Tirana HI Solicitation QA number 3 Cleared.docx

19AL6020R0001 Questions & Answers November 9, 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: Based on the first round of Q&A document: 1. Response No. 43 and Response No. 45 contradict Response No. 42. We have found not only covered limits (for annual maximum, optical, dental, etc.) have significantly increased under the new plan but also new benefits (i.e. implants are new coverage under the dental coverage, frames are new coverage under optical, orthodontic. Psychiatric and drug abuse, pediatric etc) have been added to new table of benefits mandated by the Embassy. Please clarify if we will be required to meet the new plan benefits or required to retain the old benefits as implied in Response No. 42.

Response No. 1: There is no contradiction between Q. 42, Q.43 and Q.45.

Q.42 refers to the current health insurance contract that Embassy has still in effect. As such, Embassy has confirmed that there has been no changes to the current table of benefits under the current health insurance contract during the last years of coverage.

Q. 43 refers to a completely new benefit “Excess Coverage “added under the terms of the new health insurance contract. Therefore, since this benefit is newly added to become effective in the new contract, there is no claim history linked to this benefit during the current contract. Please note that Excess Coverage is priced separately, is a rider to the contract and any employee wishing to enroll will do so separately and pay the entire premium for that one optional benefit directly to the vendor.

Q.45 also refers to a newly added benefit as mentioned in C.1.1.13 Mental Health and Substance Abuse Care, and as such there is no claim history related to this benefit under the current contract.

Summary: The offeror is required to meet the new health insurance plan benefits as stipulated in the RFP. Please note that “implants” are not covered under the dental benefit per Amendment One.

Question No. 2: The 5th year claims amount in the Claims Table listed under Response No.3 contain certain estimated amounts. Please clarify the methodology used for the estimating an amount of ALL 23,244,746; and if this amount indeed includes ongoing catastrophic claims and the COVID risks (fairly recent claims/risk)?

Response No. 2: These are calculated based on payments to the current contractor (paid claims + retention amounts). Year 5 are estimates based on the number of families and trend of claims. We have calculated an estimated amount of claims for 5th year of coverage, meaning we expect the current vendor to provide us with final claim amount information once the year is completed, and also specify if catastrophic claims and Covid claims are included. From April 2020-October 2020 no Covid related claims have been accepted from the current vendor to be reimbursed.

Question No. 3: Response no. 1 on first round of Q&A states “All documents shall be translated into English and certified by notary”. Please explain if the answer is applicable for all documents i.e. such as references from clients or only to L.9 – Financial Statement

Response No. 3: As specified on Response no.1 of the first round of Q&A document, all documents shall be translated into English and certified by a notary.

Question No. 4: I would like to kindly ask for clarification on the following:In Section B Price proposal this table is required Biweekly rate per Premium. Shouldn’t it be annual rate?

Response No. 4: This should be as specified in the solicitation document.

Thank you for your interest in this solicitation.

Sincerely, Sally B. Lewis image1.png