Schedule B Pricing.xlsx
XLSX spreadsheet 21 KB Posted
- Attached to
- MPSERS Dental Benefit Plan Administration
- Solicitation number
- RFP 171 200000001290 3
- Issued by
- Michigan
About this file
This Schedule B Pricing document is a pricing submission template for the State of Michigan RFP No. 200000001290. Contractors must submit pricing schedules using the eight table formats provided for contract activities identified in Schedule A, with proposals required for both self-insured and fully-insured plan options. The contract term spans four years, commencing January 1, 2021, and ending December 31, 2024, with pricing submitted on a flat monthly fee basis. Membership assumptions range from 167,447 contracts and 260,696 members in Year 1 to 177,696 contracts and 276,653 members in Year 4, reflecting an estimated 2% annual growth rate. Contractors must complete claims repricing based on data provided in Schedules C1 and C2, calculating one-year averages for covered amounts and member out-of-pocket claims costs and entering these figures into specified cells within the pricing tables.
Pricing must be submitted in modifiable format (Microsoft Word or Excel) and may include a non-modifiable PDF version. All costs must be included in the proposal, encompassing administration fees, one-time charges, setup fees, and any other potential charges to the State. Contractors must provide firm prices for each of the four annual years on Annual Rate Pricing tables and one fixed rate for the entire contract term on Fixed Rate Pricing tables. The State of Michigan does not guarantee minimum or maximum service volumes or claims conversions. Pricing proposals must certify independent price development without consultation or agreement with other contractors. Contractors must also respond to specific questions regarding additional products or services available at no cost to the plan sponsor and, for fully-insured options, any variations from the benefit plan described in Schedule J.
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Sheet1
STATE OF MICHIGAN
| RFP No. 200000001290 |
| SCHEDULE B |
| PRICING |
| 1. The Contractor must provide a pricing schedule for the proposed Contract Activities identified in Schedule A using the 8 table formats included in this schedule for the State’s choosing. The Contractor must submit pricing for both self-insured and fully-insured plans for the State’s consideration. The Contractor must complete only areas shaded in yellow and must not alter data or formulas in cells that are not shaded yellow. |
| 2. The Contractor must also complete repricing for the claims data in Schedule C1 and C2. The Contractor must add their "Covered Amount" totals from C1 and C2, then divide by 2 for a 1-Year average. The Contractor must enter this average into the tables below in Cells: E34, J34, O31, T31. The Contractor must also add their "Member Out-of-Pocket Claims Costs" totals from C1 and C2 , then divide by 2 for a 1-Year average. The Contractor must enter this average into the tables below in Cells: E38, J38, O35, T35, E63, J63, O60, T60. |
| 3. 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., shipping and handling, per piece pricing, and palletizing). |
| 4. By submitting its proposal, the Contractor certifies that the prices were arrived at independently, and without consultation, communication, or agreement with any other Contractor. |
| 5. The Contract will be for a four-year period with service commencing January 1, 2021, and ending December 31, 2024. Firm prices are to be quoted for each of the four years on the "Annual Rate Pricing" tables, and one fixed rate for the term on the "Fixed Rate Pricing" tables. The price quoted each year must be firm for the period January 1 of that year through December 31 of that year. Prices are to be quoted on a flat monthly fee for all services specified by this Contract. |
| Membership Assumptions: | ||||
| The Membership assumptions are listed below. Future years were estimated at an average growth rate of 2% annually. These are only estimates based on the best available data, and are subject to change throughout the year. | ||||
| Plan Year 1 | Plan Year 2 | Plan Year 3 | Plan Year 4 | |
| Total Contracts: | 167,447 | 170,796 | 174,212 | 177,696 |
| Total Members: | 260,696 | 265,910 | 271,228 | 276,653 |
| Pricing Proposal |
| Enter the administration fees or premium for the rate types listed below and your Claims Cost from the claims repricing as detailed in the RFP. The assumed membership counts above will be used in the calculation and a 2% illustrative growth rate will be applied to the Claims Cost. Also include the estimated Member Out-of-Pocket costs from the claims repricing. Only the light yellow boxes should be populated, and it is necessary that they only be populated with numeric values. For any comments, use the boxes below the tables to enter any explanation of claims that couldn't be repriced, caveats to the pricing quote, or other notes relevant to your pricing. |
| Self Funded Option | |||
| Annual Rate Pricing | Fixed Rate Pricing | ||
| Contract Pricing -Annual Rate | Member Pricing - Annual Rate | Contract Pricing - Fixed Rate | Member Pricing - Fixed Rate |
| Year | Estimated Contract Count | Rate (Per Contract Per Month Administration Fee) | Annual Total | Year | Estimated Member Count | Rate (Per Member Per Month Administration Fee) | Annual Total | Term | Estimated Contract Count | Rate (Per Contract Per Month Administration Fee) | Annual Total | Term | Estimated Member Count | Rate (Per Member Per Month Administration Fee) | Annual Total |
| 2021 | 167,447 | $ - 0 | $ - 0 | 2021 | 260,696 | $ - 0 | 2021-2024 | 172,538 | 0 | $ - 0 | 2021-2024 | 268,622 | - 0 | ||
| 2022 | 170,796 | $ - 0 | $ - 0 | 2022 | 265,910 | $ - 0 | 4-Year total | $ - 0 | 4-Year total | $ - 0 | |||||
| 2023 | 174,212 | $ - 0 | $ - 0 | 2023 | 271,228 | $ - 0 | |||||||||
| 2024 | 177,696 | $ - 0 | $ - 0 | 2024 | 276,653 | $ - 0 | 1-Year Claims Cost (From Claims Repricing) | 1-Year Claims Cost (From Claims Repricing) | |||||||
| 4-Year total | $ - 0 | 4-Year total | $ - 0 | Estimated 4-Year Claims Cost | $ - 0 | Estimated 4-Year Claims Cost | $ - 0 |
| 1-Year Claims Cost (From Claims Repricing) | $ - 0 | 1-Year Claims Cost (From Claims Repricing) | Estimated Total System Cost | $ - 0 | Estimated Total System Cost | $ - 0 | |
| Estimated 4-Year Claims Cost | $ - 0 | Estimated 4-Year Claims Cost | $ - 0 | Member Out-of-Pocket Claims Costs | Member Out-of-Pocket Claims Costs | ||
| Notes: |
(1) The State of Michigan does not guarantee a minimum or maximum volume of services, claims and conversions.
(2) For purposes of proposal comparison, estimates in the tables above and Schedule C will be utilized. Also see above Note 1.
| Estimated Total System Cost | $ - 0 | Estimated Total System Cost | $ - 0 |
| Member Out-of-Pocket Claims Costs | Member Out-of-Pocket Claims Costs | ||
| Notes: |
(1) The State of Michigan does not guarantee a minimum or maximum volume of services, claims and conversions.
(2) For purposes of proposal comparison, estimates in the tables above and Schedule C will be utilized. Also see above Note 1.
Enter Pricing Proposal Notes Here, including any discussion of claims that couldn't be repriced, caveats, etc.: Enter Pricing Proposal Notes Here, including any discussion of claims that couldn't be repriced, caveats, etc.:
a. Please list any additional products or services (if any) that would be available to Members at no cost to Plan Sponsor with a Self-Funded Plan.
Bidder Response:
| Fully Insured Option | |||
| Annual Rate Pricing | Fixed Rate Pricing | ||
| Contract Pricing - Annual Rate | Member Pricing - Annual Rate | Contract Pricing - Fixed Rate | Member Pricing - Fixed Rate |
| Year | Estimated Contract Count | Rate (Per Contract Per Month Administration Fee) | Annual Total | Year | Estimated Member Count | Rate (Per Member Per Month Administration Fee) | Annual Total | Term | Estimated Contract Count | Rate (Per Contract Per Month Administration Fee) | Annual Total | Term | Estimated Member Count | Rate (Per Member Per Month Administration Fee) | Annual Total |
| 2021 | 167,447 | $ - 0 | 2021 | 260,696 | $ - 0 | 2021-2024 | 172,538 | $ - 0 | 2021-2024 | 268,622 | $ - 0 | ||||
| 2022 | 170,796 | $ - 0 | 2022 | 265,910 | $ - 0 | 4-Year Total System Cost | $ - 0 | 4-Year Total System Cost | $ - 0 | ||||||
| 2023 | 174,212 | $ - 0 | 2023 | 271,228 | $ - 0 | ||||||||||
| 2024 | 177,696 | $ - 0 | 2024 | 276,653 | $ - 0 | Member Out-of-Pocket Claims Costs | Member Out-of-Pocket Claims Costs | ||||||||
| 4-Year Total System Cost | $ - 0 | 4-Year Total System Cost | $ - 0 | Notes: |
(1) The State of Michigan does not guarantee a minimum or maximum volume of services, claims and conversions.
(2) For purposes of proposal comparison, estimates in the tables above and Schedule C will be utilized. Also see above Note 1.
| Member Out-of-Pocket Claims Costs | Member Out-of-Pocket Claims Costs |
| Notes: |
(1) The State of Michigan does not guarantee a minimum or maximum volume of services, claims and conversions.
(2) For purposes of proposal comparison, estimates in the tables above and Schedule C will be utilized. Also see above Note 1.
Enter Pricing Proposal Notes Here, including any discussion of claims that couldn't be repriced, caveats, etc.: Enter Pricing Proposal Notes Here, including any discussion of claims that couldn't be repriced, caveats, etc.:
a. Please list the variations from the benefit plan described in Schedule J that would be required if Plan Sponsor were fully insured instead of self-funded.
Bidder Response:
| b. Please list any additional products or services (if any) that would be available to Members at no cost to Plan Sponsor for a Fully-Insured Plan. |
| Bidder Response: |
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