Attachment 1 - Pricing Table - 21R0013.xlsx

XLSX spreadsheet 14 KB Posted

Attached to
LES Health Insurance - Zagreb, Croatia
Solicitation number
19GE5021R0013
Issued by

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Other files

File Type Posted
Questions Answers - Health Insurance Zagreb.pdf PDF
21R0013 Amendment 0001 - original signed.pdf PDF
Cover Letter 21R0013 - original signed.pdf PDF
Exhibit A Employe Statistic.xlsx XLSX spreadsheet
21R0013 Zagreb Health Insurance - original signed.pdf PDF
Attachment 2 - Experience.pdf PDF
Attachment 3 W-14 Certificate of Foreign Contracting Party.pdf PDF

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Pricing Tables

Number of employees is an estimate only, based on the current situation
BASE YEAR
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
0001ASingle Employees (Self Only)470- 0
0001BEmployee + 1260- 0
0001CFamily Plan910- 0
Base YEAR TOTAL**- 0
OPTION YEAR 1
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
1001ASingle Employees (Self Only)470- 0
1001BEmployee + 1260- 0
1001CFamily Plan910- 0
OPTION YEAR 1 TOTAL**- 0
OPTION YEAR 2
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
2001ASingle Employees (Self Only)470- 0
2001BEmployee + 1260- 0
2001CFamily Plan910- 0
OPTION YEAR 2 TOTAL**- 0
OPTION YEAR 3
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
3001ASingle Employees (Self Only)470- 0
3001BEmployee + 1260- 0
3001CFamily Plan910- 0
OPTION YEAR 3 TOTAL**- 0
OPTION YEAR 4
Sub-CLINDescriptionNumber of Employees*Rate per monthRate per YearSubtotal
4001ASingle Employees (Self Only)470- 0
4001BEmployee + 1260- 0
4001CFamily Plan910- 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.

19GE5021R0013

Locally Engaged Staff Health Insurance Attachment 1 Pricing Schedule

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