PR16070805-Sources Sought.pdf

US Consulate General

REGIONAL PROCUREMENT SUPPORT OFFICE (RPSO)

Gießener Str. 30, 60435 Frankfurt, Germany

August 13, 2026

SOURCES SOUGHT

PR16070805

The Department of State is conducting market research to determine the degree of interest and capability of experienced vendors in providing health insurance to Locally Employed Staff (LES) at U.S. Embassy Maputo in Mozambique.

The Government of the United States of America requires Health Insurance coverage for its employees in Maputo, as further described in this Section.

The insurance company will reimburse covered medical expenses incurred, subject to the stated limits. Payment will be made for reasonable and customary costs of covered benefits. The medical treatment must be prescribed or provided by a physician or nurse licensed in Mozambique or

South Africa or in the country in which the treatment or prescription is received. Covered individuals shall have access to treatments and consultations from licensed healthcare providers in both Mozambique and South Africa. Coverage of expenses will be made in the local currency, Metical, or in South African Rand at the official exchange rate.

Responses to this sources sought must demonstrate the following minimum capabilities by providing past performance history clearly demonstrating coverage of the following health service benefits at the minimum:

• Hospitalization (treatment in the hospital for inpatient care)

Services and supplies provided during hospitalization, including but not limited to services provided by a licensed healthcare provider, bed & board, operating room, recovery room, intensive care, imaging and diagnostic testing, general hospital nursing care, physical therapy, as well as drugs and medicines administered while in-patient. 100% Coverage

See Mental, Nervous and Substance Abuse care (below) for details concerning inpatient psychiatric care.

See Outpatient Services (below) for details concerning professional services.

• Emergency Services (trips to emergency room)

Services provided for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness.100% Coverage

• Ambulance

Professional ground transport to move a patient from the place where s/he is injured or becomes ill to the nearest hospital able to provide treatment or to move a patient from one medical facility to another. 90% Minimum Coverage

• Outpatient Services:

Services provided by a certified healthcare provider on an ambulatory or outpatient basis (without being admitted to a hospital), including surgeon’s fees and other medical services that may be provided in a hospital, clinic, doctor’s office, medical facility, etc. Examples include, but are not limited to:

-- Annual physical examinations

-- Specialist consultations and treatment, including second surgical opinion

-- Minor surgical interventions

-- Chemotherapy and radiation treatments

-- Immunizations recommended by local authorities and/or the World Health Organization

-- Diagnostic tests and diagnostic imaging

90% Minimum Coverage

See Rehabilitative and Habilitative Services and Devices (below) for details concerning physical therapy.

See Mental Health and Substance Abuse Care (below) for details concerning psychiatric therapy.

• Obstetric and Newborn Care

Care and services that women receive during pregnancy (prenatal care), throughout labor and delivery, and post-delivery, and outpatient care for newborn babies. Hospitalization during pregnancy and/or delivery will be reimbursed as Hospitalization (treatment in the hospital for inpatient care).

Inpatient: 100% Coverage; Outpatient: 90% Minimum Coverage

• Pediatric Services

Primary and preventive routine care services for covered dependent children, including, but not limited to: physical examination, developmental assessment, laboratory tests, and immunizations recommended by local authorities or the World Health Organization.

• Prescription Drugs

Medications prescribed by a certified health care provider that are medically necessary. Examples include, but are not limited to: prescription antibiotics to treat an infection; medication used to treat an ongoing condition, such as high cholesterol; prophylaxis; or contraceptive medication.

• Preventive and Wellness and Chronic Disease Management

Counseling or preventive care designed to prevent or detect medical conditions and care for chronic conditions such as asthma and diabetes. Examples include, but not limited to: physicals, immunization, and cancer screenings. 90% Minimum Coverage

• Hearing Aids

Examinations and Treatment: 80% Minimum Coverage

Hearing Aid Apparatus: Minimum of one apparatus per ear up to a minimum of USD 1,500 per covered individual per three-year period. 90% Minimum Coverage

• Optical

Examinations and Treatment: 90% Minimum Coverage

Prescription lenses and frames, or contact lenses: Covered up to a minimum of USD 300 per covered individual every two years. 90% Minimum Coverage

• Dental

Examination and Treatment: Including but not limited to dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a minimum of

USD 3,200 per covered individual per contract year.

90% Minimum Coverage

Orthodontia treatment: covered only if treatment begins before age 18, or if required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per covered individual up to a minimum of USD 2,400 lifetime limit.

90% Minimum Coverage

• Reproductive Health

Prescribed contraceptive devices, preventive care and routine examinations, voluntary sterilization, and diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments, and reversal of sterilization are not covered (see Exclusions to Coverage).

90% Minimum Coverage

• Mental Health and Substance Abuse Care

Inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. This includes, but is not limited to, behavioral health treatment, counseling, and psychotherapy. Services must be provided by a licensed psychiatrist, psychoanalyst, psychologist, or psychiatric social worker. Inpatient care for alcohol and substance abuse must be carried out at a facility licensed for detoxification and rehabilitation

50% Minimum Coverage

• Rehabilitative and Habilitative Services and Devices

Rehabilitative services (e.g., recovering skills, such as speech therapy after a stroke or physical therapy after an accident) and habilitative services (e.g., developing skills, such as speech therapy for children) that help develop skills needed for everyday life.

Devices to help gain or recover mental or physical skills lost due to injury, disability or a chronic condition, and devices needed for habilitative reasons.

50% Minimum Coverage per beneficiary per year

• HIV/AIDS

Medications to suppress opportunistic infections (such as tuberculosis or toxoplasmosis for covered individuals who have HIV/AIDS). Brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV/AIDS to the child.

100% Coverage up to USD 10,000 change per contract year per covered individual

• Excess Coverage

Additional coverage equal to 40,525 USD to be applied to any covered individual to any covered benefit. Staff must pay 100% of the premium if they elect Excess Coverage. Not applicable to direct reimbursement posts. This can be used for any individual coverage for any covered expense that exceed annual maximum.

• Catastrophic Coverage

Catastrophic Coverage: Additional coverage equal to $56,728 USD, the maximum FSN 9 annual salary, per person per contract year. Catastrophic conditions shall be defined as major medical conditions occurring as a result of a single/illness/accident or closely related set of major illnesses

(or conditions relating to a single accident) that exceed the standard maximum coverage limit.

• 60 Day Extended Dependent Coverage After Employee’s Death

At the time of a covered employee’s death, his/her eligible dependents covered under post’s medical plan as designated in the official personnel file and eligible to temporarily continue receiving the same level of medical coverage for up to 60 days.

• Out-of-country Medical Treatment

Medical expenses incurred out-of-country will be covered at the same benefit levels and subject to the same total maximum annual limit as medical expenses incurred in-country.

• Out-of-country Medical Travel

Transportation for out-of-country medical treatment will be a covered expense for covered employees and eligible family members. To be considered a covered expense, the attending certified health care provider must certify in advance that the treatment is medically necessary and unavailable locally.

Minimum 90% of covered individual’s transportation expenses by the least expensive, appropriate means of transportation to the nearest city with adequate medical facilities will be covered.

Minimum 90% of the transportation expenses of an attendant will also be covered, but only if the covered individual's attending certified health care provider certifies that an attendant for the patient is necessary, (e.g., a parent in the case of a patient who is a minor, or a family member to make medical decisions in the case of a patient who is unwell or unconscious).

All coverage for transportation for out-of-country medical treatment is subject to the total maximum annual limit. Transportation to a neighboring country without the attending certified health care provider certifying that the treatment is medically necessary and unavailable locally will not be covered.

• Employee Assistance Program (EAP)

An Employee Assistance Program (EAP) is a voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.

• Annual Limit

The maximum annual coverage per covered individual per contract year, not including expenses covered under HIV/AIDS benefits if selected by post, is 6,600,000 meticais*.

*The official US Department of State Rate of Exchange effective in the solicitation submission date, shall be used to calculate to USD equivalent.

(ROE from May 28, 2021: US$ 1.00 = MZN 60.200)

• Geographic Coverage – Mozambique and South Africa

Covered individuals shall have access to medical treatments, consultations, and services from licensed healthcare providers in both Mozambique and South Africa. The insurance company shall maintain an adequate network of healthcare providers in both countries to ensure timely access to covered benefits. All services provided in South Africa by licensed healthcare providers shall be reimbursed at the same benefit levels as services provided in Mozambique, subject to the same coverage limits and requirements outlined in this Statement of Work.

Moreover, the vendor must provide the following in response to this source sought:

• Provide authorizing to operate and do business in Mozambique.

• Provide copies of current required licenses and permits to provide health insurance services in Mozambique.

• Provide confirmation of ability to provide health insurance services for a total period of 5 years and 6 months.

• Provide filled out “Vendor Information Sheet” which is attached to this document

(pages 6 to 7).

• Provide proof of active System for Award Management (SAM) registration. If no

SAM registration exists, mark so on the following Vendor Information Sheet.

• Confirm ability to provide a Project Manager who can speak English and possesses at least 2 years of experience in working with contracts of similar size.

• Provide any supplemental information that demonstrates capability.

It is requested that all interested parties submit their capabilities by e-mail to Contracting Specialist

Hakim Dyane at DyaneA@state.gov addressing each of the above requirements and capabilities.

The deadline for submission is August 23, 2026.

At this time, the U.S. Department of State does not guarantee that any future contracts may be awarded covering the aforementioned duties and responses to this Sources Sought notice and therefore does not bind the U.S. Department of State to any agreement with the responder, be it explicit or implied.

mailto:DyaneA@state.gov

Vendor Information Sheet

Please fill in all information below, type or print information clearly.

Legal Business Name:

Local Tax ID No: UEI:

Address:

City, State, Zip Code:

Toll Free Number: Website Address:

Point of Contact:

Phone Number: Fax:

E-mail Address:

Country:______

Registered in System for Award Management (SAM): Yes No _

Size of Business:

Large ___

Small ___

Corporate Status:

Corporation ___

S-Corporation ___

Sole Proprietorship ___

Partnership ___

Other: _______________

Type of Ownership:_____________

Woman ___

Veteran-owned___ (Service-disabled ____)

Minority___

None of the Above ___

Other: _________________

Socio-Economic Status:

8(a) Status ___

HUBZone___

Disadvantaged____

Woman Owned___

SDVOSB___

None of the Above ___

Other:_________________

Do you currently do business with the U.S. Government? Yes____(please state in what capacity) No____