MURIEL BOWSER
MAYOR
December 5, 2024
The Honorable Phil Mendelson
Chairman, Council of the District of Columbia
1350 Pennsylvania Avenue NW, Suite 504
Washington, DC 20004
Dear Chairman Mendelson:
Pursuant to section 451 of the District of Columbia Home Rule Act (D.C. Official Code § 1-
204.51) and section 202 of the Procurement Practices Reform Act of 2010 (D.C. Official Code §
2-352.02), enclosed for consideration and approval by the Council of the District of Columbia is
proposed Modification No. M0013 to Contract No. CW95405 with Cigna Health and Life
Insurance Company (“Cigna”) to exercise option year three in the not-to-exceed amount of
$17,907,521. The period of performance is from January 11, 2025, through January 10, 2026.
Under the proposed modification, Cigna will continue to provide and administer the dental benefits
program for employees of the District, their eligible dependents, and retirees.
My administration is available to discuss any questions you may have regarding the proposed
contract modification. In order to facilitate a response to any questions you may have, please have
your staff contact Marc Scott, Chief Operating Officer, Office of Contracting and Procurement, at
(202) 724-8759.
I look forward to the Council’s favorable consideration of this contract modification.
Sincerely,
Muriel Bowser
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement
Pursuant to section 202(c-3) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code § 2-352.02(c-3), the following contract summary is provided:
COUNCIL CONTRACT SUMMARY
(Options)
(A) Contract Number: CW95405
Modification No. M0013
Proposed Contractor: Cigna Health and Life Insurance Company
Contract Amount (Option Period Three): Not-to-exceed (NTE) $17,907,521
Term of Contract: January 11, 2025, through January 10, 2026
Type of Contract: Requirements Contract
(B) Identifying number of the underlying contract, including the identifiers assigned to the
underlying contract by the Council for the base period and any subsequent option periods:
Base Period Amount: NTE $16,562,066
Council Approval Legislation #: A24-0549
Option Period One Estimated Amount: NTE $30,646,918
Council Approval Legislation #: CA24-0770
Explanation of difference from base period (if applicable): Changes in the District’s estimated
enrollment, annual rate review for the upcoming benefit year and the terms of the contract, the
contractor submits revised fixed unit prices for all line items for all option periods that are reviewed
and approved by the agency prior to each option exercise.
Option Period Two Estimated Amount: NTE $31,897,091
Council Approval Legislation #: CA25-0507
Explanation of difference from option period one (if applicable): Changes in the District’s
estimated enrollment, annual rate review for the upcoming benefit year, and the terms of the contract,
the contractor submits revised fixed unit prices for all line items for all option periods that are
reviewed and approved by the agency prior to each option exercise.
Option Period Three Estimated Amount: NTE $17,907,521
Explanation of difference from option period two (if applicable): Changes in the District’s
1
 estimated enrollment, annual rate review for the upcoming benefit year, and the terms of the contract,
the contractor submits revised fixed unit prices for all line items for all option periods that are
reviewed and approved by the agency prior to each option exercise.
(C) A statement that the Citywide Clean Hands database indicates that the proposed contractor is
current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District; or
(2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code § 2-353.01(b):
The contractor’s Citywide Clean Hands report, received on October 1, 2024, indicates no
outstanding liabilities with the District.
(D) A statement that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code §§ 47-392.01 and 47-392.02:
On October 30, 2024, the Office of the Chief Financial Officer certified that funds are available for
option period three.
2
 Government of the District of Columbia
Office of the Chief Financial Officer 1101 4th Street, SW
Office of Tax and Revenue Washington, DC 20024
Date of Notice: October 1, 2024 Notice Number: L0012711098
CIGNA HEALTH AND LIFE INSURANCE COMPANY FEIN: **-***1071
900 COTTAGE GROVE RD Case ID: 18307205
HARTFORD CT 06152-0001
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
CO
liability with the District of Columbia Office of Tax and Revenue or the Department of Employment
Services. As of the date above, the individual/entity has complied with DC Code § 47-2862, therefore
this Certificate of Clean Hands is issued.
TITLE 47. TAXATION, LICENSING, PERMITS, ASSESSMENTS, AND FEES
CHAPTER 28 GENERAL LICENSE
SUBCHAPTER II. CLEAN HANDS BEFORE RECEIVING A LICENSE OR PERMIT
D.C. CODE § 47-2862 (2006)
PY
§ 47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
Authorized By Melinda Jenkins
Branch Chief, Collection and Enforcement Administration
To validate this certificate, please visit MyTax.DC.gov. On the MyTax DC homepage, click the
“Validate a Certificate of Clean Hands” hyperlink under the Clean Hands section.
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
Glen Lee
Chief Financial Officer
CERTIFICATION OF THE AVAILABILITY OF FUNDING
FOR THE DENTAL HEALTH MAINTENANCE ORGANIZATION (DHMO) AND
FOR THE DENTAL PREFERRED PROVIDER ORGANIZATION (DPPO)
FOR
NON-UNION EMPLOYEES AND EMPLOYEES IN
COMPENSATION UNITS 1 AND 2,
COMPENSATION UNIT 10 (UNIVERSITY OF THE DISTRICT OF COLUMBIA
FACULTY ASSOCIATION/NATIONAL EDUCATION ASSOCIATION),
COMPENSATION UNIT 13 (DC NURSING ASSOCIATION), AND
COMPENSATION UNIT 33 (AMERICAN FEDERATION OF GOVERNMENT
EMPLOYEES OFFICE OF THE ATTORNEY GENERAL ATTORNEYS)
FOR THE PERIOD January 11, 2025 THROUGH September 30, 2025
and
FOR THE PERIOD October 1, 2025 THROUGH January 10, 2026
The District’s share of premiums (100% of the Dental Health Maintenance Organization
(DHMO) premium and a partial cost equivalent to the DHMO premium, for the Dental Preferred
Provider Organization (DPPO) premium) for the dental plan contract for the calendar year 2025
is estimated at $5,700,880. In addition, the employees’ share is estimated at $12,206,641, for a
total contract cost of $17,907,521. Based on estimates using enrollment data and premium rates
provided by the Office of Contracting and Procurement and the D.C. Department of Human
Resources, this is to certify that the District’s share of $4,275,660 is available to fund the
DHMO/DPPO dental contract number CW95405 with Cigna Health and Life Insurance
Company from January 11, 2025 through September 30, 2025. For the remaining period of the
contract, October 1, 2025 through January 10, 2026, the District will seek budget authority
through the FY 2026 appropriation for the District’s share of $1,425,220. The District’s cost of
the dental coverage is included in Account Group 701400C, Fringe Benefits, which is part of
each agency’s budget, as appropriate. The employees’ cost will be deducted from their
paychecks.
Please certify the availability of funding by signing below:
November 27, 2024
Glen Lee Date
John A. Wilson Building * 1350 Pennsylvania Avenue, NW * Suite 203 * Washington, DC 20004
Phone: (202) 727-2476 * Fax: (202) 727-1643 * www.cfo.dc.gov
 1. Contract Number Page of Pages
AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT CW95405 1 2
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase Request 5. Solicitation Caption
No.
M0013 Block 16C Dental Benefits Program
6. Issued by: Code MT 7. Administered by (If other than line 6)
District of Columbia Government District of Columbia Government
Office of Contracting and Procurement Department of Human Resources
441 4th Street, NW, Suite 330 South 1015 Half Street, SE, 9th Floor
Washington, DC 20001 Washington, DC 20003
8. Name and Address of Contractor (No. street, city, county, state and zip code) 9A. Amendment of Solicitation No.
Cigna Health and Life Insurance Company 9B. Dated (See Item 11)
900 Cottage Grove Road
Bloomfield, CT 06002 10A. Modification of Contract/Order No.
CW95405
10B. Dated (See Item 13)
Code Facility
1/11/2022
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended. is not
extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
(a) By completing Items 8 and 15, and returning one (1) copy of the amendment: (b) By acknowledging receipt of this amendment on each copy of the offer
submitted; or (c) BY separate letter or fax which includes a reference to the solicitation and amendment number. FAILURE OF YOUR ACKNOWLEDGMENT
TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN
REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such may be made by letter or fax, provided
each letter or telegram makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. Accounting and Appropriation Data (If Required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS ,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14
A. This change order is issued pursuant to (Specify Authority): 27 DCMR, Chapter 36, Section 3601.2(b)
The changes set forth in Item 14 are made in the contract/order no. in item 10A.
B. The above numbered contract/order is modified to reflect the administrative changes (such as changes in paying office, appropriation
data, etc.) set forth in item 14, pursuant to the authority of: 27 DCMR, Chapter 36, Section 3601.3
X C. This supplemental agreement is entered into pursuant to authority of: 27 DCMR 3601.2(c)
D. Other (Specify type of modification and authority)
E. IMPORTANT: Contractor is not is required to sign this document and return ( 1 ) copy to the issuing office.
14. Description of Amendment/Modification (Organized by UCF Section headings, including solicitation/contract subject matter where feasible.)
CW95405 is modified as follows:
1. Pursuant to contract Section 4, Option to Extend the Term, the District hereby exercises option period
three (OP3). OP3 is from January 11, 2025, through January 10, 2026.
2. Updates the price schedule for OP3. (See Attachment A.)
3. The not-to-exceed amount for OP3 is $17,907,521.00.
Except as provided herein, all terms and conditions of the document is referenced in Item 9A or 10A remain unchanged and in full force and effect.
15A. Name and Title of Signer (Type or print) 16A. Name of Contracting Officer
Kimberly Funderburk, Vice President Julius Wiggins
15B. Cigna Health and Life Insurance Company 15C. Date Signed 16B. District of Columbia 16C. Date Signed
(Sign)
10/24/2024
(Signature of person authorized to sign) (Signature of Contracting Officer)
 Attachment A
Dental Preferred Provider Organization
Contract Line
Estimated
Item Number Description of Services Bi-Weekly Rates
Quantity
(CLIN)
3001 Single 5,947 $33.35
3002 Single + 1 3,003 $47.34
3003 Single + 2 or more 4,004 $61.39
Dental Health Maintenance Organization
Contract Line
Estimated
Item Number Description of Services Bi-Weekly Rates
Quantity
(CLIN)
3004 Single 7,509 $6.64
3005 Single + 1 2,233 $9.43
3006 Single + 2 or more 2,580 $12.23