191D3222R0016 Post Jakarta QandA Package 2.pdf

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QUESTIONS AND ANSWERS

(SECOND SET OF QUESTIONS)

HEALTH INSURANCE JAKARTA

SOLICITATION NUMBER 191D32-22-R0016

Q.1 Where we can check the updates?

A.1 All updates are available on SAM.gov

Q.2 Section B, total employees and dependents in page 4 is different from page 44, could you advise which number we should follow?

A.2 The pricing in Section B and the employee statistics were revised in Amendment 0002.

Please download a copy of the amendment from SAM.gov.

Q.3 In order of proposal, bidder must complete dan submit

a. SF33

b. Section K, Representations and Certifications

c. Additional information as required in Section L.

Could you explain about it ?

A.3 The offeror must submit their offer as identified in Section L. this section outlines all of the requirements to be included in your offer. Please ensure that you read Section L and Section K very carefully.

Q.4 SF33:

a. Discount Prompt Payment: regarding expedited payment, will the insurance give a discount (10 calendar days and so on) ?

b. How long is the standard term of payment?

c. What does it mean by ACKNOWLEDGMENT OF AMENDMENTS on page 1 number 14?

d. What does no.15A on page 1 mean (Code and Facility)?

A.4 a. If the Offeror wants to give the Government a discount for an earlier payment, you will state your discount here with how many days for payment such as 10% 20 days. Please see FAR 52.232-8

b. The standard term of payment is 30 days after receipt of a proper invoice. Please see FAR 52.232-25.

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c. When the Government makes changes to the solicitation, we issue an amendment and post all amendments on SAM.gov. The Offeror should acknowledge all amendments to ensure that they have considered all the amendments and have included them in their offer.

d. CODE and FACILITY is the NCAGE Code and the address of the offeror

Q.5 How will embassy pay premiums, are we going to claim annually, semiannually, or quarterly? Because price for quarterly will be higher than semi-annually or annually. But we can make all three in biweekly.

A.5 Please see Section G, paragraph G.4 for frequency of payments.

Q.6 Page 6 Point B.4.1, The adjustment of the economic price requested by the insurance company is adjusting their premium on an annual basis per year, but the payment period is conducted every 3 months or every 6 months?

A.6 Please see Section B, paragraph B.4.1 for adjustments based on experience and Section G, paragraph G.4 for frequency of payments.

Q.7 In SF33 payments are made on a 3-month basis. Could you confirm?

A.7 Please see A.6.

Q.8: Page 7 Point B.4.2.1 and Page 66 Point L.4.3.4: What does it mean by Employee Pool?

A.8: The Employee Pool refers to the risk pool in which individuals’ medical costs are combined in order to calculate premiums. It does not refer to specific employees in the offeror’s organization. The employee pool may be restricted to only the number of LES participants under this solicitation and resultant contract, or it could be a larger employee pool, which includes participants from the prospective offeror’s other contracts for health insurance. If the prospective offeror is going to use an employee pool the offer must describe the employee pool it will be using as required by Section L, paragraph L.4.3.4.

Q.9 Page 66 Points 4 and 5: What does It mean? Giving advice? Or anything else?

A.9 Please See Section L, paragraph L.4.3, Part 3, 4&5 which requires past performance information to be included in your offer. This work should be the same size and scope as this solicitation. If the offeror has had any performance problems on contracts, then you must identify the problems and explain how it was resolved.

Q.10 Can we offer two or more version of pricing? So you could opt.

A.10 Please see Section L, Section L.4.3. Volume 3, Technical Proposal, Part 1 Health Insurance Services.

Q. 11 What is the meaning of “Extended biweekly”

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A.11 Extended biweekly is every two weeks.

Q.12 Page 32 Point 52.216-19: What does it mean by Minimum and Maximal Order?

A.12 Section I, FAR 52.216-19 states the minimum and maximum amounts for orders to be placed under the contract.

Q.13 Page 37 Point 52.237-7:

a. Whether liabilities insurance Is mandatory or not?

b. Whether in point a refesr to bid bond offer?

c. Whether in point b refers to performance bond insurance?

d. Can you replace it with a bank guarantee?

A.13 Section I, FAR 52.237-7 is only required, if you are offering for non-personal medical services such as an HMO. HMO stands for Health Maintenance Organization and the coverage restricts the patients to a particular group of physicians called a network. If you are offering Health Insurance, then the liabilities insurance does not apply to your offer. In addition, there is no bonding requirement in the solicitation.

Q.14 Is the packaging has 1 cover or 2 covers? How about multiple proposals, can they be combined with the main proposal or will it be a separate proposal?

A.14 Please see Section L, paragraph L.2 for information on how many copies and please see Section L, Section L.4.3. Volume 3, Technical Proposal, Part 1 Health Insurance Services.

Q.15 Page 46 Exhibit E – Claim Paid for the Past 5 Years:

Could you please provide the CLAIM DETAILS including diagnose without the member name?

Could you please provide the information of TOTAL MEMBER for each policy period?

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Aug 2017 – July 2018

Aug 2018 – July 2019

Aug 2019 – July 2020

Aug 2020 – July 2021

Aug 2021 – July 2022

A.15 Please see below:

The government does not track claim details with a diagnose. Please see Amendment 0002 for total members for each policy period.

Q.16 Page 66 L.4.3.3 PROFIT SHARING CREDIT - Could you please provide the formula in your existing policy in order for us to arrange the take over clause?

A.16 There is not profit-sharing credit in the current contract.

Q.17 L.4.3.4 EMPLOYEE POOL - Could you please provide the total rupiah value for Employee Pool in your existing policy in order for us to arrange the take over clause?

A.17 There is no employee pool value in current contract.

Q.18 The rate categories mentioned in the price tables in Section B of the solicitation reads “Male Employee/Spouse”, “Female employee/spouse ≥ 45 years of age”, Female employee/spouse < 45 years of age”, “Child”. Could you please explain what category/type of members comes under each rate category?

A.18 The categories are asking for premiums for a Male and their spouse. Female and their spouse that are over the age of 45. Female and their spouse that are under the age of 45. Also, please see Section C paragraph C.1.4.1 for Identification of Eligible Employees and Dependents

Q.19 The number of members in each category in section B does not match with the number of members in Section J- Exhibit A of the solicitation. Please confirm the actual number of employees and dependents.

A.19 Please see A.2

Q.20 Please provide average insured member counts for the last 5 years – 2021, 2020, 2019, 2018 & 2017. 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.

A.20 Please Section J, Exhibit E for the claims for 2017 to 2022.

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Q.21 Section J- Exhibit E has the overall claims history for the past 5 years. Could you please provide an age-wise breakdown of the claims amount?

A.21 The Government does not track this information.

Q.22 When is this plan likely to commence?

A.22 The Government is planning on awarding this contract before the end of the calendar year.

Q.23 Page 5. B.2.9, with Minimum And Maximum Amount, says a nominal value of Rp.

385,000,000,000, does it include rider excess claim?

A.23 It includes all costs associated with the contract.

Q.24 Would you inform us, do we will get the list of participant that contain Name, DOB, Gender, Status of the member (Employee/Spouse/Child), benefit Plan and tabel benefit on excel format to prepare the proposal

A.24 No, the Government does not provide this information prior to award of the contract, as this information is considered Personal Identifiable Information (PII).

Q.25 Whether the main proposal will be submitted in hardcopy and multiple proposals via email, or can it be vice versa?

A.25 Please see the cover letter which describes how to submit your offer either by hard copy or electronically. Also, please see Section L, paragraph L.3

Q.26 Zadroga Act, total 2% will be deducted directly from the payment to us, correct?

A.26 Correct. This tax applies to every invoice for the life of the contract. Please see Section I

FAR 52.229-12.

Q.27 Page 65 point 3: based on what classification?

Are the same LOBs?

The premium value is less than the same?

Number of participants?

A.27 Please Section L, Part 3, Experience and Past Performance, which asks for the required information.

Q.28 Page 66 points 4 and 5: what does that mean? Give advice?

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A.28 Please see A.9

Q.29 Page 24 Point H.3, Task Order within 90 Days? With the Total number of Participants at the time of SPK(Surat Perintah Kerja/Work Order Permit), whether the decrease is equal to or more than 15%?

A.29 If the total number participant is not correct, there will be an adjustment by modification to the task order or a new task ordered will be issued.

Q.30 Would you provide detail claim with diagnose information

A.30 The Government does not track this information.

Q.31 The data required is quite a summary or detail provider?

L.4.3.5. Network of Cashless Provider Licensed Hospitals

The contractor shall list the licensed hospitals which meet the minimum numbers set under paragraph H.9.2. of cashless hospital providers. This list must be segregated for each location

A.31 This paragraph states the requirement is for a list of licensed hospitals which meet the minimum numbers, and it is to be segregated for each location.

Q.32 Please inform the meaning of (d x 26)

A.32 This is how you figure the total amount for the base and each option year. You total all the lines for the year and times them by 26.

Q.33 Please inform the biweekly rate per premium

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A.33 Please see A.11 for the meaning of “Biweekly” This rate is developed by the offeror and include in the offer. Since this is for excess coverage please refer to Section C, paragraph C.1.1.21.

Q.34 Please inform us the different between base year, first option, second option

During 5 (five) year contract, is it fix amount per year or referring to the claim ratio?

A.34 . Each contract period is for a total of 12 months which equals one year for a total of 5 years. This is a firm fixed price contract for the duration of the contract. Please see Section B, paragraph B.2.2.

Q.35 Please inform us the meaning of 10 calendar days, 20 days etc, which stated on SF page 1

no. 13

A.35 Please see A.4a

Q.36 Is this the outgoing letter number from insurance company? Would you inform us why it needed two number?

A.36 Please see A.4c