SOURCES SOUGHT
Q -- TRICARE Dental Program 7/Third Party Administrator RFI
- Notice Date
- 9/29/2025 2:20:07 PM
- Notice Type
- Sources Sought
- NAICS
- 524114
— Direct Health and Medical Insurance Carriers
- Contracting Office
- DEFENSE HEALTH AGENCY AURORA CO 80011 USA
- ZIP Code
- 80011
- Solicitation Number
- HT9402-25-RFI-0230
- Response Due
- 10/13/2025 3:00:00 PM
- Archive Date
- 03/15/2026
- Point of Contact
- Kristin Moore, Chelsea Lavelle
- E-Mail Address
-
kristin.m.moore13.civ@health.mil, chelsea.m.lavelle.civ@health.mil
(kristin.m.moore13.civ@health.mil, chelsea.m.lavelle.civ@health.mil)
- Small Business Set-Aside
- NONE No Set aside used
- Description
- Request for Information, TRICARE Dental Program 7th Generation Contract and Third-Party Administrator Contract Introduction: 1. This announcement constitutes a Request for Information (RFI). This announcement does not constitute a commitment, implied or otherwise, that a solicitation will be issued. This is not a Request for Proposal (RFP) or an Invitation for Bids (IFB). In accordance with Federal Acquisition Regulation (FAR) 15.201, responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Contractors responding to this request are advised that participation does NOT ensure opportunities for future solicitations or contract awards. 2. The DHA invites all interested parties to submit a written response to this RFI. This RFI is issued for the sole purpose of conducting market research in accordance with the FAR Part 10. 3. Please respond to as many of the questions as are applicable to your company. The questions cover a broad range of topics that may not be applicable to all responders. 4. Please note that the collection of this requested information does not obligate the Government to incorporate any responses or comments provided nor does it obligate the Government to procure the services. Responses to this RFI will not be returned. The Government is not liable to pay any costs associated with companies responding to this RFI. 5. All information received resulting from this RFI will be used by the Defense Health Agency (DHA) for acquisition planning and market research purposes only. However, your response may be releasable to the public under the Freedom of Information Act. If you wish for the DHA to consider any portion of your response as �confidential commercial information,� you should clearly mark the portion as �confidential commercial information.� 6. DHA, at its discretion, may request respondents to this RFI to elaborate on information in their written response. Respondents to this RFI will not be notified of any results derived from a review of the information provided. Description: The DHA expects to contract with two to four dental insurance carriers in support of the seventh generation TRICARE Dental Program contract (TDP-7). Among other things, the TDP-7 acquisition will incorporate changes mandated in National Defense Authorization Act for Fiscal Year 2023 (NDAA 2023), Sec. 701. These changes to the TDP include offering beneficiaries the opportunity to: (1) enroll in plans offered by multiple (two to four) dental carriers; (2) enroll as self, self+1, or family; and (3) choose between a standard (low cost) and non-standard (higher cost) dental plan. NDAA 2023 mandates that DHA contract with a Third Party Administrator (TPA) to manage the administrative features of TDP-7 including eligibility determinations, enrollments in plans, changes to enrollment, premium payment process, submission of qualifying life events, and address changes in DEERS. The dental insurance carriers will deliver the TRICARE dental benefit to up to 3 million eligible family members of Active-Duty service members, members of the Selected Reserve and Individual Ready Reserve (IRR), and their eligible family members, as described in 10 U.S.C. Chapter 55 � 1076a. Of the 3 million eligible beneficiaries, approximately 1.7 million are currently enrolled in the TDP. TDP is a worldwide program, and over 35,000 beneficiaries reside overseas. The standard, lower cost plans offered by the dental insurance contractors must provide the coverage outlined in 32 CFR 199.13. The non-standard/higher cost plans, must provide the coverage offered in the standard plan plus additional services chosen by the dental insurance contractors themselves. Premium subsidies paid by the Government will remain at the same rate as the subsidy paid by the Government under the standard plan. Enrollees will have to pay the difference between the standard premium and the non-standard plan. RFI Response Format: Please utilize the link titled �Industry RFI Responses� under the �Attachments/Links� section to provide your responses to the questions/requested information below. NDAA Questions/Requested Information: The DHA is seeking the following information on how interested contractors could meet the NDAA requirements and deliver the specific capabilities outlined below leveraging best industry practices. DHA may use responses in designing the future direction of the TRICARE Dental Program or TPA: A. Would insurance carriers prefer to have control over collecting premiums, verifying eligibility, enrolling members, performing changes to enrollments, submission of qualifying life events, and address changes OR to have a TPA perform these administrative functions? Please note the following: The Government anticipates that the TPA contract will reduce administrative burden on the multiple TDP-7 dental carriers by providing the eligibility, enrollment, and premium administrative services for the two to four dental carriers providing dental health services to beneficiaries. Having this centralized platform will eliminate the need for each dental carrier to establish its own eligibility, enrollment, and premium administration services and to interface directly with the Defense Manpower Data Center (DMDC), multiple Service payroll offices for allotments, and DHA for monthly invoices to collect Government-subsidized premiums. The TPA contractor will provide beneficiaries the ability to pay for these benefits through payroll allotments, direct billing (credit/debit card), or automatic bank withdrawals. If the TPA is in place, there will be an undetermined delay (potentially between 30-90 day delay) on the carriers receiving the beneficiary premiums. Carriers would not have a contract with the TPA. The TDP contract would only be with the Government, with a separate contract between the Government and TPA. The TPA or the dental insurance carriers would be required to establish Memorandums of Understanding with multiple service pay centers. The Government will allow for open enrollment for eligibles who missed the enrollment period. Eligibles could enroll by the 20th of the month to gain coverage by the 1st of the following month. This is the government�s current practice. B. Assuming establishment of a TPA, what mechanism (if any) would your company use to establish mutually binding obligations between the TDP and TPA during performance? C. How likely would your company be to bid on a TDP contract if TRICARE were to contract with 2 carriers? 3 carriers? 4 carriers? D. TDP is considering setting up a one-time 90-120 day enrollment period towards the end of the current TDP contract to allow for current enrollees and all other eligibles to review the contracted carriers� plans, enrollment options, premiums, and network providers. During this period, current and eligible members will be able to enroll in a plan of their choosing. Would your company prefer a 60 day enrollment period? Is a 90 or 120 day period too long? What has worked for you in the past? Dental Insurance Carrier Capabilities/Requested Information: Describe your capabilities for enrollment, eligibility, premium management, customer service, and reporting if a TPA is NOT contracted to perform these administrative functions. Outline your capabilities or experience with working with a TPA. Describe the type and frequency of reports and data you would need from a TPA to manage enrollments and premium administration. Is your company currently engaged in a TPA style business arrangement? What are the benefits and drawbacks of using a TPA versus direct administration with carriers? What are the benefits and drawbacks, at the start of the contract, for current enrollees to either (a) manually enroll to dental carriers and plans, and those who don�t take action are dropped, vs (b) allowing beneficiaries to manually enroll, and then fair sharing all remaining beneficiaries who have not manually enrolled? Fair sharing, as used here, would mean to equally divide the remaining, unenrolled beneficiaries to the awarded (2 to 4) dental carriers. What are the benefits and drawbacks of an open season/qualifying life event enrollment versus continuous open enrollment? How would the use of a TPA impact your premium structure, if at all? Upcoming Industry Day The DHA intends to hold an industry day in Aurora, CO with all interested TPA and TDP7 parties from November 4-6, 2025. Additional details are forthcoming and will be posted to sam.gov.
- Web Link
-
SAM.gov Permalink
(https://sam.gov/workspace/contract/opp/b3c42ca5bcfa4f1dbfc0166ab5e842ee/view)
- Place of Performance
- Address: Aurora, CO, USA
- Country: USA
- Country: USA
- Record
- SN07607846-F 20251001/250929230045 (samdaily.us)
- Source
-
SAM.gov Link to This Notice
(may not be valid after Archive Date)
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