1. Complete the requested questionnaire. 2. Demonstrate capability to communicate, enroll and administer the voluntary programs at no cost to Hampton. 3. Provide or make available appropriate and high-quality dental insurance benefits to each Hampton member. 4. Offer provider networks that are sufficiently broad to ensure that all members have “reasonable access” to an adequate number of highly qualified general and specialist dental providers. Offerors should understand that the use of the phrase “reasonable access” when used in this RFP with respect to the dental network means that members should be able to locate several qualified providers within all proposed dental plan networks who: a. Have offices convenient to members’ homes or job site; b. Are accepting new patients; and c. Can schedule appointments for routine services within a few weeks and emergency appointments immediately. 5. Provide high quality, efficient program administration and services, including, but not limited to: a. Maintaining central claims and membership files for each covered member that includes identification numbers, dates of coverage, tier level of coverage, plan option elected, etc. b. Maintaining payment records and providing separate electronic and paper billing as required by Hampton. 6. Providing state-of-the-art data tracking and claims payment services. 7. Maintaining separate accounts or sub-groups as required by Hampton. 8. Providing identification cards to all covered members prior to the effective date of the program (1/1/2025). During the contract year, provide identification cards to new members within seven (7) business days of receipt of eligibility information. 9. Meet with representatives of Hampton within 15 days after the contract award date to review the dental program, to present the proposed communication material, and to jointly establish a preliminary implementation plan and an open enrollment program and schedule. 10. Maintain complete and total compliance with the HIPAA legislation as it pertains to Private Health Information. 11. Agree to release all pertinent data related to the administration and management of the dental program under the Business Associate Agreement to designated personnel of Hampton and their consulting team. 12. Provide open enrollment materials in hard copy and PDF format for Internet and intranet posting on a timely basis. 13. Commit to providing staff to participate in annual open enrollment meetings and health fairs. 14. Agree to assist with electronic and paper bill reconciliations. 15. Provide Hampton with monthly reports that reflect premiums paid, claims paid, and enrollment by contract and by members. 16. Provide a detailed renewal underwriting analysis each June 15 (or earlier if requested by Hampton) for potential contract renewals. 17. Provide Hampton with plan utilization data on an annual basis. 18. Commit to designating a primary, dedicated customer service team responsible for resolving problems, answering claims, eligibility and coverage questions and administrative or billing issues, and expediting services related to overall performance of the contract. 19. Provide an organizational chart and list of contacts (with phone numbers, email addresses, departments, and titles) in relevant functional areas and provide updates as changes occur. 20. Provide an administrative procedures manual to Hampton to be used to administer the program, including necessary forms and instructions. 21. Provide a systematic procedure for appeal of claims. 22. Provide specific performance guarantees which include financial penalties for non- performance. See Attachment H. 23. The Offeror must agree that in the event of termination or expiration of the contract, all data and records shall be transferred to the new contractor within thirty (30) days of Hampton’s request. Such transfer should be accomplished electronically.
