Exhibit L-7 - TMEP2 Pricing Template.xlsx

XLSX spreadsheet 31 KB Posted

Attached to
TRICARE Medicare Eligible Program Second Generation (TMEP2)
Solicitation number
HT940226R0001
Issued by

About this file

This is a Firm Fixed-Price pricing template for the TRICARE Medicare Eligible Program Second Generation (TMEP2) contract (HT9402-26-R-0001) administered by the Defense Health Agency. The template is designed for offerors to submit pricing proposals for healthcare claims processing and administrative services for dual-eligible Medicare and TRICARE beneficiaries across the United States and U.S. territories.

The pricing structure spans a base transition-in period, seven one-year option periods, a transition-out period, and a potential six-month extension under FAR 52.217-8. Pricing is submitted on a per-unit basis across multiple CLINs covering electronic claims processing (measured in estimated annual quantities ranging from approximately 63.9 million to 71.5 million claims across option periods), paper claim processing (measured in estimated annual quantities ranging from approximately 904,000 to 1.4 million claims), administrative services (monthly maintenance for DHP non-accrual and accrual functions), data delivery per contract data requirements, transition services, and quarterly performance incentives for beneficiary satisfaction (with incentive amounts ranging from $285,249 to $340,603 per quarter depending on the period). The template also includes tiered pricing options with low and high quantity ranges for electronic and paper claims across all contract periods. The evaluated total price shown in the template is $8,853,552 across the base and all option periods, with separate accounting for transition-in and transition-out activities and the highest-priced transition-out CLIN. This is a template document requiring offerors to populate unit prices for all line items.

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Estimated

TMEP HT9402-26-R-0001
52.212-1 Exhibit L-7 Price Proposal Template
OFFEROR:
Price Proposal by CLIN
PeriodCLIN/ SLINCLIN DescriptionUnit of IssueQuantityUnit PricePrice Total
Transition-In0001Transition-In/Phase-In: To include Security

(Physical, Personnel and NIST) Certifications.

(Fixed Price)LO1$0.00
0002Data delivered in accordance with Section J (Not
Separately Priced)NSP
Base total$0.00
Option Period 11001/1002Option Period 1 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA63,896,832$0.00
1003/1004Option Period 1 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA1,361,016$0.00
1005

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@Tompkins, Hudson W CIV DHA DHA CONTRACTING ACT (USA), please update this spreadsheet IAW latest RFP CLIN structure: RFP HT940226R0001-20260826.pdfOption Period 1 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
1006Option Period 1 Admin AccrualMO12$0.00
1007Option Period 1 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
1008Option Period 1 TRANSITION-OUT (Fixed Price)LO1$0.00
1009Option Period 1 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR2$285,249.00$570,498.00
Option Period 1 Total$570,498.00
Option Period 22001/2002Option Period 2 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA65,104,664$0.00
2003/2004Option Period 2 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA1,271,394$0.00
2005Option Period 2 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
2006Option Period 2 Admin AccrualMO12$0.00
2007Option Period 2 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
2008Option Period 2 TRANSITION-OUT (Fixed Price)LO1$0.00
2009Option Period 2 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$293,807.00$1,175,228.00
Option Period 2 Total$1,175,228.00
Option Period 33001/3002Option Period 3 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA66,335,327$0.00
3003/3004Option Period 3 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA1,187,674$0.00
3005Option Period 3 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
3006Option Period 3 Admin AccrualMO12$0.00
3007Option Period 3 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
3008Option Period 3 TRANSITION-OUT (Fixed Price)LO1$0.00
3009Option Period 3 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$302,621.00$1,210,484.00
Option Period 3 Total$1,210,484.00
Option Period 44001/4002Option Period 4 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA67,589,254$0.00
4003/4004Option Period 4 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA1,109,466$0.00
4005Option Period 4 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
4006Option Period 4 Admin AccrualMO12$0.00
4007Option Period 4 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
4008Option Period 4 TRANSITION-OUT (Fixed Price)LO1$0.00
4009Option Period 4 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$311,699.00$1,246,796.00
Option Period 4 Total$1,246,796.00
Option Period 55001/5002Option Period 5 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA68,866,883$0.00
5003/5004Option Period 5 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA1,036,409$0.00
5005Option Period 5 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
5006Option Period 5 Admin AccrualMO12$0.00
5007Option Period 5 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
5008Option Period 5 TRANSITION-OUT (Fixed Price)LO1$0.00
5009Option Period 5 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$321,050.00$1,284,200.00
Option Period 5 Total$1,284,200.00
Option Period 66001/6002Option Period 6 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA70,168,663$0.00
6003/6004Option Period 6 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA968,162$0.00
6005Option Period 6 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
6006Option Period 6 Admin AccrualMO12$0.00
6007Option Period 6 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
6008Option Period 6 TRANSITION-OUT (Fixed Price)LO1$0.00
6009Option Period 6 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$330,682.00$1,322,728.00
Option Period 6 Total$1,322,728.00
Option Period 77001/7002Option Period 7 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA71,495,050$0.00
7003/7004Option Period 7 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA904,409$0.00
7005Option Period 7 Admin DHP/Non-Accrual (Fixed Price)MO12$0.00
7006Option Period 7 Admin AccrualMO12$0.00
7007Option Period 7 DATA, delivered in accordance with Section F and Section J (CDRL submission)NSP
7008Option Period 7 TRANSITION-OUT (Fixed Price)LO1$0.00
7009Option Period 7 Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR4$340,603.00$1,362,412.00
Option Period 7 Total$1,362,412.00
52.217-8 6-month Extension8001/800252.217-8 6-month Extension Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA35,747,525$0.00$0.00
8003/800452.217-8 6-month Extension Paper Claim Rate (Estimated Quantity) (Fixed Price)EA452,205$0.00$0.00
800552.217-8 6-month Extension Administration - Admin DHP/Non-Accrual (Fixed Price)MO6$0.00$0.00
800652.217-8 6-month Extension Administration - Admin AccrualMO12$0.00$0.00
800752.217-8 6-month Extension DATA, delivered in accordance with Section F and Section J (CDRL submission) (Fixed Price)NSP
800852.217-8 6-month Extension TRANSITION-OUT (Fixed Price)LO1$0.00$0.00
800952.217-8 6-month Extension Quarterly Incentive - Beneficiary Satisfaction (Reference Section H.4 which outlines criteria for earning incentive monies. The total Amount shown reflects the maximum incentive available). (Fixed Price)QTR2$340,603.00$681,206.00
52.217-8 6-month Extension Total$681,206.00
Transition-In$0.00
Total, Less Transition-In and Transition-Out$8,172,346.00
Highest Priced Transition-Out CLIN$0.00
Total Evaluated Price$8,853,552.00

@Tompkins, Hudson W CIV DHA DHA CONTRACTING ACT (USA), please update this spreadsheet IAW latest RFP CLIN structure: RFP HT940226R0001-20260826.pdf

Low & High Quantity Tiers

TMEP HT9402-26-R-0001
52.212-1 Exhibit L-7 Price Proposal Template [to be added to Section J]
Refer to Section F.5 TIERED PRICING
OFFEROR:
Price Proposal by CLINLow Quantity TierHigh Quantity Tier
PeriodCLIN/ SLINCLIN DescriptionUnit of IssueQuantity RangeUnit Price (Low)Quantity RangeUnit Price (High)
Option Period 11001/1002Option Period 1 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA25,558,732 - 51,117,46576,676,200 - 102,243,933
1003/1004Option Period 1 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA544,406 - 1,088,8121,633,220 - 2,177,626
Option Period 22001/2002Option Period 2 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA26,041,864 - 52,083,73078,125,598 - 104,167,464
2003/2004Option Period 2 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA508,556 - 1,017,1141,525,674 - 2,034,232
Option Period 33001/3002Option Period 3 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA26,534,130 - 53,068,26179,602,394 - 106,136,525
3003/3004Option Period 3 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA475,069 - 950,1381,425,209 - 1,990,278
Option Period 44001/4002Option Period 4 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA27,035,701 - 54,071,40281,107,105 - 108,142,806
4003/4004Option Period 4 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA443,785 - 887,5721,331,361 - 1,775,148
Option Period 55001/5002Option Period 5 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA27,546,752 - 55,093,50582,640,260 - 110,187,013
5003/5004Option Period 5 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA414,562 - 829,1261,243,692 - 1,658,256
Option Period 66001/6002Option Period 6 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA28,067,464 - 56,134,92984,202,396 - 112,269,861
6003/6004Option Period 6 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA387,264 - 774,5291,161,796 - 1,549,061
Option Period 77001/7002Option Period 7 Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA28,598,019 - 57,196,03985,794,061 - 114,392,081
7003/7004Option Period 7 Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA361,762 - 723,5261,085,292 - 1,447,056
52.217-8 6-month Extension8001/800252.217-8 6-month Extension Electronic Claims Processing (Estimated Quantity) (Fixed Price)EA14,299,010 - 28,598,02042,897,031 - 57,196,041
8003/800452.217-8 6-month Extension Paper Claim Rate (Estimated
Quantity) (Fixed Price)EA180,881 - 361,763542,646 - 723,528

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