009 Exhibit A Pricing Sheet.xlsx
XLSX spreadsheet 27 KB Posted
- Solicitation number
- 2132029
- Issued by
- Brookhaven CDP, New York
About this file
This is an Exhibit A Pricing Sheet for RFB# OCA-DGCP-009 issued by the New York State Unified Court System (UCS), Office of Court Administration (OCA), soliciting sealed bids for a group life insurance and accidental death and dismemberment insurance coverage plan. The Plan covers qualified UCS active employees and retirees at no cost to enrollees. As of December 8, 2025, there are 2,330 Active Enrollees categorized by age group (0-64, 65-69, and 70 and up) and 2,026 Retired Enrollees. Active Enrollees receive both group life insurance and accidental death and dismemberment coverage, while Retired Enrollees receive group life insurance only. The bid issue date was February 24, 2026, with initial questions due by March 17, 2026 at 2:00 PM EST and final questions due by March 31, 2026 at 2:00 PM EST. The bid submission deadline is April 13, 2026 at 2:00 PM EST, with an estimated contract start date of January 1, 2027. The contact for this RFB is Jillian Halse, Court Analyst.
Bidders must quote monthly premium rates per $1,000 of insurance coverage for three coverage tiers: Group Life Insurance for Active Enrollees (0-64 at $50,000, 65-69 at $25,000, and 70 and up at $20,000 coverage amounts), Accidental Death and Dismemberment for Active Enrollees (same coverage amounts by age tier), and Group Life Insurance for Retired Enrollees (any age at $15,000 coverage amount). The spreadsheet is pre-programmed to calculate estimated monthly costs and the 36-month initial term cost based on projected enrollee numbers across three years. Bidders must enter only the monthly premium rates in designated blue cells and complete bidder verification information with an authorized representative signature and date. Emblem Health is the current incumbent, having held an identical or substantially similar contract within the past five years. The spreadsheet explicitly prohibits any alterations, changes, deletions, or additions, with non-compliance resulting in bid rejection.
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Text version
Sheet1
| EXHIBIT A PRICING SHEET - RFB# OCA-DGCP-009: UCS Supplemental Insurance Plan | ||||||||
| Bidder shall quote Premium Rates per $1,000 of insurance coverage, as set forth below. The required insurance policy amounts are set below in Article II of Exhibit B, Plan Specifications . Do not alter this Pricing Sheet in any manner. Any changes, deletions, or additions to the Pricing Sheet may result in rejection of the bid response. | ||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | |
| Monthly Premium Rate per $1,000 of insurance coverage | Required Coverage Amount per Group Enrollee | Cost Per Group Enrollee Per Month (A x B) / 1,000 | Estimated Number of Group Enrollees in Year 1 (average monthly #s) | Estimated Number of Group Enrollees in Year 2 (average monthly #s) | Estimated Number of Group Enrollees in Year 3 (average monthly #s) | Estimated monthly cost C x (D + E + F) | Initial Term Cost (G x 36 months) | |
| 1. Group Life Insurance Premiums for ACTIVE ENROLLEES | ||||||||
| 0-64 | $ 50,000.00 | $ - 0 | 1,959 | 1,979 | 1,999 | $ - 0 | $ - 0 | |
| 65-69 | $ 25,000.00 | $ - 0 | 256 | 259 | 262 | $ - 0 | $ - 0 | |
| 70 and up | $ 20,000.00 | $ - 0 | 115 | 116 | 117 | $ - 0 | $ - 0 | |
| 2. Accidental Death and Dismemberment Premiums for ACTIVE ENROLLEES | ||||||||
| 0-64 | $ 50,000.00 | $ - 0 | 1959 | 1979 | 1999 | $ - 0 | $ - 0 | |
| 65-69 | $ 25,000.00 | $ - 0 | 256 | 259 | 262 | $ - 0 | $ - 0 | |
| 70 and up | $ 20,000.00 | $ - 0 | 115 | 116 | 117 | $ - 0 | $ - 0 | |
| 3. Group Life Insurance Premium for RETIRED ENROLLEES | ||||||||
| ANY AGE | $ 15,000.00 | $ - 0 | 2,026 | 2,046 | 2,066 | $ - 0 | $ - 0 | |
| Grand total cost initial term (36 months) | $ - 0 |
| Bidder Verification Information |
| Name of Company Submitting Bid Pricing: |
| Authorized Representative: |
| Name |
| Title |
| Signature |
| Date |
| Please fill out all requested bid information in the blue shaded cells. The spreadsheet is pre-programmed to calculate all columns except the Monthly Premium Rate per $1,000 of insurance coverage, in BLUE. The Bidder is expected to enter all information requested in the blue cells. Once complete, print out the Exhibit A Pricing Sheet, affix a "wet" ink signature and date, and submit with the rest of the required bid documents. |
File details come from the government source that posted it. Updated .