Questions and Answers for 19UK5621R0002.pdf

Questions and Answers for 19UK5621R0002

SBU - CONTRACTING AND ACQUISITIONS

Health Insurance for Locally Employed Staff in Hamilton, Bermuda

No Question Answer

Please could you supply the following information for each individual to be covered:

• Gender

• Date of Birth

• Coverage Tier (single, employee +1, etc)

• Home country (country of residence)

• Current/Renewal Rates

We are unable to provide all of this data for privacy reasons, the data we have which is approved for release is contained in Section J, Exhibit A.

We can confirm the home country for all covered employees is Bermuda.

Current/Renewal Rates – per month are as follows:

Employee Only - $1,312.89 Employee and Child(ren) - $1,830.60 Employee, Child(ren) and Spouse - $3,176.98

However staff are paid Biweekly basis rather than monthly, so Biweekly Rates are required to keep in line with the deductions to staff wages and these are as follows:

Employee Only - $605.59 Employee and Child(ren) - $844.89 Employee, Child(ren) and Spouse - $1,466.30

The claims for 2019 have been quite high totaling $288 000 USD. Can you advise whether this is comprised of one big claim, for example for a catastrophic disease like cancer or does this amount come from several smaller claims.

This amount is a result of multiple employee claims, not one specific big claim.

In regards to a Worker’s Compensation quote, we will need salary information for the employees to be covered.

Worker’s Compensation coverage is not required for the staff of the Consulate who will be covered by the Health Insurance. Workers Compensation Insurance under the Defense Base Act is however required for staff employed by the Supplier providing the Insurance.

Please see the Department of Labor website for further information regarding this:

https://www.dol.gov/agencies/owcp/dlhwc/ExplainingDBA

Please provide 3 full years of claims experience (Premium Paid, Claims Paid) and Historical rates for those years

Pease see Amendment 00001

Are there any large claims in excess of $25,000 for any of those 3 year periods? If yes, care they ongoing?

This information is not available.

Can the 5 year fixed pricing be adjusted based on loss ratio at health renewal?

The only mechanism which allows for changes to the firm fixed prices under this Contract is detailed under Section B, paragraph B.4. ECONOMIC PRICE

ADJUSTMENT-HEALTH INSURANCE PREMIUMS.

The request to cover children until age 26, is this regardless of student status?

Yes, please see Section C, paragraph C.1.4.1.1.2.

Please provide 5 years of loss data by year of account including annual net premium, incurred claims and membership history.

Please see Amendment 00001 https://www.dol.gov/agencies/owcp/dlhwc/ExplainingDBA

Please provide number of employees with single coverage and with family coverage at the end of each year.

Have you been informed of Catastrophic cases, such as: Hemodynamics, Open Heart Surgery, Orthopedic Major Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases (Radio and Chemotherapy), and hospitalizations with more than 10 days.

The Government does not track this information, so we are unable to answer this.

What is the name of the insurance company that currently provides coverage?

Colonial Medical Insurance Company – name changed to CG Insurance

(Coralisle Group Ltd.) in 2020.

Is there a preferred list of Hospitals, Clinics or other Medical Facilities that the Embassy employees prefer?

If yes, please provide a list of these facilities

There is only one medical hospital, the King Edward VII Memorial hospital and one mental health hospital, the Mid-Atlantic Wellness Institute (MWI) in country in Bermuda.

There are private physicians and specialists that employees choose for primary care, but we do not have a list.

Could you please provide information about the claims you have had outside of Bermuda during your current coverage?

This is unknown and we are unable to request information due to the requirement for privacy for employees regarding health matters.

Has there been any changes to the Table of Benefits over the past 5 years?

No, there have been no changes.

Would the Embassy accept proposals in USD where premium are also paid in USD from non US companies?

No, this is not allowed. Please see B.5 of the solicitation:

Can also claims be paid in USD or is there a need to be paid in the local currency

Please see Amendment 00001