RFP_26_041-Attachment 3_1 of 2_Claims Experience.pdf
PDF 12 KB Posted
- Attached to
- Multiple Option Dental Program
- Solicitation number
- RFP 680 26-041/DJ 4
- Issued by
- Palm Beach County, Florida
About this file
This is an attachment to a Request for Proposals (RFP) document for the Multiple Option Dental Program issued by Palm Beach County, Florida, covering dental insurance services for county employees, Palm Tran employees, and Supervisor of Elections staff. The RFP solicits proposals for five distinct dental plan options: two Dental Health Maintenance Organization (DHMO) plans—Basic (Option I) and Enhanced (Option II)—and three Dental Preferred Provider Organization (DPPO) plans—Low (Option III), High (Option IV), and Premier (Option V). Each plan establishes differentiated copayment structures, deductibles, coinsurance percentages, annual maximums, and frequency limitations across diagnostic, preventive, basic restorative, major restorative, endodontic, periodontic, oral surgery, prosthodontic, implant, and orthodontic services. The contract term runs from January 1, 2027 through December 31, 2029. Proposals were due July 6, 2026, under RFP 26-041/DJ.
Proposers must submit monthly pricing across four coverage tiers (Employee Only, Employee + 1, Employee + 2, and Employee + 3 or more) with either multi-year rate guarantees beginning January 1, 2027, or single-year rate guarantees for calendar year 2027 with optional subsequent proposals. Mandatory submission requirements include a questionnaire addressing provider network adequacy, claims administration, and member services; detailed benefit comparison worksheets for each plan option; a DPPO fee and UCR schedule; and a price proposal with proposer certifications regarding fair competition, financial stability, and non-discrimination compliance. Proposers must guarantee provider network adequacy with performance guarantees up to $50,000 per requirement and confirm willingness to contract with identified top providers. Additional requirements include COBRA administration, retiree billing and administration for approximately 80 retirees, personalized ID cards at no additional cost, and aggregate monthly reporting on enrollment, premiums, claims, and capitation data for awarded DHMO contracts. The County currently does not contribute to dental premiums but reserves the right to elect contributions in the future.
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Text version
April 16, 2026
PBC Board of County Commissioners
Month Sub Member Claims Premium
3/1/2024 2053 3668 $84,308.57 $93,587.66
4/1/2024 2057 3677 $92,508.77 $93,903.18
5/1/2024 2063 3678 $87,402.13 $94,044.14
6/1/2024 2067 3680 $86,762.25 $94,227.08
7/1/2024 2075 3687 $93,783.79 $94,298.26
8/1/2024 2073 3678 $78,513.24 $94,164.46
9/1/2024 2074 3675 $79,248.48 $94,098.96
10/1/2024 2076 3671 $91,110.46 $94,021.56
11/1/2024 2084 3684 $75,314.90 $94,408.02
12/1/2024 2101 3703 $74,909.10 $94,914.40
1/1/2025 2257 3983 $106,030.32 $110,078.88
2/1/2025 2257 3971 $97,956.33 $109,827.00
3/1/2025 2258 3969 $100,410.71 $109,997.90
4/1/2025 2263 3980 $96,441.76 $110,153.98
5/1/2025 2269 3990 $100,113.95 $110,438.52
6/1/2025 2279 4000 $90,359.68 $111,047.36
7/1/2025 2290 4007 $87,952.76 $111,472.16
8/1/2025 2299 4029 $89,043.92 $112,001.28
9/1/2025 2305 4050 $98,926.69 $112,380.04
10/1/2025 2314 4054 $100,593.64 $112,426.96
11/1/2025 2314 4054 $89,157.84 $112,349.90
12/1/2025 2325 4071 $98,774.59 $112,874.40
1/1/2026 2499 4470 $120,288.39 $125,223.36
2/1/2026 2519 4501 $136,355.10 $126,300.76
As a valued client of Solstice, we thank you for your business over the past year. Below is the experience report for date range 3/1/2024-2/1/2026.
PPO
PO Box 19199 * Plantation, FL * 33318 * Tel: 954.370.1700 * Fax: 954.370.1701
Month Sub Member Claims Premium 3/1/2024 2242 4008 $49,997.58 $40,134.76
4/1/2024 2228 3979 $38,301.41 $39,875.76
5/1/2024 2217 3939 $40,331.93 $39,555.48
6/1/2024 2221 3944 $34,205.66 $39,610.50
7/1/2024 2228 3955 $44,460.31 $39,749.62
8/1/2024 2226 3957 $48,338.37 $39,792.14
9/1/2024 2217 3933 $40,060.70 $39,591.78
10/1/2024 2221 3941 $37,537.36 $39,686.38
11/1/2024 2232 3937 $30,738.25 $39,723.20
12/1/2024 2247 3948 $28,192.16 $39,922.30
1/1/2025 2095 3693 $39,669.59 $39,610.22
2/1/2025 2083 3677 $47,509.53 $39,449.52
3/1/2025 2077 3665 $42,827.67 $39,344.08
4/1/2025 2068 3645 $42,026.59 $39,193.66
5/1/2025 2078 3658 $29,489.43 $39,376.54
6/1/2025 2073 3648 $37,216.66 $39,294.80
7/1/2025 2072 3645 $42,682.74 $39,260.68
8/1/2025 2068 3638 $27,330.03 $39,152.82
9/1/2025 2068 3646 $33,736.22 $39,210.10
10/1/2025 2084 3664 $31,653.53 $39,459.84
11/1/2025 2079 3663 $33,412.31 $39,398.30
12/1/2025 2090 3680 $35,082.55 $39,585.88
1/1/2026 1977 3479 $40,466.92 $37,403.32
2/1/2026 1984 3495 $26,443.54 $37,544.96
Should you have any questions regarding your account, please contact your dedicated Account Manager, Laura Wicks at (954) 370-4306.
Solstice Has You Covered!
DHMO
PO Box 19199 * Plantation, FL * 33318 * Tel: 954.370.1700 * Fax: 954.370.1701
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