Public Service Health Care Plan: Administrative Services Only

Attestation of assurance

The fairness monitor (FM) hereby provides the below unqualified assurance statement concerning the competitive procurement process of the Public Service Health Care Plan (PSHCP): Administrative Services Only (ASO).

It is our professional opinion that the competitive procurement process that we observed or monitored was carried out in a fair, open and transparent manner.

Original signed by:

Project requirement

BDO Canada LLP (BDO) was engaged on January 24, 2018 as a fairness monitor (FM) to observe the competitive procurement process for the PSHCP: ASO, issued by Public Works and Government Services Canada (PWGSC) on behalf of Treasury Board of Canada Secretariat (TBS). BDO is an independent third party with respect to this activity.

This report covers the activities of the FM, during the entire procurement process from January 24, 2018 to March 16, 2021.

PWGSC, on behalf of its client, TBS, has a requirement for a third party contractor to provide ASO claims processing and other related services for the PSHCP.

The PSHCP provides supplementary health care protection, including emergency benefits while traveling and emergency travel assistance services, as well as hospital benefits (1, 2 and 3 levels) for members and their eligible dependents who are covered under a provincial or territorial health insurance plan.

As of December 31, 2017, the PSHCP had over 670,000 members, of which over 324,000 are retired members, and covers approximately 1.5 million Canadians and had total annual expenditures of approximately $1.22 billion. It is the largest employer-sponsored health care plan in Canada.

It is anticipated that Canada will issue a single contract for a period of 8 years plus a 20 month estimated start-up period, with options to extend by 4 additional option periods of 1 year each, for a total of 13.7 consecutive years.

We reviewed all of the information provided and observed all relevant activities.

This report includes our:

• attestation of assurance
• a summary of the scope and objectives of our assignment
• relevant observations from the activities undertaken

Fairness monitor engagement and observations

In accordance with the terms of our engagement, we familiarized ourselves with the relevant project documentation, observed entire procurement process, identifying fairness-related matters to the contracting and technical authorities and ensuring that responses and actions were reasonable and appropriate.

Letter of interest phase

During the letter of interest (LOI) phase, the FM observed the following relevant activities:

• the FM reviewed all draft and final documents prior to posting, and provided feedback to the contracting authority (CA)
  • feedback was incorporated as appropriate
• the LOI was published on buyandsell.gc.ca on February 19, 2018
• the period for clarification questions was clearly stated and sufficient to allow review of the LOI
• the submission instructions were clearly stated
• the FM reviewed all clarification questions and responses prior posting, and provided feedback to the CA
  • feedback was incorporated as appropriate where required
• addenda were issued with any amendments to the bidding documents in a timely manner
• requests for extension were considered and provided where reasonable
• the solicitation closed on March 16, 2018

FM observations:

All interested respondents were treated fairly. The CA and the TBS project team addressed all observations or requests for clarification made by the FM.

Respondent’s responses review phase

The review of responses began shortly after March 16, 2018 and has concluded late in July 2018. On August 3, 2018, the FM was provided with the LOI review summary report.

Request for information 1 phase

During the request for information (RFI) 1 phase, the FM observed the following relevant activities:

• the FM reviewed all draft and final documents prior to posting, and provided feedback to the CA
  • feedback was incorporated as appropriate
• the RFI 1 was published on buyandsell.gc.ca on September 13, 2018
• the period for clarification questions was clearly stated and sufficient to allow review of the RFI 1
• the submission instructions were clearly stated
• the FM reviewed all clarification questions and responses prior to posting, and provided feedback to the CA
  • feedback was incorporated as appropriate where required
• there were no addenda nor requests for extension during this phase
• the solicitation closed on October 15, 2018

FM observations:

The process conducted conformed to the requirements of the RFI 1. All interested respondents were treated consistently and fairly. The CA and the TBS project team addressed all observations or requests for clarification made by the FM.

Respondent’s responses review

The review of responses began shortly after October 15, 2018, and concluded late in November 2018. During that period, the CA and the TBS project team prepared a number of questions for industry response at the forthcoming industry one-on-one post submission review meetings (PSRM).

FM observations:

No fairness-related issues were observed with respect to the communications between the CA and respondents. The respondent’s responses review was conducted in accordance with the process defined in the RFI 1. There were no fairness-related concerns raised.

Post submission review meetings

On October 17, 2018, the 4 respondents were invited simultaneously to attend the PSRM. Between November 27, 2018, and December 7, 2018, all respondents attended their respective PSRM as scheduled.

Request for information 2 phase

The purpose of this request for information (RFI) 2 was to:

• inform industry of Canada’s decision to adopt the agile engagement process (AEP) for the PSHCP ASO requirement
• share details on Canada’s AEP
• invite industry to register for the AEP
• provide an updated procurement timeline

During the RFI 2 phase, the FM observed the following relevant activities:

• the FM reviewed all draft and final documents prior to issuance and provided feedback to the CA:
  • feedback was incorporated as appropriate
• the RFI 2 was published on buyandsell.gc.ca on March 01, 2019, amended on March 28, 2019 and closed on February 28, 2020
• the period for clarification questions was clearly stated and sufficient to allow review of the RFI 2
• the submission instructions were clearly stated

The RFI 2 included 3 AEP releases and are as detailed below.

Request for information 2: Agile engagement process release 1

During the RFI 2: AEP release 1, the FM observed the following relevant activities:

• the FM reviewed all draft documents prior to posting, and provided feedback to the CA:
  • feedback was incorporated as appropriate
• the RFI 2: AEP release 1 draft documents were provided to the RFI 2 AEP registered suppliers via email on April 17, 2019
• the RFI 2: AEP release 1 included the following draft documents for industry feedback:
  • cover: release 1
  • basis of payment: strategy
  • security: start-up phase
  • security: operations phase
  • service levels
  • mandatory technical evaluation criteria
  • aboriginal participation component
  • greenhouse gas emissions reduction
• the RFI 2: AEP release 1 deadline for the registered AEP suppliers was May 9, 2019 to allow the review of the draft documents provided and the provision of feedback

Request for information 2: Agile engagement process release 2

During the RFI 2: AEP release 2, the FM observed the following relevant activities:

• the FM reviewed all draft documents prior to posting, and provided feedback to the CA:
  • feedback was incorporated as appropriate
• the RFI 2: AEP release 2 draft documents were provided to the RFI 2 AEP registered suppliers via email on June 6, 2019
• the RFI 2: AEP release 2 included the following draft documents for industry feedback:
  • cover: release 2
  • 3.5 Provider registration services: Start-up phase
  • 3.6 Financial management services: Start-up phase
  • 4.5 Provider registration services: Operations phase
  • 4.6 Financial management services: Operations phase
  • questions to industry
• the RFI 2: AEP release 2 deadline for the registered AEP suppliers was June 20, 2019 to allow the review of the draft documents provided and the provision of feedback

Request for information 2: Agile engagement process release 3

During the RFI 2: AEP release 3, the FM observed the following relevant activities:

• the FM reviewed all draft documents prior to posting, and provided feedback to the CA
  • feedback was incorporated as appropriate
• the RFI 2: AEP release 3 draft documents were issued to the RFI 2 AEP registered suppliers via email on October 11, 2019
• the RFI 2: AEP release 3 included the following draft documents for industry feedback:
  • cover release 3 (email)
  • request for proposal (RFP) body: parts 1 to 7
  • 01. Annex A: Statement of work (SOW)
  • 02. Appendix 1 to Annex A: Overview of the PSHCP Directive
  • 03. Appendix 2 to Annex A: Contract resource categories and requirements
  • 04. Appendix 3 to Annex A: Standard report categories and examples
  • 05. Attachment 1 to Appendix 3: Audit year to date template
  • 06. Attachment 2 to Appendix 3: Claims and population templates
  • 07. Attachment 3 to Appendix 3: Desk and onsite audit template
  • 08. Attachment 4 to Appendix 3: Finance template
  • 09. Attachment 5 to Appendix 3: Monthly operations template
  • 10. Attachment 6 to Appendix 3: PSHCP investigations template
  • 11. Appendix 4 to Annex A: PSHCP data elements
  • 12. Appendix 5 to Annex A: Acronyms and glossary of terms
  • 13. Appendix 6 to Annex A: PSHCP member eligibility files formats and frequencies
  • 14. Appendix 7 to Annex A: Work deliverables
  • 15. Appendix 8 to Annex A: Government of Canada Event Logging Strategy
  • 16. Security requirement check list (SRCL) and information technology security requirements
  • 17. Attachment 2.1 to Part 2: PSHCP volumetrics
  • 18. Appendix 1 to attachment 3.1 to Part  3 (mandatory technical submission requirements and mandatory evaluation criteria)
  • 19. Appendix 2 to attachment 3.1 to Part 3 (point rated technical submission requirements and point rated evaluation criteria)
• the RFI 2: AEP release 3 deadline of November 15, 2019 seemed sufficient to allow the review of the draft documents provided and the provision of feedback
• further to the RFI 2: AEP release 3 documents that were issued October 11, 2019, the CA has issued additional draft documents via RFI 2: AEP release 3, addendum 1 to the RFI 2 AEP registered suppliers via email on November 8, 2019
• the RFI 2: AEP release 3, addendum 1 included the following draft documents for industry feedback:
  • cover release 3, addendum 1 (email)
  • Basis of payment (BOP) fee credits
  • Annex D: Insurance requirements

The RFI 2: AEP release 3, addendum 1 deadline of November 22, 2019 seemed sufficient to allow the review of the draft documents provided and the provision of feedback.

FM observations:

The process conducted conformed to the requirements of the RFI 2. Any requests for clarification from the respondents during were addressed by the CA. All interested respondents were treated consistently and fairly. The CA and the TBS project team addressed all observations or requests for clarification made by the FM.

Request for proposal phase

In this section

• Documents reviewed
• Bid open period
• Phase 1: Financial bid evaluation
• Phase 2: Technical bid evaluation
• Phase 3: Final evaluation of the bid
• Fairness monitor observations

Documents reviewed

During the RFP phase, the FM was provided with the following documents for review:

• draft and final RFP documents
• clarification questions and answers during bid open period
• addenda
• correspondence with industry

Bid open period

The RFP was posted on buyandsell.gc.ca on September 1, 2020. During the bid open period, 7 amendments were issued responding to all clarification questions.

In RFP amendment 5, issued on October 22, 2020, the solicitation closing date was extended to November 20, 2020. Correspondingly, the deadline for bidders to submit enquiries was extended to October 30, 2020.

Three bid responses were received by the solicitation closing date and time.

FM observations:

The process conducted conformed to the requirements of the RFP. Any requests for clarification from the qualified suppliers during the bid open period were addressed via amendments by the CA. All bidders were treated consistently and fairly. The CA and the TBS project team addressed all observations or requests for clarification made by the FM. No fairness-related issues were observed with respect to the communications between the CA and the bidders.

Phase 1: Financial bid evaluation

Based on the phased bid compliance process (PBCP) phase 1, an examination of the financial submissions was undertaken and it was determined by the CA that both financial bids included all information required.

Phase 2: Technical bid evaluation

The CA conducted the pre‑evaluation orientation session on November 16, 2020. The RFP evaluation material was provided to the FM on November 17, 2020. The FM attended the evaluation kickoff meeting held on December 4, 2020. The FM attended all of the consensus evaluation meetings held between December 9, 2020 and March 4, 2021 for the 3 proposals.

The following process was undertaken to evaluate the technical responses to the RFP:

• each evaluator conducted their own independent review and scoring of the response in their evaluator workbook
• once the independent reviews were completed, the evaluators participated in meetings to agree on the consensus assessment
• evaluators recorded and marked any changes agreed to during consensus in their individual workbooks
• the CA confirmed with each member of the evaluation team that they were in agreement with the final consensus scores and rationale
• all 3 bid submissions were declared responsive

Phase 3: Final evaluation of the bid

In this phase, the CA confirmed to the FM on March 16, 2021, that the financial evaluation was completed for the 3 bids found responsive to the requirements reviewed at phase 1 and 2. The bids were assessed in accordance with the entire requirement of the bid solicitation including the technical and financial evaluation criteria.

Fairness monitor observations

The FM reviewed the draft and final RFP documents and all draft amendments to the RFP including responses to clarification questions.

Any requests for clarification from the potential bidders during the bid open period were addressed via amendments by the CA.

Any observations or requests for clarification made by the FM were addressed by the CA. The CA was responsive in providing clarification when requested by the FM.

The FM’s review of documents and monitoring of activities during the RFP evaluation phase considered the following principles of fairness, openness and transparency:

• the evaluation plan was consistent with the published procurement documents
• 17 evaluation team members were chosen and confirmed prior to the receipt of responses
• evaluator orientation training was provided to all evaluators
• the CA informed all evaluators of the following as a minimum:
  • identity of the responses received and requested evaluators to declare any conflict of interest
  • confidentiality protocols
  • document control
  • virtual evaluation process
  • clarification process
  • consensus process
  • overview of scoring workbooks and method for individual assessment
  • explanation of hidden criteria
  • explanation of fairness and the need for objectivity, consistency and equitable treatment of all responses
  • guidance with respect to only assessing the information that is in the response (not information from previous contracts, personal knowledge)
• the scoring criteria and assessment tools were established prior to the receipt of responses and were consistent with the RFP
• the submissions were logged and recorded upon receipt, clearly identifying that these were submitted on time

No potential fairness issues were noted by the FM during the evaluation phase.

Reference documents

Documents related to solicitation number 24062-180558/D are available on CanadaBuys or through the project office.

Addendum to the fairness monitor final report

January 19, 2022

Addendum to the FM final report dated June 1, 2021 for the procurement process of the PSHCP: ASO.

This addendum covers the period following the conclusion of the evaluation phase including contract award and debriefings.

Contract award, communications, and debriefing

The contract was awarded on November 30, 2021. Along with the notification of award, information was provided on November 30, 2021, explaining the results of the evaluation. Three debriefings were requested which took place December 15 and 16, 2021 and January 18, 2022 via conference calls. The FM reviewed the correspondence and observed the meetings with the bidders. The process conducted conformed to the requirements of the RFP. All bidders were treated fairly.

Attestation of assurance

The FM hereby provides the below unqualified assurance statement concerning the competitive procurement process of the of the PSHCP: ASO concluding on December 16, 2021.

It is our professional opinion that the solicitation process we observed or monitored was carried out in a fair, open and transparent manner.

Original signed by: