5. Request for Information (RFI) Questions and Answers_Amend 1.pdf

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RFI Questions and Answers

1. Statement of Work (SOW) 2.1.1 and 2.2.1 – Define pre-paid amount.

The pre-paid amount referenced in these SOW elements is the amount specified in RFP Section B - Part 1.a for NASA travelers group membership and 2.a for NASA identified independent traveler membership, and if ordered 1.b and 2.b for Portable Medical Isolation Unit (PMIU) level coverage for these travelers respectively.

Note: Section B, Part 3 has pre-paid amounts listed for Soyuz backup reservation and call-up of medical transport via air ambulance.

2. SOW 2.1.4 - How does the contractor know that the individual’s insurer will work with the contractor? Are all insurers and insurance policies US Based, or might they be global and issued by foreign issuers? How does the contractor know that the insurer will cover the same level of costs as the NASA requested set of benefits? Some clarity around the current working practice would be useful to better understand this process and the risks involved for the supplier.

The NASA requested set of benefits listed in the SOW are the responsibility of the Medevac 5 Contractor. The Medevac 5 contract with prepaid membership constitutes a direct agreement between NASA and the Contractor. The Contractor is not required to verify if a traveler's individual health insurer will 'work with them' or authorize the evacuation before executing a mission. The Contractor will initiate services based on the joint NASA/Contractor medical directive, not a third-party insurance authorization. The Contractor is responsible for paying for the medical evacuation if the evacuation is needed. Therefore, the contractor does not bear the risk of a traveler’s insurer refusing to pay for the core medical evacuation; the Medevac 5 contract fixed-price membership covers the evacuation.

NASA travelers may possess a mix of U.S.-based health insurance, global insurance policies, or coverage via federal programs (e.g., Federal Employees Health Benefits). These individual policies vary.

The Contractor’s responsibility regarding insurance in this SOW paragraph is limited to the coordination of patient insurance information for the personal medical expenses not arranged for or covered by the Contractor.

3. SOW 2.2 – Air Ambulance Evacuation - will the travelers have their own insurance, or will they be billed directly? Will the vendor need to contract with each traveler in advance?

The Medevac 5 contract covers these air ambulance evacuation services. In accordance with the SOW Section I. General, paragraph 1.1.3, the Contractor shall be responsible for all medevac and medical travel service costs. The Contractor will not contract with each traveler in advance. The Contractor will not utilize a traveler’s personal insurance or bill directly the traveler for the air ambulance evacuation services. The traveler, through their health insurance, is responsible for any hospital or medical doctor consult costs.

4. SOW 2.2 - Please confirm that patients have medical insurance that covers medevac services? If their insurance does not cover medevac services, is there a guarantee of payment for medevac?

See answer to question 3. In addition, the Government is not providing a guarantee of payment for medevac services provided under the Medevac 5 contract. NASA will only pay the pre-paid, firm- fixed price group membership established at the time of contract award as outlined in the SOW and priced in Section B Firm Fixed Price (FFP) Group Membership.

Kendrea Vallien Cross-Out

5. SOW 2.2.1 - Can you please clarify integration protocols for NASA flight surgeons as attending physicians.

The Government intends for NASA flight surgeons/physicians to operate in close coordination and collaboration with the Contractor’s designated medical director and on-duty flight crew to ensure seamless continuity of care and the safety of the NASA traveler.

Detailed clinical integration protocols, joint operational workflows, and real-time communication channels will be mutually established and finalized during the post-award implementation phase. For the purposes of proposal preparation, offerors should assume that NASA physicians will provide high-level clinical oversight, mission-specific aeromedical context, and patient history to complement the Contractor's capabilities.

In scenarios where a NASA physician is present on-site and requests to accompany the patient on the air ambulance, they will serve as an additive medical asset to the mission. While on board, the NASA physician will integrate into the medical team's workflow in accordance with post-award protocols, while strictly adhering to the aircraft commander's final safety and aviation authorities. Offerors are encouraged to propose their standard corporate frameworks, past performance examples, or best practices for integrating client-provided medical personnel into their standard air ambulance operations.

6. SOW 2.2.1 - Will NASA assist the Contractor with authorization requests to the host country when/if flying into controlled airspace?

NASA’s expectation is that the Contractor obtains any necessary authorizations, permits, licenses, invitation letters, visas, etc. for entry into host countries. In accordance with Section L Instructions to Offerors A.1.g, the Offeror shall provide all steps with rationale required by the Government to execute a Contractor-provided medevac. NASA will evaluate all requests for assistance from the Contractor on a case-by-case basis and if deemed necessary by NASA, NASA may assist the Contractor.

7. SOW 2.2.1 - If flying into Baikonur, it is mandatory to have a Russian-speaking escort navigator onboard. Is NASA aware of this and can they assist?

NASA is aware a Russian-speaking escort navigator onboard may be required to fly into Baikonur. See answer to question 6.

8. SOW 2.2.1 - Kyzylorda is the nearest airport to Baikonur, which has normal flight operations, but it is 251 kilometers from Baikonur. If landing permissions and approval at Baikonur cannot be obtained, will NASA approve patient movement to Kyzylorda, given the medical risks?

NASA approval of patient movement will be assessed on a case-by-case basis in accordance with SOW Section II, paragraph 2.2.3, Decision to Evacuate.

9. SOW 2.2.1 - Will there be a regularly nominated destination for evacuated patients? Or will they be on case-to- case basis?

The destination for evacuated patients will be determined by NASA on a case-by-case basis depending on the specific medical evacuation.

10. SOW 2.2.2 - Clarification on vetting expectations would be helpful as corporations all have different annual requirements. Is there a NASA preference?

NASA has no structural preference between CAMTS, NAAMTA Global, and EURAMI. Contractors are not required to hold all three. Holding either a valid CAMTS, NAAMTA Global, or EURAMI accreditation satisfies this requirement. If an alternative equivalent is proposed, Offerors must submit a compliance mapping matrix alongside their technical proposal. The RFP is updated to state “Active credentials must be maintained according to the standard renewal timelines dictated by the respective accrediting body.”

11. SOW 2.2.3 - Decision to Evacuate – Can NASA provide who is the independent third party on the current Medevac 4 contract?

For the Medevac 4 contract, the mutually agreed independent third party is The Cleveland Clinic. For the Medevac 5 contract, per SOW 2.2.3, the independent third party will be mutually agreed within 30 calendar days of contract award.

12. SOW 2.2.3 – Decision to Evacuate - Is there currently any alignment with the individual’s recommended insurance policy benefits and this decision-making process (i.e.: NASA may wish to evacuate but the insurer does not deem it to be medically necessary and therefore will not honor the claim.)?

See answers to questions 3 and 4.

13. SOW 3.1.1 – Can NASA provide insight into how often it intends to order the Soyuz Landing Backup Medical Transport via Air Ambulance service?

NASA cannot commit to a specific frequency for ordering the Soyuz Landing Backup Medical Transport via Air Ambulance under Medevac 5. Soyuz landings typically occur approximately every eight months, with the most recent landing on July 26, 2026. While NASA cannot definitively state how often the Soyuz Landing Backup Medical Transport via Air Ambulance will be ordered, NASA can provide historical insight. Under the current Medevac 4 contract, NASA has consistently ordered the Reservation service for each Soyuz landing but has not elected to order the Call-up/Execution service.

While this historical usage may help inform Offerors’ planning assumptions, the Medevac 5 ordering will remain dependent on NASA’s specific mission needs.

14. SOW 3.1.1 – For Soyuz Landing Backup Medical Transport via Air Ambulance, what is NASA’s required on‑ground availability timeline for the aircraft once a Call‑Up/Execution order is issued?

NASA’s target planning assumption is that, when a Call‑Up/Execution order is issued, the Contractor’s aircraft should be on the ground, fully fueled, crewed, and mission‑ready no later than approximately six hours prior to the scheduled Soyuz landing time. This readiness target supports NASA’s ability to rapidly execute medical transport. However, NASA emphasizes that final timing requirements may vary based on mission‑specific circumstances, operational constraints, and real‑time decisions made by NASA. As such, NASA may adjust this readiness window depending on landing location, weather conditions, flight surgeon guidance, or other operational factors.

15. Section B – Part 1 - To provide more accurate pricing, does NASA have any historic claims data?

See attachments with the following in the file names: ‘NASA Actual Usage Data – 2011 – June 2026’ and ‘NASA Internal Risk Assessment - Through July 2026’.

16. Section B – Can NASA provide the Medevac 4 contract number which includes information such the period of performance, workload indicators, and current contract value, etc.?

The current Medevac 4 contract number is 80JSC021PA007.

17. Section B – Part 1 and Part 2 – What if my offering includes the PMIU as part of the base offering in Table 1.a and Table 2.a, how do I reflect that in the pricing tables for Table 1.b and 2.b?

If medevac using a Portable Medical Isolation Unit (e.g. infectious disease medevac) is included in the base membership price in Tables 1.a and 2.a, then fill in “$0” in Table 1.b and Table 2.b. I

18. Section B – Part 2. Can NASA estimate the number of NASA identified independent travelers it anticipates needing this service?

NASA cannot provide a specific estimate for the number of independent travelers who will use this service under the Medevac 5 contract. However, to give an idea based on past usage, the current Medevac 4 contract has seen about 5-10 travelers each year enroll themselves or their entire immediate family for these memberships.

19. Section B – Part 2. How does this direct contractor to independent traveler contract/agreement work currently? Does each individual have insurance that they will want to use?

The NASA Identified Independent Traveler is provided with enrollment instructions by the Contractor.

This traveler then uses these instructions to self-enroll and pay directly to the Contractor the cost of the individual’s pre-paid membership. Once enrolled and paid, this traveler receives the same benefits NASA receives under the Medevac contract. Should the traveler require an air ambulance evacuation, the cost of the evacuation is the sole responsibility of the Contractor. The Contractor will not utilize the traveler’s personal insurance or bill directly the traveler for the air ambulance evacuation services.

The Decision to Evacuate remains the same as Medevac 5 contract terms and conditions. Note that the number of days this traveler purchases coverage for is not counted against the number of days that NASA receives under the Medevac contract.

20. Section B – Part 2.b, is it the intention that this price is incurred in arrears, if needed? Or is it agreed up front? How will a traveler decide if they want/need this level of cover?

The intention is that the Portable Medical Isolation Unit (PMIU)-level coverage for the NASA identified independent traveler is pre-paid by the traveler prior to the service being executed. NASA does not dictate or govern whether the NASA identified independent traveler selects to enroll in the Portable Medical Isolation Unit (PMIU)-level coverage.