Questions-Answers 23R0033.pdf

LE Staff Health Insurance Services

Embassy of the United States of America

Harare, Zimbabwe Solicitation 19GE5023R0033

Questions and Answers

Q1: Are the employees/families local nationals, based in Zimbabwe, who do not travel outside of the country?

A1: Employees are local nationals who may travel outside Zimbabwe.

Q2: Will the contract be administered or signed from Germany or Zimbabwe?

A2: Germany

Q3: Who is the current insurer and what is the renewal date?

A3: Fidelity Life Medical Aid Society (FLIMAS). 1 July 2023

Q4: 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

dd/mm/2018 – dd/mm/2019 dd/mm/2019 – dd/mm/2020 dd/mm/2020 – dd/mm/2021 dd/mm/2021 – dd/mm/2022 dd/mm/2022 – dd/mm/2023

Table 2

Please, provide headcounts for the last 5 years:

Contractual year

Employee Spouse Children

A4: Please see completed tables below:

year

Total claims paid (local currency)

Retention amount (local currency)

Total premium paid to Insurer

(USD)

Net gain (local currency)

Net gain USD or

EUR

dd/mm/2018 – dd/mm/2019

Data Unavailable

Data Unavailable

704 534.62 Data Unavailable

Data Unavailable dd/mm/2019 – dd/mm/2020

536,403.59 Data Unavailable

797 567.21 Data Unavailable

Data Unavailable dd/mm/2020 – dd/mm/2021

482,630.40 Data Unavailable

618 827.94 Data Unavailable

Data Unavailable dd/mm/2021 – dd/mm/2022

349,270.81

Data Unavailable

613 282.92 Data Unavailable

Data Unavailable dd/mm/2022 – dd/mm/2023

341,203.46 year

Employee Spouse Children

1 251

2 251

3 260

4 271 223 559

5 274 222 567

Q5: 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.

A5: Yes, three oncology cases in the past 5 years, however there could be more cases we were not informed of.

Q6: Does current provider has “direct billing” in place also for outpatient treatments with medical facilities in Zimbabwe?

A6: Yes

Q7: Could you please provide information about all claims / year occurred out of country during the current coverage?

A7: Data unavailable.

Q8: Has there been any changes to the Table of Benefits over the past 5 years?

A8: This is going to be a new contract with different benefit levels than the previous contract we had in place for the past five years.

Q9: Are there any differences between the current Table of Benefits and new solicitation.

A9: This is going to be a new contract with different benefit levels.

Q10: Final proposal can be submitted electronically or does the Embassy insist on hard copies?

A10: Electronically as stated in Section 3.

Q11: Health Insurance services for Locally Engaged Staff and their dependents at the US Embassy in Harare, Zimbabwe, is a voluntary or mandatory plan?

A11: Individuals will be covered on a voluntary basis.

Q12: If voluntary, meaning all employees of the Embassy will be covered on voluntary basis – to the employees will be given the option to sign up for the health insurance - is there any guarantee of min. number of insured LES?

A12: No, the quantities are reasonable estimates only. The Government is not obligated to order the estimated quantities.

Q13: The number of insured persons is essential for the risk evaluation (premium rates calculation) and for the requested enrollment procedure (without individual medical underwriting). What is impact on the proposed premium rates and prices if, compared to the estimated figures (EXHIBIT A, EXHIBIT B, EXHIBIT C), less than 75% of the US Embassy staff and their dependents decide to be enrolled in the insurance plan?

A13: None.

Q14: All LE Staff covered under post’s medical benefit plan will pay a 10% share of the premium. The Embassy will collect 10% share of the premium?

A14: Yes.

Q15: Solicitation wording doesn’t’ request offeror to have license/certificate/-accreditation, which demonstrates that the offeror is licensed/certified/accredited or otherwise authorized by the Government of Zimbabwe to provide medical insurance within Zimbabwe as the host country?

A15: Please read Section 3.Volume 2 Technical Proposal,Tab (B)b Licensing Information.

Q16: Would the Embassy accept a proposal from an international insurance company under an “off shore” jurisdiction?

A16: 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.

Q17: Would 2 % tax based on James Zadroga Act be applicable to this solicitation ?

A17: Yes.

Q18: Would DBA insurance be applicable to this solicitation?

A18: No.

Q19: Would the Embassy accept proposals shown in USD or EURO?

A19: USD.

Q20: Would the Embassy accept to pay invoices and insurance premium in USD (or EURO) to the non-Zimbabwian companies?

A20: As stated in the Solicitation, USD.

Q21: Is there a US address where the monthly billing will go to?

If not, what address will the billing be mailed to?

A21: No, Invoices shall be issued in accordance with the instructions in Section 1. V.11.3 Invoices, Review and Payment.

Q22: Please provide Primary work activity for the employees?

A22: Employee work activities vary, the embassy employs, gardeners, custodians, technicians, engineers, and administrative and program positions. See below approximate split.

Category Percentage Manual Work 22 Technical Work (artisans, technicians etc.) 19 Administrative 59

Q23: Are the employees, US citizens, or Zimbabwe nationals?

A23: We have one U.S. Citizen, and the rest are Zimbabwean nationals , however employees from other nationalities can be hired as long as they meet the legal employment requirements.

Q24: Can I have the current coverage and current plan description, premium and claims data from the last three years showing premiums paid and claims paid for each annual period?

A24: This is going to be a new contract with different benefit levels. For a claims history please see Exhibit A – Employee Statistic.

Q25: Our premium rates depend on whether a beneficiary is a child or an adult. For example, a plan may cost USD75 per adult and USD 45 per child, so give below like Employee + 3, how do we produce the prices? Do these employee +1, employee +2 etc. for adults only?

Therefore, in the table below it is not clear whether the additional member is a child or adult.

A25: The pricing model accounts for employee + dependents regardless of age. An offeror would need to produce a price that caters for this category.

Q26: What is the difference between the annual maximum limit (68,000) and the excess coverage limit (68,000)?

A26: Annual maximum limit is the total benefit per year. The excess coverage is an additional $68,000 of coverage that employees would individually opt in for and pay.

Q27: Is the Excess coverage benefit mandatory?

A27: Yes, it is mandatory to provide prices for benefit “Excess coverage”. This excess coverage will be offered as an optional benefit to LE Staff. For this, please use updated Pricing Schedule that shows a separate line Item for this Benefit Level.

Q28: Is there a deadline to register on SAM.gov or will only be require when offeror is successful?

A28: The Contractor needs to have an active SAM Registration at the time of award.

This is mandatory to be considered for award.

Q29: Is Administrative Retention Amount going to be quoted separately or it is only needed when there are price adjustments

A29: Administrative Retention Amounts have to be quoted with your proposal (Attachment 1 – Pricing).

Q30: Can you clarify FAR52.222-50 Trafficking in Persons and Compliance?

A30: Please read the instructions in FAR 52.222-56 – CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE PLAN. If it is not applicable, please state that in your Proposal.

Q31: Tax Identification Certificate (TIN) issued by your country’s Ministry of Finance as well as annual letter of tax clearance. In Zimbabwe Tax Clearance is offered by Zimbabwe Revenue Authority, is this good enough?

A31: Yes.

Q32: Document name: SF1449

Block 17 (a) Code and Facility Code Block 17 (b) Remittance

A32: You can leave it open – Please insert the Company name, address, Contact, Telephone No., and UEI.