QA_Final.docx

1. SF-33: Based on the totality of the Questions submitted, will the Government grant a 15 day extension to allow prospective bidders to fully evaluate and consider the government's answers in the preparation of their respective proposals?

RESPONSE: Amend 0001 will extend the SF-33 response date in Blk 9 to April 28, 2015 at 12:00 MST.

2. General Question: Can the Government clarify whether the Contractor is required to pay the Health Insurance Providers Fee imposed under section 9010 of the Affordable Care Act?

RESPONSE: The Government confirms that the contractor is required to pay the fee under section 9010 of the Affordable Care Act and that it should be rolled up in the premium, per L.8.3. Administrative Costs. Each of the unit prices proposed for CLINs 0001 through X012 (except for CLINs 1005, 2005, 3005, 4005, 5005, X006, and X008) shall represent an all-inclusive price (administrative, profit, dental service, travel, all taxes and fees). The administrative portion of the all-inclusive price is defined as all direct costs and indirect costs.

Question: Does the offeror have to be a licensed insurance company?

RESPONSE: No, the offeror does not have to be a licensed insurance company.

3. Claims data files. The claims data provided has several million claims shown as 'Paid' for procedure codes D8061, D8071, D8081, and D8091 which are not a covered benefit under TDP. Have these procedures been listed in error? If yes, please provide a correction. If no, please explain this discrepancy.

RESPONSE: These codes are used in the processing of repetitive orthodontic payments. The initial placement/banding would be processed under 8010, 8020, 8030, 8040, 8050, 8060, 8070, 8080, and 8090.

4. Claims data files. Please expand on the field #21 of the claims data, the Claim Status Indicator. What is meant by 'Cancelled/ Batch Paid', 'Batch Declined' and 'Charge Killed'?

RESPONSE: Status code 4 - Cancelled/Batch Paid is used to indicate either 1) a claim that was adjusted pursuant to the current contractor's internal claims processing procedures or 2) Batch Paid has the same definition as status code 1 (Paid). The difference in the coding is related only to the incumbent contractor’s internal processing of the claim.

Status code 5 - Batch Declined has the same definition as status code 2 (Declined). The difference in the coding is related only to the internal processing of the claim.

Status code 6 - Charge Killed is used to indicate a procedure that is determined by the adjudication process as no longer a valid order line.

5. Claims data files. For any given month, we would expect the 'Previous Month' enrollment to match the 'Total Contracts' column of the prior month's report, but these do not match identically. For example: May 2012 'Total Contracts' for Active Duty is reported as 586,415, however, June 2012 'Previous Month' is reported as 587,814. Please explain this discrepancy.

RESPONSE: Since DEERS is the source for determining eligibility and due to the constant changes in this population, these reports provide a snapshot at a point in time. The contractor only has a current picture of the data so all counts that are done are real time counts calculated at the time the report is run.

6. Claims data files. Request that the Government provide claims paid in foreign currency in each of the last 5 years. This information will be needed by offerors to understand the magnitude of this requirement.

RESPONSE: The TDP contractor does not pay claims in foreign currency. Any claims billed in foreign dollars are converted to U.S. dollars for payment. The claims data indicates the OCONUS claims by the Special Processing Code (CONUS or OCONUS) and also the Billing Provider ZIP Code.

7. Claims data files. With regards to the TDP data set, can DHA confirm if the call volume represents the total number of calls received by the incumbent, or does it represent the total number of calls answered by an agent per month (which would exclude calls answered via automated voice response technologies)? Will the government provide data segregating calls by agent vs. automated voice response technology?

RESPONSE: The call volume represents the total number of calls from beneficiaries and enrollees who select the prompt on the automated voice system to speak to a customer service representative. The Government will provide additional data indicating the number of calls received segregated by those completed by IVR and also provider calls.

8. Claims data files. For the TDP data set, can DHA provide information about the types of calls received by the call center? For example, the percentage of call volumes associated with enrollment, billing, general benefits or eligibility, etc.

REPONSE: No, the Government does not track this data.

9. Does DHA make available a file showing all current certified TRICARE providers? Is the contractor responsible for certifying providers before they are brought on to our system/contract? If so, can we assume they will follow the existing recertification date?

RESPONSE: a) The current list of providers will be provided after award.

b) The incoming contractor is responsible for certifying providers. If a non-incumbent contractor is awarded the contract, they are responsible for re-negotiating with the TOPDs. Just because the provider is on the list does not mean that the provider will automatically do business with the new contractor.

c) If the provider is on the list at time of award they would follow the existing recertification date.

10. TSM C3S1.4 1.2.8. The referenced section addresses requirements related to Other Health Insurance (OHI). Are the OHI provisions required for TDP?

RESPONSE: TSM C3S1.4 does not apply to the TDP contract; see Section C.2.8 of the RFP. The OHI requirements are stated in TSM C3S1.5. As stated under 3.9.2 of TSM C3, Sec. 1.5 “DEERS allows the MHS and contractor systems to add an OHI policy for a person when information is presented to them.” If the contractor does not have all of the required OHI data then the contractor does not post the OHI information.

11. C.2.5 and C.4.1. Which NIST revision does the government intend to apply to the Solicitation? Attachment J-5, Paragraph 14.7 references Rev 4; Paragraph C.2.5 and C.4.1 do not have a reference. Could you update references for consistency throughout the Solicitation?

RESPONSE: The Government does not agree that additional references are needed in Section C. Attachment J-5 spells out the requirements for the various revisions that are to be followed in paragraph 14.2, 14.4.2 and 14.7. The Government is considering adding the revision number to the ‘checklist’ in CDRL A050.

12. C3.3.4 6a. Do the claim processing metrics include both retained and non-retained claims (clean vs. non-clean)?

RESPONSE: Yes, it includes both. This is based on the Government’s interpretation of (“retained claims”) per the TRICARE Operations Manual, Chapter 1, Section 3 paragraphs 1.5.1 and 1.5.2. Please note that Section 3 does not apply to the TDP contract. The claim processing standards stated in the RFP Section C.3.3.4.a, are for all paid and denied claims that are processed to completion. For example if 3 out of 4 procedures on a claim were paid within 14 business days and the 4th procedure was paid in 30 business days, then the claim would be considered as processed to completion within 30 business days.

13. C.3.3.7. Will the Government release the questions asked by the DHCAPE survey?

RESPONSE: No, the Government will not release the survey questions. The questions are general in terms of satisfaction with the program.

14. C.3.3.2. The contractor shall provide and maintain access to general and specialty network providers for enrollees.

Performance Standards

a) Standard: The contractor shall establish networks for general dental care in the United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands in accordance with 32 CFR 199.13 and Section J, Attachment J-5.

AQL: 95% of enrollees shall have access to a general dentist within 35 driving miles of their place of residence and 21 days of requesting an appointment.

L.6.2.1. The offeror shall describe how its existing or proposed network, will meet or exceed the minimum access standard of 95% of enrollees shall have access to a general dentistry network provider within 35 driving miles of their place of residence, and be able to obtain an appointment within 21 calendar days of requesting an appointment (see C.3.3.2.a).

H.4.1.1. Network Provider Access Standard: Ninety-five percent of enrollees shall have access to a network general dentistry provider within 35 driving miles of their primary residence, and be able to obtain an appointment within 21 calendar days of requesting an appointment.

Question: C.3.3.2(a) AQL and L.6.2.1 say 95% of enrollees shall have access to a general dentist within 35 driving miles of their place of residence. H.4.1.1 says 95% of enrollees shall have access to a network general dentistry provider within 35 driving miles of their primary residence. Can the Government please clarify if there is a difference between place of residence and primary residence and if so, will the difference be noted in DEERS?

RESPONSE: Section H.4.1.1 is incorrect and will be corrected to state “place of residence” in Amend 0001.

15. C.4.10. Required Data. C.4.10.1. The contractor shall provide the Government with read-only access to their full TDP data set with download capability for data manipulation purposes. Access shall be on-line, and as near real-time as possible. The data set shall include, but not be limited to network providers, non-network providers, enrollment information, claims processing, claims payment, enrollee care and service data. Access is required for the DHA Dental Care Office, Contracting Officer, Contract Specialist, Contracting Officer’s Representative, and the Tri- Service Center for Oral Health Studies (TSCOHS), for a total of 10-15 user accounts.

Question: Section C.4.10.1 states that the contractor’s full data set shall include data on network and non-network providers. Please confirm this data is specific only to those providers who have submitted claims for TDP beneficiaries as contractors would not otherwise have information related to non-network providers.

RESPONSE: Your assumption is correct.

16. C.4.9.2. How many program integrity related case referrals have been made by year over the past 5 years of contract performance?

RESPONSE: No cases have been forwarded to DHA.

17. E.5. Will the Government provide an example of its current or intended QASP for the solicitation?

RESPONSE: No. The QASP will cover the requirements in Section C.

18. G.4.2. Does DHA have current data stating the percentage or ratio (or an estimate) of the quantity of Reserve Enrollees who request the Contractors to direct bill them?

RESPONSE: No, the Government does not track this information.

19. Attachment J-6a Section 10.2 & 10.2.2, and Attachment J-2 Section 2

The percentile for Allowable Charge Schedule for OCONUS claims is mentioned in two locations in the RFP documents. In Attachment J-6a Section 10.2, the 95th percentile is referenced. In Attachment J-2 Section 2 Bullet 8, the 90th percentile is referenced. Can the government please clarify which percentile should be applied to OCONUS claims?

RESPONSE: OCONUS claims shall be paid at the 95th percentile. Attachment J-2 will be corrected in Amend 0001.

20. J-5 Section 9.3; 32 CFR 199.13(g)(2)(i). In attachment J-5 Section 9.3 Non-Network Reimbursement, it is stated that in compliant areas, the allowed amount for out of network claims for CONUS is the lesser of billed charges or the network maximum allowable charge for similar services in that same locality (region) or state. However, in the 32 CFR 199.13(g)(2)(i) it is stated that this amount be the lesser of billed or charges or the 50th percentile of prevailing charges made for similar services in the same locality. Can the government please clarify which of these two options is required by the plan?

RESPONSE: As stated in L.4.9, offerors are to propose as if the regulatory change reflected in Attachment J-5 Section 9.3 has been published.

21. J5 & J6a - 4.1. Based on the report supplied with the RFP: "J-15 #8 TOPD Listing" there are no TOPD's in Canada. Can you confirm that this is correct?

RESPONSE: Your assumption is correct; there are no TOPDs in Canada.

22. Section J, Attachments J-5 and Attachment J-6a. Section 7.0 of Attachment J-6a specifies that "The contractor shall comply with the provider requirements stated in Section J, Attachment J-5." Is the contractor's compliance limited to the provider requirements listed in attachment J-5, paragraph 8? Or does the government intend for other requirements of Attachment J-5 to apply? If so, which ones?

RESPONSE: Yes, it is limited to paragraph 8. Clarification will be added to Attachment J-6a in a Amend 0001.

23. Attachment J-5, Section 16.1.1.2. This section states that for contractors working outside the U.S., the prescreening shall "verify citizenship". Does this mean U.S. citizenship?

RESPONSE: The contractor is to verify the person’s citizenship. Please note that non-U.S. citizens cannot obtain ADP/IT I or II clearance.

24. J-5, H.2. Attachment J-5, Paragraph 8.4 is redundant with Section H.2; to avoid potential future inconsistency, will the government delete H.2?

RESPONSE: Attachment J-5, paragraph 8.4 will be revised to reference H.2 in Amend 0001.

25. J-5, Paragraph 6. Attachment J-5, Paragraph 6 indicates that network providers shall complete DD Form 2813 upon request. When can the request be made, and by whom? How many requests have been made for providers complete the DD Form 2813? Can the requests be broken down by the category of the requestor? Is the requirement to complete a DD Form 2813 limited to Participating or Network Providers?

RESPONSE: a) The National Guard or Reserve enrollee may request it at any time.

b) The Government does not track the requests. The Dental Readiness Classification was given in the claims data set per Attachment J-15 #7 Claims Data.

c) Yes, it is limited to Network Providers as stated in Attachment J-5, paragraph 6. The request may be made to a non-network provider, but the contractor does not control whether the provider will do it and/or charge for it.

26. In section 9.3 of attachment J-5, CONUS non-network reimbursement is defined as the lesser of: 1) billed charges; or 2) the network maximum allowable charge for similar services in that same locality (region) or state. Read literally, this gives the Contractor flexibility to determine out of network reimbursement.

To illustrate the point, we provide two examples. Please note that we have used actual fee schedule data for these examples, because we feel it is important to accurately illustrate potential disparities. In each of the examples, let’s assume that the service is a crown and the TDP beneficiary receives services from an out-of-network provider located in a Northern California suburb.

Contractor A defines “same locality (region) or state” as the actual zip code of the Northern California suburb in which the care is rendered. Using the network fee schedule for this zip code, Contractor A would have a network maximum allowable charge of $935.00.

Contractor B defines “same locality (region) or state” as the state in which the care is rendered (i.e., California). In this example, the contractor could use any fee schedule for the State of California. Assuming the lowest California fee schedule is chosen, Contractor B’s network maximum allowable charge would be $760.00.

As demonstrated by just this one scenario, assuming a 50% cost-share, the TDP beneficiary would have a significantly higher out-of-pocket cost in the case of Contractor B’s definition of “same locality, region or state” (i.e., the beneficiary cost share would be $87.50 higher) and there would also be a very significant disparity in Contractor cost depending on the definition of “same locality (region) or state”. Moreover, since the words “same locality (region) or state” are subject to such varying definitions by each Contractor, it appears that the Government will not be able to perform an apples to apples comparison on how a contractor is calculating the out-of-network fee reimbursement.

Can the Government provide more clarity around how the terms “same locality (region) or state” should be defined for purposes of calculating out-of-network reimbursement?

RESPONSE: Your example in which Contractor B can select "any fee schedule for the State of California" is not accurate. The purpose of the proposed regulatory change was to put reimbursement for non-network providers on parity with that for network providers, thus, removing any financial disadvantage of being a network provider. Thus, the non-network provider's reimbursement rate is determined by the lesser of the billed charges or the contractor's network maximum allowable charge for the locality where the service was performed. Whether these rates are established by zip code or by State is within the discretion of the contractor. DHA recognizes that contractors may divide geographic areas differently for purposes of establishing network maximum allowables. This is up to the contractor; however, maximum reimbursement rate for a non-network provider will be determined by the network maximum allowable charge for that same location.

27. RFP Attachment 6-6c, Sample OCONUS Non-Availability and Referral Form (NARF) and Instructions.

This reference states, “This form is only necessary for OCONUS orthodontic and implant care.” Implant care is listed in addition to orthodontic care, but the remainder of the TDP RFP only speaks to orthodontic care. Is there a requirement to use the NARF for implant care?

RESPONSE: No, there is no requirement to use the NARF for implant care. Attachment 6c will be replaced with the correct NARF in a Amend 0001.

28. a) RFP Attachment J-11, Transition Requirements, Paragraph 2.2, Receipt of Files, Table “Transition-In/Information Files Transfers”

b) RFP Attachment J-2, Benefits, Limitations and Exclusions, text at the top of page one

The referenced Attachment J-11 includes Processed Orthodontic Claims Histories as one of the files that will be provided to the incoming TDP contractor. Additionally, Attachment J-2 includes text stating, “All time-restricted benefits start new with the start of dental care delivery for this contract.” Is it the Government’s intent to provide only claims history information related to Processed Orthodontic Claims? If so, this will limit the incoming contractor’s ability to detect and prevent incorrect or fraudulent claims for services in cases where services are performed after start of the new TDP contract would not be allowed based on related services performed under the old contract (i.e., the incoming contractor would not have access to the necessary claims history to detect the situation). Would the government please update this requirement to include the full history of claims data from the previous contract?

RESPONSE: It is the Government’s intent for the outgoing contractor to only provide processed orthodontic claims (paid and denied) history to the incoming contractor. The transfer of claims history was discussed at the TDP industry one-on-one meetings. Industry indicated that it was more trouble and costly to import claims history files into their systems than it would be to pay a few claims that did not meet time-restricted benefits. Therefore the Government also determined to start time-restricted benefits over at the beginning of a new contract.

29. Claims data files, J-15. Can the government confirm that the telephone inquiries and correspondence volumes provided in attachment J-15 represent actual volumes experienced for the period of performance represented? The data appears low based on our experience.

RESPONSE: The call volume represents the total number of calls from beneficiaries and enrollees who select the prompt on the automated voice system to speak to a customer service representative. The Government will provide additional data indicating the number of calls received segregated by those completed by IVR and also provider calls.

30. Attachment J-15, metlife_TDP_FY12-FY15 claims. The RFP has requirements to provide prices by Single Enrollment, Family Enrollment, Survivor Benefit-Single Enrollment and Survivor Benefit-Family Enrollment; however, breakouts for Survivors are not available in the claims data. Can the government please provide these breakouts for the claims data?

RESPONSE: The Government does not track claims by Survivor status. The Survivor benefit is the same as the other enrollment categories, only the premium payment structure differs. The Survivor CLINs are only broken out because the Government pays 100% of the premium.

31. Attachment J-15. The enrollment history provided appears to only include counts of contracts which we assume to be counts of sponsors, and not all enrolled lives. For example, the "J-15 #2 TDP EnrolleesFile-2015JAN" has a total of 1,889,732 enrollees, however December 2014 in the "J-15 #3 TDP CONUS Enroll. Report" and "J-15 #4 TDP OCONUS Enroll. Report" shows combined OCONUS and CONUS Contracts of 788,605. Can the total enrolled lives and the total contracts (sponsors) be provided for each month from May 2012 – January 2015?

RESPONSE: No, the Government will not provide the total enrolled lives by month. The J-15 #2 TDP Enrollees File represents the number of individual covered lives enrolled in the TDP as of January 2015. The J-15 #3 & #4 files represent the number of contracts (plans) by Plan type. Premiums are paid based on plan type (individual/family). The number of contracts (plans) will be less than the number of enrollee covered lives.

32. Attachment J-15. We acknowledge that a breakdown of claims by Pay Grade is not available, as previously communicated by DHA. To allow analysis of past performance, can a split of enrollees be provided for each month from May 2012-January 2015 between the Pay Grade Categories (Category A: Pay Grades E1, E2, E3, and E4; Category B: all other Pay Grades) so that we may develop an expectation as to the mix of cost sharing levels?

RESPONSE: No, the Government will not provide the total enrolled lives by pay category by month. The total number of enrollees as of Jan 2015 by pay grade categories was provided and is representative of a point-in-time.

33. Attachment J-15 / Data File. File J-15 #1 TDP RFP EligibileFile-2015JAN contains fewer data lines than J-15 #2 RFP EnrolleeFile-2015Jan. Since Enrolled counts should be a subset of Eligible counts, this suggests that either the Eligible data is not accurate or is not on the same basis as the Enrollment data supplied. As an example, the Eligible file shows there are only 100,566 eligible members in Pay Grades E1-E4, but the Enrollee file shows 187,628 members enrolled in Pay Grades E1-E4. Can eligibility data be provided so that an accurate comparison can be made between members eligible and members enrolled?

RESPONSE: Attachment J-15 data file #1 is the total number TDP eligibles that are not enrolled in the TDP. Therefore the number of eligibles could be less than the number of enrolled members. Clarification will be added to the description in Attachment J-15 #1 TDP Eligibles Report.

34. RFP Attachment J-15#2 Enrollee File. It appears the ZIP codes for 1,551 enrollees are reflected as non-U.S. but are really U.S. ZIP codes. Can the Government please clarify if offerors should ignore the country listed and replace with the corresponding state?

RESPONSE: DHA will provide a response in the near future.

35. RFP Attachment J-15

a) What is the definition of ‘Total Calls Offered’? Does the volume reported include incoming calls from all sources, including Dental Providers, beneficiaries and enrollees? Does the volume reported include incoming calls that were answered and resolved by an IVR?

RESPONSE: The call volume represents the total number of calls from beneficiaries and enrollees who select the prompt on the automated voice system to speak to a customer service representative. The Government will provide additional data indicating the number of calls received segregated by those completed by IVR and also provider calls.

b) What is the definition of ‘Non-Priority Correspondence’? Does the volume reported include incoming correspondence from all sources, including Dental Providers, beneficiaries and enrollees? Does the volume reported include all incoming methods of correspondence, including e-mail, web form, fax and postal sources?

RESPONSE: Non-Priority Correspondence is routine correspondence that is not considered a priority correspondence, appeal or grievance. Per the definition in TOM Appendix B, Routine Correspondence is any correspondence which is not designated as Priority Correspondence. Per the definition in TOM Appendix B Priority Correspondence is correspondence received by the contractor from the Office of the (ASD(HA)) (OASD(HA)), TMA, and Members of Congress, or any other correspondence designated for priority status by the contractor’s management. The term Non-Priority Correspondence will be changed to Routine Correspondence in Amend 0001.

RESPONSE: The volume reported includes incoming correspondence from Dental providers, sponsors, beneficiaries and enrollees. It does not include any correspondence which is considered to be a Priority correspondence, appeal or grievance.

RESPONSE: Yes, the volume reported includes all incoming methods of correspondence, including e-mail, web form, fax and postal sources.

36. CDRL M100. The Dental Health Plan Report Card, CDRL M100, specifies that the report card is to provide information on the effectiveness of care. What parameters should be considered within the effectiveness of care measure?

RESPONSE: As previously stated in our RFI responses, the report card will summarize and report the volume of care delivered in a manner that will provide the Government with quantified data to evaluate program effectiveness. The minimum requirements regarding conditions to be monitored are contained in C.4.7.1.2.

The minimum parameters are the items to be monitored as stated in C.4.7.1.2. There are no specific percentages or ranges.

37. L.4.1. The table shown on Page L6 includes "Wage Determinations or CBAs (Section L.5.5.2)"; however there is no Section L.5.5.2 in the RFP and no further mention of Wage Determinations. Can you update the table to remove the existing references to Wage Determination and the sections of L.5.5.2?

RESPONSE: Wage Determination language will be removed from L.5.5.2 in Amend 0001.

38. L.4.8. Are routine changes in the org chart that do not materially affect the overall structure acceptable between the advance copy (due 15 days prior to bid submission) and the final submission?

RESPONSE: Yes, routine changes are acceptable.

39. L.4.3. Section L.4.3 specifies that "The font for both CD ROM and paper submissions shall be Times New Roman, not smaller than 12 points...". Later in the same section, it specifies that "Proposals shall be printed only double-sided, double spaced...". Note that the typographical definition of spacing between baselines of text is leading, expressed in points. Please confirm that 12-point Times New Roman set on 24-point leading (that is, exactly twice the type size) will meet the requirement for double-spaced text.

RESPONSE: The Government confirms that 12-point Times New Roman set on 24-point leading will meet the requirement for double-spaced text.

40. L.4.1. The table in Section L.4.1 requests bidders complete Paragraph G.1.3 (Points of Contact). Please confirm that the paragraph reference should be Paragraph G.3.5.

RESPONSE: The reference should be G.3.5. This will be corrected in a future amendment.

41. L.4.8. The second full sentence of Section L.4.8 asks for “the organizational structure shall include addresses and telephone numbers.” Will the government confirm that the addresses and telephone numbers requirement is for the office of the organization and not for the individual personnel listed on the organizational structure?

RESPONSE: The addresses and phone numbers are for the organization. For example certain offices could be located in another city from the headquarters or CEO.

42. L.4.3. Paper Copies. Proposals shall be printed only double-sided, double spaced, with nonduplicative, sequential page numbers at the bottom of each printed page. Double spacing does not apply to the table of contents, illustrations, organization charts, supporting data exhibits, report listings, or labels on process flows. Each page will also include the offeror’s name, and solicitation number.

Question: Is it the Government’s intent that offeror’s add to each printed page the following: sequential page numbers, the offeror’s name and solicitation number to pre-existing materials to include items such as past performance questionnaires, Section K, financial reports, consent letters, etc.?

RESPONSE: It is the Government’s intent to be able to recognize to which offeror a document belongs to. Clarification will be added to L.4.3 to state that it does not have to be shown on documents such as past performance questionnaires, Section K, financial reports, or consent letters. Clarifications in Amend 0001.

43. L.4.1. L.4.1 for Volume 1 lists Wage Determinations or CBAs (Section L.5.5.2) however there is no corresponding section in the final RFP. It appears to have been deleted from the previous draft RFP. Can the Government please clarify if the Wage Determinations or CBAs are required?

RESPONSE: The Wage Determination language will be removed in Amend 0001.

44. L.5.5. The contractor’s point of contact information for paragraph G.1.3 shall be included in Volume 1.

Question: Please clarify if this should be G.3.5? Does this need to be submitted with the proposal? G.3.5 indicates its required upon award.

RESPONSE: Your assumption is correct, and yes G.3.5. needs to be submitted with proposal. It will be corrected in Amend 0001.

45. L.5.2. Offerors shall submit a completed original Section B (Supplies or Services and Prices/Costs) in Volume 1 and a copy shall be provided in Volume 4. Offerors are instructed to price the appropriate line item and sub-line items in Section B and Exhibit A. Offers submitted in response to this solicitation shall be in terms of U.S. dollars. Offers received in other than U.S. dollars and cents shall be rejected. Quantities identified by the Government are only estimates.

L.8.6. CLINs 0003 and X009, Contract Data Requirements List (CDRLs). CLINs 0003 and X009 shall not be separately priced, but included as part of administrative costs.

Question: L.5.2 includes submission of Exhibit A. Exhibit A is the CDRLs. L.8.6 says CDRLs shall not be separately priced, but included as part of administrative costs. Is the CDRL pricing (box 17 &18) required for submission?

RESPONSE: No, pricing shall not be entered in boxes 17 and 18 of the CDRLs.

46. L.5.7. In light of the parent performance guarantee requirement in L.5.6, to the extent a prospective bidder's financial information is consolidated within the SEC reporting of its parent company and does not exist on a standalone basis as requested in Paragraph L.5.7, will the contracting officer accept the consolidated financials of the prospective bidder's parent organization to meet the requirements outlined in Paragraph L.5.7?

RESPONSE: Yes, the parent organization’s financials would be appropriate.

47. L.6.1.1. Section L.6.1.1 specifies that "Offerors should refrain from using any formatting or symbols to bring attention to any portion of the proposal." However, good page design and typographical practice do require that certain page elements, such as structural headers to organize the hierarchy of sections, appear in bold type, larger type size, or both. Additional elements may include italicizing certain names to improve readability; italicizing certain words for emphasis to improve readability of a sentence; and so on. Please confirm that these typographical conventions are permitted.

Also, tabular elements and graphical exhibits may tend to emphasize certain elements of the presentation by the very nature of existing as a unique and different visual object on the page. Please confirm that these elements are permitted.

RESPONSE: What you’ve stated here in general would be acceptable; however it must remain in the required font size. What the Government does not want to see is symbols indicating an item is of greater importance in the proposal.

48. L.6.1.2. L.6.1.2 specifies that "The technical proposal shall not exceed 70 pages...". Please confirm that the definition of a "page" in this instance is a single impression on a single side of a sheet of paper. (Hence, a single sheet of paper printed on both sides constitutes two pages by this definition.)

RESPONSE: Yes, a single sheet of paper printed on both sides constitutes two pages.

49. L.7.11. The RFP states, "...all correspondence by the Contracting Officer or Small Business Specialist regarding its compliance for the past three years on current or past Government contracts." The phrase "for the past three years," implies years 2012, 2013, and 2014. Does the Government mean the last three years of each contract? What if the contract duration was less than three years?

RESPONSE: The offeror shall submit past performance information from January 1, 2012 to the date of RFP release. The duration of the contract is not relevant. Clarification will be added to Section L.7.11 in Amend 0001.

50. L.7.1. Section L.7.1 defines first-tier subcontractors as “… either a company with a direct contractual relationship with the offeror whose total contract price exceeds $25,000,000 for all option periods or a company who performs claims processing, or operates a call center. A first tier subcontractor does not include providers, mobile dental clinics, related functions such as data entry or copying for core claims processing functions, nor does it include subcontractors performing functions not relevant to core dental insurance functions.”

Does this definition apply to the requirement to include first tier subcontractors in the organizational chart (Section L.4.4 Page Limitations and L.4.8 Organizational Chart)? And across the RFP?

RESPONSE: Yes, first tier subcontractor should be addressed in the organization chart and anywhere else that is pertinent in the RFP.

51. L.7.7. Page L7 includes a table that references L.7.7; this table states that L.7.7 is applicable to "offeror and first tier subcontractor(s)"; however, Section L.7.7 itself does not mention first tier subcontractors. Do first tier subcontractors need to be included in Section L.7.7?

RESPONSE: Yes, if they are considered key personnel. Clarification will be added to L.7.7 in Amend 0001.

52. In reference to L.7.11, please confirm this information is required from the offeror for Defense Health Agency contracts only. If the intended requirement is broader than DHA contracts only, please advise as to the contract criteria (e.g., contract value, types of services) to which this requirement is applicable.

RESPONSE: The Small Business information as required in L.7.11 is for all of your Government contracts, not just DHA contracts.

53. L.4.2. Section L.4.2 specifies that "If tables, charts, etc. are used within volumes 2 and 3, the offeror should ensure that the information is captured within the narrative portion of the proposal." Please confirm that the intent is for the narrative to provide a constructive overview of the information contained in the table or chart and not intended to repeat every element or detail of the table or chart.

RESPONSE: Your assumption is correct.

54. M.4.1.1. Technical Merit Rating..The Government will assess a technical merit rating to each Factor 1 subfactor. The purpose of the technical merit rating is to assess the offeror’s proposed approach for each subfactor, and the degree to which the proposed approach meets or exceeds the requirements based on the evaluation criteria below. In evaluating the offeror’s proposal, the Government will review the offeror’s compliance with the requirements, whether the offeror demonstrates that it understands the requirements and whether the offeror demonstrates a sound approach to accomplish the requirements. For those subfactors below that include acceptable/unacceptable ratings, if an unacceptable rating is determined for any criterion then that subfactor will receive an overall subfactor merit rating of “red/unacceptable”.

Question: Can offerors earn strengths in sections that are being rated on an acceptable/ unacceptable basis?

RESPONSE: No. Per Section M.4.1.1 under the definition of “Acceptable”, “Strengths are not assessed for this evaluation.”

55. M.7. EVALUATION OF FACTOR 4 – SMALL BUSINESS PARTICIPATION

M.7.1. The Government will evaluate the subcontracting plan and participation of small businesses on an acceptable/unacceptable basis.

Acceptable – Proposal clearly meets the minimum requirements of the solicitation.

Unacceptable – Proposal does not clearly meet the minimum requirements of the solicitation.

The Contracting Officer will review the subcontracting plan submitted under Volume I for the submission requirements identified under FAR 19.702, Statutory requirements; FAR 19.704, Subcontracting plan requirements; FAR 52.219-8 Utilization of Small Business Concerns, FAR 52.219-9 Small Business Subcontracting Plan, and DFARS 252.219-7003, Small Business Subcontracting Plan (DoD Contracts).

M.7.2. In accordance with Section L.9, the Government will assess how the offeror’s proposed subcontracting goals compare with the following subcontracting goals. If the offeror proposes subcontracting goals that are higher or lower from those below, the Government will assess how well the offeror describes how and why their proposed goals are set at levels that are realistic and that the parties can reasonably expect.

Question: M.7.1 indicates that acceptable rating for the Small Business Subcontracting Plan requires meeting the minimum requirements of the solicitation. M.7.2 says that if the offeror proposes subcontracting goals that are higher or lower from those below, the Government will assess how well the offeror describes how and why their proposed goals are set at levels that are realistic and that the parties can reasonably expect. Please clarify if offeror’s can propose less than the goals included in the RFP and still receive an acceptable rating.

RESPONSE: Yes, the offeror may propose lower goals than the subcontracting goals stated in the RFP. However, to meet the intent of FAR Subpart 19.7, the proposed goals must represent the maximum practical goals consistent with efficient contract performance. This is what is meant by the term ‘realistic’ in Section M.7.2. This language will be modified to clarify the Agency’s intent.

HT9402-15-R-0001 Page 13 of 14 Questions and Responses