Gaborone LES Health Insurance Solicitation Pre-Proposal Meeting Minutes.docx

U.S. EMBASSY GABORONE

LES Health Insurance Solicitation

Pre-Proposal Meeting

March 15, 2012

Purpose of the meeting – To allow contractors interested in submitting proposals for the U.S. Embassy Gaborone local employee health insurance contract to meet the U.S. Embassy staff involved in the process and ask any questions that they may have about the solicitation or to request clarification on specific points in the solicitation.

REPRESENTATIVES

· Pula Medical Aid

· Doctor’s Aid Medical Aid Scheme

· BOMAID

QUESTIONS AND COMMENTS FROM THE MEETING:

Q1. DUNS

· There is a section that talks about DUNS, do we need to register for DUNS?

ANSWER

· The service provider will not need to register for DUNS.

Q2. BENEFITS C1.1.2

· Since the last meeting, there has been an increase in medical costs and a change in the maximum reimbursements for doctors and medical aid schemes, how is this going to be handled?

· Some Doctors charge higher tariffs than are allowed in the medical aid schemes. Should reimbursements cover what the doctors charge or 100% of the scheme’s maximum tariff amount?

ANSWER Q2.

· The plan should reimburse only the maximum medical aid scheme charge for that service, not what the doctors charge.

Q3 C.1.2ANNUAL MAXIMUM LIMIT

· Regarding the annual maximum limit, do we use the doctor’s tariff or the scheme’s tariff?

ANSWER

· The scheme’s tariff.

Q4

· Annual maximum limit – is it for individual employee or family?

· It is the limit for employee and family together, refer to C.1.12.

COMMENT BY EMBASSY REP

· C.1.11 – This will be amended to strike “For Employees Only.” This medication will be available to dependents at the same level and limitations explained in C.1.1.11 and C.1.1.12. The amendment will be published in FedBizOps

Q5

· C.1.1.7 Optical care – Pula 7,550 refers to what?

ANSWER

· It would refer to any medication prescribed for optical care, not glasses.

Q6

· Are the lenses included as prescription?

ANSWER

· No, that is a separate line item in C.1.1.7.

Q7

· Why do you tend to have limits for benefits instead of having medical aids propose their limits to you?

ANSWER

· These are limits proposed by Washington based on prevailing circumstances in each post. We want a quality insurance program for our employees. Economic factors are also considered. A plan should not exceed the maximum benefits, but may go lower. The proposals will be judged not solely on price, but quality of the program. Excessively low reimbursements and a low cost would not be an advantage for a company.

Q8

· Botswana has pre-packaged medical benefits, do you want us to go and design something that will suit you?

· The program must fit our general outline and not exceed our maximum benefit levels. This is a relatively large program, so a company who wanted to be competitive would ensure that their proposal fits our general needs and requirements.

Q9

· Some of your limits don’t fit into our limits as medical aids, we have annual limits

· E.g. General hospitalization exceeds our package by P100.00

ANSWER

· P887,000 is our annual maximum limit. Some of your limits may be lower than ours, but in the end, the program should not pay out more than 887,000 Pula in a year.

Q10

· What if my package is P600, 000 i.e. what is your minimum limit?

· What if we propose less than the limit

ANSWER

· The benefit level proposed should not be above the annual maximum limit. We do not have authority to enter into a contract with a health insurance scheme that offers more that P887, 000

· C1.1. of the contract states that “proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than stated in the solicitation may be deemed technically unacceptable.” Take note of the word”may”, we look at the totality of your package both the quality of service and the price.

Q11

· What if you provide a benefit at P600,000 and less expensive than one with P700, 000 but has a benefit of 100% on optical care.

ANSWER

· The evaluation panel will consider the specific items as part of the total package

Q12

· Should contractors offer their pre-designed plans that currently exist or design a program exactly like what is described in the solicitation?

ANSWER

· Contractors may present either though they should keep in mind that the further a program deviates from the solicitation, the greater competitive disadvantage they may have.

Q13

· Why do you set specific limits on our ceiling?

ANSWER

· We want a program that is comparable to the health insurance programs and benefit levels that are offered for similar organizations and employers in Botswana.

Q14 PREMIUMS

· Medical aid has a specified social benefit where certain individuals who earn more will fall in a certain category and have a higher amount that they pay, then those who earn less would pay less contributions

ANSWER

· The price per employee quoted in your proposal and per dependent should be the same for all income levels. In other words, we should receive one number for employees and one number for dependents.

Q15

· Does that mean the gardeners would be paying as their higher-paid manager?

ANSWER

· Currently there is a different payment amount, but how the costs are apportioned within the employee pool is an internal Embassy matter. See Answer to question 15 for clarification.

Q16

· Will parents be considered as dependents?

ANSWER

· In the new amendment 31 parents who are currently covered will be available for coverage on the new plan. No additional parents of employees will be admitted into the new plan.

Q17

· Will there be an age distribution?

· After investigating this, we are not able to provide exactly the number and age of every person covered in this plan. Proposals should be based on Section J, exhibit A of the proposal which gives age ranges and the number of people in each sub-category. Additionally, an excel spreadsheet on our FedBizOps solicitation page gives updated information in for all the sub-categories

Q18

· What are the economic adjustments?

ANSWER

· This is discussed in B4 of the solicitation. Your proposal should present your prices for the first year and the subsequent 4 option year. If there are unforeseen circumstances that fundamentally alter these prices in the future, you have options to petition a price adjustment in the future.

Q19

· Is it possible to get salaries, date of birth and gender of the employees including their dependents, so that we can easily make the pricing of the premiums? Instead of giving confidential information, you can say i.e. employee A – J then age and gender of each.

· See answer to Q16b

NOTICE TO ALL PARTIES:

· Issues of medical expenses covered outside Botswana- On the original solicitation, this was not allowed. It is now, see C.1.2 of the latest amendment.

· The costs are reimbursed (per the same regulations covering reimbursement in Botswana) but not for transportation

Q20

· How does reimbursement currently work for treatment outside of Botswana?

ANSWER

· BOMAID has arrangements in South Africa. If you go to places where BOMAID is not known, you pay for yourself and claim from the medical aid, same for PULA.

· I.E. If you travel outside for personal reasons you pay your medical bill and claim from the medical aid

· PULA – Pre authorization by local doctors is not really to limit member choices but to ensure their hospitalization is taken care of.

Q21

· Some companies will have an option for employees to choose what medical aid they want, will you by any chance give your employees that choice and have two contracts for medical aids

· We are going to use only one contract, in the U.S. law it is impossible to have two contracts for one project.

Q22 – EMBASSY REP

· Can an employee decide to choose a higher scheme?

ANSWER

· Yes but the employee has to pay the difference between our base program and the cost of the higher scheme

END OF MEETING