SF-30 - Solicitation Amendment 19T04026R0001-P0003.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 10

2. AMENDMENT/MODIFICATION NO.

19T04026R0001 P0003

3. EFFECTIVE DATE

March 17, 2026

4. REQUISITION/PURCHASE REQ. NO.

PR15128714-V3

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE T0400 7. ADMINISTERED BY (If other than Item 6) CODE

American Embassy Lome

4332, Blvd Eyadema, BP 852 Lome Togo

Phone: 228 22 61 54 70 Fax: Fax:

228 22 61 5503/228 22 61 5504

General Services Office-

American Embassy Lome

4332, Blvd Eyadema, BP 852 Lome Togo

Phone: 228 22 61 54 70 Fax: Fax:

228 22 61 5503/228 22 61 5504

8. NAME AND ADDRESS OF CONTRACTOR (NO., street,city,county,State,and ZIP Code)

X

9a. AMENDMENT OF SOLICITATION NO.

19T04026R0001

9b. DATED (SEE ITEM 11)

February 06, 2026

10a. MODIFICATION OF CONTRACT/ORDER NO.

10b. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

[X ] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

[X ] is extended, [ ] is not extended Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing Items 8 and 15, and returning _1_ copies of the amendment;(b) By acknowledging receipt of this amendment on each copy of the offer submitted; or(c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers.

FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b)

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor [ ] is not, [ ] is required to sign this document and return ___ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of this amendment is to include the questions and answers received for clarification purposes only. See attached Q&A document.

All other terms and conditions remain unchanged

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

16A. NAME OF CONTRACTING OFFICER

Amruta Dixit

15B. NAME OF CONTRACTOR/OFFEROR

BY

(Signature of person authorized to sign)

15C.DATE SIGNED 16B. UNITED STATES OF AMERICA

BY

(Signature of Contracting Officer)

16C.DATE SIGNED

NSN 7540-01-152-8070 Standard Form 30 (revised 10/83) Previous edition unusable Prescribed by GSA FAR (48 CFR) 53.243

1. Question:

Please confirm the intended effective date of the new policy and the base and option periods.

➢ Answer #1:

This plan is likely to commence in August 2026 or shortly thereafter, depending on the contract award process. The current contract was extended to satisfy all necessary solicitation criteria. The new policy will be set for One Base Year and

Four Option Years.

See Section B and F.2. and revise RFQ for the duration of the new policy.

2. Question:

Please provide the current enrolled census, including employees and dependents, and confirm whether material enrollment changes are anticipated.

➢ Answer #2:

See doc “Staff census”. Currently, we are not tracking any hires through May

2026. Future recruitments are at the Human ressources discretion

3. Question:

Please provide age band distribution for ORE employees and dependents, if available.

➢ Answer #3:

Not available

4. Question:

Is updated claims experience available beyond the 2024 data currently provided? If so, please provide the most recent available data.

➢ Answer #4:

February 28, 2025 to January 31, 2026 73,108,130.00

5. Question:

For each period of claims data provided, please confirm the corresponding average enrolled membership and measurement basis used.

➢ Answer #5:

We do not provide a calculated claims ratio. Historical Claims paid and estimated number of employees are found in section J, Exhibit A, C & D. Historical expenditures under the legacy contract can be found at SAM.gov/fpds

See “Note to the Offerors” on page 83 of 147 of the solicitation.

6. Question:

Please confirm whether the claims data provided is incurred, paid, or incurred but not reported, and the extraction date of the data.

➢ Answer #6:

The claims data provided are incurred and paid.

7. Question:

Is the group currently insured? If so, please confirm whether the benefits outlined in the solicitation reflect the current benefit structure or a revised design.

➢ Answer #7:

Yes, the LE Staff are currently insured. The medical benefits categories and definitions is updated and expanded to reflect worldwide best practices and the benefit levels have been established based on analysis of global norms. Minimum levels of coverage are standardized at 50%, 80% and 100%.

Higher coverage may be provided by lowest cost, technically acceptable contract, or if local law includes higher coverage. The reimbursement of the claims is also expected to be done through Electronic Funds Transfer or/and by check.

8. Question :

Are alternative cost-sharing structures (copayments or coinsurance) acceptable provided that minimum benefit levels are maintained?

➢ Answer #8:

Information about evaluation and award criteria are included into this solicitation.

See also I.3.9. 652.242-73 Authorization and Performance (Aug 1999)

9. Question:

If permitted, can the Embassy disclose any prior-year premium information or

Government Estimate?

➢ Answer #9:

number of employees are found in section J, Exhibit A, C & D. Historical

10. Question

Kindly confirm:

• The name of the incumbent insurer

• The expiration date of the current policy

• Whether a run-off period will apply for claims incurred before the new contract start date

➢ Answer #10:

Current Insurer name: OLEA AFRICA TOGO

Date of expiration of current policy: August 27, 2026

Contract is running in accordance with the terms and conditions with the

Contractor. Any supplemental agreement that may need to be added will be formalized

11. Question

Transition of Open Claims: Will the incoming contractor assume responsibility for any open or ongoing treatments initiated under the previous contract?

➢ Answer #11:

Contract is running in accordance with the terms and conditions with the

Contractor. Any supplemental agreement that may need to be included will be formalized

12. Question:

Loss Experience (Five-Year Overview): For actuarial and pricing purposes, we would appreciate receiving aggregated loss experience data for the past five (5) contractual years. No personal or confidential data is required.

Understanding claims development in relation to changes in insured population is essential for responsible underwriting.

We would appreciate receiving aggregated loss experience for the past five (5) contractual years, but especially for last 3 years.

➢ Answer #12:

13. Question:

Financial Overview

➢ Answer #13:

14. Question:

Pre-Existing Conditions: Please confirm whether coverage must be provided without exclusions or waiting periods for pre-existing conditions for all currently enrolled members at contract inception.

➢ Answer #14

Please see paragraph I.2.11.- 52.237-3 - CONTINUITY OF SERVICES (JAN

1991)

15. Question:

Out-of-Country Medical Travel: Under C.1.1.17, please clarify whether Out-of-Country Medical Travel refers exclusively to medical evacuation, or to any medically necessary and pre-approved treatment abroad.

➢ Answer #15:

All coverage for transportation for out-of-country medical treatment is subject to the total maximum annual limit. 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.

16. Question:

Is residency in Togo required for covered dependents (e.g., students studying abroad)?

➢ Answer #16:

See paragraph C.1.4 - Eligible Participants

17. Question:

Please confirm whether over-the-counter medications and supplements remain excluded even if prescribed.

➢ Answer #17:

See paragraph C.1.3 – Exclusions and Limitations

18. Question:

Minimum Guarantee: Section B.2.10 references a minimum of 75 annual premiums per performance period. In the event of substantial workforce reduction below this level, how is contractor risk addressed?

➢ Answer #18:

See paragraph B2.10. Minimum and Maximum Amounts, L.2.4 Order Limitation

(Oct 1995) and other related clauses.

19. Question:

Premium Contributions: Please clarify whether employees contribute toward:

Their own premium? Dependents’ premiums?

➢ Answer #19:

See paragraph C.1.3 – Exclusions and Limitations

20. Question:

Local Presence Requirement: Is physical presence in Lomé mandatory for contract performance, or may claims administration be managed regionally or internationally?

➢ Answer #20:

See I.3.9 – 652.242-72 Authorization and Performance (Aug 1999)

21. Question:

Electronic Claims Submission: Section H.4.3.1 references physical submission via drop box. Would secure electronic submission (online platform or encrypted email) be acceptable?

➢ Answer #21:

Terms and conditions described in this solicitation and under the paragraph

H.4.3.1. remain unchanged. New requirements in the terms and conditions must be formalized by mutual agreement.

22. Question:

Electronic Delivery of Documents: Would electronic delivery of brochures and ID cards (including photo ID cards) be acceptable instead of hard copies?

➢ Answer #22:

Terms and conditions described in this solicitation remain unchanged. New requirements in the terms and conditions must be formalized by mutual agreement.

23. Question:

Direct Billing Network: Is the establishment of a local direct billing medical network mandatory for outpatient services?

➢ Answer #23

24. Question:

Payment Cycle: Please clarify billing frequency under task orders (monthly, quarterly, or annually) and whether premiums are payable in advance or arrears.

➢ Answer #23

See G.4.2. Frequency of Payments.

25. Question

Complaint Threshold: Section E references a performance threshold of no more than two (2) customer complaints per month. Are contractual penalties applicable if this threshold is exceeded?

➢ Answer #25

See E.2.3. Procedures and FAR 52.246-4, Inspection of Services – Fixed Price

(AUG 1996

26. Question

Premium Currency: May premiums under Sections B.2.4 to B.2.8 be offered in

USD or EUR instead of XOF?

➢ Answer #26

Payment shall be made in the currency identified in B.2.3 and M.10 - 52.225-17

Evaluation of Foreign Currency offers (FEB 2000)

27. Question

Retention Amount Currency: Must retention amounts per category under B.3.2 be shown in XOF (FCFA), or may they be expressed in the currency of the offered premium?

➢ Answer #27

Payment shall be made in the currency identified in B.2.3 and M.10 - 52.225-17

Evaluation of Foreign Currency offers (FEB 2000)

28. Question

James Zadroga Act: If applicable and not waived, please clarify how the 2% excise tax under the James Zadroga Act is administratively handled.

➢ Answer #28

See paragraph B.1. which stipulates that: “JAMES ZADROGA 9/11 VICTIMS

HEALTH AND COMPENSATION ACT OF 2010 NOTICE: UNLESS A WAIVER

OR EXCEPTION APPLIES, PAYMENTS SUBSEQUENT TO THIS

PROCUREMENT ARE SUBJECT TO AN EXCISE TAX OF 2% PERSUANT TO

26 U.S.C. 5000C”

An amount equal to 2% of tax is retained on each invoice.

29. Question

Defense Base Act (DBA): Please confirm whether DBA insurance is applicable to this contract.

➢ Answer #29

DBA is applicable to this Contract - Please see Section L The offeror shall obtain

DBA insurance directly from any Department of Labor approved providers at the

DOL website at http://www.dol.gov/owcp/dlhwc/lscarrier.htm+ http://www.dol.gov/owcp/dlhwc/lscarrier.htm

30. Question

Reinsurance: Is the contractor expected to arrange specific reinsurance coverage, or is reinsurance structure fully at contractor discretion?

➢ Answer #30

See 52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT (JUNE 2020)

31. Question

Data Protection Requirements: Are there specific data protection or HIPAA-equivalent standards required for handling employee medical data?

➢ Answer #31

See paragraph H.4. - CONTRACTOR RESPONSIBILITY IN CLAIMS AND

REIMBURSEMENT TO CLAIMANTS

32. Question

Benefit Adjustments: Would benefit enhancements or additional services be permitted during the contract term if not initially specified in the RFP?

➢ Answer #32

The medical benefits categories and definitions is updated and expanded to reflect worldwide best practices and the benefit levels have been established based on analysis of global norms. Minimum levels of coverage are standardized at 50%, 80% and 100%.

Higher coverage may be provided by lowest cost, technically acceptable contract, or if local law includes higher coverage. The reimbursement of the claims is also expected to be done through Electronic Funds Transfer or/and by check.