Questions-Answers-2 22R0041.pdf

LES Health Insurance

Embassy of the United States of America

Rabat, Morocco Solicitation 19GE5022R0041

Questions and Answers

Amendment 0002

Q1: Please provide five years of loss data(table 1) by year of account including annual net premium (for the same period), incurred claims and membership history. For membership history(Table 2) please provide the number of Employees with single coverage and with family coverage at the end of each year. Please do not include any confidential information, just the overall statistics for the group. Claims information is critical to our pricing and the relationship of claims to employee growth or shrinkage is part of the claims analysis.

Table 1

Contractual year Total claims paid (local currency)

Retention amount (local currency)

Total premium paid to Insurer (local currency)

Net gain (local currency)

Estimated Net gain

USD

dd/mm/2016 – dd/mm/2017 dd/mm/2017 – dd/mm/2018

5596182 / 3561398 -2034784 -$208,695 dd/mm/2018 – dd/mm/2019

6141642 / 3858099 -2283543 -$234209 dd/mm/2019 – dd/mm/2020

5545387 / 4588350 -957037 -$98,157 dd/mm/2020 – dd/mm/2021

6046083 / 3863886 -2182197 -$223815

Table 2

Contractual year Single Self plus ONE Family plans dd/mm/2016 – dd/mm/2017 / / / dd/mm/2017 – dd/mm/2018 / / / dd/mm/2018 – dd/mm/2019 / / / dd/mm/2019 – dd/mm/2020 / / / dd/mm/2020 – dd/mm/2021 / / /

A1: Please see tables above.

Reference Table 1 Retention amount: We cannot provide this information.

Reference Table 2.: We cannot provide this information because that is not how the current contract is structured.

Q2: We would like to know if you have been informed of Catastrophic cases, such as: Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases (Radio and Chemotherapy), and hospitalizations with more than 10 days

A2:

Prostate adenoma 2 Heart disease 8

Chronic renal failure 6 Hodgkin lymphoma 13

Gastric tumors 14 Tympanoplasty 1 Thyroid nodules 1

Radiotherapy-Chemotherapy 4 Respiratory Oncology 2

Neuropsychiatry 1 Nerve paralysis 1

Prostatitis 1 Breast tumor 2

Prostate tumor 2

Q3: Could you please provide information about the Claims you have had out of country during your current coverage?

A3: The current vendor paid out of country claims at the same rate as in country claims.

So for example, if someone were to go to Switzerland for some treatment, it would paid at the rate that treatment would have cost in Morocco.