7-Appendix H Dental Cost Proposal 7-7-25.xlsx
XLSX spreadsheet 51 KB Posted
- Solicitation number
- RFP-2025-710-HRM-CG
- Issued by
- Bernalillo County, Albuquerque City, New Mexico
About this file
This is a comprehensive dental insurance cost proposal document for the City of Albuquerque, New Mexico, covering fully insured and self-funded dental insurance programs. The document outlines a four-year contract period from July 1, 2024, to June 30, 2028, with a total enrollment of 6,924 participants across four coverage tiers: Employee Only (2,865), Employee + Spouse (1,208), Employee + Child(ren) (808), and Employee + Family (2,043). The solicitation seeks proposals for dental benefit programs for city employees and participating entities, with a focus on multi-year rates and rate caps.
The cost proposal includes detailed performance guarantees and service level expectations, such as claims processing accuracy (99%), claims payment turnaround time (97% processed within 14 calendar days), and specific telephone service standards like 90% of calls answered within 30 seconds and an abandonment rate under 3%. Notably, all rate fields in the document are currently populated with $0.00, indicating that vendors are expected to complete the pricing sections. The document emphasizes strict submission requirements, including maintaining the original Excel format, completing all sections entirely, and warning that incomplete submissions may be deemed non-responsive. Performance guarantees cover areas like eligibility updates, call return times, implementation milestones, and data exchange processes.
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Text version
Instructions Exhibit Instructions to Vendors
When completing the exhibits in the Excel workbook, please follow the directions below:
| 1. Do not add or delete rows, columns or alter-pre-labeled text in the exhibits |
| 2. Electronic copies of these exhibits must be returned in Excel. Do not provide in a PDF |
format. The signed copies of your documents are required for the hardcopy binder only.
3. Do not extract individual worksheets (exhibits) and submit as separate Excel workbooks in the electronic copy. If a sheet is required under a separate tab, make a copy.
Current Plan Cost Proposal
| City of Albuquerque |
| DENTAL PPO COST PROPOSAL FORM |
| Appendix H |
This form must be completed in its entirety. Please do not alter, add or delete rows. Multi-year rates and rate caps will be considered more favorably. Failure to complete this form in its entirety may deem your submission as non-responsive.
| REQUESTED AND/OR PROPOSED PLAN DESIGN RATES | ||||
| Dental PPO Cost Form | Current Plan Design | |||
| 7/1/2024 - 6/30/2025 | 7/1/2025 - 6/30/2026 | 7/1/2026 - 6/30/2027 | 7/1/2027- 6/30/2028 | |
| Enrollment Assumptions | ||||
| Employee Only | 2,865 | 2,865 | 2,865 | 2,865 |
| Employee + Spouse | 1,208 | 1,208 | 1,208 | 1,208 |
| Employee + Child(ren) | 808 | 808 | 808 | 808 |
| Employee + Family | 2,043 | 2,043 | 2,043 | 2,043 |
| Total | 6,924 | 6,924 | 6,924 | 6,924 |
| Monthly Fully Insured Premium Rates | Rate Tiers | ||||
| Employee Only | $0.00 | $0.00 | $0.00 | $0.00 | |
| Employee + Spouse | $0.00 | $0.00 | $0.00 | $0.00 | |
| Employee + Child(ren) | $0.00 | $0.00 | $0.00 | $0.00 | |
| Employee + Family | $0.00 | $0.00 | $0.00 | $0.00 | |
| Total Monthly Premium | $0 | $0 | $0 | $0 | |
| Total Annual Premium | $0 | $0 | $0 | $0 |
| Are there any additional costs not included in your rates? If so, please identify. |
| Rate Guarantees |
| Rate Guaranteed? |
| Implementation/Communication/Tech Credits |
| Indicate if any credits are included in your proposal. |
| Participation |
| Minimum Participation Requirements |
Comments
| Authorized Signature |
| Authorized Name |
| Vendor Name |
| Date |
| Contact Phone Number |
Self-Funded Admin
| City of Albuquerque |
| SELF FUNDED DENTAL ADMINISTRATION |
| Appendix H |
This form must be completed in its entirety. Please do not alter, add or delete rows. Multi-year rates and rate caps will be considered more favorably. Failure to complete this form in its entirety may deem your submission as non-responsive.
| REQUESTED AND/OR PROPOSED PLAN DESIGN RATES | ||||
| Dental PPO Cost Form | Current Plan Design | |||
| 7/1/2024 - 6/30/2025 | 7/1/2025 - 6/30/2026 | 7/1/2026 - 6/30/2027 | 7/1/2027- 6/30/2028 | |
| Enrollment Assumptions | ||||
| Employee Only | 2,865 | 2,865 | 2,865 | 2,865 |
| Employee + Spouse | 1,208 | 1,208 | 1,208 | 1,208 |
| Employee + Child(ren) | 808 | 808 | 808 | 808 |
| Employee + Family | 2,043 | 2,043 | 2,043 | 2,043 |
| Total | 6,924 | 6,924 | 6,924 | 6,924 |
| Monthly Self Insured Administration (PEPM) | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Annual Self Insured Administative Cost | $0.00 | $0.00 | $0.00 | $0.00 |
| Are there any additional costs not included in your rates? If so, please identify. |
| Rate Guarantees |
| Rate Guaranteed? |
| Implementation/Communication/Tech Credits |
| Indicate if any credits are included in your proposal. |
| Participation |
| Minimum Participation Requirements |
Comments
| Authorized Signature |
| Authorized Name |
| Vendor Name |
| Date |
| Contact Phone Number |
Performance Guarantees
| City of Albuquerque |
| COST PROPOSAL - PERFORMANCE GUARANTEES |
| Appendix H |
| For the following categories, provide the performance standard you are willing to offer, the financial penalty (maximum dollar amount or % of administrative fees) you will agree to pay if the standard is not met, and the method of measuring the penalty. |
| PERFORMANCE GUARANTEES | VENDOR RESPONSE |
| 1. Vendor attendance at the Client meetings | |
| Attendance by vendor representatives when requested at meetings scheduled by the Client during the contract period and implementation phase. | |
| 2. Vendor call (or e-mail) return timeliness | |
| The Client or designated consultant’s calls (or e-mails) to vendor are returned within 48 business hours. | |
| 3. Processing monthly eligibility updates | |
| All updates to eligibility or enrollment records will be made within 3 business days after the information is received by the vendor. | |
| 4. Telephone call availability & answering speed | |
| 90% of all calls are answered within 30 seconds, and telephone service is available between 8:00 am and 4:30 pm MST on business days. | |
| 5. Telephone call on-hold (in-queue) time | |
| An average of less than 2 minute(s) on hold before a human being answers. | |
| 6. Telephone Abandonment Rate | |
| An abandonment rate of less than 3% is maintained during standard business hours. | |
| 7. Claims Processing Accuracy | |
| 99% of claims dollars submitted for payment will be accurately processed and paid. Regardless of whether or not these standards of performance are satisfied, the vendor must reimburse the Client for all overpayments that are not recovered from the recipient within 60 days after the overpayment is discovered. The Client will assign its right to any recover such overpayments to the vendor. | |
| 8. Turnaround Time on Claims Payments | |
| 97% of all claims received will be completely processed (paid, denied, or pended for additional information) within 14 calendar days after they are received. 100% of claims will be processed within 30 calendar days of receipt. | |
| 9. Timeliness of Claim Reports | |
| Each report the vendor will supply the Client will be provided within a mutually agreed upon timeframe. | |
| 10. Claims Coding | |
| 99% of all claims will be coded with no errors. | |
| 11. Implementation | |
| Successful implementation as defined by key milestones. Include measurable milestones in your proposal. | |
| 12. Data Exchange | |
| Receive and transmit data with vendors based on a frequency defined by the business needs of the Client. |
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