HT940217R0001__SF_33_pages_1-124_11-27-17.pdf

HT940217R0001

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

DO-C9 1 124

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) depository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

X

HT9402

DEFENSE HEALTH AGENCY

DEFENSE HEALTH AGENCY-AURORA

16401 E CENTRETECH PARKWAY

AURORA CO 80011

until 1200 MT local time TBD

MARGARET ZANCANELLA 303

Margaret.a.zancanella.civ @mail.mil676-3451

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

MARGARET A. ZANCANELLA

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

2-24

C1-C19 D1 E1 F1-F2 G1-G10 H1-H7

I1-I11

J1-J2

K1-K14

L1-L23

M1-M10

See Section L

303-676-3451

MARGARET.A.ZANCANELLA.civ@mail.mil

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

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(A) (B) (C) (D) (E) (F)

TRICARE Dental Readiness and Wellness (TDRAW)Indefinite Delivery/Indefinite Quantity Dental Services Contract in accordance with FAR 52.216-1, Contract Type, for the scheduled period and for Option Periods 1-7 if exercised. All services shall be ordered in accordance with Sections G and I, FAR Clauses 52.216-18, Ordering; 52.216-19, Order Limitations; and 52.216-22,Indefinite Quantity; and DFARS Clause 252.216-7006, Ordering. PSC: Q503, Medical-Dental Services; NAICS: 524114, Direct Health and Medical Insurance Carriers.

Guaranteed Minimum: TBD (Award value of CLIN 0001) Contract Ceiling: TBD (Award value, including all CLINs X005, Transition-Out) Delivery Location Code: HT9402

DEFENSE HEALTH AGENCY

DEFENSE HEALTH AGENCY-AURORA

16401 E CENTRETECH PARKWAY

AURORA CO 80011-9066 USA

Period of Performance: 01/01/2019 to 12/31/2026

SECTION B, SUPPLIES OR SERVICES AND PRICES/COSTS.

Base Period (TRANSITION-IN): 12 months from the date of award

0001 Transition-In ADSMs & TRICARE Overseas ADSM Remote (12 months) Firm fixed price LO = Lot

0002 NIST and Physical and Personnel Security Firm fixed price MO = Monthly

0003 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

Option Period (OP) 1 (12 months) Active Duty Dental Services (CONUS/OCONUS)Commence

1001 OP 1 RESERVED

Continued ...

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1002 OP 1 NIST and Physical & Personnel Security Firm fixed price MO = Month

1003 OP 1 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

1004 OP 1 Incentives up to $550.000.00.

See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available.

Firm fixed price LO = Lot

1005 OP 1 Transition-out Firm fixed price LO = Lot

1006 OP 1 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price LO = Lot

1007 OP 1 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

1008 OP 1 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table Firm fixed price LO = Lot

Option Period (OP) 2 (12 months)

2001 OP 2 Transition-in TRICARE Dental Program 12-month transition-in Firm fixed price LO = Lot

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2002 OP 2 NIST and Physical & Personnel Security Firm fixed price MO = Month

2003 OP 2 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

2004 OP 2 Incentives up to $550.000.00.

Reference Section H.3. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.

Firm fixed price LO = Lot

2005 OP 2 Transition-out Firm fixed price LO = Lot

2006 OP 2 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price LO = Lot

2007 OP 2 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

2008 OP 2 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table Firm fixed price LO = Lot

Option Period (OP) 3 (12 months) TRICARE Dental Program (TDP) Services Commence

3001 OP 3 RESERVED

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3002 OP 3 NIST and Physical & Personnel Security Firm fixed price MO = Monthly

3003 OP 3 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

3004 OP 3 Incentives up to $550.000.00.

See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available. Firm fixed price LO = Lot

3005 OP 3 Transition-out Firm fixed price LO = Lot

3006 OP 3 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price LO = Lot

3007 OP 3 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

3008 OP 3 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table Firm fixed price LO = Lot

3009 OP 3 TDP Single Enrollment Premium. Estimated Quantity: 3,119,208 Enrollee Share(40%):

Government Share(60%):

Total Premium:

Firm fixed price EA = Each beneficiary per month

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3010 OP 3 TDP Family Enrollment Premium. Estimated Quantity: 5,438,628 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each family per month

3011 OP 3 TDP Selected Reserve Single Enrollment Premium. Estimated Quantity: 200,856 Enrollee Share(100%):

Firm fixed price EA = Each beneficiary per month (Not Separately Priced)

3012 OP 3 TDP Selected Reserve Family Enrollment Premium. Estimated Quantity: 423,804 Enrollee Share(100%):

Firm fixed price EA = Each family per month (Not Separately Priced)

3013 OP 3 TDP Survivor Benefit Single Enrollment Premium. Estimated Quantity: 34,236 Government Share(100%):

Firm fixed price EA = Each beneficiary per month

3014 OP 3 TDP Survivor Benefit Family Enrollment Premium. Estimated Quantity: 44,112 Government Share(100%):

Firm fixed price EA = Each family per month

3015 OP 3 TDP Reimbursement for Costs in Excess of Allowable OCONUS. Estimated Value: $703,800.00 Cost reimbursable, no fee LO = Lot

3016 OP 3 TDP Reimbursement for Cost Shares and Additional Allowable Charges for OCONUS claims.

Estimated Value: $3,570,000.00 Cost reimbursable, no fee

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Option Period (OP) 4 (12 months) Reserve Readiness and Wellness Services (CONUS/OCONUS) Commence

4001 OP 4 Reserve Readiness & Wellness Dental Services 6-month transition-In Firm fixed price LO = Lot

4002 OP 4 NIST and Physical & Personnel Security Firm fixed price MO = Monthly

4003 OP 4 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

4004 OP 4 Incentives up to $550.000.00.

See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available.

Firm fixed price LO = Lot

4005 OP 4 Transition-out Firm Fixed Price LO = Lot

4006 OP 4 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price LO = Lot

4007 OP 4 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

4008 OP 4 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table

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Firm fixed price LO = Lot

4009 OP 4 TDP Single Enrollment Premium. Estimated Quantity: 2,550,360 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each beneficiary per month

4010 OP 4 TDP Family Enrollment Premium. Estimated Quantity: 5,438,628 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each family per month

4011 OP 4 TDP Selected Reserve Single Enrollment Premium. Estimated Quantity: 200,856 Enrollee Share(100%):

Firm fixed price EA = Each beneficiary per month (Not Separately Priced)

4012 OP 4 TDP Selected Reserve Family Enrollment Premium. Estimated Quantity: 423,804 Enrollee Share(100%):

Firm fixed price EA = Each family per month (Not Separately Priced)

4013 OP 4 TDP Survivor Benefit Single Enrollment Premium. Estimated Quantity: 34,236 Government Share (100%) Firm fixed price EA = Each beneficiary per month

4014 "OP 4 TDP Survivor Benefit Family Enrollment Premium. Estimated Quantity: 44,112 Government Share (100%) Firm fixed price EA = Each family per month

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4015 OP 4 TDP Reimbursement for Costs in Excess of Allowable OCONUS.

Estimated Value: $717,876.00 Cost reimbursable, no fee LO = Lot

4016 OP 4 TDP Reimbursement for Cost Shares and Additional Allowable Charges for Orthodontic Costs Charges for OCONUS Claims.

Estimated Value: $3,641,400.00 Cost reimbursable, no fee LO = Lot

4017 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

4018 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

4019 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

4020 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

4021 OP 4 Selected Reserve and Individual Ready

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Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

4022 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table. Six month period of performance.

Firm fixed price LO = Lot

Option Period (OP) 5 (12 months)

5001 OP 5 RESERVED

5002 OP 5 NIST and Physical & Personnel Security Firm fixed price MO = Monthly

5003 OP 5 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

5004 OP 5 Incentives up to $550.000.00.

See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available.

Firm fixed price LO = Lot

5005 OP 5 Transition-out Firm fixed price LO = Lot

5006 OP 5 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price

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5007 OP 5 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

5008 OP 5 Active Duty Dental Services CONUS/OCONUS, 1 LO Exhibit A-3 CDT Pricing Table Firm fixed price LO = Lot

5009 OP 5 TDP Single Enrollment Premium. Estimated Quantity: 1,981,512 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each beneficiary per month

5010 OP 5 TDP Family Enrollment Premium. Estimated Quantity: 5,438,628 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each family per month

5011 OP 5 TDP Selected Reserve Single Enrollment Premium. Estimated Quantity: 200,856 Enrollee Share(100%):

Firm fixed price EA = Each beneficiary per month (Not Separately Priced)

5012 OP 5 TDP Selected Reserve Family Enrollment Premium. Estimated Quantity: 423,804 Enrollee Share(100%):

Firm fixed price EA = Each family per month (Not Separately Priced)

5013 OP 5 TDP Survivor Benefit Single Enrollment Premium. Estimated Quantity: 34,236 Government Share (100%)

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Firm fixed price EA = Each beneficiary per month

5014 OP 5 TDP Survivor Benefit Family Enrollment Premium Estimated Quantity: 44,112 Government Share (100%) Firm fixed price EA = Each family per month

5015 OP 5 TDP Reimbursement for Costs in Excess of Allowable OCONUS Estimated value: $732,234 Cost reimbursable, no fee LO = Lot

5016 OP 5 TDP Reimbursement for Cost Shares and Additional Allowable Charges for Orthodontic Costs Charges for OCONUS Claims Estimated Value: $3,714,228 Cost reimbursable, no fee LO = Lot

5017 OP 5 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price LO = Lot

5018 OP 5 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price LO = Lot

5019 OP 5 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm fixed price

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5020 OP 5 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price LO = Lot

5021 OP 5 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price LO = Lot

5022 OP 5 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm fixed price LO = Lot

Option Period (OP) 6 (12 months)

6001 OP 6 RESERVED

6002 OP 6 NIST and Physical & Personnel Security Firm fixed price MO = Monthly

6003 OP 6 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

6004 OP 6 Incentives up to $550.000.00.

See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available.

Firm fixed price LO = Lot

6005 OP 6 Transition-out Firm fixed price

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LO = Lot

6006 OP 6 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm fixed price LO = Lot

6007 OP 6 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm fixed price LO = Lot

6008 OP 6 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table Firm fixed price LO = Lot

6009 OP 6 TDP Single Enrollment Premium. Estimated Quantity: 1,981,512 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each beneficiary per month

6010 OP 6 TDP Family Enrollment Premium. Estimated Quantity: 5,438,628 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each family per month

6011 OP 6 TDP Selected Reserve Single Enrollment Premium. Estimated Quantity: 200,856 Enrollee Share(100%):

Firm fixed price EA = Each beneficiary per month (Not Separately Priced)

6012 OP 6 TDP Selected Reserve Family Enrollment Premium. Estimated Quantity: 423,804

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Enrollee Share(100%):

Firm fixed price EA = Each family per month (Not Separately Priced)

6013 OP 6 TDP Survivor Benefit-Single Enrollment Premium. Estimated Quantity: 34,236 Government Share (100%) Firm fixed price EA = Each beneficiary per month

6014 OP 6 TDP Survivor Benefit Family Enrollment Premium Estimated Quantity: 44,112 Government Share (100%) Firm fixed price EA = Each family per month

6015 OP 6 TDP Reimbursement for Costs in Excess of Allowable OCONUS.

Estimated value: $746,879 Cost reimbursable, no fee LO = Lot

6016 OP 6 TDP Reimbursement for Cost Shares and Additional Allowable Charges for Orthodontic Costs Charges for OCONUS Claims Estimated value: $3,788,513 Cost reimbursable, no fee LO = Lot

6017 OP 6 Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price LO = Lot

6018 OP 6 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price

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6019 OP 6 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm fixed price LO = Lot

6020 OP 6 OP 4 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price LO = Lot

6021 OP 6 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price LO = Lot

6022 OP 6 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm Fixed Price LO = Lot

Option Period (OP) 7 (12 months)

7001 OP 7 RESERVED

7002 OP 7 NIST and Physical & Personnel Security Firm fixed price MO = Monthly

7003 OP 7 Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) LO = Lot (Not Separately Priced)

7004 OP 7 Incentives up to $550.000.00.

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See Section H.4. for criteria for earning Incentives. The amount shown is the maximum incentive available.

Firm fixed price LO = Lot

7005 OP 7 Transition-out Firm fixed price LO = Lot

7006 OP 7 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table Firm Fixed Price LO = Lot

7007 OP 7 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table Firm Fixed Price LO = Lot

7008 OP 7 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table Firm Fixed Price LO = Lot

7009 OP 7 TDP Single Enrollment Premium. Estimated Quantity: 1,981,512 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each beneficiary per month

7010 OP 7 TDP Family Enrollment Premium. Estimated Quantity: 5,438,628 Enrollee Share (40%):

Government Share (60%):

Total Premium:

Firm fixed price EA = Each family per month

7011 OP 7 TDP Selected Reserve Single Enrollment Premium. Estimated Quantity: 200,856

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Enrollee Share(100%):

Firm fixed price EA = Each beneficiary per month (Not Separately Priced)

7012 OP 7 TDP Selected Reserve Family Enrollment Premium. Estimated Quantity: 423,804 Enrollee Share(100%):

Firm fixed price EA = Each family per month (Not Separately Priced)

7013 OP 7 TDP Survivor Benefit Single Enrollment Premium. Estimated Quantity: 34,236 Government Share (100%) Firm fixed price EA = Each beneficiary per month

7014 OP 7 TDP Survivor Benefit Family Enrollment Premium Estimated Quantity: 44,112 Government Share (100%) Firm fixed price EA = Each family per month

7015 OP 7 TDP Reimbursement for Costs in Excess of Allowable OCONUS Estimated value: $761,816 Cost reimbursable, no fee.

LO = Lot

7016 OP 7 TDP Reimbursement for Cost Shares and Additional Allowable Charges for Orthodontic Costs Charges for OCONUS Claims Estimated value: $3,864,283 Cost reimbursable, no fee LO = Lot

7017 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price

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7018 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price LO = Lot

7019 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm fixed price LO = Lot

7020 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-1 CDT Pricing Table Firm fixed price LO = Lot

7021 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-2 CDT Pricing Table Firm fixed price LO = Lot

7022 OP 7 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-3 CDT Pricing Table Firm fixed price

SECTION B, SUPPLIES OR SERVICES AND PRICES/COSTS, CONTINUATION

TDRAW HT9402-17-R-0001, Section B Page 20 of 24 Contract Line Item Number (CLIN) Descriptions

CONTRACT LINE ITEM NUMBER (CLIN) DESCRIPTIONS

Transition-in CLINs X001. This CLIN establishes a fixed price for transition-in services as defined in Section C, Description/ Specifications/Work Statement, and Section J, Attachment J- 17 a, Transition-In Requirements for all Contracts; J-17b, Transition-In Requirements for ADSM; and J-17c Transition-In Requirements for TRICARE Overseas Program (TOP) Remote ADSM. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. This amount shall include all costs and profit which the contractor will incur in performing transition-in tasks and shall not include any costs associated with any other priced CLIN.

Active Duty Dental Services CONUS/OCONUS. CLIN 0001 establishes a fixed price for the 12- month transition-in services related to the start of the contract and Active Duty supplemental dental services in the CONUS and OCONUS as defined in Section C, Description/Specifications/Work Statement; Section J, Attachments J-2.a, Benefits, Limitations and Exclusions for Active Duty Service Members; J-3a, Program Operations for all TDRAW Beneficiaries; J-3b, Program Operations for Active Duty Service Members; J-4a, OCONUS Program Operations; J-5, Procedures for Certain Remote ADSM Categories and J-6a.

Instructions for Remote ADSM’s Dental Care; J-6b, Sample Command Memorandum for Authorization Request; J-17a, Transition-In Requirements for all Contracts; J-17b, Transition-In Requirements for ADSM; J-17c, Transition-In Requirements for OCONUS ADSMs; and Exhibit A, CDT Pricing Table for ADSMs (Regions 1, 2, and 3). The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract.

The fixed price includes all costs and profit, which the contractor will incur in performing transition-in tasks and shall not include any costs associated with any other priced CLIN.

Transition-In TRICARE Dental Plan (TDP) (Reservists and Family Members). Option Period 2 CLIN 2001 TDP Transition-in establishes a fixed price for the 12-month transition-in services related to the start of worldwide dental services to eligible Active Duty Family Members (ADFMs) and Selected Reserve and Individual Ready Reserve (IRR) members and their eligible family members. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in accordance with Section C, Description/ Specifications/Work Statement; and Section J, Attachments J-2b, Benefits, Limitations and Exclusions for Reservists and Family Members; J-3a, Program Operations for all TDRAW Beneficiaries; J-3c, Program Operations for Reservists and Family Members; J-3e, Program Operations for Data Interfaces; J-4a, OCONUS Program Operations; J-17a; Transition-In Requirements for all Contracts; and J-17d, Transition-In Requirements for Reservists and Family Members. The fixed price includes all costs and profit, which the contractor will incur in performing TDP transition-in tasks and shall not include any costs associated with any other priced CLIN.

Transition-In Reserve Health Readiness Program (RHRP) Dental Services. CLIN 4001 establishes a fixed price for the 6-month transition-in services related to the start of worldwide (CONUS and OCONUS) dental services to Selected Reserve and Individual Ready Reserve (IRR) mobilization asset members. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in accordance with Section C, Description/Specifications/ Work Statement; Section J, Attachments J-2c, Benefits, Limitations and Exclusions for Reservists and Individual Ready Reserve Mobilization Asset; J-3d Program

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Operations for Selected Reserve and Individual Ready Reserve Mobilization Asset; J-3e, Program Operations for Data Interfaces; J-4a, OCONUS Program Operations; J-17a, Transition- In Requirements for all Contracts; and J-17e, Transition-In Requirements for Selected Reserve and IRR Mobilization-Asset. The fixed price includes all costs and profit, which the contractor will incur in performing the RHRP transition-in tasks and shall not include any costs associated with any other priced CLIN.

CLINs 1001, 3001, 5001, 6001, and 7001 are Reserved.

National Institute of Standards and Technology (NIST) Systems Security, and Physical and Personnel Security). CLINs X002 establish a monthly fixed price for NIST system security standards, physical, and personnel security tasks in accordance with Section C, Description/ Specifications/Work Statement. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. The price shall include costs and profit which the contractor will incur in the performance of security (NIST, Physical, and Personnel) requirements for the contract and shall not include any costs associated with any other priced CLIN.

Reports & Deliverables, Exhibit C, Contract Data Requirements List (CDRLs) (DD Forms 1423-1) Not Separately Price (NSP). CLINs X003 are not separately priced CLINs for contract deliverables (DD Form 1423-1, Contract Data Requirements List), which include, but are not limited to, data submissions, plans, reporting, and other documents which are prepared and delivered in accordance with Section C, Description/Specifications/Work Statement; Section F, Deliveries or Performance; and Section J, Exhibit C, Contract Data Requirements List.

Incentives. CLINs X004. The Government establishes the value of the incentive CLINs X004, which are firm, fixed price with a unit of issue “Lot.” See Section H.4.for the criteria for earning the incentive and Section G for invoicing instructions.

Transition-out. CLINs X005. CLINs X005 establish a firm, fixed price for transition-out services for each option period in accordance with Section C, Description/Specifications/Work Statement; Section J, Attachment J-18, Transition-Out and Residual Services Requirements; and the TRICARE Manuals. Although priced for each option period, transition-out occurs only once during the contract. The transition-out period will run concurrently with the last exercised option period of the contract and includes residual services for claims processing, grievances, and appeals for up to 1 year after the date of service. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. The firm fixed price includes all costs and profit, which the contractor will incur in performance of transition-out tasks and shall not include any costs associated with any other priced CLIN.

CLIN Descriptions for Services Beginning in Option Period 1 Active Duty Dental Services CONUS/OCONUS (ADDP & TOP). CLINs X006, X007, X008 establish firm, fixed prices with a unit of issue “Lot” for supplement dental care services provided to Active Duty Service Members (ADSMs) in accordance with Section C, Description/Specifications/Work Statement; Section J, Attachments J-2.a, Benefits, Limitations and Exclusions for Active Duty Service Members; J-3a, Program Operations for all TDRAW Beneficiaries; J-3b, Program Operations for Active Duty Service Members; J-4a, OCONUS Program Operations; J-5, Procedures for Certain Remote ADSM Categories; and J-6a.

Instructions for Remote ADSM’s Dental Care; J-6b, Sample Command Memorandum for

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Authorization Request; and Exhibit A, CDT Pricing Table for ADSMs (Regions A-1, A-2, and A-3). The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. The fixed price includes all costs and profit, which the contractor will incur in the performance ADSM supplemental dental service requirements and shall not include any costs associated with any other priced CLIN.

X006 Active Duty Dental Services CONUS/OCONUS, Exhibit A-1 CDT Pricing Table;

X007 Active Duty Dental Services CONUS/OCONUS, Exhibit A-2 CDT Pricing Table (if applicable) X008 Active Duty Dental Services CONUS/OCONUS, Exhibit A-3 CDT Pricing Table (if applicable)

CLIN Descriptions for Services Beginning in Option Period 3 TRICARE Dental Premiums (TDP) (Reservists and Family Members). CLINs X009, X010, X011, X012, X013, X014 establish a fixed price premium per member per month (PM/PM) for dental services, network management, claims processing, and customer support necessary to provide worldwide dental coverage to eligible Active Duty Family Members (ADFMs) and Selected Reserve and Individual Ready Reserve (IRR) members and their eligible family members. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in accordance with Section C, Description/Specifications/Work Statement; and Section J, Attachments J-2b, Benefits, Limitations and Exclusions for Reservists and Family Members; J-3a, Program Operations for all TDRAW Beneficiaries; J-3c, Program Operations for Reservists and Family Members; J-3e, Program Operations for Data Interfaces; J- 4a, OCONUS Program Operations;. The fixed price premium includes all costs and profit, which the contractor will incur in performing tasks for TDP dental services and shall not include any costs associated with any other priced CLIN.

The Government has established an estimated quantity for each option period as provided in Section B, Supplies or Services and Prices/Costs. The Government will adjust the quantities annually when each option is exercised. For CLINs X009-X010, the Government pays 60% of the premium, and the enrolled beneficiary pays 40%. Beginning in OP 5, the estimated quantities for CLINs X009 decrease to reflect the work performed under the Reserve Readiness and Wellness CLINs 5017-5022.

For CLINs X011-X012, the enrolled beneficiary pays 100% of the premium, and no appropriated funds will be added to these CLINs. For CLINs X013-X014, the Government pays 100%. TDP Reimbursement for Costs in Excess of Allowable OCONUS. CLINs X015 establish a cost-reimbursed (no fee) not-to-exceed amount for costs in excess of allowable OCONUS in accordance with Section C, Description/Specifications/Work Statement; and Section J, Attachment J-3c, Program Operations for Reservists and Family Members; and J-4a, OCONUS Program Operations. The Government has established the not-to-exceed amount for these CLINs. The Government pays 100% of allowable costs.

TDP Reimbursement for Cost Shares and Additional Allowable Charges for Orthodontic Costs Charges for OCONUS Claims. CLINs X016 establish a cost-reimbursed (no fee) not-to-exceed amount for costs in excess of allowable in accordance with Section C, Description/ Specifications/Work Statement; and Section J, Attachment J-3c, Program Operations for Reservists and Family Members; and J-4a, OCONUS Program Operations. The Government has

TDRAW HT9402-17-R-0001, Section B Page 23 of 24 Contract Line Item Number (CLIN) Descriptions established the not-to-exceed amount for these CLINs. The Government pays 100% of allowable costs.

CLIN Descriptions for Services Beginning Option Period 4 Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Readiness Dental Services CONUS/OCONUS Exhibit B, CDT Pricing Table for Selected Reserve and IRR (Mobilization Asset Only) (Regions B-1, B-2, and B-3 if applicable), and CLINs X017, X018, and X019. CLINs X017, X018, and X019 establish firm, fixed prices with a unit of issue “Lot” for CONUS readiness dental care services provided for Dental Readiness Classification (DRC) 4 and 3. CLINs 4017-4022 have a 6-month period of performance. Option Periods 5-7 have 12-month periods of performance. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in accordance with Section C, Description/Specifications/Work Statement; and Section J, Attachments J-2c, Benefits and Exclusions for Selected Reserve and IRR Mobilization-Asset; J-3a, Program Operations for all TDRAW Beneficiaries; J-3d, Program Operations for Selected Reserve and IRR Mobilization- Asset; J-3e, Program Operations for Data Interfaces; J-4a, OCONUS Program Operations; and J- 8b, Department of Defense Oral Health and Readiness Classification System. The fixed price includes all costs and profit to be incurred in performing the Reserve Health Readiness requirements and shall not include any costs associated with any other priced CLIN. The CDT codes with an asterisk in Exhibit B are typically readiness care codes applicable to CLINs X017, X018 and X019. The CDT codes with an asterisk are not all inclusive of the CDT codes which may be used for readiness care. Other CDT codes may be required to correct a patient’s Dental Readiness Classification (DRC) from 3 to 2 depending on the case.

X017 Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Readiness Dental Services, CONUS/OCONUS Exhibit B-1, CDT Pricing Table X018 Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-2 (if applicable), CDT Pricing Table X019 Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Readiness Dental Services, CONUS/OCONUS, Exhibit B-3 (if applicable), CDT Pricing Table

Selected Reserve and Individual Ready Reserve (IRR) Mobilization Asset Wellness Dental Services CONUS/OCONUS Exhibit B, CDT Pricing Table for Selected Reserve and IRR (Mobilization Asset Only) (Regions B-1, B-2, and B-3), and CLINs X020, X021, X022.

CLINs X020, X021, X022 establish firm, fixed prices with a unit of issue “Lot” for wellness dental care services provided DRCs 2 and 1. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in accordance with Section C, Description/ Specifications/Work Statement; and Section J, Attachments J-2c, Benefits and Exclusions for Selected Reserve and IRR Mobilization-Asset; J-3a, Program Operations for all TDRAW Beneficiaries; J-3d, Program Operations for Selected Reserve and IRR Mobilization- Asset; J-3e, Program Operations for Data Interfaces; J-4a, OCONUS Program Operations; and J- 8b, Department of Defense Oral Health and Readiness Classification System. The fixed price includes all costs and profit, which the contractor will incur in performing the Reserve Health Wellness requirements and shall not include any costs associated with any other priced CLIN.

The CDT codes without an asterisk in Exhibit B are typically wellness care codes and used for CLINs X020, X021 and X022.

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X020 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-1, CDT Pricing Table;

X021 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-2 (if applicable) CDT Pricing Table X022 Selected Reserve and Individual Ready Reserve Mobilization Asset Wellness Dental Services, CONUS/OCONUS, Exhibit B-3 (if applicable) CDT Pricing Table

SECTION C

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

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C.1. MISSION.

C.1.1. The Department of Defense (DoD) through the Defense Health Agency (DHA) has a mission to offer dental care services to eligible TRICARE beneficiaries. In order to fulfill DHA’s mission, the contractor shall provide comprehensive dental care services worldwide to eligible TRICARE beneficiaries under the TRICARE Dental Readiness and Wellness (TDRAW) contract.

C.1.2. Scope.

C.1.2.1. In support of the DHA Dental Care Section of the TRICARE Health Plan, TDRAW provides worldwide dental coverage to Active Duty Service Members (ADSMs) of the Uniformed Services, eligible members of the Reserves and National Guard, Reserve Component members discharged after serving more than 30 days on active duty in support of a contingency operation, and those Foreign Forces Members (FFMs) eligible for care pursuant to an approved agreement (e.g., reciprocal health care agreement, North Atlantic Treaty Organization [NATO] Status of Forces Agreement [SOFA], Partnership for Peace [PFP] SOFA). The Uniformed Services include the U.S. Army, the U.S. Navy, the U.S. Air Force, the U.S. Marine Corps, the U.S. Coast Guard, the Commissioned Corps of the National Oceanic and Atmospheric Administration (NOAA), and the Commissioned Corps of the Public Health Service (PHS). The Commissioned Corps of the PHS is not currently included in the TDRAW program. However, the Government reserves the right to expand coverage to include PHS personnel under this contract.

C.1.2.1.1. Active Duty Dental Services. TDRAW will supplement ADSM care provided in the DoD’s Dental Treatment Facilities (DTFs), as well as provide care to those ADSMs living in regions without access to DTFs. The contractor shall supplement authorized care by developing and maintaining a dental provider network in the Continental United States (CONUS), which includes the 50 United States, District of Columbia, U.S. Virgin Islands, Guam, Puerto Rico, American Samoa, and the Northern Mariana Islands. The Outside Continental United States (OCONUS) service area includes all other countries, island masses and territorial waters.

C.1.2.1.2. Optional TRICARE Overseas Program (TOP) Remote Dental Services. The ADSM OCONUS dental coverage is currently provided by the TRICARE Overseas Program (TOP) contract. Under TDRAW, the contractor shall provide routine, urgent, and emergency dental care services to ADSMs who are enrolled in remote areas. The Kingdom of Bahrain and Souda Bay, Greece, areas are exceptions because, for these two locations, ADSMs do not have to be enrolled as a remote ADSM in order to receive care. Additionally, the contractor shall provide OCONUS urgent and emergency dental care to ADSMs who are on Temporary Duty/Temporary Additional Duty (TDY/TAD), deployed, deployed on liberty, or in an authorized leave status in a remote overseas location (greater than 50 miles from the nearest Military Treatment Facility (MTF) capable of providing dental care services). The Government anticipates it will transition the TOP remote dental services into TDRAW at award. The Government reserves the right to modify the contract to add the TOP remote dental services at a later date (See Section B, Contract Line Item Number [CLIN] 0001; and Section J, Attachment

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J-4a-c, OCONUS Program Operations; and Attachment J-17c, Transition-In TOP Remote ADSM Dental Services).

C.1.2.2. Optional TRICARE Dental Program (TDP). The TDP contract currently provides worldwide dental coverage to eligible Active Duty Family Members (ADFMs) and Selected Reserve and Individual Ready Reserve (IRR) members and their eligible family members.

Former spouses, parents, in-laws, disabled veterans, family members of foreign personnel, and retirees and their families are not eligible for TDP. The Government has determined the TDP dental services are within the scope of the TDRAW requirement. The Government anticipates it will transition the TDP dental services into TDRAW in Option Period (OP) 2, and dental care services will begin in OP 3. The Government reserves the right to modify the contract to add the TDP services at a later date (See Section B, CLIN 2001, and Section J, Attachment J-3c, Program Operations for Reservists and Family Members; and Attachment J-17d, Transition-In

TDP).

C.1.2.2.1. DHA is proposing changes to revise 32 Code of Federal Regulations (CFR) 199.13 CONUS and OCONUS definitions to match the definitions as stated in C.1.2.1.1. The proposed CFR change will be effective with the start of dental care delivery for ADFMs and Selected Reserve and Individual Ready Reserve (IRR) members and their eligible family members.

C.1.2.3. Optional Reserve Health Readiness Program (RHRP) Readiness and Wellness Dental Services. The RHRP currently provides dental coverage to Selected Reserves and IRR mobilization assets only. TDRAW will offer worldwide dental coverage to eligible members of the Selected Reserve and IRR mobilization assets only. Coverage includes both readiness care at Dental Readiness Classifications (DRCs) 4 and 3 and ongoing wellness care at DRCs 2 and 1 (See Section J, Attachment J-8b, Department of Defense Oral Health and Readiness Classification System). The Government has determined the RHRP dental services are within the scope of the TDRAW requirement. The Government anticipates it will transition the RHRP dental services to TDRAW in OP 4. The Government reserves the right to modify the contract to add the RHRP services at a later date (See Section B, Optional CLIN 4001, and Section J, Attachment J-3d, Program Operations for Selected Reserve and Individual Ready Reserve Mobilization Asset, which describes the requirements if legislation authorizes the change; and Attachment J-17e, Transition-In RHRP Dental Services).

C.1.2.3.1. The dental coverage for Selected Reserve and IRR mobilization assets only members will initially be provided the same as for family members and non-mobilization asset IRR (See Section J, Attachment J-3c, Program Operations for Reservists and Family Members). Coverage will remain as stated in Section J, Attachment J-3c, Program Operations for Reservists and Family Members, until legislation has authorized the amendment to 10 U.S.C., Chapter 55, Section 1074a. Following the amendment, 32 CFR 199.13 will be updated to comply with the revised statute.

C.2. GENERAL REQUIREMENTS.

C.2.1. Contract Management and Administration. The contractor shall establish clear organizational lines of authority and responsibility to ensure adequate, effective resources are

TDRAW HT9402-17-R-0001 Page C3 of C19 assigned to the requirement. The contractor shall have primary and alternate points of contact who are authorized to negotiate with the Government and commit to contract implementation and compliance (See Section G.2.5). The contractor shall notify the Government within 5 business days of personnel changes to the contractor’s leadership (e.g. president, vice president, etc.) and the primary and alternate point of contacts.

C.2.1.1. The contractor shall establish and maintain effective management strategies, staff education and training programs, lines of authority, and reporting and coordination interfaces with the Government. The contractor shall comply with the directives cited in paragraph C.4.5, Applicable Directives.

C.2.2. The contractor shall notify the Government when its primary and alternate points of contact will be out of the office for a full day or more. The contractor shall notify the Government when it or its subcontractors have unscheduled closures of their offices.

C.2.3. Proper Identification of Contractor Personnel. Contractors, including subcontractors at all tiers, shall provide for a clear distinction from Government personnel. Contractor employees shall not act, advertise, or presume to be Government employees, agents, or representatives. Contractor employees are required to appropriately identify themselves as contractor employees at all times, including in telephone conversations, formal and informal written correspondence, paper and electronic, and in any other situation where their actions could be construed as acts of Government officials, unless, in the judgment of the Government, no harm can come from failing to identify themselves. Contractor employees shall be introduced as contractor personnel and display distinguishing visible identification at all times whether in conversations, meetings, or other forms of communication with Government personnel.

C.2.3.1. Contractor personnel, while performing in a contractor capacity, shall refrain from using their retired or reserve component military rank or title (if applicable) in written or verbal communications associated with the contracts for which they provide services.

C.2.3.2. The contractor shall incorporate the substance of this requirement in all subcontracts awarded under this contract.

C.2.4. Government and Contractor Visits/Meetings. Generally, a 14-day notice will be provided for all meetings hosted by DHA at one of its Government locations. The Government anticipates hosting approximately four meetings per year. These meetings are in addition to those stated Section J, Attachment J-17a, Transition-In for all Contracts; and Attachment J-18, Transition-Out and Residual Services. All contractor travel costs associated with any of these meetings shall be the responsibility of the contractor.

Deliverables M090 Employee Access to DoD IS/Networks Report A020 Proposed Freedom of Information Act (FOIA) Releasable Contract R020 Identification of Systems of Records Notice Report

C.3. PERFORMANCE REQUIREMENTS.

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C.3.1. The contractor shall provide dental care services for ADSMs, Reservists and family members.

C.3.1.1. The contractor shall comply with the most current version of American Dental Association's (ADA) Current Dental Terminology (CDT) manual for covered services and update its systems.

Performance Standards

a) Standard: Whenever the ADA issues an updated CDT manual, the contractor shall provide the DHA Dental Care Section with its recommended changes for Section J, Attachments J-2 a-c, Benefits, Exclusions and Limitations. The contractor shall identify CDT codes to be added, deleted and/or updated. The ADA updates CDT codes approximately once a year and the revisions are effective January 1 of the following year.

Acceptable Quality Level (AQL): The contractor shall submit its CDT recommendation within 30 days of the release of the ADA’s updated…