Attachment 1 - Pricing.xlsx

XLSX spreadsheet 24 KB Posted

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HEALTH INSURANCE FOR LES FOR THE U. S. EMBASSY ANKARA, TURKEY
Solicitation number
19GE5025R0041
Issued by

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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A. Contract Pricing

ALL OFFERORS SHALL SUBMIT A PRICING

SOLICITATION NO. 19GE5025R0041

CLINCategoryEstimated number of employeesMonthly premiumAnnual premiumTOTAL
001BASE YEAR
001ASingle Employee (Self Only)265- 0- 0
001BEmployee plus one (two individuals)210- 0- 0
001CFamily (three or more individuals)505- 0- 0
TOTAL BASE YEAR- 0
1001OPTION YEAR ONE
1001ASingle Employee (Self Only)265- 0- 0
1001BEmployee plus one (two individuals)210- 0- 0
1001CFamily (three or more individuals)505- 0- 0
TOTAL OPTION YEAR ONE- 0
2001OPTION YEAR TWO
2001ASingle Employee (Self Only)265- 0- 0
2001BEmployee plus one (two individuals)210- 0- 0
2001CFamily (three or more individuals)505- 0- 0
TOTAL OPTION YEAR TWO- 0
3001OPTION YEAR THREE
3001ASingle Employee (Self Only)265- 0- 0
3001BEmployee plus one (two individuals)210- 0- 0
3001CFamily (three or more individuals)505- 0- 0
TOTAL OPTION YEAR THREE- 0
4001OPTION YEAR FOUR
4001ASingle Employee (Self Only)265- 0- 0
4001BEmployee plus one (two individuals)210- 0- 0
4001CFamily (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
CURRENCYTURKISH 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
CLINCategoryestimated number of employeesmonthly premiumAnnual premiumtotal
5001BASE YEAR
5001ARetired Employees and their dependents68- 0
Retired Employee plus one (two individuals)
5001BExcess coverage of $30,000.0015- 0
TOTAL BASE YEAR RIDERS- 0
6001OPTION YEAR ONE
6001ARetired Employees and their dependents68- 0
Retired Employee plus one (two individuals)
6001BExcess coverage of $30,000.0015- 0
TOTAL OPTION YEAR ONE RIDERS- 0
7001OPTION YEAR TWO
7001ARetired Employees and their dependents68- 0
Retired Employee plus one (two individuals)
7001BExcess coverage of $30,000.0015- 0
TOTAL OPTION YEAR TWO RIDERS- 0
8001OPTION YEAR THREE
8001ARetired Employees and their dependents68- 0
Retired Employee plus one (two individuals)
8001BExcess coverage of $30,000.0015- 0
TOTAL OPTION YEAR THREE RIDERS- 0
9001OPTION YEAR FOUR
9001ARetired Employees and their dependents68- 0
Retired Employee plus one (two individuals)
9001BExcess coverage of $30,000.0015- 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
CURRENCYTURKISH LIRA

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