SLED Opportunity · CALIFORNIA · COUNTY OF SAN MATEO
AI Summary
County of San Mateo seeks proposals for comprehensive dental coverage services for active employees and retirees. The RFP aims to ensure competitive pricing, robust provider networks, quality customer service, and efficient administration.
The Benefits Division within the Human Resources Department of the County of San Mateo is responsible for the design, administration, and oversight of employee and retiree benefit programs. The Division is located in San Mateo, California and serves a diverse population of active employees, eligible dependents, and retired employees across multiple departments and service locations throughout the County.
The Benefits Division administers comprehensive health and welfare programs that support the County’s workforce and retirees. These programs are structured to promote employee well-being, support recruitment and retention efforts, and ensure fiscal responsibility to taxpayers and plan participants.
The County is issuing this Dental Services Request for Proposal (RFP) to solicit competitive proposals from qualified vendors to provide comprehensive dental coverage for its active employees and retired population.
As part of its fiduciary and administrative responsibilities, the County conducts a full market evaluation of its dental benefits approximately every five years. This periodic RFP process ensures that the County:
The nature of this project is to secure a dental services provider that can deliver high-quality, accessible, and cost-effective dental care benefits. The selected vendor will be expected to administer dental coverage for both active and retired members, provide a broad and accessible provider network, deliver responsive customer service, and offer strong account management and administrative support.
The County provides dental insurance to its employees, retirees and their dependents. The employee and retiree PPO plan is a self-insured plan in which the County pays claims costs, and also pays an administrator to adjudicate claims and administer the claim payments. The employee and retiree DHMO is a fully-insured plan in which employees and retirees pay a premium for the plan.
For employees, a “core” dental plan is offered, along with a richer “buy-up” plan in which the incremental additional cost is borne by the employee. For retirees, a fully voluntary dental plan that approximates a retiree design is available at retirees’ expense.
Currently, the DPPO core plan has 2,723 subscribers, the DPPO buy-up plan has 1,701 subscribers and the DHMO plan has 1,300 subscribers enrolled in the plan. The retiree plans have 2,505 enrolled subscribers. The total lives covered under all plans is approximately 16,000.
The current provider for the dental program is Cigna. The County conducts a RFP every 5 years for dental services.
The current agreement with Cigna expires on December 31, 2026. This RFP applies to both the employee plan and the retiree plan.
Full Cigna SPD
Proposer must meet the definition per County Code of Ordinances, §2.89
please see sheet (MIN Qual) in County of San Mateo Dental RFP Workbook Final in Exhibit and Attachments
As Defined by Chapter 2.89.020 of the San Mateo County Ordinance Code, a “Local Business” means any for-profit business which has its principal place of business, or is headquartered, in San Mateo County. If this designation applies to the proposer, a self-attestation form must be completed and provided with this response.
Please download the below documents, complete, and upload. If this designation is not applicable, please leave blank.
A Non-Profit is defined as a tax-exempt public charity organization (within the meaning of section 501(c)(3) of the Internal Revenue Code) that is formed for purposes other than making a profit, is exempt from paying federal income taxes on the income generated for their exempt purposes.
As Defined by Chapter 2.89.020 of the San Mateo County Ordinance Code, a “Local Non-Profit" means a tax-exempt public charity organization (within the meaning of section 501(c)(3) of the Internal Revenue Code) that is formed for purposes other than making a profit, is exempt from paying federal income taxes on the income generated for their exempt purposes, and has its principal place of business, or is headquartered, in San Mateo County. If this designation applies to the proposer, a self-attestation form must be completed and provided with this response.
Please download the below documents, complete, and upload. If this designation is not applicable, please leave blank.
As Defined by Chapter 2.89.020 of the San Mateo County Ordinance Code:
“Small Business” means any business which holds a Small Business Certification awarded by the California Office of Small Business and Disabled Veteran Business Enterprise Services (OSDS).
“Micro Business” means any Small Business certified by the OSDS which is automatically designated by the OSDS as a Micro Business due to gross annual receipts falling below the OSDS-designated dollar amount.
If the above designations apply, please provide the OSDS provided Certification ID.
If this designation is not applicable, please leave blank.
As Defined by Chapter 2.89.020 of the San Mateo County Ordinance Code:
“Small Non-Profit" means a Local Non-Profit with an annual revenue of $1,000,000 to $2,500,000 according to its most recently filed IRS Form 990.
“Micro Non-Profit" means a Local Non-Profit with an annual revenue of less than $1,000,000, according to its most recently filed IRS Form 990.
If the above designations apply, please provide your latest filed IRS form 990. A filing from the last two calendar years is acceptable.
If this designation is not applicable, please leave blank.
Please see sheet (Questionnaire) in County of San Mateo Dental RFP Workbook FINAL in Exhibits and Attachments Section
Please upload completed workbook here
Update below if needed.
Is there an extension to this agreement?
Modify the extension information below, if needed
How many references are required by the vendor? (Number)
In rare circumstances where there is an expectation that proposers will need to submit trade secrets or other confidential information in order to respond to an RFP.
Q (Contract Exceptions Request): According to the RFP, a Contract Exceptions Request must be submitted by the deadline for questions. However, the online bidding platform does not permit uploading our Exceptions attachment under the Question & Answer tab. Could you please advise on the appropriate method for submitting our contract exceptions?
A: The Contract exceptions are not part of the RFP as the County will review and provide feedback after evaluation, and during contract negotiations, if selected.
Q (No subject): Please confirm that this is required to go out to market every five years regardless of whether there are any caps in place.
A: As noted in the RFP, our contract term is normally 5 years with an option to extend up to 2 years
Q (No subject): Is this guaranteed full takeover? If not, what are the portions it could split into?
A: We are evaluating the entire Dental plan as a full RFP and will not evaluate or consider a split
Q (No subject): What are the chances the County would want to keep the DHMO with a separate carrier or the incumbent?
A: We are looking at having 1 Dental vendor that can provide both plan options
Q (No subject): Please provide full certificates for each benefit option.
A: This information should be available in the attached RFP Dental Workbook in one of the tabs
Q (No subject): Please provide a detailed, broken out claims file in order to perform a full claims repricing.
A: This information should be available in the attached RFP Dental Workbook in one of the tabs
Q (No subject): Please provide benefit summaries for Year 2 active self-funded and management.
A: All summaries are inlcuded in the RFP workbook.
Q (No subject): How important is it to the County to keep PPO and DHMO with a single carrier?
A: This is very important to us
Q (No subject): Does the County expect the dental carrier to proactively advise on regulatory or legislative changes affecting public sector plans?
A: We value collaborative vendor partnerships and are seeking a vendor who will proactively monitor and communicate regulatory or legislative changes that could impact dental coverage or program administration.
Q (No subject): What level of ongoing reporting and governance does the County expect (monthly vs quarterly, standard vs custom reports)?
A: The County expects regular reporting and a collaborative governance structure to ensure transparency, performance monitoring, and ongoing program improvement. At a minimum, the County would expect quarterly reporting and governance meetings to review plan performance, utilization trends, member experience, and any emerging issues. Standard reports should include key metrics such as enrollment, claims utilization, network access, customer service performance, and financial summaries. The County may also request custom reports as needed to support program evaluation, budgeting, or strategic decision-making. In addition, the County values a vendor that will proactively provide insights, trend analysis, and recommendations, and communicate any regulatory, legislative, or market changes that may impact the dental program.
Q (No subject): Are there any known service, claims, or reporting pain points with Cigna that the County is looking to resolve in this RFP?
A: We have nothing to report at this time
Q (No subject): What feedback has the County received from bargaining units regarding the current Cigna dental program (PPO and DHMO)?
A: The County has not received any consistent or trending feedback from bargaining units regarding the current Cigna dental program (PPO and DHMO). At this time, there are no recurring concerns or issues that have been formally raised by bargaining unit representatives related to the program.
Q (No subject): Will the evaluation methodology give credit for carrier capabilities that actively manage the provider network—such as identifying outlier practice patterns, engaging providers to change behavior, and improving care delivery—even if the impact of those efforts is not immediately visible in year one claim projections?
A: The evaluation committee will evaluate proposals based on all of the evaluation criteria outlined in the RFP. In addition, the committee will also consider information provided during the vendor presentations. This process will allow the committee to review and assess many of the capabilities referenced in this question.
Q (No subject): Will the County of San Mateo be willing to entertain a proposal for Supplemental Health since our Dental and Vision coverages connect with Supplemental Health (via autopayment of Health Screening Benefit upon completion of a dental or vision exam)?
A: The County of San Mateo is currently evaluating proposals based on the criteria outlined in the RFP for dental plan coverage. At this time, the County is not considering proposals for supplemental health coverage as part of this procurement.
Q (No subject): Commission level is listed as 0% on the general info tab. Please provide clarification on what the requested commission is on both the ASO PPO and the DHMO.
A: This is correct. Please do not inlcude any commission in your quotes.
Q (No subject): Who will be the contract holder?
A: The County of San Mateo
Q (No subject): What is the structure of the self-funded represented plans? Are all three offered to union ees? Is each plan offered to a specific union piece?
A: The represented plans are available for all Union groups to choose from.
Q (No subject): All the represented plans are indicated year 2+. What are the year 1 benefits? Why is no one on them?
A: Please refer to the Census which indicates who is on the Representative Year 1 plan.
Q (No subject): Are the represented plans closed benefits? i.e. will there be new subscribers who become eligible for these benefits at the year 2+ or at a year 1 benefit level?
A: New hires will be enrolled in Year 1 Core plan. On year 2 and beyond, the represented employee can choose the Core plan, or one of the buy- up plans duing the following Open Enrollment.
Q (No subject): Are the PPO retirees moving to self-insured?
A: The retiree ASO PPO is self-funded. We apply the same increase to the funding rates as the active plans.
Q (No subject): Please provide a timeline of when each plan option moved to or from Cigna.
A: The County has been with Cigna dental since January 1, 2017.
Q (No subject): Please provide a timeline of any benefit changes that occurred prior to the issuing date of the benefit documents.
A: No benefit changes have been made
Q (No subject): If carriers cannot offer a 5-year guarantee with an additional 2-year option afterwards, is it a dealbreaker? Is the County looking for that on the DHMO and the FI PPO as well?
A: The RFP is requesting a 3 year Rate Guarantee on the ASO and DHMO rates. Separately, the County is requesting a 5 year agreement withthe option to extend up to 2 years
Q (No subject): Has there been any plan changes since 1/1/2024? If so, please provide what the changes were and the effective date of the changes by plan.
A: There has been no benefit changes
Q (No subject): Please confirm that retirees are not limited to the voluntary retiree DHMO and PPO plans shown in the RFP workbook. It appears that most of the retiree and Medicare individuals are enrolled in Active dental plans. For the individuals enrolled in core plans based on the census, is the County paying 90% for the coverage or the participants paying 100% of cost?
A: Confirming retirees are not limited to these plan as some retirees based on their MOU have the option to selct a core plan at retirement. The County pays 90% for active employees enrolled in the Core plan. Retirees have different payment structures based on their MOU
Q (No subject): Can retirees who are enrolled in Active plans continue to be covered under Active plans indefinitely or do they need to move to one of the retiree plans after a certain period of time?
A: Retirees who are eligible to retain their active plan at retirement may keep that plan indefinitely, provided there is no break or gap in coverage.
Q (Vendor Supporting Documents): Can you please confirm if we are to provide any additional supporting documents to the RFP Workbook section within the procurement portal?
A: Yes, you can submit addistionl documents in the portal
Q (Document size limits): Are there any file size limitations when uploading documents?
A: There should not be but you are welcome to upload a zip file if you run into any issues.
Q (No subject): Does the client want greater integration between dental and medical?
A: At this time, we are only exploring options for our Dental plan
Q (No subject): Are there new priorities for the dental program (cost savings, improved access, enhanced benefits, expanded preventive care, etc.)?
A: You are welcome to elaborate on your own capabilities in this realm
Q (No subject): Please provide the full SPD for all plans rather than the plan summaries so that we can properly understand the current plan provisions and details.
A: The full SPD for all plans is now attached under Addendum #1
Q (No subject): Claims substantially increase from11/2024 to 12/2024 on the Product_Account_Branch tab of the experience. Why?
A: We encourage you to review the workbook again as claims decreased from November to December 2024
Q (No subject): Please provide 2024 enrollment info.
A: Please refer to the Claims tab which includes 2024 enrollment
Q (No subject): Is there any sort of cost containment, shared savings, retained savings, etc. currently included in the ASO fee?
A: Not at this time
Q (No subject): Please provide a monthly aggregate report of total claims and enrollment by self-funded, FI PPO, and DHMO for 2023 and 2024.
A: Please reference what is provided in the RFP workbook
Q (No subject): Please provide monthly EOB or claim count data corresponding to the monthly claims data provided. Our ASO pricing depends heavily on the EOB volume and having this information would help us provide a more accurate quote.
A: Not available as it is not included in our standard reporting
Q (No subject): Please confirm that the experience shown under “Retire-County of San Mateo Retirees” only reflects experience for retirees enrolled in retiree plans and for retirees enrolled in Active plans, their experience is included with the regular Active experience.
A: Yes, confirmed
Q (No subject): Please confirm the enrollment data shows employee/retiree count, and not member count.
A: Yes, confirmed
Q (No subject): Please provide a copy of the most recent billing showing enrolled lives by plan and by tier.
A: Please reference the enrollment provided in the RFP workbook
Q (No subject): Is the DHMO plan being billed based on a flat composite rate? Is the RFP requesting a single composite rate for all tiers? If not, please provide the current tiered rates.
A: Yes, it is a composite rate
Q (No subject): Is County of San Mateo open to plan design recommendations supported by benchmarking.
A: We asked for matches to current plan design
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
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