Tirana HI Solicitation QA number 2.docx

19AL6020R0001 Questions & Answers November 4, 2020

All Prospective Offerors

Re: Solicitation 19AL6020R0001: Health Insurance Contract

Dear Prospective Offerors:

In reference to this solicitation, please find below a second list of questions and answers received from prospective offerors. These questions are listed below, with responses embedded therein.

Question No. 1: Can you please confirm if both parties can exit the contract if in year 2 if we fail to reach an agreement on premium adjustment?

Response No. 1: Once the CO exercises an option, unless there is another reason during the period of performance to terminate, performance is expected to be completed as contracted for by the contractor. EPA adjustments will be considered; however, we expect that an agreed upon process will prevail.

Question No. 2: Can you please provide us with the details of the Dispute Clause mentioned in section “B.4. ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS”

Response No. 2: The Disputes clause is located in Section I 52.233-1 DISPUTES (MAY 2014) Alternate I (DEC 1991) and the full text version can be provided at www.acquisition.gov.

Question No. 3: Can we add the following Renewal clause:

►Rate Insurance Year N+1= Rates Insurance Year N * (1+X) ►Example: (1+X)= 1.05; Then Rate Insurance Year N+1 = Rates Insurance Year N * (1.05) → i.e. +5% increase to premium rates.

1+X = ((R+IBNR)*(1+i))/(P*(1-Fees)) “R” Total amount of claims settled in respect of Insurance Year N "IBNR" Incurred But Not Reported: are calculated by the insurer up to end of Insurance Year N "P" Total amount of Gross Premiums collected and remaining to be collected in respect of Insurance Year N, as projected by the insurer Fees All applicable account fees (Administration fees and Insurance margin) "i" Medical inflation - as calculated by the insurer.

Response No. 3: NO

Question No. 4: B.1.1. Official Residence Expense (ORE) Staff and American Employee Recreation Association (AERA) are included under this contract only as a riders.

Please confirm that the enrolment for these categories is optional ?

Response No. 4: Riders are part of this contract requirement per the contract paragraph provided below; however, it is up to the individual enrollee if they choose to have coverage.

B.1.1. Official Residence Expense (ORE) Staff and American Employee Recreation Association (AERA) are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff), and the Embassy Association (for AERAs) at the rates specified below. Excess Coverage (C.1.1.19) is included under this contract only as rider benefits; the Contractor shall bill the individual covered at the rates specified below. See Section G for billing procedures. Note that USG is not responsible, nor liable, for any riders.

Question No. 5: Can we review the Premium for riders on a yearly basis?

Response No. 5: Unless there is an EPA adjustment approved by the CO, riders will be billed to the individual enrollee at the option year rates already specified in the contract

Thank you for your interest in this solicitation.

Sincerely, Sally B. Lewis