Exhibit L-7 - TMEP2 Pricing Template.xlsx
XLSX spreadsheet 31 KB Posted
- Solicitation number
- HT940226R0001
- Issued by
-
Defense Health Agency
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 | ||||||
| Period | CLIN/ SLIN | CLIN Description | Unit of Issue | Quantity | Unit Price | Price Total |
| Transition-In | 0001 | Transition-In/Phase-In: To include Security |
(Physical, Personnel and NIST) Certifications.
| (Fixed Price) | LO | 1 | $0.00 | |||
| 0002 | Data delivered in accordance with Section J (Not | |||||
| Separately Priced) | NSP | |||||
| Base total | $0.00 | |||||
| Option Period 1 | 1001/1002 | Option Period 1 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 63,896,832 | $0.00 | |
| 1003/1004 | Option Period 1 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 1,361,016 | $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.pdf | Option Period 1 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 1006 | Option Period 1 Admin Accrual | MO | 12 | $0.00 | |||
| 1007 | Option Period 1 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 1008 | Option Period 1 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 1009 | Option 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) | QTR | 2 | $285,249.00 | $570,498.00 | ||
| Option Period 1 Total | $570,498.00 | ||||||
| Option Period 2 | 2001/2002 | Option Period 2 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 65,104,664 | $0.00 | ||
| 2003/2004 | Option Period 2 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 1,271,394 | $0.00 | ||||
| 2005 | Option Period 2 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 2006 | Option Period 2 Admin Accrual | MO | 12 | $0.00 | |||
| 2007 | Option Period 2 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 2008 | Option Period 2 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 2009 | Option 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) | QTR | 4 | $293,807.00 | $1,175,228.00 | ||
| Option Period 2 Total | $1,175,228.00 | ||||||
| Option Period 3 | 3001/3002 | Option Period 3 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 66,335,327 | $0.00 | ||
| 3003/3004 | Option Period 3 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 1,187,674 | $0.00 | ||||
| 3005 | Option Period 3 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 3006 | Option Period 3 Admin Accrual | MO | 12 | $0.00 | |||
| 3007 | Option Period 3 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 3008 | Option Period 3 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 3009 | Option 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) | QTR | 4 | $302,621.00 | $1,210,484.00 | ||
| Option Period 3 Total | $1,210,484.00 | ||||||
| Option Period 4 | 4001/4002 | Option Period 4 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 67,589,254 | $0.00 | ||
| 4003/4004 | Option Period 4 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 1,109,466 | $0.00 | ||||
| 4005 | Option Period 4 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 4006 | Option Period 4 Admin Accrual | MO | 12 | $0.00 | |||
| 4007 | Option Period 4 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 4008 | Option Period 4 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 4009 | Option 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) | QTR | 4 | $311,699.00 | $1,246,796.00 | ||
| Option Period 4 Total | $1,246,796.00 | ||||||
| Option Period 5 | 5001/5002 | Option Period 5 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 68,866,883 | $0.00 | ||
| 5003/5004 | Option Period 5 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 1,036,409 | $0.00 | ||||
| 5005 | Option Period 5 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 5006 | Option Period 5 Admin Accrual | MO | 12 | $0.00 | |||
| 5007 | Option Period 5 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 5008 | Option Period 5 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 5009 | Option 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) | QTR | 4 | $321,050.00 | $1,284,200.00 | ||
| Option Period 5 Total | $1,284,200.00 | ||||||
| Option Period 6 | 6001/6002 | Option Period 6 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 70,168,663 | $0.00 | ||
| 6003/6004 | Option Period 6 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 968,162 | $0.00 | ||||
| 6005 | Option Period 6 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 6006 | Option Period 6 Admin Accrual | MO | 12 | $0.00 | |||
| 6007 | Option Period 6 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 6008 | Option Period 6 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 6009 | Option 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) | QTR | 4 | $330,682.00 | $1,322,728.00 | ||
| Option Period 6 Total | $1,322,728.00 | ||||||
| Option Period 7 | 7001/7002 | Option Period 7 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 71,495,050 | $0.00 | ||
| 7003/7004 | Option Period 7 Paper Claim Rate (Estimated | ||||||
| Quantity) (Fixed Price) | EA | 904,409 | $0.00 | ||||
| 7005 | Option Period 7 Admin DHP/Non-Accrual (Fixed Price) | MO | 12 | $0.00 | |||
| 7006 | Option Period 7 Admin Accrual | MO | 12 | $0.00 | |||
| 7007 | Option Period 7 DATA, delivered in accordance with Section F and Section J (CDRL submission) | NSP | |||||
| 7008 | Option Period 7 TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | |||
| 7009 | Option 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) | QTR | 4 | $340,603.00 | $1,362,412.00 | ||
| Option Period 7 Total | $1,362,412.00 | ||||||
| 52.217-8 6-month Extension | 8001/8002 | 52.217-8 6-month Extension Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 35,747,525 | $0.00 | $0.00 | |
| 8003/8004 | 52.217-8 6-month Extension Paper Claim Rate (Estimated Quantity) (Fixed Price) | EA | 452,205 | $0.00 | $0.00 | ||
| 8005 | 52.217-8 6-month Extension Administration - Admin DHP/Non-Accrual (Fixed Price) | MO | 6 | $0.00 | $0.00 | ||
| 8006 | 52.217-8 6-month Extension Administration - Admin Accrual | MO | 12 | $0.00 | $0.00 | ||
| 8007 | 52.217-8 6-month Extension DATA, delivered in accordance with Section F and Section J (CDRL submission) (Fixed Price) | NSP | |||||
| 8008 | 52.217-8 6-month Extension TRANSITION-OUT (Fixed Price) | LO | 1 | $0.00 | $0.00 | ||
| 8009 | 52.217-8 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) | QTR | 2 | $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 CLIN | Low Quantity Tier | High Quantity Tier | ||||||
| Period | CLIN/ SLIN | CLIN Description | Unit of Issue | Quantity Range | Unit Price (Low) | Quantity Range | Unit Price (High) | |
| Option Period 1 | 1001/1002 | Option Period 1 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 25,558,732 - 51,117,465 | 76,676,200 - 102,243,933 | |||
| 1003/1004 | Option Period 1 Paper Claim Rate (Estimated | |||||||
| Quantity) (Fixed Price) | EA | 544,406 - 1,088,812 | 1,633,220 - 2,177,626 |
| Option Period 2 | 2001/2002 | Option Period 2 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 26,041,864 - 52,083,730 | 78,125,598 - 104,167,464 | |
| 2003/2004 | Option Period 2 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 508,556 - 1,017,114 | 1,525,674 - 2,034,232 |
| Option Period 3 | 3001/3002 | Option Period 3 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 26,534,130 - 53,068,261 | 79,602,394 - 106,136,525 | |
| 3003/3004 | Option Period 3 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 475,069 - 950,138 | 1,425,209 - 1,990,278 |
| Option Period 4 | 4001/4002 | Option Period 4 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 27,035,701 - 54,071,402 | 81,107,105 - 108,142,806 | |
| 4003/4004 | Option Period 4 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 443,785 - 887,572 | 1,331,361 - 1,775,148 |
| Option Period 5 | 5001/5002 | Option Period 5 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 27,546,752 - 55,093,505 | 82,640,260 - 110,187,013 | |
| 5003/5004 | Option Period 5 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 414,562 - 829,126 | 1,243,692 - 1,658,256 |
| Option Period 6 | 6001/6002 | Option Period 6 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 28,067,464 - 56,134,929 | 84,202,396 - 112,269,861 | |
| 6003/6004 | Option Period 6 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 387,264 - 774,529 | 1,161,796 - 1,549,061 |
| Option Period 7 | 7001/7002 | Option Period 7 Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 28,598,019 - 57,196,039 | 85,794,061 - 114,392,081 | |
| 7003/7004 | Option Period 7 Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 361,762 - 723,526 | 1,085,292 - 1,447,056 |
| 52.217-8 6-month Extension | 8001/8002 | 52.217-8 6-month Extension Electronic Claims Processing (Estimated Quantity) (Fixed Price) | EA | 14,299,010 - 28,598,020 | 42,897,031 - 57,196,041 | |
| 8003/8004 | 52.217-8 6-month Extension Paper Claim Rate (Estimated | |||||
| Quantity) (Fixed Price) | EA | 180,881 - 361,763 | 542,646 - 723,528 |
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