19GE5021R0009_00003_Q and A_set three.pdf

LES Health & Life Insurance 19GE5021R0009_00003

US Embassy Cairo, Egypt

Questions and Answers (Q&A)

RPSO has received the following thirty-two (32) questions (Q), and is hereby providing the following answers (A).

1. Q: Please provide average insured member counts for health insurance for the last 3 years - 2018, 2019, 2020. It is standard practice in the insurance industry (and in other

Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

A:

Year Average Number of insured employees

Average Number of insured dependents

2018 1,340 3,270

2019 1,310 3,110

2020 1,270 3,275

2. Q: When is this plan likely to commence?

A: March/April 2021

3. Q: The file titled ‘DOB Report.pdf’ that was released recently has annual salaries that do not reconcile with the bi-week salaries listed in the file titled ‘Attachment 1 –

Pricing.xlsx’. Either the annual salaries in the PDF file are incorrect or the bi-week salaries in the Excel file are incorrect. Please advise.

A: We only added the average bi-weekly salary. Please note that salaries may differ on a daily basis, as we may hire new employees and some senior employees may retire which may affect the overall average salary up or down. There was a time difference between the first report when we first drafted the solicitation and the recent DOB report. Accordingly, the DOB report includes the most updated salaries, which you can use to base your calculations on.

4. Q: Please include the gender (i.e, male or female) in the file titled ‘DOB Report.pdf’

A: Please see the attached

5. Q: Referring to Section 1, Sub Section I, C Minimum (page 5 of the solicitation).

We need more clarification.

A: The resulting contract will be an Indefinite Quantity Indefinite Delivery type contract.

That means the quantities (number of insured employees) to be ordered are an estimate only and not a guaranteed number, therefore a minimum and a maximum need to be set.

Under the resulting contract the Government guarantees it will order services in the amount of at least $5,000.00. The maximum amount to be ordered is $50,000,000.00

6. Q: Referring to Section 1, Sub Section IV, Part I, A.1.1.4 (Page 16 of the solicitation) “Immunization recommended by local authorities and/or the WHO” And Section 1, Sub Section IV, Part I, A.1.1.8 (Page 17 of the solicitation) “….and immunizations recommended by local authorities or the WHO”

We cannot offer this benefit due to uncertainty during COVID-19 circumstances. We can offer approved vaccination list with capped amount.

A: This is the requested Benefit under this solicitation. If you do not offer this benefit, that shall be stated in your proposal.

7. Q: Referring to Section 1, Sub Section IV, Part I, A.1.1.7 (Page 17 of the solicitation) “….prophylaxis…”

We cannot offer this. Insurance covers only treatment not prophylaxis, as this is considered undefined coverage.

A: This is a requested Benefit under this solicitation. If you do not offer this Benefit, that shall be stated in your proposal.

8. Q: Referring to Section 1, Sub Section IV, Part I, A.1.1.8 (Page 17 of the solicitation) “Preventive and Wellness and Chronic Disease Management”

We can offer either our wellness programs or approved check up list.

A: Please state in your technical proposal what exactly you are offering and which benefits are included.

9. Q: Referring to Section 1, Sub Section IV, Part I, A.1.1.11.2 (Page 18 of the solicitation) “Orthodontia 80% Minimum coverage; with contract lifetime cap EGP 15,000”

We cannot offer coverage limit for more than one year.

A: This is a requested Benefit under this solicitation. If you cannot offer this Benefit, that shall be stated in your proposal.

10. Q: Referring to Section 1, Sub Section IV, Part I, A.1.1.13 (Page 18 of the solicitation) “Rehabilitative and Habilitative Services and Devices: 50% Minimum Coverage”

We need clear and detailed specification for conditions covered under this benefit with capped amount.

A: The cap for this benefit is up to the overall cap of 400K with 50% minimum coverage.

Please note that we did not receive detailed specifications for conditions covered under this benefit. Examples of Rehabilitative and Habilitative Services are as follows:

“Rehabilitative services (e.g., recovering skills, such as speech therapy after a stroke or physical therapy after an accident). Devices to help gain or recover mental or physical skills lost due to injury, disability or a chronic condition”

11. Q: Referring to Section 1, Sub Section IV, Part I, A.1.3 (Page 19 of the solicitation) “Exclusions to coverage”

We need a clear explanation if psychiatric, congenital and hereditary conditions are covered or not and if not to be added clearly in the exclusions.

A: Psychiatric is not a required benefit under this solicitation however; congenital and hereditary conditions are covered and not part of the exclusion.

12. Q: Referring to Section 1, Sub Section IV, Part II, A.2.1 (Page 21 of the solicitation)

“Group Life Insurance coverage”

Please provide Maximum or FSA.

A: This is a requested Benefit under this solicitation. If you cannot offer this Benefit, that shall be stated in your proposal. There is no maximum life insurance coverage nor FSA.

Life insurance is tied to employees’ salaries regardless of the amounts of their salaries.

13. Q: Referring to Section 1, Sub Section IV, Part II, A.2.1.3 (Page 21 of the solicitation) “Total Permanent Disability Coverage”

There is no mention for waiting period for PTD (6 months) and elimination period for new addition which should be placed. Please advise.

A: Correct, our solicitation does not mention a waiting period for PTD or for new addition. This is a requested Benefit under this solicitation.

14. Q: Referring to Section 1, Sub Section IV, Part II, A.2.6.1 (Page 23 of the solicitation) “During a period of Leave Without Pay or unpaid leave that is one pay period or less, coverage under the insurance contract will continue. The USG will pay the total premium cost to the contractor. The employee’s share of the premium will be collected through payroll deduction in that or the subsequent pay period”

As per our insurance guidelines we can't cover employees not active at work

A: The US Government will pay the contractor the premiums and will handle and collect the premiums from employees who are on leave without pay. The contractor shall receive the premium in full as scheduled.

This is a requested benefit under this solicitation. If you cannot offer this benefit, it should be annotated in your proposal.

15. Q: Referring to Section 1, Sub Section V.1, (Page 25 of the solicitation); Quality Assurance and Surveillance Plan (QASP) “Performance Threshold: No more than one customer complaint is received per month”

This cannot be guaranteed for many factors not related to the contractor.

A: Including a QASP in a services contract is standard for US Government contracts. It is a tool for the Contracting Officer´s Representative to work together with the contractor on achieving satisfactory performance.

16. Q: Please provide Excel census file with following details: date of birth, gender, type of insured (main insured, spouse, child), category of participant, nationality, country of residence, occupation, annual salary).

A: Please refer to earlier reports that were uploaded containing the excel census. Please note that all embassy employees are Egyptian citizens except for one employee who holds Turkish nationality. Kindly note that all our insured employees reside in Egypt.

Please note that we cannot share the occupations for our staff.

As for the dependent data, please see the attached report.

17. Q: Please confirm if the population already covered for Health is the same to be covered for Life.

A: Yes, the employees shall be covered for both Health and Life Insurance. Please note that dependents will be covered for medical insurance only, and not life insurance.

18. Q: Please provide the loss ratio statistics for the past 5 years for Health & Life.

A: Please see data analytics reports uploaded earlier.

19. Q: Please provide the renewal terms for the past 5 years for Health & Life.

A: Please see the plan uploaded earlier.

20. Q: Please provide information about high claims : occurrence date/amount/status for Health & Life

A: Claims analysis for Health insurance has been provided with amendment 00001 and for Life Insurance with amendment 00002.

21. Q: Please confirm if there is an exit clause after the 1 year of cover for Health & Life

A: No, the contract is binding for 5 years. The Government has the right not to exercise an option year if the services are no longer required, funds are not available or the contractor has not performed satisfactory.

22. Q: Please provide Current Premium and Target Premium for Health & Life

A: This information cannot be shared due to the data privacy of our current vendor and to maintain fair competition.

23. Q: Please provide evolution of the insured members over the past 5 years for Health & Life

A: Please provide more clarification, the question is not clear.

24. Q: Please provide evolution of the insured members over the past 5 years for Health &

Life

A: Has been provided with amendment 00002.

25. Q: Please provide information about claims you outside of Egypt during current coverage for Health & Life

A: see amendment 00002.

26. Q: Please confirm the exact start date the contract (Contract performance is estimated to start in April 2021)

A: The contract is anticipated to start in April but a fixed contract start date cannot be stated.

It depends on how long the technical evaluation of proposal will take and if discussions/negotiations with offerors will be necessary.

27. Q: Please include the claims report for May 2018 to April 2019.

A: Please see the reports uploaded earlier.

28. Q: Please confirm the claim fund can be adjusted each year with an economic adjustment formula to be submitted by the insurer for Medical and for Life

A: The contractor may under the Economic Price Adjustment clause request an adjustment in premiums on an annual basis to be effective per contract year, but not during the Base year of the contract.

29. Q: Please confirm our understanding that the retention amount will not be adjusted for the entire 5 years period.

A: The Retention amounts shall be quoted with the price proposal and cannot be changed during the term of the contract.

30. Q: Referring to 52.216-4 ECONOMIC PRICE ADJUSTEMENT.

Please confirm if this section refers to the medical and Life prices or only the administration service of the plan?

C-3 and c-4, please confirm if the of 3% (c-3) or maximum of 10% (c-4) refers to medical and Life rates?

A: The clause is a standard clause required for all fixed-priced contracts and does not apply to the Health or Life insurance premiums.

The Economic Price adjustment for the Health Insurance premiums shall be done in accordance with the prescriptions in the subject paragraph in Section 1 of the solicitation.

The percentages stated in the Clause do not apply to the Health and Life insurance premiums.

31. Q: Can you confirm that only the first year (base year) would be a binding offer and the next year budget would be only indicative and non binding?

A: No the contract is binding for all five years. If the Contractor failing to quote all five years their proposal is nonresponsive

32. Q: Please also confirm that the contract can exit the contract after the 1st year, if no agreement is reached on the premiums with the adjustment formula?

A: No the contract is binding for all five years, price adjustment must negotiated under

ECONOMIC PRICE ADJUSTEMENT.