Mission India Medical Health Insurance Plan SOLICITATION .doc

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

1 | 61

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

3. SOLICITATION NO.

S-IN650-11-R-0005

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

May 12, 2011

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

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

U.S. Embassy, Shanti Path, Chanakyapuri

New Delhi 110021, India

Phone: 24198000 Fax: 24198278 The Contracting Officer

U.S. Embassy, Gate-C, Chandragupta Marg, Chanakyapuri, New Delhi 110021, India

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

SOLICITATION

9. Sealed offers in original for furnishing the supplies or services in the Schedule will be received at the place specified in Block 8 above, until 3:00 P.M. local time on June 13, 2011.

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

10. FOR INFORMATION

CALL:

A. NAME

KIMBERLY A. KECK

Contracting Officer

B. TELEPHONE (NO COLLECT CALLS)

AREA CODE NUMBER EXT

91-11-24198728

C. E-MAIL ADDRESS

keckka@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 120 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

(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

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

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

SECTION B

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 India 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.1.3. This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.1.1.

1. Official Residence Expense (ORE) Staff and American Community Support Association (ACSA) Staff are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff) and the Embassy Association (for ACSA) separately, at the rates specified below. Please note that the estimated number of employees provided below do not include these employees. See Section G for billing procedures.

2. Employees may opt to enroll their eligible parents under this policy as a rider. This is a Supplemental Benefit funded and paid by the employee. This expense will not be funded by the USG. The employee and the insurance company will arrange the most favorable method of payment to handle premiums and claims incurred under the supplemental benefit. The United States Government is not responsible for payment of premiums or claims incurred under said supplement benefit.

B.2.

PRICES.

This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The fixed premium rates (in local currency) for the health insurance services as specified in Section C and Exhibit A of Section J are as follows:

B.2.1.

BASE YEAR OF CONTRACT.

B.2.1.1.

Annual Premium with Hospitalization Annual Limits of Rs.400,000 and Domiciliary Annual Limits of Rs.30,000 per family plan:

(Rupees) Total

(Rupees)

Family Plan

(Self and dependents)

TOTAL BASE PERIOD PRICES (B.2.1.1):

Rs. ______________

B.2.2.

FIRST OPTION YEAR OF THE CONTRACT:

B.2.2.1.

Annual Premium with Hospitalization Annual Limits of Rs.400,000 and Domiciliary Annual Limits of Rs.30,000 per family plan:

(Rupees) Total

(Rupees)

Family Plan

TOTAL FIRST OPTION YEAR PRICES (B.2.2.1):

Rs.____________

B.2.3.

SECOND OPTION YEAR OF THE CONTRACT:

B.2.3.1.

Annual Premium with Hospitalization Annual Limits of Rs.400,000 and Domiciliary Annual Limits of Rs.30,000 per family plan:

(Rupees) Total

(Rupees)

Family Plan

TOTAL SECOND OPTION YEAR PRICES (B.2.3.1):

Rs. ___________ B.2.4.

THIRD OPTION YEAR OF THE CONTRACT:

B.2.4.1.

Annual Premium with Hospitalization Annual Limits of Rs.400,000 and Domiciliary Annual Limits of Rs.3 0,000 per family plan:

(Rupees) Total

(Rupees)

Family Plan

TOTAL THIRD OPTION YEAR PRICES (B.2.4.1):

Rs. ____________ B.2.5.

FOURTH OPTION YEAR OF THE CONTRACT:

B.2.5.1.

Annual Premium with Hospitalization Annual Limits of Rs.400,000 and Domiciliary Annual Limits of Rs.30,000 per family plan:

(Rupees) Total

(Rupees)

Family Plan

TOTAL FOURTH OPTION YEAR PRICES (B.2.5.1): Rs. ____________

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 once expressed, shall remain fixed and cannot be adjusted for any reason whatsoever during the term of the contract, including all extensions under FAR 52.217-8 and 52.217-9.

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 below sets forth the retention amounts per premium and for each period of performance.

NOTE TO OFFEROR - Fill in the fixed retention amounts for each period of performance. These fixed amounts must be expressed in the currency in which the premium amount is proposed. The fixed retention amounts shall NOT be expressed in terms of a percentage of the premium.

B.3.2.1 Retention Amounts per separate premium paid per family plan.

(Rupees)

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 and relevant financial statements 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 relevant financial statements and make recommendations regarding the appropriateness of the requested adjustment. . Any price 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

HEALTH INSURANCE

C.1.

HEALTH_INSURANCE_SERVICES.

The Government of the United States of America requires Health Insurance coverage for its employees as further described in C.1.2 in India. The Government has determined that the prevailing practice by employers in India is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne by the employer. Health insurance protection will be representative of locally prevailing compensation practice as further described in C.1.2. The specific health benefit 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/CMD.

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 coverage. 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.

The Contractor shall cover the pre-existing conditions of existing and new employees and their dependents unconditionally.

Benefits per Family Plan (in Rupees)

Type of Benefits Annual Coverage.

Hospitalization Annual Limits:

Rs.400,000 (Includes Maternity Hospitalization with a cap of

Rs.50,000)

Domiciliary Annual Limits:

Rs. 30,000 (Includes Dental and Optical coverage without cap, but limited to the coverage amount) Reimbursements or payments shall be made for the following covered benefits:

C.1.1.1 HOSPITALIZATION. Treatment given in a hospital. The patient should be admitted to a hospital for at least 24 hours to claim hospitalization except in cases of surgery, treatment requiring advanced technology and/or other exceptional circumstances, including but not limited to dialysis, chemotherapy, radiotherapy, eye surgery, dental surgery, lithotripsy (kidney stone removal), tonsillectomy, D & C, and angiography.

C.1.1.2 Surgery:

(i) Operative procedures

(ii) Treatment of fractures and dislocations, including casting.

(iii) Plastic surgery by a qualified surgeon when necessitated by injury or disease.

C.1.1.3 Doctors Visits: Visiting a doctor in a hospital/clinic/nursing home shall be deemed to be an institution operated by a qualified physician or surgeon or a team of qualified physicians and/or surgeons for the treatment of disease/illness/injuries. Home visits by a doctor will be payable only under exceptional circumstances.

C.1.1.4 Prescription Drugs: Medicines procured may be allopathic, ayurvedic, unani, homeopathy or any other form of treatment including those that suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS.

C.1.1.5 Maternity: Claims for childbirth are allowed for the first two children. Operations associated therewith will be considered for any employee covered under the policy. Brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the child shall be covered. The duration of treatment is to be determined by the employee’s personal physician, following WHO and CDC guidelines.

C.1.1.6 Outpatient Services: Medical treatment, Diagnostic services, any outpatient surgery and pre-maternity and post maternity expenses.

C.1.1.7 Optical Service: Expenses incurred for vision and diagnostic tests, cataract removal, vision therapy and operations required for medical reasons are payable. Cost of contact lens, spectacles, laser surgery to improve vision, and lens cleaner are not payable.

C.1.1.8 Rehabilitative Therapies: Physical therapy, occupational therapy, and speech therapy required for medical reasons and performed by a licensed therapist or physician.

C.1.1.9 Psychiatric Treatment: Professional services, including individual or group therapy by licensed providers such as psychiatrists, psychologists and psychiatric nurses.

C.1.1.10 Ambulance Service: Local professional ambulance transport services to or from the nearest hospital equipped to adequately treat patient’s condition related to medical emergency.

C.1.1.11 Dentures: Dentures will be payable only when necessitated by injury.

C.1.1.12 Geographic Coverage: Only expenses incurred within the geographic boundaries of India are payable.

C.1.1.13 Vaccinations that may be necessary due to an accident or an illness will be payable.

C.1.2 Health Benefits Conditions and Limitations.

Conditions and limitations on the entitlement to health care under this contract are as follows:

C.1.2.1 Limitations The following are excluded from the scope of the Policy, i.e., no benefit is payable in respect of:

1. Vaccination, inoculation, change of life, cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness, circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident.

2. Convalescence, general debility, run-down condition or test cure, venereal disease, intentional self injury, use of intoxicating drugs or alcohol, or any injury, disease or illness directly or indirectly due to any one or more of them.

3. Injury or disease directly or indirectly caused by or arising from or attributable to war, invasion, act of foreign enemy, or warlike operations (whether war be declared or not); hunting, steeple chasing, pole or winter sports, riding or driving in races; employment in military, naval or air services; engaging in aviation or ballooning; entering, traveling or leaving an aircraft or balloon, but this exclusion shall not apply to injuries resulting from an accident to a fully licensed type of aircraft operated by recognized airlines or a regular schedule air route in which the insured person is traveling as a passenger.

4. Tonics and vitamins unless forming part of treatment for injury or disease as certified by the attending physician.

5. Injury, disease or illness directly or indirectly caused by or contributed to by or arising from ionizing radiation or contamination by radioactivity from any source whatsoever. The indemnity provided by this policy shall not apply to nor include any accident or disease or illness directly caused by or contributed to by or arising from nuclear weapons material.

6. Any expenses or treatment taken outside the Republic of India.

7. Educational or training services.

8. Psychoanalysis or psychotherapy credited toward earning a degree or furtherance of education or training regardless of diagnosis or symptoms that may be present.

C.1.2.2 Conditions.

a. Claims should be submitted to the Contractor within 45 days of incurring the expense.

b. The insured shall obtain and furnish the Contractor with original bills, receipts and other documents upon which the claim is based, and shall also give the Company any additional information and assistance as may be required to process the claim.

C.1.3 Eligible Participants.

C.1.3.1 Eligible Employees.

The employees eligible for the health insurance services include the following:

C.1.3.1.1 All current active employees of the United States Government, employed within the geographic boundaries of India paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.1.3.1.2.

Foreign Service Nationals (FSNs) employed under direct hire appointments, Personal Services Agreements (PSAs) and Personal Services Contracts (PSCs);

C.1.3.1.3.

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

C.1.3.1.4.

Third Country Nationals (TCNs) employed under direct hire appointments, PSAs, and PSCs.

C.1.3.2 Location of Employment.

The individuals covered by C.1.3.1 must be employed within the geographic boundaries of India by:

All agencies functioning under the aegis of the U.S. Mission, including, but not limited to Department of State, U.S. Agency for International Development, Foreign Commercial Service, Defense Attaché, etc.

C.1.3.3

Participants Covered Under a Rider C.1.3.3.1 All current active employees of the Chief of Mission and the Deputy Chief of Mission at U.S. Embassy, New Delhi and the Consul Generals at Mumbai, Kolkata, Chennai and Hyderabad assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.1.3.3.2 All current active employees of the American Community Support Association (ACSA) at U.S. Embassy , New Delhi and the Consulates at Mumbai, Kolkata, Chennai and Hyderabad (see separate rider, Exhibit C). All costs for ACSA employees are the responsibility of the Employee Association, not the U.S. Government.

C.1.3.3.3 All current active employees parents at U.S.Embassy, New Delhi and the Consulates at Mumbai, Kolkata, Chennai and Hyderabad (see separate rider, Exhibit D). All costs for the employees parents are the responsibility of the employees and not the U.S.Government.

C.1.4 Individuals Not Eligible for Coverage.

Individuals not eligible for coverage under this contract are non-personal services contract personnel; Peace Corps Personal Services Contractors as required by MS 743; 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.1.5.

Other Eligible Participants.

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

This plan covers reimbursement of hospitalization and domiciliary treatment undertaken by the employees and their dependant family members, anywhere in India. The family is comprised of the spouse and legitimate unmarried dependent children until the end of the contract year in which he/she reaches age 23 and disabled unmarried dependent children (irrespective of age).

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

For eligible employees who are regularly scheduled to work less than 30 hours per week: The U.S. Government 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.

All employees under the age of 63 are covered by this plan. Spouses of employees are covered, irrespective of age.

C.1.6.

Eligibility.

C.1.6.1. Term of Eligibility and Effective Date.

Each current active employee and their dependents are eligible for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new employee and his or her dependents will be eligible upon entering on duty with the United States Government. An employee is considered active ("on the rolls") whenever the employee is on annual or sick leave, with or without pay.

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

C.1.6.2. 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.

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.

C.1.7.

Brochure Requirement.

C.1.7.1 The Contractor shall provide a document (brochure/pamphlet/other written document) in English that sets forth a complete list of health insurance benefits provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.1.7.2 The Contractor shall provide the document described in C.1.7.1 to the COR not later than 30 days after the date of the contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.1.7.3 The Contractor assumes full responsibility for ensuring that the document described in C.1.7.1 accurately reflects the requirements of the contract, as implemented by the Contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the Contractor will be notified in writing; however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the Contractor to fully comply with all contract terms.

C.2.0.

Reserved C.3.0

DEFINITIONS

FMO

The Financial Management Officer or the paying office for all U.S. Government

Agencies except AID.

COR

Contracting Officer's Representative (Embassy Human Resources Officer).

Premium Employers’ 100 % contribution towards the Insurance.

Dependent Spouse and legitimate unmarried dependent children until the end of the contract year in which he/she reaches age 23 and disabled unmarried dependent children (irrespective of age).

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

Employee All current active employees of the United States Government, employed within the geographic boundaries of India, and paid under the local compensation plan.

All current active employees paid under an ORE account. All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

Eligible The mother, father, stepparent or legally adoptive parent of the employee.

Parents Employee All current active employees paid under the American Community Support Association Association (ACSA) account. All costs for ACSA employees are the

Employees responsibility of ACSA, not the U.S. Government.

(EAE)

Employer The United States Government, employing officer of ORE staff, ACSA.

GSO

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

Hospital Hospital/Nursing Home shall be deemed to be an institution operated by a qualified physician or surgeon or a team of qualified physicians and/or surgeons for the treatment of disease/illness/injuries.

The term "Hospital" shall not include an establishment, which is incidentally a place for rest, a place for the aged, a place for drug/addicts, a place for alcoholics, or a hotel unless and to the extent that such institution is accepted by the Insurance Company.

Hospital An individual who has been admitted to a hospital, is assigned a bed, Patient and is given diagnostic tests or receives treatment for a disease or an injury.

Maximum The total amount that will be paid to any one covered individual for covered Benefit medical expenses or life insurance/disability benefit.

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

Treatment Qualified An individual who has graduated from an accredited medical school and is

Physician licensed to practice medicine in the jurisdiction in which the services are performed. If the individual is a medical specialist, then he or she must be

Board Certified in that specialty.

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

Illness: Any one illness will be deemed to mean continuous period of illness and it includes relapse within 45 days from the date of last consultation with the Physician/Hospital/Nursing Home where treatment may have been taken. Occurrence of same illness after a lapse of 45 days as stated above will be considered as fresh illness for the purpose of this policy.

SECTION D

PACKAGING AND MARKING

(Reserved)

SECTION E

INSPECTION AND ACCEPTANCE

E.1.

52.252‑2 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.1.0 thru C.3.0

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.

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:

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.

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 October 1, 2011with four one-year options to renew.

F.3

OPTIONS

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.

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:

The Human Resources Officer

U.S. Embassy

Gate 6, Nyaya Marg, Chanakyapuri

SECTION G

CONTRACT ADMINISTRATION DATA

G.1.

652.242-70 CONTRACTING OFFICER’S REPRESENTATIVE (COR) (AUG 1999)

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.

The COR for this contract is the Human Resources Officer (HRO).

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 Contractor 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 Indian rupees.

G.4

SUBMISSION OF INVOICES AND PAYMENT

G.4.1.

Invoices for U.S. Government employees shall be submitted in an original and two (2) copies to the following address (designated billing office only for the purpose of submitting invoices):

The Human Resources Officer

U.S. Embassy, New Delhi Gate 6, Nyaya Marg, Chanakyapuri

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 monthly for payment to be made at the beginning of the month for which insurance coverage is provided in accordance with FAR 32.404. Each quarterly payment of the premiums shall be one-quarter of the total amount of the annual premium for each employee, unless pro-rated as described under H.3.

G.4.3. U.S. Government Employees. The Government shall make payments directly to the Contractor for all Government employees, whether or not the employee is contributing to the premium amount.

G.4.4 ORE Staff. The Chief of Mission and/or Deputy Chief of Mission and Consul Generals in Mumbai, Kolkata, Hyderabad and Chennai will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount.

G.4.5. ACSA Staff. (ACSA will make payment directly to the Contractor for the entire premium amount of the ACSA employee, whether or not the ACSA employee is contributing to the premium amount.

G.4.6. Employee Parent(s). Employee will make payment directly to the Contractor for the entire premium amount.

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 (10) calendar days of receipt of the request.

G.6 The Contractor shall show Value Added Tax (VAT) as a separate item on invoices submitted for payment.

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. Each Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

H.3.

ORDERING PROCEDURES. The Government will issue a task order as soon as possible after contract award to identify all employees to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered. The COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor. All such revisions shall be consolidated, and a new or modified task order will be issued by the Contracting Officer. If any changes have been made to the coverage listing, the Government anticipates issuance of a new task order on a [ ] monthly, [X] quarterly basis. This new task order will include all changes made since the previous task order was issued and will include any increase or decrease in necessary funding. The changes to the list of eligible individuals will supersede the initial list provided under prior task orders without prejudice to the ineligibility clause. Task orders will indicate the effective date of employment, for purposes of calculating the premium due.

H.3.1. The ORE staff and ACSA employees under separate riders are not included under the task orders issued by the Contracting Officer. Because their coverage is under a rider, their employer is responsible for directly interacting with the Contractor to order any coverage for their employees. When contacted by the employer, the Contractor shall advise the employer of the paperwork and payment that will be necessary to order coverage for the identified individuals. Because more than one employer may have ORE staff, more than one employer (typically the Chief of Mission, Deputy Chief of Mission and Consul Generals) may contact the Contractor.

Employees’ parents under separate rider are not included under the task order issued by the Contracting Officer. Because their coverage is under a rider, the employee is responsible for directly interacting with the Contractor to order any coverage for their parents. When contacted by the employee the Contractor shall advise of the paperwork and payment necessary to order coverage for the identified individual.

H.3.2.

Actual insurance premium payments to the Contractor shall be made on a quarterly basis as per the amounts obligated via each Task Order.

H.3.3.

The Contracting Officer shall issue new Task Orders for new employees who join during the coverage period. The new Task Orders shall also list departed employees, for deducting the amount of premium that was already paid for the period that employee is not on payroll. No further premium shall be paid for departed employees.. The new employees will be listed in all future routine quarterly Task Orders that shall be issued per H.3.1. above. Payment shall again, be made on a quarterly basis.

H.3.4.

If any employee departs during the coverage period without submitting a single claim, then any part of the premium paid for the departed employee shall be adjusted to provide coverage to a new employee provided the new employee is joining the same funding agency/program. The balance premium, if any, shall be paid at the scheduled quarterly rests. The quarterly Task Orders shall reflect this change.

H.3.5. If an employee departs midway through the contract performance period and has submitted claims that were settled, only pro-rated premium for the period that employee was on payroll shall be paid, instead of the full premium. The benefits and coverage limits for such employees and their dependents as provided in Paragraph C.1.1. of Section C shall remain unchanged and shall not be pro-rated.

H.3.6. If a new employee joins midway through the contract performance period, pro-rated premium be paid for the period he shall be on the payroll, instead of the full premium. The benefits and coverage limits for such employees and their dependents as provided in Paragraph C.1.1. of Section C shall remain unchanged and shall not be pro-rated.

H.3.7.

The COR shall make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor. Before providing the Contractor with a revised listing of employees that would increase the amount due to the Contractor, the COR shall ensure that Task Orders obligating sufficient funds have been issued. These are the funds to be obligated by the Contracting Officer when issuing the task order.

H.4.

CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO CLAIMANTS

GENERAL. The Contractor shall be responsible for all planning, estimating, programming, project management, scheduling, dispatching, supervision, and inspection of work. The Contractor shall maintain his own reference library of technical reference works and local laws and regulations, including current tariffs and registries. The Contractor shall treat the information provided by the Embassy concerning employee' personal data, medical information, and salaries as highly sensitive and not divulge any employee information to unauthorized persons. The Contractor shall establish procedures for handling medical insurance claims as follows:

ADMINISTRATIVE RECORDS.

(1) The Contractor shall maintain medical insurance files for each covered employee and each covered dependent including receipts and proof of paid claims, requests for claim reimbursements, and accounting of paid benefits with balances of amounts remaining in the annual per person reimbursement ceiling.

(2) The Contractor shall provide the COR with the necessary claim forms for each type of benefit that can be claimed under the contract. These forms shall specify a list of documents required to be appended to each claim and otherwise provide instructions for claim filing.

(3) The Contractor shall use the English spelling of the employees' names in all transactions, including reimbursement checks.

(4) The Contractor shall send employee claim reimbursement checks to employees not later than two weeks after a claim is submitted.

MEDICAL INSURANCE CLAIMS. Settlement of medical insurance shall be completed as follows:

All medical claims shall be submitted directly to the Contractor by employees, through a drop box in the COR's office. The claims shall be picked up from the COR each Tuesday and Friday.

The Contractor shall date stamp and screen all claims submitted on the day of receipt. If there are any missing documents or information thereby disallowing said claim to be payable, the Contractor shall notify the employee within two days, with a copy to the COR (if notification is written).

The Contractor shall settle the claims no later than two weeks from the date the claim is submitted to the Contractor.

Settlement shall be by issuance of checks in the name of the employee for each claim submitted. Each check shall be accompanied by a form providing details of the amount reimbursed with an explanation of deductions, if any.

(5) The Contractor shall accept the employee's or dependent's choice to go for surgery to hospitals designated by the Contractor in order that the Contractor will pay the expenses directly to the hospitals.

(6) All administrative fees, registration fees, file charges, OPD (out patient department) charges, and casualty charges will be payable for any covered treatment. These expenses, if incurred, shall be included in the claims submitted by the employees covered under this contract.

H.5.

REPORT REQUIREMENTS. The Contractor shall provide the following reports monthly. All reports must be received by the COR no later than the 10th day of each month. These reports shall report on the previous month's activities.

EMPLOYEE CLAIMS REPORT. The report will list all claims paid by the Contractor to a claimant, including the name of the claimant, date claim is received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of why claim has not been paid.

H.6.

MISCELLANEOUS CONTRACTOR REQUIREMENTS

H.6.1.

GENERAL. The Contractor shall take all such steps as are necessary, and obtain and pay for all permits, taxes and fees as are required by the Indian government to establish and/or operate a commercial venture locally. A contract with the U.S. Government conveys no special privileges or immunities to the Contractor. The Contractor is an independent commercial concern and not a part of the U.S. mission. The Contractor's employees are not U.S. Government employees. Registration of this contract with the Indian government, if required by law, will be the sole responsibility of the Contractor, and any fees, taxes, or other duties shall be payable by the Contractor without recourse to the Government of the amounts thereof.

H.6.2.

LICENSES AND LOCAL LAWS. The Contractor shall possess all permits, licenses, and any other appointments required for the prosecution of work under this contract, all at no additional cost to the Government. The Contractor shall perform this contract in accordance with local laws.

H.7. ERRONEOUS PAYMENTS. If the Government becomes eligible for a refund of payment because of erroneous overpayment or other cause, the Contractor shall refund the amounts or use them to offset future payments owed by the Government, whichever the Government prefers. The Contractor shall refund any refunds not complete or discovered after the completion date of this contract.

H.8. REQUIRING ACTIVITY. The requiring activity under this contract is the U.S. Embassy/Consulate.

SECTION I

CONTRACT CLAUSES

I.1.

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:

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.gov/home.htm 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.

52.202-1

DEFINITIONS (JUL 2004)

52.203-3

GRATUITIES (APR 1984)

52.203-5

COVENANT AGAINST CONTINGENT FEES (APR 1984)

52.203-6

RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT (SEP 2006)

52.203-7

ANTI-KICKBACK PROCEDURES (OCT 2010)

52.203-8

CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS

FOR ILLEGAL OR IMPROPER ACTIVITY (JAN 1997)

52.203-10

PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER

ACTIVITY (JAN 1997)

52.203-12

LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN

FEDERAL TRANSACTIONS (OCT 2010)

52.204-4

PRINTING/COPYING DOUBLE-SIDED ON RECYCLED PAPER

(AUG 2000)

52.204-9

PERSONAL VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

52.204-10

REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT AWARDS (JUL 2010)

52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN SUBCONTRACTING WITH CONTRACTOR’S DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT (DEC 2010)

52.215-2

AUDIT AND RECORDS - NEGOTIATION (OCT 2010)

52.215-8

ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT

(OCT 1997)

52.215-11

PRICE REDUCTION FOR DEFECTIVE CERTIFIED COST OR

PRICING DATA – MODIFICATIONS (OCT 2010)

52.215-13

SUBCONTRACTOR CERTIFIED COST OR PRICING DATA -

MODIFICATIONS (OCT 2010)

52.215-21

REQUIREMENTS FOR COST OR PRICING DATA OR

INFORMATION OTHER THAN COST OR PRICING DATA--

MODIFICATIONS (OCT 2010)

52.222-19

CHILD LABOR – COOPERATION WITH AUTHORITIES AND REMEDIES (JULY 2010)

52.222-39 NOTIFICATION OF EMPLOYEE RIGHTS CONCERNING PAYMENT OF UNION DUES OR FEES (DEC 2004) (only if over $100,000) 52.222-50

COMBATTING TRAFFICKING IN PERSONS (FEB 2009)

52.223-18

CONTRACTOR POLICY TO BAN TEXT MESSAGING WHILE

DRIVING (SEP 2010)

52.224-1

PRIVACY ACT NOTIFICATION (APR 1984)

52.224-2

PRIVACY ACT (APR 1984)

52.225-13

RESTRICTIONS ON CERTAIN FOREIGN PURCHASES

(JUN 2008)

52.225-14

INCONSISTENCY BETWEEN ENGLISH VERSION AND

TRANSLATION OF CONTRACT (FEB 2000)

52.228-4

WORKERS’ COMPENSATION AND WAR-HAZARD INSURANCE

OVERSEAS (APR 1984)

52.228-5

INSURANCE-WORK ON A GOVERNMENT INSTALLATION

(JAN 1997)

52.229-6

TAXES - FOREIGN FIXED PRICE CONTRACTS (JUN 2003)

52.232-1

PAYMENTS (APR 1984)

52.232-8

DISCOUNTS FOR PROMPT PAYMENT (FEB 2002)

52.232-11

EXTRAS (APR 1984)

52.232-17

INTEREST (OCT 2010)

52.232-18

AVAILABILITY OF FUNDS (APR 1984)

52.232-24

PROHIBITION…