QA_19PL9019R0001.pdf

Questions and Answers

Solicitation Number 19PL9019R0001 Health Insurance Services for Locally Employed Staff of the U.S. Mission in Poland.

Questions 1: What is the claims history for health Insurance for the current year (year-to-date) and of previous years:

2014 – 2018?

Answer 1: There is no claim history that is applicable to the current contract. The incumbent contractor is a local medical service provider and has delivered the full range of required services subscribed under fixed premium rates.

There is no claim/reimbursement procedure in the health care system in Poland. Consequently, no claim reimbursements have been made to the local employees of the U.S. Mission in Poland. Under local laws, the contractor does not disclose the value of the rendered services.

Q 2: Do these claims include claims from ORE employees?

A 2: See answers to A1 above.

Q 3: What is the premium history for health Insurance for the current year (up to date) and of previous years: 2014 – 2018?

A 3: Below are premium payments under the current contract:

- Total Price for Base Year: 04.01.2014-03.31.2015 – USD $239,256.88

- Total Price for Option Year 1: 04.01.2015-03.31.2016 - USD $210,679.87

- Total Price for Option Year 2: 04.01.2016-03.31.2017 - USD $216,770.94

- Total Price for Option Year 3: 04.01.2017-03.31.2018 - USD $248,837.95

- Total Price for Option Year 4: 04.01.2018-03.31.2019 - USD $251,519.18

Exhibit C – PREMIUM STATISTICS

Period Premiums

Billed in USD

Number of Single

Plans

Number of Family

Plans

Number of

Spouses

Number of

Dependents

Average Number of

Members per Month

04.01.2014 – 03.30.2015 239,256.88 1023 2939 244 249 330

04.01.2015 – 03.30.2016 210,679.87 1067 2995 248 246 339

04.01.2016 – 03.30.2017 216,770.94 1196 3110 256 248 359

04.01.2017 – 03.30.2018 248,837.95 1181 3217 264 246 367

04.01.2018 – 03.30.2019 251,519.18 1169 3232 263 242 367

Q 4: Has VAT been included in it? If yes, what percentage?

A 4: VAT charges apply to all local services. However, during the contract period 2014-2019, the VAT rate in Poland for health care services was 0.

Q 5: Did the premium history for insurance include Insurance Premium Tax (IPT)? If so, what percentage of IPT was included in the historical premiums?

A 5: No, IPT has not been applied to these services.

Q 6: What is the average number of dependents (spouses and children) for the current year and each of the last 5 years:

2014, 2015, 2016, 2017, 2018 and 2019 (till now)?

A 6: Please see the demographic statistics under Exhibit C above, and D. The solicitation is amended to include the Exhibits A.2, C and D under Section J - see Amendment A0002, item 3.

Exhibit D – DEPENDENTS STATISTICS

Dependents (spouses and children) by Gender within Age Range

Period: 2014 - 2015 2015-2016 2016-2017 2017-2018 2018-2019

Age

Group

Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total

2 or less 6 4 10 7 3 10 6 3 9 5 2 7 7 2 9

2-15 50 52 102 51 49 100 50 52 102 51 54 105 50 53 103

15-25 84 53 137 81 55 136 83 54 137 82 52 134 81 49 130

26-35 12 22 34 11 21 32 11 19 30 12 23 35 10 19 29

36-45 19 36 55 18 33 51 19 35 54 19 33 52 20 34 54

46-55 29 51 80 26 49 75 30 52 82 29 55 84 31 53 84

56-65 20 40 60 26 47 73 26 48 74 29 51 80 32 56 88

66 or more

1 1 2 2 2 4 2 3 5 3 4 7 3 5 8

TOTAL 221 259 480 222 259 481 227 266 493 230 274 504 234 271 505

Q 7: Is the 2019 benefit schedule for health insurance the same as the benefit schedule currently being requested under 19PL9019R0001? If so, please provide a description of benefits.

A 7: Yes, it is the same. Please see Section C of the solicitation.

Q 8: Are there any HIV/AIDs cases? If yes, what is the total number of people who are currently being treated for HIV/AIDs?

A 8: Information on individual medical records is not available under European and Polish GDPR laws.

Q 9: Is out-of-country medical treatment covered by the service?

A 9: No. Out-of country medical treatment is not covered under this solicitation – see Amendment A0002 item 2.

Q 10: When is this plan likely to commence?

A 10: The contract is expected to start on/about October 1st, 2019 however this date may vary. The performance period of this contract shall start from the date indicated in the Notice to Proceed (see Section F, paragraph F.2).

Q 11: What is the claims history? Were there any catastrophic cases (in excess of $10,000) within the last year to date?

a) If yes, please provide numbers

b) Status of claim – paid/incurred

A 11: Please refer to the answer given for A1 above. a) Not public; b) No claims paid.

Q12: Are there any persons who are currently hospitalized? If yes, please provide number.

A 12: Please refer to A8, above.

Q 13: Are any major illnesses (i.e. hemodynamics, open heart surgery, orthopedic major surgeries, organ transplants, traumatic accident, cancer and oncology cases) being treated? If yes, please provide the number of cases.

A13: Please refer to A8, above.

Q 14: Are any employees currently disabled? If yes, please provide number.

A 14: Please refer to A8, above.

Q 15: Please provide current vendor information a. Name; b. Contract Number; c. Value; d. Date of award; e. Date of expiration.

A 15:

a. Medicover Sp. z o.o.

b. Contract number: SPL90014D0001

c. Value: USD $1,167,064.82

d. Date of award: April 1st, 2015

e. Date of expiration: September 30th, 2019

Q 16: Membership each of last 3 years by Single, Married and Family Status.

A 16: See Exhibit C under A3. Solicitation will be amended accordingly.

Q 17: What is the percentage of local nationals?

A 17: 99%

Q 18: Are there dependent children to be covered who are studying outside the country? If yes, please provide the country and number of dependent children studying there.

A 18: No

Q 19: Where are the insured employees located?

A 19: Poland (Warsaw & Krakow).

Q 20: Does this solicitation number 19PL9019R0001 contain the same requirements as the current contract? If not what are the differences?

A 20: Requirements for this contract are the same as the current contract.

Q 21: What currency should proposers use in submitting bids?

A 21: See Section B, paragraph B2. U.S. firms desiring to be paid in U.S. dollars should submit their offers in U.S.

dollars. All other firms shall submit their prices in local currency.

Q 22: Is it possible for a non-insurance company that has cooperation with a big insurance company and would deliver their insurance plans, to submit the bid or is this solicitation limited only to insurance companies?

A 22: See Section L, paragraph L.4.3.2.2.

Q23: What does HIV/AIDS health care mean?

A23: HIV/AIDS health care under this solicitation means a standard of health care customarily provided to HIV/AIDS patients consistent with the medical standards and laws in Poland.

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.

Q24: Please provide more details about specialist doctors. What specialists are to be covered? What are the expected time limits for availability and access to doctor specialists and primary physicians?

A24: The access shall be provided to customarily available standard health care specialists in Poland. Please refer to

Section C, paragraph C.1.1.5, C.1.1.6, C1.1.14 and C1.1.6 for information regarding availability and access to the primary physicians (internists, pediatricians, family doctors) and other specialists.

Q25: Please explain the scope of the ambulance service. What is the required geographic range for ambulance service?

Is first aid ambulance service required within the geographic boundaries of Poland or limited to the administrative boundaries of Warsaw and Krakow?

A25: Ambulance service shall cover first aid in emergency cases, transportation and admission to a hospital within the geographic boundaries of Poland, see Amendment A0002 and Section C paragraph C.1.1.3.

Q26: What is the time limit for provision of urgent emergency ambulance services?

A26: Provision of urgent emergency ambulance services shall be consistent with the Polish national emergency medical standards under the local laws and regulations. The Contractor shall perform under this contract in accordance with the local laws as stated in H.6.2.

Q27: Shall all medical services subscribed under the contract be available within the geographic boundaries of Poland or limited to the administrative boundaries of Warsaw and Krakow?

A27: All medical services subscribed under the contract shall be available within the geographic boundaries of Poland -see Amendment A0002 item 1 subparagraph Medical Coverage under C.1.1.

Q28: Please elaborate on the 100% reimbursement paragraphs and who is responsible for the threshold reflected in the local prices, and what are the bases for such a threshold?

A28: 100% reimbursement means that the total cost of the services, delivered by service providers, must be covered by the contractor. The annual threshold is set by the U.S. Government, as stated in Section C, paragraph C.1.1.15. The

Contractor shall adhere to this threshold under the scope of this contract.

Q29: What law applies to the contract? What court is to handle jurisdiction?

A29: The contract is subject to the U.S. Federal Acquisition Regulations. All disputes shall be settled in accordance with

FAR 52.233-1 DISPUTES (MAY 2014) Alternate 1 (DEC 1991), as referenced in Section I, Contract Clauses.

Q30: Will all offerors be informed about the winning offer?

A30: Yes. The award will be publicized on Federal Business Opportunities (FedBizOpps) website. In addition, upon award of the contract, all offerors will be notified about the successful awardee’s name, contract value and date of the award.

Q31: Which dental services are to be subscribed under the contract? What is the time limit for provision of dental services?

A31: Please see Section C, paragraphs C.1.1.11. and C.1.1.12 for the scope and time requirements on dental services under this solicitation.

Q32: What is Defense Base Act (DBA) insurance? Is it obligatory?

A32: Please refer to FAR 52.228-3 in Section I for full text of the Defense Base Act insurance clause. The DBA insurance is mandatory under this solicitation for all offerors. The Offerors shall include the Defense Base Act (DBA) cost in Section

B, paragraph B.2 Prices. 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 , as stated in Section L.

Q33: Will the cost of Defense Base Act (DBA) Insurance be paid back to the contractor?

A33: Yes, the cost of DBA Insurance will be reimbursed based on the invoice issued by the contractor.

http://www.dol.gov/owcp/dlhwc/lscarrier.htm