260125_Chapter_1E_-_Dental_Scope_of_Work.docx

RFP# 212558 Attachment 1E - Dental

Dental

Introduction The City of Tucson is soliciting proposals for Dental PPO (DPPO) coverages for employees and retirees for a July 1, 2026, effective date.

The City moved to a self-funded DPPO effective July 1, 2025. The City currently has a DHMO that is fully insured. The City plans to eliminate the DHMO and replace the plan with a Self-Funded Basic Preventive Care Only benefit with 100% coverage for preventive care up to a $500 annual max. Out of network benefits should be a MAC reimbursement covered at 25% up to a $500 max.

Contractors should match or improve upon plan design features as closely as possible, specifically noting any differences in benefit design in the Deviations section of this Attachment.

The City requires Contractors to provide ALL services in this Attachment. Contractors must (1) own their own or (2) work with partners to provide ALL services included in this Attachment. Offers with partners must be returned under one submission.

The City’s website, https://tucsonaz.gov/benefits contains current benefit plan information and contribution rates (employer and employee); eligibility can be found in the Insurance Handbook. Current benefit booklets can be found on the City’s Procurement website with the RFP documents.

Please note that the requirements listed in the Scope of Work in this RFP are minimum service levels the City expects to receive through this solicitation. Any offeror may introduce enhanced services as part of their comprehensive response to this solicitation given that the minimum service levels are met.

MINIMUM REQUIREMENTS

At minimum, Contractor shall meet the following:

Any offeror not meeting the minimum requirements will be rejected.

Background CIGNA Dental has been the exclusive provider of dental benefits since July 1, 2010. Cigna offers a three tier benefit design. Tier I is a narrow network option (“CIGNA Advantage Network” approximately 33% of Cigna’s broad DPPO network in Tucson), Tier II is the broad CIGNA DPPO network, Tier III is out-of-network paid at the 80th Percentile. This design is offered to residents within Arizona only. Outside Arizona, the design is a passive DPPO that matches Tier I benefit levels.

The City currently offers CIGNA Dental benefits to approximately 8,386 eligible employees and retirees. Approximately 1,683 retirees have waived coverage but are eligible to enroll at a future date with proof of continuous coverage.

Underwriting Information Current Carrier: CIGNA Dental has been the carrier since July 1, 2010.

Eligibility: Can be found in the Insurance Handbook on the City’s website: https://tucsonaz.gov/benefits

Funding: The City moved to a self-funded DPPO effective July 1, 2025. The DHMO is currently fully insured. The City plans to eliminate the DHMO and replace the plan with a Self-Funded Basic Preventive Care Only benefit with 100% coverage for preventive care up to a $500 annual max. Out of network benefits should be minimal with a MAC reimbursement covered at 25% up to a $500 annual max.

Current Monthly DHMO Rates:

Current Monthly DPPO Admin Fees: $2.75 PEPM (Includes ASO & Network Access Fee)

Current Rate Contribution Strategy:

The City pays 100% of employee and their dependent cost for DHMO and plans to continue this contribution for the Basic Preventive Only DPPO. For the current DPPO, the City contributes approximately 50% of employee and their dependent cost. Retirees generally pay the full cost for themselves and their dependents. The retiree dental program has a continuous coverage provision that requires nonparticipating retirees who wish to add coverage for themselves and/or family members to provide proof of continuous dental insurance through another dental insurance carrier for the 36 months immediately preceding the date the retiree would like to join the City’s plan.

The City reserves the right to change future contributions (note the City currently has no plans to change the existing contribution strategy). Please note any minimum contribution strategy required for re-rating.

Requested Plan Design and Other Pricing Information:

Match or improve upon the current three tier DPPO benefit design and provisions in Arizona and passive DPPO outside Arizona. It is not a requirement to provide a three tier network in Arizona and Offerors may propose a more traditional DPPO network configuration.

For the 2nd plan option assume a self-funded DPPO plan covering Preventive Care only at 100% with an annual maximum of $500 per year. Out of network benefits should be minimal with a MAC reimbursement of 25% up to a $500 max.

Include a 60 day premium drag (i.e., July 1 premiums or ASO fees would be due August 29).

You must use the Rate and Fee Illustration Forms provided in submitting your proposal. You may additionally include your normal underwriting pricing worksheets and caveats. However, we will use your responses on the required rate sheets and questionnaire as your proposal response when they differ from any supplemental underwriting materials you provide.

Non-Network Claims: Non-network claims are paid at the 80th percentile of the recognized charge (aka usual & customary). For the Preventive Only plan non-network claims can be paid on a MAC reimbursement.

Commissions: All proposals should be submitted net of commissions.

Reason Bidding: Market evaluation.

Underwriting Workbook: An Excel workbook with historical claims, pricing exhibits, re-pricing & provider disruption, plan design exhibits, enrollment, and census data will be provided (See Request for Confidential Documents form in Request for Proposal document). The only plan change that has occurred in the past 36 months was moving the DPPO from fully insured to self funded.

SCOPE OF WORK

The City’s goal is to select the firm that will be the most effective and proactive partner. The minimum program services shall include:

General

1. Proposal, Interview, and Best and Final Responses Become Part of Contract: Contractor’s written response to this RFP, written information provided as part of an interview and written responses provided during a Best and Final negotiation become part of the contract between Contractor’s organization and the City of Tucson.

2. Contractor’s Proposal Terms: Are guaranteed for at least 180 days from the proposal due date.

3. Contract Length: The Contract has a length of one (1) year with the option to renew for six (6) additional one-year periods.

4. Rate/Fee Guarantee: Rates and/or fees are guaranteed for a minimum of three (3) years (July 1, 2026, through June 30, 2029).

5. Renewal Notification: The Contractor must provide any fee/rate changes in writing at least 180 days prior to the contract anniversary date (i.e., January 1 of the prior plan year for a July 1 effective date). Any requested increase must be provided in writing and must include the following with your renewal package:

a. Any contract language changes requested.

b. Specific justification of fee/rate changes

c. Current enrollment by plan option, branch classification, and premium rate tier

d. Supporting underwriting fee/rate development including monthly paid claims and enrollment, utilization statistics, and underwriting projection analysis.

e. Additional options for consideration

f. All underwriting caveats

6. Flexibility: The City reserves the right to change any service or program, contribution strategies, funding, premium contributions, benefit designs or any aspect of its program in the future as it deems appropriate.

7. Variance Provision: Contractor agrees that any provisions relating to reevaluation of proposed rates or re-rate during the contract due to variation in enrollment from the census provided or other contingencies of the quote or renewal will not be applicable unless total program enrollment variance is at least 20%.

8. Proper Licensure: Contractor agrees to maintain proper licensure as required by any state law and Department of Insurance regulations pertaining to this coverage where it relates to the services that Contractor will be performing for the City of Tucson.

9. Prior Notice of Major Operational Changes: Contractor agrees to provide no less than 30-day notice to the City of Tucson for any changes involving the sale, merger, data breaches, layoffs, participating provider facility terminations, consolidation or outsourcing of services to foreign workers that will impact/involve services provided to the City of Tucson.

10. Subcontracting: Unless otherwise explained in this RFP, Contractor agrees to disclose all subcontractor arrangements, and any additional fees associated with the subcontractor arrangements, that involve the services provided to the City of Tucson.

11. Subcontracting: Contractor agrees that all subcontract relationships are subject to the City’s consent prior to implementation.

12. Damages: Contractor accepts responsibility for all damages caused by its own negligence, gross negligence, willful misconduct, and/or breaches of the contract. The Contractor will not require the City to indemnify bidder for its own negligence.

13. HIPAA Compliance: Contractor attests to meeting all applicable HIPAA EDI, Privacy, Security, and HITECH requirements and agrees to hold the City of Tucson harmless for breaches that are the result of the Contractor’s actions. Further, Contractor agrees to perform all of the duties associated with breach notification, and assume financial responsibilities for the breach notice and notify plan participants if there is a breach and will pay for 24 months of identity theft repair and credit monitoring services for those plan participants impacted by the breach.

14. HIPAA Compliance: Contractor certifies that all services provided as part of this contract will be in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and HITECH and their subsequent amendments and changes. Violations shall be reported immediately to the City in writing. Contractor will notify the City of any and all actions taken as a result of any violation.

15. Contractor’s proposal contains provisions reserving these rights to CITY OF TUCSON: Any “actively-at-work” requirements will be waived on the effective date for all members or dependents participating in the plans immediately prior to the effective date of its contract with the City of Tucson.

16. Eligibility Rules and Uncertain Claimant Eligibility Situations: Contractor agrees to the specified eligibility rules established by City of Tucson. The Contractor must communicate directly with the City of Tucson regarding any uncertain claimant eligibility situations before notifying the claimant of ineligibility.

17. Eligibility Rules and Procedures for Retroactive Termination and Reconciliation: The Contractor agrees to the specified eligibility rules established by the City of Tucson. Upon receipt of a retroactive termination, the Contractor must review the applicable participant histories and initiate recovery efforts for any overpayments resulting from the late termination notice. The City generally will notify Contractor of terminations within 60 days after coverage termination date. However, the City reserves the right to terminate more than 60 days retroactively, under unusual circumstances.

18. Member Services: Contractor will record one hundred percent (100%) of member calls into a Customer Service Center and the recordings will be available to the City for inspection within 24 hours of recording and should be retained for a minimum of 12 months.

19. Termination Provisions: Contractor agrees the City of Tucson may terminate the contract at any time with or without cause, by giving 30 days written notice. The City may terminate any contract early if it deems such action necessary or appropriate to fulfil its duties to employees, retirees, and beneficiaries. Please refer to the Termination clause in the Standard Terms and Conditions provided in the RFP.

20. Termination: Upon termination Contractor agrees to cooperate with the City in transitioning services and providing necessary reporting to a successor Contractor in a manner designed to mitigate disruption to participants and beneficiaries at no additional cost to the City.

21. Termination: In the event of termination, the City will only be obligated to pay premiums/fees for services actually provided through the termination date (note the City is requesting that the ASO fee include any runout administration cost and other ancillary costs associated with a transition to a successor).

22. Claims and Appeals Regulations: Contractor agrees that its systems, internal operations, correspondence, and services will be compliant with ERISA Claims and Appeals Regulations and the City of Tucson’s plan document.

23. Maintenance, Ownership, and Transfer of Records:

a. The Contractor will be required to maintain all pertinent records (e.g., claims data (all fields indicated on the billing, eligibility information, member complaints, etc.) for seven years. This is in conjunction with prudent business practice and ERISA provisions; and

b. The Contractor will be charged with the safekeeping of plan experience information; and

c. In the event of contract termination, and related to contract termination, the Contractor will be required to cooperate with the City of Tucson, or their representative, in the prompt, accurate, and orderly transfer of the City of Tucson's plan experience, claims and utilization information to the City of Tucson or its designated succeeding health plan/carrier at no additional cost to the City (that is, if the City elects self-funding) and:

d. Contractor shall maintain a record of all complaints from all members and shall provide the same to the City of Tucson within ten (10) business days of the initial request. Such record shall include all correspondence relating to the disposition of the complaint.

e. In Compliance with Standard Terms and Conditions, Paragraph 33.

24. Assignment or Transfer of Rights: Contractor agrees that they will not assign or transfer the rights or obligations of the contract or any portion thereof, without the prior written approval of the City of Tucson.

25. Duties: Contractor acknowledges that their firm will perform all duties contracted for in accordance with the standard of care for a professional with expertise in all areas contracted for.

26. Applicable Law: This Contract shall be governed, and the City and Contractor shall have all remedies afforded to each, by the Tucson Procurement Code and the law of the State of Arizona. State law claims shall be brought only in Pima County Superior Court. Contractor agrees to comply with all applicable federal, state, and local laws, rules, regulations, and ordinances. Further, Contractor certifies compliance with all provisions, laws, acts, regulations, etc.

27. Contract: Contractor shall represent the complete contractual understanding of the parties and changes must be signed by both parties. The contract shall not incorporate policies or documents that are subject to unilateral change or are not agreed to in advance.

28. Contract: Contractor agrees that any service contract arising from this RFP will not include any limitations of liability or disclaimer of warranties.

29. Contract: Contractor shall provide with this proposal any additional documents or contracts the City will be required to sign. The documents provided must be updated with language based upon the specific requirements of this RFP. The documents should contain the following language: To the extent there is an inconsistency between the contract and the Request for Proposal (RFP) between the parties, the RFP responses will govern. Any documents not provided are subject to rejection after the contract is awarded.

30. Business Associate Agreement: Contractor shall agree to sign the City’s Business Associate Agreement as written and provided prior to award.

31. Plan Design and Plan Provisions: Contractor’s plan(s) must match or improve upon the current plan designs, provisions, exclusions, and limitations. Specific deviations, if any, are identified in the proposal responses and not just a general disclaimer indicating “some differences may exist” or “refer to our proposal.” The burden is on the Contractor to point out any differences. Differences not noted on the deviation form, shall not be accepted, even if not negotiated.

32. Offshore Performance: Due to security and identity protection concerns, direct services under this contract shall be performed by Contractor within the borders of the United States. Any services that are described in the contract or scope of work that directly serve the City and may involve access to secure or sensitive data or personal client data or development or modification of software for the City shall be performed within the borders of the United States. Unless specifically stated otherwise in the contract, this definition does not apply to indirect or “overhead” services, redundant back-up services or services that are incidental to the performance of the contract. This provision applies to work performed by Contractor and subcontractors at all tiers.

Data and Reporting

1. Contractor shall provide on a monthly basis in Excel, enrollee, and member counts and by contribution tier, plan option, and employee status (Active, Retiree, Cobra). Likewise, paid claims data by plan option and employee status no later than 15 days following the end of the month.

2. Contractor shall provide an annual lag report combined for Active and Retirees in Excel.

3. Annually provide a utilization report by service class including reports showing in-network vs non-network usage, discounts achieved and savings from plan design features and utilization management.

4. An eligibility file (name, social, relationship) must be made available quarterly, if needed, to reconcile any differences between the Contractor’s eligibility system and the City’s internal records.

Administration

1. Contractor shall provide all required services to all eligible members including a toll free number for member questions and claim inquiries.

2. Contractor agrees to provide performance guarantees, measured periodically as specified, and to financial penalties for failure to meet standards.

3. Contractor shall provide quality services, meeting or exceeding the City-approved industry standards as specified in the Proposed Performance Guarantees below. Contractor shall take immediate corrective action and provide a written plan, as requested by the City, should the City identify any issue related to poor quality or lack of responsiveness uncovered by way of observation or audit, either internally or externally, of Contractor’s required processes or procedures. This action plan shall clearly outline the corrective steps and timeframes for completion when services do not meet industry standards to include standards that are inappropriate, undesirable, and/or of poor quality, as identified by the City. Any additional resources required to support corrective actions shall be provided at no additional cost to the City. Corrective measures taken to ensure the City quality standards, reporting standards or performance standards will be provided at no additional cost to the City through fees or hidden charges.

4. Contractor shall provide resources to respond within five business days to all inquiries related to quality assurance, corrective actions, deficiencies, and/or inefficiencies in operations. In matters of extreme urgency and time-sensitive issues, contractor agrees to provide resolution within two business days of City notification.

5. Contractor shall produce plan documents and plan summaries.

Implementation

1. Upon completion of the award, Contractor shall provide to the City communications and data support within a specified timeframe designated by the City for a successful transition to the new Contractor.

2. Contractor shall provide a team of individuals designated to implementing the provisions of this contract upon award. The implementation team shall include, but not be limited to: programmers; data analysts; project manager; account manager; enrollment specialists; and claims and member service staff.

3. Contractor’s implementation team shall meet with the City no less than bi-weekly (as needed) during the implementation process.

4. Contractor shall perform comprehensive system testing and quality assurance checks prior to the implementation date of July 1, 2026. Contractor shall report the results to the City no later than May 1, 2026.

5. Contractor shall have its customer call center and website available in advance of the July 1, 2026 effective date.

Open Enrollment, New Hire Orientations & Health Fairs

1. Contractor must comply with the following open enrollment procedures:

a. Contractor shall provide, at no additional cost to the City, the necessary staff for planning, transition, implementation, and ongoing administration of services.

b. Contractor shall begin services prior to the plan year effective date in order to prepare for the City’s open enrollment. The plan year for City of Tucson is July 1 through June 30, with open enrollment generally scheduled during the month of May. The City of Tucson reserves the right to change these dates with a fourteen (14) day notice to Contractor.

c. Conduct an orderly transition for an implementation date of July 1 of each contract year for Active employees and Retirees.

Claims Administration

1. Contractor shall provide the City with a minimum of 12 months advance notice of any claim system conversion or other changes that may disrupt the current processes.

2. Contractor receiving claims missing information that prevents contractor payments shall pend claims for a period of not more than 60 days allowing time for additional information for processing.

Account Management and Member Service

1. Account Manager – Contractor shall provide one (1), day-to-day point of contact for City of Tucson with the primary responsibilities of responding to all plan issues, coordinating with the Contractor’s various departments to resolve issues, and overseeing all aspects of project management including, but not limited to, initial implementation and any ongoing or new program facilitation. The Account Manager shall have a minimum of five (5) years’ experience with the Contractor’s organization or in a similar industry. If possible, the Account Manager shall also be a local resident of Arizona or have intensive familiarity with factors influencing care and services in the local market.

2. Contractor shall respond to account issues and member service issues within one to two business days at minimum with a plan to resolve the issue within a specified timeframe established to do so.

3. Contractor shall provide a designated account management/service team and a designated call and claim unit with toll free telephone access, at a minimum.

4. Contractor shall provide exceptional customer service support via phone, e-mail, and website for the City and their plan participants as documented by consistent reporting through performance guarantees and City specific customer satisfaction surveys.

5. Contractor shall provide an account management team that is experienced in providing services for similar entities, trained in the City’s plan issues, is accessible to the City during normal business hours (8:00 a.m. to 5:00 p.m. AZ time) and with capacity and authority to respond to the City’s issues in a timely manner.

6. Contractor shall provide an escalation process to assist in matters that cannot be resolved at the customer service unit level.

7. Contractor shall provide documentation of a process for prompt issue resolution and maintain an issue log.

8. Contractor shall attend in person or via video conference quarterly and annual program review meetings, meetings with the Business Service Department, Trust Board, Benefits Committee, and periodic telephone calls, as requested by the City’s insurance benefits office at no additional cost to the City.

Appeals and Disputes

1. Contractor shall handle all levels of claims appeals.

2. Contractor shall adhere to appeals and dispute processes as developed and directed by the City and stipulated in the subscriber’s certificate/booklet section relating to the written appeals process, including meeting timeframes and reporting on all levels of appeals with responses and results. Also, processes shall be kept current and made available at any interval requested by the City.

3. Contractor shall maintain procedures for responding to appeals and disputes as well as reporting the responses and results to the City.

4. Contractor shall provide the City a clear path (representative phone number or email, etc.) for plan participants to register complaints.

Eligibility

1. Contractor agrees that the City shall be the final authority in deciding eligibility of participants.

2. Contractor agrees to receive eligibility and enrollment information via weekly electronic feed from the City’s online enrollment system (currently Workday), at no additional cost to the City. The City reserves the right to change enrollment system providers at any time. Should a different enrollment system provider be used, there shall be no additional charge from the Contractor to the City to change providers including any changes to data files or feeds, etc.

3. Contractor shall establish appropriate FTP site(s) to exchange eligibility data at no additional cost to the City.

4. Contractor must agree to load eligibility file weekly within 2 working days of receipt and notify City of discrepancies and errors within the eligibility file within 2 working days of receipt of each eligibility file.

5. Contractor shall absorb any/all programming costs associated with data file transfers (weekly eligibility feed) in current data file compliant formats (acceptable file formats are 834, CSV or flat file).

6. Contractor agrees to accept the City's self-bill (no true up of any eligibility discrepancies other than those based on eligibility file transfer).

7. Contractor agrees to accept payment 60 days in arrears. For example, July’s premium (or ASO fees) would be considered late after August 29.

8. Contractor shall provide eligibility services including but not limited to tracking and determination of disability for adult children (submission via paper applications) approaching and over age 26 and provide notification and verification to the City (this process must be initiated by the Insurance company or TPA).

9. Contractor agrees to determine and maintain eligibility for all dependents age 26+ who are disabled. This includes mailing, accepting, and evaluating disability determination applications for dependent children who are approaching age 26 and annual recertification thereafter, as needed. Load an end date for dependents to age 26 (end of the month) and ensure it remains in place when new eligibility files are received (does not overwrite the end date as long as the dependent remains on the plan).

10. Contractor shall provide City benefits/finance/management with access to secure email at no additional cost to the City for resolving any eligibility issues, transmit secure data and have secure discussions.

11. Contractor shall agree to communicate through HIPAA-compliant electronic sites to exchange data between themselves and any other required contractors as requested by the City at no additional cost.

12. Contractor shall provide unlimited, online eligibility updating entry capabilities for a minimum of six (6) City of Tucson- approved users.

13. Contractor agrees to continue eligibility for surviving spouses and/or child(ren) of retirees who age out or pass away. Surviving spouses may remain on the dental plan indefinitely (with appropriate premium payment) and child(ren) until age 26.

Plan Member Communication Materials

1. Contractor shall submit all copies of member materials, web portal member communications communication distributed in any fashion to 50 or more plan members.

2. Contractor shall ensure that members with limited English proficiency, Spanish-speaking, and those that are deaf or hearing impaired have access to communication services that enable them to utilize the phone lines.

3. Contractor shall supply both written and electronic bilingual communication materials (flyers, plan summaries, etc.) at no additional cost to the City. Documents will be requested in both English and Spanish (when available)

4. Contractor shall prepare and provide policy document(s), summary plan descriptions (SPDs) and all other communications including educational videos to describe the City’s plan benefits and provisions at no additional cost to the City.

5. Contractor shall provide a website and/or mobile application(s) for use by employees, retirees and eligible dependents to obtain information on the City’s benefit plans, online provider directory, services offered, individual account information, claim status, Explanations of Benefits (EOBs) and price and quality transparency tools at no additional cost to the City.

Public Information Requests or Other Communications

1. Contractor shall notify the City within 1 business day of receipt of any public information written request regarding any information that relates to the City’s benefit plans. Contractor shall review all responses with the City and obtain approval prior to the release or response of any inquiry.

2. No member communication without the City’s consent: The Contractor will not automatically enroll the City of Tucson in any programs that involve any type of communication with members, without express written consent from the City of Tucson.

Commissions, Overrides and Bonuses

1. Contractor agrees commissions shall not to be included in the fees/rates submitted, (i.e., all fees/rates are to be quoted net of commission.). Any proposal that includes payment of commissions to a third party may be deemed non-responsive.

2. Contractor agrees that if commissions are included in their filed rates and cannot be removed from the rates provided, the level of commissions included in the proposed rates must be disclosed. Contractor agrees to disclose all direct and indirect compensation, fees, commissions, incentive awards, rebates, payments, fees, or remuneration of any sort, however characterized, as a result of or arising from the City account. If commissions cannot be removed dollar for dollar from Contractor’s rates commissions will be payable to the City’s consulting firm.

Dental Network

1. Contractor shall own all contracts with dental providers and take responsibility for all subcontracted networks/providers proposed by the Contractor within this RFP.

2. Contractor shall update the online provider directory every 96 hours for any changes reported by a provider.

3. Contractor shall maintain for the duration of the contract a network of providers in the client’s geographic locations no less than that proposed in this RFP.

4. Contractor shall adopt and disseminate practice guidelines that consider the needs of enrolled members and are:

a. Based on ADA guidelines or a consensus of dental care professionals in the particular field;

b. Developed and/or adopted in consultation with contracting dental care professionals;

c. Reviewed and updated periodically within timeframes determined appropriate by the Contractor and approved by the City; and

d. Applied consistently to all members covered under the program.

5. Contractor shall provide monitoring and evaluation of all types of provider performance and remove providers that do not meet the performance and quality standards required by Contractor to be part of the network.

6. Contractor shall resolve provider issues that relate to the City’s members in a timely fashion.

7. Contractor shall assist members in disputes between provider contract and claims administration. This includes customer service representatives reaching out to providers to work toward resolution. This assistance must be proactive to assist the City’s members toward reaching resolution; the assistance may not be simply passive where members have to figure out how to resolve issues on their own.

PROPOSAL EVALUATION REQUIREMENTS

I. PROPOSAL EVALUATION CRITERIA – (listed in relative order of importance)

A. Network/Provider Access B. Method of Approach C. Cost including ASO Fees and Discounts D. Qualifications of Contractor

II. REQUIREMENTS SPECIFIC TO EVALUATION CRITERIA: The narrative portion, including the Questionnaire responses, and the materials presented in response to this Request for Proposal should be submitted in the same order as requested and must contain, at a minimum, the following:

A. Network/Provider Access

1. Complete the Network/Provider Access in the Questionnaire

2. Complete the re-pricing in the Excel workbook for evaluation of provider disruption

3. Complete a Geo Access analysis (provide in Excel) using the access criteria specified in the RFP

4. Complete the Provider Network information in the Excel workbook provided B. Method of Approach

1. Complete ALL sections of the Method of Approach Questionnaire

2. Complete the Plan Design templates in the Excel Workbook

3. Complete the Performance Guarantees Chart

4. Complete the Deviations exhibit C. Cost (Rates/Financial)

1. Complete the Cost/Rates/ASO Fees Financial Questionnaire

2. Complete the Rates/Fee exhibits in the Excel Workbook

3. Complete the re-pricing exhibit in the Excel workbook for evaluation of network discounts D. Qualifications and Experience

1. Complete the Qualifications and Experience Questionnaire

DEVIATIONS AND EXCEPTIONS

Offerors shall indicate ANY and ALL deviations or exceptions taken to the provisions or specifications in this RFP below. If exceptions or deviations are not listed, it will be assumed you will conform to all of the requirements in this RFP.

List each specific deviation by reference in the RFP or reference any materials included or referenced in the RFP along with the specific deviation. General deviation statements such as “our intent is to conform” or unclear statements are not desired and may impact our ability to fully understand your offer.

Exceptions (mark one):

__________ No exceptions

__________ Exceptions taken (describe below). Please list each and every deviation to anything written in this RFP and this Attachment. If you do not list any deviations, it will be assumed that your proposal conforms to all of the requirements unless otherwise noted. Use additional pages as needed.

Deviations

Offeror Name:

Signature:

Date:

CONFIDENTIAL/PROPRIETARY SUBMITTAL FORM

Confidential/Proprietary Submittals (mark one):

No confidential/proprietary materials have been included with this offer

Confidential/proprietary materials included. Offerors should identify below any portion of their proposal deemed confidential or proprietary. The City will only review the specific areas listed below and will not review the entire proposal for confidential information indicators. Identification in this section does not guarantee that disclosure will be prevented but that the items will be subject to review by the Contractor and the City prior to any public disclosure. Requests to deem the entire proposal or price as confidential will not be considered.

Offeror

Authorized Signature Date

ADDITIONAL MATERIALS SUBMITTED

(Mark One):

__________ No additional materials have been included with this offer

__________ Additional Materials attached (describe—attach additional pages if needed)

Offeror

Authorized Signature

ATTACHMENTS:

· Dental Cost Proposal

· Technical Workbook

· Dental Questionnaire

· CIGNA OHIP Flyer

· 3342865 Plan Document

· PPO Summary AZ

· PPO Summary All States

· DHMO Schedule

· Census and Dental Claim Reporting (provided by McGriff upon receipt of Attachment A – Request for Confidential Documents Form)

FINAL CHECKLIST:

The items listed below must be included electronically in the file format noted. Other materials with your proposal may be provided in pdf format.

Attachments (Excel workbooks)

· Dental Cost Proposal

· Technical Workbook

· Dental Questionnaires