9523ZY25R0001.pdf

U.S. COMMODITY FUTURES TRADING COMMISSION

Three Lafayette Centre 1155 21st Street, NW, Washington, DC 20581

Telephone: (202) 418-5000 Facsimile: (202) 418-5529

Business Operations Branch

Request for Proposals (RFP) No. 9523ZY-25-R-0001

Issuance Date: May 16, 2025

Due Date: June 16, 2025

To Whom It May Concern:

You are invited to submit a proposal in response to the subject RFP for “Dental Insurance Plan for the Commodity Futures Trading Commission”, as described in Part I, “Statement of Work”, of the RFP.

It is the Government’s intent to award one Fixed Unit Price with Economic Price Adjustment contract for this plan. The best value tradeoff award approach will be utilized by the Government. To ensure a fair and thorough evaluation, your response should be tailored according to the proposal preparation instructions contained in Part III of the RFP, to ensure a fair and thorough evaluation of your response.

The due date and time for receipt of proposals is June 16, 2025, at 12:00 p.m. local (Washington, DC) time at the issuing office. Instructions for the proper preparation and submission of your proposal are set forth in Part III of the RFP.

All questions pertaining to this RFP must be received by the Contracting Officer no later than 9:00 a.m. local (Washington, DC) time on May 26, 2025. CFTC expects, but does not guarantee, to answer questions submitted by this time. Questions, if answered, will be responded to in the form of an amendment to this RFP.

All communication in response to the RFP shall be directed to Contracting Officer William M.

Roberson, who may be contacted on (202)418-5367 or by e-mail at wroberson@cftc.gov.

Collect calls will not be accepted.

This letter is intended to be an introduction to the RFP, but is not an integral part thereof. In the event of any inconsistency between this letter and the RFP, the RFP shall govern.

Sincerely, William M. Roberson Contracting Officer mailto:wroberson@cftc.gov

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

CFTC-BOB

Washington DC 20581 1155 21st Street NW Three Lafayette Center Commodity Futures Trading Comm

CODE 16. ADMINISTERED BYCODE

X

X

524114

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED ORCFTC-BOB

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

05/16/2025 (No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIME

06/16/2025 1200 ET

b. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

9523ZY25R0001

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 80OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Washington DC 20581 1155 21st Street NW Three Lafayette Center

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$47.0

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Commodity Futures Trading Comm

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

n/a

William M. Roberson 202-418-5367

See Clause II.6 "ELECTRONIC INVOICING AND

PAYMENT REQUIREMENTS - DENTAL BENEFITS"

Commodity Futures Trading Comm Three Lafayette Center 1155 21st Street NW Washington DC 20581

"Dental Insurance Plan for the Commodity Futures Trading Commission"

(see continuation pages) n/a

X X

X 1

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

80 2 of

9523ZY-25-R-0001 Page 3

PART I

STATEMENT OF WORK

Dental Insurance Plan for the Commodity Futures Trading Commission Background

The U.S. Commodity Futures Trading Commission (“CFTC” or “Commission”) was created by Congress in 1974 as an independent agency with the mandate to regulate commodity futures and option markets in the United States. The mission of the Commission is to promote the integrity, resilience, and vibrancy of the U.S. derivatives markets through sound regulation. As part of the Farm Security and Rural Investment Act of 2002 (FSRIA), CFTC received authority to implement pay and benefit parity with other Federal Financial Regulatory Agencies to better attract and retain employees. Following a study of pay and benefits, CFTC implemented a new dental insurance program for employees and their dependents effective July 11, 2004.

The CFTC provides and shall continue to provide health care benefits to eligible employees, spouses, and eligible dependents through the Office of Personnel Management’s (OPM) Federal Employee Health Benefits (FEHB) program. Information about this program is available at www.opm.gov.

CFTC currently employs 667 eligible employees who primarily work in Washington, DC; New York, NY; Chicago, IL; and Kansas City, MO. Of those eligible employees, currently 656 have elected to enroll in the CFTC’s existing supplemental benefits program. (i.e., dental)

As of April 24, 2025 # of CFTC Employees Total Covered

Self Only 141 141 Self Plus One 146 336

Self and Family 369 1,507

Appendix A of this Statement of Work summarizes the plan design applicable to the contract.

The successful contractor shall administer and insure the CFTC supplemental benefits program (“the Program”). All permanent employees and temporary employees with appointments of one year or more that are eligible to enroll in the Federal Employees Health Benefits (FEHB) Program are eligible to enroll in CFTC’s dental benefits program. Eligible family members include:

• spouse, including domestic partners of CFTC employees and same-sex spouses,

• children up to age 26 including biological child, stepchild, adopted child or foster child, and

• children age 26 or older incapable of self-support because of a mental or physical disability that began before age 26.

Retirees are not eligible for the Program and will remain ineligible, despite being covered under FEHB.

http://www.opm.gov/

9523ZY-25-R-0001 Page 4

Purpose

For the January 1, 2026, plan year, CFTC will continue to provide the current dental benefits. Under this solicitation, the contractor shall provide standard dental as reflected in Appendix A.

Scope

Dental Plan

The contractor shall provide a comprehensive core dental plan to eligible CFTC employees and their eligible dependents at no cost to the employee. (the CFTC pays the basic overall premiums).

Requirements

The contractor’s products and services shall comply with the Affordable Care Act as well as the Department of Health and Human Services (HHS) Health Insurance Portability and Accountability Act (HIPAA) requirements. The contractor shall provide CFTC employees with HIPAA certificates of coverage and CFTC-specific HIPAA notices of privacy practices.

The contractor shall, at a minimum, provide the following administrative services for the Plan.

1. Administrative and Enrollment Services

• At the time of enrollment, the system shall generate a participant enrollment identification number which does not use a social security number (SSN). The contractor shall issue identification cards for each participant and family member enrolled within 10 business days of enrollment.

• Design, produce and distribute, subject to the approval of CFTC, enrollment forms, claim forms, employee booklets, summary plan descriptions (SPDs), and all other forms required to administer the plan.

• Provide electronic files of the Plan materials (booklets, SPDs, etc.) and fillable forms in a .pdf format to be uploaded to the CFTC Intranet.

• As requested by CFTC, assist in the communication to employees regarding benefits, including initial employee meetings at Headquarters in Washington, DC; Chicago, IL; Kansas City, MO;

and New York, NY.

• Receive initial eligibility data and updates electronically or by hardcopy (CFTC may or may not be able to provide current enrollment data files sufficient to accomplish initial Plan enrollment electronically).

• Provide monthly enrollment reports, included with the monthly invoice. These reports shall account for the covered employees in the plan, including enrollment code, reconciled with the invoice submitted for the reporting period. These reports shall also indicate any employees or

9523ZY-25-R-0001 Page 5 other covered individuals that were added or removed during the previous month. Additionally, the reports shall provide the loss ratio for the month being reported, as well as the cumulative loss ratio for the trailing 12-month period. The loss ratio is defined as the actual dental paid claims for covered CFTC employees and dependents divided by the premium paid for the identified time period.

• Meet with CFTC on an as needed basis to review status of overall operation of the program.

• Provide a network of providers sufficient to cover the CFTC population. (See CFTC Census Data for required network statistics.)

• Provide an electronic portal where covered employees and eligible individuals may enroll, change coverage, submit documentation, access claim related information and access a list of providers.

2. Claims Processing Requirements

• Adjudicate and process claims, including:

o Processing all claims on a direct claims’ verification and payment basis.

o Establishing and maintaining a clean turnaround time. (i.e., 90% of claims received are processed in 10 workdays or less, and 98% are processed in 15 workdays or less.)

o Verifying claim charges are for covered employees and dependents.

o Determining eligibility for benefits.

o Providing Explanation of Benefits (EOB) statements.

o Maintaining current, complete and confidential records for each covered person.

o Maintaining a claims and technical services unit(s) with standard office hours, Monday through Friday (except Federal holidays), and installing a message device to handle calls after business hours or on weekends, located inside of the U.S. The contractor shall provide a toll-free telephone service that has the capability to place calls on hold and queue during peak calling hours.

o Providing for direct communication between CFTC administrative staff and the assigned program administrator.

o Providing legal defense on disputed claims except when a legal action or proceeding alleges conduct on the part of CFTC which gives rise to claims for other than contractual damages.

o Providing effective coordination of claims payment and reporting formats.

9523ZY-25-R-0001 Page 6 o Providing service personnel who are accessible and knowledgeable in all aspects of the Plan.

o Maintaining an automated calendar system to ensure follow-up to correspondence and claims review and establishing a mechanism to resolve errors expeditiously.

• Preparing a customized administrative manual (i.e., policies, procedures, and forms for administering the Plan) to be used by CFTC.

3. Management Information System / Reporting and Monitoring Service Requirements

Provide an annual utilization report including, but not limited to, a breakdown of claims experience by types of service (i.e., total amounts paid and number of claims for each type of service).

4. System and Security Requirements

Section 508 Accessibility. The contractor’s products and services shall comply with all applicable provisions of the standards issued by the Architectural and Transportation Barriers Compliance Board (Access Board) to ensure the accessible use of Federal electronic and information technology.

The contractor shall have a systems security Authorization to Operate (ATO) as a Federal Government Contractor. The contractor shall be FedRamp Certified if hosting its application on the Cloud.

The contractor’s web-enabled service shall accommodate concurrent access without degrading the quality or accessibility of the service. The service shall have sufficient capacity to meet all functional and performance requirements specified in this statement of work. The service shall provide CFTC personnel with an intuitive click and key-stroke user interface using standard Internet browsers. The service shall support the current version level of the browsers. The system shall provide immediate online acceptance or rejection of user responses.

The contractor shall work with CFTC’s IT representatives to identify, define, and document the contractor’s data specifications for CFTC-provided data, as well as the data interfaces, file formats, and schedule requirements for needed data transfers between the CFTC and the contractor’s system(s). The contractor shall work with the CFTC to establish data formats, processes, and procedures that will ensure the efficiency of system set-up and data integrity and will support ongoing system administration.

The contractor shall incorporate initial personnel information from the CFTC into its files before the Program goes live for CFTC employees. The contractor shall receive and incorporate an encrypted feed of updated personnel information provided by the CFTC on a bi-weekly basis into its files within 5 days after receiving the updated file. The contractor shall maintain the currency, accuracy, and consistency of the data in its system so that claims are not wrongfully denied. The contractor shall maintain current benefit transaction information for all participating CFTC employees and their dependents.

The contractor’s system shall (1) process open and non-open season transactions from employee input; 2) produce a summary view of pending transactions for employees; 3) cancel a transaction

9523ZY-25-R-0001 Page 7 based on employee input; and (4) provide confirmation of completed/successful transactions. The service shall allow for an electronic confirmation and approval.

The contractor shall periodically archive all CFTC data associated with the service components including (1) all benefit transactions; (2) a history of all benefit transactions and cancellations; and

(3) all data necessary to audit and reconstruct benefit actions. The contractor shall store the detail in a database with the ability to export using CSV files provided on Encrypted Removable Media or via a secure transmission method.

The contractor shall provide an integrated backup strategy for its system that includes daily, weekly, monthly, and yearly full system backups. The contractor shall retain daily and weekly system backup media for 4 weeks; monthly system backup media for 12 months; and yearly system backup media for 3 years. The contractor shall store system backup media off-site in an environmentally controlled, secure location approximately 30 miles from the contractor’s production site.

The contractor shall provide recovery processes and procedures including: (1) database recovery and file recovery from backup locations; and (2) annual testing of recovery procedures and backup accuracy.

The contractor shall provide procedures for disposing of sensitive data to be approved by the CFTC.

Unless the CFTC specifically directs the contractor otherwise, at the conclusion of the CFTC’s relationship with the contractor, regardless of the cause or timing, the contractor shall archive and return all CFTC data within the service using CSV files provided on Encrypted Removable Media or via a secure transmission method and in a readable format. The contractor shall then dispose of (and certify to the CFTC that it has disposed of) all CFTC data within the service as specified in the contractor’s data disposal procedures.

The contractor shall provide technical support in fulfilling CFTC requirements for (1) testing the Program system, including any subsystem, prior to putting it into production; and (2) deploying the successfully tested system while in production.

The contractor shall support, at a minimum, (1) application information security C&A testing; (2) QCTC compliance testing for usability and section 508 accessibility; and (3) UAT for functionality.

The contractor shall provide a project plan and schedule to (1) support certification and accreditation (C&A) testing, billing and contractor application configuration, contractor application demonstrations, billing and contractor quality assurance testing, QCTC testing, UAT testing, and billing and contractor end-to-end testing, and fix problems that arise; (2) remediate identified security issues; (3) provide the information necessary to support all testing and deployment requirements; and (4) deploy the successfully tested system into production.

The contractor shall provide CFTC with the access and information necessary to assess the ability of the subscribed service as operated by the contractor under this contract to meet these requirements.

9523ZY-25-R-0001 Page 8

The contractor shall provide for real-time intrusion detection and active security monitoring of the service’s Internet site. The security mechanisms built into the service shall meet or exceed current best practices for electronic commerce.

The contractor’s service shall protect all communications between remote CFTC users and the contractor’s systems that are conducted over the Internet or other public networks. The service shall initiate and control a secured session with a remote user’s system and shall maintain a secure interface until the session ends.

The contractor shall establish and maintain individual user accounts to provide access to service.

The contractor shall maintain security logs and access audits for the service’s Internet site and shall make them available to the CFTC. The contractor shall provide the CFTC with access and information necessary to conduct periodic security audits on service to ensure proper safeguards are being maintained and potential security threats are minimized.

The contractor shall ensure its employees, and all subcontractors, fill out required CFTC forms accurately, timely and completely. The contractor’s employees and subcontractors with access to CFTC data, must pass and have a favorable security clearance determination in order to work on the contract with the CFTC. The contractor shall provide weekly reports of cleared personnel. The contractor must notify the Contacting Officer (CO) if a subcontractor is hired and provide a reason for the use of a subcontractor. The CO must approve the use of a subcontractor under the contract.

5. Privacy Requirements

Personally Identifiable Information (PII) consists of information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other information that is linked or linkable to a specific individual. The contractor shall notify the CFTC of all entities (that is, systems, companies, and individuals) that will retain PII on CFTC employees under this contract as such entities are all subject to the federally mandated C&A testing for moderate-rated impact systems.

Each contracted personnel (CP) who has access to PII covered under this contract must complete the applicable onboarding and offboarding procedures prescribed by the CFTC. A favorable suitability determination must be provided by the Personnel Security Office prior to commencing work or gaining access.

o Privacy Act Notification.

The contractor will have access to records contained in a system of records on individuals to accomplish an agency function subject to the Privacy Act of 1974, 5 U.S.C. § 552a (“Privacy Act” or “the Act”) and applicable agency regulations. For purposes of the Act, the contractor will be considered an employee of the agency, and violation of the Act (such as the unauthorized use or disclosure of records) may involve the imposition of penalties under subsections (i) – criminal penalties.

9523ZY-25-R-0001 Page 9

Specifically, the contractor will be responsible for maintaining records falling within the scope of system of records notice(s) (SORN(s)), including but not necessarily limited to CFTC-55, Dental Benefits Records (85 FR 82458). These systems of records maintain information about participating employees and their enrolled dependents to administer the CFTC’s dental benefits programs for its employees and their enrolled dependents, and to assist in personnel management.

The contractor agrees to:

o Comply with the Privacy Act and the CFTC’s rules and regulations issued under the

Privacy Act at 17 CFR § 146, Records Maintained on Individuals, in the maintenance of CFTC systems of records;

o Ensure the records falling within the scope of CFTC systems of records are maintained in accordance with the most recently published version of the applicable SORN(s) and will communicate to the Contracting Officer any changes to the system or underlying information technology that would require a modification to the applicable SORN(s);

o Include this section, Privacy Act Notification, in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the access, use, or maintenance of records falling within the scope of a CFTC system of records from which the contractor is provided information; and o Include the following clause in all subcontracts awarded that require the access, use, or maintenance of records in a CFTC system of records:

In the event of violation of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, operation, or maintenance of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the contractor is considered to be an employee of the agency.

9523ZY-25-R-0001 Page 10

Definitions. As used in this section:

• “Operation of a system of records,” means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records.

• “Record,” as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person’s name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

• “System of records,” as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.

o E-Government Act, Section 208: Privacy Impact Assessments.

The contractor will be responsible for maintaining information technology that collects, maintains, and disseminates information that is in identifiable form.

• Prior to collecting, maintaining, or disseminating information that is in identifiable form, work with the CFTC privacy program to conduct or update any relevant privacy impact assessment(s) in accordance with Section 208 of the E-Government Act of 2002, Public Law 107-347, December 17, 2002, OMB guidance, and CFTC policies and procedures.

• The privacy impact assessment(s) will be reviewed and signed by the Commission’s Chief Privacy Officer prior to the collection, maintenance, or dissemination of information that is in identifiable form.

• “Information that is in identifiable form” means information in an information technology system or online collection: (i) that directly identifies an individual (e.g., name, address, social security number or other identifying number or code, 9523ZY-25-R-0001 Page 11 telephone number, email address, etc.) or (ii) by which an agency intends to identify specific individuals in conjunction with other data elements, i.e., indirect identification.

• “Information technology” means any equipment, software or interconnected system or subsystem that is used in the automatic acquisition, storage, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information.

• “Privacy impact assessment” means an analysis of how information is handled: (i) to ensure handling conforms to applicable legal, regulatory, and policy requirements regarding privacy, (ii) to determine the risks and effects of collecting, maintaining and disseminating information in identifiable form in an electronic information system, and (iii) to examine and evaluate protections and alternative processes for handling information to mitigate potential privacy risks.

o Privacy Control Assessment.

The contractor will collect, maintain, or disseminate Federal information that includes personally identifiable information (PII), or operate an information system that processes PII on behalf of the CFTC.

The contractor will agree to work with the Contracting Officer’s Representative and the

CFTC privacy program prior to collecting, maintaining, or disseminating information that includes PII or operating an information system that processes PII on behalf of CFTC to:

• Develop and maintain a privacy plan that details the privacy controls selected for the information system;

• Conduct a privacy control assessment to verify the effectiveness of all privacy controls selected for the information system;

• Correct any deficiencies identified through the privacy control assessment; and

• If necessary, agree on a plan of action with key milestones to mitigate any identified control weaknesses or deficiencies not accepted by the agency.

9523ZY-25-R-0001 Page 12

• “Information system” means a discrete set of information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of information;

• “Federal information” means information in any medium or form that is created, collected, processed, maintained, disseminated, disclosed, or disposed of by or for the Federal Government;

• “Personally identifiable information” means information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other information that is linked or linkable to a specific individual.

• “Privacy control” means the administrative, technical, and physical safeguards employed within an agency to ensure compliance with applicable privacy requirements and manage privacy risks;

• “Privacy control assessment” means the assessment of privacy controls to determine whether the controls are implemented correctly, operating as intended, and sufficient to ensure compliance with applicable privacy requirements and manage privacy risks. A privacy control assessment is both an assessment and a formal document detailing the process and the outcome of the assessment; and

• “Privacy plan” means a formal document that details the privacy controls selected for an information system or environment of operation that are in place or planned for meeting applicable privacy requirements and managing privacy risks, details how the controls have been implemented, and describes the methodologies and metrics that will be used to assess the controls.

o Breach Response.

The contractor may maintain personally identifiable information (PII) on behalf of the

CFTC and in such an event will be responsible for maintaining that information in accordance with CFTC’s policies and procedures for safeguarding PII, which includes reporting a breach. Reporting a breach shall not, by itself, be interpreted as evidence that the contractor, or a subcontractor, failed to provide adequate safeguards for PII.

9523ZY-25-R-0001 Page 13

• Encrypt PII in accordance with OMB Circular A-130, Managing Information as a Strategic Resource (July 28, 2016);

• Report a suspected or confirmed breach in any medium or form, including paper, oral, and electronic, as soon as possible and without unreasonable delay, to the Contracting Officer and to potentialincident@cftc.gov;

• Maintain capabilities to determine what PII was or could have been accessed and by whom, construct a timeline of user activity, determine methods and techniques used to access PII, and identify the initial attack vector;

• Cooperate with and exchange information with CFTC officials, as determined necessary by the Commission, in order to effectively report and manage a suspected or confirmed breach;

• Allow for an inspection, investigation, forensic analysis, and any other action necessary to ensure compliance with applicable OMB guidance (including OMB M-17-12, Preparing for and Responding to a Breach of Personally Identifiable Information), the Commission's breach response plan, and to assist the CFTC with responding to a breach;

• Regularly train its staff on how to identify and report a breach; and

• Include this section, Breach Response, in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract necessitates that the subcontractor access PII maintained by the contractor on the CFTC’s behalf.

• “Breach” means the loss of control, compromise, unauthorized disclosure, unauthorized acquisition, or any similar occurrence where (1) a person other than an authorized user accesses or potentially accesses personally identifiable information or (2) an authorized user accesses or potentially accesses personally identifiable information for an other than authorized purpose; and mailto:potentialincident@cftc.gov

9523ZY-25-R-0001 Page 14

• “Personally identifiable information” means information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other information that is linked or linkable to a specific individual.

o Privacy Training.

• Ensure that initial privacy training, and annual privacy training thereafter is completed by contractor employees and officers who:

o Have access to records maintained in a CFTC system of records; or o Create, collect, use, process, store, maintain, disseminate, disclose, dispose, or otherwise handle PII on behalf of the CFTC;

Privacy training must have measures in place to test the knowledge level of users. At a minimum, the privacy training shall cover:

• The key provisions of the Privacy Act of 1974 (5 U.S.C. 552a), including penalties for violations of the Act;

• The appropriate handling and safeguarding of PII;

• The authorized and official use of a system of records or any other PII;

• The restriction on the use of unauthorized equipment to create, collect, use, process, store, maintain, disseminate, disclose, dispose or otherwise access PII;

• The prohibition against the unauthorized disclosure, access, handling, or use of PII;

and

• The procedures to be followed in the event of a suspected or confirmed breach.

Completion of an agency-developed or agency-conducted privacy training course shall be deemed to satisfy these elements.

The contractor may be required to maintain and, upon request, provide documentation of completion of privacy training to the Contracting Officer.

9523ZY-25-R-0001 Page 15

The contractor will not allow any employee access to a CFTC system of records, or permit any employee to create, collect, use, process, store, maintain, disseminate, disclose, dispose or otherwise handle PII, or to design, develop, maintain, or operate a system of records unless the employee has completed privacy training, as required by this section.

The contractor will include this section, Privacy Training, in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract necessitates that the subcontractor access PII maintained by the contractor on the CFTC’s behalf.

6. Phase-Out / Transition of Operations and Cooperation with Successor

The contractor shall perform phase-out activities to transition work to a successor contractor.

Specifically, the contractor shall cooperate with any successor contractor and, perform all actions necessary to transfer operations to ensure full continuity of services. If requested by the Contracting Officer or the Contracting Officer’s Representative (“COR”), the contractor shall submit a transition plan, which addresses certain areas including, but not limited to, specific phase-out milestones, actions that implement cooperation with the successor, and transfer of data to the successor. The contractor shall incorporate all comments received from the Contracting Officer and/or the COR into the transition plan.

Deliverables and Reports

The following table summarizes the required deliverables and reports under this contract.

Deliverable Due Date Claim Forms, Employee Booklets, Summary Plan Descriptions, and all other forms required to administer the plan. (hardcopy and .pdf format)

As required by the Contracting Officer or the Contracting Officer’s Representative.

Enrollment Report Monthly; with invoice submittal.

Customized Administrative Manual December 31, 2025; updates submitted each December 31st thereafter.

Annual Utilization Report January 31, 2026; subsequent reports submitted January 31st following each contract year.

Transition Plan As required by the Contracting Officer or the Contracting Officer’s Representative

All reports shall be submitted to the COR electronically in a format agreeable to the COR (e.g., Word, Excel, PowerPoint, .pdf, etc.). Additionally, a copy of each report shall be provided electronically to the Contracting Officer.

9523ZY-25-R-0001 Page 16

Appendix A – Dental Insurance Plan Design

Description of Dental Plan(s)

Eligibility Employees and Dependents

All employees eligible under current (or future, if more expansive) coverage provisions of the Federal Employees Health Benefits (FEHB)

Program (generally excludes those employees on temporary appointments of one year or less)

All dependents eligible under current (or future, if more expansive) coverage provisions of the Federal Employees Health Benefits (FEHB)

Program (generally includes spouses, including domestic partners of CFTC employees and same-sex spouses and children up to age 26)

Children up to age 26.

Children who are incapable of self-support because of a mental or physical disability that began before age 26.

Enrollment

Employees must enroll. Employees not enrolling will not be covered by the Plan.

Employees may make an election change consistent with a qualifying status change during the plan year.

Effective Date of Coverage

New Employee First full pay period of their enrollment election and onboard date.

Employees may elect to enroll up to 60 days after their start date.

Qualifying Life Event

(QLE)

First pay period following QLE. Employees may change or enroll up to 30 days prior to or 60 days after their QLE.

*Status changes follow the guidelines of a QLE as set forth by OPM’s FEHB plan.

Premium Sharing Arrangement CFTC pays full cost of premium – Core Benefit

Opt Out Provision Employees may opt out of the Plan at any time. However, to reenroll, employees must submit proof of a QLE, otherwise, must wait until the

FEHB Open Season Risk Arrangement Fully-Insured

Type of Plan Passive Preferred Provider Organization (PPO) – percent of reimbursement is the same if the member goes in- or out-of-network

Eligible Providers Any Licensed Dentist

9523ZY-25-R-0001 Page 17

Description of Dental Plan(s) – continued

In- and Out-of-Network

Annual Deductible

Individual $50; not required for Diagnostic & Preventive (Class I) Services Individual + 1 $100; not required for Diagnostic & Preventative (Class I) Services

Family $150 for 3 or more family members; not required for Diagnostic & Preventive Services

Maximum Reimbursement

Annual (Classes I-III) $3,000 per individual (Core benefit plan) Orthodontia $3,500 Lifetime Limit per individual (Core benefit plan)

Plan Reimbursement

Plan reimburses specified percentage of allowable expenses, based on class of expense. Allowable expenses will be based on the 90th percentile of Usual and Customary. In-network reimbursement will be based on negotiated fee schedules.

In-Network Out-of-Network Diagnostic & Prevention (Class I)

100% of fee schedule 100% of allowable expenses

Covered Services

Periodic oral exam (no more than 2 per calendar year) Additional cleanings for diabetics (2 per calendar year)

Intra-oral and Bitewing x-rays Prophylaxis cleaning with or without oral exam (2 per calendar year) Additional prophylaxis cleanings for diabetics (2 per calendar year)

Periodontal prophylaxis Topical application of stannous fluoride for individual under 19 yrs (1 per calendar year) Space maintainers, fixed, unilateral

Topical application on a posterior tooth for individual under 14 years (sealant)

Emergency pain treatment In-Network Out-of-Network Basic Restorative, Endodontics, Periodontics, Maintenance of Prosthodontics & Oral Surgery (Class II)

80% of fee schedule, after deductible 80% of allowable expenses, after deductible

9523ZY-25-R-0001 Page 18

Covered Services:

General anesthesia Amalgam fillings Silicate cement

Acrylic or plastic filling Composite acrylic resin filling

Root canal therapy Apicoectomy

Gingivectomy or gingivoplasty Gingival Curettage and Root Planning

Osseous surgery Osseous Graft, Multiple Site

Periodontal scaling Adjustments to dentures (partial denture)

Replace broken tooth on complete or partial denture, not in conjunction with other repairs Recement bridge

Simple extractions Surgical extractions (impacted); soft tissue; bone-partial; bone-complete

Biopsy of oral tissue (hard) Biopsy of oral tissue (soft)

Routine post-operative care is considered part of each Dental Service for oral surgery under this Schedule

In-Network Out-of-Network Major Restorative, Installation of Prosthodontics (Class III Services)

60% of fee schedule, after deductible 60% of allowable expenses, after deductible

Implants

Covered Services:

Gold inlay fillings Crowns (porcelain) Crowns-cast gold

Complete dentures (upper or lower) Partial dentures

Bridge pontics (cast gold) Bridge pontics (porcelain fused to gold)

Bridge pontics (plastic processed to gold) Abutment crowns (porcelain)

Abutment crowns (porcelain with gold) Abutment crowns (full, cast gold)

9523ZY-25-R-0001 Page 19

In-Network Out-of-Network Orthodontics (Class IV Services) 60% of fee schedule, after deductible 60% of fee schedule after deductible

Covered services: Preliminary study including cephalometric radiographs, diagnostic casts and treatment plan.

First month of active treatment including all active and retention appliances.

Active treatment per month after the first month.

Removable and/or fixed appliance(s) insertion for interception treatment or to control harmful habits (e.g., night guards to control grinding) General Exclusions

Exclusions

No payment will be made for expenses incurred for:

1) Services performed solely for cosmetic reasons.

2) Replacement of a lost or stolen appliance.

3) Replacement of a bridge, crown, denture or mandibular orthopedic repositioning appliance within 5 years after the date it was originally installed unless: (a) such replacement is made necessary by the placement of an original opposing full denture or the necessary extraction of natural teeth; or (b) the bridge, crown, denture or mandibular orthopedic repositioning appliance, while in the mouth, has been damaged beyond repair as a result of an injury received while the covered member is insured for such benefits.

4) Any replacement of a bridge, crown, denture or mandibular orthopedic repositioning appliance that is or can be made useable according to common dental standards.

5) Procedures, appliance or restorations, except for full dentures, whose main purpose is to: (a) alter vertical dimension; (b) diagnose or treat conditions or dysfunction of the temporomandibular joint; (c) stabilize periodontally involved teeth or (d) restore occlusion.

6) Porcelain or acrylic veneers of crowns or pontics on or replacing the upper and lower first, second and third molars.

7) Bite registrations; precision or semi-precision attachments; or splinting.

8) A surgical implant of any type. (However, payment will be made for expenses incurred for prosthetic devices attached to an implant.)

9) Instruction for plaque control, oral hygiene and diet.

10) Dental services that do not meet common dental standards.

11) Services that are deemed to be medical services.

12) Services and supplies received from a hospital.

13) Services for which benefits are not payable according to the "General Limitations" section.

14) Any adjustment or repair to a denture performed within six months of the installation of the denture

9523ZY-25-R-0001 Page 20

Other Exclusions

General Limitations No payment will be made for expenses incurred:

1) For missing teeth except that the amount payable for replacement of teeth missing on the date an individual becomes insured will be 100% of the amount otherwise payable. (No limitation. Reflects the contractor’s proposal deviation.)

2) For or in connection with an injury arising out of, or in the course of, any employment for wage or profit.

3) For or in connection with a sickness which is covered under any workers' compensation or similar law.

4) For charges made by a hospital owned or run by the United States

Government.

5) To the extent that payment is unlawful where the employee or dependent resides when the expenses are incurred.

6) For charges which the employee or dependent is not legally required to pay.

7) For charges which would not have been made if the employee or dependent had no insurance.

8) To the extent that they are more than Reasonable and Customary.

9) For charges for unnecessary care, treatment or surgery.

10) To the extent that the employee or dependent is in any way paid or entitled to payment for those expenses by or through a public program, other than Medicaid.

11) For or in connection with experimental procedures or treatment methods not approved by the American Dental Association or the appropriate dental specialty society.

12) Services to the extent the covered person is compensated for them under any automobile insurance policy Other General Limitations

Coordination of Benefits

This plan is primary for employees. The “Birthday Rule” applies to dependent children when parents have another contract for dental benefits that limits total payments to 100% of allowable expenses.

Other Coordination of Benefits

Termination of Insurance

Coverage will terminate on the last day of the month in which an employee separates from employment with the CFTC or when the group policy terminates, whichever happens first.

9523ZY-25-R-0001 Page 21

Approved Leave Without Pay: Insurance will be continued for up to 12 months while employee is in a non-pay status.

Completion of Existing Treatment: This Program provides coverage for a dental service rendered within three months after termination of insurance or employment, whichever occurs first, provided the service was started before the termination date. All services started after the termination date, including Orthodontia, are not payable.

Other Termination of Insurance

Retirement Coverage not continued.

Rest of Page Intentionally Left Blank

9523ZY-25-R-0001 Page 22

PART II

ADDITIONAL TERMS AND CONDITIONS / CONTRACT CLAUSES

1. FIXED UNIT PRICES FOR SERVICES

The following fixed unit prices for servicing the dental insurance policies shall apply for the duration of the contract.

CLIN

DESCRIPTION QUANTITY UNIT PRICE TOTAL

AMOUNT

BASE PERIOD (phase-in) (date of award thru 12/31/25)

The contractor shall implement the Dental Insurance Plan for the Commodity Futures Trading Commission and train staff.

1 Job $ $

CLIN DESCRIPTION QUANTITY UNIT PRICE

NOT-TO-

EXCEED

AMOUNT

OPTION PERIOD I

(01/01/2026 –12/31/2026)

Dental Benefits in accordance with Part I, Statement of Work

(SOW).

12 Months

Plan Coverage

Estimated Number of Employees*

Unit Price

Fixed Unit Price (Self Only) 141 $ Fixed Unit Price (Self plus One) 146 $ Fixed Unit Price (Self & Family) 369 $

9523ZY-25-R-0001 Page 23

OPTION PERIOD II

(01/01/2027 –12/31/2027)

Dental Benefits in accordance with Part I, Statement of Work

Number of

Fixed Unit Price (Self Only) 141 $ Fixed Unit Price (Self plus One) 146 $ Fixed Unit Price (Self & Family) 369 $

OPTION PERIOD III

(01/01/2028 – 12/31/2028)

Dental Benefits in accordance with Part I, Statement of Work

Number of

Fixed Unit Price (Self Only) 141 ** Fixed Unit Price (Self plus One) 146 ** Fixed Unit Price (Self & Family) 369 **

OPTION PERIOD IV

(01/01/2029 –12/31/2029)

Dental Benefits in accordance with Part I, Statement of Work

Number of

Fixed Unit Price (Self & Family) 369 **

9523ZY-25-R-0001 Page 24

OPTION PERIOD V

(01/01/2030 – 12/31/2030)

Dental Benefits in accordance with Part I, Statement of Work

Number of

Fixed Unit Price (Self & Family) 369 **

OPTION TO EXTEND

SERVICES

Subject to Clause II.5

Dental Benefits in accordance with Part I, Statement of Work

(SOW).

Not-to-Exceed 6 Months

Number of

Fixed Unit Price (Self & Family) 369 **

TOTAL VALUE OF THE CONTRACT (base plus all option periods)

* The number of persons likely to enroll in the dental plan is estimated. Contract Option Periods I and II dental premiums are fixed unit prices. Population fluctuations may occur. In the event the actual number of employees in any category exceeds a 20% variance from the estimated levels of participation, either party may request an adjustment to the respective Fixed Unit Price(s). Any requested adjustments resulting from exceeding the variance will be negotiated to ensure the modified Fixed Unit Prices are fair and reasonable. The incorporation of any adjustment to the Fixed Unit Prices is not guaranteed.

** Except in the event the number of employees in any category exceeds a 20% variance, the unit prices for Contract Option Periods I and II shall not be subject to price adjustment. However, the unit prices for Contract Option Periods III, IV, V and Option to Extend Services shall be determined in accordance with clause II.2 “Economic Price Adjustment – Contract Option Periods III, IV, V, and Option to Extend Services Premiums” of this contract and may be adjusted in accordance with the 20% variance in actual number of employees in a given category.

9523ZY-25-R-0001 Page 25

2. ECONOMIC PRICE ADJUSTMENT – CONTRACT OPTION PERIODS III, IV, V AND

OPTION TO EXTEND SERVICES PREMIUMS

The prices for Contract Option Periods III, IV, V, and Option to Extend Services shall be established based on the claims experience of the Plan. These prices may represent an increase or decrease from the respective prior period, as they will be determined by the contractor’s demonstrated loss ratio. The demonstrated loss ratio is defined as the actual dental paid claims for covered CFTC employees and dependents divided by the premium paid for the identified time period. The unit prices (i.e., Self Only, Self Plus One and Self & Family) for the applicable contract period shall be determined by applying the appropriate unit price change percentage in the below tables to the unit prices of the respective prior period.

The data used to calculate the loss ratio shall be taken from the contractor’s monthly enrollment reports for the previous period of November 1st through October 31st. The Contracting Officer may require the contractor to provide additional information to support the accuracy and reliability of the data in these reports. The Government reserves the right to have an independent third party review the data and make recommendations regarding the appropriateness of the proposed unit prices. The determination of the adjusted unit prices shall be made by the Contracting Officer on a unilateral basis.