4-Vanguard Insurance Cost Proposal.xlsx

XLSX spreadsheet 19 KB Posted

Attached to
Vanguard Academy - Employee Benefits Insurance Programs
Solicitation number
VAN 2026-10
Issued by
Utah

About this file

This is a cost proposal form for employee benefits insurance programs submitted by Vanguard Academy through the State of Utah Division of Purchasing. The solicitation (VAN 2026-10) requests comprehensive insurance coverage including medical, dental, vision, short-term disability, basic life insurance, and voluntary benefits for approximately 100 eligible employees. Offerors must propose two required medical plans—an HSA-qualified high-deductible health plan compatible with HealthEquity and a non-HSA option—with an optional third medical plan. Proposals are due November 12, 2026, with contract award anticipated to the responsive and responsible offeror providing best value. The rate guarantee period and contract term duration are to be specified by the offeror on the cost proposal form.

The cost proposal requires offerors to submit monthly premium rates for all coverage tiers across medical plans, dental, vision, and short-term disability, as well as basic life insurance rates per $1,000 of coverage. Vanguard's contribution structure is built into the evaluation formulas: 90 percent of employee-only medical costs, zero percent of dependent costs, 50 percent of dental, 80 percent of vision, 100 percent of short-term disability and basic life (capped at $25,000), and zero percent of voluntary benefits, which are fully employee-paid. Offerors must also complete a Coverage Details tab specifying plan design elements such as deductibles, out-of-pocket maximums, copays, coinsurance percentages, and benefit durations to enable calculation of a Plan Equivalency Factor. All yellow cells in the spreadsheet require offeror input; blue cells auto-calculate totals; and grey cells are fixed by Vanguard and cannot be modified. Voluntary benefit rates for accident, critical illness, hospital indemnity, long-term disability, and extended life insurance are informational and do not affect the cost evaluation.

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Cost Proposal

Cost Proposal
1.0Offeror must provide a cost in all line items in yellow to be considered responsive.
2.0All cells in yellow require an input. Cells in blue will auto populate. Grey cells are set by Vanguard and must not be changed.
3.0Enter rates on the "Core Rates" and "Voluntary Rates" tabs and the coverage values on the "Coverage Details" tab. The totals on this tab populate automatically.
4.0Vanguard's contribution rules from the RFP (Medical 90% of employee cost / 0% dependents; Dental 50%; Vision 80%; STD 100%; Basic Life 100% up to $25,000; voluntary benefits 0%) are built into the formulas.
Offeror Name:
Carrier(s) proposed:
Rate guarantee period (months):
#Total Overall CostCOST
1.0Total annual evaluated premium for core benefits plus fees (auto-calculated from the breakdown below)$ - 0
Total Overall Cost (Cost Points shall be determined by this amount, adjusted for plan equivalency)$ - 0
#Cost Breakdown: premiums and fees for all work associated with providing the services described in the RFPTotal Annual Premium / FeeVanguard Share (Annual)Employee Share (Annual)
1.0Medical Insurance (all proposed plans)$ - 0$ - 0$ - 0
2.0Dental Insurance$ - 0$ - 0$ - 0
3.0Vision Insurance$ - 0$ - 0$ - 0
4.0Short-Term Disability$ - 0$ - 0$ - 0
5.0Basic Life Insurance (up to $25,000)$ - 0$ - 0$ - 0
6.0Annual administrative, implementation, or service fees charged to Vanguard$ - 0$ - 0
7.0$ - 0$ - 0
8.0$ - 0$ - 0
9.0Offeror may add additional lines if necessary (describe in column B).$ - 0$ - 0
Total Overall Cost (This total should match the amount in C13)$ - 0$ - 0$ - 0
Voluntary benefits (Accident, Critical Illness, Hospital Indemnity, Long-Term Disability, Extended Life) are quoted on the "Voluntary Rates" tab, are 100% employee-paid, and are not included in the cost score.

Core Rates

Core Benefit Rates: Medical, Dental, Vision, Short-Term Disability, Basic Life (SOLICITATION #VAN 2026-10)
Legend:Yellow = Offeror inputBlue = auto-calculatedGrey = set by Vanguard (do not change)
Enter monthly rates as numbers, e.g. 612.45 for $612.45 per month. Leave Medical Plan 3 blank if not proposed.
Vanguard Contribution Rules and Evaluation Assumptions (set by Vanguard)
Medical: Vanguard pays this % of the employee's coverage cost (Employee Only rate)90%
Medical: Vanguard pays this % of the cost of added dependents0%
Dental: Vanguard pays this % (employee and added dependents)50%
Vision: Vanguard pays this % (employee and added dependents)80%
Short-Term Disability: Vanguard pays this %100%
Basic Life: Vanguard pays this %100%
Basic Life: maximum employer-paid coverage amount ($)$25,000
Eligible employees (approximate, used for Basic Life estimate)100
NOTE: The "Assumed Enrolled" counts below are illustrative placeholders used only to compare proposals on equal terms. Vanguard replaces them with actual census data before the RFP is released.
#Benefit / PlanCoverage TierMonthly Premium RateAssumed Enrolled EmployeesAnnual PremiumVanguard Share (Annual)Employee Share (Annual)
MEDICAL: Plan 1, HSA-qualified HDHP (required; HealthEquity-compatible)
Plan name / carrier / network:
1.0Employee Only20$ - 0$ - 0$ - 0
Employee + Spouse5$ - 0$ - 0$ - 0
Employee + Child(ren)5$ - 0$ - 0$ - 0
Family10$ - 0$ - 0$ - 0
MEDICAL: Plan 2, non-HSA option (required)
Plan name / carrier / network:
2.0Employee Only15$ - 0$ - 0$ - 0
Employee + Spouse5$ - 0$ - 0$ - 0
Employee + Child(ren)5$ - 0$ - 0$ - 0
Family10$ - 0$ - 0$ - 0
MEDICAL: Plan 3 (optional)
Plan name / carrier / network:
3.0Employee Only0$ - 0$ - 0$ - 0
Employee + Spouse0$ - 0$ - 0$ - 0
Employee + Child(ren)0$ - 0$ - 0$ - 0
Family0$ - 0$ - 0$ - 0
Medical Subtotal (all plans)$ - 0$ - 0$ - 0
DENTAL (Vanguard pays the % above for the employee and added dependents)
Plan name / carrier / network:
4.0Employee Only25$ - 0$ - 0$ - 0
Employee + Spouse10$ - 0$ - 0$ - 0
Employee + Child(ren)10$ - 0$ - 0$ - 0
Family25$ - 0$ - 0$ - 0
Dental Subtotal$ - 0$ - 0$ - 0
VISION (Vanguard pays the % above for the employee and added dependents)
Plan name / carrier / network:
5.0Employee Only20$ - 0$ - 0$ - 0
Employee + Spouse8$ - 0$ - 0$ - 0
Employee + Child(ren)8$ - 0$ - 0$ - 0
Family14$ - 0$ - 0$ - 0
Vision Subtotal$ - 0$ - 0$ - 0
SHORT-TERM DISABILITY (100% Vanguard-paid)
Plan design: benefit %, weekly max, elimination period, max duration, and rate basis:
6.0Estimated annual premium for all eligible employees (based on census)$ - 0$ - 0
BASIC LIFE (100% Vanguard-paid up to the maximum above)
Plan design notes (AD&D, accelerated benefit, conversion/portability):
7.0Monthly rate per $1,000 of coverageAll eligible employees100$ - 0$ - 0$ - 0
Assumptions: Annual premium = monthly rate x assumed enrolled employees x 12. Medical Vanguard share = (Employee Only rate x 90% + added-dependent cost x 0%) per enrolled employee. Dental/Vision share = Vanguard % x tier rate. Basic Life assumes every eligible employee is covered at the maximum employer-paid amount. All percentages come from the RFP (VAN 2026-10) and are set by Vanguard.

Coverage Details

Coverage Details (SOLICITATION #VAN 2026-10)
Enter the value of each coverage element for the plans you are proposing. These values are used to calculate the Plan Equivalency Factor (see RFP, Cost/Budget). Yellow cells require an input. Enter percentages as percents (e.g., 80%).
#Coverage ElementUnitOffered Value
Medical: HSA-qualified HDHP (Plan 1)
1.0HSA-qualified HDHP: individual deductible$
2.0HSA-qualified HDHP: individual out-of-pocket maximum$
3.0HSA-qualified HDHP: member coinsurance after deductible%
Medical: non-HSA plan (Plan 2)
4.0Non-HSA plan: individual deductible$
5.0Non-HSA plan: individual out-of-pocket maximum$
6.0Non-HSA plan: primary care visit copay$
7.0Non-HSA plan: specialist visit copay$
8.0Non-HSA plan: member coinsurance after deductible%
9.0Non-HSA plan: preferred brand prescription copay$
Dental
10.0Dental: annual maximum per person$
11.0Dental: in-network preventive services coverage%
12.0Dental: in-network major services coverage%
Vision
13.0Vision: eye exam copay$
14.0Vision: frame allowance$
Short-Term Disability (base plan)
15.0STD: benefit (% of wages replaced)%
16.0STD: maximum benefit durationweeks
17.0STD: elimination perioddays

Voluntary Rates

Voluntary Benefit Rates (employee-paid; SOLICITATION #VAN 2026-10)
Vanguard makes no contribution to these benefits. Rates are informational and are considered under the Service criteria. Yellow cells require an input.
#ProductPlan Design / Benefit SummarySample Monthly Rate (Employee Only)Rating Basis (age bands, tobacco, per $1,000, etc.)Vanguard Contribution
Ex.EXAMPLE: Accident InsuranceExample: lump-sum benefits for injuries, ER visits, and hospital admission; $1,000 hospital admission benefit$ 18.50Example: flat rate, no age banding, tobacco-neutraln/a (example row)
1.0Accident0%
2.0Critical Illness0%
3.0Hospital Indemnity0%
4.0Long-Term Disability0%
5.0Extended Life Insurance (above $25,000 basic benefit)0%
6.00%
7.00%
Offeror may add additional voluntary products in the open yellow rows.

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