J.44 CLIN 0011 Cost Proposal Template - Option Year 1 (MPIP) clean Amend 1.xlsx
XLSX spreadsheet 32 KB Posted
- Solicitation number
- 75FCMC20R0008
About this file
This document contains a cost proposal template for a Medicare Administrative Contractor contract. The template provides cost categories including direct labor, fringe benefits, travel, subcontractors, and other direct costs for Contract Line Item Number 0011. Labor rates and hours are to be provided by labor category. The travel schedule requires details on trip purpose, origin and destination, number of travelers, number of trips and days, applicable lodging and per diem rates, airfare costs, and other expenses. The other direct costs section allows itemization of miscellaneous expenses.
The related opportunity is a solicitation to provide Part A and Part B Medicare claims processing and payment services for Jurisdiction L, covering Delaware, Maryland, New Jersey, Pennsylvania, Washington D.C., and parts of Virginia. The Centers for Medicare and Medicaid Services intends to award an indefinite-delivery/indefinite-quantity contract to administer specified health insurance benefit administration services in support of the Medicare Fee-For-Service Program.
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Text version
CLIN 00011
RFP # 75FCMC20R0008
COST TEMPLATE - Attachment J.44
| (Provide a cost spreadsheet for each CLIN proposed) | ||||
| CLIN 0011 | P.1.11 | |||
| Total FTEs | Medicare Healthcare Provider Intervention Program (MPIP) | |||
| Hours | Rates | Total | ||
| COST ELEMENTS |
| Direct Labor | |||
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| Add Other Appropriate Labor Categories (note: labor categories should match WBS) | 0 | $0.00 | $0.00 |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| Subtotal Direct Labor | 0 | $0.00 | $0.00 |
Fringe Benefits (at ____%) $0
Total Direct Labor $0
| Travel (See separate schedule. Total should match) | $0 | |
| SUBCONTRACTORS | ||
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Total Subcontractor | 0 | $0.00 |
Other Direct Costs (See separate schedule. Total should match.) $0
TOTAL ALL DIRECT COSTS $0
Indirect Costs (at ______ %) $0
TOTAL OTHER BEFORE FEE $0
| Base Fee (at ____%) | $0 |
| Award Fee (at ______%) | $0 |
| Fixed Fee (at ______%) | $0 |
TOTAL OTHER AFTER FEE $0
| GRAND TOTAL | $0 |
| v1 04252012 |
20181115
75FCMC20R0008
PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR
Confidential Procurement Sensitive &P
TRAVEL
RFP # 75FCMC20R0008
COST TEMPLATE - Attachment J.44
| TRAVEL SUMMARY |
| CLIN 0011 |
| Purpose of Trip | SOW WBS | |||
| Crosswalk | Labor Category Taking Trip | Trip Origin | Destination | # People |
| (A) | # Trips | |||
| (B) | # Days | |||
| (C) | # Nights | |||
| (D) | Lodging Rate | |||
| (E) | Lodging | |||
| (F=E*D*A) | M&IE | |||
| (G) | Total Lodging |
and M&IE
| (H=F+G) | Airfare |
| (I) | Car Rental |
| (J) | Misc |
| (K) | Local |
Mileage
| (L) | Total Per Trip |
| (M=H+I+J+K+L) | Total For All Trips |
(N=M*B )
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| $ - | $ - | $ - | $ - | ||
| TOTAL TRAVEL | $ - | ||||
| Travel Assumptions: |
75FCMC20R0008
PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR
Confidential Procurement Sensitive &P
ODC
RFP # 75FCMC20R0008
COST TEMPLATE - Attachment J.44
| CLIN 0011 | GRAND | |
| Cost Element | Amount | TOTAL |
| $0.00 | ||
| Add costs by category | $0.00 | |
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| TOTAL ODCs | $0.00 | $0.00 |
75FCMC20R0008
PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR
Confidential Procurement Sensitive &P
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