ESBD_521004_1780004547468_Exhibit B-3 - Fully-insured Vision Pricing Sheet.pdf

This is a Vision Insurance Pricing Sheet exhibit for RFP 2604-002, outlining the requirements for a fully-insured vision insurance contract. The selected vendor must provide comprehensive vision coverages and services as detailed in the associated exhibits, specifically Exhibit A-3 (2026 Vision Summary of Benefit Coverages), Exhibit A-6 (Vision Plan and Claim Information), Exhibit A-11 (Vision Provider Utilization Report), and Exhibit A-12 (Census Coverage/Service Cost data). The RFP requests pricing quotes for eight distinct plan configurations: Vision Low Plan and Vision High Plan, each available in Employee Only, Employee + Spouse, Employee + Child(ren), and Employee + Family coverage tiers.

Respondents must provide complete quotes that include all required coverages and identify any additional necessary costs or fees beyond the base plan pricing. The pricing structure differentiates between two benefit level options (Low and High plans) across four family composition categories, requiring vendors to demonstrate pricing flexibility and comprehensive understanding of the organization's workforce composition and benefit needs. Supporting documentation and utilization data have been provided to enable accurate quote development based on historical claims experience and current enrollment levels.