19VM3020Q0001Solicitation QA.pdf

U.S. EMBASSY HANOI, VIETNAM

Contracting Unit

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 1/12

QUESTIONS & ANSWERS FOR SOLICITATION # 19VM3020Q0001

VIETNAM MISSION‐WIDE HEALTH INSURANCE SERVICES

Mar 18, 2020

No. Questions Answers

GENERAL QUESTION

1 As an insurance broker, we represent and negotiate with different insurers to get the best proposal to the Embassy.

Can we submit more than 1 quotation, providing that each quotation is from each insurer?

You may submit more than 1 offer following guidance given in Section L. However, each offer must be a complete and separate offer.

2 In case broker can represent 2 or more insurers, then all information required to "offeror" or "contractor" is meant broker or insurer?

As per Section L “offeror” & “contractor” refers to the broker in your case. Each offer must consist of complete package as required in Section L.

3 When is the desired effective date? August 23, 2020.

4 Could you provide us claim details for each benefit such as number of claim cases, claim paid amount, number of claimants / total number of insured. Are there any cases of compensation related to cancer?

Please refer to Section J – List of Exhibits/Attachments for claims history. As for identifying specific diseases the government does not track this information

5 Please provide claims details including the following information for each period of the current contract including the extension period.

o Incurred Date o Type of Insured (Main Insured/Spouse/Children) o Condition: Retired/Not Retired o Age o Type of Event/Benefit/Coverage use o Paid Amount

The Government does not track this information.

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6 In addition to the above please provide claims information for all periods of the current contract including the extension.

Please present the data by policy period. The information we are requesting includes:

• Total Paid Claims

• Total Number of claims paid

• The largest dollar amount claims paid

• The lowest dollar amount claim paid

• The average dollar amount claim paid

• Please indicate the number of claims in excess of US$ 10,000 and the aggregate amount of these claims for each year presented.

• Please indicate maximum, minimum and average claim per policy period.

• Please separate this information for retirees and everyone else or present the information for each separately.

The Government does not track this information.

7 Premiums

• Please provide the premium billed in all periods, grouped by policy period and split by (retired/not retired)

• Please provide average number members during all periods.

This is the average number of employees + spouses + dependents.

(1) Please if the amount is VAT included let us know the percentage.

Since this contract is for global medical coverage, and not a Vietnam specific requirement, the premium billed in the previous contract is not pertinent for reference to this solicitation.

VAT is not included in the current contract. It is not applied to health insurance service as regulated by the Government of Vietnam.

8 Exposures

• Please Include the detail of the actual Census including:

o Gender o Condition (Retired/Not Retired) o Type of Insured (Main Insured/Spouse/Children) o Birthdate

Please refer to Section J – List of Exhibits/Attachments

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9 Are there any limit in the number of Children included? How many members, in the average, has each family group?

No, there is no limit on the number of children to be included in the plan. Please refer to Section C – paragraph C.1.4.1.1.2.

10 Does this solicitation number 19VM3020Q0001 contain the same requirements as the current contract? If not, please provide section C from the current contract.

No. The requirements in this solicitation are not the same as the current contract. The information of Section C from the current contract is not included in this solicitation package.

11 We would like to know if you have been informed of Catastrophic cases presented last year, such as:

Hemodynamics, Open Heart Surgery, Orthopedic Mayor 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.

12 Are there dependent children to be covered who are studying outside the country? If yes, please provide the country and number of dependent children studying there.

Dependent children who are studying outside the country are not excluded from the plan. However, they should be referred to the coverages implemented in Section C – paragraph C.1.1.17 ‐ Out‐of‐Country Medical Treatment, and C.1.1.18 ‐ Out‐of‐Country Medical Travel: 80% Reimbursement

13 We believe your current contract includes coverage for retired employees. What is the retire age? If your current coverage does provide benefits for retirees please provide the number of retired employees covered, the number and amount of claims paid in each of the past 5 years and extension period.

The Mission mandatory retirement age is 62. The new contract doesn’t include retirees so we will not provide this information.

14 Please confirm this solicitation number 19VM3020Q0001does not provide coverage for retirees?

Please refer to answer for question 13

15 Claim paid out: please indicate actual number of the lives per year matching to claim paid past 5 years

Please refer to Section J – List of Exhibits/Attachments

16 Is the proposed technically acceptable solution conditional upon coverage for the Official Residence Expense Staff (ORE) staff? We hope to confirm if we have to offer cover for ORE

Please refer to Section B ‐ paragraph B.1.1., Section C ‐ paragraph C.1.4.3 and Section G – paragraph G.4.

The offer should cover ORE staff.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 4/12

staff as part of our response in order to be acceptable for consideration.

17 If a quote for the ORE staff is provided, are we obligated to provide benefits as described in C.1.1 – C.1.3? The introductory sentence states, “The Government of the United States of America requires Health Insurance coverage for its employees as described herein.” However, the RFQ contemplates that ORE staff are not employees of the U.S.

Government but instead are employees of the Chief (or Deputy Chief) of the Mission.”

Please refer to answer for Question 16.

18 If we intend to provide a quote for the ORE staff, is the RFQ insisting that we provide that cover under a rider; or could we split the coverage into two policies?

Please refer to Section C – paragraph C.1.4.3.: The ORE staff are participants covered as riders.

19 Are offers through the carrier or through agents permissable. Please refer to Section K and Section L for conditions and guidance to submit offer.

SECTION A – SF 33

20 Please clarify how to fill in Form 33.

Can broker submit more than 1 SF form for more than 1 insurer?

14. Acknowledgement of amendments: Please clarify which amendments are referred to?

15.A: What is Code and Facility?

Please refer to Section L, paragraph L.4.1. and Answer No. 1 & 2 above.

14. Acknowledgement of Amendment: this is used only if there is a solicitation amendment.

15.A.: the Code is the DUNs Number and Facility are not required.

SECTION B – PRICE

21 B.2.3 What is meant by "Estimated number of Premium"?

Insurance term "premium" means "insurance cost". Do you mean "Estimated number of insured person?" instead?

What is meant by "Rate per premium", do you mean "Rate per insured person". According to market practice, insurance company apply premium rate per person per year, can you change the "extended bi‐weekly total" to "annual premium per person"?

“Estimated number of Premiums”: The estimated number of employees, spouses, and dependent children participated in this insurance program.

"Rate per premium": The premium/insurance fee per insured person.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 5/12

No, the solicitation in Section B, paragraphs B.2.3 through B.2.7 and Section G, paragraph G.4.2 requires premiums to be paid bi‐weekly.

22 B.3. Please clarify "administrative retention amount". How to understand this term and apply to this RFP?

Refer to Section B, paragraph B.3.1 the administrative retention amount is a fixed amount that is a part of the premium amount 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 claimant.

Offerors are required to fill in the fixed bi‐weekly retention amount in Section B, paragraph B.3.2. The fixed retention amount shall not be expressed in terms of a percentage of the premium.

23 B.4. Please confirm: "Economic price adjustment‐health insurance premiums": means that at the end of each option year contract, insurer can review claim ratio and make adjustment for the next option year contract based on the claim ratio of the previous year?

The Economic Price Adjustment (EPA) allows both the government and the contractor to look at the claims paid verse the premiums. If the claims are more than the premiums, the contractor can request an EPA adjustment to the contract. If the claims are less than the premiums, then the government can negotiate reduced premiums in the contract.

24 B.4.1. What/who is the "Mission(s)" The U.S. Embassy in Hanoi and the U.S. Consulate General in Ho Chi Minh City.

25 B.4.2. Who is "host Government" The Government of Vietnam.

SECTION C – DESCRIPTION/SPECIFICATION/WORK STATEMENT

26 C.1. Copay 80%: please confirm 80% of single medical claim

OR 80% x $15,000?

Same with copay 50%

80% or 50% copay of single medical claim until the total reimbursement amount reaches the maximum limit of $15,000.00

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27 C.1.1.4. Out‐patient services cover for "annual physical examination": do you mean annual health check up? If yes, is there any limit for annual health check up, or just copay 20%?

Yes, annual physical examinations and annual health check‐ up have the same meaning. Yes, the annual physical is once a year and yes, the employee is responsible for the 20%.

28 C.1.1.4. Out‐patient services cover for "immunizations recommended by local authorities and/or WHO", do you mean vaccination? If yes, all vaccination are covered? Who are local authorities?

Yes. All vaccinations are covered. Local authorities mean Vietnamese government authorities.

29 C.1.1.6 Pediatric services cover for "immunizations recommended by local authorities and WHO". Do you mean vaccination? If yes, all kind of vaccination are covered from a newborn to a 26 year old dependant children?

Yes.

30 C.1.1.16. What is "Reserved"? It means that the paragraph is not applied.

31 C.1.1.17. Please clarify: Medical expenses incurred out of country will be covered similar to medical expense incurred in‐country, does it mean that this plan cover Worldwide? Any exclusion applied for sanction countries? If yes, please clarify

Yes, this plan is for worldwide coverage.

No to exclusion for sanction countries.

32 C.1.1.18. Please clarify: is this the travel expense in country and out of country when medical treatment is not available locally?

This is the travel expenses for out‐of‐country medical treatment.

33 C.1.2. Please confirm: total annual maximum limit per person is USD 15,000 plus USD 10,000 for HIV/AIDS treatment?

Yes, the total max annual limit per person is US$15,000 plus US$10,000 for HIV/AIDS treatment.

34 C.1.3. Besides these noted exclusions, all insurers have their own separate exclusions, examples can be: medical expense due to actions against local law and regulation will not be covered or medical expense due to war, terrorist.. will not be covered. These exclusions are their fixed terms and condition within their product which is agreed by local MOF, will it be accepted?

C.1.3. 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. Refer to Section L, L.4.3, Part 1, which states any proposal that reduces a benefit definition or offers lower than the minimum required reimbursement rate may be determined technically unacceptable.

35 C.1.4.1.1. What is meant by "LE staff"? Locally Employed staff of the U.S. Embassy in Hanoi and the U.S. Consulate General in Ho Chi Minh City.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 7/12

36 C.1.4.1.1.2.

‐ How to define a dependent child reach age 26? For example:

If the contract's effective date is 1 May 2020, any child was born before 1 May 1994 will be not covered. Child was born from and after 1 May 1994 will be covered until the end of base year contract and will be not covered for the next contract year. Please confirm ‐ For local practice, there will be no maternity benefit applicable for dependent children. It doesn’t mention in the RFP but can it be acceptable if insurer exclude maternity benefits for dependent children?

‐ A dependent child who have not reached the age of 26 at the effective date of the Contract will be eligible to participate in this insurance program until s/he turns 26 years old or until the contract expires, whatever comes first.

- No, maternity for dependent children will not be excluded.

37 C.1.1.5. We request for clarification of outpatient care for newborn babies: Newborns (who do not need to be enrolled in insured list) will be paid for examination visits according to the doctor's appointment, no need to be sick. Is there a limit on the period of coverage for newborn babies?

Newborn Care coverage ends once an infant is discharged from the hospital and registered as an individual member of the plan.

38 C.1.1.17. We want to clarify that, medical expenses incurred out‐of‐country will be covered without any conditions, such as medical travel be considered a covered expense, the attending certified health care provider must certify in advance that the treatment is medically necessary and unavailable locally.

If there is no condition attached to the content of section C.1.1.17, will the covered geographic scope of this insurance program be global?

Refer to answers for questions 31 and 32.

SECTION D – PACKAGING AND MARKING

39 Reserved. Please clarify Section D is included in the general contract solicitation format, but not applicable to this solicitation.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 8/12

SECTION J – LIST OF EXHIBITS/ATTACHMENTS

40 Exhibit A ‐ Data of number of employees in Section B and J is slightly different (employee: 698 vs 696; dependant: 389 vs 395 respectively). Please provide the final data

The contractor shall price premiums based on the number of employees and dependents in Section B for their proposal.

41 Exhibit A ‐ What is the proportion of changing headcount annually?

Exhibit A – Employee Statistics shows a snapshot in time and actual numbers will vary over time. However, employee turnover is very low. The latest turnover rate for the entire Mission is 6 .67%.

42 Exhibit C Please provide details of claim paid amount & number of claim cases of the most recent contract year, which cover:

‐ Hospitalization & surgical ‐ Out‐patient services ‐ Obstetric & newborn care (Maternity) ‐ Out of country treatment cost, where exactly?

‐ Out of country medical travel cost ‐ Health check & vaccination Please provide more details:

‐ Proportion of treatment case and amount within Vietnam versus out of Vietnam? Where is the most popular place of treatment out of Vietnam?

‐ Any critical cases? for example: cancer, heart disease, major accident...

‐ Top 5 biggest claim? (which disease, claim paid amount)

The government does not track this information.

43 Exhibit C If the effective date is 23 Aug 2020, please provide claim amount and details as above from 23 Aug 2019 up to date

The exhibits are for reference. There will not be any update.

44 Number of employees as per the price tables in Section B is 698, whereas number of employees as per Section J, Exhibit A is 696. Number of dependents as per the price tables in

The contractor shall price premiums based on the number of employees and dependents in Section B for their proposal.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 9/12

Section B is 389, whereas number of dependents as per Section J, Exhibit A is 395. Please confirm.

45 Provide Premium history for health Insurance for the current year and EACH of the last 5 years ‐ 2020 (till now), 2019, 2018, 2017, 2016, 2015. It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

Please refer to Section J – List of Exhibits/Attachments.

46 Did the Premium history requested above (question #2) include the VAT? If it did then what % VAT was included in the historical health premiums?

VAT is not included because it is currently not applied for health insurance service in Vietnam.

47 Provide Average insured member counts for the current year and EACH of the last 5 years ‐ 2020 (till now), 2019, 2018, 2017, 2016, 2015. It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

Please refer to Section J – List of Exhibits/Attachments.

48 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).

No

49 When is this plan likely to commence?

August 23, 2020

SECTION G – CONTRACT ADMINISTRATION DATA

50 G.3. According to local law, premium must be made in

Vietnamese Dong (VND) and within 30 days from the Please refer to G.3. and G.4.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 10/12

effective date. As it is the law, all insurer will apply the same and can insurer add on this condition into the RFP?

SECTION I – CONTRACT CLAUSES

51 These questions regard Section I.1. Clause: 52.222‐50

COMBATING TRAFFICKING IN PERSONS (MAR 2015)

As you guys mentioned during the pre‐proposal conference that we have to provide evidences/ examples to prove that we are committing to this clause. Therefore, can you please explain more clearly about what kind of evidences/ examples that you prefer to receive (we have the same question as someone also asked during the conference: Could a statement in which our chairmen sign on serve as an evidence for this?)

And also in which volume in the final proposal that we have to include them on?

Please refer to the guidance noted in Section I – Contract Clauses, paragraph I.1 for access to the full text of the clause use the following link http://www.acquisition.gov/far/.

This should be included in Volume 3 as instructed in Section L – Instructions, Conditions and Notices to Offerrors, paragraph L.5 – Clause 52.222.56 Certification Regarding Trafficking in Person.

SECTION K – PRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENT OF OFFERORS

52 Which page need to be filled up and provided? Can you provide the soft copy in doc or docx file?

Please follow the guidance provided in Section K. No soft copy will be provided.

SECTION L – INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

53 L4, Part 2. Item 7

"Describe how, and at what monetary level, the offeror will maintain an adequate reserve level to pay claims". Please clarify

How an offeror meets, this requirement is up to the offeror.

This paragraph requires the offer to provide information on how they will maintain an adequate reserve level to pay claims.

54 L4, Part 3 Please clarify the requirement. Do you mean insurer need to submit all the contracts they have in the past 3 years for similar work? Based on their data protection, they might not provide details of other clients' contract to third party without client's confirmation.

Yes. Section L, paragraph L.4 Part 2 requires the offeror list all contracts and subcontracts it has held over the past three years for the same or similar work. This information will used only for past performance information by the US Government.

55 L4, Part 4 The Request for Proposal (PRP) is open for all Insurance providers or brokers which are eligible to provide health

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 11/12

[quote] 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 Vietnam or its agent (e.g., insurance commission, board) to provide health insurance coverage to persons (to include organizations, companies, groups) within the host country.

[unquote] Aon Vietnam Limited is licensed by Vietnam’s Ministry of Finance to provide ‘Insurance and reinsurance brokerage services’. Our operation consists of representing the insured’s benefits to approach and negotiate with numerous insurers, obtain insurers’ insurance quotations (terms & conditions, premium), analyse and compare the quotations then presenting the results/ options to the insured for their decision/ selection.

We are not technically the party who provide health insurance coverage but we are able to source the quotation and manage the policy placement process as well as policy implementation thorough the policy year(s), providing post‐ placement services including insurance training seminar, day‐ to‐day advisory to the insured persons, claim advocacy and support, etc.

We would like to seek your confirmation that whether or not Aon Vietnam is eligible as offeror for the aforementioned Solicitation in case we are able to provide the insurance proposal which is supported by the Insurers who meet US Embassy’s requirements? In this case, Aon Vietnam will provide all services to US Embassy as mentioned above in addition to those provided by Insurers, insurance services in Vietnam. But the offer shall disclose any business arrangements such as joint ventures in their offer.

Q&A FOR SOLICITATION# 19VM3020Q0001 – PAGE 12/12

56 This question regards item 4. of part 2, Section L.4.3. Volume 3, ‐ Can you please explain more about the requirement of this criterion?

If the contractor is using employee pools and intends to add our employees to an existing pool then the contractor must disclose those details in its offer. Please refer to Section B, paragraph B.4.2.1 and Section L, paragraph L.4.3.4.

End of Q&A