S02 - Attachment 05 - Historical Workload and Planning Info - IV Buffer Support - 19AUG2026.pdf

Attachment 05 – Historical Workload and Planning Information

Purpose This attachment provides historical workload and planning information for Quoters to use in preparing quotations and completing the Section B pricing schedule.

It supports the Insurance Entry and Verification Buffer Support Services IDIQ described in the Performance Work Statement [PWS].

This information is provided for quotation planning, pricing support, and evaluation of quoted prices only. It does not guarantee future workload, work mix, delivery periods, payment, staffing levels, or Task Order award.

The IDIQ guaranteed minimum and maximum are stated in Section B. Except for the guaranteed minimum, the Government is not obligated to order any minimum quantity or dollar value of services. Task Orders will identify the applicable CPACs, VAMCs, facilities, or facility groupings; estimated quantities; delivery periods; phased starts; Government-furnished resources; access dependencies; reporting instructions; points of contact; and facility-specific procedures.

Estimated Ordering-Period Quantities The following quantities will be used to evaluate quoted prices on a common basis. These quantities must correspond to the evaluated CLINs in the Section B pricing schedule. They are evaluation quantities only and are not guaranteed order quantities.

Action Type

Estimated Quantity

Planning Note

Reverification actions

643,200 Actions to review, update, verify, or otherwise maintain existing insurance information

New-policy actions, including Medicare policy actions

1,800,800 Actions to add new insurance information, including Medicare policy actions

Total evaluated actions

2,444,000 Used only to evaluate quoted prices on a common basis

Ordering Period Allocation Table

Ordering Period Reverification Actions New Policy Actions Total Actions

OP1: 30 Sep 2026–29 Sep 2027 643,200 160,800 804,000

OP2: 30 Sep 2027–29 Sep 2028 0 820,000 820,000

OP3: 30 Sep 2028–29 Sep 2029 0 820,000 820,000

Total 643,200 1,800,800 2,444,000

Current Planning Information The Government’s current planning information includes:

Workload Item Current Planning Information

Existing insurance-buffer backlog Approximately 804,000 actions

Estimated backlog mix Approximately 80 percent reverification actions and 20 percent new-policy actions

Estimated Medicare policy workload Approximately 1,640,000 new-policy actions

Planning productivity assumption — reverification actions Approximately 35 actions per labor hour

Planning productivity assumption — new-policy actions Approximately 24 actions per labor hour

Planning Productivity Assumptions The planning productivity assumptions are provided solely to assist Quoters in understanding the Government’s planning estimates. They are not contractual productivity standards, staffing requirements, delivery-period requirements, or performance standards.

Contractor performance will be evaluated under the PWS, Performance Requirements Summary Matrix [PRSM], Quality Assurance Surveillance Plan [QASP], and applicable Task Order.

Historical Workload Data The Government will provide available historical workload data by CPAC, VA Medical Center [VAMC], transaction type, and reporting period, as available.

Historical data may include assigned workload, completed workload, backlog, rejection information, non-chargeable-exception information, workload patterns, and seasonal trends.

A historical-data row normally represents one CPAC, one VAMC or facility, and one reporting period. The Government will identify the source, reporting cutoff date, and material workload conditions for each dataset provided.

CPAC VAMC or Facility

Reporting Period

Reverification Actions

New-Policy Actions, including Medicare Policy Actions

Contractor/Performer-caused Rejected Actions

Non- Chargeable Exceptions

Ending Backlog

Notes

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

CPAC VAMC or Facility

Reporting Period

Reverification Actions

New-Policy Actions, including Medicare Policy Actions

Contractor/Performer-caused Rejected Actions

Non- Chargeable Exceptions

Ending Backlog

Notes

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

[CPAC] [Facility] [MM/YYYY] [Quantity] [Quantity] [Quantity] [Quantity] [Quantity] [Source, reporting cutoff, and material workload conditions]

Definitions

How to Read the Data

▪ Reverification actions:

Actions involving review, update, verification, or maintenance of existing insurance information.

▪ New-policy actions:

Actions involving the addition of new insurance information, including Medicare policy actions.

▪ Contractor-caused rejected actions:

Actions returned for correction because of an error or omission attributable to the Contractor. These actions are not accepted completed actions and must be corrected at no additional cost to the Government.

▪ Non-chargeable exceptions:

Actions that cannot be loaded, linked, or otherwise processed because of payer, system, or source-data conditions outside the Contractor’s control. Non-chargeable exceptions are not contractor-caused rejected actions and are not accepted completed actions for payment.

▪ Ending backlog:

Actions remaining pending as of the end of the reporting period. Historical backlog may include actions that were not available for Contractor processing because complete source information or required system access was unavailable. Known limitations will be identified in the Notes column.

Only accepted completed actions, as defined in PWS Section 4.2 and validated and accepted in accordance with the contract’s invoice and acceptance procedures, are payable.

Quoter Instructions Quoters should use this attachment, the PWS, and the Section B pricing schedule to develop their technical approach and proposed unit prices.

Quoters should consider, as applicable:

▪ The evaluation quantities, planning estimates, action mix, and available historical workload information.

▪ The distinction between reverification actions and new-policy actions, including Medicare policy actions.

▪ Contractor-caused rejected actions and non-chargeable exceptions, which are not payable accepted completed actions.

▪ Task Order-specific locations, estimated quantities, delivery periods, phased starts, access dependencies, Government-furnished resources, reporting instructions, and facility-specific procedures.

▪ The requirement to provide all resources necessary for performance, except Government-furnished resources expressly identified in the contract or applicable Task Order.

Quoters may explain material pricing assumptions in the required Basis of Estimate. Assumptions may not conflict with the PWS, Section B, applicable contract clauses, or other solicitation requirements.

Important Notice Historical and planning information does not alter the PWS or create an entitlement to any quantity, level of effort, payment, or Task Order. The PWS, Section B, applicable contract clauses, and Task Orders govern performance, acceptance, and payment.