In addition to general day-to-day services, Sullivan will release a Request for Proposal to the marketplace in order to review all of your vendor options now and at renewal. Evaluating, negotiating with, and recommending insurers and providers to our clients are Sullivan specialties. Our position in the marketplace allows us to enjoy preferred financial arrangements with insurance vendors and third party administrators across the United States. We actively cultivate long-standing relationships with major carriers, and those relationships allow us to negotiate aggressively and obtain cost-efficient proposals for our clients.

As we negotiate with vendors, we will also examine your loss history, establish the necessary types of coverage consistent with your risk tolerance, choose carriers that provide superior services, and adopt the optimal funding mechanisms for your specific needs.

We have established rigorous selection criteria for potential vendors, and recommend a selection based on the following considerations.

Activity	Suggested Objective	Activity	Suggested Objective
Delivery of renewal information	Employee satisfaction	Availability of general service representative	As needed
Claim turnaround time	90% in 10 calendar days	Delivery of management reports	Standard reports: within 1 week of request
Claim processing standards	Financial accuracy: 99% Payment accuracy: 98% Coding accuracy*: 97%		Custom reports: within 2 weeks of initial request or as agreed upon
Internal audits	Quarterly reports	Personnel changes	Notification before changes
External audits	As needed	Telephone responsiveness	Call abandonment rate: <5%
Updated eligibility information	Within 5 work days of receipt		Average speed to answer: 90% within 30 seconds
Updated network provider file	Within 10 work days of receipt	Employee satisfaction	Survey results (to be determined)

Critical Vendor Selection Criteria

Overall service and quality
Experience in administering network-based programs
Commitment to continuous quality improvement processes
Experience in administering multiple option health programs
Quality of communication materials (e.g. booklets, EOBs, etc.)
Effective administration procedures (e.g. coordination of benefits, subrogation, etc.)
Responsiveness of group representative
Cost efficiency
Responsiveness to client feedback
Professionalism of response to RFP
Willingness to adapt to changing needs and circumstances
Adequate staffing ratios
Superior network coverage in relation to location of client employees

*Definitions

Financial accuracy: total amount of claims dollars paid correctly, divided by the total claims dollars paid.

Payment accuracy: total amount of checks issued for the correct dollar amount divided by the total number of checks issued.

Coding accuracy: total number of claims processed without a coding error (i.e. any inaccurate entry of information that does not result in a payment error), divided by the total number of claims processed.

Activity

Suggested Objective

Activity

Suggested Objective

Delivery of renewal information

Employee satisfaction

Availability of general service representative

As needed

Claim turnaround time

90% in 10 calendar days

Delivery of management reports

Standard reports: within 1 week of request

Claim processing standards

Financial accuracy*: 99% Payment accuracy*: 98% Coding accuracy*: 97%

Custom reports: within 2 weeks of initial request or as agreed upon

Internal audits

Quarterly reports

Personnel changes

Notification before changes

External audits

As needed

Telephone responsiveness

Call abandonment rate: <5%

Updated eligibility information

Within 5 work days of receipt

Average speed to answer: 90% within 30 seconds

Updated network provider file

Within 10 work days of receipt

Employee satisfaction

Survey results (to be determined)

Critical Vendor Selection Criteria

Financial accuracy: total amount of claims dollars paid correctly, divided by the total claims dollars paid.

Payment accuracy: total amount of checks issued for the correct dollar amount divided by the total number of checks issued.

Coding accuracy: total number of claims processed without a coding error (i.e. any inaccurate entry of information that does not result in a payment error), divided by the total number of claims processed.

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Claim processing
standards

Financial accuracy: 99%
Payment accuracy: 98%
Coding accuracy*: 97%