Appendix_1_-County_of_Orange_Dental_Plan.pdf

This appendix document supports the County of Orange Human Resource Services, Employee Benefits Department's Request for Proposal for claims administration services for their self-insured dental plan. The RFP seeks a qualified third-party administrator to manage dental claims for approximately 5,800 county employees and their dependents. Key services include comprehensive claims processing, customer service support, provider network management, eligibility tracking, and detailed reporting. The successful vendor must provide both California and national dental PPO networks, maintain claims system functionality, and implement robust cybersecurity protections compliant with the county's Information Technology Security Guidelines. Proposals were due on March 7, 2024, by 4:00 PM Pacific Time, with services commencing January 1, 2025. The initial contract term is three years with two optional one-year renewal periods. Evaluation criteria encompass proposed cost, network capabilities, administrative functions, performance guarantees, experience with public entities, claims processing accuracy, turnaround times, customer service metrics, and member satisfaction.

The dental plan currently offers an annual maximum benefit of $2,000, with recent enhancements including implant and orthodontia coverage. Historical claims expenditures totaled $2.1 million in 2022 and $2.2 million in 2023, providing baseline contract value estimates. Full-time eligible county employees do not pay premiums for the dental plan. The incumbent claims administrator is Blue Shield of California, utilizing Dental Benefit Providers as a subcontractor. Proposing firms must demonstrate comprehensive administrative capabilities including implementation planning, detailed reporting, technological infrastructure documentation, and integration capability with existing county technology platforms. The RFP does not explicitly indicate specific set-aside designations or restrictions for disadvantaged enterprises.