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UNIT PRICING
| Quote Schedule | | Offeror Name: |
| RFP# | 24361820R0002 | Offeror DUNS: |
| FSAFEDS Administration Services | | |
| Instructions: Offeror shall fill in the YELLOW and BLUE areas of the pricing table. All pricing must be entered in WHOLE CENTS. Do not enter formulas in the YELLOW fields, as they may cause rounding errors which affect thecalculation of extensions and cause your quote schedule to be unbalanced. The Government reserves the right to reject any Offeror proposals which contain more than two decimals in any YELLOW pricing field below, without requesting corrected pricing tables from the Offeror to correct this error. | | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Price | Terms |
| 00001 | Start Up Services | Start Up Period | Award through 12/31/2020 | Firm Fixed Price | | Firm Fixed Price, paid in arrears following timely acheivement of ATO. Start Up Costs are not renegotiable after award. |
| Breakdown of Start Up Costs is required on the Start Up Cost Breakdown Tab. If your quoted price for CLIN 00001 is $0.00, please state clearly here whether the reason for that $0.00 is that you expect to charge NO START UP COSTS, and explain why. DO NOT LEAVE THIS FIELD BLANK if your startup costs are $0.00 --------------------------------------------> | | | | | | |
| 00002 | BASE PERIOD ONE | | | | Rate (Total Agency Fee) | Unit of Measure | Estimated Quantity * | Extension | Terms |
| HCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | Per Participant, Per Month | 475,451 | $0.00 | Estimated Quantities shown to the left are the quantities the government will use for evalation purposes ONLY. Actual Quantities (Post-Award) may vary. The Awarded Contractor will be paid only for the actual number of participant accounts being administered in each month, payment is QUARTERLY IN ARREARS. Extensions will automatically calculate. Quantities and Extensions shown are NOT a guaranteed minimum. |
| LEXHCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | Per Participant, Per Month | 14,001 | $0.00 | |
| DCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | Per Participant, Per Month | 99,646 | $0.00 | |
| Subtotal: BASE PERIOD ONE | | | | | | | | $0.00 | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee) | Unit of Measure | Estimated Quantity * | Extension | Terms |
| 00003 | BASE PERIOD TWO | | | | | | | | Estimated Quantities shown to the left are the quantities the government will use for evalation purposes ONLY. Actual Quantities (Post-Award) may vary. The Awarded Contractor will be paid only for the actual number of participant accounts being administered in each month, payment is QUARTERLY IN ARREARS. Extensions will automatically calculate. Quantities and Extensions shown are NOT a guaranteed minimum. |
| HCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | Per Participant, Per Month | 494,340 | $0.00 | |
| LEXHCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | Per Participant, Per Month | 17,063 | $0.00 | |
| DCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | Per Participant, Per Month | 106,764 | $0.00 | |
| Subtotal: BASE PERIOD TWO | | | | | | | | $0.00 | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee) | Unit of Measure | Estimated Quantity * | Extension | |
| 00004 | BASE PERIOD THREE | | | | | | | | |
| HCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | Per Participant, Per Month | 513,979 | $0.00 | |
| LEXHCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | Per Participant, Per Month | 20,795 | $0.00 | |
| DCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | Per Participant, Per Month | 114,391 | $0.00 | |
| Subtotal: BASE PERIOD THREE | | | | | | | | $0.00 | |
| | | | | | | | | Estimated Quantities shown to the left are the quantities the government will use for evalation purposes ONLY. Actual Quantities (Post-Award) may vary. The Awarded Contractor will be paid only for the actual number of participant accounts being administered in each month, payment is QUARTERLY IN ARREARS. Extensions will automatically calculate. Quantities and Extensions shown are NOT a guaranteed minimum. |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee) | Unit of Measure | Estimated Quantity * | Extension | |
| 10001 | OPTION PERIOD ONE | | | | | | | | |
| HCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | Per Participant, Per Month | 534,399 | $0.00 | |
| LEXHCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | Per Participant, Per Month | 25,343 | $0.00 | |
| DCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | Per Participant, Per Month | 122,562 | $0.00 | |
| Subtotal: OPTION PERIOD ONE | | | | | | | | $0.00 | |
| As a reminder, OPTION PERIODS are not guaranteed, and it is the unlateral right of the Government to determine whether to exercise or not exercise. Exercise of options will be based at least partially on Performance in all prior years of performance. Should the Government determine Performance is not adequate to warrant exercise of any option, the Government reserves the right to make alternate award, and the final year of performance will require transition to the Government's new contractor as described in the PWS. | | | | | | | | | |
STARTUP COST BREAKDOWN
| Quote Schedule | | Offeror Name: |
| RFP# | 24361820R0002 | Offeror DUNS: |
| FSAFEDS Administration Services | | |
| Instructions: Offeror shall provide a detailed breakdown of their start-up costs below. Add as many lines as needed, and add expense types/categories as needed. Be certain your total adds up to the pricing entered in CLIN 00001 on the Unit Pricing Tab. DO NOT SUBSTITUTE /ATTACH YOUR OWN SPREADSHEET. | | | | | | |
| IF ANY PORTION OF STARTUP LABOR WILL BE SUBCONTRACTED, YOU MUST INCLUDE/DISCLOSE IT IN YOUR SUBCONTRACTING PLAN | | | | | | |
| Expense Type | Description | Quantity | Unit Price | Unit of Measure | Extension | Additional Detail / Notes |
| LABOR - PRIME CONTRACTOR | | | | | | |
LABOR - SUBCONTRACTED
MATERIALS / SUPPLIES
EQUIPMENT
FACILITIES
OTHER (DEFINE)
PROFIT
CLIN 00001: TOTAL STARTUP COSTS *Be sure this total matches the total shown in CLIN 00001 on Unit Pricing Tab
AGENCY FEE PRICE BREAKDOWN
| Quote Schedule | | Offeror Name: |
| RFP# | 24361820R0002 | Offeror DUNS: |
| FSAFEDS Administration Services | | |
| Instructions: Offeror shall fill in the YELLOW areas of the table below. All pricing must be entered in WHOLE CENTS. Do not enter formulas in the YELLOW fields, as they may cause rounding errors which affect other calculations and cause your quote schedule to be unbalanced. The Government reserves the right to reject any Offeror proposals which contain more than two decimals in any YELLOW pricing field below, without requesting corrected pricing tables from the Offeror to correct this error. | | |
| 1. As stated in the PWS, Section VI. H. Fee Structure and Profit, Base Periods and Option Period shall have an established, FIRM FIXED PRICE fee structure and profit amount for each contract term. | | |
| 2. Account Maintenance / Administrative Fee: This portion of the fee represents all costs for operating the FSA accounts during each calendar year. Charges shall be specified by type of account (Health Care versus Dependent Care). This is a fixed fee. You need to include ALL costs of doing business and provision of all services and reports required in the PWS. The awarded pricing is not renegotiable after award other than for changes related to the Service Contract Act Wage determinations. | | |
| 3. Profit: These are the profits for operating during that calendar year only. Charges may be specified by type of account (Health Care versus Dependent Care). A portion of the Profit is “at risk” to enforce performance as specified in the QASP. | | |
| 4. Total Agency Fee: The Total Agency Fee is the total of the elements noted above. The Total Agency Fee as noted below must match the figures entered on the Unit Pricing tab of this spreadsheet. The Government reserves the right to reject any Offeror proposals which contain inconsistencies in the Total Agency Fee between the Unit Pricing Tab and the Price Breakdown Tab, without requesting corrected pricing tables from the Offeror to correct this error. | | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee | Profit | Total Agency Fee | Unit of Measure |
| 00002 | BASE PERIOD ONE | | | | | | | |
| HCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | | Per Participant, Per Month |
| DCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee | Profit | Total Agency Fee | Unit of Measure |
| 00003 | BASE PERIOD TWO | | | | | | | |
| HCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | | Per Participant, Per Month |
| DCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee | Profit | Total Agency Fee | Unit of Measure |
| 00004 | BASE PERIOD THREE | | | | | | | |
| HCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | | Per Participant, Per Month |
| DCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee | Profit | Total Agency Fee | Unit of Measure |
| 10001 | OPTION PERIOD ONE | | | | | | | |
| HCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | | Per Participant, Per Month |
| LEXHCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | | Per Participant, Per Month |
| DCFSA Administration | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | | Per Participant, Per Month |
OPT DEBIT CARD UNIT PRICING
| Quote Schedule | | Offeror Name: |
| RFP# | 24361820R0002 | Offeror DUNS: |
| FSAFEDS Administration Services | | |
| Applicability: IF THE GOVERNMENT DECIDES TO IMPLEMENT DEBIT CARDS FOR FSAFEDS, the ADD ON prices stated below will be added to corresponding prices for the existing requirement. | | |
| Instructions: The Offeror shall fill in the YELLOW areas of the pricing table. The PINK areas will carry over from the UNIT PRICING tab. The Adjusted Rate (Total Agency Fee WITH Debit Card column will calculate on its own. The Extension column will calculate on its own. All pricing must be entered in WHOLE CENTS. Do not enter formulas in the YELLOW fields, as they may cause rounding errors which affect thecalculation of extensions and cause your quote schedule to be unbalanced. The Government reserves the right to reject any Offeror proposals which contain more than two decimals in any YELLOW pricing field below, without requesting corrected pricing tables from the Offeror to correct this error. | | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee, without Debit Card) | DEBIT CARD ADD-ON FEE | Adjusted Rate (Total Agency Fee WITH Debit Card) | Unit of Measure | Estimated Quantity * | Extension | Terms |
| 00002 | BASE PERIOD ONE, WITH DEBIT CARD OPTION | | | | | | | | | | Estimated Quantities shown to the left are the quantities the government will use for evalation purposes ONLY. Actual Quantities (Post-Award) may vary. The Awarded Contractor will be paid only for the actual number of participant accounts being administered in each month, payment is QUARTERLY IN ARREARS. Extensions will automatically calculate. Quantities and Extensions shown are NOT a guaranteed minimum. |
| HCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 475,451 | $0.00 | |
| LEXHCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 14,001 | $0.00 | |
| DCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 99,646 | $0.00 | |
| Subtotal: BASE PERIOD ONE with Debit Card | | | | | | | | | | $0.00 | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee, without Debit Card) | DEBIT CARD ADD-ON FEE | Adjusted Rate (Total Agency Fee WITH Debit Card) | Unit of Measure | Estimated Quantity * | Extension |
| 00003 | BASE PERIOD TWO, with Debit Card | | | | | | | | | |
| HCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 494,340 | $0.00 |
| LEXHCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 17,063 | $0.00 |
| DCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 106,764 | $0.00 |
| Subtotal: BASE PERIOD TWO with Debit Card | | | | | | | | | | $0.00 |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee, without Debit Card) | DEBIT CARD ADD-ON FEE | Adjusted Rate (Total Agency Fee WITH Debit Card) | Unit of Measure | Estimated Quantity * | Extension | Terms |
| 00004 | BASE PERIOD THREE, with Debit Card | | | | | | | | | | Estimated Quantities shown to the left are the quantities the government will use for evalation purposes ONLY. Actual Quantities (Post-Award) may vary. The Awarded Contractor will be paid only for the actual number of participant accounts being administered in each month, payment is QUARTERLY IN ARREARS. Extensions will automatically calculate. Quantities and Extensions shown are NOT a guaranteed minimum. |
| HCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 513,979 | $0.00 | |
| LEXHCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 20,795 | $0.00 | |
| DCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 114,391 | $0.00 | |
| Subtotal: BASE PERIOD THREE with Debit Card | | | | | | | | | | $0.00 | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Rate (Total Agency Fee, without Debit Card) | DEBIT CARD ADD-ON FEE | Adjusted Rate (Total Agency Fee WITH Debit Card) | Unit of Measure | Estimated Quantity * | Extension |
| 10001 | OPTION PERIOD ONE, with Debit Card | | | | | | | | | |
| HCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 534,399 | $0.00 |
| LEXHCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 25,343 | $0.00 |
| DCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | $0.00 | | $0.00 | Per Participant, Per Month | 122,562 | $0.00 |
| Subtotal: OPTION PERIOD ONE with Debit Card | | | | | | | | | | $0.00 |
| As a reminder, OPTION PERIODS are not guaranteed, and it is the unlateral right of the Government to determine whether to exercise or not exercise. Exercise of options will be based at least partially on Performance in all prior years of performance. Should the Government determine Performance is not adequate to warrant exercise of any option, the Government reserves the right to make alternate award, and the final year of performance will require transition to the Government's new contractor as described in the PWS. | | | | | | | | | | |
OPT DEBIT CARD BREAKDOWN
| Quote Schedule | | Offeror Name: |
| RFP# | 24361820R0002 | Offeror DUNS: |
| FSAFEDS Administration Services | | |
| Applicability: IF THE GOVERNMENT DECIDES TO IMPLEMENT DEBIT CARDS FOR FSAFEDS, the ADD ON prices stated below will be added to corresponding prices for the existing requirement. | | |
| Instructions: Offeror shall fill in the YELLOW areas of the table below. The PINK areas will carry over from the OPTIONAL DEBIT CARD UNIT PRICING TAB. All pricing must be entered in WHOLE CENTS. Do not enter formulas in the YELLOW fields, as they may cause rounding errors which affect other calculations and cause your quote schedule to be unbalanced. The Government reserves the right to reject any Offeror proposals which contain more than two decimals in any YELLLOW pricing field below, without requesting corrected pricing tables from the Offeror to correct this error. | | |
| Otherwise, same instructions as for PRICE BREAKDOWN tab. | | |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee with Debit Card | Profit | Total Agency Fee WITH Debit Card | Unit of Measure |
| 00002 | BASE PERIOD ONE, WITH DEBIT CARD OPTION | | | | | | | |
| HCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| DCFSA Administration | Base Period One | 1/1/2021 - 12/31/2021 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee with Debit Card | Profit | Total Agency Fee WITH Debit Card | Unit of Measure |
| 00003 | BASE PERIOD TWO, with Debit Card | | | | | | | |
| HCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| DCFSA Administration | Base Period Two | 1/1/2022 - 12/31/2022 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee with Debit Card | Profit | Total Agency Fee WITH Debit Card | Unit of Measure |
| 00004 | BASE PERIOD THREE, with Debit Card | | | | | | | |
| HCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| LEXHCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| DCFSA Administration | Base Period Three | 1/1/2023 - 12/31/2023 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| CLIN # | Description | Period of Performance | Dates of Service | Line Item Type | Account Maintenance / Administrative Fee with Debit Card | Profit | Total Agency Fee WITH Debit Card | Unit of Measure |
| 10001 | OPTION PERIOD ONE, with Debit Card | | | | | | | |
| HCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| LEXHCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |
| DCFSA Administration, with Debit Card | OPTION PERIOD ONE | 1/1/2024 - 12/31/2024 | FIXED, per unit | | | $0.00 | Per Participant, Per Month |