AB348, s. 6
19Section
6. 149.16 (3m) of the statutes is created to read:
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149.16
(3m) The plan administrator shall submit regular reports to the
21department and to the board regarding the operation of the plan. The frequency,
22content, and form of the reports shall be determined by the department and the
23board.
AB348, s. 7
24Section
7. 149.16 (5) of the statutes is repealed.
AB348, s. 8
25Section
8. 149.16 (6) of the statutes is created to read:
AB348,4,4
1149.16
(6) The plan administrator shall be paid as provided in the contract for
2plan administration for direct and indirect expenses that the department
3determines are incurred by the plan administrator in the administration of the plan,
4including all of the following:
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(a) Printing costs.
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(b) Claims administration costs.
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(c) Management costs.
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(d) Building overhead expenses.
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(e) Other actual operating and administrative expenses.
AB348, s. 9
10Section
9. 149.162 of the statutes is created to read:
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11149.162 Plan administrator selection process. (1) Subject to s. 149.15 (3)
12(g) 2. a., the department and the board shall prepare and issue a request for proposals
13that specifies and describes the requirements for work to be performed under the
14contract for administration of the plan and the form in which cost proposals must be
15submitted, and that discloses the evaluation process and the evaluation criteria that
16will be used to select the plan administrator.
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17(2) The request for proposals shall include, at a minimum, contract award
18specifications related to all of the following:
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(a) The offeror's demonstrated experience and ability to administer large group
20health benefit plans.
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(b) The offeror's technical proposal for performing the work required under the
22contract, including descriptions and documentation of all of the following:
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1. The technical capabilities of the offeror's computerized system of
24administration.
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12. The qualifications of the offeror's management staff designated for
2administration of the plan.
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3. The range and scope of procedures and resources that will be used to perform
4various functions and to provide various services under the contract, including, at
5a minimum, functions and services related to all of the following:
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a. Claims administration.
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b. Policyholders.
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c. The premium and deductible subsidy program.
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e. Financial transactions, including collection of and accounting for plan
11revenues.
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f. The plan budget and reconciliation.
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g. Other plan administration.
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(c) The offeror's cost proposal for performing the work required under the
15contract.
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16(3) After initially evaluating the proposals submitted, the committee
17established under s. 149.15 (3) (g) 2. for this purpose may enter into negotiations
18with, and request best and final offers from, no more than 3 of the offerors that are
19the most likely to receive the contract to administer the plan. After receiving any
20best and final offers and completing the final evaluation, the committee shall
21recommend to the board the selection of a plan administrator. Taking the
22recommendation into consideration, the department and board shall award a
23fixed-price contract to the person submitting the proposal that the department and
24board determine offers the most advantageous combination of price and technical
25expertise.
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1(4) Any contract awarded under this section shall have a term of 3 years,
2beginning on July 1 and ending on June 30 of the 3rd year beginning after the year
3in which the contract term commences.
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(1) This act first applies to administration of the health insurance risk-sharing
6plan under a contract beginning on July 1, 2002.
