Questions_and_Answers_SHO80016R0001.pdf

RFP SHO80016R0001 Locally Employed Staff Life and Health Insurance

Questions and Answers

Questions transcribed as received:

Q.1. As brokers, we can present quotations ALL the insurance companies in Honduras. However, is this request only for insurance brokers or will you also be receiving proposals from insurance company directly?

A.1. The current health and life insurance contract is handled directly with the vendor. A broker must submit a proposal on behalf of a particular insurance provider as opposed to representing various insurance provider’s coverage and pricing from which we must choose. The actual insurance company would be required to have the necessary licenses and permits and would sign the SF 33. A broker’s proposal must comply with the solicitation requirements and would be evaluated in accordance with the solicitation requirements. We would not deviate from the terms and conditions of the solicitation, and payments would be made in accordance with the solicitation requirements. As a practical matter, the entity signing the SF 33 and certifications normally the insurance company.

Q.2. Is there any company of your preference from which you would like to receive quotations?

A.2.See response to Q&A 1.

Q.3. As an Insurance Broker can participate in the Solicitation or if it is just focused to Insurance companies?

A.3. This is an open and full competed solicitation. See response to Q&A 1. Offers will be evaluated in according with the solicitation requirements in Section L.4.3.2.2.

Q.4. Please clarify the number of employees: In Section 2.3 the total number of employees is listed as 502 (146 + 356) while in Exhibit J the total number of employees is 441 (303+10+26+86+16)

A.4. Amendment 002 will be issued to reflect the correct estimate of employees in the pricing section. Participants covered under riders are not included in the estimated participants in the pricing section.

Q.5. Do the numbers listed in Section B 2.3 include employees listed under Exhibit B through E?

A.5. Yes; please see answer to question 4 as well.

Q.6. Claims history for health Insurance for the current year and last 5 years - 2016 (till now), 2015, 2014, 2013, 2012. It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

A.6.

Year Claims Paid by

Insurance Company

2012 - 2013 (14,295,613.73)

2013 - 2014 (14,060,830.33)

2014 - 2015 (15,483,959.68)

2015 - 2016 (13,957,000.25)

2016 Extensions (11,073,650.98)

Total (68,871,054.95)

Q.7. Premium history for health Insurance for the current year and last 5 years - 2016 (till now), 2015, 2014, 2013, 2012.

It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

A.7.

Year Payments by USG

2012 - 2013 18,343,157.70

2013 - 2014 19,672,120.38

2014 - 2015 17,168,972.09

2015 - 2016 22,100,026.37

2016 Extensions 17,258,451.70

Total 94,542,728.25

Q.8. Average insured member counts for the last 5 years - 2016 (till now), 2015, 2014, 2013, 2012. It is standard practice in the insurance industry (and in other Department of State insurance solicitations) to provide this information to ensure equal/fair opportunity for all offerors in an open solicitation.

A.8. The following are estimated member counts:

Year Staffing

2012 420

2013 424

2014 424

2015 425

2016 425

Q.9. Advise if 2015 benefit schedule for health insurance is the same as the benefit schedule currently being requested under SHO80016R0001; and if not advise us on the differences. Alternatively, you can simply provide the previous solicitation document.

A.9 No, it is not the same benefit schedule. Previous solicitation document is SHO800-11-R-0001.

Q.10. Are any major illnesses (Hemodynamics, Open Heart Surgery, Orthopedic Mayor Surgeries, Organ Transplant, Traumatic Accident, Cancer and Oncology Cases) being treated? If Yes, please provide number (we do not need the names or identification, we just need to know the total number of people hospitalized to assess the risk).

A.10. Yes, 12 cases.

Q.11. Are there any large losses (in excess of $10,000) within the last year to date. If Yes, please provide number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of large losses and the amounts to assess the risk and price accordingly).

A.11. None

Q.12. Are there any HIV/AIDs cases. If Yes, please provide number (please note we are not seeking protected private information, we do not need the names or identification; we just need to know the total number of people who are currently being treated for HIV/AIDs to assess the risk and price accordingly).

A.12. No, there are no HIV/AIDs cases that have been informed to us and reviewed by the current carrier.

Q.13. When is this plan likely to commence?

A.13. April 1, 2017

Q.14. We would appreciate it if you could let us know the current carrier so we can come up with a better value solution than the current.

A.14. Seguros Atlántida, S.A.

Q.15. Is this a follow-on requirement? If so, could you please provide the incumbent contract number for this opportunity?

If not, is this a new requirement?

A.15. Benefit levels have changed; therefore, this is a new requirement.

Q.16. Does the offer (quote) have to be in English?

A.16. Yes, it must be in English.

Q.17. In case the U.S Embassy decides to change its actual Insurance Company we will negotiate a continuity of coverage, can we have a copy of last year claim report?

A.17. We are not able to provide last year’s claim report since it includes personal identifiable information and other sensitive information. However, the amount of claims paid can be seen in the answer to Q18 below.

Q.18. Medical Insurance: Claims percentage in detail for the period of the last contract (4 years).

A.18.

Year Claims Paid by

Insurance Company

2012 - 2013 (14,295,613.73)

2013 - 2014 (14,060,830.33)

2014 - 2015 (15,483,959.68)

2015 - 2016 (13,957,000.25)

2016 Extensions (11,073,650.98)

Total (68,871,054.95)

Q.19. Life Insurance: Total of claims paid and number of deaths corresponding to the last contract (4 years) and the amount of persons with disability indemnities active to date.

A.19. Number of deaths during the whole contract: 6

Number of people with disability indemnities: 0

Q.20.What conditions and base percentage of claims will be considered regarding upward or downward yearly premium adjustments.

A.20. Please refer to section B.4 Economic price adjustment – Health insurance premiums and Section B.8 Economic price adjustment – Life Insurance Premiums.

Q.21. For the 356 employees in the family plan, please confirm if these 356 include the number of dependents or if this just means there are 356 employees with dependents.

A.21. It refers to the number of employees who have dependents only.

Q.22. Could you please give us the number of employees working -30 hrs. weekly.

A.22. Two

Q.23. Deductible per year or per event?

A.23. Per year.

Q.24. Suicide Coverage: Does it have a waiting period or is it covered since the first day of enrollment?

A.24. No waiting period. It is covered immediately.

Q.25. Are retirees eligible for the Life Insurance Plan or just the Medical?

A.25. Only eligible for the medical plan.

Q.26. Premium Payment Process: Please describe how the payments are going to be made (monthly, yearly; etc).

A.26. Refer to Section G.4.2. All payments under this contract will be made at the conclusion of the period covered or quarterly.

Q.27. Can you provide the number of employees suffering from grave or catastrophic illnesses.

A.27. 12 cases.

Q.28. Regarding the enrollment process, once given the award, is the Government willing to submit a list of every employees and dependents in the policy with Id or passport numbers in accordance to the Compliance Regulations and know your customer forms in Honduras.

A.28. Once the award is made, yes, the Embassy will submit all required forms to enroll employees and dependents.

Q.29. Amount of claims paid out of the country.

A.29. 24 claims.

Q.30. Please provide the names of the most frequently used hospitals of the insured group.

A.30.

Honduras Medical Center

Centro Medico Hondureño

Policlinica

Clinicas Viera

Hospital San Jorge

Q.31. Regarding the Health Insurance, Section C, is there any difference in the percentages of reimbursement establish for the different coverages if the expense is incurred in Honduras or outside Honduras?

A.31. The only differences are in the Out-of-pocket maximum. In country, the out-of-pocket maximum is L.50,000.00 and the deductible of L.400.00. Out of country, the out-of-pocket maximum is L.100,000.00 and the deductible is

$300.00.

Q.32. The Maximum Limit defined in Section C.1.1.13 is establish per lifetime of the contract (five years); define the annual maximum limit mention in Section C.1.1.10, C.1.1.11 and C.1 with relation to eligible employees who work less than 30 hours per week?

A.32. For eligible employees who are regularly scheduled to work less than 30 hours per week, the annual maximum limit will be prorated (reduced) based on the number of hours in the employee’s regular workweek schedule (see Section C.1). No exact amount can be provided at this point as the workweek schedule may vary.

Q.33. Section C.1.1.7 Optical Care: Does this coverage have any exclusions or limitations in terms of its provision per year?

A.33. No exclusions or limitations are laid out for optical care.

Q.34. Section C.1.1.8 Dental Care: Describe minor restorative care, major restorative care and preventive care. Does this coverage have exclusions or limitations in terms of its provision per year?

A.34. No definitions are available for the minor, major or preventive care. No limitations or exclusions are laid out for dental care.

Q.35. Section C.2.1.1 Amount of Employee Life Insurance: is there a Maximum establish for the total amount of this coverage?

A.35. The coverage is 26 times employee basic salary and the maximum will vary depending on the salary earned per month.

Q.36. Section C.2.1.2 Amount of Accidental Death and Dismemberment Coverage: is there a Maximum establish for the total amount of this coverage?

A.36. The coverage is 41 times employee basic salary and the maximum will vary depending on the salary earned per month.

Q.37. Section C2.2; define the terms for the optional life insurance for employees and spouses’ life insurance (sum insured, maximum amount).

A.37. Section C.2.2. Life Insurance Benefits Conditions and Limitations includes a paragraph that states: Employees contracting optional insurance and insurance of spouses shall pay for its costs. Offerors should base their proposals on the information in this paragraph and other relevant paragraphs in the RFP.

Q.38. Section G.4.2 Frequency of Payments: Confirm if the invoices are submitted quarterly; are the payments going to be made monthly or quarterly?

A.38. Refer to Section G.4.2. All payments under this contract will be made quarterly at the conclusion of the period covered.