Employee Benefits - Ancillary Coverage

In compliance with this Request for Proposals, and subject to all the conditions thereof, the
undersigned offers, if the offer is accepted within one hundred and eighty (180) calendar days
from the date of the receipt of proposals, to furnish any or all of the items and/or services upon
which prices are quoted, at the price set, to be delivered at the time and place specified herein.
The above signed certifies he has read, understands, and agrees to all terms, conditions, and
requirements of this Request for Proposals, and is the authorized point of contact on behalf of
firm on the previous page.
SOLICITATION DOCUMENTS
Additional Request for Proposal documents is available on the Purchasing website:
http://www.suffolkva.us/bids/ or on the Commonwealth's bid board (eVA), or at Demandstar.com.
An e-mail request for the complete RFP form may be sent to the Contract Officer listed on the
front page.
Proposals shall be sent to: Purchasing Agent, 442 W. Washington Street, Room 1086,
Suffolk, VA, 23434 prior to the closure date and time shown. Offerors shall provide one (1)
original and five (5) copies and two (2) electronic versions (flashdrive or CD). For confirmation of
receipt of proposal, contact the Contract Officer at jsmigielski@suffolkva.us.
Questions concerning this project must be in writing (email is preferred) and addressed to the
Contract Officer listed on the front page of this solicitation, and, should be received no later than
five (5) business days preceding the date that the proposals are to be received. E-mail is the
preferred method and will get a faster response.
IF YOU NEED ANY REASONABLE ACCOMMODATION FOR ANY TYPE OF DISABILITY IN
ORDER TO PARTICIPATE IN THIS PROCUREMENT, PLEASE CONTACT THIS DIVISION AS
SOON AS POSSIBLE.
Jay Smigielski, Purchasing Agent, is the designated authorized spokesperson for the City of
Suffolk with respect to the RFP. All questions and/or comments should be directed to his
attention. The respondents to this RFP shall not contact, either directly or indirectly, any other
employee or agent of the City regarding this RFP. Any such unauthorized contact may disqualify
the offeror from the procurement.
Offerors are to submit Attachments A1, A2, A3, A4, A5, A6, A7, A8, A9, A10, A11, B, C, and D in
Excel format. Attachment E is to be sent in Word format. The Attachments are to be included in
the flashdrive or CD, as part of your proposal.
The Attachments and/or Appendixes A and C1, C2, C3 may be sent to Offeror in Excel upon
request.
RFP 26067-JS Page 2

RFP 26067-JS
Employee Benefits: Ancillary Coverage
Table of Contents
1.0 PURPOSE ............................................................................................................ 4
2.0 BACKGROUND ................................................................................................... 5
3.0 COMPETITION INTENDED ................................................................................. 6
4.0 SCOPE OF SERVICES ........................................................................................ 6
5.0 INSTRUCTIONS FOR SUBMITTING PROPOSALS ........................................... 7
6.0 SPECIFIC PROPOSAL REQUIREMENTS ........................................................ 10
7.0 EVALUATION AND AWARD CRITERIA ........................................................... 12
8.0 ADDITIONAL INSTRUCTIONS ......................................................................... 12
9.0 CONTRACT TERMS AND CONDITIONS .......................................................... 16
SIGNATURE SHEET ................................................................................................... 25
PROPRIETARY/CONFIDENTIAL INFORMATION IDENTIFICATION ........................ 26
EXCEPTIONS TO RFP ................................................................................................ 27
ANTICOLLUSION ........................................................................................................ 28
PROOF OF AUTHORITY TO TRANSACT BUSINESS IN VIRGINIA ......................... 29
ATTACHMENT A1 to A11 - Pricing Quotation and Information Exhibits
ATTACHMENT B - Dental Provider Utilization Report
ATTACHMENT C - Vision Provider Utilization Report
ATTACHMENT D - Performance Guarantee Exhibit
ATTACHMENT E - Dental and Vision Questionnaire
APPENDIX A - Census Data
APPENDIX B1 to B3 - Dental, Vision, Legal, and Identity Theft Rate Information
APPENDIX C1 to C3 - Dental Claims Experience
APPENDIX D1 to D11 - Plan Summaries
APPENDIX E - Long Term Disability Claims Experience
RFP 26067-JS Page 3

1.0 PURPOSE
1.1. The purpose and intent of this Request for Proposal (RFP) is to solicit proposals for
The City of Suffolk ("City") from licensed qualified sources to establish one or more
contracts through competitive negotiation for administration of its Employee Benefits:
Ancillary Coverage program effective January 1, 2027.
As noted herein, The City will accept and consider proposals for the following
voluntary insurance products (all 100% employee paid):
Fully-Insured Dental
Fully-Insured Vision
Short-Term Disability
Long-Term Disability
Accident
Critical Illness
Hospital Indemnity
Legal Plan
Identity Theft
Pet Insurance
Offerors shall choose the pricing exhibit(s) and questionnaire(s) in which they will be
providing a proposal for the City's considerations. Please outline any additional
savings The City would receive if multiple lines of coverage were selected, and also
provide pricing for all products on both a stand-alone and bundled basis. All pricing
should be net of commissions.
1.2. The City's Objectives:
1.2.1 To provide employees with a quality, affordable ancillary benefits responsive
to the diverse needs of employees;
1.2.2 To ensure employees and their dependents are provided with the highest
quality of care by providers and superior customer service;
1.2.3 To ensure plans are managed effectively by taking advantage of cost and
utilization management opportunities available in the marketplace while
increasing quality;
1.2.4 To provide employees access to consumer enhancing technology that
assist in education and communication on provider choice, quality,
transparency, personal health care, and cost;
1.2.5 To assist the City in building a community/culture of wellness, accountability
and responsibility.
The City reserves the right to award the contract to one or multiple firms. The initial term
of this agreement shall be for two (2) years effective from the date of the agreement with
coverage to begin on January 1, 2027. The initial term will end on December 31, 2028,
with coverage to end on December 31, 2028. The City reserves the exclusive right to
renew the contract for an additional four (4) successive one year periods contingent upon
rate adjustment and satisfactory performance of contract terms.
RFP 26067-JS Page 4

2.0 BACKGROUND
2.1. The following is a basic summary of information provided for Offeror reference and
to assist Offerors in assessing the City's history and requirements.
Employer: The City of Suffolk (The City)
Address: 442 W. Washington Street, Suffolk, VA 23434
Location of Employees: Virginia
Number of Employees 1491 Active Full Time
Currently Enrolled: 1162 Dental
1036 Vision
344 Short Term Disability
493 Long Term Disability
614 Accident
522 Employee / 203 Spouse - Critical Illness
403 Hospital Indemnity
427 Legal Plan
224 Identity Theft Plan
Industry: Municipal, City government
Voluntary Coverages to be Quoted: Dental, Vision, Short Term Disability, Long Term Disability,
Accident, Critical Illness, Hospital Indemnity, Legal Plan,
Identity Theft Plan, Pet Insurance
Current Carrier: Dental: Delta Dental
Vision: MetLife
Short Term Disability: MetLife
Long Term Disability: The Standard
Accident: MetLife
Critical Illness: MetLife
Hospital Indemnity: MetLife
Legal Plan: Legal Resources
Identity Theft Plan: Legal Resources
Pet Insurance: MetLife
RFP 26067-JS Page 5

Renewal Date Coverage: (initial January 1, 2029
term)
Coverage Effective Date: January 1, 2027
Proposal Due Date: May 6, 2026 by 3:00pm; proposals submitted after 3:00pm
will not be accepted.
Deviations: Please specify any deviations in writing. Otherwise it will be
assumed that carrier is willing to accept ALL conditions
outlined in this request for proposal.
Current & Proposed Plans See Appendixes
Employee Census: See Appendixes
Enrollment History: See Appendixes
Claims Experience: See Appendixes
3.0 COMPETITION INTENDED
It is the City's intent that this Request for Proposal (RFP) permits competition. It shall be
the offeror's responsibility to advise the Purchasing Agent in writing if any language
requirement, specification, etc., or any combination thereof, inadvertently restricts or limits
the requirements stated in this RFP to a single source. Such notification must be received
by the Purchasing Agent not later than five (5) business days prior to the date set for
acceptance of proposals.
4.0 SCOPE OF SERVICES
Offerors shall restate and specifically address each provision of the Statement of Needs
in their proposal response.
Rate Guarantees: All rates and/or fees must be guaranteed for at least one year. Multi-year
rate guarantees are an important component to The City's decision-making
process and are preferable.
Technology Enrollment, Changes and Terminations processed on electronic file
Requirements: transfers.
Member and Employee Websites with access to claims, tools and
resources
RFP 26067-JS Page 6

Education Materials
Mobile App
Compliance: The City requires all vendors who submit a proposal to ensure
compliance with all federal and state regulatory laws; including but not
limited to all laws pertaining to the Affordable Care Act
Offeror shall confirm the organization is currently compliant with HIPAA
HITECH legislation as it pertains to Private Health Information and EDI
Standards
Actively-at-Work and Dependent Non-Confinement rules must be
Transition Issues: waived on effective date
Include no loss/no gain
Offeror must be willing to accept the current eligibility guidelines
Selected carrier must be willing to commit to enrollment meetings and
ensure I.D. card distribution no later than December 18th annually.
Administrative and The City requires a dedicated billing and eligibility representative and a
Service Issues: dedicated account management team.
The City requires monthly "paid" claim data, accounting statements
outlining all fees and large claims.
The City requires vendors to provide quarterly and annual claims
utilization data.
The City requires annual vendor led meetings throughout the year on
Dental and Vision claims and services review.
Carrier/Administrator is expected to provide an electronic version of all
summary plan descriptions and Summary of Benefits Coverage
documents
The City extends Dental and Vision coverage to "Retirees" under age
65
Dependents are eligible to the end of the calendar month age 26
Ideally, The City wishes to have access to a reporting tool in "real time"
The City may periodically request basic "ad hoc" reporting in order to
analyze certain aspects of the program. Outline additional cost and
timeframes to provide these reports.
It is assumed that all ongoing administrative costs associated with
meeting these proposal specifications are included in the proposed
administrative fees.
The City requires claim processing lag reports.
5.0 INSTRUCTIONS FOR SUBMITTING PROPOSALS
A. Submission of Proposals
RFP 26067-JS Page 7

Proposals shall be sent to: Purchasing Agent, 442 W. Washington Street,
Room 1086, Suffolk, VA, 23434 prior to the closure date and time shown. Offerors
shall provide one (1) original and five (5) copies and two (2) electronic versions
(flashdrive or CD). For confirmation of receipt of proposal, contact the Contract
Officer at jsmigielski@suffolkva.us or 757-514-7523.
Offerors may be selected to make a formal presentation of their qualifications and
job approach, and may be selected for final negotiations of contract. Therefore,
care should be given to address the issues relating to the criteria to follow.
Read the entire solicitation before submitting a proposal. Failure to read any part
of this RFP shall not relieve any offeror from his or her contractual
obligations.
The following Appendixes are provided as separate documents for information
purposes:
Appendices A, B1, B2, B3, C1, C2, C3, D1 - D11, & E
Addendum and Supplement to RFP
If it becomes necessary to revise any part of this request or if additional data
are necessary to enable an exact interpretation of provisions of this RFP, an
addendum will be issued. It is the responsibility of the offeror to ensure
that he has received all addendums prior to submitting a proposal. All
addenda can be downloaded from https://www.suffolkva.us/Bids.aspx?CatID=17
B. Firm Pricing for City Acceptance
Offers made during negotiation must be honored for City acceptance for 180 days
from the date of offer.
C. Proprietary Information
Trade secrets or proprietary information submitted by an offeror in connection with
this solicitation shall not be subject to disclosure under the Virginia Freedom of
Information Act; however, the offeror must invoke the protections of this section
prior to or upon submission of the data or other materials, and must clearly identify
the data or other materials to be protected and state the reasons why protection is
necessary. Offerors shall not mark sections of their proposal as proprietary if they
are to be part of the award of the contract and are of a "Material" nature. Any
propriety information must be listed on the attached "Proprietary/confidential
Information Identification" form and submitted with the proposal. Proposals
declared confidential in their entirety will be declared unresponsive and will not be
considered.
D. Authority to Bind Firm in Contract
Proposals MUST give full firm name and address of offeror. Failure to sign
proposal may disqualify it. Person signing proposal should show title or authority
to bind firm in a contract. Firm name and authorized signature must appear on
proposal in the space provided on the signature page.
RFP 26067-JS Page 8

E. Preparation and Submission of Proposals
1. All proposals shall be signed by the individual or authorized principals of
the firm.
2. All attachments to the Request for Proposal requiring executing by the firm
are to be returned with the proposals.
3. Proposal title shall indicate the RFP number and the title of the proposal.
4. It is the Offeror's responsibility that the proposals are received by the
Purchasing Division BEFORE the hour specified on the opening date.
Requests for extensions of this time and date will not be granted. Proposals
or unsolicited amendments to proposals received by the City after the
acceptance date will not be considered.
Attachments and Appendices can be sent in Excel or Word upon request.
F. Miscellaneous Requirements
1. The City will not be responsible for any expenses incurred by a firm in
preparing and submitting a proposal. All proposals shall provide a
straightforward, concise delineation of the firm's capabilities to satisfy the
requirements of this request. Emphasis should be on completeness and
clarity of content.
2. Offerors who submit a proposal in response to this RFP may be required
to make a presentation of their proposal. The Purchasing Division will
schedule the time and location for this presentation.
3. The contents of the proposal submitted by the successful offeror and this
RFP will become part of any contract awarded as a result of the Scope of
Services contained herein. The successful firm will be expected to sign a
contract with the City.
4. The City reserves the right to reject any and all proposals received by
reason of this request, or to negotiate separately in any manner necessary
to serve the best interests of the City. The City reserves the right to award
to multiple vendors.
RFP 26067-JS Page 9

6.0 SPECIFIC PROPOSAL REQUIREMENTS
Proposals should be as thorough and detailed as necessary to allow the City of Suffolk to
properly evaluate the offeror's capabilities to provide the required services. In accordance
with the specifications herein, the proposal shall provide a straight forward, concise
delineation of capabilities, experience and approach to the tasks outlined in this request.
Offerors are requested to submit the following items in the format provided as a complete
proposal:
A. Proposal Format
The offeror shall complete and submit a brief cover letter. The cover letter should
summarize key elements of the proposal. An individual authorized to bind Offeror
must sign the letter and Signature Sheet, as well. Indicate the address and
telephone number of the Consultant's office.
Offeror are to complete the following Attachments:
Attachment A contains Pricing Quotation and Information Exhibits that will assist
the City in evaluating the quality of care and benefits being offered to City
employees, retirees and dependents as well as the financial information of the
offeror. An offeror's evaluation will not be adversely impacted if a specific question
does not apply.
A1 - Dental
A2 - Vision Exhibit
A3 - Short Term Disability
A4 - Long Term Disability
A5 - Accident
A6 - Hospital Indemnity
A7 - Critical Illness
A8 - Legal
A9 - Identity Theft
A10 - Pet Insurance
A11 - Underwriting Assumptions
Attachment B - Dental Provider Utilization Report
Attachment C - Vision Provider Utilization Report
Attachment D - Performance Guarantee Exhibits
Attachment E - Dental and Vision Questionnaire
RFP 26067-JS Page 10