Attachment_A-Medical_Pricing-Categories_A_and_B.xlsx
XLSX spreadsheet 40 KB Posted
- Solicitation number
- SFR63016R0011
- Issued by
-
Department of State US Embassy Paris
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RFP Health Insurance
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| File | Type | Posted |
|---|---|---|
| Attachment_F_-_Statistic_Report_of_Incumbent_Contractor-PREVOYANCE.pdf | ||
| Attachment_E-Staff_Statistics_-_Unclassified_Information.xls | XLS spreadsheet | |
| Attachment_F_-_Statistic_Report_of_Incumbent_Contractor-HEALTH.pdf | ||
| Attachment_C-Prvoyance_Pricing.xlsx | XLSX spreadsheet | |
| Attachment_B-1_Medical_Coverage_-_Social_Security_with_English_translation.xlsx | XLSX spreadsheet | |
| Attachment_B-2_Medical_Coverage_-_CSR_with_English_Translation.xlsx | XLSX spreadsheet | |
| Attachment_A-1-Medical_Pricing-Categories_C_and_D.xlsx | XLSX spreadsheet | |
| RFP_Health_Insurance-Final.docx | DOCX document | |
| Attachment_D-Prvoyance_Coverages_-_SS_and_CSR_w_Translation.xlsx | XLSX spreadsheet |
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A Health-Base Year
| ATTACHMENT A - PRICES/PREMIUMS FOR MEDICAL COVERAGE | |||||||||
| CLIN | Current Members of the U.S. Mission | Estimated Members | Premium per Month & per Member, € | Retention Amount per Mo, € per pers.* | Total / mo / pers | Total / Est mem/ mo | Total Amount for one contract year, € | AG2R Category | Contract Value based on current members/Yr |
Category A - Employees Affiliated to French Social Security
A-1 Basic Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Base) Empl-PP USG-PP
| 1001 | Employees (Cadres et Non-cadres) | 111 | 111 | € 0.00 | € 0.00 | € - 0 | AB1 | € - 0 | 0 | 0 |
| 1002 | Spouses | 11 | 11 | € 0.00 | € 0.00 | € - 0 | AB5 | € - 0 | ||
| 1003 | Children | 34 | 34 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-2 High Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Haute)
| 2001 | Employees (Cadres et Non-cadres) | 285 | 285 | € 0.00 | € 0.00 | € - 0 | AH1 | € - 0 | 0 | 0 | 0 |
| 2002 | Spouses | 58 | 58 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 2003 | Children | 110 | 110 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-3 Basic Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Base)
| 3001 | Employees (Cadres et Non-cadres) | 0 | 1 | € 0.00 | € 0.00 | € - 0 | AB2 | € - 0 | 0 | 0 |
| 3002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | |||
| 3003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-4 High Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Haute)
| 4001 | Employees (Cadres et Non-cadres) | 5 | 5 | € 0.00 | € 0.00 | € - 0 | AH2 | € - 0 | 0 | 0 | 0 |
| 4002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 4003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
Category B - Employees Not-Affiliated to French Social Security
B-1 Basic Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Base)
| 5001 | Employees (Cadres et Non-cadres) | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AB3 | € - 0 | 0 |
| 5002 | Spouses | 1 | 1 | € 0.00 | € 0.00 | € - 0 | AB4 | € - 0 | |
| 5003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B-2 High Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Haute)
| 6001 | Employees (Cadres et Non-cadres) | 14 | 14 | € 0.00 | € 0.00 | € - 0 | AH3 | € - 0 | 0 | 0 | 0 |
| 6002 | Spouses | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AH4 | € - 0 | |||
| 6003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B.2.2.1 Base Year Prices for Medical Coverage € - 0 € - 0
* Retention amount shall remain unchanged throughout the whole period of contract. Offeror shall enter a value not a percentage
Solicitation: SFR63017R0013 Attachment A - Base Year Page: &P of &N
A Health-First Option Yr
| ATTACHMENT A - PRICES/PREMIUMS FOR MEDICAL COVERAGE | |||||||||
| CLIN | Current Members of the U.S. Mission | Estimated Members | Premium per Month & per Member, € | Retention Amount per Mo, € per pers.* | Total / mo / pers | Total / Est mem/ mo | Total Amount for one contract year, € | AG2R Category | Contract Value based on current members/Yr |
Category A - Employees Affiliated to French Social Security
A-1 Basic Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Base) Empl-PP USG-PP
| 1001 | Employees (Cadres et Non-cadres) | 111 | 111 | € 0.00 | € 0.00 | € - 0 | AB1 | € - 0 | 0 | 0 |
| 1002 | Spouses | 11 | 11 | € 0.00 | € 0.00 | € - 0 | AB5 | € - 0 | ||
| 1003 | Children | 34 | 34 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-2 High Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Haute)
| 2001 | Employees (Cadres et Non-cadres) | 285 | 285 | € 0.00 | € 0.00 | € - 0 | AH1 | € - 0 | 0 | 0 | 0 |
| 2002 | Spouses | 58 | 58 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 2003 | Children | 110 | 110 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-3 Basic Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Base)
| 3001 | Employees (Cadres et Non-cadres) | 0 | 1 | € 0.00 | € 0.00 | € - 0 | AB2 | € - 0 | 0 | 0 |
| 3002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | |||
| 3003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-4 High Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Haute)
| 4001 | Employees (Cadres et Non-cadres) | 5 | 5 | € 0.00 | € 0.00 | € - 0 | AH2 | € - 0 | 0 | 0 | 0 |
| 4002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 4003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
Category B - Employees Not-Affiliated to French Social Security
B-1 Basic Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Base)
| 5001 | Employees (Cadres et Non-cadres) | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AB3 | € - 0 | 0 |
| 5002 | Spouses | 1 | 1 | € 0.00 | € 0.00 | € - 0 | AB4 | € - 0 | |
| 5003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B-2 High Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Haute)
| 6001 | Employees (Cadres et Non-cadres) | 14 | 14 | € 0.00 | € 0.00 | € - 0 | AH3 | € - 0 | 0 | 0 | 0 |
| 6002 | Spouses | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AH4 | € - 0 | |||
| 6003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B.2.2.2 First Option Year Prices for Medical Coverage € - 0 € - 0
* Retention amount shall remain unchanged throughout the whole period of contract. Offeror shall enter a value not a percentage
Solicitation: SFR63017R0013 Attachment A - First Option Year Page: &P of &N
A Health-Second Option Yr
| ATTACHMENT A - PRICES/PREMIUMS FOR MEDICAL COVERAGE | |||||||||
| CLIN | Current Members of the U.S. Mission | Estimated Members | Premium per Month & per Member, € | Retention Amount per Mo, € per pers.* | Total / mo / pers | Total / Est mem/ mo | Total Amount for one contract year, € | AG2R Category | Contract Value based on current members/Yr |
Category A - Employees Affiliated to French Social Security
A-1 Basic Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Base) Empl-PP USG-PP
| 1001 | Employees (Cadres et Non-cadres) | 111 | 111 | € 0.00 | € 0.00 | € - 0 | AB1 | € - 0 | 0 | 0 |
| 1002 | Spouses | 11 | 11 | € 0.00 | € 0.00 | € - 0 | AB5 | € - 0 | ||
| 1003 | Children | 34 | 34 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-2 High Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Haute)
| 2001 | Employees (Cadres et Non-cadres) | 285 | 285 | € 0.00 | € 0.00 | € - 0 | AH1 | € - 0 | 0 | 0 | 0 |
| 2002 | Spouses | 58 | 58 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 2003 | Children | 110 | 110 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-3 Basic Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Base)
| 3001 | Employees (Cadres et Non-cadres) | 0 | 1 | € 0.00 | € 0.00 | € - 0 | AB2 | € - 0 | 0 | 0 |
| 3002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | |||
| 3003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-4 High Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Haute)
| 4001 | Employees (Cadres et Non-cadres) | 5 | 5 | € 0.00 | € 0.00 | € - 0 | AH2 | € - 0 | 0 | 0 | 0 |
| 4002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 4003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
Category B - Employees Not-Affiliated to French Social Security
B-1 Basic Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Base)
| 5001 | Employees (Cadres et Non-cadres) | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AB3 | € - 0 | 0 |
| 5002 | Spouses | 1 | 1 | € 0.00 | € 0.00 | € - 0 | AB4 | € - 0 | |
| 5003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B-2 High Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Haute)
| 6001 | Employees (Cadres et Non-cadres) | 14 | 14 | € 0.00 | € 0.00 | € - 0 | AH3 | € - 0 | 0 | 0 | 0 |
| 6002 | Spouses | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AH4 | € - 0 | |||
| 6003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B.2.2.3. Second Option Year Prices for Medical Coverage € - 0 € - 0
* Retention amount shall remain unchanged throughout the whole period of contract. Offeror shall enter a value not a percentage
Solicitation: SFR63017R0013 Attachment A - Second Option Year Page: &P of &N
A Health-Third Option Yr
| ATTACHMENT A - PRICES/PREMIUMS FOR MEDICAL COVERAGE | |||||||||
| CLIN | Current Members of the U.S. Mission | Estimated Members | Premium per Month & per Member, € | Retention Amount per Mo, € per pers.* | Total / mo / pers | Total / Est mem/ mo | Total Amount for one contract year, € | AG2R Category | Contract Value based on current members/Yr |
Category A - Employees Affiliated to French Social Security
A-1 Basic Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Base) Empl-PP USG-PP
| 1001 | Employees (Cadres et Non-cadres) | 111 | 111 | € 0.00 | € 0.00 | € - 0 | AB1 | € - 0 | 0 | 0 |
| 1002 | Spouses | 11 | 11 | € 0.00 | € 0.00 | € - 0 | AB5 | € - 0 | ||
| 1003 | Children | 34 | 34 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-2 High Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Haute)
| 2001 | Employees (Cadres et Non-cadres) | 285 | 285 | € 0.00 | € 0.00 | € - 0 | AH1 | € - 0 | 0 | 0 | 0 |
| 2002 | Spouses | 58 | 58 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 2003 | Children | 110 | 110 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-3 Basic Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Base)
| 3001 | Employees (Cadres et Non-cadres) | 0 | 1 | € 0.00 | € 0.00 | € - 0 | AB2 | € - 0 | 0 | 0 |
| 3002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | |||
| 3003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-4 High Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Haute)
| 4001 | Employees (Cadres et Non-cadres) | 5 | 5 | € 0.00 | € 0.00 | € - 0 | AH2 | € - 0 | 0 | 0 | 0 |
| 4002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 4003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
Category B - Employees Not-Affiliated to French Social Security
B-1 Basic Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Base)
| 5001 | Employees (Cadres et Non-cadres) | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AB3 | € - 0 | 0 |
| 5002 | Spouses | 1 | 1 | € 0.00 | € 0.00 | € - 0 | AB4 | € - 0 | |
| 5003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B-2 High Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Haute)
| 6001 | Employees (Cadres et Non-cadres) | 14 | 14 | € 0.00 | € 0.00 | € - 0 | AH3 | € - 0 | 0 | 0 | 0 |
| 6002 | Spouses | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AH4 | € - 0 | |||
| 6003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B.2.2.4. Third Option Year Prices for Medical Coverage € - 0 € - 0
* Retention amount shall remain unchanged throughout the whole period of contract. Offeror shall enter a value not a percentage
Solicitation: SFR63017R0013 Attachment A - Third Option Year Page: &P of &N
A Health-Fourth Option Yr
| ATTACHMENT A - PRICES/PREMIUMS FOR MEDICAL COVERAGE | |||||||||
| CLIN | Current Members of the U.S. Mission | Estimated Members | Premium per Month & per Member, € | Retention Amount per Mo, € per pers.* | Total / mo / pers | Total / Est mem/ mo | Total Amount for one contract year, € | AG2R Category | Contract Value based on current members/Yr |
Category A - Employees Affiliated to French Social Security
A-1 Basic Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Base) Empl-PP USG-PP
| 1001 | Employees (Cadres et Non-cadres) | 111 | 111 | € 0.00 | € 0.00 | € - 0 | AB1 | € - 0 | 0 | 0 |
| 1002 | Spouses | 11 | 11 | € 0.00 | € 0.00 | € - 0 | AB5 | € - 0 | ||
| 1003 | Children | 34 | 34 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-2 High Option-Employees affiliated to Social Security (Actif Régime Sécurité Sociale Option de Haute)
| 2001 | Employees (Cadres et Non-cadres) | 285 | 285 | € 0.00 | € 0.00 | € - 0 | AH1 | € - 0 | 0 | 0 | 0 |
| 2002 | Spouses | 58 | 58 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 2003 | Children | 110 | 110 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-3 Basic Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Base)
| 3001 | Employees (Cadres et Non-cadres) | 0 | 1 | € 0.00 | € 0.00 | € - 0 | AB2 | € - 0 | 0 | 0 |
| 3002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | |||
| 3003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
A-4 High Option-Employees affiliated to Alsace Social Security (Actif Régime Alsace Option de Haute)
| 4001 | Employees (Cadres et Non-cadres) | 5 | 5 | € 0.00 | € 0.00 | € - 0 | AH2 | € - 0 | 0 | 0 | 0 |
| 4002 | Spouses | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | ||||
| 4003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 |
Category B - Employees Not-Affiliated to French Social Security
B-1 Basic Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Base)
| 5001 | Employees (Cadres et Non-cadres) | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AB3 | € - 0 | 0 |
| 5002 | Spouses | 1 | 1 | € 0.00 | € 0.00 | € - 0 | AB4 | € - 0 | |
| 5003 | Children | 1 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B-2 High Option-Employees not-affiliated to Social Security (Actif NON Sécurité Sociale Option de Haute)
| 6001 | Employees (Cadres et Non-cadres) | 14 | 14 | € 0.00 | € 0.00 | € - 0 | AH3 | € - 0 | 0 | 0 | 0 |
| 6002 | Spouses | 2 | 2 | € 0.00 | € 0.00 | € - 0 | AH4 | € - 0 | |||
| 6003 | Children | 0 | 1 | € 0.00 | € 0.00 | € - 0 | € - 0 | 0 |
B.2.2.5. Fourth Option Year for Medical Coverage € - 0 € - 0
* Retention amount shall remain unchanged throughout the whole period of contract. Offeror shall enter a value not a percentage
Solicitation: SFR63017R0013 Attachment A - Fourth Option Year Page: &P of &N
Total
| Estimated Prices for Categories A & B |
| B.2.2.1. Base Year for Medical Coverage: |
B.2.2.2 First Option Year for Prices for Medical Coverage :
B.2.2.3 Second Option Year for Prices for Medical Coverage :
| B.2.2.4. Third Option Year Prices for Medical Coverage: |
| B.2.2.5. Fourth Option Year for Medical Coverage: |
| B.2.2.6. Total Estimated Contract Price for Medical Coverage: |
B.3.6. Total Estimated Contract Price for Prevoyance Insurance
Estimated Grand Total for Category A & B
Solicitation: SFR63016D0011
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