San Bernardino County - 2026 Dental RFP Questionnaire (Attachment M)~1.xlsx

XLSX spreadsheet 30 KB Posted Oct 2, 2026

Attached to: RFP 2026 Active and Retired Employee Dental Benefits
Solicitation number: HRD127-HR-6551
Issued by: San Bernardino County, California

About this file

Written by GovTribe AI · Oct 2, 2026

This is a Request for Proposal (RFP) questionnaire for dental benefits administration issued by San Bernardino County, California, through Segal for Active and Retired Employee Dental Benefits effective 2026. The RFP seeks vendors to provide comprehensive dental benefits administration services, including both Dental Preferred Provider Organization (DPPO) and Dental Health Maintenance Organization (DHMO) plan options. Vendors must demonstrate capability to administer claims processing, maintain provider networks throughout San Bernardino County and surrounding areas, manage eligibility and enrollment, and support open enrollment and new employee orientation meetings. The proposal requires responses in Excel format with specific answers to detailed questionnaires covering general qualifications, minimum requirements, account management, administrative services, network dental provisions, and plan-specific details for both PPO and HMO offerings. Responses must include network provider tables, geographic access reports, and financial exhibits with copay schedules. The contract term may extend up to five years, structured as either an initial five-year term or an initial three-year term with an option to renew for one additional two-year term, with rate guarantees of a minimum of 36 months from contract commencement.

Vendors must confirm that all quoted fees are firm and guaranteed for the specified period with no automatic annual renewals, and that pricing includes all services and supplies without additional charges such as start-up costs, booklets, or printing. The RFP requires vendors to maintain compliance with HIPAA and privacy laws, execute Business Associate Agreements, and agree to comprehensive audit rights allowing the County to review and audit all records pertaining to services delivered for three years post-payment. Vendors must provide implementation allowances to offset the County's programming and communication costs and confirm that pricing does not include commissions. The County reserves the right to award contracts to multiple bidders or waive its right to award for any plan of benefits, maintains the right to terminate the contract with 30 days' notice, and requires vendors to transfer all enrollment cards, claim information, and administrative records to any replacement carrier at no charge. Additional requirements include maintaining Spanish-language communication capabilities, providing dedicated account management with 24-hour response times, offering customer service availability from 8:00 AM to 6:00 PM PDT, and maintaining member websites with claim status, provider locators, and cost calculators.

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File	Type	Posted
2026 San Bernardino County - Dental RFP~2.pdf	PDF	Oct 2, 2026
San Bernardino County - 2026 Active and Retiree Dental RFP Workbook~1.xlsb	XLSB spreadsheet	Oct 2, 2026

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Vendor Instructions RFP Response Sheet

Please read the directions below as our process has changed.

Please read, review and provide the information requested in this workbook. The cells will automatically expand as needed if your response is longer than the space shown in the cell, however, brevity is expected. Limitations do exist.

Beware that some questions request only a Yes or No response. Some questions contain limits on the length of your response.

The purpose of these limitations is to allow the client to asses the responses as appropriate in a brief manner.

The worksheet is also locked so that you can only enter information in the Answers column or on the exhibits as requested.

Do NOT insert tabs or extra attachments unless instructed to do so.

Do NOT respond by "referring the Client to an attachment".

Do NOT delete sections of the questionnaire. If something does not apply to you leave it blank, or mark N/A. If you take something out, it will cause your responses to not line up correctly with the questions when we do the analysis.

Should you have any questions concerning the Questionnaire in this RFP, please reach out to the following contact(s) at Segal:

Document Required for this Request for Proposal:

1) Questionnaire - Excel. Requires responses completed and returned in Excel format. DO NOT PDF

This Request For Proposal form is the sole property of Segal and is not intended to be reproduced for any purpose other than review by the Plan Sponsor contracted with Segal to prepare a procurement analysis. This file cannot be copied or reproduced in any method without the written consent by Segal.

Questions

ID	Questions	Answers
Section 1 - GENERAL QUESTIONS / QUALIFICATIONS & EXPERIENCE
1.1	What is your company name?
1.2	How many years has your firm offered the benefits outlined in the referenced Scope of Work ?
1.3	Would you match the benefits outlined in the Benefit Plan Summary to all participants included in the attached census?
1.4	Are you able to administer the Benefit Plan Summary per the attached?
1.5	In the last 5 years, has your organization been involved in any Litigation that would prohibit your organization from delivering the Scope of Work outlined in the RFP?
1.6	If you have been involved in any litigation in the last 5 years, please explain.
1.7	Have you ever had any litigation specific to the County?
1.8	If you have had any litigation specific to the County, please explain.
1.9	Has your organization completed any mergers or acquisitions in the last 24 months?
1.10	If you have completed a merger or acquisition in the last 24 months, will this impact the services requested, specifically the following:
1.10.a	Claim Processing?
1.10.b	Network Management?
1.10.c	Administrative Services?
1.11	If you have completed a merger or acquisition in the last 24 months, what impact will this have on the services provided?
1.12	Have you made any recent changes in your operational platform that will impact the success of delivering the services outlined in the Scope of Work?
1.13	Does your firm have affiliates with any other company? Name the parent company of your organization if applicable.
1.14	If your firm is not a corporation, do you have any partners, proprietor, or other owners who have any interest in any provider firms utilized to provide the services of this RFP?
1.15	Are you a broker or agency offering the products in this Scope of Work?
1.16	Please respond to the following:
1.16.a	Is your firm the sole responder to this RFP or are you partnering with other vendors to deliver the Scope of Work?
1.16.b	If you are partnering with other vendors, please explain who and why?
1.17	Do you anticipate any restructuring or reorganizing within the next two years? (this includes addition, reductions, relocations, or redesign of systems)
1.18	What are the most recent ratings, including the date of the rating for your company by the following (If not applicable, include a N/A)?
1.18.a	AM Best
1.18.b	Standard and Poor's (S&P)
1.18.c	Moody's
1.19	What is your firm's Net Promoter Score (NPS)?
1.20	Do you have a local office to serve the County?
1.21	Do you agree that any data and information regarding the County supplied to you for purposes of responding to this RFP will be destroyed immediately upon receiving notice that you were not the successful winner?
1.22	Recipient confirms and agrees that the data and information provided, which may include protected health information related to plan’s participants and beneficiaries, provided under the Agreement (“Plan Data”) is and shall remain the property of the plan. Recipient is not granted any right, title or interest in any Plan Data. Recipient may use and disclose Plan Data solely as necessary to effectuate the purpose and will not use, disclose, decompile, or reverse engineer, any Plan Data in support of Recipient’s other business activities. Specifically, Recipient will not de-identify any Plan Data or aggregate Plan Data (whether or not de-identified) with data received from Recipient’s other clients, customers or data sources.
1.23	Do you anticipate any transition issues with the following:
1.23.a	Eligibility
1.23.b	Benefit administration
1.23.c	Transition of care
1.23.d	Deductible and out of pocket transitions (if applicable)
1.24	Should your firm be awarded this RFP, how soon after notification (# of business days) of award would you be able to prepare the rough draft for the following:
1.24.a	Master Policy
1.24.b	Plan Booklet
1.24.c	Summary of Benefits or SBC
1.24.d	Contract Draft
1.25	Should your firm be awarded this RFP, identify any services performed outside the borders of the United States of America.
1.26	Does your firm have the capability to prepare communication pieces for the enrollees in Spanish?
1.27	Will you provide an Implementation / Communications / RFP allowance that the County can use to offset the costs of programming, communication efforts, and/or County incurred professional fees (Consulting Fees) of administering this RFP? If so, please provide the amount and confirm that this allowance will not be loaded into the premium rates in any form. To be clear, while the use of the funds may differ, this request is applicable to both incumbent and prospective Bidders.
1.28	Please list here all underwriting conditions that apply to your proposal.
1.29	If your proposed coverage does not duplicate exactly the coverage currently in effect, clearly list any and all deviations in the attached benefit summary in Attachment N. Unless there is a deviation listed in this summary, it will be assumed that your proposed coverage exactly duplicates the coverage provided in Attachment N.
1.30	Do you agree that all books, records, lists or names, plates, seals, passbooks, journals and ledgers and all data specific to this Plan shall be the property of and shall be used exclusively for this Plan at the direction of the County? Your proposal must specifically answer this question.
1.31	Please respond to the following:
1.31.a	Do you have a formal HIPAA compliance plan in place?
1.31.b	Will you provide us with a sample copy upon request?
1.32	Will your organization be issuing Notices of Privacy Practices as required by HIPAA to each new plan enrollee?
Section 2 - MINIMUM REQUIREMENTS
2.1	Proposal Responses (Initial and Best and Final, if applicable) and Interviews (if applicable) will become part of the final contract. Do you agree that your written response to this RFP, written information provided as part of the interview or clarification questions will become part of the final contract for services outlined in the Scope of Services?
2.2	Do you agree that the terms for the RFP/bid are guaranteed for at least 270 days (9 months) from the proposal due date?
2.3	Do you agree that the contract will not "auto" renew annually, and you will send a renewal confirmation each year, whether or not under a rate/fee guarantee, no later than 180 days from the effective date of coverage?
2.4	Confirm that your proposal fees are guaranteed for a minimum of 36 months from the commencement of the contract. Multi-year contracts are favored.
2.5	Confirm the rates and fees quoted in your proposal are firm and will not be recalculated based on actual enrollment or subsequent shifts in enrollment.
2.6	Do you agree that the terms of the RFP responses are valid until a final contract is executed?
2.7	Confirm that you understand the Contract, if awarded, may be for a maximum term of five (5) years, structured as either an initial five-year term or an initial three (3) year term with the option to renew for one (1) additional two (2) year term. The Contract will expire at the end of the applicable term and will not automatically renew.
2.8	Do you agree that this bid response is NOT contingent on purchasing any services other than in the Scope of Work?
2.9	Do you agree to provide no less than 30 day notice for any changes involving the sale, merger, data breaches, layoffs, participating provider terminations, consolidations, or outsourcing of services to foreign workers?
2.10	Do you agree that the County shall have the option not to pay any additional fee that associated with the vendor's subcontractor arrangement.
2.11	Do you agree to include in your contract a hold harmless provision that indemnifies the County against liability that arises as the result of negligent acts, errors, omissions, fraud and other criminal acts committed by your network providers, officers, employees, and agents of the organization?
2.12	Confirm you will not solicit the County's members for any other products or services that your firm might offer, and confirm you will not sell any mailing or other list that includes the County member information without express written consent from the County.
2.13	Do you agree to the County has the right to review and audit the plan's files and financial accounting data to assure that claims subject to each proposed coverage are evaluated in accordance with the plan documents?
2.14	Right to Audit: Confirm Yes or No to the following audit right requirements.
2.14.a	Bidder agrees that all records pertaining to Services delivered and all fiscal, statistical and management books and records shall be available for examination and audit by County representatives for a period of three years after final payment under the Agreement or until all pending County, State and Federal audits are completed, whichever is later.
2.14.b	Bidder agrees to grant the right of the County or its representative(s) to audit claims at any time during and up to two years following termination of the business relationship with prior written notification. The County will have access to 100% of all valid claim records to complete the audit at no cost to the plan sponsor. Bidder agrees to provide all necessary claims details, data definitions and reasonable support to complete an independent claim audit for each completed year under the contract in effect. The County will not be held responsible for time or miscellaneous costs incurred by the bidder in association with an audit including, but not limited to, the costs associated with providing audit reports, systems access, or onsite space.
2.14.c	Such audits may be based on either a 100% review of claims or a statistically representative sample thereof, or combination of methodologies. Auditor’s preliminary findings will be shared with Vendor. Any findings from a statistically representative sample of claims will be extrapolated to the total claims population for purposes of measuring overall financial dollar and incidence processing achievements; Vendor will produce financial impact reports for confirmed systemic errors. In the instance where Auditor has reviewed 100% of claims and identified suspect claims, Vendor may elect to review a mutually-agreed upon representative sample of the suspect claims.
2.14.d	The audit may include an onsite review of the sample claims by the Auditor at Vendor’s office. The Auditor will provide Vendor with the sample claims thirty (30) calendar days in advance of the onsite review. The onsite review will last up to five (5) business days.
2.14.e	The scope of such audits may include up to three (3) benefit plan years as determined by the County.
2.14.f	Any and all costs and expenses of each party associated with the County's audit shall be borne by the party incurring the cost. The parties agree that the scope of audits by the County or Auditor will not be duplicative of the SSAE-18 audit, but may include inspection and/or verification of certain information provided in the SSAE-18 audits to the extent necessary to give a more thorough understanding of and support for such information. Audit materials or documentation provided by Vendor will be confined to the County-specific information.
2.14.g	If the audit discovers any validated overpayment of fees or claim payments by Vendor or other errors that result in economic losses to the County for failure to meet all vendor guarantees or performance standards, then Vendor shall pay the amount owed to the County following completion of the audit, within 30 days of written confirmation from the County as to the agreed upon settlement terms and amounts.
2.15	Do you agree to maintain all required records for seven years, pertaining to the administration of the plans in force?
2.16	Do you agree to the transition of all records as requested by the County in the case of termination? This may include claim accumulators, plan experience, premiums (if applicable) and eligibility at no added fee to the County?
2.17	Do you agree to pay the run out claims for the County (including at a minimum 12 months of claim payments) following termination at no added fees to the County?
2.18	Do you agree to supply the necessary underwriting documentation for all renewals 180 days prior to the effective date?
2.19	If selected, are you able to provide the services outlined in the Scope of Work?
2.20	Do you agree to maintain compliance with HIPAA and other privacy laws, including Business Associate Agreement (BAA), for the duration of the contract with the County?
2.21	Confirm that your pricing does not include commissions?
2.22	Do you agree that if this proposal results in your company being awarded a contract and if, in the preparation of that contract, there are inconsistencies between what was proposed and accepted versus the contract language that has been generated and executed, that any controversy arising over such discrepancy will be resolved in favor of the language contained in the proposal or correspondence relating to your proposal?
2.23	Do you agree to all the terms and conditions in Section X of this RFP?
2.24	The County reserves the right to offer awards of contract to multiple Bidders for any, or all, plans of benefits contained in this RFP. The County also reserves the right to waive its right to award a contract for any plan of benefits contained in this RFP. Confirm your agreement with this provision.
2.25	Other than the quoted premium rates in Attachment E of this RFP, there should not be any other charges or fees of any kind that will or could apply to the County such as start-up costs, booklets or printing. The fees quoted shall include all services and supplies that could reasonably be expected to be provided to the County during the course of your administration of the plans. Confirm your agreement to this requirement
2.26	The County requires that it maintain the right to terminate the contract at any time provided that it gives 30 days advance written notification to the contractor. Do you agree to this provision?
2.27	Will you transfer enrollment cards, claim information, and other administrative records to any carrier that would replace you in the event of termination of this contract at no charge?
2.28	Do you agree to the provision that changes in the rates may only occur on the anniversary date unless required by mandatory benefit changes?
2.29	Confirm that your company is in compliance with all state and federal laws applicable to the programs you are proposing.
Section 3 - ACCOUNT MANAGEMENT
3.1	Confirm the Account Manager will respond to phone calls or emails within 24 hours of receipt.
3.2	Confirm you will attend the Open Enrollment meetings and New Employee Orientation to review benefits and respond to questions.
3.3	How many clients does the Account Manager currently support?
3.4	Confirm your Account Manager will meet with the County to define the group, subgroup, and other reporting criteria necessary to support the County's decision making process.
3.5	Confirm that Account Manager will be present for monthly/quarterly meetings established by the County or as requested.
3.6	Confirm the Account Manager will present any legislative impacts to the employee/member benefits or any changes recommended for approval by the County.
3.7	Do you agree that all sample forms and communication materials will be provided to the County in advance of distribution for approval (i.e., claim forms, enrollment forms, booklets, brochures, flyers, mailers, etc.)?
3.8	Can you provide onsite mobile dental services for employees and/or financial support to promote oral health? Describe the services and/or support you can provide.
3.9	Do your provider contracts prohibit providers from balance billing patients for amounts over any negotiated charges?
Section 4 - ADMINISTRATIVE SERVICES/CLAIM ADMINISTRATION
4.1	What is the minimum time for implementation needed to initiate the proposed benefits or scope of work?
4.2	Will dedicated customer service representatives / team be assigned to this account?
4.3	Confirm your customer service team is available to serve the County's participants from 8:00AM - 6:00PM, PDT.
4.4	Are the calls received "after hours" of operation handled by a service or voicemail system allowing participants to leave a message?
4.5	Do you offer access assistance for the Hearing Impaired, 24 hour toll-free automated benefits, eligibility, and customer service via internet? Specify which.
4.6	Do you offer customer service representatives with multiple languages such as Spanish, Tagalog, and Chinese, etc.?
4.7	Please provide the geographic location for the Customer Service unit that will be serving the County. (City/State)
4.8	Confirm all customer service representatives are located in the continental United States of America.
4.9	Do you agree to the following:
4.9.a	Do you agree to provide summary and claim line detail, including accumulator data at such time the County chooses to terminate a future contract?
4.9.b	Do you agree to supply this information within 30 days of the termination date?
4.9.c	Do you agree to supply this information at no additional charge to the County?
4.10	Of the services listed below, indicate those services that are available on your member website and/or mobile app:
4.10.a	Check Claim Status
4.10.b	View Claim History
4.10.c	Contact Customer Service
4.10.d	Cost Treatment Calculators
4.10.e	Provider Locator
4.10.f	On-line Provider Directories
4.10.g	Plan Benefit Descriptions
4.10.h	Provider Price Comparison Tool (for common services such as office visits, etc.)
4.10.i	Provider Quality Ratings
4.10.j	Patient Satisfaction Information
4.10.k	Print ID Card
4.11	Discuss your organization's dental utilization review program, quality control protocols, provide % of dentists audited annually, and % of contracts termed due to result of audit.
4.12	Do you agree to accept any specified eligibility rules established by the County?
4.13	The County requires that retroactive changes, additions and deletions to eligibility be permitted up to 90 days in arrears of the initial eligibility effective dates. Does your company accept these terms?
4.14	Confirm that you agree to waive any and all actively at work restrictions and pre-existing condition limitations for employees enrolled in the plan on the contract effective date and waive any pre-existing limitation for employees that enroll after the policy effective date. Contract should include such language.
4.15	Will you guarantee that all insured (including COBRA participants), who would have continued to be covered on the plan effective date if there had been no change in carriers, will be covered by your policy on the plan effective date?
4.16	Describe the grievance protocols in place for plan participants. Do you have a response time goal for which to respond to claim and other questions and complaints?
4.17	What disaster recovery protocols does your company have in place?
4.18	When you are the secondary payor in a COB situation, do you use your UCR profiles, reduced network fees, or those of the primary carrier in determining your level of reimbursement?
4.19	Do you have a secure website that the County can use to maintain eligibility enrollments, changes and addresses?
4.20	What is the standard required amount of malpractice coverage (individual and aggregate)?
Section 5 - NETWORK DENTAL
5.1	What is the marketing name of your network(s) being proposed to the County?
5.2	Do you contract directly with the providers within California?
5.3	Do you contract directly with providers outside California?
5.4	Please complete the following:
5.4.a	Do you lease any portion of the network offered as part of this proposal?
5.4.b	If so, list who and for what services? Include wrap networks.
5.5	Do you agree to maintain the size of your San Bernardino County network for the duration of the contract to be no less than the size provided in your response to this RFP?
5.6	Do you anticipate a change in the size or location of your network in the next year that would affect the County's participants?
5.7	Do you anticipate any network changes over the next twelve months for:
5.7.a	General Providers?
5.7.b	Specialists?
5.8	Confirm you have completed the Network Provider table and provided Geo Access reports for the network(s) proposed using the criteria as outlined in the RFP workbook.
5.9	Do any network providers include night or weekend hours?
5.10	Can the County or plan participant nominate providers to be considered for inclusion in the DHMO or DPPO network panel?
5.11	Are there any dental services or specialties which are not available in your DHMO or DPPO network in any of the areas in which there are plan participants based on the census provided? If so, what are they? What provisions are made for patients requiring these services?
5.12	How often are network fees, capitations and out-of-network allowances updated?
5.13	Do you offer a discounted or preferred provider networks? Describe network and cost savings.
5.14	How do you propose to provide services to outlying areas such as Needles, Trona, and Baker?
5.15	Are your DPPO and DHMO networks licensed in the State of California?
5.16	Are the DPPO and DHMO networks solely owned and operated by your organization? If not, explain the contractual relationship you have with outside parties. Are your provider contracts based on exclusive arrangements? Include any leasing arrangements currently in effect.
Section 6 - DENTAL PPO CLAIM ADMINISTRATION
6.1	From what location would the County's claims be processed?
6.2	What are your claim processing standards for turnaround time, procedural accuracy and financial accuracy? Provide actual results for the last two (2) years.
6.3	Please complete the following:
6.3.a	Does your claim system have any protections against unbundling and/or upgrading claims?
6.3.b	If yes, explain.
6.4	Does your claim system have protections against fraud by:
6.4.a	Providers
6.4.b	Members
6.4.c	Employers/Trust
6.5	If you use a pre-treatment review process, please explain.
6.6	What is the turnaround time for a pretreatment review process?
6.7	How are network claims processed?
6.8	Are authorization forms necessary?
6.9	Are ID cards required?
6.10	Do members pay up-front and submit claims for reimbursement or are members responsible for only plan, deductibles and coinsurance?
6.11	Do you have any paper claims still in process?
6.12	How do you process any non-network provider claims?
6.13	Currently the 80th percentile is used to determine the usual and customary for out-of-network claims. Can you administer the 80th percentile?
6.14	Does your plan use maximum allowable cost for limiting non-network allowances?
6.15	For your BoB, on average what percent of Fair Health is your non-network allowance for San Bernardino County?
6.16	How do you determine the maximum allowable charges?
6.17	Do maximum allowable charges differ by zip code?
6.18	How often to update the maximum allowable charges?
6.19	What steps are taken if the maximum allowable charge is uncoded?
6.20	How can a claimant find out what the maximum allowable charge is for a particular procedure in advance of having the procedure performed?
6.21	Does your proposed plan include any exclusions or limitations that are more restrictive than the current plan?
6.22	Are you offering any deductible or coinsurance levels that differ from the current plan?
6.23	Are you offering any maximums that differ from the current plan?
6.24	Does your proposed plan include any services that are paid in a different benefit class than the current plan?
6.25	Does your proposed plan have any frequency limits that differ from the current plan?
6.26	Does your proposed plan have any waiting period limitations where none exist under the current plan?
6.27	Does your proposed plan include any pre-existing condition limitations?
6.28	Describe how you would handle a late entrant?
6.29	How will your plan pay benefits for students who reside outside of the State?
6.30	Up to what age do you cover fluoride treatments and how often?
6.31	Up to what age do you cover sealants and how often?
6.32	Confirm that you agree to waive the retiree waiting period for Class III – major restorative work under the DPPO plan as long as the subscriber had no break in coverage.
6.33	Describe the way in which the banking arrangement works for an ASO arrangement. Include explanations of the nature of the account from which claims are paid (e.g., in whose name it appears, where it will be, the timing of the call for funds (e.g., as checks are issued, as they are cashed), any deposit amount required in the account, its term (weekly, monthly) how it is determined and any interest earned on the deposit, or on amounts held in the account until checks are cashed. In addition, please explain how excess deposits are handled during the term of the plan and when deposits are returned upon plan termination (including whether a deposit can be retained to pay for any deficit etc.). If banking charges are not included and detailed separately in your minimum premium rate or/and administrative fee and retention illustration, please provide an estimate of such charges and describe the basis on which they are made.
6.34	For your ASO plan, will you stock pile claims to a certain level before releasing them, so that the plan

sponsor can fund claims less frequently?

6.35	What audits of reconciliations are done?
6.36	Can a plan sponsor provide its own set of allowances or “freeze” the existing level of reimbursement for non-PPO dentists? If so, is there any limitation on, or is there any extra charge for doing so? If so, what are the limitations/charges?
Section 7 - DENTAL HMO
7.1	The County currently offers a Dental HMO/Pre-paid Plan. Are you able to administer the current program benefits?
7.2	Indicate the Name for the plan you are proposing.
7.3	Is each participant of a family allowed to select their own individual primary care dentist under your Dental HMO plan?
7.4	How often can a member change their primary dentist selection?
7.5	How can the selection change be made (i.e., calling customer service, online, etc.)?
7.6	When would the change be effective?
7.7	Does your plan's copay schedule apply to specialists or must participants pay a different fee (e.g. discount from provider's normal charge)?
7.8	What performance standards do you require of dentists with respect to scheduling routine dental care?
7.9	What performance standards do you require of dentists with respect to emergency care?
7.10	Do your primary care dentists serve as "gatekeepers" for specialty referrals?
7.11	Do you monitor self referred visits to specialty care providers?
7.12	What is the average waiting time for routine cleanings, other routine appointments, first appointments, emergency appointments for in-network providers?
7.13	What method do you use to verify that participants are treated the same as the provider's fee for service patients?
7.14	Does your plan cover nitrous oxide analgesia?
7.15	Does your plan cover dental implants?
7.16	What types of sedatives do you cover and what are the coverage limitations?
7.17	Do you cover temporary filings?
7.18	Do you cover Guided Tissue Regeneration?
7.19	Confirm you completed a DHMO copay schedule in the Financial Exhibits following.
7.20	Do you agree not to change the schedule for the duration of the period you have guaranteed rates?
7.21	Describe how treatment in progress (at initial takeover) will be covered?
7.22	How will orthodontic claims in process be adjudicated at transition?
7.23	Please explain what happens when an enrollee obtains services outside the DHMO network. Are there any situations in which benefits are payable?
7.24	How will your plan pay benefits for students who reside outside of the State?

File details come from the government source that posted it. Updated Oct 2, 2026.