Posted Date : November 20,2020
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-4727
Government Authority located in Arizona; USA based organization looking for expert vendor for voluntary HMO and PPO dental service.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide voluntary HMO and PPO dental service.
• Provide a designated Account Manager and Account Management Team
• Provide a designated call and claim unit with toll free telephone access.
• Provide customer service to answer inquiries on claims, eligibility, provider network, services, coverage, or other inquiries from participants Monday through Friday from 8:00 AM to 6:00 PM (AZ time)
• Attend four days of Annual Open Enrollment Meetings in Phoenix, Arizona during normal business hours. This is contingent on COVID guideline requirements at the time.
• Provide bilingual communication/educational materials
• Coordinate and mail ID cards and policy summary/certificates to participants’ homes, (as applicable).
• Provide claims forms (as applicable)
• Receive claims and process payments of benefits in accordance with the plan designs for all claims incurred
• Correspond with participants and providers if additional information is necessary to complete the processing of claims
• Determine benefits payable under the Plan, pursuant to the terms and conditions of the District’s Benefit Plan booklets
• Coordinate benefits payable under the Plan and with other benefit plans, if applicable
• Provide notice to the Participants regarding the reason(s) for denial of benefits (which are denied) and provide for the review of such denied claims
• Accept weekly eligibility updates from District’s online eligibility system (file formats 834, CVS or flat file)
• Administer eligibility based on the District’s eligibility criteria
• Provide eligibility services, including, but not limited to, tracking and determination of disability for adult children approaching and over age 26
• Access to Enrollment/Eligibility Administration Portal for Employer
• Access to Claims Administration Portal for Employee to track dental history, estimate dental costs, compare dental service providers for quality and price, search for providers and print/request personal ID cards
(2) All the questions must be submitted no later than December 08, 2020
(3) The contract period will be for one year.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: January 13,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
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Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-4727
Government Authority located in Arizona; USA based organization looking for expert vendor for voluntary HMO and PPO dental service.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide voluntary HMO and PPO dental service.
• Provide a designated Account Manager and Account Management Team
• Provide a designated call and claim unit with toll free telephone access.
• Provide customer service to answer inquiries on claims, eligibility, provider network, services, coverage, or other inquiries from participants Monday through Friday from 8:00 AM to 6:00 PM (AZ time)
• Attend four days of Annual Open Enrollment Meetings in Phoenix, Arizona during normal business hours. This is contingent on COVID guideline requirements at the time.
• Provide bilingual communication/educational materials
• Coordinate and mail ID cards and policy summary/certificates to participants’ homes, (as applicable).
• Provide claims forms (as applicable)
• Receive claims and process payments of benefits in accordance with the plan designs for all claims incurred
• Correspond with participants and providers if additional information is necessary to complete the processing of claims
• Determine benefits payable under the Plan, pursuant to the terms and conditions of the District’s Benefit Plan booklets
• Coordinate benefits payable under the Plan and with other benefit plans, if applicable
• Provide notice to the Participants regarding the reason(s) for denial of benefits (which are denied) and provide for the review of such denied claims
• Accept weekly eligibility updates from District’s online eligibility system (file formats 834, CVS or flat file)
• Administer eligibility based on the District’s eligibility criteria
• Provide eligibility services, including, but not limited to, tracking and determination of disability for adult children approaching and over age 26
• Access to Enrollment/Eligibility Administration Portal for Employer
• Access to Claims Administration Portal for Employee to track dental history, estimate dental costs, compare dental service providers for quality and price, search for providers and print/request personal ID cards
(2) All the questions must be submitted no later than December 08, 2020
(3) The contract period will be for one year.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: January 13,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$