Contract_Appendix_VI_-_Dental_Plan_Document_2024_Signed.pdf

This is a Dental Plan Document appendix for the County of Orange, California's Employee Benefits division, supporting the Medical, Dental and Pharmacy Auditing solicitation. The document outlines the specifications and requirements for the self-insured dental plan that will be subject to audit as part of the comprehensive claims, rebates, and operational auditing services being procured. The RFP seeks qualified firms to conduct audits of one self-insured dental plan with a specific audit period scheduled for 2027, as part of a broader engagement that also includes auditing five self-insured PPO health plans and pharmacy benefit plans. All questions and requests for interpretations must be submitted by Wednesday, September 24, 2025, before 2:00 pm, with proposals due on October 3, 2025. The selected contractor will be awarded a three-year initial term with one optional two-year renewal, potentially extending the engagement to five years total, with an estimated Board of Supervisors approval date of January 13, 2026.

The contract will be structured as a firm fixed fee arrangement, with total contract cost determined by the approved costs proposed by the selected respondent. The County has established preference policies for Local Small Businesses (OCLSB) and Disabled Veteran Business Enterprises (DVBE), which provide additional scoring advantages in the evaluation process. Respondents must meet minimum qualifications, including at least five years of experience providing auditing services to major public or private organizations and three years of experience auditing health and dental plans comparable to Blue Shield of California and OptumRx. The proposal evaluation will be based on a 1,000-point scoring system: 600 points for the written proposal, 300 points for presentation/interview, and 100 points for cost proposal. Submissions must be made exclusively through the County's online eProcurement Portal, with facsimile and email proposals not accepted.