Exhibit M - Cost Proposal.xlsx

XLSX spreadsheet 370 KB Posted

Attached to
Pharmacy Drug Benefits
Solicitation number
HHS0017240
Issued by
Texas

About this file

This is a Cost Proposal Exhibit for Pharmacy Benefits Management Services for the Texas HIV Medications Program (THMP), administered by the Texas Health and Human Services Commission (HHSC) under Solicitation Number HHS0017240. The solicitation encompasses pharmacy benefits management services for three programs: the State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS). Respondents must complete all cost proposal worksheets in the original Microsoft Excel format (.xlsx), providing all-inclusive unit prices for Claim Adjudication Fees (estimated 8,455 claims per month), Premium Payment Fees (estimated 334 participants per month), and operational services including Medication Claim Fees and Premium Payment Fees. The contract includes an initial term of 12 months and optional extension terms totaling 48 months, for a total potential contract period of 60 months. The cost proposal requires pricing for transition activities (including transition plan, disaster recovery plan, and turnover plan as a fixed fee), operations phases across all five years, and supplemental services at all-inclusive blended hourly rates.

All-inclusive unit prices must encompass dispensing fees, processing fees, medication costs, administrative fees, labor, materials, equipment, travel expenses, and all incidental costs necessary to provide services according to the solicitation specifications. The evaluation methodology awards the highest rating to the lowest total cost proposal, with higher-priced proposals receiving lower ratings calculated using the formula: [1-(total cost-lowest total cost)/highest total cost] × maximum percentage available for cost criterion. Historical utilization quantities provided (8,455 monthly claims and 334 monthly participants) are for evaluation purposes only, with no guaranteed volume or compensation to any respondent. The cost proposal includes an example Operations section showing sample pricing of $3.00 per medication claim in Year 1 (declining to $2.75 in Years 2-5) and $5.00 per member per month in Year 1 (declining to $4.25 in Years 2-5). Failure to submit mandatory cost proposal requirements or entering $0.00 pricing indicates the respondent will provide that deliverable at no cost, potentially resulting in proposal disqualification. Any exceptions to pricing must be submitted in a separate exceptions document.

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Total Price Summary

Exhibit M - Cost Proposal
Total Price Summary
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent Name[To be entered by the Respondent]
Total Price Summary Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Total Price Summary
Line No.DescriptionQuantity

(Estimated # of

Units Ordered)Unit of MeasureInitial TermTotal Initial Term
12 MonthsOptional Extension TermsTotal Optional Extension Terms
48 MonthsTotal
60 MonthsCost Formula
Year 1
12 MonthsYear 2
12 MonthsYear 3
12 MonthsYear 4
12 MonthsYear 5

12 Months

All-Inclusive Unit Price ($)Annual CostAll-Inclusive Unit PriceAnnual CostAnnual CostAnnual CostAnnual Cost
1Claim Adjudication Fee8,455Estimated number of claims per month$0.00$/approved claim/per month$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price x 12 Months
2Premium Payment Fee334Estimated number of participants per month$0.00$/per participant/month$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price x 12 Months
3Total Cost$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.

&F &A &P of &N

Transition

Exhibit M - Cost Proposal
Transition
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Transition Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.

Transition 1 Months

Line No.DescriptionUnit of MeasureQuantityAll-Inclusive Unit PriceTotal CostCost Formula
1Transition Plan

Disaster Recovery Plan

Turnover PlanFixed Fee1$0.00$0.00=Quantity x Price
2Total Transition Cost$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8A term of less than 12 months may occur for a given phase and as such is considered a period term. Terms of 12 months are identified as an annual term.

&F

Operations

Exhibit M - Cost Proposal
OperationsOperations
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Operations Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Operations
Line No.DescriptionUnit of MeasureQuantityInitial TermTotal Initial Term
12 MonthsOptional Extension TermsTotal Optional Extension Terms
48 MonthsTotal
60 MonthsCost Formula
Year 1
12 MonthsYear 2
12 MonthsYear 3
12 MonthsYear 4
12 MonthsYear 5

12 Months

All-Inclusive Unit PriceAnnual CostAll-Inclusive Unit PriceAnnual CostAnnual CostAnnual CostAnnual Cost
1Medication Claim FeePer Claim, Per Year101,460$3.00$304,380.00$304,380.00$2.75$279,015.00$279,015.00$279,015.00$279,015.00$1,116,060.00$1,420,440.00=Quantity x Price
2Premium Payment FeePer Member, Per Month334$5.00$20,040.00$20,040.00$4.25$17,034.00$17,034.00$17,034.00$17,034.00$68,136.00$88,176.00=Quantity x Price x 12 Months
3Total Operations Period or Annual Cost$324,420.00OOB$296,049.00$296,049.00$296,049.00$296,049.00$1,184,196.00OOB
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8A term of less than 12 months may occur for a given phase and as such is considered a period term. Terms of 12 months are identified as an annual term.

&F

Operations Var Qty

Exhibit M - Cost Proposal
OperationsOperations
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Operations Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Operations
Line No.DescriptionUnit of MeasureInitial TermTotal Initial Term
12 MonthsOptional Extension TermsTotal Optional Extension Terms
48 MonthsTotal
60 MonthsCost Formula
Year 1
12 MonthsYear 2
12 MonthsYear 3
12 MonthsYear 4
12 MonthsYear 5

12 Months

QuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual Cost
1Brief Description of Deliverable or ServicePer _ Per Month, Per Call Per Month, Transactions Per Month, etc.$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price x 12 Months
2Brief Description of Deliverable or ServicePer Month, Fixed Fee, Each, etc.$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price
3Add additional lines as necessaryUpdate Formulas and Cost Formulas based on Unit of Measure used from above formats$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price
4$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price
5Total Operations Period or Annual Cost$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8A term of less than 12 months may occur for a given phase and as such is considered a period term. Terms of 12 months are identified as an annual term.

&F

Operations Volume

Exhibit M - Cost Proposal
Operations
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Operations Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Operations
Line No.DescriptionUnit of MeasureInitial TermTotal Initial Term
12 MonthsOptional Extension TermsTotal Optional Extension Terms
48 MonthsTotal
60 MonthsCost Formula
Year 1
12 MonthsYear 2
12 MonthsYear 3
12 MonthsYear 4
12 MonthsYear 5

12 Months

QuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual CostQuantityAll-Inclusive Unit PriceAnnual Cost
1Brief Description of Deliverable or Service from Volume worksheet that is being pulled into this row.Per _ Per Month, Per Call Per Month, Transactions Per Month, etc.1$0.00$0.001$0.00$0.001$0.00$0.00$0.001$0.00$0.005$0.00$0.00$0.00$0.00=Quantity x Price x Months
2Brief Description of Deliverable or Service from Volume worksheet that is being pulled into this row.Update qty and ensure Vlook-up formula aligns with correct grey tier of pricing from volume1$0.00$0.002$0.00$0.003$0.00$0.00$0.004$0.00$0.005$0.00$0.00$0.00$0.00=Quantity x Price x Months
3Brief Description of Deliverable or Service from Volume worksheet that is being pulled into this row.see above1$0.00$0.002$0.00$0.003$0.00$0.00$0.004$0.00$0.005$0.00$0.00$0.00$0.00=Quantity x Price x Months
4Add additional lines if need to pull pricing from Volume worksheetsee above1$0.00$0.002$0.00$0.003$0.00$0.00$0.004$0.00$0.005$0.00$0.00$0.00$0.00=Quantity x Price x Months
5Brief Description of Deliverable or ServicePer _ Per Month, Per Call Per Month, Transactions Per Month, etc.$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price x Months
6Brief Description of Deliverable or ServicePer Month, Fixed Fee, Each, etc.$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price
7Add additional lines as necessaryUpdate Formulas and Cost Formulas based on Unit of Measure used from above formats$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00=Quantity x Price
8Total Operations Period or Annual Cost$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8Respondent shall provide all-inclusive pricing for the Transition and Operations phases that does not exceed the Year 1 term of 12 months.
9The estimated number of {remove parenthesis once the edits are made to reference the correct units for the blue bands. Some examples are users, users per month, surveys, surveys per month, staff, etc.} in the cost proposal is for evaluation purposes only and the evaluation tiers are identified in grey above. Total compensation to be paid to any Respondent is based on actual number of {Update this section accordingly and remove parentheses. Some examples are users per month, surveys per month, etc.}
10A term of less than 12 months may occur for a given phase and as such is considered a period term. Terms of 12 months are identified as an annual term.

&F

Volume

Exhibit M - Cost Proposal
Volume
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Be sure to update Table Titles accordingly for all Tables used in CP. Review and edit Volume notes accordingly. If using this worksheet be sure to add the "Note_blue_band" and "Note_Vol_Tier" notes in the Total Price Summary worksheet and edit notes accordingly. Update Magenta shading in Tables below to grey. Delete any magenta notes not used or if used remove magenta highlight.
Volume Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Table 1 - (update title accordingly, for example, "Pricing Schedule, or External Users - Software Costs or Internal Users - Software Costs")
Line No.Number of XXXXXInitial TermOptional Extension Terms
Year 1Year 2Year 3Year 4Year 5
12Months12Months12Months12Months12Months
All-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per Month
11-5$0.00$0.00$0.00$0.00$0.00
26-10$0.00$0.00$0.00$0.00$0.00
311-15$0.00$0.00$0.00$0.00$0.00
416-20$0.00$0.00$0.00$0.00$0.00
521-25+$0.00$0.00$0.00$0.00$0.00
Table 2 - (update title accordingly, for example, "Pricing Schedule, or External Users - Software Costs or Internal Users - Software Costs")
Line No.Number of XXXXXInitial TermOptional Extension Terms
Year 1Year 2Year 3Year 4Year 5
12Months12Months12Months12Months12Months
All-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per Month
11-50$0.00$0.00$0.00$0.00$0.00
251-100$0.00$0.00$0.00$0.00$0.00
3101-150$0.00$0.00$0.00$0.00$0.00
4151-200$0.00$0.00$0.00$0.00$0.00
5201-250$0.00$0.00$0.00$0.00$0.00
6251-300$0.00$0.00$0.00$0.00$0.00
7301-350$0.00$0.00$0.00$0.00$0.00
8351-400$0.00$0.00$0.00$0.00$0.00
9401-450$0.00$0.00$0.00$0.00$0.00
10451-500+$0.00$0.00$0.00$0.00$0.00
Table 3 - (update title accordingly, for example, "Pricing Schedule, or External Users - Software Costs or Internal Users - Software Costs")
Line No.Number of XXXXXInitial TermOptional Extension Terms
Year 1Year 2Year 3Year 4Year 5
12Months12Months12Months12Months12Months
All-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per Month
11-100$0.00$0.00$0.00$0.00$0.00
2101-200$0.00$0.00$0.00$0.00$0.00
3201-300$0.00$0.00$0.00$0.00$0.00
4301-400$0.00$0.00$0.00$4.00$0.00
5401-500$0.00$0.00$0.00$0.00$0.00
6501-600$0.00$0.00$0.00$0.00$0.00
7601-700$0.00$0.00$0.00$0.00$0.00
8701-800$0.00$0.00$0.00$0.00$0.00
9801-900$0.00$0.00$0.00$0.00$0.00
10901-1,000+$0.00$0.00$0.00$0.00$0.00
Table 4 - (update title accordingly, for example, "Pricing Schedule, or External Users - Software Costs or Internal Users - Software Costs")
Line No.Number of XXXXXInitial TermOptional Extension Terms
Year 1Year 2Year 3Year 4Year 5
12Months12Months12Months12Months12Months
All-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per MonthAll-Inclusive Unit Price Per User Per Month
11-500$0.00$0.00$0.00$0.00$0.00
2501-1,000$0.00$0.00$0.00$0.00$0.00
31,001-1,500$0.00$0.00$0.00$0.00$0.00
41,501-2,000$0.00$0.00$0.00$0.00$0.00
52,001-2,500$0.00$0.00$0.00$0.00$0.00
62,501-3,000$0.00$0.00$0.00$0.00$0.00
73,001-3,500$0.00$0.00$0.00$0.00$0.00
83,501-4,000$0.00$0.00$0.00$0.00$0.00
94,001-4,500$0.00$0.00$0.00$0.00$0.00
104,501-5,000+$0.00$0.00$0.00$0.00$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8A term of less than 12 months may occur for a given phase and as such is considered a period term. Terms of 12 months are identified as an annual term.
9The estimated number of {remove parenthesis once the edits are made to reference the correct units for the blue bands. Some examples are users, users per month, surveys, surveys per month, staff, etc.} in the cost proposal is for evaluation purposes only and the evaluation tiers are identified in grey above. Total compensation to be paid to any Respondent is based on actual number of {Update this section accordingly and remove parentheses. Some examples are users per month, surveys per month, etc.}

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Page &P of &N

Supplemental Services

Exhibit M - Cost Proposal
Supplemental ServicesTurnover
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Supplemental Services Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.

Update instructions and notes accordingly. Delete this worksheet if there are no Supplemental Services in the CP. Update the Table # to align with any other tables in CP so they are in chronological order. Update table format if an inflator is used and add appropriate notes. If pricing is to be provided for each year update this worksheet accordingly. Enter the # for year range in Initial and Optional Terms. Delete this note and any empty rows if using this worksheet in the CP. Remove all magenta highlight if instructions/notes are used.

Table # - Supplemental Services
Line No.Resource Role DescriptionUnit of MeasureAll-Inclusive Blended Hourly RateCost Formula
Initial Term Years 1 - 1
1Supplemental Services Blended Hourly RatePer Hour$0.00=Hourly Rate
Optional Extension Terms Years 4 - 5
2Supplemental Services Blended Hourly RatePer Hour$0.00=Hourly Rate
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Optional extension term costs and total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8The all-inclusive blended hourly rate is the total hourly rate for all required positions necessary to perform the required supplemental services.
9Supplemental Services may be initiated during the Initial Term or the Optional Extension Terms and are based on available funding. The Supplemental Services total cost is not reflected in the Total Price Summary worksheet.

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Turnover

Exhibit M - Cost Proposal
TurnoverTurnover
Solicitation NumberHHS0017240
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)
Respondent NameEnter Respondent Name on Total Price Summary Worksheet
Turnover Instructions and Information
1Respondent shall complete all "yellow" highlighted cells.
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.
Turnover
Line No.DescriptionUnit of MeasureQuantityAll-Inclusive Unit PriceTotal CostCost Formula
1Turnover ActivitiesOne Time, Fixed Fee1$0.00$0.00=Quantity x Price
2Total Turnover Cost$0.00
Notes
1Respondent shall only submit a saved-as version of the posted cost proposal in the original Microsoft Excel Workbook (*.xlsx) format. The file name may be revised to identify the Respondent. Do not submit an alternative version of the cost proposal that contains edits, changes to structure or formulas, the addition of comments or clarifications, or is saved as an Adobe PDF Files (*.pdf) format. Any edited or alternative version of the cost proposal submitted in lieu of this requirement may lead to Respondent disqualification.
2Respondent's proposed all-inclusive unit prices are for the Goods and/or Services as specified in this Solicitation and shall include all dispensing fees, processing fees for medication costs, plans, reports, lists, other administrative fees, labor, materials, tools, supplies, equipment, and personnel, including but not limited to, travel expenses, associated costs and incidental costs necessary to provide the products and Services according to the minimum specifications, requirements, provisions, terms, and conditions set forth in the Solicitation.
3Respondent shall provide all-inclusive unit prices for a minimum order quantity of one (1) unit. Failure to submit any mandatory requirement with the cost proposal may be grounds for deeming the proposal non-responsive and may disqualify the proposal. If Respondent elects not to enter a price where required, and the cell retains $0.00, then Respondent shall provide the Deliverable to System Agency at no cost.
4The cost proposal with the lowest total cost will receive the highest available rating allocated to the relevant objective cost criterion in the evaluation, if applicable. Each proposal that has a higher cost than the lowest will have a lower rating for the relevant objective cost criterion in the evaluation, if applicable. The percentage allocated to higher-priced proposals will be calculated using the following formula: [1–(total cost–lowest total cost)/highest total cost] x max percentage available for cost criterion.
5The quantity is based on historical utilization and provided for evaluation purposes only. System Agency makes no guarantee of volume, usage, or total compensation to be paid to any Respondent under any awarded Contract, if any, resulting from this Solicitation.
6Total costs are included in the cost proposal for evaluation purposes only. The all-inclusive unit prices will be used for evaluation purposes and will apply to the Contract and any Amendments executed to incorporate new Services and/or Deliverables to the Contract.
7Any exception to pricing should be included in the exceptions document.
8Turnover costs are allocated to the final year of the initial contract term; however, they may not be incurred until the completion of any optional extension term.

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IT Categoy Descriptions

1
To populate this worksheet go to the Data Worksheet and down to cell B145. Select which of the positions you want to use in your procurement. There are further instructions about how to remove the rows not used for your procurement.1
1
1
Exhibit M - Cost Proposal1
IT Category DescriptionsOperations1
1
Solicitation NumberHHS00172401
Solicitation TitlePharmacy Benefits Management Services for Texas HIV Medications Program (THMP): State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program-PLUS (TIAP-PLUS)1
Respondent NameEnter Respondent Name on Total Price Summary Worksheet1
IT Category Descriptions Instructions and Information1
1The Respondent shall Accept or Reject the IT Category Descriptions for resource roles in Column D in the "yellow" highlighted cells. If rejected, please provide an Alternative Position Description in Column E.1
2Blue cell totals and subtotals are automatically calculated. Other Blue cells may be informational, auto-populated, or do not require data.1
1
IT Category Descriptions

Rodriguez,Janette (HHSC): Rodriguez,Janette (HHSC):

This Tab needs to be updated to current guidance from CQC as of 7/10/25 in which Respondents are to enter their position and price. The Accept/Reject needs to be removed and any Respondent's acceptance or rejection of roles should be indicted in the Assumption/Exception of their response.1
CategoryDescriptionAccept/RejectAlternative Position Description1
1. Applications/Software Development1
DevOps EngineerWorks with IT developers to facilitate better coordination among operations, development, and testing functions by automating and streamlining integration and deployment processes. DevOps aims at coupling a tighter alignment between IT operations and businesses.1
DevOps Engineer 11‐3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre‐established guidelines to perform the functions of the job. Primary job functions do not typically require exercising independent judgment.1
DevOps Engineer 24‐7 years of experience in the field or in a related area. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.1
DevOps Engineer 38 or more years of experience, relies on experience and judgment to plan and accomplish goals, independently performs a variety of complicated tasks, a wide degree of creativity and latitude is expected.1
Systems AnalystUnderstands business objectives and problems, identifies alternative solutions, performs studies and cost/benefit analysis of alternatives. Analyzes user requirements, procedures, and problems to automate processing or to improve existing computer system: Confers with personnel of organizational units involved to analyze current operational procedures, identify problems, and learn specific input and output requirements, such as forms of data input, how data is to be summarized, and formats for reports. Writes detailed description of user needs, program functions, and steps required to develop or modify computer program. Reviews computer system capabilities, specifications, and scheduling limitations to determine if requested program or program change is possible within existing system.1
Systems Analyst 11‐3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre‐established guidelines to perform the functions of the job. Primary job functions do not typically require exercising independent judgment.1
Systems Analyst 24‐7 years of experience in the field or in a related area. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.1
Systems Analyst 38 or more years of experience, relies on experience and judgment to plan and accomplish goals, independently performs a variety of complicated tasks, a wide degree of creativity and latitude is expected.1
Application ArchitectApplication architects are responsible for designing, developing and implementing applications for computer systems. They must direct the development process from conception to completion and oversee the efforts of all associated technical staff.1
Application Architect 11‐3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre‐established guidelines to perform the functions of the job. Primary job functions do not typically require exercising independent judgment.1
Application Architect 24‐7 years of experience in the field or in a related area. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.1
Application Architect 38 or more years of experience, relies on experience and judgment to plan and accomplish goals, independently performs a variety of complicated tasks, may lead and direct the work of others, a wide degree of creativity and latitude is expected.1
Business AnalystReviews, analyzes, and evaluates business systems and user needs. Formulates systems to parallel overall business strategies. Experienced with business process reengineering and identifying new applications of technology to business problems to make business more effective. Familiar with industry standard business process mapping, and reengineering. Prepares solution options, risk identification, and financial analyses such as cost/benefit, ROI, buy/build, etc. Writes detailed description of user needs, program functions, and steps required to develop or modify computer programs.1
Business Analyst 11‐3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre‐established guidelines to perform the functions of the job. Primary job functions do not typically require exercising independent judgment.1
Business Analyst 24‐7 years of experience in the field or in a related area as a senior Business Analyst (Technical). Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Works under limited supervision with considerable latitude for the use of initiative and independent judgment. 2+ years of experience as a data analyst analyzing raw data using Excel, Tableau, etc.1
Business Analyst 38 or more years of experience, relies on experience and judgment to plan and accomplish goals, independently performs a variety of complicated tasks, a wide degree of creativity and latitude is expected. Min 5 years of experience, served as a liaison between the Business community and Customer IT Teams (i.e., Architecture, Project Delivery, Application Sustain, etc.). Strong experience as a Data Analyst in analyzing raw data, and as a Business Analyst in requirements gathering, understanding technology, and any project management experience with PMP are a huge plus.1
Cloud Solutions ArchictectThe cloud architect is responsible for the cloud computing initiatives within an organization and for directing the architectural aspects of a cloud brokering team across all aspects of IT and the business. Responsible for the planning and engineering of an organization's cloud computing infrastructure and applications. Implements and designs hardware and software. Familiar with standard concepts, practices, and procedures of cloud technology, including Software as Service (SaaS), Platform as Service (PaaS), or Infrastructure as a Service (IaaS)..1
Cloud Solutions Archictect 11‐3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre‐established guidelines to perform the functions of the job. Primary job functions do not typically require exercising independent judgment.1
Cloud Solutions Archictect 24‐7 years of experience in the field or in a related area. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.1

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