10-Addendum 1 QA RFP-2025-710-HRM-CG Fully Insured Self-Funded Group Dental Insurance 7.28.25 McGriff Updates (SB) 8.14.25.pdf

RFP-2025-710-HRM-CG “Fully Insured & Self-Funded Group Dental Insurance”

City of Albuquerque

Addendum #1 Issued August 14, 2025

Solicitation Number: RFP-2025-710-HRM-CG

Fully Insured & Self-Funded Group Dental Insurance

Deadline for Receipt of Proposals: August, 20, 2025: 4:00 p.m. (Mountain Time)

The City eProcurement System will not allow Proposals to be submitted after this date and time.

City of Albuquerque Department of Finance and Administrative Services

Purchasing Division

The purpose of this Addendum is to answer questions received that were timely submitted.

A. Questions Received:

1. QUESTION: As a Texas resident, may I submit a proposal?

ANSWER: Yes. The City seeks a competitive bid process

2. QUESTION: On average, how many in-person meetings take place each year, in which the benefits consultant would participate?

ANSWER: Typically, an average of 4-5 in person meetings occur each year.

3. QUESTION: Please provide clarification on the geo request. Per the RFP, 6,900 employees must be used in the Geo determination; however, the census reflects around 7,700 zip codes. Either a revised census reflecting the 6,900 zips will need to be provided or provide confirmation that we should run the geo off of the current census which reflects 7,700.

ANSWER: Utilize 7,700 zip codes as is in the census

4. QUESTION: Page 21 of the RFP mentions to submit our cost proposal (Appendix A) separately from our technical proposal. To clarify, the Cost Proposal is labeled Appendix H, not Appendix A. Can you confirm this was a typo and that there is no separate Appendix A that should be submitted?

ANSWER: Confirmed. Cost Proposal is Appendix H

5. QUESTION: The Bonfire site includes a section to upload 'Preferences'. Can you confirm if you are looking for our Local Preference Certificate?

ANSWER: We are only looking for the Pay Equity Preference or the New Mexico State Certification preferences, as referenced in Section 1.21.

6. QUESTION: What platform and provider do you use for your HRIS system?

ANSWER: The City uses PeopleSoft.

7. QUESTION: Please explain the reason(s) that this RFP is out to the market.

ANSWER: The City desires to test the marketplace for dental services.

8. QUESTION: Does the customer currently partner with or have plans to partner with a third-party entity that will assist in their benefit administration? Please include the name(s) of the entity partner(s) being considered and explain the scope of services they will provide.

ANSWER: The City uses PeopleSoft for benefits administration.

9. QUESTION: What specific services would the requested credit(s) funds cover?

Who will be performing the services (customer, broker, TPA)?

ANSWER: Credits would be applied towards Technology/BenAdmin fees, Communications, Internal Resources, Marketing Materials, etc.

10. QUESTION: Can you provide the full booklet/SPD? While a high level plan design was provided, Plan documents are necessary to properly understand the current plan provisions, limitations, and exclusions as well as to complete a list of deviations needed for the RFP response.

ANSWER: See attached Dental Booklet

11. QUESTION: Appendix F (Dental Technical Workbook) indicates that Preventive and Diagnostic (Routine) services do not apply towards the annual maximum.

However, this is not reflected in Appendix D (Current Dental PPO Plan Design).

Please confirm if Preventive and Diagnostic services apply toward the annual maximum.

ANSWER: The current Dental Plan has a $1,500 plan year maximum and a separate $1,200 orthodontic lifetime maximum benefit. Class 1 preventive/diagnostic services benefits do not apply to the $1,500 plan year maximum.

12. QUESTION: Appendix F (Dental Technical Workbook) indicates that TMJ is covered. However, this is not reflected in Appendix D (Current Dental PPO Plan Design). Please confirm if TMJ is covered.

ANSWER: Radiographic images, and appliances for the diagnosis and/or treatment of temporomandibular joint dysfunction (TMJ) are covered under the dental plan.

13. QUESTION: What, if any, changes to the current plan design are being requested?

ANSWER: No changes are being requested at this time. Please adhere to the RFP terms and conditions and other requested and required information.

14. QUESTION: Please outline any plan changes that occurred with the 7/2024 carrier change.

ANSWER: Plan changes were minimal.

15. QUESTION: Is runout claim experience from the prior carrier Delta available?

The reason for asking is that claims drop for several months starting in July 2024, which implies the claims provided are only from the new incumbent.

ANSWER: Claim Run-out experience is not available.

16. QUESTION: Please provide claim counts or EOBs.

ANSWER: For the period July 1, 2024 through May 31, 2025, the total number of in-network billed/approved procedures is 50,122 and the total number of out of network billed/approved procedures was 7,549.

17. QUESTION: Is a claim split available between in-network and out of network? If not, please confirm the percentage of claims paid In-Network.

ANSWER: For the current Dental Plan, the current In-network utilization is 86.4% based on billed/approved claim dollars.

18. QUESTION: If possible, please provide a Network Savings report or similar that shows, split into in-network/out-of-network, over a recent 12-month time period:

Submitted Charges, Allowed amounts after dentist discounts/R&C rollbacks are applied, and ultimately, paid claims.

19. QUESTION: Are the renewal rates available, or are they in a rate guarantee for 7/1/2026?

ANSWER: The BCBS Dental rates are under rate guarantee for 7/1/2026.

20. QUESTION: Are there are any pass-through or explicit administrative charges included in the current and historical rates?

ANSWER: The City’s obligation under the current insured contract is captured in the current premium rates.

21. QUESTION: Is the City of Albuquerque and its participating entities exempt from premium tax?

ANSWER: Yes

22. QUESTION: Does the City of Albuquerque expect to pay premiums within a 30 day grace period?

ANSWER: The City would prefer a 60 day grace period.

23. QUESTION: Please provide full SPD for benefit review?

ANSWER: See attached Dental Booklet

24. QUESTION: Primary reason for the group’s marketing?

25. QUESTION: Are there any current service or network concerns with their dental carrier?

ANSWER: There are no service issues. The City is looking to expand network and possibly move to self funding.

26. QUESTION: How is the current MAC out of network reimbursement calculated, is it based on the in-network provider schedule/contracted fees or something else?

ANSWER: The MAC OON Reimbursement is calculated based on the in-network provider schedule/contracted fees.

27. QUESTION: #3.8 in the RFP document under Scope of Services notes that the

“successful Offeror shall assist in preparation of publishing of City’s benefit booklet and pay a pro rata share of the benefit booklet” – can additional clarification be provided on which costs specifically the City is looking for the dental vendor to fund?

ANSWER: Each vendor pays for their portion of the cost for the pages outlining benefits in the benefit booklet. Based off the 2025 booklet, the dental pages cost came out to $5,427. The cost for the dental pages in the 2026 booklet is expected to be in this same price range.

28. QUESTION: Please confirm the experience exhibit provided (Exhibit E) includes Delta data prior to 7/1/24 vs BCBS data July 2024 through May 25, and whether the BCBS data is immature or if there was some sort of maturation factor or other adjustments applied to paid claims for any of the months on the exhibit?

ANSWER: No maturation factor was applied.

29. QUESTION: Are there any dental rate caps or guarantees currently in place with the incumbent carrier for the 2026/2027 policy year or beyond?

ANSWER: The dental plan with BCBS included a 3 year rate guarantee.

30. QUESTION: Is the provider disruption file included with the RFP a complete list of all providers utilized by the City’s employees and associated entities?

Can an updated file be provided to also include submitted charge data by provider?

ANSWER: Yes, the provider file is a complete list for the City and entities.

31. QUESTION: Were any plan changes made during the experience period provided, or when the dental business moved from Delta to BCBS?

ANSWER: Minimal changes were made in the move from Delta to BCBS.

32. QUESTION: Are there any historic or anticipated changes to the current % employer contribution strategy for dental?

ANSWER: No anticipated changes at this time.

33. QUESTION: What is the current in-network usage as a % of submitted charges?

34. QUESTION: The benefit summary indicates that Preventive services are covered at 80% OON. Is this correct?

ANSWER: Yes, that is correct.

35. QUESTION: Can we get more recent additional experience?

ANSWER: No additional experience is available.

36. QUESTION: What was Delta’s proposed renewal when the group left?

ANSWER: The City is not disclosing this information at this time.

37. QUESTION: What codes are included in current implant coverage?

ANSWER: Implant codes are: 6020, 6011, 6013, 6040, 6050, 7994

38. QUESTION: Are composite fillings currently covered at the alternate amalgam benefit level on posterior teeth?

ANSWER: An alternate benefit of an amalgam filling is not applied to composite fillings on posterior teeth.

39. QUESTION: What additional benefits are currently offered for pregnant women?

Are they offered to people with any other health conditions?

ANSWER: Additional benefits are offered to members with a health condition of: Cardiovascular disease, Diabetes, Pre-Diabetes or Pregnancy.

The BlueCare Dental Enhanced Benefit program offers an additional one of the following procedures after regular benefits have been used:

• Scaling & Root Planing

• Periodontal Maintenance

• Preventive Cleaning

40. QUESTION: Can we get some form of weighting (ie claim dollars, counts, services, members, etc.) added to the disruption

ANSWER: Updated file attached.

41. QUESTION: Do the deductible and max run calendar year or contract year?

ANSWER: The deductible and annual maximum run on a contract year (July 1st through June 30th)

42. QUESTION: Can we get the full cert booklet?

ANSWER: Attached.

43. QUESTION: The Cuba tab of the census does not have all zip codes listed, please advise?

ANSWER: Please utilize zip code 87013

44. QUESTION: #14 under the minimum contract requirements states that we are not to contact the members unless we have the group's express written consent.

Can we get confirmation on what all that would include?

ANSWER: The City requests approval of Marketing Materials as we do not want employees to be sold additional benefits. General information on the dental plan offering is allowable, but the City would like to be aware of what material is being sent out.

45. QUESTION: Please provide a full dental certificate/booklet of current benefits?

ANSWER: Attached

46. QUESTION: On the provider disruption, Appendix F, Can the city please state the matching criteria that they expect? For example, will the city accept single criteria matches such as TIN, NPI or location?

ANSWER: Single criteria matches of TIN or NPI is acceptable.

47. QUESTION: On the provider disruption in order to better understand overall utilization, can the city provide claims, claimants or paid claim dollars within Appendix F?

ANSWER: An updated Appendix F is attached.

48. QUESTION: Can you provide details of why the City is out to bid?

END OF ADDENDUM

Please incorporate the change in this Addendum into the original Proposal document. Offeror must acknowledge receipt of this addendum in the City’s eProcurement system. Failure to acknowledge an Addendum may result in your response being deemed non-responsive.

The purpose of this Addendum is to answer questions received that were timely submitted.