Attachment 6 - Questions and Answers.pdf

SOLICITATION 19GE5026R0003 – AMENDMENT 0001

QUESTIONS AND ANSWERS

QUESTION 1:

Why are Date of Birth not being disclosed in this solicitation when removing the names?

Answer: The Government is not providing dates of birth, or other personally identifiable information (PII) such as names in solicitations. Under FAR Part 24, DOSAR Part 624, and Department of State policy (12 FAM 540), PII must be protected and may only be disclosed in accordance with the Privacy Act. Even when names are removed, Date of Birth and similar demographic data can be used to identify individuals, particularly in small overseas posts. Therefore, disclosure of this information to offerors is prohibited. Offerors should prepare pricing proposals based on the information provided in this solicitation. The only information available at this stage is provided in Attachment 5 – Employee Statistics, which provides e.g. gender and age ranges without disclosing PII information.

QUESTION 2:

Please provide average insured member counts (employees, dependent children, and dependent spouse) for Health Insurance for the last 5 years – 2025, 2024, 2023, 2022 & 2021.

Answer: Please see amended Attachment 5 – Employee Statistics which now includes claims data for the available time periods and average member counts.

QUESTION 3:

Please provide claims data for data for Health Insurance for the last 5 years – 2025, 2024, 2023, 2022 & 2021.

Answer: Please see amended Attachment 5 – Employee Statistics which now includes claims data for the available time periods.

QUESTION 4:

When is the plan likely to commence?

Answer: The period of performance is set to commence on August 01, 2026 as provided in Section I, Sub-Sections A.1.2 and Section D.13.

QUESTION 5:

Is participation in the medical plan voluntary or mandatory?

Answer: Participation is voluntary. The current participation rate is 99% of employees.

QUESTION 6:

Premium rates: Do both groups have a common premium or separate premiums based on each group’s risk profile?

Answer: They have a common premium, no premium differentiation based on risk profile, unless someone opts for excess coverage.

QUESTION 7:

Who pays premium for each of the groups?

Answer: The employer pays 90% and the employee pays 10%. Employee contributions towards the premium are handled by the employer, so full premium would be paid directly from the employer.

QUESTION 8:

Does EPA clause section B.3 apply to both groups?

Answer: Please see Section I, Sub-Section B.1.3. The EPA clause applies to all premiums except for riders. Riders are outlined in Section I, Sub-Section C.5.2. Section B.3 refers to the administrative retention amounts. As stated in Section B.3, the retention amount will not be adjusted for any reason. The administrative retention amounts are fixed, non-claim costs that do not fluctuate based on medical cost trends or external market indices.

QUESTION 9:

Average insured member counts for the years are provided in Attachment 5. Please add a column to each of tables indicating average member counts for corresponding years.

Answer: See answer to question 2.

QUESTION 10:

Are multi-year historical loss runs available for the covered population? If so, please confirm the number of years available and whether they will be provided prior to proposal submission.

Answer: Please see answer to question 3.

QUESTION 11:

Please confirm whether the Embassy intends for the premium rate for “Employee + Spouse” to be the same as the rate for “Employee + One Child,” or whether these should be priced as separate coverage tiers.

Answer: Yes, “Employee+ Spouse” is the same as “Employee+ One Child”. Both are treated as “Employee +1” as stated on Attachment 1 – Price Proposal Breakdown.

QUESTION 12:

Are there any geographic exclusions for required coverage under this policy, such as services rendered in the United States, or is worldwide coverage required without exclusions?

Answer: All minimum requirements provided in Section C – Statement of Work need to be fulfilled.

QUESTION 13:

With respect to Section C.3.18, Out-of-Country Medical Travel, does the required coverage include both air transportation and ground transportation, or is the requirement limited to ground transport only?

Answer: Required coverage includes air transportation for out-of-country medical travel.

QUESTION 14:

If available, can the Embassy provide historical utilization data for medical evacuation or out-of-country medical travel benefits?

Answer: All benefits are covered under the claims report provided in amended Attachment 5 – Employee Statistics. There is no separate historical data on medical evacuation or out-of-country medical travel benefits available.

QUESTION 15:

Please confirm whether HIV/AIDS is the only benefit category for which coverage is expected to exceed the stated USD 68,000 threshold, or whether other benefit categories are also expected to exceed this amount.

Answer: $68,000 is the annual global limit for the plan as stated in Sub-Section C.8.

HIV/AIDS alone has its annual cap of $10,000 as stated in Sub-Section C.3.15.

QUESTION 16:

For eligibility and enrollment purposes, should the hire date be interpreted as the employee’s onboarding date, or another effective date defined by the Embassy?

Answer: Yes, the hiring date is the onboarding date.

QUESTION 17:

What is the maximum eligibility age for employees, spouses, or dependents that the Embassy will accept under the proposed health plan?

Answer: There is no age limit for employees and their spouses. There is an age limit on dependent children who are covered up to the age of 26 as stated in Sub-Section C.5.3 – Dependents – Dependent Children.

QUESTION 18:

Rating Structure: Our usual pricing format is in the form of adult/child rates or age banded. Do you only need pricing based on family size (EE, EE+1, EE+2, etc) as per your Price Proposal Breakdown?

Answer: Yes, pricing needs to be provided in the structure of the price proposal breakdown.

QUESTION 19:

Is there any broker involved? If so, what broker commission should be factored into the pricing?

Answer: No, there is no broker involved.

QUESTION 20:

Census: Is there a possibility for us to get an accurate member list showing dates of birth, country of location, and nationality? No need for full names for now.

Answer: See answer to question 1.

QUESTION 21:

Excise Tax: What are the implications of the excise tax mentioned in section B.1.2 of the Solicitation document? Should we apply it in our pricing?

Answer: The 2 % excise tax under the James Zadroga 9/11 Health and Compensation Act is a tax the U.S. Government must collect on certain federal procurement payments to foreign contractors (meaning Non-U.S. contractors) when goods or services come from countries not part of international procurement agreements. The government withholds it from payments, and agencies may not reimburse contractors for it. Please refer to FAR 52.229-11 provided in the solicitation and check applicable boxes.

You may also refer to FAR clause 52.229-12 provided by reference in the solicitation and in full text on https://www.acquisition.gov/far/52.229-12.

The 2% excise tax is not reimbursable and may not be included in the contract price.

https://www.acquisition.gov/far/52.229-12

QUESTION 22:

Will economic price adjustment at renewals be based on LES group only or also include rider groups?

Answer: See Sub-Section B.1.3.1.

QUESTION 23:

Regarding benefits: What is your preferred Outpatient Benefit limit?

Answer: See Sub-Section C.3.4. 80% is the minimum acceptable coverage.

QUESTION 24:

Regarding benefits: Is $68,000 the only overall limit the Government will accept, or is it the minimum the Government will accept?

Answer: It is the overall limit the Government will accept.

QUESTION 25:

We understand that additional rider groups are not part of this quote for now. What is the approximate size of potential rider groups that might be interested in getting cover?

Answer: This is unknown at the moment as their participation is voluntary as well.

QUESTION 26:

Claims Reports: Can we provide these on a quarterly basis instead of monthly?

Answer: No, they are required on a monthly basis as stated in Section D.3.3.

QUESTION 27:

Is the group currently covered on a group medical plan? If so, is it possible to know who the current provider is?

Answer: The identity of the current contractor is not disclosed in order to maintain a fair and open competition, in accordance with FAR 3.104-4 and FAR 15.506(d).

QUESTION 28:

If group has some past medical cover, can we get their claims experience for the last 3 policy years and benefits?

This will allow us to more accurately price the group based on their performance.

Answer: Please see amended Attachment 5 – Employee Statistics which now includes claims data for the available time periods. There is no personal information available due to the reasons specified in answer to question 1. Offerors are encouraged to use available data in order to prepare their proposals.

QUESTION 29:

Is it guaranteed that the group will stay on cover for the next four years with the insurer that wins the tender (assuming operational requirements are met)?

Answer: The government intends to maintain coverage for eligible participants for the duration of the contract, and continuity of coverage will be a priority in future procurements, but this cannot be guaranteed beyond the terms of the current contract.

The contract will be for the duration for one base year and four option years to commence on August 01, 2026 as stated in Section A.1.2.

QUESTION 30:

Can you provide guidance on SAM registration?

Answer: Please see added attachment 7 to provide the SAM registration guide and attachment 8 to provide the SAM registration process.

[END OF QUESTIONS AND ANSWERS]