QA_-_SOLICITATION_NO._19GY2019R0001_(FINAL).docx

HEALTH INSURANCE SERVICES

SOLICITATION NO. 19GY2019R0001

QUESTIONS & ANSWERS

1. Date contract is expected to start.

The contract is expected to start on or around August 1, 2019.

2. Advise if previous benefit schedule for life/health/disability insurance is the same as the benefit schedule currently being requested.

This solicitation is only for health insurance coverage. The benefit schedule is new and will not match existing coverages and/or benefit descriptions.

3. Are there any persons who are currently hospitalized?

No. The current insurance provider informed us on March 5 that they are unware of any hospitalizations under the existing contract.

4. Are any major illnesses (i.e. hemodynamics, open heart surgery, orthopedic major surgeries, organ transplants, traumatic accident, cancer and oncology cases) being treated?

No. The current insurance provider informed us on March 5 that they are unware of any major illnesses currently being treated.

5. Are there any pregnant employees/spouses?

Yes. The current insurance provider informed us on March 5 that they are aware of only three (3) individuals that are pregnant under our contract.

a. If yes, please provide number.

Employee: one (1) Family Members: two (2)

6. Are there any catastrophic cases (in excess of $10,000) within the last year to date?

No. The current insurance provider informed us on March 5 that they are unware of any catastrophic cases (in excess of $10,000 USD) within the last year.

7. Are there any HIV/AIDS cases?

No. The current insurance provider informed us on March 5 that are unaware of any diagnoses of HIV/AIDS under the current contract.

8. Are any employees currently disabled?

No. The current insurance provider informed us on March 5 that they are unware of any disabled employees. In addition, our employees have not self-identified themselves to Human Resources as having a disability.

10. What currency should proposers use in submitting bids?

Guyanese Dollars.

11. Membership each of last 3 years by Single, Married and Family Status.

The Government is unable to provide an accurate picture of membership over the past three (3) years due to continuous changes in employment statuses and qualifying life events.

12. Percentage of local nationals.

100%

13. Are there dependent children to be covered who are studying outside the country?

a. If yes, please provide the country and number of dependent children studying there.

The current insurance provider informed us on March 5 that they are not aware of any children studying outside the country.

14. Location(s) of insured employees.

All employees live within the Co-operative Republic of Guyana.

15. Claims history for health insurance for the current year and each of the last 5 years

Offerors shall refer to attachment 1 of this document.

16. Do the above claim numbers include claims from ORE employees? (if applicable)

N/A – ORE employees did not enroll in the current plan.

17. Premium history for health insurance for the current year and each of the last 5 years

Offerors shall refer to attachment 1 of this document.

18. Did the premium history for insurance include the VAT?

No.

19. Did the premium history for insurance include Insurance Premium Tax (IPT)

No.

20. Kindly provide details about the DUNS and NCAGE number and SAM registration. Also please indicate whether local (Guyana) companies are required to provide this.

Yes. All current and potential government vendors are required to register in SAM in order to be awarded contracts by the U.S. Government. Vendors are required to complete a one-time registration to provide basic information relevant to procurement and financial transactions. This registration requires a valid DUNS & BRADSTREET (D&B) DUNS number and a NATO COMMERCIAL AND GOVERNEMNT ENTITY (NGAGE) number. Vendors must update or renew their SAM registration annually to maintain an active status.

For detailed instructions on how to register for free, please visit: https://www.state.gov/documents/organization/233461.pdf

21. B.2.2. – Defense Base Act insurance - Is it compulsory for local (Guyana) companies to provide this.

Yes. In accordance with Section B Part B.2.2, “The Offeror shall include Defense Base Act (DBA) insurance premium costs covering employees. The offeror may obtain DBA insurance directly from any Department of Labor approved providers at the DOL website at http://www.dol.gov/owcp/dlhwc/lscarrier.htm.”

22. The data input areas are not interactive (SK 33, premium fields in B.2.3 to B.2.7. and B.3.2. and the required areas under Section K)

The United States Government will upload the original word document of the solicitation. This will allow offerors to input values into the document.

23. Amounts in C.1.1. 9., C.1.1. 10, C.1.1. 11 and C.1.1. 15 are in US dollars. Kindly provide the equivalent in Guyana dollars.

The United States Government intends to issue an amendment to the solicitation to change the currency in C.1.1.9, C.1.1.10, C.1.1.11, and C.1.1.15 from U.S. Dollars to Guyanese Dollars.

24. C.1.1.1.6 - Out of Country Medical Treatment – This clause does not indicate whether such coverage would be subject to the individual’s attending physician certifying in advance that the treatment is medically necessary and unavailable locally. Is it the intention to provide this benefit as is?

Yes.

25. C.1.1.1 9 Excess coverage (optional) - Is it the intention that employees would be given this option at the inception of the employee’s coverage? Or, would they be able to select this at a later date?

The employee may elect or terminate excess coverage under the following circumstances: (1) within 30-days of start of starting coverage under the contract (2) upon employment, (3) upon retirement, (4) at the beginning of each calendar year.

26. Re: C.1.3.3.1 – Coverage for employees who separate from employment via retirement - Can you kindly provide your normal retirement age.

The normal retirement age is 60 years of age.

27. When can a retiree elect continued coverage?

An employee must elect to continue supplemental medical insurance before retirement. According to the solicitation, “Employees who separate from employment via retirement have the option to continue supplementary medical insurance by paying 100% of premium. All costs for this coverage is the responsibility of the retired employee, not the United States Government.” (Section C Part C.1.3.3)

28. Can a current retiree elect to be covered?

No. The current contract does not contain a rider for retiree coverage and, as such, there are no retirees under our existing health insurance contract. Under the solicitation a rider allows, “Employees who separate from employment via retirement have the option to continue supplementary medical insurance by paying 100% of premium.” (Section C Part C.1.3.3)

29. When can an employee elect “excess coverage?” Is there an open season?

See Question 25.

30. How much employees are over the age of 60?

Offerors shall refer to Exhibit A in Section J of the solicitation.

31. How long will a retiree be covered? Is there a cut off age?

The retired employee shall continue supplementary medical coverage as long as he/she continues to pay 100% of the premium. There is no cut off age under the solicitation.

32. Are retirees’ dependents covered under the continuous coverage?

A retired employee shall maintain the same benefits/coverages under the solicitation as long as the conditions of Section C Part C.1.3.3 continued to be met.

33. Can employees who already retired sign up for coverage?

No. Employees that have already retired are not eligible for coverage under the solicitation. An employee must elect to continue supplemental medical insurance before retirement. According to the solicitation, “Employees who separate from employment via retirement have the option to continue supplementary medical insurance by paying 100% of premium. All costs for this coverage is the responsibility of the retired employee, not the United States Government.” (Section C Part C.1.3.3)

34. What are the termination events for retirees under the continuous coverage?

A retired employee is responsible for paying 100% of premium. If a retired employee does not meet this requirement, the contractor may decide to terminate coverage.

ATTACHMENT 1 – GROUP MEDICAL CLAIMS EXPERIENCE

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