{"text_format":"3","workbook":"xlsx","n_sheets":9,"sheets":["ListBox","Introduction","Explanation","Financial Questionnaire","County Self-Insured Quote","HSA","Clinic Implementation Costs","Clinic Operating-Proposed Model","Monthly Claims and Enrollment"],"not_rendered":{"external_links":40,"defined_names":5292},"read":"whole","date_system":"1900"}

{"sheet":"ListBox","index":0,"n_rows":10,"n_cols":18,"rows_kept":10,"hidden":true}
["WSClientName","Company ABC"]
["WSPlanType","HMO/PPO/POS"]
["ListYesNo","Yes","No"]
["ListModel","Group","IPA","Mixed","Network","Staff","PPO Platform"]
["ListTaxStatus","For-Profit","Not-For-Profit"]
["ListAccreditation","Excellent","Commendable","Accredited","Provisional","Denied","Appealed by Plan","In Process","Revoked","Scheduled","Suspended","Under Review by NCQA","NHP Accreditation","NHP Under Review","NHP Expired","NHP NCQA Discretionary Review","NHP Initial Decision Pending","NHP Future Review Scheduled"]
["ListJCAHO","Accreditation Not Requested","Accreditation With Commendation","Accreditation Without Type I Recommendations","Accreditation With Type I Recommendations","Provisional Accreditation","Conditional Accreditation","Preliminary Denial of Accreditation","Accreditation Denied","Accreditation Watch"]
["ListAccreditationPPO","Full","One - Year","Provisional","Denied","Under Review","NCQA Discretionary Review"]
["ListURAC","Accredited","Not Accredited"]
["ListComplete","Completed","Not Completed"]

{"sheet":"Introduction","index":1,"n_rows":30,"n_cols":4,"rows_kept":30,"merged":[[0,1,0,3],[1,1,1,2],[2,1,2,4],[4,1,4,6],[5,1,5,3],[12,1,12,3],[13,1,13,3],[15,1,15,3],[16,2,16,5],[25,1,25,2],[26,1,26,2],[27,1,27,2],[28,1,28,2],[33,2,33,5],[34,2,34,5],[35,2,35,5]]}
[null,"Request for Medical Proposal (RFP) for Arlington County Government"]
[null,"RFP No. 21-HRD-RFP-141 Medical Plan"]
[null,"Arlington County Government hereinafter referred to as \"County\""]
[null,"Medical Financial Instructions"]
[null,"The cost portion of the Medical RFP will consist of the following:"]
[null,"Questionnaire File (s):  The Questionnaires and sheets to provide Explanations are contained in this Excel file.  You are expected to respond to the Questionnaire by entering your responses in this file.  The majority of the questions in the Questionnaire have been structured to elicit declarative responses through the use of drop down boxes."]
[]
[null,"To record your response:"]
[null,"*  Click on the response cell in the Response column;"]
[null,"*  Click on the down arrow which appears directly to the right of the cell;"]
[null,"*  Click on the response that best describes your answer."]
[]
[null,"To enter your responses where a numeric, percent or ratio value is indicated as the answer format, simply enter the value in the corresponding response cell."]
[null,"Next to each response cell, additional space is available for a brief text explanation.  However, if the length of the explanation is greater than 400 characters, you must go to the \"Explanation\" worksheet to provide your detailed explanation.  All explanations must be numbered to correspond to the questions to which they pertain and should be brief."]
[]
[null,"Worksheet Files:  Worksheet(s) to enter your proposal are contained within this Excel file.  Generally, the types of information that you will be entering into this file are financial quotes.  You are expected to provide the requested information by completing this workbook.  In addition, this file may also contain reference information (rate history, enrollment data, etc.) that will assist you in putting together your quote."]
[]
[null,"Questionnaire File (s):"]
[null,"Information",null,"Name of Worksheet"]
[null,"Introduction",null,"Introduction"]
[null,"Financial Questionnaire                                                                             ",null,"Financial Questionnaire"]
[null,"Explanations, if necessary                                                    ",null,"Explanation"]
[]
[null,"Worksheet File:"]
[null,"Information",null,"Name of Worksheet"]
[null,"Arlington County Government Self-Insured Quote- Full Replacement",null,"County Self-Insured Quote"]
[null,"Arlington County Government HSA Quote",null,"HSA"]
[null,"Arlington County Government Clinic Implementation Quote",null,"Clinic Implementation Costs"]
[null,"Arlington County Government Clinic Operating Quote",null,"Clinic Operating-Proposed Model"]
[null,"Claims and Enrollment",null,"Monthly Claims and Enrollment"]

{"sheet":"Explanation","index":2,"n_rows":9,"n_cols":3,"rows_kept":9}
[null,{"$f":"'Financial Questionnaire'!D1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[null,{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
[null,"Explanation"]
[]
[null,"This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response was given."]
[null,"Explanations must be numbered to correspond to the question to which they pertain and they must be brief."]
[]
[]
[null,"Section/ Question #","Explanation"]

{"sheet":"Financial Questionnaire","index":3,"n_rows":91,"n_cols":8,"rows_kept":91,"merged":[[0,3,0,6],[4,4,4,5]]}
[{"$nulls":3},{"$f":"Introduction!B1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[{"$nulls":3},{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
[{"$nulls":3}," Financial Questionnaire"]
[]
[{"$nulls":3},"To Offeror:  Use Column Q to provide a brief explanation. However if the length of the explanation is greater than 400 characters, you must use the \"Explanation\" worksheet to provide your detail explanation."]
[null,""]
[null,"","","MEDICAL RFP - Financial Questionnaire","Answer Format","Response","Explanation"]
[]
["I.","","","General Plan Information","Answer Format","Response","Explanation"]
[null,"1.",null,"Offeror Brand Name","text"]
[null,"2.",null,"Confirm the networks included in your quote for each of the County's plans.  If network varies for any particular geographical area, please explain and provide networks in those areas.","text"]
[null,"",""]
[null,"","","Financial - Underwriting Requirements/Premium Quotation and Program Fees","Answer Format","Response","Explanation"]
[null,"3.","","For self-insured quotes, provide your financial quotation in the worksheet(s), \"County's Quote\"","drop down box"]
[null,"4.",null,"Guaranteed Rate/Fee: four-year fixed price ASO initial contract term ","drop down box",null,null,"07/08/2020 Initial contract term will be 5 years"]
[null,"5.",null,"Rate Cap: optional years 5 - 10","drop down box",null,null,"07/08/2020 \"Optional years 6 -10"]
[null,"6.","","Describe the terms and conditions under which you have the right to modify the rates or administrative agreement and/or its fees.  If you need more space, please use the \"Explanation\" column and/or worksheet.","text"]
[null,"7.",null,"Offeror accepts that the County will not wire funds, pre-fund (imprest) the account, or allow a Offeror direct access to debit from the County account.  County preferred method is to be billed monthly.  The County will send ACH payments monthly based on that bill.","drop down box"]
[null,"8.","","The quoted rates/fees do not include commissions/compensation.","drop down box"]
[null,"9.","","The County will be reimbursed for 100% of claims paid in error, regardless of whether Offeror recoups the amount paid in error","drop down box"]
[null,"10.","","For the self-insured coverages requested, the claim amount paid will be the negotiated amount. In other words, the County will pay actual negotiated amount; none of the savings will be retained by your organization or shared with any other organization.","drop down box"]
[null,11,null,"Confirm that administrative fees will be paid monthly and that the administrative cost will be assessed on a per-employee-per-month (PEPM) basis based on the County's enrollment counts (self-bill), with no subsequent accounting or year-end reconciliation.  The PEPM fee can differ by plan type but not by enrollment tier (e.g. single/family).","drop down box"]
[null,12,"","Have you identified the costs for any services beyond those specified that you recommend the County consider that are not included in your quoted fees?  A description of each service, the charge of said service and your best estimate of the annual cost must be indicated on the pricing worksheets.","text"]
[null,"13.",null,"Confirm that in the event of termination, the Offeror selected will be responsible for administration of all claims incurred but not paid prior to termination date.  These claims will be processed for at least one year and no additional administrative fees will be charged.  The negotiated financial arrangement will remain in place for the duration.  ","drop down box"]
[null,"14.","a.","Confirm how Behavioral Health claims will be billed? Will this be a fully insured component that is billed or will BH claims be passed through to the County?","text"]
[null,null,"b.","Are Behavioral Health claims included in capitation fees?  If so, please provide the amount per charge or per claim.","text"]
[]
[null,"","","Financial - Ongoing Services","Answer Format","Response","Explanation"]
[null,"15.","a.","Confirm that you will provide a financial allowance for any communications requested by the County.","drop down box"]
[null,null,"b.","What is your financial allowance?","text"]
[null,"16.","a.","Your firm will support health plan legislation reporting and other requirements (Federal PPACA and other state health care reform).","drop down box"]
[null,null,"b.","Confirm that this service is included in your quoted fees.","drop down box"]
[null,"17.","a.","Your firm will be responsible for contracting with independent review firms (“IROs”) to provide external review of denied medical benefit claims under the County's Plan(s) to the extent required by the Patient Protection and Affordable Care Act of 2010.","drop down box"]
[null,null,"b.","Confirm that this service is included in your quoted fees.","drop down box"]
[null,"18.","a.","Your firm agrees to cover the cost of periodic plan wide mailings (e.g. SBCs, ID cards).","drop down box"]
[null,null,"b.","Confirm that this service is included in your quoted fees.","drop down box"]
[null,"",""]
[null,"","","Discount Guarantees","Answer Format","Response","Explanation"]
[null,null,"","Indicate the discount percent off of normal R&C charges that you are willing to guarantee for each of the following service categories:"]
[null,"19.",null,"Is your firm willing to guarantee discounts?","drop down box"]
[null,"20.","a.","Guaranteed Discounts","text"]
[null,"","","Network Name","text"]
[null,"","","Hospital Inpatient Discount ","percent, 1"]
[null,"","","Hospital Outpatient Discount","percent, 1"]
[null,"","","Physician Discount","percent, 1"]
[null,"","","Other Services Discount","percent, 1"]
[{"$nulls":3},"Overall Discount","percent, 1"]
[null,"","b.","Threshold for Penalty","text"]
[null,"","","Network Name","text"]
[null,"","","Hospital Inpatient Discount ","percent, 1"]
[null,"","","Hospital Outpatient Discount","percent, 1"]
[null,"","","Physician Discount","percent, 1"]
[null,"","","Other Services Discount","percent, 1"]
[{"$nulls":3},"Overall Discount","percent, 1"]
[null,"21.",null,"Penalty if Discount Guarantee not met.  Provide  the maximum dollar amount of the penalty at risk.","text"]
[]
[{"$nulls":3},"Trend Guarantees","Answer Format","Response","Explanation"]
[null,"22.",null,"Is your firm willing to guarantee medical trend?","drop down box"]
[null,"23.",null,"If so, what is your firm's medical trend guarantee?","text"]
[null,"24.",null,"Penalty if Trend Guarantee not met.  Provide  the maximum dollar amount of the penalty at risk.","text"]
[null,"",""]
["II.",null,null,"Cost Containment / Shared Savings Programs","Answer Format","Response","Explanation"]
[null,"1.","a.","List any other services for which shared savings fees or other non-claims/non-ASO fees are charged.  Provide a description of services/program including frequency of program, percentage of savings for recovery, estimated total fees for recovery on a per employee per month basis, and how fees for hospital audits are reported to the County.\n\nExamples of other services may include but are not limited to diagnosis related group (DRG) audit, overpayment recovery programs, credit balance recovery, bill negotiation services (professional and facility), facility R&C bill management, bill review and recovery, eligibility overpayment recovery, secondary vendor recoveries, medical implant device audits, provider credit balance recovery, inpatient admission retrospective review, pharmacy vendor recovery, class action recovery, fraud and abuse.","text"]
[null,null,"b.","Bill Negotiation Services Program Fees (% of Savings / PEPM)","text"]
[null,null,"c.","Complex Claim Review Fees (% of Savings / PEPM)","text"]
[null,null,"d.","Network Savings Program Fees (% of Savings / PEPM)","text"]
[null,null,"e.","Overpayment Program Fees (% of Savings / PEPM)","text"]
[null,null,"f.","Other (% of Savings / PEPM)","text"]
[]
["III.",null,null,"Wellness Allowance","Answer Format","Response","Explanation"]
[null,"1.","a.","Is your firm willing to provide a minimum of $50,000 allotment that the County may use for Wellness related services?","drop down box"]
[null,null,"b.","What is the amount the firm is willing to provide?","text"]
[null,null,"c.","Confirm that this allotment may be used at the County’s discretion to fund services provided by your organization, County developed and provided programs/services or services and/or programs/services provided by a third party.","drop down box"]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]
[null,"",""]

{"sheet":"County Self-Insured Quote","index":4,"n_rows":66,"n_cols":10,"rows_kept":66,"merged":[[6,2,6,3],[6,4,6,5],[6,6,6,7],[6,8,6,9],[18,1,19,1],[18,2,18,3],[18,4,18,5],[18,6,18,7],[18,8,18,9],[44,2,44,3],[44,4,44,5],[44,6,44,7],[44,8,44,9],[45,2,45,3],[45,4,45,5],[45,6,45,7],[45,8,45,9],[47,2,47,3],[47,4,47,5],[47,6,47,7],[47,8,47,9],[48,2,48,3],[48,4,48,5],[48,6,48,7],[48,8,48,9],[49,2,49,3],[49,4,49,5],[49,6,49,7],[49,8,49,9],[50,2,50,3],[50,4,50,5],[50,6,50,7],[50,8,50,9],[51,2,51,3],[51,4,51,5],[51,6,51,7],[51,8,51,9],[52,2,52,3],[52,4,52,5],[52,6,52,7],[52,8,52,9],[55,1,56,1],[55,2,55,3],[55,4,55,5],[55,6,55,7],[55,8,55,9],[56,2,56,3],[56,4,56,5],[56,6,56,7],[56,8,56,9],[57,2,57,3],[57,4,57,5],[57,6,57,7],[57,8,57,9],[58,2,58,3],[58,4,58,5],[58,6,58,7],[58,8,58,9],[59,2,59,3],[59,4,59,5],[59,6,59,7],[59,8,59,9],[60,2,60,3],[60,4,60,5],[60,6,60,7],[60,8,60,9],[61,2,61,3],[61,4,61,5],[61,6,61,7],[61,8,61,9],[65,2,65,3],[65,4,65,5],[65,6,65,7],[65,8,65,9]]}
[null,{"$f":"'Financial Questionnaire'!D1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[null,{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
[null,"Arlington County Government Self-Insured Rate Quote"]
[]
[]
[null,"Medical Enrollment Assumptions (April 2020)"]
[null,null,{"$f":"C19","v":"OAPIN Copay"},null,{"$f":"E19","v":"OAPIN Coinsurance"},null,{"$f":"G19","v":"HDHP"},null,"Comp (for Virgin Islands and Puerto Rico sited members)"]
[null,"Rating Tiers","# Active/COBRA","#  Retirees < 65","# Active/COBRA","#  Retirees < 65","# Active/COBRA","#  Retirees < 65","# Active/COBRA","#  Retirees < 65"]
[null,"EE",398,91,587,95,19,11,0,0]
[null,"EE + Sp",112,32,148,121,5,8,0,0]
[null,"EE + Child(ren)",123,22,194,27,3,1,0,0]
[null,"Family",261,25,473,22,6,0,0,0]
[null,"Total",{"$f":"SUM(C9:C12)","v":894},170,{"v":1402,"d":"1,402"},265,33,20,{"$f":"SUM(I9:I12)","v":0},0]
[null,"Note:  The County pays an ASO fee for each plan under which there is an enrollment.   There are Pre-65 spouses and children associated with Medicare-enrolled retirees that are included in the enrollment assumptions above."]
[]
[null,"Financial Quotation "]
[null,"Proposed Program Costs (Fees and Claims)"]
[null,"All quotes must be good for +/-15% enrollment fluctuations for each 12 month period."]
[null,"Fees Per Employee Per Month","OAPIN Copay",null,"OAPIN Coinsurance",null,"HDHP",null,"Comp"]
[null,null,"Included\n(Y/N)?","7/1/2021 - 6/30/2022\nProposed Mature Fees","Included\n(Y/N)?","7/1/2021 - 6/30/2022\nProposed Mature Fees","Included\n(Y/N)?","7/1/2021 - 6/30/2022\nProposed Mature Fees","Included\n(Y/N)?","7/1/2021 - 6/30/2022\nProposed Mature Fees"]
[null,"Claim Administration"]
[null,"Utilization Review Fees "]
[null,"Network Access Fees "]
[null,"Non-Standard Customer Service Hours"]
[null,"Behavioral Health Network Capitation, if applicable"]
[null,"Behavioral Health Claims Administration Fee"]
[null,"Care Management"]
[null,"Disease Management"]
[null,"Wellness Fees (Bundled Fee included in Wellness Quote)"]
[null,"Prescription Drugs - Interface Fee"]
[null,"Claims Fiduciary"]
[null,"Standard Reporting"]
[null,"Ad Hoc Reporting"]
[null,"800 Telephone Links (installation and usage)"]
[null,"Nurse Line"]
[null,"SBC's"]
[null,"Audits"]
[null,"HSA Administration"]
[null,"Decision Support Tool"]
[null,"Telehealth"]
[null,"Health risk assessment "]
[null,"Maternity Management "]
[null,"Other"]
[null,"Total",null,{"$f":"SUM(D21:D43)","v":{"v":0,"d":"$0.00"}},null,{"$f":"SUM(F21:F43)","v":{"v":0,"d":"$0.00"}},null,{"$f":"SUM(H21:H43)","v":{"v":0,"d":"$0.00"}},null,{"$f":"SUM(J21:J43)","v":{"v":0,"d":"$0.00"}}]
[null,"Shared Savings Fee (Please indicate the % of savings charged back to the plan and the cap on the fee per claim for any services not included in the fixed fees above)",{"$f":"C19","v":"OAPIN Copay"},null,{"$f":"E19","v":"OAPIN Coinsurance"},null,{"$f":"G19","v":"HDHP"},null,"Comp"]
[null,"Coordination of Benefits"]
[null,"Subrogation"]
[null,"Facility Fee Negotiation"]
[null,"Wrap Network Discounts"]
[null,"Additional Costs or Fees not Identified Above or in the Cost Containment/Shared Savings section of the Financial Questionnaire",{"$f":"C19","v":"OAPIN Copay"},null,{"$f":"E19","v":"OAPIN Coinsurance"},null,{"$f":"G19","v":"HDHP"},null,"Comp"]
[null,"Insert Here"]
[null,"Insert Here"]
[null,"Insert Here"]
[]
[null,"Rate Guarantees"]
[null,"Plan Year",{"$f":"C19","v":"OAPIN Copay"},null,{"$f":"E19","v":"OAPIN Coinsurance"},null,{"$f":"G19","v":"HDHP"},null,"Comp"]
[null,null,"Fee Guarantee Cap",null,"Fee Guarantee Cap",null,"Fee Guarantee Cap",null,"Fee Guarantee Cap"]
[null,"Second Year Rate Guarantee (7/1/2022 - 6/30/2023)"]
[null,"Third Year Rate Guarantee\n(7/1/2023 - 6/30/2024)"]
[null,"Fourth Year Rate Guarantee\n(7/1/2024 - 6/30/2025)"]
[null,"Rate Cap-  Year 5\n(7/1/2025 - 6/30/2026)"]
[null,"Rate Cap-  Year 6\n(7/1/2026 - 6/30/2027)"]
[null,"Rate Cap-  Year 7\n(7/1/2027 - 6/30/2028)"]
[null,"Rate Cap-  Year 8\n(7/1/2028 - 6/30/2029)"]
[null,"Rate Cap-  Year 9\n(7/1/2029 - 6/30/2030)"]
[null,"Rate Cap-  Year 10\n(7/1/2030 - 6/30/2031)"]

{"sheet":"HSA","index":5,"n_rows":26,"n_cols":6,"rows_kept":26,"merged":[[1,0,1,2],[5,0,5,3]]}
[{"$f":"Introduction!B1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
["Arlington County Government - Health Savings Account"]
[]
["Instructions: "]
["Please specify PEPM, Per account, or Fixed Fee.   Financial decisions will be based on total overall costs. Be sure to add any specific descriptions of cost items in the description column. "]
[]
[null,"Year 1 (7/1/2021-6/30/2022)","Year 2 (7/1/2022-6/30/2023)","Year 3 (7/1/2023-6/30/2024)","Year 4 (7/1/2024-6/30/2025)","Description"]
["Assumed HDHP Enrollment"]
["HSA Admin Fees (Per Account)"]
["Monthly Maintenance Fee"]
["Debit Card Fee "]
["Annual Renewal Fee"]
["Minimum Monthly Fee"]
["Enrollment Fees"]
["Paper Enrollment Materials Fee"]
["Electronic Enrollment Materials Fee"]
["HSA Fees Per Transaction"]
["Replacement of lost or stolen cards"]
["Account Closing Termination Fee"]
["Check Transaction Fee"]
["Withdrawal Form Fee"]
["Check Request Fee"]
["Periodic Statement Fee"]
["Terminated Employee HSA Monthly Continuation Fee"]
["Other Fees (specify)"]

{"sheet":"Clinic Implementation Costs","index":6,"n_rows":26,"n_cols":5,"rows_kept":26,"merged":[[5,0,5,4],[11,1,11,2],[11,3,11,4],[13,5,13,11],[25,0,25,4],[26,0,26,4],[27,0,27,4],[28,0,28,4]]}
[{"$f":"Introduction!B1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
["Arlington County Government - Clinic Implementation Cost"]
[]
["Instructions: "]
["All pricing models will be considered. (Cost+, PEPM, Fixed Fee)  Financial decisions will be based on total overall costs.  Space will be provided and maintained by Arlington at no cost to operating vendor.  General janitorial services, security and utilities will be provided at not cost.\n\nAll proposals should include estimates for all items including supplies, lab and pharmacy.\n\nPlease fill the table below with your cost estimates based on the pre-determined assumptions stated below. Be sure to add any specific descriptions of cost items in the description column. Ensure to fill the bottom table stating any further explanation or details on items in the pricing provided. "]
[]
["Staffing (Primary, Preventive and Acute Care) "]
["1 - Advanced Practitioner  NP (32 Hours Week)\n1 - Certified Medical Assistant (32 Hours Week)"]
[]
[]
["Expenses","Current (4 days per week)",null,"Alt Option (5 days per week)"]
["Primary, Preventive and Acute Clinic","Description ","Implementation ","Description ","Implementation "]
["Furnishings, Fixture and Equipment"," ",0," ",0]
["Salaries, wages and benefits "," ",0," ",0]
["Staff Recruitment, Training, Implementation",null,0,null,0]
["Dues, Licenses and Permits",null,0,null,0]
["Information Systems Hardware and Software (includes EMR)\nNote: These expenses are for setting up an internet service connection.  Vendors cannot use the County Network.",null,0,null,0]
["Promotion and Communication",null,0,null,0]
["General and Administrative Fee",null,0,null,0]
["Management Fee",null," ",null," "]
["Other direct expenses- specify in descriptions column ",null,0,null,0]
["Billed as incurred consumables- specify in descriptions column ",null,0,null,0]
["Total Annual Cost",null,{"$f":"SUM(C14:C23)","v":0},null,{"$f":"SUM(E14:E23)","v":0}]
[]
["Pricing Details (if needed)"]

{"sheet":"Clinic Operating-Proposed Model","index":7,"n_rows":34,"n_cols":7,"rows_kept":34,"merged":[[5,0,5,6],[24,2,24,6],[34,0,34,6],[35,0,35,6],[36,0,36,6]]}
[{"$f":"Introduction!B1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
["Arlington County Government - Clinic Operating Cost"]
[]
["Instructions: "]
["All pricing models will be considered. (Cost+, PEPM, Fixed Fee)  Financial decisions will be based on total overall costs.  Space will be provided and maintained by Arlington at no cost to operating vendor.  General janitorial services, security and utilities will be provided at not cost.  If PEPM or Fixed Fee pricing, show any variable or pass-through expenses in the line items below.  Show PEPM or Fixed Fee pricing in the \"Pricing Details\" at the bottom.\n\nAll proposals should include estimates for all items including supplies, lab and pharmacy.\n\nPlease fill the table below with your cost estimates based on the pre-determined assumptions stated below. Be sure to add any specific descriptions of cost items in the description column. Ensure to fill the bottom table stating any further explanation or details on items in the pricing provided. "]
[]
["Staffing (Primary, Preventive and Acute Care) "]
["1 - Advanced Practitioner  NP (24 Hours Week)\n1 - Certified Medical Assistant (24 Hours Week)"]
[]
[]
["Expenses"]
["Primary Clinic and Physical Therapy Costs","Description ","Year 1","Year 2","Year 3","Year 4","Year 5"]
["Salaries, wages and benefits ",null,0,0,0,0,0]
["Staff Training and Development",null,0,0,0,0,0]
["Staff replacement",null,0,0,0,0,0]
["Insurance- professional and general liability ",null,0,0,0,0,0]
["Dues, Licenses and Permits",null,0,0,0,0,0]
["Supplies- (Medical supplies, Vaccinations and injections supplies, Office Supplies, Lab Supplies)",null,0,0,0,0,0]
["Equipment maintenance",null,0,0,0,0,0]
["Professional services- third party lab diagnostic services ",null,0,0,0,0,0]
["Information Systems Hardware and Software (includes EMR)",null,0,0,0,0,0]
["Data lines",null,0,0,0,0,0]
["Promotion and Communication",null,0,0,0,0,0]
["Travel",null,"Travel expenses not allowed by County"]
["Utilities - (Postal Services, Express Delivery, Hazardous & Other Waste Removal, Other Utilities) -- County provides gas/electric, water/sewer",null,0,0,0,0,0]
["General and Administrative Fee",null,0,0,0,0,0]
["Management Fee",null,0,0,0,0,0]
["Other direct expenses- specify in descriptions column ",null,0,0,0,0,0]
["Billed as incurred consumables- specify in descriptions column ",null,0,0,0,0,0]
["Total Annual Cost (Current - 4 days per week)",null,{"$f":"SUM(C14:C30)","v":0},{"$f":"SUM(D14:D30)","v":0},0,0,0]
["Total Annual Cost (Alt Option - 5 days per week / 40 hours)",null,{"$f":"SUM(C15:C31)","v":0},0,0,0,0]
[]
["Pricing Details (if needed)  "]

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[null,{"$f":"'Financial Questionnaire'!D1","v":"Request for Medical Proposal (RFP) for Arlington County Government"}]
[null,{"$f":"Introduction!B2","v":"RFP No. 21-HRD-RFP-141 Medical Plan"}]
[null,"Monthly Claims and Enrollment"]
[]
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