3- Task Order Exhibit A 05-21-07.doc
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- Attached to
- Welfare Benefits Program Federal contract opportunity
- Solicitation number
- 002WP-JM-08
- Issued by
- Department of Energy
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Exhibit A Pricing information.
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EXHIBIT A
NATIONAL SECURITY TECHNOLOGIES, LLC
TASK ORDER SUBCONTRACT
QUANTITIES, PRICES AND DATA
TABLE OF CONTENTS
FORM FORM TITLE
PAGE
2Form A Consideration Schedule
9Form B Subcontractor and Vendor List
10Form C Evaluation Criteria
14Form D Past Performance Questionnaire
16Form E Administrative and Technical Data
18Form F Demonstrated Experience
19Form G Experience Statement
20Form H Lower-Tier Subcontractor Experience Statement
21Form I Project Approach
22Form J Key Personnel
23Form K Exceptions and Deviations
24Form L Attachment A - Labor Categories Descriptions
QUANTITIES, PRICES AND DATA
Form A Consideration Schedule
1. FIXED PRICE TASKS
Unit prices quoted in the Schedule of Quantities, Prices and Data shall be firm all-inclusive unit prices to include all travel. Payment of the unit prices shall constitute full payment for performance of Work and shall cover all costs of whatever nature incurred by Subcontractor in accomplishing the Work in accordance with the provisions of the Subcontract.
Table I (ITEMS 1 – 4 - Tasks for NSTec Welfare Benefit PROGRAM Services)
| Item |
| Description of Fixed Price Tasks |
| Job |
| July 1, 2008 through June 30, 2009 |
| July 1, 2009 through June 30, 2010 |
| July 1, 2010 |
through June 30, 2011
| July 1, 2011 through June 30, 2012 |
| July 1, 2012 through June 30, 2013 |
| 1 |
| Conduct Section 125 nondiscrimination testing for the NSTec welfare benefit plans. |
| 1 |
| $ |
| $ |
| $ |
| $ |
| $ |
| 2 |
| Prepare Health & Welfare Plan and Severance Pay Plan Form 5500’s and Summary Annual Reports and submit to NSTec for review/signature. |
| 1 |
| $ |
| $ |
| $ |
| $ |
| $ |
| 3 |
| Conduct welfare benefit vendor marketings: prepare and issue Requests for Proposals, analyze vendor submissions, coordinate interviews with finalists, complete negotiations with selected vendors, report changes and cost/savings impact to NSTec, and implementation. Provide separate estimates for: |
a) Self-insured medical plan
b) Self-insured prescription drug plan
c) Insured medical/prescription drug plan
d) Exclusive Provider Organization (EPO) medical plan
e) Health Maintenance Organizations (HMOs)
f) Insured or self-insured dental plan
g) Insured or self-insured vision plan
h) Insured short and long-term disability plans
i) Insured life insurance plans (basic, supplemental, dependent, voluntary personal accident)
j) Insured business travel accident plans
k) Flexible spending accounts administration
l) COBRA administration
m) Retiree/Cobra/Displaced Worker billing
| a) |
| $ |
| 4 |
| Negotiate annual welfare benefit vendor rate renewals for insured plans: Provide separate estimates for: |
a) Health Maintenance Organizations (currently offer 7)
b) Life insurance plans (basic, supplemental, dependent, voluntary personal accident)
c) Dental Plan
d) Business travel accident plans
e) Short and long-term disability plans a) b) c) d) e)
| Total |
| $ |
| $ |
| $ |
| $ |
| $ |
Total FIXED PRICE TASKS for 5 years
2. OPTIONAL FIXED PRICE TASKS
Unit prices quoted in the Schedule of Quantities, Prices and Data shall be firm all-inclusive unit prices to include all travel. Payment of the unit prices shall constitute full payment for performance of Work and shall cover all costs of whatever nature incurred by Subcontractor in accomplishing the Work in accordance with the provisions of the Subcontract.
Table II (ITEM 5- 7 Tasks for NSTec Welfare Benefit PROGRAM Services)
| Item |
| Description of Optional Fixed Price Tasks |
| Job |
| July 1, 2008 through June 30, 2009 |
| July 1, 2009 through June 30, 2010 |
| July 1, 2010 |
through June 30, 2011
| July 1, 2011 through June 30, 2012 |
| July 1, 2012 through June 30, 2013 |
| 5 |
| Provide on-line enrollment capability for welfare benefit annual enrollment which is scheduled for November of each year. Employee benefit annual enrollment includes medical and dental plan options; basic, supplemental, voluntary personal accident and dependent life insurance options; supplemental short- and long-term disability options; health and dependent care flexible spending accounts; and the Vacation Purchase Plan. |
| 1 |
| $ |
| $ |
| $ |
| $ |
| $ |
| 6 |
| Provide annual total compensation Employee Benefit Statements for NSTec active employees. Information to be contained in the statement includes annual salary, company cost of benefits, and narratives on what benefits are provided to active employees. Statements are issued each May. Provide estimates for on-line and hard copy capabilities. |
| 1 |
| $ |
| $ |
| $ |
| $ |
| $ |
| 7 |
| Conduct stop-loss insurance marketing for NSTec self-insured medical plan; prepare and issue Request for Proposal, analyze and evaluate vendor submissions; prepare final report and make recommendations to NSTec. |
| 1 |
| Total |
| $ |
| $ |
| $ |
| $ |
| $ |
Total Optional FIXED PRICE TASKS for 5 years
3.
UNIT BILLING OR
PRICE TASKS
Proposed Unit Billing Prices for the following Tasks quoted in the Pricing Table of this Schedule shall be firm all-inclusive unit prices including travel. Payment of the unit prices shall constitute full payment for performance of Work and shall cover all costs of whatever nature incurred by Subcontractor in accomplishing the Work in accordance with the provisions of the Subcontract.
Unit Billing Tasks:
8. Provide on-going on-site and/or web-based educational opportunities for NSTec Benefits Committee and Benefits staff, to include local seminars/conferences.
9. Conduct analysis of NSTec’s self-insured medical and prescription drug plan costs to determine whether a fully insured plan or other option is more cost effective. Provide NSTec with cost analysis and recommendations.
10. Review NSTec’s self-insured medical plan design (including consumerism approaches) and make recommendations for changes by established due date.
11. Conduct review of National Health Maintenance Organization option as a replacement for current Health Maintenance Organizations; make recommendations for changes/ implementation.
12. Evaluate and recommend changes to current medical and dental plan premium structure (including flexible credits) for active employees, retired employees (including grandfathers), COBRA participants, Displaced Workers, and BPOI retirees.
13. Develop and provide spreadsheet capability to capture medical, prescription drug, dental, and vision plan costs, trend, projected changes to plans and enrollments, etc. which will allow client to develop medical and dental plan premiums for active, retired (including grandfathered retirees), COBRA, Displaced Workers and BPOI retirees.
14. Provide services related to the Medicare Retiree Drug Subsidy program including annual actuarial attestation, and evaluation of options.
15. Respond to ad-hoc requests for data, technical assistance, regulatory guidance, special studies, etc. as they relate to welfare benefit plan design or administration.
Table III (ITEMS 8 – 15 - Task List for NSTec Welfare Benefit Services) July 1, 2008 through June 30, 2009
| Labor Category |
| Estimated Hours |
| Hourly Rate |
| Extended Amount |
Unburdened
Hourly Rates Fully Burdened hourly Labor Rates
| Project Manager |
| 100 |
| $ |
| $ |
| $ |
| Senior Consultant |
| 90 |
| $ |
| $ |
| $ |
| Consultant |
| 100 |
| $ |
| $ |
| $ |
| Analyst |
| 110 |
| $ |
| $ |
| $ |
| Support Staff |
| 65 |
| $ |
| $ |
| $ |
| Total |
| $ |
July 1, 2009 through June 30, 2010
| Labor Category |
| Estimated Hours |
| Hourly Rate |
| Extended Amount |
Unburdened
Fully Burdened hourly Labor Rates
| Project Manager |
| 100 |
| $ |
| $ |
| $ |
| Senior Consultant |
| 90 |
| $ |
| $ |
| $ |
| Consultant |
| 100 |
| $ |
| $ |
| $ |
| Analyst |
| 110 |
| $ |
| $ |
| $ |
| Support Staff |
| 65 |
| $ |
| $ |
| $ |
| Total |
| $ |
July 1, 2010 through June 30, 2011
| Labor Category |
| Estimated Hours |
| Hourly Rate |
| Extended Amount |
Unburdened
Fully Burdened hourly Labor Rates
| Project Manager |
| 100 |
| $ |
| $ |
| $ |
| Senior Consultant |
| 90 |
| $ |
| $ |
| $ |
| Consultant |
| 100 |
| $ |
| $ |
| $ |
| Analyst |
| 110 |
| $ |
| $ |
| $ |
| Support Staff |
| 65 |
| $ |
| $ |
| $ |
| Total |
| $ |
July 1, 2011 through June 30, 2012
| Labor Category |
| Estimated Hours |
| Hourly Rate |
| Extended Amount |
Unburdened
Fully Burdened hourly Labor Rates
| Project Manager |
| 100 |
| $ |
| $ |
| $ |
| Senior Consultant |
| 90 |
| $ |
| $ |
| $ |
| Consultant |
| 100 |
| $ |
| $ |
| $ |
| Analyst |
| 110 |
| $ |
| $ |
| $ |
| Support Staff |
| 65 |
| $ |
| $ |
| $ |
| Total |
| $ |
July 1, 2012 through June 30, 2013
| Labor Category |
| Estimated Hours |
| Hourly Rate |
| Extended Amount |
Unburdened
Fully Burdened hourly Labor Rates
| Project Manager |
| 100 |
| $ |
| $ |
| $ |
| Senior Consultant |
| 90 |
| $ |
| $ |
| $ |
| Consultant |
| 100 |
| $ |
| $ |
| $ |
| Analyst |
| 110 |
| $ |
| $ |
| $ |
| Support Staff |
| 65 |
| $ |
| $ |
| $ |
| Total |
| $ |
Total Unit Billing PRICE TASKS for 5 years
GRAND TOTALS
| Total Price for Fixed Price Tasks for all Years |
| $ |
| Total Price for Optional Fixed Price Tasks for all Years |
| $ |
| Total Price for Unit Billing PRICE Tasks for all Years |
| $ |
| Grand Total for all Years |
| $ |
2. PAYMENT TERMS
Enter any prompt payments discount or Net 30 Days .
3. FUNDING LIMITATION
For Task Orders issued under this Subcontract, the total payment for each Task Order shall not exceed the estimated value of the Task order without a written revision to such Task Order.
Form B Subcontractor and Vendor List Subcontractor shall employ the following lower-tier subcontractors in performance of the work and/or vendors who will furnish major components, materials or equipment:
If no lower-tier subcontracts or purchases are anticipated, enter the word “NONE”.
| Name & Address |
| Work Description |
| Terms (1.) |
| Value |
| SB/SDB/WOSB (2.) |
NOTES:
(1.)
TERMS: Enter Lump Sum, Unit Price, etc.
(2.)
SB/SDB /WOSB:
Enter SB for Small Business, SDB for Small Disadvantaged Business, and WOSB for Woman-Owned Small Business.
Form C Evaluation Criteria
1.
The CONTRACTOR intends to award one subcontract resulting from this RFP to the responsible SUBCONTRACTORS whose proposals conforming to the RFP will be most advantageous to the CONTRACTOR. The CONTRACTOR reserves the right to determine that proposals are outside the competitive range at any time during the evaluation process. SUBCONTRACTOR’S whose proposals are determined to be outside the competitive range will be promptly notified. CONTRACTOR also reserves the right to:
(i) Make an award without entering into discussions with SUBCONTRACTOR (other than discussions conducted for the purpose of minor clarifications);
(ii) Reject any and all proposals;
(iii) Award to other than the lowest SUBCONTRACTOR;
(iv) Waive informalities and minor irregularities;
(v) Negotiate further with any SUBCONTRACTOR(s) in regard to price, terms, delivery schedules, conditions and general provisions and clarify any proposal.
Accordingly, all SUBCONTRACTOR’S are cautioned to submit their best offer with their initial proposal and to complete and submit all required documents.
2.
GENERAL CONSIDERATIONS
In addition to the evaluation of each SUBCONTRACTOR’S proposal, CONTRACTOR will consider each SUBCONTRACTOR’S adherence to the terms and conditions. All Exceptions and Deviations will be evaluated on a case-by-case basis.
3.
EVALUATION METHOD - BEST VALUE
This procurement will use a Best Value process assessing merit factors as well as cost/price. This selection process will allow tradeoffs among cost/price and non-cost factors allowing CONTRACTOR to accept other than the lowest priced proposal. Proposals will be rated using a scoring system which depicts how well the SUBCONTRACTOR’S proposal meets the evaluation standards and RFP requirements.
The CONTRACTOR will select the SUBCONTRACTOR whose proposal is technically acceptable and whose technical and price relationship is most advantageous to the CONTRACTOR and the Government. The CONTRACTOR will award to a SUBCONTRACTOR, other than the lowest responsive and responsible SUBCONTRACTOR, if evaluation renders that SUBCONTRACTOR to be sufficiently superior from a technical standpoint so as to warrant payment by the CONTRACTOR of a premium (i.e., difference in price between the superior proposal and lower responsive proposals) for such superiority. The proposed price between SUBCONTRACTOR’S in the competitive range, especially between proposals which have fairly equal technical ratings, may be the major deciding factor in the selection of multiple proposals for award, unless the CONTRACTOR determines, after evaluation, that only one SUBCONTRACTOR is capable of providing the services.
The following criteria will be used as the basis of award:
Scored Criteria
The following Criteria will be evaluated and scored. The scored criteria are listed in descending order of importance. Criterion 1, Demonstrated Company Experience; Criterion 2, Project Approach; and Criterion 3, Key Personnel are equal in importance. Criterion 4, Past Performance is of least importance.
NOTE: Failure of the OFFEROR to provide complete information may impair the CONTRACTOR's ability to accurately evaluate the proposal, resulting in potentially lower scores for one or more of the Criteria described below.
Criterion 1:
Demonstrated Company Experience
The OFFEROR shall demonstrate company experience as described in Exhibit B, Statement of Work in by providing the following at a minimum:
1 OFFEROR must demonstrate minimum ten (10) years experience and, if applicable, its lower-tier subcontractor(s) experience, in program strategy, design, management, and administration with projects involving welfare benefit plan administration, research and analysis, legislative compliance, negotiations with vendors, and technical expertise on insured and self-insured active and retiree medical plans, prescription drug plans, dental plans, vision plans, short-and long-term disability plans, life insurance plans, flexible spending account plans, and other employee voluntary benefit plans. For full experience credit, past and present, experience of proposed OFFEROR’s must be demonstrated consistent with the proposed subcontracting arrangements. Use Forms titled “Experience Statement”, and “Lower-tier Subcontract Experience Statement” (if applicable).
2 OFFEROR shall provide a minimum of two relevant project examples and include: Project Description, Proposed Solution, and Benefit.
3 OFFEROR shall include experience with the Centers for Medicare and Medicaid Retiree Drug Subsidy Program, medical plan premium structuring, vendor negotiations, welfare benefit vendor re-bids, and on-line benefits enrollment capabilities.
4 OFFEROR shall demonstrate cost savings, quality of work performed, and cost control by providing samples of studies conducted, research performed, results and reports prepared within the last 10 years.
The technical evaluation will focus on experience that demonstrates quality of performance with companies who have employees located throughout the United States relative to the size and complexity of the acquisition under consideration and illustrated by relevant project example(s). OFFEROR’s demonstrating “Significant Benefit or Cost Savings” methods to their customer will result in a higher ranking for the OFFEROR.
Criterion 2:
Project Approach
The OFFEROR’s Project Approach shall address the following at a minimum:
1 The OFFEROR’s approach as to how the OFFEROR will provide the welfare benefit plan administrative support services, research and analysis capability, legislative compliance guidance, vendor negotiation capability, and technical expertise on the National Security Technologies LLC (NSTec) Welfare Benefit Program for employees and retirees throughout the U.S.
2 The OFFEROR’s System capability and reliability to conduct annual on-line benefits annual enrollment and provide hard copy and/or on-line annual benefit statements and other studies or reports.
3 The OFFEROR’s educational opportunities or training on all aspects of compliance and plan management provided to Contractor, including newsletters (electronic or hard-copy), training, seminars, conferences, etc.
4 The OFFEROR’s approach for managing the liabilities associated with retiree health benefits, and for identifying alternative retiree health benefit vehicles.
5 The OFFEROR’s ability to develop support materials and resources necessary to run effective programs.
6 The OFFEROR’s complete staffing plan, including an organizational chart, identifying the key personnel assigned to this account, and their functional assignments.
An approach that demonstrates an understanding of the services required, that shows its research and analysis capabilities, that shows an in-depth knowledge of legislative requirements and understanding and knowledge of the local (Las Vegas, NV) and national marketplaces, who’s approach will provide the basis for maintaining program continuity, uninterrupted work of high quality and that ensures sufficient and qualified resources and people are available to respond to requirements, and whose systems ensure the accuracy of records and data reported will be scored higher.
Criterion 3:
Key Personnel
The OFFEROR shall address at a minimum:
1 The OFFEROR shall provide the resumes Subcontractor Key Personne that will be assigned to this account including those Key Personnel listed Exhibit D, “Approval of Subcontractor Key Personnel.” Form “Resumes of Key Personnel” or equivalent shall be used for providing this information.
2 The OFFEROR shall demonstrate that proposed Key Personnel are qualified in supporting all facets of employee benefit plans, possess the appropriate certification requirements, as well as the understanding of the healthcare market and the skill and ability to effectively plan, manage, and complete the work required on schedule.
The OFFEROR’s Key Personnel will be evaluated on their requisite skills and appropriate background for the specific positions for which they are proposed. The evaluation of Key Personnel will focus on the individuals’ education, professional credentials, and experience relevant to the Statement of Work. The OFFERORS with Key Personnel who have demonstrated a comprehensive understanding of the objectives and requirements identified in the Statement of Work will be scored higher.
Criterion 4:
Past Performance The OFFEROR must identify past performance under existing and prior contracts for similar projects at similar value. Similar projects include where the Offeror has provided reliable and experienced welfare benefit plan administrative support services for active and retiree medical plans, prescription drug plan, dental plans, vision plan, short- and long-term disability plans, life insurance plans, flexible spending accounts, and other voluntary employee benefit plans. Use the enclosed Past Performance Questionnaire. Provide this questionnaire to at least five of your clients and have them return the form as indicated. Proposers are cautioned to include all projects of a similar or reasonably similar nature for at least the previous 10 year period. The evaluation will focus on the degree of customer satisfaction, quality of work performed, timeliness of performance, and cost control. Past performance that shows where the OFFEROR has demonstrated a “Benefit or Cost Savings” to their customer will result in a higher ranking for the OFFEROR The Offeror will include in its proposal the list of companies selected to submit a Past Performance Questionnaire, including the company name, address, and phone number. If no past performance questionnaire is received on an OFFEROR then this criterion will receive a neutral rating.
For each criterion or sub-criterion the evaluator shall assign an adjective rating with a corresponding numerical rating within the range indicated (below). This will be the basis for determining how many of the available points will be assigned to each proposal for each criterion.
Superior (81-100) - Significantly exceeds desired performance or capability in a beneficial way; substantial and clearly defined response; an innovative response; has no weaknesses.
Exceptional (61-80) - Exceeds specified performance or capability in a beneficial way; a substantial and clearly defined response; has value added features; has no significant weakness.
Acceptable (41-60) - Meets desired requirements; all critical criteria met; proof of experience supplied; has good probability of satisfying the requirement; any weaknesses can be readily corrected.
Marginal (21-40) - Fails to meet evaluation standards; unacceptable deviation from desired requirements; there is not sufficient data to permit a comprehensive evaluation; the proposal does not provide a good match to requirements; has low probability of satisfying the requirement.
Unacceptable (0-20) - Fails to meet minimum requirements; gross deficiencies from desired requirements; gross lack of understanding of requirements; would require a major revision to make the proposal acceptable.
Although price will not be scored, it can be the determining factor between proposals within the competitive range.
4.
PREPARATION OF PROPOSAL (Technical and Pricing)
Written Proposals shall be submitted to arrive at this office by the date and time specified in the RFP cover letter. Proposals shall be submitted on the forms furnished, or copies thereof, and must be manually signed. No erasures are permitted. If changes appear on the forms, the erroneous information must have a single line drawn through the information, and be initialed and dated by the person signing the proposal.
Proposals must be submitted in separate volumes as identified in Exhibit A, Form “Administrative and Technical Data”. The proposal shall contain all pertinent information requested in sufficient detail to permit a thorough evaluation. If the requested information is not located in the proper section, the information may be considered omitted.
Written Proposals will be evaluated as set forth in paragraph 3 above.
[List any requirements of how you want the proposals provided, such as “The technical [or price] proposal shall include the following components: a. Table of contents, b. List of tables and figures, c. All pages, including tables and figures, shall be numbered, d. Short introduction, e. The technical proposal should clearly address each of the technical proposal evaluation criteria in paragraph above. It should be presented in as much detail as practical and include the following as a minimum: (list the technical evaluation criteria here again, but provide more detail of what you want)].
Form D Past Performance Questionnaire
Upon completion please return to:
National Security Technologies, LLC
Attention: Jeanette Matthews, CF018
PO Box 98521
Las Vegas, NV 89193-8521
RFP: 002WP-JM-08
Fax: 702-295-2088
Firm Name: [Insert the name of the Firm being evaluated] Contract Number: [Insert No.] The above noted firm’s past performance is being assessed for technical evaluation purposes. You are requested to complete the following and fax or mail to the above noted address no later than [insert date]. Additional comments are welcome. Provide additional sheets if necessary.
Please provide a brief narrative/description of the services provided or product furnished, including contract period of performance, type of contract (firm fixed price, cost plus, etc.), and contract award amount:
Were there any Benefit or Cost Savings associated with this contract?
YES
NO
Please describe:
Were there any change orders made to this contract?
If yes, please explain:
Has this contract been partially or completely terminated for default or convenience?
Please describe the circumstances:
Was the quality compliant with the contract requirements? (i.e. accuracy of reports, technical excellence, quality control, etc.)
Additional Comments:
Was the project completed/delivered on time, and within budget?
Additional Comments:
How effective was the contractor in the following areas:
Excellent = 4 Exceeded Minimum Requirements Good = 3 Met Minimum Requirements
Fair = 2
Less than Minimum Requirements with Satisfactory Results Poor = 1 Did not meet minimum requirements Responsive to Customer Needs
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel
Additional Comments:
How would you rate the contractor’s overall performance?
EXCEPTIONAL SATISFACTORY POOR
ADDITIONAL COMMENTS:
Name & Date
Company
Title
Address
Phone
Address
Note: This form is for evaluation and will not be part of the subcontract.
Form E Administrative and Technical Data
OFFEROR shall submit the following data with their proposal via the NNSA eSourcing Service at https://www.sourcingservice.com/nnsa.
Volume 1- Price Proposal:
1. Subcontractor’s Proposal Letter, signed and dated. (Include IRS Form W-9)
2. Exhibit A, Form (Consideration Schedule)
3. Exhibit A, Form (Subcontractor and Vendor List) [Note a copy of this form is to be included in Volume 1 with “value” (prices). And in all other volumes without “value” (prices)]
4. Exhibit A, Form (Past Performance Questionnaire) List of firms, including points of contact with phone numbers, who were sent a Past Performance Questionnaire to complete.
5. Exhibit A, Form (Exceptions and Deviations) *[Note a copy of this form is to be included in both Volume 1 and Volume 2.]
6. Exhibit D, Attachment - Organizational Conflicts of Interest Questionnaire and Representations or Disclosure Form.
7. Preliminary Subcontracting Plan (Exhibit D, “SUBCONTRACTING PLAN”) If you are a large business, you will be required to submit your Subcontracting Plan for approval by the CONTRACTOR, prior to award. (See Special Condition titled, “SUBCONTRACTING PLAN” and in accordance with FAR Clause 52.219-9 – Small, Small Disadvantaged and Women‑Owned Small Business Subcontracting Plan.
Volume 2 – Technical Proposal:
No cost information is to be included in technical proposal. Proposal shall not merely offer to perform work in accordance with the special conditions, but shall explain how the OFFEROR plans to accomplish the requirements.
The technical proposal shall include the following components:
a. Table of contents
b. List of all attachments
c. All pages shall be numbered.
The technical proposal should clearly address each of the technical proposal evaluation criteria in Form C, paragraph 3. It should be presented in as much detail as practical and include the following as a minimum:
1. Exhibit A, Form (Subcontractor List). [Note a copy of this form is to be included in all Volumes without “value” (prices)]
2. Exhibit A, Form (Past Performance Questionnaire) List of firms, including points of contact with phone numbers, who were sent a Past Performance Questionnaire to complete.
3. Exhibit A, Forms (Demonstrated Experience and Experience Statement).
4. Exhibit A, Form (Lower-Tier Subcontractor Experience Statement).
5. Exhibit A, Form (Project Approach).
6. Exhibit A, Form Resumes of Key Personnel Assigned to this account.
7. Exhibit A, Form (Exceptions and Deviations) [Note a copy of this form is to be included in both Volume 1 and Volume 2.] NOTE: This form is for proposal evaluation and will not be part of the subcontract.
Form F Demonstrated Experience
The OFFEROR shall describe its Demonstrated Experience not to exceed 50 pages. The OFFEROR shall provide at a minimum:
1 OFFEROR must demonstrate minimum ten (10) years experience and, if applicable, its lower-tier subcontractor(s) experience, in program strategy, design, management, and administration with projects involving welfare benefit plan administration, research and analysis, legislative compliance, negotiations with vendors, and technical expertise on insured and self-insured active and retiree medical plans, prescription drug plans, dental plans, vision plans, short-and long-term disability plans, life insurance plans, flexible spending account plans, and other employee voluntary benefit plans. For full experience credit, past and present, experience of proposed OFFEROR’s must be demonstrated consistent with the proposed subcontracting arrangements. Use Forms, Experience Statement, and Lower-tier Subcontract Experience Statement (if applicable).
2 OFFEROR shall provide a minimum of two relevant project examples and include: Project Description, Proposed Solution, and Benefit.
3 OFFEROR shall include experience with the Centers for Medicare and Medicaid Retiree Drug Subsidy Program, medical plan premium structuring, vendor negotiations, welfare benefit vendor re-bids, and on-line benefits enrollment capabilities.
4 OFFEROR shall demonstrate cost savings, quality of work performed, and cost control by providing samples of studies conducted, research performed, results and reports prepared within the last 10 years.
NOTE:
This form is for proposal evaluation and will not be part of the subcontract.
Form G Experience Statement
The offeror submits the following statement as to its experience qualifications. In the case of a joint venture, separate forms will be submitted for previous experience of the joint venture and the experience of each party of the joint venture.
This company has been engaged in the contracting business under its present business name for years.
Experience in work of a nature similar in type and magnitude to that set forth in the Statement of Work (SOW) extends over a period of years.
All awarded contracts have been satisfactorily completed, except as follows (name any and all exceptions and reasons therefore, attaching additional pages if necessary):
The following contracts, covering work similar in type and magnitude to that set forth in the SOW, has been satisfactorily completed within the last Ten (10) years or are now in progress for the following owners or prime contractors.
| Name, address/contact and telephone number |
| work description |
| value |
| location |
| start/stop |
NOTE:
This form is for proposal evaluation and will not be part of the subcontract.
Form H Lower-Tier Subcontractor Experience Statement This statement of experience qualifications is submitted for the following lower-tier subcontractor or supplier. In the case of multiple lower-tier subcontractors or suppliers, separate forms will be submitted for previous experience of each lower-tier subcontractor or supplier.
| COMPANY NAME: |
| PHONE: |
| CONTACT: |
| FACSIMILE: |
ADDRESS:
Lower-tier Subcontractors shall provide the same information as required by the Subcontractor as listed above in Form Experience Statement.
A list of contracts, covering work similar in type and magnitude to that set forth in the SOW, has been satisfactorily completed within the last 10 years or are now in progress for the following owners or prime contractors. (Attach additional pages if necessary):
| Name, address/contact and telephone number |
| work description |
| value |
| location |
| start/stop |
All awarded contracts have been satisfactorily completed, except as follows (name any and all exceptions and reasons therefore, attaching additional pages if necessary):
NOTE:
This form is for proposal evaluation and will not be part of the subcontract.
Form I Project Approach [PN: Assess the need to have the Offeror submit this information. If Project Organization is an evaluation criteria, include this Form in the RFP.] The OFFEROR shall describe its approach, not to exceed 50 pages, the OFFEROR shall address at a minimum:
1. The OFFEROR’s approach as to how the OFFEROR will provide the welfare benefit plan administrative support services, research and analysis capability, legislative compliance guidance, vendor negotiation capability, and technical expertise on the National Security Technologies LLC (NSTec) Welfare Benefit Program for employees and retirees throughout the U.S.
2. The OFFEROR’s System capability and reliability to conduct annual on-line benefits annual enrollment and provide hard copy and/or on-line annual benefit statements and other studies or reports.
3. The OFFEROR’s educational opportunities or training on all aspects of compliance and plan management provided to Contractor, including newsletters (electronic or hard-copy), training, seminars, conferences, etc.
4. The OFFEROR’s approach for managing the liabilities associated with retiree health benefits, and for identifying alternative retiree health benefit vehicles.
5. The OFFEROR’s ability to develop support materials and resources necessary to run effective programs.
6. The OFFEROR’s complete staffing plan, including an organizational chart, identifying the key personnel assigned to this account, and their functional assignments.
NOTE:
This form is for proposal evaluation and will not be part of the subcontract.
Form J Key Personnel
The OFFEROR shall address at a minimum:
1. The OFFEROR shall provide the resumes of the Key Personnel that will be assigned to this account. Form “Resumes of Key Personnel” or equivalent shall be used for providing this information.
2. The OFFEROR shall demonstrate that proposed Key Personnel are qualified in supporting all facets of employee benefit plans, possess the appropriate certification requirements, as well as the understanding of the healthcare market and the skill and ability to effectively plan, manage, and complete the work required on schedule.
1. TITLE:
2. NAME:
3. EDUCATION/QUALIFICATIONS:
4. PRESENT POSITION IN Offeror’s COMPANY:
5. RELEVANT EXPERIENCE:
6. EMPLOYMENT HISTORY:
7. CITIZENSHIP:
NOTE: This form is for evaluation purposes only and will not be a part of the Subcontract.
Form K Exceptions and Deviations
Offeror submits herein any exceptions and deviations Offeror wishes to make to any part of the proposal documents, taking care to refer precisely to which part of the proposal documents the exception or deviation is being made. All exceptions and deviations shall be submitted in the form of amendments to the proposal documents and must be listed separately by each Exhibit. No exceptions or deviations to the proposal documents shall be recognized unless expressly set forth herein and all other terms and conditions of the proposal documents remain in full force and effect except as recognized herein.
In addition, any special or unique terms and/or conditions that the Offeror wants considered must be provided with the proposal. Attempting to provide this type of information after the proposal due date may preclude the proposal from further consideration.
failure to comPlete this form may be cause for rejection of offeror’s proposal
FORMCHECKBOX
No Exceptions
FORMCHECKBOX
Exceptions taken are detailed below or on a separate sheet
No. Reference
Exception or Deviation
Reason
NOTES:
List the Request for Proposal document location under the column above entitled “Reference” to which any proposed exception or deviation applies (e.g.: Exhibit B, Section 5.2.1, etc.).
Under the “Reason” column, list the reason(s) for each exception or deviation proposed by the Offeror. Offerors are requested to keep their reasoning language as short as possible.
This form is for proposal evaluation and will not be a part of the Subcontract. Acceptable exceptions and deviations will be incorporated into the appropriate Subcontract Documents.
Form L Attachment A - Labor Categories Descriptions
Project Manager – Shall possess an MBA, MPA or related Master s degree, or equivalent work experience at a senior management level. Shall have demonstrated experience in working with or consulting with Medicare/Medicaid programs, HMO s, prepaid health programs,, and/or equivalent experience in management, operations, or organizational consultation relative to the Health Care industry; shall be considered an expert in this field; shall be responsible for quality control, utilization review, and oversight of projects and final report review/approval.
Senior Consultant - Shall possess a PhD, MBA, and/or equivalent work experience at a senior management level. Shall have extensive experience working with or consulting with Retirement Medicare/Medicaid programs, HMO s, prepaid health programs, and/or equivalent experience in management, operations, or organizational consultation relative to the Retirement/Benefit programs industry; shall be responsible for managing external quality and developing client strategy.
Consultant - Shall possess a Master s degree in Mathematics, Statistics, Computer Science, Economics, Finance, Business, other Liberal Arts, or equivalent work experience; Shall have experience working with or consulting with Medicare/Medicaid programs, HMO s, prepaid health programs, and/or equivalent experience in management, operations, or organizational consultation relative to the Retirement/Benefit industry; must have must be able to lead analytic teams in the analysis and synthesis of qualitative and quantitative information.
Analyst - Shall have a Bachelor s degree in Mathematics, Statistics, Computer Science, Economics, Finance, Business, or other Liberal Arts; shall possess strong command of relevant spreadsheet/database software; shall have demonstrated proficiency in analytical and mathematical skills; must have firm understanding of key health care issues.
Support Staff - Shall be well versed in and have advanced skills in the editorial peer review process, including proofreading, grammar, spelling, editing, and formatting; must be able to work simultaneously on numerous projects; must possess strong skills relevant to word processing and spreadsheet software.
Task Order Exhibit A Solicitation No. 002WP-JM-08 Welfare Benefit Program Subcontract No.
10/30/07
File details come from the government source that posted it. Updated .