SOLICITATION_HEALTH_AND_LIFE_INSURANCE_SOLICITATION_FINAL.pdf

April 30 th

, 2015

American Embassy Abidjan

Riviera Golf

01 BP 1712 Abidjan 01

Abidjan, Côte d’Ivoire

Dear Prospective bidders

SUBJECT: Solicitation Number SIV100-15-R-0002

The Embassy of the United States of America invites you to submit a proposal for customized health and life insurance coverage for local engaged employees of US Mission in Abidjan

The Embassy intends to conduct a pre-proposal conference, and all prospective offerors who have received a solicitation package are invited to attend. See Section L of the attached Request for Proposals (RFP).

Your proposal must be submitted in a sealed envelope marked "Proposal Enclosed" to the attention of the Contracting Officer on or before 4:00 pm on June 10, 2015. No proposal will be accepted after this time.

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

1. SF-33

2. Section B, Pricing Schedule

3. Section B, Retention Amounts in B.3 and B.7

3. Section K, Representations and Certifications;

4. Additional information as required in Section L.

The successful offeror(s) will be required to have a DUNS number and be registered in

SAM/CCR through the following sites: DUNS – www.dnb.com and SAM/CCR www.sam.gov .

Direct any questions regarding this solicitation to the Contracting Officer or Mrs. Assy-Traore

Bintou by letter or by telephone 2249-4000 – 0672-1225 during regular business hours.

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.

http://www.dnb.com/ http://www.sam.gov/

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, Jason Azevedo

Contracting Officer

NSN 7540-01-152-8064 STANDARD FORM 33 (REV 9-97)

PREVIOUS EDITION NOT USABLE Prescribed by GSA

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE OF PAGES

2 | 67

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

3. SOLICITATION NO.

S-IV100-15-R-0002

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

04-30-2015

6. REQUISITION/PURCHASE NO.

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

American Embassy, Abidjan

Riviera Golf – 01 BP 1712 ABJ 01, Côte d’Ivoire

Phone: (225) 2249-4000 Fax: (225) 2249-4221

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

SOLICITATION

9. Sealed offers in original and 01 copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in until 06/10/2015 local time 04:00pm .

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

10. FOR

INFORMATION

CALL:

A. NAME

Assy-Traore Bintou

B. TELEPHONE (NO COLLECT

CALLS)

(225) 2249-4390

C. E-MAIL ADDRESS

Traorebx@state.gov

11. TABLE OF CONTENTS

(x) SEC. DESCRIPTION PAGE(S) (x) SEC. DESCRIPTION PAGE(S

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

X A SOLICITATION/CONTRACT FORM 3 X I CONTRACT CLAUSES 34-44

X B SUPPLIES OR SERVICE AND PRICES/COSTS 4-13 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK STATEMENT 14-24 X J LIST OF ATTACHMENTS 45-55

X D PACKAGING AND MARKETING 25 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 25-26 X K REPRESENTATIONS, CERTIFICATIONS, AND 56-66

X F DELIVERIES OR PERFORMANCE 27 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 28-29 X L INSTRS., COND., AND NOTICES TO OFFERORS 67-74

X H SPECIAL CONTRACT REQUIREMENTS 30-33 X M EVALUATION FACTORS FOR AWARD 75-77

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 inseted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT SEE 14

(See section I, Clause No 52.232-8)

10 CALENDAR

DAYS

20 CALENDAR DAYS

30 CALENDAR

DAYS

CALENDAR DAYS

14. ACKNOWLEDGMENT OF

AMENDMENTS

AMENDMENT NO. DATE AMENDMENT NO. DATE

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

15A. NAME CODE FACILITY 16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE

ADDRESS [ ] IS DIFFERENT FROM

ABOVE - ENTER SUCH ADDRESS

17. SIGNATURE 18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS SHOWN

IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7)

CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

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

SECTION B

PART I: 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 Abidjan, Cote d’Ivoire 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 (medical) and C.2.3 (life). This insurance shall be provided in accordance with Section C .

B.1.1. Official Residence Expense (ORE) Staff, Embassy Association Employees (EAE) and the retirees 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), the Embassy Association (for EAEs) and the retirees at the rates specified below. See Section G for billing procedures.

B.2. PRICES

B.2.1 VALUE ADDED TAX.

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

B.2.2 This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The prices are stated in_____(Offeror to fill in currency). The fixed prices/premium rates for the health insurance services as specified in

Section C are as follows:

Category

Estimated Number of Employees Rate per Employee Bi-Weekly Total

a. Employees ( Self Only) 335

b. Employee's Spouse 268

c. Employee's dependent Children 732

VAT

Bi-weekly rates per Employee, Spouses and children

B.2.3. Base Year of Contract

d. Subtotal (a + b + c)

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

B.2.3. Base Year of Contract

Category

Estimated Number of Employees Rate per Employee Bi-Weekly Total

a. Employees ( Self Only) 335

b. Emplyee's Spouse 268

c. Employee's dependent Children 732

VAT

Bi-Weekly Rates per Employee, Spouse and children

B.2.5. Option Year 2 of Contract

d. Subtotal (a + b +c )

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

Category

Estimated Number of Employees Rate per Employee Bi-Weekly Total

a. Employees ( Self Only) 335

b. Employee's Spouse 268

c. Employee's dependent Children 732

VAT

Bi-Weekly Rates per Employee, Spouses and Children

B.2.4. Option Year 1 of Contract

d. Subtotal (a + b + c)

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

B.2.8. Grand Total of Base plus All Option Years

Base Year Total

Option Year 1 Total

Option Year 2 Total

Option Year 3 Total

Option Year 4 Total

Grand Total of Base plus All Option Years

Category

Estimated Number of Employees Rate per Employee Bi-Weekly Total

a. Employees ( Self Only) 335

b. Employee's Spouse 268

c. Employee's dependent Children 732

VAT

Bi-Weekly Rates per Employee, Spouse and Children

B.2.7. Option Year 4 of Contract

d. Subtotal (a + b + c)

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

Category

Estimated Number of Employees Rate per Employee Bi-Weekly Total

a. Employees ( Self Only) 335

b. Employee's Spouse 268

c. Employee's dependent Children 732

VAT

Bi-Weekly Rates per Employee, Spouse and Children

B.2.6. Option Year 3 of Contract

d. Subtotal (a + b + c)

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

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount must be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall

NOT be expressed in terms of a percentage of the premium.

B.3.2.1 Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan.

Period of

Performance Employees (Self Only) Employee’s Spouse

Employee’s

Dependent

Children

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. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the Contractor agrees to provide the Government a balance sheet showing three main components for the time period: (1) receipts (premiums received) minus the retention amount, (2) number of insurance plans and (3) claims paid. This information shall be provided per type of premium, ie per line item. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet and claims and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract.

Mutually agreed to adjustments shall be effective thirty days after complete information is received by the Government. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.4.2. Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the Contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the

Contractor to modify the contract to adjust the premium rate. The Contractor agrees to provide all documentation necessary to support any requested adjustment.

B.4.2.1 Employee Pool – This clause is only in effect if the Contractor included details in its offer regarding a pooling arrangement, of which this contract is a part.

Before any adjustment is made under this price adjustment clause, the Contractor must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

PART II: PRICE - GROUP LIFE INSURANCE

B.5. GROUP LIFE INSURANCE SERVICES

The Contractor shall provide the Group Life Insurance services described herein to employees of the Government of the United States of America in Abidjan, Cote d’Ivoire. The groups of employees who shall be provided this insurance are listed in C.2.3. This insurance shall be provided in accordance with Section C.

B.6. GROUP LIFE INSURANCE RATES

B.6.1 This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The prices are stated in ____________

(offeror to identify currency.) The fixed prices/premium rates for the life insurance services as specified in Section C are as follows:

Type of Insurance

Premium

(per 1,000 of Salary) bi-weekly payroll amount rounded to the nearest thousand Bi-Weekly Total

a. Basic Life 184,821,964

b. Accidental Death & Dismemberment 184,821,964

Bi-Weekly Rates per Employee in FCFA

B.6.1. Base Year of Contract

c. Subtotal (a + b )

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

Type of Insurance

Premium

(per 1,000 of Salary) bi-weekly payroll amount rounded to the nearest thousand Bi-Weekly Total

a. Basic Life 184,821,964

b. Accidental Death & Dismemberment 184,821,964

Bi-Weekly Rates per Employee in FCFA

B.6.4. Option Year 3 of Contract

c. Subtotal (a + b)

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

Type of Insurance

Premium

(per 1,000 of Salary) bi-weekly payroll amount rounded to the nearest thousand Bi-Weekly Total

a. Basic Life 184,821,964

b. Accidental Death & Dismemberment 184,821,964

Bi-Weekly Rates per Employee in FCFA

B.6.3. Option Year 2 of Contract

c. Subtotal (a + b)

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

Type of Insurance

Premium

(per 1,000 of Salary) bi-weekly payroll amount rounded to the nearest thousand Bi-Weekly Total

a. Basic Life 184,821,964

b. Accidental Death & Dismemberment 184,821,964

Bi-Weekly Rates per Employee in FCFA

B.6.2. Option Year 1 of Contract

c. Subtotal (a + b )

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

B.7 ADMINISTRATIVE RETENTION AMOUNTS

B.7.1 If the Contractor requests a price adjustment under B.8 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.6. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the claimant.

B.7.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

B.6.6. Grand Total of Base plus All Option Years

Base Year Total

Option Year 1 Total

Option Year 2 Total

Option Year 3 Total

Option Year 4 Total

Grand Total of Base plus All Option Years

Type of Insurance

Premium

(per 1,000 of Salary) bi-weekly payroll amount rounded to the nearest thousand Bi-Weekly Total

a. Basic Life 184,821,964

b. Accidental Death & Dismemberment 184,821,964

Bi-Weekly Rates per Employee in FCFA

B.6.5. Option Year 4 of Contract

c. Subtotal (a + b)

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

NOTE TO OFFEROR: Fill in the bi-weekly 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.

Bi-weekly Retention Amounts per Separate Premium Paid per Employee:

Period of Performance Basic Life

Accidental Death and

Dismemberment

Base Period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

B.8 ECONOMIC PRICE ADJUSTMENT (EPA)-LIFE INSURANCE PREMIUMS

B.8.1. Premium Adjustment Based on Experience: For life 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. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the Contractor agrees to provide the Government a balance sheet showing three main components for the time period: (1) receipts (premiums received) minus the retention amount, (2) number of insurance plans and (3) claims paid. The information shall be provided per type of premium, ie per line item. The retention amount is not subject to adjustment. The Government reserves the right to select an independent third party to review the balance sheet and claims and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Mutually agreed to adjustments shall be effective thirty days after complete information is received by the Government. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.8.2. Premium Adjustment Based on Law: 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 rate contracted for herein. 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.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

PART I - HEALTH INSURANCE

C.1. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as described below in Cote d’Ivoire. The Government has determined that the prevailing practice by employers in Cote d’Ivoire 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 as follows:

a. For active employees who are regularly scheduled to work 30 or more hours per week:

the USG will pay 80% of the premium cost for employee and dependent coverage and the employee will pay 20% of the premium.

b. 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 coverage, based on the number of hours the employee is regularly scheduled to work. The employee will pay

100% of the premium cost for dependent coverage.

c. For retired employees: the retired employee will pay 100% of the premium cost for the employee and dependent coverage.

Health insurance protection will be representative of locally prevailing compensation practice as below. The specific health benefit coverage under this contract is set forth in

Section C.

The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care.

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.

C.1.1 Employee and Dependent Health Services Benefits

C.1.1.1. Hospitalization: 100% reimbursement of room and board for a ward room or semi-private room. 80% reimbursement of room and board for a private room, not to exceed

100% of the cost of a semi-private room. 100% reimbursement of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room costs, intensive care, prescription medicines, and physical therapy. 100% reimbursement of ambulance service.

C.1.1.2 Professional Services and Treatment: 80% reimbursement 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% reimbursement for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, physical therapy, routine annual physical examination, and inoculations.

C.1.1.3. Prescription Drugs and Medicines: 100% reimbursement when hospitalized, and 80% reimbursement when not hospitalized, of the cost of medicines and drugs for which a prescription is legally required. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician.

C.1.1.4 For Employees and dependents: 100% reimbursement for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS. For employee and employee's covered spouse/partner: 100% reimbursement for 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.

The maximum limit for expenses reimbursed under section C.1.1.4 is 10,000 US Dollars per patient per contract year.

C.1.1.5 Obstetrical Care: 100% reimbursement when hospitalized, and 80% reimbursement when not hospitalized, of obstetrical medical care including prenatal and postnatal care.

C.1.1.6 Family Planning: 80% reimbursement of prescribed contraceptive devices and drugs, voluntary sterilization, and diagnosis and treatment of infertility. Not covered is reversal of voluntary sterilization, infertility treatment after voluntary sterilization, genetic counseling, fertility drugs, and assisted reproductive technology.

C.1.1.7 Hearing Aids: 80% reimbursement of the cost of a hearing aid apparatus and related examination, limited to one apparatus per year per patient in a three-year period.

C.1.1.8 Optical Care: 50% reimbursement for eye examination and treatment and prescription eyeglass or contact lenses, limited to two lenses per patient every two years. No reimbursement for eyeglass frames, nonprescription lenses, or tinting.

C.1.1.9 Dental Care: 50% of expenses for dental services including dentists’ fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges. Orthodontia treatment is covered only if treatment begins before age 15, unless required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per patient.

C.1.1.10 Psychiatric Treatment: 50% reimbursement.

C.1.1.11 Medical Expenses Incurred Out of Country:

Medical expenses incurred out of country will be covered for employees and dependents when (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.

C.1.1.12 Transportation for Out of Country Treatment

Transportation for out of country treatment is a covered expense for employees and dependents. The patient’s attending physician must certify in advance that the treatment is medically necessary and unavailable locally. 80% 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. 80% 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 parent in the case of a patient who is a minor or a family member to make medical decisions in the case of a patient who is unconscious. All reimbursements for transportation expenses are subject to the annual maximum limit.

C.1.1.13 Annual Maximum Limit

With the exception of expenses incurred under section C.1.1.4 of the plan, the contractor shall reimburse covered expenses up to an annual limit of 20,000,000 FCFA (local currency. The maximum limit for employees regularly scheduled to work on a part-time basis for fewer than 30 hours per week will be prorated based on hours in the work week. For example, the maximum limit for an employee regularly scheduled to work 20 hours per week is 20,000,000FCFA x

20/40, or 10,000,000 FCFA.

Expenses incurred under section C.1.1.4 of the plan are subject to a separate annual maximum limit of 10,000 US Dollars per employee. This limit also will be prorated for employees regularly scheduled to work on a part-time basis for fewer than 30 hours per week.

C.1.2 Health Benefits Conditions and Limitations

There is no reimbursement 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.

There is no reimbursement for expenses that will be reimbursed or paid directly under a host country medical program or workers' compensation program; the U.S. workers’ compensation program; or post’s LES workers’ compensation program.

There is no reimbursement for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; 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 reimbursement will be made for expenses incurred after an employee leaves the service of the U.S. Mission unless the employee enrolls as a retired employee.

C.1.3 Eligible Participants

C.1.3.1 Eligible Employees - 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 Cote d’Ivoire paid under the Local

Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.1.3.1.2. Locally Engaged Staff (LES) employed as direct hires;

C.1.3.1.3. LES employed under Personal Services Agreements (PSAs);

C.1.3.1.4. LES employed under Personal Services Contracts (PSCs);

C.1.3.1.5 Third country nationals (TCNs) employed as direct hires;

C.1.3.1.6 TCNs employed under PSAs;

C.1.3.1.7 TCNs employed under PSCs;

C.1.3.1.8 Locally hired U.S. citizens employed as direct hires; and

C.1.3.1.9 Locally hired U.S. citizens employed under PSCs.

C.1.3.2 Location of Employment

The individuals covered by C.1.3.1 must be employed within the geographic boundaries of Cote d’Ivoire by:

- US Department of State

- CDC/PEPFAR

- Open Source Center

- USAID

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 assigned to their respective official Government residences and paid under an ORE account. 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 Employee Association at

Embassy/Consulate Abidjan. All costs for EAEs are the responsibility of the Employee

Association, not the U.S. Government.

C.1.3.3.3 All retired Employees of Embassy/Consulate Abidjan. All costs for retirees are the responsibility of the retiree, 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; 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

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 21, 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 24. 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.1.6. Eligibility

C.1.6.1. Term of Eligibility and Effective Date

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 (LWP) 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 (LWP) 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 French and English 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 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 date of 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.

PART II: GROUP LIFE INSURANCE

C.2.0 GROUP LIFE INSURANCE

The Government of the United States of America requires group life insurance coverage for its employees, as further described in C.2.2. The Government has determined that the prevailing practice by employers in Côte d’Ivoire is to provide for their employees life insurance protection and that 100% of such insurance protection is usually borne by the employer.

C.2.1. Group Life Insurance Coverage

The amount of group life insurance coverage is as follows:

C.2.1.1 . Amount of Employee Basic Life Insurance.

In the event of the employee’s natural death, an amount equal to one (1) times the employee’s annual basic salary will be paid to the employee’s beneficiary or estate.

C.2.1.2 Amount of Accidental Death and Dismemberment

In the event of the employee’s accidental death or dismemberment, an amount equal to one (1) times the employee’s annual basic salary will be paid to the employee’s beneficiary or estate.

This payment is made in lieu of, not in additional to, the payment in C.2.1.1.

C.2.2 Life Insurance Benefits Conditions and Limitations

C.2.2.1. No benefit shall be payable under this contract if the employee’s death is caused directly or indirectly and totally or partially by:

C.2.2.1.1. Suicide, unless it occurs after 2 years of continuous coverage under this contract.

C.2.2.1.2 Excessive consumption of alcohol or narcotics or similar drugs or agents unless they were prescribed by a licensed physician.

C.2.2.1.3 participating in an illegal activity or resisting detention or arrest.

C.2.2.1.4 Deliberate exposure to exceptional danger except in an effort to save human life.

C.2.2.1.5 An aviation or aeronautics accident, unless the employee is a fare paying passenger on a duly licensed commercial aircraft operated by licensed pilot on a scheduled air service over an established passenger route.

C.2.2.1.6 War or any act of war, declared or undeclared, except as required by applicable legislation of Côte d’Ivoire; active duty in the military of any country or international authority, revolution; or any warlike operation.

C.2.2.2. A death which occurs as a result of the following shall be considered a natural death and not an accidental death, and payment shall be made under C.2.2.1.

C.2.2.2.1. Death as a result of a disease or physical or mental infirmities, or medical or surgical treatment thereof, except infection due to an accidental cut or wound.

C.2.2.2.2. Death which occurs more than 180 calendar days after the accident.

C.2.2.2.3. Death as the result of a terrorist activity.

C.2.2.2.4. Death as the result of war when required by applicable legislation of Cote d'Ivoire.

C.2.2.2.5. Death as the result of an aircraft accident which is not excluded under C.2.2.1.5 and the insured is the pilot or performing paid work on the aircraft.

C.2.2.2.6. Death as the result of racing of any kind except foot racing; motorcycling on other than roadways designed primarily for motor traffic; aerial sports and activities such as skydiving, gliding, and parasailing; deep water diving requiring the use of breathing apparatus; mountain climbing and rock climbing; snow or ice sports; speleologist; and unarmed combat sports such as boxing, wrestling, judo, and karate.

C.2.2.2.7. Death as the result of big game hunting requiring a Special Big Game or Sport

Hunting permit.

C.2.2.3. The burden of proof that the death is not excluded under this contract or is not precluded from being considered an accidental death under C.2.2.2. is the responsibility of the representative of the employee.

C.2.3. Eligible Participants

C.2.3.1 Eligible Employees.

The employees eligible for the group life insurance coverage include the following:

C.2.3.1.1 All current active employees of the United States Government, employed within the geographic boundaries of Côte d’Ivoire paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.2.3.1.2. Locally Employed Staff who are (1) employed on a full time or part time basis under non-temporary direct hire appointments or under personal services agreements/contracts that are not time limited to less than one year and (2) paid under the terms of the Local

Compensation Plan.

C.2.3.2 Location of Employment

The individuals covered by C.1.3.1 must be employed within the geographic boundaries of Cote d’Ivoire by: The Embassy of the United States of America:

- U.S. DEPARTMENT OF STATE

- CDC/PEPFAR

- OPEN SOURCE CENTER

- DAO

- USAID

C.2.4 Individuals Not Eligible for Coverage

Individuals not eligible for coverage are employees working under temporary appointments;

employees working under personal services agreements/contracts that are time limited to less than one year; employees working on an intermittent or When Actually Employed (WAE) schedule; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Ivory Coast 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 any other individual not falling within one of the categories of eligible employees described in this clause..

C.2.5. Reserved

C.2.6 Eligibility and Effective Date

C.2.6.1. Term of Eligibility and Effective Date

Each current active eligible employee is enrolled for life insurance 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 (LWP) 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.2.6.2. Period of Ineligibility

Employees are not entitled to lie insurance hereunder during any period of employment for which premiums are not paid.

During a period of extended (beyond one pay period) of Leave without Pay (LWP) or unpaid leave, the employee is responsible for the full cost of the insurance premiums. 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.2.7. Brochure Requirement

C.2.7.1. The Contractor shall provide a document (brochure/pamphlet/other written document) in French & English that sets forth a complete listing of the life insurance benefits to be 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.2.7.2. The document described in C.2.7.1 shall be provided to the COR not later than 30 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten days of the COR’s request.

C.2.7.3. The Contractor assumes full responsibility for ensuring that the document described in C.2.7.1 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.

FMO The Financial Management Officer (FMO) or the paying office for all U.S.

Government Agencies, except U.S. AID.

COR Contracting Officer's Representative (COR) is the Human Resources Officer

(HRO) at post.

Contributory Insurance Insurance for which the employee contributes toward the premium.

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

Dependent Participants such as a spouse, children and any other individuals who through a blood or other relationship with the employee are eligible for coverage as per C.1.5.

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 (PSC), or personal services agreement (PSA), as further defined in Section C.1.3 for health insurance and C.2.3 for life insurance. . This may also include ORE Staff, EAE, and

Peace Corp PSCs, if this category of individual is listed as participating under a rider in C.1.3.3 for health insurance and C.2.3.3 for life insurance.

Employer The United States Government or in the case of ORE and Embassy

Employee Association and EAE employees, the Chief of Mission/Deputy

Chief of Mission and the Employee Association, respectively.

GSO General Services Officer in charge of the General Services Office at post.

This officer is usually the Contracting Officer (CO) for this contract.

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 or life insurance/disability benefit.

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.

C.3.0 DEFINITIONS

SECTION D

PACKAGING AND MARKETING

(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://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search engine” (for example, Google, Yahoo, Excite) to obtain the latest location of the most current

FAR.

The following Federal Acquisition Regulation clause(s) is/are incorporated by reference:

CLAUSE TITLE AND DATE

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.

Performance Objective

PWS

Paragraph Performance Threshold

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 http://www.acquisition.gov/far/ http://farsite.hill.af.mil/vffara.htm http://www.statebuy.state.gov/

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. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search

The following Federal Acquisition Regulation clauses are incorporated by reference:

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 base period with four one-year options to renew beginning on October 1, 2015 .

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:

Human Resources Officer

American Embassy Abidjan

Riviera Golf

01 BP 1712 Abidjan 01

Abidjan, Côte d’Ivoire http://www.acquisition.gov/far/

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…