Questions_and_Answers.pdf

Questions and Answers

Q1. Hospitalization - (In Patient/Out Patient)

A. In Patient. Please refer the Section C.1.1.1 of the Solicitation for more details

Q2. No. of Family unit and individuals

A. 357 Family Units. Please refer the below charts for more details

Employees by Gender within age Range

Age (in years)

Number Total

Female Male

20-34 24 41 65

35-44 25 118 143

45-54 15 106 121

55-64 3 25 28

Total 357

Employee Spouses by Gender within age Range

Age (in years)

Number Total

Female Male

20-34 59 11 70

35-44 112 15 127

45-54 86 9 75

55-64 12 5 17

65+ 0 0 0

Total 269 40 309

Note : Above information are provided as per the current records.

Approx.

Dependent Children by Gender within age range

Age

(in years)

Number Total

Female Male

0-5 48 54 102

6-10 52 64 116

11-15 64 68 132

16-20 51 46 97

21-25 15 17 32

Total 479

Q3. Current Insurer

A. Sri Lanka Insurance

Q4. Claims experience for the last 5 year

A. Refer the below chart

Period of insurance Number of claims

Total amount paid(Rs.)

2016/12/01 - 2017/11/30 857 36,212,815.23

2015/12/01 - 2016/11/30 710 34,444,531.92

2014/12/01 - 2015/11/30 561 28,081,289.19

2013/12/01 - 2014/11/30 584 31,447,271.70

2012/12/01 - 2013/11/30 602 26,989,003.02

Q5. C.1.1.3. Benefit limit is restricted to family unit or per person

A. Family Unit

Q6. As there is tax component to be paid by the patient on hospital bills due to the new Inland

Revenue act ?? -

A.Tax to be paid within the limit of cover. Please refer the section H.6.1 and H.6.2 of the solicitation for more details

Q7. Existing indoor limits and benefits

A. In Patient. Rs.520,000 per family unit. Please refer the section C.1.2.2 of the solicitation for more details.

Q8. Whether the existing policy is with sub limits or without sub limits

A. There are sub limits. Please refer the section C of the solicitation for more details

Q9. Renewal Date of existing policy

A. June 01, 2018

Q10. Are there any persons who are currently hospitalized?

A. Information not available

Q11. 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 number

A. We do not have any info but all illnesses are covered as per the SOW

Q12. Are there any pregnant employees/spouses? If yes, please provide number

Q13. Are there any catastrophic cases (in excess of $10,000) within the last year to date? If yes, please provide numbers and status of claim – paid/incurred

Q14. Are there any HIV/AIDS cases? If yes, please provide total number.

Q15. Current vendor information: a. Name b. Contract number c. Value d. Date of award e.

e. Date of Expiration?

A. Sri Lanka Insurance corporation Ltd. Contact 071-472-9619, Value USD 1.22

Millions (Approx.), Date of Award December 1, 2012, Date of Expiration May 1, 2018

Q16. Percentage of local nationals.

A. Sri Lanka 99.45% and Maldives 0.55%

Q17.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.

Q18. Location(s) of insured employees.

A. Sri Lanka and Maldives. Please refer the section C.1.3.2 of the solicitation for more details.

Q19. Do the above claim numbers include claims from ORE employees? (if applicable)

A. Yes

Q20. Premium history for health insurance for the current year and each of the last 5 years.

A.

2013 2014 2015 2016 2017

Q1

7,514,400.0

8,302,700.0

9,067,500.0

9,973,950.0

10,192,000.0

Q2

7,663,200.0

8,200,450.0

8,820,000.0

10,118,850.0

8,554,000.0

Q3

7,588,800.0

8,159,550.0

8,910,000.0

10,191,300.0

8,814,000.0

Q4

7,607,400.0

8,180,000.0

9,180,000.0

10,070,550.0

9,178,000.0

30,373,800.0

32,842,700.0

35,977,500.0

40,354,650.0

36,738,000.0

Q21. Did the premium history for insurance include the VAT & %

A. Not include. Please refer the section B.2.1 of the solicitation for more details.

Q22. Did the premium history for insurance include Insurance Premium Tax (IPT)

A. NO, Per Subpart VAT B.2.1, VAT is not include. "

Q23. Can we send the bid over email?

A. No. Courier would do

Q24.Invoice submission for Payment monthly or Quarterly?

A. Please refer the section G.4.2 of the solicitation for more details.

Q25.What is Administrative Retention?

A. Need to be calculated based on the instruction given in Section B.3

Q26.What is deduction of 5%?

A. 5% has to be borne by the employee from each claim

Q27.Premium Adjustment Monthly/ Quarterly?

A. Annually. Please refer the section B.4.1 of the solicitation for more details

Q28. What currency should proposers use in submitting bids

A. SLR or USD

Q29. Number of Disabled or Handicapped?

Q30. Benifit Schedule for Health Insurance is the same as the benefit schedule currently being

Requested

A. Except the benefits mentioned in section C.1.1.3 (Prescription Drugs) and C.1.2.2

(Room Rates) , all other benefit level are same as last option year of the existing