Common use of Program Design Clause in Contracts

Program Design. 1. Contractor will assist with long-term and short-term benefits strategy development. 2. Contractor will coordinate semi-annual benefit strategy meetings. 3. Contractor will compare features of County benefit programs against those of other public sector and private industry institutions. 4. Contractor will apprise the County of benefit developments at other California counties, to the extent doing so does not violate any confidentiality obligations of Contractor. 5. Contractor will advise about health care marketplace developments/changes. 6. Contractor will advise about industry developments/changes. 7. Contractor will propose plan design changes and enhancements. 8. Contractor will facilitate discussions on emerging trends and potential impact to the County. 9. Contractor will help assess employee benefit priorities/needs. 10. Contractor will provide benchmark financial comparisons. 11. Contractor will participate in labor/management meetings, Retirement Association committee meetings and the Health Plans Rate Committee meetings, as appropriate. 12. Contractor will provide support materials and benefit cost analysis for labor negotiations. 13. Contractor will advise on proposed plan design changes for retirement health programs. 14. Contractor will assist and coordinate the implementation of new vendors. 15. Contractor will review and make recommendations to the County’s Employee Benefits Division (Employee Benefits) for value added benefit plans and programs as well as modifications to the design, cost (rates), and quality of current employee benefit plans and programs. 16. Contractor will project value of proposed plan design or program changes 17. Contractor will develop RFPs for review by Employee Benefits and/or approval by the Board, including assisting in the development of the RFP and evaluation criteria, answering written questions from offerors, participating on the Evaluation Committee and preparing a comprehensive report of the proposals received in response to the RFP. Contractor will assist Employee Benefits in developing responses to protests from the RFP process. 18. Contractor will assist in the design, implementation and administration of new and existing programs. 19. Contractor will make recommendations for items of negotiation with benefit plan providers including, but not limited to, plan design, cost (rates), wellness support and quality of services. 20. Contractor will assist with the development, negotiation and implementation of performance standards and guarantees with the County’s various benefit plan providers. 21. Contractor will at designated intervals, evaluate and report the performance of plan providers to Employee Benefits. 22. Contractor will provide Employee Benefits with general guidance on items such as trends in benefit plans and wellness, methods for improving cost containment, financial arrangements, and administration. 23. Contractor will provide supporting backup and testimony to Board and Board staff, as needed. 24. Contractor will develop and/or assist in developing and evaluating employee needs and satisfaction surveys. 25. Contractor will as requested by Employee Benefits, provide comparison reports of other employers benefit plans and programs to determine competitiveness. 26. Contractor will evaluate impact of cost control approaches such as disease management. 27. Contractor will assist with contribution modeling and setting for alternative contribution approaches. 28. Contractor will assist the County with the process of Medicare Retiree Drug Subsidy (RDS) program. This includes performing actuarial equivalence test for Medicare prescription drug coverage subsidy, reviewing and reconciling cost reports for the County’s contracted vendors before submission for reimbursement of payments to Centers of Medicare & Medicaid Services (CMS) quarterly and annually. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on pharmacy trends and County demographics.

Program Design. 1. Contractor will assist with long-term and short-term benefits strategy development. 2. Contractor will coordinate semi-annual benefit strategy meetings. 3. Contractor will compare features of County benefit programs against those of other public sector and private industry institutions. 4. Contractor will apprise the County of benefit developments at other California counties, to the extent doing so does not violate any confidentiality obligations of Contractor. 5. Contractor will advise about health care marketplace developments/changes. 6. Contractor will advise about industry developments/changes. 7. Contractor will propose plan design changes and enhancements. 8. Contractor will facilitate discussions on emerging trends and potential impact to the County. 9. Contractor will help assess employee benefit priorities/needs. 10. Contractor will provide benchmark financial comparisons. 11. Contractor will participate in labor/management meetings, Retirement Association committee meetings and the Health Plans Rate Committee meetings, as appropriate. 12. Contractor will provide support materials and benefit cost analysis for labor negotiations. 13. Contractor will advise on proposed plan design changes for retirement health programs. 14. Contractor will assist and coordinate the implementation of new vendors. 15. Contractor will review and make recommendations to the County’s Employee Benefits Division (Employee Benefits) for value added benefit plans and programs as well as modifications to the design, cost (rates), and quality of current employee benefit plans and programs. 16. Contractor will project value of proposed plan design or program changes 17. Contractor will develop RFPs for review by Employee Benefits and/or approval by the Board, including assisting in the development of the RFP and evaluation criteria, answering written questions from offerors, participating on the Evaluation Committee and preparing a comprehensive report of the proposals received in response to the RFP. Contractor will assist Employee Benefits in developing responses to protests from the RFP process. 18. Contractor will assist in the design, implementation and administration of new and existing programs. 19. Contractor will make recommendations for items of negotiation with benefit plan providers including, but not limited to, plan design, cost (rates), wellness support and quality of services. 20. Contractor will assist with the development, negotiation and implementation of performance standards and guarantees with the County’s various benefit plan providers. 21. Contractor will at designated intervals, evaluate and report the performance of plan providers to Employee Benefits. 22. Contractor will provide Employee Benefits with general guidance on items such as trends in benefit plans and wellnessplans, methods for improving cost containment, financial arrangements, and administration. 23. Contractor will provide supporting backup and testimony to Board and Board staff, as needed. 24. Contractor will develop and/or assist in developing and evaluating employee needs and satisfaction surveys. 25. Contractor will as requested by Employee Benefits, provide comparison reports of other employers benefit plans and programs to determine competitiveness. 26. Contractor will evaluate impact of cost control approaches such as disease management. 27. Contractor will assist with contribution modeling and setting for alternative contribution approaches. 28. Contractor will assist the County with the process of Medicare Retiree Drug Subsidy (RDS) program. This includes performing actuarial equivalence test for Medicare prescription drug coverage subsidy, reviewing and reconciling cost reports for the County’s contracted vendors before submission for reimbursement of payments to Centers of Medicare & Medicaid Services (CMS) quarterly and annually. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on pharmacy trends and County demographics. 29. Contractor will assist the County with the Early Retiree Reinsurance Program (ERRP). This includes reviewing and reconciling cost reports from the County’s contracted vendors before submission of reimbursement requests to the Department of Health and Human Services (HHS) as well as any additional ERRP reconciliation requirements or additional information that may be requested by HHS. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on claim trends.

Program Design. 1. Contractor will assist with long-term and short-term benefits strategy development. 2. Contractor will coordinate semi-annual benefit strategy meetings. 3. Contractor will compare features of County benefit programs against those of other public sector and private industry institutions. 4. Contractor will apprise the County of benefit developments at other California counties, to the extent doing so does not violate any confidentiality obligations of Contractor. 5. Contractor will advise about health care marketplace developments/changes. 6. Contractor will advise about industry developments/changes. 7. Contractor will propose plan design changes and enhancements. 8. Contractor will facilitate discussions on emerging trends and potential impact to the County. 9. Contractor will help assess employee benefit priorities/needs. 10. Contractor will provide benchmark financial comparisons. 11. Contractor will participate in labor/management meetings, Retirement Association committee meetings and the Health Plans Rate Committee other meetings, as appropriate. 12. Contractor will provide support materials and benefit cost analysis for labor negotiations. 13. Contractor will advise on proposed plan design changes for retirement health retiree medical programs. 14. Contractor will assist and coordinate the implementation of new vendors. 15. Contractor will review and make recommendations to the County’s Employee Benefits Division (Employee Benefits) for value added benefit plans and programs as well as modifications to the design, cost (rates), and quality of current employee benefit plans and programs. 16. Contractor will project value of proposed plan design or program changes. 17. Contractor will develop RFPs for review by Employee Benefits and/or approval by the Board, including assisting in the development of the RFP and evaluation criteria, answering written questions from offerors, participating on providing technical support to the Evaluation Committee Committee, and preparing a comprehensive report of the proposals received in response to the RFP. Contractor will assist Employee Benefits in developing responses to protests from the RFP process. 18. Contractor will assist in the design, implementation implementation, and administration of new and existing programs. 19. Contractor will make recommendations for items of negotiation with benefit plan providers including, but not limited to, plan design, cost (rates), wellness support and quality of services. 20. Contractor will assist with the development, negotiation and implementation of performance standards and guarantees with the County’s various benefit plan providers. 21. Contractor will at designated intervals, evaluate and report the performance of plan providers plans to Employee Benefits. 22. Contractor will provide Employee Benefits with general guidance on items such as trends in benefit plans and wellnessplans, methods for improving cost containment, financial arrangements, and administration. 23. Contractor will provide supporting backup and testimony to Board and Board staff, as needed. 24. Contractor will develop and/or assist in developing and evaluating employee needs and satisfaction surveys. 25. Contractor will as requested by Employee Benefits, provide comparison reports of other employers benefit plans and programs to determine competitiveness. 26. Contractor will evaluate impact of cost control approaches such as disease management. 27. Contractor will assist with contribution modeling and setting for alternative contribution approaches. 28. Contractor will assist the County with the process of Medicare Retiree Drug Subsidy (RDS) program. This includes performing actuarial equivalence test for Medicare prescription drug coverage subsidy, reviewing and reconciling cost reports for the County’s contracted vendors before submission for reimbursement of payments to Centers of Medicare & Medicaid Services (CMS) quarterly and annually. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on pharmacy trends and County demographics. 29. Contractor will assist County with the Patient Center Outcome Research Institute (PCORI) fee calculations.

Program Design. 1. Contractor will assist with long-term and short-term benefits strategy development. 2. Contractor will coordinate semi-annual benefit strategy meetings. 3. Contractor will compare features of County benefit programs against those of other public sector and private industry institutions. 4. Contractor will apprise the County of benefit developments at other California counties, to the extent doing so does not violate any confidentiality obligations of Contractor. 5. Contractor will advise about health care marketplace developments/changes. 6. Contractor will advise about industry developments/changes. 7. Contractor will propose plan design changes and enhancements. 8. Contractor will facilitate discussions on emerging trends and potential impact to the County. 9. Contractor will help assess employee benefit priorities/needs. 10. Contractor will provide benchmark financial comparisons. 11. Contractor will participate in labor/management meetings, Retirement Association committee meetings and the Health Plans Rate Committee other meetings, as appropriate. 12. Contractor will provide support materials and benefit cost analysis for labor negotiations. 13. Contractor will advise on proposed plan design changes for retirement health retiree medical programs. 14. Contractor will assist and coordinate the implementation of new vendors. 15. Contractor will review and make recommendations to the County’s Employee Benefits Division (Employee Benefits) for value added benefit plans and programs as well as modifications to the design, cost (rates), and quality of current employee benefit plans and programs. 16. Contractor will project value of proposed plan design or program changes. 17. Contractor will develop RFPs for review by Employee Benefits and/or approval by the Board, including assisting in the development of the RFP and evaluation criteria, answering written questions from offerors, participating on providing technical support to the Evaluation Committee and preparing a comprehensive report of the proposals received in response to the RFP. Contractor will assist Employee Benefits in developing responses to protests from the RFP process. 18. Contractor will assist in the design, implementation and administration of new and existing programs. 19. Contractor will make recommendations for items of negotiation with benefit plan providers including, but not limited to, plan design, cost (rates), wellness support and quality of services. 20. Contractor will assist with the development, negotiation and implementation of performance standards and guarantees with the County’s various benefit plan providers. 21. Contractor will at designated intervals, evaluate and report the performance of plan providers plans to Employee Benefits. 22. Contractor will provide Employee Benefits with general guidance on items such as trends in benefit plans and wellnessplans, methods for improving cost containment, financial arrangements, and administration. 23. Contractor will provide supporting backup and testimony to Board and Board staff, as needed. 24. Contractor will develop and/or assist in developing and evaluating employee needs and satisfaction surveys. 25. Contractor will as requested by Employee Benefits, provide comparison reports of other employers benefit plans and programs to determine competitiveness. 26. Contractor will evaluate impact of cost control approaches such as disease management. 27. Contractor will assist with contribution modeling and setting for alternative contribution approaches. 28. Contractor will assist the County with the process of Medicare Retiree Drug Subsidy (RDS) program. This includes performing actuarial equivalence test for Medicare prescription drug coverage subsidy, reviewing and reconciling cost reports for the County’s contracted vendors before submission for reimbursement of payments to Centers of Medicare & Medicaid Services (CMS) quarterly and annually. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on pharmacy trends and County demographics. 29. Contractor will assist County with the Patient Center Outcome Research Institute (PCORI) fee calculations.

Program Design. 1. Contractor will assist with long-term and short-term benefits strategy development. 2. Contractor will coordinate semi-annual benefit strategy meetings. 3. Contractor will compare features of County benefit programs against those of other public sector and private industry institutions. 4. Contractor will apprise the County of benefit developments at other California counties, to the extent doing so does not violate any confidentiality obligations of Contractor. 5. Contractor will advise about health care marketplace developments/changes. 6. Contractor will advise about industry developments/changes. 7. Contractor will propose plan design changes and enhancements. 8. Contractor will facilitate discussions on emerging trends and potential impact to the County. 9. Contractor will help assess employee benefit priorities/needs. 10. Contractor will provide benchmark financial comparisons. 11. Contractor will participate in labor/management meetings, Retirement Association committee meetings and the Health Plans Rate Committee meetings, as appropriate. 12. Contractor will provide support materials and benefit cost analysis for labor negotiations. 13. Contractor will advise on proposed plan design changes for retirement health programs. 14. Contractor will assist and coordinate the implementation of new vendors. 15. Contractor will review and make recommendations to the County’s Employee Benefits Division (Employee Benefits) for value added benefit plans and programs as well as modifications to the design, cost (rates), and quality of current employee benefit plans and programs. 16. Contractor will project value of proposed plan design or program changes 17. Contractor will develop RFPs for review by Employee Benefits and/or approval by the Board, including assisting in the development of the RFP and evaluation criteria, answering written questions from offerors, participating on the Evaluation Committee and preparing a comprehensive report of the proposals received in response to the RFP. Contractor will assist Employee Benefits in developing responses to protests from the RFP process. 18. Contractor will assist in the design, implementation and administration of new and existing programs. 19. Contractor will make recommendations for items of negotiation with benefit plan providers including, but not limited to, plan design, cost (rates), wellness support and quality of services. 20. Contractor will assist with the development, negotiation and implementation of performance standards and guarantees with the County’s various benefit plan providers. 21. Contractor will at designated intervals, evaluate and report the performance of plan providers to Employee Benefits. 22. Contractor will provide Employee Benefits with general guidance on items such as trends in benefit plans and wellness, methods for improving cost containment, financial arrangements, and administration. 23. Contractor will provide supporting backup and testimony to Board and Board staff, as needed. 24. Contractor will develop and/or assist in developing and evaluating employee needs and satisfaction surveys. 25. Contractor will as requested by Employee Benefits, provide comparison reports of other employers benefit plans and programs to determine competitiveness. 26. Contractor will evaluate impact of cost control approaches such as disease management. 27. Contractor will assist with contribution modeling and setting for alternative contribution approaches. 28. Contractor will assist the County with the process of Medicare Retiree Drug Subsidy (RDS) program. This includes performing actuarial equivalence test for Medicare prescription drug coverage subsidy, reviewing and reconciling cost reports for the County’s contracted vendors before submission for reimbursement of payments to Centers of Medicare & Medicaid Services (CMS) quarterly and annually. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on pharmacy trends and County demographics. 29. Contractor will assist the County with the Early Retiree Reinsurance Program (ERRP). This includes reviewing and reconciling cost reports from the County’s contracted vendors before submission of reimbursement requests to the Department of Health and Human Services (HHS) as well as any additional ERRP reconciliation requirements or additional information that may be requested by HHS. Contractor will also provide on an as needed basis the estimated amount of subsidies to be acquired in future years based on claim trends.