attachment_6_-_cost_proposal.pdf
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- Solicitation number
- 0000040419
- Issued by
- California
About this file
This is a Cost Proposal attachment for RFP 27-3001 issued by the California Department of Social Services seeking a third-party workers compensation claims administrator. The proposal requires bidders to provide annualized flat-rate costs for administering claims under three programs: IHSS/WPCS, CalWORKs, and CalFresh E&T. The contract term consists of a 36-month base period from December 1, 2027 through November 30, 2030, with a 36-month option term extending from December 1, 2030 through November 30, 2033. Implementation and transition services are to be provided at no cost to the State between June 1, 2027 and November 30, 2027. The cost proposal is divided into two sections: Section A covers annual flat-rate administration and storage fees across all three programs, while Section B addresses managed care rates for specialized services including bill review, nurse case management, field case management, and utilization review services.
Section B establishes unit-based pricing for specific services based on FY 2024/2025 historical volumes. Bill review services are estimated at 63,991 reviews annually across all programs, telephonic case management at 8,029 hours, field case management at 1,491 hours, non-physician utilization review at 27,404 hours, physician review at 3,406 hours, and medical director review at 5,740 hours. These managed care services are to be paid as Allocated Loss Expenses through individual claims rather than as part of the annual flat fees. Storage requirements include 1,749 boxes for IHSS/WPCS, 572 boxes for CalWORKs, and 29 boxes for CalFresh. The proposal explicitly states that cost submissions must not include any qualifications or contingencies, and the GRAND TOTAL in Box (C) serves as the evaluated cost for scoring purposes, with 180 points allocated to the proposed cost evaluation phase.
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RFP 27-3001 Attachment 6 California Department of Social Services Page 1 of 5
COST PROPOSAL
Section A and Section B are in accordance with the requirements of the RFP Section C, 4., c. Cost Proposal Requirements, and shall be submitted in accordance with Section C, 5., Submission of Proposal.
Proposer shall provide the total proposed annualized flat rate cost to provide third party claims administration services as outlined in the RFP, including Sample Agreements.
The GRAND TOTAL [Box (C)] listed on page 34 is the cost to be evaluated as stated in the RFP, Section C(7)(k)(3), Phase III: Proposed Cost – Cost Proposal (180 Points). On this page below, (A) NOT-TO-EXCEED, PROPOSED CONTRACT TOTAL (12/01/27 – 06/30/30) will be the flat rate fee amounts of the awarded agreements for administration services guaranteed by the Contractor throughout the term of the awarded agreements.
Implementation and Transition Services estimated to be from 06/01/27 through 11/30/27 shall be provided by the Contractor at no cost to the State.
Firm name: ________________________________________________ proposes the following:
Cost Proposal – Section A
ANNUAL FLAT RATE COST
Item Contract Year Program Administration Services
Storage Fees* Flat Rate
1 36 Month Base Term (12/01/27 – 11/30/30)
IHSS/WPCS $ + $ = $
2 36 Month Option Term (12/01/30 – 11/30/33)
IHSS/WPCS $ + $ = $
4 36 Month Base Term (12/01/27 – 11/30/30)
CalWORKs $ + $ = $
5 36 Month Option Term (12/01/30 – 11/30/33)
CalWORKs $ + $ = $
7 36 Month Base Term (12/01/27 – 11/30/30)
CalFresh E&T
8 36 Month Option Term (12/01/30 – 11/30/33)
CalFresh E&T
*Storage Fees: IHSS/WPCS: 1,749 boxes; CalWORKs: 572 boxes; CalFresh: 29 boxes
California Department of Social Services Page 2 of 5
(A) NOT-TO-EXCEED, PROPOSED CONTRACT TOTAL
(12/01/2027 – 11/30/2030) Add Items 1 through 12, enter total here and transfer to the corresponding row on the Cost Proposal Grand Total (Attachment 6, page 5)
Cost Proposal – Section B
MANAGED CARE RATE SCHEDULE
The Managed Care fees and costs for Bill Review, Nurse Case Management Services, Field Case Management Services and Utilization Review Services shall be paid as Allocated Loss Expenses through individual claims and not included in the annual administration and storage fees paid to the awarded Contractor. However, the rates identified shall be applicable throughout the agreement term and will be incorporated into the awarded agreements. The most recent statistics are provided for calculation purposes only and are subject to variation throughout the term of the awarded agreements. Enter the total amount in each table and transfer to the corresponding row on the Cost Proposal Grand Total (Attachment 6, Page 5).
Bill Review Services FY 2024/2025 Bill Reviews = 63,991 Bill Reviews (All Programs)
Contract Term Number of Bill
Reviews FY 24/25
Flat Rate Fee Per Bill Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
63,991 x 1 year and 7 months x $ = $
36 Month Option Term (12/01/27 – 11/30/33)
63,991 x $ = $
(B.1) Total = $
California Department of Social Services Page 3 of 5
Nurse Case Management Services FY 2024/2025 Telephonic Case Management Hours = 8,029 Hours (All Programs)
Contract Term Telephonic Case Mgmt
Hrs FY 24/25 Hourly Rate Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
8,029 x 1 year and 7 months x $ = $
36 Month Option Term (12/01/30 – 11/30/33)
8,029 x $ = $
(B.2) Total = $
Field Case Management Services FY 2024/2025 Field Case Management Hours = 1,491 Hours (All Programs)
Contract Term Field Case
Mgmt Hrs FY 24/25
Hourly Rate Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
1,491 x 1 year and 7 months x $ = $
36 Month Option Term
1,491 x $ = $
(B.3) Total = $
Utilization Review Fees Non-Physician Review Services FY 2024/2025 Non-Physician Review Hours = 27,404 Hours (All Programs)
Contract Term Non-Physician Review Hrs FY
24/25 Hourly Rate Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
27,404 x 1 year and 7 months x $ = $
36 Month Option Term
27,404 x $ = $
(B.4) Total = $
California Department of Social Services Page 4 of 5
Physician Review Services FY 2024/2025 Physician Review Hours = 3,406 Hours (All Programs)
Physician
Review Hrs as of Date
Hourly Rate Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
3,406 x 1 year and 7 months x $ = $
36 Month Option Term
3,406 x $ = $
(B.5) Total = $
Medical Director Review Services FY 2024/2025 Physician Review Hours = 5,740 Hours (All Programs)
Physician
Review Hrs as of Date
Hourly Rate Total Cost
36 Month Base Term (12/01/27 – 11/30/30)
5,740 x 1 year and 7 months x $ = $
36 Month Option Term
5,740 x $ = $
(B.5) Total = $
California Department of Social Services Page 5 of 5
Cost Proposal Grand Total The amount proposed below [Box (C)] is the cost to be evaluated as stated in the RFP, Section C(7)(k)(3).
Description Total Cost
(A) Annual Flat Rate Total (Administration and Storage Fees)
(B.1) Bill Review Services $ (B.2) Nurse Case Management Services $ (B.3) Field Case Management Services $ (B.4) Non-Physician Review Services $ (B.5) Physician Review Services Total $ (B.6) Medical Director Review Services Total $
(C) Cost Proposal Grand Total $
The Cost Proposal shall not detail any text that could be construed as a qualification or contingency of the costs proposed.
| COST PROPOSAL |
| Cost Proposal – Section A |
| Cost Proposal – Section B |
| Cost Proposal Grand Total |
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