Retiree Dental Benefits for Health Options Program

Background
The Public School Employees’ Retirement Board (the 'Board'), an independent administrative board of the Commonwealth of Pennsylvania, is seeking proposals for Retiree Dental Benefits for the Health Options Program (HOP).

The Board aims to engage a qualified insurance carrier to provide a fully insured, voluntary Dental Preferred Provider Organization (DPPO) Plan for Medicare-eligible participants enrolled in HOP Medical Plan or similar plans. This initiative is part of the Board's mission to offer comprehensive health benefits to its eligible members.

Work Details
The contractor will provide a fully insured DPPO plan that includes:
- Coverage for preventive services such as oral exams, cleanings, and x-rays with specific frequency limits.
- Basic services including fillings and periodontal maintenance with defined coverage percentages.
- Major services such as crowns and dentures with specified limitations on frequency.
- An annual benefit amount of $1,400 per individual (excluding preventive services).
- Claims adjudication services effective from January 1, 2026, including customer service support and management reporting.

The contractor must ensure adequate access to dental providers within specified geographic areas and maintain performance standards related to customer service and claims processing.

Period of Performance
The contract will commence on January 1, 2026, and will remain effective through December 31, 2027. The Board has the option to renew the agreement on a year-to-year basis for up to three additional years until December 31, 2030.

Place of Performance
The services will be performed primarily in Pennsylvania, specifically targeting Medicare-eligible participants within the Commonwealth's Health Options Program.

Bidder Requirements
Bidders must comply with all applicable laws and regulations including HIPAA compliance. They must also provide proof of various insurances including workers' compensation, general liability, professional liability, and fidelity coverage. Additionally, bidders should not be under suspension or debarment by any governmental entity.