2026_Dental-Vision_RFP.xlsx
XLSX spreadsheet 23 KB Posted
- Attached to
- Employee Benefits-Dental and Vision
- Solicitation number
- 27-010CH-32RFP
- Issued by
- Maricopa County, Tucson City, Arizona
About this file
This is a Request for Proposal (RFP) questionnaire for Employee Benefits-Dental and Vision services issued by the Tempe Union High School District in Arizona. The District seeks proposals for three voluntary benefit plans: a Dental Preferred Provider Organization (PPO), a Dental Health Maintenance Organization (HMO) pre-paid plan, and a Vision plan. The District intends to maintain current plan designs for the July 1, 2027 through June 30, 2032 contract period, which includes an initial one-year term with four optional one-year renewal periods. Proposals must be submitted through the Procurement Portal at https://procurement.opengov.com/portal/tuhsd no later than 2:00 pm on Wednesday, November 4, 2026. The District currently utilizes Cigna for DHMO, Delta Dental for PPO, and Davis Vision for vision coverage, and vendors are requested to match these existing benefit designs as closely as possible or document any deviations.
The RFP requires vendors to complete a detailed Excel questionnaire addressing general qualifications, minimum requirements, account management, administrative services, claim administration, network specifications, and benefit design details. Responses must be submitted in Excel format only, without attachments or external references. All proposal responses and interview information will become part of the final contract. Pricing must be guaranteed for a minimum of 12 months, with firm rates that will not be recalculated based on enrollment changes, and must exclude commissions. Vendors must confirm compliance with specific operational requirements including 24-hour response times for account managers, customer service availability from 8:00 AM to 6:00 PM MST, maintenance of Maricopa County network sizes throughout the contract term, and seven-year retention of administrative records. Vendors are required to maintain confidentiality of plan data, provide 30-day notice for major operational changes, and deliver underwriting documentation 180 days prior to renewal effective dates.
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Text version
Vendor Instructions RFP Response Sheet
| Please read the directions below as our process has changed. |
| Please read, review and provide the information requested in this workbook. The cells will automatically expand as needed if your response is longer than the space shown in the cell, however, brevity is expected. Limitations do exist. |
| While the questionnaire may be available upon notice of RFP to the market, the financial exhibits will require a current NDA on file with Segal to obtain them for completion. No exceptions will be made for this process. |
| Beware that some questions request only a Yes or No response. Some questions contain limits on the length of your response. |
| The purpose for these limitations allows the Client to assess the responses as appropriate in a brief manner. |
| The worksheet is also locked so that you can only enter information in the Answers column or on the exhibits as requested. |
| Do NOT insert tabs or extra attachments unless instructed to do so. |
| Do NOT respond by "referring the Client to an attachment". |
| Do NOT delete sections of the questionnaire. If something does not apply to you leave it blank, or mark N/A. If you take something out, it will cause your responses to not line up correctly with the questions when we do the analysis. |
| Should you have any questions concerning the Questionnaire in this RFP, please reach out to the following contact(s) at Segal: |
| 0 |
| 0 |
| Response Documents Required for this Request for Proposal: |
| 1) Questionnaire - Excel. Requires responses completed and returned in Excel format. DO NOT PDF |
| Copyright © 2026 by Segal. All rights reserved. |
| This Request For Proposal form is the sole property of Segal and is not intended to be reproduced for any purpose other than review by the Plan Sponsor contracted with Segal to prepare a procurement analysis. This file cannot be copied or reproduced in any method without the written consent by Segal. |
Questions
| ID | Questions | Answers |
| Section 1 - GENERAL QUESTIONS / QUALIFICATIONS & EXPERIENCE | ||
| 1.1 | What is your company name? | |
| 1.2 | How many years has your firm offered the benefits outlined in the referenced Scope of Work ? | |
| 1.3 | Would you match the benefits outlined in the Benefit Plan Summary to all participants included in the attached Census? | |
| 1.4 | Are you able to administer the Benefit Plan Summary per the attached? | |
| 1.5 | In the last 5 years, has your organization been involved in any Litigation that would prohibit your organization from delivering the Scope of Work outlined in the RFP? | |
| 1.6 | If you have been involved in any litigation in the last 5 years, please explain. | |
| 1.7 | Have you ever had any litigation specific to the Client? | |
| 1.8 | If you have had any litigation specific to the Client, please explain. | |
| 1.9 | Has your organization completed any mergers or acquisitions in the last 24 months? | |
| 1.10 | If you have completed a merger or acquisition in the last 24 months, what impact will this have on the services provided? | |
| 1.11 | Have you made any recent changes in your operational platform that will impact the success of delivering the services outlined in the Scope of Work? | |
| 1.12 | Are you a broker or agency offering the products in this Scope of Work? | |
| 1.13 | Please respond to the following: | |
| 1.13.a | Is your firm the sole responder to this RFP or are you partnering with other vendors to deliver the Scope of Work? | |
| 1.13.b | If you are partnering with other vendors, please explain who and why? | |
| 1.14 | Do you anticipate any restructuring or reorganizing within the next two years? (this includes addition, reductions, relocations, or redesign of systems) | |
| 1.15 | What are the most recent ratings, including the date of the rating for your company by the following (If not applicable, include a N/A)? | |
| 1.15.a | AM Best | |
| 1.15.b | Standard and Poor's (S&P) | |
| 1.15.c | Moody's | |
| 1.16 | What is your firm's Net Promoter Score (NPS)? | |
| 1.17 | Do you agree that any data and information regarding our client supplied to you for purposes of responding to this RFP will be destroyed immediately upon receiving notice that you were not the successful winner? | |
| 1.18 | Recipient confirms and agrees that the data and information provided, which may include protected health information related to plan’s participants and beneficiaries, provided under the Agreement (“Plan Data”) is and shall remain the property of the plan. Recipient is not granted any right, title or interest in any Plan Data. Recipient may use and disclose Plan Data solely as necessary to effectuate the purpose and will not use, disclose, decompile, or reverse engineer, any Plan Data in support of Recipient’s other business activities. Specifically, Recipient will not de-identify any Plan Data or aggregate Plan Data (whether or not de-identified) with data received from Recipient’s other clients, customers or data sources. | |
| 1.19 | Do you anticipate any transition issues with the following: | |
| 1.19.a | Eligibility | |
| 1.19.b | Benefit administration | |
| 1.19.c | Transition of care | |
| 1.19.d | Deductible and out of pocket transitions (if applicable) | |
| 1.20 | Should your firm be awarded this RFP, how soon after notification (# of business days) of award would you be able to prepare the rough draft for the following: | |
| 1.20.a | Master Policy | |
| 1.20.b | Plan Booklet | |
| 1.20.c | Summary of Benefits or SBC | |
| 1.20.d | Contract Draft | |
| 1.21 | Should your firm be awarded this RFP, identify any services performed outside the borders of the United States of America. | |
| 1.22 | Does your firm have the capability to prepare communication pieces for the enrollees in Spanish? | |
| Section 2 - MINIMUM REQUIREMENTS | ||
| 2.1 | Proposal Responses (Initial and Best and Final, if applicable) and Interviews (if applicable) will become part of the final contract. Do you agree that your written response to this RFP, written information provided as part of the interview or clarification questions will become part of the final contract for services outlined in the Scope of Services? | |
| 2.2 | Do you agree that the contract will not "auto" renew annually, and you will send a renewal confirmation each year, whether or not under a rate/fee guarantee, no later than 180 days from the effective date of coverage? | |
| 2.3 | Confirm that your proposal fees are guaranteed for a minimum of 12 months. Multi-year contracts are favored. | |
| 2.4 | Confirm the rates and fees quoted in your proposal are firm and will not be recalculated based on actual enrollment. | |
| 2.5 | Do you agree that the terms of the RFP responses are valid until a final contract is executed? | |
| 2.6 | Confirm you understand that the Contract, if awarded, will be written for the length of one (1) year with the option to renew for four (4) additional one-year periods. | |
| 2.7 | Do you agree that this bid response is NOT contingent on purchasing any services other than in the Scope of Work? | |
| 2.8 | Do you agree that any provisions for restating premium rates due to changes in enrollment that exceed a 15% need to be confirmed as acceptable with the client? | |
| 2.9 | Do you agree to provide no less than 30 day notice for any changes involving the sale, merger, data breaches, layoffs, participating provider terminations, consolidations, or outsourcing of services to foreign workers? | |
| 2.10 | Confirm you will not solicit Client's members for any other products or services that your firm might offer, and confirm you will not sell any mailing or other list that includes Client member information without express written consent from the Client. | |
| 2.11 | Do you agree to maintain all required records for seven years, pertaining to the administration of the plans in force? | |
| 2.12 | Do you agree to the transition of all records as requested by the Client in the case of termination? This may include claim accumulators, plan experience, premiums (if applicable) and eligibility at no added fee to the Client? | |
| 2.13 | Do you agree to supply the necessary underwriting documentation for all renewals 180 days prior to the effective date? | |
| 2.14 | Are you able to provide the services outlined in the Scope of Work? | |
| 2.15 | Confirm that your pricing does not include commissions? | |
| Section 3 - ACCOUNT MANAGEMENT | ||
| 3.1 | Confirm the Account Manager will respond to phone calls or emails within 24 hours of receipt. | |
| 3.2 | Confirm you will attend the Open Enrollment meetings to review benefits and respond to questions. | |
| 3.3 | Confirm your Account Manager will meet with the client to define the group, subgroup, and other reporting criteria necessary to support the Client's decision making process. | |
| 3.4 | Confirm that Account Manager will be present for monthly/quarterly meetings established by the client or as requested. | |
| 3.5 | Confirm the Account Manager will present any legislative impacts to the employee/member benefits or any changes recommended for approval by the client. | |
| 3.6 | Do you agree that all sample forms and communication materials will be provided to the Client in advance of distribution for approval (ie, claim forms, enrollment forms, booklets, brochures, flyers, mailers, etc.)? | |
| Section 4 - ADMINISTRATIVE SERVICES/CLAIM ADMINISTRATION | ||
| 4.1 | What is the minimum time for implementation needed to initiate the proposed benefits or scope of work? | |
| 4.2 | Confirm your customer service team is available to serve the Client's participants from 8:00AM - 6:00PM, MST. | |
| 4.3 | Do you offer customer service representatives with multiple languages such as Spanish, French, etc.? | |
| 4.4 | Confirm all customer service representatives are located in the continental United States of America. | |
| 4.5 | Of the services listed below, indicate those services that are available on your member website and/or mobile app: | |
| 4.5.a | Check Claim Status | |
| 4.5.b | View Claim History | |
| 4.5.c | Contact Customer Service | |
| 4.5.d | Cost Treatment Calculators | |
| 4.5.e | Provider Locator | |
| 4.5.f | On-line Provider Directories | |
| 4.5.g | Plan Benefit Descriptions | |
| 4.5.h | Provider Price Comparison Tool (for common services such as office visits, etc.) | |
| 4.5.i | Provider Quality Ratings | |
| 4.5.j | Patient Satisfaction Information | |
| 4.5.k | Print ID Card | |
| 4.6 | Discuss your organization's dental utilization review program and quality control protocols. | |
| 4.7 | Do you have a secure website that the Client can use to maintain eligibility enrollments, changes and addresses? | |
| Section 5 - NETWORK DENTAL | ||
| 5.1 | What is the marketing name of your network(s) being proposed to the Client? | |
| 5.2 | Please complete the following: | |
| 5.2.a | Do you lease any portion of the network offered as part of this proposal? | |
| 5.2.b | If so, list who and for what services? Include wrap networks. | |
| 5.3 | Confirm you have provided an electronic copy of your proposed network providers in Microsoft Excel format. Fields should include the following: Provider last name (do not put generation indicator, i.e., Jr, III, or designation such as DDS or DMD in this field), Provider first name, (do not combine first and last names in the same field), NPI, Tax ID, Street Address (only include physical locations not billing addresses such as PO Box), City, State, 5 digit zip code, Provider Specialty (GD, Pedodontist, Endodontist, Oral Surgeon, Periodontist). | |
| 5.4 | Do you agree to maintain the size of your Maricopa County network for the duration of the contract to be no less than the size provided in your response to this RFP? | |
| 5.5 | Do you anticipate a change in the size or location of your network in the next year that would affect the Client's participants? | |
| 5.6 | Have you provided Geo Access reports for the network(s) proposed using as criteria 1 provider in 10 miles? Break out results by General Dentists, Pediatric Dentists, Periodontists, Endodontists, Orthodontists, and Oral Surgeons. Results must be based on the census provided. Do not exclude any locations or employee groups. Very important - Geo results must include a report showing locations where the access criteria was not met, including the number of people impacted, name of the City, County, State and Zip Code. | |
| Section 6 - NETWORK VISION | ||
| 6.1 | What is the marketing name of your network(s) being proposed to the Client? | |
| 6.2 | Please complete the following: | |
| 6.2.a | Do you lease any portion of the network offered as part of this proposal? | |
| 6.2.b | If so, list who and for what services? Include wrap networks. | |
| 6.3 | Confirm you have provided an electronic copy of your proposed network providers in Microsoft Excel format. Fields should include the following: Provider last name (do not put generation indicator, i.e., Jr, III, or designation such as MD or OD in this field), Provider first name, (do not combine first and last names int he same field), NPI, Tax ID, Street Address (only include physical locations not billing addresses such as PO Box), City, State, 5 digit zip code, Type of provider (MD, OD, etc.). | |
| 6.4 | Do you agree to maintain the size of your Maricopa County network for the duration of the contract to be no less than the size provided in your response to this RFP? | |
| 6.5 | Do you anticipate a change in the size or location of your network in the next year that would affect the Client's participants? | |
| 6.6 | Have you provided Geo Access reports for the network(s) proposed using as criteria 1 provider in 10 miles? Break out results by Optometrists, Ophthalmologists, and Opticians. Results must be based on the census provided. Do not exclude any locations or employee groups. Very important - Geo results must include a report showing locations where the access criteria was not met, including the number of people impacted, name of the City, County, State and Zip Code. | |
| 6.7 | Do you provide services through Costco as in-network? | |
| 6.8 | If services provided by Costco are covered as in-network, are contracted Costco providers also covered as in-network? | |
| 6.9 | Do you provide services through all Walmart locations? | |
| 6.10 | If services are provided by Walmart, are they covered as in-network? | |
| 6.11 | If services provided by Walmart are covered as in-network, are contracted Walmart providers also covered as in-network? | |
| 6.12 | Do you provide services through Sam's Club as in-network? | |
| 6.13 | If services provided by Sam's Club are covered as in-network, are contracted Sam's Club providers also covered as in-network? | |
| 6.14 | Do you provide services through Target as in-network? | |
| 6.15 | If services provided by Target are covered as in-network, are contracted Target providers also covered as in-network? | |
| Section 7 - DENTAL PPO CLAIM ADMINISTRATION | ||
| 7.1 | How long does claim processing turn-around time for a clean claim take? | |
| 7.2 | Please complete the following: | |
| 7.2.a | Does your claim system have any protections against unbundling and/or upgrading claims? | |
| 7.2.b | If yes, explain. | |
| 7.3 | Does your claim system have protections against fraud by: | |
| 7.3.a | Providers | |
| 7.3.b | Members | |
| 7.3.c | Employers/Trust | |
| 7.4 | Are ID cards required? | |
| 7.5 | Do members pay up-front and submit claims for reimbursement or are members responsible for only plan, deductibles and coinsurance? | |
| 7.6 | How do you process any non-network provider claims? | |
| 7.7 | Currently the 51st percentile is used to determine the usual and customary for out-of-network claims. Can you administer the 51st percentile? | |
| 7.8 | Does your plan use maximum allowable cost for limiting non-network allowances? | |
| 7.9 | Does your proposed plan include any exclusions or limitations that are more restrictive than the current plan? | |
| 7.10 | Are you offering any deductible or coinsurance levels that differ from the current plan? | |
| 7.11 | Are you offering any maximums that differ from the current plan? | |
| 7.12 | Does your proposed plan include any services that are paid in a different benefit class than the current plan? | |
| 7.13 | Does your proposed plan have any frequency limits that differ from the current plan? | |
| 7.14 | Does your proposed plan have any waiting period limitations where none exist under the current plan? | |
| 7.15 | Does your proposed plan include any pre-existing condition limitations? | |
| 7.16 | Up to what age do you cover fluoride treatments and how often? | |
| 7.17 | Up to what age do you cover sealants and how often? | |
| 7.18 | Does the plan offer special healthcare needs benefits for individuals with intellectual or development disabilities such as additional visits, cleanings, or treatment delivery modifications? | |
| 7.19 | Does the plan offer a 3rd cleaning benefit for individuals with certain medical conditions (i.e., cancer, renal failure, periodontal disease)? | |
| Section 8 - DENTAL PRE PAID (HMO) | ||
| 8.1 | If the Client currently offers a Dental HMO/Pre-paid Plan, are you able to administer the current program benefits? | |
| 8.2 | Indicate the Name for the plan you are proposing. | |
| 8.3 | Is each participant of a family allowed to select their own individual primary care dentist under your Dental HMO plan? | |
| 8.4 | How often can a member change their primary dentist selection? | |
| 8.5 | When would the change be effective? | |
| 8.6 | Do your primary care dentists serve as "gatekeepers" for specialty referrals? | |
| 8.7 | What is the average waiting time for routine cleanings, other routine appointments, first appointments, emergency appointments? | |
| 8.8 | Does your plan cover nitrous oxide analgesia? | |
| 8.9 | Does your plan cover dental implants? | |
| 8.10 | What types of sedatives do you cover and what are the coverage limitations? | |
| 8.11 | Do you cover temporary filings? | |
| 8.12 | Up to what age do you cover fluoride treatments and how often? | |
| 8.13 | Up to what age do you cover sealants and how often? | |
| Section 9 - VISION | ||
| 9.1 | Provide a complete description of the benefit limitations and exclusions which your company proposes to make a part of the vision programs. Be specific about any provision which could be construed as pre-existing condition limitations. | |
| 9.2 | Does your proposed plan include any exclusions or limitations that are more restrictive than the requested plan? | |
| 9.3 | Does your proposal include any pre-existing condition limitations? | |
| 9.4 | Does your eye examination include a contact lens fitting, or is there an additional charge for this service? | |
| 9.5 | What services are covered with respect to the dispensing of frames and lenses? | |
| 9.6 | How long are the frames and lenses guaranteed? | |
| 9.7 | What is your replacement policy for frames and lenses? | |
| 9.8 | What is the frequency for exams and frames in the plan proposed? | |
| 9.9 | Does your plan design offer glass or plastic lenses at the patient's request. | |
| 9.10 | If your plan design offers glass or plastic lenses at the patient's request, is there an additional charge? | |
| 9.11 | Is scratch coating covered for lenses in your proposed plan? | |
| 9.12 | If your plan design offers glass or plastic lenses at the patient's request, is there an additional charge? | |
| 9.13 | Are photochromic lenses covered in your proposed plan? | |
| 9.14 | If photochromic lenses are covered in your proposed plan, is there an additional charge? | |
| 9.15 | How long are the contact lenses guaranteed? | |
| 9.16 | How many "standard" frames are included under your proposed plan that would not involve an extra charge to the participant? | |
| 9.17 | Do any services covered by your proposed plan require pre-authorization? | |
| 9.18 | Vision exams can be used as early indicators of diabetes, CAD, etc. Does your organization participate in any programs that can integrate with disease management or wellness programs? |
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