Employee_Assistance_Program_-_Appendix_B_Detailed_Cost_Summary_-_Cost_of_Services_Form_.doc
DOC document 41 KB Posted
- Solicitation number
- RFP- 25 - 003
- Issued by
- Pinellas County, Florida
About this file
This document is a Cost of Services Form (Appendix B) for an Employee Assistance Program (EAP) Request for Proposal (RFP No. 7058) issued by the City of St. Petersburg, Florida, covering EAP services for active employees, dependents, and COBRA participants. The initial contract term is from April 1, 2025, through March 31, 2026, with potential renewal options for subsequent years through March 31, 2029. The City seeks comprehensive EAP services that include counseling for alcohol and drug abuse, emotional support, family and occupational stress management, and 24/7 accessibility to licensed mental health professionals.
The cost form requires vendors to provide their company name, plan name/number, and per-employee monthly premium rates, with options to propose rate guarantees or renewal caps for each contract year. The document allows vendors to detail additional costs and provides space for supplementary information. The City expects the selected vendor to deliver administrative services and documentation in compliance with city specifications and applicable laws, with no additional compensation for extra time or personnel. The RFP emphasizes a flexible approach, allowing vendors to propose enhancements to the EAP service model while reserving the right to modify the scope of work before final agreement execution.
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Text version
RFP No. 7058
Appendix A, Detailed Cost Summary
Appendix B Detailed Cost Summary - Cost of Services Provide your Company’s Name, Plan Name/Number and premium rates for the proposed plan. Complete one form per proposed plan. Initial Plan year is April 1, 2025 – March 31, 2026 The electronic version of this document is available for download at www.stpete.org/internal-bids.php Instructions: Use tab key to move to each field. After completion, print form out and include in your proposal submission in Section D. If you require additional space, check “additional info attached” in the space provided and include a full response on the separate page included with this Appendix.
Company Name:
Plan Name / Number:
| Cost Per Employee Per Month |
| $ |
| Additional Costs (please detail on page 2): |
| FORMCHECKBOX |
Yes
| $ |
| $ |
1. Are you willing to provide a guarantee or a rate renewal cap for Plan year
April 1, 2025 through March 31, 2026?
FORMCHECKBOX
Yes
FORMCHECKBOX
No If yes, provide details:
2. Are you willing to provide a guarantee or a rate renewal cap for Plan year
April 1, 2026 through March 31, 2027?
FORMCHECKBOX
Yes
FORMCHECKBOX
No
If yes, provide details:
3. Are you willing to provide a guarantee or a rate renewal cap for Plan year
April 1, 2027 through March 31, 2028?
FORMCHECKBOX
Yes
FORMCHECKBOX
No
If yes, provide details:
4. Are you willing to provide a guarantee or a rate renewal cap for Plan year
April 1, 2028 through March 31, 2029?
FORMCHECKBOX
Yes
FORMCHECKBOX
No
If yes, provide details:
Additional Information:
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