Questions-Answers Part2.pdf

Health Insurance for LES

Embassy of the United States of America

Zagreb, Croatia

Solicitation 19GE5021R0013

Questions and Answers

Part 2

Q1: Which range of age of your employees/contractors/dependents as well as the country of residence do you have? Do you have other ages (other than between 18-39 years) and countries of residence?

A1: All employees and dependants are Croatian Citizens or legal residents of

Croatia. Range of age is between 1 through 65. There are currently no third country nationals.

Q2: Kindly confirm how many people are interested in receiving a policy?

A2: We estimate approximately 115 employees and approximately 200 dependents.

Q3: Are the members interested in worldwide cover or cover in Europe only?

A3: Solicitation imply only required benefits while it is not specified where the benefits can/ should be utilized (in terms of country or region).

Considering Eligible Participants requirements (under part C) we expect offer includes coverage for CROATIA (host country) at minimum.

If the service provider offers coverage in Europe and worldwide with no additional cost, please indicate this on your bids. Same terms and conditions should be applicable.

Q4: What is important to have covered?

A4: The mandatory required benefits listed in the solicitation not covered by host country.

Q5: Do any of the staff live in the embassy?

A5: No

Q6: Will the applicants and dependents spend the majority of the next 12 months in

Croatia?

A6: Yes, applicants and dependents spend most of the year in Croatia.

Q7: In Exibit A Employee Statistics, we have noted

- DP Adult (ages 43, 40, 41)

- Siblings (age 54)

In attached document 21R0013 Zagreb Health Insurance, page 4, Acronyms and

Abbreviations, Dependant, we found:

Dependents are defined as the covered employee’s legal spouse as defined by law (limit one) and children (natural, adopted, stepchild, or foster children). 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. Parents, grandparents, siblings, and other relatives are not eligible dependents

Please could you confirm that the aforementioned DP Adult and Siblings would be eligible to the contract?

A7: Unmarried children up to the age of 26 who are financially dependent upon LE staff member would be eligible for the contract.

Q8: Are all the members in the group US Citizens?

A8: No – The vast majority are Croatian citizens.

Q9: Could you please confirm the right number of dependents. The numbers in your list of employees and in the table do not match.

Total number of dependents in the table is 292, and in the list of employees is 279.

A9: Total number of dependents is currently 292. However as coverage is optional, we cannot guarantee all employees will enroll in this program, so the number of dependents may change as well.

1. Q10: Croatia maintains a mandatory healthcare system for all residents in Croatia under the. However, there are many exemptions in place currently. Under the diplomatic status of the US embassy, does your staff enjoy exemption from this requirement or; does your staff have a local healthcare requirement?

a. If the embassy is not exempt from local mandatory health insurance, can you please confirm the policy in place and any benefit schedules aligned to this policy for your members? (If exemption is in place please ignore)

b. If the embassy is not exempt, please can you confirm whether state care is primary care and this policy is considered as a supplemental policy? (if exemption is in place, please ignore)

A10: Local employees of the Embassy are not exempt from mandatory government healthcare system. This policy is therefore considered supplemental to the local health system.

Q11: Where will the contract be signed (situs) – US soil or Croatian soil. We have fully understood the plan to be regulated under US Law.

A11: It will be signed in the US consulate in Frankfurt.

Q12: Is cover for treatment in the US required?

A12: Solicitation implies only required benefits while it is not specified where the benefits can/ should be utilized (in terms of country or region).

Considering Eligible Participants requirements (under part C) we expect offer includes coverage for CROATIA (host country) at minimum.

please indicate this on your bids. Same terms and conditions should be applicable

Q13: Is treatment outside of Croatia required?

Solicitation implies only required benefits while it is not specified where the benefits can/ should be utilized (in terms of country or region).

Considering Eligible Participants requirements (under part C) we expect offer includes coverage for CROATIA (host country) at minimum.

please indicate this on your bids. Same terms and conditions should be applicable

Q14: Is medical evacuation of cover required?

A14: No – medical evacuation is not required.

Q15: It has been requested all claims are paid by check. Can you please confirm your staff would be open to receiving payments through check and through alternative means such as bank transfer? The latter may be more cost efficient and customer friendly, negating any costly bank charges per check / claim.

A15: Bank transfer is preferable.

Q16: Can you please share which hospitals in Zagreb Croatia or internationally are utilized the most by your staff:

Are there any special agreements currently in place between the embassy and any medical facilities that we should know about?

Is there any ongoing care or planned treatment (in or outpatient) that we should know about for which a transition of care should be arranged to ensure continuity of service and care to your staff? If so please list and confirm any cases and the treating hospital so we may prepare for transition of care

A16: Currently there are no special arrangements with hospital/clinics or other medical facilities for Embassy local employees.

Q17: Can you please share some more information about the weighting of the scoring of the tender, e.g. what are the weighting percentages of the technical vs. the financial pricing?

A17: not applicable - see section 1, IV SPECIFICATIONS

Q18: Regarding the pricing process, will there be a round of Best and final offer (BAFO) or a Last and Final offer (LAFO)?

A18: The government intends to award to initial proposal but reserves the right to negotiate

Q19: Are there any other areas of focus beside the administration of the plan which are of particular importance such as virtual GP or any other related services? Please list your top requirements.

A19: The solicitation coverage requirements and efficient processing of claims.

Q20: Can you please share with us in which areas of the plan administration your needs are the greatest please list your top three priorities if they differ from your top three challenges

A20: All medical services listed in solicitation document are equally important.

Q21: Given this is a new policy review, can you please list the top three challenges you’ve encountered during the self-administration of the plan?

A21: Embassy Zagreb is implementing this plan for the first time, so there is no previous experience that can be shared.

Q22: Section V.9.1. - what does the following sentence mean?

"state the frequency of inspections and the use of operational records"

A22: Provide information if and how often you use internal inspections as part of your internal quality control. Provide information on SOPs (Standard Operating Procedures) to assure high quality services.

Q23: Joint venture of company x and company y. The company X submitting the proposal (the company which has completed and signed the SF449 and provided their DUNS number and in which name the SAM registration is and will be considered as the contractor?

A23:

Option 1

If company x and y are creating a joint venture, that joint venture company would be company z and that company needs to have a duns number, SAM registration, and need to complete SF1449.

Or Option 2

If you want to submit a proposal with a main contractor and a subcontractor, only the main contractor needs to have a duns number, SAM registration and needs to complete the SF1449

Form. The information about the sub-contractor needs to be mentioned in the technical proposal.

Q24: The contractor may work with a sub-contractor on this contract. Additional to the list of subcontractors do you need any additional documents; past experience and references, financial details, business management proposal, training plan, licenses etc. from subcontractors.

A24: You only need to provide the name, the sub-contractor information and what the sub-contractor will perform in your proposal.

Q25: Which currencies can be used for the price proposal?

A25:: The Proposal can be quoted in any currency.

Q26: Embassy in Zagreb will pay monthly invoices. Which currency will be use for the payment, same as in price proposal, with or without exchange rate e.g. HKN to EUR or USD?

A26: Payment will be made in the currency the contract has been issued in. (The price proposal has to be quoted in).

If the your monthly firm fixed pricing rate per person is fore example $200.00, then $200.00 will be paid.

Q27: Please clarify the Capping at max contract value requirement, what if a high-cost claim occurs which typically would be above this threshold?

A27: Insurance provider is obliged to cover the costs up to a maximum cap, as set by the plan. If there is a high-cost claim which exceeds the cap, then the benefit is paid only up to a maximum cap.

Q28: Can you please confirm worldwide as the region of cover.

A28: The plan at a minimum must cover services in Croatia.

Q29: The Government intends to award to the lowest priced, technical acceptable. If company X offers some additional benefits / higher benefit that shall be stated in the proposal. How you compare additional benefits and provided prices? Should we any additional benefit be priced separately, as a rider to the contract?

A29: To be technical acceptable, the offeror needs to offer the minimum benefit levels requested in the solicitation. If an offeror is offering benefit levels above the minimum, we do not compare additional benefit levels.

Q30: Croatian basic (obavezno) state medical insurance is in place?

A30: Yes – all Croatian citizen employees (locally employed employees) are enrolled in the state medical scheme.

Q31:Who is covering cost for benefits that are covered by Croatian basic (obavezno) state medical insurance, but also medical plan for LES purchased by the Embassy?

A31: If medical service is provided by the private medical clinic and the service is paid at the clinic, then the cost is covered by the medical plan purchased by the Embassy. This is regardless of the fact that the same service may be also covered by the state medical system.

Q32: Economic Price Adjustment is mentioned in the Solicitation, but there are no retention tables in Attachment 1 - Pricing Tables. Can we submit the retention at the bottom of Attachment 1 - Pricing Tables worksheet?

A32: Yes, you can submit retention

Q33:Are there any persons who are currently hospitalized? If Yes, please provide number (we do no t need the names or identification, we just need to know the total number of people hospitalized to assess the risk)

A33: There are no hospitalized employees at the moment.

Q34:Are there any large losses (in excess of $10,000) within the last year to date? If Yes, please prov ide number (please note we are not seeking protected private information, we do not need the nam es or identification; we just need to know the total number of large losses and the amounts to asses s the risk and price accordingly)

A34: It is a new project. We have no historical values

Q35: Could you provide spilt per category:

Employee + 1 26

Family Plan 91

Principal Members

Adult Dependents

Child Dependents

A35: Please see exhibit A – employee statistic