Caracas_RFP_19VE3018R0005_Health_and_Life_Insurance_QA_v6.DOCX

RFP 19VE3018R0005 Locally Employed Staff Health and Life Insurance Questions & Answers

Q.1. Price tables for health insurance have four categories: Employee (Male or Female), Spouse (Male or Female), children up to 25 years old, and Parents up to 88. Whereas, the retention table has only two categories: Single Employees (Self Only) and Family Plan. Could you please confirm that a family plan would cover the employee and any/all of the other three categories (spouse, children & parents)?

A.1. Yes, the family plan will cover the other categories.

Q.2. Is there a maximum limit of the number of children covered on the family plan? If yes, what is it?

A.2. No, there is no limit to the number of children covered.

Q.3. Claims history for health Insurance for the current year and EACH of the last 5 years: 2018 (January to present), 2017, 2016, 2015, 2014, and 2013.

A.3.

Q.4. Do the above claim numbers include claims from ORE employees?

A.4. No, ORE Staff are not currently covered by the health plan.

Q.5. Claims history for life Insurance for the current year and EACH of the last 5 years: 2018 (January to present), 2017, 2016, 2015, 2014, and 2013.

A.5.

Q.6. Do the above claim numbers include claims from ORE employees?

A.6. No, ORE Staff are not currently covered by Life insurance plan.

Q.7. Premium history for health Insurance for the current year and EACH of the last 5 years: 2018 (January to present), 2017, 2016, 2015, 2014, and 2013.

A.7.

Q.8. Did the Premium history for health insurance above include the VAT? If it did, then what percentage VAT was included in the historical health premiums?

A.8. VAT does not apply.

Q.9.Premium history for life Insurance for the current year and EACH of the last 5 years: 2018 (January to present), 2017, 2016, 2015, 2014, and 2013.

A.9.

Q.1O. Did the Premium history for life insurance above include the VAT? If it did, then what percentage VAT was included in the historical health premiums?

A.10. VAT does not apply.

Q.11. Average insured member counts for the current year and EACH of the last 5 years: 2018 (January to present), 2017, 2016, 2015, 2014, and 2013.

A.11.

Q.12. Please inform if the 2016 benefit schedule for health insurance is the same as the benefit schedule currently being requested under 19VE3018R0005. If it is not the same, advise us of the differences. Alternatively, you can provide the previous solicitation document.

A.12. The health benefits currently solicited are different from our current contract. In addition, the current contract (2016 benefit schedule) is expressed in local currency (bolivars) and the current requirement solicited under 19VE3018R0005 is expressed in USD. See “Excerpt of Health Benefits from Current Contract U.S. Embassy Venezuela” uploaded as separate document.

Q.13. Are any persons covered currently hospitalized? If yes, please provide number (we do not need the names or identification, we just need to know the total number of people hospitalized to assess the risk).

A.13. No hospitalizations have been reported as of June 14, 2018.

Q.14. Are any major illnesses (Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases) being treated? If Yes, please provide number (we do not need the names or identification, we just need to know the total number of people hospitalized to assess the risk).

A.14. Yes. Six (6) people with cancer.

Q.15. Are there any pregnant employees/spouses. If yes, please provide number (please note we are not seeking protected private information, we do not need the names or identification, we just need to know the total number of people who are pregnant to assess the risk to price accordingly).

A.15. There are four pregnancies reported at this time.

Q.16. Are there any large losses (in excess of $10,000) within the last year to date? If yes, please provide number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of large losses and the amounts to assess the risk and price accordingly).

A.16. No

Q.17. Are there any HIV/AIDs cases. If yes, please provide number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of people who are currently being treated for HIV/AIDs to assess the risk and price accordingly).

A.17. No

Q.18. Please advise whether any of the persons covered are required to carry firearms and if so, please indicate them appropriately in Exhibit A or in the census.

A.18. Currently 11 employees are in the process of being reauthorized to carry firearms.

Q.19. Are any persons not actively at work? If yes, please let us know the total number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of people who are not actively at work to assess the risk and price accordingly).

A.19. Two (2) people are not actively at work.

Q.20. Are there any employees with disabilities. If yes, indicate in Exhibit A or just let us know the total number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of disabled people to assess the risk and price accordingly).

A.20. No

Q.21 When is this plan likely to commence?

A.21 August 1, 2018.

Q.22. What licenses are required?

A.22. MISCELLANEOUS CONTRACTOR REQUIREMENTS

· H.6.1. General. The Contractor shall take all such steps as are necessary, and obtain and pay for all permits, taxes and fees as are required by the Venezuelan government to establish and/or operate a commercial venture locally. A contract with the U.S. Government conveys no special privileges or immunities to the Contractor. The Contractor is an independent commercial concern and not a part of the U.S. mission. The Contractor's employees are not U.S. Government employees. Registration of this contract with the Venezuelan government, if required by law, will be the sole responsibility of the Contractor, and any fees, taxes, or other duties shall be payable by the Contractor without recourse to the Government of the amounts thereof.

· H.6.2. Licenses and Local Laws. The Contractor shall possess all permits, licenses, and any other appointments required for the prosecution of work under this contract, all at no additional cost to the Government. The Contractor shall perform this contract in accordance with local laws.

· L.4.3.2.2 Licensing Information

· The offeror shall include a notarized copy of the most current license/certificate/-accreditation, which demonstrates that the offeror is licensed/certified/accredited or otherwise authorized by the Government of Venezuela or its agent (e.g., insurance commission, board) to provide health insurance coverage to persons (to include organizations, companies, groups) within the host country. If the offeror is not licensed/certified/accredited or otherwise authorized by the government of Venezuela, it must demonstrate that it is licensed/certified/accredited by a government other than Venezuela to provide health insurance for persons in Venezuela and must demonstrate its capacity to provide health benefits in Venezuela to meet the minimum requirements and other conditions set forth in this solicitation.

· This section shall demonstrate that the offeror is licensed/certified/accredited through no less than the final day of the base performance period and that the offeror is eligible for renewal for the option periods. This section shall also summarize and describe any probationary, disciplinary or actions taken upon the offeror, which are in force or are about to be imposed upon the offeror by the government of Venezuela or its agents.

· Failure to demonstrate that the offeror is an authorized insurance company permitted to write and administer health insurance policies in Venezuela shall be grounds for rejection of the proposal.

Q.23. As brokers, we can present quotations ALL the insurance companies in the country. However, is this request only for insurance brokers or will you also be receiving proposals from insurance companies directly?

A.23. The current health and life insurance contract is handled directly with the vendor. A broker must submit a proposal on behalf of a particular insurance provider as opposed to representing various insurance providers’ coverage and pricing from which we must choose. The actual insurance company would be required to have the necessary licenses and permits and would sign the SF-33. A broker’s proposal must comply with the solicitation requirements and would be evaluated in accordance with the solicitation requirements. We would not deviate from the terms and conditions of the solicitation, and payments would be made in accordance with the solicitation requirements. As a practical matter, the entity signing the SF 33 and certifications normally the insurance company.

Q.24. Please inform us of the current carrier.

A.24. Seguros Caracas.

Q.25. Does the offer (quote) have to be in English?

A.25. Yes, it must be in English.

Q.26. Should the employee pay directly to the Insurance Company for the Excess Coverage?

A.26. Yes, employees are responsible for direct payment to the insurance company for 100% of Excess Coverage.

Q. 27. Are companies required to be licensed in both the United States and Venezuela?

A. 27. No, companies must be licensed in Venezuela. Companies must be registered in the System for Award Management (SAMS), but SAMS is not a license.

Q. 28. Can solicitations include only health insurance, or must they include all types: health, life, and personal accidents insurance?

A. Solicitations for part or all three requested insurances are permitted.

Q. 29. Until what age and exact day are dependent children covered?

A. 29. Dependent children are covered until the age of 26 and through till the end of the contract end in the same year. Ex: If the child turns 26 years old on January 15, then they are covered until August 31 of the same year when the contract year ends.

Q. 30. Is partial or total disability covered?

A. 30. No, there is no coverage for partial or total disability beyond social security. (Part II, C.2.1.3)

Q. 31. Please define Dismemberment Coverage and confirm benefits thereof.

A. 31. Dismemberment (partial or full) is not covered in this contract. However, please note the contract only lists benefits for dismemberment cases resulting in death. See contract text C.2.1.2 which states “The employee will receive an amount equal to 26 times the amount of the monthly basic salary, in addition to the life insurance benefit in C.2.1.1, in the event the employee is killed in an accident.)

Q. 32. Does the Health and Life Insurance contract allow for Economic Price Adjustment (EPA)?

A. 32. Yes, after a period of 12 months, the contractor or the U.S. Government may request an adjustment in premiums on an annual basis. Please refer to section B.4. of the solicitation for full text.

Q. 33. Are companies allowed to provide different coverage for excess coverage?

A. No. Optional excess coverage should be priced to provide $36,000 USD in coverage and must be universally offered to all covered persons.

Q. 34. How was the annual coverage limit of $36,000 calculated?

A. 34. The annual coverage limit was established by the Department of State through an internal process.

Q. 35. Please confirm how the optional excess coverage pricing should be submitted in the proposals.

A. 35. The U.S. Embassy issued a solicitation amendment (0001) on July 9, 2018 to solicitation 19VE3018R0005 to provide pricing charts for excess coverage benefits. Please refer to the solicitation amendment 0001 for further guidance.

Q. 36. Are Excess Health Insurance Coverage Premiums included in the Economic Price Adjustment Clause B.4?

A. 36. No. Excess Health Insurance Coverage Premiums are excluded in the EPA clause Section B. 4. See solicitation amendment A001 for further guidance.

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