Dental_Claims_Administration_RFP_(Word_Version).docx

COUNTY OF ORANGE

HUMAN RESOURCE SERVICES

EMPLOYEE BENEFITS

REQUEST FOR PROPOSAL

FOR

CLAIMS ADMINISTRATION FOR THE SELF-INSURED

COUNTY OF ORANGE DENTAL PLAN

RFP NO. 017-202401-MC

REQUEST FOR PROPOSAL

Instructions:

For further information, contact Melvin Chua via e-mail through OPENGOV at https://procurement.opengov.com

[RFP #017-202401-MC].

PROPOSALS MUST BE RECEIVED ON OR BEFORE

March 7, 2024 By

4:00 P.M. PST

RFP Number

017-202401-MC

File Folder No: 017-2569101

County of Orange County Procurement Office 400 W Civic Center Dr 5th Floor Santa Ana, CA 92701

DATE: February 8, 2024

REQUEST FOR PROPOSAL (RFP) COVER PAGE

The County of Orange Human Resource Services, Employee Benefits Division, hereinafter referred to as “County”, is soliciting proposals (“Proposals”) from interested and qualified firms, hereinafter referred to as “Offeror” or “Offerors,” to provide Claims Administration for the Self-Insured County of Orange Dental Plan. Offerors are invited to propose for the Claims Administration for the Self-Insured County of Orange Dental Plan for eligible participants in accordance with the terms and conditions set forth in Section III – Model Contract of this Request for Proposal (RFP), including all Attachments and Exhibits. The awarded contract, if any (hereinafter “Contract”), will be based on the fee terms specified in the Contract between the County and awarded Offeror. Awarded Offeror will be referred to in the Model Contract as “Contractor.”

This RFP is set out in the following format:

PROPOSALS ARE DUE MARCH 7, 2024; BY 4:00 PM PACIFIC TIME.

Proposals must be submitted electronically. See complete instructions in Section I.

All questions and inquiries related to this RFP must be directed to: Melvin Chua hereinafter also referred to as “Deputy Purchasing Agent” or “DPA”, via e-mail through OPENGOV at https://procurement.opengov.com [RFP #017-202401-MC]. For OPENGOV assistance, please contact the OPENGOV Support Team via chat at https://procurement.opengov.com or via email at procurement-support@opengov.com. Offerors are not to contact other County personnel with any questions or clarifications concerning this RFP.

The County Procurement Office DPA will provide all official communication concerning this RFP. With respect to this RFP, any County response other than from the DPA and in writing will be unauthorized and the County shall bear no responsibility for any and all reliance upon the unauthorized communication.

I HAVE READ, UNDERSTOOD, AND AGREE TO ALL STATEMENTS IN THIS REQUEST FOR PROPOSAL (RFP) AND TO THE TERMS, CONDITIONS, ATTACHMENTS AND EXHIBITS REFERENCED HEREIN.

Company Name (as it appears on your invoice and W9) Fed ID#

Address

*Authorized Signature Title Date

*Authorized Signature Title Date

* If a corporation, this document must be signed by two corporate officers. The first signature must be either the Chairman of the Board, President, or any Vice President. The second signature must be the Secretary, an Assistant Secretary, the Chief Financial Officer, or any Assistant Treasurer.

**INCLUDE THIS SHEET DIGITALLY SIGNED WITH YOUR RESPONSE**

TABLE OF CONTENTS

Page No.

COVER PAGE 2

TABLE OF CONTENTS 3

SECTION I: INTRODUCTION AND INSTRUCTIONS TO OFFEROR

1. County of Orange Local Small Business (OCLSB) and Disabled Veteran Business

SECTION II: PROPOSAL RESPONSE REQUIREMENTS

Proposal Requirements 18 Part 1

Part 2 Offeror’s Proposal Questionnaire 24

Part 3

SECTION III: MODEL CONTRACT

ATTACHMENTS

EXHIBITS

Exhibit 1 – EDD Independent Contractor Reporting Requirements 91 Exhibit 2 – County of Orange Local Small Business and/or Disabled Veteran Business

APPENDICES

SECTION I

INTRODUCTION

AND

INSTRUCTIONS TO OFFERORS

SECTION I: INTRODUCTION AND INSTRUCTIONS TO OFFERORS

A. INTRODUCTION

This Request for Proposal (RFP) is being released for Claims Administration for the Self-Insured County of Orange Dental Plan. This RFP is an opportunity to allow qualified vendors to present proposals that will assist the County of Orange, CEO/Employee Benefits in selecting a contractor that will best meet the needs of the County for a three (3) year contract with two (2) optional one (1) year renewal terms. Services will be according to the Scope of Service stated in Section III, Attachment A.

Background Information

County of Orange Dental Plan:

The County currently provides one self-insured preferred provider organization (PPO) dental plan for eligible employees and their dependents with claims administration provided by Blue Shield of California (Blue Shield) through their subcontractor Dental Benefit Providers. Full-time eligible employees do not pay a premium for their dental plan. Employees on an unpaid leave pay 100% of the premium. The 2023 monthly premiums are $49.94 for employee only, $104.13 for employee plus one, and $159.38 for employee plus two or more.

For calendar year 2023, Blue Shield processed dental claims for approximately 5,800 members of the County of Orange Dental Plan. Expenditures for calendar year 2022 are $2.1 million, and for 2023 are $2.2 million.

Remaining County employees that are not eligible for County dental, do not receive County paid dental benefits, but instead receive dental benefits from their applicable labor organizations.

The County of Orange Dental Plan Document (Plan Document) is included as Appendix 1. The Plan Document, effective January 1, 2024, was recently modernized to bring the plan in line with industry standards. The modernized plan increased the annual maximum to $2,000 and added implant and orthodontia coverage with a separate annual maximum.

County Benefits Administrator:

County employees (participants) receive benefits information, make all benefit elections, and direct all benefits customer service inquiries to the County of Orange Benefits Administrator (Benefits Administrator). These services are provided through Alight Solutions LLC. Participants can make their elections on the County of Orange MyOCBenefitsTM website or by calling the toll-free Benefits Resource Line and speaking with a Benefits Specialist. The Benefits Administrator is the owner of eligibility on behalf of the County and therefore: 1) maintains and distributes all eligibility and coverage information to vendors for all the County’s benefits programs; 2) provides full customer service for benefits enrollment and eligibility; 3) submits all data necessary to collect and calculate premiums through payroll; 4) provides monthly billing for employees on leave of absence; and 5) administers COBRA when coverage terminates.

Alight manages all calls regarding eligibility and enrollment as follows:

· Responds to questions from participants and County staff.

· Assists employees with web enrollment/access needs.

· Serves in a participant advocate role to facilitate inquiries related to eligibility issues with carriers.

· Eligibility Inquiry: Verifies eligibility, updates vendors when applicable and provides verification of coverage to providers.

· Claim Payment Inquiry: Verifies correct claims address, verifies coverage date, provides employee with carrier/administrator contact information and/or transfers employee to carrier if appropriate.

· Assists participants by taking benefit elections/transactions (Open Enrollment, life events, etc).

· Advises the County of any employee benefit issues and/or problems and provides solution where applicable.

· Conducts customer service performance surveys and provides results to the County quarterly.

· Handles exceptions that require manual processing, as defined in implementation and/or on an ongoing basis.

Alight provides electronic eligibility files to the County’s vendor and administrator. Alight receives confirmation of all file transmissions and will work with the County’s vendor in resolving error reports. It is the responsibility of the vendor to correct their eligibility records to match Alight’s. All enrollment requests must be directed to Alight.

The County desires that its selected vendor be capable of working with Alight via linked access through a unified web portal.

Key Laws and Regulations:

As a governmental entity, the County’s self-funded County of Orange Dental Plan is not subject to ERISA (Employment Retirement Income Security Act). Under HIPAA privacy requirements, the selected Contractor will be required by the County to follow all privacy guidelines required under the law and comply with all contractual provisions in the Proposed Contract related to HIPAA.

Contract Intent:

The intent of this Contract is to provide complete Claims Administration services, including customer service for the County’s self-funded County of Orange Dental Plan, and a California and National Dental PPO network with access to providers and negotiated discounts for eligible employees.

The County’s goal is to find a single Contractor who has demonstrated a history of successfully providing dental Claims Administration services for public employers of a size and complexity as the County of Orange. The desired Contractor will provide our County participants with high quality customer service, industry standard technologies and systems, and best practice methods to ensure accurate administration of claims in accordance with the Plan Document, as well as efficient, effective, and timely claims processing and reporting. The desired Contractor will provide access to a large network of quality PPO providers with discounts negotiated to provide optimum savings to the County of Orange and its plan participants.

B. PROPOSED TIME SCHEDULE

* Please note the County reserves the right to modify the proposed RFP time schedule in its sole and absolute discretion if the County determines a modification is necessary.

C. INSTRUCTIONS TO OFFERORS AND PROCEDURES FOR SUBMITTAL

By submitting a Proposal, the Offeror represents that it has thoroughly examined and agrees to provide the services required under this RFP as detailed in Section III, Attachment A, and that it is capable of providing the services to achieve the County’s objectives. Offeror must abide by all provisions of the Model Contract unless Offeror notes its objections in its Proposal. As noted below, if the Offeror cannot abide by any provisions of the Model Contract, Offeror must make notice of which provisions it cannot comply with in its Proposal.

Each Offeror must submit its Proposal in strict accordance with all requirements of this RFP and compliance must be stated in the Proposal. Deviations, clarifications and/or exceptions must be clearly identified and listed separately as alternative items for the County’s consideration.

1. Proposal Close Date and Time: Proposals are due on or before March 7, 2024, no later than 4:00 P.M. (Pacific Time) and must be submitted electronically via OPENGOV, https://procurement.opengov.com [RFP #017-202401-MC]. For assistance on uploading proposals to OPENGOV, please contact the OPENGOV Support Team via email at procurement-support@opengov.com. The County will not accept proposal(s) after the due date and time specified above in section B.

RE: RFP No. 017-202401-MC for Claims Administration for the Self-Insured County of Dental Plan

Paper, Facsimile and Email proposals will NOT be accepted.

HUMAN RESOURCE SERVICES, EMPLOYEE BENEFITS REGULAR BUSINESS HOURS:

Monday through Friday 8:00 A.M. to 5:00 P.M. (PT)

COUNTY OFFICES WILL BE CLOSED FOR THE FOLLOWING HOLIDAYS:

2. Clarifications: The County has attempted to provide all information available. It is the responsibility of each Offeror to review, evaluate, and, where necessary, request any clarification prior to submission of a Proposal. If any person contemplating submitting a Proposal for the proposed contract is in doubt as to the true meaning of any part of this RFP or finds discrepancies in or omissions from the specifications, he/she may submit a written request for clarification to the assigned Deputy Purchasing Agent, via https://procurement.opengov.com [RFP #017-202401-MC]. For OPENGOV assistance, please contact the OPENGOV Support Team via chat at https://procurement.opengov.com or via email at procurement-support@opengov.com.

3. Addenda: Any interpretation of, or correction to, this RFP will be made only by addendum issued by the Deputy Purchasing Agent or through OPENGOV. It is the Offeror’s responsibility to access the website, https://procurement.opengov.com,throughout the entire process to obtain the most up-to-date information regarding this procurement process. The County will not be responsible for any other explanations, corrections to, or interpretations of the documents, including any oral information.

There will be No Pre-Proposal Conference for this RFP. Questions regarding the contents of this Proposal must be submitted electronically (via https://procurement.opengov.com [RFP #017-202401-MC] on or before February 15, 2024 at 4:00 pm. (Pacific Time), and directed to the Deputy Purchasing Agent.

4. Validity of Proposals: Proposals must be valid for a period of at least three hundred and sixty-five (365) days from the Closing Date. No Proposal may be withdrawn after the Closing Date.

5. Submission Format: Each Respondent must provide: (1) complete electronic copy of their proposal. Proposals shall be formatted in the requested format type (PDF, Excel or Word). All pages must be identified sequentially as listed below. Please try to limit file names to 80 characters or less.

Note: Special signature requirements for Corporations

Part 1 –Offeror’s Concurrence/Compliance (PDF format)

Part 2 – Proposal Description (PDF format) Offeror’s Proposal Questionnaire – Exhibit 4 (MS Excel format)

Part 3 – Redlined Model Contract, including Attachments A through L, with any additions or deletions shown using “tracked changes”. (Word Format)

Part 4 – Additional Items:

· Section III, Exhibit 1 – EDD Independent Contractor Reporting Requirements (PDF format), if not applicable please omit;

· Section III, Exhibit 2 – County of Orange Local Small Business Preference Certification Requirement (PDF format), if not applicable please omit;

· Section III, Exhibit 3 - County of Orange Campaign Contribution Disclosure Form, required for all Offerors (PDF format).

Part 5 –Attachments requested in Proposal Questionnaire

· List of Subcontractors

· Annual Reports

· SOC Reports

· Staffing Information- Team Biographies and Organizational Chart

· Communications Plan

· Implementation Plan

· Network Discount Methodology

· Explanation of Benefits Examples

It is imperative that all Respondents responding to this RFP comply exactly and completely with the instructions set forth herein. All responses to this RFP shall be word-processed (except where otherwise provided or noted), concise, straightforward, and must fully address each requirement and question. Although not as a substitute for a complete written response, additional material, such as technical documents, may be referenced in any response, if the material is included in the same section as additional information.

Note: Allow sufficient time to upload all required files. OPENGOV will not allow any uploads after the due date and time specified herein, e.g., if Part 1 and 2 uploaded successfully at 3:58:38 P.M. and Part 3 is in progress of being uploaded at 4:00:01 P.M., Part 3 will not upload successfully.

6. Confidential, Proprietary or Trade Secret Information: Proposals are not to be marked as confidential or proprietary and must not constitute or contain confidential, proprietary, or trade secret information. The County may refuse to consider any Proposal so marked.

All Proposals shall become the property of the County. The County reserves the right to make use of any information or ideas in the Proposals submitted. Proposals submitted in response to this RFP may become subject to public disclosure per the requirements of the California Public Records Act, Government Code Section 6250 et seq. Please be advised that all information and documents submitted to the County by Offeror shall become non-confidential, non-proprietary, non-trade secret, public records without exception and subject to public disclosure by the County at any time without prior notice to Offeror. The County shall not be liable in any way for disclosure of any such records or part thereof related to this RFP or any Proposal, including, but not limited to, evaluations, proposals, or any other information or records. In submitting the information and documents, the Offeror is agreeing to the County’s release of such information and documents in response to a Public Records request without further notice to the Offeror and is agreeing to indemnify and hold harmless the County for release of such information and documents.

Furthermore, all Proposals shall become the exclusive property of the County. The County reserves the right to make use of any information or ideas contained in the Proposals submitted without exception.

By submitting information and documents to the County as part of this RFP, Offerors acknowledge and agree to the terms of this Section 6.

7. Qualifications: By submitting a Proposal, the Offeror represents that it has thoroughly examined and become familiar with the services required under this RFP and that it is capable of providing the services to achieve the County’s objectives.

8. Compliance: Each Offeror must submit its Proposal in strict accordance with all requirements of this RFP and such compliance must be stated in the Proposal. Deviations, clarifications and/or exceptions must be clearly identified and listed separately as alternative items for the County’s consideration, as specified in Section II, Part 1, Subsection 10, Statement of Compliance. The County, in its sole and absolute discretion, may reject a Proposal if it is conditional, incomplete or deviates from the specifications in this RFP.

9. Presentations/Demonstrations: After the Closing Date, evaluation and Proposal clarification will commence. Offerors who submit Proposals most responsive to the County’s requirements in this RFP, and therefore receive the highest score in the evaluation process, may be invited to give a presentation/demonstration of their Proposal to County staff. This presentation/demonstration will be provided to the County at no cost to the County.

Invited Offeror(s) should be prepared to make their oral presentation/demonstrations virtually within seven (7) calendar days after notification and be prepared to discuss all aspects of the Proposal in detail, including technical questions regarding the Proposal. Invited Offeror(s) shall not be allowed to alter or amend the Proposal through the use of the virtual presentation/demonstration process. Invited Offeror(s) who cannot attend the virtual presentation/demonstration scheduled as requested may be subject to elimination from the selection process at the County’s sole and absolute discretion.

10. County Rights: The County reserves the right to negotiate modifications with any Offeror as necessary to serve the best interests of the County. Any Proposal may be rejected as non-responsive if it is conditional, incomplete or deviates from specifications in this RFP. The County reserves the right to waive, at its discretion, any procedural irregularity, immaterial defects or other improprieties which the County deems reasonably correctable or otherwise not warranting rejection of the Proposal. No such waiver will excuse a proponent from full compliance.

11. Expenses: Pre-contractual expenses are not to be included in, or as part of Attachment B –Compensation/Payment for Contractor Services, under the Model Contract. Pre-contractual expenses are defined as including, but not limited to, expenses incurred by the Offeror such as costs incurred in; a.) preparing its Proposal in response to this RFP; b) submitting that Proposal to the County; c) negotiating with the County any matter related to the Offeror’s Proposal; and d) any other expenses incurred by the Offeror prior to the date of award and execution, if any, of the Contract.

12. Notice: The County reserves the right to: a) negotiate the final Contract with any Offeror(s) as necessary to serve the best interests of the County; b) withdraw this RFP, in whole or in part, at any time without prior notice; c) award its total requirements to one Offeror or to apportion those requirements among two or more Offerors as the County may deem to be in its best interests; and d) reject any Proposal if it is conditional, incomplete or deviates from the specification in this RFP.

The County makes no representations that any Contract will be awarded to any Offeror responding to this RFP. Moreover, the County may decide to forego negotiations with the Offeror and accept the Proposal submitted; therefore, the Proposal submitted should contain the Offeror’s most favorable terms and conditions.

13. Joint Venture: Where two or more Offerors desire to submit a single Proposal in response to this RFP, they should do so on a prime/subcontractor basis rather than as a joint venture. The County intends to contract with a single firm or multiple firms but not with multiple firms doing business as a joint venture.

14. Lobbyist: The County does not require and neither encourages nor discourages the use of lobbyists or other consultants for the purpose of securing business.

15. D-U-N-S Number: The County requires a valid Data Universal Number System (D-U-N-S) number prior to Contract Award. If needed, your company may obtain one at no cost at www.dnb.com. If you are unable to provide/obtain a D-U-N-S number, please indicate so in your proposal/bid submission response.

D. EVALUATION PROCESS AND CRITERIA

Proposals will be evaluated on the basis of the response to all requirements in this RFP. The County shall use the following criteria in its evaluations and comparisons of Offeror(s). No inference is to be drawn concerning relative importance of criteria based on the order presented.

Contract award shall be made to the responsible Offeror(s) whose proposal is most advantageous to the County, taking into consideration the applicable evaluation criteria set forth below. Please note, however, that the listing of fees as an evaluation criterion does not require the County to select the Offeror(s) with the lowest fee proposal.

Proposals will be evaluated on the basis of responsiveness to the questions and requirements in this RFP by an evaluation panel.

Proposals will be competitively evaluated on the basis of the following criteria listed in random sequence not in the order of importance:

· Proposed cost to County (claims cost with network discount, administrative fees, guaranteed network discounts, and other fees/credits);

· Ability to duplicate current/ proposed plan design, including ability to auto-adjudicate plan provisions;

· Network disruption for the County of Orange Dental Plan;

· Administrative capabilities (implementation plan, customer service, claim system capabilities, funding arrangements, cybersecurity);

· Ability to duplicate or enhance proposed performance guarantees;

· Qualifications and experience with similarly sized public entities; and,

· Responsiveness to the RFP, including edits to Model Contract and Scope of Service.

Proposals deemed to meet all minimum RFP requirements will be scored based on established criteria, which have been weighted and will be assigned points that measure the responsiveness to each identified criterion. The total number of points earned will be tallied for each Proposal, and the Proposals will be rank-ordered, based upon the Offeror(s) submitted written materials.

Following the initial evaluation process, the highest-ranking Offeror(s) (if deemed necessary by the evaluation panel) may be required to complete an additional questionnaire regarding more specific processes and capabilities, as well as provide additional pricing information. In addition, Offeror’s may be required to provide an on-site interview or clarification as it relates to the requested and/or proposed services.

The cybersecurity questions on Tabs O and Q of Exhibit 4 for the highest-ranking Offerors must be reviewed and approved by Orange County Information Technology Enterprise Privacy and Cybersecurity Officer(s). Offerors may be required to provide additional information as requested. Award of final contract is subject to review and approval of Offerors cybersecurity policies and practices.

E. SELECTION/AWARD PROCESS

Upon completion of the evaluation process, the Evaluation Panel will make a recommendation for award to the DPA. The recommendation for award may be presented to the County’s Board of Supervisors for approval of the Contract for the services requested in this solicitation.

The Model Contract contained in Section III of this RFP is the Contract proposed for execution. It may be modified to incorporate negotiated items and other pertinent terms and conditions set forth in this RFP, including special conditions and requirements and those added by addendum, necessary attachments, and to reflect the Offeror’s Proposal and qualifications.

Negotiations may or may not be conducted with the finalist(s); therefore, the proposal submitted should contain Offeror’s most favorable terms and conditions, since the selection and award may be made without further discussion or need for clarification. Any exceptions to the terms and conditions of the proposed Contract or the statements regarding Offeror’s inability to comply with any of the provisions thereof are to be declared in the Offeror’s proposal: Section II entitled Proposal Response Requirements. Any additional exceptions to the terms and conditions made by any Offeror after submission of its proposal may result in elimination from further consideration.

If a satisfactory Contract cannot be negotiated in a timely manner, the County, in its sole discretion, may terminate negotiations with the selected Contractor and begin Contract negotiations with the next finalist.

F. PROTEST PROCEDURES

Any actual or prospective Offeror, who alleges a grievance in the solicitation or award of the Contract may submit a protest to the Deputy Purchasing Agent. All protests shall be type written on the protester’s letterhead and submitted in accordance with the provisions stated herein.

1. Procedure All protests shall be typed under the protester’s letterhead and submitted in accordance with the provisions stated herein. All protests shall include at a minimum the following information:

· The name, address and telephone number of the protestor;

· The signature of the protestor or protestor’s authorized representative;

· The solicitation number;

· A detailed statement of the legal and/or factual grounds of the protest;

· The form of relief requested.

2. Protest of Bid/Proposal Specifications All protests related to bid or proposal specifications must be submitted to the Deputy Purchasing Agent no later than five (5) business days prior to the close of the proposal. Protests received after the five (5) business day deadline will not be considered by the County.

In the event the protest of specifications is denied and the protester wishes to continue in the solicitation process, they must still submit a bid prior to the close of the solicitation in accordance with the bid/proposal submittal procedures provided in the bid/proposal.

3. Protest of Award of Contract:

In protests related to the award of a Contract, the protest must be submitted no later than five (5) business days after the notice of the proposed contract award is provided by the Deputy Purchasing Agent. Protest relating to a proposed contract award which is received after the five (5) business day deadline will not be considered by the County.

4. Protest Process In the event of a timely protest, the County shall not proceed with the solicitation or award of the contract until the Deputy Purchasing Agent, the County Purchasing Agent or the Procurement Appeals Board renders a decision on the protest.

Upon receipt of a timely protest, the Deputy Purchasing Agent will within ten (10) business days of the receipt of the protest, issue a decision in writing which shall state the reasons for the actions taken.

The County may, after providing written justification to be included in the procurement file, make the determination that an immediate award of the Contract is necessary to protect the substantial interests of the County. The award of a Contract shall in no way compromise the protester’s right to the protest procedures outlined herein.

If the protester disagrees with the decision of the Deputy Purchasing Agent, the protestor may submit a written notice to the Office of the County Purchasing Agent requesting an appeal to the Procurement Appeals Board, in accordance with the process stated below.

5. Appeal Process If the protester wishes to appeal the decision of the Deputy Purchasing Agent, the protester must submit, within three (3) business days from receipt of the Deputy Purchasing Agent’s decision, a written appeal to the Office of the County Purchasing Agent.

Within fifteen (15) business days, the County Purchasing Agent will review all materials in connection with the grievance, assess the merits of the protest and provide a written determination that shall contain his or her decision on whether the protest shall be forwarded to the Procurement Appeals Board.

The decision of the County Purchasing Agent on whether to allow the appeal to go forward will be final and there shall be no right to any administrative appeals of this decision.

G. EDD INDEPENDENT CONTRACTOR REPORTING REQUIREMENTS

Effective January 1, 2001, the County is required to file federal Form 1099-Misc for services received from a “service provider” to whom the County pays $600 or more or with whom the County enters into a contract for $600 or more within a single calendar year. The purpose of this reporting requirement is to increase child support collection by helping to locate parents who are delinquent in their child support obligations.

The term “service provider” is defined in California Unemployment Insurance Code Section 1088.8, subparagraph B.2 as “an individual who is not an employee of the service recipient for California purposes and who received compensation or executes a contract for services performed for that service recipient within or without the state.” The term is further defined by the California Employment Development Department to refer specifically to independent contractors. An independent contractor is defined as “an individual who is not an employee of the government entity for California purposes and who receives compensation or executes a contract for services performed for that government entity either in or outside of California.”

The reporting requirement does not apply to corporations, general partnerships, limited liability partnerships, and limited liability companies.

Additional information on this reporting requirement can be found at the California Employment Development Department website located at http://www.edd.ca.gov/Payroll_Taxes/FAQ_-_California_Independent_Contractor_Reporting.htm.

H. County of Orange Local Small Business (OCLSB) and Disabled Veteran Business Enterprise (DVBE) Preference

I. OCLSB: Effective January 1, 2020, County of Orange Board of Supervisors adopted the County of OCLSB Preference policy. Implementation of the OCLSB Preference policy supports local businesses, the local economy and the development of the County’s tax base.

To be certified as a Local Small Business by the County of Orange, a business shall meet (1) and (2) below:

1) Local Business requirements:

a. maintains their principal center of operations (i.e., headquarters) within Orange County, and;

b. has:

i. a business address located in the County of Orange that is not a post office box, or

ii. a valid business license or certificate of occupancy issued by the County of Orange or by an Orange County city, or other documentation acceptable to the County of Orange.

2) Small Business Requirements:

a. must be certified as a Small Business by the State of California Department of General Services (DGS); and,

b. DGS Small Business requirements must be valid at the time of bid/proposal submittal.

II. DVBE: Effective January 1, 2021, County of Orange Board of Supervisors adopted the DVBE Preference policy. The DVBE Preference policy supports local business opportunity, economy and the development of the County’s tax base, and in addition recognizes the service and sacrifice given by the men and women of our Armed Forces.

To be certified as a Disabled Veteran Business Enterprise by the County of Orange, a business shall meet (1) below:

(1) Disabled Veteran Business Enterprise Requirements:

a. must be certified as a DVBE by the State of California Department of General Services (DGS); and,

b. DGS DVBE requirements must be valid at the time of bid proposal submittal.

To participate as an OCLSB and/or DVBE, please read and follow the process outlined on EXHIBIT 2 – COUNTY OF ORANGE LOCAL SMALL BUSINESS (OCLSB) AND DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) PREFERENCE CERTIFICATION REQUIREMENTS.

I. County of Orange Campaign Contribution Disclosure (Levine Act)

Exhibit 3, the Campaign Contribution Disclosure Form, must be completed by applicants for, or persons who are the subject of, any proceeding involving a license, permit, or other entitlement for use, including most contracts and franchises, pending before the Board of Supervisors (“Board”) of the County of Orange or any of its affiliated agencies.

IMPORTANT NOTICE

Government Code section 84308 (also known as the “Levine Act”) contains requirements that are summarized generally as follows:

A. If you are an applicant for, or the subject of, any proceeding involving a license, permit, or other entitlement for use, you are prohibited from making a campaign contribution of more than $250 to any member of the Board of Supervisors or other County official who may participate in your proceeding. This prohibition begins on the date your application is filed or the proceeding is otherwise initiated, and the prohibition ends 12 months after a final decision is rendered by the Board of Supervisors or other County officer. In addition, no Board member or other County official who may participate in your proceeding alternate may solicit or accept a campaign contribution of more than $250 from you during this period.

B. These prohibitions also apply to your agents, and, if you are a closely held corporation, to your majority shareholder as well. These prohibitions also apply to your subcontractor(s), joint venturer(s), and partner(s) in this proceeding. Also included are parent companies and subsidiary companies directed and controlled by you, and political action committees directed and controlled by you.

C. You must file the attached disclosure form and disclose whether you or your agent(s) have in the aggregate contributed more than $250 to any Board member or other County officer who may participate in your proceeding during the 12-month period preceding the filing of the application or the initiation of the proceeding.

D. If you or your agent have in the aggregate contributed more than $250 to any individual Board member or other County officer who may participate in your proceeding during the 12 months preceding the decision on the application or proceeding, that Board member or other County officer must disqualify himself or herself from the decision. However, disqualification is not required if the Board member or other County official returns the campaign contribution within 30 days from the time the member or official knows, or should have known, about both the contribution and the fact that you are a party in the proceeding. The Campaign Contribution Disclosure Form should be completed and filed with your application or proposal, or with the first written document you file or submit after the proceeding commences.

1. A proceeding involving “a license, permit, or other entitlement for use” includes all business, professional, trade and land use licenses and permits, and all other entitlements for use, including all entitlements for land use, all contracts (other than competitively bid, labor or personal employment contracts), and all franchises.

2. Your “agent” is someone who represents you in connection with a proceeding involving a license, permit or other entitlement for use. If an individual acting as an agent is also acting in his or her capacity as an employee or member of a law, architectural, engineering, consulting firm, or similar business entity, both the business entity and the individual are “agents.”

3. To determine whether a campaign contribution of more than $250 has been made by you, campaign contributions made by you within the preceding 12 months must be aggregated with those made by your agent within the preceding 12 months or the period of the agency relationship, whichever is shorter. Contributions made by your majority shareholder (if a closely held corporation), your subcontractor(s), your joint venturer(s), and your partner(s) in this proceeding must also be included as part of the aggregation. Campaign contributions made to different Board of Supervisors members or other County officer who may participate in your proceeding are not aggregated.

A list of the Board of Supervisors members and other County officials are listed on Exhibit 3. This notice summarizes the major requirements of Government Code section 84308 of the Political Reform Act and California Code of Regulations, Title 2 sections 18438.1-18438.8.

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SECTION II

PROPOSAL RESPONSE REQUIREMENTS

SECTION II: PROPOSAL RESPONSE REQUIREMENTS

Proposals must be prepared simply and economically, providing a straightforward, concise description of capabilities to satisfy the requirements of this RFP. Emphasis should be on completeness and clarity of content with sufficient detail to allow for accurate evaluation and comparative analysis.

Proposals must include all sections as listed in Section I.C.5 of this RFP:

Part 1 – Offeror’s Concurrence/Compliance (PDF format)

Part 2 – Proposal Description (PDF format) Offeror’s Proposal Questionnaire – Exhibit 4 (MS Excel format) Part 3 – Redlined Model Contract, including Attachments A through L, with any additions or deletions shown using “tracked changes”. (Word Format) Part 4 – Additional Items:

· Section III, Exhibit 1 – EDD Independent Contractor Reporting Requirements (PDF format), if not applicable please omit;

· Section III, Exhibit 2 – County of Orange Local Small Business Preference Certification Requirement (PDF format), if not applicable please omit;

· Section III, Exhibit 3 - County of Orange Campaign Contribution Disclosure Form, required for all Offerors (PDF format).

Part 5 –Attachments requested in Proposal Questionnaire

· List of Subcontractors

· Annual Reports

· SOC Reports

· Staffing Information- Team Biographies and Organizational Chart

· Communications Plan

· Implementation Plan

· Network Discount Methodology

· Explanation of Benefits Examples

List questions and your responses and/or attachments as numbered and listed within each section.

Part 1:

Offeror’s Concurrence/Compliance (Complete this section and submit as Part 1 of the Proposal. Refer to Section I C.5)

1. Signed RFP Cover Page

All Proposals shall include, in this first section, the RFP cover page (pages 1 and 2 of the RFP) and any subsequent Addenda or Attachments or Exhibits issued in connection with this RFP with appropriate signatures*, as required.

An unsigned or improperly signed may be deemed as non-responsive and therefore grounds for rejection of the Proposal and disqualification of the Offeror from further participation in this RFP process.

*If the Offeror contracting party is a corporation, two (2) signatures are required: one (1) signature by the Chairman of the Board, the President or any Vice President; and one (1) signature by the Secretary, any Assistant Secretary, the Chief Financial Officer or any Assistant Treasurer. The signature of one person alone is sufficient to bind a corporation, as long as he or she holds corporate offices in each of the two categories described above. For County purposes, proof of such dual office holding will be satisfied by having the individual sign the instrument twice, each time indicating his or her office that qualifies under the above described provision.

In the alternative, a single corporate signature is acceptable when accompanied by a corporate resolution demonstrating the legal authority of the signature to bind the company.

2. Validity of Proposal

The County requires that all Proposals be valid for at least three hundred and sixty-five (365) days from this RFP’s Closing Date. Proposals which are not valid for at least three hundred and sixty-five (365) days will be considered non-responsive and subject to rejection. Please state below how long this Proposal will be valid for.

Offeror hereby certifies that Offeror’s Proposal is valid for three hundred and sixty-five (365) days from the RFP Closing Date.

3. Certification of Understanding

The County assumes no responsibility for any understanding of the Offeror or representation made by any of the County’s officers, employees or agents during or prior to the execution of any Contract or Service Agreement resulting from this RFP unless such understanding or representations are expressly stated in the Contract or Service Agreement.

By signing below, Offeror certifies that such understanding has been considered in this Proposal.

(Signature required) (Date)

County of Orange HRS/Employee Benefits

RFP #017-202401-MC

Claim Administration for Dental PPO File Folder No.: 017-2569101

County of Orange HRS/Employee Benefits

RFP #017-202401-MC

Claim Administration for Dental PPO File Folder No.: 017-2569101

4. Minimum Qualifications Statement

Offeror hereby certifies that it meets all minimum qualifications and requirements as set forth in this RFP under Exhibit 4 (Excel), Tab E-Minimum Qualifications.

(Signature required) (Date)

5. Certificate of Insurance

Offeror hereby certifies Offeror’s willingness and ability to provide the required insurance coverage and certificates as set forth in Section III, Model Contract, Paragraph 19, et seq.

(Signature required) (Date)

If Offeror is unwilling or unable to provide the required insurance coverage, such exception to the Model Contract must be specifically stated and Offeror must provide a complete statement regarding the insurance coverage as required by this RFP.

6. Financial Information

Selected Offeror may be requested to submit a complete financial statement for the two (2) most recent years. Financial Statements shall be prepared in conformity with generally accepted accounting principles. A complete financial statement must include, but is not limited to, a balance sheet and income statement. Offeror must be prepared to substantiate all information shown.

NOTE: Offeror hereby certifies Offeror’s willingness and ability to provide complete financial statements upon the County’s request.

(Signature required) (Date)

7. Bankruptcy Information

Offeror hereby certifies that, if Offeror’s company has or had a controlling interest in a company that has filed for bankruptcy or has ever been declared bankrupt, Offeror has attached a statement to the Proposal indicating the bankruptcy date, court jurisdiction, trustee’s name (if any) and telephone number, amount of liabilities, amount of assets and current status of the bankruptcy.

Attach detailed information regarding any prior and pending bankruptcy, litigation involving the Offeror.

No action pending

Information attached

(Signature required) (Date)

8. Pending Litigation

Offeror represents that: (a) there is no outstanding or anticipated civil or criminal litigation, arbitration, or other dispute (including action by any regulatory body), in any forum, to which Offeror or any of its predecessors, successors, direct and indirect parent companies, direct and indirect subsidiary companies, companies under common control with any of the foregoing, affiliates, partners, principals, members, officers, directors, shareholders or key employees (individuals providing direct service to the County) is a party that, if decided unfavorably, would reasonably be expected to have a material adverse effect on Offeror’s ability to fulfill its obligations hereunder; and (b) Offeror knows of no basis that might give rise to any such litigation, arbitration, or other dispute in the foreseeable future. Offeror warrants that it shall notify the County as soon as reasonably possible after Offeror first learns of any litigation, arbitration, or other dispute, or any investigation thereof, that would reasonably be expected to have a material adverse effect on Offeror’s ability to fulfill its obligations hereunder.

Attach detailed information regarding any pending or anticipated litigation, arbitration, or other dispute, or any investigation thereof, involving the Offeror.

No action pending

Action pending Information attached

(Signature required) (Date)

9. Conflict of Interest

Offeror hereby certifies that: (I) Offeror has provided the County with the disclosures required in (A) and (B) below as part of its Proposal, or (II) that no relationships as outlined in (A) and (B) exist.

A. Disclose any financial, business or other relationship with the County, any other entity that the County Board of Supervisors governs, or any County Board member, officer or employee, which may have an impact, effect or influence on the outcome of the services you propose to provide. Provide a list of current clients, employees, principals or shareholders (including family members) who may have a financial interest in the outcome of services you proposed to provide.

B. Disclose any financial, business or other relationship within the last three (3) years with any firm or member of any firm who may have a financial interest in the outcome of the work.

Information Attached

No Information Attached

(Signature required) (Date)

10. Statement of Compliance

A Statement of Compliance with all parts of this RFP or a listing of exceptions and suggested changes must be submitted in response to this RFP.

Offeror hereby certifies (Offeror must certify either A or B, but not both, by signing below):

A. This Proposal is in strict compliance with this RFP including, but not limited to, the terms and conditions set forth in Section III – Model Contract, including the Attachments and Exhibits, and no exceptions are proposed.

(Signature required) (Date)

OR

B. This Proposal is in strict compliance with this RFP, including, but not limited to, the terms and conditions set forth in Section III – Model Contract and its Attachments and Exhibits, except for those exceptions expressly listed as required by this RFP and attached hereto.

(Signature required) (Date)

The attachments for each proposed exception to this RFP, including, but not limited to Section III – Model Contract, must include:

1. The complete provision to which Offeror is taking exception;

2. The RFP page number and section for which the Offeror is taking exception;

3. The suggested rewording of the provision in a manner that…