Attachment B- Questions and Answers.pdf

SENSITIVE BUT UNCLASSIFIED

Health and Life Insurance Services

Attachment B - Questions and Answers

Solicitation #19-J010-22-R-0001 – Amendment 0001

Question (1): Can you provide us with member list that specifies the dates of birth, classes, and gender for all members for the past 5 years?

Answer: Please refer to attachment D in the solicitation amendment 0001 for the requested information, and section J, Exhibit A of the solicitation.

Question (2): Can you provide us with the current tables of benefits and additional benefits?

Answer: Please treat the entire solicitation as new requirements.

Question (3): For health insurance, can you provide us with updated detailed utilization report along with the report’s extraction date for the past 5 years?

Answer: Please refer to attachment C in the solicitation amendment 0001 for the requested information, and section J, Exhibit F of the solicitation.

Question (4): Can you provide us with the current maternity cases?

Answer: The requested information is not available, more information can be found in the solicitation amendment 0001 and section J of the solicitation.

Question (5): Can you provide us with the current chronic and pre-existing cases including chronic medication list &/or cost specifying the diagnosis, medication name and dosage?

Answer: The requested information is not available, more information can be found in the solicitation amendment 0001 and section J of the solicitation.

Question (6): Can you provide us with the policy inception date?

Answer: The U.S. Embassy, Amman anticipates the policy inception date to be the same as the contract award date.

Question (7): Can you provide us with member list that specifies the dates of birth, gender, salary amount?

Answer: See response to Question 1 above

Question (8): For life insurance, can you provide us with the claim experience for the past 5 years detailing the type of claim (Death or Disability) and date of claim, claim status (Paid, outstanding or rejected), claimed amount?

Answer: Please refer to attachment C in the solicitation amendment 0001 for the requested information, and section J of the solicitation.

Question (9): For life insurance, can you provide us with the total sum insured for each year for the past

5 years?

Answer: More information can be found in the solicitation amendment and Section J for the available information.

Question (10): Could you provide us with the incumbent contract # and or vendor name?

Answer: The current contractor is Al-Nisr Al-Arabi Insurance, contract #19J01018D0007.

Question (11): Article C.1.1.17: Out-of-Country Medical Treatment reading “Medical expenses incurred out-of-country will be covered at the same benefit levels and subject to the same total maximum annual limit as for medical expenses incurred in-country”. There is no longer mention that this benefit is for the treatment of emergency cases, which means that your members are free to travel abroad to undergo non-emergency cold cases treatment at international prices. This means that your policy will become an international insurance plan and will be priced accordingly, and premium per person per annum will exceed JOD10,000. We believe this should be covered by separate travel insurance rather than by this plan. We suggest that the old definition is reintroduced, and that treatment abroad is only permitted for emergency cases but reimbursed at local prices and tariffs.

Answer: Out of the country medical treatment is only for treatment of emergency cases, please refer to

Point C.1.1.17 for more information.

Question (12): Article C.1.1.21: Excess Coverage reading “Additional coverage equal to JOD 80,000.00 per covered individual per contract year. This excess coverage will be offered as an optional benefit to

LE Staff. This can be used for any covered individual for any covered expense that exceeds annual maximum. LE Staff must pay 100% of the premium if they elect Excess Coverage. The premium for this additional coverage is a rider to be paid by the employee to the vendor directly and USG will not be responsible for collecting these premium payments”. We believe that such a cover shall open a room for

“anti-selection” whereby any insured member who is anticipating a serious and costly sickness shall opt to take this coverage while other healthy members shall not take it. Additionally, we believe that this coverage should be opted for at the beginning of the Insurance Year, and cannot be opted for during the

Insurance Year. Finally, shall this coverage be an option for an individual within a family; thus, the coverage should be priced individually (per individual)? This cover will likely negatively affect the performance of the contract.

Answer: At the beginning of the contract and each option year exercised, the employee will be given the option to participate in the excess coverage benefit.

Question (13): Article C.1.3: Exclusions and Limitations and in particular “…Advanced reproductive technology (e.g., in-vitro fertilization, intra-cellular sperm injection, artificial insemination, microsurgical epididymal sperm aspiration, testicular sperm extraction, cryopreservation, etc.). We believe that “Fertility treatments” and “reversal of Sterilization” should be added to the preceding statement since they are mentioned as not covered under Article C.1.1.12 Reproductive Health (page 14 of the Solicitation).

Answer: It is specified in C.1.1.12, section C in the solicitation that “Assisted reproductive technology (ART), fertility treatments, and reversal of sterilization are not covered (see Exclusions to

Coverage).”

Question (14): The total number of employees is 582 (130+44+408) as per the base year price table in Section B, whereas the total number of employees is 492 as per the count mentioned in Exhibit A in Section J. Please confirm the actual number of employees, spouse, and dependents.

Answer: The numbers in Section B are only estimation, please refer to the solicitation amendment and Section J for the available information.

Question (15): Please provide average insured member counts for Health & Life for the last 5 years – 2021, 2020, 2019, 2018 & 2017. It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

Answer: Please refer to section J of the solicitation, Exhibit A for the requested information.

Question (16): Claims history provided in Exhibit F (Section J) does not have the data for 2021. Please provide the claims amount for 2021 as well. Also, please confirm if the claims amount mentioned in Exhibit F includes health and life claims. If yes, please give a breakup of the health and life insurance claims separately for 2018, 2019, 2020, and 2021.

Answer: Please refer to attachment C in the solicitation amendment 0001 for the requested information.

Question (17): Please provide employee-wise salary breakdown for life premium computation.

Answer: Please refer to attachment D in the solicitation amendment 0001 for the requested information.

Question (18): When is this plan likely to commence?

Answer: The U.S. Embassy, Amman anticipates the policy inception date to be the same as the contract award date.

Question (19): Is this requirement considered a new requirement?

Answer: Please treat the entire solicitation as new requirements.

Question (20): Can you provide us with list of Members including the following details (Class, Relation, and Date of Birth)?

Answer: See response to Question 1 above

Question (21): Can you provide us with the previous 3 years performance (claims experience) line by line with treatment dates.

Answer: The requested information is not available, more information can be found in the solicitation amendment 0001 and section J of the solicitation.

Question (22): Can you provide us with the current table of benefits (Major Benefits) that reflect the claims experience.

Answer: Please treat the entire solicitation as new requirements.

Question (23): Can you provide us with requested Table of Benefits (proposed).

Answer: Please refer to the solicitation package and Section C for the requested benefits and coverage.

Question (24): Can you provide us with chronic cases, cancer and/or congenital cases details.

Answer: See response to Question 5 above

Question (25): Can you provide us with ongoing maternity cases.

Answer: See response to Question 4 above

Question (26): Can you provide us with proposed inception date?

Answer: See response to Question 6 above.

Question (27): Can you provide us with detailed census including date of birth, gender, salary, occupation, type of employment (full/part time)?

Answer: See response to Question 1 above.

Question (28): Can you provide us with detailed claims for the past 5 years including date of the claim, type, amount, notification date?

Answer: The requested information is not available, more information can be found in the solicitation amendment 0001, and section J of the solicitation.

Question (29): Can you provide us with the required benefits and the current Free cover Limit (FCL) Answer: Please refer to the solicitation package for the requested benefits , coverage and the annual maximum limit as defined in Section C point C.1.2.

Question (30): Please advise If the benefits, definition of the sum insured and FCL has been the same for the last 5 years.

Answer: This is a new requirement and benefits which differs from the current contract, please refer to Section C point C.1.2. for the annual maximum limit.

Question (31): Provide us with a detailed census list including DOB, gender, occupation, nationalities, and monthly salary?

Answer: See response to Question 1 above.

Question (32): Advise on the existing definition of sum insured and the requested sum insured?

Answer: This is a new requirement and benefits which differs from the current contract, please refer to Section C point C.1.2 for the annual maximum limit.

Question (33): Provide us with the loss history for the past five years including COVID claims, if any?

Answer: The requested information is not available, more information can be found in the solicitation amendment 0001 and section J of the solicitation.

Question (34): Please advise on the existing benefits and FCL?

Answer: This is a new requirement and benefits which differs from the current contract, please refer to Section C point C.1.2 for the annual maximum limit.

Question (35): Advise if you require an alternative option on the benefits offered?

Answer: The Embassy encourages prospective offerors to offer off-the-shelf plans that meet and exceed the minimum benefit levels required in the solicitation, proposals that contain less than the minimum reimbursement levels or do not provide all benefit categories may be deemed technically unacceptable.

Question (36): Effective date and policy duration?

Answer: The U.S. Embassy, Amman anticipates the policy inception date to be the same as the contract award date, the performance period of this contract is for one year from the start date in the Notice to Proceed, with option to extend up to four (4) additional 12-months periods in accordance with the option clause 52.217-9 and FAR 52.217-8 option to extend the services, for up to an additional six months of optional performance, if required by the Government.

Question (37): Census list: in the meeting you mentioned that there will be a link containing comprehensive members data in Section L, but I could not find it to be honest, can you please elaborate more?

Answer: Please refer to the exhibits in section J of the solicitation and the solicitation amendment 0001 for more information.

Question (38): Life census list: when is expected to receive the salaries sheet? (Names are not required).

Answer: See response to Question 1 above.

Question (39): Number of married females (if not mentioned in the comprehensive data)?

Answer: Please refer to attachment D in the solicitation amendment 0001 for the requested information, and section J, Exhibit A of the solicitation.

Question (40): Utilization report: is it possible to have an insight into the policy consumption for the full year of 2021-2022?

Answer: Please refer to attachment C in the solicitation amendment 0001 for the requested information, and section J, Exhibit F of the solicitation.

Question (41): Life claims history for the past 5 years (if any).

Answer: See response to Question 8 above.

Question (42): The required table of benefits.

Answer: Please refer to the solicitation package and Section C for the requested benefits and coverage.

Question (43): SAM registration: we are working on the registration and then received an incident note during the entity registration, now all the processes should be completed only on the FSD platform?

Answer: Please refer to the links in the cover letter and guidelines for completing the registration.

Question (44): If Extension or automatic renewal terms shall be agreed upon in coordination between two parties (Mutual agreement)?

Answer: Please refer to Section F point 3 “Options” and Section I FAR 52.217-8 and 52.217-9.

(a) The Government may extend this contract in accordance with the option clause at Section I, clause I.2, FAR Clauses Incorporated by Full Text (FAR 52.217-9, Option to Extend the Term of the Contract), which also specifies the total potential duration of the contract.

(b) The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services".

Question (45): If rates upon extension or renewal will be affected by the performance of policy expressed by Loss Ratio and the inflation?

Answer: Please refer to Section B point B.4. and B.8. (“Economic Price adjustment – Health Insurance Premiums” and “Economic Price adjustment (EPA) – Life Insurance Premiums”)

Question (46): Article C.2.1.2: Amount of Accidental Death and Dismemberment Coverage (page 20):

The language in the current Contract states that the amount payable - if the death is due to a covered accident - is “in addition to the life insurance benefit in C.2.1.1” (current Contract page 20). Could you please confirm that the language did change and that the reimbursement in case of accidental death is a single amount equal to 33 times the monthly basic salary.

Answer: Confirmed, this is a new requirement and benefits which differs from the current contract.

Question (47): Under article C.1.15 “Obstetric and Newborn Care”, is epidural steroid injection for pain management covered?

Answer: Article C.1.1.5 Obstetric and Newborn Care: Care and services that women receive during pregnancy (prenatal care), throughout labor (including but not limited to epidural analgesia), delivery and post-delivery, and outpatient care for newborn babies. Hospitalization during pregnancy and/or delivery will be covered as Hospitalization (treatment in the hospital for inpatient care). All medical procedures, tests and medications requested by a certified health care provider for medical reasons should be covered at the same benefit levels and subject to the same total maximum annual limit and cap, not including expenses defined under exclusions and limitations (C.1.3).

Question (48): Are subcontractors required to have Defense Base Act insurance? If we sub the workout, does that subcontractor have to have their own DBA insurance or can they be covered under ours?

Answer: DBA coverage is required for all personnel working on the contract to include American citizens, Individuals hired in the United States or its possessions, regardless of citizenship, Host Country Nationals (HCNs) and Third Country Nationals (TCNs) working overseas, unless a country/territory specific waiver has been granted by the Secretary of Labor. Contracting Officers may not waive DBA. If the contractor sub the workout, the subcontractor must have their own DBA insurance. DBA Insurance is intended for those workers for a company that is under their payroll and is doing the work themselves. The sub-contractor cannot pass down the work to a sub-sub-contractor and have them covered under their DBA insurance. The insurance requirements under the DBA require every employer (including contractors, subcontractors, sub sub contractors..etc) either to secure insurance for the payment of workers' compensation benefits provided under the Act or to be permissibly self-insured. If a subcontractor fails to secure the payment of compensation, the contractor will be liable and will be required to secure the payment of such benefits.