Dental Administration Services

Kansas seeks a dental administration provider to manage benefits, promote wellness, and deliver data analytics for program benchmarking.

Maintain quality dental benefits while managing costs
Establish a long-term relationship with a carrier or third-party administrator
Provide a six-year rate guarantee (minimum three years required)
Offer an initial three-year contract term with options to renew for three additional one-year periods
Quote matching current plan designs using Exhibit E – Dental Plan Administration RFP Costs
Provide administrative services only (ASO) but consider fully-insured if cost-competitive
Detail any differences between current and proposed dental plans
Include any enhancements and/or incentive programs
List all services in the current vendor service agreement
Ensure all costs are net of commissions
Provide requested information including Dental RFP Questionnaire, Exhibit E, Example of Summary Plan Description, and Proposed Summary of Dental Plan Benefits
Demonstrate administrative flexibility and significant experience with ASO dental plans
Provide exemplary customer service with knowledge of County plan, preferably with a dedicated unit
Offer competitive rates
Provide competitive network access focused on the Kansas City metropolitan area with proven provider discounts
Ability to duplicate current plan designs
Provide dedicated implementation support
Offer cutting-edge financial and utilization reporting capabilities
Possess strong carrier financial ratings
Demonstrate means and ability to satisfactorily perform the contract with relevant experience, facilities, reputation, and financial resources
Submit a response aligning with all specifications and requirements
Show capacity to meet required delivery schedules and adequate financial means
Provide a history of satisfactory performance on previous contracts
Be a legally registered entity authorized to conduct business in Kansas with proof of registration, licenses, and certifications
Ensure all employees hold valid licenses issued by appropriate authorities
Not be listed on the Excluded Parties List System on SAM.gov
Have no suspensions or revocations of state, county, or county-issued business, trade, or contracting licenses
Comply with tax laws of local governments and obtain Tax Clearance Certification for contracts over $150,000
Furnish specified insurance and bonds within ten calendar days of contract notification
Agree that fees must be on an 'incurred' basis for run-out claims (12 months at no additional cost)
Waive file fees applicable to third-party data warehouse vendors
Confirm no implementation or ongoing costs for a third-party data warehouse
Provide all claims data, including complete financial and clinical information, to consultant/broker upon request
Provide requested data to other County benefit partners
Acknowledge that County records, data, and files are property of the County and must be furnished upon termination
Provide data electronically within a mutually agreed timeframe
Provide data in compliance with HIPAA requirements, including reproductive health regulations
Place no restraints on the use of data provided to the County and its designated partners
Cooperate with third-party information partners
Allow the County to audit claim processing records and processes upon reasonable written notice
Ensure data quality is sufficient to support analyses, including specific claimant, financial, clinical, and service fields
Keep all provided information confidential
Provide preliminary renewal numbers by June 30th and final renewal numbers by September 30th, with final not exceeding preliminary
Meet onsite bi-annually to review experience and utilization
Provide ad hoc, customized reporting at no cost
Assist the Benefits & Wellness Manager with all reporting requests and member complaints/appeals
Provide a bi-weekly report of preventive dental exams to the County’s wellness plan administrator
Provide an annual benefit management report at the close of each plan year
Undergo targeted recruiting of providers currently treating County employees but not in the network
Notify County staff or employees when a provider/facility leaves the network
Maintain appropriate physical and electronic safeguards for Protected Health Information
Comply with all HIPAA Electronic Transactions and Security Standards
Provide statistics on claims system processing accuracy and eligibility determination
Ensure claims adjudication system is connected to eligibility system with safeguards against post-termination payments
Perform all claims processing functions, including instructions, forms, ID cards, handling claims, and EOB generation
Describe cost containment programs for unnecessary utilization
Clarify if clinical staff for claim reviews are internal or external and associated costs
Describe proposed claims administration computer system and program
Ensure claims adjudication program screens for inappropriate unbundling and charges exceeding usual/customary fees
Provide professional and training background for proposed staff
Describe electronic claim processing capabilities
Describe database used for usual, customary, and reasonable fee allowances and appropriateness of care
Describe internal methodology for complex/difficult claim referrals to dental professionals or legal staff
Describe grievance/dispute resolution system compliant with PPACA
Ability to administer customization to dental and orthodontic benefit limits/frequencies
Describe claim audit/processing program for quality assurance
Provide a dedicated unit for customer service, membership, and billing with a unique, US-based, toll-free number and extended hours
Ensure customer service representatives can reprocess claims and access claims information
Outline proposed engagement strategy for member awareness and education
Confirm communications can be co-branded and customized at no additional cost, including mailers and shipping
Confirm custom data and advocacy number/logo can be added to member ID cards at no additional cost
Describe member website access to provider information, cost estimators, plan documents, claims history, and other features
Provide sample copies of employee communications and wellness/promotional documents
Describe capabilities for providing annual EOBs (online or paper)
Summarize philosophy and detail programs for wellness integration with dental
Willingness to staff bi-annual wellness fairs with marketing materials and innovative exhibits
Have established criteria for referral to other external County-sponsored programs
Accept and incorporate a monthly eligibility spreadsheet for COBRA and retiree programs, allocating an eligibility contact for review/audit
Provide Flexible Account Administrator with an auto-substantiation file for FSA Debit Card confirmation, clarifying associated fees and existing relationships
Confirm no cost for SSO to external vendors
Ensure mobile app has same functionality as website
Create a pre-member microsite at no additional cost for open enrollment and new hires
Describe how AI is leveraged to streamline administrative processes and observed improvements
Detail safeguards and compliance measures for AI-driven solutions to adhere to HIPAA regulations
Describe processes for testing overall strength of defenses through simulated attack scenarios, vulnerability identification/remediation, and incident response protocols
Confirm background checks for personnel handling sensitive information
Agree to proposed Operational Performance Guarantees (PGs) and fees at risk
Complete Geo Access information on the corresponding tab
Complete Total Revenue Disclosure information on the corresponding tab
Discuss procedures for handling claim and benefit history transfer during transition
Discuss handling of pre-certified but incomplete services during transition
Discuss employee communications regarding administrator change
Discuss recruiting current providers
Include a detailed transition plan/timeline assuming a January 1, 2027 business award date
Describe transition of care policy for treatments started prior to effective date

$200,000 – $300,000

Issue RFP: March 2, 2026

Clarification Deadline: March 13, 2026

Open RFP: March 27, 2026

Interviews To Be Held: May 12th, 2026 and/or May 13th, 2026

Board Approval: TBD

Project Begins: January 1st, 2027

Johnson County Financial Management & Administration

Organization overview and procurement intelligence available on paid plans.

The government authority in Kansas is seeking a vendor to provide dental administration services. The successful provider should be capable of maintaining quality dental benefits for members while effectively managing costs in the context of a long-term partnership with either a carrier or third-party administrator.

The scope includes supporting a wellness fund that promotes preventive oral care and specifically targets members who have not received periodic dental services within the past 24 months. Vendors are expected to offer tools for benchmarking utilization statistics by demographics, preferably using Healthentic or similar analytical platforms, to enhance program oversight and effectiveness.

Prospective vendors must submit any questions related to this RFP by March 13, 2026.

Dental Administration Services

Overview

Fit Score

SUMMARY

KEY REQUIREMENTS

BUDGET

CONTRACT DURATION

TIMELINE

QUESTION DEADLINE

Issuing Agency

DESCRIPTION

Similar RFPs