REVISED_260125_Chapter_1E_-_Dental_Cost_Proposal-RETURN_WITH_BID-11.04.2025.xlsx
XLSX spreadsheet 48 KB Posted
- Solicitation number
- 260125
- Issued by
- Pima County, Tucson City, Arizona
About this file
This document is a Cost Proposal Exhibit for the City of Tucson's dental services procurement, covering multiple dental plan options including Self-Funded Admin DPPO, Self-Funded Admin DPPO Basic Preventive, and Fully Insured DHMO. The procurement seeks dental administration services for a five-year contract period from July 1, 2026 through June 30, 2031, targeting approximately 4,627 total enrollees across three coverage tiers (Employee Only, Employee + Dependent, and Employee + 2 or more Dependents). The exhibit includes detailed performance guarantees across 11 categories, such as call return timeliness, claims processing accuracy, implementation readiness, and network maintenance, with specific measurement frequencies and potential financial penalties for non-compliance.
The cost proposal indicates zero-dollar administrative costs and premiums across all plan designs and years, suggesting vendors are expected to provide detailed pricing information separately. Performance guarantees include stringent requirements like 99.3% financial accuracy, 95% claims turnaround time within 14 calendar days, and maintaining a provider network in Pima County. The solicitation is part of a comprehensive benefits procurement that allows vendors to bid on one or more service lines, with the dental coverage being one of five potential service areas. The contract includes an initial one-year term with options for six additional one-year renewals, providing potential long-term stability for the selected vendor.
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Instructions Exhibit Instructions to Vendors
When completing the exhibits in the Excel workbook, please follow the directions below:
| 1. Do not add or delete rows, columns or alter-pre-labeled text in the exhibits |
| 2. Electronic copies of these exhibits must be returned in Excel. Do not provide in a PDF |
format. The signed copies of your documents are required for the hardcopy binder only.
3. Do not extract individual worksheets (exhibits) and submit as separate Excel workbooks in the electronic copy. If a sheet is required under a separate tab, make a copy.
Self-Funded Admin DPPO
| City of Tucson |
| DPPO SELF FUNDED DENTAL ADMINISTRATION |
This form must be completed in its entirety. Please do not alter, add or delete rows. Multi-year rates and rate caps will be considered more favorably. Failure to complete this form in its entirety may deem your submission as non-responsive.
| REQUESTED AND/OR PROPOSED PLAN DESIGN RATES | |||||
| Dental PPO Cost Form | Current Plan Design | ||||
| 7/1/2026 - 6/30/2027 | 7/1/2027 - 6/30/2028 | 7/1/2028 - 6/30/2029 | 7/1/2029 - 6/30/2030 | 7/1/2030 - 6/30/2031 | |
| Enrollment Assumptions | |||||
| Employee Only | 1,924 | 1,924 | 1,924 | 1,924 | 1,924 |
| Employee + Dependent | 1,392 | 1,392 | 1,392 | 1,392 | 1,392 |
| Employee + 2 or more Dependents | 1,311 | 1,311 | 1,311 | 1,311 | 1,311 |
| Total | 4,627 | 4,627 | 4,627 | 4,627 | 4,627 |
| Monthly Self Insured Administration (PEPM) | |||||
| Total Monthly Self Insured Administrative Cost | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Annual Self Insured Administative Cost | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Are there any additional costs not included in your rates? If so, please identify. |
| Rate Guarantees |
| Rate Guaranteed? |
| Implementation/Communication/Tech Credits |
| Indicate if any credits are included in your proposal. |
| Do you offer discounted or bundling pricing for being awarded multiple coverage lines? |
| Participation |
| Minimum Participation Requirements |
Comments: List Additional Rate Guarantees Below as well as any additional cost for any additional programs
| Authorized Signature |
| Authorized Name |
| Vendor Name |
| Date |
| Contact Phone Number |
Self-Funded Admin DPPO Basic
| City of Tucson |
| DPPO SELF FUNDED DENTAL ADMINISTRATION - BASIC PREVENTIVE ONLY PLAN |
This form must be completed in its entirety. Please do not alter, add or delete rows. Multi-year rates and rate caps will be considered more favorably. Failure to complete this form in its entirety may deem your submission as non-responsive.
| REQUESTED AND/OR PROPOSED PLAN DESIGN RATES | |||||
| Dental PPO Cost Form | Current Plan Design | ||||
| 7/1/2026 - 6/30/2027 | 7/1/2027 - 6/30/2028 | 7/1/2028 - 6/30/2029 | 7/1/2029 - 6/30/2030 | 7/1/2030 - 6/30/2031 | |
| Enrollment Assumptions | |||||
| Employee Only | 896 | 896 | 896 | 896 | 896 |
| Employee + Dependent | 477 | 477 | 477 | 477 | 477 |
| Employee + 2 or more Dependents | 414 | 414 | 414 | 414 | 414 |
| Total | 1,787 | 1,787 | 1,787 | 1,787 | 1,787 |
| Monthly Self Insured Administration (PEPM) | |||||
| Total Monthly Self Insured Administrative Cost | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Annual Self Insured Administative Cost | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Are there any additional costs not included in your rates? If so, please identify. |
| Rate Guarantees |
| Rate Guaranteed? |
| Implementation/Communication/Tech Credits |
| Indicate if any credits are included in your proposal. |
| Do you offer discounted or bundling pricing for being awarded multiple coverage lines? |
| Participation |
| Minimum Participation Requirements |
Comments: List Additional Rate Guarantees Below as well as any additional cost for any additional programs
| Authorized Signature |
| Authorized Name |
| Vendor Name |
| Date |
| Contact Phone Number |
Fully Insured DHMO
| City of Tucson |
| FULLY INSURED DHMO |
This form must be completed in its entirety. Please do not alter, add or delete rows. Multi-year rates and rate caps will be considered more favorably. Failure to complete this form in its entirety may deem your submission as non-responsive.
| REQUESTED AND/OR PROPOSED PLAN DESIGN RATES | |||||
| Dental HMO Cost Form | Current Plan Design | ||||
| 7/1/2026 - 6/30/2027 | 7/1/2027 - 6/30/2028 | 7/1/2028 - 6/30/2029 | 7/1/2029 - 6/30/2030 | 7/1/2030 - 6/30/2031 | |
| Enrollment Assumptions | |||||
| Employee Only | 896 | 896 | 896 | 896 | 896 |
| Employee + Dependent | 477 | 477 | 477 | 477 | 477 |
| Employee + 2 or more Dependents | 414 | 414 | 414 | 414 | 414 |
| Total | 1,787 | 1,787 | 1,787 | 1,787 | 1,787 |
| Monthly Fully Insured Premium Rates | Rate Tiers | |||||
| Employee Only | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Employee + Dependent | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Employee + 2 or more Dependents | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Total Monthly Premium | $0 | $0 | $0 | $0 | $0 | |
| Total Annual Premium | $0 | $0 | $0 | $0 | $0 |
| Are there any additional costs not included in your rates? If so, please identify. |
| Rate Guarantees |
| Rate Guaranteed? |
| Implementation/Communication/Tech Credits |
| Indicate if any credits are included in your proposal. |
| Do you offer discounted or bundling pricing for being awarded multiple coverage lines? |
| Participation |
| Minimum Participation Requirements |
Comments: List Additional Rate Guarantees Below as well as any additional cost for any additional programs
| Authorized Signature |
| Authorized Name |
| Vendor Name |
| Date |
| Contact Phone Number |
Performance Guarantees
| City of Tucson |
| COST PROPOSAL - PERFORMANCE GUARANTEES |
For the following categories, provide the performance standard you are willing to offer, the financial penalty (maximum dollar amount or % of administrative fees) you will agree to pay if the standard is not met, and the method of measuring the penalty.
| PERFORMANCE GUARANTEES | OFFEROR RESPONSE | ||
| For each of the following categories, provide the financial penalty (maximum dollar amount or % of administrative fees) you will agree to pay if the standard and method of measuring the penalty is not met. | Measurement Frequency | Target | Dollars at Risk |
(% or $)
| 1 | Contractor Call (or e-mail) Return Timeliness | Quarterly | No more than 2 missed responses in the timeframe. |
| 1a | Contractor returns the City of Tucson’s and/or their designated consultant’s calls (or e-mails) within 1 business day (even if the answer is “I am working on it”). | ||
| 2 | Processing Eligibility and Enrollment Updates | Monthly | Receipt of eligibility and enrollment information via a weekly electronic feed, eligibility file loaded in 2 working days of receipt and notification to City of discrepancies and errors within the eligibility file within 2 working days of receipt of each eligibility file. |
| 2a | Contractor agrees to receive eligibility and enrollment information via a weekly electronic feed from the City’s online enrollment system, at no additional cost to the City. The City reserves the right to change enrollment system providers at any time. Should a different enrollment system provider be used, there shall be no charge from the Contractor to the City to change providers including any changes to data files or feeds, etc. | ||
| 2b | Contractor agrees to load eligibility file within 2 working days of receipt and notify City of discrepancies and errors within the eligibility file within 2 working days of receipt of each eligibility file. | ||
| 3 | Member Satisfaction Survey | Annual | Contractor will obtain at least a 90% satisfaction rate on the survey. |
| 3a | Contractor will develop and conduct a City specific member satisfaction survey. | ||
| 4 | Implementation (if appropriate) | One Time | Pass or Fail |
| 4a | Contractor shall perform comprehensive system testing and quality assurance checks prior to the implementation date of July 1, 2026 Contractor shall report the results to the City no later than May 1, 2026 Meeting these milestones shall be provided at no additional cost to the City. | ||
| 4b | Contractor shall have its customer call center in advance of the July 1, 2026 effective date. | ||
| 4c | Contractor shall have City of Tucson’s specific toll-free telephone number available to all plan members in advance of the July 1, 2026 effective dates. | ||
| 5 | Financial Accuracy (dollar value): | Annual | ≥99.3% |
| 5a | At least 99.3% of claims dollars submitted for payment will be accurately processed and paid. Financial accuracy will be based on Contractor’s self-reported numbers using City specific claims and as verified through any claims audit conducted by the City and/or their selected auditor. | ||
| 6 | Claims Turnaround Time: | Annual | ≥95% |
| 6a | 95% of all claims received will be completely processed within fourteen (14) calendar days after they are received. 100% of claims will be processed within 30 calendar days of receipt. Claims turnaround time will be based on Contractor’s self-reported numbers using City specific claims and as verified through any claims audit conducted by the City and/or their selected auditor. | ||
| 7 | Claims Processing Turnaround Time: | Monthly | ≥99% |
| 7a | At least 99% of all fully documented claims will be processed within thirty (30) calendar days of receipt. Claims processing turnaround time will be measured through monthly system-generated reports from the contractor showing time periods for claim processing and payments applicable to the City’s claims and as verified through any claims audit conducted by the City and/or their selected auditor. A claim is defined as a request for a payment of a plan benefit by a plan participant or health care provider; a claim is deemed received when it has been time-stamped by the Contractor. Claims pended for missing information or benefit eligibility will be included as a documented claim. | ||
| 8 | Processing Accuracy: | Monthly | ≥99% |
| 8a | At least 99% of all claims will be processed accurately. Accurate processing includes payment amount, communication to claimant or provider, data entry errors affecting current or future benefit determinations, and management reports. Processing accuracy will be measured through monthly system-generated reports from the contractor showing time periods for claim processing and payments applicable to the City’s claims and as verified through any claims audit conducted by the City and/or their selected auditor. | ||
| 9 | Payment Incident Accuracy: | Monthly | ≥98% |
| 9a | Claim payment accuracy should be at least 98% as measured as the total number of claims with dollars paid correctly divided by the total number of paid claims audited in a statistically valid sample of claims for all members. Payment incident accuracy will be measured through monthly system-generated reports from the contractor showing time periods for claim processing and payments applicable to the City’s claims and as verified through any claims audit conducted by the City and/or their selected auditor. | ||
| 10 | Procedural (non-payment accuracy): | Monthly | ≥95% |
| 10a | 95% of all claims will be processed accurately. Accurate processing includes payment amount, communication to the claimant or provider, data entry errors affecting current or future benefit determinations and management reports. Payment incident accuracy will be measured through monthly system-generated reports from the contractor showing time periods for claim processing and payments applicable to the City’s claims and as verified through any claims audit conducted by the City and/or their selected auditor. | ||
| 11 | Network: | Ongoing | Pass/Fail |
| 11a | Maintain a network of medical providers in Pima County network at no less than that proposed in this RFP. Contractor shall provide notice to the City of any network provider (any individual entity, person, or other provider of medical service) change or potential change affecting at a minimum five percent (5%) or one hundred (100) enrolled members (whichever is less) in Pima County. | ||
| 11ai | Tier 1 DPPO | ||
| 11aii | Tier 2 DPPO |
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