SGE50017Q0094-A001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE RATING

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE

08/31/2017

4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

CODE

AMERICAN CONSULATE GENERAL FRANKFURT

GIESSENER STRASSE 30

ATTN: RPSO

FRANKFURT, 60435

GERMANY

Wencke Jacobsen

NAME

TEL.

jacobsenw@state.gov

EMAIL

6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)

9A. AMENDMENT OF SOLICITATION NO.

SGE50017Q0094

CONTACT DUNS

CODE FACILITY CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, country, state and ZIP Code) (X)

X 9B. DATED (SEE ITEM 11)

08/15/2017

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X XThe above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, 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 ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

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

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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 above cited solicitation is hereby amended as follows:

1) Questions and Answers letter is hereby incorporated and made part of this Amendment A001.

2) The Proposal Due date of September 11, 2017, 12:00 p.m. (noon) German time remains unchanged.

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 AND TITLE OF CONTRACTING OFFICER (Type or print)

Fabiola A. Bellevue

(Signature of person authorized to sign)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED

By (Signature of Contracting Officer)

16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

08/30/2017

NSN 7540-01-152-8070

Previous edition unusable

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SGE50017Q0094

X

[ORIGINAL SIGNED]

RPSO has received the following eight (8) questions, and is hereby providing the following answers.

1. Question: Census - We note you have provided limited information on the employees, spouses and their dependents, Retirees and their dependents and ORE employees, their spouses and dependents, as to their sex or the age bracket they fall into. This is commonly provided and is not confidential and together with information about claims are the primarybasis for any quotation of the cost of insurance.

Answer: See Attachment A attached hereto.

2. Question: Historical claims activity in prior years is the second element an insurance company uses to price insurance. We find that claims information is usually provided in the initial solicitation and if not there then provided after requested by a prospective contractor. Again, as this information is available to the incumbent we would be at a disadvantage unless we had it also.

Please provide the last three full years and the current partial year of premium's billed and loss data by year of account for health insurance including:

three + years premium paid three + years number of incurred claims three + years amount of incurred claims three + years total membership on the last day of the contract year. Member ship is the total number of employees + spouses + dependents.

Answer: See Attachments B and C attached hereto.

3. Question: We would like to know if you have been informed of Catastrophic cases presented last year, such as: Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases (Radio and Chemotherapy), and hospitalizations with more than 10 days.

Answer: No such cases in Tunis.

4. Question: Does this solicitation contain requirements similar to the current contract? If not what are the differences?

Answer: Yes, it has exactly the same requirements.

5. Question: Have there been any claims in excess of $10,000 within the last year? If yes please indicate the number and amounts of such claims.

Answer: No such claims.

6. Question: Are their dependent children to be covered who are studying outside the country? If yes please provide the country and number of dependent children studying there.

Answer: We do not have this information. The solicitation (Section 2.0 Description/Specification/Work Statement) states that medical expenses incurred out of the country shall not be covered (page 11 of the solicitation).

7. Question: The number of family plan employees is 249 (including 2 ORE employees) while the number is 209 in the pricing tables (Attachment B). On what basis should we work?

Answer: All Pricing shall be based on the estimated number of persons found in the Pricing Tables (Attachment B of the solicitation)

8. Question: How to access to the SAM website and which information is required to complete the annual representation and certification?

Answer: The SAM registration shall be done on the website www.sam.gov.

Attached hereto you will find the following information to assist you with your registration:

How to enter a foreign entity in SAM SAM Common Registration Issues SAM Quick Start Guide

Attachment A to SGE50017Q0094A001 ‐ 8/30/2017

Age (years) Female Male Total Age (years) Female Male Total Age (years) Female Male Total

20‐34 18 21 39 20‐34 1 1 20‐34 0

35‐45 21 68 89 35‐45 1 1 35‐45 0

46‐55 21 64 85 46‐55 1 3 4 46‐55 0

56‐60 6 21 27 56‐60 1 1 2 56‐60 16 30 46

Total 66 174 240 Total 4 4 8 Total 16 30 46

Age (years) Female Male Total Age (years) Female Male Total Age (years) Female Male Total

20‐34 37 4 41 20‐34 1 1 20‐34 0

35‐45 70 15 85 35‐45 0 35‐45 0

46‐55 35 17 52 46‐55 3 3 46‐55 8 8

56‐60 7 7 14 56‐60 1 1 56‐60 21 14 35

Total 149 43 192 Total 4 1 5 Total 29 14 43

Age (years) Female Male Total Age (years) Female Male Total Age (years) Female Male Total

0‐5 16 17 33 0‐5 1 1 0‐5

6‐10 18 20 38 6‐10 0 6‐10

11‐15 10 27 37 11‐15 1 1 11‐15

16‐20 13 16 29 16‐20 1 1 16‐20

21 et 22 6 2 8 21 et 22 1 1 21 et 22

Total 63 82 145 Total 1 3 4 Total

Age (years) Female Male Total Age (years) Female Male Total Age (years) Female Male Total

20‐34 20‐34 20‐34

35‐45 35‐45 35‐45

46‐55 46‐55 46‐55

56‐60 56‐60 56‐60

Total 5 3 Total Total

Gender and Age

LES EMPLOYEES ORE STAFF RETIREES

Adherents Adherents Adherents

Parents Parents Parents

Spouses Spouses Spouses

Children Children Children

Month CLAIMS Health Premium Received (TND)

Health Insurance Reimbursement (TND)

Medical Experience

2014‐05 6 48,064.02 38,816.28 80.8% 2014‐06 5 33,724.36 28,613.90 84.8% 2014‐07 5 29,713.80 24,765.93 83.3% 2014‐08 1 22,605.10 19,112.36 84.5% 2014‐09 5 47,059.66 39,892.56 84.8% 2014‐10 3 22,772.37 19,273.32 84.6% 2014‐11 6 54,941.41 45,923.25 83.6% 2014‐12 3 32,799.53 26,735.37 81.5% 2015‐01 5 43,241.59 35,902.14 83.0% 2015‐02 4 57,673.92 49,105.96 85.1% 2015‐03 6 55,714.95 47,151.00 84.6% 2015‐04 8 58,357.18 49,395.64 84.6% 2015‐05 2 29,818.12 23,304.81 78.2% 2015‐06 11 45,886.79 39,400.87 85.9% 2015‐07 7 28,571.79 25,001.03 87.5% 2015‐08 9 34,589.91 28,980.30 83.8% 2015‐09 8 28,705.02 22,775.20 79.3% 2015‐10 4 55,499.99 45,446.22 81.9% 2015‐11 5 40,841.11 34,100.73 83.5% 2015‐12 9 59,597.26 49,474.26 83.0% 2016‐01 6 54,053.63 44,222.11 81.8% 2016‐02 3 44,869.17 37,234.65 83.0% 2016‐03 5 49,776.39 40,300.04 81.0% 2016‐04 5 48,928.68 39,445.17 80.6% 2016‐05 4 44,765.94 37,086.51 82.8% 2016‐06 4 50,646.63 41,531.56 82.0% 2016‐07 6 33,154.62 27,365.45 82.5% 2016‐08 4 33,496.12 28,030.14 83.7% 2016‐09 3 57,725.65 46,647.19 80.8% 2016‐10 5 34,376.01 29,323.63 85.3% 2016‐11 4 66,420.76 54,968.76 82.8% 2016‐12 4 54,022.55 45,753.84 84.7% 2017‐01 3 59,631.04 48,090.03 80.6% 2017‐02 2 36,931.86 31,333.37 84.8% 2017‐03 5 62,569.92 50,292.82 80.4% 2017‐04 3 56,109.66 47,429.50 84.5% 2017‐05 3 48,649.34 39,805.86 81.8% 2017‐06 4 46,700.24 35,853.82 76.8% 2017‐07 2 28,317.11 21,335.40 75.3%

Attachment B - SGE50017Q0094A001, 8/30/2017

Premiums vs Claims 2014 - 2017

Description 2014-05 to 2015-04 2015-05 to 2016-04 2016-05 to 2017-04 Total

# Claims 57 74 47 178

Claims (TND) 424,688 429,685 487,853 1,342,226

# of Pregnancies 4 5 9 18

# Hospital Admissions 31 30 26 87

# Claims over $10,000 0 0 0 0

Note:

EMBASSY OF THE UNITED STATES OF AMERICA, TUNISIA

HEALTH

CLAIMS REPORT

The Embassy has obtained the following historical data from the current contractor but cannot certify as to whether this data will be indicative of future claims. Therefore, it is each offeror’s decision on whether or not to use this information. However, under no circumstances shall the U.S. Government be liable for this information or shall it become the basis for a request to adjust the premium rates once the contract is awarded. Rather, offerors are advised any adjustments to contract premium rates shall be in accordance with the Price Adjustment clauses (B.4 and B.8) of the contract.

Attachment C - SGE50017Q0094A001, 8/30/2017