Att 1 - Pricing Table.xlsx
XLSX spreadsheet 21 KB Posted
- Solicitation number
- 19GE5023R0039
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Other files
| File | Type | Posted |
|---|---|---|
| 19GE5023R0039 0001.pdf | ||
| Questions-Answers 23R0039.pdf | ||
| A0001 updated Benefit Levels.pdf | ||
| 23R0039 Cover Letter.pdf | ||
| Att 2 - Experience.pdf | ||
| Exhib. A - Employee Statistic.pdf | ||
| 19GE5023R0039.pdf | ||
| Att 3 W14 Certificate.pdf |
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Pricing Tables
| Number of employees is an estimate only, based on the current situation | |||||
| BASE YEAR | |||||
| Sub-CLIN | Description | Number of Employees* | Rate per month | Rate per Year | Subtotal |
| 0001A | Single Employees (Self Only) | 7 | 0 | - 0 | |
| 0001B | Employee + 1 | 10 | 0 | - 0 | |
| 0001C | Family Plan | 335 | 0 | - 0 | |
| Base YEAR TOTAL** | - 0 |
| OPTION YEAR 1 | |||||
| Sub-CLIN | Description | Number of Employees* | Rate per month | Rate per Year | Subtotal |
| 1001A | Single Employees (Self Only) | 8 | 0 | - 0 | |
| 1001B | Employee + 1 | 14 | 0 | - 0 | |
| 1001C | Family Plan | 340 | 0 | - 0 | |
| OPTION YEAR 1 TOTAL** | - 0 |
| OPTION YEAR 2 | |||||
| Sub-CLIN | Description | Number of Employees* | Rate per month | Rate per Year | Subtotal |
| 2001A | Single Employees (Self Only) | 8 | 0 | - 0 | |
| 2001B | Employee + 1 | 14 | 0 | - 0 | |
| 2001C | Family Plan | 340 | 0 | - 0 | |
| OPTION YEAR 2 TOTAL** | - 0 |
| OPTION YEAR 3 | |||||
| Sub-CLIN | Description | Number of Employees* | Rate per month | Rate per Year | Subtotal |
| 3001A | Single Employees (Self Only) | 8 | 0 | - 0 | |
| 3001B | Employee + 1 | 15 | 0 | - 0 | |
| 3001C | Family Plan | 341 | 0 | - 0 | |
| OPTION YEAR 3 TOTAL** | - 0 |
| OPTION YEAR 4 | |||||
| Sub-CLIN | Description | Number of Employees* | Rate per month | Rate per Year | Subtotal |
| 4001A | Single Employees (Self Only) | 9 | 0 | - 0 | |
| 4001B | Employee + 1 | 16 | 0 | - 0 | |
| 4001C | Family Plan | 345 | 0 | - 0 | |
| OPTION YEAR 4 TOTAL** | - 0 |
| TOTAL BASE + ALL OPTIONS | - 0 | ||||
| VAT (if applicable) | Percentage: _______ % | ||||
| GRAND TOTAL | - 0 | ||||
| CURRENCY: | |||||
| *estimated number of premiums does not include any Riders (III, D) | |||||
| **does not include any premiums for Riders. | |||||
| Section 1, III Prices , E. Administrative Retention Amounts | |||||
| Period of | |||||
| Performance | Single Employees | ||||
| (Self Only) | Employee + 1 | Family Plan | |||
| Base Year | |||||
| Option Year 1 | |||||
| Option Year 2 | |||||
| Option Year 3 | |||||
| Option Year 4 |
19GE5023R0039
Locally Engaged Staff Health Insurance Attachment 1 Pricing Schedule
File details come from the government source that posted it. Updated .