CTR078138_Pricing_Document.xlsx
XLSX spreadsheet 309 KB Posted
- Attached to
- Master Agreement AZ|CTR078138
- Contract number
- CTR078138
- Issued by
- Arizona
About this file
This document is a Pricing Document from the Arizona Department of Administration (ADOA) State Procurement Office, specifically Solicitation No. BPM006762, detailing a contract for Health Savings Account (HSA) and Flexible Spending Account (FSA) administration. The offeror and apparent contract awardee is Inspira Financial Health, Inc., who submitted a response to a Request for Proposal for account administration services.
The contract includes a total monthly administrative fee of $0.00, with optional HSA and FSA services priced at $0.00 per participant per month, with a $0.50 PAPM charge if no bulk transfer is provided. The contract includes $250,000 in total annual allowances distributed across a five-year period ($50,000 per year), which can be allocated by ADOA for defined categories and are forfeited if not used annually. Additional included services are HSA account closure fee waivers for accounts transitioned during the first 90 days, up to three annual HSA investment educational online seminars, and a waiver of HSA investment account maintenance fees for members who open and fund an investment account. The contract appears to cover approximately 11,900 HSA participants with potential for bulk transfer of 8,000 accounts during the initial 90-day period.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CTR078138_COI_2025-12-01.PDF | ||
| CTR078138_Performance_Guarantees.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Pricing Document
| Attachment 18 - Pricing Document | Arizona Department of Administration | |
| Request for Proposal | State Procurement Office | |
| Solicitation No. BPM006762 | 100 N 15th Avenue | |
| Health Savings Account and Flexible Spending Account Administration | ||
| Phoenix, AZ 85007 |
| Instructions: | |
| 1 | Please fill out your pricing for the items listed below. |
| 2 | Please fill out $1.00 for the pricing on the “Item (F)” tab in APP. |
| 3 | Offeror shall provide a firm, fixed guaranteed not-to-exceed price regardless of actual enrollment. |
| 4 | All prices provided on this sheet shall include all services required within this solicitation unless specifically stated otherwise on this price sheet. |
| 5 | Provide all fees on a per participant per month basis. |
| 6 | If discounts are available if the amount of people enrolled exceeds a certain number, please indicate on this price sheet. |
| 7 | Offeror shall propose, if any, additional optional program offerings and price in the space provided. |
Offeror Name Inspira Financial Health, Inc.
| Offeror's BAFO Response | |
| Total Monthly Administrative Fee: | $0.00 |
OTHER Optional Services (Other programs offered and services included)
| Health Savings Account (HSA) | ||
| (*20m of AUC & 8,000 accounts transferred via Bulk Transfer during the first 90 days of your effective date.) | $0.00 PAPM* |
| $0.50 if no bulk transfer is provided. | |
| Flexible Spending Account (FSA) | $0.00 PAPM |
Allowances (Please specify program name and services below) *$250,000 in total Annual Allowances over 5-year period
• Year 1: $50,000
• Year 2: $50,000
• Year 3: $50,000
• Year 4: $50,000
• Year 5: $50,000
ADOA reserves the right to determine the final allocation amounts each contract year for the defined categories agreed upon in a Statement of Work. The allowance is forfeited at the end of each year if not fully utilized (it is not rolled over for a cumulative amount).
| Other | ||
| (Please specify program name and services below) | $ | |
| Allowances |
The following allowances will be assumed by Inspira Financial:
• HSA Account Closure Fee – Applies to those accounts transitioned during the first 90 days of your effective date via the bulk transfer process. Value calculated by $25 times your 4/25 HSA population (11,900).
• HSA Plan Sponsor Investment Educational Series – We are including live Q&A HSA Investment educational online seminar up to 3 per year. This online seminar offer will be available per year as we continue our administrative partnership together in year one as well as available in the second through fifth contract years.
• Investment Account Wavier - For ADOA members who open and fund an HSA investment account, we are willing to waive our typical member-paid HSA investment account maintenance fee.
image1.png
File details come from the government source that posted it. Updated .