Proposed Contract with Standard Insurance Company to Contract No. CW124798

MURIEL BOWSER
MAYOR

December 2, 2025

The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, NW, Suite 504
Washington, DC 20004

Dear Chairman Mendelson:

Pursuant to section 451 of the District of Columbia Home Rule Act (D.C. Official Code § 1 -
204.51) and section 202 of the Procurement Practices Reform Act of 2010 (D.C. Official Code §
2-352.02), enclosed for consideration and approval by the Council of the District of Columbia is
proposed Contract No. CW124798 with Standard Insurance Company (Standard) in the not -to-
exceed amount of $36,471,579. The period of performance is one year from the date of award.

Under the proposed contract, Standard will manage and administer life and disability insurance
benefits for District employees and retirees.

My administration is available to discuss any questions you may have regarding the proposed
contract. In order to facilitate a response to any questions you may have, please have your staff
contact Marc Scott, Chief Operating Officer, Office of Contracting and Procurement, at (202) 724-
8759.

I look forward to the Council’s favorable consideration of this contract.

Sincerely,

Muriel Bowser
1

GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement

Pursuant to section 202(c) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code § 2-352.02(c), the following contract summary is provided:

COUNCIL CONTRACT SUMMARY
(Standard)

(A) Contract Number: CW124798

Proposed Contractor: Standard Insurance Company (Standard)

Proposed Contractor’s Principals: Chris Beaulieu, Susan Bruechner, Lauren Canfield,
Greg Chandler, Rob Erickson, Jeremy Horner, AJ
Ijaz, Dan McMillan, J. Greg Ness, David Payne

Contract Amount (Base Period): Not-to-Exceed (NTE) $36,471,579

Unit and Method of Compensation: Fixed unit prices (premium rates)

Term of Contract: Date of award through one year

Type of Contract: Requirements

Source Selection Method: Cooperative purchasing agreement

(B) For a contract containing option periods, the contract amount for the base period and for
each option period. If the contract amount for one or more of the option periods differs from
the amount for the base period, provide an explanation of the reason for the difference:

Base Period Amount: NTE $36,471,579

Option Period 1 Amount: TBD
Explanation of difference from base period (if applicable): As is standard for the District’s
benefits contracts, the amounts for each option period will be reviewed and adjusted on an annual
basis, reflecting standard rate redeterminations and changes in District enrollment numbers.

Option Period 2 Amount: TBD
2

Explanation of difference from base period (if applicable): As is standard for the District’s
benefits contracts, the amounts for each option period will be reviewed and adjusted on an annual
basis, reflecting standard rate redeterminations and changes in District enrollment numbers.

Option Period 3 Amount: TBD
Explanation of difference from base period (if applicable): As is standard for the District’s
benefits contracts, the amounts for each option period will be reviewed and adjusted on an annual
basis, reflecting standard rate redeterminations and changes in District enrollment numbers.

(C) The goods or services to be provided, the methods of delivering goods or services, and any
significant program changes reflected in the proposed contract:

The proposed contractor will manage and administer life insurance, short-term disability insurance,
and long-term disability insurance benefits for District employees and retirees.

(D) The selection process, including the number of offerors, the evaluation criteria, and the
evaluation results, including price, technical or quality, and past performance components:

This contract will be awarded through a cooperative purchasing agreement. D.C. Official Code §
2-354.11 authorizes and encourages the Chief Procurement Officer and her delegated procurement
officer to participate in, sponsor, conduct, or administer cooperative purchasing agreements with
any state, county, or municipal jurisdiction for the procurement of goods and services or
construction.

Standard currently has a competitively awarded contract with the government of Fairfax County,
Virginia, providing the same services as those required by the D.C. Department of Human
Resources (DCHR). The District will utilize that contract as the master agreement.

(E) A description of any bid protest related to the award of the contract, including whether the
protest was resolved through litigation, withdrawal of the protest by the protestor, or
voluntary corrective action by the District. Include the identity of the protestor, the grounds
alleged in the protest, and any deficiencies identified by the District as a result of the protest:

None.

(F) A description of any other contracts the proposed contractor is currently seeking or holds
with the District:

CW87285 – Employee Life and Disability Insurance Benefits.

(G) The background and qualifications of the proposed contractor, including its organization,
financial stability, personnel, and performance on past or current government or private
sector contracts with requirements similar to those of the proposed contract:

The proposed contractor has provided the same services to the District for over 20 years. DCHR has
consistently rated their performance as satisfactory or above. They have demonstrated through their
3

technical approach and past performance that they have the organization, financial stability,
personnel, and performance history required to successfully meet the requirements of the proposed
contract.

(H) A summary of the subcontracting plan required under section 2346 of the Small, Local, and
Disadvantaged Business Enterprise Development and Assistance Act of 2005, as amended,
D.C. Official Code § 2-218.01 et seq. (“Act”), including a certification that the subcontracting
plan meets the minimum requirements of the Act and the dollar volume of the portion of the
contract to be subcontracted, expressed both in total dollars and as a percentage of the total
contract amount:

The contract will be awarded through a cooperative purchasing agreement and does not require a
subcontracting plan.

(I) Performance standards and the expected outcome of the proposed contract:

The proposed contractor will adhere to specific performance requirements relating to
implementation, enrollment assistance, claims administration, financial accuracy, customer service
response, and reporting. They will be required to administer claims completely and accurately.
They will also regularly report on their performance against established performance guarantee
measures.

(J) The amount and date of any expenditure of funds by the District pursuant to the contract
prior to its submission to the Council for approval:

None.

(K) A certification that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code §§ 47-392.01 and 47-392.02:

The Office of the Chief Financial Officer has certified that the proposed contract is within the
appropriated budget authority for fiscal year 2026.

(L) A certification that the contract is legally sufficient, including whether the proposed
contractor has any pending legal claims against the District:

The Office of the Attorney General has certified that the contract is legally sufficient and that the
proposed contractor does not have any pending legal claims against the District.

(M) A certification that the Citywide Clean Hands database indicates that the proposed contractor
is current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District;
or (2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code § 2-353.01(b):
4

The Citywide Clean Hands report indicates that the proposed contractor is current with its District
taxes.

(N) A certification from the proposed contractor that it is current with its federal taxes, or has
worked out and is current with a payment schedule approved by the federal government:

The proposed contractor has certified that they are current with their federal taxes.

(O) A certification that the proposed contractor has been determined not to violate section 334a of
the Board of Ethics and Government Accountability Establishment and Comprehensive
Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2) A
certification from the proposed contractor that it currently is not and will not be in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a:

The proposed contractor has been determined not to violate section 334a of the Board of Ethics and
Government Accountability Establishment and Comprehensive Ethics Reform Act of 2011, and
they have certified that they are not and will not be in violation of section 334a of the Board of
Ethics and Government Accountability Establishment and Comprehensive Ethics Reform Act of
2011.

(P) The status of the proposed contractor as a certified local, small, or disadvantaged business
enterprise as defined in the Small, Local, and Disadvantaged Business Enterprise
Development and Assistance Act of 2005, as amended; D.C. Official Code § 2-218.01 et seq.:

The proposed contractor is not a certified local, small, or disadvantaged business enterprise.

(Q) Other aspects of the proposed contract that the Chief Procurement Officer considers
significant:

None.

(R) A statement indicating whether the proposed contractor is currently debarred from providing
services or goods to the District or federal government, the dates of the debarment, and the
reasons for debarment:

The proposed contractor is not currently debarred from providing services or goods to the District
or federal government.

(S) Any determination and findings issues relating to the contract’s formation, including any
determination and findings made under D.C. Official Code § 2-352.05 (privatization
contracts):

Determination and Findings for Contractor Responsibility
Determination and Findings for Price Reasonableness
5

Determination and Findings for Use of a Cooperative Purchasing Agreement

(T) Where the contract, and any amendments or modifications, if executed, will be made
available online:

www.ocp.dc.gov

(U) Where the original solicitation, and any amendments or modifications, will be made available
online:

www.ocp.dc.gov

1101 4th Street, SW
Washington, DC 20024
Date of Notice: October 8, 2025 L0015033582Notice Number:
FEIN: **-***2990
Case ID: 18731966

Government of the District of Columbia
Office of the Chief Financial Officer
Office of Tax and Revenue
STANDARD INSURANCE COMPANY
1100 SW 6TH AVE
PORTLAND OR 97204-1020

Branch Chief, Collection and Enforcement Administration
Authorized By Melinda Jenkins
To validate this certificate, please visit MyTax.DC.gov. On the MyTax DC homepage, click the
“Validate a Certificate of Clean Hands” hyperlink under the Clean Hands section.
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
liability with the District of Columbia Office of Tax and Revenue or the Department of Employment
Services. As of the date above, the individual/entity has complied with DC Code § 47-2862, therefore
this Certificate of Clean Hands is issued.
TITLE 47. TAXATION, LICENSING, PERMITS, ASSESSMENTS, AND FEES
CHAPTER 28 GENERAL LICENSE
SUBCHAPTER II. CLEAN HANDS BEFORE RECEIVING A LICENSE OR PERMIT
D.C. CODE § 47-2862 (2006)
§ 47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov

COPY
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER

Glen Lee
Chief Financial Officer

John A. Wilson Building * 1350 Pennsylvania Avenue, N.W. * Suite 203 * Washington, D.C. 20004
Phone: (202) 727-2476 * Fax: (202) 727-1643 * www.cfo.dc.gov
MEMORANDUM

TO: Julius Wiggins
Supervisory Contract Specialist / Contracting Officer
Office of Contracting and Procurement

FROM: Glen Lee
Chief Financial Officer

DATE: October 22, 2025

SUBJECT: Certification of Available Funds for 2026 Standard Life Insurance Contract

The District’s share of premiums (33 percent of basic coverage) for the base year of the life insurance
contract (contract number CW124798) with the Standard Insurance Company (“Standard Life
Insurance Contract”) is estimated at $1,968,000, based on estimated enrollment data and premium
levels provided by the Office of Contracting and Procurement and the D.C. Department of Human
Resources. Under this contract, employees pay 100 percent of the premiums for additional optional
life insurance benefits, acciden tal death and dismemberment insurance, and long- and short -term
disability insurance. The base year of the contract is from January 1, 2026 through December 31, 2026.
This statement is to certify that the District’s estimated $1, 476,000 premium cost and the employees’
estimated $ 25,877,684 premium cost, for a total estimated premium cost of $ 27,353,684, will be
available to fund the Standard Life Insurance Contract from the beginning of the base year (January 1,
2026) through the end of FY 2026 (September 30, 2026). For the remaining period of the base year of
the Standard Life Insurance Contract, October 1, 2026 through December 31, 2026, the District will
seek budget authority through the FY 202 7 appropriation for its share of the premium cost in the
estimated amount of $492,000. The employees’ share of the premium cost from October 1, 202 6
through December 31, 2026 is estimated to be $ 8,625,895, for a total estimated premium cost of
$9,117,895. The total maximum amount of the contract for the base year of the Standard Life Insurance
Contract is estimated at $36,471,579. The approval of each option year beginning January 1 st and
ending December 31st is contingent upon the approval of that fiscal year’s appropriated budget. The
cost of life insurance benefit premiums is included in Account Group 701400C, Fringe Benefits, which
is part of each agency's budget, as appropriate. The employees’ cost will be deducted from their
paychecks.

Vendor Standard Insurance Company
Contract Number CW124798
Contract Option/Modification Base Year
Certified Amount
FY 2026 - From 1/1/2026 to 9/30/2026 and
FY 2027 - From 10/1/26 to 12/31/26 $ 36,471,579

Certification of Available Funding: Standard Life Insurance Contract
Page 2

If there are any questions regarding this matter, please feel free to contact Samuel Terry, Director,
Financial Planning and Analysis, Office of Budget and Planning, at 202-724-7477.
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER

Glen Lee
Chief Financial Officer

John A. Wilson Building * 1350 Pennsylvania Avenue, NW * Suite 203 * Washington, DC 20004
Phone: (202) 727-2476 * Fax: (202) 727-1643 * www.cfo.dc.gov
CERTIFICATION OF THE AVAILABILITY OF FUNDING
FOR THE STANDARD LIFE INSURANCE CONTRACT
FOR POST- SEPTEMBER 30, 1987 DISTRICT EMPLOYEES
FOR THE PERIOD JANUARY 1, 2026 THROUGH SEPTEMBER 30, 2026
And
FOR THE PERIOD OCTOBER 1, 2026 THROUGH DECEMBER 31, 2026

The District’s share of premiums (33 percent of basic coverage) for the base year of the life insurance
contract (contract number CW124798) with the Standard Insurance Company (“Standard Life
Insurance Contract”) is estimated at $1,968,000, based on estimated enrollment data and premium
levels provided by the Office of Contracting and Procurement and the D.C. Department of Human
Resources. Under this contract, employees pay 100 percent of the premiums for additional optional
life insurance benefits, accidental death and dismemberment insurance, and long- and short-term
disability insurance. The base year of the contract is from January 1, 2026 through December 31,
2026. This statement is to certify that the District’s estimated $1,476,000 premium cost and the
employees’ estimated $25,877,684 premium cost, for a total estimated premium cost of $27,353,684,
will be available to fund the Standard Life Insurance Contract from the beginning of the base year
(January 1, 2026) through the end of FY 2026 (September 30, 2026). For the remaining period of the
base year of the Standard Life Insurance Contract, October 1, 2026 through December 31, 2026, the
District will seek budget authority through the FY 2027 appropriation for its share of the premium
cost in the estimated amount of $492,000. The employees’ share of the premium cost from October
1, 2026 through December 31, 2026 is estimated to be $8,625,895, for a total estimated premium cost
of $9,117,895. The total maximum amount of the contract for the base year of the Standard Life
Insurance Contract is estimated at $36,471,579. The approval of each option year beginning January
1st and ending December 31st is contingent upon the approval of that fiscal year’s appropriated
budget. The cost of life insurance benefit premiums is included in Account Group 701400C, Fringe
Benefits, which is part of each agency's budget, as appropriate. The employees’ cost will be
deducted from their paychecks.

Please certify the availability of funding by signing below:

Glen Lee Date
Chief Financial Officer
October 22, 2025
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
Office of Budget and Planning

Eric M. Cannady
Deputy Chief Financial Officer

John A. Wilson Building * 1350 Pennsylvania Avenue, N.W.* Suite 229 * Washington, DC 20004
Phone: (202) 727-6234 * Fax: (202) 724-5222 * www.cfo.dc.gov

MEMORANDUM

TO: Glen Lee
Chief Financial Officer

FROM: Eric M. Cannady Eric M. Cannady
Deputy Chief Financial Officer
Office of Budget and Planning

DATE: October 22, 2025

SUBJECT: Certification of Availability of Funding: District of Columbia Employees Life
Insurance Contract for Post-1987 District Employees for the Period of
January 1 through December 31, 2026
______________________________________________________________________________
The D.C. Department of Human Resources (DCHR) and the Office of Contracting and
Procurement (OCP) have requested that the Chief Financial Officer certify that funds are available
to pay the contract renewal for life insurance benefits for District employees hired after September
30, 1987 (“post-1987 District employees”). Certific ation is requested fo r the period January 1,
2026 through December 31, 2026 for the group basic life insurance contract renewal.

The District’s share of premiums (33 percent of basic coverage) for the length of the base year of
the contract is estimated at $1,968,000. The employees are responsible for 67 percent of this basic
coverage and 100 percent of the other contract options.

Time Period (January 1 – September 30) District’s
Cost
Employees’
Cost
Total Cost of
Contract
FY 2026 – Basic Life
$1,445,374 $2,888,972 $4,334,346
FY 2026 – Other Options $30,626 $22,988,712 $23,019,338
Total $1,476,000 $25,877,684 $27,353,684
Certification of Availability of Funding: District of Columbia Employees Life Insurance Benefits for the Period of
January 1, 2026 through December 31, 2026
Page 2

Time Period (October 1 – December 31) District’s
Cost
Employees’
Cost
Total Cost of
Contract
FY 2027 - Basic Life $481,791 $962,991 $1,444,782
FY 2027 – Other Options $10,209 $7,662,904 $7,673,113
Total $492,000 $8,625,895 $9,117,895

Time Period (January 1 – December 31) District’s
Cost
Employees’
Cost
Total Cost of
Contract
Calendar Year 2026 - Basic Life 1,927,165 3,851,963 5,779,128
Calendar Year 2026 - Other Options 40,835 30,651,616 30,692,451
Total 1,968,000 34,503,579 36,471,579

Background
Under the current life insurance contract, the Dist rict pays 33 percent of the cost of employees’
basic life insurance pr emiums for post-1987 Dist rict employees. Cost estimates are based on
estimates provided by DCHR using current basic life insurance enrollment data. Under this
contract, employees pay 100 percent of the cost of additional optional life insurance benefits,
accidental death and dismemberment insurance, and long- and short-term disability insurance.

Analysis
The total proposed contract amount is estimated at $36,471,579, including the employees’ share,
subject to actual enrollment. The District’s cost will decrease compared to FY 2025 based on the
proposed premium rates and this year’s proposed enrollment provided by DCHR. The District’s
FY 2026 cost for this proposed contract is $1,476,000, a decreas e of $215,229, or 12.7 percent,
from the same period last year. The District’s FY 2027 cost for this proposed contract is $492,000,
a decrease of $71,743, or 12.7 percent, from the same period last year.

Recommendation
I recommend that you cert ify that funds for the District’s co sts are available for the January 1,
2026 through September 30, 2026 period of this cont ract within the District’s FY 2026 budget,
based on OBP analysis of data provided by DCHR and recent payroll data. For the remaining
October 1, 2026 through December 31, 2026 period of the base year of the contract, the District
will seek budget authority in the FY 2027 appropriation. The cost of life insurance benefit
premiums is included in Account Group 701400C, Fringe Benefits , which is part of each agency's
budget, as appropriate. The employees’ portion of all costs will be deducted from their paychecks.

Certification of Availability of Funding: District of Columbia Employees Life Insurance Benefits for the Period of
January 1, 2026 through December 31, 2026
Page 3

If you have any questions, please do not hesitate to contact me.

cc: Angell Jacobs, Deputy Chief Financial Offi cer and Chief of Staff, Office of the Chief
Financial Officer
Charles Hall, Jr., Director, D.C. Department of Human Resources
Paul Shaw, Plan Administrator, Associate Director, Benefits and Retirement Administration,
D.C. Department of Human Resources
Wendy Rooker, Manager, Plan Administration, D.C. Department of Human Resources
Leslie Canales, Contract Compliance Monitor, D.C. Department of Human Resources
Julius Wiggins, Contracting Officer/Supervisory Contract Specialist, Office of Contracting
and Procurement
Matthew Thompson, Contract Specialist, Office of Contracting and Procurement
Samuel Terry, Director, Financial Planning and Analysis, Office of Budget and Planning

400 6th Street NW, Suite 9100, Washington, DC 20001 (202) 727-3400

GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Attorney General

ATTORNEY GENERAL
BRIAN L. SCHWALB

Commercial Division

MEMORANDUM

TO: Tomás Talamante
Director
Office of Policy and Legislative Affairs

FROM: Robert Schildkraut
Section Chief
Government Contracts Section

DATE: November 14, 2025

SUBJECT: Approval of Contract for Underwriting and Administering the District’s Life
and Disability Insurance Benefit Program
Contractor: Standard Insurance Company
Contract Number: CW124798
Contract Amount: NTE $36,471,579.00

This is to Certify that this Office has reviewed the above- referenced Contract and that we have
found it to be legally sufficient.

If you have any questions in this regard, please do not hesitate to call me at (202) 724-4018.

______________________________
Robert Schildkraut

GOVERNMENT OF THE DISTRICT OF COLUMBIA
TASK ORDER/DELIVERY ORDER FOR SERVICES
OFFEROR TO COMPLETE BLOCKS 18 & 29
1. Requisition
Number

1a. PAGE

1 of 62
2. Agreement No.

CW124798
3. Award/Effective Date

Block 30C
4. Contract No.
Fairfax County, VA,
Contract No. 4400009393
5. Solicitation No.

N/A
6.Solicitation Issue Date

N/A
7. FOR SOLICITATION INFORMATION
CONTACT: Email:
Matthew.Thompson@dc.gov
A. Name:

Matthew Thompson, Contract Specialist
Phone:

202-961-6468
8.Offer Due Date:

N/A
9. ISSUED BY

The Government of the District of Columbia
Office of Contracting and Procurement
441 4th Street NW, Suite 330 South
Washington, DC 20001
10. THIS ACQUISITION IS
UNRESTRICTED
SET ASIDE %FOR
SMALL BUSINESS
SMALL DISADV. BUS.
GSA
COOPERATIVE
PURCHASING AGREEMENT :
11. DELIVERY FOR FOB
DESTINATION UNLESS
BLOCK IS MARKED
SEE SCHEDULE
12. PAYMENT DISCOUNT
TERMS

Net 30 days
13. RESERVED
14. METHOD OF SOLICITATION
RFTOP IFB RFP 2-STEP
15. CONTRACTOR / OFFEROR

Standard Insurance Company
1100 SW 6th Ave
Portland, OR 97204
16. PAYMENT WILL BE MADE BY CODE

D.C. Department of Human Resources
1015 Half Street SE
8th Floor
Washington, DC 20003
15A DUNS NO.: 83-224-9960 15B TAX ID NO.: 93-0242990
17. DELIVER TO

D.C. Department of Human Resources
1015 Half Street SE
9th Floor
Washington, DC 20003
18. ADMINISTERED BY

D.C. Department of Human Resources
1015 Half Street SE
9th Floor
Washington, DC 20003
18A. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18B. SUBMIT INVOICES TO ADDRESS SHOWN IN
BLOCK 16 UNLESS BLOCK BELOW IS CHECKED
19. ITEM NO. 20. SCHEDULE OF SUPPLIES/SERVICES 24 AMOUNT
CLINs See Attachment B – Price/Rate Schedule
25. ACCOUNTING AND APPROPRIATION DATA
ENCUMBRANCE CODE:
26. TOTAL AWARD (FOR GOVT. USE ONLY)

Not-to-Exceed (NTE) $36,471,579.00
27. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ONE COPY
TO THE ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL
ITEMS SET FORTH OR OTHERWIS E IDENTIFIED ABOVE AND ON ANY ADDITI ONAL
PAGES SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. THIS ORDER
IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE CONTRAC T
IDENTIFIED IN BLOCK 4.
28. AWARD OF CONTRACT: REFERENCE YOUR OFFER DATED 8/6/02 & 10
YOUR OFFER ON SOLICITATION (BLOCK 5) INCLUDING ANY ADDITIONS OR
CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS: 1 THRU
3. THIS ORDER IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF T HE
CONTRACT IDENTIFIED IN BLOCK 4.
29A . STANDARD INSURANCE COMPANY (SIGNATURE OF OFFEROR/CONTRACTOR )

30A . DISTRICT OF COLUMBIA (SIGNATURE OF CONTRACTING OFFICER)
29B. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

29C. DATE SIGNED

30B. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

Julius Wiggins
30C DATE SIGNED

CW124798 D.C. Employees Life & Disability Insurance Program

2
1. SERVICES REQUIRED
The District of Columbia Office of Contracting and Procurement, on behalf of the District of
Columbia’s Department of Human Resource (DCHR and/or the District) , is awarding Standard
Insurance Company, l ocated at 1100 SW 6th Ave., Portland, OR 97204 (Contractor), a contract to
underwrite and administer the District’s life and disability insurance benefits program.
2. CONTRACT TYPE
This is a requirements contract based on fixed-unit prices/premium rates per enrollee with a not-
to-exceed (NTE) amount of $36,471,579.00 for the base period . The premium rates for option
periods two and three will be subject to annual prospective redetermination, in accordance with 27
DCMR Chapter 24.
The District will purchase its requirements of the articles or services included herein from the
Contractor. The estimated quantities stated herein reflect the best estimates available. The estimate
shall not be construed as a representation that the estim ated quantity will be required or ordered,
or that conditions affecting requirements will be stable. The estimated quantities shall not be
construed to limit the quantities which may be ordered from the Contractor by the District or to
relieve the Contract or of its obligation to fill all such orders.
Delivery or performance shall be made only as authorized in accordance with the Ordering Clause,
Section 1 0. The District may issue orders requiring delivery to multiple destinations or
performance at multiple locations. If the District urgently requires delivery before the earliest date
that delivery may be specified under this contract, and if the Contractor shall not accept an order
providing for the accelerated delivery, the District may acquire the urgently required goods or
services from another sourc e.
There is no limit on the number of orders that may be issued. The District may issue orders
requiring delivery to multiple destinations or performance at multiple locations.
Any order issued during the effective period of this contract and not completed within that period
shall be completed by the Contractor within the time specified in the order. The contract shall
govern the Contractor's and District's rights and obligations with respect to that order to the same
extent as if the order were completed during the contract's effective period; provided that the
Contractor shall not be required to make any deliveries under this contract after December 31,
2029 .
The premium rates are as set forth in the price schedule (Attachment B) . The premium rates for
option periods two and three may be reviewed and adjusted, increase or decrease, reflecting
changes in District enrollment numbers and the Contractor’s claims experience with the District.
The Contractor shall propose adjusted prices no later than July 1 prior to the first day of an option
period. The proposed adjustment shall be sent in writing to the Contracting Officer. The District
may conduct an actuarial analysis of the proposed adjustment, and the proposed prices may be
subject to negotiation between the District and the Contractor. After approval of the adjusted
prices, the Contracting Officer will issue a contract modification to exercise the subsequent option
period and to incorporate the adjusted prices for that option period. Any adjusted prices determined
in the annual prospective price redetermination process will be effective as of the first day of the
plan year to which the adjusted premium rates apply.
CW124798 D.C. Employees Life & Disability Insurance Program

3
In the event that the District, pursuant to the Changes Clause of the Standard Contract Provisions,
adds, deletes, or changes any services to be covered by the Contractor in the option period, the
District will review the effect of the change with the Contractor and may equitably adjust the
premium rates following completion of an actuarial review.
3. TERM OF CONTRACT
The period of performance is from the date of award through one year .
4. OPTION TO EXTEND THE TERM
The District may extend the term of this agreement for a period of three (3) one-year option
periods, or successive fractions thereof, by written notice to the Contractor before the expiration
of the task order; provided that the District will give the Contractor preliminary written notice of
its intent to extend at least thirty (30) days before the agreement expires. The preliminary notice
does not commit the District to an extension. The exercise of this option is contingent on the
exercise of each option period in the Master Agreement and is subject to the availability of funds
at the time of the exercise of this option. The Contractor may waive the thirty (30) day preliminary
notice requirement by providing a written waiver to the Contracting Officer prior to expiration of
the task order.
If the District exercises this option, the extended agreement shall be considered to include this
option provision.
The price for the option period(s) shall be as specified in Attachment B. The price for option
periods two and three shall be subject to redetermination per the process described in Section 2,
Contract Type.
The total duration of this task order, including the exercise of any options under this clause, shall
not exceed four (4) years.
5. CONTRACTING OFFICER (CO)
Contracts may be entered into and signed on behalf of the District Government only by Contracting
Officers. The name, address and telephone number of the Contracting Officer for this Agreement
is:
Julius Wiggins
District of Columbia O ffice of Contracting and Procurement
1015 Half Street SE, 8 th Floor
Washington, DC 20003
Desk: 202-741-8781
Cell: 202-497-6441
Email: Julius.Wiggins@dc.gov
6. CONTRACT ADMINISTRATOR (CA)
The CA is responsible for the t echnical administration of the agreement and advising the
contracting officer as to the contractor’s compliance or noncompli ance with the contract . In
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addition, the CA is responsible for the day-to -day monitoring and supervision of the contract , of
ensuring that the work confor ms to the requirements of this agreement and such other
responsibilities and authorities as may be specified in writing by the contracting officer . The CA
for this contract is:
Maria Prescott
Supervisory HR Specialist
District of Columbia Department of Human Resources
Benefits and Retirement Administration
1015 Half Street, SE, 9 th Floor
Washington, DC 20003
Main: 202-442-7627
Desk: 202-442-9 729
Email: Maria.Prescott@dc.gov
It is und erstood and agreed that the CA shall not have the authority to make changes in the
specifications/scope of work or terms and conditions of the contract .
The contractor shall be held fully responsible for any changes not authorized in advance, in writing ,
by the contracting officer, may be denied compensation or other relief for any additional work
performed that is not so authorized, and may also be required, at no additional cost to the District,
to take all corrective action necessitated by reason of the unauthorized changes.
7. RIGHTS IN DATA
A. Definitions
1. “Products” - A deliverable under any contract that may include commodities, services and/or
technology furnished by or through Contractor, including existing and custom Products, such as,
but not limited to: a) recorded information, regardless of form or t he media on which it may be
recorded; b) document research; c) experimental, developmental, or engineering work; d) licensed
software; e) components of the hardware environment; f) printed materials (including but not
limited to training manuals, system an d user documentation, reports, drawings); g) third party
software; h) modifications, customizations, custom programs, program listings, programming
tools, data, modules, components; and i) any intellectual property embodied therein, whether in
tangible or intangible form, including but not limited to utilities, interfaces, templates, subroutines,
algorithms, formulas, source code, and object code.
2. “Existing Products” - Tangible Products and intangible licensed Products that exist prior to the
commencement of work under the contract. Existing Products must be identified on the Product
prior to commencement of work or else will be presumed to be Custom Products.
3. “Custom Products” - Products, preliminary, final or otherwise, which are created or developed
by Contractor, its subcontractors, partners, employees, resellers or agents for the District under the
contract.
4. “District” – The District of Columbia and its agencies.
B. Title to Project Deliverables
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The Contractor acknowledges that it is commissioned by the District to perform services detailed
in the contract. The District shall have ownership and rights for the duration set forth in the contract
to use, copy, modify, distribute, or adapt Products as follows:
1. Existing Products : Title to all Existing Licensed Product(s), whether or not embedded in,
delivered or operating in conjunction with hardware or Custom Products, shall: (1) remain with
Contractor or third party proprietary owner, who retains all rights, title and interest (including
patent, trademark or copyrights). Effective upon payment, the District is granted an irrevocable,
non-exclusive, worldwide, paid-up license to use, execute, reproduce, display, perform, adapt
(unless Contractor advises the District as part of Contractor’s proposal that adaptation will violate
existing agreements or statutes and Contractor demonstrates such to the District’s satisfaction) and
distribute Existing Product to District users up to the license capacity stated in the contract with
all license rights necessary to fully effect the general business purpose(s) of the project or work
plan or contract; and (2) be licensed in the name of the District. The District agrees to reproduce
the copyright notice and any other legend of ownership on any copies authorized under this
paragraph.
2. Custom Products : Effective upon Product creation, Contractor hereby conveys, assigns, and
transfers to the District the sole and exclusive rights, title and interest in Custom Product(s),
whether preliminary, final or otherwise, including all patent, trademark and copyrights. Contractor
hereby agrees to take all necessary and appro priate steps to ensure that the Custom Products are
protected against unauthorized copying, reproduction and marketing by or through Contractor.
C. Transfers or Assignments of Existing or Custom Products by the District
The District may transfer or assign Existing or Custom Products and the licenses thereunder to
another District agency. Nothing herein shall preclude the Contractor from otherwise using the
related or underlying general knowledge, skills, ideas, concepts, techniques and experience
developed under a project or work plan in the course of Contractor’s business.
D. Subcontractor Rights
Whenever any data, including computer software, are to be obtained from a subcontractor under
the contract, the Contractor shall use this clause, Rights in Data , in the subcontract, without
alteration, and no other clause shall be used to enlarge or diminish the District’s or the Contractor’s
rights in that subcontractor data or computer software which is required for the District.
E. Source Code Escrow
1. For all computer software furnished to the District with the rights specified in section B.2, the
Contractor shall furnish to the District, a copy of the source code with such rights of the scope as
specified in section B.2 of this clause. For all computer software furnished to the District with the
restricted rights specified in section B.1 of this clause, the District, if the Contractor either directly
or through a successor or affiliate shall cease to provide the maintenance or warranty services
provided the District under the contract or any paid-up maintenance agreement, or if the Contractor
should be declared insolvent by a court of competent jurisdiction, shall have the right to obtain,
for its own and sole use only, a single copy of the current version of the source code supplied under
the contract, and a single copy of the documentation associated therewith, upon payment to the
person in control of the source code the reasonable cost of making each copy.
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2. If the Contractor or Product manufacturer/developer of software furnished to the District with
the rights specified in section B.1 of this clause offers the source code or source code escrow to
any other commercial customers, the Contractor shall either: (1) provide the District with the
source code for the Product; (2) place the source code in a third party escrow arrangement with a
designated escrow agent who shall be named and identified to the District, and who shall be
directed to release the deposi ted source code in accordance with a standard escrow arrangement
acceptable to the District; or (3) will certify to the District that the Product manufacturer/ developer
has named the District as a named beneficiary of an established escrow arrangement wit h its
designated escrow agent who shall be named and identified to the District, and who shall be
directed to release the deposited source code in accordance with the terms of escrow.
3. The Contractor shall update the source code, as well as any corrections or enhancements to the
source code, for each new release of the Product in the same manner as provided above, and certify
such updating of escrow to the District in writing.
F. Indemnification and Limitation of Liability
The Contractor shall indemnify and save and hold harmless the District, its officers, agents and
employees acting within the scope of their official duties against any liability, including costs and
expenses, (i) for violation of proprietary rights, copyrights, or rights of privacy, arising out of the
publication, translation, reproduction, delivery, performance, use or disposition of any data
furnished under this contract, or (ii) based upon any data furnished under this contract, or based
upon libelous or other unlawful matter contained in such data.
8. INSURANCE
A. GENERAL REQUIREMENTS. The Contractor at its sole expense shall procure and maintain,
during the entire period of performance under this contract, the types of insurance specified below.
The Contractor shall submit a Certificate of Insurance to the Contracting Officer (CO) giving
evidence of the required coverage prior to commencing performance under this contract . In no
event shall any work be performed until the required Certificates of Insurance signed by an
authorized representative of the insurer(s) have been provided to, and accepted by, the CO.
If the Contractor and/or its subcontractors maintain broader coverage and/or higher limits than the
minimums shown below, the District requires and shall be entitled to the broader coverage and/or
the higher limits maintained by the Contractor and subcontr actors.
B. INSURANCE REQUIREMENTS
1. Commercial General Liability Insurance (“CGL”) - The Contractor shall provide evidence
satisfactory to the CO with respect to the services performed that it carries a CGL policy,
written on an occurrence (not claims -made) basis, on Insurance Services Office, Inc. (“ISO”)
form CG 00 01 04 13 (or another occurrence -based form with coverage at least as broad and
approved by the CO in writing), covering liability for all ongoing and completed operations of
the Contractor and under all subcontracts, covering claims for bodily injury, including without
limitation sickness, disease or death and mental anguish of any persons, broad form property
damage, including loss of use resulting therefrom, personal and advertising injury, and
including coverage for liability a rising out of an Insured Contract (including the tort liability
of another assumed in a contract) and acts of terrorism (whether caused by a foreign or
domestic source). Such coverage shall have limits of liability of not less than $1,000,000 for
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each occurrence, $2,000,000 general aggregate, $2,000,000 products and completed operations
aggregate, and $1,000,000 personal and advertising injury aggregate limit.
The Commercial General Liability shall be further endorsed to:
a) To the fullest extent permitted by law, provide additional insured coverage using ISO form
CG 2010 0413 and CG2037 04 13 (or its equivalent) to The Government of the District of
Columbia
b) Coverage available to the additional insureds shall apply on a primary and non-contributing
basis as respects any other insurance, deductibles, or self -insurance available to the
additional insureds
c) A waiver of subrogation in favor of The Government of the District of Columbia
d) Any Annual Aggregate shall apply on a per location or per project basis
e) Defense costs shall be in addition to and not erode the limits of liability
2. Automobile Liability Insurance - The Contractor shall provide evidence satisfactory to the CO
of commercial (business) automobile liability insurance written on ISO form CA 00 01 10 13
(or another form with coverage at least as broad and approved by the CO in writing) including
coverage for all owned, hired, borrowed and non-owned vehicles and equipment used by the
Contractor in connection with work under this agreement, with a minimum combined sing le
limit of $1,000,000. Such policy or policies of automob ile liability insurance shall be written
on an "occurrence" (as opposed to a "claims made") basis .
The Commercial Auto Liability policy shall be further endorsed to:
a) To the fullest extent permitted by law, provide additional insured coverage to The
Government of the District of Columbia
b) Coverage available to the additional insureds shall apply on a primary and non-contributing
basis as respects any other insurance, deductibles, or self -insurance available to the
additional insureds
c) A waiver of subrogation in favor of The Government of the District of Columbia
d) Defense costs shall be in addition to and not erode the limits of liability
e) If applicable, include Form CA 99 48 03 06 Pollution Liability - Broadened Coverage for
Covered Autos - Business Auto, Motor Carrier, and Truckers (or its equivalent)
f) Moving and Storage Companies shall be required to provide evidence of BMC91 or
BMC91X filing
For Contractors providing transportation:
Contractors providing transportation must additionally comply with the following:
a) Operators holding a restricted WMATC Certificate of Authority must have a single limit
of $1.5 million in combined (bodily injury and physical damage) coverage, or
b) Operators holding an unrestricted WMATC Certificate of Authority must have a single
limit of $5M in combined (bodily injury and physical damage) coverage.
In addition, both types of WMATC certificate holders must have in place the following
Licensing Requirements as applicable:
a) Commercial Driver’s License (CDL) with the following endorsements:
i) P (Passenger): All drivers MUST have a P endorsement enabling them to transport
passengers (16 or more).
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ii) S (School Bus): All drivers operating school buses (flashing lights, swing arm w/stop
sign) must also have an S endorsement. Please note that driver credentials for any vehicles
that are converted school buses must have S.
b) Valid (unexpired) US Department of Transportation Medical Examiner Certification
(“Medical Card”).
For Contractors using District Government -Owned Vehicles :
Agencies that provide Contractors with District Government -owned or leased motor vehicles
are responsible for ensuring that such vehicles are used only for the performance under this
Contract. Contractor and its subcontractors are prohibited from using such vehicles for home-
to-work transportation unless specifically provided for under the terms of the contract and
approved in writing by the Contracting Officer, or otherwise provided by law. Contractor shall
obtain automobile liability insurance with a minimum combined single limit of $1,000,000 to
cover bodily injury and property damage to protect the Contractor and the District Government
against third-party claims arising from the use of District Government -owned vehicles. The
Commercial Auto Liability Policy shall be endorsed to include:
a) To the fullest extent permitted by law, provide additional insured coverage to The
Government of the District of Columbia;
b) Coverage available to the additional insureds shall apply on a primary and non-contributing
basis as respects any other insurance, deductibles, or self -insurance available to the
additional insureds; and
c) A waiver of subrogation in favor of The Government of the District of Columbia.
In the event of loss, destruction, or damage to any government -owned vehicles used in the
performance of contact, Contractor shall be liable for full cost of repair or replacement of lost,
destroyed, or damaged vehicle.
3. Workers’ Compensation Insurance - The Contractor shall provide evidence satisfactory to the
CO of Workers’ Compensation insurance in accordance with the statutory mandates of the
District of Columbia or the jurisdiction in which the contract is performed.
Employer’s Liability Insurance - The Contractor shall provide evidence satisfactory to the CO
of employer’s liability insurance as follows: $500,000 per accident for injury; $500,000 per
employee for disease; and $500,000 for policy disease limit.
The Workers Compensation and Employers Liability shall be further endorsed to:
a) Include a Waiver of Subrogation in favor of The Government of the District of Columbia.
b) Where applicable, include United States Longshore and Harbor Workers Compensation
Act (USL&H)
c) Where applicable, include Jones Act Coverage for seamen or crew members on an “if any”
basis.
4. Network Security/Privacy (Cyber) Liability Insurance covering acts, errors, omissions, and
violation of any consumer protection laws arising out of Contractor’s operations or services
with a limit of $5,000,000 per claim and in the aggregate. Such coverage shall include but not
be limited to, third party an d first party coverage for loss or disclosure of any data, including
personally identifiable information and payment card information, network security failure,
violation of any consumer protection laws, unauthorized access and/or use or other intrusions,
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infringement of any intellectual property rights (except patent), negligence or breach of duty
to use reasonable care, breach of any duty of confidentiality, invasion of privacy, or violations
of any other legal protections for personal information, defamation, libel, slander, commercial
disparagement, negligent transmission of computer virus, or use of computer networks in
connection with denial of service attacks. Such coverage shall include regulatory defense and
fines/penalties in any jurisdiction anywhere in the world. Such coverage shall include
contractual privacy coverage for data breach response and crisis management costs that would
be incurred by Contractor on behalf of The Government of the District of Columbia in the
event of a data breach inclu ding legal and forensic expenses, notification costs, credit
monitoring costs, and costs to operate a call center. Contractor shall maintain coverage in force
during the term of this Agreement and for an extended reporting period of not less than two
(2) years after.
5. Professional Liability Insurance (Errors & Omissions) - The Contractor shall provide
Professional Liability Insurance (Errors and Omissions) to cover liability resulting from any
error or omission in the performance of professional services under this Contract. The policy
shall provide limits of $1,000,000 per claim or per occurrence for each wrongful act and
$2,000,000 annual aggregate. The Contractor warrants that any applicable retroactive date
precedes the date the Contractor first performed any profess ional services for the Government
of the District of Columbia and that continuous coverage will be maintained or an extended
reporting period will be exercised for a period of at least ten years after the completion of the
professional services. Limits may not be shared with other lines of coverage.
6. Commercial Umbrella or Excess Liability - The Contractor shall provide evidence satisfactory
to the CO of commercial umbrella with minimum limits of $10,000,000 per occurrence and
$10,000,000 in the annual aggregate. Coverage must excess of required commercial general
liability, commercial auto liability, and employers’ liability. The insurance required under this
paragraph shall be written in a form that annually reinstates all required limits. Coverage shall
be primary to any insurance, self -insurance or reinsurance maintained by The Government of
the District of Columbia and the “other insurance” provision must be amended in accordance
with this requirement and principles of vertical exhaustion.
C. SUBCONTRACTOR INSURANCE REQUIREMENTS. Any and all subcontractors engag ed by
Contractor for work under this agreement shall be required to have the same insured required of
Contractor. Should the Contractor wish to propose different insurance requirements for the
subcontractor than the ones outlined in the Contract, then, prior to commencement of work by the
subcontractor, the Contractor shall submit in writing the name and brief descrip tion of work to be
performed by the subcontractor to the CO. The CO will promptly provide in writing to the
Contractor with a decision regarding the insurance requirements applicable to the subcontractor.
When requested by the CO, the Contractor must provide proof of the subcontractor's required
insurance prior to commencement of work by the subcontractor.
D. PRIMARY AND NONCONTRIBUTORY INSURANCE. The insurance required herein shall be
primary to and will not seek contribution from any other insurance, reinsurance or self -insurance
including any deductible or retention, maintained by the Government of the District of Columbia.
E. DURATION. The Contractor shall carry all required insurance until all contract work is accepted
by The Government of the District of Columbia and shall carry listed coverages for ten years for
construction projects following final acceptance of the work performed under this contract and
two years for non-construction related contracts.
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F. LIABILITY. These are the required minimum insurance requirements established by The
Government of the District of Columbia. However, it is understood that The Government of the
District of Columbia does not in any way represent that the insurance or the limits of ins urance
specified herein are sufficient or adequate to protect your interests or liabilities and will not in any
way limit the contractor’s liability under this contract.
G. CONTRACTOR’S PROPERTY. Contractor and subcontractors are solely responsible for any loss
or damage to their personal property, including but not limited to tools and equipment, scaffolding ,
and temporary structures, rented machinery, or owned and leased equipment . A waiver of
subrogation shall apply in favor of The Government of the District of Columbia.
H. MEASURE OF PAYMENT. The Government of the District of Columbia shall not make any
separate measure or payment for the cost of insurance and bonds . The Contractor shall include all
the costs of insurance and bonds in the contract price.
I. NOTIFICATION. The Contractor shall ensure that all policies provide that the CO shall be given
thirty (30) days prior written notice in the event of cancellation, non-renewal, or material chang es
to the extent such cancellation or material changes results in Contractor no long complying with
the above requirements. The Contractor shall provide the CO with ten (10) days’ prior written
notice in the event of non-payment of premium. The Contractor will also provide the CO with an
updated Certificate of Insuran ce should its insurance coverages renew during the contract. The
Government of the District of Columbia may reasonably change the above insurance coverag e
requirements during the Term by giving Contractor at least 30 days’ notice of the chang e.
Contractor must comply, at your expense, and deliver to the CO evidence of compliance before
the change becomes eff ective.
J. CERTIFICATES OF INSURANCE . The Contractor must send to CO, at least 10 days after
execution of this Agreement, certificates of insurance evidencing the required insurance coverag e
and endorsements required herein. Contractor must also provide us with evidence of renewal
before the expiration date of each insurance policy. Contractor is responsible for providing us with
30 days advanced written notice if the certificate of insurance by the insurer has been canceled,
reduced in coverage, or otherwise altered . Certificates of insurance must reference the
corresponding contract number . Evidence of insurance shall be submitted to:
The Government of the District of Columbia

And mailed to the attention of:

Julius Wiggins
D.C. Office of Contracting and Procurement
1015 Half Street SE, 8th Floor
Washington, DC 20003
Desk: 202-741-8781
Cell: 202 -497-6441
Email: Julius.Wiggins@dc.gov
The CO may request, and the Contractor shall promptly deliver , updated certificates of insurance,
endorsements indicating the required coverages, and/or certified copies of the insurance policies .
If the insurance initially obtained by the Contractor expires prior to completion of the contract,
renewal certificates of insurance and additional insured and other endorsements shall be furnished
to the CO prior to the date of expiration of all such init ial insurance. For all coverage required to
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be maintained after completion, an additional certificate of insurance evidencing such coverag e
shall be submitted to the CO on an annual basis as the coverage is renewed (or replaced) .
K. DISCLOSURE OF INFORMATION. The Contractor agrees that The Government of the District
of Columbia may disclose the name and contact information of its insurers to any third party which
presents a claim against The Government of the District of Columbia for any damages or claims
resulting from or arising out of work performed by the Contractor, its agents, employees, servants
or subcontractors in the performance of this contract.
L. CARRIER RATINGS. All Contractor’s and its subcontractors’ insurance required in connection
with this contract shall be written by insurance companies with an A.M. Best Insurance Guide
rating of at least A- VII or better (or the equivalent by any other rating agency) and licensed in the
District of Columbia.
M. WARRANTIES. When applicable, the Contractor should be named as an additional insured on
the applicable manufacturer’s/distributer’s Commercial General Liability policy using Insurance
Services Office, Inc. (“ISO”) form CG 20 15 04 13 (or another occurrence -based form with
coverage at least as broad) . CO should collect, review for accuracy, and maintain all warranties
for goods and services.
9. PAYMENT OF PREMIUMS
PLAN 1 - ACTIVE EMPLOYEES
The District will collect premium payments from employee withholdings for government agencies
and forward them to the Contractor. The payments are based upon employee withholdings and
District contributions for Plan 1. The District's contribution for its s hare and the employee's share
of the premium are based on various group pay schedules for employees .
The District will remit payment to the Contractor within fifteen (15) days following the close of a
pay cycle. The Contractor shall accept the District's payroll records and remittance based on those
enrollments as full payments for the period for which the payment was collected. This arrangement
applies to agencies under the authority of the Mayor and other District government agencies .
The District will make payroll deductions based upon the price schedule and the employee’s
employment status, age, salary, and other circumstances, as applicable.
Some independent agencies are permitted by law to participate in the D.C. Employees Group Life
Insurance (DCEGLI) Program. Agencies that are independent and have their own payroll system
will transmit premium payments and payroll records, on behalf of their own agencies, separately
from the District government. As of August 2025, independent agencies remitting payment
separately are the D.C. Housing Authority (905 employees) and the D.C. Retirement Board (retired
police, firefighters, and teachers).
The District will make payments of premiums for District government employees to the Contractor
by check, el ectronic funds transfer (EFT), or a combination of both, and independent agencies will
establish independent payment arrangements with the Contractor for their employees .
PLAN 1 - RETIREES
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The District will maintain enrollment information for each retiree, which will include name, social
security number, date of birth, life insurance amount, beneficiary information (when available) ,
and the mailing address. If required by the District, the Contractor shall send bills directly to
retirees to collect their share of premiums due and bill the District for its share of the retirees’
premiums. Currently , the District collects premiums from retirees via invoice.
SHORT AND LONG TERM DISABILITY INSURANCE PREMIUM (PLANS 2 & 3)
Premiums are paid 100% by employees. The District will make payments to the Contractor from
employee withholdings by check, EFT , or a combination of both.
10. ORDERING CLAUSE
Any supplies and services to be furnished under this contract must be ordered by issuance of
delivery, task or purchase orders by the CO. Such orders may be issued during the term of this
contract.
All delivery, task, or purchase orders are subject to the terms and conditions of this contract. In the
event of a conflict between a delivery, task or purchase orders and this contract, the contract shall
control.
If mailed, a delivery, task or purchase order is considered "issued" when the District deposits the
order in the mail. Orders may be issued by facsimile or by electronic commerce methods.
11. ESTIMATED QUANTITIES
It is the intent of the District to secure a contract for all of the needs of the designated agencies for
items specified herein which may occur during the contract term. The District agrees that it will
purchase its requirements of the articles or services included herein from the Contractor. Articles
or services specified herein have a history of repetitive use in the District agencies. The estimated
quantities stated in the agreement reflect the best estimates available. They shall not be construed
to limit the quantities which may be ordered from the Contractor by the District or to relieve the
Contractor of his obligation to fill all such orders. Orders will be placed from time to time if and
when needs arise for delivery, all charges prepaid, to the or dering agency. The District does not
guarantee to order any specific quantities of any item(s) or work hours of service.
12. LICENSES & PERMITS
The Contractor shall, without additional expense to the District, be responsible for obtaining all
licenses and permits which are necessary to fulfill the requirements of the Specifications/Work
Statement (Attachment A) , including the appropriate license or certificate from the D .C.
Department of Insurance, Securities, and Banking.
13. DATA PROTECTION
Contractor shall keep confidential, restrict, safeguard, maintain, and dispose of all Personally
Identifiable Information (PII) , including, without limitation, individual health information, about
individuals related to services provided under this Agreement, in accordance with all relevant
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federal and District privacy, security, and confidentiality statutes, regulations, and publications
and agrees not to use or disclose such PII other than as permitted by this Agreement or as Required
by Law. Contractor agrees to use appropriate technical, physical, and administrative safeguards to
protect PII and to prevent use or disclosure, other than as provided in this Agreement, and further
agrees to the following:
1. Contractor shall name a Privacy and/or Security Officer who is accountable for overseeing the
protection of PII and implementing policies and procedures for the physical, administrative, and
technical safeguards, including training and sanctions, to enforce protection of PII as indicated in
this Agreement and applicable law within Contractor’s business.
2. The Contractor may use and disclose PII for the proper management and administration of its
business, provided that the disclosures are Required By Law or that the Contractor obtains
reasonable assurances from the person or entity to whom the information is disclosed that it will
remain confidential, private , and secure, used for the purpose for which it was disclosed, and that
the person or entity must notify the Contractor of any instances where it has knowledge that the
confidentiality, privacy or securi ty of the information has been impacted.
3. Contractor agrees that its employees and other workforce members, agents , and Subcontractors
who fail to protect PII under this Agreement or other applicable federal or District privacy law will
be subject to discipline in accordance with Contractor’s policies and applicable collective
bargaining agreements.
4. Contractor may use District data for artificial intelligence (AI) technology and AI -related
technology solely for only the proper management and administration of its internal business to
effect the best outcomes for the District and its employees, and such usage shall be subject to the
data retention provisions in paragraphs 6 and 7 below. “District data” includes, without limitation,
PII and all other information about individuals covered under Contractor’s insurance plans or
related to services provided under this Contract. Notwithstanding the foregoing, District data shall
not include any of Contractor’s non-anonymized proprietary records created in the ordinary course
of its business, including, but not limited to sales, contract, claim and underwriting files. Contractor
shall maintain a comprehensive description and summary of all categories of AI-related uses, in
such detail as the District shall require from time to time in its sole and absolute discretion, and in
accordance with all applicable insurance, AI regulations , and laws . Contractor shall provide
advance written notice, in such detail as the District shall re quire from to time in its sole and
absolute discretion, before any material expansion or change of AI -related use that impacts
services provided to the District and use of District data and derivatives in accordance with all
applicable insurance , AI regulations, and laws. The District reserves the right to deny any use of
District data and derivatives (including, without limitation, PII) which, in the District’s sole and
absolute discretion, may compromise the best interests of the District government or its employees.
The District will not unreasonably deny such use of District data and derivatives but will be guided
by relevant laws, policies, and best practices when making its determination. Contractor shall
implement industry standard data security measures to prevent unauthorized access, copying, or
usage for AI -related purposes. Contractor shall not anonymize, pseudonymize, aggregate, or
otherwise manipulate District data for the purpose of circumventing the restrictions set forth in
this Agreement.
5. Contractor shall report to the District government, including the District-wide Privacy and Security
Official, within the Office of the Attorney General, any unauthorized use, disclosure, or condition
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constituting a threat to PII within ten (10) calendar days from the time Contractor becomes aware.
However, if the Contractor is an agent of the District (i.e., performing delegated essential
governmental functions), the Contractor must report the incident or condition, including non -
permitted use or disclosure, successful or anomalous Security Incident or Breach of Unsecured PII
immediately. Reports shall be made both in writing and by telephone to confirm prompt receipt.
The Parties acknowledge and agree that this Section constitutes notice by Contractor to the District
of the ongoing occurrence of events that may constitute Security Incidents but that are routine
(such as typical pings and port scans) and are considered unsuccessful, as distinguished from
anomalous threats and attacks, do not constitute a material threat to the security of PII, and no
additional notice to the District is required. Upon the determination of an actual data Breach, and
in cons ultation with the District’s Privacy and Security Official, the Contractor will reasonably
cooperate and will provide notifications to individuals, other notice required by law and potentially
to the media, including on behalf of the District of appropriate.
6. Upon termination or conclusion of this Agreement, for any reason, and only if it would not violate
the personal privacy of the subjects of the PII, the Contractor shall return PII in a mutually agreed
upon format or confidentially destroy all PII received or created under this Agreement, within
thirty (30) business days of termination. This provision shall apply to PII that is in the possession
of ALL Subcontractors, agents , or other workforce members of Contractor.
7. In the event that the Contractor determines that returning or destroying the PII is infeasible, the
Contractor shall provide written notification to the District of the conditions that make the return
or confidential destruction infeasible. Upon determination by the District, in consultation with the
Districtwide Privacy and Security Official, that the return or confidential destruction of the PII is
infeasible, the Contractor shall extend the protections of this Agreement to such PII . The
Contractor shall limit further uses and disclosures for as long as the Contractor maintains such PII.
Additionally, the Contractor shall:
(i) Retain only that PII which is necessary for Contractor to continue its proper management
and administration or to carry out its legal responsibilities;
(ii) Return or destroy the remaining PII of under this Agreement that Contractor still maintains
in any form;
(iii) Continue to use appropriate technical, physical and administrative safeguards and comply
with applicable law for as long as Contractor retains the PII;
(iv) Not use or disclose the PII contained in District data that is retained by Contractor other
than for the purposes for which such PII was initially retained; and
(v) Return or destroy the PII of District, when it is no longer needed by Contractor for its
proper management and administration or to carry out its legal responsibilities.
8. The Contractor shall ensure that any agent, including a Subcontractor, and recipient of information,
other than when required by law, agrees to the same or substantially similar restrictions and
conditions with respect to PII received or created through this Agreement.
14. CONTINUITY OF SERVICES
The Contractor recognizes that the services provided under this contract are vital to the District
and must be continued without interruption and that, upon contract expiration or termination, a
CW124798 D.C. Employees Life & Disability Insurance Program

15
successor, either the District or another contractor, at the District’s option, may continue to provide
these services. To that end, the Contractor agrees to:
1. Furnish phase -out, phase -in (transition) training; and
2. Exercise its best efforts and cooperation to effect an orderly and efficient transition to a
successor.
The Contractor shall, upon the CO’s written notice, furnish phase -in, phase-out services for up to
90 days after this contract expires .
Only in accordance with a modification issued by the CO, the Contractor shall be reimbursed for
all reasonable phase -in, phase-out costs (i.e., costs incurred within the agreed period after contract
expiration that result from phase -in, phase-out operations) and a fee (profit) not to exceed a pro
rata portion of the fee (profit) under this contract.
15. ORDER OF PRECEDENCE
A conflict in language shall be resolved by giving precedence to the document in the highest order
of priority that contains language addressing the issue in question. The following documents are
incorporated into the contract and made a part of the contract in the following order of precedence:
1. Contract Document CW124798
2. Attachment A : Specifications/Work Statement
3. Attachment B: Price Schedule
4. Attachment C: Master Agreement, County of Fairfax, Virginia, Contract Award, 4400009393,
and associated amendments and modifications (by reference)
5. Attachment D: Government of the District of Columbia Standard Contract Provisions for use
with the Supplies and Services Contracts (July 2010) (by reference : available at
www.ocp.dc.gov. U nder Quick Links , click on “Required Solicitation Documents” )
6. Attachment E: Performance Guarantees
7. Attachment F: System Integration Requirements
8. Attachment G: Contractor Group Policy Nos. 641332 -B (GTL), 641332-C (STD), 641332-D
(LTD) and any and all associated amendments and modifications (by reference)

CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
Attachment A
SPECIFICATIONS/WORK STATEMENT
1 SCOPE
The Department of Human Resources (DCHR ), on behalf of t he Government of the District of
Columbia (the District), requires a licensed insurance carrier to underwrite and administer the
following insurance plans:
A. Plan One: Group term life (GTL) and accidental death and dismemberment
(AD&D) as well as conversion life insurance which shall include portable term life
insurance
B. Plan Two: Disability insurance, to include s hort-term disability (STD) and long-
term disability (LTD) insurance
The Contractor shall provide P lan One coverage under this contract to District employees and
retirees, hired on or after October 1, 1987, and their eligible dependents . The Contractor shall
provide plan two coverage to enrolled District employees.
2 APPLICABLE DOCUMENTS
The Contractor shall administer life insurance and disability insurance plans in accordance with
all laws, regulations , and other requirements of the Government of the District of Columbia,
including the following:
Item
No.
Title
1
DC Code, Title 1, Chapter 6, Subchapter XXII ( DC Code §§ 1–622.03 - 1–622.16),
District Life Insurance Benefits
https://code.dccouncil.gov/us/dc/council/code/titles/1/chapters/6/subchapters/XXII
2
District Personnel Manual, Chapter 22, Life Insurance Benefits (6-B DCMR §§ 2200 et
seq.)
https://edpm.dc.gov/chapter/22/
3 DC Code § 1 –612.10b. Short -term disability insurance policies.
https://code.dccouncil.gov/us/dc/council/code/sections/1 -612.10b
4
District Personnel Manual, Issuance 1-2025 -3, Impact of Non -Pay Statuses on
Employee Deductions and Benefit Programs
https://edpm.dc.gov/issuances/impact -non-pay -statuses-employee -deductions -and-
benefit-programs/

CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
3 DEFINITIONS
The following words and acronyms, when used in the Specifications/Work Statement, are defined
as stated:
1. Accidental Death and Dismemberment (AD&D) : Unintentional death or
dismemberment of the insured due to an accident in accordance with District Personnel
Manual, Chapter 22.
2. Basic Life Insurance Amount (BIA): The annual rate of pay, rounded to the next
highest multiple of $1,000, plus $2,000 , or a minimum of $10,000. To determine the
enrollee’s basic life insurance coverage, the BIA will be multiplied by a factor
determined based on the age of the insured individual at the time of death, in accordance
with District Personnel Manual, Chapter 22, if an enrollee dies before the age of 45.
3. Beneficiary Designations : An employee may make separate beneficiary designations
for Plan One (basic and option(s)).
4. Benefits Personnel: Employees of the DCHR Benefits and Retirement Administration
(BRA) or other District employees as designated by the contract administrator (CA).
5. Biweekly: Once every two weeks (not twice a week).
6. Certificate of Authority (COA): A license issued by the D.C. Department of
Insurance, Securities, and Banking (DISB) authorizing a corporate entity to operate as
an insurance producer in the District.
7. Defined Contribution Plan: The District’s 401(a) retirement plan for employees hired
on or after October 1, 1987, in benefit -eligible position s.
8. D.C. Department of Insurance, Securities, and Banking (DISB) : District
government agency authorized to regulate insurance companies, insurance producers,
health maintenance organizations, captive insurance companies, risk retention groups,
and other financial services entities operating within the District.
9. Domestic Partner: A person in a committed relationship sharing a residence with an
employee who has been granted a domestic partnership certification.
10. Disability: The inability to engage in any substantial gainful activity by reason of any
medically determinable physical or mental impairment(s).
11. Dependent: Includes an employee’s or retiree’s spouse, domestic partner, natural child,
stepchild, foster child, adopted child, spouse or domestic partner ’s child, if living in
employee’s home.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
12. Earnings Cap (for STD and LTD insurance) : The maximum amount of an
employee’s earnings that may be used to calculate the applicable premium amount
and/or the applicable Monthly Benefit amount is $108,000 per year or $9,000 per
month.
13. Eligible Employee (for life insurance) : An employee first employed by the District
on or after October 1, 1987, except those employees serving under an appointment of
one year or less; employees whose employment is of a temporary duration; an
intermittent employee who is a non-full-time employee without a regularly scheduled
tour of duty or an employee paid on a contract or fee basis as defined in District
Personnel Manual, Chapter 22B, Life Insurance Benefits (6 -B DCMR § 2203). An
eligible employee (for life insurance) also includes an employee hired on or after
October 1, 1987, who had prior service with the District government, but who was not
eligible for Federal Employee Group Life Insurance coverage during that prior service,
and a Retiree that has don e all of the following:
a. Been enrolled for basic insurance for - five years of service immediately preceding
the date of retirement;
b. Met all requirements for immediate retirement as provided (including ten years of
District government service and any other District retirement eligibility
requirements , when necessary) whether final administrative action has been taken;
and
c. Not exercised his or her right to convert to an individual policy.
14. Eligible Employee (for STD and LTD insurance): full-time and part-time permanent
employees (at least 30 hours per week).
15. Elimination Period: The length of time between when an injury or illness begins and
receiving benefit payments from an insurer.
16. Enrollee: Eligible employees and retirees who are enrolled in one or more insurance
plans.
17. Executive Service: An employee that holds an executive management position in the
District of Columbia government.
18. Late Enrollee : An employee who does not elect insurance coverage during Open
Enrollment season, within 31 days of becoming eligible, or within 60 days following a
Qualifying Life Event which includes, but is not limited to, marriage, divorce, death of
a spouse, birth, and adoption or fostering of a child.
19. Licensed Insurance Carrier: An insurance company with a COA from DISB
authorizing them to sell insurance plans in the District.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
20. Monthly Benefit (for STD and LTD insurance): The benefit a covered employee is
entitled to receive each month. The m onthly benefit is based on two-thirds (66 2/3%)
of the employee’s base monthly earnings (exclusive of bonuses and overtime) and shall
not exceed the e arnings cap.
21. Portability: The ability of an employee to retain life insurance coverage following
termination of employment . This only applies to l ife insurance.
22. Premium Stabilization Reserve (PSR): A fund to be reserved by the Contractor when
the District is entitled to a premium credit at the end of each policy period if the total
premium payment for basic life insurance exceeds claims plus retention.
23. Open Enrollment (OE): The period during which an eligible employee may enroll in,
change, or waive some benefit elections. This period typically runs from the Monday
of the second full week of November through the Monday of the second full week in
December of each year and is subject to change.
24. Recurrent Disability: A disability resulting from the same or a related condition as a
prior disability. If an insured suffers a relapse (a disability that is related to a prior
disability) and if this relapse occurs within six months of return to work, then the second
disability is considered a continuation of the initial disability and the elimination period
does not have to be satisfied a second time.
25. Retiree: An annuitant as defined in 6-B DCMR § 2299, which includes an employee
first employed by the District of Columbia government after September 30, 1987, who
retires under the Teachers' Retirement System, the Police and Fire Retirement System,
the Judges' Reti rement System, the Teachers' Insurance and Annuity Association
programs, or the District’s Retirement Benefits program after reaching retirement
eligibility as outlined in 6 -B DCMR § 2299.
26. Qualifying Life Event: A significant change in an employee and retiree life that allows
changes to benefits outside of Open Enrollment, which includes, but is not limited to,
marriage, divorce, domestic partnership, death of a spouse or dependent , birth,
adoption, fostering a child , or change in employment status.
4 REQUIREMENTS
4.1 General Administrative Requirements
4.1.1 General Requirements
4.1.1 .1 The Contractor shall have at least three years of experience administering life and
disability insurance benefits to a population of comparable size to the District ’s
enrollment in each plan .
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.1.2 Before contract award, t he Contractor shall possess a COA issued by DISB licensing
the Contractor to issue and administer the policies required for Plans One and Two. The
Contractor shall maintain the COA throughout the duration of the contract.
4.1.1.3 The Contractor and all Subcontractors shall comply with all applicable federal and
District of Columbia laws, regulations, executive orders, and ordinances, as they may
be amended from time to time during the term of this contract.
4.1.1.4 The Contractor shall adhere to the p erformance guarantee standar ds listed in
Attachment E, Performance Guarantees . The Contractor shall report its performance
for each guarantee on a quarterly basis electronically, on a report provide d by or
approved by the CA. The Contractor shall pay any liquidated damages due to the
District on an annual basis by April 30 each year.
4.1.1.5 The Contractor shall make all files, records, and documentation related to the District
life and disability insurance programs available to independent third-party auditors or
actuaries, as agreed upon by both parties ; such auditors will not be competitors of the
Contractor. The Contractor shall provide this access during regular business hours and
within ten business days’ advance written notice by the District. All audits will be
subject to applicable privacy and confidentiality laws.
4.1.2 Transition and Implementation
4.1.2.1 The Contractor shall provide transition and implementation services such that the
program is fully functioning, in place, and operational by January 1, 2026, and the first
day of each plan year thereafter.
4.1.2.2 The Contractor shall submit a preliminary implementation plan to the CA electronically
within ten days after contract award. The plan shall include all transition activities, such
as securing claims history from the current provider, scheduling meetings with the CA
regarding implementation, coordinating claims for services in process as of the
effective date of the insurance coverage, creating benefit plan summaries, educating
employees about insurance policy coverage, developing both hard copy and digital
forms and communication materials, and enrolling eligible employees and retirees .
4.1.2.3 The Contractor shall confer with the District’s payroll and technology office s to
establish an electronic eligibility system for maintaining eligibility data, in accordance
with the CA’s instructions.
4.1.2.4 The Contractor shall provide a final implementation plan to the CA electronically
within ninety days prior to the start of the plan year. The plan shall outline all transition
activities, including a description of the process and method for ensuring that eligibility
data is accurately uploaded and prepared for use by the anticipated first day of the
upcoming plan year.
4.1.2.5 The Contractor shall be compliant with the technical requirements in Attachment F,
System Integration Requirements .
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.2.6 The Contractor shall provide the necessary interface between the District’s electronic
eligibility and payment systems (PeopleSoft HRIS System V 9.2, as of January 2025).
The Contractor’s eligibility and payment systems shall be ready for testing within 60
days after contract award , and sample enrollment and billing files shall be exchanged
with the District as soon as practicable. The Contractor shall ensure that its systems are
compatible and can interface with the current version of PeopleSoft HRIS and any
changes implemented.
4.1.2.7 During the transition period, the Contractor shall prepare all digital and hard copy
communication materials (includ ing, but not limited to , e-blasts, flyers, and posters
created for use during open enrollment) as well as administration manuals that explain
the Contractor’s internal processes for making changes to employee records.
4.1.2.8 The Contractor shall provide an a dministrative manual to the CA electronically within
30 days after the contract is awarded. The a dministrative manual shall, at minimum,
outline the Contractor’s policies and procedures for administering plans one and two,
including summary plan document s; customer service; forms; filing and processing
claims; submission of settlements and assignments; underwriting; conversions; and
medical underwriting for late enrollments or employees desiring to increase life
insurance coverage; and contact information for the District’s account
representative(s).
4.1.2.9 The Contractor shall update the administrative manual as changes are made and
existing policies and procedures are revised. When applicable, t he Contractor shall
notify the CA of changes electronically for approval within thirty days prior to
implementation. The Contractor shall submit the updated administrative manual
electronically to the CA within thirty days of any changes .
4.1.2.10 The Contractor shall, at a minimum, provide the services specified in this statement of
work. Adjustments to the plan design shall be made by written contract modification
executed by the contracting officer.
4.1.2.11 The Contractor shall waive the eligibility waiting period with no interruption to the
employees’ prior plan claims under the new group policy .
4.1.3 Plan Administration
4.1.3.1 The Contractor shall provide Plan One coverage to enrolled eligible District
employees , retirees, and their eligible dependents . The Contractor shall provide Plan
Two coverage to enrolled District employees.
4.1.3.2 The Contractor shall insure and administer a life and disability insurance program for
the District on a group basis with no or minimal medical underwriting.
4.1.3.3 The Contractor shall provide all the services associated with the administration and
support of the life and disability insurance program.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.3.4 The Contractor shall, at a minimum, replicate the current procedures of the District in
administering the life and disability insurance program as set forth in the District
Personnel Manual (DPM: https://edpm.dc.gov/ ).
4.1.3.5 The Contractor shall maintain and secure current, complete, and confidential records
for each enrollee, as necessary and in accordance with industry best practices for
privacy, security, and data protection .
4.1.3.6 The Contractor shall comply with the District’s technological requirements and any
updates or changes to the file formats, as required by the District throughout the term
of this contract .
4.1.4 Online Resources
4.1.4.1 The Contractor shall provide an interactive calculator for District benefits personnel to
use as a tool to calculate premium cost s for retired employees . The calculator shall be
aligned with the different plan options and premiums pertaining to employees ’ or
retirees’ elections and shall reflect the separate contributions from the employee and/or
retiree and the District. The calculator may be web -based, in the administrative portal
or on the microsite, or it may be an independent software file, such as Microsoft Excel.
The Contractor shall update the calculator annually and when there are plan changes
affecting it.
4.1.4.2 The Contractor shall provide the CA and benefit s personnel with an online
administration access tool for claim status reports, policy information, claim payment
history, status of medical underwriting determinations, and online claims initiation and
processing, all of which shall reflect real-time status updates for all functions .
4.1.4.3 The Contractor shall provide District employees and retirees with online interactive
calculators and a decision -making guide, allowing them to access coverage options and
determine premiums for the optional life and disability insurance coverages.
4.1.4.4 The Contractor shall maintain an interactive website for eligible employees and
enrollees that contains information specific to the District’s coverage, including but not
limited to the benefits to which enrollee s are entitled, the procedure for obtaining
benefits, claim forms, the principal provisions of the policies, and the certificate of
group life insurance .
4.1.4. 5 The Contractor shall maintain the District-specific website , with all online calculators,
tools, guides, resources, and information , to reflect accurate information pertaining to
plan year.
4.1.5 Enrollment
4.1.5.1 The Contractor shall accept electronic payment files in EDI 820 federal format for Plan
One: Group Term Life Insurance and Accidental Death and Dismemberment , on a
biweekly basis from the District. The Contractor shall process a ll payment files within
five business days of receipt. If processing will be delayed, the Contractor shall notify
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
the CA within two business days of recei ving the files or within one business day of
becoming aware of a possible delay. The notification shall include the reason for the
delay, the anticipated completion date, and any corrective actions taken to prevent
future delays.
4.1.5.2 The Contractor shall accept electronic eligibility files in EDI 834 federal format for
Plan Two: Short -Term Disability and Long -Term Disability Insurance , on a weekly
basis from the District. The Contractor shall upload all eligibility files into its database
within one business day of receipt. If processing will be delayed, the Contractor shall
notify the CA within one business day of becoming aware of the possible delay . The
notification shall include the reason for the delay, the anticipated completion date, and
any corrective actions taken to prevent future delays.
4.1.5.3 The Contractor shall establish a method for processing eligibility and update the
payment methods and frequencies for each agency with independent enrollment and
payment systems. Agencies that currently operate independently with their own
eligibility and payment systems are the D.C. Housing Authority (DCHA) , D.C. Office
of the Chief Financial Officer –Office of Finance & Treasury (OCFO/OFT), and the
D.C. Retirement Board (DCRB).
4.1.6 Customer Service and Quality Assurance
4.1.6.1 The Contractor shall ensure the highest level of customer service for all inquiries
regarding the District’s life and disability insurance programs.
4.1.6.2 The Contractor shall provide direct access for employees to the service center and
claims office with local and toll-free phone numbers available for all employee
inquiries. The toll-free line shall be staffed by a live representative during, at minimum,
office hours from 8:00 a.m. to 6:00 p.m. (Eastern Time ), Monday through Friday ,
excluding District holidays. Telephone calls received after hours , on weekends , or on
District holidays shall be accommodated by a voicemail recording system. The
Contractor shall respond to all messages received outside of business hours by the next
business day with a live customer service representative.
4.1.6.3 The Contractor’s telephone responses shall be provided by members of a designated
unit who are knowledgeable in all aspects of the District's life and disability insurance
programs and personnel operations. If responses cannot be given immediately, the
designated unit member shall contact the employee on the same day as the initial
inquiry with a response or with an estimate of when a response will be provided.
4.1.6.4 The Contractor’s customer service center shall include representatives fluent in English
and Spanish. The Contractor shall provide access to interpretation and translation
services for other languages, as designated by the District. The Contractor shall provide
telecommunication relay services for individuals with hearing and speech disabilities.
The customer service center shall be staffed, at a minimum, from 8:00 a.m. to 6:00 p.m.
(Eastern Time), Monday through Friday, excluding District holidays.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.6.5 The Contractor shall respond to, or acknowledge, all written inquiries from enrollees,
requests for forms, and appeals of decisions within 48 hours of receipt .
4.1.6.6 The Contractor shall , as agreed by the CA and the Contractor, conduct CA -approved
routine surveys of enrollees during the plan year to determine satisfaction with the
program. The Contractor shall provide the survey results to the CA electronically at
least once per plan year .
4.1.7 Training and Communication
4.1.7.1 The Contractor shall provide a representative knowledgeable about the District’s life
and disability insurance program to participate in and assist with enrollment and
educational sessions. The Contractor shall provide digital and hard-copy
communication materials , including plan summaries and rates, for such sessions at no
additional cost to the District.
4.1.7.2 The Contractor shall provide information about the life and disability insurance
coverage program in the form of digital and printed communication materials on an
ongoing basis for eligible employees, enrollees, and District benefits personnel, as
requested by the CA.
4.1.7.3 The Contractor shall provide other plan-related information to eligible employees and
enrollees at the District's request, including outreach communications, brochures, and
booklets.
4.1.7.4 The Contractor shall update communication materials annually to reflect current dates
and relevant information. The Contractor shall provide all communication materials to
the CA for approval no less than 60 days prior to issuance.
4.1.7.5 The Contractor shall provide and assist with ongoing training and educational sessions
on life and disability insurance coverage programs for eligible employees and enrolled
retirees throughout the term of this contract, as indicated by the CA.
4.1.7.6 The Contractor shall assist and coordinate with DCHR during new employee
orientations and the annual o pen enrollment season by providing personnel
knowledgeable on the District’s life and disability insurance coverage programs to
attend orientation sessions and open enrollment fairs and provide information and
communication materials to educate eligible employees and enrollees.
4.1.7.7 The Contractor shall, at minimum, annually participate in 26 new employee
orientations or as required by the District, under the general direction of the CA. The
Contractor shall attend all assigned in-person and virtual orientation sessions.
4.1.7.8 The Contractor shall, at minimum, participate in 20 annual open enrollment fairs or as
otherwise required by the District, under the general direction of the CA. The
Contractor shall attend all assigned in -person and virtual fairs for the duration of the
event.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.7.9 The Contractor shall, in addition to assisting with o pen enrollment and n ew employee
orientation, make up to 20 written, oral, and video presentations each plan year ,
describing the life and disability insurance coverage options, as required by the CA
throughout the term of this contract.
4.1.7.10 The Contractor shall provide the finalized, approved versions of all digital and hard
copy communication materials to the CA 15 days prior to each open enrollment period.
4.1.7.11 The Contractor shall submit all digital and hard copy communication materials that
describe the life and disability insurance programs and available services (i.e.,
summary plan descriptions , certificates of group life insurance , and summaries of
benefits and coverage) in quantities as needed by the District. The Contractor shall ship
hard copies directly to the D.C. Department of Human Resources , Benefits and
Retirement Administration, located at 1015 Half St, SE, 9 th Floor, Washington, DC
20003, or to a designee at a specified District agency, as indicated by the CA.
4.1.7.12 The Contractor shall provide a minimum of one and up to four plan meetings annually ,
at the request of the CA, with District benefits personnel to discuss administrative
procedures, program goals, coverage and performance metrics, and policies to be
adhered to under this contract.
4.1.7.13 The Contractor shall advise and instruct District benefits personnel about how to
discuss life and disability insurance coverage and administrative procedures with
eligible employees and enrollees, at the request of the CA.
4.1.8 On-site Account Specialist
4.1.8.1 The Contractor shall provide an on-site account specialist to assist the District in the
administration of the life and disability insurance programs. The specialist shall be the
Contractor’s employee or temporary personnel, and the Contractor shall direct ,
supervise, and manage the specialist. The Contractor shall comply with all employment
and workplace laws applicable to the specialist.
4.1.8.2 The specialist shall work a hybrid schedule between one or more District g overnment
offices and the Contractor -designated office. The specialist’s working hours shall be
determined by the Contractor but shall take place during the District’s standard business
hours, between 8:00 a.m. and 6:00 p.m. (Eastern Time) , Monday through Friday ,
excluding District holidays.
4.1.8.3 The duties of the specialist shall be limited to assisting the District, its employees, and
insured members with understanding, implementi ng, and administering the
Contractor’s insurance policies, as requested by the District.
4.1.8.4 In the event that the specialist’s employment with the Contractor or assignment to the
District is terminated, the Contractor shall promptly replace the specialist with another
qualified specialist.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.8.5 At the request of the CA, the Contractor shall terminate the specialist’s services to the
District. The District will provide two weeks’ written notice to the Contractor.
4.1.8.6 The Contractor shall establish the specialist’s compensation and benefits and shall
maintain all responsibility for the specialist’s salary , wages, benefits, payroll taxes,
withholdings, unemployment contributions, and workers’ compensation coverage.
4.1.8.7 At no time shall the specialist represent themselves as an employee of the District. The
specialist shall not perform any inherently governmental function.
a. The specialist shall not be entitled to any compensation or benefits from the
District, including bonuses, holiday pay, vacations, disability, insurance, pensions,
commuter benefits, flexible spending accounts, healthcare insurance, vision care
insurance, dental care insurance, employee assistance, or any other employee
benefits or programs offered by the District to its employees .
b. The specialist shall not bind the District to take or not to take any action by contract,
policy, regulation, authorization, order, or otherwise .
c. The specialist shall not appoint, direct, or control officials or employees of the
District.
d. The specialist shall not exert control over the acquisition, use, or disposition of the
property, real or personal, tangible or intangible, of the District, including the
control, or disbursement of, appropriated and other District funds .
e. The specialist shall not determine what supplies or services are to be acquired by
the District, or at what prices.
4.1.8.8 The Contractor shall be responsible for all District government property issued to the
account specialist and shall be held liable for damaged, missing, or unreturned District
government property or equipment. At the conclusion of the specialist’s assignment to
the District, the Contractor shall coordinate with the CA to ensure District equipment
and other resources are returned to DCHR in accordance with the Electronic -District
Personnel Manual Instruction No. 4-17, Procedures for the Return of Dis trict
Government Property upon Separation from District Government Service, as follows:
a. The surrender of all District government -owned property or equipment .
b. The surrender of all passes, special identification badges, and credentials,
passwords, combinations, etc., issued in connection with services in the agency.
c. The return of all official files, sensitive materials, file cabinet(s), and office and/or
desk keys, manuals, and handbooks, etc.
d. The liquidation of all debts owed to the District government for outstanding
reimbursable items and/or services.
e. The submission of a detailed written explanation of the circumstances surrounding
the failure to account for and clear any accountable items.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.1.9 Reports
4.1.9.1 The Contractor shall provide reports electronically in a format specified by the District,
which includes utilization, claims reporting, accounting, and administrative services,
as required by the CA.
4.1.9.2 The Contractor shall provide separate electronic reporting for the life and disability
insurance programs by plan and subgroup, in a format agreed upon by the Contractor
and the CA.
4.1.9. 3 If the Contractor discovers during the course of an audit any overpayment made by the
District or e nrollee, the Contractor shall promptly notify the District and provide a
detailed explanation for the overpayment. The Contractor shall remit the overpayment
identified by the Contractor, the District, or the enrollee, either to the District or to the
enrollee, as directed by the District.
4.1.9 .4 The Contractor shall provide an a nnual accounting report of gross premiums, paid
claims, incurred claims, conversion charges, and plan expenses (including retention,
administration fees, and formulas regarding calculated experience based on usage)
electronically, in an agreed-upon format, to the CA within 90 days after the end of each
plan year.
4.1.9. 5 The Contractor shall provide a premium stability report to the CA electronically on an
annual basis. The report shall include an analysis of the premium trends, factors
influencing premium stability, and projections for future premium fluctuations.
4.1.9. 6 The Contractor shall cooperate with and act in good faith in working with the District’ s
consulting actuary and shall be prepared to respond to the actuary’s requests promptly .
In that regard, or for other purposes, the District may, on an ad hoc basis, request that
the Contractor prepare customized reports or provide the District with individual claims
data on a timely basis at no additional cost to the District. The Contractor’s reports shall
be submitted electronically to the CA within two weeks of the request or a mutually
agreed -upon timeline.
4.1.9. 7 The Contractor shall maintain ad hoc reporting flexibility to accommodate up to ten
requests annually, upon request by the CA, at no additional charge to the District.
4.1.9. 8 The Contractor shall provide life insurance reports to the CA electronically on a
quarterly basis in an agreed format, which shall include the reports listed in Sections
4.1.9. 9 through 4.1.9.1 3.
4.1.9. 9 Claims paid report for each month that includes all of the following information:
a. The name of the deceased
b. The date of birth of the deceased
c. The amount of the claim
d. The plan that was paid
e. The cause of death , if available
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
f. The name of the claimant(s)
4.1.9.1 0 Conversion report that provides the enrollees who converted their coverage or enrolled
in portable life insurance, which shall include:
a. Names of the insured
b. Plan that was transitioned
c. Amounts of life insurance coverage
d. Date of plan transition
4.1.9.11 The Contractor shall provide a report detailing premiums and claims by age group and
plan option. The report must include the following:
a. Premiums paid, categorized by age group and plan option.
b. Claims paid, categorized by age group and plan option.
4.1.9.1 2 The Contractor shall provide a final utilization report showing utilization on an annual
basis during the term of the contract and shall provide all claims data.
4.1.9.1 3 At contract termination, the Contractor shall provide the CA, upon request, electronic
copies of all eligibility and claims information, records, and files related to the District’ s
life and disability insurance programs. Transfer of data shall be consistent with
applicable law. Data transfer includes, but is not limited to, supporting electronic files
containing individual benefit accumulation data relevant to the provisions of the
insurance plans. At the request of the District, the Contractor shall adjudicate and pay
all unpaid claims incurred prior to the expiration or termination of the contract.
4.2 Plan One: Group Term Life Insurance (GTL) and Accidental Death and
Dismemberment (AD&D)
4.2.1 Program Requirements
4.2.1.1 The Contractor shall provide the District with GTL, AD&D, and conversion life
insurance for all eligible employees and retirees, in accordance with the District
Employee Group Life Insurance (DCEGLI) program, as referenced in the District of
Columbia Personnel Manual Chapter 22 (Section 2, Applicable Documents, Item 2) .
The District is required to allow some independent agencies to participate in the
DCEGLI program. As authorized by the District, the Contractor shall also provide
coverage to those a gencies.
4.2.1.2 The Contractor shall not reduce coverage based on age for active employees. Changes
made by the Federal Employees’ Group Life Insurance Program (FEGLI), including
open enrollments, may also be adopted by the District.
4.2.1.3 The Contractor shall perform individual medical underwriting review and eligibility
determination for late enrollees into the GTL plan and when an increase in coverage is
requested.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.2.1.4 The Contractor shall not require medical underwriting for enrollees who enroll or
increase coverage during open enrollment or within 60 days of a Qualifying Life Event.
4.2.1. 5 The Contractor shall allow an enrollee who is reinstated or restored to duty on the
grounds that an adverse action was unwarranted or unjustified to, at the election of the
enrollee, either re-enroll as a new employee or, if all unpaid back premiums have been
paid, have the enrollee’s coverage restored during the period of absence from
employment to the same extent and effect as though the removal or suspension had not
taken place. The Contractor shall not require medical underwriting and shall trea t the
enrollee’s re-enrollment or restoration of coverage as a Qualifying Life Event, without
regard to the timing of the reinstatement , restoration, or the enrollee’s election.
4.2.1.6 The Contractor shall render a decision to approve or deny submitted claims within three
business days upon receipt of the initial claim for GTL and AD&D.
4.2.1.7 The Contractor shall provide executive service enrollees with additional o ptional life
insurance up to two times the executive service employee’s basic pay. This shall not
include additional AD&D. The cost of coverage shall be paid solely by the District in
compliance with D.C. Official Code § 1 –622.07(b).
4.2.1.8 The Contractor shall establish a separate premium payment structure for such executive
service enrollees who participate.
4.2.1.9 The Contractor shall provide 31 days of extended coverage following the termination
of life insurance coverage to the enrollee at no charge to the District, enrollee, or person
losing coverage. The Contractor shall not provide 31 days of extended coverage when
enrollees voluntarily cancel the ir insurance coverage.
4.2.2 Life Insurance Coverage Levels
4.2.2.1 The Contractor shall provide GTL insurance plans that offer, at minimum, the coverage
levels detailed below:
4.2.2.1.1 Basic Life. An enrollee’s basic life insurance amount (BIA) shall be the greater of:
a. the annual rate of pay, as determined by the DPM Chapter 22, rounded to the next
highest multiple of $1,000, plus $2,000; or
b. a minimum of $10,000.
4.2.2.1.2 The amount of an enrollee’s basic life coverage will be equal to the enrollee’s BIA
multiplied by a factor determined based on the age of the insured individual at the time
of death , in accordance with DPM , Chapter 22, if the enrollee dies before the age of
45. The factors are as follows :
Age Factor
35 or under 2
36 1.9
37 1.8
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
38 1.7
39 1.6
40 1.5
41 1.4
42 1.3
43 1.2
44 1.1
45 or over 1
4.2.2.1.3 Optional life insurance coverage. The Contractor shall provide employees enrolled in
basic life insurance with three options for additional life insurance coverage.
4.2.2.1.4 Option A. Additional life insurance coverage in the amount of $10,000.
4.2.2.1.5 Option B. Additional life insurance coverage in multiples of one (1), two (2), three (3),
four (4), or five (5) times an enrollee’s annual rate of pay, rounded to the next highest
thousand.
4.2.2.1.6 Option C . Additional life insurance coverage providing family coverage with the
following options:
a. Insurance coverage for the life of an enrollee’s spouse, including domestic partner,
in amount s of $10,000, $25,000, and $50,000; and
b. Insurance coverage for the life of each dependent child in the amount of $10,000.
4.2.3 Accidental Death & Dismemberment (AD&D)
4.2.3.1 The Contractor shall provide AD&D insurance as additional coverage for death or
dismemberment resulting from an accident.
4.2.3.2 The Contractor shall provide all enrollees under Basic Life, Option A, and Option B
with AD&D coverage equal to the amount of the enrollee’s insurance coverage.
4.2.3.3 The Contractor shall pay dismemberment benefit s under Basic Life resulting from an
accident for the following losses:
a. One hand or one foot : 50% of BIA
b. Sight in one eye : 50% of BIA
c. Two or more losses listed above : 100% of BIA
4.2.3.4 The Contractor shall apply the accidental death benefit under Basic, Option A , and
Option B to the loss-of-life benefit.
4.2.4 Beneficiary
4.2.4.1 The Contractor shall allow enrollees to update beneficiary designations for the basic
life and additional optional coverage at any time.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.2.4.2 The Contractor shall notify affected beneficiaries within ten business days of receipt of
their claims submission to advise them of any outstanding information necessary to
adjudicate any claim, for example, guardianship documents, affidavits regarding heirs
of decedent, form notarizations at the time of death or when dismemberment claim is
filed.
4.2.4.3 The Contractor shall pay interest to the beneficiary if a claim is not paid within 30 days.
The Contractor shall not charge the interest against the District’s experience rating.
4.2.5 Premiums
4.2.5.1 The enrollees shall pay two -thirds of the premium for Basic coverage level and 100%
of the premium for the optional insurance plan coverage, in accordance with 6 -B
DCMR 2212.
4.2.5.2 The basic life and AD&D insurance plan shall be experience -rated, and the District
shall be entitled to a premium credit at the end of each policy period if the total premium
payment for basic life exceed s claims plus retention. The retention amount shall not
exceed (1 – Expected Loss Ratio) times the premium, where the e xpected loss ratio is
the amount for basic life insurance. The Contractor shall maintain a p remium
stabilization reserve (PSR) in which to maintain such credits .
4.2.5.3 The Contractor shall maintain the PSR, which shall be used at the discretion of the
District to stabilize rates, guard against adverse claim fluctuations, increase benefits, or
reduce premiums until the term of the contract expires or is terminated. The Contractor
may recoup deficits against positive balances in the reserve fund. The Contractor shall
credit interest to positive balances and may charge interest to negative balances. If upon
contract expiration or termination a new contractor replaces the incumbent, the
incumbent Contractor shall transfer any positive balances in the reserve to the new
contractor. All claims incurred prior to termination or expiration of the contract but not
paid shall remain the liability of the incumbent Contractor.
4.2.5.4 The Optional Life Insurance shall be prospectively rated from the effective date of the
contract until notified otherwise by the District. The District may change the rating
arrangement by providing written notification from the Contracting Officer to the
Contractor. The Contractor shall not combine Optional Life Insurance with Basic Life
when establishing rates or determining year -end results. The Optional coverage shall
not be entitled to a premium credit based on premium and claim s experience.
4.2.5.5 The Contractor shall continue to provide Plan One coverage for up to 365 days while
an enrollee remains in a non-pay status with the District. The non-pay status may be
continuous, or it may be broken by periods of less than four consecutive months in a
pay status .
4.2.5.6 The Contractor shall defer P lan One premiums incurred by an enrollee in a non-pay
status until the enrollee returns to an active pay status with the District.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
a. In the event that a life insurance claim is submitted while an enrollee is in a
non-pay status, the Contractor shall withhold outstanding premium payments
from the benefit payout.
4.2.5. 7 The Contractor shall continue to provide Plan One coverage for enrollees on STD or
LTD status for the full period of their disability. The Contractor shall waive Plan One
premium amounts for an enrollee on STD or LTD status until the enrollee returns to an
active pay status with the District. The enrollee will be responsible for their share of
the costs of P lan One coverage incurred during an unpaid period. When an enrollee
returns to a pay status, as determined by the District, the debt will be recaptured by the
District in the amount of $50 per pay period for each individual benefit, in addition to
ongoing premium costs.
4.2.5.8 The Contractor shall provide premium rates for any proposed benefit changes
suggested by the Contractor or the CA within a timeframe approved by the District.
4.2.5.9 The Contractor shall terminate P lan One coverage for an enrollee following 365 days
in a non-pay status, unless the enrollee exercises the right to convert. The non-pay status
may be continuous, or it may be broken by periods of less than 4 months.
4.2.6 Post-Employment Benefits
4.2.6.1 The Contractor shall provide a conversion provision that allow s the enrollee whose
coverage has terminated to convert their life insurance coverage without a medical
examination, enabling them to purchase either an individual whole life insurance policy
or an individual portable term life insurance policy. This conversion provision shall
apply when an enrollee’s coverage has terminated for any reason other than voluntary
cancellation and the enrollee has submitted the request within the 31 days of extended
coverage following the termination of life insurance coverage. The enrollee will be
responsible for the premium for the converted coverage, and the Contractor shall accept
payments directly from the enrollee.
4.2.6.2 The Contractor shall provide the enrollee with the appropriate application and
information regarding the conversion of the GTL insurance policy to an individual
portable term life insurance policy or the purchase of an individual whole life insurance
policy. This conversion request must be submitted within the 31 days of extended
coverage following the termination of life insurance coverage . The enrollee will pay
the premium for the converted life insurance coverage directly to the Contractor.
4.2.6.3 The Contractor may, in consultation with DCHR, provide additional opportunity for a
former enrollee to convert to an individual policy after the 31-day extension of
coverage, if the former enrollee makes a request to convert the coverage to DCHR
within six months from the date that the coverage terminated.
4.2.6.4 The whole life insurance converted policy pays the face amount of the policy upon the
death of the enrollee and has cash value.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.2.6.5 The portable term life insurance coverage pays the face amount of the insurance policy
upon death of the insured and has no cash value.
4.2.7 Post-Employment Benefits for Retirees
4.2.7.1 Coverage Continuation
4.2.7.1.1 The Contractor shall allow enrollees to continue their coverage upon retirement.
4.2.7.1.2 The Contractor shall provide the same basic insurance coverage amount that an enrollee
had upon transitioning to retirement.
4.2.7.1.3 The Contractor shall allow retirees to choose either to maintain the same coverage or
to opt for a reduction in coverage as outlined below.
a. Basic: At the time of retirement, retirees will have the option of 75% reduction,
50% reduction, or no reduction.
i. 75% reduction: Basic Life Insurance will reduce to the final reduced
value beginning the January immediately after the date the retiree
becomes 65 or retires, whichever is later. The amount will not reduce to
less than 25% of the amount in effect prior to retirement.
ii. 50% reduction: Basic Life Insurance will reduce to the final reduced
value beginning the January immediately after the date the retiree
becomes 65 or retires, whichever is later. The amount will not reduce to
less than 50% of the amount in effect prior to retirement.
iii. No reduction: Basic Life insurance will not reduce . The retiree’s Basic
Life insurance will equal the amount in effect immediately prior to
retirement, and 100 percent of the pre-retirement amount is payable as
a death benefit.
b. Option A: Option A will automatically decrease to the final reduced value, 25%
of the amount in effect prior to retirement , beginning the January immediately
after the date the retiree becomes 65 or retires, whichever is later. The AD&D
coverage is excluded from the Option A plan.
c. Options B and C : Retirees will have the option of a 100% reduction or no
reduction. The AD&D coverage is excluded from Option s B and C.
i. 100% reduction: Life Insurance will reduce to the final reduced value
beginning the January immediately after the date the retiree becomes 65
or retires, whichever is later.
ii. No reduction: Life insurance will not reduce, and the retiree’s Life
Insurance will equal the amount in effect immediately prior to
retirement.
4.2.7.2 Contribution
4.2.7 .2.1 The Contractor shall allow retirees to pay the same premium rate as active employees
until they reach age 65 for Basic and Optional coverages. After age 65, the contribution
schedule will be as outlined below, based on the retiree’s election. The age band for the
selected coverage for the plan year will be based on the retiree’s age as of January 1.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
a. Basic Coverage : Retirees who choose the 75% reduction, 50% reduction, or no
reduction will pay the same rate as active employees until age 65 plus an additional
amount at age 65 through the remaining period of retirement. The District will
contribute the equivalent of one -third of the premium for the 75% reduction option
for all basic coverage levels.
b. Optional Coverages . For all options, no contributions from the retiree will be
required once the benefit begins reducing. Retirees who elect no reduction under
Options B and C will pay the same rates, negotiated under contract , as active
employees.
4.2.7 .3 Billing
4.2.7 .3.1 The District will, on the Contractor’s behalf, bill and collect life insurance premiums
for retirees who were hired on or after October 1, 1987.
4.2.7 .3.2 The Contractor shall accept payment s from the District and retiree s via a contracted
third-party vendor.
4.3 Plan Two: Short-Term Disability (STD) and Long -Term Disability (LTD)
Insurance
4.3.1 Program Requirements
4.3.1.1 The Contractor shall provide a group STD and LTD insurance program that offers
partial salary continuation to enrollees unable to work due to a serious illness or injury
not related to their job. Premiums for disability insurance plans are paid by enrollees
through payroll deductions.
4.3.1.2 The Contractor shall insure and administer services related to and in support of the STD
and LTD insurance program.
4.3.1.3 The Contractor shall waive the eligibility waiting period with no interruption to the
employees’ prior plan claims under the new group policy.
4.3.1.4 The Contractor shall allow late enrollment and accept applications from eligible
employees for enrollment, coverage increases, and reinstatements, with the appropriate
penalty.
4.3.1.5 The Contractor shall conduct disability determinations in person, by telephone, or
electronically for initial and subsequent claims eligibility determination s and
continuing benefit eligibility.
4.3.1.6 The Contractor shall provide the enrollee with a decision on a submitted claim within
5 days for short-term disability and within 7 days for long-term disability, after receipt
of the initial claim. If, however, the Contractor requires additional information before
approving or denying the claim, the Contractor may provide the decision within 10
days for a short-term disability claim or within 30 days for a long-term disability claim.
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.3.1.7 The Contractor is responsible for adjudicating and processing claims, which includes
the following responsibilities :
a. V erifying that claims charges are for eligible employees.
b. Determining eligibility for benefits.
c. Paying claims to eligible enrollees.
4.3.1.8 The Contractor shall provide vocational rehabilitation and return-to -work services,
where appropriate, to assist in returning disabled employees to work.
4.3.1.9 The Contractor shall provide continued coverage if an enrollee experiences a recurrent
disability. If the enrollee relapses within six months of returning to work, the second
disability will be treated as a continuation of the initial disability, and the elimination
period will not apply.
4.3.1.10 The Contractor shall provide a conversion provision in the LTD insurance program
policies that allow s an enrollee whose coverage has terminated to convert LTD
insurance coverage without a medical examination, enabling them to purchase either
an individual LTD insurance policy or an individual portable LTD insurance policy .
This provision applies when an enrollee submit s a request within 31 days of losing
coverage. The enrollee will be responsible for the premium , and the Contractor shall
accept pay ments directly from the enrollee.
4.3.2 Short-Term Disability Insurance
4.3.2.1 The Contractor shall provide a n STD insurance program that pays a weekly benefit in
the event that an enrollee is unable to work due to a n illness or injury not related to
their job.
4.3.2.2 The Contractor shall calculate the weekly STD benefit at 66 2/3% of the enrollee’s base
monthly pre -disability earnings, subject to an earning cap of $2,07 8.00.
4.3.2.3 The Contractor shall disburse STD benefits directly to the enrollee on a weekly basis.
Enrollees may elect to receive the benefits by electronic funds transfer or check.
4.3.2.4 The Contractor shall provide benefits under the STD insurance program for 180 days.
4.3.2.5 The Contractor shall provide STD benefits with an elimination period not to exceed 14
days.
4.3.2.6 The Contractor shall allow late enrollments in the STD insurance program without
individual medical underwriting review.
4.3.3 Long-Term Disability Insurance
4.3.3.1 The Contractor shall provide an LTD insurance program that pays a monthly benefit in
the event that an enrollee is unable to work due to an illness or injury that is continuous
beyond six months .
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
4.3.3.2 The Contractor shall calculate the monthly LTD benefits at 66 2/3% of the enrollee’s
base monthly pre -disability earnings, reduced by deductible income and excluding
bonuses and overtime , subject to an earning cap of $9,000. 00.
4.3.3.3 The Contractor shall disburse LTD benefits directly to the enrollee on a monthly basis.
Enrollee may elect to receive the benefits by electronic funds transfer or check.
4.3.3.4 The Contractor shall provide individual medical underwriting review and determine
eligibility for late enrollments in the LTD insurance program within 30 days of receipt
of enrollment application .
4.3.3.5 The Contractor shall notify the late-enrollment applicant and District personnel of the
approval or denial determination regarding the late enrollment application
electronically within two business days.

CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
5 DELIVERABLES
The Contractor shall perform the activities required to successfully complete the District’s
requirements and submit each deliverable to the CA identified below in accordance with the
following:
Item
No.
Contract
Section Deliverable Quantity Format/
Method Due Date
1 4.1.1.4 Performance Guarantee
Report 4 Email
By the 30th of
each month
following the
quarter
2 4.1.2.2 Preliminary Transition
Plan 1 Email 10 days after
award
3 4.1.2.4 Final Transition Plan 1 Email 90 days before
plan year
4 4.1.2.7 Communication Materials As
needed
Digital/
Hard Copy
90 days before
plan year
5 4.1.2.8 Administrative Manual 1 Email 30 days after
award
6 4.1.2.9 Administrative Manual
Revisions
As
needed Email 30 days before
effective date
7 4.1.4.1 Premium Calculator for
District Personnel 1 Web/ Email 30 days after
award
8 4.1.4.2 District Administration
Portal 1 Web 5 days after award
9 4.1.4.3 Employee Calculators As
needed Web 5 days after award
10 4.1.4.4 Employee Website 1 Web 5 days after award
11 4.1.6.6 Satisfaction Survey Results 1 Email Annually
12 4.1.7.1 Educational Session
Materials
As
needed
Digital/
Hard Copy As needed
13 4.1.7.2 Informational Materials As
needed
Digital/
Hard Copy As needed
14 4.1.7.3 Other Employee
Communications
As
needed
Digital/
Hard Copy As needed
15 4.1.7.4 Revisions to Employee
Communications
As
needed
Digital/
Hard Copy As needed
16 4.1.7.5 Training and Educational
Sessions
As
needed
In-person/
Virtual As needed
17 4.1.7.7 New Employee Orientation 26
sessions
In-person/
Virtual As needed
CW124798 D.C. Employees Life & Disability Insurance Program
Attachment A: Specifications/Work Statement
18 4.1.7.8 Open Enrollment Fairs 20 fairs In-person/
Virtual As needed
19 4.1.7.9 Presentations 20 As needed Annually
20 4.1.7.10 Open Enrollment
Communication Materials
As
needed
Digital/
Hard Copy
15 days before
open enrollment
21 4.1.7.11
Open Enrollment
Communication Materials
Copies
As
needed
Digital/
Hard Copy
Before open
enrollment
22 4.1.7.12 Performance Meeting As
needed
In-person/
Virtual
Annually, 90 days
after plan year
23 4.1.9.1 Reports As
needed Email As needed
24 4.1.9.3 Notification of
Overpayment
As
needed Email As needed
25 4.1.9.4 Accounting Report 1 Email Annually , 90 days
after plan year
26 4.1.9.5 Premium Stability Report 1 Email Annually, 90 days
after plan year
27 4.1.9.6 Ad Hoc Actuarial Reports As
needed Email 2 weeks after
request
28 4.1.9.7 Ad Hoc Reports As
needed Email As needed
29 4.1.9.8 Life Insurance Reports 1 Email Quarterly, 30 days
after quarter end
30 4.1.9.9 Claims Paid Report 1 Email Quarterly, 30 days
after quarter end
31 4.1.9.10 Conversion Report 1 Email Quarterly, 30 days
after quarter end
32 4.1.9.11 Report on Premiums and
Claims by Age Group 1 Email Quarterly, 30 days
after quarter end
33 4.1.9.12 Utilization Report 1 Email Annually, 90 days
after plan year
34 4.1.9.13 Program Records As
needed Digital As needed
35 4.2.5.8 Premium Rate Change
Proposals
As
needed Email As needed
36 4.3.3.5 Late Enrollment
Determination Notification
As
needed Email As needed

CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
0001
0001A Basic GTL & AD&D $3,388,262,168.00 $0.065 $5,726,163.07
0001B Premium for Retirees with 75% Reduction (4.2.7) $1,480,451.00 $0.065 $2,501.97
0001C Premium for Retirees with 50% Reduction (4.2.7) $1,480,451.00 $0.328 $12,625.29
0001D Premium for Retirees with No Reduction (4.2.7) $1,480,451.00 $0.983 $37,837.37
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $10,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/10,000
0002
0002A Under age 35 $9,402,185.00 $0.350 $8,555.99
0002B 35 through 39 $9,137,024.00 $0.420 $9,977.64
0002C 40 through 44 $10,440,734.00 $0.570 $15,473.17
0002D 45 through 49 $13,324,366.00 $0.920 $31,871.89
0002E 50 through 54 $10,507,025.00 $1.490 $40,704.22
0002F 55 through 59 $6,374,925.00 $3.000 $49,724.42
0002G 60 through 64 $3,800,649.00 $4.520 $44,665.23
0002H 65 through 69 $1,878,228.00 $4.520 $22,072.94
0002I 70 through 74 $497,178.00 $4.520 $5,842.84
0002J 75 through 79 $99,436.00 $4.520 $1,168.58
0002K 80 through 84 $22,097.00 $4.520 $259.69
0002L 85 and above $11,049.00 $4.520 $129.85
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
0003
0003A Under age 35 $597,902,875.00 $0.034 $528,546.15
0003B 35 through 39 $690,815,014.00 $0.042 $754,370.00
0003C 40 through 44 $835,086,715.00 $0.058 $1,259,310.77
0003D 45 through 49 $1,017,232,073.00 $0.095 $2,512,563.23
0003E 50 through 54 $737,508,042.00 $0.156 $2,991,332.62
0003F 55 through 59 $315,966,650.00 $0.317 $2,604,197.13
0003G 60 through 64 $147,910,839.00 $0.480 $1,845,927.28
0003H 65 through 69 $40,748,298.00 $0.480 $508,538.76
0003I 70 through 74 $6,877,000.00 $0.480 $85,824.96
0003J 75 through 79 $2,175,872.00 $0.480 $27,154.89
0003K 80 through 84 $1,061,992.00 $0.480 $13,253.67
0003L 85 and above $207,556.00 $0.480 $2,590.30
Plan One: Basic Group Term Life (GTL) and Accidental Death and Dismemberment (AD&D)
Plan One: Option A GTL & AD&D
Plan One: Option B
Attachment B
Price Schedule
Basic GTL & AD&D
Option A - Optional Life Insurance and AD&D for the age bands listed below:
Option B - Optional Life Insurance and AD&D for the age bands listed below:
Base Period
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Optional Life Insurance Plan -
Option C Coverage Levels
Family Coverage by Coverage Option and Employee Age
Group
(C)
Estimated Quantity of
Family Units
(D)
Biweekly Premium Rate
(E)
Estimated Annual Premium
(CxDx26)
0004
0004A Under age 45 2069 $0.770 $41,421.38
0004B 45 through 54 2656 $1.460 $100,821.76
0004C 55 and above 1261 $3.530 $115,734.58
0005
0005A Under age 45 375 $1.500 $14,625.00
0005B 45 through 54 195 $3.220 $16,325.40
0005C 55 and above 120 $8.390 $26,176.80
0006
0006A Under age 45 1311 $2.690 $91,691.34
0006B 45 through 54 908 $6.140 $144,953.12
0006C 55 and above 309 $16.460 $132,239.64
(A)
CLIN
(B)
STD Insurance Plan Coverage by Age Band
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
0007
0007A 17 through 49 $42,402,275.00 $0.470 $5,181,558.01
0007B 50 and above $18,200,822.00 $0.610 $2,886,650.37
(A)
CLIN
(B)
Disability Insurance Plan Coverage
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
0008
0008A 17 through 24 $624,545.00 $0.170 $27,604.89
0008B 25 through 29 $3,715,203.00 $0.210 $202,850.09
0008C 30 through 34 $8,234,041.00 $0.250 $535,212.67
0008D 35 through 39 $8,819,880.00 $0.320 $733,814.02
0008E 40 through 44 $9,073,965.00 $0.470 $1,108,838.53
0008F 45 through 49 $9,070,297.00 $0.700 $1,650,794.06
0008G 50 through 54 $6,286,243.00 $1.040 $1,699,800.11
0008H 55 through 59 $4,011,949.00 $1.380 $1,439,487.31
0008I 60 through 64 $2,344,407.00 $1.470 $896,032.36
0008J 65 and above $685,889.00 $1.580 $281,763.21
Plan One: Option C - Family Coverage
Long Term Disability Insurance for the age bands listed below (4.3.3):
Plan Two: Long Term Disability Insurance
Option C - Family Coverage of $10,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $25,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $50,000 for spouse and $10,000 per dependent child:
Short Term Disability Insurance for the age bands listed below (4.3.2)
Plan Two: Short Term Disability Insurance
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
1001
1001A Basic GTL & AD&D $3,388,262,168.00 $0.065 $5,726,163.07
1001B Premium for Retirees with 75% Reduction (4.2.7) $1,480,451.00 $0.065 $2,501.97
1001C Premium for Retirees with 50% Reduction (4.2.7) $1,480,451.00 $0.328 $12,625.29
1001D Premium for Retirees with No Reduction (4.2.7) $1,480,451.00 $0.983 $37,837.37
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $10,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/10,000
1002
1002A Under age 35 $9,402,185.00 $0.350 $8,555.99
1002B 35 through 39 $9,137,024.00 $0.420 $9,977.64
1002C 40 through 44 $10,440,734.00 $0.570 $15,473.17
1002D 45 through 49 $13,324,366.00 $0.920 $31,871.89
1002E 50 through 54 $10,507,025.00 $1.490 $40,704.22
1002F 55 through 59 $6,374,925.00 $3.000 $49,724.42
1002G 60 through 64 $3,800,649.00 $4.520 $44,665.23
1002H 65 through 69 $1,878,228.00 $4.520 $22,072.94
1002I 70 through 74 $497,178.00 $4.520 $5,842.84
1002J 75 through 79 $99,436.00 $4.520 $1,168.58
1002K 80 through 84 $22,097.00 $4.520 $259.69
1002L 85 and above $11,049.00 $4.520 $129.85
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
1003
1003A Under age 35 $597,902,875.00 $0.034 $528,546.15
1003B 35 through 39 $690,815,014.00 $0.042 $754,370.00
1003C 40 through 44 $835,086,715.00 $0.058 $1,259,310.77
1003D 45 through 49 $1,017,232,073.00 $0.095 $2,512,563.23
1003E 50 through 54 $737,508,042.00 $0.156 $2,991,332.62
1003F 55 through 59 $315,966,650.00 $0.317 $2,604,197.13
1003G 60 through 64 $147,910,839.00 $0.480 $1,845,927.28
1003H 65 through 69 $40,748,298.00 $0.480 $508,538.76
1003I 70 through 74 $6,877,000.00 $0.480 $85,824.96
1003J 75 through 79 $2,175,872.00 $0.480 $27,154.89
1003K 80 through 84 $1,061,992.00 $0.480 $13,253.67
1003L 85 and above $207,556.00 $0.480 $2,590.30
Attachment B
Price Schedule
Option Period One
Plan One: Basic Group Term Life (GTL) and Accidental Death and Dismemberment (AD&D)
Basic GTL & AD&D
Plan One: Option A GTL & AD&D
Option A - Optional Life Insurance and AD&D for the age bands listed below:
Plan One: Option B
Option B - Optional Life Insurance and AD&D for the age bands listed below:
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Optional Life Insurance Plan -
Option C Coverage Levels
Family Coverage by Coverage Option and Employee Age
Group
(C)
Estimated Quantity of
Family Units
(D)
Biweekly Premium Rate
(E)
Estimated Annual Premium
(CxDx26)
1004
1004A Under age 45 2069 $0.770 $41,421.38
1004B 45 through 54 2656 $1.460 $100,821.76
1004C 55 and above 1261 $3.530 $115,734.58
1005
1005A Under age 45 375 $1.500 $14,625.00
1005B 45 through 54 195 $3.220 $16,325.40
1005C 55 and above 120 $8.390 $26,176.80
1006
1006A Under age 45 1311 $2.690 $91,691.34
1006B 45 through 54 908 $6.140 $144,953.12
1006C 55 and above 309 $16.460 $132,239.64
(A)
CLIN
(B)
STD Insurance Plan Coverage by Age Band
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
1007
1007A 17 through 49 $42,402,275.00 $0.470 $5,181,558.01
1007B 50 and above $18,200,822.00 $0.610 $2,886,650.37
(A)
CLIN
(B)
Disability Insurance Plan Coverage
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
1008
1008A 17 through 24 $624,545.00 $0.170 $27,604.89
1008B 25 through 29 $3,715,203.00 $0.210 $202,850.09
1008C 30 through 34 $8,234,041.00 $0.250 $535,212.67
1008D 35 through 39 $8,819,880.00 $0.320 $733,814.02
1008E 40 through 44 $9,073,965.00 $0.470 $1,108,838.53
1008F 45 through 49 $9,070,297.00 $0.700 $1,650,794.06
1008G 50 through 54 $6,286,243.00 $1.040 $1,699,800.11
1008H 55 through 59 $4,011,949.00 $1.380 $1,439,487.31
1008I 60 through 64 $2,344,407.00 $1.470 $896,032.36
1008J 65 and above $685,889.00 $1.580 $281,763.21
Short Term Disability Insurance for the age bands listed below (4.3.2)
Plan Two: Long Term Disability Insurance
Long Term Disability Insurance for the age bands listed below (4.3.3):
Plan Two: Short Term Disability Insurance
Plan One: Option C - Family Coverage
Option C - Family Coverage of $10,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $25,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $50,000 for spouse and $10,000 per dependent child:
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
2001
2001A Basic GTL & AD&D $3,388,262,168.00 $0.065 $5,726,163.07
2001B Premium for Retirees with 75% Reduction (4.2.7) $1,480,451.00 $0.065 $2,501.97
2001C Premium for Retirees with 50% Reduction (4.2.7) $1,480,451.00 $0.328 $12,625.29
2001D Premium for Retirees with No Reduction (4.2.7) $1,480,451.00 $0.983 $37,837.37
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $10,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/10,000
2002
2002A Under age 35 $9,402,185.00 $0.350 $8,555.99
2002B 35 through 39 $9,137,024.00 $0.420 $9,977.64
2002C 40 through 44 $10,440,734.00 $0.570 $15,473.17
2002D 45 through 49 $13,324,366.00 $0.920 $31,871.89
2002E 50 through 54 $10,507,025.00 $1.490 $40,704.22
2002F 55 through 59 $6,374,925.00 $3.000 $49,724.42
2002G 60 through 64 $3,800,649.00 $4.520 $44,665.23
2002H 65 through 69 $1,878,228.00 $4.520 $22,072.94
2002I 70 through 74 $497,178.00 $4.520 $5,842.84
2002J 75 through 79 $99,436.00 $4.520 $1,168.58
2002K 80 through 84 $22,097.00 $4.520 $259.69
2002L 85 and above $11,049.00 $4.520 $129.85
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
2003
2003A Under age 35 $597,902,875.00 $0.034 $528,546.15
2003B 35 through 39 $690,815,014.00 $0.042 $754,370.00
2003C 40 through 44 $835,086,715.00 $0.058 $1,259,310.77
2003D 45 through 49 $1,017,232,073.00 $0.095 $2,512,563.23
2003E 50 through 54 $737,508,042.00 $0.156 $2,991,332.62
2003F 55 through 59 $315,966,650.00 $0.317 $2,604,197.13
2003G 60 through 64 $147,910,839.00 $0.480 $1,845,927.28
2003H 65 through 69 $40,748,298.00 $0.480 $508,538.76
2003I 70 through 74 $6,877,000.00 $0.480 $85,824.96
2003J 75 through 79 $2,175,872.00 $0.480 $27,154.89
2003K 80 through 84 $1,061,992.00 $0.480 $13,253.67
2003L 85 and above $207,556.00 $0.480 $2,590.30
Attachment B
Price Schedule
Option Period Two
Plan One: Basic Group Term Life (GTL) and Accidental Death and Dismemberment (AD&D)
Basic GTL & AD&D
The biweekly premium rates for option period two shall be subject to prospective price redetermination, per the process in Section 2, Contract Type. If prices are adjusted, they will be
incorporated into the contract via contract modification.
Plan One: Option A GTL & AD&D
Option A - Optional Life Insurance and AD&D for the age bands listed below:
Plan One: Option B
Option B - Optional Life Insurance and AD&D for the age bands listed below:
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Optional Life Insurance Plan -
Option C Coverage Levels
Family Coverage by Coverage Option and Employee Age
Group
(C)
Estimated Quantity of
Family Units
(D)
Biweekly Premium Rate
(E)
Estimated Annual Premium
(CxDx26)
2004
2004A Under age 45 2069 $0.770 $41,421.38
2004B 45 through 54 2656 $1.460 $100,821.76
2004C 55 and above 1261 $3.530 $115,734.58
2005
2005A Under age 45 375 $1.500 $14,625.00
2005B 45 through 54 195 $3.220 $16,325.40
2005C 55 and above 120 $8.390 $26,176.80
2006
2006A Under age 45 1311 $2.690 $91,691.34
2006B 45 through 54 908 $6.140 $144,953.12
2006C 55 and above 309 $16.460 $132,239.64
(A)
CLIN
(B)
STD Insurance Plan Coverage by Age Band
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
2007
2007A 17 through 49 $42,402,275.00 $0.470 $5,181,558.01
2007B 50 and above $18,200,822.00 $0.610 $2,886,650.37
(A)
CLIN
(B)
Disability Insurance Plan Coverage
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
2008
2008A 17 through 24 $624,545.00 $0.170 $27,604.89
2008B 25 through 29 $3,715,203.00 $0.210 $202,850.09
2008C 30 through 34 $8,234,041.00 $0.250 $535,212.67
2008D 35 through 39 $8,819,880.00 $0.320 $733,814.02
2008E 40 through 44 $9,073,965.00 $0.470 $1,108,838.53
2008F 45 through 49 $9,070,297.00 $0.700 $1,650,794.06
2008G 50 through 54 $6,286,243.00 $1.040 $1,699,800.11
2008H 55 through 59 $4,011,949.00 $1.380 $1,439,487.31
2008I 60 through 64 $2,344,407.00 $1.470 $896,032.36
2008J 65 and above $685,889.00 $1.580 $281,763.21
Short Term Disability Insurance for the age bands listed below (4.3.2)
Plan Two: Long Term Disability Insurance
Long Term Disability Insurance for the age bands listed below (4.3.3):
Plan Two: Short Term Disability Insurance
Plan One: Option C - Family Coverage
Option C - Family Coverage of $10,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $25,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $50,000 for spouse and $10,000 per dependent child:
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
3001
3001A Basic GTL & AD&D $3,388,262,168.00 $0.065 $5,726,163.07
3001B Premium for Retirees with 75% Reduction (4.2.7) $1,480,451.00 $0.065 $2,501.97
3001C Premium for Retirees with 50% Reduction (4.2.7) $1,480,451.00 $0.328 $12,625.29
3001D Premium for Retirees with No Reduction (4.2.7) $1,480,451.00 $0.983 $37,837.37
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $10,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/10,000
3002
3002A Under age 35 $9,402,185.00 $0.350 $8,555.99
3002B 35 through 39 $9,137,024.00 $0.420 $9,977.64
3002C 40 through 44 $10,440,734.00 $0.570 $15,473.17
3002D 45 through 49 $13,324,366.00 $0.920 $31,871.89
3002E 50 through 54 $10,507,025.00 $1.490 $40,704.22
3002F 55 through 59 $6,374,925.00 $3.000 $49,724.42
3002G 60 through 64 $3,800,649.00 $4.520 $44,665.23
3002H 65 through 69 $1,878,228.00 $4.520 $22,072.94
3002I 70 through 74 $497,178.00 $4.520 $5,842.84
3002J 75 through 79 $99,436.00 $4.520 $1,168.58
3002K 80 through 84 $22,097.00 $4.520 $259.69
3002L 85 and above $11,049.00 $4.520 $129.85
(A)
CLIN
(B)
Life Insurance Plan
Coverage Level
(C)
Estimated Aggregate Life
Insurance Volume Based on
Salary Levels
(D)
Biweekly Premium Rate
per $1,000 of Coverage
(E)
Estimated Annual Premium
(CxDx26)/1,000
3003
3003A Under age 35 $597,902,875.00 $0.034 $528,546.15
3003B 35 through 39 $690,815,014.00 $0.042 $754,370.00
3003C 40 through 44 $835,086,715.00 $0.058 $1,259,310.77
3003D 45 through 49 $1,017,232,073.00 $0.095 $2,512,563.23
3003E 50 through 54 $737,508,042.00 $0.156 $2,991,332.62
3003F 55 through 59 $315,966,650.00 $0.317 $2,604,197.13
3003G 60 through 64 $147,910,839.00 $0.480 $1,845,927.28
3003H 65 through 69 $40,748,298.00 $0.480 $508,538.76
3003I 70 through 74 $6,877,000.00 $0.480 $85,824.96
3003J 75 through 79 $2,175,872.00 $0.480 $27,154.89
3003K 80 through 84 $1,061,992.00 $0.480 $13,253.67
3003L 85 and above $207,556.00 $0.480 $2,590.30
Attachment B
Price Schedule
Option Period Three
Plan One: Basic Group Term Life (GTL) and Accidental Death and Dismemberment (AD&D)
Basic GTL & AD&D
The biweekly premium rates for option period three shall be subject to prospective price redetermination, per the process in Section 2, Contract Type. If prices are adjusted, they will be
incorporated into the contract via contract modification.
Plan One: Option A GTL & AD&D
Option A - Optional Life Insurance and AD&D for the age bands listed below:
Plan One: Option B
Option B - Optional Life Insurance and AD&D for the age bands listed below:
CW124798 D.C. Employees Life Disability Insurance Program
Attachment B: Price Schedule
(A)
CLIN
(B)
Optional Life Insurance Plan -
Option C Coverage Levels
Family Coverage by Coverage Option and Employee Age Group
(C)
Estimated Quantity of
Family Units
(D)
Biweekly Premium Rate
(E)
Estimated Annual Premium
(CxDx26)
3004
3004A Under age 45 2069 $0.770 $41,421.38
3004B 45 through 54 2656 $1.460 $100,821.76
3004C 55 and above 1261 $3.530 $115,734.58
3005
3005A Under age 45 375 $1.500 $14,625.00
3005B 45 through 54 195 $3.220 $16,325.40
3005C 55 and above 120 $8.390 $26,176.80
3006
3006A Under age 45 1311 $2.690 $91,691.34
3006B 45 through 54 908 $6.140 $144,953.12
3006C 55 and above 309 $16.460 $132,239.64
(A)
CLIN
(B)
STD Insurance Plan Coverage by Age Band
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
3007
3007A 17 through 49 $42,402,275.00 $0.470 $5,181,558.01
3007B 50 and above $18,200,822.00 $0.610 $2,886,650.37
(A)
CLIN
(B)
Disability Insurance Plan Coverage
(C)
Estimated Annual Benefit
Level
(D)
Biweekly Premium Rate
per $100 of monthly covered
benefit
(E)
Estimated Annual Premium
(CxDx26)/100
3008
3008A 17 through 24 $624,545.00 $0.170 $27,604.89
3008B 25 through 29 $3,715,203.00 $0.210 $202,850.09
3008C 30 through 34 $8,234,041.00 $0.250 $535,212.67
3008D 35 through 39 $8,819,880.00 $0.320 $733,814.02
3008E 40 through 44 $9,073,965.00 $0.470 $1,108,838.53
3008F 45 through 49 $9,070,297.00 $0.700 $1,650,794.06
3008G 50 through 54 $6,286,243.00 $1.040 $1,699,800.11
3008H 55 through 59 $4,011,949.00 $1.380 $1,439,487.31
3008I 60 through 64 $2,344,407.00 $1.470 $896,032.36
3008J 65 and above $685,889.00 $1.580 $281,763.21
Short Term Disability Insurance for the age bands listed below (4.3.2)
Plan Two: Long Term Disability Insurance
Long Term Disability Insurance for the age bands listed below (4.3.3):
Plan Two: Short Term Disability Insurance
Plan One: Option C - Family Coverage
Option C - Family Coverage of $10,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $25,000 for spouse and $10,000 per dependent child:
Option C - Family Coverage of $50,000 for spouse and $10,000 per dependent child:
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment E: Performance Guarantees
Measure Target Reporting Methodology Formula Reporting FrequencyAssessment
Frequency
Annual % of
Total Funds at
Risk
Comments
STD Claims
95% of STD claims will
receive a determination
to approve, pend, or
deny within 5 business
days of claim
assignment
Via timeliness report
Number of claims determined
within 5 business days
÷
Total number of claims
determined during the reporting
period
Semi-Annual Annually 6.66%
Measured from the date all information is
available to process the claim to the date
claim decision is made. Measurement is
based upon business days.
LTD Claims
Decisions made on
average =<30 calendar
days from claim
assignment, excluding
days waiting on
information from
claimant
Via timeliness report
Total number of calendar days to
decide all claims during the
reporting period
÷
Total number of decided claims
during the reporting period
Semi-Annual Annually 6.66%
Measured from the date all information is
available to process the claim to the date
claim decision is made. Measurement is
based upon calendar days.
Life Claims
Payment will be made
within an average of 5
business days of receipt
of final information
needed to issue
payment.
Via audit sampling of Life
claim decisions. Audit 100%
of Life claims up to a
maximum of 30 for any
quarter.
Sum of days of all payments
÷
Total number of payments
Semi-Annual Annually 6.66%
Measured from the date all information is
available to process the claim to the date
claim decision is made. Measurement is
based upon business days.
STD claims transitioning to LTD
95% of all STD claims
that transition to LTD will
be reviewed and a
decision will be made to
approve or deny by LTD
payment due date
Via timeliness report
Total number of claims decided
by LTD Payment Due date
÷
Total number of claims
transitioned in period
Semi-Annual Annually 6.66%
Excludes late filed claims, LTD only claim,
claims requiring additional medical
documentation due to a preexisting condition
investigation or STD claims that were closed
at the 17-week Mandatory Review Date.
STD Claims 98.00%
Via audit sampling of STD
claim decisions. Audit 100%
of STD claims up to a
maximum of 30 for any
quarter.
Total number of procedures
handled correctly
÷
Total number of procedural
requirement
Semi-Annual Annually 6.66%
Procedural accuracy is how accurately the
claim was handled. Key claim procedures
measured are member’s address, Social
Security Number, date of birth, division
name/administrative unit, diagnosis code,
future close date and communication to
Employees and Employer within 2 business
days of approval or 5 business days of
approval for closed period or denial.
LTD Claims 98.00%
Via audit sampling of LTD
claim decisions. Audit 100%
of LTD claims up to a
maximum of 30 for any
quarter.
Total number of procedures
handled correctly
÷
Total number of procedural
requirement
Semi-Annual Annually 6.66%
Procedural accuracy is how accurately the
claim was handled. Key claim procedures
measured are member’s address, Social
Security Number, date of birth, division
name/administrative unit, diagnosis code,
future close date and communication to
Employees and Employer within 2 business
days of approval or 5 business days of
approval for closed period or denial.
PERFORMANCE GUARANTEES - Government of the District of Columbia
Initial Decision Turnaround Time
STD to LTD Rollover Turnaround Time
Procedural Accuracy
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment E: Performance Guarantees
Measure Target Reporting Methodology Formula Reporting FrequencyAssessment
Frequency
Annual % of
Total Funds at
Risk
Comments
PERFORMANCE GUARANTEES - Government of the District of Columbia
Life Claims 98.00%
Via audit sampling of Life
claim decisions. Audit 100%
of Life claims up to a
maximum of 30 for any
quarter.
Total correct procedures
÷
Total procedures in claim
Semi-Annual Annually 6.66% Beneficiaries and payees associated with the
claim verified accurately 98% of the time.
STD Claims 98.00%
Via audit sampling of STD
claim decisions. Audit 100%
of STD claims up to a
maximum of 30 for any
quarter.
1- Total dollar amount of
payment errors
÷
Total dollars payable
Semi-Annual Annually 6.66%
Payment accuracy is how accurately the
computation of the benefits is for a given
claim, including all deductions, taxes,
offsets, and adjustments.
LTD Claims 98.00%
Via audit sampling of LTD
claim decisions. Audit 100%
of LTD claims up to a
maximum of 30 for any
quarter.
1- Total dollar amount of
payment errors
÷
Total dollars payable
Semi-Annual Annually 6.66%
Payment accuracy is how accurately the
computation of the benefits is for a given
claim, including all deductions, taxes,
offsets, and adjustments.
Life Claims 98.00%
Via audit sampling of Life
claim decisions. Audit 100%
of Life claims up to a
maximum of 30 for any
quarter.
1- Total dollar amount of
payment errors
÷
Total dollars payable
Semi-Annual Annually 6.66%
Payment accuracy is the accurate benefit
calculation, per the policy, and the accurate
percentage of benefit paid to each
beneficiary, per the designation.
Member Satisfaction with Initial Claim
Decision
Average score of
“Satisfied” (3 or higher)
on member surveys
Monthly Transaction Report
Sum of responses to Overall
Satisfaction question
÷
Total number of respondents
Semi-Annual Annually 6.66%
100% of all initial STD, LTD, and Life claim
decisions will be surveyed. Survey
instrument rating is on a 1 to 5 scale.
If the Member Satisfaction metric fails at the end of the
annual assessment period, the amount at risk will be
tied to the product line that caused the metric to fail.
Average speed to answer Average speed <==30
seconds
Via call management
system report.
Number of seconds to answer all
calls during the reporting period
÷
Total number of calls answered
during the reporting period
Semi-Annual Annually 6.66%
Must have a toll free 800 number to have
guarantees around phone service.
If the Speed To Answer metric fails at the end of the
annual assessment period, the amount at risk will be
tied to the product line that caused the metric to fail.
Calls Abandoned
3% or less (Excludes
calls abandoned within
10 seconds.)
Via call management
system report.
Number of calls abandoned
during the reporting period
÷
Total number of incoming calls
during the reporting period
Semi-Annual Annually 6.66%
Must have a toll free 800 number to have
guarantees around phone service.
If the Calls Abandoned metric fails at the end of the
annual assessment period, the amount at risk will be
tied to the product line that caused the metric to fail.
Account Satisfaction Survey Average score of
“Satisfied” (3 or higher) on
account surveys.
Sum of responses to
Overall Satisfaction question
Total number of respondents
Semi-Annual Annually 6.66%
Reports – Financial and Claims
• STD and LTD Experience report
• Performance Guarantee report
• Claim Detail report
• STD and LTD Utilization reports
Financial Accuracy
Customer Telephone Service
Disability Member/Claimant Satisfaction
Account Management
<=60 days after
end of reporting
period
Via electronic distribution Not applicable Semi-Annual Annually 6.76% If due date falls on a vendor holiday or a
weekend, reports are due next business day.
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment E: Performance Guarantees
Measure Target Reporting Methodology Formula Reporting FrequencyAssessment
Frequency
Annual % of
Total Funds at
Risk
Comments
PERFORMANCE GUARANTEES - Government of the District of Columbia
IMPORTANT NOTES:
Penalties will not apply to any line of coverage that has less than 20 paid claims during the annual assessment period.
FORMULA: All performance guarantee metrics are measured and reported on Government of the District of Columbia's own results, not The Standard's book of business.
Effective Date:
Government of the District of Columbia:
Signature of authorized representative Date
Print name and title of authorized representative
Standard Insurance Company:
Signature of authorized representative Date
Print name and title of authorized representative
The Standard shall not be considered to have failed to perform its obligations under the agreement if any delay or nonperformance on its part is due, in whole or in part, to Government of the District of Columbia's failure to discharge its own obligations timely.
The Performance Guarantee will remain in force for the current policy period. At the end of the policy period The Standard and policyholder will review and determine if the Performance Guarantee shall remain in force and if so, what the terms shall be for the new policy period.
The Standard shall be exempted from the liability for failure to perform the obligations partially or fully under this agreement in cases of force majeure which includes natural disasters, accidents, fires, civil disorders, war, prohibitions of the government, enactments of legislative
and executive authorities which impede the fulfillment of the obligations by The Standard under this agreement and other circumstances beyond the control of The Standard. If The Standard cannot perform this agreement due to force majeure, it shall immediately notify the
policyholder, and try its best to minimize the possible losses as sustained by the policyholder.
TOTAL FUNDS AT RISK: For each Policy Period, the maximum penalty payable in aggregate by The Standard to Government of the District of Columbia as a consequence of failing to meet any or all of the foregoing Performance Guarantees is an amount not to exceed
2% of all insured products annual premium at risk. Life metrics will be tied to Life & AD&D premium, STD metrics are tied to STD premium/or fees, LTD metrics are tied to LTD premium.
ASSESSMENT PERIOD: All performance guarantee metrics are guaranteed on an annual basis. At the end of the annual assessment period, The Standard will not payout any penalties if Government of the District of Columbia's overall satisfaction is met.
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
District of Columbia Access System (DCAS)
A.

B.
C.
D.
A.
Classification Acronym
Mandatory or Optional M / O
B.
Configuration Acronym
Out of Box OOB
Client-Configurable CC
Vendor-Configurable VC
Modifiable M
Custom C
Not Supported N
C.
Complexity Section Acronym
In Use "X"
Complexity
N/A, L,
M, H, VH
D.
Comments Section
Comments
Attachment F
System Integration Requirements
The Offeror shall identify if the requirement functionality is currently in use. The Offeror shall
The Offeror shall provide a list of assumptions while responding to the Functional and
Offerors must follow the instructions below in completing the Funcational and Technical Requirements
Each of the Functional and Technical Requirements are numbered and identified as Mandatory or Optional.
For Mandatory Requirements (M), the Offeror must always indicate explicitly whether or not
For Optional Requirements, the Offeror must always indicate explicitly whether or not the
The District’s strong preference is to have Offerors propose highly configurable solutions.
Complete the Functional and Technical Requirements matrices below using the following instructions.
Column has been pre-filled based on The District's needs:
Description
Indicates whether the functionality is (M)andatory or
Place an "X" in the applicable column identifying configuration type:
Description
Indicates no configuration or modification or
Indicates the requirement is supported, and can be
Indicates the requirement is supported, and can be
Indicates the requirement can be supported with some
Indicates the complexity of the configuration,
customization, or modification if required. (N/A – if
OOB) L – Low, M – Medium, H – High, VH – Very
Complete comments section as applicable for each requirement
Description
Describe what product / feature / capability will be used
Indicates the functionality necessary to meet the
Indicates the vendor cannot meet the requirement.
Place an "X" in the column if the functionality is currently in use and the corresponding
Description
Indicates that the functionality that fulfills the
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
ENTERPRISE APPLICATION INTEGRATION
PRESENTATION
Category Requirement Description M / O
Standards The system's presentation tier must provide a uniform "look and
feel" across web interfaces to provide a consistent user experience.
Optional
Standards The system's presentation tier must leverage District approved
graphic/style elements (e.g., templates, stylesheets, logos, other
branding elements), where feasible. The implementer must identify
where District approved graphic/style elements cannot be utilized,
or are not advisable, in the proposed solution and why.
Mandatory
User
Interface
The system must provide a secure, browser-based solution. The
presentation tier must not require that any application, applet, or
plug-in be installed in order to provide its functionality.
Mandatory
User
Interface
The system's presentation layer must support multiple views
tailored to the end user's role and purpose (e.g. individual citizen,
SHOP employee, employer, caseworker, etc.).
Mandatory
User
Interface
The system must not depend solely on client-side validation
(screen edits) of user input (e.g., proper formatting of SSN, etc.).
Validation of user inputs must also be performed server-side.
Mandatory
User
Interface
The system must allow for the collection, reporting, and analysis
of website(s)/portal(s) usage and usage patterns.
Mandatory
User
Interface
The system must provide accessibility to persons with disabilities
and be in compliance with the following standards and guidelines:
* Rehabilitation Act of 1973, Section 508(c);
* US Access Board Guidelines for Section 508 (http://www.access-
board.gov/sec508/guide/index.htm); and
* W3C’s Web Content Accessibility Guidelines (WCAG) 2.0
(http://www.w3.org/TR/WCAG20).
* Human Centered User Experience UX2014
(http://http://www.ux2014.org/).
* Americans with Disability Act
(http://www.ada.gov/2010ADAstandards_index.htm).
Mandatory
User
Interface
The implementer must include a Section 508 Product Assessment
Package as part of their SDLC, and must perform regularly
scheduled (i.e., automatic) scans and manual testing for Section
508(c) compliance for all types of user interface screens (static,
dynamic, Web, mobile, etc.).
Mandatory
User
Interface
The system must present information, and solicit responses at an
appropriate literacy level that meets the language needs of the
consumer. The implementer should take reasonable steps to
provide meaningful access by persons with limited English
proficiency.
Mandatory
User
Interface
The system must provide the capability for mobile browsing on
small form factor devices and mobile computing platforms (i.e.,
smartphones, tablets, and PDA applications) in a manner suitable
for use.
Optional
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
User
Interface
The system must allow any web browser-based component to
operate consistently and fully across web browsers in widespread
use for all users, including support at the minimum for the
following browser platforms:
* Microsoft Internet Explorer;
* Apple Safari;
* Mozilla FireFox; and
* Google Chrome
The implementer must identify the complete list of browsers
(including version numbers) the system will support.
Optional
User
Interface
The system must employ consistent error handling that catches
both known and unknown errors, and displays "user friendly"
error messages.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
ENTERPRISE APPLICATION INTEGRATION
INTEGRATION SERVICES
Category Requirement Description M / O
Standards The system must provide support for EDI, HL7,
and HIPAA-compliant transactions.
Mandatory
Standards The system must support core data element
translation to and from a NIEM-based data model
to support consistent, transparent, data exchange
with external entities, States, and other health and
human services programs.
Mandatory
Standards The system must leverage an open web services
architecture and adhere to key MITA 3.0 standards,
such as SOAP, XML, WSDL, UDDI, SAML, and
other web services standards and specifications as
relevant from the OASIS WS-* and WS-I
specifications.
Mandatory
Interfaces The system must transmit data leveraging the
HIPAA 270/271 transaction set for eligibility data,
the HIPAA 834 transaction set for enrollment data,
and 820 Premium Payment transaction.
Mandatory
Interfaces The system must interface with other District
eligibility verification services as required to
determine eligibility within the District.
Mandatory
Integration The system must use only standard network
communication protocols (e.g. TCP, HTTP, UDP).
Mandatory
Interfaces The system must employ XML-based interfaces as
the primary integration vehicle for internal and
external interfaces.
Mandatory
Workflow The implementer must propose a solution for
managing, developing, monitoring, and executing
business process workflows.
Mandatory
Workflow The system must allow for the collection,
reporting, and analysis of workflow execution.
Mandatory
Workflow The system must provide the ability to define and
manage rules-based and user-defined alerts for
critical processes and events.
Mandatory
Workflow The system must allow for grouping, activation,
and suppression of alerts based on configurable
rules and/or thresholds.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Workflow The system must provide support for defining and
managing task (or worklist) events as part of
business process workflows.
Mandatory
Workflow The system must support manual task/activity
assignment and reassignment by a user or
supervisor role, as well as automatic task/activity
assignment and reassignment based on
configurable business rules.
Mandatory
Workflow The system must provide the ability to configure
reminders for time-sensitive workflows and events.
Mandatory
Workflow The system's workflow component must support
escalation of overdue worklists items, based on
configurable business rules.
Mandatory
Workflow The system must provide business activity
sensors\receptors for monitoring and reporting on
task and activity queues.
Mandatory
Workflow The system must provide a full-featured workflow
capability that supports invocation of web services
and nested workflows, execution of custom scripts
or routines, complex branching logic, and the
execution of rules engine policies.
Mandatory
Workflow The system must support a variety of mechanisms
to instantiate workflows, including but not limited
to: inbound communication events (email,
document upload, mail, form submission, or
phone)user initiated events, or exception
processing events.
Mandatory
Workflow The system must provide the ability to resume
suspended workflows.
Mandatory
Workflow The system must be able to read workflow
configuration data from a configuration store
during execution.
Mandatory
Workflow The system must provide the ability for privileged
roles to modify workflow executions through
maintenance of workflow configuration data.
Mandatory
Workflow The system must support long running workflows,
for example, workflows that span multiple days.
Mandatory
Workflow The system must allow all workflows to resume
following system outages, scheduled maintenance,
and disaster recovery scenarios.
Mandatory
SOA The system must be developed as a collection of
well-defined, independent services.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
SOA The system must be capable of writing data to
legacy data systems in real-time, as appropriate,
during phased data migration where attributes of an
entity may exist in multiple implementer solutions.
Mandatory
SOA The system must design and architect business and
technical services to promote reuse by other
District systems and applications as well as by
other States.
Mandatory
SOA The system must avoid implementing multiple
services that provide overlapping functionality.
Mandatory
SOA The system must have the ability to integrate with
common authoritative data sources and data
exchange services, including but not limited to,
federal, other district agencies, and commercial
entities as needed.
Mandatory
SOA The system must comply with open architecture
standards (non-proprietary), using guidance from
MITA 3.0, for ease of information exchange with
both internal and external entities.
Mandatory
SOA The implementer must develop and document an
approach for SOA Governance
Mandatory
SOA The system must support the ability to monitor
service usage and execution history for enforcing
adherence to established Service Level
Agreements.
Mandatory
Repository /
Registry
The system must incorporate a centralized
registry/repository for managing web services and
related metadata, including, but not limited to,
defining, exposing, locating, managing, and
governing web services.
Mandatory
Repository /
Registry
The implementer’s registry/repository solution
must be able to stand alone as well as provide the
capability to federate with other
registries/repositories
Mandatory
Repository /
Registry
All metadata artifacts must be tracked in the
registry/repository according to a taxonomy to be
defined by the implementer.
Mandatory
Repository /
Registry
The system must incorporate a registry/repository
that is interoperable, and leverages open standards
and specifications in alignment with MITA 3.0
guidance, including but not limited to, UDDI.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Repository /
Registry
The system's registry/repository solution for
managing web services must support endpoint
discovery and policy application at runtime.
Mandatory
Services
Design
The system must establish consistent
communication patterns and protocols for data
exchange with external entities. Interfaces must be
developed using common, widely used transport
protocols.
Mandatory
ESB The system's ESB component must support
messaging, guaranteed delivery, message queuing,
and routing based on message content or context.
Mandatory
ESB The system's ESB component and supporting ESB
services must support message transformation and
translation when needed.
Mandatory
Services
Design
The system must support both automatic and
manual retry for failed messages.
Mandatory
Services
Design
The system must leverage standard, reusable
integration design patterns (e.g., publish/subscribe,
request/reply, event-driven consumer, etc.) as
functional requirements dictate.
Mandatory
Services
Design
The system must be capable of producing
customized historical reports on service execution
metrics.
Mandatory
Business
Process
Management
The system must be based on a modular, business
process centric design that simplifies the ability to
modify or extend business processes, such as
eligibility determinations and enrollments.
Mandatory
Business
Process
Management
The system must provide the capability to monitor
and report business processes against established
key performance indicators (KPIs) which will be
established jointly by the District and the
implementer.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
District of Columbia Access System (DCAS)
SECURITY
Category Requirement Description M / O
Regulatory and
Policy
Compliance
The system must support compliance with federal and state,
regulations and policies relevant to system security,
confidentiality and safeguarding of information, including, but
not limited to:
* HIPAA Privacy Rule, 45 CFR Part 160 and Subparts A and
E of Part 164, established under the Health Insurance
Portability and Accountability Act, Public Law 104-191 (42
USC 1320d) to protect the security, confidentiality, and
integrity of health information;
* HIPAA Security Rule, 45 CFR Part 160 and Subparts A and
C of Part 164, established under the Health Insurance
Portability and Accountability Act, Public Law 104-191 (42
USC 1320d) to protect individuals’ electronic personal health
information that is created, received, used, or maintained by a
covered entity;
* Health Insurance Portability and Accountability Act of 1996
(HIPAA), pursuant to sections 1104 and 1501 of Affordable
Care Act, including the privacy, security and transaction
requirements;
* Internal Revenue Code (IRC) ss. 6103, 7213, and 7213A
* IRS Publication 1075, all requirements addressing handling
and storage of federal tax information (FTI) data pursuant to
IRC section 6103;
* Privacy Act of 1974
Where policies overlap, the system must always strive to attain
the more stringent policy. The most recent versions for
standards and specifications will be applicable.
Mandatory
Regulatory and
Policy
Compliance
The system must address the IRS Publication 1075
requirements restrictions, in particular, the ones
regarding the use of commingled data.
Mandatory
Regulatory and
Policy
Compliance
The system must follow all IRS required processes
during the stages prior to go-live including, but not
limited to, required agreements to protect Federal Tax
Information, training and other handling requirements of
FTI during the system development.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Regulatory and
Policy
Compliance
The system must support the NIST SP 800-53 Rev. 3
Moderate Control Baseline for security controls
guidance.
The implementer must identify and explain any planned
deviations from this standard, and justification for why
this standard cannot be adhered to within the system.
Mandatory
Regulatory and
Policy
Compliance
The proposing implementer must interact with a 3rd
party company to complete a Certification and
Accreditation of the system controls prior to go-live.
This Certification and Accreditation must follow NIST
SP 800-53 Rev. 3 guidance and standards for Moderate
Controls Baseline. The outcome of the Certification and
Accreditation must be delivered in both an electronic
and a paperbound format.
Mandatory
Regulatory and
Policy
Compliance
The system must provide automated technical security
controls that meet or exceed (in capability and in usage)
those specified by the NIST SP 800-53 Rev. 3 Moderate
Control Baseline. The specific families of controls
identified by this requirement are:
• Access Control (AC) (i.e view, modify, delete and
add);
• Audit and Accountability (AU);
• Identification and Authentication (IA); and
• System and Communications Protection (SC).
The system's implementation of these security controls
must incorporate the guidance described by the relevant
publications of the NIST and the SANS (SysAdmin,
Audit, Network, Security) Institute.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Regulatory and
Policy
Compliance
The system must provide sufficient capabilities,
automating as many as possible, to enable DHCF &
DHS to implement operational, management, or
procedural security controls as specified by NIST SP
800-53 Rev. 3 Moderate Control Baseline. The specific
families of controls identified by this requirement are:
• Awareness and Training (AT);
• Certification, Accreditation, and Security (CA);
• Configuration Management (CM);
• Contingency Planning (CP);
• Incident Response (IR);
• Maintenance (MA);
• Media Protection (MP);
• Physical and Environmental Protection (PE);
• Planning (PL);
• Personnel Security (PS);
• Risk Assessment (RA);
• System and Services Acquisition (SA); and
• System and Information Integrity (SI).
The system implementation of these security controls
must incorporate the guidance described by the relevant
publications of the NIST and the SANS Institute.
Mandatory
Encryption The system must provide encryption capabilities
provided by and used by the solution.
Mandatory
Encryption The system must provide the bility to encrypt both data
at rest and data in motion.
Mandatory
Encryption The system must require message-level encryption
(signed, encrypted messages) between application tier
boundaries to mitigate against the risk of any one tier
being comprised by malicious intent.
Mandatory
Encryption The system must provide for database-level encryption
at multiple levels (e.g., instance, tablespace, table,
column.)
Mandatory
Encryption The system must provide a re-usable architecture service
for the encryption and decryption of application shared
secrets/keys.
Mandatory
Encryption The system must support file-based encryption of flat or
XML files received from external entities.
Mandatory
Encryption The system must provide transport-level encryption of
data submitted from client to server devices using
Secure Sockets Layer encryption over HTTP.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Encryption The system must implement message-level security in
support of multiple node message delivery, including
reliance on standards specified in MITA version 3.0,
such as WS-Security, XML encryption, XML Signature,
WS-Trust, WS-Secure Conversation and WS-Security
Policy, and SAML.
Mandatory
Encryption The system must encrypt data in motion that contains
personally identifiable information or personal health
information using encryption processes that are FIPS
140-2 validated or compliant with NIST SP 800-52, 800-
77, and 800-113, as outlined in the Office of National
Coordinator for Health Information Technology's Patient
Protection And Affordable Care Act Section 1561
Recommendations, Recommendation 5.3 for Privacy
and Security.
Mandatory
Audit The system must maintain information on all changes to
critical records and/or data fields (e.g., SSN, Name,
etc.), including identification of the responsible system
user and date and time of the change.
Mandatory
Audit The system must routinely monitor the access to the
system.
Mandatory
Audit The system must collect sufficient detail to produce an
immutable audit log (e.g., user identification, machine or
IP identification, time of access, data viewed/accessed,
etc.) to be in compliance with privacy & disclosure
reporting requirements as required by federal and state
regulations (e.g., HIPAA.)
Mandatory
Audit The system must provide the ability to produce sortable
audit logs on-demand.
Mandatory
Audit The system must provide audit logging for access
control events that occur within the application
(unattended (batch) authentication attempts - successful
and failed events, resource-level access events -
successful and failed events, etc.)
Mandatory
Audit The system shall generate alerts for conditions that
violate security rules,
this includes but is not limited to:
a). Attempts to access unauthorized data and system
functions
b). Logon attempts that exceed the maximum allowed
c). Termination of authorized sessions after a specified
time of no activity
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Audit The system shall provide security incident reporting and
mitigation
mechanisms, including but not limited to:
a). Generates warning or report on system activity
based on security parameters
b). Terminates access and/or generates report when
potential security violation detected
c). Preserves and reports specified audit data when
potential security violation detected
Mandatory
Audit The system must provide audit logging for security
administration events that occur (e.g., shared secret/key
creation, reads/updates of shared secrets, etc.)
Mandatory
Privacy The system must capture, maintain and dispose of data
in accordance with applicable federal and state
standards and policies to protect the privacy of District
stakeholders and the integrity of the information on the
system.
Mandatory
Privacy The system must have security warning banners, headers
and footers, adhering to federal, and other applicable
standards that are prominently displayed on all screens
and reports and be readily customizable by support staff.
Mandatory
Privacy The system must provide the capability for auditing user
(application and administration operations) access to
PHI/PII data, including logging of events and user
dialogs explaining access.
Mandatory
Privacy The system must provide the capability to produce an
immutable audit log in sufficient detail (e.g., access date
and time, user identification, machine or IP
identification, event actions/activity identification and
chronology) for PII/PHI data related events in
compliance with Office of National Coordinator for
Health Information Technology's Patient Protection And
Affordable Care Act Section 1561 Recommendations,
Recommendation 5.3 for Privacy and Security.
Mandatory
Privacy The system must provide the capability for designating,
maintaining and reporting data at multiple levels (e.g.,
case, individual) as restricted or sensitive (e.g., domestic
abuse situation.)
Mandatory
Privacy The system must provide for data classification
strategies of privacy protected information for use
during design and implementation activities.
Mandatory
CW124798 D.C. Employees Life and Disability Insurance Program
Attachment F: System Integration Requirements
Privacy The system must be protected against unauthorized
access to computer resources and data in order to reduce
erroneous or fraudulent activities and protect the privacy
rights of individuals against unauthorized disclosure of
confidential information.
Mandatory
Privacy The system must provide the ability to warn the user
about accessing sensitive data (e.g., PII/PHI, Domestic
abuse protected individuals, etc.) and allow the user to
confirm and proceed with such actions.
Mandatory
Privacy The system must provide the ability to confirm the
access to Privacy Protected data and enter a reason to
justify.
Mandatory
Privacy The system must provide the capability to monitor, log,
and report access to Privacy Protected data. Reporting
by protected person, as well as by system user, must be
provided.
Mandatory
Privacy The system must notify and require users to read and
accept privacy policies and rules with regard to
application use.
Mandatory
Privacy The system must inform users of privacy policy
regulations enforced by the application - including the
logging of user's access attempts to PII/PHI and other
actions taken within the application that are subject to
privacy reporting and disclosure notification.
Mandatory
Privacy The system must provide the ability to apply format
masks to sensitive data that is displayed on the screen
(e.g., PHI, SSN).
Mandatory
Vulnerability The system must provide mechanisms that prevent XML-
specific security vulnerabilities, including:
• Whether the solution will rely on XML-aware
networking devices;
• Protection against XML Denial of Service Attacks
(invalid or non-well-formed messages, self-referencing
entity definitions, large number of nodes, etc.); and
• Protection against XML attachments that may contain
malware (viruses, worms, etc.).
Mandatory
Vulnerability The system shall provide mechanisms to prevent against
client-side specific security vulnerabilities (e.g., cross-
site scripting.)
Mandatory