Schedule B - Pricing.xlsx
XLSX spreadsheet 24 KB Posted
- Solicitation number
- RFP - 171 - 240000001469
- Issued by
- Ingham County, Lansing City, Michigan
About this file
The provided document is a pricing schedule for a Workers Compensation Services contract solicited by the State of Michigan. The contract covers the administration of Workers Compensation claims, including services such as medical bill auditing, utilization review, and independent medical examinations. The pricing schedule outlines fixed annual rates and fixed term rates for various components of the contract, including new claim filings, administrative fees, and maintenance fees for claims open longer than 36 months. The historical claim data for 2021-2023 is provided to assist bidders with their pricing. The contract term is 4 years, with an estimated total contract utilization of $90 million. Bidders are required to provide pricing for the contract and indicate any multi-contract discounts if awarded both Workers Compensation and Long-Term Disability contracts.
The pricing schedule includes requirements for quick payment terms and certifications that the prices were arrived at independently. Bidders must also provide a range of payable Independent Medical Examination (IME) costs by specialty. The contract opportunity is for the State of Michigan, with Ingham County and the City of Lansing identified as the local jurisdictions involved.
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Other files
| File | Type | Posted |
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| IRS Publication 1075.pdf | ||
| Schedule A Statement of Work.docx | DOCX document | |
| Schedule C Insurance Requirements.docx | DOCX document | |
| Exhibit 7 Safeguarding Contract Language.pdf | ||
| Hybrid Contract Terms.docx | DOCX document | |
| Schedule D Service Level Agreements for Hybrid Purchases.docx | DOCX document | |
| Schedule G Section 2 Software Table.xlsx | XLSX spreadsheet | |
| Proposal Instructions Vendor Questions Worksheet.docx | DOCX document | |
| Schedule F File Layout.doc | DOC document | |
| 240000001469 WC Questions Answers.pdf | ||
| Department of Treasury Safeguard Requirements of Confidential Tax Data.doc | DOC document | |
| Schedule E Data Security Requirements for Hybrid Purchases.docx | DOCX document | |
| Schedule H Service Availability Report.xlsx | XLSX spreadsheet |
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Text version
Informations Data Tab 1 Historical Claim Data
| Number of New Claims Filed | ||
| CY 2021 | CY 2022 | CY 2023 |
| 4253 | 3832 | 2290 |
| NUMBER OF CLAIMS closed | ||
| CY 2021 | CY 2022 | CY 2023 |
| 4069 | 4433 | 2711 |
| Total claims open longer than 36 months | ||
| CY 2021 | CY 2022 | CY 2023 |
| 5870 | 5512 | 4693 |
Workers Comp Pricing
| SCHEDULE B - PRICING | |
| Request For Proposal No. 240000001469 | |
| Workers Compensation Services | |
| 1. The Contractor must provide a pricing schedule for the proposed Contract Activities using the 2 table formats below, Pricing Table 1: fixed annual rate (calendar year) and fixed term rate (Contract Term). The Bidder must only complete areas shaded in light green with numeric values and must not alter data or formulas in cells that are not shaded light green. Bidder must also enter your range of payable IME costs in the provided Table 3 below. | |
| 2. The pricing schedule should be submitted in a modifiable format (e.g., Microsoft Word or Excel); however, you may also submit an additional pricing schedule in a non-modifiable format (e.g., PDF). Failure to complete the pricing schedule as requested may result in disqualification of your proposal. | |
| 3. Price proposals must include all costs, including but not limited to, any one-time or set-up charges, fees, and potential costs that Contractor may charge the State (e.g., Payment Issuance Fee, shipping and handling, per piece pricing, and palletizing). Administrative Fee rates in tables below must be all-inclusive of all Contract Activities in Schedule A, including but not limited to Attorney fees, field case management fees, investigation fees, medical bill audit fees, pharmacy medication review fee, surveillance, utilization review fee, etc. | |
| 4. The Contractor is encouraged to offer quick payment terms. The number of days must not include processing time for payment to be received by the Contractor's financial institution. | |
| Quick payment terms: Bidder is to indicate their quick payment terms in theunderlined spaces provided: Bidder Response: | ________ % discount off invoice if paid within __________ days after receipt of invoice. |
| 5. By submitting its proposal, the Contractor certifies that the prices were arrived at independently, and without consultation, communication, or agreement with any other Contractor. | |||||||
| 6. The historical data on Tab 1 may be used to assist the Contractor with their pricing response. | |||||||
| 7. Multi-Contract Discount: Bidder is to indicate their Multi-Contract Percentage Discount if awarded both Workers Compensation and Long Terms Disability Contracts (additional discount to be provided in table below). | |||||||
| Table 1 - Fixed Annual Rate Pricing Proposal | Table 2 - Fixed Term Rate Pricing Proposal | ||||||
| Fee Description | Rates | Annual Estimated Qty. | Total | Fee Description | Rates | 4-Year Estimated Qty. | Total |
| New Claim Filed (Medical) | New Claim Filed (Medical) | ||||||
| Price Per Claim Year 1 2025 (9 MONTHS) | 1,755 | $0.00 | Price Per Claim - 4 Years | 9,360 | $0.00 | ||
| Price Per Claim Year 2 2026 | 2,340 | $0.00 | |||||
| Price Per Claim Year 3 2027 | 2,340 | $0.00 | |||||
| Price Per Claim Year 4 2028 | 2,340 | $0.00 | |||||
| Price Per Claim Year 5 2029 (3 MONTHS) | 585 | $0.00 | |||||
| New Claim Filed (Indemnity) | New Claim Filed (Indemnity) | ||||||
| Price Per Claim Year 1 2025 (9 MONTHS) | 1,533 | $0.00 | Price Per Claim - 4 Years | 7,665 | $0.00 | ||
| Price Per Claim Year 2 2026 | 1,533 | $0.00 | |||||
| Price Per Claim Year 3 2027 | 1,533 | $0.00 | |||||
| Price Per Claim Year 4 2028 | 1,533 | $0.00 | |||||
| Price Per Claim Year 5 2029 (3 MONTHS) | 1,533 | $0.00 | |||||
| Annual Administrative Fee | Administrative Fee | ||||||
| Administrative Fee Year 1 2025 (9 MONTHS) | 1 | $0.00 | Annual Administrative Fee - 4 Years | 4 | $0.00 | ||
| Administrative Fee Year 2 2026 | 1 | $0.00 | |||||
| Administrative Fee Year 3 2027 | 1 | $0.00 | |||||
| Administrative Fee Year 4 2028 | 1 | $0.00 | |||||
| Administrative Fee Year 5 2029 (3 MONTHS) | 1 | $0.00 | |||||
| Maintenance Fee (Open > 36 Months) | Maintenance Fee (Open > 36 Months) | ||||||
| Price Per Claim Year 1 2025 (9 MONTHS) | 4,032 | $0.00 | Price Per Claim - 4 Year | 21,504 | $0.00 | ||
| Price Per Claim Fee Year 2 2026 | 5,376 | $0.00 | |||||
| Price Per Claim Fee Year 3 2027 | 5,376 | $0.00 | |||||
| Price Per Claim Fee Year 4 2028 | 5,376 | $0.00 | |||||
| Price Per Claim Fee Year 5 2029 (3 MONTHS) | 1,344 | $0.00 | |||||
| Bill Review Fee | Bill Review Fee | ||||||
| Per Line Fee Year 1 2025 (9 MONTHS) | 60,000 | $0.00 | Per Line Fee - 4 Year | 320,000 | $0.00 | ||
| Per Line Fee Year 2 2026 | 80,000 | $0.00 | |||||
| Per Line Fee Year 3 2027 | 80,000 | $0.00 | |||||
| Per Line Fee Year 4 2028 | 80,000 | $0.00 | |||||
| Per Line Fee Year 5 2029 (3 MONTHS) | 20,000 | $0.00 | |||||
| 4 Year Estimated Total Administration Costs before discount | $0.00 | 4 Year Estimated Total Administration Costs before discount | $0.00 | ||||
| Multi-Contract Discount (to be taken off of rates above) | $0.00 | Multi-Contract Discount (to be taken off of rates above) | $0.00 |
| Claims Funding Estimates | Claims Funding Estimate | ||||
| Claims Reimbursement Year 1 2025 (9 MONTHS) | $16,875,000.00 | 1 | $16,875,000.00 | Claims Reimbursement - 4 Years | $90,000,000.00 |
| Claims Reimbursement Year 2 2026 | $22,500,000.00 | 1 | $22,500,000.00 | ||
| Claims Reimbursement Year 3 2027 | $22,500,000.00 | 1 | $22,500,000.00 | ||
| Claims Reimbursement Year 4 2028 | $22,500,000.00 | 1 | $22,500,000.00 | ||
| Claims Reimbursement Year 5 2029 (3 MONTHS) | $5,625,000.00 | 1 | $5,625,000.00 |
| Claims Funding & Administrative Fees Estimated TOTAL | Claims Funding & Administrative Fees Estimated TOTAL | ||
| Year 1 2025 (9 MONTHS) | $16,875,000.00 | Total Estimated Contract Utilization | $90,000,000.00 |
| Year 2 2026 | $22,500,000.00 | ||
| Year 3 2027 | $22,500,000.00 | ||
| Year 4 2028 | $22,500,000.00 | ||
| Year 5 2029 (3 MONTHS) | $5,625,000.00 | ||
| Total Estimated Contract Utilization | $90,000,000.00 |
| Notes: | ||||||||||
| (1) The State of Michigan does not guarantee a minimum or maximum volume of claims. | ||||||||||
| (2) For purposes of proposal comparison, estimates in the tables above will be utilized. | ||||||||||
| (3) No show fees and cancellation fees vary between physicians and will not be evaluated. | ||||||||||
| (4) IME Fees are evaluated separately from Administrative Fees as part of overall best value consideration. | ||||||||||
| IME - Table 3 | ||||||||||
| Independent Medical Examinations (IME by Specialty) - Range for Michigan | 2025 | 2026 | 2027 | 2028 | 2029 | |||||
| LOW | HIGH | LOW | HIGH | LOW | HIGH | LOW | HIGH | LOW | HIGH | |
| PM &R | ||||||||||
| Neuro | ||||||||||
| Ortho | ||||||||||
| Psych |
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