Att_E_VISS Pricing Template.xlsx

XLSX spreadsheet 25 KB Posted

Attached to
OCC Vision Insurance Federal contract opportunity
Solicitation number
2031JW26Q00058
Issued by
Department of the Treasury Office of the Comptroller of the Currency

About this file

Written by GovTribe AI ·

This is a pricing template for Vision Insurance Support Services (VISS) in response to solicitation 2031JW26Q00058 issued by the Department of the Treasury Office of the Comptroller of the Currency. The template establishes pricing structure for an Administrative Services Only (ASO) arrangement covering vision insurance for OCC employees and OFR employees over a multi-year contract period.

The contract includes a transition period from the date of award through December 31, 2026, followed by a base period from January 1, 2027 through December 31, 2027, and four one-year option periods extending through December 31, 2031. Pricing is required for two primary line items during the base period and option periods: ASO monthly fees for 2,739 OCC employees and OCC disabled retirees, and ASO monthly fees for 101 OFR employees. Additionally, quoters must provide an estimated government-funded annual Not-To-Exceed (NTE) amount for in and out-of-network claim costs, which are payable only for actual covered claims and separate from ASO fees. The template notes that employee enrollment numbers are estimates subject to fluctuation, and the government assumes all financial risk for claims. All highlighted cells in the pricing template, including NTE cells, must be completed by quoters, with Attachment C (Census Data, Premium History, and Claims Detail) provided as a reference resource for estimating annual claims costs.

View the file

Other files for this federal contract opportunity

Other files attached to OCC Vision Insurance, newest first.
File Type Posted
A00002 SF 30 2031JW26Q00058_RFQ Extension.pdf PDF
A00001 SF 30 2031JW26Q00058_QA Wksht-Govt Updated.pdf PDF
Att_F_VISS QA Worksheet_Govt.xlsx XLSX spreadsheet
Att_B_VISS Non-Disclosure Agreement.pdf PDF
Att_C_Census Data_Premuim History_Claims Detail.xlsx XLSX spreadsheet
Att_A_Quoter Attestation-Provision Responses_Clean.docx DOCX document
Att_F_VISS QA Worksheet for Questions.xlsx XLSX spreadsheet
2031JW26Q00058_Vision Insurance RFQ 1449 and Cont Pages_Final.pdf PDF
Att_D_VISS Past Performance Questionnaire_Clean.docx DOCX document

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

OCC VISS Att E Pricing Template

ATTACHMENT E PRICING TEMPLATE VISION INSURANCE SUPPORT SERVICES
Attention Quoter: All highlighted cells must contain an amount, including the NTE cells (in column F). Attachment C (Census Data_Premuim History_Claims Detail) is provided as a resource to estimate the annual claims NTE cost (all other cells contain a formula within for the extended totals).
Transition Period: Date of Award Through December 31, 2026
LI #DescriptionQTYUOMUnit $Extended $
0001Administration Costs Related to Enrollment (TRANSITION-IN ACTIVITIES)TBDMONSPN/A
VISS Contract Administrative Support Services
Base Period (BP): January 1, 2027 - December 31, 2027
LI #DescriptionQTYUOMUnit $Extended $
0002ASO Monthly Fee – OCC Employees and OCC Disabled Retirees2,739EA$0.00
0003ASO Monthly Fee – OFR Employees101EA$0.00
0004Estimated Government-Funded Total (Annual) In and Out-Of-Network Claim Costs – Payable Only For Actual Covered Claims and Not Included in the ASO CLINs 0002 and 0003 FeesNTE$0.00
BP TOTAL$0.00
Option Period One (OP1): January 1, 2028 - December 31, 2028
LI #DescriptionQTYUOMUnit $Extended $
1001RESERVEDN/AN/AN/AN/A
1002ASO Monthly Fee – OCC Employees and OCC Disabled Retirees2,739EA$0.00
1003ASO Monthly Fee – OFR Employees101EA$0.00
1004Estimated Government-Funded (Annual) Total In and Out-Of-Network Claim Costs – Payable Only For Actual Covered Claims and Not Included in the ASO CLINs 1002 and 1003 FeesNTE$0.00
OP1 TOTAL$0.00
Option Period Two (OP2): January 1, 2029 - December 31, 2029
LI #DescriptionQTYUOMUnit $Extended $
2001RESERVEDN/AN/AN/AN/A
2002ASO Monthly Fee – OCC Employees and OCC Disabled Retirees2,739EA$0.00
2003ASO Monthly Fee – OFR Employees101EA$0.00
2004Estimated Government-Funded Total (Annual) In and Out-Of-Network Claim Costs – Payable Only For Actual Covered Claims and Not Included in the ASO CLINs 2002 and 2003 FeesNTE$0.00
OP2 TOTAL$0.00
Option Period Three (OP3): January 1, 2030 - December 31, 2030
LI #DescriptionQTYUOMUnit $Extended $
3001RESERVEDN/AN/AN/AN/A
3002ASO Monthly Fee – OCC Employees and OCC Disabled Retirees2,739EA$0.00
3003ASO Monthly Fee – OFR Employees101EA$0.00
3004Estimated Government-Funded Total (Annual) In and Out-Of-Network Claim Costs – Payable Only For Actual Covered Claims and Not Included in the ASO CLINs 3002 and 3003 FeesNTE$0.00
OP3 TOTAL$0.00
Option Period Four (OP4): January 1, 2031 - December 31, 2031
LI #DescriptionQTYUOMUnit $Extended $
4001RESERVEDN/AN/AN/AN/A
4002ASO Monthly Fee – OCC Employees and OCC Disabled Retirees2,739EA$0.00
4003ASO Monthly Fee – OFR Employees101EA$0.00
4004Estimated Government-Funded Total (Annual) In and Out-Of-Network Claim Costs – Payable Only For Actual Covered Claims and Not Included in the ASO CLINs 4002 and 4003 FeesNTE$0.00
OP4 TOTAL$0.00
BASE + ALL OPTION PERIODS TOTAL$0.00
Note: The number of eligible employees enrolled in the vision plan is estimated and used for the purpose of establishing a funding amount for each performance period. The OCC employee population may fluctuate within each performance period resulting in an increase or decrease throughout the year (i.e., there may be a variation in quantity). The number of eligible employees enrolled in the vision plan is also subject to change. The OCC assumes financial risk/cost for all claims.

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