RFP%2031786-00192%20Attachment%206.3%20Cost%20Proposal.xlsx
XLSX spreadsheet 27 KB Posted
- Solicitation number
- RFP 31786-00192
- Issued by
- Tennessee
About this file
This is a Cost Proposal and Scoring Guide for RFP 31786-00192 issued by the State of Tennessee for a Voluntary, Fully-Insured Vision Insurance Plan. The RFP requests pricing for two distinct vision insurance benefit options: a Basic Vision Insurance Plan and an Expanded Vision Insurance Plan. Both plans cover four coverage categories per subscriber: Employee/Retiree, Employee/Retiree & Spouse, Employee/Retiree & Child(ren), and Employee/Retiree & Spouse & Child(ren). Respondents must provide guaranteed monthly premium rates for each category across a five-year contract period spanning January 1, 2028, through December 31, 2032. The Cost Proposal must be completed exactly as specified, with all monetary amounts in U.S. currency limited to two decimal places and numeric figures only. The Cost Proposal remains valid for a minimum of 120 days following the opening date and thereafter in accordance with any resulting contract.
Evaluation of cost proposals will be conducted separately for each plan using weighted evaluation factors that are for scoring purposes only and do not guarantee minimum purchase quantities or volumes. The Basic Vision Insurance Plan evaluation factors are: Employee/Retiree (51), Employee/Retiree & Spouse (16), Employee/Retiree & Child(ren) (13), and Employee/Retiree & Spouse & Child(ren) (20), yielding a maximum section score of 15 points. The Expanded Vision Insurance Plan evaluation factors are: Employee/Retiree (48), Employee/Retiree & Spouse (19), Employee/Retiree & Child(ren) (12), and Employee/Retiree & Spouse & Child(ren) (21), yielding a maximum section score of 25 points. The Cost Proposal must be signed by an individual authorized to bind the respondent, with evidence of authority required if the signatory is not the President or Chief Executive Officer. All calculations are performed by the State using the lowest evaluation cost among all proposals as the baseline for determining point allocations for competing proposals.
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Instructions and Signature
| RFP 31786-00192 | |
| RFP ATTACHMENT 6.3. | |
| COST PROPOSAL & SCORING GUIDE | |
| NOTICE: THIS COST PROPOSAL MUST BE COMPLETED EXACTLY AS REQUIRED | |
| COST PROPOSAL SCHEDULE— The Cost Proposal, detailed below, shall indicate the proposed price for goods or services defined in the Scope of Services of the RFP Attachment 6.6., Pro Forma Contract and for the entire contract period. The Cost Proposal shall remain valid for at least one hundred twenty (120) days subsequent to the date of the Cost Proposal opening and thereafter in accordance with any contract resulting from this RFP. All monetary amounts shall be in U.S. currency or percentages and limited to two (2) places to the right of the decimal point. | |
| Enter numeric figures only. Anything else, including blank cells or any deviated text, will be considered as a zero (0) by the State. | |
| NOTICE: | The Evaluation Factor associated with each cost item is for evaluation purposes only. The evaluation factors do NOT and should NOT be construed as any type of volume guarantee or minimum purchase quantity. The evaluation factors shall NOT create rights, interests, or claims of entitlement in the Respondent. |
| Notwithstanding the cost items herein, pursuant to the second paragraph of the Pro Forma Contract section C.1. (refer to RFP Attachment 6.6.), “The State is under no obligation to request work from the Contractor in any specific dollar amounts or to request any work at all from the Contractor during any period of this Contract.” | |
| This Cost Proposal must be signed, in the space below, by an individual empowered to bind the Respondent to the provisions of this RFP and any contract awarded pursuant to it. If said individual is not the President or Chief Executive Officer, this document must attach evidence showing the individual’s authority to legally bind the Respondent. | |
| Respondents must complete Tables A and B, as instructed on each tab. If the sum of the Evaluation Cost on a table equals zero, the Respondent will receive the maximum section score in the table. In this scenario, the State will use one cent (.01) in the formula listed in the table as the 'lowest evaluation cost amount from all proposals" to calculate all other proposals' point allocations. | |
| RESPONDENT SIGNATURE: | |
| PRINTED NAME & TITLE: | |
| DATE: |
Table A - Basic Premium Basic Vision Insurance Plan
• The State is requesting pricing for two different vision insurance benefit options, as described in RFP 31786-00192 Attachment 6.6 Pro Forma Contract Attachment F Vision Insurance Minimum Benefit Plan Provisions.
• The Proposer should not complete the shaded areas; the State will perform all calculations.
• In Table A below, indicate your organization's guaranteed monthly premium rates for the Basic Vision Insurance Plan.
| TABLE A: BASIC VISION INSURANCE PLAN GUARANTEED MONTHLY PREMIUM RATES PER SUBSCRIBER | State Use ONLY | |||||||
| BASIC VISION INSURANCE PLAN | January 1, 2028 – December 31, 2028 | January 1, 2029 – December 31, 2029 | January 1, 2030 – December 31, 2030 | January 1, 2031 – December 31, 2031 | January 1, 2032 – December 31, 2032 | SUM (B+C+D+E+F) | Evaluation Factor | Evaluation Cost |
(SUM x Evaluation Factor)
| A. Employee/Retiree | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 51 | ERROR:#VALUE! |
| B. Employee/Retiree & Spouse | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 16 | ERROR:#VALUE! |
| C. Employee/Retiree & Child(ren) | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 13 | ERROR:#VALUE! |
| D. Employee/Retiree & Spouse & Child(ren) | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 20 | ERROR:#VALUE! |
| TOTAL EVALUATION COST AMOUNT (sum of evaluation costs above) |
| The Solicitation Coordinator will use this sum and the formula below to calculate the Cost Proposal Score. Numbers rounded to two (2) places to the right of the decimal point will be standard for calculations. | ERROR:#VALUE! | ||||
| lowest evaluation cost amount from all proposals | |||||
| evaluation cost amount being evaluated | x 15 | = SCORE: | |||
| (maximum section score) | |||||
| State Use – Solicitation Coordinator Signature, Printed Name & Date: |
Table B - Expanded Premium Expanded Vision Insurance Plan
• The State is requesting pricing for two different vision insurance benefit options, as described in RFP 31786-00192 Attachment 6.6 Pro Forma Contract Attachment F Vision Insurance Minimum Benefit Plan Provisions.
• The Proposer should not complete the shaded areas; the State will perform all calculations.
• In Table B below, indicate your organization's guaranteed monthly premium rates for the Expanded Vision Insurance Program.
| TABLE B: EXPANDED VISION INSURANCE PLAN GUARANTEED MONTHLY PREMIUM RATES PER SUBSCRIBER | State Use ONLY | |||||||
| EXPANDED VISION INSURANCE PLAN | January 1, 2028 – December 31, 2028 | January 1, 2029 – December 31, 2029 | January 1, 2030 – December 31, 2030 | January 1, 2031 – December 31, 2031 | January 1, 2032 – December 31, 2032 | SUM (B+C+D+E+F) | Evaluation Factor | Evaluation Cost |
(SUM x Evaluation Factor)
| A. Employee/Retiree | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 48 | ERROR:#VALUE! |
| B. Employee/Retiree & Spouse | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 19 | ERROR:#VALUE! |
| C. Employee/Retiree & Child(ren) | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 12 | ERROR:#VALUE! |
| D. Employee/Retiree & Spouse & Child(ren) | $N.NN | $N.NN | $N.NN | $N.NN | $N.NN | ERROR:#VALUE! | 21 | ERROR:#VALUE! |
| TOTAL EVALUATION COST AMOUNT (sum of evaluation costs above) |
| The Solicitation Coordinator will use this sum and the formula below to calculate the Cost Proposal Score. Numbers rounded to two (2) places to the right of the decimal point will be standard for calculations. | ERROR:#VALUE! | ||||
| lowest evaluation cost amount from all proposals | |||||
| evaluation cost amount being evaluated | x 25 | = SCORE: | |||
| (maximum section score) | |||||
| State Use – Solicitation Coordinator Signature, Printed Name & Date: |
Total Cost Proposal Score
| TOTAL COST PROPOSAL SCORE | |
| STATE USE ONLY | |
| The RFP Coordinator shall use the scores from all tables (A and B) to calculate the TOTAL COST PROPOSAL SCORE. Calculations shall result in numbers rounded to two (2) decimal places. | |
| TABLE A SCORE: | |
| TABLE B SCORE: | |
| TOTAL COST PROPOSAL SCORE | 0.00 |
| State Use – RFP Coordinator Signature, Printed Name & Date: |
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