HL_QA1_090722.docx

Health & Life Solicitation Questions and Answers #1

QUESTIONS AND ANSWERS #1

19PM0722R0001 – Health & Life Insurance Coverage

1. Question – Could you please advise why there is a difference between this 210 on the tender and the headcount in the xls. summarized as follows:

45.520

MONTHLY SAL

702.986

Answer – The solicitation includes the estimated number of people that will be covered in the insurance (see Section B.2.3 – B.2.7.) Exhibit A, list the current employees’ salaries and ages Exhibits B, C & D list the possible rider participants’ salaries and ages.

Because the Embassy will pay 90% of the premium for health insurance and the employee will be responsible for the remaining 10%, each of the current 277 employees will need to decide if they will elect to enroll. We estimate 210 employees will enroll based on previous enrollment rates when employees were responsible for part of the premium, but we cannot provide precise future numbers or guarantee levels of enrollment. Please refer to estimated numbers in B.2.3-B.2.7

2. Question – Could you please clarify this difference: the monthly payroll value in the tender is $754k but the xls data gives only $703k?

Answer – For the Life table, the amount listed is the Estimated Payroll. It may be more or less depending on the actual number of employees. Currently, there are several vacant positions so the current payroll amount is $703k, but we project having more employees and greater payroll during the life of this contract.

3. Question – Does the 2 % James Zadroga Act tax apply to the medical and life insurance premium?

Answer – The James Zadroga Act applies to all foreign vendors; however, there is a 5000C exemption for countries with an international agreement with the U.S. Currently, Panama has an international agreement with U.S.; therefore, the Offeror shall submit a completed IRS Form W-14, found at www.irs.gov/w14, to ensure compliance with FAR 52.229-11. In addition to the initial W-14 submitted with the proposal, the awarded vendor is required to submit this form with each monthly invoice to obtain the exception.

4. Question – Please provide five years of loss data (table 1) by year of account including annual net premium (for the same period), incurred claims and membership history. For membership history (Table 2) please provide the number of Employees with single coverage and with family coverage at the end of each year. Please do not include any confidential information, just the overall statistics for the group. Claims information is critical to our pricing and the relationship of claims to employee growth or shrinkage is part of the claims analysis.

Table 1

dd/mm/2016 – dd/mm/2017 dd/mm/2017 – dd/mm/2018 dd/mm/2018 – dd/mm/2019 dd/mm/2019 – dd/mm/2020 dd/mm/2020 – dd/mm/2021

Table 2

Please, provide headcounts for the last 5 years:

Answer – The Solicitation includes in Exhibit E claims paid since the start of the current contract. Proposals should include a premium price and retention percentage based on those claims costs. Historical data about previous premium and retention rates will not be shared.

Headcounts are listed below:

Employees:

Retirees:

5. Question – We would like to know if you have been informed of Catastrophic cases, such as: Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases (Radio and Chemotherapy), and hospitalizations with more than 10 days

Answer – We are amending the RFP to add Exhibit F to Section J. The new exhibit will list all types of claims for claims paid between December 2018 and June 2022.

The details of the claims are considered confidential and will not be released.

Please note that data provided in response to this question is provided for informational purposes and under no circumstances shall it be construed to change any terms or conditions or requirements within the solicitation. In addition, for any answer provided regarding claims data incurred under the existing contract, please be advised that the benefits levels are not the same nor may this data be indicative of future claims. Therefore, it is each offeror’s decision on whether to use or not to use this information. However, under no circumstances shall the U.S. Government be liable for this data or shall it become the basis for a request to adjust the premium rates once the contract is awarded. Rather, offerors are advised any adjustments to contract premium rates shall be in accordance with the Economic Price Adjustment clause B.4.

6. Question – What is the name if the insurance company that currently provides coverage?

Answer – The current contract number is 19PM0718D0001 and our current contractor is Pan-American Life Insurance Group.

7. Question - Is there a preferred list of Hospitals, Clinics or other Medical Facilities that the Embassy employees prefer? If yes, please provide a list of these facilities

Answer – There is no list of preferred medical facilities.

8. Question - Could you please provide information about the Claims you have had out of country during your current coverage?

Answer – There has been one case processed under current coverage. Claim for medical expenses incurred out of country was paid at 80% and subject to maximum limit of $240,000. Claim reimbursement payment of $14,751.11 was processed under the prices expected in Panama for the same treatment.

9. Question - Has there been any changes to the Table of Benefits over the past 5 years?

Answer – Solicitation 19PM0722R0001 includes medical benefits similar to our current contract, but it has some differences. There were no changes in benefits during the performance of the current contract.

10. Question - Would the Embassy accept proposals in USD where premium are also paid in USD from non US companies?

Answer – The proposals shall be presented in USD and see Currency under C.3. & G.3.

11. Question - Can also claims be paid in USD or is there a need to be paid in the local currency?

Answer - Refer to Question 10 and See also C.2.

12. Question – Can proposals be submitted electronically or does the Embassy insist on hard copies?

Answer – Please see the Invitation Letter uploaded in SAM for reference on how to submit the proposal.

13. Question - Would the Embassy accept a proposal from an internationally licensed insurance company under an offshore jurisdiction or does it insist on a locally licensed insurance company only?

Answer – Please refer to Section L.4.3.1 Part 4, Licensing Information, and Section H.6.2. Licenses and Local Law.

14. Question - Is this a mandatory plan, meaning all employees of the Embassy will be covered or voluntary, meaning the employees will be given the option to sign up for the health insurance?

Answer – This is a voluntary plan for the health portion but is mandatory for the life portion.

15. Question - What are the possible differences to the provided “Estimated Number of Premiums under a, b, c” as the number of insured persons is essential for the risk evaluation (premium rates calculation)?

Answer – See Question 1.

16. Question - Is this Solicitation addressed only to Insurance companies or would Insurance intermediaries/brokers also be eligible offerors?

I Answer – The current health and life insurance contract is handled directly with an insurance company. A broker must submit a proposal on behalf of a particular insurance provider as opposed to representing various insurance provider’s coverage and pricing from which we must choose. The actual insurance company would be required to have the necessary licenses and permits and would sign the SF 33. A broker’s proposal must comply with the solicitation requirements and would be evaluated in accordance with the solicitation requirements. We would not deviate from the terms and conditions of the solicitation, and payments would be made in accordance with the solicitation requirements. As a practical matter, the entity signing the SF 33 and certifications normally the insurance company.

17. Question - Regarding the Life Insurance part of the Solicitation: Please provide a census list with all the dates of birth, genders and annual salaries for each current employee.

We ask this because the development of life insurance rates for a group of this size requires a proper appreciation of the risk profile.

We ask for salary data because the benefits are a function of the individual’s salary. It follows that our group rate would be higher if the older employees all had the higher salaries and conversely would be lower if the opposite were true. Without it, we are left with making assumptions and since your current insurer has access to this information, we would be at an unfair disadvantage unless we had it too.

Answer – Please see document Section J – List of exhibits, TAB EXHIBIT A - EMPLOYEE STATISTIC published with the RFP. It lists the current census with genders, ages, and salaries.

18. Question - Please provide the loss data for the current policy year and date at which those claims were last reported, plus at least the three prior years of loss data by year of account.

All claims should be individually itemized detailing date and cause of the person’s death or disability plus the benefit paid.

Please also provide the corresponding membership history, detailing the number of employees at the beginning and end of each policy year.

Answer – Please see document Section J – List of exhibits, TAB EXHIBIT E – CLAIMS PAID published with the RFP. Life Insurance claims paid were missing from the initial publication in SAM so look at the latest version of Exhibit E.

In addition, we are amending the RFP to add Exhibit G to Section J. The new exhibit will list all types of Life Insurance claims for claims paid between May 2018 and June 2022.

The details of the claims are considered confidential and will not be released.

19. Question - Please confirm whether there have been any changes to the benefit structure (i.e. new benefits added / change in salary multiple etc.) over this period.

Claims information is critical to our pricing as we need to analyze the relationship of claims to a fluctuating group profile. Without it, we are left with making assumptions and since your current insurer has access to this information, we would be at an unfair disadvantage unless we had it too.

Answer – Solicitation 19PM0722R0001 includes life benefits similar to our current contract, but it has some differences. There were no changes in benefits during the performance of the current contract.

20. Question - The total number of employees is 277 as per Exhibit A (Section J), whereas the total number of employees is 210 as per the price tables in Section B. Please confirm the actual number of employees.

Answer – See Question 1.

21. Question - Dependent count is not provided in Section J. Please let us know the total number of dependents for health insurance.

Answer – See Question 4.

22. Question - 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 – See Question 4.

23. Question - Exhibit E only has the historical claims for health insurance. Please provide a category-wise report (i.e. Basic Life, AD&D, and Partial & Total Disability) of claims paid for Life Insurance in the last 5 years – 2021, 2020, 2019, 2018 & 2017. Please

Answer – See Question 18.

24. Question - When is this plan likely to commence?

Answer – This plan is likely to commence in December 2022.

25. Question – Does contractors needs to be registered in SAM (System for Award Management) before presenting their quote?

Answer - Offerors shall be registered in the SAM (System for Award Management) database at https://www.sam.gov prior to submittal of their offer/proposal as prescribed under FAR 4.1102. Failure to be registered at time of proposal submission may deem the offeror’s proposal to be considered non-responsible and no further consideration will be given.

Please find attached Entity Validation Documentation Checklist (PDF 2MB) and a link to SAM Frequently Asked Questions:

SAM Entity Registration – Frequently Asked Questions

26. Question – is the offeror expected to provide coverage for all pre-existing conditions of employees?

Answer – Yes, the U.S. Embassy is requiring all eligible employees to be covered when the period of performance of the contract begins which is 30 days after contract award.

This plan allows for continued coverage of active and retired employees and their spouses as provided under previous plans. Each new eligible employee will be enrolled upon entering on duty with the USG.

Any employee that does not enroll within the 30 days of signing this contract or within 30 days of entering on duty with the USG can be subject to limitation of pre-existing conditions.

27. Question – Is DBA insurance required for this Solicitation.

Answer - The Offeror shall include DBA as required in sections L. 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

28. Question - When the contract is awarded, can the contract be submitted in Spanish according to local laws, and then translated accordingly.

Answer – The questions shall be sent in English, the proposal shall also be sent in English (52.214-34 SUBMISSION OF OFFERS IN ENGLISH LANGUAGE (APR 1991)) and the Contract will be awarded in English, but the winning contractor can translate it, however (Section I, Contract Clauses) - 52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION AND TRANSLATION OF CONTRACT (FEB 2000):

“In the event of inconsistency between any terms of this contract and any translation into another language, the English language meaning shall control.”

29. Question – Will it be an issue to provide a U.S. soil address (not PO box) as for participants?

Answer – This Solicitation is for the Health & Life Insurance coverage for the Local Employee Staff (LES) of the U.S. Embassy Panama, located in Panama, Republic of Panama. Most of the LES are Panamanians, some have dual nationalities (U.S.) and some are third party nationals with residence in Panama.

30. Question – Will I need to get licensed to sell insurance in Panama?

Answer – See Question 13.

31. Question – How many employees don't have an address on US soil?

Answer – Please see Question 29.

32. Question – My company specializes in Life insurance and only some forms of health insurance, would I be able to combine my services with a health insurance partner to fulfill the requirements?

Answer – Please see Question 16 and DOSAR 652.242-73.

33. Question – We don't charge anything to provide services for employers, essentially it would be free to have us as a benefit because we get paid from commissions. A colleague pointed out that might be an issue, so I also wanted to know if that's not approved.

Answer – See Question 16.

34. Question – How long are employees tenured in Panama?

Answer – This Solicitation is for the Health & Life Insurance coverage for the Local Employee Staff (LES) of the U.S. Embassy Panama, located in Panama, Republic of Panama. Most of the LES are Panamanians, some have dual nationalities (U.S.) and some are third party nationals with residence in Panama. U.S. Foreign Service Employees who serve two-to-three-year tours in Panama are covered by health insurance benefits administered centrally by the Department of State and are not a part of this solicitation.

Please note if the question refers tenured as permanency, all local employees per local labor law are subject to a probationary period of 90 days, once employee has completed the probationary period it automatically obtains a permanent and indefinite contract.

35. Question – would you be able to send me the Section J file posted to the solicitation? I haven't been able to open it for some reason.

Answer – Please see updated Section J as per Amendment # 2. It will only be uploaded in MS Excel.

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