Att 1 Pricing Table.xlsx

XLSX spreadsheet 21 KB Posted

Attached to
LES Health Insurance - U. S. Embassy Addis Ababa, Ethiopia
Solicitation number
19GE5023R0005
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Other files

File Type Posted
0001 Exhibit A - Employee Statistic.pdf PDF
Questions-Answers 23R0005.pdf PDF
0001 23R0005.pdf PDF
0001 Solicitation Pages.pdf PDF
Exhibit C Dependent List.pdf PDF
Cover Letter 23R0005.pdf PDF
Attachment 2 - Experience.pdf PDF
Solicitation 19GE5023R0005.pdf PDF
Exhibit B Employee Statistic.pdf PDF
Att 3 W14 Certificate.pdf PDF
Exhibit A Employee Statistic.pdf PDF
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Pricing Tables

Number of employees is an estimate only, based on the current situation
BASE YEAR
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
0001ASingle Employees (Self Only)1820- 0
0001BEmployee + 11510- 0
0001CFamily Plan8610- 0
Base YEAR TOTAL**- 0
OPTION YEAR 1
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
1001ASingle Employees (Self Only)3050- 0
1001BEmployee + 11690- 0
1001CFamily Plan8390- 0
OPTION YEAR 1 TOTAL**- 0
OPTION YEAR 2
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
2001ASingle Employees (Self Only)3200- 0
2001BEmployee + 11890- 0
2001CFamily Plan8490- 0
OPTION YEAR 2 TOTAL**- 0
OPTION YEAR 3
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
3001ASingle Employees (Self Only)3300- 0
3001BEmployee + 12090- 0
3001CFamily Plan8640- 0
OPTION YEAR 3 TOTAL**- 0
OPTION YEAR 4
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
4001ASingle Employees (Self Only)3350- 0
4001BEmployee + 12290- 0
4001CFamily Plan8840- 0
OPTION YEAR 4 TOTAL**- 0
TOTAL BASE + ALL OPTIONS- 0
VAT (if applicable)Percentage: _______ %
GRAND TOTAL- 0
CURRENCY:
Note: All quantities are reasonable estimates per year based on past experience. They do not obligate the USG to order those quantities.
*estimated number of premiums does not include any Riders (III, D)
**does not include any premiums for Riders.

19GE5023R0005

Locally Engaged Staff Health Insurance Attachment 1 Pricing Schedule

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