, include the

ability to assist in eligibility determination, confirm enrollment, assist with

automated call transfers, etc.

Does the Exchange envision a direct, real time connection to the Eligibility System to support these

capabilities? If so, can the Exchange provide information on the

anticipated capabilities of the Eligibility System to support this interface?

Not in the short term. This capability may be developed

in the long term.

43 10/24/2012 Appendi

x B Item 59

The system shall have the ability to manage outbound

IVR campaigns.

How many outbound campaigns does the

Exchange anticipate per year? What is the

anticipated volume for each campaign?

Outbound IVR campaigns are expected to happen

around renewal periods or for customer satisfaction

surveys.

44 10/24/2012 Appendi

x B Item 64

The system shall have the functionality to export IVR and

CRM statistical data and contact information.

Is the export required to be a real time process or is a batch process sufficient?

Batch is acceptable.


Question #

Date of Answer

RFP Section

#

RFP Page #


45 10/24/2012 Appendi

x B Item 70

The system shall allow for Call Center and support staff

to view information about Exchange consumer status

(eligibility, enrollment, as well as plan information).

Will the Call Center staff have role based access to

the Health Insurance Exchange and Eligibility System to support these

requirements or is the CRM required to support data

exchange with these systems to maintain the integrated client record?

Is the CRM required to maintain the “source of

truth”?

Call Center CSRs will have a role based access to the

Exchange system.

46 10/24/2012 Appendi

x C 40

“…has decided to submit its intention to propose for such

services on the terms and conditions stated in the RFP and by the due date stated

therein.”

Appendix C asks the bidder to submit its intention to

submit a proposal under the terms and conditions stated in the RFP. However, there

does not appear to be a terms and conditions

section of the RFP, nor is there a model contract for bidders to review. Can the

State please provide a model contract or terms and

conditions for review?


47 10/24/2012 Appendi

x E 43

Appendix E – Notice of State Ethics Representations and Certifications Required of

Connecticut Health Insurance Exchange Vendors

Please confirm that the Prospective Responders do

not need to submit the certifications listed in this

section within the proposal.

Please submit with the proposal.

48 10/24/2012 2.1.1 6 What is meant by “entrance significant channel into the

Exchange”?

Please read as "In addition to the Exchange website, the Exchange Call Center will provide a significant

entrance channel and will be utilized (in conjunction with the website) for a significant portion of the consumers. "

49 10/24/2012

2.1.2 – Tier 1

Exchange Call Center

7

What connectivity will be available to the vendor’s

IVR system? Will real-time transaction be possible between the IVR and

systems developed and maintained by the State or

its vendors?

It is expected that the IVR will make real-time calls to web services or other types

of IPI capabilities.

50 10/24/2012 2.1.2,

Figure 1 7

The chart implies that Email and Chat are not functions supported by the Exchange Call Center. Is this correct? Who will handle email and

chat?

We do not envision chat capabilities rolled-out in the

short term. E-mail is supported.


Question #

Date of Answer

RFP Section

#

RFP Page #


51 10/24/2012 2.2.2 9

This sections says “…Medicaid enrollment-

related inquiries and inquiries from existing Medicaid clients will be

transferred over to the DSS Benefits Center via a “warm

transfer” as appropriate.” Please clarify what kinds of

inquiries from Medicaid clients, both new and

expansion, the Exchange Call Center will be expected

to handle completely without transfer.

Prescreen clients for QHP, MAGI Medicaid and CHIP,

APTC, CSR

Determine and re-determine eligibility for QHP, MAGI

Medicaid and CHIP, APTC, CSR

Enroll in QHP

52 10/24/2012 2.2.2 10

In Figure 3, who receives, scans, indexes and

processes paper and fax applications and verification

documents?

Please see answer to question #14

53 10/24/2012 2.2.2 10

Are licensed insurance brokers the only people who are allowed to assist callers

who have yet to make a decision to enroll in a

specific plan with their plan selection?

Yes. The call center will enroll clients who have

independently determined the plan in which to enroll. If

clients are indecisive and need consultative insurance

advice, they should be directed to licensed brokers

for assistance.

54 10/24/2012 2.2.2 10

If licensed brokers are the only people allowed to

assist with plan selection, what kind of information or

assistance should a customer service

representative offer a caller who has questions about

the health plan choices and the enrollment process?

They can answer all questions with regard to

general information about each plan, but not provide

consultative advice or direction on which plan the

person should choose. Additionally, please refer to

question #53.

55 10/24/2012 2.2.3 11

What is the % of the estimated exchange user

population that is expected to access Tier 2 and Tier 3?

Please follow industry standards and benchmarks

and your professional experience. Please also

document any assumptions.

56 10/24/2012 2.2.3 11 What is the role of the Call Center in re-determination?

Conduct re-determinations and re-enrollments for clients that require Call

Center Assistance.


Question #

Date of Answer

RFP Section

#

RFP Page #


57 10/24/2012 2.2.3 11

Is the “Steady State Exchange” populations

shown in Table 2 in addition to the “Open Enrollment

Exchange” shown in Table 1? If so, should the

103,500 in Open Enrollment Exchange be added to the 931,105 total steady state

population?

These estimates are separate and do not overlap.

One estimate is for 5 months of initial enrollment,

the other for the steady state.

58 10/24/2012 2.2.3 11

How will the current Medicaid population be

rolled into the exchange? Will this occur on their

current anniversary date, starting in March 2014? Is it

expected that 616,655 current Medicaid members

will be brought into the exchange between March

2014 and September 2014, or will it be over 12 months?

Existing Medicaid population will go through the

Exchange to re-determine their eligibility based on

MAGI rules stating March 2014.

59 10/24/2012 2.2.3 11

Understanding that most of the Medicaid population will

be able to renew their benefits automatically, will Medicaid renewals in the

future follow the member’s current anniversary date, or will it coincide with the Oct-

Jan open enrollment period?

Medicaid renewals will happen throughout the year on the current anniversary

date for Medicaid enrollment.

60 10/24/2012 2.2.3 – Table 3

13

What specific transactions does the State expect to be automated through the IVR

and the Web Portal?

Web Portal: Shopping/plan comparison, eligibility

screening, actual enrollment in QHP.

IVR: Minimal IVR to

expedite direct customer to call center status and

messages.

61 10/24/2012 4.1.1 20

To enhance presentation, is it permissible to include font sizes smaller than 11 point

in tables, charts, and exhibits, with the

understanding that the text is still clearly legible?


62 10/24/2012 4.1.1 20

Please confirm that we are to convert the

Requirements Traceability Matrix provided with the RFP in Excel format into

MS Word format for submission with the

proposal.



Question #

Date of Answer

RFP Section

#

RFP Page #


63 10/24/2012 4.4.5 23

Is the Quality Assurance Plan required for

submission with the proposal or post-award?

The Quality Assurance Plan should be developed once

the vendor is onboard; however a high level approach for quality

assurance should also be included in the proposal.

64 10/24/2012 4.4.8 23 What is required for the

proposal?

A standard, high level training plan should be

submitted as referenced in section 4.4.8. Please

reference Appendix B for additional training

requirements. Once a vendor award is made, the

exchange will work with that vendor to develop a

comprehensive training plan.

65 10/24/2012 4.4.11 24 What is meant by “as a separate document”?

Please include this as a separate attachment.

66 10/24/2012 4.4.11 24

Will the value add capabilities a Respondent describes in this section be

considered part of the overall proposal and cost? Or are they items that the State could consider for future negotiations and possible subsequent incorporation into the

contract?

Value add services should not be considered as part of the overall proposal, and as such should not be priced. The State is interested in a

high level summary of additional capabilities

related to the Exchange operations that the Vendor

is capable and has a history of providing.

67 10/24/2012 4.7 25

Please confirm that this section refers to any scope-

of-work items that the Respondent is explicitly

excluding from its proposal. If this is correct, can a

Respondent simply indicate “Not Applicable” for this

section if it is accepting the RFP scope of work “as is?”

If this is not a correct interpretation, please

provide additional clarification regarding what should be addressed in this

section.

Yes. You may indicate “not applicable" for this section if you are accepting the RFP

scope of work "as is."

68 10/24/2012 4.5 25

Does the Responder only have to indicate compliance

with the detailed requirements by completing

Appendix B, or does the Responder also have to

address these requirements in its response to Section

4?

Please provide response in both formats - within the requirements traceability matrix and a higher level

discussion of vendor capabilities in the narrative

proposal section 4.5 specifically related to

requirements detailed in this RFP.


Question #

Date of Answer

RFP Section

#

RFP Page #


69 10/24/2012 4.8 25

Should cost/pricing proposal be separately

submitted or included on the soft and hard copies of

the proposal?

Please submit both proposals as one package - in separate folders on a CD; and in separate sections of

the hard copy proposal.

70 10/24/2012 4.8 26

What is the estimate on the % of consumers requiring

licensed brokers to assist in selecting a QHP?


71 10/24/2012 4.8 26 In Pricing Structure 2, is the transfer to outside brokers a

warm or cold transfer? Cold.

72 10/24/2012 4.8 26

In Pricing Structure 2, will the broker be reimbursed on a one-time basis or will the broker have ongoing responsibilities to support

the consumer?

This has not yet been determined.

73 10/24/2012 4.8 26

Please confirm if the difference between

Scenario 1 and Scenario 2 focuses on the level of

activity of the call center staff regardless of whether the brokers are on staff or

outside of the staff.

The Vendor is expected to submit 2 estimates: 1 for

option 1 moderate automated interaction; 2 for option 2 - highly automated interaction. These scenarios

are based on expected number of consumers that

may access call center services.

Based on the chosen

staffing model (with in-house brokers; without in-house brokers), the Vendors are expected to submit PMPM

cost estimate reflecting either or both of the pricing

structures for both client population scenarios.

74 10/24/2012 Appendi

x A 30

Is the Exchange Call Center expected to handle inquiries

via chat?

Please disregard the reference to chat. Currently, Exchange does not foresee using chat capabilities for

consumer assistance in the nearest future.

75 10/24/2012 Appendi

x A 30 Who handles Tier 0?

This is the self service web portal.

76 10/24/2012 Appendi

x A 33

What is the role of the Call Center vendor in building

and implementing the consumer satisfaction

survey?

The Call Center vendor will capture consumer

satisfaction on the events in which they manage.


Question #

Date of Answer

RFP Section

#

RFP Page #


77 10/24/2012 Appendi

x A 33

How will consumer satisfaction be defined?

The Call Center vendor collaboratively with the

Exchange will determine the consumer satisfaction

feedback criteria.

78 10/24/2012 Appendi

x A 33

Is the CRM in Tier 0 the call center vendor’s CRM?

No. The Portal is Tier 0.

79 10/24/2012 Appendi

x A 33

Is the call center vendor expected to enter

applications into the IES portal directly or through post-call interface? If the latter, via batch or real-

time?

Direct entry.

80 10/24/2012 Appendi

x A 35

Is the call center vendor expected to scan and index re-enrollment packets? In what document repository?

See answer to question #14.

81 10/24/2012 Appendi

x A 35

Under what circumstances would interviews be

needed? What percent of the total would need an

interview?


82 10/24/2012 Appendi

x A 37

What is meant by “Flag for follow up in Tier 3”?

Tier 3 will flag an issue for follow-up with Tier 2

representatives as needed.

83 10/24/2012 Appendi

x A 38

Who is the supervisor in Tier 3?

Tier 3 is supervised by the Exchange.

84 10/24/2012 Appendi

x B

Items #51 and

92

Is it permissible to use staff members who are not

dedicated exclusively to the Exchange as part of our

approach to disaster recovery or for (1.)

temporary periods where calls are overflowed to a

different Call Center location to handle major outages and business

releases, and (2.) calls that overflow to a different Call

Center location and are handled by Call Center

personnel who have been trained and are

knowledgeable on the Exchange environment (see Appendix B, items 47 – 49.)

Yes as long as they are well trained and ready to assist

in this event. Please reference section 4.3.4 of

the RFP to provide a resource/staffing plan to

address.

85 10/24/2012 Appendi

x B Item #52

What is the purpose of the web cams?

For potential future use.


Question #

Date of Answer

RFP Section

#

RFP Page #


86 10/24/2012 Appendi

x B Item #56

This requirement states that call recordings shall be retained according to

Exchange records archival requirements. Please provide details on the

Exchange records archival requirements, including retention time for call

recordings.

The Exchange expects that the Call Center vendor

already retains call recordings for quality

assurance purposes. The Exchange also expects that

the selected vendor will share its retention policies with the Exchange. The

Exchange and the selected vendor will then work together to make any

modifications necessary for Exchange related call

recordings.

87 10/24/2012 Appendi

x B Item #65

What is the purpose of the IVR periodic call list?

This will be used for Customer satisfaction

surveys.

88 10/24/2012 Appendi

x B Item # 75-76

Are the speed of answer standards (90% of calls within 30 seconds, 95% within 45 seconds, etc) referring to the speed of answer by the IVR/ACD system or the speed of answer by a live agent?

The live agent.

89 10/24/2012 Appendi

x B Item #74-

85

If the answer to question #88 is “no”, would the state

consider changes to the requirements on average

speed of answer to become internally consistent with the

5% abandonment rate? (note that the ASA required will result in a much lower

abandonment rate than 5%)

The Exchange respectfully declines to consider

changes to the requirements.

90 10/24/2012 Appendi

x B Item #75-

76

Requirement 75 presents standards of 90% in 30

seconds, 95% in 45 seconds, and 99% in 60

seconds. Requirement 76 refers to standards for

average speed of answer for 20 seconds or less.

These two requirements are incompatible – meeting Requirement 76 would

cause the vendor to miss Requirement 75 which

implies a far lower average delay. Please clarify which

standard applies.

The State does not consider these requirements

conflicting, they are based on the industry standards and both should be met.


Question #

Date of Answer

RFP Section

#

RFP Page #


91 10/24/2012 Appendi

x B Items

#78-79

Please provide the definition of first call

resolution and the way it must be measured.

First call resolution (FCR), a common CRM industry term,

is when the call center is able to address the caller's need the first time they call, thus not requiring a second

call to the call center.

92 10/24/2012 Appendi

x B Item #85

Does the weekly average hold time cited (120 seconds) refer to the

average weekly wait time to speak to a live agent?

Yes

93 10/24/2012 Appendi

x B Item #88

Which other agency call centers is the vendor

expected to integrate with seamlessly? What is the nature of the integration –

does the CRM or IVR need to be integrated with these

agencies? If so, please provide more information on the equipment and systems

used by these agencies.

The Exchange IVR is expected to be integrated

with DSS IVR.

94 10/24/2012 Appendi

x B Items

#182-188

To what extent is the call center vendor expected to

resolve problems, complaints, and appeals

before routing them to the appropriate State agency?

The call center vendor is expected to resolve

complaints such as client account set-up, password

reset, walking clients thought the web portal

interface, answering FAQ, etc. As related to appeals and complaints, the Call

Center Vendor is expected to log, resolve, and track

complaints related to Exchange system,

Exchange performance, incorrect enrollment in the

QHP, etc. CID and OHA will resolve consumer

complaints related to insurance plans and issuers,

e.g.. market conduct, coverage, premium

payments, etc.

95 10/24/2012 Appendi

x B Item #193

Whose online solution is

this?

Transferrable NextGen Healthcare Information Systems, LLC solution provided by Deloitte

Consulting LLP.

96 10/24/2012 Appendi

x B Item #199

What online solution is used to invoke the chat feature?

See answer to question 50 and 74


Question #

Date of Answer

RFP Section

#

RFP Page #


97 10/24/2012 Appendi

x B Items

#204-206

What is the role of the call center vendor in publishing FAQs to various channels (web portal, mobile portal,

phone, etc.), providing answers to FAQs, and

tracking usage of FAQs by consumers?

Call Center Vendor should be able to build a knowledge

base reflective of the information they are gathering from their

interaction with the public. Exchange will update the knowledge base on the

Web Portal that is reflective of Call Center Vendor input.

98 10/24/2012 Appendi

x B

Items #222 –

224

Please elaborate on what is meant by the term “crisis”.

A definition of a "crisis" event should be leveraged

from industry standards and be a part of the disaster recovery plan. Exchange and selected call center

vendor can agree upon a definition acceptable by both

parties.

99 10/24/2012 General NA

Please provide the contractual terms and

conditions governing this contract.


100 10/24/2012 General NA

Please provide the parameters for marking

portions of the proposal as confidential trade secrets

and therefore not subject to Freedom of Information Act

requests.

The final submitted proposal should have any sections, or

part of a section, that are confidential trade secrets, clearly identified as such.

The Exchange reserves the right to make public any

information that is necessary under applicable laws. All 10 submitted copies of the

proposal should be identical.

101 10/24/2012 General NA

Please provide the evaluation criteria and the

proportion of weight between each of the

sections of the proposal.


102 10/24/2012 General NA

Is there a role for the HIX Call Center to support

employers and employees in the SHOP Exchange?


103 10/24/2012 4.4.9 24

The fourth bullet states: "Incorporation of the

Exchange's corporate standards/expectations for disaster recovery into the

initial and on-going disaster recovery plans." Can the

State please specify where the bidder can

obtain the Exchange's corporate standards and

expectations?

The Exchange's Systems Integrator vendor is

responsible for developing a DR plan for the project. The Call Center BPO Vendor DR plan will have to be aligned with and incorporated into the overall Exchange DR

plan


Question #

Date of Answer

RFP Section

#

RFP Page #


104 10/24/2012

4.8. Cost/Pric

ing Proposal

25

Does the State intend to pay the vendor the total Fixed Price to Stand Up upfront? If not, can the

State please provide the payment schedule for the

Stand Up effort?

Stand up cost can be broken down by milestones or by

monthly payments.

105 10/24/2012 BP-CA-FS-05

34

Does the handoff between CA-FS-05.50 and CA-FS-05.55 take place between

the eligibility and enrollment specialist and the licensed

broker? Please clarify.

Yes

106 10/24/2012 BP-CA-FS-05

34

Does the licensed broker enroll after the enrollment counseling? Or do they

pass it back to the eligibility and enrollment specialist for enrollment? Please clarify.

Licensed brokers will be able to enroll the

consumers.

107 10/24/2012 BP-CA-FS-06

35 What system generates the

re-enrollment packet?

Most re-enrollments are expected to be done through

the web portal or the call center. It is expected that

the use of paper re-enrollment forms will be

minimized.

108 10/24/2012 BP-CA-FS-06

35 What is the approximate size and weight of the re-

enrollment packet?

Most re-enrollments are expected to be done through

the web portal or the call center. It is expected that

the use of paper re-enrollment forms will be

minimized.

109 10/24/2012 16 Appendix

B

How should "size" be described for state

government clients?

Total size of the consumer base served; and a number of consumers assisted by

the Vendor

110 10/24/2012 18 Appendix

B

What federal law or regulations require 18

months of licensure; is the 18 months related to

medical insurance only or can it relate to any kind of

insurance such as life, property or casualty?

Medical insurance.

111 10/24/2012 68 Appendix

B

How is the idea of a ticket used in the context of the call center request for info that is tracked in the CRM; is a ticket for a request or event the same as a call

center inquiry or assistance with completing an

application?

Yes

112 10/24/2012 91 Appendix

B

For what technology would the emergency help desk

support? IVR and web portal


Question #

Date of Answer

RFP Section

#

RFP Page #


113 10/24/2012 92 Appendix

B

Do the on-staff brokers have to be exclusively

dedicated?

The number of brokers should be scaled to

consumer inquiries that need consultative insurance

advise.

114 10/24/2012 104 Appendix

B

What is meant by "sourcing arrangements"?

Business process outsourcing relationship

between the Exchange and the Call Center Vendor and

any transfers/escalation procedures as defined and agreed upon between the

stakeholder parties.

115 10/24/2012 111 Appendix

B

Is this referencing training that the vendor would

provide to the Exchange team? What is meant by

the "Exchange's governance team"?

The Vendor through maintaining a detailed knowledge base may

recommend specific topics to be covered in the overall Exchange training program

based on their everyday experience with the

consumer.

The Exchange's Governance Team refers to

its leadership.

116 10/24/2012 140 Appendix

B

Is the self-help for the IVR and website or would

consumers have access to the CRMs? For what purpose? Which call centers are included?

Yes, the self help is for the IVR and website.

The Call Centers references

are call centers of stakeholder agencies where

the Vendor will provide "warm" or "cold" transfer of the consumers depending on the type of their inquiry.

117 10/24/2012 146 Appendix

B

Please clarify what is meant by “all applicable locations

where the services are performed.”

CRM system should be centralized if the vendor

uses several locations for its staff.

118 10/24/2012 146 Appendix

B

Is “Exchange” referring to the Exchange staff or is it

meant to include consumers?

The Exchange staff.

119 10/24/2012 146 Appendix

B

Is the knowledge database to be viewed by

consumers? Via what channels? For example,

would the HIX portal have a link to the knowledge

database?

Elements of the knowledge database will be shared on

the Web Portal.

120 10/24/2012 152 and

159 Appendix

B

Please confirm that this is a requirement of the ACD

rather than the CRM.

This is a requirement of the ACD.


Question #

Date of Answer

RFP Section

#

RFP Page #


121 10/24/2012 226 Appendix

B

Per #226 in Appendix B – "The vendor shall actively

participate in the Exchange Change Management

process in coordination with the State's System Integrator Change

Management process." Can the State please

provide bidders with the Exchange's Change

Management process and the State's System

Integrator's Change Management process?


becomes available.

122 10/24/2012 236 Appendix

B

Per #236 in Appendix B – "The vendor shall provide an Impact Analysis and Risk Management plan, including mitigations and

contingencies, to minimize the business and technical risks in the implementation

of the Exchange Call Center services." Can the State please clarify when this

plan is due?

Initial plan should be provided within 30 calendar

days of the Vendor on board. The Plan will have to be updated and maintained

throughput the life of the project.

123 10/24/2012 240 Appendix

B

Per #240 in Appendix B – "The vendor shall ensure

that DR Plans comply with the Exchange external audit

requirements." Can the State please provide its

external audit requirements?


becomes available.

124 10/24/2012 244 Appendix

B

Per #244 in Appendix B – "The vendor shall test all

DR processes at least annually against stated DR Service Levels and provide

a copy of test results comparing actual test

recovery times to stated DR Service Levels to the

Exchange for review." Can the State please provide its DR Service Levels?


becomes available.

125 10/24/2012 280 Appendix

B

Please clarify the types of status updates envisioned. Since the web portal is not managed by the vendor,

how would status updates be provided via web link?

Status of open tickets could be communicated through e-

mail or other preferred method of communication that the client specified.

126 10/24/2012 304 Appendix

B

What is meant by "service, region, and classification"?

The structure of the monthly report will be confirmed with

the selected vendor.


Question #

Date of Answer

RFP Section

#

RFP Page #


127 10/24/2012 305 Appendix

B

What is meant by requests? Is this the same as calls by

type? Yes.

128 10/24/2012 307 Appendix

B

Please clarify what is meant by this requirement.

Known system related errors indentified by the clients

129 10/24/2012 313 Appendix

B

Please provide examples of what is referred to as "open

request".

Specific categories of requests will be tracked by

the Vendor through resolution. These requests will remain open until they are resolved and closed.

130 10/24/2012 321 Appendix

B

Please clarify what is meant by "Skillset reports"--is this the same as level of activity

in each tier?

This is an industry term. Example skillset reports may

include number of calls handled by type of agent

skillset (e.g. broker skillset, tier 1 general inquiry, tier 2),

average call length by skillset, etc.

131 10/24/2012 329 Appendix

B

What kind of "new Exchange requests" would

this involve?

The Exchange will require the vendor to have flexibility

for changes and unforeseeable

circumstances following the roll out of the solution

132 10/24/2012 330 Appendix

B

What is meant by "market information"?


133 10/24/2012 NA General

What is the intention of the State concerning ownership of assets purchased for use

during the course of this project? Will the State be taking ownership of the

assets implemented during the course of the Stand Up

phase, or will that ownership be with the

vendor?

Please propose pricing to cover purchased assets.

The State desires a vendor to leverage their own

infrastructure as much as possible.

134 10/24/2012 NA General

What is the role of the Exchange Call Center in

processing paper and faxed applications and handling

missing verifications?

Please refer to questions 14 and 52.

135 10/24/2012 2.2.4.1 13

Provide multichannel access into the State including Web, IVR, and Web-chat through a “no wrong door” approach for

a seamless consumer assistance experience.

Will the Call Center vendor have the capability to

integrate our existing Web chat solution with the

Exchange’s Web portal? Or will the Exchange

implement a new Web chat solution the Call Center

vendor will have access to?

Please refer to question #50 and 74.


Question #

Date of Answer

RFP Section

#

RFP Page #


136 10/24/2012 Appendi

x B Item 193

1. If approved by the Exchange, make the

knowledge base available online to consumers for

consumer self-help.

Does the Exchange envision the consumer-

accessible knowledge base as a separate web portal or

will it be made available through integration with the

Exchange Web portal?

Consumer facing knowledge base will be available as

part of the web portal.

137 10/24/2012 Appendi

x B Item 195

3. Manage content in conjunction with the

Exchange knowledge owners to insure continued accuracy

applicability of knowledge elements to the State

environment.

Does the Exchange envision that the Call Center vendor will be

responsible for writing and getting all content for the

Knowledge Base approved by various state agencies or

will the state agencies be responsible for providing content? Or will the state agencies need write/edit access to the Knowledge

Base? If so, please provide guidance on the anticipated

number of agencies and users.

Elements of the knowledge base that are to be shared on the web portal will be

reviewed and approved by the Exchange and other

applicable state agencies.

It is not anticipated that the stakeholder agencies will

need write/edit access to the vendor knowledge base, however may request to

review materials contained within the knowledge base

for quality assurance purposes.

138 10/24/2012 Appendi

x B Item 269

The vendor shall conduct random surveys of consumers

immediately after they have used the Call Center, and report the results of the random survey to the

Exchange each month. With these monthly surveys, the

vendor will include a minimum survey sample of 25 percent

of the requests reported.

Are surveys the responsibility of the

Exchange/IES vendor? Are surveys conducted by phone, or via the Web

portal?

The surveys following the integration with the Call

Center personnel may be conducted by either phone/IVR or web.

Surveys conducted through the web will be reported on

by the Exchange/IES vendor. Surveys conducted through the phone will be reported on by the Call

Center BPO vendor.

139 10/24/2012 - - Is it a preference for you to

have a call-center in the state of Connecticut?

Although it is not mandatory for the selected vendor to

build a call center in Connecticut, the call center

should be located in the United States (preferably

Connecticut), with staff who are fluent in American

English. There must be dedicated Spanish speakers

as well.


Question #

Date of Answer

RFP Section

#

RFP Page #


140 10/24/2012 - -

To the extent that the state would prefer to host a call-center in Connecticut, we

would have a modest preference for an earlier project start data to nail

down long lead items like location and office facilities. Does the state see it in its

best interest to reserve such flexibility for itself or is it simply not a possibility to begin certain targeted work

ahead of April 1, 2013?

The Exchange would not be able to begin targeted work with the vendor before April

1, 2013.

Additionally, please refer to question #139.

141 10/24/2012 Figure 1

With reference to Figure 1, will the vendor be required

to develop some of the content and information for

customers relative to healthcare reform or will this all be supplied by the state?

The vendor will develop the script related to health care reform and will forward it to

the Exchange for review and approval.

142 10/24/2012 Figure 1

With reference to Figure 1, you have indicated that this

call-center will be responsible for providing a view of the relative quality of programs to customers across tiers. Will all of the

data corresponding to such assistance be available on a dashboard that is part of

the state's technology infrastructure?

To be determined.

143 10/24/2012 2.2.1

With respect to the narrative on section 2.2.1 -- how large is the current DSS benefits center by way of

number of customer service agents?

To be determined.

144 10/24/2012 Figure 3

Figure 3 implies that any issues related to premium

billing should be referred to external carriers. Are you expecting that carriers will also have access to the

subsidies available to each customer?

Yes.


Question #

Date of Answer

RFP Section

#

RFP Page #


145 10/24/2012 - -

Is it a reasonable expectation that the

eligibility determination, plan selection, enrollment

and all other consumer facing functions will also be available to the Level 1 and Level 2 customer support

representatives?

Yes, however Medicaid specific information is only viewable by DSS licensed

employees.

146 10/24/2012

4.8 Cost/Pric

ing Proposal

25

For Exchange Call Center operations costs starting September 1, 2013, the

Responder will include a cost proposal at a capitated Per Member Per Month (PMPM) fee for all services, hosting,

licensing, operations, maintenance and

enhancements of the solution. Note that the PMPM fee should be derived from

estimates using utilization for a target population described in Section 2.2.3: Volumetrics and should account for the

two interaction scenarios. The State expects however that

the Responder has the necessary expertise to

properly anticipate load and staffing requirements for the

Exchange Call Center. Responder services and

responsibilities included in the PMPM fee are listed in

Appendix B: Requirements Traceability Matrix.

In order to calculate the PMPM fee for operations costs, Responders are

relying on the accuracy of the estimates using

utilization for a target population described in

Section 2.2.3: Volumetrics, as well as their expertise to

properly anticipate call volume, call duration, and staffing needs. Given that

all of these assumptions are estimates and there are no true statistics upon which to base the fixed PMPM fee,

should the PMPM fee prove to be incorrect by a

variance of ten percent (10%) higher or lower, will

the Exchange agree to negotiate an equitable

adjustment to Responder’s price through an

amendment or change order to the Contract?

The Exchange will take this under consideration and discuss further with the

vendor finalists.


Question #

Date of Answer

RFP Section

#

RFP Page #


147 10/24/2012

Appendix D –

Notices of

Affirmation and Non-

Discrimination

Representations

and Warranti

es Required

of Connecti

cut Health

Insurance

Exchange

Vendors, Good Faith

Efforts, paragrap

h 4)

42

The Contractor agrees to comply with the statutes and regulations cited above as

they exist on the date of the Contract and as they may be

adopted or amended from time to time during the term of

this Contract and any amendments thereto.

The enactment of new or modification of existing

applicable laws that may occur during the term of the Contract is unknown by the

parties at this time. Contractors are unable to price for such changes in

current law or for the enactment of new laws, and

we request that the Exchange add language to the Contract that the parties

will negotiate an amendment or change order to the Contract in

order for Contractor to meet such new or changed laws.

Such change order and amendment should also

include an equitable adjustment to Contractor’s

price for the services. It would be impossible to price for such unknown

risks and unfair to expect the Contractor’s services to remain compliant with such

new or changed laws without compensating

Contractor.

This requirement is not unique to the Exchange or

this project. Non discrimination and

affirmative action provisions are part of every existing

contract a vendor has with any state agency in

Connecticut. The Exchange views this as the vendor’s

cost of doing business in the state.

148 10/24/2012 General Proposed Terms and

Conditions

Would the Exchange clarify whether it intends to

negotiate contract terms and conditions prior to

awarding and executing the Contract?

In addition, would the Exchange clarify how

Responders are to submit, with the proposal, any

“contractual differences”, “exceptions” and

“variations” to the RFPs terms and conditions that Responder would like the Exchange to consider for Contract negotiations?

It is our understanding that

the Contract terms and conditions will be posted on the Exchange’s website as

soon as it is completed.

Most of the contract Terms and Conditions are not negotiable due to state

requirements. If a vendor has questions or concerns related to specific areas, please submit those in a

separate attachment titled "Terms and Conditions

Exceptions" along with the RFP response. Please note

that the State will be the final decision maker

regarding what information is to stay confidential.

The contract Terms and Conditions along with

related attachments are now available on the HIX

website.


Question #

Date of Answer

RFP Section

#

RFP Page #


149 10/24/2012

Table 3 –

Consumer

Support Scenario

s and Cost

Proposal Templat

e

13 and 26

Please explain how the contractor will actually be compensated. Will actual consumer interaction be compared to the planned

interaction of each scenario? Will the vendor be paid based upon which is closer? How often will this comparison be done?

Please propose a pricing methodology you would find

acceptable.

Please also refer to question #146.

150 10/24/2012

Table 1 and 2 –

Volumetrics and Cost

Proposal Templat

e

11 and 26

Please define a member for purposes of the

denominator of the PMPM. In reference to those

identified in Tables One and Two, does it include:

• The open enrollment exchange population

• The DSS Medicaid Newly Eligible Population

• The Low-Income Children Population

• The Current Medicaid Population?

The vendor should scale up its operations (staff and otherwise) for the open

enrollment period.

For steady state, it is expected that the majority of

the current Medicaid population will be able to

renew their benefits automatically.

PMPM estimates should

account for both open enrollment and steady state.

151 10/24/2012

Table 1 and 2 –


Proposal Templat

e

11 and 26

When does an individual become a “member” for PMPM purposes? For

example, if no enrollment is effective prior to January 1,

2014, should the vendor assume no PMPM for the

months of September through December 2013?

An individual becomes a member on September 1, 2013 for PMPM purposes.

An individual's benefits begin on January 1, 2014. See section 4.8 of the RFP

for further details.

152 10/24/2012

Table 1 and 2 –


Proposal Templat

e

11 and 26

Would CT please provide

an estimate of members for each month of the contract?

The Exchange cannot provide an estimate at this

time.

153 10/24/2012 4.8 Cost Proposal

26

Is the Contractor’s PMPM expected to remain the

same throughout the term of the contract including

extensions?

Yes.


Question #

Date of Answer

RFP Section

#

RFP Page #


154 10/24/2012 4.8 Cost Proposal

26

Please elaborate on the inclusion of broker

compensation in the Bidder’s PMPM under

Scenario One.

Are the brokers to be employees of the contractor

and paid a salary by the contractor?

The Exchange will not compensate brokers for any

services under any circumstance.

155 10/24/2012 4.8 Cost Proposal

26

Would the State please elaborate on the Vendor’s responsibilities regarding the brokers? Is the Call

Center Vendor expected to recruit, screen, hire, train

and oversee the work of all brokers? Or, is the Call

Center Vendor expected to only provide office space and furniture for brokers?


156 10/24/2012 4.8 Cost Proposal

26

What responsibilities does the Call Center Vendor

have with regard to supervision for the brokers?

The State will bear no responsibility for the

supervision of brokers. Please follow industry

standards.

157 10/24/2012 4.8 Cost Proposal

26

Please elaborate on the inclusion of broker

compensation in the Bidder’s PMPM under

Scenario Two.


158 10/24/2012 2.2.3

Volumetrics

11

Does CT have an estimate of how of many of these individuals will actually

enroll in a QHP?

95,000 - 150,000 individuals

159 10/24/2012 2.2.3

Volumetrics

11 - 13

As it relates to the columns in table 3, please confirm

that the entire user population is expected to use the Exchange Call Center for the columns

labeled “simple inquiry or IVR support” as well as

“MAGI eligibility support”.

It is expected that the entire user population is expected

to use the Exchange call center.

160 10/24/2012 2.2.3

Volumetrics

11 - 13

As it relates to the columns in table 3, please confirm that the column labeled “QHP plan enrollment”

would exclude all Medicaid and Husky B individuals as they would be enrolled by

DSS.

Yes.


Question #

Date of Answer

RFP Section

#

RFP Page #


161 10/24/2012 2.2.3

Volumetrics

11 - 13

As it relates to the columns in table 3, please confirm that the Call Center would

assist those that have already made a plan choice, while licensed brokers must assist those who have not

yet chosen.

Yes.

162 10/24/2012 2.2.3

Volumetrics

13

Does CT have any estimates of the amount of time each Tier One or Tier

Two customer contact would take?


163 10/24/2012 2.2.3

Volumetrics

11

Please elaborate on the instances where the current

Medicaid population of 616,655 is expected to utilize the Call Center.

They might only call for an initial inquiry and then be

transferred to DSS.

164 10/24/2012 2.2.3

Volumetrics

11

Please elaborate on the instances where those

newly eligible for Medicaid on a regular basis are

expected to utilize the Call Center.


165 10/24/2012

2.2.4.1 Simplified Citizen Access

13

This section mentions web-chat. Is the Call Center vendor is responsible for providing this service? It

does not appear so in table 2.1.2. Is the estimated

number of contacts included in the Table 3 data?


166 10/24/2012

Appendix B,

Section 2.02,

Item 75

4

Call Center standards have a direct bearing on price.

Would CT consider removing the 99%

requirement as the 90% and 95% standards still provide quality service?

No. Please also refer to question #90.

167 10/24/2012

Appendix B,

Section 2.02,

Item 75

4

Call Center standards have a direct bearing on price.

Would CT consider relaxing or waiving standards during

initial and/or open enrollment, resulting in

more competitive pricing to CT?


168 10/24/2012

Appendix B,

Section 2.02,

Item 76

4 (App B)

Please confirm that this standard relates to the amount of time for a

consumer to reach the IVR/recorded message and

that item 75 is the live answer standard after the caller clears this message.

The caller should reach the IVR within 20 seconds of calling. They should also reach a live rep within the

standards identified in Item 75.


Question #

Date of Answer

RFP Section

#

RFP Page #


169 10/24/2012

Tier 1 Exchang

e Call Center

and Appendix B, Item

81

12 and 5 – (app B)

It appears on page 12 that Tier One inquiries are

expected to be resolved in three minutes, while in Appendix B Item 81 it

appears that the standard for all Tier One calls is 9.5 minutes or less. Could CT

please provide the calculations and estimates for the MAGI Eligibility and QHP health plan support

Tier One calls that result in the overall standard

expected of 9.5 minutes?

These metrics will not be available until the Exchange

is fully operational.

170 10/24/2012

Appendix A BP-CA-FS-

06

35 of 43

In the business model it is noted the consumer will be

sent a consumer Re-enrollment packet. Will the

Call Center Vendor be expected to mail Re-

enrollment packets to the consumer or will the Call Center Vendor notify the

Exchange to send a packet? Will the Call Center Vendor have

responsibilities for mailing packets? If so, how many

packets should the Call Center Vendor anticipate it

will be mailing?


171 10/24/2012


06

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In the business model it is noted the Call Center

Vendor will receive and review completed Re-

Enrollment packets. What criteria should be used to

review the completed packet? Will the review

consist of ensuring all items are completed or is the

review a more sophisticated process? Will any

supporting verification documents be submitted in the Re-enrollment packets? Will the Call Center Vendor

be responsible for identifying that any

supporting documents are acceptable types of

information? Will the Call Center Vendor be required

to verify any of the information supplied by the

consumer?

The Call Center is not responsible for enrollment or

re-enrollment collateral. These items may be

provided to the Call Center for reference or review only.


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172 10/24/2012


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In the business model it is noted the Call Center Vendor will receive a notification to Change

Status from EMS. The next step for the Call Center Vendor is to request a

verification CA-FS-07.30. Is the expectation the Call Center Vendor will call every consumer that

requests a change of status and verify the request generated by EMS?

What information is being

requested that will verify the change request?


173 10/24/2012 General Question

n/a

Please elaborate on the contractor’s responsibilities related to SHOP, interaction

with employers, and whether these have been

reflected in the volume estimates provided in the

RFP.

The Call Center will have no responsibilities related to

SHOP.

174 10/24/2012 General Question

Does the CT HIX and/or its affiliates have a list of approved Connecticut

Licensed Health Insurance Brokers?

Yes. A list will be provided to the selected vendor.

175 10/24/2012 Appendi

x B #226

Where may a copy of the “System Integrator Change Management process” be

obtained?

This will be provided to the selected vendor.

176 10/24/2012 Appendi

x B #291

Where may a copy of the “State Approved Security

Process” be obtained?

This will be provided to the selected vendor.


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177 10/24/2012 2.2.2 What is the CT HIX’s

definition of “warm transfer” and “cold transfer”?

A warm transfer is when a Call Center customer service representative

transfers a call and introduces the caller to the

transfer party. A cold transfer is where a call is

transferred without introduction and the Call Center customer service representative hangs up

once the transfer is complete.


What information will the IVR need to pass through to the ConneCT IVR during a

call transfer?

Please confirm that the State will be responsible for programming their IVR to receive any required data.



Will the Exchange require single sign-on capabilities

between the Exchange and the CRM?

No.


Please confirm that the Exchange Call Center vendor will utilize the

Exchange’s ESB to connect to information maintained

by the Exchange vendor or state systems as required to

support data exchange.

Please provide information on the ESB and web services capabilities.



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Please clarify the responsibilities of the Call Center vendor in assisting the Exchange in accepting

payments.

Will the call center staff be required to accept

payments during enrollment utilizing the Exchange

system?

Will the IVR be required to accept payments? If so,

can the call center vendor utilize the

Exchange’s banking partner to do so instead of incurring

additional costs for a separate banking vendor?

No payments will be made to the Call Center or the

Exchange. The carriers will manage all billing and collection of payments.


Will the state please confirm that there will need to be an

initial population of information to the CRM?

Will the Exchange be the anticipated source of this

initial information?

Is there additional information that needs to be converted from other state

systems?

If so, will the call center vendor be responsible for

that conversion?

What is the anticipated volume of that data?

No.

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