Attachment_J.2_-_WCRC_CLIN_Cost_Template_Amendment_3.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Workers Compensation Review Contractor
- Solicitation number
- RFP-CMS-2016-8A-0008
About this file
WCRC Cost Template
View the file
Other files
Show 40 more
Latest 50 of 80 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1 CLIN 0001 Transition Period (July 1, 2017 – September 30, 2017) Total FFP
| CLIN 0001 | Transition Activities | |||
| SLIN 0001AA | Month #1 Transition | |||
| SLIN 0001AB | Month #2 Transition | |||
| SLIN 0001AC | Month #3 Transition | |||
| CLIN 0002 Base Year (October 1, 2017 – June 30, 2018) | Quantity | Unit Price | Total FFP | |
| (# of Proposal Submissions) | (Per Recomm) | |||
| CLIN 0002 | Price Per WCMSA Recommendation | |||
| SLIN 0002AA | WCMSA Recommendations - MIP | 14,400* | ||
| SLIN 0002AB | WCMSA Recommendations - Part D | |||
| SLIN 0002AC | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0002AD | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0002AE | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0002AF | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0002AG | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0002AH | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0002AI | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0002AJ | Optional WCMSA Recomm Additional Quantity - Part D | |||
| Total |
| CLIN 0003 Option Year 1 (July 1, 2018 – June 30, 2019) | Quantity | Unit Price | Total FFP | |
| (# of Proposal Submissions) | (Per Recomm) | |||
| CLIN 0003 | Price Per WCMSA Recommendation | |||
| SLIN 0003AA | WCMSA Recommendations - MIP | 19,200* | ||
| SLIN 0003AB | WCMSA Recommendations - Part D | |||
| SLIN 0003AC | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AD | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0003AE | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AF | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0003AG | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AH | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0003AI | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AJ | Optional WCMSA Recomm Additional Quantity - Part D | |||
| Optional NGHP Price Per LMSA Recommendation | ||||
| SLIN 0003AK | Optional LMSA & NFMSA Recomm - MIP | 1,000 | ||
| SLIN 0003AL | Optional LMSA & NFMSA Recomm- Part D | |||
| SLIN 0003AM | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AN | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0003AO | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0003AP | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0003AQ | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0003AR | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0003AS | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0003AT | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| Total |
| CLIN 0004 Option Year 2 (July 1, 2019 – June 30, 2020) | Quantity | Unit Price | Total FFP | |
| (# of Proposal Submissions) | (Per Recomm) | |||
| CLIN 0004 | Price Per WCMSA Recommendation | |||
| SLIN 0004AA | WCMSA Recommendations - MIP | 19,200* | ||
| SLIN 0004AB | WCMSA Recommendations - Part D | |||
| SLIN 0004AC | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AD | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0004AE | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AF | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0004AG | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AH | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0004AI | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AJ | Optional WCMSA Recomm Additional Quantity - Part D | |||
| Optional NGHP Price Per LMSA Recommendation | ||||
| SLIN 0004AK | Optional LMSA & NFMSA Recomm - MIP | 3,000 | ||
| SLIN 0004AL | Optional LMSA & NFMSA Recomm- Part D | |||
| SLIN 0004AM | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AN | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0004AO | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0004AP | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0004AQ | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0004AR | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0004AS | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0004AT | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| Total |
| CLIN 0005 Option Year 3 (July 1, 2020 – June 30, 2021) | Quantity | Unit Price | Total FFP | |
| (# of Proposal Submissions) | (Per Recomm) | |||
| CLIN 0005 | Price Per WCMSA Recommendation | |||
| SLIN 0005AA | WCMSA Recommendations - MIP | 19,200* | ||
| SLIN 0005AB | WCMSA Recommendations - Part D | |||
| SLIN 0005AC | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AD | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0005AE | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AF | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0005AG | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AH | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0005AI | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AJ | Optional WCMSA Recomm Additional Quantity - Part D | |||
| Optional NGHP Price Per LMSA Recommendation | ||||
| SLIN 0005AK | Optional LMSA & NFMSA Recomm - MIP | 5,000 | ||
| SLIN 0005AL | Optional LMSA & NFMSA Recomm- Part D | |||
| SLIN 0005AM | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AN | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0005AO | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0005AP | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0005AQ | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0005AR | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0005AS | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0005AT | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| Total |
| CLIN 0006 Option Year 4 (July 1, 2021 – June 30, 2022) | Quantity | Unit Price | Total FFP | |
| (# of Proposal Submissions) | (Per Recomm) | |||
| CLIN 0006 | Price Per WCMSA Recommendation | |||
| SLIN 0006AA | WCMSA Recommendations - MIP | 19,200* | ||
| SLIN 0006AB | WCMSA Recommendations - Part D | |||
| SLIN 0006AC | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AD | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0006AE | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AF | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0006AG | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AH | Optional WCMSA Recomm Additional Quantity - Part D | |||
| SLIN 0006AI | Optional WCMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AJ | Optional WCMSA Recomm Additional Quantity - Part D | |||
| Optional NGHP Price Per LMSA Recommendation | ||||
| SLIN 0006AK | Optional LMSA & NFMSA Recomm - MIP | 9,000 | ||
| SLIN 0006AL | Optional LMSA & NFMSA Recomm- Part D | |||
| SLIN 0006AM | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AN | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0006AO | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 5,000 | ||
| SLIN 0006AP | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0006AQ | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0006AR | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| SLIN 0006AS | Optional LMSA & NFMSA Recomm Additional Quantity - MIP | 10,000 | ||
| SLIN 0006AT | Optional LMSA & NFMSA Recomm Additional Quantity- Part D | |||
| Total | ||||
| *Fixed Price will be paid in 3 increments, 20% for Month #1, 30% for Month #2, and 50% for Month #3. | ||||
| **Minimum Quantity Guaranteed |
Sheet3
File details come from the government source that posted it. Updated .