Department of Employee Trust Funds

Third Party Administration of Dental Benefits for the Department of Employee Trust Funds (ETF) On behalf of the Group Insurance Board

To: Whom It May Concern:
This Request for Proposal (RFP) is issued by the Department of Employee Trust Funds (ETF). The purpose of this RFP is to provide interested and qualified third party dental administrators with information to enable them to prepare and submit competitive Proposals for dental benefit administration to ETF. ETF intends to use the results of this process to award a Contract. The Contract term for providing the third party administration of dental benefits will commence on the Contract start date and shall extend through December 31, 2017. The Board retains the option, by mutual agreement of the Board and the successful Proposer, to renew the Contract for two (2) additional two (2)-year periods extending the Contract through December 31, 2021, subject to the satisfactory negotiation of terms, including pricing. ETF is a Wisconsin State agency that administers retirement, health, life, income continuation, long-term disability, and long term care insurance programs for 570,000 state and local government employees and annuitants. This RFP details the procedures the proposer must follow to submit a Proposal for the administrative services for dental benefits offered in conjunction with the State of Wisconsin Group Health Insurance Program offered by the State of Wisconsin Group Insurance Board, and the minimum requirements that the proposer must meet to be eligible for consideration. This procurement is authorized under Chapter 40 of the Wisconsin State Statutes. All decisions and actions under this RFP are solely under the authority of the State of Wisconsin Group Insurance Board. Procurement statutes and rules that govern other State agencies may not be applicable. Any news releases or release of broadcast e-mails pertaining to this RFP, resulting Contract, or to the acceptance, rejection, or evaluation, or review of proposals shall not be made without the prior written approval of the State of Wisconsin or ETF. The deadline for receipt of proposals for this RFP is March 26, 2015, 2:00 p.m. CST. Late submissions will not be considered. Questions may be submitted as indicated in the RFP via email to


RFP Title


Third Party Administration of Dental Benefits


Revision History


Contract Amendment #4


Contract Amendment #3


Contract Amendment #2


Contract Amendment #1




Bid Abstract


Notice of Intent to Award


Addendum #2 Posted.


Bid Due Date Changed to March 30, 2015, 2:00 p.m. per Addendum #1


Addendum #1 Posted which also includes PDF & Excel versions of an updated APPENDIX E.


Request for Proposal

Request for Proposal

ETE0020 Addendum #2 Dated 03-25-2015

ETE0020 Addendum #1 Dated 03-18-2015

APPENDIX E per ETE0020 Addendum #1 – PDF Version

APPENDIX E per ETE0020 Addendum #1 – EXCEL Version

ETE0020 Third Party Administration of Dental Benefits RFP *

APPENDIX B - Business Associate Agreement

APPENDIX C - DOA-3054 Standard Terms and Conditions

APPENDIX C - DOA-3681 Supplemental Standard Terms and Conditions 

APPENDIX D - DOA-3027 Designation of Confidential and Proprietary Information

APPENDIX D - DOA-3477 Vendor Information

APPENDIX D - DOA-3478 Reference Information

ATTACHMENT C – Cost Proposal 

ATTACHMENT D – Financial Compliance

* Attachment A, Attachment B and Form DOA-3261 are embedded within the ETE0020 Third Party Administration of Dental Benefits RFP document.

Reference Materials


State Employee It’s Your Choice Reference Guide: Pages 78-84 – Uniform Dental Benefits

Dental Comparison Chart

Wisconsin Office of the Commissioner of Insurance (OCI) website

Employee Trust Funds Internet Site

WI State Statutes Ch. 40

WI Administrative Code Ch. 11

ETF Grievance and Appeals Process