RFP_No._SCA52514R0001.pdf

October 23, 2014

Dear Prospective Offeror:

SUBJECT: Request for Proposal Number SCA52514R0001

The Embassy of the United States of America invites you to submit a proposal for customized Health and Life Insurance for LES Employees for U.S. Embassy Canada.

A pre-proposal conference will be held on November 4, 2014, 1:30 P.M. at U.S. Embassy Ottawa, 490 Sussex Drive Ottawa, ON K1N 1G8, and all prospective offerors will be invited to attend. For additional information or arrange for access to the building please contact Alma Andico at 613-688-5310 or Janet Hart at 613-688-5246 on or before 12:00 noon on October 31, 2014 and provide the names of all individuals planning to attend the conference.

If you would like to submit a proposal, follow the instructions in Section L of the solicitation and complete the required portions of the attached document as follows:

1) Standard Form (SF) 33, Cover Sheet, page 1

2) Section B, Pricing Schedule and Retention Amounts, pages 2-19

3) Section K, Representations and Certifications, pages 55-63

4) Additional information required under Section L, pages 64-66

Proposals must be submitted in a sealed envelope marked "Proposal Enclosed – SCA52514R0001" on or before 4:00 P.M. EST on November 28, 2014. No proposal will be accepted after this time.

Proposals can be submitted via courier to:

U. S. Embassy-Canada 207 Bank St, Suite 418, Ottawa, ON, Canada K2P 2N2 to the attention of Mary Oliver, Contracting Officer

NO ELECTRONIC OFFERS OR PROPOSALS WILL BE ACCEPTED.

Please note: Proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than those stated in the solicitation may be deemed technically unacceptable.

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.

Questions regarding this solicitation should be submitted on or before October 29, 2014 to Mary Oliver and Alma Andico at the following email addresses OliverMX@state.gov and AndicoA@state.gov or by fax to 613-688-3091 Attention: Alma Andico.

The Embassy appreciates your interest in this solicitation.

Sincerely, /signed Mary Oliver Contracting Officer U.S. Embassy, Canada

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE OF PAGES

1 | 72

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

3. SOLICITATION NO.

SCA52514R0001

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

October 23, 2014

6. REQUISITION/PURCHASE NO.

PR3660201

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than item 7) U.S. Embassy 490 Sussex Drive, Ottawa, Ontario, K1N 1G8 Phone: 613-688-5335 Fax: 613-688-3091

Mary Oliver U.S. Embassy 207 Bank Street, Suite 418 Ottawa, Ontario, K2P 2N2

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

SOLICITATION

9. Sealed offers in original and 3 copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in Block 8 until November 28, 2014 local time 4:00 P.M.

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

Mary Oliver, Contracting Officer Alma Andico, Procurement Agent

B. TELEPHONE (NO COLLECT

CALLS)

613-688-5250 613-688-5310

C. E-MAIL ADDRESS

OliverMX@state.gov AndicoA@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 44-53

X B SUPPLIES OR SERVICE AND PRICES/COSTS 2-19 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK STATEMENT 20-33 X J LIST OF ATTACHMENTS 54

X D PACKAGING AND MARKETING 34 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 35-36 X K REPRESENTATIONS, CERTIFICATIONS, AND 55-63

X F DELIVERIES OR PERFORMANCE 37 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 38-39 X L INSTRS., COND., AND NOTICES TO OFFERORS 64-69

X H SPECIAL CONTRACT REQUIREMENTS 40-43 X M EVALUATION FACTORS FOR AWARD 70-72

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 inserted 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 14

(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

RFP No. SCA52514R0001 Health and Life Insurance Benefits for LES Employees of the United States Mission in Canada

SECTION B

PART I: PRICE – HEALTH AND DENTAL INSURANCE

PRICE – HEALTH INSURANCE

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 Canada as described in Section C and the Exhibits in Section J. The groups of employees who shall be provided this insurance are listed in C.1.5. This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

All employees who were hired before February 1, 2010 are eligible for early retiree health services only (exclusive of dental benefits) between the ages of 55 to 65 years. All other employees hired after February 1, 2010 are ineligible for early retiree benefits.

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, Deputy Chief of Mission and Consuls General (for ORE Staff) separately. See Exhibit C of Section J for details.

B.2 PRICES

B.2.1 VALUE ADDED TAX

The Contractor shall include VAT or applicable tax 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 and Exhibit A of Section J are as follows:

B.2.3. Base Year of Contract

B.2.3.1 Bi-Weekly Rates per Employee

Category

Estimated Number of Employees

Rate per

Employee

Total

a. Single Employees (Self only) 54

b. Family Plan 184

c. Subtotal (a+b) --

d. Tax (VAT) --

e. Total Price for Base Year (c + d x 26) --

B.2.3.2 Bi-Weekly Rates per Early Retiree

a. Single Employees (Self only) 7

b. Family Plan 13

B.2.3.3 Total Price for Base Year (B.2.3.1 + B.2.3.2) -- ________________

B.2.4. Option Year 1 of Contract

B.2.4.1 Bi-Weekly Rates per Employee

b. Family Plan 184

e. Total Price for Option Year 1 (c + d x 26) --

B.2.4.2 Bi-Weekly Rates per Early Retiree

b. Family Plan 13

B.2.4.3 Total Price for Option Year 1 (B.2.4.1 + B.2.4.2 ) -- ________________

B.2.5. Option Year 2 of Contract

B.2.5.1 Bi-Weekly Rates per Employee

b. Family Plan 184

e. Total Price for Option Year 2 (c + d x 26) --

B.2.5.2 Bi-Weekly Rates per Early Retiree

b. Family Plan 13

B.2.5.3 Total Price for Option Year 2 (B.2.5.1 + B.2.5.2) -- ________________

B.2.6. Option Year 3 of Contract

B.2.6.1 Bi-Weekly Rates per Employee

b. Family Plan 184

e. Total Price for Option Year 3 (c + d x 26) --

B.2.6.2 Bi-Weekly Rates per Early Retiree

b. Family Plan 13

B.2.6.3 Total Price for Option Year 3 (B.2.6.1 + B.2.6.2) -- ________________

B.2.7. Option Year 4 of Contract

B.2.7.1 Bi-Weekly Rates per Employee

b. Family Plan 184

e. Total Price for Option Year 4 (c + d x 26) --

B.2.7.2 Bi-Weekly Rates per Early Retiree

b. Family Plan 13

B.2.7.3 Total Price for Option Year 4 (B.2.7.1 + B.2.7.2) -- ________________

B.2.8 Grand Total of Base plus All Option Years – Health Insurance Services

Base Year Total -- Option Year 1 Total -- Option Year 2 Total -- Option Year 3 Total -- Option Year 4 Total --

Grand Total of Base plus All Option Years --

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 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.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 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.3.2.1 Health Insurance - Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan.

Period of Performance Employees Single Employees Family

Early Retirees Single

Early Retirees Family

Base Period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

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 two 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 must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

PRICE – DENTAL INSURANCE

B.5 DENTAL INSURANCE

The Contractor shall provide the Dental Insurance services to employees of the Government of the United States of America in Canada as described in Section C and the Exhibits in Section J. The groups of employees who shall be provided this insurance are listed in C.1.5. This insurance shall be provided in accordance with Section C and the Exhibits in Section J. Early Retirees are not eligible for dental insurance.

B.5.1 Official Residence Expense (ORE) staff are included under this contract only as a rider; the Contractor shall bill the Chief of Mission, Deputy Chief of Mission and Consuls General (for ORE Staff) separately. See Exhibit C of Section J for details.

B.6 PRICES

B.6.1 VALUE ADDED TAX

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

B.6.2 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 dental insurance services as specified in Section C and Exhibit A of Section J are as follows:

B.6.3. Base Year of Contract

B.6.3.1 Bi-Weekly Rates per Employee

b. Family Plan 184

B.6.4. Option Year 1 of Contract

B.6.4.1 Bi-Weekly Rates per Employee

b. Family Plan 184

B.6.5. Option Year 2 of Contract

B.6.5.1 Bi-Weekly Rates per Employee

b. Family Plan 184

B.6.6. Option Year 3 of Contract

B.2.6.1 Bi-Weekly Rates per Employee

b. Family Plan 184

B.6.7. Option Year 4 of Contract

B.6.7.1 Bi-Weekly Rates per Employee

b. Family Plan 184

B.6.8 Grand Total of Base plus All Option Years – Dental Insurance Services

Option Year 1 Total -- Option Year 2 Total -- Option Year 3 Total --

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 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 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.7.2.1 Dental Insurance - Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan.

Period of Performance Employees Single Employees Family

Early Retirees Single

Early Retirees Family

B.8. ECONOMIC PRICE ADJUSTMENT-DENTAL INSURANCE PREMIUMS

B.8.1 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.5.1. 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 two 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.8.2 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.8.2.1 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 must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

PART II: PRICE – GROUP LIFE INSURANCE

B.9 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 Canada. 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.9.1 Official Residence Expense (ORE) staff are included under this contract only as a rider; the Contractor shall bill the Chief of Mission, Deputy Chief of Mission and Consuls General (for ORE Staff) separately. See Exhibit C of Section J for details.

B.10 PRICES

B.10.1 VALUE ADDED TAX

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

B.10.2 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 per one thousand of salary to provide basic life insurance and accidental death and dismemberment insurance are as follows:

B.10.3. Base Year of Contract

B.10.3.1 Bi-Weekly Rates per Employee

Type of Insurance

Premium (per 1,000 of Salary)

Estimated Payroll

(Bi-Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 23,097,000

b. Accidental Death & Dismemberment 15,934,000

c. Subtotal (a+b+c) --

B.10.4. Option Year 1 of Contract

B.10.4.1 Bi-Weekly Rates per Employee

b. Accidental Death & Dismemberment 15,934,000

B.10.5. Option Year 2 of Contract

B.10.5.1 Bi-Weekly Rates per Employee

b. Accidental Death & Dismemberment 15,934,000

B.10.6. Option Year 3 of Contract

B.10.6.1 Bi-Weekly Rates per Employee

b. Accidental Death & Dismemberment 15,934,000

B.10.7. Option Year 4 of Contract

B.10.7.1 Bi-Weekly Rates per Employee

b. Accidental Death & Dismemberment 15,934,000

B.10.8 Grand Total of Base plus All Option Years – Group Life Insurance Services

Option Year 1 Total -- Option Year 2 Total -- Option Year 3 Total --

B.11 ADMINISTRATIVE RETENTION AMOUNTS

B.11.1 If the Contractor requests a price adjustment under B.12 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.10. 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.11.2 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 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

B.11.2.1 Group Life Insurance – Retention Amounts per Separate Premium Paid per Employee:

Period of Performance Basic Life Accidental Death and

Dismemberment

Base Period

Option Year 1

Option Year 2

B.12. ECONOMIC PRICE ADJUSTMENT-GROUP LIFE INSURANCE PREMIUMS

B.12.1 Premium Adjustment based on Experience – For group life 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.9.1. 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 two 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.12.2 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.

PART III: PRICE – GROUP LONG TERM DISABILITY INSURANCE (LTD)

B.13 GROUP LONG TERM DISABILITY INSURANCE SERVICES

The Contractor shall provide the Group Long Term Disability Insurance services described herein to employees of the Government of the United States of America in Canada. 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.13.1 Official Residence Expense (ORE) staff are included under this contract only as a rider; the Contractor shall bill the Chief of Mission, Deputy Chief of Mission and Consuls General (for ORE Staff) separately. See Exhibit C of Section J for details.

B.14 PRICES

B.14.1 VALUE ADDED TAX

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

B.14.2 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 per one hundred of salary to provide basic life insurance and accidental death and dismemberment insurance are as follows:

B.14.3. Base Year of Contract

B.14.3.1 Bi-Weekly Rates per Employee

(per 100 of Salary)

a. Long Term Disability Coverage 864,001

b. Tax (VAT) --

d. Total Price for Base Year (c x 26) --

B.14.4. Option Year 1 of Contract

B.14.4.1 Bi-Weekly Rates per Employee

d. Total Price for Option Year 1 (c x 26) --

B.14.5. Option Year 2 of Contract

B.14.5.1 Bi-Weekly Rates per Employee

d. Total Price for Option Year 2 (c x 26) --

B.14.6. Option Year 3 of Contract

B.14.6.1 Bi-Weekly Rates per Employee

d. Total Price for Option Year 3 (c x 26) --

B.14.7. Option Year 4 of Contract

B.14.7.1 Bi-Weekly Rates per Employee

d. Total Price for Option Year 4 (c x 26) --

B.14.8 Grand Total of Base plus All Option Years – Group Long Term Disability Insurance Services

Option Year 1 Total -- Option Year 2 Total -- Option Year 3 Total --

B.15 ADMINISTRATIVE RETENTION AMOUNTS

B.15.1 If the Contractor requests a price adjustment under B.16 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.14. 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.15.2 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 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

B.15.2.1 Group Long Term Disability Insurance - Retention Amounts per Separate Premium Paid per Employee:

Period of Performance Long Term Disability

Coverage

B.16. ECONOMIC PRICE ADJUSTMENT-LONG TERM DISABILITY INSURANCE PREMIUMS

B.16.1 Premium Adjustment based on Experience - For group life 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.13.1 . 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 two 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.16.2 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.

OFFERS AND PAYMENT

B.17 Offers and payment in U.S. Dollars. U.S. firms are eligible to be paid in U.S. dollars. U.S. firms desiring to be paid in U.S. dollars should submit their offer in U.S. dollars. A U.S. firm is defined as a company which operates as a corporation incorporated under the laws of a state within the United States.

B.18 Foreign Firms. Any firm, which is not a U.S. firm, is a foreign firm. Any firm that does not meet the definition of U.S. firm described under B.17 shall submit its prices and receive payment in local currency.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

PART I – HEALTH & DENTAL INSURANCE

C.1 HEALTH INSURANCE SERVICES

The Government of the United States of America requires health and dental insurance coverage protection for its employees in Canada as further described in C.1.1. The Government has determined that the prevailing practice by employers in Canada is to provide for their employees health (beyond what is provided by the provincial health care plans) and dental insurance coverage and that the cost of such supplemental insurance protection is usually borne by both the employee and the employer. For active employees who are regularly schedule to work 30 or more hours per week, the USG will pay 85% of the premium cost and the employee will pay 15% for employee coverage and dependent coverage. For eligible employees who are regularly scheduled to work less than 30 hour per week, the USG will pay a prorated share of the premium cost for employee and dependent coverage, based on the number of hours the employee is regularly scheduled to work.

The health and dental insurance coverage protection will be representative of locally prevailing compensation practice as further described in C.1.2. The specific health insurance and dental coverage under this contract is set forth in Section C and the Exhibits in Section J.

The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care, unless exclusion has been authorized by HR/OE/CM.

C.1.1 Employee and Dependent Health Services Benefits

The maximum health benefits for Employees and their dependents covered by this contract are described in two categories of participants – Current Employees and Early Retirees.

Reimbursement of covered expenses is limited to the stated percentages of reasonable and customary costs.

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.

C.1.2 Current Employees

Medical Coverage

The contractor shall reimburse covered medical expenses incurred, subject to the stated limits. Payment shall be made for reasonable and customary expenses of covered benefits. The medical treatment must be prescribed or provided by a physician or nurse licensed in Canada, the United States, or in the country in which the treatment or prescription is received. Coverage of expenses shall be made in Canadian Dollars (CAD), unless otherwise stated.

C.1.2.1 Hospitalization: 100% coverage semi-private room while hospitalized.

C.1.2.2 Prescription Drugs and Medicines: Authorized charges via a pay direct drug card program reimbursable at 80% up to $10,000 coverage of the cost of medicines and drugs for which a prescription is legally required. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician. A generic substitution is mandatory for prescription medication when available.

C.1.2.3 For Active Employees Only: $10,000 USD or equivalent in local currency of expenses for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS; as well as brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. This expanded coverage generally excludes medications for the long-term suppression of AIDS through the combination of anti-retroviral drugs at those posts with inadequate local healthcare infrastructures. This expanded coverage does not apply to dependents or to retired employees.

C.1.2.4 Professional Services and Treatment

Covers medically necessary expenses which are reasonable and customary, and recommended and prescribed by a legally licensed physician or surgeon, and which are not prohibited by provincial government sponsored plans.

Benefits cannot exceed the difference between the actual cost of the charges and amounts that employees are entitled to apply for and receive under provincial health care plans. With the exception of the out-of-country expenses, reimbursement is at 80%. This includes:

C.1.2.4.1 Nursing Care: When ordered by a physician or surgeon legally licensed to practice medicine, the services of a registered nurse or registered nurse assistant in the home of the employee up to a maximum of $5,000 per calendar year. Reimbursable at 100%. The maximum benefit is limited to $25,000 lifetime in all provinces. Services shall terminate on the employee or employee’s dependents 65th birthday.

C.1.2.4.2 Hospital Expenses and Supplies: Charges incurred for services furnished by a licensed Hospital and supplies which are obtained from an out-patient department of a licensed Hospital or surgical supply company (in the province of residence), while not confined to the Hospital.

C.1.2.4.3 Ambulance: For ambulance or other emergency service used to transport employees and/or their dependents from any place where injury, illness, or any other emergency medical situation occurs to the nearest hospital where adequate treatment can be obtained. Also, transportation from one hospital to another or from a hospital to home. Charges for the cost of one attendant if transportation is not provided via an ambulance. Reimbursable at 100%.

C.1.2.4.4 Aids, services and supplies: Purchase of approved braces, crutches, artificial limbs or eyes and prosthetic devices. An initial breast prosthesis following a mastectomy plus a replacement every two calendar years and two surgical brassieres per calendar year. Rental of a wheelchair, hospital bed or other approved durable equipment for temporary therapeutic use. Oxygen as ordered by a surgeon or physician.

A maximum of one pair of custom made orthopedic shoes or orthotics per calendar year as prescribed by a podiatrist or physician. Two pairs of surgical stockings per calendar year. Hair pieces and wigs needed as a result of chemotherapy up to a lifetime maximum of $100.00. A lifetime maximum of $250.00 for wigs purchased due to a total loss of hair from Alopecia Totalis. Hearing aids and repairs to a maximum of $500 in four consecutive years. The purchase of an initial pair of frames and one corrective prosthetic lens for each eye that is prescribed after cataract surgery.

C.1.2.4.5 Accidental Dental: Treatment for accidental blow to the mouth which is received within 12 months of the injury. Benefit is limited to amounts consistent with the current Dental Association Schedule of Fees for General Practitioners in the province of residence.

C.1.2.4.6 Optical Care: 100% reimbursement in any for a 24 consecutive month period of eye examination and treatment. 100% reimbursement up to $300 for prescription eyeglass or contact lenses and corrective eyeware.

C.1.2.4.7 Clinical Psychology: Services of a legally licensed clinical psychologist, 100% up to an individual maximum of $1,000 per calendar year.

C.1.2.4.8 Diagnostic tests: Diagnostic tests, radium treatments and x-ray examinations, except for dental x-rays that are incurred in the Province or Territory of residence.

C.1.2.4.9 Speech Therapy: Services of s qualified speech therapist, 100% up to an individual maximum of $1,000 per calendar year.

C.1.2.4.10 Referral Benefits: Services provided in Canada and the United States but outside the province of residence if not available in the province of residence and based on a written referral of a physician or surgeon who regularly attends the employee or dependent in the province of residence. These services must be approved in advance and are subject to a lifetime limit of $10,000:

a) Room and board in a licensed Hospital up to the hospital’s standard ward rate for each day of confinement;

b) Hospital services and supplies furnished by a licensed Hospital; and

c) Diagnosis and treatment by a physician or surgeon legally licensed to practice medicine.

C.1.2.4.11 Travel Assistance Benefit: 100% reimbursement. The following required services relating to a medical emergency, while away from the Province or Territory of residence for business or pleasure (but not for Health reasons):

1. Emergency medical assistance.

2. Emergency medical payments.

3. Telephone interpretation service.

4. Medical evacuation.

5. Assistance with lost documents or luggage.

6. Return of dependent children, or a traveling companion.

7. Visit of a family member.

8. Transmission and retention of urgent messages.

9. Help in contacting the nearest Canadian Embassy or Consulate.

10. Assistance to transport remains in the event of death.

11. Return of a vehicle to plan member’s home or nearest rental agency.

C.1.2.4.12 Paramedical Services: Reimbursable at 80%. Laboratory tests and x-ray examinations recommended by a legally licensed chiropractor, osteopath, chiropodist or podiatrist. The maximum amount payable per classification of practitioner is limited to $500.00 per calendar year, per practitioner.

Practitioners include Physiotherapists, Chiropractors, Osteopaths, Chiropodists or Podiatrists, Naturopaths, Masseurs and Acupuncturists.

C.1.2.5 Dental Care: 100% reimbursement for preventative and minor restorative up to $1,200 per family member per calendar year and 50% up to $2,000 per family member per calendar year for major restorative.

Employee contribution shall be 85% and the USG will pay 15% for employees and dependents. There is no deductible.

C.1.3 Health Benefits Conditions and Limitations

There is no reimbursement for elective cosmetic surgery; spa cures; rejuvenation cures; exercise therapy; long term rehabilitative therapy; non-medical hospital charges such as telephones or television; home help, family help, or similar household assistance; fees of persons who are not licensed physicians or nurses; or services or supplies which have not been prescribed or approved by a physician or nurse.

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

There is no reimbursement for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; excessive or illegal use of alcohol or drugs; a self-inflicted wound; or service in the armed forces of any country.

C.1.4 Early Retirees

Retirees in all provinces are eligible for the early retiree medical coverage beginning on his/her 55th birthday and ending upon his/her 65th birthday. New early retirees will pay 15% of the monthly premiums. Newly hired employees will not be eligible for early retiree benefits. These changes go into effect on the date the plan is revised and are not retroactive.

Medical Coverage

The contractor shall reimburse covered medical expenses incurred, subject to the stated limits. Payment shall be made for reasonable and customary expenses of covered benefits. The medical treatment must be prescribed or provided by a physician or nurse licensed in Canada, the United States, or in the country in which the treatment or prescription is received. Coverage of expenses shall be made in Canadian Dollars (CAD), unless otherwise stated.

C.1.4.1 Hospitalization: 100% coverage semi-private room while hospitalized.

C.1.4.2 Prescription Drugs and Medicines: Authorized charges via a pay direct drug card program reimbursable at 80% up to $10,000 coverage of the cost of medicines and drugs for which a prescription is legally required. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician. A generic substitution is mandatory for prescription medication when available.

C.1.4.3 For Active Employees Only: $10,000 USD or equivalent in local currency of expenses for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS; as well as brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. This expanded coverage generally excludes medications for the long-term suppression of AIDS through the combination of anti-retroviral drugs at those posts with inadequate local healthcare infrastructures. This expanded coverage does not apply to dependents or to retired employees.

C.1.4.4 Professional Services and Treatment

Covers medically necessary expenses which are reasonable and customary, and recommended and prescribed by a legally licensed physician or surgeon, and which are not prohibited by provincial government sponsored plans.

Benefits cannot exceed the difference between the actual cost of the charges and amounts that employees are entitled to apply for and receive under provincial health care plans. With the exception of the out-of-country expenses, reimbursement is at 80%. This includes:

C.1.4.4.1 Nursing Care: When ordered by a physician or surgeon legally licensed to practice medicine, the services of a registered nurse or registered nurse assistant in the home of the employee up to a maximum of $5,000 per calendar year. Reimbursable at 100%. The maximum benefit is limited to $25,000 lifetime in all provinces. Services shall terminate on the employee or employee’s dependents 65th birthday.

C.1.4.4.2 Hospital Expenses and Supplies: Charges incurred for services furnished by a licensed Hospital and supplies which are obtained from an out-patient department of a licensed Hospital or surgical supply company (in the province of residence), while not confined to the Hospital.

C.1.4.4.3 Ambulance: For ambulance or other emergency service used to transport employees and/or their dependents from any place where injury, illness, or any other emergency medical situation occurs to the nearest hospital where adequate treatment can be obtained. Also, transportation from one hospital to another or from a hospital to home. Charges for the cost of one attendant if transportation is not provided via an ambulance. Reimbursable at 100%.

C.1.4.4.4 Aids, services and supplies: Purchase of approved braces, crutches, artificial limbs or eyes and prosthetic devices. An initial breast prosthesis following a mastectomy plus a replacement every two calendar years and two surgical brassieres per calendar year. Rental of a wheelchair, hospital bed or other approved durable equipment for temporary therapeutic use. Oxygen as ordered by a surgeon or physician.

A maximum of one pair of custom made orthopedic shoes or orthotics per calendar year as prescribed by a podiatrist or physician. Two pairs of surgical stockings per calendar year. Hair pieces and wigs needed as a result of chemotherapy up to a lifetime maximum of $100.00. A lifetime maximum of $250.00 for wigs purchased due to a total loss of hair from Alopecia Totalis. Hearing aids and repairs to a maximum of $500 in four consecutive years. The purchase of an initial pair of frames and one corrective prosthetic lens for each eye that is prescribed after cataract surgery.

C.1.4.4.5 Accidental Dental: Treatment for accidental blow to the mouth which is received within 12 months of the injury. Benefit is limited to amounts consistent with the current Dental Association Schedule of Fees for General Practitioners in the province of residence.

C.1.4.4.6 Optical Care: 100% reimbursement in any for a 24 consecutive month period of eye examination and treatment. 100% reimbursement up to $300 for prescription eyeglass or contact lenses and corrective eyeware.

C.1.4.4.7 Clinical Psychology: Services of a legally licensed clinical psychologist, 100% up to an individual maximum of $1,000 per calendar year.

C.1.4.4.8 Diagnostic tests: Diagnostic tests, radium treatments and x-ray examinations, except for dental x-rays that are incurred in the Province or Territory of residence.

C.1.4.4.9 Speech Therapy: Services of s qualified speech therapist, 100% up to an individual maximum of $1,000 per calendar year.

C.1.4.4.10 Referral Benefits: Services provided in Canada and the United States but outside the province of residence if not available in the province of residence and based on a written referral of a physician or surgeon who regularly attends the employee or dependent in the province of residence. These services must be approved in advance and are subject to a lifetime limit of $10,000:

a) Room and board in a licensed Hospital up to the hospital’s standard ward rate for each day of confinement;

b) Hospital services and supplies furnished by a licensed Hospital; and

c) Diagnosis and treatment by a physician or surgeon legally licensed to practice medicine.

C.1.4.4.11 Travel Assistance Benefit: 100% reimbursement. The following required services relating to a medical emergency, while away from the Province or Territory of residence for business or pleasure (but not for Health reasons):

1. Emergency medical assistance.

2. Emergency medical payments.

3. Telephone interpretation service.

4. Medical evacuation.

5. Assistance with lost documents or luggage.

6. Return of dependent children, or a traveling companion.

7. Visit of a family member.

8. Transmission and retention of urgent messages.

9. Help in contacting the nearest Canadian Embassy or Consulate.

10. Assistance to transport remains in the event of death.

11. Return of a vehicle to plan member’s home or nearest rental agency.

C.1.4.4.12 Paramedical Services: Reimbursable at 80%. Laboratory tests and x-ray examinations recommended by a legally licensed chiropractor, osteopath, chiropodist or podiatrist. The maximum amount payable per classification of practitioner is limited to $500.00 per calendar year, per practitioner.

Practitioners include Physiotherapists, Chiropractors, Osteopaths, Chiropodists or Podiatrists, Naturopaths, Masseurs and Acupuncturists.

C.1.5 Eligible Participants

C.1.5.1 Eligible Employees

Eligible employees are Locally Employed Staff (LE Staff) who are (1) working on a full-time or part-time basis under non-temporary direct-hire appointments, personal services agreements, or personal services contract and (2) paid under the terms of the Local Compensation Plan. Participation in Health and Dental coverage is voluntary.

C.1.5.2. Location of Employment

The individuals covered by C.1.6.1 must be employed within the geographic boundaries of Canada by the following agencies/categories: State-ICASS; Defence Attache Office; Public Affairs; USAITC; DHS-ICE/CBP; Foreign Commercial Service; Foreign Agricultural Service; U.S. Secret Service; State-MRV, Internal Revenue Service;

NASA Liaison; Diplomatic Security-RSO; Early Retiree (Former Employees); State-Program.

C.1.6 Individuals Not Eligible for Coverage

Individuals not eligible for coverage are those working under temporary appointments; those working under a PSC or PSA that is time limited to less than one year; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Canada 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.1.7 Other Eligible Participants

The following additional categories of persons are covered by this insurance:

C.1.7.1 Early retirees. All employees who were hired before February 1, 2010 are eligible for early retiree health services only (exclusive of dental benefits) between the ages of 55 to 65 years. All other employees hired after February 1, 2010 are ineligible for early retiree benefits.

C.1.7.2 Dependent Coverage. Expenses incurred by an enrolled employee’s eligible dependents are covered under this plan. Enrollment of eligible dependents is voluntary. For the purposes of this plan, an employee’s dependents are defined as the employee’s legal spouse (limit one) and each unmarried, economically dependent child who primarily resides with the employee unless away at school.

C.1.7.3 An eligible child is defined as the employee’s natural child, adopted child, stepchild, or foster child.

An eligible child will be covered until each calendar year in which the child turns age 22, or in the case of a child who is a full-time student, until the end of the calendar year in which the child…