Attachment 8 - Questions and Answers.pdf
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- Attached to
- Life and Health Insurance Services for Locally Employed Staff at U. S. Embassy Kingston, Jamaica
- Solicitation number
- 19GE5026R0041
About this file
This is a Questions and Answers document (Amendment 0002) for Combined Synopsis/Solicitation 19GE5026R0041 concerning health and life insurance services for the U.S. Embassy in Kingston, Jamaica.
The document clarifies that the stated benefits represent proposed benefits rather than current benefits, with the complete benefit schedule located in Section C.1.1 of the Statement of Work. Regarding benefit coverage, minimum coverage percentages of 80% refer to the percentage of provider costs rather than Reasonable and Customary rates. Corrected benefit maximums are provided for optical care and dental care: optical care covers prescription lenses, frames, or contact lenses up to $47,700 Jamaican Dollar (JMD) per individual every two years with 80% minimum coverage and annual cap; dental care covers examinations, treatments, cleanings, fillings, extractions, false teeth, crowns, and bridges up to $508,800 JMD per individual per contract year with 80% minimum coverage and annual cap, while orthodontia coverage (limited to four years) is capped at $381,600 JMD lifetime limit. Catastrophic coverage is confirmed as an employer-sponsored benefit. The Government tracks claims data only at the aggregate level rather than by specific benefit categories; however, utilization rate data for September 2023 through September 2025 is provided showing dental/optical, drugs, hospitalization, laboratory/diagnostics, office visits, and surgery claims. Excess coverage remains optional despite historical zero enrollment. The proposal submission deadline has been extended from April 17, 2026 to April 23, 2026 at 3:00pm Central European Summer Time (CEST).
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Combined Synopsis/Solicitation 19GE5026R0041-0002 LES Health and Life Insurance, U.S. Embassy Kingston, Jamaica
COMBINED SYNOPSIS/SOLICITATION 19GE5026R0041
AMENDMENT 0002
ATTACHMENT 8 – QUESTIONS AND ANSWERS
Question 1: Referring to: Combined Synopsis / Solicitation 19GE5026R0041- Attachment 1 – Schedule and Clauses:
a. Kindly confirm whether the benefits stated are the current benefits matching the claims submitted or is it a set of proposed benefits? Please provide a copy of the current schedule of benefits.
Answer: It is the set of proposed benefits. See Section C.1.1. of the SOW for benefit schedule.
b. Regarding C.1.1 Employee and Dependent Health Service benefits: Please provide benefit maximums where applicable. Example: C.1.1.4 - Outpatient services, minimum coverage - 80%. Is there a stated dollar value maximum, for office visits as an example?
Answer: Refer to Section C.1.1 of the SOW for all available specific dollar value maximums. All benefits without dollar maximum are subject to the annual maximum limit provided in C.1.2.
c. Is the reference to minimum coverage of 80% (as stated in the example above), a percentage of Reasonable and Customary rates (R&C) or percentage of cost (of provider charge)?
Answer: The minimum coverage is in reference to the percentage of cost.
d. Regarding C.1.1.11 – Dental Care: Please clarify the maximum amount. Is it $508 USD or $3200?
Anwer: Refer to solicitation amendment 0001 where following corrected amounts had been provided for both, Sub-Section C.1.1.10 and C.1.1.11:
1. Sub-Section C.1.1.10 - Optical Care: Prescription lenses and frames or contact lenses: Covered up to a maximum of $47,700 Jamaican Dollar (JMD) per covered individual every two years. 80% Minimum Coverage; with annual cap.
2. Sub-Section C.1.1.11 - Dental Care: Examinations and Treatment: Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a maximum of $508,800 Jamaican Dollar (JMD) per covered individual per contract year. 80% Minimum Coverage: with annual cap. Orthodontia: Treatment is covered only if treatment begins before age 18, or if required as the result of an accident. A maximum of four years of orthodontia
LES Health and Life Insurance, U.S. Embassy Kingston, Jamaica treatment will be covered per covered individual up to a maximum of $381,600 Jamaican Dollar (JMD) lifetime limit. 80% Minimum Coverage; with contract lifetime cap.
e. Regarding C.1.1.16 – Catastrophic Coverage: Kindly confirm that this is an employer sponsored benefit.
Answer: Yes, this is an employer sponsored benefit.
Question 2: Referring to Solicitation 19GE5026R0041 – Attachment 2 - Employee Statistics:
#6 Claims History:
a. Based on the years provided, please submit a breakdown of the claims’ figures broken out by Group Life, Group Health, Catastrophic and Excess coverage claims. A further breakdown of the health claims by Medical and Dental & Vision is requested.
Answer: The Government only tracks claims data at the aggregate level. A further breakdown by category is not available for this solicitation. Offerors shall base their proposals on the consolidated claims history provided in Attachment 2.
b. In addition, can the Group Health claim data be provided and outlined as per the health service benefits stated in C.1.1 for the past three years?
Answer: See utilization rate for period September 2023-September 2025 as follows:
LES Health and Life Insurance, U.S. Embassy Kingston, Jamaica
c. Regarding Excess Coverage, please provide a member count for this benefit.
Answer: See employee statistics for total eligible members. While historically no employees have elected to enroll in this optional coverage, this will remain an optional benefit.
Question 3: Will the deadline for submission of proposals be extended?
Answer: Yes, the deadline for submission of proposals is extended from April 17, 2026 to April 23, 2026 by 3:00pm Central European Summer Time (CEST).
[END OF QUESTIONS AND ANSWERS]
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