Contact Center Operations - Request for Information

This RFI is modified as of 04/28/2016: 1. Attachment 1 has been updated to include all volume assumption tables. Additionally, the Attachment 1 has been renamed from "historical weekly volume" to "volume assumptions." This RFI if modified as of 04/19/2016: 1. Please see RFI Attachment 1 (historical weekly volume) 2. The due date in the "Requested Information" section has been corrected to May 16, 2016 Synopsis: THIS IS A REQUEST FOR INFORMATION (RFI). This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this RFI is to obtain knowledge and information for project planning purposes, exploring alternative solutions and determining industry best practices for managing large scale contact center operations with the demands of multiple program needs and large spikes in volume during the Open Enrollment Period. Background: CMS is the largest purchaser of health insurance in the United States. CMS works to ensure high quality health care at a reasonable price and to provide information about benefits, health promotion, and choices. CMS is responsible for accurate, timely, relevant, understandable, and easily accessible information that will help individuals evaluate health plan options, nursing home options, and make decisions on their individual health care needs. On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act (P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable Care Act. The Affordable Care Act creates new competitive private health insurance markets - called Marketplaces that will give millions of Americans and small businesses access to affordable coverage and the same insurance choices members of Congress will have. Marketplaces will help individuals and small employers shop for, select, and enroll in high quality, affordable private health plans that fit their needs at competitive prices. CMS's Contact Center Customer Service (CCCS) objective is to establish a Contact Center Operations (CCO) environment that will provide customer service functions which are able to efficiently handle and answer inquiries with a high level of service across the United States and its territories. The operations include offering the same range of services and quality across multiple contact channels, such as telephone, mail, email, TDD/TTY, fax, and web chat, enabling multi-channel access. In order to meet national program missions and strategies as well as legislative mandates (Balanced Budget Act of 1997 and Medicare Modernization Act of 2003), CMS operates a toll-free, nation-wide, 24/7 contact center with multiple sites to provide customer service and address inquiries, which includes 1-800 MEDICARE. In addition to this, with new reform and regulations and with the advent of the Affordable Care Act (ACA), calls and inquiries may also include issues regarding the Affordable Care Act (ACA), consumer health choices or other Federal programs and Department of Health and Human Services (DHHS) initiatives including the operation of a Federal Marketplace, which includes the operations of a contact center to support all non-state based Marketplaces.. The inquiries that CCO will be responsible for generally align with the different traditional benefits and programs, as well as questions about general policies, referrals for assistance in decision-making or other individual healthcare needs. Annually, CMS experiences a - peak inquiry volume from October through the mid-January time frame. This peak period is driven by high call volumes due to mass mailing of the Medicare & You handbook: annual enrollment in prescription drug plans, Marketplace plans or other health plans: managed care non-renewal notices: managed care enrollment period; and information sent by the Social Security Administration (SSA) each December concerning cost of living adjustments and Medicare premiums for the next calendar year. CMS may also experience unforeseen peak periods at other times in the year based on changes in Medicare, Marketplace or other federal health program policy; tax season; legislation; media and outreach activities, etc. The complexity and various factors of the CMS programs will drive many of the inquiries to the CCO environment. It is important that the CCO contractor understands the magnitude and complexity of the program and the scope of information that Customer Service Representatives (CSRs) will provide in response to inquiries. The contact center serves as one of the primary outreach channels for a significant population of individuals and therefore requires high performance standards, disaster planning (business continuity), and other important oversight and monitoring functions. Description: CMS is seeking information from the contact center industry on operational insights related to large swings in staffing, best practices in utilizing part time verses full time staffing, as well as managing and balancing two large scale programs (1-800 MEDICARE as well as the Marketplace) within the same 24/7 infrastructure. Please use the following volume assumptions for reference when formulating responses: IVR Offered Call Volume by Program Medicare Marketplace January 2,662,614 4,320,735 February 2,254,072 5,504,509 March 2,257,485 2,854,979 April 1,929,569 2,262,536 May 1,715,854 1,659,404 June 1,907,676 1,663,763 July 1,881,090 1,540,112 August 1,764,614 1,246,418 September 1,872,365 1,242,072 October 2,340,840 1,489,085 November 2,411,900 3,243,276 December 2,450,955 6,828,111 Total annual call volume 25,449,034 33,855,000 The following is a historical breakdown by week of the incoming volume for both programs: See RFI A160939 Attachment 1 (historical weekly volumes) Please use the following monthly Average Handle Time assumptions for reference: Monthly AHT by Program Medicare Marketplace January 9 1/2 min 18 min February 9 1/2 min 13 1/2 min March 8 min 13 1/2 min April 8 min 13 1/2 min May 8 min 13 1/2 min June 8 min 13 1/2 min July 8 min 13 1/2 min August 8 min 13 1/2 min September 8 min 13 1/2 min October 9 1/2 min 13 1/2 min November 9 1/2 min 18 min December 9 1/2 min 18 min Information Requested: Respondents interested in this RFI may provide a response that includes the following information for CMS internal use and consideration. CMS is interested in recommendations on the following operational areas: - Have you had previous contact center contracts requiring yearly, large ramp ups and ramp downs of staffing? If so, how did you manage these staffing/recruiting challenges? - Do you utilize part time staffing? If so, what are the advantages and corresponding challenges? What are the ratios of full time CSRs to part time CSRs? - How do you factor overtime and authorized time off (ATO) into your workforce management strategy? - Do you utilize seasonal staffing? If so, describe your retention strategy to avoid attrition particularly as it gets closer to the program ending date? - Do you manage multiple high level program initiatives? If so, how do you leverage staffing resources for overlapping program needs? - How do you maintain reasonable service levels on high volume deadline days when IVR offered can exceed 1 million? - Any other feedback you consider constructive. We appreciate your time and effort in responding to this request for information. Requested Information: The response to this RFI shall be in writing submitted to the point of contact below. Any company may respond to this RFI, and there is no limit on the number of responses that may be submitted. The response should contain the following information: 1. Name of submitter and contact information: a. Company Name b. Company Address c. Company Point of Contact, Phone and Email address 2. Submit responses to the above questions as well as any other relevant information. Submissions to this RFI are due by Monday, May 16, 2016 not later than 3:00 PM EST electronically to the below addresses: brian.humes@cms.hhs.gov - Brian Humes (Contract Specialist) deborah.lester@cms.hhs.gov - Deborah Lester (Contracting Officer) Disclaimer and Important Notes: This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed. Information provided will be used to assess tradeoffs and alternatives available for the potential requirement and may lead to the development of a solicitation. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. Confidentiality: No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s). Questions may be submitted electronically up to the date and time for responses to Brian Humes at (410) 786-8898 or at brian.humes@cms.hhs.gov.