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IL <br />The Proposal rest contain the following information in the order listed. If you <br />are unable to provide the items listed, please explain in your Proposal why the <br />item is omitted. For Proposals consisting of more than one vendor, it is the <br />vendors' responsibility to work together and submit one sat of Requested <br />Information, including one Proposal Questionnaire ("Questionnaire"). <br />1. A list of each vendor that is part of the Proposal, including name, address, <br />phone, fax, e-mail, and the name of a contact person with respect to that <br />vendor, and a description of the services provided by that vendor. <br />2. Request for Proposal Form, signed by an officer of each vender that is part of <br />the Proposal. <br />3. Narrative Proposal, clearly stating all charges and fees, including but not <br />limited to investment and management charges made against funds invested <br />in the funding vehicles, and per head, per occurrence, etc. administrative <br />fees, initial set up fees (e.g., plan document, trust document, IRS <br />determination letter request). <br />4. Information pertaining to each vendor(s) compliance activities with respect to <br />the Head Insurance Portability and Accountability Act ( "HIPAX). If a <br />covered entity under HIPAA in your own right, please provide copies of your <br />HIPAA privacy policy and procedures. If not a covered entity in your own <br />right, please provide evidence of your ability to perform as a business <br />associate. <br />5. The completed Questionnaire. Answers to the questions are a critical part of <br />your Proposal. For purposes of simplicity, please respond to the <br />Questionnaire in the following format: <br />Restate the question. <br />Provide as brief an answer yet as complete a response as possible. <br />Avoid the use of "N/A." If you feel a question does not apply to you, <br />briefly explain why. <br />Respond fully to the question, every if you are restating information <br />already provided. If you mare any reference to a document or <br />information that was stated earlier in the Proposal: please provide the <br />exact reference and page number in the Proposal where the additional <br />information can be found. <br />6. Please provide copies of the following information: <br />Sample or examples of communication pieces used to inform d <br />employees about this new benefit. <br />Sample or examples of Plan summary brochures given to employees. <br />Trust documents,. <br />IRS determination letter(s). <br />Paige 12 <br />