Attachment G - Cost Schedule.docx

This document is the Cost Schedule attachment for RFP 74BAI-S1476 for Workers' Compensation Uninsured Claims Administration services issued by the State of Nevada. The RFP covers claims administration services for Clark County and the City of Las Vegas. The Cost Schedule requires proposers to provide a summary of all claims administration fees, including services related to data conversion, takeover of existing open claims, claim system access, index bureau checking, hearing representation, check stock, banking fees, ACH/Bank Clearing House, 1099 processing, ad-hoc/custom reports, state/federal regulatory reporting, Medicare reporting, medical bill review, pharmacy benefit management, and PPO network. Proposers must detail all components of their charges, identifying any fees based on time, per claim, and/or expense.

The cost proposal must include the annual fee for Contract Year 1 and Contract Year 2, as well as any additional costs. Proposers are required to provide the total cost for the 2-year contract period. The RFP does not mention any set-asides, incumbent providers, or funding sources, but does state that any costs, fees or expenses not provided in the cost proposal will be assumed at no additional charge to the State.