Specifications include, but are not limited to: Sunnyside Unified School District is requesting Group PPO Dental and/or DHMO proposals and/or Group Vision proposals. A low-cost option PPO dental program to replace or coincide with the prepaid option is also requested, along with alternate high plan options and recommended plan changes to reduce the overall premium. Examples include adding deductible to basic and major services, higher out of networkcost share, etc. 4.1Account Management4.1.1Provide a dedicated Account Manager and Account Management Team4.2Customer Service4.2.1Provide customer service to answer inquiries on claims, eligibility, provider network, services,coverage, or other inquiries Monday through Friday from 8:00 AM to 6:00 PM (AZ time).4.3Open Enrollment Support4.3.1Prepare and provide Benefit Presentations in collaboration with the District4.3.2Attend Open Enrollment Meetings4.4Claims Administration4.4.1Provide claims forms.4.4.2Receive claims and process payments of benefits in accordance with the plan designs.4.4.3Correspond with participants and providers if additional information is necessary to completethe processing of claims.4.4.4Coordinate benefits payable under the Plan and with other benefit plans, if applicable.4.4.5Provide notice to the Participants regarding the reason(s) for denial of benefits (which aredenied) and provide for the review of such denied claims.
