A. Specific Project or Service Needs It is the purpose of LES to award a contract for a group dental insurance carrier. 1. LES currently has a self-insured dental contract. The proposal must match the current plan design. If you provide other alternatives in addition to the current plan design, you must specifically identify the differences in your proposal and indicate any impact on the rate. 2. Currently, LES has limited eligibility in the following manner: “any person who is a full-time active employee working at least 20 hours per week.” 3. LES contributes 80% of the premiums for both employee and dependent coverage. 4. LES has 492 participants out of 548 eligible employees (90% participation rate). In addition, LES currently has 2 COBRA participants. LES will continue its current eligibility and contribution practices. 5. Each proposal shall include a copy of the contracts and policies which may be used. The terms, conditions and endorsements for all proposed policies of insurance should be outlined in the contracts and policies. LES is requesting an Administrative Services Only (ASO) contract for this RFP that mirrors the current plan design. 6. If any of the items cannot be furnished or cannot be furnished in the manner requested, please attach an explanatory memo describing any alternative proposals. 7. Specifically, each proposal must provide at a minimum: PPO Network Provide a listing of the current providers for Lincoln, Nebraska, for the provider network that would be used by the successful contractor. Include overall percentage or provider participation in the Lincoln market. Within your network analysis of providers, please clearly identify those providers that your company has as IN NETWORK, where Ameritas does not. Furthermore, please identify those that Ameritas has IN NETWORK that your company does not. Attachment “A” is the provider utilization in the past rolling 12 months. Service Model A complete outline of the service model used by your company to provide the necessary service for LES. The proposal shall include biographies of the representatives designated for the account. Please indicate the area of responsibility each representative will have for example, party in charge of the project to conduct all coordination, company liaison, claims adjudication, marketing, legal matters, financial arrangements, computer reports, and renewal.
