8-RFP Draft Dental V2024.07.10 (NO FEDERAL FUNDS) 7.21.25.pdf

RFP-2025-710-HRM-CG, " Fully Insured & Self-Funded Group Dental Insurance "

City of Albuquerque

Request for Proposals

Solicitation Number: RFP-2025-710-HRM-CG

“Fully Insured & Self-Funded Group Dental Insurance”

RFP Open Date July 21, 2025

Deadline for Receipt of Proposals: August 20, 2025 4:00 p.m. (Mountain Time) The City eProcurement System will not allow Proposals to be submitted after this date and time.

City of Albuquerque Department of Finance and Administrative Services

Purchasing Division

V2024.07.10 JLB

TABLE OF CONTENTS

Page

Introduction 3

Part 1 Instructions to Offerors 9

Part 2 Proposal Format 19

Part 3 Scope of Services 22

Part 4 Evaluation of Proposals 24

Appendix A Dental Eligibility, Participation and Rates Located in Bonfire

Appendix B Dental Questionnaire Located in Bonfire

Appendix C Census Located in Bonfire

Appendix D Current Plan Design Located in Bonfire

Appendix E Enrollment and Claims Located in Bonfire

Appendix F Technical Workbook Located in Bonfire

Appendix G Offerors Financials Offeror to Upload in Bonfire

Appendix H Cost Proposal Located in Bonfire

INTRODUCTION

City Background The City of Albuquerque (“City”) is the largest city in New Mexico with a population of over 560,000. The City employs a Mayoral-Council form of government. The City Council is comprised of nine (9) Councilors who serve staggered four (4) year terms. The City has over 6,500 employees in thirty-one (31) municipal departments located in both the City Hall complex and throughout the City limits.

For more information about the City, please visit our website at http://www.cabq.gov/

In addition, the City has intergovernmental agreements with eighteen (18) government agencies within the State of New Mexico. These entities range in size from four (4) to 625 employees. The agreements allow the entities (“Participating Entities”) to offer the same employee benefit options to their employees for the same rates that the City has contracted for its employees. Total covered lives for the City and all Participating Entities are approximately 16,400.

Purpose The City is seeking proposals that offer fully insured and self-funded dental benefit program(s) provided to employees and their dependents of the City and Participating Entities. For the remainder of the solicitation, any reference to City includes Participating Entities. The proposed dental benefit program should promote cost-effective, value-based directions and patient-oriented care to lower collective health risks by improving individual lifestyles.

The coverage will be available for employees of the City during the fiscal year, which begins July 1, 2026 (Fiscal Year 27). Offerors shall submit proposals in response to this solicitation with the understanding that the City may, at its discretion, offer the plan either as a stand-alone or as a dual carrier option to its employees. If there is more than one carrier (vendor) selected, the City will conduct a positive open enrollment, requiring each employee to elect coverage without defaulting them to current coverage.

http://www.cabq.gov/

The City is the contracting entity. The Participating Entities affiliated with this Request for Proposals (“RFP”) are:

Employees Albuquerque Bernalillo County Water Utility Auth 641 Albuquerque Housing Authority 71 City of Belen 109 Middle Rio Grande Conservancy District 196 Southern Sandoval County Arroyo Flood Control Authority 12 Town of Bernalillo 107 Town of Cochiti Lake 5 Town of Edgewood 27 Town of Mountainair 17 Village of Bosque Farms 45 Village of Corrales 59 Village of Cuba 17 Village of Jemez Springs 7 Village of Los Ranchos de Albuquerque 15 Village of San Ysidro 4 Village of Tijeras 24

Offerors shall assume participation by all Participating Entities for proposal purposes.

Participation in any of the benefits the City offers is not mandatory for any Participating Entities; however, participation in dental insurance has been constant.

Additional government entities located in reasonable proximity to the Albuquerque service area may request to participate in the City’s plans. The City reviews such requests based on available experience data to make a determination that such requests are not expected to negatively impact the City’s rates in the future.

The census data (Appendix C) is available on the City’s eProcurement website.

Participant Eligibility

• Regular employees (both part-time and full-time, including those on probation)

• Elected officials

• Unclassified employees scheduled to work twenty (20) hours or more each week

• Legal spouse of an employee (must provide most current federal tax return (front page only) or marriage certificate and two forms of joint financial relationship)

• Domestic partner of an employee* (must provide City’s Affidavit of Domestic

Partnership)

• Children (must provide birth certificate) married, or unmarried, to the last day of the month in which the child attains age twenty-six (26) AND meet at least one (1) of the following criteria:

• Natural child of the employee, spouse or domestic partner

• Adopted child or a child placed in the employee’s home and in process for being adopted by the employee, spouse or domestic partner

• Court order that requires the employee, spouse or domestic partner provide health coverage for the child. (i.e. Qualified Medical Child Support Order (QMCSO))

• Child under legal guardianship: court document that shows the employee, spouse or domestic partner has full, permanent custody of the child

• Children age twenty-six (26), and older, may continue participating in the group insurance plans if they are permanently and totally physically or mentally disabled, unmarried, covered under the plan on the day before their twenty-sixth (26th) birthday, eligible for tax free coverage as a qualified child or qualified relative. A child who has terminated coverage due to reaching the age limit, and then becomes disabled, is not eligible to re-enroll for coverage

* A domestic partner is defined as a person of the same or opposite sex who lives with the employee in a long-term relationship of indefinite duration. There must be an exclusive mutual commitment similar to that of marriage, in which the partners agree to be financially responsible for each other’s welfare and share financial obligations. These benefits are also available to the domestic partner’s children provided that the child meets the definition of eligibility stated above.

Effective Date of Coverage (May have slight variations for participating entities)

• New Employees – Coverage begins on the employee’s hire date. Employees have thirty-one (31) days from their hire date to enroll through Employee Self Service and provide verification of dependent eligibility.

• Qualifying Events – Coverage begins on the event date as long as the employee enrolls through Employee Self Service and provides verification of the event and of dependent eligibility within thirty-one (31) days of the event. Losing or gaining eligibility for Medicare and Medicaid allows a sixty (60)-day enrollment period. An ex-spouse is not eligible to continue participation in the insurance program, except through COBRA. Therefore, when the divorce decree is submitted to the City of Albuquerque Human Resources Department’s Benefits Office the end of coverage will be back dated to the day following the court stamped date on the decree.

• Reinstatement – An employee who is terminated from the City and subsequently reinstated is eligible to have the same benefits started up again in which he/she was enrolled prior to termination. If termination was prior to the last open enrollment period, then the employee may elect to participate in the benefit options as a new employee. The employee must enroll through Employee Self Service with documentation of the reinstatement. The effective date of coverage will be the date of reinstatement.

• Open Enrollment – Benefit changes elected during open enrollment are effective on

July 1st or if cancelling coverage then the last day of coverage will be June 30th.

• Termination of Coverage

• Insurance ends at the end of the pay period in which the event that results in termination of coverage occurs. Exceptions to this are:

o Retirement coverage stops at the end of the month prior to the PERA retirement date o Dependents reaching the age limit lose coverage at the end of the month of their 26th birthday o Ex-spouses lose coverage the day after the divorce

Additionally, it is important to note that at annual renewal, Participating Entities have the option to add additional lines of coverage or drop lines of coverage. The City requires the entities to provide a ninety (90)-day notice before making any such changes.

Current Dental Insurance Plans The City currently offers BCBS’s Dental PPO plan to employees and Participating Entities on a fully insured basis. The current vendor, BCBS, has been under contract with the City for a total of 1 year, with the prior twenty-four (24) years under contract with Delta Dental.

As of August 1, 2025, the total covered employees by the City and the Participating Entities are more than 6,000 employees in the City’s group dental insurance

As identified in the City’s census (Appendix C) there are four tiers of coverage:

Employee only (Coverage Code 1) Couple (two (2) adults) (Coverage Code 2) Single parent (one (1) adult plus one or more children) (Coverage Code 3) Family (two (2) adults plus one (1) or more children) (Coverage Code 4)

The City is asking that Offerors quote the current plan design provided in the RFP (See Page 8). Identify any deviations as instructed in 2.1.3 of this RFP. It is anticipated that the proposed coverage(s) will meet or exceed those provided by the current provider. The City is seeking self-insured and fully insured proposals.

Contributions The City contributes eighty percent (80%) of the premium for all four (4) tiers of coverage for dental. The City will continue to provide the eighty percent (80%) premium contribution to any new plan(s). Participating entities have the authority to select their own contributions.

The City reserves the right to modify employer contributions.

Dental Plan Notes Proposals will be accepted from carriers capable of offering a fully insured or self-insured plan that matches or exceeds the current plan design.

The City may modify benefits for 2026/2027. It is expected that the plan designs will remain relatively the same or be enhanced

Deductible: $50 Deductible per person total per Benefit Period limited to a maximum Deductible of $150 per family per Benefit Period

Maximum Benefit Amount: $1,500 per person total per Benefit Period Orthodontic Lifetime Maximum: $1,200 per person total per lifetime

The City reserves the right to select more than one dental insurance provider.

Note: Please provide a self-funded and a fully insured quote as well as an implementation timeline. The City reserves the right to select more than one insurance provider.

PART 1

INSTRUCTIONS TO OFFERORS

1.1 RFP Number and Title: RFP-2025-710-HRM-CG, " Fully Insured & Self- Funded Group Dental Insurance"

1.2 Proposal Due Date: August 20, 2025 - NLT 4:00 PM (Local Time)

1.3 Purchasing Division: This Request for Proposals (“RFP”) is issued on behalf of the City of Albuquerque by its Purchasing Division, which is the sole point of contact during the entire procurement process.

1.4 Authority: Chapter 5, Article 5 of the Revised Ordinances of the City of Albuquerque, 1994, (“Public Purchases Ordinance”). The City Council, pursuant to Article 1 of the Charter of the City of Albuquerque and Article X, Section 6 of the Constitution of New Mexico, has enacted this Public Purchases Ordinance as authorized by such provisions and for the purpose of providing maximum local self-government. To that end, it is intended that this Public Purchases Ordinance shall govern all purchasing transactions of the City and shall serve to exempt the City from all provisions of the New Mexico Procurement Code, as provided in Section 13-1-98K, NMSA 1978.

1.5 Acceptance of Proposal: Acceptance of Proposal is contingent upon Offeror's certification and agreement by submittal of its Proposal, to comply and act in accordance with all provisions of the following:

1.5.1 City Public Purchases Ordinance

1.5.2 City Purchasing Rules and Regulations: These Rules and Regulations (“Regulations”) are written to clarify and implement the provisions of the Public Purchases Ordinance. These Regulations establish policies, procedures, and guidelines relating to the procurement, management, control, and disposal of goods, services, and construction, as applicable, under the authority of the Ordinance.

1.5.3 Civil Rights Compliance: Acceptance of Proposal is contingent upon the Offeror's certification and agreement by submittal of its Proposal, to comply and act in accordance with all provisions of the Albuquerque Human Rights Ordinance, the New Mexico Human Rights Act, Title VII of the U.S. Civil Rights Act of 1964, as amended, and all federal statutes and executive orders, New Mexico statutes and City of Albuquerque ordinances and resolutions relating to the enforcement of civil rights and affirmative action. Questions regarding civil rights or affirmative action compliance requirements should be directed to the City of Albuquerque Human Rights Office.

1.5.4 Americans with Disabilities Act Compliance: The Offeror certifies and agrees, by submittal of its Proposal, to comply and act in accordance with all applicable provisions of the Americans With Disabilities Act of 1990 and federal regulations promulgated thereunder.

1.5.5 Insurance and Bonding Compliance: Acceptance of Proposal is contingent upon Offeror's ability to comply with the insurance requirements as stated herein.

Please include a certificate or statement of compliance in your Proposal and bonds as required.

1.5.6 Ethics:

1.5.6.1 Fair Dealing. The Offeror warrants that its Proposal is submitted and entered into without collusion on the part of the Offeror with any person or firm, without fraud and in good faith. Offeror also warrants that no gratuities, in the form of entertainment, gifts or otherwise, were, or will be offered or given by the Offeror, or any agent or representative of the Offeror to any officer or employee of the City with a view toward securing a recommendation of award or subsequent contract or for securing more favorable treatment with respect to making a recommendation of award.

1.5.6.2 Conflict of Interest. The Offeror warrants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of services required under the contract resulting from this RFP. The Offeror also warrants that, to the best of its knowledge, no officer, agent or employee of the City who shall participate in any decision relating to this RFP and the resulting contract, currently has, or will have in the future, a personal or pecuniary interest in the Offeror’s business.

1.5.7 Participation/Offeror Preparation: The Offeror may not use the consultation or assistance of any person, firm company who has participated in whole or in part in the writing of these specifications or the Scope of Services, for the preparation of its Proposal or in the management of its business if awarded the contract resulting from this RFP.

1.5.8 Debarment or Ineligibility Compliance: By submitting its Proposal in response to this RFP, the Offeror certifies that (i) it has not been debarred or otherwise found ineligible to receive funds by any agency of the federal government, the State of New Mexico, any local public body of the State, or any state of the United States; and (ii) should any notice of debarment, suspension, ineligibility or exclusion be received by the Offeror, the Offeror will notify the City immediately.

Any Proposal received from an Offeror that is, at the time of submitting its Proposal or prior to receipt of award of a contract, debarred by or otherwise ineligible to receive funds from any agency of the federal government, the State of New Mexico, any local public body of the State, or any state of the United States, shall be rejected.

Upon receipt of notice of debarment of an Offeror awarded a contract as a result of this RFP (“Contractor”), or other ineligibility of the Contractor to receive funds from any agency of the federal government, the State of New Mexico, any local public body of the State, or any state of the United States, the City shall have the right to cancel the contract with the Contractor resulting from this RFP for cause in accordance with the terms of said contract.

1.5.9 Goods Produced Under Decent Working Conditions: It is the policy of the City not to purchase, lease, or rent goods for use or for resale at City owned enterprises that were produced under sweatshop conditions. The Offeror certifies, by submittal of its Proposal in response to this solicitation, that the goods offered to the City were produced under decent working conditions. The City defines “under decent working conditions” as production in a factory in which child labor and forced labor are not employed; in which adequate wages and benefits are paid to workers;

in which workers are not required to work more than 48 hours per week (or less if a shorter workweek applies); in which employees are free from physical, sexual or verbal harassment; and in which employees can speak freely about working conditions and can participate in and form unions. [Council Bill No. M-8, Enactment No. 9-1998]

1.5.10 Graffiti Free: When required, the Contractor will be required to furnish equipment, facilities, or other items required to complete these services, that are graffiti-free. Failure of Contractor to comply with this requirement may result in cancellation of the contract resulting from this RFP.

1.6 City Contact: The sole point of contact for this RFP is the City of Albuquerque Purchasing Division. Questions regarding this RFP should be directed to the following Purchasing representative unless otherwise specified in the solicitation. The City Contact will communicate with Offerors through its e-procurement system, Bonfire. Offerors will receive e-mail notifications from Bonfire to the e-mail that Offeror included in its Bonfire registration. Offerors are responsible for monitoring any communications sent through Bonfire and responding to any requests for information or directives within stated deadlines.

Offerors who fail to abide by this instruction may be deemed nonresponsive.

• Cassaundra Gomez, Senior Buyer, Department of Finance and Administrative Services, Purchasing Division

• Phone: (505) 768-3329 or E-Mail: cgomez@cabq.gov

• Post Office Box 1293, Albuquerque, New Mexico 87103

1.7 Contract Management: The contract resulting from this RFP will be managed by the Human Resources Department, Benefits Division.

mailto:cgomez@cabq.gov

1.8 Clarification: Any explanation desired by an Offeror regarding the meaning or interpretation of this RFP must be requested in writing not less than ten (10) working days prior to the deadline for the receipt of Proposals to allow sufficient time for a reply to reach all Offerors before the submission of their Proposals. No extension of time will be granted based on submission of inquiries subsequent to the required date nor will such inquiries be answered. All inquiries must be directed to the Purchasing Division as stated herein and must be submitted through the City’s eProcurement system Bonfire. The City will not respond to questions that are submitted by any other means than electronically through the City’s eProcurement system. Oral explanations or instructions given before the award of the contract or at any time will not be binding. Purchasing shall prepare answers to questions in the form of Addenda to this RFP and shall post all such Addenda to the online eProcurement System.

1. 9 Submission of Proposals. The Offeror’s Proposal must be submitted electronically through the eProcurement system pursuant to the following requirements:

1.9.1 Electronic Copy. Submit your complete Proposal including all forms, attachments, exhibits, Technical Proposal, Cost Proposal, etc. using the eProcurement System at https://cabq.bonfirehub.com/portal/?tab=openOpportunities. Please allow a minimum of two (2) business days to submit your proposal. If you do not have a username and password, please register as this is the only method to submit electronically on the Bonfire portal. Please make sure to register on the system in order to receive notices and submit a response to a solicitation. For assistance, please contact support@gobonfire.com or 1-800-354-8010. Failure to submit your proposal electronically through the City’s eProcurement system shall result in your proposal being deemed nonresponsive.

1.9.2 Format. Each file uploaded to the eProcurement System shall be in single PDF format unless otherwise indicated. The City’s preferred format is Optical Character Recognition (OCR) searchable PDF format. Do not encrypt files and do not password protect the documents submitted.

1.9.3 ALL PROPOSALS MUST BE RECEIVED BY THE CITY PURCHASING

DIVISION AS SPECIFIED HEREIN. IF YOU FAIL TO COMPLY WITH THE SUBMISSION

REQUIREMENTS IN THIS SECTION 1.9, THE CITY SHALL DEEM YOUR PROPOSAL

NONRESPONSIVE.

1.9.4 No other methods of Proposal delivery. Neither telephone, facsimile, nor telegraphic Proposals shall be accepted.

1.9.5 Modification. Proposals may be modified or withdrawn only by written notice, provided such notice is received prior to the Proposal Due Date.

1.9.6 Receipt of Proposals. The only acceptable evidence to establish the time of receipt of Proposals by City Purchasing Office is the time-date stamp of the eProcurement System.

https://cabq.bonfirehub.com/portal/?tab=openOpportunities http://www.cabq.gov/vendor/email-notification mailto:support@gobonfire.com

1.9.7 Acknowledgment of Addenda to the Request for Proposals. Receipt of Addenda to this RFP by an Offeror must be acknowledged in the City’s eProcurement system. Failure to acknowledge an Addendum may result in your response being deemed non-responsive.

1.10 Modifications to Scope of Services: In the event that sufficient funds do not become available to complete each task in the Scope of Services, the Scope of Services may be amended, based upon the cost breakdown required in the Cost Proposal.

1.11 Required Contract Terms: The Required Contract Terms can be accessed at this link https://www.cabq.gov/dfa/purchasing-division/vendor-services/terms-and-conditions, click on “Request for Proposals Required Contract Terms”. The Offeror certifies that it accepts the Required Contract Terms, or has uploaded its exceptions to the Required Contract Terms in the City’s e-Procurement system, under “Requested Information” “Exceptions to Section 1.11 Required Contract Terms.” Any exceptions shall be identified by the RFP Section, Subsection, and must state the specific exception the Offeror has, as well as any alternative language. The City’s receipt of exceptions in a response is not an acceptance of any requested changes to the Required Contract Terms. The Required Contact Terms may differ from the terms in the final contract awarded under this RFP.

1.12 Contract Term: The contract resulting from this solicitation is anticipated to have a term of four (4) with no extensions.

1.13 Evaluation Period: The City reserves the right to analyze, examine and interpret any Proposal for a period of ninety (90) days after the hour and date specified for the receipt of Proposals. The City reserves the right to extend the evaluation period if it feels, in its sole discretion, such an extension would be in the best interest of the City.

1.14 Evaluation Assistance: The City, in evaluating Proposals, reserves the right to use any assistance deemed advisable, including City contractors and consultants.

1.15 Rejection and Waiver: The City reserves the right to reject any or all Proposals and to waive informalities and minor irregularities in Proposals received.

1.16 Award of Contract:

1.16.1 When Award Occurs: Award of contract occurs when a Purchase Order is issued or other evidence of acceptance by the City is provided to the Offeror. A Recommendation of Award does not constitute award of contract.

1.16.2 Award: If a contract is awarded, it shall be awarded to the responsive and responsible Offeror whose Proposal conforming to this RFP will be most advantageous to the City as set forth in the Evaluation Criteria.

1.17 Cancellation: This RFP may be canceled for any reasons and any and all Proposals may be rejected in whole or in part when it is in the best interests of the City.

https://www.cabq.gov/dfa/purchasing-division/vendor-services/terms-and-conditions

1.18 Negotiations: Negotiations may be conducted with the Offeror(s) recommended for award of contract.

1.19 City-Furnished Property: No material, labor, or facilities will be furnished by the City unless otherwise provided for in this RFP.

1.20 Public Records:

1.20.1 The Purchasing Division’s procurement file and any documents relating to this RFP, including the Proposals submitted by Offerors, shall be open to public inspection in accordance with applicable law after the recommendation of award of a contract has been approved by the Mayor or the Mayor’s designee.

1.20.2 An Offeror who chooses to submit material they consider a “Trade Secret” must do so in a segregated file clearly designated as containing trade secrets both in the file name and within the contents of the file itself. These segregated files are to be used by the City for reference only. An Offeror’s failure to segregate such materials constitutes a failure to reasonably, under the circumstances, maintain the materials’ secrecy and Offeror indemnifies and holds the City harmless for any and all liability resulting from the disclosure of any materials not segregated as described above.

1.20.3 If an Offeror submits with a proposal material required by law to be kept confidential, the Offeror must segregate such material in a separate file. Such a file should be clearly designated as “Legally Confidential” in both the file name and within the contents of the file. The contents of the file must include a description and citation to the legal basis for why the material must be kept confidential. Failure to segregate the material and describe the legal basis for why it is to be kept confidential may result in the information being disclosed. Designating the entire proposal confidential is not acceptable without providing the legal basis and may result in the information being disclosed. Offeror indemnifies and holds the City harmless for any and all liability resulting from such disclosure resulting from information not segregated as described above.

1.20.4 Pricing, makes and models or catalog numbers of items offered, delivery terms, and terms of payment shall not be designated as trade secrets or required to be kept confidential by law.

1.20.5 The City will endeavor to restrict the release of material segregated and designated as “Trade Secret” or “Legally Confidential to only those individuals involved in the review and analysis of the Proposals, and to any other party as required by law or court order. Under the New Mexico Inspection of Public Records Act (Sections 14-2-1 et seq, NMSA 1978) (“Act”) the City may redact trade secrets and other material required to be kept confidential by law, but may not redact proprietary or confidential information. Any Proprietary or Confidential Data provided as part of a Proposal is subject to public inspection under the Act.

Notwithstanding any provision of this RFP, the City shall not be responsible or liable to the Offeror for any disclosure of records required by the Act or an order of a court or other tribunal with jurisdiction over the City.

1.21 Procurement Preferences: A Pay Equity Preference as provided in Section 5-5-31 R.O.A. 1994 (as amended by C/S O-17-33) and the State Preferences as provided in 13-1- 21 NMSA 1978 are applicable to this solicitation. To request the application of a preference, as applicable, Offeror shall submit with its Proposal a City Pay Equity Preference Form or the New Mexico State Certification for the requested preference.

1.22 Request for Proposals Protest Process:

1.22.1 RFP Documents: If the protest concerns the specifications for the RFP or other matters pertaining to the solicitation documents, the protest must be filed with the Chief Procurement Officer no later than 5:00 p.m., ten (10) business days prior to the deadline for the receipt of Proposals.

1.22.2 Recommendation of Award: If the protest concerns the Recommendation of Award, the protest must be filed with the Chief Procurement Officer no later than 5:00 p.m. of the tenth (10th) business day after the receipt of notice of the Recommendation of Award.

1.22.3 Timely Protests: Protests must be received by the Chief Procurement Officer prior to the appropriate deadline as set out herein, or they will be rejected.

The Chief Procurement Officer may waive the deadline for good cause, including a delay caused by the fault of the City. Late delivery by the U.S. Postal Service or other carrier shall not be considered good cause.

1.22.4 How to File a Protest: Any Offeror who is aggrieved in connection with a competitive solicitation or recommendation of award of a contract may protest to the City Chief Procurement Officer. The protest shall be addressed to the Chief Procurement Officer, must be submitted in written form and must be legible.

Protests may be electronically delivered via email or mailed. Facsimile, telephonic, telegraphic or any other type of electronic protests will not be accepted.

1.22.5 Required Information: The protest shall contain at a minimum the following:

1.22.5.1 The name and address of the protesting party;

1.22.5.2 The number of the competitive solicitation;

1.22.5.3 A clear statement of the reason(s) for the protest detailing the provisions believed to have been violated;

1.22.5.4 Details concerning the facts, which support the protest;

1.22.5.5 Attachments of any written evidence available to substantiate the claims of the protest; and

1.22.5.6 A statement specifying the ruling requested.

1.22.6 Delivery of Protests:

1.22.6.1 By Mail: Protests may be mailed in an envelope marked “PROTEST” with the solicitation number. Protests which are mailed should be addressed as follows:

Chief Procurement Officer City of Albuquerque, Purchasing Division P.O. Box 1293 Albuquerque, NM 87103 PROTEST, RFP Number

1.22.6.2 By Electronic Mail: Protests may be emailed to:

Kathleen Oney, Chief Procurement Officer koney@cabq.gov

The message should clearly indicate “PROTEST” and the RFP number in the subject line.

1.22.7 Protest Response by Chief Procurement Officer: The Chief Procurement Officer will, after evaluation of a protest, issue a response. Only the issues outlined in the written protest will be considered by the Chief Procurement Officer.

1.22.8 Protest Hearing: If a hearing is requested, the request must be included in the protest and received within the time limit. Only the issues outlined in the protest will be considered by the Chief Procurement Officer, or may be raised at a protest hearing. The granting of a hearing shall be at the discretion of the Chief Procurement Officer following review of the request.

1.23 Insurance:

1.23.1 General Conditions: The City will require the successful Offeror, referred to as the Contractor, to procure and maintain at its expense during the term of the contract resulting from the RFP, insurance in the kinds and amounts hereinafter provided with insurance companies authorized to do business in the State of New Mexico, covering all operations of the Contractor under the contract. Upon execution of the contract and on the renewal of all coverages, the Contractor shall furnish to the City a certificate or certificates in form satisfactory to the City as well as the rider or endorsement showing that it has complied with these insurance requirements. All certificates of insurance shall provide that thirty (30) days written notice be given to the Risk Manager, Department of Finance and Administrative mailto:koney@cabq.gov

Services, City of Albuquerque, P.O. Box 470, Albuquerque, New Mexico, 87103, before a policy is canceled, materially changed, or not renewed. Various types of required insurance may be written in one or more policies. With respect to all coverages required other than professional liability or workers’ compensation, the City shall be named an additional insured. All coverages afforded shall be primary with respect to operations provided.

1.23.2 Approval of Insurance: Even though the Contractor may have been given notice to proceed, it shall not begin any work under the contract resulting from this RFP until the required insurance has been obtained and the proper certificates (or policies) are filed with the City. Neither approval nor failure to disapprove certificates, policies, or the insurance by the City shall relieve the Contractor of full responsibility to maintain the required insurance in full force and effect. If part of the contract is sublet, the Contractor shall include any or all subcontractors in its insurance policies, or require the subcontractor to secure insurance to protect itself against all hazards enumerated herein, which are not covered by the Contractor's insurance policies.

1.23.3 Coverage Required: The kinds and amounts of insurance required are as follows:

1.23.3.1 Commercial General Liability Insurance. A commercial general liability insurance policy with combined limits of liability for bodily injury or property damage as follows:

$2,000,000 Per Occurrence

$2,000,000 Policy Aggregate

$1,000,000 Products Liability/Completed Operations

$1,000,000 Personal and Advertising Injury

$ 5,000 Medical Payments

Said policy of insurance must include coverage for all operations performed for the City by the Contractor and contractual liability coverage shall specifically insure the hold harmless provisions of the contract resulting from this RFP.

1.23.3.2 Automobile Liability Insurance. A comprehensive automobile liability insurance policy with liability limits in amounts not less than $1,000,000 combined single limit of liability for bodily injury, including death, and property damage in any one occurrence. The policy must include coverage for the use of all owned, non-owned, hired automobiles, vehicles and other equipment both on and off work.

1.23.3.3 Workers' Compensation Insurance. Workers' compensation insurance policy for the Contractor's employees, in accordance with the provisions of the Workers' Compensation Act of the State of New Mexico, (the "Act"). If the Contractor employs fewer than three employees and has determined that it is not subject to the Act, it will certify, in a signed statement, that it is not subject to the Act. The Contractor will notify the City and comply with the Act should it employ three or more persons during the term of the contract resulting from this RFP.

1.23.3.4 Cyber Liability Coverage: Cyber liability insurance in an amount not less than $2,000,000 combined single limit of liability per occurrence with a general aggregate of $2,000,000. This coverage should be required, unless specific circumstances that eliminate potential risks indicate otherwise, if the vendor/contractor may have cybernetic access to the City’s confidential information, taxpayer data, information technology, personnel, healthcare, accounting, or finance systems.

1.23.3.5 Professional Liability/Medical Malpractice: Professional liability/medical malpractice insurance policy shall be not less than $5,000,000.

1.23.4 Increased Limits: During the life of the contract the City may require the Contractor to increase the maximum limits of any insurance required herein. In the event that the Contractor is so required to increase the limits of such insurance, an appropriate adjustment in the contract amount will be made.

1.23.5 Additional Insurance: The City may, as a condition of award of a contract, require a successful Offeror to carry additional types of insurance. The type and limit of additional insurance is dependent upon the type of services provided via the contract by the successful Offeror.

1.24 Pay Equity Documentation. All Proposals shall include a Pay Equity Reporting Form that can be accessed at https://www.cabq.gov/gender-pay-equity-initiative. Offerors who believe they are exempt because they are an out-of-state contractor (meaning that you have no facilities and no employees working in New Mexico) are not required to report data, but must still submit a Pay Equity Reporting Form with the box verifying the exempt status checked. Any Proposal that does not include a Pay Equity Reporting Form shall be deemed nonresponsive, as stated in the Public Purchases Ordinance, 5-5-

31. A Pay Equity Reporting Form will be automatically issued within two (2) business days of completing your information at the link above. To ensure you have your form before the deadline for solicitation close, please access the link at least three (3) business days prior to the solicitation deadline. Please contact the “City Contact” identified above in Section

1.6 with any questions about the Pay Equity Reporting Form.

https://www.cabq.gov/gender-pay-equity-initiative

PART 2

PROPOSAL FORMAT

A “Proposal” consists of two distinct sections—a “Technical Proposal” and a “Cost Proposal”—that are submitted separately in Bonfire.

Failure to submit the Technical Proposal and Cost proposal separately shall result in the City deeming your submission non-responsive.

2.1 Technical Proposal Format, Section One

2.1.1 Offeror Identification: State name and address of your organization or office and nature of organization (individual, partnership or corporation, private or public, profit or non-profit). Subcontractors, if any, must be identified in a similar manner. Include name, email address and telephone number of person(s) in your organization authorized to execute the contract resulting from this RFP. Submit a statement of compliance with all laws stated herein. Submit a statement of agreement to the Required Contract Terms; state exceptions as directed in Section

1.11. Show receipt of Addenda if applicable. Provide a statement or show ability to carry the insurance specified.

2.1.2 Experience:

2.1.2.1 Current Experience. State relevant experience of the company and person(s) who will be actively engaged in the proposed project, including experience of subcontractors. Submit resumes for the individuals who will be performing the services for the City.

2.1.2.2 Past Experience. Describe a minimum of three (3) projects of similar scope and size, which are now complete; state for whom the work was performed, year completed, and a letter of reference for each regarding the work. References must be for work performed in the past three to five (3 to

5) years. DO NOT use City employees or any City elected officials as a reference. The City will not contact and will not assign any evaluation points for references from City employees or elected officials. State relevant experience with other municipalities or government entities.

2.1.2.3 The minimum information that must be provided about each reference is:

1. Name of the individual or company the services were provided for

2. Address of individual or company

3. Name of contact person

4. Telephone number of contact person

5. Type of services provided and dates services were provided

2.1.3 Client Management Team Qualifications: Submit resumes of key proposed professional staff members who will be performing services under the contract awarded under this RFP. Experience narratives shall be attached that describe the specific relevant experience of the staff members in relation to the role that the member will perform for the contract resulting from this solicitation. The narrative(s) must include the name of the individual(s) proposed and should include a thorough description of the education, knowledge, and relevant experience, as well as certifications or other professional credentials that clearly show how they are qualified to provide the required services to the City.

2.1.4 Management Summary: Describe individual staff and subcontractor's responsibilities with lines of authority and interface with the City of Albuquerque staff. Describe resources to be drawn from in order to complete tasks.

2.1.5 Organizational Strength:

2.1.5.1 Submit a statement of relevant corporate qualifications, strengths, and experience, including similar experience of subcontractors. The documentation must thoroughly describe how the Offeror has supplied expertise for similar contracts and work related to dental services.

2.1.5.2 Provide a copy of the company's most recent audited financial report labeled Appendix G.

2.1.6 Proposed Approach to Tasks: Discuss fully your proposed approach to each of the tasks described in Part 3, Scope of Services.

2.1.7 Proposed Plan Design: Discuss fully your proposed plan design.

2.1.8 Implementation Plan: Discuss fully your proposed approach to the services described in Part 3, Scope of Services to fulfill all requirements of the Scope of Services. Offerors shall provide with their proposals a detailed implementation plan assuming a July 1, 2026, effective date or Alternate January 1, 2026 effective date.

2.1.9 Proposed Plan design: Provide information demonstrating that your plan design has the size and service capability with management systems and procedures capable of providing benefits to a major employer of the magnitude encompassed by the City and its Participating Entities. Offerors must demonstrate a fully insured and/or self-funded plan that matches or exceeds the current plan design.

2.1.10 Utilization Management: Show your demonstrated commitment to providing consistent, valuable and timely utilization information, which must comply with data requirements and reporting frequency as defined in Part 3, Scope of Services, of this RFP. The City wishes to identify cost drivers within its program and develop action plans to increase awareness or engagement in activities that demonstrate a reduction in healthcare costs.

2.1.11 Wellness programs: Provide detailed information about your wellness programs.

2.1.12 Broad Provider Network: Provide detailed information regarding the maintenance and the composition of a broad provider network to include but not limited to the following:

a. Outline with specificity how plan members will be provided with comparable or superior geographic access (See Appendix B and F.)

b. Describe how the Offeror’s provider network will result in minimum disruption to current plan member services (See Appendix B and F.)

2.1.13 Network Composition and Access: Provide comprehensive information on their provider networks. This information shall indicate where provider networks are directly contracted and where they are leased from another entity. Do not provide hard copy provider directories Provide the website address where such directories can be viewed.

Where requested, geo-access and disruption analysis shall be included (refer to RFP Appendix F.) Further, the details on the management and operation of the network shall be included. Information on the expected provider and network membership shall be provided.

2.1.14 Questionnaire: Complete Questionnaire, Appendix B. Any response of “No” to Minimum Contractual Requirements shall result in lower scoring. Your response to the Deviations may result in lower scoring

2.1.15 Technical Workbook: Complete Technical Workbook, Appendix F. Any response of “No” to Minimum Contractual Requirements shall result in lower scoring. Your response to Deviations may result in lower scoring.

2.2 Cost Proposal Format, Section Two

2.2.1 Total Cost: Submit your Cost Proposal (Appendix A) separately from your

Technical Proposal (upload Appendix A in the City’s eProcurement system).

Failure to submit your cost separately from your Technical Proposal shall result in your proposal being deemed non-responsive.

2.2.2 All Costs: All costs to be incurred and billed to the City should be described by the Offeror for each item, to allow for a clear evaluation and comparison, relative to other Proposals received. All costs should include any applicable gross receipts taxes.

The Offeror should understand that the City will not pay for any amounts not included in the cost Proposal -- for example, insurance or taxes -- and that liability for items not included remains with the Offeror.

PART 3

SCOPE OF SERVICES

The successful Offeror shall provide the following Services:

3.1 The successful Offeror shall maintain all provider records, contracts, terms and conditions, and maintain a recordkeeping system for the administration of the City’s dental plan.

3.2 The successful Offeror shall align incentives and a business model that drives value for the City and its members.

3.3 The successful Offeror shall provide comprehensive account management and designated customer service representatives including resources and personnel as necessary to support the City’s broader health care strategy.

3.4 The successful Offeror’s account management shall attend all enrollment meetings, entity meetings, and health fairs.

3.5 The successful Offeror shall provide effective coordination and integration with the City’s other external vendor partners.

3.6 The successful Offeror shall comply with the detailed process measurement model/performance guarantees that will evaluate the successful Offeror’s performance and hold it accountable for certain guaranteed standards.

3.7 The successful Offeror shall prepare summary plan descriptions, and any other employee notices required by State or Federal Law; and shall provide recommendations and advice on the City's benefit plan design.

3.8 The successful Offeror shall assist in preparation of publishing of City’s benefit booklet and pay a pro rata share of the benefit booklet.

3.9 The successful Offeror shall provide best in class enrollee focus with staff that are determined to get any issues resolved in a timely manner.

3.10 The successful Offeror shall adjudicate and pay claims according to the City's benefit plan design including the application of benefit determinations and other cost saving value-based measures.

3.11 The successful Offeror shall provide a customer service call center, online member access website, and other support services for members.

3.11.1 The successful Offeror shall ensure that members at a minimum are able to access a member portal which houses plan information on plan design, claims payment and year to date deductible and out of pocket maximum levels, locate a provider, and lookup basic educational materials via provider’s secured website.

3.11.2 The successful Offeror shall handle customer service calls related to the plan and provide a dedicated toll-free customer service number for City members.

Trained staff must be available for member inquires at minimum between the hours of 8:00 am and 5:00 pm Mountain Time.

3.11.3 The successful Offeror shall provide sufficient staff and technology to be able to run ad hoc financial and utilization reporting, assist the City in development and distribution of plan materials to members regarding plan design features, wellness initiatives, educational information, and member service information.

3.11.4 The successful Offeror shall provide a standard report package which includes at a minimum the following reports and frequency:

• Monthly Reporting o Premium and paid claims by entity o Enrollment, both contracts and members, by entity and coverage tier

• Quarterly Reporting o Utilization data o Financial data, to include billed charges, allowed charges, paid amounts year to date, member share, etc.

o Enrollment data contract year to date o Top providers for dental offices, physicians, etc.

• Annual Reporting o Dental 36-month claim lag report o Performance Guarantee Reporting

PART 4

EVALUATION OF PROPOSALS

4.1 Selection Process. The Mayor of Albuquerque shall name, for the purpose of evaluating the Proposals, an Ad Hoc Advisory Committee. On the basis of the evaluation criteria established in this RFP, the committee shall submit to the Mayor a list of qualified firms in the order in which they are recommended. Proposal documentation requirements set forth in this RFP are designed to provide guidance to the Offeror concerning the type of documentation that will be used by the Ad Hoc Advisory Committee. Offerors should be prepared to respond to requests by the Purchasing Office on behalf of the Ad Hoc Advisory Committee for oral presentations, facility surveys, demonstrations or other areas deemed necessary to assist in the detailed evaluation process. Offerors are advised that the City, at its option, may award this request on the basis of the initial Proposals.

4.1.1 Selection of Finalist Offerors (If Applicable). The Ad Hoc Advisory Committee may select Finalist Offerors (also known as the “short list”). The Purchasing Office will notify the Finalist Offerors. Only Finalist Offerors will be invited to participate in the subsequent steps of the procurement if this Finalist process is used.

4.1. 2. Oral Presentation or Demonstrations by Finalists (If Applicable). Finalist Offerors may be required to present their proposals to the Ad Hoc Advisory Committee (“Oral Presentation”). The Purchasing Office will schedule the time for each Finalist Offeror’s presentation. All Finalist Offeror Oral Presentations will be held remotely via Zoom unless notified otherwise. Each Oral Presentation will be limited to one (1) hour in duration unless notified otherwise. NOTE: The scores from the initial proposal evaluation will only carry over to the Oral Presentation evaluation in the case of a tie score after Oral Presentations.

4.2 Evaluation Criteria. The following general criteria, not listed in order of significance, will be used by the Ad Hoc Advisory Committee in…