AM 003 life.docx

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

PAGE OF PAGES

1 10

2. AMENDMENT/MODIFICATION NO.

Ammendment A 003

3. EFFECTIVE DATE

05/08/2012

4. REQUISITION/PURCHASE REQ. NO.

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE

7. ADMINISTERED BY (If other than Item 6) CODE

Department of State American Embassy La Paz – GSO

Av. Arce # 2780 – La Paz, Bolivia

8. NAME AND ADDRESS OF CONTRACTOR (NO., street,city,county,State,and ZIP Code)

9a. AMENDMENT OF SOLICITATION NO.

SBL400-12-R-0150

X

9b. DATED (SEE ITEM 11) 02/29/2012

10a. MODIFICATION OF CONTRACT/ORDER NO.

10b. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

[X] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers [ ] is extended, [X ] is not extended Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing Items 8 and 15, and returning _______ copies of the amendment;(b) By acknowledging receipt of this amendment on each copy of the offer submitted; or(c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers.

FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor [ ] is not, [ ] is required to sign this document and return ___ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of this amendment is to include life insurance coverage for Embassy employees as per attached levels and information reflected in additional paragraphs of Part B (Pricing) and Part C (Work Statement).

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

16A. NAME OF CONTRACTING OFFICER

Andrew F. Longworth

15B. NAME OF CONTRACTOR/OFFEROR

GROUP LIFE INSURANCE

B.5. GROUP LIFE INSURANCE SERVICES

The Contractor shall provide the Group Life Insurance services described herein to employees of the Government of the United States of America in Bolivia. The groups of employees who shall be provided this insurance are listed in C.2.3. This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.5.1. Official Residence Expense (ORE) Staff and Peace Corp Personal Service Contracts (PSC) 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. See Section G for billing procedures.

B.6. GROUP LIFE INSURANCE RATES

This is a fixed-price with economic-price- adjustment-requirements type contract under which the Government will issue firm-fixed price task orders. The fixed prices/premium annual rates in US Dollars to provide life insurance, accidental death and dismemberment and partial and total disability coverage are as follows:

B.6.1. BASE YEAR OF CONTRACT

Annual Rates per Employee:

Basic Life

Accidental Death and Dismemberment

Partial and Total Disability Coverage

Total Price for Base Year: __________________

B.6.2. FIRST OPTION YEAR OF CONTRACT:

Annual Rates per Employee:

Basic Life

Accidental Death and Dismemberment

Partial and Total Disability Coverage

Total Price for Option Year 1: ________________

B.6.3. SECOND OPTION YEAR OF CONTRACT:

Basic Life

Accidental Death and Dismemberment

Partial and Total Disability Coverage

Total Price for Option Year 2: _____________________

B.6.4. THIRD OPTION YEAR OF CONTRACT:

Annual Rates per Employee:

Basic Life

Accidental Death and Dismemberment

Partial and Total Disability Coverage

Total Price for Option Year 3: ________________

B.6.5. FOURTH OPTION YEAR OF CONTRACT:

Annual Rates per Employee:

Basic Life

Accidental Death and Dismemberment

Partial and Total Disability Coverage

Total Price for Option Year 4: _______________

GRAND TOTAL PRICE FOR ALL YEARS: __________________

B.7 ADMINISTRATIVE RETENTION AMOUNTS

B.7.1 If the Contractor requests a price adjustment under B.8 below, the Contractor must 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.6. 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 claimant.

B.7.2 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 retention amounts for each period of performance and for each category of premium. This fixed amount must 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.7.2 Retention Amounts per separate premium paid per employee

Base Period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

B.8 ECONOMIC PRICE ADJUSTMENT-LIFE INSURANCE PREMIUMS

B.8.1. Premium Adjustment Based on Experience - For life insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract. 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. Before any such adjustment is made, the contractor agrees to provide the Government a balance sheet showing two main components for the time period: (1) receipts (premiums received) minus the retention amount and (2) claims paid. The retention amount is not subject to adjustment. The Government reserves the right to select an independent third party to review the balance sheet 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. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.8.2. Premium Adjustment Based on Law - 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 rate contracted for herein. 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.

C.2.0 GROUP LIFE INSURANCE

The Government of the United States of America requires group life insurance coverage for its employees, as further described in C.2.2, throughout Bolivia. The Government has determined that the prevailing practice by employers in Bolivia is that group life insurance coverage is representative of locally prevailing compensation practice and that the cost of such insurance protection is usually borne by the employer.

Therefore, the Government desires to adopt such locally prevailing practice as part of its compensation plan for its employees as further described in C.2.2. The specific group insurance coverage under this contract is set forth in this part of Section C.

C.2.1. Group Life Insurance Coverage.

The amount of group life insurance coverage is as follows:

C.2.1.1 Amount of Employee Life Insurance.

The amount of life insurance coverage for each employee is as follows:

This category covers the death of the employee only, regardless of his/her residence, occupation, behavior, location, travel, place or cause of the death.

C.2.1.2 Amount of Accidental Death and Dismemberment Coverage.

The employee's estate or employee will receive an amount equal to US$ 9,000.00, in addition to the life insurance benefit in C.2.1.1, in the event the employee is killed in an accident.

C.2.1.3 Partial and Total Disability Coverage

Total or partial permanent amputation and/or disability – one hundred percent (100%) coverage in accordance with the following breakdown. This benefit may be improved by the Contractor but not reduced in the percentage coverage:

· Total loss of vision in both eyes, uncorrectable to better than 20/400 (0.05);

· Loss of any two or more extremities above the wrists or ankles;

· Mental disability, complete and permanent.

Amputation of an upper or lower limb and/or partial or permanent disability of a sight or auditive organ. Coverage shall be provided in accordance with the following percentage scale:

· In the event of the loss of many limbs, the percentages will be proportionately computed. The percentages shall not exceed the one hundred percent (100%) coverage.

· In the case of a left-handed person, the above-mentioned percentages will be reversed.

This category covers misfortunes caused to the employee by accidents, terrorist acts, or social unrest, such as: death, body injuries, amputations, total or partial permanent disability. In addition to the active employees, this category shall provide coverage to the annuitants and their children above age twenty-five (25), provided they have an independent coverage policy.

C.2.2 Life Insurance Benefits Conditions and Limitations.

Conditions and limitations on the entitlement to life insurance benefits under this contract are as follows:

· Regardless of age, the policy must cover all active employees on the rolls, and their eligible family members.

· Coverage shall be provided for personal accidents during official and/or personal trips taken abroad and in country, while using any means of transportation.

· Beneficiaries of the Personal Accident Coverage: Those expressly named by the employee or those inheritors designated by law.

C.2.3. Eligible Participants.

C.2.3.1 Eligible Employees. The employees eligible for the group life insurance coverage include the following:

C.2.3.1.1 All current active employees of the United States Government, employed within the geographic boundaries of Bolivia paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.2.3.1.2. Locally Employed Staff (LES) employed under non-temporary direct hire appointments, Personal Services Agreements (PSAs) and Personal Services Contracts (PSCs);

C.2.3.1.3. Locally hired U.S. citizens employed under direct hire appointments, PSAs, and PSCs.

C.2.3.2 Location of Employment

C.2.3.2 The individuals covered by C.2.3.1 must be employed within the geographic boundaries of Bolivia by:

· Department of State – DOS (ICASS, PROG, PAS, NAS and SY)

· Agency for International Development – AID

· Military Group – MILGP

· Peace Corp – PC

· Department of Defense / Defense Attaché Office – DOD/DAO

· Animal and Plant Health Inspection Service – APHIS

· United States Corp of Engineers – USCOE

C.2.3.3 Participants Covered Under a Rider

C.2.3.3.1 All current active employees of the Chief of Mission and the Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.2.3.3.2 Reserved.

C.2.4 Individuals Not Eligible for Coverage

C.2.4.1. Reserved.

C.2.4.2 Individuals not eligible for coverage under this contract are PSA limited contract personnel; employees working on a temporary basis less than 30 days; employees with an intermittent, seasonal, or WAE (when actually employed) schedule; and any other individual not falling within one of the categories of employees described in this clause.

C.2.5. Other Eligible Participants

Reserved.

C.2.6 Eligibility and Effective Date

C.2.6.1. Term of Eligibility and Effective Date

Each current active eligible employee is enrolled for life insurance and disability benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee 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.

During a period of Leave Without Pay or unpaid leave that is one pay period or less, coverage under the insurance contract will continue. The USG will pay the total premium cost to the contractor. The employee’s share of the premium will be collected through payroll deduction in that or the subsequent pay period.

C.2.6.2. Period of Ineligibility

Employees are not entitled to life insurance disability hereunder during any period of employment for which premiums are not paid.

During a period of extended (beyond one pay period) of Leave Without Pay or unpaid leave, the employee is responsible for the full cost of the insurance premiums. 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.2.7. Brochure Requirement

C.2.7.1. The contractor shall provide a document (brochure/pamphlet/other written document) in Spanish that sets forth a complete listing of the life 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.2.7.2. The document described in C.2.7.1 shall be provided to the COR not later than 60 days after date of contract award. The contractor shall provide additional brochures for new employees within ten days of the COR’s request.

C.2.7.3. The contractor assumes full responsibility for ensuring that the document described in C.2.7.1 accurately reflects the requirements 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 brochure contains inaccuracies, the contractor will be notified in writing; however, failure on the part of the 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.

C.2.8. Demographic Data

FORECAST DATA