EXHIBIT K - Insurance Coverage.pdf

PDF 76 KB Posted

Attached to
Medical, Dental, Vision Insurance Services
Solicitation number
2604-002
Issued by
Travis County, Austin City, Texas

About this file

This is an insurance coverage exhibit document that establishes the insurance requirements for a state and local contract opportunity. The document requires bidders to complete Table K1, which functions as a disclosure form detailing the types and amounts of insurance coverage currently maintained by the applicant company. The specified insurance categories include General Liability, Professional Liability, Cyber Liability/Data Breach, Errors and Omissions, Commercial Auto Insurance, Commercial Umbrella Insurance, and Workers Compensation. Bidders must indicate whether they carry each type of coverage with a yes or no response and specify the corresponding coverage amounts. The exhibit also allows for the addition of relevant insurance coverage types not listed in the standard table that pertain to the specific business category.

Upon selection, the successful contractor must provide an Accord Certificate of Insurance to document and verify the insurance coverage disclosures made during the bidding process. This requirement ensures that the selected vendor maintains the insurance protections necessary to cover potential liabilities and risks associated with contract performance and service delivery.

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Other files

File Type Posted
EXHIBIT I - Form 1295 Certificate of Interested Parties.pdf PDF
Exhibit A-5 - Dental Plan and Claim Information.xlsx XLSX spreadsheet
EXHIBIT C - Acknowledgement of Receipt Form.pdf PDF
Exhibit A-4 - Medical, Prescription Drug and Claim Information.xlsx XLSX spreadsheet
Exhibit A-1 -2026 Medical, Prescription Drug, Summary of Benefit Coverages.pdf PDF
Exhibit A-10 - DPPO Provider Report.xls XLS spreadsheet
Exhibit A-3 - 2026 Vision Member Summary.pdf PDF
Exhibit A-11 - Vision Provider Report.xlsx XLSX spreadsheet
Exhibit A-7 - Medical, prescription drug, Large Claim Report.xls XLS spreadsheet
Exhibit A-14 - PBM Questionnaire.xlsx XLSX spreadsheet
Exhibit B-1 - Medical ASO Pricing Sheet.pdf PDF
EXHIBIT G - Sample Contract.pdf PDF
Exhibit A-6 - Vision Plan and Claim Information.xlsx XLSX spreadsheet
Exhibit A-2 - 2026 Dental Summary of Benefit Coverages.pdf PDF
EXHIBIT F - Certificate of Secretary.pdf PDF
Exhibit A - Scope of Work.pdf PDF
Exhibit A-15 - Data Requirements.pdf PDF
Exhibit A-13 - Medical ASO, Dental, Vision Questionnaire.xlsx XLSX spreadsheet
Exhibit A-12 - Census.xlsx XLSX spreadsheet
Exhibit A-9 - Medical, prescription drug, Provider Utilization Report.xls XLS spreadsheet
EXHIBIT E - Conflict of Interest.pdf PDF
Exhibit A-8 - Top 50 Drugs Report.xlsx XLSX spreadsheet
Exhibit B-2 - Fully-insured Dental Pricing Sheet.pdf PDF
ESBD_510133_1776997796981_RFP 2604-002 Medical, Dental, Vision.pdf PDF
EXHIBIT D - Business Development Form.pdf PDF
Exhibit B-3 - Fully-insured Vision Pricing Sheet.pdf PDF
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Text version

Exhibit K

INSURANCE COVERAGE

Insurance Coverage

Using table K1 provide the Insurance coverage currently carried by your company. If you carry coverage not listed that is relevant to this business category add coverage to the bottom of the list. Indicate yes or No if that coverage is carried and what the coverage amount is currently carried. *

Table K1:

Insurance Type Coverage Yes/No

Coverage Amount if Applicable

General Liability Professional Liability Cyber Liability/Data Breach Errors and Omissions Commercial Auto Insurance Commercial Umbrella Insurance Workers Compensation

* Accord Certificate of Insurance will be required upon Selection.

File details come from the government source that posted it. Updated .