Questions and Answers - 19C02024R0004.pdf
PDF 102 KB Posted
- Solicitation number
- 19C02024R0004
- Issued by
-
Department of State US Embassy Bogota
About this file
This document contains Questions and Answers related to Solicitation 19C02024R0004 for Health and Life Insurance Services for Locally Employed Staff of the U.S. Embassy in Caracas, Venezuela.
The solicitation requests proposals to provide group health insurance services for employees and dependents, and group life, accidental, and work-related insurance coverage for locally hired employees at the U.S. Embassy in Caracas. The contract is for a one-year base period with four one-year option periods. The U.S. Government intends to award to the lowest priced technically acceptable offeror. Offerors must be registered in the SAM database prior to submitting a proposal. The Questions and Answers provide clarification on service coverage requirements, calculation of life insurance amounts, required insurance documentation, and annual premium adjustment procedures. The answers reference specific sections of the solicitation document for additional details.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| SF-30 - 19C02024R0004 - 0002.pdf | ||
| Pre-proposal conference minutes - 19C02024R0004.pdf | ||
| Claims October 2023 - March 2024.xlsx | XLSX spreadsheet | |
| Data Salaries - Age.xlsx | XLSX spreadsheet | |
| SF-30 - 19C02024R0004-0001.pdf | ||
| 19C02024R0004 - Health and Life Insurance for Caracas LE Staff.pdf |
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Questions and Answers 19C02024R0004
Health and Life Insurance for LE Staff of U.S. Embassy Caracas
Q: Regarding clinics, shall we consider all clinics available nationwide to provide services?
A: Services should be provided by a licensed healthcare provider as per Section C.1.
Q: Does the Embassy require that we apply reasonable costs to surgeries, emergencies and reimbursements or that claims are paid at 100% of cost?
A: Claims should be paid to the authorized percentage covered by the benefits detailed in Section C.1. There is no mention of reasonable cost.
Q: Requested Coverage: Does the solicitation exclusively request health and life insurance coverage, or are there other types of coverage or insurance services that should be considered in the proposal?
A: Solicitation requests a Price Proposal to provide Health Insurance services to Employees and dependents and Life Insurance services to the Employees of U.S. Embassy Caracas.
As detailed in Section L.4, Offerors shall include Defense Base Act (DBA) insurance premium costs covering their employees working on the contract. DBA insurance shall be obtained directly from any Department of Labor-approved providers at the DOL website.
Please refer to Section I Contract Clauses, Clause 52.237-7 for the liability insurance requirement during the contract term.
Q: Insured Sums: Could you please provide details on the required insured sums for health and life coverage, as well as any other coverage that may not have been specified?
A: For Health Insurance please refer to C.1.2 Annual Maximum Limit.
For Life Insurance and Accidental or Work-Related Insurance please refer to C.2.1.1 and C.2.1.2
Q: Calculation of Life Insurance Sum: We understand that the life insurance sum is calculated based on monthly base salaries. Could you please confirm if the following coverage segmentation is correct for this calculation?
o Natural Death: 20 times the monthly base salary o Accidental Death: 26 times the monthly base salary
A: Please refer to C.2.1.1. for Life Insurance Coverage and C.2.1.2 for Accidental or Work- Related Death Coverage
C.2.1.1 Amount of Employee Life Insurance.
The amount of life insurance coverage for each employee is based upon:
Natural Death: 20 times the monthly basic rate (BR) at the time of death. Salary is defined as one-twelfth of the employee’s annual basic salary, exclusive of premium pay, allowances, bonuses, or any other separate payments.
Funeral Benefit: USD 178
C.2.1.2 Amount of Accidental or Work-Related Death Coverage.
The employee's estate or employee will receive an amount equal to 26 times the amount of monthly basic salary, in addition to the life insurance benefit in C.2.1.1, in the event the employee is killed in an accident. Salary is defined as one-twelfth of the employee’s annual basic salary, exclusive of premium pay, allowances, bonuses, or any other separate payments.
Q: Salary Details: In order to accurately calculate the life insurance sum, would it be possible for you to provide a detailed list (insured data in MS-Excel format) of the monthly base salaries (including ages) of the employees who will be covered by the insurance?
A: See attached file with Annual Salaries and Age of employees.
Q: Provide, if possible, details of claims with pathology, health care provider, certificate affected, amount claims, etc.
A: See attached file with claims from October 2023 to March 2024.
Q: What is the basic health coverage and how many people of the total population have contracted excess health care?
A: Please refer to amendment 0002 for changes to the solicitation.
52 people (20 employees and 32 dependents) are enrolled on the Excess Coverage.
Q: Is the coverage of the health policy, local or international?
A: Please refer to Section C, C.1.3 Exclusions and Limitations.
“There is no coverage for medical expenses incurred out-of-country. There is no reimbursement for out-of-country treatment.”
Q: Are annual premium adjustments considered after the first year? Is it possible to reconsider the $12,000,000 cap for the 5 years of the program?
A: For Economic Price Adjustment Based on Experience please refer to Section B, B.4.1 and B.8.1
“No adjustment will be allowed during the first twelve months. After such time, the Contractor or the Government may request an adjustment of premiums on an annual basis. Adjustments are not retroactive to previous contract terms”
Contractor must provide all documentation detailed in B.4.1 and B.8.1 to support his request for adjustment. Any adjustment shall be subject to mutual agreement of the parties.
For Premium Adjustment Based on Law please refer to B.4.2 and B.8.2. This type od adjustment is a result of laws enacted by the host Government if such change has a direct impact on the cost to the Contractor.
What is referred to in the Minimum and Maximum Amounts in Section B is not a contract cap.
Q: Is the current health provider network (clinics, pharmacies, etc.) concentrated in Caracas or others cities?
A: The current health insurance does not have a provider network. Health services are provided in Venezuela at licensed health care providers.
Q: Detail of ages per person for the calculation of Life Group average rate.
A: Life Insurance is solely for employees. Age detail is provided in Section J, Exhibit A, 1.
Q: We have requested in NCAGE Code since Monday 08/07 and we do not have it yet, how can you help us?
A: You should contact ncage@nspa.nato.int for assistance and check on https://eportal.nspa.nato.int/Codification/CageTool/cage-view/srrk5
Q: The SF 33 form, where should it be auto-filled?
A: Please refer to Section L, L.4.1. Volume I:
“Complete Blocks 12 through 18, as appropriate”
File details come from the government source that posted it. Updated .