1.Q&A DMS-2122-027_5.23.22.pdf

RFP No.: DMS-21/22-027 Questions and Answers Page 1 of 6

QUESTIONS AND ANSWERS TO THE FOLLOWING REQUEST FOR PROPOSALS (RFP):

GROUP DENTAL INSURANCE

RFP NO.: DMS-21/22-027

Date: May 23, 2022

The Department’s responses to timely submitted questions are below.

Question Number Section Page

Number Question Response

1 Will the plans be Employer/Employee Contribution? If so, what is the percentage? Does the Employer pay all or Voluntarily?

The plans will be one hundred percent (100%) employee contribution.

2 Attachment I Pages 2-6 Please add a column for total enrollment count by month and plan to the claims experience.

See Exhibit 1 – Dental Premium and Enrollment of these Questions and Answers.

3 Attachment I Page 1 Please provide claim experience detail by plan (utilization by service category) for the existing PPO plans. See response to Question #2.

4 1.4 Page 6 How will the current five (5) “grandfathered” dental plans that are offered through the Program today be affected by the RFP?

The current five (5) “grandfathered” dental plans are outside the scope of, and are not intended to be affected by, this RFP.

5 Attachment A 43 Please expand around 11.30 Best Pricing Clause and how it applies to this solicitation.

See AR-33 bullet e. in Attachment 2, of the Draft Contract (Attachment A).

6 N/A N/A Please provide a list of top utilized dentists that includes services and charges so that we may perform a disruption.

A disruption is outside the scope of this RFP. Complete and submit the Network Information in accordance with the instructions described in Attachment F, of the RFP.

7 Attachment 4 75 What percentile should be used to approximate R&C? 80th percentile for all plans?

The Department cannot offer guidance on Reasonable & Customary (R&C) charges.

8 N/A N/A Please provide monthly enrollment and monthly claims paid and premium paid for the last two years.

See Attachment I: Dental Claims Experience. Also, see Exhibit 1 –

RFP No.: DMS-21/22-027 Questions and Answers Page 2 of 6

Number Section Page

Number Question Response

Dental Premium and Enrollment of these Questions and Answers for the other requested information.

9 Attachment 4 75 Are plan deviations allowed? No.

10 Attachment 4 75 Are the Pre-paid plans part of this RFP? If so, is there a pricing sheet for pre-paid? No.

11 Attachment C N/A The SunLife Indemnity w/PPO plan does not appear on the census file nor is it on the pricing sheet. Is this plan not being considered for the purposes of this RFP?

No. The SunLife Indemnity PPO Plan is a “grandfathered” plan and outside the scope of this RFP. Also, see response to Question #4.

12 1.4 & Attachment A

6 (RFP) &

77-79 (Att.

A)

Please confirm that the only plan designs requested for bidders to quote on are: Indemnity with Preferred Provider Organization (PPO), Standard PPO, and Preventative PPO, all on a fully insured basis – and that the Prepaid DHMO plans are not in the scope of this RFP.

Confirmed. Also, see response to Question #10.

13 3.6, Tab 8 18 Can you please update the thirty-six (36) months of historical experience (Attachment I: Dental Claims Experience) to break out by enrollment (carrier and plan).

See response to Question #2.

14 Attachment 3, PG-16 85

Based on the prior RFP, this Performance Guarantee is new and different than what has been requested in the past.

Proposed: See below of the proposed performance guarantee.

No, negotiations are not permitted as part of this RFP process. Also, refer to section 2.6 Contract Formation, of the RFP.

RFP No.: DMS-21/22-027 Questions and Answers Page 3 of 6

Number Section Page

Number Question Response

A Performance Guarantee of this nature could drive the winning carrier to deny claims that would have been otherwise approved just to satisfy meeting the decision deadline and therefore impact employee and dependent satisfaction and out of pocket expenses.

Would the State consider replacing it with the current claims approval PG which was worded as:

(See below of the prior Performance Guarantee.)

15 Attachment B Tabs B1, B2, B3

We noticed the enrolled lives listed on each tab of “Attachment B – Price Sheet” are the same across all three plan options when current enrollment varies between plans based on the Census file provided. As a result, each plans pricing is scored and weighted exactly the same even though the actual enrollments are significantly different.

Attachment B: Form B4 (Total Blended Rate), is used to account for variances.

RFP No.: DMS-21/22-027 Questions and Answers Page 4 of 6

Number Section Page

Number Question Response

Below are the enrolled lives that appear in all three tabs of “Attachment B – Price Sheet”:

Tier All Plans Combined Employee 28,975 Employee + Spouse 11,945 Employee + Children 8,655 Employee + Family 18,282 Total 67,857

Below are the enrolled lives by plan based on the “Attachment C – Census File Dental February 2022”:

Tier Indemnity w/PPO Standard

PPO

Preventive

PPO

Employee 7,820 16,855 4,300 Employee + Spouse

3,510 7,171 1,264

Employee + Children

2,553 5,186 916

Employee + Family

5,249 10,858 2,175

Total 19,132 40,070 8,655

Has the State considered using actual enrolled lives shown above from “Attachment C – Census File Dental February 2022” in its evaluation rather than the total enrolled lives that were pre-populated in “Attachment B – Price Sheet”, thus allowing for more equitable scoring and weighting?

RFP No.: DMS-21/22-027 Questions and Answers Page 5 of 6

Number Section Page

Number Question Response

16 1.4 6

Please provide monthly paid premium, monthly enrolled lives, and monthly claim counts for 2019 through 2021 that correspond with the claims data provided in Attachment I, broken out for the following plans: Ameritas Indemnity w PPO, Ameritas Standard PPO, Ameritas Preventative PPO, and Sun Life Indemnity w PPO.

See responses to Question #8 and Question #11.

17 1.4 6 What population(s) is eligilble for the Sun Life Indemnity w PPO and when was the plan effective? See response to Question #11.

18 1.4 6 Please provide historical rates for 2019, 2020, and 2021 for the plans: Ameritas Indemnity w PPO, Ameritas Standard PPO, Ameritas Preventative PPO, and Sun Life Indemnity w PPO.

See Exhibit 2 – Premium Rates of these Questions and Answers. Also, see response to Question #11.

19 1.4 6 Please provide detailed certificates for the Ameritas Indemnity w PPO, Ameritas Standard PPO, Ameritas Preventative PPO, and Sun Life Indemnity w PPO.

See Exhibit 3 – Combined Certificates of Coverage of these Questions and Answers. Also, see response to Question #11.

20 1.4 6 Have there been any plan design changes to the Ameritas Indemnity w PPO, Ameritas Standard PPO, Ameritas Preventative PPO, and Sun Life Indemnity w PPO plans in the last 3 years?

No. Also, see response to Question #11.

21 1.4 6 Is the intent to continue offering the Dental program through multiple carriers as it is designed today, or will a single carrier be awarded all plans in scope of this bid?

The Department intends to make a single award; however, the Department reserves the right to award to one (1) or multiple Respondent(s), statewide or to make no award, as determined to be in the best interest of the State.

Also, refer to section 4.4, Basis of Award, of the RFP.

22 Attachment C Enrolled

Employees Worksheet

Attachment C – Census File Dental February 2022 contains enrolled lives data for only the Ameritas and MetLife plans. Please update the file to include current enrolled lives information for the Sun Life Indemnity w PPO plan if that plan is in scope.

See response to Question #11.

23 1.1 4 Please confirm if the State requires a DHMO (Pre-paid) Plan bid.

The benefit plan document includes this plan, however, the RFP and

The Department intends to make an award for the three (3) Plan Designs (Indemnity with Preferred Provider Organization (PPO), Standard

RFP No.: DMS-21/22-027 Questions and Answers Page 6 of 6

Enclosures:

Exhibit 1 – Dental Premium and Enrollment Exhibit 2 – Premium Rates Exhibit 3 – Combined Certificates of Coverage

END OF QUESTIONS AND ANSWERS

Number Section Page

Number Question Response financial exhibit do not. The guidance in the bid is to duplicate existing plan design.

PPO, and Preventative PPO) contemplated in this RFP. Also, refer to section 1.1, of the RFP and see response to Question #12.

24 Attachment C

Key for Enrolled

Employees Tab

Key for Enrolled Employees Tab shows Benefit Plan key detail for Ameritas and MetLife PPO plans only. Is the State only looking to replace the Ameritas and MetLife PPO plans?

Yes. Also, see responses to Question #4, Question #11 and Question #23.

25 Attachment C All 3 tabs Please provide an updated census with an indicator for subscriber/member plan election if looking to replace all dental plans.

A current census was provided as Attachment C, of the RFP. Also, see responses to Question #23 and Question #24.

26 Attachment I N/A Please provide claim detail with monthly enrollment. See response to Question #16.

27 Attachment F N/A Please clarify what is meant by “combined average” under the “total field” as it is not feasible to average urban, suburban and rural details. Also, is it your expectation we run all employees for the total?

The combined average can be achieved by adding the percentages of urban, suburban, and rural, and dividing the sum by three (3). The information provided in Attachment C, of the RFP, for the 175,078 Eligible Employees should be used.

28 N/A N/A If a new census is required to provide a response to this RFP, would the State consider an extension? No. See response to Question #25.