26-V9 - Vision RFP Questionnaire.xlsx
XLSX spreadsheet 898 KB Posted
- Attached to
- RFP 2026-015 Dental & Vision Insurance Benefits
- Solicitation number
- RFP 2026-015
- Issued by
- Johnson County, Texas
About this file
This is a Request for Proposal (RFP) questionnaire and benefits specification document issued by the City of Burleson, Texas, for vision insurance coverage prepared by Lockton Companies, LLC. The City seeks fully insured vision benefit proposals effective January 1, 2027, for all eligible employees and dependents. Bidders must provide proposals matching or enhancing the current plan design, including four-tier rates for all options quoted, network GeoAccess accessibility information for all locations, benefit summaries, and standard proposal materials. The RFP requires detailed responses to a comprehensive questionnaire addressing company background, differentiators, experience with public entities, transition timelines, performance guarantees across implementation, ID card delivery, customer service, claims processing, and reporting functions. Bidders must confirm their willingness to provide 30-day cancellation notification provisions by the City and 120-day provisions by the vendor for any reason other than non-payment, participate in the City's annual open enrollment health fair, and commit to annual performance review meetings.
The current vision vendor is UnitedHealthcare (UHC), with vision coverage established as voluntary and fully insured. Current enrollment includes 154 employees only, 42 employee plus spouse, 38 employee plus child(ren), and 118 employee plus family members, generating a total annual premium of $52,557.12. Bidders must provide detailed pricing for both a matched plan design and an enhanced plan design option, specify commission structures (including flat fees, capitated fees, flat percentages, or graded percentages), and clearly define any deviations from the requested plan specifications. The proposal requires bidders to address performance guarantees with specific dollar amounts or percentages at risk in multiple service categories, including claim turnaround time, processing accuracy, financial accuracy, member inquiry resolution, abandoned calls, average speed to answer, and eligibility processing. Additionally, bidders must provide comprehensive information on their vision provider networks, indicating whether major retail chains and top-utilized providers are in-network or out-of-network, along with details on claims processing capabilities, customer service resources, multilingual support, online tools, and any value-added wellness or health management programs for employees.
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Front Cover
Request for Proposal - Vision
City of Burleson
| Prepared by: |
| Lockton Companies, LLC |
| Date: |
| Effective Date 1/1/2027 |
| 2100 Ross Avenue, Suite 1200 |
| Dallas, TX 75201 |
| (214) 969-6100 phone |
| www.lockton.com |
Introduction
| Introduction |
| Background |
| City of Burleson has requested Lockton Companies complete an evaluation of the market for all benefit plans. |
We have provided all plan design, claims/enrollment and census data information.
| The current vision vendor is UHC. | |
| Proposal Guidelines | |
| v | Please provide fully insured vision proposals. |
| Proposal Guidelines | ||
| For all proposals: | ||
| v | Quote matching the requested plan designs and clearly define all deviations. | |
| v | Please provide the following information: | |
| v | Applicable four tier rates for all options quoted. | |
| v | Network GeoAccess for all locations using criteria specified in proposal. | |
| v | Benefit summaries for all plans quoted. | |
| v | Standard proposal material. | |
| Effective Date | ||
| January 1, 2027 |
| Commission Level |
| NET |
| Please do not modify or change formatting. Any additional information can be provided in the Additional Info tab. |
| Service |
| Rates |
| Rate Validation/Check |
| Network Accessibility |
| Claims Service |
| New Client/Prospect |
| Renewal Review |
| Other |
| Flat fee |
| Capitated fee (per employee per month) |
| Flat percentage of premium |
| Graded percentage of premium |
| Member-based sliding schedule |
| Net of commission |
| Other |
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Benefit Summary and Premiums Requested Vision Benefit Summary
| Please either mirror or enhance this plan design. | Proposed - Matching Plan Design | Proposed - Enhanced Plan Design | |||||
| United Healthcare | Bidder Name | Bidder Name | |||||
| Effective Date | Current | Current | Current | ||||
| 1-Jan-27 | In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Exams | |||||||
| Frequency | 1x every 12 months | 1x every 12 months | 1x every 12 months | ||||
| Copay | $10 | To a max of $40 allowance | $10 | N/A | |||
| Lenses | |||||||
| Frequency | 12 months | 12 months | 12 months | ||||
| Single Vision | covered in full after $25 co-payment | Up to $40 | Covered in full after Co-payment | Up to $40 | $32 allowance | ||
| Bifocal | covered in full after $25 co-payment | Up to $60 | Covered in full after Co-payment | Up to $60 | $46 allowance | ||
| Trifocal | covered in full after $25 co-payment | Up to $80 | Covered in full after Co-payment | Up to $80 | $61 allowance | ||
| Lenticular | covered in full after $25 co-payment | Up to $80 | Covered in full after Co-payment | Up to $80 | $46 allowance | ||
| * If Eyeglass Lenses and Eyeglass Frames are purchased at the same time from the same Network Provider, only one Co-payment will apply to those Eyeglass Lenses and Eyeglass Frames together. | |||||||
| Contact Lenses | |||||||
| Frequency | 12 months | 12 months | 12 months | ||||
| Copay | $25 | N/A | $25 | N/A | |||
| Covered Formulary Contacts | Up to 6 Boxes | Up to $150 | Up to 6 Boxes | Up to $150 | |||
| Non-Formulary Contacts | Up to $150 | Up to $150 | Up to $150 | Up to $150 | |||
| Necessary Contact Lenses | covered in full after $25 co-payment | Up to $210 | Covered in full after Co-payment | Up to $210 | |||
| Frames | |||||||
| Frequency | 1x every 12 months | 1x every 12 months | 1x every 12 months | ||||
| Copay | $25 | N/A | |||||
| Allowance | Up to $150 | Up to $45 | Up to $150 | Up to $45 | |||
| Discount on amount over allowance | 30% | N/A | 30% | N/A | |||
| * If Eyeglass Lenses and Eyeglass Frames are purchased at the same time from the same Network Provider, only one Co-payment will apply to those Eyeglass Lenses and Eyeglass Frames together. | |||||||
| Upgrades | |||||||
| Standard Scratch Coating | Copayment $0 | Not Covered | Copayment $0 | Not Covered | 1x every 12 months | ||
| Oversize Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | |||
| Blended Bifocal Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $55 or retail billed charge | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $55 or retail billed charge | Not Covered | |||
| Standard Progressive Lenses | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $105 or retail billed charge | Not Covered | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $105 or retail billed charge | Not Covered | |||
| Deluxe Progressive Lenses | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $150 or retail billed charge | Not Covered | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $150 or retail billed charge | Not Covered | |||
| Premium Progressive Lenses | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $180 or retail billed charge | Not Covered | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $180 or retail billed charge | Not Covered | |||
| Platinum Progressive Lenses | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $200 or retail billed charge | Not Covered | $47 Copayment after a Copayment of $25 toward Covered Eyeglass Lenses and the lesser of $200 or retail billed charge | Not Covered | |||
| Aspheric Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | |||
| Digital Single Vision Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | |||
| Polycarbonate for Dependent children up to age 19 | Copayment $0 | Not Covered | Copayment $0 | Not Covered | |||
| Cataract Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | |||
| Occupational Double Lenses | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | 80% of retail billed charge after a Copayment of $25 toward Covered Eyeglass Lenses | Not Covered | |||
| Other Services | |||||||
| Retinal Screening Photography for Diabetics | $0 Retinal Screening | ||||||
| $10 copay for 2nd Exam | $0 Retinal Screening |
$10 copay for 2nd Exam
| Laser Vision Discount | UnitedHealthcare is proud to add value to your vision care program by offering access to discounted laser vision correction procedures through QualSight LASIK, the largest LASIK manager in the United States. Member savings represent up to 35% off the national average price of LASIK. Discounts are also provided on newer technologies such as Custom Bladeless (all laser) LASIK. Visit myuhcvision.com for more information. | UnitedHealthcare is proud to add value to your vision care program by offering access to discounted laser vision correction procedures through QualSight LASIK, the largest LASIK manager in the United States. Member savings represent up to 35% off the national average price of LASIK. Discounts are also provided on newer technologies such as Custom Bladeless (all laser) LASIK. Visit myuhcvision.com for more information. |
| Blue Light Protection Discount | UnitedHealthcare Vision has collaborated with industry partners to provide members with discount off the retail price on blue-light screen filters for their devices. Members can learn more and access discount information by visiting their plan website. $10 copay for 2nd Exam | UnitedHealthcare Vision has collaborated with industry partners to provide members with discount off the retail price on blue-light screen filters for their devices. Members can learn more and access discount information by visiting their plan website. $10 copay for 2nd Exam |
| Additional eyeglass frame/lenses due to prescription change (ages 0-12 and pregnant or breastfeeding women). | Members ages 0-12 and members pregnant or breastfeeding who have a prescription change of 0.5 diopter or more are eligible for a replacement frame and lenses. The replacement benefits are the same as the benefits for the initial frame and lenses. Not applicable for Exam Core or Exam with Discounted Material Plans. | Members ages 0-12 and members pregnant or breastfeeding who have a prescription change of 0.5 diopter or more are eligible for a replacement frame and lenses. The replacement benefits are the same as the benefits for the initial frame and lenses. Not applicable for Exam Core or Exam with Discounted Material Plans. |
| 20% discount on additional pairs of eyeglasses, including prescription sunglasses at participating providers |
&G &P
Rates & Contributions
| Vision is currently voluntary and fully insured. | ||||
| UHC | Bidder Name | Bidder Name | ||
| Vision Plan | Proposed Plan (Match Current Plan) | Proposed Plan (Enhanced Plan) | ||
| To be completed by bidder | To be completed by bidder | |||
| Current | PROPOSED | PROPOSED | ||
| Counts | Monthly Rate | Monthly Rate | Monthly Rate | |
| Employee Only | 154 | $7.56 | ||
| Employee + Spouse | 42 | $16.24 | ||
| Employee + Child(ren) | 38 | $16.24 | ||
| Employee + Family | 118 | $16.24 | ||
| Total Montly Premium | $4,379.76 | $0.00 | $0.00 | |
| Total Annual Premium | $52,557.12 | $0.00 | $0.00 | |
| Bidder to confirm all totals to be accurate |
Questionnaire
| Vision Questionnaire | ||||
| Please do not modify or change formatting. Do not add rows or columns. Any additional information can be provided in the Additional Info column. | ||||
| General | [Insert Carrier Name] | Additional Info | ||
| v | Provide a brief overview of your company | |||
| v | What differentiates your organization from other vision care benefit companies? | |||
| v | Describe unique benefit add-ons that your organization can offer. | |||
| v | Describe your experience working with public entity clients. | |||
| Fees, Renewals and Guarantees | ||||
| v | Assuming a business award date of 6/1, for an effective coverage date of January 1, please include a copy of your detailed transition plan/timeline that includes completion dates for each specific task. List any start-up fees. | |||
| v | What type of cost and performance guarantees are you willing to provide for the following areas, along with the amount you will be putting at risk: | |||
| v | Implementation | |||
| v | Delivery of ID Cards (if applicable) | |||
| v | Delivery of Contract/SPD | |||
| v | Account Management | |||
| v | Claims Processing | |||
| v | Customer Service | |||
| v | Reporting | |||
| v | Do you agree to 30-day cancellation notification provision by the City for any reason and a 120-day cancellation notification provision by the vendor for any reason other than non-payment? | |||
| v | Do you provide introductory letters and/or ID cards to member homes? | |||
| v | If so, please provide a copy of your standard new member communications materials. | |||
| v | Are you willing to work with the incumbent vendor to transfer data electronically throughout the implementation phase? | |||
| v | What resources will you provide to ensure effective and timely communication of the new program? |
| v | Will you agree to have a representative onsite at the City for their annual OE health fair? | |
| v | Will you agree to at least an annual meeting to review plan performance? | |
| v | Do you agree to provide the renewal no later than 120 days prior to the renewal date? | |
| v | What credibility blend will be used for the first year renewal for this client? | |
| v | What credibility blend will be used for subsequent renewals for this client? | |
| v | What is your required retention/administrative expense percentage for a group of this size? | |
| v | When available, do you use more than the most recent 12 months of claims in the calculation of the renewal? Please describe. | |
| v | Will you use incurred or paid claims for the renewal calculation? | |
| Claims Processing | ||
| v | Do you provide a dedicated account manager? | |
| v | How long have you been processing claims in this location(s)? | |
| v | How many employees are located in this claims office(s)? | |
| v | In this claims office(s), how many covered members do you process claims for? | |
| v | What is the TAT for processing a claim? | |
| v | In this claims office(s), specify the number of accounts you process claims for. | |
| v | In this claims office(s), how many covered employees are included in the largest account for which you serve as claims administrator? | |
| v | In this claims office(s), what is the average size account? | |
| v | Do you have the capability to feed the client's Flexible Spending Account (FSA) vendor claims data to be used for substantiation of claims under the FSA program? | |
| v | Is it available for this client? | |
| v | If so, is there an additional cost for this service? | |
| Customer Service | ||
| v | What are your hours of operation? | |
| v | Provide examples of educational materials for employees | |
| v | What are your online resources and tools? | |
| v | Will you provide support to the City to manage client eligibility and other administrative tasks? Can the City update in real time on-line? | |
| v | Are in-network providers required to consistently administer all benefits, regardless of provider type (ie: independent or retail provider)? | |
| v | Over the last three years, what percentage of claims were for services from in-network providers? | |
| v | What standard reports are available and with what frequency (monthly, quarterly, annually)? Are there additional costs associated with any of these reports? | |
| v | Provide samples of your standard claims reporting package this client would receive. | |
| v | Are these reports available online or must they be sent to the client? | |
| v | Do you have multilingual capabilities for customer service? If so, what languages? | |
| v | Describe capabilities for billing structures by plan/tiers, divisions, employee classifications, what are the requirements or limits? | |
| v | Member access to a robust website and mobile friendly app for digital ID cards, claims data and benefit coverages | |
| v | Can claims be processed and reported out by employee classification in Active, Retiree, COBRA and plan tier? | |
| Additional Health Management Programs | ||
| v | Do you offer any value add programs for employees? If so, please describe. | |
| v | Do you have any wellness programs/special benefits for individuals with chronic diseases? | |
| v | Describe your wellness tools and resources. | |
| v | Outline any unique programs that you are offering that the city does not currently have on their plan currently. |
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Provider Network
| Vision Provider Network | ||
| Please indicate if the below major retail chains are in your network | ||
| Major Chains | TYPE IN: In-Network or Out-of-Network | |
| v | America's Best | |
| v | Cohen's Fashion Optical | |
| v | Costco | |
| v | Doctor's Vision Center | |
| v | ECCA (Eye Care Centers of America) | |
| v | Eyeglass World | |
| v | Eyeland | |
| v | EyeMart Express | |
| v | EyeMasters | |
| v | For Eyes Optical | |
| v | LensCrafters | |
| v | Pearle Vision | |
| v | Sam's Club Optical | |
| v | Shopko Eyecare Center | |
| v | Sterling Optical | |
| v | Target Optical | |
| v | Vision Works | |
| v | Vision World | |
| v | Wal-Mart Vision Centers | |
| v | [Insert Applicable Regional Retailers] | |
| v | [Insert Applicable Regional Retailers] | |
| v | [Insert Applicable Regional Retailers] | |
| Top Utilized Providers | TYPE IN: In-Network or Out-of-Network | |
| v | ||
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&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Performance Guarantees
| Vision Performance Guarantees | ||||
| Please summarize your proposed performance guarantees for the City below including the minimum standard, how that standard is measured and the dollar or percentage you are willing to place at risk. | ||||
| Service | Definition | Minimum Standard | How is the Minimum Standard Measured? | % at Risk (include what amount of risk is based on, i.e., Base Admin. Fee) |
| Implementation | ||||
| Account Implementation | ||||
| ID Cards | ||||
| Claim Readiness | ||||
| Call Readiness | ||||
| Account Management | ||||
| Overall Account Management | ||||
| Claim Administration | ||||
| Claim Turnaround Time | ||||
| Claim Processing Accuracy | ||||
| Claim Financial Accuracy | ||||
| Total Claim Accuracy | ||||
| External Audits | ||||
| Member Services | ||||
| Inquiry Resolution | ||||
| Abandoned Calls | ||||
| Average Speed to Answer | ||||
| Eligibility Processing | ||||
| Member Satisfaction | ||||
| Other Performance Guarantee(s) | ||||
| Other | ||||
| Other | ||||
| Other | ||||
| Performance Guarantee Questions | ||||
| When are the PGs measured? | ||||
| When are PGs paid out? | ||||
| Are you willing to offer a separate implementation guarantee agreement? | ||||
| Are the guarantees combined with other coverage? |
Overall Total At Risk $ %
&"Garamond,Regular"&8&G &"Garamond,Regular"&8&P
Additional Info
Back Cover
| OUR MISSION |
| To be the worldwide value and service leader in insurance brokerage, risk management, employee benefits, and retirement services |
| OUR GOAL |
| To be the best place to do business and to work |
lockton.com
© 2023 Lockton, Inc. All rights reserved.
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