RFP_26_041-DJ_Appendix B Price Proposal Pages 04212026.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Multiple Option Dental Program
- Solicitation number
- RFP 680 26-041/DJ 1
- Issued by
- Palm Beach County, Florida
About this file
This is a price proposal appendix for RFP 26-041/DJ issued by a Florida county for a Multiple Option Dental Program. The RFP solicits pricing for five dental plan options: Option I (DHMO Plan Basic), Option II (DHMO Plan Enhanced), Option III (DPPO Low Plan), Option IV (DPPO High Plan), and Option V (PPO Premier Plan). Proposers must submit monthly rates for five coverage tiers (Employee Only, Employee + 1, Employee + 2, and Employee + 3 or more) under both a multiyear rate guarantee structure commencing January 1, 2027, and extending through December 31, 9999, and a single-year rate guarantee structure for the period January 1, 2027, through December 31, 2027. The document requires proposers to confirm whether rates reflect current benefit provisions or improvements, whether rates are inclusive of all services and materials, and whether DHMO and DPPO rates will be quoted together at subsequent renewals if a single carrier is selected. Bidders may propose rate caps for optional years beyond the guaranteed periods.
Proposers must certify that pricing is current, accurate, and complete, representing total compensation including out-of-pocket expenses for contract performance in accordance with all RFP requirements. All proposers must complete the price proposal pages with signatures from an authorized representative, provide the proposer's name, title, company, address, and contact information, and demonstrate financial stability to perform contract terms. The RFP requires certification of commercial non-discrimination compliance and disclosure of any legal proceedings. Failure to submit the completed and signed Appendix B price proposal pages with all required information will result in immediate rejection of the entire proposal response.
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Appendix B
| APPENDIX B | |
| PRICE PROPOSAL PAGES | |
| RFP NO. 26-041/DJ | |
| I. | CURRENT MULTIPLE DENTAL PROGRAM STRUCTURE - |
| MULTIPLE YEAR RATE GUARANTEE FROM 01/01/2027 - | 99/99/9999 | |
| A. | Option I - DHMO PLAN (Basic) | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| B. | Option II - DHMO PLAN (Enhanced) | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| C. | Option III - DPPO Low PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| D. | Option IV - DPPO High PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| E. | Option V - PPO Premier PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| 1. | The Option I - DHMO Plan (Basic) Plan rates are guaranteed from 01/01/2027 through: | 99/99/9999 |
| 2. | The Option II - DHMO Plan (Enhanced) rates are guaranteed from 01/01/2027 through: | 99/99/9999 |
| 3. | The Option III - DPPO Low Plan rates are guaranteed from 01/01/2027 through: | 99/99/9999 |
| 4. | The Option IV - DPPO High Plan rates are guaranteed from 01/01/2027 through: | 99/99/9999 |
| 5. | The Option V - DPPO Premier Plan rates are guaranteed from 01/01/2027 through: | 99/99/9999 |
| 6. | Will you provide a rate cap for optional years not included in your multiyear rate guarantee? | Yes/No |
| Rate cap percentage | 0% | |
| 7. | Do rates reflect the current benefits as presented in current DHMO Option I and II Benefit Slates or better? | Yes/No |
| If no, specify any differences. | ||
| 8. | Do rates reflect the current benefits as presented in current DPPO Benefit Slate Options III, IV, and V or better? | Yes/No |
| If no, specify any differences. | ||
| 9. | Are rates inclusive of all services and materials? | Yes/No |
| 10. | Confirm that the DHMO and DPPO rates will be quoted together rather than stand-alone at subsequent renewals (if one Carrier is selected). | Yes/No |
II. CURRENT MULTIPLE DENTAL PROGRAM STRUCTURE -
| SINGLE YEAR RATE GUARANTEE FROM 01/01/2027 - 12/31/2027). USE DUPLICATE COPIES TO PROPOSE RATE CAPPED SUBSEQUENT SINGLE YEARS. | ||
| A. | Option 1 - DHMO PLAN (Basic) | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| B. | Option II - DHMO PLAN (Enhanced) | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| C. | Option III - DPPO Low PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| D. | Option IV - DPPO High PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| E. | Option V - PPO Premier PLAN | MONTHLY RATE |
| Employee Only | $0.00 | |
| Employee + 1 | $0.00 | |
| Employee + 2 | $0.00 | |
| Employee + 3 or more | $0.00 | |
| 1. | Do rates reflect the current benefits as presented in current DHMO Option I and II Benefit Slates or better? | Yes/No |
| If no, specify any differences. | ||
| 2. | Do rates reflect the current benefits as presented in current DPPO Benefit Slate Options III, IV, and V or better? | Yes/No |
| If no, specify any differences. | ||
| 3. | Are rates inclusive of all services and materials? | Yes/No |
| If no, specify all excess charges in detail. |
| 4. | Confirm that the DHMO and DPPO rates will be quoted together rather than stand-alone at subsequent renewals (if one Carrier is selected). | Yes/No | |
| The proposer certifies by signature below the following: | |||
| a. | This pricing is current, accurate complete, and is presented as the Total Pricing, including "out-of-pocket" expenses (if any), for the performance of this Contract in accordance with the Requirements/Scope of Work/Services of this RFP. | ||
| b. | This Proposal is current, accurate, complete, and is presented to the County for the performance of this Contract in accordance with all the requirements as stated in this RFP. | ||
| c. | The Proposal is submitted without prior understanding, agreement, or connection with any corporation, firm, or person submitting a Proposal for the same materials, services, and supplies and is, in all respects, fair and without collusion or fraud. | ||
| d. | The financial stability to fully perform the terms and conditions as specified herein. The County reserves the right to request financial information from the proposer at any time during the solicitation process and in any form deemed necessary by the County. | ||
| e. | The information in Section 3.8 Commercial Non-Discrimination Certification is true and correct to the best of the Proposer's knowledge. | ||
| f. | There are no legal proceedings required to be disclosed, as required by Section 3.8 Commercial Non-Discrimination, except as disclosed in Proposer's proposal, if any. | ||
| Note: Failure to certify and submit the required information, if applicable, shall deem your proposal non-responsive. | |||
| IMPORTANT: FAILURE TO SUBMIT THESE PAGES, INCLUDING ALL REQUIRED INFORMATION AND SIGNATURES, WILL BE CAUSE FOR "IMMEDIATE REJECTION" OF THE ENTIRE PROPOSAL RESPONSE. | |||
| NAME (PRINT/TYPE): | |||
| TITLE: | |||
| COMPANY: | |||
| ADDRESS: | |||
| CITY/STATE/ZIP: | |||
| TELEPHONE NO.: | |||
| SIGNATURE: |
APPENDIX B - PRICE PROPOSAL PAGES CONFIDENTIAL AND PROPRIETARY Page &P of &N
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