Health_Solicitation_package_v2.docx

Embassy of the United States of America Athens, Greece

November 20, 2013

Dear Prospective Offeror:

SUBJECT: Solicitation Number SGR100-14-R-0001 – Health Insurance services

The Embassy of the United States of America invites you to submit a proposal for Health Insurance services for the U.S. Embassy Athens, Greece.

Your proposal must be submitted electronically by email with the subject line "Proposal SGR100-14-R-0001 Enclosed" to Athensoffers@state.gov on or before 12:00 noon (Athens Time) on December 20, 2013. You may also elect to submit your proposal in hard copy marked for the attention of the “Contracting Officer – Proposal SGR100-14-R-0001 Enclosed”, which may be delivered to the Embassy Gate on Doryleou Street, on or before 12:00 noon (Athens Time) on December 20, 2013. No proposal will be accepted after the cut-off date and time.

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

Please direct any questions regarding this solicitation in writing to the attention of Ms. Alexandra Kouyentaki, Procurement Supervisor. Questions must be written in English, and may be sent by email to AthProcurement@state.gov by 14.00 hours local time, on December 2, 2013.

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.

Sincerely,

UNDER DPAS (15 CFR 350)

1 | 626

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

3. SOLICITATION NO.

SGR100-14-R-0001

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

11/20/2013

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

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

American Embassy – GSO 91 Vas. Sofias Avenue

GR 101 60 ATHENS

Phone: +30-210-720-2296 Fax: +30-210-722-7255

Refer to the Cover Letter

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

SOLICITATION

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

Ms. Alexandra E. Kouyentaki

AthProcurement@state.gov

11. TABLE OF CONTENTS

OTHER STATEMENTS OF OFFERORS

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

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

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

AWARD (To be completed by Government)

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 of print)

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

SECTION B

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

B.2. PRICES

B.2.1 VALUE ADDED TAX (VAT). The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices as the U.S. Embassy has a tax exemption certificate with the host government.

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:

Annual Rates:

Estimated

Estimated

Number of

Annual

A. CSR Employees

B. CSR Annuitants

C. Non-CSR LE Staff

TOTAL PRICE FOR BASE YEAR

* Unit rate per person

** Multiply (a) times the sum of (b).

B.2.4. FIRST OPTION YEAR OF CONTRACT:

Annual Rates:

Estimated

Estimated

Number of

Annual

A. CSR Employees

B. CSR Annuitants

C. Non-CSR LE Staff

TOTAL PRICE FOR FIRST OPTION YEAR

* Unit rate per person

** Multiply (a) times the sum of (b).

B.2.5. SECOND OPTION YEAR OF CONTRACT:

Annual Rates:

Estimated

Estimated

Number of

Annual

A. CSR Employees

B. CSR Annuitants

C. Non-CSR LE Staff

Employees

TOTAL PRICE FOR SECOND OPTION YEAR

* Unit rate per person

** Multiply (a) times the sum of (b).

B.2.6. THIRD OPTION YEAR OF CONTRACT:

Annual Rates:

Estimated

Estimated

Number of

Annual

A. CSR Employees

B. CSR Annuitants

C. Non-CSR LE Staff

TOTAL PRICE FOR THIRD OPTION YEAR

* Unit rate per person

** Multiply (a) times the sum of (b).

B.2.7. FOURTH OPTION YEAR OF CONTRACT:

Annual Rates:

Estimated

Estimated

Number of

Annual

A. CSR Employees

B. CSR Annuitants

C. Non-CSR LE Staff

TOTAL PRICE FOR FOURTH OPTION YEAR

* Unit rate per person

** Multiply (a) times the sum of (b).

GRAND TOTAL BASE YEAR PLUS 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 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 Retention Amounts per separate premium paid per single employee and per family plan.

Family Plan

Employee/Eligible Dependent

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. 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 have an independent third party 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.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.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

PART I – CSR Active Employees and Annuitants

C.1. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its a) CSR Active Employees and b) CSR Annuitants and their dependents, as further described in C.1.1.A. and B. in Greece. The Government has determined that the prevailing practice by employers in Greece 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. The specific health benefit coverage under this contract is set forth in Section C.1.1. 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 health benefits under this contract are as follows. 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.

Reimbursements or payments shall be made for the following covered benefits, subject to reasonable and customary costs in the locality where treatment was provided.

A. Eligible Employees:

Employees eligible for the health insurance services provided for herein include:

(a) Current employees of the United States Mission to Greece who will receive a pension from the United States Civil Service Retirement Fund, are employed within the geographic boundaries of Greece, paid under the Local Compensation Plan, and certified by the Contracting Officer, and

(b) Former employees retired from employment with the United States Mission to Greece, were paid under the Local Compensation Plan when employed, are receiving a pension from the United States Civil Service Retirement Fund and are certified by the Contracting Officer.

B. Dependent Coverage

Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. 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.

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 18, or in the case of a child who is a full-time student, until the end of the calendar year in which the child turns age 22. 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.

Parents, grandparents, siblings, and other relatives are not eligible dependents.

C. Coverage after Retirement:

Employees who were covered under the medical insurance plan at the time of retirement may elect to continue coverage for themselves and their dependents after retirement.

D. Premium Expenses

A. For Active Employees

Active employees who are regularly scheduled to work 30 or more hours per week: the USG will pay 75% of the premium cost and the employee will pay 25% of the premium cost for employee and dependent coverage.

Active employees who are regularly scheduled to work less than 30 hours 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.

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 (beyond one pay period) of Leave Without Pay or unpaid leave, 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.

B. For CSR Annuitants

The USG will pay 75% of the premium cost and the employee will pay 25% of the premium cost for employee and dependent coverage.

CSR Annuitants are not entitled to health benefits hereunder during any period of coverage for which premiums are not paid. The Annuitant is responsible for paying (directly to the insurance contractor) his/her share twice a year. Alternatively, the Annuitant may elect to have coverage cease if that Annuitant prefers not to pay the premium.

E. Medical Coverage:

The insurance company will reimburse covered medical expenses incurred, subject to the stated limits. Payment will 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 Embassy Athens, the United States, or in the country in which the treatment or prescription is received. Coverage of expenses will be made in Euro.

F. Deductible:

90 Euro, for each insured person, must be paid out of pocket per policy year.

G. Hospitalization:

80% coverage of room and board expenses for a ward room, private, or semi-private room up to a maximum of 210 Euro/day in Greece and 400 Euro/day outside of Greece. A maximum of 480 Euro/day is given for stay in the ICU for a maximum of 8 days. 80% coverage of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room expenses, intensive care, prescription medicines, and physical therapy.

80% coverage of ambulance service up to a limit of 350 Euro per year.

80% coverage for nursing home care up to a maximum of 14 days following a hospitalization up to a limit of 45 Euro per night.

For CSR Annuitants: It is the responsibility of the Contractor to ensure all in-hospital medical expenses are submitted to the National Organization for Health Care (EOPYY) or any other insurance carrier as applicable, prior to the acceptance of submitted expenses for reimbursement.

H. Professional Services and Treatment:

80% coverage of doctors’ and surgeons' fees incurred while hospitalized, at a hospital on an out-patient basis, at a clinic or doctor's office, or at home.

80% coverage for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, physical therapy, routine annual physical examinations, and inoculations. A maximum limit of 80 Euro is covered per doctor’s visit for examinations and 65 Euro per visit for physical therapy.

80% coverage of out-of-hospital medical supplies. The supplies include diabetic supplies (strips and needles for the measurement of blood sugar levels, orthopedic supplies (splint, neck brace, orthopedic shoes, waist belt and other pertinent to the above mentioned supplies).

I. Prescription drugs and medicines:

80% coverage for 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.

J. HIV/AIDS coverage (for active employees only):

100% coverage 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.

K. Obstetrical Care:

The Mission does not cover expenses for obstetrical care.

L. Family Planning:

The Mission does not cover expenses of prescribed contraceptive devices and drugs, voluntary sterilization, diagnosis and treatment of infertility, fertility drugs, reversal of voluntary sterilization, infertility treatment after voluntary sterilization, genetic counseling and assisted reproductive technology.

M. Hearing Aids:

The Mission does not cover the cost of a hearing aid apparatus and related examinations.

N. Optical Care:

The Mission does not cover expenses for eye examination, treatment, prescription eyeglass or contact lenses. Diseases of the eye will be covered under Section G of the plan.

O. Dental Care:

The Mission does not cover expenses for dental services including dentists' fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

P. Psychiatric Treatment:

80% coverage of expenses for psychiatric treatment up to a limit of 65 Euro per visit.

Q. Medical Expenses Incurred Out of Country:

Medical expenses incurred out of country will be covered for employees and dependents when (a) a life threatening condition occurs when the individual is out of the country and treatment is medically necessary before the individual returns home or (b) 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 annual maximum limit as for expenses incurred in country.

80% coverage for repatriation, evacuation or transportation of mortal remains up to limit of € 1,800.

R. Expenses not covered:

Expenses will not be covered for elective cosmetic surgery; spa cures; rejuvenation cures; massage; exercise therapy; long term rehabilitative therapy; eyeglass frames; 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.

No coverage of will be made for expenses that will be reimbursed or paid directly under a host country medical program, the U.S. workers' compensation program, or any Greek workers' compensation type program.

No coverage of will be made for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; the practice of a dangerous sport; excessive or illegal use of alcohol or drugs; a self- inflicted wound; or service in the armed forces of any country.

S. Maximum Annual Coverage:

Active Employees Only: The Insurance company will reimburse covered expenses up to a limit of €30,000 per person per contract year. Expenses incurred under paragraph 2.J of the plan are subject to a separate annual maximum limit of USD 10,000 per employee per contract year. The maximum annual reimbursement for outpatient expenses per person per contract year is €1,800.

CSR Annuitants: The Insurance company will reimburse covered expenses up to a limit of €15,000 per person per contract year. The maximum annual reimbursement for outpatient expenses per person per contract year is €1,800.

II. Non-CSR Locally Employed (LE) Staff

C.2. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its non- CSR LE Staff and their dependents as further described in C.2.1.A. and B. in Greece. The Government has determined that the prevailing practice by employers in Greece is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne by the employer. The specific health benefit coverage under this contract is set forth in Section C.2.1 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/CMD.

C.2.1 Health Services Benefits

The health benefits under this contract are as follows. 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.

Reimbursements or payments shall be made for the following covered benefits, subject to reasonable and customary costs in the locality where treatment was provided.

A. Eligible Employees:

Eligible employees are LE Staff who are:

Working on a full time or part time basis under non-temporary direct hire appointments, personal services agreements, or personal services contracts and paid under the terms of the Local Compensation Plan including Ordinarily Resident Americans who pay U.S. Social Security. Participation will be voluntary.

Not eligible are employees who will receive retirement benefits under the U.S. Civil Service Retirement (CSR) System; 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 Embassy Athens 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.

B. Dependent Coverage

Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. 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.

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 18, or in the case of a child who is a full-time student, until the end of the calendar year in which the child turns age 25. 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.

Parents, grandparents, siblings, and other relatives are not eligible dependents.

C. Coverage after Retirement:

Employees who were covered under the medical insurance plan at the time of retirement are not eligible to receive coverage for themselves or their dependents after retirement.

D. Premium Expenses

For active employees who are regularly scheduled to work 30 or more hours per week: the USG will pay 100% of the premium cost for employee and dependent coverage.

For active employees who are regularly scheduled to work less than 30 hours 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.

During a period of leave without pay or unpaid leave beyond one pay period the employee is responsible for the full cost of premiums. Alternatively, the employee may elect to have coverage cease if he/she prefers not to pay the premium.

E. Medical Coverage:

The insurance company will reimburse covered medical expenses incurred, subject to the stated limits. Payment will 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 Embassy Athens, the United States, or in the country in which the treatment or prescription is received. Coverage of expenses will be made in Euro.

F. Deductible:

120 Euro, for each insured person, must be paid out of pocket per policy year.

G. Hospitalization:

90% coverage of room and board expenses for a ward room, private, or semi-private room up to a maximum of 200 Euro/day. A maximum of 250 Euro/day is given for stay in the ICU for a maximum of 14 days.

80% coverage of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room expenses, intensive care, prescription medicines, and physical therapy.

50% coverage of ambulance service.

For non-CSR LE Staff: It is the responsibility of the Contractor to ensure all in-hospital medical expenses are submitted to the National Organization for Health Care (EOPYY) or any other insurance carrier as applicable, prior to the acceptance of submitted expenses for reimbursement. This is not applicable to locally-hired Ordinarily Resident American employees paying into U.S. Social Security.

H. Professional Services and Treatment:

90% coverage of doctors’ and surgeons' fees incurred while hospitalized, at a hospital on an out-patient basis, at a clinic or doctor's office, or at home.

80% coverage of for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, physical therapy, routine annual physical examinations, and inoculations. A maximum limit of 55 Euro is covered per doctor’s visit for examinations.

I. Prescription drugs and medicines:

90% coverage for 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.

J. HIV/AIDS coverage (for active employees only):

100% coverage 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.

K. Obstetrical Care:

Coverage of expenses for obstetrical medical care when hospitalized and not hospitalized is as follows:

Normal Delivery: 600 Euros Cesarean Delivery: 800 Euros Miscarriage: 300 Euros

80% coverage of expenses is covered for prenatal and postnatal doctor visits.

L. Family Planning:

The Mission does not cover expenses of prescribed contraceptive devices and drugs, voluntary sterilization, diagnosis and treatment of infertility, fertility drugs, reversal of voluntary sterilization, infertility treatment after voluntary sterilization, genetic counseling and assisted reproductive technology.

M. Hearing Aids:

The Mission does not cover the cost of a hearing aid apparatus and related examinations.

N. Optical Care:

The Mission does not cover expenses for eye examination, treatment, prescription eyeglass or contact lenses. Optical Care is only covered in accidental cases.

O. Dental Care:

The Mission does not cover expenses for dental services including dentists' fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

P. Psychiatric Treatment:

The Mission does not cover expenses for psychiatric treatment.

Q. Medical Expenses Incurred Out of Country:

Medical expenses incurred out of country will be covered for employees and dependents when (a) a life threatening condition occurs when the individual is out of the country and treatment is medically necessary before the individual returns home or (b) 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 annual maximum limit as for expenses incurred in country.

R. Transportation for Out of Country Medical Treatment:

Transportation for out of country treatment will be a covered expense for employees only. The employee's attending physician must certify in advance that the treatment is medically necessary and unavailable locally.

50% of the patient's transportation expenses by the least expensive, appropriate means of transportation to the nearest city with adequate medical facilities will be reimbursed.

50% of the transportation expenses of an attendant will be reimbursed if the patient's attending physician certifies that an attendant for the patient is necessary, e.g., a family member to make medical decisions in the case of a patient who is unconscious.

Transportation expenses are subject to the annual maximum limit.

S. Expenses not covered:

Expenses will not be covered for elective cosmetic surgery; spa cures; rejuvenation cures; massage; exercise therapy; long term rehabilitative therapy; eyeglass frames; 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.

No coverage of will be made for expenses that will be reimbursed or paid directly under a host country medical program, the U.S. workers' compensation program, or any Greek workers' compensation type program.

No coverage of will be made for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; the practice of a dangerous sport; excessive or illegal use of alcohol or drugs; a self- inflicted wound; or service in the armed forces of any country.

No coverage will be made for expenses incurred after an employee leaves the service of the U.S. Mission.

T. Maximum Annual Coverage:

The insurance company will reimburse covered expenses up to a limit of 15,000 Euro per person per contract year. Expenses incurred under paragraph 2.J of the plan are subject to a separate annual maximum limit of USD 10,000 per employee per contract year.

U. Eligibility

Each current active eligible employee is enrolled for health 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.

V. 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.

W. Extended Coverage

In the event of an employee’s death while in active service, the eligible dependents may temporarily continue receiving medical coverage up to 180 days. The eligible dependents must have been covered under post’s medical plan at the time of death and designated in the official personnel file. The continued coverage is limited to a maximum of 180 days and may not be extended. Extended coverage is subject to availability of funds at post.

C.3. Location of Employment

The individuals covered by this contract must be employed within the geographic boundaries of Greece by:

U.S. Department of State U.S. Department of Commerce U.S. Department of Justice – DEA U.S. Department of Homeland Security U.S. Department of Defense – ODC, SDDC, DAO U.S. Department of Agriculture

C.4 Individuals Not Eligible for Coverage

Individuals not eligible for coverage under this contract are non-personal services contract personnel; employees working on a temporary basis; 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.5. BROCHURE REQUIREMENT

C.5.1. The contractor shall provide a document (brochure/pamphlet/other written document) in the Greek and English language 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 or annuitant receives a copy. The contractor shall be responsible for distributing the brochures to the employees or annuitants.

C.5.2. The contractor shall provide the document described in C.5.1 to the COR not later than thirty (30) days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.5.3. The contractor assumes full responsibility for ensuring that the document described in C.5.1 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.6.0 DEFINITIONS

FMO The Financial Management Officer or the paying office for all U.S. Government Agencies except AID.

COR Contracting Officer's Representative (Human Resources Officer at post).

Person The Subscriber.

Contributory Insurance for which the employee contributes toward the premium.

Family A married couple or a married couple with children or an employee with his children.

Disability Total and Permanent. A physical or mental impairment which precludes the individual from performing ordinary motor or bodily functions and which requires separation from employment. If the impairment is the result of a previous impairment, it shall be considered a continuation of the prior impairment.

Employee An individual employed by the U.S. Government, under a direct-hire appointment, personal services contract, or personal services agreement and paid under the terms of the Local Compensation Plan including locally-hired Ordinarily Resident American employees.

Employer The United States Government.

GSO General Services Officer in charge of the General Services Office at post. This officer is usually the Contracting Officer for this contract.

Eligible Dependent The employee’s legal spouse (limit one) and each unmarried, economically dependent child who primarily resides with the employee unless away at school.

CSR United States Civil Service Retirement Fund

CSR Annuitant The individual who has retired from U.S. Government active service with the U.S. Mission to Greece, and who receives a pension from the United States Civil Service Retirement Fund.

CSR Employee A direct hire active employee of the U.S. Government who is eligible and entitled to receive an annuity from the United States Civil Service Retirement Fund, following retirement from employment with the Government in Greece and is not eligible to received retirement and/or health benefits from the Greek Government.

Legally Designated Beneficiary The individual who is entitled to receive annuity from the United States Civil Service Retirement Fund, following the Employee’s or Annuitant’s death.

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.

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

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.

Surgical procedure Any invasive medical procedure by manual or instrument operation undertaken for diagnosis or treatment of a diseased patient.

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1. 52.2522 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following 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. Also, the full text of a clause may be accessed electronically at this address:

http://acqusition.gov/far/index.html or, http://farsite.hill.af.mil/search.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Dept. of State Acquisition Website at http://www.statebuy.state.gov to see the links to the FAR. You may also use a network “search engine” (e.g., Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the most current FAR.

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

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.

Services.

Performs all the insurance services set forth in the performance work statement (PWS)

C.1. thru C.2.

All required services are performed and no more than one (1) 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 one (1) customer complaint per month. The COR shall notify the Contracting Officer of the 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. 52.2522 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following 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. Also, the full text of a clause may be accessed electronically at this address:

http://acqusition.gov/far/index.html or, http://farsite.hill.af.mil/search.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Dept. of State Acquisition Website at http://www.statebuy.state.gov to see the links to the FAR. You may also use a network “search engine” (e.g., Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the most current FAR.

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

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 March 1, 2014 with four (4) 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:

U.S. Embassy Athens Attention: Human Resources Office 91 Vas. Sofias Avenue

GR 101 60 ATHENS

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 Officer.

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 (Euros).

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):

U.S. Embassy Athens Attention: Financial Management Office 91 Vas. Sofias Avenue

GR 101 60 ATHENS

G.4.2. Frequency of Payments. All funds under this contract will be obligated by issuance of task orders, as described in H.3. 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 semi-annually for payment to be made at the beginning of the six-month period for which insurance coverage is provided in accordance with FAR 32.404.

The Contractor shall submit invoices for changes in covered personnel, e.g., new hires, or departed employees, at the end of each six-month period.

G.4.3. U.S. Government Employees.

G.4.3.1. The Government shall make payments directly to the contractor for all U.S. Government employees, whether or not the employee is contributing to the premium amount.

G.4.3.2. The Contractor shall be responsible for collecting Annuitants’ portion of the insurance premiums on a semi-annual basis, at the beginning of each six-month period.

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.

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.