provision of medical aid brokerage services for sars ... · a) medical aid brokerage reports: •...

PROVISION OF MEDICAL AID BROKERAGE SERVICES

FOR SARS

Briefing Session : 09 May 2013, 14h00

RFP No : RFP 03/2013

Closing Date : 29 May 2013, 14h00

Procurement

Senior Manager: Professional Services

Commodity Leader: Professional Services

Finance Evaluator: Value Delivery Plan

BBBEE Specialist: Support Services

Operations Specialist: Governance, Compliance & Risk

Procurement Trainee

SARS – Human Resources

Senior Manager: CHVT

Acting Executive: Remuneration & Benefits

Operational Specialist

Manager: Human Resources

Operational Specialist

HR Finance

Corporate Legal Services

Legal Specialist

Bid Evaluation Committee

2

1. Welcome and Introduction

2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE

7. RFP submission and contact details

8. Q&A

Table of Content

3

4

As an organ of state, SARS’s mandate outlines its obligations towards the state and

its people by:

Background

5

As a large employer group, the South African Revenue Service is mandated

by the Council of Medical Aid Schemes to appoint a medical aid broker to

ensure that the members of medical aid schemes (employees) are properly

serviced in terms of medical aid cover. Therefore, it is a business need to

appoint a medical aid broker to manage and administer membership matters

of the SARS employees.

Background Cont.…

6


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE


8. Q&A

Table of Content

RFP Timelines

ACTIVITY DUE DATE

RFP Advertisement in Sunday Times 28 April 2013

RFP Advertisement in Government Tender Bulletin

26 April 2013

Tender documents on SARS website 29 April 2013

Non-Compulsory briefing session 09 May 2013, 14H00

Questions relating to RFP 21 May 2013

RFP Closing Date 29 May 2013, 14h00

Notice to bidders SARS will endeavour to inform bidders

of the progress until conclusion of the

tender

7


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE


8. Q&A

8

Table of Content

9

The successful bidder will be required to:

A. Be fully responsible of the Medical Aid membership management of SARS employees.

B. Have an existing a CRM (Customer Relations Management) system, Web functionality,

contact centre facility, SMS functionality and Business Continuity report.

C. Do electronic interface of Medical Aid membership data to SARS payroll system to avoid

manual intervention that will include:

• Troubleshooting and resolution of breakdowns between systems and administrative

processes

• Interfaces of combined Medical Aid Schemes membership data (Three accredited

schemes)

• The annual absolute arrears maintained for members at medical schemes within 1%

• SAP end user knowledge/experience

• IT infrastructure and business continuity

Scope of Work Refer to section 8 of RFP doc

10

D. Have a dedicated administration team

E. Provide services, reports on services rendered that include evidence of services rendered

with supporting documents (as an addendum) for and on the following:

Strategic Services

a) Report on the previous year end revision process

b) Review of demographic profile of active members

c) Scheme and option comparisons

d) Scheme demographics

e) Legislative review and update

f) Project planning and implementation

g) Market trend analysis and forecasting


11

Consulting Services

a) Independent broker advice

b) Query helpdesk specific to SARS

c) One on One consultation pertaining to medical aid cover

d) Monthly on site visits and consultations at all offices

e) Induction and comprehensive training

f) Independent consultations

g) Escalated query assistance

h) Regular product presentations and training

i) Communication including newsletters, hot topics, etc.


12

Year End Revision Services

a) Project planning and implementation for all offices

b) Year-end revision training of members and human resources

c) Communication

d) Record Keeping of sessions i.e. attendance registers

e) Presentation and facilitation of session

Reporting

a) Medical Aid brokerage reports

• Billing results and analysis

• Process management

• Quarterly reporting

• Risk management

• Executive and annual reports

• Benchmark review


13

b) Wellness reports to Health and wellness unit:

• Provide regular and ad hoc comprehensive report (monthly dashboard, quarterly and annual)

on wellness days Reports to be broken down according to regions, office, division and

business unit.

• Provide comprehensive report / data of chronic disease registrations onto the medical

aids and follow-ups (provide by regional distribution) – quarterly

• Comprehensive report on the executive wellness days –after each regional intervention and

quarterly


14

F. Provide Health Care consulting to SARS and its individual employee

G. Facilitate and administer SARS initiated wellness days with Accredited SARS Medical Aid

Schemes for identified wellness services which includes:

• Wellness days: Health screening (through medical aid insured benefits)

• Wellness days to be conducted by one provider to ensure consistency and uniformity

(SARS does not expect each MA to conduct a separate wellness day for its members –

broker to ensure one provider for all three MAs)

• Provide health information material (e.g. health passports, brochures, leaflets, posters and

so forth)

• Facilitate Nurses to provide onsite group information sessions during the wellness days

• To be able to integrate with other Medical Aid Schemes outside of SARS preferred 3

Medical Aid Schemes (Employees who are not on SARS preferred MAS should also be

covered during wellness days).


15

• To identify employees with chronic conditions through the wellness days and refer to

SARS EAP (Employee Assistance Program) and wellness provider for registration on

the relevant medical aid chronic disease programme.

• Participate in scheduled meetings (e.g. monthly and ad hoc) at mutually agreed

location.

• Ensure that points are allocated to employees who have participated as per the

relevant Medical Aid Schemes’ reward programmes (i.e. Vitality points)

• Provide long stay hospital admissions to facilitate continuous interventions – quarterly

• Executive Wellness days screening (through medical aid insured benefits)

H. Have a dedicated national coordinator to oversee wellness days

I. Do reconciliation and contribution management

J. Ensure comprehensive member administration, management and reporting


16


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation Process

6. BBBEE


8. Q&A

Table of Content

17

Pre-Qualification

Gate 0 Gate 0

BBBEE Evaluation 10 points

Gate 2 Gate 2

• Tax Clearance Certificate - SBD 2

• Invitation to Bid - SBD 1

• Response to Bid Letter

• SARS General Conditions of Contract

• SARS Oath of Secrecy

• Declaration of Interest - SBD 4

• Preference Point Claim form - SBD 6.1

• Declaration of Bidder’s Past Supply Chain Management Practices – SBD 8

• Certificate of Independent Bid Determination – SBD 9

• 3 Years Audited Financial Statements

• Accreditation to the council for medical schemes

• Financial Service Board Accreditation

• SAS 70 or other

• Indemnity insurance certificates

• Electronic Bid Information Pack

• Tax Clearance Certificate - SBD 2

• Invitation to Bid - SBD 1

• Response to Bid Letter

• SARS General Conditions of Contract

• SARS Oath of Secrecy

• Declaration of Interest - SBD 4

• Preference Point Claim form - SBD 6.1

• Declaration of Bidder’s Past Supply Chain Management Practices – SBD 8

• Certificate of Independent Bid Determination – SBD 9

• 3 Years Audited Financial Statements

• Accreditation to the council for medical schemes

• Financial Service Board Accreditation

• SAS 70 or other

• Indemnity insurance certificates

• Electronic Bid Information Pack

• Experience in delivering Brokerage Services for

Medical Aid Schemes

• Infrastructure/ Systems

• Human Resources

• National Footprint

• Services

• Record keeping and document management

• Reporting

• Bidders to achieve 70 points of 100 points and

only top three scoring bidders will proceed to

Gate 2.

• Experience in delivering Brokerage Services for

Medical Aid Schemes

• Infrastructure/ Systems

• Human Resources

• National Footprint

• Services

• Record keeping and document management

• Reporting

• Bidders to achieve 70 points of 100 points and

only top three scoring bidders will proceed to

Gate 2.

Technical Evaluation 100 points

Gate 1 Gate 1

• BBBEE Evaluation and submission of SBD 6.1

• BBBEE Evaluation and submission of SBD 6.1

Bid Evaluation Process

Annexure A – Technical

Scorecard

18

1. Experience in Providing Brokerage Services for Medical Aid Schemes

a) Provide the reference letters from current/recent 3 contactable clients where you have

delivered brokerage service for medical aid schemes

• Provide the reference letters from at least three (3) contactable current/recent customers

within the past 5 years, from organisations with more than 1 500 employees and covered on

more than 1 medical aid scheme. The letter must include: company name, contact name,

address, phone number, and duration of contract, a brief description of the services that you

provided and the level of satisfaction.

Technical Scorecard

19

b) Please elaborate and where possible provide proof on your experience in providing

brokerage services regarding medical aid scheme;

• List the Companies, with approximate staff compliment for whom you have rendered the

services to.

• Indicate years of service in rendering brokerage services (Must have minimum five years’

experience providing brokerage services for an organisation with more than 1 500 employees

and covered more than 1 medical aid scheme.

• As per the Scope / Type of services covered within the brokerage services regarding:

Heath care broker consulting services for companies and their employees

Strategic services

Year-end revision service

Membership and contribution management with full electronic file interface into SAP

payroll for more than one Medical Aid Scheme all at once.

Facilitation and administration of Employer initiated wellness days with medical aid

schemes and related providers

Reporting

Technical Scorecard

20

2. Infrastructure/Systems

a) Provide the following infrastructure information

• Company organogram

• Branch infrastructure (Geographic locations)

• Disaster Recovery plan and certificate

b) Provide proof of the following existing systems

• CRM (Customer Relations Management) system

• Web functionality

• Contact/call centre facility

• SMS functionality

• Business continuity report

Technical Scorecard

21

3. Human Resources

a) Provide the capacity to deliver the medical aid brokerage services. The number of resources

dedicated to this project (dedicated administration team).

b) Provide a profile and qualifications of the administration team and key account manager,

demonstrating the project management, project coordination and customer management

proficiency. Provide the level of the key account manager.

4. National Footprint

a) SARS has offices in nine provinces, rural areas and borders posts: Provide an example of

how you have provided services (e.g. wellness days) concurrently at multiple sites (with a

client more or less similar to SARS.

b) Demonstrate the implementation plan on how to manage multiple sites in different

regions/province within required lead time.

Technical Scorecard

22

5. Services

Provide the details of medical aid brokerage services with regards to the following that your

company offers and any other value added service.

a) Heath care consulting services for companies and their employees

b) Strategic services

c) Year-end revision service

d) Membership and contribution management with full electronic file interfaces into SAP payroll

e) Facilitation and administration of Employer initiated wellness days with medical aid schemes

and related providers

f) Reporting

6. Record Keeping and Document Management

a) Describe your document management system for keeping employee files.

b) Describe your document hand over process to another Service Provider (Broker) upon expiry

of the contract

Technical Scorecard

23

7. Reporting

Provide examples of your reports for all scope of work for medical aid brokerage services:

a) Medical Aid brokerage reports:

• Billing results and analysis

• Process management

• Quarterly reporting

• Risk management

• Executive and annual reports

• Benchmark review

b) Wellness Days reports:

• Provide regular and ad hoc comprehensive report (monthly dashboard, quarterly and annual) on

wellness days reports to be broken down according to regions, office, division and business unit.

• Provide comprehensive report / data of chronic disease registrations onto the medical aids and

follow-ups (provide by regional distribution) – quarterly

• Comprehensive report on the executive wellness days – after each regional intervention and

quarterly

Technical Scorecard

24

8. Employee Wellness Days/Sessions

a) Marketing And Awareness

• Provide examples of health information material (e.g. health passports, brochures, leaflets,

posters and so forth) relevant to wellness days.

• Provide detail on how you can improve visibility and or attendance of employees during

wellness days.

b) Wellness Days

• Provide proof of and a plan of facilitating and liaising between employer and medical aid

schemes and related providers to provide identified wellness services for employer initiated

wellness days

Technical Scorecard

25


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE


8. Q&A

Table of Content

Classification Turn Over

Submission Requirement

Exempted Micro Enterprise (EME) Below R5 million p.a

Certified Copy of BBBEE Rating Certificate from a SANAS Accredited rating agency or a Registered Auditor approved by IRBA or a letter from an Accounting Officer as contemplated in the CCA

Qualifying Small Enterprise (QSE) Between R5 million and R35 million p.a

Certified Copy of BBBEE Rating Certificate from a SANAS Accredited rating agency or a Registered Auditor approved by IRBA

Large Entity (LE) Above R35 million p.a

Certified Copy of BBBEE Rating Certificate from a SANAS Accredited rating agency or a Registered Auditor approved by IRBA

Joint Ventures and Consortiums (JV's collectively) Incorporated JV's must submit the B-BBEE status of the entity. Unincorporated JV's must submit a consolidated B-BBEE scorecard as if they were a group structure for every separate tender. Submit SBD 6.1

SARS BBBEE Requirements

6. BID DECLARATION 6.1 Bidders who claim points in respect of B-BBEE Status Level of Contribution must complete the following:

7. B-BBEE STATUS LEVEL OF CONTRIBUTION CLAIMED IN TERMS OF PARAGRAPHS 1.3.1.2

AND 5.1

7.1 B-BBEE Status Level of Contribution: …………. = ……………(maximum of 10 or 20 points)

(Points claimed in respect of paragraph 7.1 must be in accordance with the table reflected in paragraph 5.1 and

must be substantiated by means of a B-BBEE certificate issued by a Verification Agency accredited by SANAS

or a Registered Auditor approved by IRBA or an Accounting Officer as contemplated in the CCA).

8. SUB-CONTRACTING 8.1 Will any portion of the contract be sub-contracted? YES / NO (delete which is not applicable)

8.1.1 If yes, indicate:

(i) what percentage of the contract will be subcontracted? ............……………….…%

(ii) the name of the sub-contractor? …………………………………………………………..

(iii) the B-BBEE status level of the sub-contractor? ……………..

(iv) whether the sub-contractor is an EME? YES / NO (delete which is not applicable)

BBBEE Key Sections to complete in SBD 6.1

B-BBEE Contributor Level Number of Points

(80/20 system)

Number of Points

(90/10 system)

1 20 10

2 18 9

3 16 8

4 12 5

5 8 4

6 6 3

7 4 2

8 2 1

Non-Compliant Contributor 0 0

Points Awarded for BBBEE Contribution

29


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE


8. Q&A

Table of Content

30

+

TENDER BOX SARS Brooklyn Bridge,570 Fehrsen Street, Linton

House, Brooklyn

Any enquiries must be referred, in writing via email to:

[email protected] or [email protected]

1 1 2 2

Bidders must submit copies of each file (Original and Duplicate) and a CD-ROM with

content of each file by the 29 May 2013 at 14:00

Original Duplicate

Bid Submission

+

Electronic Bid Information

Pack; consisting of the

following:

• Bidder Details

• Supplier Registration

Form

• Annual Financial

Statements

• Technical Evaluation

Criteria

(Available for download

from the SARS website

under Tenders section)

mailto:[email protected]




31

Section1 Section1

Pre-qualification documents (SBD documents)

o Response to Bid Letter

o Tax Clearance Certificate – SBD 2

o SARS Oath of Secrecy

o Invitation to Bid – SBD 1

o Declaration of Interest – SBD 4

o Preference Point Claim Form – SBD 6.1

o Declaration of Bidders Past SCM Practices – SBD 8

o Certificate of Independent Bid Determination – SBD 9

o Accreditation to the council for medical schemes

o Financial Service Board Accreditation

o SAS 70 or other

o Indemnity Insurance certificates

o Electronic Bid Information Pack

Section 2 Section 2

• Technical Responses

• Supporting documents for technical responses

• References/ testimonials

• 3 years audited Financial Statements (the last one being 2011/2012)

Section 3 Section 3 • Company profile

• Supplementary information

File 1: Original/ Duplicate

32

File 1 :Original/ Duplicate cont.

Section 4 Section 4

Section 5 Section 5

• General Conditions of Contract (GCC)

• Draft Service Level Agreement (SLA)

• BBBEE Certificate

Each file and CD-ROM must be marked correctly and sealed separately for easy

reference during the evaluation process. NB

33


2. Background

3. RFP Timelines

4. Scope of Work

5. Bid Evaluation

6. BBBEE


8. Q&A

Table of Content

provision of medical aid brokerage services for sars ... · a) medical aid brokerage reports: •...

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