Dental and Optical Insurance Plans for Nassau County

Important Additional Information
The qualified vendor(s) shall be a New York State licensed insurance company and not an insurance
agent, broker, company or organization whose business is to sell any financial or insurance products or
services. Additionally, the qualified vendor(s) shall not have any conflicting contractual relations, receive
bonuses, over-rides or commissions from insurance companies or third-party administrators.
The County is seeking fully insured proposals that will respond to Option A: Dental and Vision Plan,
and/or Option B: Dental only, and/or Option C: Vision only.
Statements of Qualifications (SOQ), if accepted, will result in the opportunity to present plan options that
meet the needs described in the Scope of Services.
The orginal and six copies of the SOQ, proposed Plan(s), and all attachments in PDF format must be
submitted to the Office of Human Resources as well as electronic versions submitted by the appropriate
due date through the “Nassau Shares” application.
Work Description
The purpose of this RFQ is to solicit statements of qualifications and related proposals from qualified
Dental and Vision Insurers who are licensed to do business in the State of New York to provide Dental
and/or Vision coverage to Nassau County employees and retirees as outlined below.
The County is seeking fully insured proposals that will respond to Option A: Dental and Vision Plan, and/or
Option B: Dental only, and/or Option C: Vision only. These Options are more fully described below and in
the full RFQ Section C, Scope of Services.

The County is bound by labor agreements as to how much it can spend on these benefits per employee.
The Dental Plan cost cannot exceed $561 per employee per year and the Vision Plan cannot exceed
$110.40 per employee per year. Therefore, a combined Dental and Vision Plan cannot exceed $671.40 per
employee per year.
It is the County's intent to award contracts for a five (5) year period starting January 1, 2027, with the
option to renew.
DENTAL PLAN BENEFITS:
Key aspects of the current Dental Plan are below.
a) Basic Program: The County offers a choice of a scheduled indemnity coverage or prepaid
managed care (i.e., DHMO). Premiums for the dental coverage are paid entirely by the County. The fiscal
year for the Dental Programs begins January 1st. Employee participation is compulsory and the plan (non-
contributory) is paid a fixed annual premium of $561 for each enrolled employee - including all their
dependents. The Scheduled Indemnity plan (called the “Reimbursement” option) provides for no annual
deductible but there is an annual maximum benefit of $2,500 for non-orthodontic services. There is a
specific maximum payment for each covered service. Orthodontia is covered with a $1,650 lifetime
maximum and these should be considered the minimum coverage to provide under a proposed plan. The
DHMO Plan (called the “Comprehensive” option) provides comprehensive coverage with no co-payments
at participating network providers.
b) Buy-up Option: The County offers a contributory option for employees who desire a broader
range of benefits than that provided for under the Basic Program (above). Specifics of the program are at
the discretion of the proposer. The following are the rules regarding the current Buy-Up option. Only
employees enrolled in the Reimbursement/Participating Provider Option (PPO) Plan are eligible to
purchase the Buy-Up Option. The cost of the Buy-up option is the same for Single or Family. Employees
pay 100% of the cost through monthly payroll deductions of $37.25, which is $447 on an annual basis. To
avoid adverse selection, only a one-time enrollment is allowed. Employees who disenroll during open
enrollment will not be allowed to re-enter in the future. The plan automatically terminates upon job
termination but can be purchased with COBRA.
VISION PLAN BENEFITS:
Key aspects of the current Vison Plan are below.
Participants
Nassau County employees and retirees who are benefits eligible as defined by Nassau County
(approximately 16,100 participants)
Basic benefits
Eye exam: once every calendar year
In-network co-payment: $10
Out-of-network co-payment: reimbursement of up to $16
Eye-glasses
Participant: one pair every calendar year
COBRA member/spouse/child: one pair every calendar year

In-network co-payment: $25
Out-of-network co-payment: reimbursement rates up to:
$11 for frames
$25 for single vision lenses
$23 for bifocal lenses
$32 for trifocal lenses
VDT benefit (with prior enrollment)
VDT eye exam, once every calendar year in conjunction with dress eyewear (employees only)
Contact lenses
Employee: one pair every calendar year (may be selected in lieu of glasses)
Cobra member/spouse/child: Disposable 4 boxes/multi packs every calendar year in lieu of glasses.
Planned replacement Two boxes /multipacks.
In-network co-payment: $25
Out-of-network co-payment: reimbursed up to $60

Documents (sign in on the Nassau board to download): PE0803-2688.pdf