RFP S-JO100-12-R-0001 including cover letter.doc

Solicitation No. S-JO100-12-R-0001

Amman, Jordan

February 15, 2012 General Services Office American Embassy

P. O. Box 354

Amman 11118, Jordan

Dear Prospective Offeror:

SUBJECT: Solicitation Number S-JO100-12-R-0001

Health & Life Insurance

The Embassy of the United States of America invites you to submit a proposal for customized Health and Life Insurance for its employees in Amman, Jordan.

The Embassy intends to conduct a pre-proposal conference, and all prospective offerors who have received a solicitation package will be 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 Matthew S. Ferry, General Service Office, American Embassy – Amman on or before 1600 hours local time on Sunday, March 18, 2012. 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.

Direct any questions regarding this solicitation to Ali A. Bdair by letter or by telephone number 5906026 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.

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, Matthew S. Ferry Contracting Officer

SF-33

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 Jordan 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 and the Exhibits in Section J.

B.1.1.

Official Residence Expense (ORE) 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) separately, at the rates specified below. See Section G for billing procedures.

B.1.2 Retirees The Contractor shall bill the retired employees of the U.S. Embassy in Amman, Jordan individually; however the U.S. Embassy is not responsible for their premium payments, including any interest due for late payments. The retired employee will pay 100% of the premium cost for employee and dependent coverage.

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 prices/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:

Bi-Weekly Rates per Employee:

Single Employees (Self only) 92 *

Family Plan

288 *

SUBTOTAL

Total Price for Base Year (Subtotal x 26): _______

* ORE and retirees not included in the total above are persons mentioned in paragraphs B.1.1. & B.1.2. However, estimated total persons are 7 singles for ORE and 20 for retirees.

(Note: An Average family represents 1 spouse and 4 children.)

B.2.2.

FIRST OPTION YEAR OF THE CONTRACT:

Bi-Weekly Rates Per Employee:

Single Employees

97 *

Family Plan

303 *

SUBTOTAL

Total Price for First Option Year (Subtotal x 26): _________

* ORE and retirees not included in the total above are persons mentioned in paragraphs B.1.1. & B.1.2. However, estimated total persons are 7 singles for ORE and 22 for retirees.

(Note: An Average family represents 1 spouse and 4 children.)

B.2.3.

SECOND OPTION YEAR OF THE CONTRACT:

Single Employees

102 *

Family Plan

318 *

SUBTOTAL

Total Price for Second Option Year (Subtotal x 26): _______

* ORE and retirees not included in the total above are persons mentioned in paragraphs B.1.1. & B.1.2. However, estimated total persons are 7 singles for ORE and 24 for retirees.

(Note: An Average family represents 1 spouse and 4 children.)

B.2.4.

THIRD OPTION YEAR OF THE CONTRACT:

Single Employees

107 *

Family Plan

334 *

SUBTOTAL

Total Price for Third Option Year (Subtotal x 26): _______

* ORE and retirees not included in the total above are persons mentioned in paragraphs B.1.1. & B.1.2. However, estimated total persons are 7 singles for ORE and 26 for retirees.

(Note: An Average family represents 1 spouse and 4 children.)

B.2.5.

FOURTH OPTION YEAR OF THE CONTRACT:

Single Employees

112 *

Family Plan

351 *

SUBTOTAL

Total Price for Fourth Option Year (Subtotal x 26): __________

* ORE and retirees not included in the total above are persons mentioned in paragraphs B.1.1. & B.1.2. However, estimated total persons are 7 singles for ORE and 30 for retirees.

(Note: An Average family represents 1 spouse and 4 children.)

GRAND TOTAL BASE PERIOD PLUS OPTION YEARS: __________

B.3

ADMINISTRATIVE RETENTION AMOUNTS

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

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

B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

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

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

(Self Only) Family Plan

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

B.4.

ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS

B.4.1.

Premium Adjustment based on Experience - For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract. No adjustment will be allowed during the first twelve months. After such time, the contractor or the Government may request an adjustment in premiums on an annual basis. Before any such adjustment is made, the contractor agrees to provide the Government a balance sheet showing two main components for the time period: (1) receipts (premiums received) minus the retention amount and (2) claims paid. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.4.2.

Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the Contractor to modify the contract to adjust the premium rate. The contractor agrees to provide all documentation necessary to support any requested adjustment.

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

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

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 Amman, Jordan. 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 and the Exhibits in Section J.

B.5.1.

Official Residence Expense (ORE) 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) separately, at the rates specified below. See Section G for billing procedures.

B.6.

GROUP LIFE INSURANCE RATES

This is a fixed-price with economic-price- adjustment-requirements type contract under which the Government will issue firm-fixed price task orders. The fixed prices/premium rates in Jordanian Dinars per one thousand JD of salary to provide life insurance, accidental death and dismemberment and partial and total disability coverage are as follows:

B.6.1.

BASE YEAR OF CONTRACT

Natural Death

JD 207

Accidental Death

JD 207

Dismemberment

JD 207

Total and Permanent Disability

JD 207

Total Price for Base Year: __________x 26 = _____________

B.6.2.

FIRST OPTION YEAR OF CONTRACT:

Bi-Weekly Rates per Employee:

Natural Death

JD 212

Accidental Death

JD 212

Dismemberment

JD 212

Total and Permanent Disability

JD 212

Total Price for First Option Year: __________x 26 = _____________ B.6.3.

SECOND OPTION YEAR OF CONTRACT:

Natural Death

JD 217

Accidental Death

JD 217

Dismemberment

JD 217

Total and Permanent Disability

JD 217

Total Price for Second Option Year: __________x 26 = _____________ B.6.4.

THIRD OPTION YEAR OF CONTRACT:

Natural Death

JD 222

Accidental Death

JD 222

Dismemberment

JD 222

Total and Permanent Disability

JD 222

Total Price for Third Option Year: __________x 26 = _____________ B.6.5.

FOURTH OPTION YEAR OF CONTRACT:

Natural Death

JD 227

Accidental Death

JD 227

Dismemberment

JD 227

Total and Permanent Disability

JD 227

Total Price for Fourth Option Year: __________x 26 = _____________

GRAND TOTAL PRICE FOR ALL YEARS: __________________

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.

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

B.7.3 Retention Amounts per separate premium paid per employee

Base Period

First

Option Year

Second Option Year

Third

Option Year

Fourth Option Year

B.8

ECONOMIC PRICE ADJUSTMENT-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. Before any such adjustment is made, the contractor agrees to provide the Government a balance sheet showing two main components for the time period: (1) receipts (premiums received) minus the retention amount and (2) claims paid. The retention amount is not subject to adjustment.

The Government reserves the right to select an independent third party to review the balance sheet and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.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 further described in C.1.2 in Jordan. The Government has determined that the prevailing practice by employers in Jordan 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 on a 90% U.S. Government (employer) share, and 10% employee share. Health insurance protection will be representative of locally prevailing compensation practice as further described in C.1.2. For active employees who are regularly scheduled to work less than 30 hours per week: the USG will pay a prorated share of the premium cost for employee and dependent coverage, based on the number of hours the employee is regularly scheduled to work. 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 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.

Employees and dependents may select hospital and doctors, pay bills, and claim reimbursements against the contractor directly.

Employees and dependents may accept treatment from the Contractor's designated hospitals and doctors. In such cases, the Contractor will pay medical expenses directly to the providers of care and invoice employees for their portion of the co-insurance.

A.

Hospital Benefits:

1. 100% reimbursement of room (for private, semi-private or ward) and board with no limit on number of days.

2. Prescription Drugs and Medicines 90% reimbursement for drugs and medicines for which a prescription is legally required with no maximum per case.

3.

Surgical expenses per case 100% reimbursement (According to the maximum official tariff in effect the day of the case).

4. Hospital service expenses per case to be reimbursed at 100% at reasonable and customary cost.

5.

X-Rays and laboratory tests 100% reimbursement.

6. Doctor’s visit (in hospital) 100 % with no limit on number of visits. The cost is according to current official tariff.

7. Outpatient Hospital Service (covering Emergency first-aid or hospital outpatient treatment) 100 % reimbursable with no maximum limit per case.

8. Ambulance Service is 100% reimbursable with no maximum limit per individual case.

B.

Out of Hospital Benefits:

1.

Doctor's visit 90 % with no limit on number of visits per year

(According to Current official tariff).

2. Prescription Drugs, vitamins, cold remedies and Medicines 90% reimbursement for which a prescription is legally required with no maximum per case.

3.

X-Rays and laboratory tests 90% reimbursement.

C.

Maternity Medical Benefits:

This benefit is for only one pregnancy but not restricts total number of pregnancies during the base plus four option year and is only available for female employees and for insured dependent wives of male employees. These ceilings include outpatient regular check-ups plus in- hospital delivery charges.

Doctor’s visit – 100 % reimbursement

Normal Delivery – 100% reimbursement up to maximum of JD 2000. This maximum includes nursing care for the baby, professional fees, and pre and post-natal care.

Caesarian Delivery – 100% reimbursement up to a maximum of JD 2000.

Miscarriage or medical abortion 100% reimbursement up to a maximum of JD 2000.

Other Benefits D.

Dental Treatment:

80% reimbursement for routine treatment only up to the maximum according to the official tariff on date of procedure. Routine Dental Services include:

Fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

E. Optical Treatment:

60% reimbursement for eye examination and treatment and prescription eyeglass or contact lenses. Limited to one lenses or frames per patient every years with maximum of JD 60. No reimbursement of nonprescription lenses, or tinting.

F. Physical Treatment:

100% reimbursement with maximum of 13 sessions per year

G. Psychiatric Treatment:

60 % reimbursement with no limit on number of visits per year.

H. Hearing Aids:

None.

I.

For employees only: 100% reimbursement for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS; as well as brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. This expanded coverage generally excludes medications for the long-term suppression of AIDS through the combination of anti-retroviral drugs at those posts with inadequate local healthcare infrastructures.

J. Retirees: This is to cover retired employees of the U.S. Embassy for the health medical benefits as described in C.1.1.

ALL ABOVE BENEFITS A THROUGH I ARE REIMBURSED TO A MAXIMUM OF 80,000 JORDANIAN DINARS PER PERSON PER ANNUM.

(For example, in a family with one employee and two dependants, each individual person in that family group has a maximum of JD 80,000 per annum).

Based on FAR clause 52.217-8 “Option to Extend Services”, the USG can require the Contractor to continue performance after Option Year Four within the limits and the rates specified in the contract, including the coverage ceiling, for up to 6 months.

All of the benefits described in paragraphs A through I are required benefits under the basic coverage priced in section B.2.1 in the base year and respective sections in option periods.

C.1.1.1 Medical expenses incurred out of country

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

(a) A life threatening condition occurs when the individual is out of the country and treatment is medically necessary before the individual returns home or (b) the individual’s attending physician certifies in advance that such treatment is medically necessary and unavailable locally. Reimbursement will be made at the same percentage rate and subject to the same annual maximum limit as for expenses incurred in country.

C.1.1.2

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 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.1.1.3

Annual Maximum Limit - The maximum annual reimbursement per patient per contract year, is JD 80,000.000 Expenses incurred under Section C.1.1.I of the plan are subject of a separate annual maximum limit of USD 10,000.00 per employee.

C.1.2 Health Benefits Conditions and Limitations.

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

No reimbursement for:

- Elective Cosmetic surgery

- Spa cures

- Rejuvenation cures

- Massage

- Exercise therapy

- Long term rehabilitative therapy

- Non-medical hospital charges such as telephones, television

- Home help, family help, or similar household assistance

- Fees of persons who are not licensed physicians or nurses

- Services or supplies which have not been prescribed or approved by a physician or nurse

- Expenses that will be reimbursed or paid directly under a host country medical program, the

U.S. workers, compensation program, or a post’s Locally Employed Staff workers, compensation program.

- An illness or injury that is a result of unlawful action on the part of the patient; the practice of a dangerous sports; excessive use of Alcohol and illegal use of drugs; a self-inflicted wound; or service in the armed forces of any country

- Expenses made after an employee leaves the service of the U.S. Mission.

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 Jordan 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.1.3.2 Location of Employment

The individuals covered by C.1.3.1 must be employed within the geographic boundaries of Jordan by the U.S. Government Agencies at the American Embassy in Amman, Jordan.

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 (see separate rider, Exhibit D). All costs for ORE employees are the responsibility of the employing officer, 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 indicated in 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:

Eligible Dependents are defined as 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 contract year in which the child turns age 18, or age 25 if a full-time student. There is no age limit for a child who is physically or mentally handicapped so as to be unable to live independently. There is no limit of 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.

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 Leave Without Pay or unpaid leave beyond one pay period, the employee is responsible for the full cost of premiums for employee and dependent coverage. The USG will pay the premium directly to the contractor, and will collect the full cost from the employee. Alternatively, the employee may elect to have coverage cease if he/she prefers not to pay the premium.

C.1.6.3. The policy shall provide that employee benefits under this policy terminate on the date of separation or retirement. Section J Exhibit A shall be updated by the COR to reflect these changes and provided the Contractor quarterly a contract year.

C.1.7.

BROCHURE REQUIREMENT.

C.1.7.1.

The contractor shall provide a document (brochure/pamphlet/other written document) in English and Arabic 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, in Jordan. The Government has determined that the prevailing practice by employers in Jordan is that group life insurance coverage is representative of locally prevailing compensation practice and that the cost of such insurance protection is usually borne by the employer on a 100% by the Government. Therefore, the Government desires to adopt such locally prevailing practice as part of its compensation plan for its employees as further described in C.2.2. The specific group insurance coverage under this contract is set forth in this part of Section C and the Attachments in Section J.

C.2.1.

Group Life Insurance Coverage.

The amount of group life insurance coverage is as follows:

C.2.1.1

Amount of Employee Life Insurance.

The amount of life insurance coverage for each eligible employee is based upon the employee's basic monthly salary. The amount of coverage for a natural death or in service from non accidental causes is 22 times the employee's basic monthly salary.

C.2.1.2 Amount of Accidental Death and Dismemberment Coverage.

The employee’s estate or employee will receive an amount equal to 19 times the amount of monthly basic salary, in addition to the life insurance benefit in C.2.1.1, in the event the employee is killed in an accident.

In the event the employee sustains an injury causing a loss of a member, the injured employee will receive an amount equal to a percentage of 9 months’ basic salary, depending on the severity of the injury and according to the insurance standard schedules which list the percentage paid for each type of injury. See Exhibit E “Percentage Scale for Total Permanent Disability and Partial Permanent Disability (Dismemberment)” C.2.1.3

Total and Permanent Disability Coverage

In the event the employee is separated from United States Government service prior to normal retirement age due to total and permanent disability, the employee will receive an amount equal to 13 times the employee’s basic monthly salary.

C.2.2

Life Insurance Benefits Conditions and Limitations.

Conditions and limitations on the entitlement to life insurance benefits under this contract are as follows:

- War, invasion, hostilities, rebellion, revolution, insurrection, riots, strikes, or civil commotion.

- Suicide or any act of intentional self-injury.

- Motorcycling, mountaineering, or racing

- Alcohol or drug addiction

- Pregnancy or miscarriage

- Radiation or contamination by radiation.

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 Jordan, paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.2.3.1.2.

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

C.2.3.1.3.

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

C.2.3.2 Location of Employment

The individuals covered by C.2.3.1 must be employed within the geographic boundaries of Jordan by the U.S. Government Agencies at the American Embassy in Amman, Jordan.

C.2.3.3 Participants Covered Under a Rider

C.2.3.3.1 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 (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.2.4

Individuals Not Eligible for Coverage

C.2.4.1 Individuals not eligible for coverage under this contract are nonpersonal 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.2.5.

Other Eligible Participants (Not Applicable).

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 and disability 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.

C.2.6.2.

Period of Ineligibility

Employees are not entitled to life insurance and disability benefits hereunder during any period of employment for which premiums are not paid.

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.

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. 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 English and Arabic 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.

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 (Human Resources Officer at post).

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

Dependent:

Eligible Dependents are defined as employee’s spouse (limit one) and all unmarried, economically dependent children under the age of 25. there is no limit on the number of children covered per employee. A child is covered until the end of the year in which he/she turns 25. Parents and other family members are not covered.

Disability, Total and Permanent:

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

Employee:

An individual employed by the U.S. Government, under a direct-hire appointment, personal services contract, or personal services agreement, as further defined in Section C.1.3 for health insurance and C.2.3 for life insurance. This may also include an ORE Staff if this category of individual is an eligible participant, as defined in C.1.3 for health insurance and C.2.3 or life insurance.

Employer:

The United States Government or in the case of ORE, the Chief of Mission/Deputy Chief of Mission, respectively.

GSO:

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

Customary and Reasonable Treatment:

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

Physician:

An individual who has graduated from an accredited medical school and is licensed to practice medicine in the jurisdiction in which the contract is to be performed. If the individual is a medical specialist, then he or she is Board

Certified in that specialty.

Surgical procedure:

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

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1.

52.252‑2 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 three (3) customer complaint is received per month

E.3.1 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.3.2 Standard. The performance standard is that the Government receives no more than three (3) 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.3.3 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 complainant.

(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 from the effective date of the contract with 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:

General Service Office

Contracting Officer

American Embassy – Amman, Jordan

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.

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 through the broker, 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 Jordanian Dinars.

G.4

SUBMISSION OF INVOICES AND PAYMENT

G.4.1.

Invoices shall be submitted in an original and three (3) copies to the following address (designated billing office only for the purpose of submitting invoices):

Financial Management Office (FMO)

American Embassy

P. O. Box 354

Amman 11118, Jordan

G.4.2.1

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. All payments under this contract will be made at the conclusion of the period covered. Invoices may be submitted monthly with payments being made monthly by the Government.

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 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.

Retirees: The retired employees will pay 100% of the premium cost for employee and dependent coverage directly to the contractor as prescribed in B.1.2.

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 and ORE staff to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered. Retirees will be in direct contact with the contractor for enrollment and payment. 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. 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 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, the contractor may be contacted by more than one employer (typically the Chief of Mission and Deputy Chief of Mission).

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:

(a) 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…