AMEND_SF30_SOW_(007_18R3007).docx

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Health Insurance Services
Solicitation number
19TU1518R3007
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amendment 7

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AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

PAGE OF PAGES 1 / 2

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

05/24/19

4. REQUISITION/PURCHASE REQ. NO.

5. PROJECT NO.

6. ISSUED BY CODE

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

Department of State American Embassy, Ataturk Bul. No. 110 Cankaya, Ankara, Turkey

8. NAME AND ADDRESS OF CONTRACTOR (street,city,county,State) PROSPECTIVE OFFERORS for HEALTH INSURANCE SERVICES

9a. AMENDMENT OF SOLICITATION NO.

19TU15-18-R-3007

9b. DATED 9/14/2018

10a. MODIFICATION OF CONTRACT NO.

10b. DATED

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 [ X] is not, [ ] is required to sign this document and return _1__ copies to the issuing office.

THIS SPACE IS LEFT EMPTY ON PURPOSE

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

PAGE 2/2

Amendment to the Request for Proposal of this solicitation has been issued as follows:

1. Option years in PRICING section are reduced to 2 option years. B.2.6. Third option year prices and B.2.7. Fourth option year prices are cancelled. Pricing for base year and 2 option years are as follows. And, B.2.8 Grand Total is changed as follows:

B.2.3. BASE YEAR OF CONTRACT:

The firm fixed price/premium rates in TL (Turkish Liras) for this contract are as follows:

No.
Category
Approx. Number

of Persons Annual Premium for Ea. Person Total for All Persons

1
Single Employee (Self Only)
315
2
Employee plus One (two individuals)
202
3
Family (three or more individuals)
239

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for BASE YEAR: __________________

B.2.4. FIRST OPTION YEAR OF CONTRACT:

The firm fixed price/premium rates in TL (Turkish Liras) for this contract are as follows:

No.
Category
Approx. Number

of Persons Annual Premium for Ea. Person Total for All Persons

1
Single Employee (Self Only)
315
2
Employee plus One (two individuals)
202
3
Family (three or more individuals)
239

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for FIRST OPTION YEAR: __________________

B.2.5. SECOND OPTION YEAR OF CONTRACT:

The firm fixed price/premium rates in TL (Turkish Liras) for this contract are as follows:

No.
Category
Approx. Number

of Persons Annual Premium for Ea. Person Total for All Persons

1
Single Employee (Self Only)
315
2
Employee plus One (two individuals)
202
3
Family (three or more individuals)
239

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for SECOND OPTION YEAR: __________________

No.
Category
Total
1
Base Year Total
2
First Option Year Total
3
Second Option Year Total

GRAND TOTAL of BASE plus ALL OPTION YEARS :

B.3.4. Third option year prices for Rider Clins and B.3.5. Fourth option year prices for Rider Clins are cancelled. Pricing for Rider Clins for Retirees are as follows. And, B.3.6 Grand Total for Rider Clins is changed as follows:

B.3 PRICING for RIDER CLINS for RETIREES and OPTIONAL BENEFITS The firm fixed price/premium rates in TL (Turkish Liras) for the rider Clins are as follows and are to be paid 100% by the enrollee; these RIDER CLINS will NOT be evaluated as part of the overall price evaluation:

B.3.1BASE YEAR for RIDER CLINS:
1
Retired Employees & their Dependents
70
2
Catastrophic Coverage: up to 29,000.TL
20
3
Catastrophic Coverage: up to 58,000.TL
20
4
Catastrophic Coverage: up to 116,000.TL
10
5
Excess Coverage: up to 29,000.TL
20
6
Excess Coverage: up to 58,000.TL
20
7
Excess Coverage: up to 116,000.TL
10

GRAND TOTAL for BASE YEAR of RIDER CLINS: __________________

B.3.2FIRST OPTION YEAR for RIDER CLINS:
1
Retired Employees & their Dependents
70
2
Catastrophic Coverage: up to 29,000.TL
22
3
Catastrophic Coverage: up to 58,000.TL
22
4
Catastrophic Coverage: up to 116,000.TL
11
5
Excess Coverage: up to 29,000.TL
22
6
Excess Coverage: up to 58,000.TL
22
7
Excess Coverage: up to 116,000.TL
22

GRAND TOTAL for FIRST OPTION YEAR of RIDER CLINS: ________________

B.3.3SECOND OPTION YEAR for RIDER CLINS:
1
Retired Employees & their Dependents
70
2
Catastrophic Coverage: up to 29,000.TL
22
3
Catastrophic Coverage: up to 58,000.TL
22
4
Catastrophic Coverage: up to 116,000.TL
11
5
Excess Coverage: up to 29,000.TL
22
6
Excess Coverage: up to 58,000.TL
22
7
Excess Coverage: up to 116,000.TL
22

GRAND TOTAL for SECOND OPTION YEAR of RIDER CLINS: _______________

No.
Category
Total
1
Base Year Total
2
First Option Year Total
3
Second Option Year Total

GRAND TOTAL of BASE plus ALL OPTION YEARS of RIDER CLINS:

2. The due date of the Request for Final Proposal (RFP) is hereby extended until May 31th, 2019, 10:00 am local time.

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. No other changes to the solicitation document is enacted.

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

N/A

16A. NAME OF CONTRACTING OFFICER

ERIC WILSON

15B. NAME OF CONTRACTOR/OFFEROR

BYN/A
(Signature of person authorized to sign)
15C.DATE SIGNED

16B. UNITED STATES OF AMERICA

BY _______________________
(Signature of Contracting Officer)
16C.DATE SIGNED

SF30

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