19GE5022R0048_Q and A set one_revised.pdf

19GE5022R0048 Questions and Answers set one revised

RPSO has received the following eighteen (18) questions and is providing the below answers.

Additions to the previous Question and Answers set one are in red.

1. Q: 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)

Net gain USD or

EUR

31.08.2016-

31.08.2017

5.665.156

5.308.973

31.08.2017-

28.02.2018

3.160.068

2.928.670

28.02.2018-

28.02.2019

7.457.910

8.208.934

28.02.2019-

31.07.2019

3.161.646

3.655.412

31.07.2019-

31.08.2019

331.968

729.994

31.08.2019-

31.08.2020

11.207.139

17.969.462

31.08.2020-

31.08.2021

13.303.171

23.496.428

Table 2

Contractual year Single Fert Self plus ONE Family plans

31/08/2019 – 31/08/2020 10.196 20.392 27.991

31/08/2020 – 31/08/2021 12.745 25.490 34.989

31/08/2021 – 31/08/2022 15.932 31.863 43.737

2. Q: 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.

A: Please see table below:

Case description

1 NASOPHARYNX, CHEMOTHERAPY FOR UNDEFINED MALIGNED NEOPLASM CANCER

2 VULVA MALIGN NEOPLASM CANCER

3 METASTATIC CARCINOMA OF THE PANCREAS CANCER

4 MALIGNANT NEOPLASM OF FACIAL SKIN, OTHER AND UNDEFINED PARTS

// BCC

CANCER

5 MYELODYSPLASTIC SYNDROMES, CEREBRAL Ischemic Attack CANCER

6 THYROID CA CANCER

ADENOCARCINOMA DEVELOPED ON BARRET'S FLOOR, MALIGNED

NEOPLASM OF THE STOMACH, UNDEFINED

CANCER

8 THYROID CA CANCER

9 CLL CANCER

10 THYROID CA CANCER

11 BREAST CA CANCER

12 BREAST CA CANCER

13 BLADDER TUMOR CANCER

14 COLUMN ADENO CA CANCER

15 PROSTATE CA CANCER

16 BREAST CA CANCER

17 THYROID PAPILLARY CA-Pituitary Macroadenoma CANCER

18 MALIGNED NEOPLASM OF THE THYROID Gland CANCER

19 NECK DISC DISORDERS, CERVICAL DISCECTOMY WITH ANTERIOR

APPROACH FOR COMBINED WITH RADICULOPATIA, CAGE+GREF

ORTHOPEDICS

20 SAĞ DİZ MENİSKÜS YIRTIĞI, KONDROMALAZİ, DİZ EKLEM KIKIRDAK YIRTIĞI

İÇİN ARTROSKOPİK MENİSKÜS ONARIMI, EKLEM KIKIRDAĞI

DEBRİDMANI+PRGF

ORTHOPEDICS

21 LUMBAR MICRODISCECTOMY FOR LACK PAIN(USING A MICROSCOPE)-

SINGLE LEVEL

ORTHOPEDICS

22 LUMBAR MICRODISCECTOMY FOR LUMBAR DISC STRENGTH (USING A

MICROSCOPE)-SINGLE LEVEL

ORTHOPEDICS

23 OTHER DORSALGIA, CERVICAL ANTERIOR DISCECTOMY FOR CERVICAL

REGION C5-6

ORTHOPEDICS

24 ARTHROSCOPIC ANCIENT CROSS-LIGATE RECONSTRUCTION FOR RIGHT

ACL rupture

ORTHOPEDICS

ESWT FOR FOOT SOLE FACIAL FIBROMATOSIS (5 SESSIONS)

ORTHOPEDICS

26 5 SESSIONS FOR LATERAL EPICONDILITIS ESWT ORTHOPEDICS

5 SESSIONS FOR RIGHT ELBOW LATERAL EPICONDILITIS ESWT

ORTHOPEDICS

28 Left shoulder strain syndrome,ARTROSCOPIC BANKART REPAIR FOR

ROTATOR KUF SYNDROME

ORTHOPEDICS

29 ESWT FOR FOOT SOLE FACIAL FIBROMATOSIS ORTHOPEDICS

30 RIGHT FOOT PAIN AND LIMITATION OF MOVEMENT, DIFFICULTY IN

WALKING, BROKEN PLASTER APP

ORTHOPEDICS

31 SOFT TISSUE DISORDER, BENIGN SOFT TISSUE TUMOR FOR UNDEFINED,

DEEP

ORTHOPEDICS

32 UNSTABLE ANGINA,CHRONIC ISCHEMIC HEART DISEASE, SELECTIVE RIGHT-

LEFT CORONARY ANGIOGRAPHY AND BY-PASS CONTROL FOR UNDEFINED,

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY AND STENT,

SINGLE VESSEL

HEART

SURGERY

STORY

3. Q: What is the name if the insurance company that currently provides coverage?

A: Bupa Acibadem Sigorta

4. Q: Is there a preferred list of Hospitals, Clinics or other Medical Facilities that the Embassy employees prefer? If yes, please provide a list of these facilities.

A: No there is no preferred list of Hospitals.

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

A: There is no abroad treatment claims in current year.

6. Q: Has there been any changes to the Table of Benefits over the past 5 years?

A: Yes there has been changes to the Table of Benefits over the past 5 years.

7. Q: Referring to the Table of Benefits it is stated that there is no requirement for coverage out of

Turkey. However, could offerors offer international coverage as well?

A: All benefits covered under table of benefits are minimum levels. Offerors can offer international coverage or any other additional coverage that they may prefer by keeping the minimum levels of benefits.

8. Q: Would the Embassy accept proposals in USD where premium are also paid in USD from non

US companies?

A: No. See Solicitation Section I, Sub Section B. Prices, 5: The contract will be issued in Turkish

Lira. Offerors shall quote their prices in Turkish Lira.

9. Q: Can also claims be paid in USD or is there a need to be paid in the local currency?

A: Claims are needed to be paid in local currency due to the high fluctuation in dollars.

10. Q: Can proposals be submitted electronically or does the Embassy insist on hard copies?

A: Email submission is requested. See Solicitation Section III - Proposal due date:

Offers shall be submitted no later than 1000hrs Central European Time (CET) on April 15, 2022, via email to Ms. Wencke Jacobsen at Jacobsenw@state.gov. The email subject line must read “Solicitation 19GE5022R0048”.

11. Q: Would the Embassy accept a proposal form an internationally licensed insurance company under an offshore jurisdiction or does it insist on a locally licensed insurance company only?

A: See Solicitation Section III – Instructions to Offerors, Volume 2 Technical Proposal

(B) Business Management proposal & Company Profile and

(D) Licensing Information

12. Q: Would the 2 % tax based on James Zadroga Act be applicable to this solicitation?

A: Yes. 52.229-12 Tax on Certain Foreign Procurements (FEB 2021) and 52.229-11 Tax on Certain

Foreign Procurements—Notice and Representation (Jun 2020) apply to this solicitation and are included in Sections II and V. IRS Form W-14 is being provided in the attachments.

Offerors need to provide representation 52.229-11 Tax on Certain Foreign Procurements—

Notice and Representation (Jun 2020) as part of their Proposal (Volume 1 – Tab C

Representations and Certifications).

As per 52.229-11, an offeror representing they are a foreign person also needs to submit the IRS

Form W-14.

On the IRS Form W-14 Offerors can seek relief from the 2% excise tax if

• they are Nationals (including corporations and individuals) of a country covered by a qualifying tax treaty (See IRS Notice 2015-35 for a list of qualified income tax treaties).

Or

• services are provided in a country which is part to an international procurement agreement with the US (World Trade Organization Government Procurement

Agreement WTO GPA, see FAR 25.400 https://www.acquisition.gov/far/part-

25#FAR_25_402).

13. Q: Is this a mandatory plan, meaning all employees of the Embassy will be covered or voluntary, meaning the employees will be given the option to sign up for the health insurance?

A: Not Mandatory. Employees will be given the option to sign up for the health insurance.

14. Q: Do the employees have a mandatory state insurance in Turkey and is this insurance meant to be supplemental to the mandatory health insurance provided by the state?

A: Yes employees have mandatory insurance provided by GoT. This insurance is a supplemental health insurance.

15. Q: Could you please clarify if the guaranteed minimum of 100 enrollees consist only of employees or family members are included to this number.

A: The number of enrollees is the same as the number of employees covered under the Pricing section. These enrollees might or might not have eligible family members covered by this contract.

16. Q: Could you please provide census of the family members as well?

A: 568 Spouse , 815 Children

17. Q: What are the possible differences to the provided “Estimated Number of Premiums under a, b, c” as the number of insured persons is essential for the risk evaluation (premium rates calculation).

A: If this question pertains to CLIN numbers A, B and C under the Pricing Chart, clarification on these categories are as follows:

· A denotes only a single employee, , i.e. one individual

· B denotes two individuals, i.e. the employee plus one eligible dependent (spouse or child of the Employee)

· C denotes three or more individuals, i.e. the employee plus two eligible dependents

(spouse and two children of the Employee)

Additional information:

The numbers shown on the pricing sheets are estimates.

The current actual employee numbers as of April 8, 2022, are:

Single Employees: 227 Employee plus one: 165 Family: 453

These numbers are subject to change.

18. Q: Is this Solicitation addressed only to Insurance companies or would Insurance intermediaries/brokers also be eligible offerors?

A: The USG intends to award the contract to the lowest priced, technically acceptable, responsible offerors that submitted a proposal in compliance with the terms of the solicitation.