22R0052_Questions and Answers set one.pdf

19GE5022R0052 Questions and Answers set one

RPSO has received the following seventeen (17) questions and is providing the below questions.

1. Q: Would health insurance be mandatory or voluntary for the local staff members?

A: Voluntary, but we assess that almost everyone will sign up, as no local health coverage exists.

2. Q: Are you looking for a local plan for the employees or an international plan?

A: Please see Section I, Sub Section C – Statement of Work.

The eligible members are Locally Employed Staff and their dependents located in the Central

African Republic. Treatment outside of the CAR shall also be covered as per C.1.16 (Out-of-

Country Medical Treatment) and C.1.17 (Out-of-Country Medical Travel).

3. 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:

A: The embassy Health Unit currently receives and evaluates claims and reimburses employees for medical expenses directly, i.e., without the involvement of a third-party insurance company.

Employees have historically submitted few receipts for reimbursement because they either

1) lacked the funds to pay for services up front

2) the services were not available in CAR, or

3) they had privacy concerns about other embassy employees processing their claims.

Or a combination of the three.

Thus, amounts of claims paid by the embassy, information about premiums to insurers, and net gains, are not entirely applicable. The embassy has paid in the low- (~$15,000) to low-mid-five-figures (~$35,000) each year for medical claims but assesses the utilization of medical coverage will go up when employees do not have to pay up front the full cost of service under the terms of the current solicitation.

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

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

Table 2:

A: The embassy has grown significantly since 2016 in tandem with the changing geo-political situation in the Central African Republic. We assess embassy numbers will remain relatively stable (+/-8%) until the last year of the contract when we may hire additional staff as we move into a new embassy. It is possible, however, that new embassy construction is delayed, and we do not hire additional staff until

2028 or beyond. Please see information in the solicitation for the number of covered individuals.

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

4. 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: There have been no cases of open-heart surgery, major orthopedic surgery, or organ transplant in the embassy community in the known past (~10 years). There has been one major trauma case, one oncology case with chemo, and two hospitalizations of ten days (the oncology case and a trauma case).

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

A: N/A. The embassy currently receives, evaluates, and processes claims and pays directly to employees without the involvement of a third party.

6. 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: General Hospital, Community Hospital, Amitie Hospital, Elizabeth Domitien Hospital, Pediatric

Clinic, Sainte Blandine Clinic (next to the 4th district police station), Cabinet Medical Hibiscus, Laennec Clinic, Yellen Clinic, Centre D’imagerie Diagnostique Avicienne, Le Bon Coeur Clinic, National Blood Bank, Al Haythan Opthamology Clinic, Institut Pasteur, National Lab, Sante Plus

Clinic, Espace Sante, CNLS (HIV clinic).

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

A: In the past one year, there have been five staff approved for out-of-country medical travel, but only three of them were able to perform it due to high out of pocket expenses. Staff also must obtain visas on their own, which sometimes complicates travel plans. Most frequent destination is Cameroon, followed by Kenya and Morocco. There are four additional out-of-country medical travels since 2019. Reasons have been: orthopedist (2x), neurology (2x), neurosurgery, ENT, endocrinology, urology.

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

A: Yes, this is a new requirement with a new Statement of Work.

In U.S. Government contracting, every solicitation is considered a new requirement for the government. A previous contract may contain the same type of services; however, a new solicitation for the same type of services may contain a different scope of work for the government’s same need. If you choose to submit a complete, responsive proposal for this solicitation, please respond accordingly to the current Solicitation Number 19GE5022R0052.

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

US companies?

A: Please see Section I, Sub Section B. Pricing, 5. The Offeror shall state the currency of price offer. The contract will be issued in the currency the offeror issued their price proposal in. The currency of the contract may not be changed during the performance period of the contract.

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

A: Claims paid to business entities in CAR would be paid in local currency.

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

A: See Section III, Proposal Due date:

Proposals should be submitted electronically.

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 19GE5022R0052”.

Delivery via a cloud file storage service (eg. GoogleDrive, etc.) is not allowed.

If the proposal is sent in multiple emails, the email shall be labeled accordingly (eg. file 1 of 2).

Individual emails may not exceed 50MB and shall not include zipped files (.zip / .rar).

Late submissions shall not be considered.

12. 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: U.S. Embassy Bangui is aware of several large multinational health insurance companies that successfully execute health insurance contracts with international organizations and international NGOs. That said, we refer to the language from the solicitation:

In accordance with 652.242-73 – AUTHORIZATION AND PERFORMANCE offerors need to warrant

a) that it has obtained authorization to operate and do business in the country or countries in which this contract will be performed;

That is has obtained all necessary licenses and permits required to perform this contract;

and that it shall comply fully with all laws, decrees, labor standards, and regulations of said country or countries during the performance of this contract.

b) If the party actually performing the work will be a subcontractor or joint venture partner, then such subcontractor or joint venture partner agrees to the requirements of paragraph (a) of this clause.

13. Q: Would 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). The Central African Republic is not part of WTO GPA.

14. 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: See response question #1

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

A: We assess that the total number of premiums will not change by more than 8% as discussed above.

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

A: We are intending to issue a contract to a contractor to provide us with Health Insurance services. Any offeror may submit a proposal conforming with the terms and conditions of our solicitation and in accordance with the Instructions to Offerors. Award will be made to the lowest priced technical acceptable and responsible offeror.

Intermediaries and brokers are acceptable if all above mentioned criteria are met.

17. Q: When is starting date of the insurance?

A: The contract is anticipated to start this calendar year as soon as possible after the solicitation has closed and the technical evaluation and source selection process has been completed.

https://www.acquisition.gov/far/part-25#FAR_25_402 https://www.acquisition.gov/far/part-25#FAR_25_402