Attachment 3 - Prices.xlsx

XLSX spreadsheet 30 KB Posted Mar 18, 2026

Attached to: Life and Health Insurance Services for Locally Employed Staff at U. S. Embassy Kingston, Jamaica
Solicitation number: 19GE5026R0041
Issued by: Department of State Office of Acquisition Management

About this file

Written by GovTribe AI · Mar 18, 2026

This is a pricing template for life and health insurance services for locally employed staff at the U.S. Embassy in Kingston, Jamaica under solicitation 19GE5026R0041. The contract encompasses a base year plus four option years, with service commencing June 1, 2026. Offerors must complete bi-weekly premium rates for three coverage tiers: Single Employees (40 members), Employee + 1 (47 members), and Family Plan (113 members). Additionally, offerors must provide bi-weekly insurance rates for Basic Life coverage and Accidental Death and Dismemberment coverage based on specified salary volumes in Jamaican Dollars, which escalate annually from the base year through Year 4. The pricing template calculates annual totals by multiplying bi-weekly rates by 26 pay periods and extends across all contract years to determine total premium and insurance contract value.

The template includes a separate section for monthly retention amounts by coverage category for each contract period. All highlighted cells require completion by the offeror. Notably, Excess Coverage Group Life Insurance bi-weekly rates are excluded from the annual totals per the instructions. The estimated member quantities provided are for evaluation purposes only and do not bind the Government, as actual numbers may vary. All pricing must be submitted in the offeror's designated currency. The proposal submission deadline is April 17, 2026 at 15:00 hours Central European Time, with a questions deadline of April 3, 2026.

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Other files

File	Type	Posted
Attachment 1 - Schedule_19GE5026R0041_0002_Kingston.pdf	PDF	Apr 13, 2026
Attachment 8 - Questions and Answers.pdf	PDF	Apr 13, 2026
19GE5026R0041_0002_Attachment 4 - Representations and Certifications.pdf	PDF	Apr 13, 2026
19GE5026R0041_0002_Combined Synopsis Solicitation-signed.pdf	PDF	Apr 13, 2026
19GE5026R0041-0001.pdf	PDF	Apr 2, 2026
19GE5026R0041_Combined Synopsis Solicitation..pdf	PDF	Mar 18, 2026
Attachment 1 - Schedule_19GE5026R0041_Kingston.pdf	PDF	Mar 18, 2026
Attachment 2 - Employee Statistics.pdf	PDF	Mar 18, 2026
Attachment 2.1 - Salary Statistics.pdf	PDF	Mar 18, 2026
Attachment 4 - Representations and Certifications.pdf	PDF	Mar 18, 2026
Attachment 6 - Instructions on Form W-14.pdf	PDF	Mar 18, 2026
Attachment 7 - Past Performance and Experience.pdf	PDF	Mar 18, 2026
Attachment 5 - Form W-14.pdf	PDF	Mar 18, 2026

Show all 13

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Pricing Tables

Solicitation 19GE5026R0041

highlighted cells to be completed by the offeror

BASE YEAR

Premium

			A	B	C	E	F
	Sub-CLIN	Description	*Number of Members (Employee + Dependents)	UNIT	Bi-weekly rate (26 Pay Periods)	Rate per year
(C*26)	Subtotal

(A*E)

0001	Single Employees (Self Only)	40	Bi-Weekly	0
0002	Employee + 1 (either plus one spouse or plus one child)	47	Bi-Weekly	0
0003	Family Plan	113	Bi-Weekly	0
				**BASE YEAR TOTAL

Rider Category***	Bi-Weekly Rate per Premium
C.1.1.21 Excess Coverage

Group Life Insurance

			A	B	C	E	F
	Sub-CLIN	Description	Salary volume in $JMD	UNIT	Bi-weekly Insurance Rate	Rate per year
(C*26)	Subtotal

(A*E)

	0004	Basic Life - Based on 26 months Salary Volume	$ 1,841,848,000.00	Bi-Weekly		0	0
	0005	Accidental Death and Dismemberment
– Based on 34 months Salary Volume	$ 2,408,541,000.00	Bi-Weekly		0	0
						**BASE YEAR TOTAL	0

TOTAL CONTRACT VALUE FOR THE BASE YEAR
Total annual premium	0
Total annual insurance	0
Total for Base Year	0

YEAR 1

Premium

			A	B	C	E	F
	Sub-CLIN	Description	*Number of Members (Employee + Dependents)	UNIT	Bi-weekly rate (26 Pay Periods)	Rate per year
(C*26)	Subtotal

(A*E)

1001	Single Employees (Self Only)	40	Bi-Weekly	0
1002	Employee + 1 (either plus one spouse or plus one child)	47	Bi-Weekly	0
1003	Family Plan	113	Bi-Weekly	0
				** YEAR 1 TOTAL

Rider Category***	Bi-Weekly Rate per Premium
C.1.1.21 Excess Coverage

Group Life Insurance

			A	B	C	E	F
	Sub-CLIN	Description	Salary volume in $JMD	UNIT	Bi-weekly Insurance Rate	Rate per year
(C*26)	Subtotal

(A*E)

	1004	Basic Life - Based on 26 months Salary Volume	$ 2,026,032,800.00	Bi-Weekly		0	0
	1005	Accidental Death and Dismemberment
– Based on 34 months Salary Volume	$ 2,649,395,100.00	Bi-Weekly		0	0
						** YEAR 1 TOTAL	0

TOTAL CONTRACT VALUE FOR YEAR 1
Total annual premium	0
Total annual insurance	0
Total for Year 1	0

YEAR 2

Premium

			A	B	C	E	F
	Sub-CLIN	Description	*Number of Members (Employee + Dependents)	UNIT	Bi-weekly rate (26 Pay Periods)	Rate per year
(C*26)	Subtotal

(A*E)

2001	Single Employees (Self Only)	40	Bi-Weekly	0
2002	Employee + 1 (either plus one spouse or plus one child)	47	Bi-Weekly	0
2003	Family Plan	113	Bi-Weekly	0
				** YEAR 2 TOTAL

Rider Category***	Bi-Weekly Rate per Premium
C.1.1.21 Excess Coverage

Group Life Insurance

			A	B	C	E	F
	Sub-CLIN	Description	Salary volume in $JMD	UNIT	Bi-weekly Insurance Rate	Rate per year
(C*26)	Subtotal

(A*E)

	2004	Basic Life - Based on 26 months Salary Volume	$ 2,228,636,080.00	Bi-Weekly		0	0
	2005	Accidental Death and Dismemberment
– Based on 34 months Salary Volume	$ 2,914,334,610.00	Bi-Weekly		0	0
						** YEAR 2 TOTAL	0

TOTAL CONTRACT VALUE FOR YEAR 2
Total annual premium	0
Total annual insurance	0
Total for Year 2	0

YEAR 3

Premium

			A	B	C	E	F
	Sub-CLIN	Description	*Number of Members (Employee + Dependents)	UNIT	Bi-weekly rate (26 Pay Periods)	Rate per year
(C*26)	Subtotal

(A*E)

3001	Single Employees (Self Only)	40	Bi-Weekly	0
3002	Employee + 1 (either plus one spouse or plus one child)	47	Bi-Weekly	0
3003	Family Plan	113	Bi-Weekly	0
				** YEAR 3 TOTAL

Rider Category***	Bi-Weekly Rate per Premium
C.1.1.21 Excess Coverage

Group Life Insurance

			A	B	C	E	F
	Sub-CLIN	Description	Salary volume in $JMD	UNIT	Bi-weekly Insurance Rate	Rate per year
(C*26)	Subtotal

(A*E)

	3004	Basic Life - Based on 26 months Salary Volume	$ 2,451,499,688.00	Bi-Weekly		0	0
	3005	Accidental Death and Dismemberment
– Based on 34 months Salary Volume	$ 3,205,768,071.00	Bi-Weekly		0	0
						** YEAR 3 TOTAL	0

TOTAL CONTRACT VALUE FOR YEAR 3
Total annual premium	0
Total annual insurance	0
Total for Year 3	0

YEAR 4

Premium

			A	B	C	E	F
	Sub-CLIN	Description	*Number of Members (Employee + Dependents)	UNIT	Bi-weekly rate (26 Pay Periods)	Rate per year
(C*26)	Subtotal

(A*E)

4001	Single Employees (Self Only)	40	Bi-Weekly	0
4002	Employee + 1 (either plus one spouse or plus one child)	47	Bi-Weekly	0
4003	Family Plan	113	Bi-Weekly	0
				** YEAR 4 TOTAL

Rider Category***	Bi-Weekly Rate per Premium
C.1.1.21 Excess Coverage

Group Life Insurance

			A	B	C	E	F
	Sub-CLIN	Description	Salary volume in $JMD	UNIT	Bi-weekly Insurance Rate	Rate per year
(C*26)	Subtotal

(A*E)

	4004	Basic Life - Based on 26 months Salary Volume	$ 2,696,649,657.00	Bi-Weekly		0	0
	4005	Accidental Death and Dismemberment
– Based on 34 months Salary Volume	$ 3,526,344,878.00	Bi-Weekly		0	0
						** YEAR 4 TOTAL	0

TOTAL CONTRACT VALUE FOR YEAR 4
Total annual premium	0
Total annual insurance	0
Total for Year 4	0

TOTAL PREMIUM AND INSURANCE
Base Year	0
Year 1	0
Year 2	0
Year 3	0
Year 4	0
TOTAL:	0

OFFEROR'S CURRENCY:

*Estimated quantity for evaluation purposes only and do not bind the Government. Actual number may be lower or higher than the estimates in the solicitation/contract.
** Does not include any premiums for Riders.
*** The bi-weekly rate per premium for Excess Coverage is not included in the total price for each year!
Sub-Section B.3.3 - Monthly Retention Amounts
Period of Performance	Single Employees (Self only)	Employee + 1	Family
Base Period
Year 1
Year 2
Year 3
Year 4

SGE50017R0136

Locally Engaged Staff Health Insurance Attachment 1 Pricing Schedule

File details come from the government source that posted it. Updated Mar 18, 2026.