Schedule B - Pricing Matrix Final.xlsx
XLSX spreadsheet 16 KB Posted
- Attached to
- Vision Insurance Plan Administration for CSC
- Solicitation number
- RFP-171-180000001030-4
- Issued by
- Grand Traverse County, Lansing City, Michigan
About this file
This is a pricing matrix (Schedule B) for RFP No. 180000001030, which outlines the pricing structure requirements for a three-year contract period from October 1, 2018, through September 30, 2021. The contract involves healthcare administration services for a membership base of 198,835 total members across 101,592 contracts, broken down into different coverage categories: Contract Holder Only (42,138), Contract Holder & Spouse (67,728), Contract Holder & Children (17,283), and Full Family (71,122).
The pricing matrix requires contractors to provide Per Contract Per Month (PCPM) administrative service fees and claims costs based on the average of FY16 and FY17 claims data from Schedule F. The document specifies that all pricing must include all costs, including one-time charges, setup fees, and potential costs. Contractors must provide Pass-Through Pricing to Plan Sponsors and cannot charge amounts above what is paid to Providers. Quick payment terms and associated discounts are encouraged, though specific percentages are to be proposed by the contractor. The pricing must be submitted in both modifiable (Excel/Word) and non-modifiable (PDF) formats.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP 180000001030 Questions and Answers Final.docx | DOCX document | |
| Schedule F - Provider Cost Claims Data Final.XLSX | XLSX spreadsheet | |
| Schedule J Safeguard Requirements of Confidential Data Final.docx | DOCX document | |
| Proposal Instructions and Vendor Questions Worksheet Final.docx | DOCX document | |
| Schedule G - Provider Location Data for Disruption Analysis Final_Rev 2-28-18.xlsx | XLSX spreadsheet | |
| Schedule H - Sample Claims Report and Invoice Format Final.xlsx | XLSX spreadsheet | |
| Schedule I - SLA Reporting Format Final.pdf | ||
| Schedule A - Final.docx | DOCX document | |
| Schedule C - Plan Design Final.docx | DOCX document | |
| Schedule E - HIPAA 834 File Layouts Final.pdf | ||
| Schedule D - GeoAccess Data Final_Rev 2-28-18.xlsx | XLSX spreadsheet | |
| Standard Contract Terms Final.docx | DOCX document | |
| Vision RPF Q&A #28.xlsx | XLSX spreadsheet | |
| Vision RPF Q&A #33.xlsx | XLSX spreadsheet |
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Text version
Pricing Matrix
| Request For Proposal No. 180000001030 |
| SCHEDULE B - PRICING MATRIX |
| 1. The Contractor must provide a pricing schedule for the proposed Contract Activities identified in Schedule A using the tables below. The Contractor must complete only areas shaded in light blue and must not alter data or formulas in cells that are not shaded light blue. |
| 2. The Contractor must also complete repricing for the claims data in Schedule F. See also Schedule A Section 1.A.11. |
| 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. |
| 4. 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. |
| 5. The Contractor must provide Pass-Through Pricing to Plan Sponsor. The Contractor must not charge Plan Sponsor or any Member any amount above that which is paid to the Provider under the terms of the contract between the Contractor and the Provider. |
| 6. By submitting its proposal, the Contractor certifies that the prices were arrived at independently, and without consultation, communication, or agreement with any other Contractor. |
| 7. The Contract will be for a three-year period with service commencing October 1, 2018, and ending September 30. 2021. For Annual-Rate Pricing, the price quoted each year must be firm for the period October 1 of that year through September 30 of that year. |
| Membership Assumptions: | |
| Current Membership is based on recent available data and is subject to change throughout the year and contract. | |
| Contract Type | Current Membership |
| Total Members: | 198,835 |
| Total Contracts: | 101,592 |
| Contract Holder Only | 42,138 |
| Contract Holder & Spouse | 67,728 |
| Contract Holder & Children | 17,283 |
| Full Family | 71,122 |
Three Year Pricing Proposal:
Instructions: Please enter your proposed administrative fees below. Also enter your estimated claims cost by taking the average of your "Total Claims Amount" from FY16 & 17 in Schedule F (from column E). The membership information above will be used for the calculations. Only the light blue boxes should be populated, and only populated with numeric values.
For comments, please use the box below this table to enter any explanation of claims that couldn't be repriced, caveats to the pricing quote, or other notes salient to your pricing.
| Pricing Option | Plan Year 1 | Plan Year 2 | Plan Year 3 | Total Cost over 3 Years |
| Self Funded Option |
Per Contract Per Month (PCPM) - Administrative Service Only Fee $ - 0 $ - 0 $ - 0 $ - 0
| Claims Cost (From Claims Repricing from Schedule F) | ||||
| (Total Claims Cost FY16 + FY17 / 2 = Average Annual Claims Cost) | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Total System Cost: $ - 0 $ - 0 $ - 0 $ - 0
Enter Three Year Pricing Proposal Notes here, including any discussion of claims that couldn't be repriced, caveats, etc.:
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: ________ % discount off invoice if paid within ________ days after receipt of invoice.
File details come from the government source that posted it. Updated .