f - 01a_Dental_Solicitation Att 1 Price Proposal Spreadsheet_09.06.24.xlsx

XLSX spreadsheet 26 KB Posted Sep 6, 2024

Attached to: Dental Insurance
Solicitation number: 2031JW24R00002
Issued by: Department of the Treasury Office of the Comptroller of the Currency

About this file

Written by GovTribe AI · Sep 6, 2024

This document is a Price Proposal Spreadsheet attachment for a federal Dental Insurance solicitation. It outlines pricing for a base period and nine option periods, with pricing for PPO and DHMO plans under various coverage tiers. The estimated number of employees/retirees is provided for each CLIN. Pricing information includes firm-fixed rates, estimated monthly and annual premiums. The document also includes a Summary Price Sheet with price caps for each option period. The federal contract opportunity is a full and open competition solicitation issued by the Department of the Treasury Office of the Comptroller of the Currency, with a period of performance from April 1, 2025 through March 31, 2035.

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Rate Proposal Attachment 1 - Price Proposal Spreadsheet

Transition Period: Date of award (April 1, 2025) through June 30, 2025
CLIN	Description	Price
0001	Transition Period - Enrolling employees into plan	Not separately priced

Base Period: April 1, 2025 through March 31, 2026
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0002	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0003	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0004	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0005	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0006	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0007	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0008	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0009	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0010	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
Option Period 1: April 1, 2026 through March 31, 2027
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0011	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0012	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0013	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0014	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0015	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0016	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0017	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0018	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0019	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
Option Period 2: April 1, 2027 through March 31, 2028
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0020	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0021	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0022	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0023	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0024	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0025	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0026	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0027	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0028	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 2 is ____%.
Option Period 3: April 1, 2028 through March 31, 2029
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0029	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0030	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0031	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0032	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0033	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0034	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0035	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0036	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0037	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 3 is ____%.
Option Period 4: April 1, 2029 through March 31, 2030
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0038	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0039	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0040	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0041	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0042	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0043	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0044	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0045	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0046	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 4 is ____%.
Option Period 5: April 1, 2030 through March 31, 2031
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0047	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0048	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0049	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0050	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0051	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0052	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0053	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0054	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0055	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 5 is ____%.
Option Period 6: April 1, 2031 through March 31, 2032
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0056	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0057	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0058	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0059	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0060	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0061	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0062	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0063	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0064	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 6 is ____%.
Option Period 7: April 1, 2032 through March 31, 2033
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0065	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0066	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0067	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0068	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0069	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0070	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0071	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0072	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0073	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 7 is ____%.
Option Period 8: April 1, 2033 through March 31, 2034
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0074	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0075	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0076	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0077	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0078	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0079	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0080	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0081	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0082	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 8 is ____%.
Option Period 9: April 1, 2034 through March 31, 2035
CLIN	Description	Estimated # of employees/ retirees (Qty)	Firm-fixed rate	Estimated Monthly Premium	Estimated Annual Premium (12 months)
PPO COMPOSITE RATES
0083	PPO OCC and OFR active employees, OCC disabled retirees - Composite	3678		$ - 0	$ - 0
PPO Composite Rate Total					$ - 0
PPO 2-TIER RATES
0084	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	1305		$ - 0	$ - 0
0085	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	2643		$ - 0	$ - 0
PPO 2-Tier Rate Total					$ - 0
PPO 3-TIER RATES
0086	PPO OCC non-disabled retirees - Employee only	195		$ - 0	$ - 0
0087	PPO OCC non-disabled retirees - 2 person	278		$ - 0	$ - 0
0088	PPO OCC non-disabled retirees - Family	41		$ - 0	$ - 0
PPO 3-Tier Rate Total					$ - 0
DHMO COMPOSITE RATES
0089	DHMO OCC and OFR active employees, OCC disabled retirees - Composite	81		$ - 0	$ - 0
DHMO Composite Rate Total					$ - 0
DHMO 2-TIER RATES
0090	PPO OCC and OFR Active Employees, OCC disabled retirees - Employee only	84		$ - 0	$ - 0
0091	PPO OCC and OFR Active Employees, OCC disabled retirees - Family	118		$ - 0	$ - 0
DHMO 2-Tier Rate Total					$ - 0
The price cap for option period 9 is ____%.

Summary Price Sheet

Scenario 1 - PPO composite, PPO 3-tier, DHMO composite
Year	Previous Year's Cost	Price Cap (%)	Price Cap ($)	Estimated Annual Premium
Base - 2025
Option 1 - 2026
Option 2 - 2027	$0.00		$0.00	$0.00
Option 3 - 2028	$0.00		$0.00	$0.00
Option 4 - 2029	$0.00		$0.00	$0.00
Option 5 - 2030	$0.00		$0.00	$0.00
Option 6 - 2031	$0.00		$0.00	$0.00
Option 7 - 2032	$0.00		$0.00	$0.00
Option 8 - 2033	$0.00		$0.00	$0.00
Option 9 - 2034	$0.00		$0.00	$0.00
Total 10-Year NTE Price				$ - 0
Scenario 2 - PPO composite, PPO 3-tier, DHMO 2-tier
Year	Previous Year's Cost	Price Cap (%)	Price Cap ($)	Estimated Annual Premium
Base - 2025
Option 1 - 2026
Option 2 - 2027	$0.00		$0.00	$0.00
Option 3 - 2028	$0.00		$0.00	$0.00
Option 4 - 2029	$0.00		$0.00	$0.00
Option 5 - 2030	$0.00		$0.00	$0.00
Option 6 - 2031	$0.00		$0.00	$0.00
Option 7 - 2032	$0.00		$0.00	$0.00
Option 8 - 2033	$0.00		$0.00	$0.00
Option 9 - 2034	$0.00		$0.00	$0.00
Total 10-Year NTE Price				$ - 0
Scenario 3 - PPO 2-tier, PPO 3-tier, DHMO composite
Year	Previous Year's Cost	Price Cap (%)	Price Cap ($)	Estimated Annual Premium
Base - 2025
Option 1 - 2026
Option 2 - 2027	$0.00		$0.00	$0.00
Option 3 - 2028	$0.00		$0.00	$0.00
Option 4 - 2029	$0.00		$0.00	$0.00
Option 5 - 2030	$0.00		$0.00	$0.00
Option 6 - 2031	$0.00		$0.00	$0.00
Option 7 - 2032	$0.00		$0.00	$0.00
Option 8 - 2033	$0.00		$0.00	$0.00
Option 9 - 2034	$0.00		$0.00	$0.00
Total 10-Year NTE Price				$ - 0
Scenario 4 - PPO 2-tier, PPO 3-tier, DHMO 2-tier
Year	Previous Year's Cost	Price Cap (%)	Price Cap ($)	Estimated Annual Premium
Base - 2025
Option 1 - 2026
Option 2 - 2027	$0.00		$0.00	$0.00
Option 3 - 2028	$0.00		$0.00	$0.00
Option 4 - 2029	$0.00		$0.00	$0.00
Option 5 - 2030	$0.00		$0.00	$0.00
Option 6 - 2031	$0.00		$0.00	$0.00
Option 7 - 2032	$0.00		$0.00	$0.00
Option 8 - 2033	$0.00		$0.00	$0.00
Option 9 - 2034	$0.00		$0.00	$0.00
Total 10-Year NTE Price				$ - 0

Example Summary Price Sheet

Year	Previous Year's Cost	Price Cap (%)	Price Cap ($)	Estimated Maximum Annual Premium
Base - 2025				$6,374,808.00
Option 1 - 2026				$6,374,808.00
Option 2 - 2027	$6,374,808.00	2%	$127,496.16	$6,502,304.16
Option 3 - 2028	$6,502,304.16	2%	$130,046.08	$6,632,350.24
Option 4 - 2029	$6,632,350.24	2%	$132,647.00	$6,764,997.25
Option 5 - 2030	$6,764,997.25	2%	$135,299.94	$6,900,297.19
Option 6 - 2031	$6,900,297.19	2%	$138,005.94	$7,038,303.14
Option 7 - 2032	$7,038,303.14	2%	$140,766.06	$7,179,069.20
Option 8 - 2033	$7,179,069.20	2%	$143,581.38	$7,322,650.58
Option 9 - 2034	$7,322,650.58	2%	$146,453.01	$7,469,103.60
Total 10-Year NTE Price				$68,558,691.36

File details come from the government source that posted it. Updated Sep 6, 2024.