Q&A_19AR2019R0003.pdf

Health Insurance Services

Solicitation No.: 19AR2019R0003

Pre-proposal Conference Question & Answers – Q&As

March 20, 2019

The U.S. Embassy Buenos Aires conducted a pre-proposal conference on Wednesday March 20, 2019 at

09:00 hours for the above referenced solicitation for the US Embassy Buenos Aires.

Five (5) firms participated in this pre-proposal conference: Galeno, Hospital Aleman, Omint, Osde and

Saccone Eduardo Anibal.

The questions and answers below are responsive to the inquiries received by email regarding this solicitation.

Question #1: Are covered employees under dependence relationship (“Relacion de dependencia”) with lawful contributions; direct employees without lawful contributions; or under a cobined system?

Answer: They are direct employees without contribution to the statutory health system.

Question #2: Is this solicitation equal to the ones released in previous years?

Answer: Although this document and the information therein may be similar, each solicitation and contract are stand-alone documents and, thus, unique. As such, they do not carry over any previous data.

Question #3: To which statutory health insurance company does the Embassy transfers contributions nowadays?

Answer: The Embassy does not have a statutory health insurance provider.

Question #4: Are covered employees in a collective bargaining agreement (Convenio, for its name in

Spanish)?

Answer: No. We work in a non-unionized environment as per U.S. Government regulations.

Question #5: Do all employees receive the same coverage?

Answer: Yes. This is a unique plan for all individuals described in Section C.1.3 and C.1.5.

Question #6: Are Embassy high-rank officers included as covered employees (i.e. Ambassador, Consul)?

Answer: No. Please, refer to Section C.1.3 and C.1.5 to learn the types of individuals covered under this contract.

Question #7: When did the current contract holder started as your service provider, and when was the last contract awarded?

Answer: They started providing services on January 2005. The last contract was issued on

December 2018.

Question #8: Can national and international companies submit an offer?

Answer: Yes. This solicitation is open to all interested entities.

Question #9: Can you provide historic data on of the covered employees? We refer to total premium paid by the Embassy per year; and the total amount paid out by current service provider for the 20-most frequent pathologies –including a description of this frequent pathologies

Answer: The premium was AR$2,198.24 (VAT Included) per individual per pay period during the period 12/1/2017 through 11/30/2018. Then, premium was AR$2,945.65

(VAT Included) from 12/1/2018 to 05/31/2019.

Unfortunately, we cannot disclose this information. This is private & confidential information that not even the employee has to share with us as employers.

Question #10: Could you inform the main geographical locations of the covered employees?

Answer: The contract shall cover employees in any location within the boundaries of

Argentina. Most of the covered employees reside in Buenos Aires City and its suburbs.

Question #11: Could you specify the total amount paid as salaries to the covered employees?

Answer: This question is not applicable as the Embassy pays the total premium per each capita whether they are employee or dependents.

Question #12: On which date is this contract expected to start?

Answer: Our intention is to award within 60 to 90 days from the date of receipt of initial offers.

Question #13: Is the current benefit schedule identical to the previous one?

Answer: Please, refer to Question #2 above and to Section C of the solicitation.

Question #14: Are there any individuals currently hospitalized? If yes, How many?

Answer: No, there are no individuals currently hospitalized.

Question #15: Are any major illnesses (i.e. hemodynamics, open heart surgery, orthopedic major surgeries, organ transplants, traumatic accident, cancer and oncology cases) being treated? If yes, please provide quantity.

Answer: We cannot disclose information related to medical records. Please, refer to Section

C of the solicitation to learn the services that shall be provided.

Question #16: Are there any pregnant employees/spouses? If yes, please provide quantity.

Answer: We cannot disclose information related to medical records.

Question #17: Were there any catastrophic cases (in excess of $10,000) within the last year to date?

i. If yes, please provide numbers.

ii. Status of claim – paid/incurred.

Answer: None.

Question #18: Are there any HIV/AIDS cases? If yes, please provide quantity

Question #19: Are any employees currently disabled? If yes, please provide total number

Question #20: Could you provide the current vendor information:

Answer: Name: OMINT S.A. de Servicios

Contract number: 19AR2019D0001

Value: ARS 18,725,497.05

Date of award: 11/30/2018

Date of expiration: 05/31/2019

Question #21: What currency should proposers use in submitting bids?

Answer: Non-Argentine offerors may submit their offers expressed in U.S. Dollars (USD).

Argentine offerors shall submit their offers expressed in Argentine Pesos (ARS), or in USD if they possess a bank account in Argentina in USD. Please, refer to Section

M.10 of the solicitation for further information.

Question #22: Could you inform the membership each of last 3 years by Single, Married and Family

Status.

Answer: Please, refer to section J for demographic information.

Question #23: What is the percentage of local nationals?

Answer: 96% circa.

Question #24: Are there dependent children to be covered who are studying outside the country? If yes, please provide the country and number of dependent children studying there.

Answer: No, there are not.

Question #25: What is the geographical location(s) of insured employees?

Answer: Please, refer to Question #10 above.

Question #26: Could you provide the claims history for health insurance for the current year and each of the last 5 years, including the quantity of covered employees in each year?

Answer: We do not hold these type of records. This information is personal in between the health provider and the employee and/or dependents.

Question #27: Do the above claim numbers include claims from ORE employees? (if applicable)

Answer: We do not have this type of records. This information is personal in between the health provider and the employee and/or dependents.

Question #28: Did the premium history for insurance include the VAT? If so, what percentage of VAT was included in the historical premiums?

Answer: VAT for private medical health insurance is 10.5% and it should be quoted as requested in the solicitation document.

Question #29: Did the premium history for insurance include Insurance Premium Tax (IPT)? If so, what percentage of IPT was included in the historical premiums?

Answer: This solicitation provides Value Added Tax (VAT) as a separate Line Item. All other taxes or fees that may apply must be included in the premium as overhead.

The contractor is required to know and comply with any provision of local law as required in Section H.6.

Question #30: Could you provide Census data?

Answer: Please, refer to Section J of the solicitation.

Question #31: Is this requirement for a unique type of coverage, or do you want options for the different types of riders? If yes; Do you have any specific specifications for these alternative plans?

Answer: A unique type of coverage shall be provided to all employees and dependents as described in Section C.

In the case of riders, they shall receive the same type of coverage. However, as riders are not bounded through this contract, they may opt to obtain a different type of coverage directly from the contractor under a private contract.

Question #32: What quality/level of brochure do you expect to receive?

Answer: A detailed and itemized chart with services included, with levels of coverage, amounts and type of services.

Question #33: The reimbursement amounts specified in Section C, may be converted to Argentine

Pesos?

Answer: Reimbursable amounts are expressed in USD. Reimbursement shall be made in

Argentine Pesos as provided in paragraph C.1.1 – Reimbursement of Covered

Medical Expenses.

Question #34: Paragraph B.3 requires to report the cost and profit within the rates. Is this mandatory?

Answer: Yes, it is mandatory.

Question #35: In those cases where 100% coverage is required, Do we have to provide 100% reimbursement without a global limit? Is it possible to set a limit per service type?

Answer: 100% coverage shall be provided in all cases as described in Section C. However, there is an Annual Maximum Limit per contract year. Please, refer to Paragraph

C.1.1.16 for further details.

Question #36: Could you clarify Paragraph C.1.1.7: Shall we provide one (1) apparatus per person per year, or one (1) apparatus per person every three years? Is it one (1) apparatus per ear, or per individual?

Answer: 75% reimbursement of 1(one) apparatus per person, per year, up to USD 2,350.00

Question #37: In Paragraph C.1.1.9 – Dental Care, Can we stablish a global limit for reimbursements?

Answer: Same as answer to question 35. The C.1.1.16 Section sets forward the Annual

Maximum Limit to reimbursements.

Question #38: Paragraphs C.1.1.12, C.1.1.15, C.1.1.16 impose a considerable impact to our Company and are not customary offered. Can they be removed?

Answer: Although this is not normal, we are bound to offer this coverage as per approved

Medical Insurance benefit from Washington DC, Office of Overseas Employment.

The reason for the particular Section C.1.1.12 is that many Locally Employed Staff travel for training and temporary duty purposes.

Question #39: In the case of retirees, shall continuing services be provided to his/her dependents during the year forthcoming his decease?

Answer: Yes, for 12 months only. After this, the survival retiree/dependent shall contract another insurance independently and separate from this medical coverage/premiums.

Question #40: In the case of contact lenses, are they considered as lenses with frames? Could you specify further more the scope of the coverage and any maximum reimbursement limits?

Answer: Yes. The amounts should either cover contact lenses or frames and glasses.

I.e. Amount USD95.00 (ROE) could be used every 14 months in either lenses, frames or contact lenses. This could be either discounted from opticians from which the Medical Insurance provider has a contract with or a reimbursement made to the beneficiary to his own bank account.

Question #41: How shall the coverage be if a covered individual suffers a stroke (ACV in Spanish) during a trip outside Argentina and must remain hospitalized for –to say- a month? Shall we set limit to this coverage?

Answer: There are limitations as set forth in Section C.1.1.12, C.1.1.15 and C.1.1.16

Question #42: Could you clarify the scope of paragraph C.1.1.9. It specifies 100% reimbursement in prosthesis. Are implants also included?

How shall orthodontic coverage be? Shall there be any maximum limit?

Answer: All services related to dental care shall be covered at 100%. Dental care is for both

“minor and major restorations” and as stated in the authorization based on

“reasonable and customary costs of covered benefits” in Argentina.

Orthodontics is covered at 90% and the aggregate annual maximum applies, there is not a separate maximum for orthodontics.

Question #43: Could you clarify the scope of paragraph C.1.1.12. Shall this coverage be equivalent to the one provided locally?

Answer: Yes.

Question #44: Could you clarify the scope of paragraph C.1.1.15. Shall we provide coverage up to the

100% as long as it is an approved treatment (validated through medical audit)? What is the current coverage?

Answer: 100% reimbursement up to USD250.000.00 per person per year as defined in the paragraph. It does not have to be approved as it is needed as defined by a catastrophic condition (major illness, conditions relating to a single accident) or closely related set of major illnesses (or conditions relating to a single accident) that exceed the standard maximum coverage limit.

Question #45: Could you clarify the scope of paragraph C.1.1.16.

Answer: The maximum annual amount for reimbursements per beneficiary should be up to

USD250.000.00 without including prescription drugs and medicines.

Question #46: For paragraph B.2. Prices; Can we submit an offer for the Base Year only?

Answer: No, you need to provide pricing for each contract period. Otherwise, your offer will be considered non-conforming and will not be considered for award.

Question #47: For paragraph C.1.1.1. 100% up to USD 47.00 per visit at a doctor’s office or for a doctor’s visit at home; Does it refer to patients being treated at the doctor’s office or at their respective homes by doctors that are not direct employees of our company?

Answer: To a visit at the doctor´s with an appointment that should be included 100% without limitations if these appointments are within their doctors lists (cartilla médica). Should the appointment be made to a doctor which is not in the listed manual provided by the Medical Insurance, the beneficiary should submit the invoice to the medical insurance provider for reimbursement up to USD47 at the rate of exchange of that time. Doctor’s visits (cartilla médica) to the beneficiary’s addresses should be 100% included.

Question #48: For paragraph C.1.3. Hospitalization, 90% reimbursement of outpatient nursing care;

Does it refer to patients hospitalized in their homes?

Answer: Yes.

Question #49: For paragraph C.1.1.12, we understand that the patient is responsible for these expenses and, thus, there would be no reason for a reimbursement. In which cases shall a reimbursement be issued?

Answer: No. Medical expenses incurred out of the country will be covered by the beneficiaries if the treatment is not medically necessary before the individual returns home or if the individual attending physician does not certify in advance that such treatment is medically necessary and unavailable locally.

Question #50: For paragraph C.1.3.3.1. All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government. Who are considered ORE employees?

Answer: ORE stands for “Official Residence Employees”. These are the direct employees of the Ambassador and the Deputy Chief of Mission, however the own employee will be held responsible for his medical insurance and his family members. Hence, although each ORE and family members will have the same coverage, administratively they will be the sole account holders.

Question #51: How shall we prepare the offer? Is there any additional information that we are required to submit.

Answer: Please, refer to Section L – Instructions, conditions and notices to offerors for specific instructions.

Question #52: Could you provide further assistance regarding how to obtain an NCAGE Code?

Answer: Please, visit https://ar.usembassy.gov/es/embassy-es/buenos-aires-es/oficinas/oportunidades-comerciales/ to obtain step-by-step guide with instructions on how to obtain a NCGA Code and register your company in SAM.

The specific address for NCAGE Code requests is https://eportal.nspa.nato.int/AC135Public/scage/CageList.aspx

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