Attachment 1 - Pricing.xlsx
XLSX spreadsheet 24 KB Posted
- Solicitation number
- 19GE5025R0041
About this file
The file is a Pricing Attachment for a health insurance solicitation (Solicitation No. 19GE5025R0041) issued by the Department of State Office of Acquisition Management for the U.S. Embassy in Ankara, Turkey. The pricing document outlines insurance coverage categories for Locally Employed Staff (LES), including single employee, employee plus one, and family plans for a base year and four option years. The estimated employee counts are 265 single employees, 210 employee-plus-one, and 505 family plans, with additional coverage options for 68 retired employees and 15 employees requiring excess coverage of $30,000.
The solicitation requires electronic proposal submission by June 04, 2025, at 15:00 Central European Time (CET), with all documents submitted in Microsoft Word or Adobe PDF format. A virtual pre-proposal conference is scheduled for April 30, 2025, at 11:00 CET, requiring prior registration. The contract will be priced in Turkish Lira, and vendors must have an active SAM registration. Proposals should be emailed to Alexandra Perez Acevedo at PerezAcevedoA@state.gov, with a maximum email attachment size of 50MB and no zipped files permitted. The Contracting Officer reserves the right to award the contract based on initial offers without further discussions.
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Text version
A. Contract Pricing
ALL OFFERORS SHALL SUBMIT A PRICING
SOLICITATION NO. 19GE5025R0041
| CLIN | Category | Estimated number of employees | Monthly premium | Annual premium | TOTAL |
| 001 | BASE YEAR | ||||
| 001A | Single Employee (Self Only) | 265 | - 0 | - 0 | |
| 001B | Employee plus one (two individuals) | 210 | - 0 | - 0 | |
| 001C | Family (three or more individuals) | 505 | - 0 | - 0 | |
| TOTAL BASE YEAR | - 0 | ||||
| 1001 | OPTION YEAR ONE | ||||
| 1001A | Single Employee (Self Only) | 265 | - 0 | - 0 | |
| 1001B | Employee plus one (two individuals) | 210 | - 0 | - 0 | |
| 1001C | Family (three or more individuals) | 505 | - 0 | - 0 | |
| TOTAL OPTION YEAR ONE | - 0 | ||||
| 2001 | OPTION YEAR TWO | ||||
| 2001A | Single Employee (Self Only) | 265 | - 0 | - 0 | |
| 2001B | Employee plus one (two individuals) | 210 | - 0 | - 0 | |
| 2001C | Family (three or more individuals) | 505 | - 0 | - 0 | |
| TOTAL OPTION YEAR TWO | - 0 | ||||
| 3001 | OPTION YEAR THREE | ||||
| 3001A | Single Employee (Self Only) | 265 | - 0 | - 0 | |
| 3001B | Employee plus one (two individuals) | 210 | - 0 | - 0 | |
| 3001C | Family (three or more individuals) | 505 | - 0 | - 0 | |
| TOTAL OPTION YEAR THREE | - 0 | ||||
| 4001 | OPTION YEAR FOUR | ||||
| 4001A | Single Employee (Self Only) | 265 | - 0 | - 0 | |
| 4001B | Employee plus one (two individuals) | 210 | - 0 | - 0 | |
| 4001C | Family (three or more individuals) | 505 | - 0 | - 0 | |
| TOTAL OPTION YEAR FOUR | - 0 | ||||
| GRAND TOTAL OF BASE PLUS ALL OPTION YEARS | |||||
| BASE YEAR TOTAL | - 0 | ||||
| OPTION YEAR ONE TOTAL | - 0 | ||||
| OPTION YEAR TWO TOTAL | - 0 | ||||
| OPTION YEAR THREE TOTAL | - 0 | ||||
| OPTION YEAR FOUR TOTAL | - 0 |
| GRAND TOTAL | - 0 | |
| CURRENCY | TURKISH LIRA |
B. Rider and Optional Benefits
| THESE RIDERS WILL NOT BE EVALUATED AS PART OF THE OVERALL PRICE EVALUATIONS | |||||
| ALL OFFERORS SHALL SUBMIT A PRICING FOR THESE CLINS | |||||
| CLIN | Category | estimated number of employees | monthly premium | Annual premium | total |
| 5001 | BASE YEAR | ||||
| 5001A | Retired Employees and their dependents | 68 | - 0 | ||
| Retired Employee plus one (two individuals) | |||||
| 5001B | Excess coverage of $30,000.00 | 15 | - 0 | ||
| TOTAL BASE YEAR RIDERS | - 0 | ||||
| 6001 | OPTION YEAR ONE | ||||
| 6001A | Retired Employees and their dependents | 68 | - 0 | ||
| Retired Employee plus one (two individuals) | |||||
| 6001B | Excess coverage of $30,000.00 | 15 | - 0 | ||
| TOTAL OPTION YEAR ONE RIDERS | - 0 | ||||
| 7001 | OPTION YEAR TWO | ||||
| 7001A | Retired Employees and their dependents | 68 | - 0 | ||
| Retired Employee plus one (two individuals) | |||||
| 7001B | Excess coverage of $30,000.00 | 15 | - 0 | ||
| TOTAL OPTION YEAR TWO RIDERS | - 0 | ||||
| 8001 | OPTION YEAR THREE | ||||
| 8001A | Retired Employees and their dependents | 68 | - 0 | ||
| Retired Employee plus one (two individuals) | |||||
| 8001B | Excess coverage of $30,000.00 | 15 | - 0 | ||
| TOTAL OPTION YEAR THREE RIDERS | - 0 | ||||
| 9001 | OPTION YEAR FOUR | ||||
| 9001A | Retired Employees and their dependents | 68 | - 0 | ||
| Retired Employee plus one (two individuals) | |||||
| 9001B | Excess coverage of $30,000.00 | 15 | - 0 | ||
| TOTAL OPTION YEAR FOUR RIDERS | - 0 |
| GRAND TOTAL OF BASE PLUS ALL OPTION YEARS | ||
| BASE YEAR TOTAL RIDERS | - 0 | |
| OPTION YEAR ONE TOTAL RIDERS | - 0 | |
| OPTION YEAR TWO TOTAL RIDERS | - 0 | |
| OPTION YEAR THREE TOTAL RIDERS | - 0 | |
| OPTION YEAR FOUR TOTAL RIDERS | - 0 |
| GRAND TOTAL | - 0 | |
| CURRENCY | TURKISH LIRA |
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