Attachment 4 - Pricing Schedule.xlsx

XLSX spreadsheet 43 KB Posted May 5, 2025

Attached to: SEC Supplemental Benefits Program
Solicitation number: 50310225R0006
Issued by: Securities and Exchange Commission

About this file

Written by GovTribe AI · May 5, 2025

The file is a Pricing Schedule Excel spreadsheet for the SEC Supplemental Benefits Program (SBP), detailing dental and vision insurance pricing projections from 2026 to 2035. The pricing schedule covers multiple coverage categories including self, self/spouse, self and children, and self/spouse and children, with population projections showing gradual increases in total participants from 4,100 in the base year to 4,550 by the final year. The document provides a comprehensive 10-year pricing breakdown for dental and vision plans, with each year's population broken down by coverage type and percentage, though specific premium and cost details are not populated in this template.

The pricing schedule is associated with Solicitation Number 50310225R0006 for the Securities and Exchange Commission (SEC), seeking a supplemental benefits program that includes dental and vision plans, medical evacuation insurance, and other voluntary benefits for SEC employees. The document includes pricing projections for nine option years following the base year, with annual population slight increases ranging from 2-3% across dental and vision coverage categories, indicating potential modest growth in employee participation over the contract period.

View the file

Other files

File	Type	Posted
Responses to Contractor Questions RFP 50310225R0006 v2.pdf	PDF	May 21, 2025
Attachment 9 - Credit Release Form.pdf	PDF	May 15, 2025
Attachment 10 - Fingerprint Form.pdf	PDF	May 15, 2025
Attachment 8 - OF306 Declaration for Federal Employment.pdf	PDF	May 15, 2025
Attachment 7 - Contractor Data Form V.3.pdf	PDF	May 15, 2025
RFP Cover Letter.pdf	PDF	May 5, 2025
Attachment 6 - Small Business Subcontracting Plan Template v3.docx	DOCX document	May 5, 2025
Attachment 1 - Non-Disclosure Agreement - Contractor Entity.docx	DOCX document	May 5, 2025
Attachment 5 - Past Performance Questionnaire v3.docx	DOCX document	May 5, 2025
Attachment 2 - Non-Disclosure Agreement - Contractor Personnel.docx	DOCX document	May 5, 2025
Combined Synopsis Solicitation v4.pdf	PDF	May 5, 2025
Attachment 3 - Statement of Work final 5-1-25.docx	DOCX document	May 5, 2025

Show all 12

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Base Year

January 1, 2026 to December 31, 2026
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	984		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	574		$ - 0	$ - 0
Self and Children	8.00%	328		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2214		$ - 0	$ - 0

Total 4,100 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	984		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	656		$ - 0	$ - 0
Self and Children	8.00%	328		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2132		$ - 0	$ - 0

Total	4,100	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 1

January 1, 2027 to December 31, 2027
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	984		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	574		$ - 0	$ - 0
Self and Children	8.00%	328		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2214		$ - 0	$ - 0

Total 4,100 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	984		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	656		$ - 0	$ - 0
Self and Children	8.00%	328		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2132		$ - 0	$ - 0

Total	4,100	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 2

January 1, 2028 to December 31, 2028
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1008		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	588		$ - 0	$ - 0
Self and Children	8.00%	336		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2268		$ - 0	$ - 0

Total 4,200 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1008		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	672		$ - 0	$ - 0
Self and Children	8.00%	336		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2184		$ - 0	$ - 0

Total	4,200	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 3

January 1, 2029 to December 31, 2029
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1020		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	595		$ - 0	$ - 0
Self and Children	8.00%	340		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2295		$ - 0	$ - 0

Total 4,250 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1020		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	680		$ - 0	$ - 0
Self and Children	8.00%	340		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2210		$ - 0	$ - 0

Total	4,250	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 4

January 1, 2030 to December 31, 2030
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1032		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	602		$ - 0	$ - 0
Self and Children	8.00%	344		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2322		$ - 0	$ - 0

Total 4,300 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1032		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	688		$ - 0	$ - 0
Self and Children	8.00%	344		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2236		$ - 0	$ - 0

Total	4,300	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 5

January 1, 2031 to December 31, 2031
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1044		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	609		$ - 0	$ - 0
Self and Children	8.00%	348		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2349		$ - 0	$ - 0

Total 4,350 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1044		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	696		$ - 0	$ - 0
Self and Children	8.00%	348		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2262		$ - 0	$ - 0

Total	4,350	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 6

January 1, 2032 to December 31, 2032
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1056		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	616		$ - 0	$ - 0
Self and Children	8.00%	352		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2376		$ - 0	$ - 0

Total 4,400 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1056		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	704		$ - 0	$ - 0
Self and Children	8.00%	352		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2288		$ - 0	$ - 0

Total	4,400	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 7

January 1, 2033 to December 31, 2033
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1068		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	623		$ - 0	$ - 0
Self and Children	8.00%	356		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2403		$ - 0	$ - 0

Total 4,450 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1068		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	712		$ - 0	$ - 0
Self and Children	8.00%	356		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2314		$ - 0	$ - 0

Total	4,450	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 8

January 1, 2034 to December 31, 2034
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1080		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	630		$ - 0	$ - 0
Self and Children	8.00%	360		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2430		$ - 0	$ - 0

Total 4,500 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1080		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	720		$ - 0	$ - 0
Self and Children	8.00%	360		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2340		$ - 0	$ - 0

Total	4,500	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Option Year 9

January 1, 2035 to December 31, 2035
Dental	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1092		$ - 0	$ - 0
Self/Spouse or Self + One	14.00%	637		$ - 0	$ - 0
Self and Children	8.00%	364		$ - 0	$ - 0
Self/Spouse and Children	54.00%	2457		$ - 0	$ - 0

Total 4,550 $ - 0 $ - 0

Vision	% Cat	Population Projection	Premium	Monthly Cost	Annual Costs
Self	24.00%	1092		$ - 0	$ - 0
Self/Spouse or Self + One	16.00%	728		$ - 0	$ - 0
Self and Children	8.00%	364		$ - 0	$ - 0
Self/Spouse and Children	52.00%	2366		$ - 0	$ - 0

Total	4,550	$ - 0	$ - 0
			$ - 0
		Medivac
		Fees
			$ - 0

Grand Total (10 Year Period)

	Years 2026-2035
2026	$
2027	$
2028	$
2029	$
2030	$
2031	$
2032	$
2033	$
2034	$
2035	$
Grand Total	$ - 0

File details come from the government source that posted it. Updated May 5, 2025.