Panama QA2 Response 100522.docx

Health & Life Solicitation Questions and Answers #2

QUESTIONS AND ANSWERS #2

19PM0722R0001 – Health & Life Insurance Coverage

1. Question – Will the Riders have the same full coverage that the Le Staff?

Answer – Yes, employees and riders will have the same benefits.

2. Question – The premiums of the riders, is based only at the experience of the Le Staff? The price adjustment for the Le Staff applies also for the riders?

Answer – An Amendment to the RFP will make clear that riders will have a similar adjustment process to the employee premium costs, but that these two groups will remain separate and reimbursed costs and premium adjustments in one category will not affect the other.

3. Question – Is the deductible not covered?

Answer – Health policy does not have deductible to cover.

4. Question – Specify the Preventive and Wellness Services and Chronic Disease Management coverage?

Answer – Counseling or preventive care is designed to prevent or detect medical conditions and care for chronic conditions such as asthma and diabetes. Examples include: physicals, immunization, cancer screenings.

5. Question – In the Reproductive Health, specify the diagnosis and treatment of conditions which may cause infertility coverage?

Answer – Reproductive Health coverage includes: Prescribed contraceptive devices, preventive care, routine exams, voluntary sterilization, diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments, reversal of sterilization are not covered.

6. Question – What is the meaning of the word RESERVED? See Page 33 G.5 / Page 17 C.1.1.16?

Answer – Reserved means that what was in originally does not apply to this RFP. “RESERVED” Label given to maintain number sequence consistency.

7. Question - Does apply pre-existing conditions and waiting period in maternity?

Answer – 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.

There is no waiting period for new employees. Each new eligible employee will be enrolled upon entering on duty with the USG. They have 30 days to enroll since the hiring date. The preexistence condition must be accepted.

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.

In regards of maternity, there is no waiting period for new employees nor eligible employees. They have 30 days to enroll since the hiring date or when period of performance of the contract begins with is 30 days after contract award. The preexistence condition must be accepted.

8. Question – The eligible coverage has two criteria. The Insurance under 75 are not covered?

Answer – There are two criteria for the active employees to be eligible to continue coverage under a rider for themselves and their dependents once they retire based on the following:

· Current active employees and currently retired employees, enrolled before February 1, 1995, are eligible for coverage under the rider until age 75 (maximum age to be covered under the rider).

· Current active employees and currently retired employees, enrolled after February 1, 1995, and before June 30, 2006, are eligible for coverage under the rider until age 70 (maximum age to be covered under the rider).

· Employees hired after June 30, 2006 are not eligible to continue coverage once retired.

9. Question - The Excess Coverage apply also for the dependents?

Answer – Excess coverage equal to 100% of the annual maximum to be applied to any covered individual to any covered benefit. LE Staff must pay 100% of the premium if they elect Excess Coverage.

10. Question The calculation rate for the Excess Coverage rider is based on category? Or is the same rate for each individual and for the dependents?

Answer – The RPP requests the rate for Excess Coverage per covered individual.

11. Question - Is the Embassy providing a report for each term of the actual policy including claims paid and premiums collected?

Answer – See Section J - List of Exhibits Amendment 1 report.

12. Question - Will the DBA be required as part of the proposal or only when the contract is awarded?

Answer – The Offeror shall include Defense Base Act (DBA) insurance premium costs covering their employees working on the contract. The rates shall include the cost for DBA, the vendor will be required to obtain a certificate after the contract is awarded. It is recommended that the proposal includes a statement that the contractor will get the required insurance, and the name of the insurance provider to be used.

13. Question - Please specify the Annual Maximum Limit per covered individual per contract year.

Answer – See C.1.2 Annual Maximum Limit - The maximum annual reimbursement per covered individual per contract year, not including expenses defined under Exclusions and Limitations (C.1.3) or those covered under C.1.1.15, HIV/AIDS, and C.1.1.19 Excess Coverage is equivalent to $240,000 USD.

14. Question - Are the benefits for Excess Coverage similar to those included in the insurance policy?

Answer – That is correct, the Excess Coverage will have same benefits.

15. Question - Please confirm if coverage for dependents is only considered for LE Staff and Retired Employees?

Answer – Coverage for dependents is considered for LE Staff, retired employees and also may be covered for Official Residence Expense (ORE) and Employee Association (EA) under a rider to the contract. The employing officer/EA, not the USG, is responsible for the employer's share of the premium costs for employee’s covered under the Official Residence Expense and Employee Association.

16. Question - Our entity is registered in SAM and has a UE ID assigned, however, we have an incident open related to our National Provider Identifier, will this allow us to participate in the event it has not been resolved by the due date?

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 actively registered at time of proposal submission may deem the offeror’s proposal to be considered non-responsible and no further consideration will be given.