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 4
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 seeks pricing for five dental plan options: Option I (DHMO Plan Basic), Option II (DHMO Plan Enhanced), Option III (DPPO Low), Option IV (DPPO High), and Option V (PPO Premier). Proposers may submit rates under two structures: a multiple-year rate guarantee commencing January 1, 2027, through an unspecified end date, or single-year rate guarantees for calendar year 2027 with optional subsequent single-year proposals subject to rate caps. All rates must be quoted on a monthly basis across four coverage tiers: Employee Only, Employee + 1, Employee + 2, and Employee + 3 or more. Proposers must confirm that rates reflect current benefit offerings or improvements, that all services and materials are included in the quoted rates, and that DHMO and DPPO plans will be quoted together rather than as standalone options at subsequent renewals if selected.

Proposers must submit complete pricing information as total contract cost including all out-of-pocket expenses and certify the accuracy and completeness of their proposals. The submission requires proposer certification regarding fair competition without collusion or fraud, financial stability to perform contract obligations, compliance with commercial non-discrimination requirements, and disclosure of any legal proceedings. Failure to submit the completed Appendix B with all required signatures and certifications will result in immediate rejection of the entire proposal. The form provides space for proposer name, title, company, address, contact information, and authorized signature, with the completed pages marked as confidential and proprietary.

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Other files

File Type Posted
RFP_26_041-DJ_Appendix A_Questionnaire.xlsx XLSX spreadsheet
RFP_26_041_Attachment 2_2022 Enhanced_DHMO_FL_Large_Group_DPPO_Certificate_S200B_Access+PBC-PBC_Board_of_County_Commissioners.pdf PDF
RFP_26_041_Attachment 2_2022 FL Large Group DPPO Certificate 11425 - PBC Board of County Commissioners.pdf PDF
RFP_26-041-DJ_Appendix C_Option I_DHMO Plan (Basic) - draft.xlsx XLSX spreadsheet
RFP_26_041_Attachment 2_2022 Basic_DHMO_Cert.pdf PDF
RFP_26_041_Attachment 2_PPO High Plan 11425 summary.pdf PDF
RFP_26_041_Attachment 2_DHMO S700B PBC Access + Basic summary.pdf PDF
RFP_26-041-DJ_Appendix E_Option III_DPPO Low Plan - draft.xlsx XLSX spreadsheet
RFP_26-041-DJ_Appendix G_Option V_DPPO Premier Plan - draft.xlsx XLSX spreadsheet
RFP_26_041_Attachment 2_PPO Premier 11426 summary.pdf PDF
RFP_26_041-Attachment 3_1 of 2_Claims Experience.pdf PDF
RFP_26_041_Attachment 2_PPO Low Plan 11424 summary.pdf PDF
RFP_26_041_Attachment 2_2022 FL Large Group DPPO Certificate 11426 - PBC Board of County Commissioners.pdf PDF
RFP_26_041_Attachment 2_2022 FL Large Group DPPO Certificate 11424 - PBC Board of County Commissioners.pdf PDF
RFP_26-041-DJ_Appendix F_Option IV_DPPO High Plan - draft.xlsx XLSX spreadsheet
RFP_26-041-DJ_Appendix D_Option II_DHMO Plan (Enhanced) - draft.xlsx XLSX spreadsheet
RFP_26_041-DJ_Appendix H_Dental DPPO Fee and UCR Schedule - draft.xlsx XLSX spreadsheet
RFP_26_041-Attachment 3_2 of 2_13001 - Palm Beach County Supervisor of Elections-PPO DHMO Experience FV.pdf PDF
RFP_26_041_Attachment 2_DHMO S200B PBC Access Enhanced summary.pdf PDF
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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 PLANMONTHLY RATE
Employee Only$0.00
Employee + 1$0.00
Employee + 2$0.00
Employee + 3 or more$0.00
D.Option IV - DPPO High PLANMONTHLY RATE
Employee Only$0.00
Employee + 1$0.00
Employee + 2$0.00
Employee + 3 or more$0.00
E.Option V - PPO Premier PLANMONTHLY 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 percentage0%
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 PLANMONTHLY RATE
Employee Only$0.00
Employee + 1$0.00
Employee + 2$0.00
Employee + 3 or more$0.00
D.Option IV - DPPO High PLANMONTHLY RATE
Employee Only$0.00
Employee + 1$0.00
Employee + 2$0.00
Employee + 3 or more$0.00
E.Option V - PPO Premier PLANMONTHLY 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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