Pre-proposal Conference Minutes - Health Insurance.docx

Embassy of the United States of America October 14, 2020

Embassy of the United States of America Paseo de la Reforma No. 305, Colonia Cuauhtémoc, 06500 Mexico City.

Minutes from Pre-Proposal Conference of September 28, 2020

This meeting was held in Spanish and English.

Introduction

The Contracting Specialist welcomed all attendees, introduced COR, C.O. Payroll & Allowance Manager, Human Resources Officer and Contracting Specialists.

Discussion of the Solicitation Package

Speakers: Contracting Specialist, Daenne Guevara Contracting Officer Representative, Christian Alvarez-Maciel Payroll & Allowance Manager, Fernando de la Cruz

Purpose:

The purpose of this pre-quotation conference is to brief all prospective offerors about the solicitation. In this meeting, you will notice how doing business with the U.S. Government differs from commercial practice because the solicitation and award processes are regulated under FAR.

Pre-proposal conference minutes will be posted on Contracts Opportunities in BETA.SAM website. We post the minute so other vendors won’t have a disadvantage for not being able to join this virtual meeting.

Before we go through the solicitation, I would like to point out the following important notes:

Statements

The statements made here do NOT change the solicitation. All changes will be made by written amendment to the solicitation.

Amendment.

It may be necessary to amend (change) the solicitation during the solicitation period for such reasons as:

•Issues raised by prospective offerors, either in a pre-proposal conference or otherwise;

•The need to change the closing date for receipt of offers;

•The need to correct ambiguities; or •Changes in quantity, specifications, or delivery schedules.

All amendments will be posted on Contracts Opportunities in BETA.SAM website. The U.S. Government implements the Fair Release of information, in other words, what you tell one, you must tell all.

Questions

I have received few questions. We will take note of additional questions that are made here today and will add them in the list of questions that will be published after submissions deadline for questions.

The Q&A will be posted on Contracts Opportunities in BETA.SAM website.

Solicitation

The solicitation is divided into to 4 Parts:

Part I – The Schedule

Part I is divided into the following 8 sections (A through H):

Section B – Supplies or service and price/costs

· The Contractor shall provide the Health Insurance services described herein to employees of the Government of the United States of America in the Embassy and Consulates in Mexico.

· Riders are also employees of the Government; however, the DOS shall not be responsible, nor liable, for any riders.

· Excess Coverage (C.1.1.21) is included under this contract only as rider benefits; the Contractor shall bill the individual covered separately, at the rates specified below.

· Employee responsible for paying 100% of premium for Excess Coverage

· Type of Contract. This is a fixed-price with economic-price adjustment-requirements type contract.

· Currency. U.S. firms are eligible to be paid in U.S. dollars. U.S. firms desiring to be paid in U.S. dollars should submit their offer in U.S. dollars. A U.S. firm is defined as a company which operates as a corporation incorporated under the laws of a state within the United States. Local companies are eligible to be paid in U.S. dollars provided that such company has a bank account in U.S. dollars at a Local Bank.

· Value Added Tax (VAT) for offers in Pesos, Mexican currency, is not included in line item rates. Instead, it will be priced as a separate amount in the contract and on the Invoices. Local law dictates the portion of the contract price that is subject to VAT; this percentage is multiplied only against that portion.

· VAT shall not be included in the CLIN rates or Invoices for U.S. firms as this is not applicable to U.S. based vendors

· Premium Rates. The fixed prices/premium rates for the health insurance services as specified in Section C. DOT INCLUDE RIDERS IN SECTION B.

· The table for excess coverage applies the same way.

· *estimated number of employees does not include any Riders (B.1.1)

· **does not include any premiums for Riders.

· Administrative Retention Amounts. The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the claimant/health care provider.

· Economic Price-adjustment – For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract, and it specifically excludes all riders in B.5.1. No adjustment will be allowed during the first twelve months. After such time, the Contractor or the Government may request an adjustment in premiums on an annual basis. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the Contractor agrees to provide the Government a balance sheet showing three main components for the time period: (1) receipts (premiums received) minus the retention amount, (2) number of insurance plans and (3) claims paid. The information shall be provided per type of premium, ie per line item. The retention amount is not subject to adjustment. The Government reserves the right to select an independent third party to review the balance sheet and claims and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract.

Speaker: Christian Alvarez-Maciel

Section C – Description of services

The Government of the United States of America requires group life insurance coverage for its employees, as further described in herein, in the U.S. Embassy Mexico City, U.S. Consulates, and other offices located in the Mexican territory.

C.1.1.Employee and Dependent Health Service Benefits

C.1.1.1.Hospitalization (Treatment in the Hospital for Inpatient Care):

Minimum Coverage - 100% No co-insurance.

C.1.1.2.Emergency Services (Trips to Emergency Room):

Minimum Coverage - 100% No co-insurance.

C1.1.3.Ambulance:

Minimum Coverage - 80% 20% of co-insurance

C.1.1.4. Outpatient Services:

Minimum Coverage - 80% 20% of co-insurance

C.1.1.5.Obstetric and Newborn Care:

Minimum Coverage - Inpatient/Emergency: 100%; Outpatient: 80% 0% and 20% of co-insurance.

C.1.1.6.Pediatric Services:

Minimum Coverage - Inpatient/Emergency: 100%, Outpatient: 80% 0% and 20% of co-insurance.

C.1.1.7.Prescription Drugs:

Minimum Coverage -Inpatient/Emergency: 100%, Outpatient: 80% 0% and 20% of co-insurance.

C.1.1.8. Preventive and Wellness Services and Chronic Disease Management:

Minimum Coverage - 80% 20% of co-insurance.

C.1.1.9.Hearing Aids:

Minimum Coverage – 80% 20% of co-insurance.

C.1.1.10.Optical Care:

Minimum Coverage – 80% 20% of co-insurance.

C.1.1.11.Dental Care:

Minimum Coverage – 80% 20% of co-insurance.

C.1.1.12.Reproductive Health:

Minimum Coverage - 80% 20% of co-insurance.

C.1.1.13.Mental Health and Substance Abuse Care:

Minimum Coverage - 50% 50% of co-insurance.

C.1.1.14.Rehabilitative and Habilitative Services and Devices:

Minimum Coverage - 50% 50% of co-insurance.

C.1.1.15.HIV/AIDS:

Minimum Coverage 100% Coverage No co-insurance.

C.1.1.16.Catastrophic Coverage

Additional coverage equal to $50,000,000.00 MXN Pesos per covered individual, per event, per contract length.

C.1.1.17.Out-of-Country Medical Treatment:

Medical expenses incurred out-of-country will be covered, but coverage will be the same and subject to the same total maximum annual limit as for medical expenses incurred in-country. However, this clause will be applicable to only those employees and dependents who are able to prove legal and daily physical residence within Mexican territory.

C.1.1.21. Excess Coverage

NOTE: Employee responsible for paying 100% of premium for Excess Coverage

Additional coverage equal to $50,000,000.00 MXN pesos per covered individual, per event, per contract length. This excess coverage will be offered as an optional benefit to LE Staff.

C.1.2. Maximum Insured Limit

The maximum coverage per covered individual per covered illness or accident for the life of the contract is $50,000,000 MXN Pesos per individual, per event, per contract length (i.e. 5 years).

C.1.3. Exclusions and Limitations

Please review exclusions and limitation.

C.1.4. Eligible Participants

C.1.4.1.Identification of Eligible Employees and Dependents:

U.S. Mission Mexico will provide a list of all eligible employees and dependents with relationship to employee (self/spouse/child) and DOB for each. Updates will be provided to add or remove individuals on a bi-weekly/monthly basis.

C.1.4.1.1.Definition of Dependents

C1.4.1.1.1.Spouse: a limit of one legal spouse as defined by local law per employee will be covered.

C.1.4.1.1.2.Children: a child is defined as the LE Staff’s natural, adopted, stepchild, or foster child. The child must be unmarried and financially dependent upon the LE Staff. A child will be covered until the end of the contract year in which s/he reaches age 26.

C.1.4.3. Participants Covered Under a Rider

C.1.4.3.1.All current active ORE Staff personally employed by the Chief of Mission and the Deputy Chief of Mission and assigned to their respective official Government residences and paid under an ORE account.

C.1.6.Brochure Requirement

The Contractor shall provide a document (brochure/pamphlet/other written document) in Spanish and English that sets forth a complete listing of the health insurance benefits to be provided under this contract.

C.1.6.4.Presentation

The Contractor shall perform annual presentations in English and Spanish to explain benefits, procedures, requirements and Q&A sessions.

Speaker: Daenne Guevara

Section D – Packaging and Marketing – N/A

Section E – Inspection and Acceptance

· QAPS designed to provide an effective surveillance method to promote effective Contractor performance. The QASP provides a method for the Contracting Officer's Representative (COR) to monitor Contractor performance, advise the Contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance. The Contractor, not the Government, is responsible for management and quality control to meet the terms of the contract.

· The Contractor shall designate a Quality Assurance Team who shall be responsible for managing issues relating to complaints. Upon receiving the complaints, the team shall take immediate corrective action to ensure effective operation.

Section F – Deliveries or Performance

· Period of Performance. The performance period of this contract is one year after contract award with four (4) one-year options to renew.

· FAR 52.217-9, Option to Extend the Term of the Contract – The U.S.G. has the right to exercise or not the following option.

· The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services" – another 6 months.

· Insurance Policies. The Contractor shall provide individual insurance policies for all U.S. Government employees within (14) fourteen calendar days of receiving the corresponding Task Order. Insurance Policies shall be provided in electronic and paper format.

· Insurance policies should end at 12:01 a.m. on Expiration Date, in other words, the insurance policies end at 12:01 a.m. on the date the period of the performance ends for the base or any option year.

Section G – Contract Administration

· The COR for this contract is Christian Alvarez-Maciel, Compensation and Legal Coordinator. COR duties are explain in section G.2. COR Duties.

Speaker: Fernando de la Cruz

· Currency. U.S. firms are eligible to be paid in U.S. dollars. U.S. firms desiring to be paid in U.S. dollars should submit their offer in U.S. dollars. A U.S. firm is defined as a company which operates as a corporation incorporated under the laws of a state within the United States. Local companies are eligible to be paid in U.S. dollars provided that such company has a bank account in U.S. dollars at a Local Bank.

· All invoices should contain the minimum requirements in Section G.4.1.1. Electronic Invoices Requirements.

· The Contractor shall submit invoices, at the beginning of covered or quarterly period, per task order with the total quarterly amount within ten (10) days of receiving a fully approved task order. All task orders delivered to the Contractor shall include the total yearly amount, however, the payments shall be made in quarterly basis.

· All invoices should be sent to mexfmcinvoices@state.gov, Cc: DelacruzFS@state.gov; and MexicoSegurosMV@state.gov

· If at any time during performance of the contract the Government finds that the Contractor has been overpaid because the number of employees covered has decreased, the Contracting Officer may either allow that overpayment to be credited to the Government’s account or require that the Contractor refund the overpayment.

· Post’s Managerial and Administrative Support – Three offices involved are General Services Office, Financial Management Center and Human Resources.

Speaker: Daenne Guevara

· Contractors Project Manager - The Contractor shall designate a Project Manager for the daily administration of this contract, as well as for any urgent requests. The project manager should comply with the level of English Proficiency outline in Section G.8.2. Project Manager Requirements.

Section H – Special Contract Requirements

· All contractors shall understand and comply with confidentiality, security, and conduct standards as well as licenses and local laws.

· Administrative Records. The Contractor shall maintain medical insurance files for each covered employee including receipts and proof of paid claims.

· How to resolve or settle medical insurance claims.

· The Contractor shall use the employees'/dependents’ full names, per Birth Certificate or Identification card, in all transactions.

· The Contractor shall send pay claim reimbursements to employees not later than two weeks after a claim is submitted.

· All medical claims shall be submitted directly to the Contractor by employees via electronic means or submitted personally to a Contractor’s representative that will be stationed at the U.S. Government facilities, as follows:

Monday 09:00 a.m. to 09:30 a.m. Aphis Building Monday 10:30 a.m. to 12:30 p.m.Embassy Building Wednesday 09:30 a.m. to 10:00 a.m.Trade Center Building Wednesday 13:00 p.m. to 15:00 p.m.Embassy Building Friday 12:00 p.m. to 15:00 p.m.Embassy Building

The above schedule is subject to change.

The contractor shall provide a representative twice a week at the following U.S. Consulates: Guadalajara, Ciudad Juarez, Monterrey, and Tijuana.

· Employee Claims Report. The report shall list all claims paid by the Contractor to a claimant, including the name, age, location (Embassy/Consulates), brief description of coverage claim of the claimant, date claim is received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of why claim has not been paid. The report shall not include any claims information for riders.

· The Contractor shall provide the corresponding formats/documents for the employees/dependents to fill out to comply with Ley Federal de Protección de Datos Personales en Posesión de los Particulares, as amended.

· All authority to change or modify the basic IDIQ contract, including the exercising of any options, remains with the Contracting Officer assigned to the General Services Office at the U.S. Embassy Mexico City.

· Signature limitations. The Contracting Officer shall not sign commercial contracts, agreements, or any other terms and conditions that are contrary to this Contract, U.S. Department of State regulations, or any Federal law or policy.

· Additionally, the Contracting Officer is not required to provide copies of any kind of identification documents neither in hardcopy nor in electronic format.

Part 2 – Contract Clauses

Section I – Contract Clauses – Go over important or new clauses.

· Reference FAR 52.222-50, Combating Trafficking in Persons and the Contractors responsibility to prevent such activities from occurring. The COR also has responsibilities to monitor these types of activities. If the government has a suspicion, it will be investigated.

· FAR Clause 52.229-12 - Tax on Certain Foreign Procurement Payments. This Act of the Internal Revenue Code imposes a tax of two percent (2%) on the amount of payment for each payment. Unless the exceptions in FAR 29.402-3 apply. If an exception does apply then you will need to highlight the requirement to fill out Internal Revenue Service Form W-14 and the form is required with their offer and every invoice.

· FAR Clause 52.204-25 and two FAR provisions in Section K. On August 13th, an update to FAR Subpart 4.21, in support of National Defense Authorization Act (NDAA) Section 889 Part B went into effect. These changes extended the prohibition on acquiring “covered technologies” to prohibit contracting with entities making use of the “covered technologies”.

Part 3 – List of documents, exhibits, and other attachments.

Section J – List of Attachments

Exhibit 1 – U.S.G. Employees

· Have provided all the information required in order to provide an economic proposal.

Exhibit 2 – APHIS Employees Rider

· Provided this list for informational purposes only.

Exhibit 3 – Payment Registration Forms

· Please pick the correct format depending if the insurance company provides economic proposal in USD or Mexican Pesos.

Exhibit 4 – How to Obtain a DUNS Number and Register to SAM

· We have provided the detailed steps in order to register in DUNS, NCAGE and SAM. We cannot award the contract if the SAM registration is not active.

Exhibit 5 – Delivery/Task Order Form Sample

· Sample of a task order that shall be completed by the USG and sent to the contractor. The contractor must send the invoice along with the task order.

Part 4 – Representations and Instructions

Section K – Representations, Certifications, and Other Statement of Offerors

· This section must be completed if the insurance company has not registered in SAM or is in the process of registering in SAM. If SAM registration is active before submitting the offer, then only FAR clauses 52.204-24 and 52.204-26 as previously mentioned, must be completed and submitted in the offer.

Section L – Instructions, conditions, and notices to offerors

· Will not go into detail, however, it is very important that each proposal contains all of the requirements stated herein. The contractor must send their proposal in 3 volumes as outlined herein.

· L.4.3. Volume III -- Technical Proposal Part 1, Health Insurance Benefits and Coverages:

Section C.1 defines the required minimum benefits and corresponding coverages. These are the minimally acceptable levels of coverage. If offerors choose to include additional benefits or higher coverages than the required minimums this is acceptable; however, evaluations will be based on meeting the stated minimums only. For each benefit listed, proposals must clearly state its coverage. Any proposal that reduces a benefit definition or offers lower than the minimum required coverage may be determined technically unacceptable. The resultant contract will contain the actual proposed coverages or increased benefit offerings if they exceed the solicitation’s minimum requirements.

(a)Multiple proposals - If an offeror has multiple plans available that meet or exceed the minimum benefit levels and wants to propose them, a separate proposal with its respective prices must be submitted individually for each.

(b)Suggested format – It’s the offeror’s responsibility to ensure their proposal is clear and meets all requirements. An example of an acceptable format for Part 1 is to submit a table that lists the Section C benefit definitions in one column and in the adjoining column list the proposed coverage.

Section M – Evaluation Factors for Award

· This section explains how each proposal will be evaluated.

· Proposals will be evaluated in two phases: a technical evaluation to determine the acceptability of the offer to the solicitation technical requirements; and a price evaluation to determine the total evaluated price proposed by each offeror.

· The award selection will go to the lowest priced, technically acceptable, responsible offeror.

Last important notes:

· Brokers may participate in this competition, however, they must involve the insurance company in all stages of the solicitation and award processes. Meaning, they must share all the information we have provided so they are aware and understand our requirements.

· The representative signing the contract must have high level of authority.

· The USG will not provide any other information that is not stated in this solicitation. We will not provide information related to the condition of each employee or habits (smoker or non-smoker).

· The contractor shall provide all the personnel necessary to perform to the highest standards possible.

\Submission deadlines:

Questions: October 5, 2020 before 12:00 noon.

Proposals: October 23, 2020 before 12:00 noon.

Conclusion

The conference concluded and attendees were thanked for their presence and expression of interest in serving the U.S. Government. The meeting was adjourned.

Sincerely, C. Melora Johnston Contracting Officer

SBU - CONTRACTING AND ACQUISITIONS

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