Copy_of_San_Mateo_County_Vision_RFP_Workbook_FINAL.xlsx

XLSX spreadsheet 6 MB Posted

Attached to
County of San Mateo Vision Request for Proposal
Solicitation number
2026-RFP-00349
Issued by
San Mateo County, San Bernardino City, California

About this file

This is a Vision Request for Proposal (RFP) workbook prepared by the County of San Mateo's Benefits Division to solicit competitive proposals for comprehensive vision coverage administration. The County seeks to serve 16,140 covered lives, including 5,734 active employees and 2,092 retirees, distributed across three plan offerings: VSP Actives Core (4,051 enrollees, self-funded), VSP Actives Buy-Up (1,695 enrollees, self-funded), and VSP Retirees Voluntary (1,100 enrollees, fully insured). The RFP was sent to market on February 23, 2026, with an RFP submission deadline of March 13, 2026. Committee evaluation and finalist selection occur on April 7, 2026, followed by finalist presentations on April 30, 2026. The selected vision provider is expected to begin implementation on September 1, 2026, with a plan effective date of January 1, 2027. The County is requesting a minimum three-year ASO rate guarantee through January 1, 2030. Bidders must meet nine minimum qualifications, including integration capability with Workday and BCC systems, at least ten years of vision coverage experience, a national provider network with 90% or greater geo-access match, at least 60% provider match, and experience with public agency clients exceeding 5,000 employees in California with three required references.

The County's current vision carriers are VSP (fully insured for retirees, ASO for actives) and requests proposals from bidders on a net-of-commission basis with no mandatory participation requirements. Pricing proposals must include both 85% UCR and MAC reimbursement options for out-of-network services, with a claims projection based on 24 months of claims data provided in the RFP workbook. The County is satisfied with incumbent carrier performance but conducts this market evaluation every five years to ensure competitiveness and fiscal responsibility. Bidders must provide a geo-access report demonstrating network adequacy, a provider disruption analysis, and detailed cost-impact analyses for optional benefits including safety glasses and prescription computer glasses. Performance guarantees are required, including 99% claims financial accuracy, 99% claims processing accuracy, and 95% processing of preferred provider claims within five business days. Proposals must remain valid for a minimum of 30 days and include implementation allowances, dedicated account management resources, 24-hour inquiry response commitments, and member communication support during open enrollment.

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Vision Timeline

County of San Mateo Vision Request for Proposal
Vision RFP Timeline
Establish RFP CommitteeNovember 1, 2020
Vision RFP Documents - 1st Draft
(Review with Benefits Team)May 4, 2021
Committee #1 Kick-Off meeting
(Review plans, market trends, goals & objectives, finalize RFP documents)May 18, 2021
ActivityDate
Kick-Off Committee Meeting #1January 27th
Send RFP to MarketFebruary 23, 2026
Alliant and the County will evaluate all proposals and prepare a comparative analysis
RFP Submission DeadlineMarch 13, 2026
Committee Meeting #2 & Alliant to Review Results
(select finalists and get clarifying questions)April 7, 2026
Committee Meeting #3

Finalists Presentations (In-Person)

Select vision providerApril 30, 2026
Present results to Benefits CommitteeJuly 23, 2025
Board Meeting/approvalAugust 25th

submission deadline is July 30th

Start ImplementationSeptember 1, 2026
Plan Effective DateJanuary 1, 2027
*Please note the County/Alliant has the authority to adjust dates

General Info

County of San Mateo Vision Request for Proposal
Vision RFP - General Information
Client InformationComments
01Client NameCounty of San Mateo
02Client Address, City, State, and ZIP Code500 County Center

Redwood City, CA 94063

03Where is the group sitused (legal jurisdiction)?CA
04Size of ClientActives - 5,734
Retirees - 2,092Vision Plan Enrollment Breakdown:

Actives Core - 4,051 Actives Buy-Up - 1,695 Retirees - 1,100 Total covered lives - 16,140

05Industry (SIC) Code9121-04
06Industry DescriptionLocal Government
Alliant Contact InformationComments
01First Vice President/ConsultantKimberly Miller

(415) 730-6255 kmiller@alliant.com 02 Client Manager Taylor Steinberg taylor.steinberg@alliant.com 03 Benefit Analyst Cole Wright cole.wright@alliant.com

Commission InformationComments
01Commission Level0%
Provider Access and Provider Disruption Reporting for RFPComments
01Is a Geo-Access Report requested?Yes
02Is a Provider Disruption Report required?Yes
03Claims Repricing?YesPlease provide a claims projection based on the 24 months of claims included in this RFP workbook.
Plan InformationComments
01Current CarrierVSP Vision
02Plan Renewal DateJanuary 1, 2027Requesting 3 year ASO rate guarantee for a next plan renewal on January 1, 2030
03Match current plan designYesThe County offers Core & Buy-Up plans and we expect that any vision provider would have the ability to do the same. Any deviations should be clearly outlined in the exhibit provided in this RFP workbook.
04Plan OptionsYesPlease provide a cost impact for adding Safety Glasses & Prescription Computer Glasses. In addition, please provide coverage levels and details on how members would access these benefits.
Detailed Plan Information
01VSP Core Plan (Self Funded)Refer to plan summaries (VSP Actives Core)Self-Funded
02VSP Buy Up plan (Self Funded)Refer to plan summaries (VSP Actives Buy Up)Self-Funded
03VSP Retiree Voluntary plan (Fully Insured)Refer to plan summaries (VSP Retirees Vol)Fully-Insured
Goals & ObjectivesComments
01RFP Objectives1. Matching or improving current vision plan designs at current or lower costs

2. Providing a strong and accessible provider network offering competitive discounts

3. Offering multi-year rate guarantees (minimum 3 years requested)

4. Exceptional customer service

5. Meaningful performance guarantees tied to service & quality

Cooperative Agreement (Piggyback)
The services, terms and conditions of any Agreement that is entered into by the County as a result of this RFP
may be used by other public entities as a Cooperative Agreement in accordance with the rules and requirements of
such public entities.

Min Qual

County of San Mateo Vision RFP
Minimum Qualifications
Minimum QualificationsBidder Attestation/Response
1. Must be able to integrate with the County's HRIS system (Workday) and the TPA for retiree administration (BCC)Yes/No - a Yes confirms you can integrate with BOTH
2. At least 10 years of experience providing vision coverageYes/No
3. National vision provider network with a 90%+ GeoAccess match - use the census to run the analysisYes/No
4. Must have a provider match of at least 60% - use the provider file to run the disruption analysisYes/No
5. Must match current plan structure at a minimumYes/No
6. Experience with Public Agency clients with over 5,000 employees in CaliforniaYes/No - must be able to provide at least 3 references with submission. Note references do not have to all be over 5,000 employees in California, but you must have experience with clients of this size.
7. Certificate of Insurance showing Errors & Omissions coverage for a minimum of $1 millionYes/No
8. Strong financial rating of A or greater (AM Best, Moody's, S&P)Yes/No
9. Must have a network that includes in-office locations for careYes/No

Carrier Questions

Questions Answers

1Please provide the budget rates on all Self-Funded plans1Included in the updated plan tabs
2Please provide the Cigna Retiree PPO rates2Included in the updated plan tabs
3How does the group currently track employee movement from, Y1 to Y2 and Management?3Rep EE's (Non MGMT) are in the Y1 plan for first year and Y2+ for the remaining years, MGMT stays in MGMT plan
4We see that you would like proposals for 85% UCR and MAC. Please confirm the current Out-of-Network Reimbursement on all PPO plans is MAC.4Confirmed, please see D31 on general info tab
5Is this a mandatory market check? If not, why is it out to bid?5We are submitting this RFP to comply with the county's procurement obligations, all submitted proposals will be considered
6Cigna DPPO is currently ASO and are you requesting a Fully Insured DPPO quote as well?6We are NOT requiring a claims repricing analysis at this time, instead we are requesting a PEPM claims projection, as well as fully insured quotes for comparison purposes (The county is not considering changing their funding type at this time)
7Delta DHMO is currently Fully Insured and are you requesting both a Full Insured and ASO quote?7No, just a fully insured quote for Delta plans
8Please confirm you are only requesting a claims re-pricing on the ASO DPPO portion of the proposal?8We are not requesting a claims repricing at this time, this may happen when we decide finalists
9Are both carriers considered for renewal?9Yes
10May our proposal be based on replacing each carrier and then a total replacement of both Delta and Cigna?10Total replacement with unbundled and bundled pricing (DHMO/DPPO)
11Please confirm the current contract period is also three years?11Current Cigna contract period is 1/1/2020 - 12/31/2022 and Delta is 1/1/2017 - 12/31/2021
12Will you provide the last 3 years of admin fee and rate history for the DPPO and DHMO?12DPPO admin fee has been at $2.75 since moving to Cigna, DHMO plans have been in a rate guarantee since 1/1/2017
13Please confirm we are submitting an electronic copy our proposal?13Confirmed
14Will you share any other bidder’s questions/responses posed along with ours?14Yes
15Are there any service issues, administration challenges with either the DHMO or DPPO incumbents to be aware of as part of this marketing?15The County is satisfied with the incumbent carriers. The primary goal of the RFP is to ensure the County plans remain competitive, however, all bids will be considered and dialogue on how administration may be improved will be welcomed at the finalist stage.
16On Cigna Core PPO Actives tab Confirm if one composite rate is wanted including Represented Year 1 and Year 2 combined or one composite for each.16One combined rate for Represented Y1/Y2
17On Cigna Core PPO Actives tab Please confirm that 3-tier rates are not wanted as they are requested for each of the buy up options.17Just composite rates for Management and Represented
18Is there a file size limitation on Alliant’s end for the proposal submission?18No
19Are zip files acceptable for the final submission?19Yes
20Are you seeking a fully insured and ASO quote?20Yes, please see response to question #6. Delta plans will remain fully insured
21Please provide a DHMO provider file for the requested disruption.21Pending
22Have there been any plan design changes over the past 24 months? If so, please provide the details and dates of any change(s).22None
23Does the monthly claims experience include any payments to dentists for the cost of Personal Protective Equipment (PPE)? If so, please provide the monthly amounts or percentage of claims payments due to Covid-related PPE.23Cigna allowed payments up to $8 for dentist billed PPE charges processed between 6/15/2020 and 7/31/2020. A breakout of these charges/payments is not available
24In the Cigna monthly claims data, do the paid dollar amounts include anything for network charges, shared savings, retained fees, or any other dollars that were not paid to the dentists or patients? If the Cigna monthly claims data include dollars for network charges, shared savings, retained fees, etc., please provide the monthly claims dollars without any such charges, savings, or fees.24Yes, Please see attached excel file to the right which has been revised to show only amount paid to dentists or patients
25The RFP requests out of network R&C at 85th percentile. Our plans can be administered at the 80th or 90th percentile. Please confirm which R&C you would like us to use for our quote, or if you would like to see both.25Please quote both
26For the GeoAccess reporting, please confirm if all carriers should use “estimated driving distance” or “straight line” methodology to determine network access.26Estimated driving distance
27On the dental provider report, can you please denote which providers are Cigna DPPO versus Cigna Advantage which comprise the Total network?27The County uses Cigna’s Total DPPO network. The report indicates whether or not the provider is in that network. Cigna will not release information on Cigna DDPO versus Cigna Advantage.
28For the management plan, please provide an annual maximum usage report showing how many enrollees reached certain levels in benefits paid. For example, the % of participants that used $0-$999, $1000-$1999, $2000-$2999, $3000-$3999, $4000-$4999, $5000-$9999, or more than $10000. If this detail isn’t available, please confirm the % of participants (or count) that exceeded $5000 in benefits for CY 2019 and CY 2020.28a. In 2020: 7.1% of membership in Management plan had payments exceeding $2,000. Breakdown is not available for participants exceeding $5,000.

b. In 2019: 9.1% of membership in Management plan had payments exceeding $2,000 The experience report shows breakdown of total payment by plan

29 Is the County of San Mateo experiencing any pain points with their current vendors? What are they looking to improve with a new carrier? 29 See # 15 above

30Provide complete booklets for all plans30Included in attached Zip
31On the census there are employees listed as “Cigna Represented Core” without further indicators of plan such as “1+ Year or 2+ Year”. Can you confirm which plans these members should be assigned to as there are two plans on the Cigna “Core” tab.31Please place the Cigna Represented Core EE's on the Y2+ Core plan

Questionnaire (Vision)

County of San Mateo Vision Request for Proposal
Vision RFP - QuestionnaireProvide a succinct response in this workbook to supplement your proposal. Please use the excel document for your submission, not a PDF.
General InformationProposed Carrier Response
Full name; Legal and Trade Name
Address
Phone Number
Parent Company (if operating as a subsidiary)
Date Company Founded
Provide relevant information providing proof of your organization’s financial soundness (i.e. AM Best, Moody's).
Provide the number of California Public Agency vision clients you service, as well as the average vision client size.
Is your company licensed to issue this insurance in all fifty United States, Puerto Rico and the District of Columbia?
Financial Proposal
Proposal Valid for (indicate date range)

30, 60, 90 or 120 days

Please indicate any assumptions made with your Financial Proposal
Minimum 3 Year ASO Rate Guarantee
Implementation
Provide an implementation timeline based on the implementation date provided in this RFP - January 1, 2027
Confirm that there will be an Implementation team assigned for The County that includes members of the assigned and ongoing service team
Confirm you will provide an implementation allowance for transition that can be used for communications, and/or soft dollar costs
Confirm you will grandfather all current Buy-Up plans and enrollment
Service & Support
Account Manager Information
Name
Office Location for Account Management
# of years with the company
# of years in current position with the company
# of years in the industry
List any other team members that will serve the County
What was the percent turnover rate for your service and support team in the past 36 months? And how will potential staff turnover be addressed during a term Agreement?
Confirm your ability to meet with the County Benefits staff upon request, as well as attend open enrollment meetings as needed
Claims Administration
What is your claims processing accuracy and average claims processing turn around time?
What is your process for fraud detection and prevention?
What cybersecurity measures are in place to protect member data?
Have you had any data breaches in the past five years?
Do you have the capability to coordinate vision claims with disease management/medical plan?
Please describe the process for submitting and getting reimbursed for OON claims
Provider Network
Provide a detailed breakdown of your contracted provider network by retail chains vs. private practice (including counts, percentages, and geographic distribution).
Identify any major chain providers not participating in your network and explain the underlying contracting barriers.
Describe your out-of-network reimbursement strategy and how you ensure competitive access in counties with low in-network saturation.
Provide a 24-month lookback of provider terminations and additions, including rationale and impact on membership.
Describe your provider retention strategy and incentives to mitigate churn within high-volume practices.
Discount Strategy & Cost of Care
Outline your discounting methodology, including how discounts vary across retail chains, private practice, and optical labs.
Explain how you monitor and control up charging, add-on fees, and non-covered services within the network.
Detail your lab strategy, including lab network penetration and how lab partnerships influence cost and quality.
Are providers in your network able to opt out of discounts or fixed pricing? If so, what percentage do not offer discounts/fixed pricing? If they do offer discounts, are they able to limit discounts to specific services or products or do discounts apply to the entire pair of eyewear?
What is your average discount on lens options?
How do you help members determine the most cost effective method to get the most out of their allowance?
Eligibility
Confirm your ability to receive electronic eligibility data from a third-party vendor. The County currently uses Workday for actives and BCC for retiree administration. Please confirm that you can accommodate these systems.
Reporting
The County expects to receive monthly reporting that includes claims and enrollment, as well as quarterly reporting on utilization metrics
Can you customize your standard reports based on client needs?
Please provide a sample of your standard reporting package
Communications & Open Enrollment
What marketing and communication material will be available to SMC at no cost? Please provide samples. Identify any of these materials that may be customized at no additional cost to SMC.
Do you have the capability to support a strategic employee communications campaign aimed at ensuring members know how to maximize the vision benefits provided to the County?
Please describe how you will help to ensure that members are using their preventive benefits on a regular basis
Do you have a representative available to present relevant plan information to SMC membership (if requested) either during Open Enrollment or for educational seminars/webinars?
Misc.…
What Value Added Benefit/Programs are included in your proposal?
Please explain how the Coordination of Benefits (COB) structure works? Dual coverage?
Is retinal imaging a covered service? Please describe the process and cost for this service.

COS

Vision Utilization and Cost of Services - Northern California
Instructions: Please fill out tan shaded cells with plan specific information for the most recent calendar year (Q2 2021)
In-NetworkOut of Network
Type of Service# of ServicesAverage Retail Cost (per service)Plan Pays
(per service)Member Pays
(per service)Allowable to Provider (plan + member)Type of Service# of ServicesAverage Retail Cost (per service)Plan Pays
(per service)Member Pays

(per service)

ExamsExams
LensesLenses
SingleSingle
BifocalBifocal
TrifocalTrifocal
FramesFrames
ContactsContacts
Lens OptionsLens Options
ProgressivesProgressives
StandardStandard
Premium Tier 1 - CustomPremium Tier 1 - Custom
Premium Tier 2 - PremiumPremium Tier 2 - Premium
Premium Tier 3 - N/APremium Tier 3
Premium Other - N/APremium Other
Other lens optionsOther lens options
UVUV
TintTint
ScratchScratch
PolycarbonatePolycarbonate
Anti-reflective Tier 1Anti-reflective Tier 1
Anti-reflective Tier 2Anti-reflective Tier 2
Anti-reflective Tier 3Anti-reflective Tier 3
Photo/TransitionPhoto/Transition

Questionnaire

County of San Mateo
Vision RFP - Questionnaire
Please provide a succinct response in this workbook to supplement the full response in your proposal.
General InformationProposed Carrier Response
Full name; Legal and Trade Name
Address
Phone Number
Website Address
Parent Company (if operating as a subsidiary)
Date Company Founded
State of Incorporation
List of branch offices or other subordinate elements that will perform or assist in performing work herein
Provide relevant information providing proof of your organization’s financial soundness (i.e. AM Best, Moody's).
Provide the number of clients you service, as well as the average size employer client.
Financial Proposal
Proposal Valid for (indicate date range)

30, 60, 90 or 120 days

Please indicate any assumptions made with your Financial Proposal
Minimum 3 Year Rate Guarantee
All bids should be net of commission
Please identify any plan participation requirements
Implementation
Provide an implementation timeline based on the implementation date provided in this RFP - January 1, 2022
Confirm that there will be an Implementation team assigned for The County that includes members of the assigned and ongoing service team
Confirm you will provide an implementaiton allowance for transition that can be used for communications, and/or soft dollar costs
Will members get ID cards upon the initial effective date?
Desctibe how treatment in progress will be handled during a transition? Including orthodontia.
Confirm that rates will not change until next renewal, even if enrollment shifts within plans
Confirm you will grandfather all current Buy-Up plans and enrollment
Service & Support
Account Manager Information
Name
Address
Phone Number
# of years with the company
# of years in current position with the company
# of years in the industry
List any other team members that will serve the County
Location, Days and Times of operation
What was the percent turnover rate for your service and support team in the past 36 months? And how will potential staff turnover be addressed during a term Agreement?
What location / city would the resources for the County's account reside?
Confirm your ability to meet with the County Benefits staff upon request, as well as attend open enrollment meetings as needed
Confirm that you will respond to all inquiries within 24 hours
Claims Administration
Confirm the operating hours for claims processing
Confirm a dedicated claims team will support The County
Describe the metrics used to track and monitor claims processing
Please confirm that claims can be filed both electronically and telephonically
Do you have a Member Portal that members can use to access/view claims and payment history?
Will there be a dedicated Claims Representative assigned to the County?
Provider Network
What are the provider network(s) you propose to use for the County?
Do you own and operate your network(s)? If not, please describe the relationship and how the network is managed.
Are you planning any changes to the network, products or programs being offered to the County?
Please descrie your willingness and capability to add providers to yur network to meet the County's needs. Are you willing to offer Performance Guarantees around provider recruitment?
Please confirm your Out of Network fee scheduleWe would like to see proposlas for 85% UCR, PPO fee schedule and MAC. Please confirm
What is your anticipated dental trend for 2021 and 2022?
Please share the level of informaiton that shows up on your website when doing a provider search (i.e. patient reviews, rating, number of years in business, etc…)
DHMO - describe how DHMO providers are evaluated and/or rated? How are those evaluations and/or ratings shared (in the aggregate?) with plan sponsors and/or target populations?
DHMO - Which of your DHMO network providers are and are not accepting new patients? What is the percentage? How is the network managed to maximize its availability to new patients?
Eligibility
Confirm your ability to receive electronic eligibility data from a third-party vendor. The County currently uses Workday for actives and BCC for retiree administration. Please confirm that you can accommodate these systems.
Payment and Banking
What are the approved methods of payment your company can receive from the County?
Describe your options for billing and payment process
Do you require a pre-fund to pay claims?
Reporting
The County expects to receive monthly reporting that includes claims and enrollment, as well as quarterly reporting on utilization metrics
Please provide a sample of your monthly/quarterly reporting package
Communications & Open Enrollment
What marketing and communication material is available to members and employers at no cost? Please provide samples.
Do you have a Mobile Application?
What level of involvement will your company play in open enrollment and annual benefit fairs?
Misc.…
What Value Added Benefit/Programs are included in your proposal?
Please explain how the Coordination of Benefits (COB) structure works? Dual coverage?
Please describe your Opiod Management programs. Are there any contract limitations for Opiod medications? Would the County have any influence over such programs?
Please describe how you will help to ensure that members are using their preventive benefits on a regular basis
Adherence to County Templates
County Service Provider TemplateConfirm - Yes/No
County Contract TemplateConfirm - Yes/No

SOW

County of San Mateo
Dental Plan Administration - Scope of Services
1)Plan Administration - Claims processing, fund accounting

2) Customer Service - answer calls on a toll free 800# between 8:00am and 5:00pm PST (at a minimum)

3) Reporting - Provide monthly statistical plan data reports including utilization, claims, enrollment

4) Account Management - Dedicated service team that will attend meetings, research and resolution of complaint, investigate and resolve problems

5) Prepare plan documents, benefit simmaries, communication materials EE's and retirees

6) Compliance - advise the County on any pending legislation affecting the administration of the dental plans and help with compliance requirements

7) Meetings - OE, annual meetings, education seminars, trainings attend various employee, benefits team and labor management meetigs as requeted

8) Dedicated claims and eligibility represntative

9) Adherence to Performance Guarantees

VSP Actives Core (SF)

County of San Mateo Vision Request for Proposal
VSP Actives / Early Retirees - Self Funded Core Plan
The below chart is a high level overview of the plans benefits. For a more comprehensive document of all covered benefits please refer to the attached Benefit Summary below.
INSTRUCTIONS: Please fill in the below chart labeled "Proposed 1/1/2027" with your quoted plan. Please also provide the full benefit summary for the quoted plan. Complete in excel, not a PDF.
Vision (Self-Funded)VSP Core Plan (Signature)Proposed 1/1/2027
BenefitsIn-NetworkNon-NetworkIn-NetworkNon-Network
Frequency
ExamEvery 12 months
Lenses/ContactsEvery 12 months
FramesEvery 24 months
Copayment
Prescription Glasses$10
Contacts15% off contact fitting and evaluation exam, not to exceed $60
ExamCopayPlan Pays up to:CopayPlan Pays up to:
Exam$10$50
Lenses
Single LensesCovered in full$50
Bifocal LensesCovered in full$75
Trifocal LensesCovered in full$100
Standard Progressive LensesCovered in fullVaries
Premium & Custom Progressive Lenses$80 - $160Varies
Frames
Frames$170 Allowance;
20% off over $170$70
Anti-Reflective CoatingNot CoveredNot Covered
UV CoatingNot CoveredNot Covered
LightCareNot CoveredNot Covered
Contacts
Elective$170 Allowance;
in lieu of lens and frame*$105**
CurrentProposed
ASO Fee PEPM$1.31
Rate Guarantee (3 years requested)N/A
Claims ProjectionN/A
Enrollment4,051

Plan Documents:

VSP Actives Buy Up (SF)

County of San Mateo Vision Request for Proposal
VSP Actives Only - Self Funded Buy up plan
The below chart is a high level overview of the plans benefits. For a more comprehensive document of all covered benefits please refer to the attached Benefit Summary below.
INSTRUCTIONS: Please fill in the below chart labeled "Proposed 1/1/2027" with your quoted plan. Please also provide the full benefit summary for the quoted plan. Complete in excel, not a PDF.
Vision (Self-Funded)VSP Buy-Up Plan (Signature)Proposed 1/1/2027
BenefitsIn-NetworkNon-NetworkIn-NetworkNon-Network
Frequency
ExamEvery 12 months
Lenses/ContactsEvery 12 months
FramesEvery 12 months
Copayment
Prescription Glasses$10
Contacts15% off contact fitting and evaluation exam, not to exceed $60
ExamCopayPlan Pays up to:CopayPlan Pays up to:
Exam$10$50
Lenses
Single LensesCovered in full$50
Bifocal LensesCovered in full$75
Trifocal LensesCovered in full$100
Standard Progressive LensesCovered in fullVaries
Premium & Custom Progressive Lenses$80 - $160Varies
Frames
Frames$250 Allowance;
20% off over $250$70
Anti-Reflective Coating$35 CopayNot Covered
UV CoatingNo ChargeNot Covered
LightCareUpgrade to LightCare

$250 Allowance for ready made non prescription sunglasses or Blue Light Computer Glasses instead of prescription glasses or contacts

Contacts
Elective$250 Allowance;
in lieu of lens and frame*$105**
CurrentProposed
ASO Fee (PEPM)$2.48
Rate Guarantee (3 years requested)N/A
Claims ProjectionN/A
Enrollment1,695

Plan Documents:

VSP Retirees Vol (FI)

County of San Mateo Vision Request for Proposal
VSP Retiree Voluntary Plan - Fully insured
The below chart is a high level overview of the plans benefits. For a more comprehensive document of all covered benefits please refer to the attached Benefit Summary below.
INSTRUCTIONS: Please fill in the below chart labeled "Proposed 1/1/2027" with your quoted plan. Please also provide the full benefit summary for the quoted plan. Complete in excel, not a PDF.
Vision (Fully-Insured)VSP (Signature)Proposed 1/1/2027
BenefitsIn-NetworkNon-NetworkIn-NetworkNon-Network
Frequency
ExamEvery 12 months
Lenses/ContactsEvery 12 months
FramesEvery 24 months
Copayment
Prescription Glasses$10
Contacts*15% off contact fitting and evaluation exam, not to exceed $60
ExamCopayPlan Pays up to:CopayPlan Pays up to:
Exam$10$50
Lenses
Single LensesCovered in full$50
Bifocal LensesCovered in full$75
Trifocal LensesCovered in full$100
Standard Progressive LensesCovered in fullVaries
Premium & Custom Progressive Lenses$80 - $160Varies
Frames
Frames$170 Allowance;
20% off over $170$70
Contacts*
Elective$170 Allowance$105
Medically NecessaryCovered in full$210
RatesCurrentProposed
Single$9.34
Two Party$18.68
Family$30.06
Enrollment1,100
Rate Guarantee (3 years requested)N/A

Plan Documents:

Claims Repricing Examples

Plan Deviations

County of San Mateo Vision Request for Proposal
Dental Plan Design Deviations
Vision Plan - Actives
Item #Current Benefit DescriptionProposed Benefit DescriptionComments/Notes
1
2
3
4
5
6
7
8
9
10
Vision Plan - Retirees
Item #Current Benefit DescriptionProposed Benefit DescriptionComments/Notes
1
2
3
4
5
6
7
8
9
10

Instructions:

Please use the attached Plan Documents for each current benefit design and indicate areas where you are unable to administer the benefit as it exists today. Please also clarify how you would propose to administer something as similar as possible. Please use the template below to respond to this component in excel. It will be understood that any benefit not identified here can be administered identically to its current form. Please note there is a separate tab for each current plan's benefit design.

References

County of San Mateo Vision Request for Proposal
Customer References - 3 CURRENT REFERENCES REQUIRED WITH SUBMISSION
CURRENT CUSTOMERS
Customer 1 (Required)Bidder
Organization Name
Contact Name
Contact Phone Number
Contact Email Address
Number of years as a Customer
Customer 2 (Required)
Organization Name
Contact Name
Contact Phone Number
Contact Email Address
Number of years as a Customer
Customer 3 (Required)
Organization Name
Contact Name
Contact Phone Number
Contact Email Address
Number of years as a Customer
FORMER CUSTOMER
Customer 1 (Required)
Organization Name
Contact Name
Contact Phone Number
Contact Email Address
Number of years as a Customer
Reason for Terming
Customer 2 (Required)
Organization Name
Contact Name
Contact Phone Number
Contact Email Address
Number of years as a Customer
Reason for Terming

INSTRUCTIONS:

Offeror shall provide a minimum of five (5) Public Entity references that are currently using or have previously used services of the type proposed in this RFP. The references should include at least two (2) prior customers who no longer obtain services with your organization, and at least three (3) current customers.

The County of San Mateo reserves the right to use any information or additional references deemed necessary to establish the ability of the offeror to perform the contract. Negative references may be grounds for proposal disqualification.

Performance Guarantees

County of San Mateo Vision Request for Proposal
Performance Guarantees
1. Are you able to match the performance measures below:
Performance Guarantee MeasurePG
ValueBidder Response
Claims Processing
Claims financial accuracy (+/- .5% margin of error)99%
Claims processing accuracy99%
All preferred provider claims processed within five business days95%
All member claims processed within five business days95%
All claims processed within 15 business days99%
Call Center Management
Abandoned call rate

Average speed of answer Average call blockage rate <=3% <=25 secs <=2%

Call resolution (same day response)98%
Complaint acknowledgement within five business days96%
Complaint resolution within 30 calendar days99%
Average response to e-mail inquiries within two business days100%
Satisfaction
Overall satisfaction with VSP96%
Overall experience with VSP preferred provider96%
VSP preferred provider retention rate (based on voluntary turnover)98%
Account Administration
Electronic eligibility online within 24 hours (based on maintenance files)98%
Online reports on VSP's Resource Center by 25th of month100%
Web portal availability99%
Total funds at risk - 1% of administrative fee up to a maximum of $100,000

Census

County of San Mateo Vision Request for Proposal
Census

Date: February 2026

Employee Status
(Active, Retiree, Cobra)Employee ID #GenderDate of BirthDate of HireZip CodeStateVision Plan ElectedVision Coverage Tier
Active000000209Male6/1/724/3/0694107CaliforniaVision - Vision Service Plan SMCEmployee
Active000000260Female8/20/5312/1/0394010CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000000290Female8/13/695/30/0194303CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000000324Female3/1/757/2/0194112CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000000359Female10/23/655/8/9594061CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000000458Female2/25/6411/17/0394539CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000000470Male8/12/609/24/0194609CaliforniaVision - Vision Service Plan SMCEmployee
Active000000518Male8/10/649/5/0094121CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000000604Female1/7/554/2/9894403CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000000622Female1/28/672/22/9994544CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000000623Female8/7/8310/27/0394002CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000000659Female10/6/671/8/0194030CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000000660Female9/16/768/10/0094062CaliforniaVision - Vision Service Plan SMCEmployee
Active000000721Female9/30/589/4/9094303CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000000993Male11/8/594/4/0194040CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000001042Female11/3/684/11/0794544CaliforniaVision - Vision Service Plan SMCEmployee + Domestic Partner
Active000001064Female5/24/7311/6/0094002CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000001177Female9/5/664/8/2194544CaliforniaVision - Vision Service Plan Buy-Up (IHSSPA)Employee, Domestic Partner + Family
Active000001281Female11/19/746/17/0294044CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000001292Female2/28/708/22/0394114CaliforniaVision - Vision Service Plan SMCEmployee
Active000001357Male6/25/624/29/1294110CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000001580Female11/9/687/13/9294403CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000001700Female9/8/623/13/1494014CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000001780Female7/26/726/11/0095051CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000001826Male3/28/741/30/0295128CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000001886Male7/15/712/5/0194019CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000001917Female11/3/7412/19/0494044CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002059Female2/14/588/1/8394070CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000002096Female12/28/748/27/0194015CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002103Female7/6/563/10/9794061-2812CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002111Female3/17/721/25/0994942-1627CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002153Male7/5/494/2/8494062CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000002195Male10/19/6811/5/9694541CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000002218Female5/13/6612/3/0394107CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000002246Male2/1/714/7/0394070CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002281Male11/7/686/17/0294062CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000002308Male2/6/678/3/9895008CaliforniaVision - Vision Service Plan SMCEmployee
Active000002367Female7/9/672/3/9294062CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000002382Male7/7/7311/24/0394070CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000002416Female2/11/719/21/9894536CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000002427Male5/19/734/15/0294080CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000002826Male6/1/678/1/0194044CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000003117Male7/16/739/6/0494018CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000003129Female6/21/625/15/0294403CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000003186Female9/2/5212/2/0794019CaliforniaVision - Vision Service Plan SMCEmployee
Active000003272Male8/18/668/26/0294541CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000003410Female7/6/6012/15/9794010CaliforniaVision - Vision Service Plan SMCEmployee
Active000003446Female4/29/645/27/0394080CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000003547Female2/6/6212/4/0094044CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000003700Female7/1/626/1/0294303CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000003759Female6/8/758/26/0794401CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000004019Male3/27/617/24/0094062CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000004125Male5/24/6610/15/9694018-1502CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000004161Female1/17/751/22/1394020CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000004308Female6/13/6111/26/0194403CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000004393Female3/7/719/17/0195117CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000004540Female2/11/669/23/9695050CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000004635Male2/16/634/20/9894010CaliforniaVision - Vision Service Plan CourtsEmployee
Active000004700Female8/16/832/12/0694403CaliforniaVision - Vision Service Plan SMCEmployee
Active000004749Female10/7/8312/11/0394002CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000004832Female2/13/677/12/9994609CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000004870Female6/11/7511/17/0394579CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000004932Female1/7/609/21/9895472CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000004971Male5/16/669/1/9994061CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000005338Male3/16/724/16/0194402-2329CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005365Female3/29/624/9/9094401CaliforniaVision - Vision Service Plan SMCEmployee, Domestic Partner + Family
Active000005386Male1/2/729/7/0494403CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000005399Female4/10/7311/1/9394541CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005419Female10/10/7510/10/9694061CaliforniaVision - Vision Service Plan CourtsEmployee + Family
Active000005440Female12/28/645/15/0094303CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005455Female9/21/638/9/9894080CaliforniaVision - Vision Service Plan CourtsEmployee + 1
Active000005472Female7/25/636/11/0094005CaliforniaVision - Vision Service Plan SMCEmployee
Active000005473Female6/18/752/26/0194544CaliforniaVision - Vision Service Plan SMCEmployee + Domestic Partner
Active000005500Male12/15/7210/16/9194074CaliforniaVision - Vision Service Plan SMCEmployee + Domestic Partner
Active000005507Female3/15/667/8/9694560CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000005565Male6/3/719/16/0294015CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005597Male12/6/645/14/0194127CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000005636Female5/6/7712/10/0094070CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000005829Female1/14/733/5/0194080CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000005842Male10/4/6511/12/8595212CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005873Female10/18/694/2/0194063CaliforniaVision - Vision Service Plan CourtsEmployee + Family
Active000005903Male10/29/761/30/0294404CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000005933Female9/30/6211/28/9494401CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000005946Male8/9/683/20/0194116CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000005950Male4/19/591/7/0394131CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000005983Female7/19/8110/29/0394015CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000005994Female11/18/6711/2/9794132CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000006008Female1/25/681/18/0094044CaliforniaVision - Vision Service Plan SMCEmployee
Active000006026Female9/28/645/15/8994587CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006029Male6/3/511/7/0194010CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006052Female6/26/799/26/0494560CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006054Female6/27/7112/11/0195118CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006055Female5/27/7612/26/0094588CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006103Female5/17/731/6/0594019CaliforniaVision - Vision Service Plan SMCEmployee
Active000006161Female2/16/6711/25/9194401CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee, Domestic Partner + Family
Active000006184Female7/20/717/22/9694044CaliforniaVision - Vision Service Plan SMCEmployee
Active000006191Female5/13/692/8/9394066CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006193Female12/10/656/14/9894610CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006204Female12/29/711/7/0394010CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006220Female5/9/6212/18/8994402CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006239Female9/21/6712/1/9694080CaliforniaVision - Vision Service Plan CourtsEmployee + 1
Active000006285Female12/18/7111/2/9895376CaliforniaVision - Vision Service Plan SMCEmployee
Active000006319Male12/13/759/16/0295304CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006432Male2/8/643/22/9995051CaliforniaVision - Vision Service Plan SMCEmployee
Active000006437Female3/4/698/7/0094112CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006456Female1/9/734/7/1994401CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006489Female5/25/558/13/8594080CaliforniaVision - Vision Service Plan Buy-Up (Courts)Employee
Active000006522Female12/2/794/26/9994403CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006535Female6/20/687/24/0094070CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006541Female10/27/696/10/0494403CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006589Female10/4/733/12/0194030CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006593Female1/12/7312/18/0094015CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006612Female10/22/696/18/9094303CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006659Female9/24/702/5/9694063CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee, Domestic Partner + Family
Active000006685Female4/21/641/3/9394560CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006721Male3/11/669/10/0194080CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006747Female12/29/737/22/0195336CaliforniaVision - Vision Service Plan SMCEmployee
Active000006752Female7/2/6811/9/9894002CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006756Female8/27/552/7/8394539CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006761Male11/13/704/4/0294134CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006773Female11/17/774/7/0395330CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006777Male3/11/772/28/0594025CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000006786Male7/22/624/19/9894061CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000006788Male1/15/682/25/0294030CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000006856Female11/17/6610/10/0094063CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006880Male10/18/713/22/9994063CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000006890Female4/17/482/6/1194112CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006954Female1/17/689/30/0394080CaliforniaVision - Vision Service Plan SMCEmployee
Active000006993Female11/29/738/17/0394541CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000006998Female10/1/623/13/9594015CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000007055Male5/5/727/10/0094070CaliforniaVision - Vision Service Plan SMCEmployee
Active000007058Female2/18/6712/22/0394544CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000007064Female2/25/577/3/9494080CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000007068Male10/1/655/3/0494404CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000007178Female11/13/758/19/0294070CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000007208Female1/1/773/3/0392563CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Family
Active000007223Female10/31/728/2/9994403CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007226Female4/28/711/22/1294403CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000007339Female8/24/7711/22/9994026CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007349Female4/16/708/3/9894018CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000007475Female11/7/583/30/0394063CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000007513Male1/25/689/26/0494568CaliforniaVision - Vision Service Plan SMCEmployee + Domestic Partner
Active000007533Female5/27/608/2/0494037CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee
Active000007581Female12/8/624/26/9694080CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000007603Female5/29/6510/14/9795357CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007677Female8/12/676/30/9694112CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007738Female11/25/7010/6/9794002CaliforniaVision - Vision Service Plan SMCEmployee
Active000007744Female2/17/798/6/0194404CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + Domestic Partner
Active000007767Male7/16/783/29/0494560CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007809Male9/4/703/8/9994010CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000007815Male8/22/7312/24/0794019CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000007896Female6/12/5612/26/9994303CaliforniaVision - Vision Service Plan SMCEmployee
Active000007922Female8/8/765/29/0194112CaliforniaVision - Vision Service Plan SMCEmployee + Family
Active000008063Male12/19/701/21/9294114CaliforniaVision - Vision Service Plan SMCEmployee + 1
Active000008065Female1/12/684/7/9794303CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000008072Male2/15/665/19/9095060CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000008074Female12/25/652/20/0094080CaliforniaVision - Vision Service Plan Buy-Up (Courts)Employee + 1
Active000008120Female2/26/705/21/0194580CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000008125Male5/26/665/19/9794019CaliforniaVision - Vision Service Plan Buy-Up (SMC)Employee + 1
Active000008126Male9/5/779/18/0094402CaliforniaVision - Vision Service Plan SMCEmployee
Active000008142Female3/29/6711/2/9794002CaliforniaVision - Vision Service Plan SMCEmployee
Active000008143Male12/5/786/9/0394122CaliforniaVision - Vision Service Plan Buy-Up (Courts)Employee + Domestic Partner

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