Attachment 1 - Price Proposal Breakdown (updated).xlsx

XLSX spreadsheet 21 KB Posted

Attached to
Health Insurance for Locally Employed Staff (LES), U. S. Embassy Skopje, North Macedonia
Solicitation number
19GE5025R0095
Issued by

About this file

The file is a Price Proposal Breakdown Excel spreadsheet for Solicitation 19GE5025R0095, detailing health insurance pricing for locally employed staff at the U.S. Embassy in Skopje, North Macedonia. The pricing schedule covers a base year and four option years, with three coverage tiers: Self Only (one individual), Self Plus One (two individuals), and Family (three or more individuals). The document shows estimated enrollment numbers for each tier across all performance periods, with 30 individuals for Self Only, 47 for Self Plus One, and 148 for Family coverage. Notably, all premium and total cost fields are currently populated with zero values, suggesting this is a template for vendors to complete their pricing proposal.

The solicitation is issued by the Department of State's Regional Procurement Support Office (RPSO) Frankfurt, with two amendments already issued. The contract opportunity seeks healthcare services specifically for locally employed staff at the U.S. Embassy in Skopje, North Macedonia. Vendors are required to acknowledge receipt of amendments by completing and returning a Standard Form (SF30) with their proposal. The solicitation involves health insurance coverage with multiple enrollment options and a multi-year performance period, allowing for potential contract extensions through four option years beyond the base year.

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Other files

File Type Posted
19GE5025R0095-A0002.pdf PDF
Attachment 5 - Exhibit A (updated).pdf PDF
19GE5025R0095-A0001.pdf PDF
Attachment 2 - Contract Information Sheet.docx DOCX document
Attachment 4 - Form W-14 Instructions.pdf PDF
Attachment 1 - Price Proposal Breakdown.xlsx XLSX spreadsheet
19GE5025R0095.pdf PDF
Attachment 5 - Exhibit A.pdf PDF
Attachment 3 - Form W-14.pdf PDF

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Text version

Pricing Schedule

SOLICITATION 19GE5025R0095 - PRICING SCHEDULE
CLINCategoryEstimated Number of Premiums*Monthly PremiumAnnual PremiumTotal
001BASE YEAR
001ASelf Only (one individual)30- 0- 0
001BSelf Plus One (two individuals)47- 0- 0
001CFamily (three or more individuals)148- 0- 0
TOTAL BASE YEAR- 0
1001OPTION YEAR ONE
1001ASelf Only (one individual)30- 0- 0
1001BSelf Plus One (two individuals)47- 0- 0
1001CFamily (three or more individuals)148- 0- 0
TOTAL OPTION YEAR ONE- 0
2001OPTION YEAR TWO
2001ASelf Only (one individual)30- 0- 0
2001BSelf Plus One (two individuals)47- 0- 0
2001CFamily (three or more individuals)148- 0- 0
TOTAL OPTION YEAR TWO- 0
3001OPTION YEAR THREE
3001ASelf Only (one individual)30- 0- 0
3001BSelf Plus One (two individuals)47- 0- 0
3001CFamily (three or more individuals)148- 0- 0
TOTAL OPTION YEAR THREE- 0
4001OPTION YEAR FOUR
4001ASelf Only (one individual)30- 0- 0
4001BSelf Plus One (two individuals)47- 0- 0
4001CFamily (three or more individuals)148- 0- 0
TOTAL OPTION YEAR FOUR- 0
BASE YEAR TOTAL- 0
OPTION YEAR ONE TOTAL- 0
OPTION YEAR TWO TOTAL- 0
OPTION YEAR THREE TOTAL- 0
OPTION YEAR FOUR TOTAL- 0
GRAND TOTAL- 0
CURRENCY
*estimated number of premiums does not include any Riders (Section I, C.4.3)
**does not include any premiums for Riders.
Monthly Retention Amounts per separate premium paid per Self Only (one individual), Self Plus One (two individuals) and Family (three or more individuals)
Period of PerformanceSelf Only (one individual)Self Plus One (two individuals)Family (three or more individuals)
Base Period
First Option Year
Second Option Year
Third Option Year
Fourth Option Year

File details come from the government source that posted it. Updated .