Cost Sheet.xlsx
XLSX spreadsheet 40 KB Posted
- Attached to
- Nebraska Medicaid Enrollment Broker
- Solicitation number
- 125920 O3
- Issued by
- Nebraska
About this file
This Cost Sheet is a pricing template for the Nebraska Medicaid Enrollment Broker solicitation (RFP #125920) issued by the State of Nebraska Department of Health and Human Services. The document requires bidders to provide pricing for operations and implementation services related to enrollment broker functions for Nebraska Medicaid. The cost sheet is structured to capture pricing across a five-year base contract period plus five optional renewal years, with member volume tiers ranging from 1 to 399,999 members. Bidders must complete all yellow-highlighted fields and provide pricing on a per-member-per-month basis for each contract year and member volume category. The document includes separate sections for implementation costs (one-time) and ongoing operations costs, with the pricing structure designed to accommodate variable member volumes and corresponding service levels throughout the contract term.
Pricing must be submitted as net costs with all transportation and delivery charges fully prepaid by the bidder on an F.O.B. destination basis, with no additional charges permitted for packing or partial deliveries. The cost sheet requires detailed expense build-up information including direct labor (salaries and benefits), consultants, subcontractors, hardware, software licenses, telecommunications, facility costs, equipment, office supplies, and administrative fees. Monthly invoices will be paid based on the pricing submitted in the cost sheet, and bidders must submit "NO BID" for any locations where they are unwilling to provide services. The document contains multiple formula references and threaded comments indicating the spreadsheet requires completion of calculations and clarification of member volume tier ranges between 199,999 and 299,999 members.
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Text version
Operations Vendor's Company Name: 0
| Nebraska Medicaid Enrollment Broker |
| Cost Sheet |
| of RFP # 125920 O3 |
Bidder Name:_________________________________________________ Important Instructions: Bidders must complete all fields highlighted in yellow. Do not alter the existing format or content within this Cost Sheet. Prices quoted shall be net, including transportation and delivery charges fully prepaid by the bidder, F.O.B. destination named in the Solicitation. No additional charges will be allowed for packing, packages, or partial delivery costs. Important: In case of a mathematical error in extension of price, unit price shall govern.
The prices indicated in Part I and II below shall reflect all applicable fees necessary to perform the project requirements and deliverables as outlined in section (VI) of the Request for Proposal (RFP) document and any related attachments and/or documents.
Instructions For Bidders:
Only Part I - Initial Contract Period. Only individual location extended prices will be used for evaluating the proposal. If a bidder does not intend to submit a bid for any of the listed locations, they must submit “NO BID” on those locations from all applicable pricing tables in this Price Sheet. Bidders should provide pricing only for the locations where they are willing to deliver services.
During the contracted years, the vendor shall accommodate requests from the State for any necessary optional cleaning services necessary to comply with any State statutory or regulatory requirements. Any optional renewal service will be billed at the appropriate rates specified in the Price Sheet under Part IV – Optional Services.
(Note: All the invoices shall be paid on monthly basis)
| Planned Member Volume | ERROR:#REF! | Year One | Year Two | Year Three | Year Four | Year Five | Total Base Contract Price |
| Expense Type | Member Volume Up To | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | |
| Base Price | 1 | $0.00 | |||||
| Additional Price Per Member Per Month | 99,999 | $0.00 | |||||
| Additional Price Per Member Per Month | 199,999 | $0.00 | |||||
| Additional Price Per Member Per Month | ERROR:#REF! |
tc={EE324A8B-68DC-4A53-841C-177E973B6C31}: [Threaded comment]
Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924
Comment:
| Is this an extra cell? Seems like the member volume increases by 100,000 but this cell is between 199,999 and 299,999. Not sure what value would go here. | ERROR:#REF! | |||
| Additional Price Per Member Per Month | 299,999 | $0.00 | ||
| Additional Price Per Member Per Month | 399,999 | $0.00 |
| Total Planned Member Volume | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Total 399,999 Member Volume | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Planned Member Volume | ERROR:#REF! | Option Year One | Option Year Two | Option Year Three | Option Year Four | Option Year Five | Total Price All Option Years |
| Expense Type | Member Volume Up To | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | Price Per Member Per Month | |
| Base Price | 1 | $0.00 | |||||
| Additional Price Per Member Per Month | 99,999 | $0.00 | |||||
| Additional Price Per Member Per Month | 199,999 | $0.00 | |||||
| Additional Price Per Member Per Month | ERROR:#REF! |
tc={99DAB023-DC0D-4E7B-A7E3-15D63014BF7F}: [Threaded comment]
Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924
Comment:
Is this an extra cell? Seems like the member volume increases by 100,000 but this cell is between 199,999 and 299,999. Not sure what value would go here.
tc={EE324A8B-68DC-4A53-841C-177E973B6C31}: [Threaded comment]
Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924
Comment:
| Is this an extra cell? Seems like the member volume increases by 100,000 but this cell is between 199,999 and 299,999. Not sure what value would go here. | ERROR:#REF! | |||
| Additional Price Per Member Per Month | 299,999 | ERROR:#REF! | ||
| Additional Price Per Member Per Month | 399,999 | $0.00 |
| Total Planned Member Volume | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Total 399,999 Member Volume | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Expense Build-Up - Base Price | ||
| Expense Type | Description | Monthly Expense Total |
| Direct Labor | ||
| Salaries | ||
| Benefits | ||
| Additional Expenses Types Not Related to Direct Labor | ||
| Consultants | ||
| Subcontractors | ||
| Hardware | ||
| Network support | ||
| Software (including license fees) | ||
| Telecommunications lines | ||
| Facility | ||
| Equipment | ||
| Office supplies | ||
| Postage/deliveries | ||
| Printing | ||
| Administrative support |
| Indirect rate cost | |
| Administrative fee | |
| Total of All Expenses | $ - 0 |
| Expand Schedule as Needed (keep formulas consistent) | |
| Pricing is based on the Total Price, which sums the total price for the price of self-selection and auto-assignment per member. | |
| Expense Build-Up is to provide the detail used by the bidder to achieve its price. The expense types shown are examples only. If more expense types are needed, add rows and link formulas if necessary. Total of All Expenses should equal the sum of all rows. |
Is this an extra cell? Seems like the member volume increases by 100,000 but this cell is between 199,999 and 299,999. Not sure what value would go here.
Is this an extra cell? Seems like the member volume increases by 100,000 but this cell is between 199,999 and 299,999. Not sure what value would go here.
Implementation Vendor's Company Name: 0
| Nebraska Medicaid Enrollment Broker |
| Cost Sheet |
| of RFP # |
Enrollment Broker Implementation
| Expense Type | Description | Price |
| Direct Labor | ||
| Salaries | ||
| Benefits | ||
| Additional Expense Types Not Related to Direct Labor | ||
| Consultants | ||
| Subcontractors | ||
| Hardware | ||
| Network support | ||
| Software (including license fees) | ||
| Telecommunications lines | ||
| Facility | ||
| Equipment | ||
| Office supplies | ||
| Postage/deliveries | ||
| Printing | ||
| Administrative support |
| Indirect rate cost | |
| Administrative fee | |
| Total of All Expenses | $ - 0 |
| Expand Schedule as Needed (keep formulas consistent) | |
| The expense types shown are only examples. If more expense types are needed, add rows and link formulas if necessary. Total of All Expenses should equal the sum of all rows. |
Pricing Summary Vendor's Company Name:
| Nebraska Medicaid Enrollment Broker |
| Cost Sheet |
| of RFP # |
Price Summary
| Base Contract | Operations | |||||||
| Category | Pricing | Implemen- tation | Year One | Year Two | Year Three | Year Four | Year 5 | Base Contract Period |
| Implementation | $0.00 | $0.00 | ||||||
| Operations | Yearly Pricing | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | $0.00 | ERROR:#REF! |
| Total Planned Members | $0.00 | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | $0.00 | ERROR:#REF! |
| Total 399,999 Members | $0.00 | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | $0.00 | ERROR:#REF! |
| Total 1 Member | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Option Years | Operations | ||||||
| Category | Pricing | Option Year One | Option Year Two | Option Year Three | Option Year Four | Option Year Five | Option Year Total |
| Operations | Yearly Pricing | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Total Planned Members | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Total 399,999 Members | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! |
| Total 1 Member | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
File details come from the government source that posted it. Updated .