19VM3023R0002 - Solicitation Questions and Answers.pdf

U.S. EMBASSY HANOI, VIETNAM

Contracting Unit

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 1/9

SOLICITATION # 19VM3023R0002 - VIETNAM MISSION-WIDE HEALTH INSURANCE SERVICES

QUESTIONS & ANSWERS

No Questions Answers

GENERAL QUESTION

1 When is this plan likely to commence? May 21, 2023.

2 Please provide the desired cashless service provider list if any. The Government does not track this information.

3 In addition, please provide more details:

- Any critical cases (such as: cancer, heart disease,...?)

- Top 10 biggest paid claim

The Government does not track this information.

4 Please confirm if the current contract has any HIV/AIDs case The Government does not track this information.

5 Please clarify direct-billing service which applied for the current contract.

Not applicable.

6 Please confirm the revised effective date is 21 May 2023 If your question is about the effective date of the contract against RFP# 19VM3023R0002 then please refer to Q&A No. 1.

7 IRS form W-14: Instructions on how to fill out the form for Offeror and note if necessary.

Is Taxpayer Identification Numbers (TIN) registration mandatory?

Please refer to Section I – Contract Clauses, FAR 52.229- 12; and Section K – FAR 52.229-11 for guidance.

8 The benefit proposed in the bid is only the Medical Expenses Benefit. So every year, does the US Embassy buy accident and illness insurance for Employees and their dependents?

This information is not included in the solicitation package.

9 How many people are insured (including staff and their eligible dependents) in 2020 and 2022?

Please refer to Section J – List if Exhibits/Attachments for necessary statistics to be provided in the solicitation.

10 Our company has a lot of subsidiaries and share financial statement with our corporation. In the details we need to Provide results of the offeror’s most recent two audits and/or

Please refer to solicitation Section L for guidance of how to build up your offer package and Section M for guidance of how your proposal is evaluated.

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 2/9

annual reports with clear (pages 70, section L) which is showed of our Head Office. However, one of our member companies will conduct the bidding. In this case we will provide a power of attorney. I would like to request besides the power of attorney, do we need to provide any other information?

11 We would like to know if you have been informed of Catastrophic cases, 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 What is the name of the current provider? Bao Minh Hanoi Insurance Company

13 Does current provider has “direct billing” in place also for outpatient treatments with medical facilities?

No.

14 Could you please provide information about all Claims/year occurred out of country during the current coverage?

The Government does not track this information.

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

Yes. Because there have been different contracts in the past 5 years.

16 Are there any differences between the current Table of Benefits and new solicitation.

Yes.

17 Final proposal can be submitted electronically or does the Embassy insist on hard copies?

Proposals must be submitted in hard copies as instructed in the solicitation cover letter.

18 Health Insurance services for Locally Engaged Staff and their dependents at the US Embassy in Vietnam is a voluntary or mandatory plan?

It is voluntary.

19 If voluntary, meaning all employees of the Embassy will be covered on voluntary basis – to the employees will be given the option to sign up for the health insurance - is there any guarantee of min. number of insured LES?

The Government guarantees the contract minimum and maximum amounts as noted in Section B – Prices.

20 The number of insured persons is essential for the risk evaluation (premium rates calculation) and for the requested enrollment procedure (without individual medical

Please refer to Section I – Contract Clauses, FAR 52.216-19

– Order Limitations.

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underwriting). What is impact on the proposed premium rates and prices if, compared to the estimated figures (EXHIBIT A and EXHIBIT B), less than 75% of the US Embassy staff and their dependents decide to be enrolled in the insurance plan?

21 All LE Staff covered under post’s medical benefit plan will pay a 10% share of the premium. The Embassy will collect 10% share of the premium?

The contractor will receive full premium fees paid by the Government. 2% tax on James Zadroga Act will be applied when the payment is made.

22 Would the Embassy accept a proposal from an international insurance company under an “off shore” jurisdiction?

The Government will accept all proposals and consider the ones that meet our requirements as instructed in Section L – Instructions, Conditions and Notices to Offerors.

23 Would 2 % tax based on James Zadroga Act be applicable to this solicitation?

Yes. Please refer to Section I – Contract Clauses, FAR 52.229-12; and Section K – FAR 59.229-11 for guidance

24 Would DBA insurance be applicable to this solicitation?

No. Vietnam has DBA waiver as in Active and Archived DBA Waivers - By Expiration Date | U.S. Department of Labor (dol.gov).

25 Would the Embassy accept proposals shown in USD or EURO? Please refer to Section B – Prices, paragraph B.2.2.1 – Offers and Payment in U.S. Dollars.

26 Would the Embassy accept to pay invoices and insurance premium in USD (or EURO) to the non-Ethiopian companies?

Please refer to Section G – Contract Administration Data, paragraph G.3. – Payment.

27 Describe the registration process and points to note to complete the SAM registration.

The guidelines for registration in SAM are available at:

https://sam.gov/content/entity-registration

SECTION A – SF 33

28 Instructions on how to fill out the form for Offeror and note if necessary.

Offeror fills in SF 33 - block 15, 16, 17, 18.

SECTION B – PRICE

29 Categories in the retention table under section B.3.2 reads "Employee”, “Employee's Spouse”, and “Employee's Dependent Children"; whereas, the categories in the price tables from

Self = Employee Self Plus One = Employee’s Spouse Family = Employee's Dependent Child https://www.dol.gov/agencies/owcp/dlhwc/dbawaivers/dbawaivers https://www.dol.gov/agencies/owcp/dlhwc/dbawaivers/dbawaivers https://www.dol.gov/agencies/owcp/dlhwc/dbawaivers/dbawaivers https://sam.gov/content/entity-registration

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 4/9

section B.2.3 to B.2.7 reads “Self”, "Self-Plus-One”, and “Family". Please confirm that the categories in the retention table must read "Self”, “Self-Plus-One”, and “Family".

30 Total number of employees for the base year as per Section B.2.3 is 2109 (754+473+882), whereas the total number of employees as per Section J-Exhibit A is 754 (350+404). Please confirm the correct number of employees and dependents.

The contractor shall price premiums based on the number of Self, Self Plus One, and Family as noted in Section B - Prices.

31 Please clarify minimum and maximum amount. This is Government’s commitment on the amounts to be covered under the contract execution.

32 Please clarify in detail the “retention rate”. Please refer to B.3 & B.4 for details.

33 Sector B & J: The census (subtotal) in sectors B and J are slightly different. Please confirm which census can use for premium calculation in the proposal.

Please refer to Q&A No. 30.

- Businesses in Vietnam will comply with Vietnamese laws, hence we understand that this tax will not be paid by the Insurance company.

- In case this tax must be paid, please guide/advise how to declare for tax refund and when to declare?

Please refer to Section I – Contract Clauses, FAR 52.229- 12; and Section K – FAR 59.229-11 for guidance.

35 B.2.2.1 Will the premium be paid in VND?

Will claim be paid in VND?

The payment will be paid according to what currency is offered in the proposal. Please refer to B.2.2.1 and G.3 for guidance.

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 5/9

36 Explain the contents circled in red in items B.2.3 to B.2.7.

Where is the premium for the Rider group shown? Are the benefits of the Rider group the same as the Employees group shown in section C?

Please provide detailed explanation of “MINIMUM AND MAXIMUM AMOUNTS” section.

Bi-Weekly Rates Per Premium: the amount to be paid per premium per bi-weekly period.

Estimated Number of Premiums: the Government’s estimation of premium to participate in the plan.

Rate per Premium: Offeror’s service price.

Extended Bi-Weekly Total = Estimated Number of Premiums X Rate per Premium

26 = there are 26 bi-weekly periods per contract year.

Category: please refer to Q&A No. 29

Premium for Rider: Please refer to B.1.1 and G.4.4.

Minimum and Maximum Amounts: Please refer to Q&A No. 31.

37 Please explain in detail “B.3 ADMINISTRATIVE RETENTION AMOUNTS” and “B.4. ECONOMIC PRICE ADJUSTMENT-HEALTH

INSURANCE PREMIUMS”

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.

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 6/9

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.

The Economic Price Adjustment (EPA) allows both the government and the contractor to look at the claims paid versus 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.

38 B.2.8 Grand Total of Base plus All Option Years (VND) - In the case of high the claim rate in the base year, can the next year's premium be adjusted against the confirmed premium?

Please refer to Q&A No. 37.

39 Item B.4.1 – Premium adjustment based on experience: will it be an amount or percentage of premium of optional years?

It will be with an amount if required.

SECTION C – DESCRIPTION/SPECIFICATION/WORK STATEMENT

40 We request for clarification of “80% Minimum Coverage: with annual cap” in paragraph C.1.1.9: The content of the terms indicates that per three years period, but at the end is with annual cap.

This benefit has a separate cap of US$ 1,500 per covered individual per three-year period. However, it is also subject to the total annual cap of US$ 15,000. This means a covered individual may not get reimbursed US$1,500 for this specific benefit if their remaining annual reimbursement limit is less than this amount.

41 We request for clarification of “80% Minimum Coverage: with annual cap” in paragraph C.1.1.10: The content of the terms indicates that every two years, but at the end is with annual cap.

This benefit has a separate cap of US$ 300 per covered individual per two-year period. However, it is also subject to the total annual cap of US$ 15,000. This means a covered individual may not get reimbursed US$ 300 for

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 7/9

this specific benefit if their remaining annual reimbursement limit is less than this amount.

42 Co-pay: it will be calculated by 80% or 50% of a single medical claim until the total paid claim reach $15,000. Please confirm.

This is correct.

43 Refer to Sector C, C1.1.18 “Out-of-country medical travel”: it means the geographical coverage is worldwide for all benefits.

Please confirm.

This is correct.

44 Does the cost of the 2nd surgical opinion (as boxed in red) be incurred at the same medical facility where the examination and treatment is performed? If not, please clarify.

The second surgical opinion may be incurred either at the same medical facility where the examination and/or treatment is performed or another medical facility.

Example: Employee and 2 dependents (3 people in total) participate in insurance. Bidder understands the maximum annual benefit of 3 people is 15,000 USD. At the time of Employee's death, Employee has used up 5,000 USD, 1 of 2 dependents uses up 2,000 USD -> so 2 dependents will enjoy the remaining insurance amount of $15,000- $5,000- $2,000= $8,000

In this example, the employee and two eligible dependents are entitled to the maximum annual reimbursement limit of US$ 15,000 each. They must be treated as separate covered individuals. The bidder’s understanding as articulated in the example is incorrect.

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 8/9

→Please explain if bidder is not understanding correctly, and make additional notes if necessary.

46 Item C1.6 – Brochure requirement: does the embassy have standard template available and the Contractor can prepare the information base on this template? Or can the Contractor will prepare the brochure template by themselves?

The Contractor shall prepare the brochure and obtain clearance from the Embassy prior to printing and distributing to covered employees and dependents.

SECTION J – LIST OF EXHIBITS/ATTACHMENTS

47 Please provide average insured member counts for the last 5 years – 2022, 2021, 2020, 2019, & 2018. 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 Exhibit C: Please provide claim paid amount for period from Oct 2022 until now.

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

49 Please provide details of paid claim & number of claim requests. The Government does not track this information.

50 Please provide five years of loss data(table 1) by year of account including annual net premium (for the same period), incurred claims and membership history. For membership history(Table

2) please provide the number of Employees with single coverage and with family coverage at the end of each year. Please do not include any confidential information, just the overall statistics for the group. Claims information is critical to our pricing and the relationship of claims to employee growth or shrinkage is part of the claims analysis.

The Government does not track this information.

Q&A FOR SOLICITATION# 19VM3023R0002 – PAGE 9/9

Table 2 - Please, provide headcounts for the last 5 years:

SECTION L – INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

51 Part 2.4 Please clarify “Pool applied” Please refer to L.4.3.4

52 Part 2.7 Please clarify reserve level to pay claim. Offeror must describe how, and at what monetary level that it will maintain an adequate reserve level to pay claims.

End of Q&A

Table 1

Contractual year Total claims paid (local currency)

Retention amount

(local currency)

Total premium paid to

Insurer

(local currency)

Net gain

(local currency)

Net gain

USD or

EUR

dd/mm/2018 – dd/mm/2019 dd/mm/2019 – dd/mm/2020 dd/mm/2020 – dd/mm/2021 dd/mm/2021 – dd/mm/2022 dd/mm/2022 – dd/mm/2023

Contractual year

Employee Spouse Children