SF30.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO.

PR8011218-001

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE EG300 7. ADMINISTERED BY (If other than Item 6) CODE

AMERICAN EMBASSY CAIRO

US EMBASSY CAIRO 8 KAMAL EL DIN SALAH, ATTN: PROCUREMENT/CONTRACTING

OFFICE

CAIRO 11519

EGYPT

AMERICAN EMBASSY CAIRO

US EMBASSY CAIRO 8 KAMAL EL DIN SALAH, ATTN:

PROCUREMENT/CONTRACTING OFFICE

CAIRO 11519

EGYPT

(X) 9A. AMENDMENT OF SOLICITATION

NO.

19EG3019R0001

x

9B. DATED (SEE ITEM 11)

01/28/2019

10A. MODIFICATION OF CONTRACT/ORDER NO.

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

CODE FACILITY CODE

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

x The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing items 8 and 15, and returning copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of this amendment 0001 to this solicitation is the following:

1. To extend the deadline submission date for interested offerors

2. To issue corrections and edits in the solicitation (See block 14 continuation page 2 thru 11)

3. To include the Questions and Answers from the pre-proposal conference (See Appendix A)

4. To include the SAM registration guides (See Appendix B)

5. To include the Claims data (See Appendix C)

6. To include the employee data (See Appendix D)

7. To include the past requirements (See Appendix E)

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

16C. DATE SIGNED

NSN 7540-01-152-8070

Previous edition unusable

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

PAGE OF PAGES

1 11

Continuation Page Block 14

Health Insurance Services Solicitation No. 19EG3019R0001

Amendment No A-0001

1. Solicitation 19EG3019R0001 is amended to extend the submission date of the proposal from May 27, 2019 to Jun 24, 2019.

2. Solicitation 19EG3019R0001 is amended to correct the following pages;

a. Page15, Section C.1.8.2, the reference is revised. Revised page is attached.

b. Page 25, Section H.4. (a) (4), payment method for claims is revised. Revised page is attached.

c. Page 55, Section L.3, the offer received address is revised. Revised page is attached.

d. Pages 4 till 6, Section B2, the numbers has been revised. Revised page is attached.

e. Pages 39 till 41, Section J, the numbers has been revised. Revised page is attached.

C.1.5.1 Individuals covered by C.1.4 must be employed within the geographic boundaries of Egypt.

C.1.6 Participants and Benefits Covered Under a Rider

C.1.6.1 All current active employees of the Chief of Mission and the Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.1.6.2 All current active employees of the Employee Association at Embassy Egypt (see separate rider, Exhibit C). All costs for AECWA employees are the responsibility of the Employee Association, not the U.S. Government.

C.1.6.3 Optional excess coverage per above item C.1.1.20. If elected, all costs for excess coverage are the responsibility of the employee, not the U.S. Government.

C.1.7 Other Eligible Participants

Dependents:

LE Staff who are eligible to participate in the medical plan automatically confer coverage to eligible family members who meet the following criteria:

Legal spouse: one legal spouse as defined by local law may be covered. LE Staff with more than one legal spouse must select only one spouse for coverage.

In cases where LE Staff and their legal spouse both work for the mission and both are eligible to participate in the medical plan, one will be designated as the lead for purposes of the medical plan, and the other will be considered a legal spouse.

Dependent children: a child is defined as the LE Staff’s natural, adopted, stepchild, or foster child. The child must be unmarried and financially dependent upon the LE Staff. A child will be covered until the end of the contract year in which s/he reaches age 26. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the LE Staff maintains coverage.

C.1.8 Brochure Requirement

C.1.8.1. The Contractor shall provide a document (brochure/pamphlet/other written document) in English and Arabic that sets forth a complete listing of the health insurance benefits to be provided under this contract.

C.1.8.2. The Contractor shall provide the document described in C.1.8.1 to the COR not later than 15 Days after date of contract award.

The Contractor shall be responsible for all planning, estimating, programming, project management, scheduling, dispatching, supervision, and inspection of work. The Contractor shall maintain his own reference library of technical reference works and local laws and regulations, including current tariffs and registries. The Contractor shall treat the information provided by the Embassy concerning employee' personal data, medical information, and salaries as highly sensitive and not divulge any employee information to unauthorized persons. The Contractor shall establish procedures for handling medical insurance claims as follows:

(a) Administrative Records

(1) The Contractor shall maintain medical insurance files for each covered employee and each covered dependent including receipts and proof of paid claims, requests for claim reimbursements, and accounting of paid benefits with balances of amounts remaining in the annual per person reimbursement ceiling.

(2) The Contractor shall provide the COR with the necessary claim forms for each type of benefit that can be claimed under the contract. These forms shall specify a list of documents required to be appended to each claim and otherwise provide instructions for claim filing.

(3) The Contractor shall use the English spelling of the employees' names in all transactions, including reimbursement checks.

(4) The Contractor shall send employee claim reimbursement checks to employees not later than two weeks after a claim is submitted.

(b) Medical Insurance Claims. Settlement of medical insurance shall be completed as follows:

(1) All medical claims shall be submitted directly to the Contractor by employees, through a drop box in the COR's office. The claims shall be picked up from the COR each Tuesday.

(2) The Contractor shall date stamp and screen all claims submitted on the day of receipt. If there are any missing documents or information thereby disallowing said claim to be payable, the Contractor shall notify the employee within two days, with a copy to the COR (if notification is written).

(3) The Contractor shall settle the claims no later than two weeks from the date the claim is submitted to the Contractor.

(4) Settlement shall be by issuance of checks in the name of the employee or by electronic wire transfer (EFT) to the employee’s bank account for each claim submitted.

Each check shall be accompanied by a form providing details of the amount reimbursed with an explanation of deductions, if any.

SECTION L

INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

The Offeror shall include Defense Base Act (DBA) insurance premium costs covering employees. The offeror may obtain DBA insurance directly from any Department of Labor approved providers at the DOL website at http://www.dol.gov/owcp/dlhwc/lscarrier.htm

L.1. SUBMISSION OF OFFERS

This solicitation is for the provision of insurance and services described in Sections C and J, under the terms and conditions set forth herein.

L.2. SUMMARY OF INSTRUCTIONS. Each proposal must consist of the following separate volumes:

Volume Title Number of

Copies

Executed Standard Form 33, Solicitation Offer and Award, and completed Section K: REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS 1

Price Proposal and completed Section B: Supplies or Services and Price/Costs 1

3 Technical Proposal containing all technical factors and sub-factors 1

L.3. DELIVERY OF PROPOSALS AND EXCEPTIONS TO SOLICITATION. The offeror shall email the complete offer to the email address indicated at Block 8, of Standard Form 33, Solicitation, Offer and Award. Any deviation, exceptions, or conditional assumptions taken with respect to any of the instructions or requirements of this solicitation shall be identified and explained/justified in the appropriate volume of the offer.

L.4. CONTENTS OF PROPOSALS. The proposals shall contain documents filled out in strict conformance with the detailed instructions set forth as follows:

L.4.1. Volume 1 -- Standard Form 33: Complete Blocks 12 through 18, as appropriate and fill in all the blanks in Section K of this solicitation.

L.4.2. Volume 2 -- Price Proposal and fill in Section B.

(a) Price proposal for the base year of both insurance programs or for only one program;

(b) Price proposal for the option years of both insurance programs or for any one program; however, a price proposal for an option year with no proposal for the base year will not be considered, nor will a proposal for a base period which does not include a proposal for all option periods for that same type of insurance.

SECTION B

PART I: PRICE - HEALTH INSURANCE

B.1. HEALTH INSURANCE SERVICES

The Contractor shall provide the Health Insurance services to employees of the Government of the United States of America in Egypt as described in Section C and the Exhibits in Section J.

This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.1.1. Official Residence Expense (ORE) Staff and the American Employees Cooperative and Welfare Association (AECWA) employees are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff), and the AECWA employees at the rates specified below. See Section G for billing procedures.

B.1.2. Optional benefit coverage is included under this contract only as a rider at the rates specified below.

B.2. PRICES

B.2.1 VALUE ADDED TAX.

The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices as the U.S. Embassy has a tax exemption certificate with the host government.

B.2.2 This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The fixed prices/premium rates in Egyptian Pounds for the health insurance services as specified in Section C are as follows:

B.2.3. Base Year of Contract

Bi-Weekly Rates per Employee

Category Estimated Number of Employees Rate per

Employee Bi-Weekly

Total

a. Single Employees (Self Only) 406

b. Family Plan 1114

c. Subtotal (a + b)

d. Total Price for Base Year (c x 26)

Solicitation No. 19EG3019R0001

B.2.4. First Option Year of Contract

Bi-Weekly Rates per Employee

Category Estimated Number of Employees Rate per

Employee Bi-Weekly

Total

a. Single Employees (Self Only) 406

b. Family Plan 1114

c. Subtotal (a + b)

d. Total Price for First Option Year (c x 26)

B.2.5. Second Option Year of Contract

Bi-Weekly Rates per Employee

Category Estimated Number of Employees Rate per

Employee Bi-Weekly

Total

a. Single Employees (Self Only) 406

b. Family Plan 1114

c. Subtotal (a + b)

d. Total Price for Second Option Year (c x 26)

B.2.6. Third Option Year of Contract

Bi-Weekly Rates per Employee

Category Estimated Number of Employees Rate per

Employee Bi-Weekly

Total

a. Single Employees (Self Only) 406

b. Family Plan 1114

c. Subtotal (a + b)

d. Total Price for Third Option Year (c x 26)

B.3 Pricing for Rider CLINS

The firm fixed price/premium rates in Egyptian Pounds for the Rider CLINS are as follows and are to be paid 100% by the enrollee; these Rider CLINS will NOT be evaluated as part of the overall price evaluation:

B.3.1 Base Year for Rider CLINS:

No Category Bi-Weekly Rates per Employee

1 Official Residence Expense (ORE) Staff and the American Employees Cooperative and Welfare Association (AECWA) and their Dependents

2 Excess Coverage: up to 365,000 EGP

B.3.2 First Option Year for Rider CLINS:

No Category Bi-Weekly Rates per Employee

1 Official Residence Expense (ORE) Staff and the American Employees Cooperative and Welfare Association (AECWA) and their Dependents

2 Excess Coverage: up to 365,000 EGP

B.2.7. Fourth Option Year of Contract

Bi-Weekly Rates per Employee

Category Estimated Number of Employees Rate per

Employee Bi-Weekly

Total

a. Single Employees (Self Only) 406

b. Family Plan 1114

c. Subtotal (a + b)

d. Total Price for Fourth Option Year (c x 26)

B.2.8. Grand Total of Base plus All Option Years

Base Year Total First Option Year Total Second Option Year Total Third Option Year Total Fourth Option Year Total

Grand Total of Base plus All Option Years

SECTION J

LIST OF EXHIBITS/ATTACHMENTS

EXHIBIT A – EMPLOYEE STATISTICS

1. EMPLOYEES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 20-34 87 20-34 205 35-45 100 35-45 443 46-55 53 46-55 296 56-60 38 56-60 196

TOTAL 278 TOTAL 1140

2. EMPLOYEE SPOUSES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number

20-34 287 20-34 27 35-45 385 35-45 51 46-55 187 46-55 25 56-65 49 56-65 25 66+ 1 66+ 8

TOTAL 909 TOTAL 136

3. DEPENDENT CHILDREN BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number

0-10 535 0-10 573

11-18 370 11-18 423 19-26

(if full-time student) 145 19-26

(if full-time student)

TOTAL 1050 TOTAL 1178

EXHIBIT B - ORE EMPLOYEES RIDER

Official Residence Employees (ORE) are eligible to fully participate in the medical insurance plan for U.S. Embassy, Cairo, if the following conditions are met:

1. Insurance provider will bill employer or ORE (either Ambassador or DCM) staff directly.

2. All current active employees of the Ambassador and the Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account are eligible. All cost for ORE employees are the responsibility of the employing officer, not the U.S. Government.

3. The ORE employees shall be identified under a separate task order. The COR will make subsequent additions or deletions to this list in writing. All such revisions shall be consolidated and new a task order will be issued by the Contracting Officer.

4. Each Ambassador or DCM has the discretion to include their ORE staff in the medical insurance plan, that fact will be specified in the individual ORE employment contract(s).

ORE benefits coverage and levels will be the same as coverage and levels outlined in the U.S.

Embassy Medical Insurance Plan.

1. EMPLOYEES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 20-34 0 20-34 1 35-45 0 35-45 2 46-55 2 46-55 6 56-60 1 56-60 1

TOTAL 3 TOTAL 10

2. EMPLOYEE SPOUSES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 20-34 0 20-34 2 35-45 4 35-45 0 46-55 4 46-55 0 56-65 0 56-65 0 66+ 0 66+ 0

TOTAL 8 TOTAL 2

3. DEPENDENT CHILDREN BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 0-10 1 0-10 3 11-18 2 11-18 0 19-26

(if full-time student) 1 19-26

(if full-time student)

TOTAL 5 TOTAL 3

EXHIBIT C – EMPLOYEE ASSOCIATION EMPLOYEES RIDER

1. EMPLOYEES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number

20-34 2 20-34 7

35-45 1 35-45 12 46-55 0 46-55 7 56-60 0 56-60 3

TOTAL 3 TOTAL 29

2. EMPLOYEE SPOUSES BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 20-34 7 20-34 0

35-45 8 35-45 1 46-55 6 46-55 0 56-65 0 56-65 0 66+ 0 66+ 0

TOTAL 21 TOTAL 1

3. DEPENDENT CHILDREN BY GENDER WITHIN AGE RANGES

FEMALE MALE

Age (years) Number Age (years) Number 0-10 14 0-10 14 11-18 8 11-18 7 19-26

(if full-time student) 5 19-26

(if full-time student)

TOTAL 27 TOTAL 27

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