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 3
- 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 solicitation requests 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. The RFP allows for two pricing submission approaches: a multi-year rate guarantee effective January 1, 2027, through an unspecified end date, or single-year rate guarantees for calendar year 2027 with optional subsequent year rate caps. The contract term begins January 1, 2027.
Proposers must certify that all pricing is current, accurate, and complete, representing total pricing inclusive of all services, materials, and out-of-pocket expenses. All proposed rates must reflect benefits equal to or better than the current benefit slates for respective plan options. Proposers must confirm that DHMO and DPPO rates will be quoted together at subsequent renewals rather than as standalone offerings. The document requires proposers to complete certification statements regarding pricing accuracy, fair competition practices, financial stability to perform contract obligations, compliance with commercial non-discrimination requirements, and disclosure of any legal proceedings. Failure to submit the completed Price Proposal Appendix with all required signatures and 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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