HEALTH_INSURANCE_SOLICATION_FINAL_v_18R3007.doc

SOLICITATION for HEALTH INSURANCE

19TU15-18-R-3007 Page 2 of 60

SOLICITATION for HEALTH INSURANCE SERVICE

(19TU15-18-R-3007)

TABLE OF CONTENTS

DESCRIPTION

NO. of PAGES

Table of Contents

A. Solicitation, Offer and Award Form SF33

CONTRACT

B.

Supplies or Services and Prices/Costs

C.

Description/Specifications/Work Statement

D.

Packing and Marking

E.

Inspection and Acceptance

F.

Deliveries or Performance

G.

Contract Administrative Data

H.

Special Contract Requirements

I.

Contract Clauses

J. List of Attachments

K.

Representations, Certifications and Other Statements of Offeror

L.

Instructions and Notice to Offerors

M. Evaluation Factors for Award

Attachments:

Exhibit A – STATISTICS for EMPLOYEES

Exhibit B – HEALTH INSURANCE COVERAGE (List of Employees)

TBA

Exhibit C –

ORE EMPLOYEES RIDER

TBA

TBA: To Be Added (Lists to be attached after open season)

SECTION A

UNDER DPAS (15 CFR 350)

1 | 60

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

19TU15-18-R-3007

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

Sept. 14th, 2018

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

8. ADDRESS OFFER TO (If other than item 7)

AMERICAN EMBASSY IN ANKARA

Ataturk Bul. No.110, Kavaklidere, Ankara

Phone: (312) 455-5555 Fax: (312) 467-0057

NOTE: In sealed bid solicitation "offer" and "offeror” mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original and copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in gate no.2 until 1600 hours local time on Oct. 15th, 2018.

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

10. FOR INFORMATION

CALL:

A. NAME

Shaun McGuire or procurement supervisor

Ankara-GSO-Procurement-DL@state.gov

11. TABLE OF CONTENTS

OTHER STATEMENTS OF OFFERORS

OFFER (Must be fully completed by offeror)

NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within 120 calendar days (120 calendar days unless a different period is inseted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

(The offeror acknowledges receipt of amendments to the solicitation and related documents ) numbered and dated:

15A.

NAME AND

CODE

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER

ADDRESS OF

OFFEROR

(Type or print)

15B. TELEPHONE NO. (Include area code)

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7) CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

NSN 7540-01-152-8064

STANDARD FORM 33 (REV 9-97)

EDITION NOT USABLE

Prescribed by GSA

SECTION B

PART I: PRICE - HEALTH INSURANCE

B.1.

HEALTH INSURANCE SERVICES

The Contractor shall provide the Health Insurance services to employees of the Government of the United States of America in Turkey as described in Section C and the Exhibits in Section J. The groups of employees who shall be provided this insurance are listed in C.1.3 (medical). This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.1.1.

Official Residence Expense (ORE) Staff and Embassy Recreational Association Employees (ERA) are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff), and the Embassy Association (for ERAs) at the rates specified below. See Section G for billing procedures.

B.1.2. Retired employees of the U.S. government and their dependents are included under this contract only as a rider at the rates specified below.

B.1.3. Optional benefit coverage is included under this contract only as a rider at the rates specified below.

B.2.

PRICES

B.2.1 VALUE ADDED TAX (VAT):

The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices as the U.S. Embassy has a tax exemption certificate with the host government.

B.2.2 This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The fixed prices/premium rates for the health insurance services as specified in Section C are 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:

of Persons Annual Premium for

Ea. Person Total for All Persons

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for BASE YEAR: __________________

B.2.4.

FIRST OPTION YEAR OF CONTRACT:

of Persons Annual Premium for

Ea. Person Total for All Persons

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for FIRST OPTION YEAR: __________________

B.2.5.

SECOND OPTION YEAR OF CONTRACT:

of Persons Annual Premium for

Ea. Person Total for All Persons

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for SECOND OPTION YEAR: __________________

B.2.6.

THIRD OPTION YEAR OF CONTRACT:

of Persons Annual Premium for

Ea. Person Total for All Persons

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for THIRD OPTION YEAR: __________________

B.2.7.

FOURTH OPTION YEAR OF CONTRACT:

of Persons Annual Premium for

Ea. Person Total for All Persons

TOTAL PRICE FOR BASE YEAR:

GRAND TOTAL for FOURTH OPTION YEAR: _______________

B.2.8.

GRAND TOTAL of BASE plus ALL OPTION YEARS:

GRAND TOTAL of BASE plus ALL OPTION YEARS :

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.3.1 BASE YEAR for RIDER CLINS:

GRAND TOTAL for BASE YEAR of RIDER CLINS: __________________

B.3.2 FIRST OPTION YEAR for RIDER CLINS:

GRAND TOTAL for FIRST OPTION YEAR of RIDER CLINS: ________________

B.3.3 SECOND OPTION YEAR for RIDER CLINS:

GRAND TOTAL for SECOND OPTION YEAR of RIDER CLINS: _______________

B.3.4 THIRD OPTION YEAR for RIDER CLINS:

GRAND TOTAL for THIRD OPTION YEAR of RIDER CLINS: ________________

B.3.5 FOURTH OPTION YEAR for RIDER CLINS:

GRAND TOTAL for FOURTH OPTION YEAR of RIDER CLINS: _______________

B.3.6.

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

These RIDER CLINS will NOT be evaluated as part of the overall price evaluation

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

B.4

ADMINISTRATIVE RETENTION AMOUNTS

B.4.1 If the Contractor requests a price adjustment under B.4 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount must be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall NOT be expressed in terms of a percentage of the premium.

B.4.2 Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan. All prices are to be in Turkish Lira currency.

(three or more individuals)

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

B.5. ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS

B.5.1. Premium Adjustment Based on Experience - For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract, and it specifically excludes all riders in B.1.1. No adjustment will be allowed during the first twelve months. After such time, the Contractor or the Government may request an adjustment in premiums on an annual basis. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the Contractor agrees to provide the Government a balance sheet showing three main components for the time period: (1) receipts (premiums received) minus the retention amount, (2) number of insurance plans and (3) claims paid. This information shall be provided per type of premium, ie per line item. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet and claims and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Mutually agreed to adjustments shall be effective thirty days after complete information is received by the Government. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.5.2.

Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the Contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the Contractor to modify the contract to adjust the premium rate. The Contractor agrees to provide all documentation necessary to support any requested adjustment.

B.5.2.1 Employee Pool – This clause is only in effect if the Contractor included details in its offer regarding a pooling arrangement, of which this contract is a part.

Before any adjustment is made under this price adjustment clause, the Contractor must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

PART I - HEALTH INSURANCE

C.1.

HEALTH INSURANCE SERVICES

The Government of the United States of America (USG) requires Health Insurance coverage for its employees as further described in in this section. For active employees and their eligible dependents, the USG will pay 90% and LE Staff 10% of the premium costs for mandatory benefits. Retired employees are 100% responsible for the premium costs for themselves and their dependents. The premium costs for any optional benefits, if elected, are 100% the responsibility of the employee or retiree.

Medical insurance premiums will be based on the number of individuals covered:

- Self-Only

- Self Plus One (two individuals)

- Family (three or more individuals)

During a period of Leave Without Pay (LWOP) or unpaid leave that is one pay period or less, coverage under the insurance contract will continue. During a period of extended (beyond one pay period) Leave Without Pay (LWOP) or unpaid leave, the employee is responsible for the full cost of the insurance premiums for self and dependents. The Mission will pay the premiums directly to the Contractor and will collect the full cost from the employee. Alternatively, the employee may elect to have coverage cease if the employee prefers not to pay the premium.

The Contractor shall ensure that health care under this contract does not exclude HIV/AIDS care.

C.1.1 EMPLOYEE and DEPENDENT HEALTH SERVICES BENEFITS

MANDATORY BENEFITS:

C.1.1.1. Hospitalization (Treatment in the Hospital for Inpatient Care): Minimum Reimbursement Rate - 100%

Services and supplies provided during hospitalization, including services provided by a licensed healthcare provider, bed and board (semi-private accommodations), operating room, recovery room, intensive care, imaging and diagnostic testing, general hospital nursing care, as well as drugs and medicines administered while in-patient. When private accommodations are provided, coverage will be limited to the cost of a semi-private room unless otherwise covered in an off the shelf plan. See Mental Health and Substance Abuse care (below) for details concerning inpatient psychiatric care.

C.1.1.2 Emergency Services (Trips to Emergency Room): Minimum Reimbursement Rate - 100%

Services provided for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness.

C.1.1.3. Ambulance: Minimum Reimbursement Rate - 80%

Professional ground transport to move a patient from the place where s/he is injured or becomes ill to the nearest hospital able to provide treatment or to move a patient from one medical facility to another.

C.1.1.4 Outpatient Services: Minimum Reimbursement Rate - 80%

Services provided by a licensed healthcare provider on an ambulatory or outpatient basis (without being admitted to a hospital), including surgeon’s fees and other medical services that may be provided at a hospital, clinic, doctor’s office, medical facility, etc. Examples include, but are not limited to:

- Annual physical examinations

- Specialist consultations and treatment, including second surgical opinion

- Minor surgical interventions

- Chemotherapy and radiation treatments

- Immunizations recommended by local authorities and/or the World Health Organization

- Diagnostic tests and diagnostic imaging

C.1.1.5 Obstetric and Newborn Care: Minimum Reimbursement Rate for Inpatient /Emergency - 100%; for Outpatient - 80%

Care and services that women receive during pregnancy (prenatal care), throughout labor, delivery, and post-delivery, and outpatient care for newborn babies. Hospitalization during pregnancy and/or delivery will be reimbursed as inpatient care. All other treatments will be considered outpatient services and reimbursed as such.

C.1.1.6 Pediatric Services: Minimum Reimbursement Rate for Inpatient /Emergency - 100%; for Outpatient - 80%

Primary and preventive routine care services for covered dependent children, including, but not limited to: physical examination, developmental assessment, laboratory tests, and immunizations recommended by local authorities or the World Health Organization.

C.1.1.7 Prescription Drugs: Minimum Reimbursement Rate for Inpatient /Emergency - 100%; for Outpatient - 80%

Medications prescribed by a licensed health care provider that are medically necessary to treat a specified diagnosis. Examples include, but are not limited to: prescription antibiotics to treat an infection; medication used to treat an ongoing condition, such as high cholesterol; or birth control medication.

C.1.1.8 Preventive and Wellness Services and Chronic Disease Management: Minimum Reimbursement Rate - 80%

Counseling or preventive care designed to prevent or detect medical conditions and care for chronic conditions such as asthma and diabetes. Examples include, but are not limited to: physicals, immunizations, and cancer screenings.

C.1.1.9 Hearing Aids: Minimum Reimbursement Rate - 80%

Hearing aid apparatus and related examinations. Limited to one apparatus per ear up to a maximum of USD 1,500 per covered individual per three-year period.

C.1.1.10 Optical Care: Minimum Reimbursement Rate - 80%

Eye examination, treatment, and prescription lenses and frames or contact lenses up to a maximum of USD 150 per covered individual per contract year.

C.1.1.11 Dental Care: Minimum Reimbursement Rate - 80%

Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges per covered individual up to a maximum of USD 3,200 per contract year. Orthodontia treatment is covered only if treatment begins before age 18, or if required as the result of an accident, including but not limited to traffic accident. A maximum of four years of orthodontia treatment will be covered per covered individual up to a maximum of USD 2,400 lifetime limit.

C.1.1.12 Family Planning: Minimum Reimbursement Rate - 80%

Prescribed contraceptive devices, preventive care and routine examinations, voluntary sterilization, and diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments, and reversal of sterilization are not covered (see item C.1.3 Heath Benefits Conditions, Limitations and Exclusions below).

C.1.1.13 Mental Health and Substance Abuse Care: Minimum Reimbursement Rate - 50%

Inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. This includes behavioral health treatment, counseling, and psychotherapy. Services must be provided by a licensed psychiatrist, psychoanalyst, psychologist, or psychiatric social worker. Inpatient care for alcohol and substance abuse must be carried out at a facility licensed for detoxification and rehabilitation.

C.1.1.14 Rehabilitative and Habilitative Services and Devices: Minimum Reimbursement Rate - 50%

Rehabilitative services (e.g., recovering skills, such as speech therapy after a stroke) and habilitative services (e.g., developing skills, such as speech therapy for children) that help develop skills needed for everyday life. Devices to help gain or recover mental or physical skills lost due to injury, disability or a chronic condition, and devices needed for habilitative reasons.

C.1.1.15 Out of Country Medical Treatment:

Medical expenses incurred out-of-country will be covered at the same benefit levels and subject to the same overall annual maximum limit as for medical expenses incurred in-country.

C.1.1.16 Out of Country Medical Travel: Minimum Reimbursement Rate – 80%

Transportation for out-of-country medical treatment will be a covered expense for covered employees and eligible family members. To be considered a covered expense, the attending certified health care provider must certify in advance that the treatment is medically necessary and unavailable locally. 80% of covered individual’s transportation expenses by the least expensive, appropriate means of transportation to the nearest city with adequate medical facilities will be covered. 80% of the transportation expenses of an attendant will also be covered, but only if the covered individual's attending certified health care provider certifies that an attendant for the patient is necessary, (e.g., a parent in the case of a patient who is a minor, or a family member to make medical decisions in the case of a patient who is unwell or unconscious). All coverage for transportation for out-of-country medical treatment is subject to the overall annual maximum 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.

OPTIONAL BENEFITS WITH SEPARATE ANNUAL MAXIMUM LIMITS:

Employees have the option of electing the benefits outlined under 1.1.17 and 1.1.18 at the beginning of the contract and may then subsequently opt in/out at the time of each extension.

C.1.1.17 Catastrophic Coverage: Employees may elect any of the following amounts as additional maximum coverage in case of catastrophic conditions: 29,000 TL, 58,000 TL, or 116,000 TL per covered individual per contract year for catastrophic coverage. Catastrophic conditions shall be defined as major medical conditions occurring as a result of a single illness/accident or a closely related set of major illnesses (or conditions relating to a single accident) that exceed the standard maximum coverage limit.

If elected, the Employee must pay 100% of the premium for this benefit.

C.1.1.18 Excess Coverage: : Employees may elect any of the following amounts as additional maximum excess coverage: 29,000 TL, 58,000 TL, or 116,000 TL per covered individual per contract year to be applied to any covered benefit once the overall annual max of TL 116,000 has been exhausted.

If elected, the Employee must pay 100% of the premium for this benefit.

C.2

OVERALL ANNUAL MAXIMUM LIMIT:

The overall annual maximum reimbursement per covered individual per contract year, not including expenses covered under optional benefits with separate annual maximum limits 1.1.17 and 1.1.18 is equivalent to 116,000 TL.

C.3 HEALTH BENEFITS CONDITIONS, LIMITATIONS and EXCLUSIONS

There is no reimbursement for elective cosmetic surgery; spa cures; rejuvenation cures; massage; exercise therapy; long-term rehabilitative therapy; non-medical hospital charges (e.g., telephone, television, etc.); home help, family help, or similar household assistance; fees of persons who are not certified health care providers; advanced reproductive technology (e.g., in-vitro fertilization, intra-cellular sperm injection, artificial insemination, micro-chirurgical epididymal sperm-aspiration, testicular sperm extraction, cryopreservation, etc.); or services or supplies which have not been prescribed or approved by a certified health care provider. Exclusions to coverage may be amended if provided in an off the shelf plan and is the lowest-cost and technically acceptable. Removal of any exclusions require prior authorization.

There is no reimbursement for expenses that will be reimbursed or paid directly under a host country medical program or workers' compensation program, the U.S. workers’ compensation program, or post’s LE Staff workers’ compensation program.

C.1.4 Eligible Participants

C.1.4.1 Eligible Employees - The employees eligible for the health insurance services include the following:

C.1.4.1.1 Current active Locally Employed (LE) Staff of the United States Government, employed within the geographic boundaries of Turkey paid under the Local Compensation Plan, and certified by the Contracting Officer. To be eligible, LE Staff must work a regular tour of duty (either full or part-time) under:

C.1.4.1.1.1 a non-temporary direct hire appointment, Personal Services Agreement (PSA), or Personal Services Contract (PSC); or

C.1.4.1.1.2 a temporary direct hire appointment or PSA fixed-term of one year or more.

C.1.4.2 Location of Employment

The individuals covered by C.1.4.1 must be employed within the geographic boundaries of Turkey by:

Department of State and U.S. Government agencies named DEA, DAO, DHS, DOJ, FAS, FBI, FCS, EXBS, OPDAT, agencies under START, and any other USG agency operating within the boundaries of Turkey.

C.1.4.3 Participants and Benefits Covered Under a Rider

C.1.4.3.1 All current active employees of the Chief of Mission and the Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.1.4.3.2 All current active employees of the Employee Association at the Embassy and U.S. Consulate General in Istanbul (see separate rider, Exhibit C). All costs for Employee Association employees are the responsibility of the Employee Association, not the U.S. Government.

C.1.4.3.3 Retired employees of the U.S. government who were enrolled at the time of retirement and their eligible dependents if they choose to continue coverage. All costs for retired employees and their dependents are the responsibility of the retired employee/dependent, not the U.S. Government. If a retired employee dies, his/her eligible family member(s) will be entitled to continue enrollment, if they elect to do so, at their own expense.

C.1.4.3.4 Optional catastrophic coverage per above item C.1.1.17. If elected, all costs for catastrophic coverage are the responsibility of the employee, not the U.S. Government.

C.1.4.3.5 Optional excess coverage per above item C.1.1.18. If elected, all costs for excess coverage are the responsibility of the employee, not the U.S. Government.

C.1.5

Individuals Not Eligible for Coverage

Individuals not eligible for coverage under this contract are those working under temporary direct hire appointments or PSAs/PSCs that are time limited to less than one year; those working on When Actually Employed (WAE) schedules; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Turkey who provides services to other local organizations as well as to the U.S. Mission; employees of USAID institutional contractors; and Peace Corps personal services contractors as indicated in MS 743.

C.1.6

Other Eligible Participants

Covered dependents include the participating employee’s spouse and children. A limit of one spouse per employee is covered. An eligible child is defined as the employee’s natural child, adopted child, stepchild, or foster child. The child must be unmarried, economically dependent upon the employee. An eligible child will be covered until the end of the contract year in which he/she reaches age 26. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the LE Staff maintains coverage.

C.1.7.

Eligibility

C.1.7.1.

Term of Eligibility and Effective Date

C.1.7.1.1 Each current active eligible employee is enrolled for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee will have the option to enroll upon entering on duty with the United States Government.

C.1.7.1.2 In cases where LE Staff and their legal spouse both work for the mission and both are eligible to participate in the medical plan, one will be designated as the lead for purposes of the medical plan, and the other will be considered a legal spouse. Children will be covered under either of the parents’ coverage.

C.1.7.1.3 All retired employees who were enrolled at the time of retirement, are entitled to renew their policies annually with no age limitations. All costs for retired employees and their dependents are the responsibility of the concerning retired employee. In case of a retired personnel’s death, the spouse may continue to be enrolled if he/she desires. If a retired employee dies, his/her eligible family member(s) will be entitled to continue enrollment, if they elect to do so, at their own expense.

C.1.7.1.4 During a period of Leave Without Pay (LWOP) or unpaid leave that is one pay period or less, coverage under the insurance contract will continue. The employee will pay the total cost of the coverage for the duration of LWOP exceeding one pay period. The USG will pay the total premium cost to the Contractor.

C.1.7.2.

Period of Ineligibility

Employees and their dependents are not entitled to health benefits during any period of employment for which premiums are not paid.

Additionally, employee's dependents are not entitled to health benefits during any period of employment during which the employee was not eligible to participate.

During a period of extended (beyond one pay period) of Leave Without Pay (LWOP) or unpaid leave, the employee is responsible for the full cost of the insurance premiums for self and dependents. The Mission will pay the premiums directly to the Contractor, and will collect the full cost from the employee on a quarterly basis. Alternatively, the employee may elect to have coverage cease if that employee prefers not to pay the premium.

C. 1.7.3.

Withdrawal from Insurance Coverage

C. 1.7.3.1 If the U.S. Mission decides that there is a valid reason to permit an employee to withdraw from the ongoing insurance coverage, he/she will be permitted and payment of premiums will cease with reference to the date of withdrawal.

C. 1.7.3.2 If the U.S. Mission decides that there is a valid reason to permit an employee to withdraw from the ongoing insurance coverage after the said employee has been paid any claims, the said employee has to reimburse the Contractor for claims previously paid by the Contractor which could have been elective/scheduled in advance for a period of six months prior to withdrawal.

C. 1.7.3.3 At the time of employment termination and/or death, claims should be disregarded. The insured will be responsible for payment of his/her share of the cost of insurance coverage up to the date of separation from duty. Retiring employees may elect continued coverage by paying all future costs. Necessary premium payments or reimbursement of premiums will be made according to G.3.

C.1.8.

BROCHURE REQUIREMENT

C.1.8.1.

The Contractor shall provide a document (brochure/pamphlet/other written document) in Turkish and English that sets forth a complete listing of the health insurance benefits to be provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.1.8.2.

The Contractor shall provide the document described in C.1.7.1 to the COR not later than 10 (ten) days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.1.8.3.

The Contractor assumes full responsibility for ensuring that the document described in C.1.7.1 accurately reflects the requirements of the contract, as implemented by the Contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the Contractor will be notified in writing; however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the Contractor to fully comply with all contract terms.

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1.

52.252‑2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search engine” (for example, Google, Yahoo, Excite) to obtain the latest location of the most current FAR.

The following Federal Acquisition Regulation clause(s) is/are incorporated by reference:

CLAUSE

TITLE AND DATE

52.246-4 Inspection of Services - Fixed Price (AUG 1996)

E.2.

QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan is designed to provide an effective surveillance method to promote effective Contractor performance. The QASP provides a method for the Contracting Officer's Representative (COR) to monitor Contractor performance, advise the Contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance. The Contractor, not the Government, is responsible for management and quality control to meet the terms of the contract. The role of the Government is to conduct quality assurance to ensure that contract standards are achieved.

Services

Performs all the insurance services set forth in the Performance Work Statement (PWS)

C.1.0 thru C.3.0

All required services are performed and no more than four (4) customer complaint is received per month.

E.2.1 Surveillance. The COR will receive and document all complaints from Government personnel regarding the services provided. If appropriate, the COR will send the complaints to the Contractor for corrective action.

E.2.2 Standard. The performance standard is that the Government receives no more than four (4) customer complaint per month. The COR shall notify the Contracting Officer of the complaints so that the Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.246-4, Inspection of Services – Fixed Price (AUG 1996) or the appropriate Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

(a) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed, they should immediately contact the COR.

(b) The COR will complete appropriate documentation to record the complaint.

(c) If the COR determines the complaint is invalid, the COR will advise the complainant. The COR will retain the annotated copy of the written complaint for his/her files.

(d) If the COR determines the complaint is valid, the COR will inform the Contractor and give the Contractor additional time to correct the defect, if additional time is available. The COR shall determine how much time is reasonable.

(e) The COR shall, as a minimum, orally notify the Contractor of any valid complaints.

(f) If the Contractor disagrees with the complaint and challenges the validity of the complaint, the Contractor will notify the COR. The COR will review the matter to determine the validity of the complaint.

(g) The COR will consider complaints as resolved unless notified otherwise by the complaint.

(h) Repeat customer complaints are not permitted for any services. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

SECTION F

DELIVERIES OR PERFORMANCE

F.1.

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search engine” (for example, Google, Yahoo, Excite) to obtain the latest location of the most current FAR.

The following Federal Acquisition Regulation clauses are incorporated by reference:

TITLE AND DATE

52.242-15 Stop Work Order (AUG 1989)

52.242-17 Government Delay of Work (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is five years following award date with base year and four one-year options to renew.

F.3

OPTIONS

The Government may extend this contract in accordance with the option clause at Section I, clause I.2, FAR Clauses Incorporated by Full Text (FAR 52.217-9, Option to Extend the Term of the Contract), which also specifies the total potential duration of the contract.

The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services".

F.4

REPORTS AND OTHER DELIVERABLES

All reports and other deliverables required under this contract shall be delivered to the following addresses:

· Embassy in Ankara

Ataturk Bul. No. 110, Kavaklidere, Ankara

· Istanbul Consulate General

Kaplicalar Mevkii Sok. No. 2, Istinye, Istanbul

· Adana Consulate

Guzelevler Mah. Girne Bul. No. 212, Yuregir, Adana

SECTION G

CONTRACT ADMINISTRATION DATA

G.1.

652.242-70 CONTRACTING OFFICER’S REPRESENTATIVE (COR) (AUG 1999)

The Contracting Officer may designate in writing one Government employee, by name or position title, to take action for the Contracting Officer under this contract. This designee shall be identified as a Contracting Officer’s Representative (COR). Such designation shall specify the scope and limitations of the authority so delegated; provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted Contracting Officer and this authority is delegated in the designation.

The COR for this contract is the Human Resources Assistant.

G.2

COR DUTIES

G.2.1 The COR is responsible for inspection and acceptance of services. These duties include review of Contractor invoices, including the supporting documentation required by the contract. The COR may provide technical advice, substantive guidance, inspections, invoice approval, and other purposes as deemed necessary under the contract.

G.2.2 In addition, the COR shall maintain updated list of employees and dependents insured, which will supersede the initial list provided under this contract and as reported to the insurer, without prejudice to the ineligibility clause.

G.2.3.

The COR has the additional responsibility of maintaining the eligible listing of employees and dependents for insurance coverage.

G.2.4 The COR may not change the terms and conditions of the contract. While the COR is authorized to provide the Contractor with updated listings of eligible employees and dependents, only the Contracting Officer may modify existing task orders or issue new task orders, reflecting these changes, since only the Contracting Officer can obligate funding and commit the Government.

G.3.

Payment shall be made in Turkish TL.

G.4

SUBMISSION OF INVOICES AND PAYMENT

G.4.1.

Invoice Submittal: Proforma invoices for U.S. Government employees shall be submitted in an original and three (3) copies to the following address (designated billing office only for the purpose of submitting invoices):

Original to:

FMC Office

Ataturk Bul. No. 110, K.Dere, Ankara

Copies to:

HR Office

Ataturk Bul. No. 110, K.Dere, Ankara G.4.2 Frequency of Premiums: All funds under this contract will be obligated by issuance of task orders, as described in H.3. Each task order will fund a specific period of time and number of employees, and the task orders will be issued at the frequency described in H.3. Contractor may submit invoices monthly for payment to be made at the beginning of the month for which insurance coverage is provided in accordance with FAR 32.404.

G.4.3 U.S. Government Employees: The Government shall make payments directly to the Contractor for all Government employees, whether or not the employee is contributing to the premium amount.

G.4.3.1 Frequency of Premium Payments: For non-retired enrollees, the US Government will pay the premiums in 26 (twentysix) pay period installment payments. Each installment payment covering 1 (one) pay period of service will be provided upon the submission of a proper monthly invoice. Payments shall be made with EFT TL payment within 30 days after receipt of accurate and a complete proforma invoice. The U.S. government is exempt from VAT. One consolidated invoice for all employees (and their dependents) will be paid through the U.S. mission’s payroll office on a per pay period basis. Such invoice shall be itemized or have an attachment as to the make-up of the costs (names and premium due). Payment will be made as one amount.

G.4.3.2 Each proforma invoice will state the contract number, the month service is rendered and the group of employees for which the invoice is billed. Separate proforma invoices will be provided for the following groups on a pay period basis: FSN, PSA, PSC, TCN employees

G.4.3.3 For eligible employees who are regularly scheduled to work 30 or more hours per week: The USG will pay 90% for the employee and for their dependents, and the employee will pay 10% of the premium cost for themselves and for their dependents.

G.4.3.4 For eligible employees who are regularly scheduled to work less than 30 hours per week: The USG will pay a prorated share of the premium cost for employee and dependent coverage, based on the number of hours the employee is regularly scheduled to work.

G.4.3.5 Employees on Leave: During a period of leave without pay or unpaid leave beyond one pay period the employee is responsible for the full cost of premiums. The USG will pay the premium directly to the contractor, and will collect the full cost from the employee. Alternatively, the employee may elect to have coverage cease if he/she prefers not to pay the premium.

G.4.4 ORE and/or ERA Staff. Contractor will submit two separate consolidated invoices for all ORE staff and a second one for the ERA staff. Such invoice shall be itemized or have an attachment as to the make-up of the costs (names and premiums due). The Chief of Mission, Deputy Chief of Mission, Consular General in Istanbul and/or Principal Officer in Adana will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount. The Employee Association will make payment directly to the Contractor for the entire premium amount of the ERA employee, whether or not the ERA employee is contributing to the premium amount.

G.4.5 LWOP and Retirees: Contractor will submit individual invoices for each of those insured persons who are responsible for the entire 100% cost of premiums, such employees on different rider (EA employees) and retirees. Such insured persons are personally and individually responsible for payment to the Contractor. These invoices shall be mailed (registered) directly to the employees at their residential address.

Retirees will pay the premiums in 6 monthly installment payments with their personal credit cards.

G.4.6 Reconciling: To settle the difference between any personnel changes and the vendor payments, reconciliation will be conducted at the end of each month and at the end of the annual performance period. The resulting difference will be reconciled between the parties.

G.4.7 Reimbursement of over payments for the separated employees shall be made to the Embassy in two weeks time following the receipt of COR's notification of separation. This also applies to the retired personnel in case of a death, with the reimbursement to be made to a bank account which will be determined by the spouse.

G.5

REFUNDS TO THE GOVERNMENT

If at any time during performance of the contract the Government finds that the Contractor has been overpaid because the number of employees and/or dependents covered has decreased, the Contracting Officer may either allow that overpayment to be credited to the Government’s account or require that the Contractor refund the overpayment. If the Contracting Officer requests a refund, the Contractor shall make that refund to the Government within ten calendar days of receipt of the request.

G.6

VALUE ADDED TAX

VALUE ADDED TAX (VAT). The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices as the U.S. Embassy has a tax exemption certificate with the host government.

SECTION H

SPECIAL CONTRACT REQUIREMENTS

H.1 SECURITY. On occasion, a Contractor employee may require entry into U.S. Government-owned or -operated facilities. If so, the Contractor should be prepared to provide the necessary identification to permit escorted access within that facility.

H.2 STANDARDS OF CONDUCT. The Contractor shall maintain satisfactory standards of employee competency, conduct, cleanliness, appearance, and integrity and shall be responsible for taking such disciplinary action with respect to employees as may be necessary. Each Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

H.3 ORDERING PROCEDURES. The Government will issue a task order as soon as possible after contract award to identify all employees to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered. The COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor. All such revisions shall be consolidated, and a new or modified task order will be issued by the Contracting Officer. If any changes have been made to the coverage listing, the Government anticipates issuance of a new task order on a [ ] monthly, [X] quarterly basis. This new task order will include all changes made since the previous task order was issued and will include any increase or decrease in necessary funding. The changes to the list of eligible individuals will supersede the initial list provided under prior task orders without prejudice to the ineligibility clause. Task orders will indicate the effective date of employment, for purposes of calculating the premium due.

H.3.1. When contacted by the employer, the Contractor shall advise the employer of the paperwork and payment that will be necessary to order coverage for the identified individuals. Because more than one employer may have ORE and/or ERA staff, the Contractor may be contacted by more than one employer (typically the Chief of Mission and Deputy Chief of Mission).

H.4.

CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO CLAIMANTS

General.

The Contractor shall be responsible for all planning, estimating, programming, project management, scheduling, dispatching, supervision, and inspection of work. The Contractor shall maintain his own reference library of technical reference works and local laws and regulations, including current tariffs and registries. The Contractor shall treat the information provided by the Embassy concerning employee' personal data, medical information, and salaries as highly sensitive and not divulge any employee information to unauthorized persons. The Contractor shall establish procedures for handling medical insurance claims as follows:

Administrative Records

(1) The Contractor shall maintain medical insurance files for each covered employee and each covered dependent including receipts and proof of paid claims, requests for claim reimbursements, and accounting of paid benefits with balances of amounts remaining in the annual per person reimbursement ceiling.

(2) The Contractor shall provide the COR with the necessary claim forms for each type of benefit that can…