Attachment 3 Retiree Dental GCPS Addendum Question.xlsx

XLSX spreadsheet 13 KB Posted

Attached to
RFP 26-025-CJ GCPS- Employee Medical, Stop Loss, Dental, Vision, Disability & Voluntary Benefits Coverage
Solicitation number
RFP-115259
Issued by
Frederick County, Virginia

About this file

This is a retiree dental benefits roster documenting coverage for Gloucester County Public Schools (GCPS) retirees enrolled in United Concordia dental plans. The spreadsheet contains member enrollment data spanning from July 2015 through February 2026, tracking 89 retiree accounts across the school division's Gloucester CPS Retiree plan. Coverage options include both high and low dental plans with varying dependent structures, including employee-only, employee-plus-spouse, employee-plus-child, and employee-plus-family configurations. The data indicates ongoing enrollment management of the retiree dental benefits program with coverage effective dates ranging across multiple years and no universal termination dates noted, suggesting continuous plan maintenance and administration.

The roster serves as an administrative reference document for the retiree dental program, capturing member identifiers, beneficiary names, dates of birth, residential zip codes, plan tier selections, and coverage type classifications. All members are enrolled in United Concordia's dental offerings provided to GCPS retirees, with the majority maintaining either DENTAL-HIGH or DENTAL-LOW plan elections. The spreadsheet appears to function as a member roster addendum supporting contract administration and benefits verification rather than a procurement solicitation document, with no pricing information, set-asides, or funding source details included in the file.

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Other files

File Type Posted
Addendum 1.pdf PDF
external extract for gloucester co.xlsx XLSX spreadsheet
Attachment T – Vision Top Providers for Disruption Analysis.xlsx XLSX spreadsheet
Attachment M – Long Term Disability Claims History.xlsx XLSX spreadsheet
Attachment 2A. HCCs Sept 2023 - Oct 2024-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_HCC-01_20260318 03_32 PM.xlsx XLSX spreadsheet
Addendum 3 FINAL.pdf PDF
Attachment O – Medical Claim Repricing File for Discount and Disruption Analysis.xlsx XLSX spreadsheet
Attachment 2B. HCCs Oct 2024 - Sept 2025-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_HCC-01_20260318 03_31 PM.xlsx XLSX spreadsheet
Addendum 1.pdf PDF
Attachment V - Hybrid STD Benefit Summary.pdf PDF
external extract for gloucester co.xlsx XLSX spreadsheet
Attachment L – Disability Benefits.pdf PDF
Attachment S – Dental Network Utilization for Disruption Analysis .xlsx XLSX spreadsheet
Gloucester County Repricing Summary 02032026 file.xlsx XLSX spreadsheet
Addendum 2.pdf PDF
Attachment 2C. HCCs Oct 2025 - Feb 2026-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_HCC-01_20260318 03_29 PM.xlsx XLSX spreadsheet
Attachment D – Current census and enrollment for all lines of coverage (including COBRA and Retirees).xlsx XLSX spreadsheet
Attachment J – Dental Claims and enrollment history.xlsx XLSX spreadsheet
Attachment 2. HCCS over 50k Feb 2024 - Jan 2025-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_HCC-01_20260317 03_43 PM.pdf PDF
Attachment H – Vision Benefits.pdf PDF
Attachment B - Price Proposal.xlsx XLSX spreadsheet
Attachment R – Current and Historical Rates - All Lines.pdf PDF
Attachment W - Hybrid LTD Benefit Summary.pdf PDF
Attachment Q – Pharmacy Questionnaire.docx DOCX document
1B Member and claims oct 2025- Feb 2026.xlsx XLSX spreadsheet
Attachment 1. Mem and Claims Oct 2023 - Sept 2024-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_FIN-01_20260317 03_29 PM (2).xlsx XLSX spreadsheet
Attachment K – Vision Claims and enrollment history.pdf PDF
Attachment U - Supplemental Plan Claims Utilization.pdf PDF
Attachment 1A. Mem and Claims Oct 2024 - Sept 2025-GLOUCESTER COUNTY SCHOOL BOARD(Total Account)_FIN-01_20260317 03_28 PM.xlsx XLSX spreadsheet
Attachment P – Pharmacy Claim Repricing & Disruption Analysis - DELETE YELLOW ONCE APPROVED.xlsx XLSX spreadsheet
Gloucester County Repricing Cover Letter 02032026.docx DOCX document
Attachment N – Accident, Critical Illness, Hospital Benefits.pdf PDF
Attachment I – Medical Claims, Enrollment, HCCs.xlsx XLSX spreadsheet
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Sheet1

MemberIDZipClientNameDivisionNameDOBPlanNameCoverageDescEventFirstDayofCoverageTerminationDateType
5065623188Gloucester County Public SchoolsGloucester CPS Retiree12/24/39RETIREE United Concordia DENTAL - HIGHEE Only20150701SPM
5926523185Gloucester County Public SchoolsGloucester CPS Retiree11/25/35RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5926623072Gloucester County Public SchoolsGloucester CPS Retiree6/16/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5926723072Gloucester County Public SchoolsGloucester CPS Retiree11/11/51RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5926823061Gloucester County Public SchoolsGloucester CPS Retiree7/23/54RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
5926923072Gloucester County Public SchoolsGloucester CPS Retiree6/22/47RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5927022469Gloucester County Public SchoolsGloucester CPS Retiree8/27/42RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5927223061Gloucester County Public SchoolsGloucester CPS Retiree9/12/48RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5935723061Gloucester County Public SchoolsGloucester CPS Retiree12/10/44RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5941123602Gloucester County Public SchoolsGloucester CPS Retiree1/4/51RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5946223061Gloucester County Public SchoolsGloucester CPS Retiree5/2/47RETIREE United Concordia DENTAL - HIGHEE + Family20150901SPM
5946323175Gloucester County Public SchoolsGloucester CPS Retiree11/11/43RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5946723149Gloucester County Public SchoolsGloucester CPS Retiree1/31/46RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5946923061Gloucester County Public SchoolsGloucester CPS Retiree12/15/48RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5947223061Gloucester County Public SchoolsGloucester CPS Retiree12/15/46RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5947323072Gloucester County Public SchoolsGloucester CPS Retiree3/15/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
5948623062Gloucester County Public SchoolsGloucester CPS Retiree8/31/50RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
5951423061Gloucester County Public SchoolsGloucester CPS Retiree11/2/56RETIREE United Concordia DENTAL - HIGHEE Only20151001SPM
5952023149Gloucester County Public SchoolsGloucester CPS Retiree10/12/50RETIREE United Concordia DENTAL – LOWEE + Spouse20151001SPM
5952123061Gloucester County Public SchoolsGloucester CPS Retiree8/23/54RETIREE United Concordia DENTAL - HIGHEE Only20151001SPM
6023123169Gloucester County Public SchoolsGloucester CPS Retiree7/22/52RETIREE United Concordia DENTAL - HIGHEE + Child20150901SPM
6027223690Gloucester County Public SchoolsGloucester CPS Retiree11/29/53RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6028423071Gloucester County Public SchoolsGloucester CPS Retiree8/22/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6028923185Gloucester County Public SchoolsGloucester CPS Retiree2/3/53RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6051723061Gloucester County Public SchoolsGloucester CPS Retiree8/8/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6051823003Gloucester County Public SchoolsGloucester CPS Retiree1/24/53RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6052123061Gloucester County Public SchoolsGloucester CPS Retiree5/8/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6052423061Gloucester County Public SchoolsGloucester CPS Retiree3/15/56RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6052823043Gloucester County Public SchoolsGloucester CPS Retiree7/27/52RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6053023061Gloucester County Public SchoolsGloucester CPS Retiree10/28/52RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6053323018Gloucester County Public SchoolsGloucester CPS Retiree11/1/51RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6053623072Gloucester County Public SchoolsGloucester CPS Retiree8/9/55RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6053723061Gloucester County Public SchoolsGloucester CPS Retiree4/24/57RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6054323149Gloucester County Public SchoolsGloucester CPS Retiree11/4/51RETIREE United Concordia DENTAL – LOWEE Only20161001SPM
6071623062Gloucester County Public SchoolsGloucester CPS Retiree10/17/42RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6085223068Gloucester County Public SchoolsGloucester CPS Retiree10/28/46RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6085423072Gloucester County Public SchoolsGloucester CPS Retiree2/26/37RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6087123188Gloucester County Public SchoolsGloucester CPS Retiree9/7/41RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6088023061Gloucester County Public SchoolsGloucester CPS Retiree7/31/46RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6088323061Gloucester County Public SchoolsGloucester CPS Retiree6/7/41RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6089023062Gloucester County Public SchoolsGloucester CPS Retiree10/8/49RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6089423061Gloucester County Public SchoolsGloucester CPS Retiree2/7/47RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6089823018Gloucester County Public SchoolsGloucester CPS Retiree2/6/41RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6090523061Gloucester County Public SchoolsGloucester CPS Retiree10/21/49RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6090923025Gloucester County Public SchoolsGloucester CPS Retiree7/30/49RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6092423131Gloucester County Public SchoolsGloucester CPS Retiree8/3/48RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6093423138Gloucester County Public SchoolsGloucester CPS Retiree8/28/48RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6093923050Gloucester County Public SchoolsGloucester CPS Retiree7/31/42RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6095123076Gloucester County Public SchoolsGloucester CPS Retiree1/16/40RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6095723072Gloucester County Public SchoolsGloucester CPS Retiree8/5/47RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6096023018Gloucester County Public SchoolsGloucester CPS Retiree4/13/49RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6098723060Gloucester County Public SchoolsGloucester CPS Retiree2/5/41RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6099423001Gloucester County Public SchoolsGloucester CPS Retiree10/12/47RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6099823061Gloucester County Public SchoolsGloucester CPS Retiree10/5/51RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6101123072Gloucester County Public SchoolsGloucester CPS Retiree9/13/47RETIREE United Concordia DENTAL - HIGHEE + Spouse20150901SPM
6102323061Gloucester County Public SchoolsGloucester CPS Retiree7/29/42RETIREE United Concordia DENTAL – LOWEE + Spouse20150901SPM
6102923183Gloucester County Public SchoolsGloucester CPS Retiree1/31/49RETIREE United Concordia DENTAL - HIGHEE Only20150901SPM
6103623062Gloucester County Public SchoolsGloucester CPS Retiree7/7/37RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6103823061Gloucester County Public SchoolsGloucester CPS Retiree10/19/79RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6104123175Gloucester County Public SchoolsGloucester CPS Retiree6/19/43RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6104223125Gloucester County Public SchoolsGloucester CPS Retiree3/30/58RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6104423061Gloucester County Public SchoolsGloucester CPS Retiree3/28/45RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6105223061Gloucester County Public SchoolsGloucester CPS Retiree8/19/47RETIREE United Concordia DENTAL – LOWEE Only20150901SPM
6916023061Gloucester County Public SchoolsGloucester CPS Retiree2/9/49RETIREE United Concordia DENTAL - HIGHEE Only20151001SPM
8708623693Gloucester County Public SchoolsGloucester CPS Retiree3/20/51RETIREE United Concordia DENTAL - HIGHEE Only20160401SPM
10589923062Gloucester County Public SchoolsGloucester CPS Retiree11/7/56RETIREE United Concordia DENTAL – LOWEE Only20160801SPM
12379923072Gloucester County Public SchoolsGloucester CPS Retiree3/3/51RETIREE United Concordia DENTAL – LOWEE Only20161001SPM
12380623062Gloucester County Public SchoolsGloucester CPS Retiree9/14/48RETIREE United Concordia DENTAL - HIGHEE + Spouse20161001SPM
17391523112Gloucester County Public SchoolsGloucester CPS Retiree1/25/63RETIREE United Concordia DENTAL - HIGHEE Only20171001SPM
17392123035Gloucester County Public SchoolsGloucester CPS Retiree4/7/54RETIREE United Concordia DENTAL - HIGHEE + Spouse20171001SPM
20863923119Gloucester County Public SchoolsGloucester CPS Retiree12/14/62RETIREE United Concordia DENTAL - HIGHEE Only20180301SPM
21367323061Gloucester County Public SchoolsGloucester CPS Retiree3/4/56RETIREE United Concordia DENTAL - HIGHEE Only20180401SPM
33794823061Gloucester County Public SchoolsGloucester CPS Retiree10/4/72RETIREE United Concordia DENTAL - HIGHEE Only20190201SPM
41026823175Gloucester County Public SchoolsGloucester CPS Retiree11/21/64RETIREE United Concordia DENTAL - HIGHEE Only20201001SPM
47804623072Gloucester County Public SchoolsGloucester CPS Retiree5/11/66RETIREE United Concordia DENTAL – LOWEE Only20211001SPM
47804723072Gloucester County Public SchoolsGloucester CPS Retiree7/22/63RETIREE United Concordia DENTAL - HIGHEE + Family20211001SPM
51586223061Gloucester County Public SchoolsGloucester CPS Retiree11/8/62RETIREE United Concordia DENTAL - HIGHEE + Spouse20220201SPM
57432123003Gloucester County Public SchoolsGloucester CPS Retiree12/20/61RETIREE United Concordia DENTAL – LOWEE Only20221001SPM
67925423602Gloucester County Public SchoolsGloucester CPS Retiree9/20/64RETIREE United Concordia DENTAL - HIGHEE Only20230801SPM
68241723430Gloucester County Public SchoolsGloucester CPS Retiree1/14/59RETIREE United Concordia DENTAL – LOWEE + Spouse20230901SPM
73201323168Gloucester County Public SchoolsGloucester CPS Retiree1/25/63RETIREE United Concordia DENTAL - HIGHEE Only20240201SPM
80669523061Gloucester County Public SchoolsGloucester CPS Retiree3/8/62RETIREE United Concordia DENTAL - HIGHEE + Spouse20241001SPM
81053423061Gloucester County Public SchoolsGloucester CPS Retiree6/11/67RETIREE United Concordia DENTAL - HIGHEE Only20241001SPM
91052323185Gloucester County Public SchoolsGloucester CPS Retiree11/25/63RETIREE United Concordia DENTAL - HIGHEE + Family20250801SPM
99740023699Gloucester County Public SchoolsGloucester CPS Retiree2/3/65RETIREE United Concordia DENTAL - HIGHEE + Spouse20260201SPM

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