Attachment 3 Price Proposal breakdown.xlsx

XLSX spreadsheet 26 KB Posted

Attached to
19GE5024R0086 - Health Insurance Services - Kyiv, Ukraine
Solicitation number
19GE5024R0086
Issued by

About this file

This document appears to be an attachment containing a pricing breakdown for a federal contract opportunity for health insurance services at the U.S. Embassy in Kyiv, Ukraine. The pricing is broken down by base year and four option years, with different employee categories and family sizes. The total estimated contract amount is $0.00.

The related federal contract opportunity is Solicitation Number 19GE5024R0086, issued by the Department of State Office of Acquisition Management, for health insurance services for Locally Employed Staff (LES) and their dependents at the U.S. Embassy in Kyiv, Ukraine. The contractor shall provide the health insurance services in accordance with the Statement of Work (SOW) and attached solicitation documents.

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pricing

Base Year: Bi-Weekly Rates per Employee
CLINCategoryNumber of EmployeesRate per Employee, USDTotal for all employees in category, per PP, USDFamilyTotal # participantsTotal Year
0001Single employees (Self only)1830.001183$0.00
0002Employee with one dependent2140.002428$0.00
0003Employee with two dependents1080.003324$0.00
0004Employee with three dependents550.004220$0.00
0005Employee with four (five/six/seven) dependents80.00540$0.00
SUBTOTAL:5680.001,195$0.00
First Option Year: Bi-Weekly Rates per Employee
CategoryNumber of EmployeesRate per Employee, USDTotal for all employees in category, per PP, USDFamilyTotal # participantsTotal Year
1001Single employees (Self only)1850.001185$0.00
1002Employee with one dependent2200.002440$0.00
1003Employee with two dependents1100.003330$0.00
1004Employee with three dependents560.004224$0.00
1005Employee with four (five/six/seven) dependents90.00545$0.00
SUBTOTAL:5800.001,224$0.00
Second Option Year: Bi-Weekly Rates per Employee
CategoryNumber of EmployeesRate per Employee, USDTotal for all employees in category, per PP, USDFamilyTotal # participantsTotal Year
2001Single employees (Self only)1870.001187$0.00
2002Employee with one dependent2220.002444$0.00
2003Employee with two dependents1150.003345$0.00
2004Employee with three dependents580.004232$0.00
2005Employee with four (five/six/seven) dependents90.00545$0.00
SUBTOTAL:5910.001,253$0.00
Third Option Year: Bi-Weekly Rates per Employee
CategoryNumber of EmployeesRate per Employee, USDTotal for all employees in category, per PP, USDFamilyTotal # participantsTotal Year
3001Single employees (Self only)1890.001189$0.00
3002Employee with one dependent2250.002450$0.00
3003Employee with two dependents1170.003351$0.00
3004Employee with three dependents600.004240$0.00
3005Employee with four (five/six/seven) dependents90.00545$0.00
SUBTOTAL:6000.001,275$0.00
Fourth Option Year: Bi-Weekly Rates per Employee
CategoryNumber of EmployeesRate per Employee, USDTotal for all employees in category, per PP, USDFamilyTotal # participantsTotal Year
4001Single employees (Self only)1900.001190$0.00
4002Employee with one dependent2260.002452$0.00
4003Employee with two dependents1180.003354$0.00
4004Employee with three dependents600.004240$0.00
4005Employee with four (five/six/seven) dependents90.00545$0.00
SUBTOTAL:6030.001,281$0.00

Estimated amount of the contract (Base + 4 Option Years): Total: $0.00

&1#&"Calibri"&14&K000000SENSITIVE BUT UNCLASSIFIED

Staff under Rider

Base Year
No.CategoryBi-Weekly Rates per Employee
1ORE/DCR Staff, AEEA Staff, Peace Corps Staff
Option Year One
No.CategoryBi-Weekly Rates per Employee
1ORE/DCR Staff, AEEA Staff, Peace Corps Staff
Option Year Two
No.CategoryBi-Weekly Rates per Employee
1ORE/DCR Staff, AEEA Staff, Peace Corps Staff
Option Year Three
No.CategoryBi-Weekly Rates per Employee
1ORE/DCR Staff, AEEA Staff, Peace Corps Staff
Option Year Four
No.CategoryBi-Weekly Rates per Employee
1ORE/DCR Staff, AEEA Staff, Peace Corps Staff

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