Attachment I - Cost Proposal.xlsx

This is a cost proposal attachment for the State of South Dakota in response to RFP #25RFP17863. The proposal template requires bidders to provide comprehensive pricing for administrative services and claims processing functions across a five-year contract period beginning July 1, 2026 and extending through June 30, 2031. Services encompass implementation fees, pre- and post-implementation audit fees, per-employee-per-month (PEPM) network access fees, utilization review services, disease management, claims fiduciary services, eligibility reporting, claims file submission to the state data warehouse, standard reporting, and summary plan description development and amendments. Additional services include summary of benefits and coverage document creation, subrogation services, ID card production and replacement, communication materials in English and non-English formats, custom communication development, benefit fair support, open enrollment materials distribution, and runout fees associated with contract termination.

The cost proposal requires bidders to complete all yellow-shaded areas with fee information for each contract year, specifying the fee type and basis of calculation, whether per-employee-per-month, annual, or incurred. Bidders must also provide pricing for ancillary services including internal and external audits, medical necessity and coverage denial determinations, data integration with prescription drug and other vendors, wire transfer interest rates, member portal customization, and any additional fees deemed applicable. The instructions explicitly prohibit any alterations to the worksheet structure, including changes to row or column order or insertion of additional rows or columns, with non-compliance potentially resulting in proposal elimination.