Specifications include, but are not limited to: Contractor must: 1. Be licensed to do business in the Commonwealth of Virginia. 2. Provide high quality, efficient dental and/or vision insurance benefits to each member. 3. Offer provider networks that are sufficiently broad to ensure that all members (active and retired) have “reasonable access” to an adequate number of highly qualified general and specialist dental providers and vision providers. 4. Provide high quality, efficient program administration and services, including, but not limited to 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. 5. Providing state-of-the-art data tracking and claims payment services. 6. Maintaining separate accounts or sub-groups as required by NNPS. 7. 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. 8. Meet with representatives of NNPS 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. 9. Maintain complete and total compliance with the HIPAA legislation as it pertains to Private Health Information. 10. 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 NNPS and their consulting team.
