DENTAL INSURANCE ASO PROGRAM

The City of Charlottesville seeks a qualified vendor to administer its self‑funded dental insurance program (ASO) for approximately 1,600 active employees and retirees. The contract runs from January 4 2027 through June 30 2028 with an option for up to six additional one‑year extensions. The vendor must handle enrollment, eligibility, claims processing, network management, member services, and technology integration (EDI/API, secure portals) while supporting the City’s existing BenefitFocus platform and possibly a new “buy‑up” plan option. Key responsibilities include: • End‑to‑end dental benefits administration (enrollment, eligibility, COBRA, ID cards) • Claims adjudication, payment, appeals, and fraud detection • Provider network credentialing, performance monitoring, and negotiations • Reporting on network adequacy, utilization, and disruption analysis • Member‑facing services (call center, online portal, mobile access, language assistance) • Secure data exchange (EDI, API) and compliance with privacy/security standards • Dedicated account, implementation, and escalation managers • Coordination with City HRIS and BenefitFocus enrollment system • Ability to support a dual‑option dental plan (current plan + optional buy‑up)