Abuja_GMC_-_Main_Solicitation_package.docx

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

1 | 79

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

19N10219R4652

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

06/18/2019

6. REQUISITION/PURCHASE NO.

8224652

7. ISSUED BY CODE

8. ADDRESS OFFER TO (If other than item 7)

U.S. Embassy Abuja Plot 1075 Diplomatic Drive Central Business District Abuja Tel: (09234-9-461-4000

NOTE: In sealed bid solicitation "offer" and "offeror mean "bid" and "Bidder".

SOLICITATION

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1 Deviation. All offers are subject to all terms and conditions contained in this solicitation.

Tyler Nunley

B. TELEPHONE (NO COLLECT CALLS)

AREA CODE 234 NUMBER 461-4000 EXT

B. E-MAIL ADDRESS

AbujaProcBids@state.gov

11. TABLE OF CONTENTS

OTHER STATEMENTS OF OFFERORS

NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within 120 calendar days calendar days (120 calendar days unless a different period is inserted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT SEE 14

(See section I, Clause No 52.232-8)

(The offeror acknowledges receipt of amendments to the solicitation for offerors and related documents numbered and dated:

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

19. AMOUNT

21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304©( ) [ ] 41 U.S.C. 253©( )

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7) CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print) Tyler Nunley

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

SECTION B

PRICE

B.1. HEALTH INSURANCE SERVICES

The Contractor shall provide the Health Insurance services to Locally Employed (LE) Staff of the Government of the United States of America in Nigeria, and the LE Staff eligible dependents. The LE Staff and their eligible dependents who shall be provided this insurance are listed in Section C. This insurance shall be provided in accordance with Section C

B.1.1. Official Residence Expense (ORE) Staff and American Employee Recreation Association (AERAA) are included under this contract only as a rider; the Contractor shall bill the Chief of Mission or the Deputy Chief of Mission (for their individual ORE Staff), and the Embassy Association (for AERAAs) at the rates specified below. The Contractor shall bill the individual covered at the rates specified below. See Section G for billing procedures. Note that USG is not responsible, nor liable, for any riders.

B.2. PRICES

B.2.1 VALUE ADDED TAX.

The U.S. Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices, as the U.S. Embassy has a tax exemption document issued by the Nigerian government.

B.2.2 This is a fixed price with economic price adjustment requirements type contract under which the contractor shall be issued firm, fixed-price task orders.

The fixed prices/premium rates for the health insurance services as specified in Section C are as follows:

B.2.3 Base Year of Contract

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Base Year (Bi-Weekly Subtotal x 26)

Estimated number of premiums does not include any Riders (B.1.1)

B.2.3.1 Catastrophic Coverage (See C.1.2.3).

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Base Year

B.2.4 First Option Year of Contract

Bi-Weekly Rates Per Premium

Subtotal

Total Price for First Option Year

B.2.4.1 Catastrophic Coverage (See C.1.2.3).

Bi-Weekly Rates Per Premium

Subtotal

Total Price for First Option Year

B.2.5 Second Option Year of Contract

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Second Option Year

B.2.5.1 Catastrophic Coverage (See C.1.2.3).

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Second Option Year

B.2.6 Third Option Year of Contract

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Third Option Year

B.2.6.1 Catastrophic Coverage (See C.1.2.3).

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Third Option Year

B.2.7 Fourth Option Year of Contract

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Fourth Option Year

B.2.7.1 Catastrophic Coverage (See C.1.2.3).

Bi-Weekly Rates Per Premium

Subtotal

Total Price for Fourth Option Year

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment in accordance with B.4 below, the Contractor shall present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and shall include, but is not limited to overhead, and administrative costs. The retention amount shall also be inclusive of any profit. The retention amount includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider and/or claimant. The Bi-Weekly Retention Schedule in B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance of the contract.

NOTE TO OFFEROR: Fill in the fixed bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount shall be expressed in the currency in which the premium amount is proposed. The fixed retention amount SHALL NOT be expressed in terms of a percentage of the premium.

B.3.2 Bi-Weekly Retention Amounts per separate premium paid.

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

B.3.3 Bi-Weekly Retention Amounts per separate premium paid.

(See 1.2.3) Catastrophic Coverage

Employee

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

B.4 ECONOMIC PRICE ADJUSTMENT - HEALTH INSURANCE PREMIUMS

B.4.1. Premium Adjustment Based on Experience - 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.1.1. The U.S. Government will not allow any price adjustment during the first twelve months of this contract. After such time, the Contractor or the U.S. Government may request an adjustment in premiums on an annual basis. Adjustments are not retroactive to previous contract terms. Before any adjustment is made, the Contractor agrees to provide the U.S. 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.

This information shall be provided per type of premium, i. e. category in the pricing tables. The retention amount is not subject to adjustment. The U.S. Government reserves the right to have an independent third party review the balance sheet, claims, and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment to be made shall be subject to mutual agreement between the U.S. Government and the contractor. The Contracting Officer will then prepare a modification to the contract based on the mutual agreement. The mutually agreed adjustments shall be effective thirty days after complete information is received by the U.S. Government. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes Clause in FAR 52:233-1.

B.4.2. Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the Nigerian Government, if such change in the laws has a direct impact on the cost to the Contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the Contractor to modify the contract to adjust the premium rate. The Contractor agrees to provide all documentation necessary to support any requested adjustment.

B.4.2.1 Employee Pool – This clause is only in effect if the Contractor included details in its offer regarding a pooling arrangement, of which this contract is a part. Before any adjustment is made under this price adjustment clause, the Contractor shall include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

SECTION C

DESCRIPTION / SPECIFICATION / WORK STATEMENT

C.1 HEALTH INSURANCE SERVICES

The Government of the United States of America in Nigeria, hereinafter referred to as Government, requires Health Insurance coverage for its Local Employed (LE) Staff.

The specific health benefit coverage to be provided under this contract is set forth in Section C.

C.1.1 Employee and Dependent Health Service Benefits

C.1.1.1 Hospitalization (Treatment in Hospital / Inpatient Care)

Services and supplies provided during hospitalization, including services provided by licensed healthcare providers, room, bed and board (semi-private accommodations), operating rooms, recovery rooms, intensive care services, imaging and diagnostic testing, and general hospital nursing care, physical therapy, as well as drugs and medicines administered during in-patient care and treatment. When private accommodations are provided, coverage will be limited to the cost of a semi-private room unless otherwise covered in an off-the-shelf plan.

Minimum Coverage: 100%

See Mental Health and Substance Abuse Care (C.1.1.13) for details concerning inpatient psychiatric care. See Outpatient Services (C.1.1.4) for details concerning professional services.

C.1.1.2 Emergency Services (Emergency Room Visits)

Services provided for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness.

Minimum Coverage: 100%

C1.1.3 Ambulance

Professional ground transport to move a patient from the place where s/he is injured or becomes ill to the nearest hospital able to provide treatment, or to move a patient from one medical facility to another.

Minimum Coverage: 80%

C.1.1.4 Outpatient Services

Services provided by a licensed healthcare provider on an ambulatory or outpatient basis (without being admitted to a hospital), including surgeon’s fees and other medical services that may be provided in a hospital, clinic, doctor’s office, medical facility, etc. Examples include, but are not limited to:

· Annual physical examinations

· Specialist consultations and treatment, including second surgical opinions

· Minor surgical interventions

· Chemotherapy and radiation treatments

· Immunizations recommended by local authorities and/or the World Health Organization

· Diagnostic tests and diagnostic imaging

· See Rehabilitative and Habilitative Services and Devices ( C.1.1.14) for details concerning physical therapy.

· See Mental Health and Substance Abuse Care ( C.1.1.13) for details concerning psychiatric therapy.

C.1.1.5 Obstetric and Newborn Care

Care and services that women receive during pregnancy (prenatal care), throughout labor, delivery and post-delivery, and outpatient care for newborn babies. Hospitalization during pregnancy, and/or delivery will be reimbursed as Hospitalization (treatment in the hospital for inpatient care). All other treatments will be considered outpatient services.

Minimum Coverage: Inpatient: 100% / Outpatient: 80%

C.1.1.6 Pediatric Services

Primary, preventive and routine care services for covered dependent children, including, but not limited to physical examinations, developmental assessments, laboratory tests, and immunizations recommended by local authorities and/or the World Health Organization.

C.1.1.7 Preventive & Wellness Services and Chronic Disease Management

Counseling or preventive care designed to prevent or detect medical conditions and care for chronic conditions, such as asthma and diabetes. Examples include, but are not limited to physicals, immunizations, and cancer screenings.

C.1.1.8 Prescription Drugs

Medications prescribed by a certified health care provider that are medically necessary. Examples include but are not limited to prescription antibiotics to treat an infection, medications used to treat an ongoing condition, such as high cholesterol prophylaxis, or contraceptive medication.

C.1.1.9 Hearing Assessments & Diagnostic Testing

Examinations and Treatment.

Hearing aid apparatuses. Limited to one apparatus per ear up to a total maximum of NGN 541,500 per covered individual per each three-year period.

C.1.1.10 Vision Assessments & Optical Care

Examinations and Treatment.

Prescription lenses and frames or contact lenses. Covered up to a maximum NGN 108,500 every two years per covered individual.

C.1.1.11 Dental Care

Examination and Treatment.

Dentist fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a maximum equivalent of NGN 1,155,500 per covered individual per contract year.

Orthodontia. Treatment is covered only if treatment begins before the age of 18, or if required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per individual up to a maximum equivalent of NGN 866,500. as a lifetime limit.

C.1.1.12 Reproductive Health

Prescribed contraceptive devices, preventive care and routine examinations, voluntary sterilization, and diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments, and reversal of sterilization are not covered. (See Exclusions from coverage in C.1.3.)

C.1.1.13 Mental Health and Substance Abuse Treatment

Inpatient and/or outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. Coverage includes behavioral health treatment, counseling, and psychotherapy. Services must be provided by a licensed psychiatrist, psychoanalyst, psychologist, or psychiatric social worker. Inpatient care for alcohol and substance abuse must be carried out at a certified facility licensed for detoxification and rehabilitation.

Minimum Coverage: 50%

C.1.1.14 Rehabilitative and Habilitative Services and Devices

Rehabilitative services (e.g., recovering life and mobility skills, such as speech therapy after a stroke or physical therapy after an accident) and habilitative services (e.g., development skills, such as speech therapy for children) that help to develop skills needed for everyday life. Devices to help gain or recover mental or physical skills lost due to injury, disability or a chronic condition, and devices needed for habilitative reasons.

Minimum Coverage: 50%

C.1.1.15 HIV/AIDS

Medications to suppress opportunistic infections (such as tuberculosis or toxoplasmosis for covered individuals who have HIV/AIDS.) Brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV/AIDS to the child.

Generally, excludes medication for the long-term suppression of HIV/AIDS through the combination of anti-retroviral drugs in locations with inadequate local healthcare infrastructures.

Minimum Coverage: 100%; up to $10,000 per contract year per covered individual.

C.1.1.16 Reserved.

C.1.1.17 Annual Maximum Limit

The maximum annual reimbursement per covered individual per contract year, not including expenses covered under HIV/AIDS benefits is NGN 15,724,000. Note that HIV/AIDS benefits have a separate annual cap (See 1.1.15).

C.1.1.18 Reserved.

C.1.2.1 Out of Country Medical Treatment

Medical expenses incurred outside of Nigeria will be covered, and coverage will be identical to in-country coverage, and subject to the same total maximum annual limit stated in C.1.1.17.

C.1.2.2 Out-of-Country Medical Travel

Transportation for out-of-country medical treatment will be a covered expense for LE Staff and eligible family members. To be considered a covered expense, the attending certified health care provider must certify in advance that the treatment is medically necessary and unavailable locally.

80% of the covered individual’s transportation expenses by the least expensive, appropriate means of transportation to the nearest city with adequate medical facilities will be covered.

80% of the transportation expenses of an attendant will also be covered, but only if the covered individual’s certified health care provider certifies that an attendant for the patient is necessary, (e.g., a parent attendant in the case of a patient who is a minor, or a family member attendant to make medical decisions in the case of a patient who is incapacitated or unconscious.)

All coverage for transportation for out-of-country medical treatment is subject to the total maximum annual limit stated in C.1.1.17. Transportation to a neighboring country without the attending certified health care provider certifying that the treatment is medically necessary and unavailable locally will not be covered.

C.1.2.3 Catastrophic Coverage

Additional coverage equal to NGN 15,724,000 per covered individual per contract year, Catastrophic conditions shall be defined as major medical conditions occurring as a result of a single illness/accident or closely related set of major illnesses (or conditions relating to a single accident) that exceed the standard minimum coverage limit.

C.1.3 Exclusions from Coverage

The following services and procedures are not covered under this contract:

· Elective cosmetic surgery;

· Spa cures;

· Rejuvenation cures;

· Massage;

· Exercise therapy;

· Long-term rehabilitative therapy;

· Non-medical hospital charges (e.g., telephone, television, etc.);

· Home help, family help, or similar household assistance;

· Fees of persons who are not certified health care providers;

· Advanced reproductive technology (e.g., in-vitro fertilization, intra-cellular sperm injection, artificial insemination, micro surgical epididymal sperm aspiration, testicular sperm extraction, cryopreservation, etc.);

· Services or supplies which have not been prescribed or approved by a certified health care provider.

There is no reimbursement for expenses that will be paid directly or reimbursed by any Nigerian government program, the Nigerian medical health program, the Nigerian workers’ compensation program, the U.S. workers’ compensation program, or post’s LE staff workers’ compensation program.

Coverage for LE Staff employees expires at midnight on the last day of paid work when an employee is leaving the service of the U.S. Mission in Nigeria.

C.1.4 Eligible Participants

To be eligible to receive medical coverage under this insurance plan, Locally Employed Staff must be:

-- Paid under the terms of the Local Compensation Plan (LCP); and -- Recruited under a non-temporary direct hire appointment, personal services agreement (PSA), or personal services contract (PSC); or -- Be on a temporary direct hire appointment or PSA Fixed Term contract of one year or more.

C.1.4.1 Location of Employment

Individuals eligible for coverage as per C.1.4 must be employed within the geographic boundaries of Nigeria by one of the following U.S. Government agencies: Department of State, U.S. Agency for International Development (USAID), Department of Agriculture, Department of Commerce, Department of Health and Human Services, Department of Justice or the Department of Defense.

C.1.4.2 Covered Dependent Participants

LE Staff who are eligible to participate in the medical plan may confer coverage to eligible family members who meet the following criteria:

Spouse: One legal spouse, as defined by Nigerian law, may be covered. LE Staff with more than one legal spouse must select only one spouse for coverage.

Dependent children: A child is defined as the employee’s natural, legally adopted, legal stepchild, or a foster child for which the employee has legal responsibility. The dependent child must be unmarried and financially dependent upon the covered employee. A child will be covered until the end of the calendar year in which s/he reaches age 26. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the LE Staff maintains coverage.

In cases where LE Staff and their legal spouse both work for the Mission and both are eligible to participate in the medical plan, one will be designated as the primary covered employee for purposes of the medical plan, and the other will be considered the legal spouse. The primary employee will carry the dependents under his/her primary employee policy.

C.1.4.3 Other Employees Who May be Covered under a Separate Policy Rider

a. ORE Employees: All current active employees of the Chief of Mission, Deputy Chief of Mission and the Consul General assigned to their respective official Government residences and paid under an ORE account may be covered under a separate policy rider. Costs of coverage may be different than those costs for employees in the general plan. Note: All costs for ORE employees are the responsibility of the employing officer, not the Government.

b. AERAA Employees: All current active employees of the Employee Association at U.S. Mission, Nigeria. All costs for AERAA are the responsibility of the Employee Association, not the U.S. Government.

C.1.5 Ineligibility for Coverage

Individuals are ineligible for coverage under this contract when they are working under temporary appointments, under a PSC or PSA contract that is time limited to less than one year; nonpersonal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Nigeria, who provides services to other local organizations as well as to the U.S. Mission; employees of USAID institutional contractors.

Also not covered are employees with an intermittent, seasonal, or “When Actually Employed (WAE) work schedule; and any other individual not falling within one of the legitimate employment status categories described elsewhere in this contract.

C.1. 7 Eligibility

C.1. 7.1 Term of Eligibility and Effective Date

Each current active eligible employee is enrolled for health benefits under this contract upon award, and thereafter during the performance period of this contract. Each new eligible employee will be enrolled upon entering on duty with the Government. An employee is considered active ("on the rolls") whenever such employee is on approved leave, whether paid or unpaid.

During a period of Leave Without Pay (LWOP) or unpaid leave that is one pay period or less, coverage under the insurance contract will continue. The Government will pay the regular premium cost to the Contractor (90% of premium). The employee’s share of the premium (10% of premium) will be collected through payroll deduction in that or the subsequent pay period.

C.1.7.2 Period of Ineligibility

Employees and their dependents are not entitled to health benefits during any period of employment for which premiums are not paid.

Additionally, an employee's dependents are not entitled to health coverage for any period of employment, during which the employee was not eligible to participate.

During an extended period (beyond one pay period) of Leave Without Pay (LWOP) or unpaid leave, the employee is responsible for the full cost of the insurance premiums for self and dependents. The Mission will pay the premiums directly to the Contractor and will collect the full cost from the employee on a quarterly basis. Alternatively, the employee may elect to have coverage cease, if that employee prefers not to pay the premium. Employees must notify the Human Resources office within 30 days of the commencement of unpaid leave status on their preferred election or declension of coverage and select a legitimate repayment period.

Should an employee who chooses to retain coverage during an unpaid leave status neglect to make a timely premium payment, coverage will cease as of the date of the missed premium payment for the employee and all dependents. Coverage may resume coverage during the first pay period that the employee returns to a legitimate paid leave status, and premiums are paid.

C.1.8 Brochure Requirement

C.1.8.1 The Contractor shall provide a document (brochure or pamphlet) in English that sets forth a complete listing of all health insurance benefits to be provided under this contract. The brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall provide additional brochures to the Government’s Contracting Officer Representative (USG COR), on request, on a periodic basis to maintain an adequate, available stock of brochures. This brochure should be updated when any substantial changes are made to coverage. The USG COR will ensure that appropriate distribution is made to participants.

C.1.8.2 The Contractor shall provide the plan description brochure described in C.1.8.1 to the USG COR no later than ten working days after date of contract award. The Contractor shall provide additional brochures on request for new employees within ten working days of the USG COR’s request.

C.1.8.3 The Contractor assumes full responsibility for ensuring that the brochure described in C.1.8.1 accurately reflects the requirements of the contract, as implemented by the Contractor’s technical proposal. In all cases, the contract shall take precedence. Should the USG COR discover that the brochure contains inaccuracies, the Contractor will be notified in writing; however, should the Government fail to notify either the contractor or covered participants of inaccuracies in any printed material provided by the Contractor, this shall in no way limit, revise or otherwise affect the performance required under this contract, and the Contractor must fully comply with all contract requirements.

C.1.9 List of Authorized Health Care Providers & Hospitals

C.1.9.1 All eligible participants are able to seek health care from any health care provider on the list provided by the Contractor. The Contractor’s provider list shall contain at a minimum all health care providers and hospitals that are specified on the Government list of required health care providers (see Exhibit C). Contractors may add additional hospitals to the network but shall maintain at a minimum the list of hospitals and health care providers on the official Government list, for the duration of this contract, and any changes made to the list shall be mutually agreed to.

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1. 52.2522 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search engine” (for example, Google, Yahoo, Excite) to obtain the latest location of the most current FAR.

The following Federal Acquisition Regulation clause(s) is/are incorporated by reference:

CLAUSE TITLE AND DATE

52.246-4 INSPECTION OF SERVICES - FIXED PRICE (AUG 1996)

E.2. QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan is designed to provide an effective surveillance method used to ensure satisfactory contractor performance. The QASP provides a method for the USG Contracting Officer's Representative (USG COR) to monitor Contractor performance, and to advise the Contractor on service improvements for unsatisfactory performance. It is also the mechanism for the USG COR to notify the Contracting Officer of continued unsatisfactory performance.

The Contractor is responsible for management and quality control to meet the terms of the contract. The role of the Government is to monitor contractor performance to ensure that contract standards are achieved.

Services Performs all insurance services set forth in the Performance Work Statement (PWS)

C.1 thru C.1.9

All required services are performed; no more than five (5) participant customer complaints are received per month

E.2.1 Surveillance. The USG COR will receive and document all complaints from employee participants regarding the services provided. If appropriate, the USG COR will send the complaints to the Contractor for corrective action.

E.2.2 Standard. The performance standard is that the Government receives no more than five (5) customer complaints per month. The USG COR shall notify both the Contractor and the Contracting Officer of the complaints on a quarterly basis, unless the complaints exceed the threshold. Should the complaints be in excess of the reporting threshold, the USG COR will notify the Contractor and the Contracting Officer within 30 days of notification of the complaints. The Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.246-4, Inspection of Services – Fixed Price (AUG 1996) or the appropriate Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

(1) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed, the participant should notify the USG COR.

(2) The USG COR will maintain a record of the complaint.

(3) If the USG COR determines the complaint is without merit, the USG COR will close the complaint with the participant, and retain a copy of the annotated written complaint in his/her COR files.

(4) If the USG COR determines the complaint is valid, the USG COR will inform the Contractor, and the USG COR will give the Contractor a reasonable period of time to correct the problem.

(5) The USG COR shall, at a minimum, notify the Contractor orally of any valid complaints.

(6) If the Contractor disagrees with the complaint, s/he should contact the USG COR, and provide an explanation, supplying proof as needed, to resolve the matter. Should there be a disagreement on the validity of the complaint between the USG COR and the Contractor, the matter should be referred to the Contracting Office for resolution.

(7) Repeat customer complaints for any service, or for any service provider facility are not permitted, and will be referred to the Contractor for resolution. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

SECTION F

DELIVERIES OR PERFORMANCE

F.1. 52.2522 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations specified above, please consult the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the current links to the FAR. You may also use an Internet “search engine,” (for example Google, Internet Explorer, Bing, etc.) to obtain the latest location of the most current FAR.

The following Federal Acquisition Regulation clauses are incorporated by reference:

CLAUSE TITLE AND DATE

52.242-15 STOP WORK ORDER (AUG 1989)

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is one base year beginning on the date of the Notice to Proceed, and continuing for twelve calendar months, and with four one-year option periods.

F.3 OPTIONS

(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."

F.4 REPORTS AND OTHER DELIVERABLES

All reports and other deliverables required under this contract shall be delivered to the following address:

U.S. EMBASSY, ABUJA

PLOT 1075 DIPLOMATIC DRIVE

CENTRAL BUSINESS AREA

ABUJA

ATTN: HRO/COR

SECTION G

CONTRACT ADMINISTRATION DATA

G.1. 652.242-70 Contracting Officer’s Representative (COR) (AUG 1999)

(a) The Contracting Officer may designate in writing one Government employee, by name or position title, to act for the Contracting Officer under this contract. This designee shall be identified as a USG Contracting Officer’s Representative (USG COR). Such designation shall specify the scope and limitations of the authority so delegated. The USG COR designee shall not change the terms or conditions of the contract, unless the USG COR is a warranted Contracting Officer and this authority is delegated in the designation.

(b) The USG COR for this contract is the Human Resources Management Specialist.

G.2 USG COR Duties

G.2.1 The USG COR is responsible for inspection and acceptance of services. These duties include review of Contractor invoices, including any supporting documentation required by the contract. The USG COR may provide technical advice, substantive guidance, inspections, invoice approval, and other purposes as deemed necessary under the contract.

G.2.2 The USG COR shall maintain an updated list of insured employees and dependents, which will supersede the initial list provided under this contract and as reported to the Health Management Office (HMO), without prejudice to the ineligibility clause.

G.2.3. The COR has the additional responsibility of maintaining the eligible listing of employees and dependents for insurance coverage.

G.2.4. The USG COR shall not change any terms or conditions of this contract. The USG COR is authorized to provide the Contractor with updated listings of eligible employees and dependents; only the Contracting Officer can modify existing task orders or issue new task orders, reflecting contractual changes. Only the Contracting Officer, not the USG COR, is authorized to obligate funding and commit the U.S. Government to a binding commitment.

G.3. Payments to Contractor

Payment shall be made in the currency identified in the pricing tables.

G.4 Submission of Invoices and Payments

G.4.1. Invoices for U.S. Government employees shall be submitted in an original copy by email to NigeriaFMCinvoices@state.gov.

G.4.2. Frequency of Payments

All funds obligated under this contract will be discharged by the issuance of task orders, as described in H.3 for all non-rider coverage. Each task order will fund a specific period of time and number of employees, and the task orders will be issued at the frequency described in H.3. All payments under this contract will be made at the conclusion of the period covered. Invoices may be submitted monthly.

G.4.3. Payment of Participant Premiums

U.S. Government Employees. The Government shall make payments directly to the Contractor for all U.S. Government employees, whether or not the employee is contributing to the premium amount.

G.4.4. Riders

a. ORE. The Chief of Mission and/or Deputy Chief of Mission will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount.

b. AERRA Staff. The Employee Association will make payment directly to the Contractor for the entire premium amount of the EA employee, whether or not the EA employee is contributing to the premium amount.

G.5 Refunds to the Government

If at any time during performance of the contract the Government finds that the Contractor has been overpaid because the number of employees and/or covered dependents has decreased, the Contracting Officer may choose at his/her sole discretion to allow the overpayment to be credited to the Government’s account or require that the Contractor refund the overpayment. If the Contracting Officer requests a refund, the Contractor shall make that refund to the Government within ten calendar days of receipt of the request.

G.6 Value Added Tax (VAT)

The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices, as the U.S. Embassy has a tax exemption certificate issued by the Nigerian government.

SECTION H

SPECIAL CONTRACT REQUIREMENTS

H.1 Security

On occasion, a Contractor employee may require entry into Government-owned or Government-operated facilities. If so, the Contractor’s representatives should be prepared to provide the necessary identification to permit escorted access within the Government facility.

H.2 Standards of Conduct

The Contractor shall maintain satisfactory standards of employee competency, conduct, cleanliness, appearance, and integrity, and shall be responsible for taking such disciplinary action as may be necessary. Each Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

H.3 Ordering Procedures

The Government will issue a task order to the contractor after contract award to identify all employees and dependents covered by the insurance benefits described in this contract. The USG COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor.

All revisions shall be consolidated, and a new or modified task order will be issued by the Contracting Officer. If any changes have been made to the coverage listing, the Government anticipates issuance of a new task order on a [ ] monthly, [x ] quarterly basis. This new task order will include all changes made since the previous task order was issued, and will include any increase or decrease in necessary funding. The changes to the list of eligible individuals will supersede the initial list provided under previous task orders without prejudice to the ineligibility clause. Task orders will indicate the effective date of employment, for purposes of calculating the premium due.

H.3.1 Riders are not included under the task orders issued by the Contracting Officer. Because their coverage is under a rider, either their employer are themselves are responsible for directly interacting with the Contractor to order any coverage. When contacted, the Contractor shall advise the person of the paperwork and payment that will be necessary to order coverage for the identified individuals. The Contractor may be contacted by more than one individual.

H.4. Contractor Responsibility in Claims and Reimbursement to Claimants

GENERAL.

The Contractor shall be responsible for all planning, estimating, programming, project management, scheduling, dispatching, supervision, and inspection of work. The Contractor shall maintain his own reference library of technical reference works, Nigerian laws and regulations, including current tariffs and registries. The Contractor shall treat the information provided by the U.S. Mission in Nigeria concerning employee's personal data, medical information, and salaries as highly sensitive and may not divulge any employee information to unauthorized persons. The Contractor shall establish procedures for handling medical insurance claims as follows:

H.4.1 Administrative Records

H.4.1.1 The Contractor shall maintain medical insurance files for each covered employee and dependent, including receipts and proof of paid claims, requests for claim reimbursements, and accounting of paid benefits, with balances of amounts remaining in the participant’s account with respect to the annual reimbursement ceiling.

H.4.1.2 The Contractor shall provide the USG COR with the necessary claim forms for each type of benefit that can be claimed under this contract. These forms shall specify a list of documents required to be appended to each claim and otherwise provide instructions for filing a claim.

H.4.1.3 The Contractor shall use the English spelling of the employees' names in all transactions, including reimbursement checks.

H.4.1.4 The Contractor shall send employee claim reimbursement checks to employees no later than two weeks after a claim is submitted.

H.4.2 Medical Insurance Claims

Settlement of medical insurance claims shall be completed as follows:

H.4.2.1 All medical claims shall be submitted to the Contractor by employee participants directly, through a drop box in the USG COR's office. The claims shall be picked up from the USG COR weekly, on the Tuesday of each week.

H.4.2.2 The Contractor shall screen and date stamp all claims submitted on the day of receipt. If there are any missing documents or information thereby disallowing said claim to be payable, the Contractor shall notify the employee within three working days, with a copy to the USG COR (if notification is written).

H4.2.3 The Contractor shall settle the claims no later than two weeks from the date the claim is submitted to the Contractor.

H.4.2.4 Settlement of claims shall be by electronic fund transfer (EFT) to the employee’s registered bank account for each claim submitted. Each payment of claim shall be accompanied by a form that itemizes the details of the amount reimbursed, with a clear explanation of deductions, if any.

H.4.2.5 The Contractor shall accept the participant’s choice of service provider, if the provider is on the Contractor’s approved provider list. The Contractor will pay the service provider directly for all covered services.

H.5. Reporting Requirements

The Contractor shall provide a report on the previous month’s activities, and this report shall be submitted to the USG COR no later than the 10th day of the month following the reporting period.

H.5.1 Employee Claims Report.

The Employee Claims Report shall list all claims paid by the Contractor, and will include the claimant’s name, the date the claim was received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of the current status of payment. The report shall be provided per type of premium, i.e. per category in the pricing tables. The report shall not include any rider’s claims information.

H.5.2 Quarterly Utilization Report. The contractor shall submit a quarterly utilization report to the USG within 30 days of the end of the quarter.

H.6. Miscellaneous Contractor Requirements

H.6.1. General. The Contractor shall take all necessary steps to obtain and pay for all permits, taxes and fees as are required by the Nigerian government to establish and/or operate a commercial venture locally. A contract with the Government conveys no special privileges or immunities to the Contractor. The Contractor is an independent commercial concern and not a part of the U.S. Mission. The Contractor's employees are not Government employees. Registration of this contract with the Nigerian government, if required by Nigerian law, will be the sole responsibility of the Contractor, and any fees, taxes, or other duties shall be payable by the Contractor without recourse to the Government of the amounts thereof.

H.6.2. Licensure and Local Laws. The Contractor shall possess all permits, licenses, and any other appointments required for the execution of work under this contract, all at no additional cost to the Government. The Contractor shall perform this contract in accordance with all applicable Nigerian laws.

H.7 Refunds

If the Government becomes eligible for a refund of payment due to overpayment or other causes, the Contractor shall refund the amounts by electronic funds transfer (EFT) or check to the Government’s account within 30 days. This includes any partial refunds and refunds due after the termination of the contract.

H.8 Requiring Activity

The requiring activity under this contract is the U.S. Embassy Mission Nigeria. The Government will provide the contractor with a list of Government-preferred hospitals.

SECTION I

CONTRACT CLAUSES

I.1. 52.2522 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm.

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations specified above, please consult the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the current links to the FAR. You may also use an Internet “search engine,” (for example Google, Internet Explorer, Bing, etc.) to obtain the latest location of the most current FAR.

The following Federal Acquisition Regulation clauses are incorporated by reference:

CLAUSE TITLE AND DATE

52.202-1 DEFINITIONS (NOV 2013)

52.203-3 GRATUITIES (APR 1984)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT (SEPT 2006)

52.203-7 ANTI-KICKBACK PROCEDURES (MAY 2014)

52.203-8 CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS FOR ILLEGAL OR IMPROPER ACTIVITY (MAY 2014)

52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY (MAY 2014)

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (OCT 2010)

52.203-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (APR 2014)

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR STATEMENTS (JAN 2017)

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POST CONSUMER FIBER CONTENT PAPER (MAY 2011)

52.204-7 SYSTEM FOR AWARD MANAGEMENT (OCT 2018)

52.204-9 PERSONAL VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011)

52.204-18 COMMERCIAL LAND GOVERNMENT ENTITY CODE MAINTENANCE (OCT 2018)

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS (DEC 2014)

52.204-23 PROHIBITION ON CONTRACTING FOR HARDWARE,…