19BK8025R0001_QAs_06Mar2025.pdf
PDF 259 KB Posted
- Attached to
- Health Insurance Services Federal contract opportunity
- Solicitation number
- 19BK8025R0001
- Issued by
- Department of State
About this file
This is a Questions and Answers document for RFP #19BK8025R0001 issued by the U.S. Embassy in Sarajevo for health insurance services for Locally Employed Staff and their family members.
The document addresses 21 clarifying questions about the health insurance requirements, revealing key details: The coverage must be global, with claims data showing 23,552 in-country and 455 out-of-country claims processed between 2020-2025 (January). The contract requires 100% coverage for specific outpatient treatments including malignant diseases, kidney diseases, tuberculosis, HIV, epilepsy, autoimmune diseases, hemophilia, and other specified conditions. The winning contractor must provide Bosnian-speaking representatives, maintain liability insurance, and offer excess coverage that can be elected annually. While direct billing arrangements with hospitals are desirable, they are not required. The contract will be structured as a fixed-price agreement with economic price adjustment provisions, though current incumbent pricing information is not publicly available. The Embassy will continue collecting 10% premium contributions from eligible surviving family members, and the retiree coverage rider requirement cannot be waived or modified despite its unconventional nature.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 19BK8025R00010005_Amendment_19Mar2025.pdf | ||
| 19BK8025R00010004_Amendment_17Mar2025.pdf | ||
| 19BK8025R00010003_06Mar2025.pdf | ||
| Questions_and_Answers_26Feb2025.pdf | ||
| PreProposalConferenceMinutes.pdf | ||
| 19BK8025R0001_Section_II_TAB_G_PreProposalPowerPresentation_24Feb2025.pdf | ||
| 19BK8025R0001_Section_II_TAB_A_Amendment0002_14Feb2025.pdf | ||
| 19BK8025R0001_0001_Amendment.pdf | ||
| 19BK8025R0001_SectionII_TAB_H_QA_12Feb2025.pdf | ||
| 19BK8025R0001_Section_II_TAB_A_RFP_HealthInsurance_31Jan2025.pdf |
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Text version
Embassy of the United States of America Sarajevo, Bosnia and Herzegovina
Friday, March 06, 2025
SUBJECT: QUESTIONS AND ANSWERS
REF: Request for Proposals number 19BK8025R0001 – Health Insurance Services – The US Embassy in Sarajevo Locally Employed Staff and their family members
Q1. Could you provide a breakdown of claims processed inside and outside Bosnia and Herzegovina?
A1. Year In Country Out of Country 2020 3218 46 2021 4775 77 2022 5757 111 2023 5121 169 2024 4020 37 2025 (January) 661 15
TOTAL: 23,552 455
Q2. Has the Embassy been notified of critical cases such as open-heart surgery, cancer treatments, organ transplants, major orthopedic procedures, extended hospitalizations exceeding ten days, or medical costs exceeding 10,000 EUR/USD?
A2. No. The Government does not keep medical records on LE Staff and their family members.
LE Staff and their family members are covered by the terms of the RFP.
Q3. Has Catastrophic Coverage (C.1.1.16) been utilized in the past five years? If so, how many times?
A3. The Government does not hold on to medical records on LE Staff and their family members.
Q4. Shall the Embassy release legal opinion from Maric & Co. referred in C.1.1.4.?
A4. Yes, the legal opinion from Maric & Co. is to be provided as an attachment in Section J, Exhibit E of the Request For Proposal (RFP). The following out-patient treatments are covered 100% for the specified diseases:
• Malignant diseases
• Kidney diseases or dialysis
• Tuberculosis
• HIV infection and other infectious diseases
• Epilepsy
• Systemic autoimmune diseases
• Hemophilia
• Insulin-dependent diabetes
• Paraplegia and quadriplegia
• Muscular dystrophy
• Multiple sclerosis
• Cerebral sclerosis
• Mental disorders
Q5. Is Maric & Co. Opinion legally binding for state and private insurance providers?
A5. It is provided in the RFP, therefore is binding to awarded contract.
Q6. Will the Embassy continue to collect 10% of contribution to premiums from eligible surviving family members?
A6. Yes.
Q7. Does Excess Coverage have same reimbursement percentages and monetary caps as base insurance coverage?
A77. Yes. Excess Coverage provides an additional annual reimbursement overall ceiling amount on the top of the required annual ceiling amount, refer to C.1.1.21. Excess Coverage
Q8. Would inclusion or exclusion from Excess Coverage be made only once during the contract performance?
A8. If elected excess coverage will be applicable for duration of one year (365 days) and shall coincide with the contract year.
Q9. How often LE Staff may elect to be enrolled to Excess Coverage?
A9. Once a year during enrollment season that will be agreed with winning contractor.
Q10. Given the high risk, administrative complexity, absence of individual underwriting, and different pricing, could the retiree coverage rider, which is unconventional in the insurance industry and mandated to be offered without any responsibility on the part of USG, be waived, modified, or improved?
A10. No.
Q11. Could you please provide claims figures for 2024?
A11. No. The Embassy does not have statistics for period form 3/29/2024 to today because the contract is still active, and we are not able to compile statistics.
Q12. Could you please confirm whether the benefits requested in this RFP align with those reflected in the claims history?
A12. Yes, except for outpatient services mandated by local social security and medical insurance law to be covered 100%.
Q13. Do you have any preferred hospitals for direct billing, and do you require evidence of such agreements?
A13. No. While it is desirable to provide a copy of evidence or a list of medical institution providers with whom the winning contractor has established direct billing methods, it is not required by the RFP.
Q14. Do you require the contractor representative and/or help desk representative to speak
Bosnian?
A14. Yes. Services must be provided to dependents who may not speak or read English or languages other than Bosnian language.
Q15. Do winning contractor has authority to provide all data requested in H.5.(a) to designated
COR?
A15. Yes.
Q16. What guaranties winning offeror/contractor shall provide under FAR 52.237?
A16. The awarded Contractor shall maintain during the term of this contract liability insurance issued by responsible insurance carrier (reference FAR 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997))
Q17. How should bidding contractors evidence service excellence, and would references from current and recent past US Embassy medical insurance offerings, or an Embassy in Bosnia from a different country, be sufficient?
A17. See Section L, L.4.3.1. Part 3 – Experience and Past Performance of the RFP.
Q18. Will all insured be Bosnian?
A18. Refer to C.1.4, Eligible Participants
Q19. What is the year on year price demanded of the incumbent insurer?
A19. Individual premiums of the current contract are not publicly available information see FAR part 24.
Q20. How payments will be made?
A20. Refer to the RFP Section G. paragraph G.4. Submission of invoices and Payment. Also review
FAR 52.232-1, 52.232-8, 52.232-25, 52.232-33.
Q21. What is the area of coverage? Should over extend to EU/Global?
A21. Global.
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