HomeMy WebLinkAboutEvaluation Committee ReportCITY OF MIAMI, FLORIDA
INTER -OFFICE MEMORANDUM
TO: Daniel J. Alfonso, DATE: February 27, 2017 FILE:
City Manager
SUBJECT: Reccomendation to Negotiate a
Contract for Third Party Claims and
Managed Care Services
FROM: Annie Perez, CPPO,C
Procurement Department Director REFERENCES: RFP No. 605386
ENCLOSURES: Evaluation Committee Score
Sheets; . Evaluation Committee Appointment
Memo; Responsiveness Letter
Recommendation:
Based on the findings below, the Procurement Department (Procurement) hereby recommends
approval to negotiate a contract with the highest ranked responsive and responsible Proposer, USIS,
Inc., pursuant to Request for Proposals (RFP) No. 605836, to provide third party claims administration,
and managed care services. AmeriSys, USIS' Medical Managers division, will provide the services
under the managed care component for USIS, Inc.
Background:
On October 17, 2016, Procurement issued RFP No 605386 under full and open competition, on behalf
of the City of Miami's (City) Risk Management Department (Risk), to obtain proposals from experienced
and qualified proposers for the purpose of providing third party claims administration and managed care
services. The RFP was divided into two (2) categories: Part 1 -Third Party Claims Administration; and
Part II - Managed Care Services. Proposers could propose on one (1) or both categories. The RFP
required that Proposers submit separate proposals for Part I and Part II. Proposers were also required
to meet all of the minimum qualification requirements established in the RFP in order to be deemed
qualified to provide the services. On November 30, 2016, five (5) proposals were received in response
to the RFP. One (1) Proposer was deemed non responsive (see enclosed ietter).
The Evaluation Committee (Committee) met on February 22, 2017, to evaluate and score the proposals
following the guidelines published in the RFP. The Committee decided not to hold oral presentations,
as the proposals did not required further clarification.
The technical and price criteria were given respective weights for a maximum of one hundred (100)
points per Committee member. The final scores are listed below in order of ranking:
Category/Ranking
Proposer
Part I: Third
Party Claims
Administration
1
Technical Score
(Max: 375)
Price Score Total
Price
125) Combined Score(Max:
(Max: 500)
USIS, Inc. 338.5 101.5 440
York Risk Services
Group, Inc,
USIS, Inc.
Part II: Managed (AmeriSys)
Care Services 2 WellComp Managed
Care Services
298.9
342.5
317.5
107.25
108
105.5
406.15
450.5
423
PR17120 1
Due diligence was conducted by Procurement to determine responsibility, including verifying corporate
status. There were no performance or compliance issues and no adverse findings related to USIS, Inc.
Negotiations:
The Committee recommends that the City enter into negotiations with USIS, Inc . the highest ranked
responsive and responsible Proposer for both Third Party Claims Administration and Managed Care
Services. Notwithstanding the foregoing, the Committee further recommends and requests approval,
that in the event the City and USIS, Inc. are unable to reach an agreement, the City will terminate
negotiations and begin negotiations with the next ranked firm(s) in each category.
The following individuals will participate in the negotiations:
Yadissa A. Calderon, CPPB, Sr. Procurement Contracting Manager, Procurement
Ann -Marie Sharpe, Director, Risk
Angella Breadwood, Claims Manager, Risk
Erica Carr, Consultant, Beecher and Carlson
Aston A. Henry, Jr., Risk Management Director, Broward Schools
Sanjeev Bissessar, Risk Manager, City of Coconut Creek
Sonia Bridges, Risk Management Director, City of Miami Beach
Consensus Statement:
The Committee recommends USIS, Inc for the following primary reasons: 1) USIS, Inc , has the
necessary qualifications and relevant experience in providing the requested services, 2) USIS, Inc., has
the capability, applicable software and experienced personnel required to service a large volume of
customers; and 3) USIS, Inc. proposed a unique program that will be beneficial to the City, as it pertains
to the current industry trends. Although the firm's proposed pricing for third party claims administration
is approximately 15% higher than the other firm in said category. and the average medical bill savings
is approximately four percent (4%) less than the other firm for managed care services, the actual prices
will be negotiated, in the best interest of the City.
Copies of the score sheets are attached for each Committee member, as well as a composite score
sheet.
Approved:`',
Daniel J. Alfonso, City Manager
AR yc
Date:
c: Fernando Casamayor, Assistant City Manager/Chief Financial Officer
Ann -Marie Sharpe, Risk Management Director
Rafael Suarez -Rivas, Sr. Assistant City Attorney
William A. Juliachs, Sr, Assistant City Attorney
Erica Carr, Consultant, Beecher and Carlson
Dr. Lydia Osborne, CPPO, Assistant Director, Procurement
PR17120 2
t't)h9Pr 1:I 11 •�t:t )I I
RIP 605386
11111217 PAR tY CLAIMS ADMINISTRATION
LVALUABBON OF PROPOSALS
,SFLE cnrrN
PROPOSE' k4 Ci4111 NIA
Proposer's General Experience, and Past Performance and exr,eprtlons
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to Perform Required Set vices
Proposer's Methodulu,Iy anti {)ver.+I1 Approach to Scope of Wurk/Specrticahons
PricelFee Proposal
TOTAL TECHNICAL and FFE POINTS
(Technical & Fee rows above)
SIGNATURE.
L hsnpuraon
Mrv,uwutl By
RANKIN('
M.0 „11 111 v[,u,lt Hc,
Mull nt1111 Total PWula
{t 11,1:1111.t.l )
10 50
25 125
20
20
25
100
100
100
125
500
PFINI NAME
York Risk Services Group, Inc.
42 50
1U1U0
78 00
7740
107 25
406.15
Usis, Inc. (Anlerisys)
4790
113 00
86 110
90 80
101 50
440.00
EVALUATION OF QUALIFICATIONS
RIP 605366
THIRD PARTY CLAIM.; ADMINISTRATION
11rl�Jc,lla Llitt.rtlwt,ilrt Wily „t Mt,+1i1i - Risk)
SELECTION I'Nt)Pt)Sl HS CHI II ILIA
ii��lN 111/1111
Points
IProposer's General Experience, and Past Performance and exceptions 10
Proposer's Category Specific Experience, ❑ualifications, and Past Performance 25
Proposer's and Proposer's Key Personnel's Ability to Perform Required Services
Proposer's Methodology and Overall Approach to Scope of Work/Specifications
PricelFee Proposal
TOTAL TECHNICAL and PRICEIFEE POINTS
(Technical & Price\Fee Criteria above)
20
20
25
York Risk Services Group, Inc. Usis, Inc. (Amerisys)
8 10
18.75 23.75
16 18
16 20
22.5 23.75
EVALUATION OF QUALIFICATIONS
lisp ti'•0S381i
1 I IIItt) PARTY CLAIMS AI)MINIS FRA I ION
I),wli! 1),yloy I1'rly ,t1 - lirnl ]
Stlt�:lIt)N r'f-v.wifit tt5 CFO lf f<lA
Proposers General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to Perform Required Services
'Proposer's Methodology and Overall Approach to Scope of Work!Specitications
10
25
20
20
Pr rce\Fee Proposal 25
TOTAL TECHNICAL and PRICE1FEE POIN IS
(Technical & Price\Fee Criteria above)
York Risk Services Group, Inc. Usis, Inc. (Amerisys)
8.5 9.9
21.2 5 24.75
17 19.8
17.4 19.8
24.75 17.25
100 88.9
915
5El EC11ON
FVALUAIION OF QUA IF1CATIONS
[ FP t 0r;dHi;
Illlkrb PARTY CLAIMS ADMINISTRATION
'.;utrl,r It111l+L (Lily rrt N 11.rrrrt lir.n.h - PJl,1114i4T01)
PR( IP(15t K5 r'K41f-tiIA
1Prol>oser's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to Perform Requited Services
Proposer's Methodology and Overall Approach to Scope of WorklSirecitic:aftions
Maximum
t'U11115
10
25
20
20
Price\Fee Proposal 25
TOTAL TECHNICAL and PHICEIFIEE POINTS
(Technical & PricelFee Criteria above)
100
York Risk Services Group, Inc. Usis, Inc, (Amerisys)
9 9
21 20
15 15
15 19
23 21
83 84
'SEI ECIION
EVALUATION Or QUALIFICATIONS
60538h
1IIIRf) PARTY CLAIMS ADMINISTRATION
AStrur A. IIt•ruy, Jr (lire„rv.ta,i Marra,lertrvrrl)
Pitt tr=trtit Its i Ftt I r I<1A
(Proposers General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposers Key Personnel's Ahitity to Perform Required Services
Proposer's Methodology and Overall Approach to Scope of Work/Specificationr
Price\Fee Proposal
TOTAL TECHNICAL and PRICE\FFF POINTS
(Technical & Price\Fee Criteria above)
M,,wm,nu„
r, r3 York Risk Services Group, Inc.
10
25
8
20
20 16
20 17
4'S
100
Usis, Inc. (Amerisys)
9
22.5
18
18
22.5
81 90
[VALUATION or QUAL IFICATIONS
RIP 605386
TIIIRD PARTY CLAIMS ADMINISTRATION
`i,iirlc c°v IiISSeS54t1 (t:ity cif r:r,R i,lrrrl Crv,+k - I<Isk IV1.trrttgt#r)
SE Li: CTION irk( P1)5r rty CRIB I IA
Proposer's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to Perform Required Services
Proposer's Methodology and Overall Approach to Scope of Work/Specifications
PriceWFee Proposal
TOTAL TECHNICAL and PRICEIFEE POINTS
(Technical & Ptice\Fee Criteria above)
10
25
20
20
25
100
York Risk Services Group, Inc.
9
20
14
12
17
Usis, Inc. (Ainerisys)
10
22
16
14
17
72 79
SE E.l:11r1N
PR(1F'[)SE KS 1'rdI I1-I21A
Proposer's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, ()notifications, and Past Per Iotitiance
Proposer's and Proposer's Key PersorllreI s Ability to Perform lterµnred Services
Proposer's Methodology and Overall Approach fo Scup of Work/Specifications
('(1MPI r'.I I I '.t:t iI I S
RIP 605386
MANAGF 1) CAitt:- St VVICES
FVALLIATION OF PROPOSALS
Ma I1111f111 1'..li.Is MJ�Illlill{� I[.1 SI 1"Ianrs
1'c. M.:,iik..:. II
10
25
20
20
PricelFee Proposal 25
TOTAL TFCt1NICAL and FFE POINTS
(Technical a Fee rows above)
RANKING
SIGNATURE/
Ny
2100
700
1050
1400
WellCulnp) Managed Care
Services
44 E10
104 50
85 00
84 00
700 1US 5U
i'14U4I NAME.
423,U0
A .
•
Lists. Inc (Antertsys)
45 90
117.00
8980
8980
108 00
450.50
•C'�1
SELECTION
EVALUATION or QUALIFICATIONS
C1093tlli
MANAGED CARL SERVICES
AIktlella Itio adwotatl (City t.I I'Vli,uni Task)
I'Sti rl'i rSk I S 1,.1:1 1 i FOP,
Proposer's General Experience, and Past Performance and exc;eptioats
Proposer's Category Specific Experience, Qualifications, and Past Peg tog nkance
•Proposer's and Proposer's Key Personnel's Ability to Pei form Reyuiied Services
Piut)ost- is Melllodolotty anti Overall Appro,ac lk to Scope of Work/Specifications
M.0 r n„in s
e',ip,1ts
10
25
20
Price\Fee Proposal 25
WellComp Managed Care
Services
9
20
17
17
Usis, Inc. (Amerisys)
10
23.75
19
19
23 24
TOTAL TECHNICAL and FEE POINTS
(Technical & Fee rows above)
100
86
95.75
EVALUATION OF QUALIFICATIONS,
REP 605386
MANAGED CAM. St ItV1CFS
David I1.114,y i{ Il f ..i f:ll.,r,ll - i.t5k)
St t t r:IIC N4 ICI CHI It MA
Ma. n unn 1
Proposer's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and F'atit Pei tor inalit.e
Proposer's and Proposer's Key Personnel's Ability to Fe in in Required Services
Proposer's Methodology and Overall Apinthlc:h to Scope of WorkISp,eriFications
Price\Fee Proposal
TOTAL TECHNICAL and FEE POINTS
(Technical & Fee rows above)
WellClutll, Managed Care
Services
2'_'.5
18
18
22.5
Usis, Inc. (Anterisys)
9.9
24.75
19.8
19.8
21.25
95.5
EVALUATION OF QUALIFICATIONS
IMF[ 605386
MANAGED CARE SERVICES
`,arrn.t 1trldrpes (l:Ity 4,1 hall,rarrl ItCerr'dr - IZI,h Mi1lragrrIIj
SE I. E C ION W12I Il'i151 f<S r:fil I EI2IA
Proposer's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to Perform Recpuirecl Services
Proposer's Methodology and Overall Approar;la to Sr:ame of WrarltlS!)ec:lfications
PricelFee Proposal
NIJK11illnli
r'„uHs
iNellCornp Managed Care
Services
10 9
25 20
20 17
_0 16
25 I 23
Usis, Inc. (Arnerisys)
8
24
17
18
21
TOTAL TECHNICAL and FEE- POINTS
(Technical & Fee rows above)
100 I 85
88
(.VALUATION OF QUALIFICATIONS
RFP 6o5:H ti
MANAGED CAI* SI ItVICFS
Astuii /1. I leery, ,Pr (lii, w u,1 li,,,,ls - I:i- k IVl.iir.atle •kilt}
1stLEC1km Pkllf'i)51 tih L14III ItIA
'Proposer's General Experience, and Past Performance and exceptions
Proposer's Category Specific Experience, Qualifications, and Past Pertorriiarrre
Proposer's and Proposer's Key Personnel's Ability to Perform Requited Services
Proposer's Methodology and Overall Approach to Scope of Wm k/:,lrea:it ctationn
Price4Fee Ploposdl
TOTAL TECHNICAL arit.t FEE POINTS
(Technical & Fee rows above)
M.rn gnunr
i'rrr,r,1
10
25
25
WeIlCouip Managed Care
Services
9
20
18
18
Usis, Inc. (Arnerisys)
22.5
18
18
20 23 75
100 85 91.25
1-VALUATION QI- Ol1ALIFICAIIUNS
IRFT 1it15 t ih
MANAGED CANE `.iF_IZVICES
`;.rriptev I(t.11y r l (Mr enrol Clot'k I;I�k M.in.rals'r)
5EI1-(-P 1N PH( l'rr5r 6:5 s'Iti1i rdlf{
1Proposer's General Experience, and Past Performance and exceptions
IIIProposer's Category Specific Experience, Qualifications, and Past Performance
Proposer's and Proposer's Key Personnel's Ability to F'ertnrin Hertriirecl Services
i
Proposer's Methodology and Overall Approach to Scope of Work/Specifications
Price\Fee Proposal
hrd..mIu 11
10
25
20
25
1NellCornp 1VLtn.agesl Care
Servir es
8
22
15
15
17
Usis, Inc. (Arnerisys)
9
22
16
15
18
TOTAL TECHNICAL and FEE POINTS
(Technical & Fee rows ,thove)
100
77
80