2019_-_LE_Staff_Health_Insurance_Questions_&_Answers.doc

Question 1: In order to be able to generate an accurate and well encompassing financial proposal, we would like to be in receipt of information in the following manner:

No. of employees (input the number of employees earning within the brackets indicated below)

BWP0-3,000

BWP 3,0001-10,000

BWP 10,000 plus

Section B of the solicitation offers the most comprehensive breakdown of employee salaries. There are no employees earning less than BWP 3,000 per month.

Question 2: What is the annual cover limit?

Per section C.1.2 of the solicitation:

Annual Maximum Limit - The maximum annual reimbursement per covered individual per contract year, not including expenses defined under Exclusions and Limitations (C.1.3) or those covered under C.1.1.15, HIV/AIDS, and C.1.1.18, Excess Coverage and C.1.1.19, Catastrophic Coverage is equivalent to BWP 475,000.

Question 3: Since you have catered for HIV separately, where does the benefit for screening and monitoring draw from?

HIV/AIDS screening could be covered under either ‘outpatient’ or “preventative and wellness and chronic disease management.” Both have an 80% minimum.

Question 4: What are the differences between Group 1 and Group 2 mentioned in Section B? Please be detailed and let us know the differences in benefit levels, exclusions, eligibility between Group 1 and Group 2?

The benefit levels, exclusions, and eligibility are the same for both groups. The difference is only in the rate.

Question 5: Price tables under Section B refer to Group 1 and Group 2, whereas the retention table does not specify 2 groups. Should we prepare 2 retention tables, one for each Group?

Because benefit levels, exclusions, and eligibility are the same for both groups, we did not divide the retention table by group. You are welcome to submit retention tables in either format.

Question 6: Premium history for health Insurance for the current year and EACH of the last 5 years - 2019 (till now),2018, 2017, 2016, 2015, 2014.

Years 2014-2017 are covered in pages 32-33 of the solicitation. We do not yet have more recent data.

Question 7: Did the Premium history for health insurance mentioned above include the VAT? If it did then what % VAT was included in the historical health premiums?

Premium history does include VAT, which is 12% in Botswana. We have historically paid VAT through the vendor and then submitted for reimbursement with the government.

Question 8: Average insured member counts for the current year and EACH of the last 5 years - 2019 (till now), 2018, 2017, 2016, 2015, 2014.

Section B includes current (2019) insured member counts. We are working on providing historical information.

Question 9: Advise if 2018 benefit schedule for health insurance is the same as the benefit schedule currently being requested under 19BC4019R0001; and if not advise us on the differences. Alternatively, you can simply provide the previous solicitation document containing the benefits and exclusions.

No. It is different. Please see attached general comparison.

Question 10: When is this plan likely to commence?

September 1, 2019

Question 11: Is this a new contract or an existing one and what is the name of the current provider?

New contract with updated requirements. The current provider is Botswana Medical Aid.