19TZ2022R004 Dar es Salaam - LE Staff Health Insurance Pre-Proposal Questions.docx

DOCX document 28 KB Posted Mar 9, 2022

Attached to: Locally Employed Staff Medical Insurance
Solicitation number: 19TZ2022R0004
Issued by: Department of State

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19TZ2022R004 Dar es Salaam Minutes_Pre-Proposal Conference.docx	DOCX document	Mar 9, 2022
Solicitation-LE Health Insurance Service.pdf	PDF	Feb 10, 2022

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Pre-Proposal February 25, 2022 U.S. Embassy Dar es Salaam Tanzania Questions and Answers submitted before and during the Pre-Proposal Conference for Solicitation Number 19TZ2022R0004-LE Staff Health Insurance Services.

S/n

QUESTIONS FROM OFFEROS

ANSWERS

When is this plan likely to commence?

Reference Section F.2 Period of Performance.

Is this requirement/services currently being performed by AAR INSURANCE TANZANIA LIMITED Contract #: SGE50017D0043 and is set to expire on September 26, 2022? Am I missing any other incumbent contracts?

Yes, they are our current contractor.

Please provide average insured member counts for the last 5 years – 2021, 2020, 2019, 2018 & 2017

(2017-2018) - 353 (2018-2019) - 351 (2019-2020) - 414 (2020-2021) - 416 (2021-2022) - 387

Please advise if it is acceptable for us to prime the contract and sub-contract the services to the insurance company ensuring that all the requirements of the solicitation will be met.

Yes, it is acceptable if all requirements of the solicitation are met.

From the experience do you know a single large claim case in excess of 30 million TZS.

This is private information and will not be released to offerors.

In tender Document in all categories of benefits under each benefit sublimit it has been indicated that there are some percentages as minimum payable claim of benefits, we would like to know that percentage is a fraction of what value?

The percentage is the minimum amount of coverage for a particular service that the health insurance provider will be responsible for paying.

Under Price Section B.23 what is expected to be quoted under weekly premium rates? Note As per Tanzania Insurance Regulation we are required to invoice full year Insurance Premium, kindly advise?

Biweekly rates are required because of setup of U.S. government payroll system. Premiums are paid monthly after the issuance of invoice from Contractor.

Is it possible that we get information about any major case that is currently undergoing treatment for major illness whether hospitalized or scheduled for hospitalization or surgeries? If known

This is private information and will not be released to offerors.

Can we please have estimated number of increase of members from one option year to another?

The yearly numbers are estimates. Should there be a change while performing the contract, a new task order will be issued. Reference Section H.3.

Should we include DBA cost in the pricing tables?

Yes

Should we add other benefits like funeral cover?

Funeral cover is not part of the solicitation.

Please, clarify on the Retention Amount

Reference Section B.3.1-B.3.2. DBA costs and other overhead costs will be included in the tables.

Do you have the actual list of members, so that we can share the quote with actual premium? This is because with the current estimated numbers, premium is prone to change upon obtaining the actual list.

The numbers in the solicitation are current and accurate. We cannot share employee names to offers.

Are all provisions in Section K to be addressed or only the ones applying to us? For those that don’t, do we indicate N/A?

All provisions apply. If a particular section does not apply, indicate N/A.

Are all clauses in section I to be agreed/ adhered to?

Yes

Do we have to submit the proposal through both physical and electronic or either option is okay?

Reference L.3.DELIVERY OF PROPOSALS AND EXCEPTIONS TO SOLICITATION. The offeror shall submit the complete offer to the address indicated at Block 7, if mailed, or Block 9, if hand delivered, of Standard Form 33, Solicitation, Offer and Award. Any deviation, exceptions, or conditional assumptions taken with respect to any of the instructions or requirements of this solicitation shall be identified and explained/justified in the appropriate volume of the offer.

What does fixed premium rates mean and why are they required in Bi-weekly rates while medical policies are underwritten on annual basis?

We are soliciting a fixed-price with economic price adjustment type contract (Section B.2.2). Rates are required on bi-weekly basis due to the U.S. government payroll system.

What does Base year, First option year, Second Option year…etc mean?

An option is an irrevocable offer, agreed to at the time of award, that allows the government to unilaterally “pick up” (or “exercise”) the option within the time frame specified in the contract. Using options, the government can purchase additional quantities (supplies) or periods of performance (services) with firm prices which were negotiated and agreed to at the time of award. The Contracting Officer exercises options by issuing a written modification

If premium payment is done by issue of government task orders on monthly or quarterly basis, does this mean the annual premium will be paid in batches and not upfront as required by Tanzania law?(Refer H.3 in the document)

Premiums are paid monthly after the contractor issues an invoice. This requirement does not change the offerors’ responsibility under Tanzania law.

Insurers provide medical insurance through the contracted private and government health facilities, so is the mandatory medical liability insurance meant to be for every health facility in contract with the insurer?

Yes

What is Defense Base Act (DBA) premium, what is it for and what does it cover?

Reference to FAR 52.228-4. Additional information is available from the U.S. Department of Labor -https://www.dol.gov/agencies/owcp/dlhwc/lsdba

Are bidders allowed to submit bids that provide benefits at higher levels than the minimums described?

Yes, however the selection process is lowest price technically acceptable. This means, an offer only needs to meet minimum requirements and be lowest price to win the contract.

Will all the questions and answers be provided to all bidders?

Yes, and they will be posted on the SAM.gov website.

Would adding a Funeral Benefit make the bid unqualified?

Adding a funeral benefit would not make the bid unqualified.

In Section H.4, clause (b) Medical Insurance Claims, section (3), it is stated that “(3) The Contractor shall settle the claims no later than two weeks from the date the claim is submitted to the Contractor.” Does this include claims which are repudiated by the insurer? Or is it supposed to be written as “(3) The Contractor shall settle valid claims no later than two weeks from the date the claim is submitted to the Contractor.” (Page 21 of 71).

The Contractor shall settle claims no later than two weeks from the date the claim is submitted. If the employee’s claim is missing information or documentation, the Contractor shall notify the employee within 2 days, with a copy to the COR. Employee will resubmit with missing information, restarting the two-week claim procedure.

52.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 1997) (d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. What does this clause mean? (Page 32 of 71)

This clause requires that the Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier. The Contractor will be asked to provide evidence of this coverage prior to contract start.

K.6 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAR 2020) (2) The small business size standard is 38,500,000 million dollars. Is this correct? (Page 47 of 71).

The current small business size standard for NAICS 524113 is $41.5M.

In Section L, it is stated “The Offeror shall include Defense Base Act (DBA) insurance premium costs covering their employees working on the contract to include American citizens, Individuals hired in the United States or its possessions, regardless of citizenship, Host Country Nationals (HCNs) and Third Country Nationals (TCNs) working overseas. 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.” Is this applicable for this solicitation, considering that no Tanzanian insurers are listed on the DOL approved providers list? (Page 62 of 71).

Yes, this section is applicable to this solicitation and Tanzania is not exempted. Please also reference question 21.

Which current providers typically quote these types of contracts?

Reference question 2.

File details come from the government source that posted it. Updated Mar 9, 2022.