RFP 19AR2024R0001.pdf

Embassy of the United States of America

U.S. Embassy Buenos Aires

General Services Office

Date: December 29, 2023

Dear Prospective Offeror:

Subject: Request for Proposals number 19AR2024R0001

The Embassy of the United States of America invites you to submit a proposal for locally employed staff health insurance coverage. The Embassy encourages prospective offerors to offer off-the-shelf plans that meet at least the minimum benefit levels required in this solicitation.

The U.S. Government intends to award a contract to the responsible company submitting an acceptable offer at the lowest price. We intend to award a contract based on initial proposals, without holding discussions, although we may hold discussions with companies in the competitive range if there is a need to do so.

The Embassy intends to conduct a pre-proposal conference at the site. The pre-proposal conference will be held on January 11, 2024, at 9:00 hours local time at the U.S. Embassy

Buenos Aires. Prospective offerors should contact Procurement Supervisor Cristian Minotti at

BNS-Procurement@state.gov by January 5, 2024, on or before 12:00 hours local time for additional information or to arrange entry to the building.

Proposals are due by February 15, 2024, at 12:00 hours local time. No proposals will be accepted after this time. Proposals must be in English and incomplete proposals will not be accepted.

Your proposal must be submitted electronically to BNS-Procurement@state.gov. It is important to make sure the submission is made in specific size and format; in MS-Word 2007/2010 or MS-

Excel 2007/2010 or Adobe Acrobat (pdf) file format. The file size must not exceed 30MB. If the file size should exceed the 30MB, the submission must be made in separate files and attached to separate emails with less than 30MB each.

In order for a quotation to be considered, you must also complete and submit the following:

1. SF-33

2. Section B, Pricing Schedule.

3. Section B, Retention Amounts in B.3 and B.7.

4. Section K, Representations and Certifications; and

5. Additional information as required in Section L.

6. Proof of SAM Registration mailto:BNS-Procurement@state.gov

Offerors shall be registered in the SAM (System for Award Management) database at https://www.sam.gov prior to submittal of their offer/proposal as prescribed under FAR 4.1102.

Failure to be registered at time of proposal submission may deem the offeror’s proposal to be considered non-responsible and no further consideration will be given. Therefore, offerors are highly encouraged to register immediately if they are interested in submitting a response to this requirement.

Sincerely, Timothy Dougherty

Contracting Officer

Enclosure:

RFP 19AR2024R0001

https://www.sam.gov/

SOLICITATION, OFFER AND

AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE OF PAGES

1 | 78

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

19AR2024R0001

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

12/29/2023

6. REQUISITION/PURCHASE NO.

7. ISSUED BY

CODE

19AR20 8. ADDRESS OFFER TO (If other than item 7)

American Embassy Buenos Aires

Av. Colombia 4300, C1425GMN, Ciudad de Buenos Aires, Argentina

Phone: 54 11 5777-4351 Fax: n/a

NOTE: In sealed bid solicitation "offer" and "offeror” mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original and 0 copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in until 12:00 local time February 15, 2024 .

(hour) (date)

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1. All offers are subject to all tems and conditions contained in this solicitation.

10. FOR

INFORMATION

CALL:

A. NAME

Cristian Minotti

B. TELEPHONE (NO COLLECT

CALLS)

AREA CODE NUMBER EXT

54 11 5777-4351 -

C. E-MAIL ADDRESS

BNS-Procurement@state.gov

11. TABLE OF CONTENTS

(x) SEC. DESCRIPTION PAGE(S) (x) SEC. DESCRIPTION PAGE(S

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

X A SOLICITATION/CONTRACT FORM 1 X I CONTRACT CLAUSES 26

X B SUPPLIES OR SERVICE AND PRICES/COSTS 2 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK STATEMENT 6 X J LIST OF ATTACHMENTS 46

X D PACKAGING AND MARKETING 16 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 17 X K REPRESENTATIONS, CERTIFICATIONS, AND 49

X F DELIVERIES OR PERFORMANCE 19 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 21 X L INSTRS., COND., AND NOTICES TO OFFERORS 69

X H SPECIAL CONTRACT REQUIREMENTS 23 X M EVALUATION FACTORS FOR AWARD 76

OFFER (Must be fully completed by offeror) NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (120 calendar days unless a different period is inseted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT SEE

(See section I, Clause No 52.232-8)

10 CALENDAR

DAYS

20 CALENDAR

DAYS

30 CALENDAR

DAYS

CALENDAR DAYS

14. ACKNOWLEDGMENT OF

AMENDMENTS

AMENDMENT NO. DATE AMENDMENT NO. DATE

(The offeror acknowledges receipt of amendments to the solicitation and related documents ) numbered and dated:

15A. NAME CODE FACILITY 16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE

ADDRESS [ ] IS DIFFERENT FROM

ABOVE - ENTER SUCH ADDRESS

17. SIGNATURE 18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN

COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS SHOWN

IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7)

CODE

25. PAYMENT WILL BE MADE BY

CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

NSN 7540-01-152-8064 STANDARD FORM 33 (REV 9-97)

PREVIOUS EDITION NOT USABLE Prescribed by GSA

SECTION B - PRICES

B.1. HEALTH INSURANCE SERVICES

The Contractor shall provide the Health Insurance services to employees of the Government of the United States of America in Buenos Aires, Argentina and their eligible dependents as described in Section C. This insurance shall be provided in accordance with Section C.

B.1.1. Official Residence Expense (ORE) Staff are included under this contract only as a rider;

the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff) at the rates specified below. Retirees are included under this contract only as riders; the Contractor shall bill the individual covered at the rates specified below. See Section G for billing procedures. Note that USG is not responsible, nor liable, for any riders.

B.2. PRICES

B.2.1 Value Added Tax

The Contractor shall include VAT as a separate charge on the Invoice and as a separate line item in Section B.

B.2.2 This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The fixed prices/premium rates for the health insurance services as specified in Section C are as follows:

B.2.3 Base Year of Contract

Bi-Weekly Rates Per Premium

Category

Estimated

Number of

Premiums*

Rate per

Premium

VAT

(10.5%)

Extended Bi-

Weekly Total (VAT included)

a. Employee 250

b. Family Members 270

c. Subtotal (a + b)

Total Price for Base Year (d x 26)**

*estimated number of premiums does not include any Riders (B.1.1)

**does not include any premiums for Riders.

JAMES ZADROGA 9/11 VICTIMS HEALTH AND COMPENSATION ACT OF 2010

NOTICE: UNLESS A WAIVER OR EXCEPTION APPLIES, PAYMENTS

SUBSEQUENT TO THIS PROCUREMENT ARE SUBJECT TO AN EXCISE TAX OF

2% PERSUANT TO 26 U.S.C. 5000C.

B.2.4 First Option Year of Contract

Number of

Premiums*

Rate per

Premium

VAT

(10.5%)

Extended Bi-

Weekly Total (VAT included)

a. Employee 250

b. Family Members 270

c. Subtotal (a + b)

Total Price for Base Year (d x 26)**

B.2.5 Second Option Year of Contract

Number of

Premiums*

Rate per

Premium

VAT

(10.5%)

Extended Bi-

Weekly Total (VAT included)

a. Employee 250

b. Family Members 270

c. Subtotal (a + b)

Total Price for Base Year (d x 26)**

B.2.6. Grand Total of Base plus All Option Years

Base Year Total

First Option Year Total

Second Option Year Total

Grand Total of Base plus All Option Years

MINIMUM AND MAXIMUM AMOUNTS

During the Base Year of the contract, and during the option year that might be exercised, the

United States Government (USG) shall place orders totaling a minimum of USD 180,000.00.

This reflects the contract minimum guarantee for each period of performance. The amount of all orders, for base and all option years shall not exceed USD 7,500,000.00. This reflects the contract maximum.

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 below, the Contractor shall present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium 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 health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount shall be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall not be expressed in terms of a percentage of the premium.

B.3.2 Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan.

Period of Performance Employee Family Members

Base Period

First Option Year

Second Option Year

B.4. ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS

B.4.1. Premium Adjustment Based on Experience - For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract, and it specifically excludes all riders in B.1.1. No adjustment will be allowed during the first twelve months. After such time, the Contractor or the Government may request an adjustment in premiums on an annual basis. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the Contractor agrees to provide the Government a balance sheet showing three main components for the time period: (1) receipts (premiums received) minus the retention amount, (2) number of insurance plans and (3) claims paid. This information shall be provided per type of premium, i.e., per line item. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet and claims and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Mutually agreed to adjustments shall be effective thirty days after complete information is received by the Government. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.4.2. Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the Contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the

Contractor to modify the contract to adjust the premium rate. The Contractor agrees to provide all documentation necessary to support any requested adjustment.

B.4.2.1 Employee Pool – This clause is only in effect if the Contractor included details in its offer regarding a pooling arrangement, of which this contract is a part.

Before any adjustment is made under this price adjustment clause, the Contractor shall include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

C.1. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as described herein. The Government has determined that the prevailing practice by employers in Argentina is to provide for their employees’ health insurance protection and that the cost of such insurance protection is usually borne by both the employee and the employer as follows:

As required by local law, GTM/OE will authorize continuation of the existing employee and employer premium split for the new solicitation this year, further solicitations will be reviewed at that time. The percentage for each employee's contribution will vary according to the amount deducted from the employee, as required by local law. For active employees, the employee would pay 3% of their remuneration (basic salary plus allowances that are regularly paid each pay period) towards the premium costs for employee and dependent coverage. The employer (U.S.

government) is responsible for paying the remainder of the premium cost for employee and dependent coverage. For parents, grandparents, parents-in-law, grandchildren, and adult children under legal guardianship of the employee, considered optional extended family care as determined by the Argentine Government’s Justice of Peace, if the employee opts to include coverage for extended family members, the employee’s contribution is 1.5% of the total salary for each extended family member falling under this category of coverage.

The Department authorizes post to include the below outlined minimum benefit levels and terms in its request for competitive proposals from local insurance carriers on a new Medical Plan for

Locally Employed Staff (LE Staff). The approved benefit levels and terms to be included in the solicitation are as outlined below. This is a supplemental medical benefit plan, meant to supplement those benefits and services available to local staff through the local social security system or available government health facilities and services. As such, although included in the request for proposal (RFP), when preparing their bids and making a competitive proposal, local vendors should take into consideration those benefits that are provided by local government entities.

The benefit levels set forth in the authorization cable are the minimum benefit levels acceptable for post’s health insurance contract. Post may accept offers of higher benefit levels as long as post complies with the applicable acquisition regulations. The GMC methodology encourages post to consider off-the-shelf insurance products which meet or exceed the minimum levels. Deviations are subject to review and approval by GTM/OE.

Local law mandates coverage levels for each benefit offered by post to LE Staff. As required by local law, GTM/OE will authorize continuation of the existing employee and employer premium split for the new solicitation this year, further solicitations will be reviewed at that time.

The percentage for each employee's contribution will vary according to the amount deducted from the employee, as required by local law. For active employees, the employee would pay 3% of their remuneration (basic salary plus allowances that are regularly paid each pay period) towards the premium costs for employee and dependent coverage. The employer (U.S. government) is responsible for paying the remainder of the premium cost for employee and dependent coverage.

For parents, grandparents, parents-in-law, grandchildren, and adult children under legal guardianship of the employee, considered optional extended family care as determined by the

Argentine Government’s Justice of Peace, if the employee opts to include coverage for extended family members, the employee’s contribution is 1.5% of the total salary for each extended family member falling under this category of coverage.

Following are the approved benefit levels and terms to be included in the solicitation. Mission

Argentina is authorized an exception to the Department mandated GMC minimum benefit levels for solicitation due to unique conditions in-country based on local law, Ref A. This authorization is an exception and will not be used to maintain any approved benefit levels for future solicitations.

C.1.1 Employee and Dependent Health Service Mandatory/Required Benefits

C.1.1.1 Hospitalization (Treatment in the Hospital for Inpatient Care):

Minimum Coverage - 100%

Services and supplies provided during hospitalization, including services provided by a licensed healthcare provider, bed & board (semi-private accommodations), 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. When private accommodations are provided, coverage will be limited to the cost of a semi-private room unless otherwise covered in an off the shelf plan. See Mental Health and Substance Abuse care (C.1.1.13) for details concerning inpatient psychiatric care.

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

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

C.1.1.2 Emergency Services (Trips to Emergency Room): Minimum Coverage - 100%

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

C1.1.3 Ambulance: Minimum Coverage - 100%

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.

C.1.1.4 Outpatient Services: Minimum Coverage - 100% Coverage. It would also include

90% Coverage of the cost of immunizations

Services provided by a certified healthcare provider on an ambulatory or outpatient basis (without being admitted to a hospital), including doctor’s and surgeon’s fees, laboratory tests, 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

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.

C.1.1.5 Obstetric and Newborn Care: Minimum Coverage – Inpatient and

Outpatient/Emergency: 100%

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 covered as Hospitalization (treatment in the hospital for inpatient care). Labor and delivery include routine delivery, C-section delivery, miscarriage. All other prenatal and postnatal care and treatments will be considered Outpatient Services.

C.1.1.6 Pediatric Services: Minimum Coverage – Inpatient and Outpatient/Emergency:

100%

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.

C.1.1.7 Prescription Drugs: Minimum Coverage -Inpatient/Emergency: 100%, Outpatient: 80%

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.

C.1.1.8 Preventive and Wellness Services and Chronic Disease Management:

Minimum Coverage - 100%

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.

C.1.1.9 Hearing Aids: Minimum Coverage – 80%

Examinations and Treatment: 80% Minimum Coverage

Hearing Aid Apparatus: Limited to one apparatus per ear up to a maximum of USD 1,500 per covered individual per three-year period. 80% Minimum Coverage: with annual cap.

C.1.1.10 Optical Care: Minimum Coverage – 100%

Examinations and Treatment: 100% Coverage as required under local law.

Prescription lenses and frames or contact lenses: For adults, the maximum coverage is USD 300 per covered individual every two years. 100% Coverage; with applicable annual cap.

C.1.1.11 Dental Care: Minimum Coverage – 100%

For employees and adult dependents: As required by local law, 100% reimbursement for preventative care, minor restorations, and major restorations. 100% reimbursement for prosthesis.

90% for orthodontics.

For minors: As required by local law, 100% reimbursement for preventative care, minor restorations, and major restorations, for prosthesis, and for orthodontics.

C.1.1.12 Reproductive Health: Minimum Coverage - 100% as required by local law and the Mandatory Medical Program

Family Planning services, prescribed contraceptive devices and drugs, preventive care and routine examinations, voluntary sterilization, and diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments and prescription drugs, and voluntary reversal of sterilization.

C.1.1.13 Mental Health and Substance Abuse Care: Minimum Coverage - 100%

Inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. This includes 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.

C.1.1.14 Rehabilitative and Habilitative Services and Devices:

Minimum Coverage - As required by local law, 100% Coverage of services and devices; 100% for up to 20 sessions per year with out-of-network providers

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.

C.1.1.15 HIV/AIDS: 100% up to USD 10,000 per contract year per covered individual

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. Generally, excludes medication for the long-term suppression of HIV/AIDS through the combination of anti-retroviral drugs in locations with inadequate local healthcare infrastructures.

Note to Contracting Officer: Post should consider electing this option if HIV/AIDS treatment is not covered as prevailing practice by local medical insurance providers or is prohibitively expensive.

C.1.1.16 Cancer Treatment: Minimum Coverage – 100%

Per local law, 100% Coverage of cancer treatments.

C.1.1.17 Gender Affirmation: Minimum Coverage – 100%

Per local law, 100% Coverage of gender affirmation services.

C.1.1.18 Out-of-Country Medical Treatment

Medical expenses incurred out-of-country will be covered for employees and dependents, when an illness or injury occurs and treatment is medically necessary before the individual returns home, or when the individual’s attending physician certifies in advance that such treatment is medically necessary and unavailable locally. Reimbursement will be made at the same percentage rate and subject to the same total annual maximum limit as for medical expenses incurred in country.

C.1.1.19 Out-of-Country Medical Travel

Transportation for out-of-country medical treatment will be a covered expense for LE Staff 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. 80% 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. 80% 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 minor patient, 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.

C.1.1.20 Coverage for Dependents After Employee’s Death – Dependent Extended

Coverage Minimum: 180 days

At the time of a covered employee’s death, their eligible dependents covered under post’s medical plan are eligible to continue receiving the same level of medical coverage. This optional benefit is subject to availability of funds at post and no extensions are permitted beyond the final contract period of extended coverage.

C.1.2 Annual Maximum Limit - The maximum annual reimbursement per covered individual per contract year, not including expenses defined under Exclusions and Limitations (C.1.3), or those covered under C.1.1.15, HIV/AIDS, is equivalent to USD 250,000.00.

C.1.3 Exclusions and Limitations

There is no coverage for elective cosmetic surgery; spa cures; rejuvenation cures; massage;

exercise therapy; long-term rehabilitative therapy; non-medical hospital charges (e.g., telephone, television, etc.); home help, family help, or similar household assistance; fees of persons who are not certified health care providers; advanced reproductive technology (e.g., in-vitro fertilization, intra-cellular sperm injection, artificial insemination, microsurgical epididymal sperm aspiration, testicular sperm extraction, cryopreservation, etc.); or services or supplies which have not been prescribed or approved by a certified health care provider. 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.

There is no coverage for expenses that will be reimbursed or paid directly under a host country medical program or workers' compensation program, the U.S. workers’ compensation program, or post’s LE Staff workers’ compensation program.

C.1.4 ELIGIBLE PARTICIPANTS

C.1.4.1 Identification of Eligible Employees and Dependents: U.S. Mission Buenos Aires will provide a list of all eligible employees and dependents with relationship to employee

(self/spouse/child) and DOB for each. Updates will be provided to add or remove individuals on a bi-weekly/monthly basis.

To be eligible to participate in the medical plan, LE Staff must be:

- Paid under the terms of the Local Compensation Plan (LCP); and –

- Under a non-temporary direct hire appointment, personal services agreement (PSA), or personal services contract (PSC); or

- Under a temporary direct hire appointment or PSA Fixed Term of one year or more.

Not eligible are non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Argentina who provides services to other local organizations as well as to the U.S. Mission; employees of USAID institutional contractors; Peace

Corps personal services contractors as indicated in MS 743; and Recreation Association employees.

Official Residence Expense (ORE) and Employee Association (EA) employees may be covered under a rider to the contract. The employing officer/EA, not the U.S. Government, is responsible for the employer's share of the premium costs for an ORE employee.

Retiree Coverage: Current employees and retirees are grandfathered and eligible to continue coverage after retirement under a rider. Employees hired after the effective date of the new contract will not be eligible for continued coverage after retirement. All health benefits and limitations outlined apply to the retired employee and covered dependents. The retired employee will be responsible for paying 100% of the premium costs for the coverage of themselves and their dependents.

C.1.4.1.1 Definition of Dependents

LE Staff who are eligible to participate in the medical plan automatically confer coverage to eligible family members who meet the following criteria:

C1.4.1.1.1 Legal Spouse: one legal spouse as defined by local law may be covered. LE Staff with more than one legal spouse must select only one spouse for coverage.

In cases where LE Staff and their legal spouse both work for the mission and both are eligible to participate in the medical plan, both LE Staff and legal spouse will be eligible to participate in the plan separately and health insurance premiums will be deducted from each employee’s salary as required by local law based on the coverage plan selected.

Dependent children: a child is defined as the LE Staff’s natural, adopted, stepchild, or foster child.

The child must be unmarried and financially dependent upon the LE Staff. As required by local law, an eligible child will be covered until the end of the calendar year in which the child turns age

21, or in the case of a child who is studying and provides the appropriate certification, until the end of the calendar year in which the child turns age 25. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the LE Staff maintains coverage.

C.1.4.1.1.2 Minors: a minor is defined as a person under 18 years of age.

C.1.4.1.1.3 Extended Family: Employees may elect to include the following extended family members under the employee’s coverage to the extent that such coverage is not mandated by the

Health Providers law. The extended family member must live with the employee to be eligible for coverage. An additional premium will be paid by the employee for each covered individual without charge to the U.S. Government.

a. Parents of the covered employee, who are not economically dependent.

b. Dependent children under legal guardianship of the covered employee as determined by the

Argentine Government’s Justice of Peace, over twenty-five (25) years old, single or married. No coverage for the child dependents spouse or adult children.

c. Parents-in-law of the covered employee.

d. Grandchildren of the beneficiary employee only, single and/or married.

e. Grandparents of the beneficiary employee only, single and/or married.

C.1.4.2 Location of Employment: The eligible employees covered by C.1.4.1 must be employed within the geographic boundaries of Argentina by the U.S. Government and its agencies.

C.1.4.3 Participants Covered Under a Rider

a. All current active ORE Staff personally employed by the Chief of Mission and the

Deputy Chief of Mission and assigned to their respective official Government residences and paid under an ORE account. All costs for coverage of ORE Staff are the responsibility of the

Chief of Mission and the Deputy Chief of Mission, not the U.S. Government.

b. All current active employees of the Employee Association at Embassy Buenos Aires. All costs for coverage of EAEs are the responsibility of the Employee Association, not the U.S.

Government.

Retiree Coverage: Current employees and retirees are grandfathered and eligible to continue coverage after retirement under a rider. Employees hired after the effective date of the new contract will not be eligible for continued coverage after retirement. All health benefits and limitations outlined apply to the retired employee and covered dependents. The retired employee will be responsible for paying 100% of the premium costs for the coverage of themselves and their dependents.

C.1.4.4 Individuals Not Eligible for Coverage

Not eligible are non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Argentina who provides services to other local organizations as well as to the U.S. Mission; employees of USAID institutional contractors; Peace

Corps personal services contractors as indicated in MS 743; and Recreation Association employees.

C.1.5 ELIGIBILITY

C.1.5.1 Term of Eligibility and Effective Date

Each current active eligible employee and their eligible dependents are enrolled for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee and eligible dependents will be enrolled upon entering on duty with the United States Government. An employee is considered active ("on the rolls") whenever such employee is on approved leave, whether paid or unpaid.

C.1.5.2. Period of Ineligibility

Employees and their dependents are not entitled to health benefits during any period of employment for which premiums are not paid.

Additionally, employee's dependents are not entitled to health benefits during any period of employment during which the employee was not eligible to participate.

During a period of extended Leave Without Pay (LWOP) or unpaid leave beyond one pay period, the employee is responsible for the full cost of the insurance premiums for self and dependents.

The Mission will pay the premiums directly to the Contractor, and will collect the full cost from the employee on a quarterly basis. Alternatively, the employee may elect to have coverage cease if that employee prefers not to pay the premium.

C.1.6 Brochure Requirement

C.1.6.1 The Contractor shall provide a document (brochure/pamphlet/other written document) in Spanish that sets forth a complete listing of the health insurance benefits to be provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.1.6.2 The Contractor shall provide the document described in C.1.6.1 to the COR not later than 30 after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) business days of the COR’s request.

C.1.6.3 The Contractor assumes full responsibility for ensuring that the document described in C.1.6.1 accurately reflects the requirements, coverage, and contract terms of the contract, as implemented by the Contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the document contains inaccuracies, the

Contractor will be notified in writing; however, failure on the part of the U.S. Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the Contractor to fully comply with all contract terms.

Child Child is defined as the employee's natural child, adopted child, stepchild, or foster child. An eligible child will be covered until the end of the calendar year in which the child turns age 21, or in the case of a child who is a full-time student, until the child turns 26 as required by law. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently. There is no limit on the number of children covered per employee.

Contributory Insurance Insurance for which the employee contributes toward the premium.

COR Contracting Officer's Representative (COR) is the Human Resources Officer

(HRO) at post, or its designee.

Customary and Reasonable Treatment A diagnostic test or medical treatment which is usually performed in the community where the individual is being treated.

Dependent Dependents are defined as the employee's legal spouse (limit one), including common law spouse, and each unmarried 100% legally dependent child.

Parents, grandparents, parents-in-law, grandchildren, and adult children are covered under this plan only if they are under the legal guardianship of the employee as determined by the Justice of the Peace. A legal ruling from the court is required in order to be eligible for coverage.

Employee An individual employed by the U.S. Government, under a direct-hire appointment, personal services contract (PSC), or personal services agreement (PSA), as further defined in Section C.1.3 for health insurance.

This may also include ORE Staff, if this category of individual is listed as participating under a rider in C.1.3.3 for health insurance.

Employer Employer: The United States Government and, in case of ORE Staff, the

Chief of Mission and Deputy Chief of Mission.

FMO The Financial Management Officer (FMO) or the paying office for all U.S.

Government Agencies, except U.S. AID.

GSO General Services Officer in charge of the General Services Office at post.

This officer is usually the Contracting Officer (CO) for this contract.

Hospital An institution established and operated for the care and treatment of sick and injured persons. It provides 24-hour nursing care and has diagnostic, laboratory, treatment, and surgical facilities. Any institution which does not meet this definition is not considered a hospital.

Hospital Patient An individual who has been admitted to a hospital, is assigned a bed, and is given diagnostic tests or receives treatment for a disease or an injury.

Maximum Benefit The total amount that will be paid to any one covered individual for covered medical expenses or life insurance/disability benefit.

Physician An individual who has graduated from an accredited medical school and is licensed to practice medicine in the jurisdiction in which the contract is to be performed. If the individual is a medical specialist, then he or she is Board

Certified in that specialty

Retiree Employees who were covered under the medical insurance plan at the time of retirement.

C.1.7 DEFINITIONS

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. In addition, the full text of a clause may be accessed electronically at: Acquisition.gov this address is subject to change.

If the Federal Acquisition Regulation (FAR) is not available at the location indicated above, use the Department of State Acquisition website at e-CFR to see the links to the FAR. You may also use an Internet “search engine” (for example, Google, Yahoo or Excite) to obtain the latest location of the most current FAR.

THE FOLLOWING FEDERAL ACQUISITION REGULATION CLAUSE(S) IS/ARE

INCORPORATED BY REFERENCE:

CLAUSE TITLE AND DATE

52.246-4 INSPECTION OF SERVICES - FIXED PRICE (AUG 1996)

E.2. QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan is designed to provide an effective surveillance method to promote effective Contractor performance. The QASP provides a method for the Contracting Officer's Representative (COR) to monitor Contractor performance, advise the Contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance. The Contractor, not the

Government, is responsible for management and quality control to meet the terms of the contract.

The role of the Government is to conduct quality assurance to ensure that contract standards are achieved.

Performance Objective

PWS

Paragraph Performance Threshold

Services

Performs all the insurance services set forth in the Performance Work Statement (PWS)

C.1.0 thru

C.1.6

All required services are performed and no more than eight (8) customer complaint is received per month.

E.2.1 Surveillance. The COR will receive and document all complaints from Government personnel regarding the services provided. If appropriate, the COR will send the complaints to the Contractor for corrective action.

E.2.2 Standard. The performance standard is that the Government receives no more than eight

(8) customer complaint per month. The COR shall notify the Contracting Officer of the https://acquisition.gov/browse/index/far https://gov.ecfr.io/cgi-bin/text-idx?SID=d9a7851186785ba2b1896db79b1b6b29&mc=true&tpl=/ecfrbrowse/Title48/48tab_02.tpl complaints so that the Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.246-4, Inspection of Services – Fixed Price (AUG 1996) or the appropriate

Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

(a) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed, they should immediately contact the COR.

(b) The COR will complete appropriate documentation to record the complaint.

(c) If the COR determines the complaint is invalid, the COR will advise the complainant. The COR will retain the annotated copy of the written complaint for his/her files.

(d) If the COR determines the complaint is valid, the COR will inform the Contractor and give the Contractor additional time to correct the defect, if additional time is available. The

COR shall determine how much time is reasonable.

(e) The COR shall, as a minimum, orally notify the Contractor of any valid complaints.

(f) If the Contractor disagrees with the complaint and challenges the validity of the complaint, the Contractor will notify the COR. The COR will review the matter to determine the validity of the complaint.

(g) The COR will consider complaints as resolved unless notified otherwise by the complaint.

(h) Repeat customer complaints are not permitted for any services. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

SECTION F

DELIVERIES OR PERFORMANCE

F.1. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

THE FOLLOWING FEDERAL ACQUISITION REGULATION CLAUSES ARE

52.242-15 STOP WORK ORDER (AUG 1989)

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is one year beginning on April 1, 2024, with two one-year options to renew.

F.3 OPTIONS

(a) The Government may extend this contract in accordance with the option clause at

Section I, clause I.2, FAR Clauses Incorporated by Full Text (FAR 52.217-9, Option to Extend the Term of the Contract), which also specifies the total potential duration of the contract.

(b) The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services".

F.4 REPORTS AND OTHER DELIVERABLES

All reports and other deliverables required under this contract shall be delivered to the following address:

Human Resources Office

Av. Colombia 4300, C1425GMN https://gov.ecfr.io/cgi-bin/text-idx?SID=d9a7851186785ba2b1896db79b1b6b29&mc=true&tpl=/ecfrbrowse/Title48/48tab_02.tpl

Buenos Aires

Argentina

SECTION G

CONTRACT ADMINISTRATION DATA

G.1. 652.242-70 CONTRACTING OFFICER’S REPRESENTATIVE (COR) (AUG 1999)

(a) The Contracting Officer may designate in writing one Government employee, by name or position title, to take action for the Contracting Officer under this contract. This designee shall be identified as a Contracting Officer’s Representative (COR). Such designation shall specify the scope and limitations of the authority so delegated; provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted Contracting Officer and this authority is delegated in the designation.

(b) The COR for this contract is the Human Resources Assistant.

G.2 COR DUTIES

G.2.1 The COR is responsible for inspection and acceptance of services. These duties include review of Contractor invoices, including the supporting documentation required by the contract.

The COR may provide technical advice, substantive guidance, inspections, invoice approval, and other purposes as deemed necessary under the contract.

G.2.2 In addition, the COR shall maintain updated list of employees and dependents insured, which will supersede the initial list provided under this contract and as reported to the insurer, without prejudice to the ineligibility clause.

G.2.3. The COR has the additional responsibility of maintaining the eligible listing of employees and dependents for insurance coverage.

G.2.4 The COR may not change the terms and conditions of the contract. While the COR is authorized to provide the Contractor with updated listings of eligible employees and dependents, only the Contracting Officer may modify existing task orders or issue new task orders, reflecting these changes, since only the Contracting Officer can obligate funding and commit the

Government.

G.3. Payment shall be made in local currency (Argentine Pesos) at the U.S. Government’s official Rate of Exchange in effect the day an invoice is processed for payment either by the

Comptroller and Global Financial Services Center located in Charleston, U.S.A., or by the

Embassy Financial Management Office.

G.4 SUBMISSION OF INVOICES AND PAYMENT

G.4.1. Invoices for U.S. Government employees shall be submitted in an original and three (3) copies to the following address (designated billing office only for the purpose of submitting invoices):

BNS-Vouchering@state.gov

Attn.: Financial Management Office – Vouchering Unit

Av. Colombia 4300, C1425GMN

Buenos Aires, Argentina

G.4.2. Frequency of Payments. All funds under this contract will be obligated by issuance of task orders, as described in H.3 for all non-rider coverage. Each task order will fund a specific period of time and number of employees, and the task orders will be issued at the frequency described in H.3. Contractor may submit invoices monthly for payment to be made at the beginning of the month for which insurance coverage is provided in accordance with FAR

32.404.

G.4.3. U.S. Government Employees. The Government shall make payments directly to the

Contractor for all Government employees, whether or not the employee is contributing to the basic premium amount.

G.4.4 Riders:

a. ORE. The Chief of Mission and/or Deputy Chief of Mission will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount.

b. EAE Staff. The Employee Association will make payment directly to the Contractor for the entire premium amount of the EA employee, whether or not the EA employee is contributing to the premium amount.

c. Retirees. The retiree will make payment directly to the Contractor for the entire premium amount.

G.5 REFUNDS TO THE GOVERNMENT

If at any time during performance of the contract the Government finds that the Contractor has been overpaid because the number of employees and/or dependents covered has decreased, the

Contracting Officer may either allow that overpayment to be credited to the Government’s account or require that the Contractor refund the overpayment. If the Contracting Officer requests a refund, the Contractor shall make that refund to the Government within ten calendar days of receipt of the request.

G.6 VALUE ADDED TAX

VALUE ADDED TAX (VAT). The Contractor shall include VAT as a separate charge on the

Invoice and as a separate line item in Section B.

mailto:BNS-Vouchering@state.gov

SECTION H

SPECIAL CONTRACT REQUIREMENTS

H.1 SECURITY. On occasion, a Contractor employee may require entry into U.S.

Government-owned or -operated facilities. If so, the Contractor should be prepared to provide the necessary identification to permit escorted access within that facility.

H.2 STANDARDS OF CONDUCT. The Contractor shall maintain satisfactory standards of employee competency, conduct, cleanliness, appearance, and integrity and shall be responsible for taking such disciplinary action with respect to employees as may be necessary. Each

Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

H.3 ORDERING PROCEDURES. The Government will issue a task order as soon as possible after contract award to identify all employees to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered.

The COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor.