Inactive

VADIP Questions for RFI Page 2 DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a Request for Quote (RFQ)/Invitation for Bid (IFB)/Request for Pr... VADIP Questions for RFI Page 2 DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a Request for Quote (RFQ)/Invitation for Bid (IFB)/Request for Proposal (RFP). This notice does not commit the U.S. Government to contract for any supply or service. Furthermore, the U.S. Government is not seeking quotes, bids or proposals at this time and will not accept unsolicited proposals in response to this Request for Information. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI. Submittals will not be returned to the responder. Please submit your company s capabilities statement and completed vendor responses electronically to Mr. Bradley Geghan at bradley.geghan@va.gov no later than February 28, 2022 at 3:00 p.m. Mountain Daylight Time (MDT). Please include your company name in the subject of the email response as: Attention: VA DENTAL INSURANCE PLAN RFI VENDOR NAME HERE . Title: Sources Sought Notice for VA Dental Insurance Plans, hereinafter called VADIP, and Associated Items in support of the Department of Veterans Affairs. The Department of Veterans Affairs (VA), Commodities & Services Acquisition Service (CSAS) is seeking information from vendors regarding the availability and business practices regarding the procurement of national dental plans for veterans. Please provide requested information using the below stated questions for the response to the VA. The qualifying NAICS code for this effort is 524114, Direct Health and Medical Insurance Carriers and size standard of $41.5 million. THIS ANNOUNCEMENT IS NOT A REQUEST FOR PROPOSAL, AND DOES NOT BIND THE GOVERNMENT TO AWARD ANY CONTRACT. What kind of geographical coverage does your organization have, i.e. regional or national? If regional how do you determine your coverage area? How many dentists are in your network? Please specify how may dentists in your network by region using the Community Care Network Regions Map at the bottom. What is your socioeconomic status and under what NAICs (North American Industry Classification System) code do you work? Does your organization provide coverage to the U.S. Territories (i.e. Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands)? Does providing coverage in U.S. Territories present any potential issues? The country will likely be divided up into four regions. The regions are defined by the MyVA regional breakdown, and are marked by state boundaries. A map of the tentative regional breakout is included at the end of this document. Does this pose any potential issues providing coverage? Do you see any potential issues for the insurance provider to be completely responsible for administering the insurance plans and managing the relationship to include premium collection directly with beneficiaries? What are the industry network adequacy standards? VHA will use EDI 270/271 Health Care Eligibility Benefit Inquiry and Requests to verify eligibility in real time. The intended verbiage is included below; please provide any issues with this solution. The Contractor must have established (time will be allotted-60 days contemplated) a contractual relationship for transactions with the VA s EDI (Electronic Data Interchange) clearinghouse contractor (To Be Determined-TBD) prior to enrolling Veterans in VADIP, or as an alternative, use their own value-added contractor that has an existing relationship with the VA s EDI contractor. If VA changes the EDI clearinghouse contractor, all contracted carriers will be given ample notice and the ability to establish a working arrangement with the new clearinghouse. All EDI transactions accepted for this effort will have to go through this clearinghouse and responses will be returned through this clearinghouse. All costs associated to transactions between the contracted entity and the EDI contractor is the responsibility of the contracted entity. This solution would only provide eligibility verification and Personally Identifiable Information (PII) information has to be maintained according to approved VA standards and regulations. Normal method for receiving eligibility information on the prospective Veteran is by submission of the standard formatted 270 transaction set that results in the responding 271 standard formatted transaction set being returned with eligibility status via the EDI clearinghouse Contractor. Standard information returned by this EDI transaction is Name, Gender, SS#, Enrolled or Not Enrolled, Enrollment Date and Veteran Primary Facility. At a minimum what information would your organization need to market the insurance program? VA will not be able to preempt state law. Does that present any obstacles in contracting at the regional or national level? If so, what are those obstacles? Please provide recommendations. What are the operating hours of your customer support department? Do you have any recommendations for the Schedule of Services, Contract Line Items (CLINS) structure? Do you foresee any problem with providing pricing for a five year, no cost contract, with 4 option years priced at time of proposal? The law mandating this program does not allow for coverage of non-beneficiary dependents. We do not intend to restrict the industry s ability to provide insurance plans outside of VA s Dental Insurance Program if the beneficiary requests coverage for non-eligible dependents. Can your organization provide similar plans to non-eligible dependents? If so, will your organization provide detailed reports to VA regarding the number of non-eligible dependents who have signed up for other plans and the premium costs that they incurred for those plans? This information might be reported to Congress. If awarded a contract, what period of time is necessary to ramp up and begin enrolling beneficiaries to include building a web page for the VA Dental Insurance Plan, and start receiving phone calls from beneficiaries? If willing, please provide an estimated timeline with associated actions. Describe how your organization would market the program and how this differs from your typical enrollment campaign and why. What do you consider the major challenges in the education/communication of the VADIP? What approaches do you propose to overcome these obstacles? How do you intend to provide individualized advice and counseling? Will customer service representatives (CSR)/counselors be dedicated to the VADIP Program account? If not, how will you ensure that they consistently represent the VADIP Program appropriately? If possible, based on your past experience and based on the estimated population please provide your enrollment projections for the first through fifth enrollment years and the rationale for your projections. Detail your web-based, text, or online capabilities. Do you have all of them in place now or are they in the planning stage? Provide examples, URLs, and references. Detail your contingency plan for system overload on education and information requests from both a technology and/or staff sufficiency basis. What education and advertising resources have you found to be most effective for large groups with mixed demographics, and why? How would you propose to utilize these for the VADIP Program? Do you have any recommendations that would simplify the insurance industries administrative efforts and reduce the price of premiums while still meeting the contract s objectives? Are there waiting periods for services such as fillings, crowns, or bridges? Do you offer a coverage for major dental costs in every plan? Are any portions of the questions above not in-line with industry standards? The Government will use responses of this notice to make appropriate acquisition decisions upon review of documentation. A request for proposals may be issued to the government wide point of entry Contract Opportunities (www.sam.gov). Responses to this Sources Sought Notice are not considered adequate responses to any corresponding solicitation announcement. Not responding to this notice does not preclude participation in any future RFQ or IFB or RFP, if any is issued. If a solicitation is released, it will be synopsized on the Government-wide Point of Entry. It is the responsibility of potential offerors to monitor the Government-wide Point of Entry for additional information pertaining to this requirement.