Addendum_02.pdf

May 1, 2015

ADDENDUM #02

To: All Vendors

From: Scott Clanton

Director of Purchasing and Printing Services

Subject: RFP Number 048-PLA-0515, Group Dental Plan

This addendum is issued to provide official responses to written questions, revisions to the RFP and/or additional information pertaining to the RFP.

The deadline for written questions and requests for additional information was

April 17, 2015, 4:00 PM.

Among other things, this addendum reflects changes to the RFP. All proposers should acknowledge receipt of this addendum by means of the Addendum

Acknowledgement Form as outlined in the RFP document.

NOTE:

This addendum is for informational purposes only and does not need to be returned with your proposal.

The School Board of Polk County

Request for Proposal (RFP)

**** Group Dental Plan, #048-PLA-0515***

Additional Information, Revisions and Questions & Answers (Q & A)

Addendum #02

ATTACHMENT A-RFP PROPOSAL WORKSHEET (REVISED), ATTACHMENT B-TOP DENTIST LIST

(REVISED) AND ATTACHMENT G-UPDATED EXPERIENCE REPORT ARE A PART OF THIS

ADDENDUM #02. PLEASE DOWNLOAD THESE ATTACHMENTS FOR A COMPLETE ADDENDUM

#02.

Attachment A-RFP Proposal Worksheet (REVISED) REPLACES Attachment A-RFP Proposal

Worksheet. Vendors must use Attachment A (REVISED) to submit with their proposal.

Attachment B-Top Dentist List (REVISED) contains additional information requested and REPLACES

Attachment B-Top Dentist List. Vendors should use Attachment B (REVISED) to submit with their proposal.

Attachment G-Updated Experience Report is a new attachment to provide additional information requested.

PLEASE NOTE THE FOLLOWING CHANGES TO THE REQUEST FOR PROPOSAL:

All additions are in brackets ([]), bold type, highlighted and double underlined for easy identification. All deletions are indicated by strikethrough (strikethrough).

SECTION 2: SCOPE OF SERVICES on Page 7 of 32

IV. Premium Proposal

C. A minimum two (2) year fixed rate is required for year 1 (January 1, 2016 – December 31, 2016) and year 2 (January 1, 2017 – December 31, 2017). A flat rate, fixed rate or rate cap on year 3 (January 1, 2018 - December 31, 2018) is required.

SECTION 3: GENERAL INSTRUCTIONS TO RESPONDENTS on page 10 of 32.

**NOTE: Changes to the dates as below supersede the dates used throughout the RFP as applicable.**

3.8 Anticipated Schedule of Events (Subject to change as conditions may dictate)

Activity Date

Release of RFP April 10, 2015

Deadline for receipt of questions in Purchasing Office – 4:00 pm (ET) April 17, 2015

Release of responses to questions

April 21, 2015

[May 1, 2015]

May

Deadline for receipt of sealed proposals in the Purchasing Office -

3:00 p.m. (ET)

May 8, 2015

[May 20, 2015]

Proposal analysis sent by RobinsonBush to carriers for verification

May 21, 2015

[June 4, 2015]

Proposal verifications due from carriers – 5:00 p.m. (ET)

May 26, 2015

[June 9, 2015]

*Evaluation Committee meeting to review responses. Purchasing

Conference Room, District Office

May 29, 2015

June 11, 2015

Finalist presentations, if necessary-Purchasing Conference Room, District Office

June 5, 2015

June 15, 2015

Posting of Award Recommendation (on or about)

June 11, 2015

June 17, 2015

Approval of recommendation by the Board (on or about) 6/23/15 or **7/28/15

*Evaluation Committee meetings will be posted as a public notice at http://www.polk-fl.net/community/doingbusinesswithus/purchasing/evaluationsandnotices.htm

** The Board meeting calendar has not yet been established. Based on historical Board meeting calendar dates, Board approval is anticipated to be on or about July 28, 2015.

SECTION 5: EVALUATION OF PROPOSALS page 14 of 32

5.4 Evaluation Criteria:

*Calculation of the premium proposal: Points for the “premium proposal” shall be determined by using the total annualized premium for the low, middle and high plan options combined, based on the counts provided, for the three year contract [24-month] period. This will represent a 3-year [2-year] combined total annual premium. Distribution of points for evaluation of Premium Proposal will be calculated using the following formula:

Lowest 3-year [2-year] combined total annual premium ÷ Proposer’s 3-year [2-year] combined total annual premium X Total Point Value = Proposer’s Premium points

For example, if Respondent A submits a proposal with a 3-year [2-year] combined total annual premium of $10,000 and Respondent B submits a proposal with a 3-year [2-year] combined total annual premium $15,000 and Respondent C submits a proposal with a 3-year [2-year] combined total annual premium $12,500, Respondent A would receive 100% of the possible points, Respondent B would receive 67% ($10,000/$15,000) of the possible points, and Respondent C would receive 80% ($10,000/$12,500) of the possible points.

QUESTIONS AND ANSWERS:

Questions are written as they were received.

Q.1. The low and middle plans have had the same rates but the high plan had an increase. Please provide rate history for the high plan.

A.1. See the table below for the rate history for the high plan.

Tier 2011-2013 2014-2015

Employee Only $36.84 $41.41

Employee + Spouse $71.33 $80.17

Employee + Child(ren) $86.45 $97.17

Employee + Family $114.94 $129.19 http://www.polk-fl.net/community/doingbusinesswithus/purchasing/evaluationsandnotices.htm http://www.polk-fl.net/community/doingbusinesswithus/purchasing/evaluationsandnotices.htm

Q.2. Have there been any plan changes in the last three years?

A.2. There have been no changes to the Low and Middle plans. Effective 1/1/2014, the Annual Maximum Benefit changed from $2,000 to $1,500 in the High plan.

Q.3. Provide the Provider tax ID numbers for Attachment B - Top Dentist List. This will help us run our Disruption Report.

A.3. The current dental carrier is not able to provide Tax Identification Numbers; but has provided the National Provider Identifier (NPI) numbers. See Attachment B-

Top Dentist List (REVISED).

Q.4. In order to run the PPO network fee allowance for the ADA codes on

Attachment C - Top Dental Procedures, I'll need to know the zip code of the area where these procedures would take place. Should I use the situs location zip code of 33831?

A.4. Proposers are requested to use zip code 33830.

Q.5. I did not see a rate history in the RFP. Can you please get this from the Standard and Delta Dental?

A.5. Regarding the Request for Proposal for Group Dental Plan, see Section 1.3 of the

RFP document and response to question #1 above (A.1.). The question regarding the information from the Standard is not part of this Request for

Proposal.

Q.6. Please describe any plan changes that have taken place in the last 3 years.

A.6. See response to question #2 above (A.2.).

Q.7. What percentage does Polk County currently contribute towards the cost of the plans?

A.7. The dental plans are voluntary and the District does not contribute towards the cost of the plans.

Q.8. Has the contribution schedule changed in the last 3 years? Did Polk County contribute a higher percentage towards the cost of the plan in the past?

A.8. The dental plans are voluntary and the District does not contribute towards the cost of the plans.

Q.9. What percentage of claims are paid in the Preferred Network under each plan?

A.9. See Attachment F – Dental_Claims_Experience, which includes reports broken out by plan, including network utilization.

Q.10. Please update the experience provided for all plans to include data through

March 2015.

A.10. See Attachment G-Updated Experience Report through March 2015. The plan codes are as follows:

15247-00001=Low Plan; 00002= Middle Plan; 00003=High Plan

15247-08001=Retiree Low Plan; 08002=Retiree Middle Plan; 08003=Retiree High Plan

15247-09001=COBRA Low Plan; 09002=COBRA Middle Plan; 09003=COBRA High Plan

Q.11. Please update the experience provided for all plans to include claims on a paid basis through March 2015.

A.11. See response to question #10 above (A.10.).

Q.12 Please update the experience provided for all plans to include claim counts through March 2015.

A.12. See response to question #10 above (A.10.).

Q.13. Do the incurred claims found on tabs 2 and 4 on the experience spreadsheets represent only claims paid in that month or do they include expenses and a reserve? For example, for the Middle plan incurred claims equal $130,845 in

March 2013. Please confirm that the $130,845 represents all services incurred in

March 2013 but paid on or after March 1, 2013. If possible, please provide only actual paid claims by month for each of the plans for January 2012 through

March 2015.

A.13. Yes, the claims incurred are service in that month and paid that month and forward through the current reporting period. The most recent 12 months will also include an estimate for IBNR. Prior 12 months are considered complete.

Q.14. The High Plan had a rate increase 1/1/2014, what were the prior rates?

A.14. See response to question #1 above (A.1.).

Q.15. Can we get 1st quarter 2015 experience - we have Jan but Feb and March would be helpful.

A.15. See response to question #10 above (A.10.).

Q.16. Please advise where the group would like our proposals to be placed in the binder.

A.16. See Section 4 Preparation of Proposals and Required Content on pages 11 and

12 of the RFP.

Q.17. On attachment B Top-Dentist –List, if possible please provide NPI or TIN, only indicator provided is license number and NPI or TIN will allow us to provide a more accurate disruption report.

A.17. See response to question #3 above (A.3.).

Q.18. Can you please describe how the 125 points will be calculated in the Network evaluation criteria? Will networks be compared to incumbent's In-Network PPO

Network, or their Out-of-Network Premier Network (defined in the Benefits definition as out-of network, and also allows the member to be balance billed in the Mid Plan)?

A.18. The Proposal Evaluation Committee will allocate points based on responses submitted, including but not necessarily limited to, Attachment A – Proposal

Worksheet, Section 2. Provider Network, questions 1-6 and Attachment B-Top

Dentist list as incorporated in this section of Attachment A.

Q.19. How is the Dental Out of Network paid on the Middle and High plans?

A.19. See Attachment D-Certificate of Coverage, page 4 for a description.

Q.20. Do the Middle and High plans pay out of network a % of UCR? If so, what %?

A.20. See Attachment D-Certificate of Coverage, page 4 for a description.

Q.21. How does your Maximum Plan Allowance (MPA) work?

A.21: See Attachment D-Certificate of Coverage, page 4 for a description.

Q.22: Some insurers interpret the Department of Financial Services OIR Regulation 690-

149.005 “Reasonableness of Benefits in Relation to Premiums” subsection (14) to limit insurers to rate guarantees and/or rate caps to no longer than 24 months in length. What is School Board of Polk County’s interpretation of this regulation as it relates to RFP #048-PLA-0515?

A.22: See the revision to the Request for Proposal noted above (on page 2 of this addendum: SECTION 2: SCOPE OF SERVICES on Page 7 of 32, IV. Premium Proposal).

Q. 23. In regards to the employee coverage:

a) Is there is a Waiting Period for coverage for the employees?

b) If so, what are the number of days an employee must wait to be eligible for coverage?

c) When is the effective date of coverage for the employees after they meet their Waiting Period? Ie: The day after their Waiting Period has been completed, the 1st day of the month following their Waiting Period, etc?

A.23. Yes, there is a waiting period for coverage for employees. Coverage is effective the first day of the month in which an employee meets a 90 day waiting period. For example, if the 90th day of employment is April 25, coverage for that employee will begin April 1.

Q.24. In the RFP document, on page 11 under Tab 1, Section B, titled Public Records-the note section refers to the vendor financial statement. Please confirm the following:

a) Do you want a vendor financial statement included in this proposal?

b) If so, please indicate in which section of the proposal it should be placed?

A.24. No, a vendor financial statement is not requested in this Request for Proposal.

Q.25. In Attachment A- RFP Proposal Worksheet, various documents are requested.

They include:

a) Provider satisfaction survey [Section 2- Provider Network-Question 6]

b) Plan Design, Schedule of Benefits and a PPO network reimbursement amounts [Section 3-Plan design-Question 2]

c) Standard report package [Section 3-Plan design-Question 5]

Please confirm if we can include these documents in Tab 2 of the proposal, along with Attachment A. If not, please indicate where these documents should be included in the proposal.

A.25. Yes, include any documents submitted in your response to Attachment A, along with Attachment A, under Tab 2.

All proposers should acknowledge receipt of this addendum by means of the Addendum

Acknowledgement Form as outlined in the RFP document.