Q_ _A__to_Health-Life_Insurance_Solicitation_Number_S-MX530-15-R-0025_.doc

Solicitation Number S-MX530-15-R-0025 Questions and Answers

1.

Q – Provide the three year premium history which is critical to determine the insurance loss ratios. The loss ratio is based on the 'amount of claims paid' to the 'amount of premiums collected'. This ratio is instrumental in ascertaining the premiums. It is an industry standard practice to use this metric for premium computation. While the solicitation documents contain the claims history there is no mention of the premium history.

A –The premium history for Health Insurance is attached to Amendment Number A006, added to Exhibit D.

2.

Q – Provide the census containing the date of birth (or age), gender and salary of employees. This information is required to compute the life insurance premiums. The solicitation requires the death benefits to be based on a multiple of the salary. As you may already know morbidity rates (probability of death) is a function of age and gender. With the current information in the solicitation we cannot develop accurate life insurance premiums because there is no established relationship between employee age, gender, and salary.

A – Please see the attached Amendment Number A006, Exhibit H added. The information provided is intended to notify potential bidders regarding how many employees fall into each category. Information such as names, DOB, or other data which could identify specific individuals is not releasable under the solicitation, but will be provided after contract award to only the awardee.

3.

Q – Please let us know the name of the current incumbent contractor/supplier for the insurance. This information will help us in focus on certain areas (i.e. service, delivery, network etc.) in providing a better value solution for the embassy.

A – For Health Insurance: the current incumbent is “Aseguradora Interacciones S. A., Grupo Financiero Interacciones”. For Life Insurance: the current incumbent is Seguros Monterrey New York Life, S. A. de C. V.

4.

Q – Will you please make sure the contract includes the 10% price evaluation clause for HUBZone small business concerns?

A – While we welcome participation from US Small businesses including HUBZones, please be advised that the Small Business Programs in FAR Part 19 do not apply to foreign acquisitions awarded overseas per FAR 19.000(b) so no price preference will be given to HUBZones.

PART I – HEALTH INSURANCE

5.

Q – Exhibit A, Employee Statistics, Page 64, please confirm that the insured holders corresponds to 633 female and 788 males giving a total of 1421,that match the same format B.2.3.

A – As stated in Exhibit A, the insured holders of 633 female and 788 males give a total of 1421 and do match B.2.3.

6.

Q – Exhibit A, Employee Statistics, Page 64, please confirm that the employee spouses correspond to 480 female and 264 males giving a total of 744.

A – As stated in Exhibit A, the employee spouses correspond to 480 female and 264 males giving a total of 744.

7.

Q – Exhibit B, Early Retirees, Page 65, please confirm they are not considered in the proposal.

A – The Solicitation does not include coverage for early retirees.

8.

Q – Exhibit D Cumulative Historical Claims Paid/Treatment Amounts Page 64. We request the Convener confirm that at the end of 30 / April / 2015 cumulative historical claims paid information is:

$1,585,470.57 USD

A – The question contains conflicting information. Please refer to Exhibit D, which states as follows:

“YEAR

U. S. DOLLARS

LOCAL CURRENCY

$1,647,356.39

$21,942,787.14

$1,343,392.92

$17,399,625.18

$1,395,608.44

$18,035,477.90”

PART II – GROUP LIFE INSURANCE

9.

Q – Exhibit A, Employee Statistics, Page 64. We request it can be provided an updated list of insured, magnetic media containing at least the following information: name, date of birth, sex and monthly salary per employee in Excel file. Please comment on this.

A – Please refer to the answer provided to question number 2, above.

10.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that ensure staff is in the amount of 1,421, which are specified in Exhibit A page 64.

A – Please refer to the answer provided to question number 5, above.

11.

Q – C.2.3. Eligible Participants, page 25. Please confirm that only considered active employees in this tender. Please comment on this.

A – Please refer to Section C.2.3.1.1, which states:

“All current active employees of the United States Government, employed within the geographic boundaries of Mexico, 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, Personal Services Agreements (PSAs) and Personal Services Contracts (PSCs).”

12.

Q – C.2.3. Eligible Participants, page 25. Please confirm that only considered permanent staff lies in Mexico in this tender.

A – Please refer to answer provided to question number 11, above.

13.

Q – C.2.3. Eligible Participants, page 25. Please confirm if there are personnel who use firearms, if so specify who they are.

A – Due to personnel security restrictions the names of the individuals who carry firearms as well as their positions cannot be provided, but there are less than (17 (seventeen)) in with number) employees which carry firearms.

14.

Q – Please indicate if you currently have the program Life Group.

A – Currently, the U. S. Government Locally Employed Staff have Life Insurance coverage.

15.

Q – Exhibit D Cumulative Historical Claims Paid/Treatment Amounts Page 64. Please provide the Cumulative Historical Claims Paid of the past three years separately according to the following headings in Excel files:

a. Name of Insured.

b. Date of Loss.

c. Record Date.

d. Payment Date.

e. Coverage affected.

f. Amount Paid.

A – PII information will not be provided at this time.

16.

Q – Please provide the premiums paid for the last three periods.

A – Please refer to the answer provided to question number 1, above.

17.

Q – Please indicate the amount of annual premium currently paid or indicate what the budget envisaged for this new period.

A – Please refer to the answer provided to question number 1, above.

18.

Q – Please indicate whether they have changed the conditions of health and life insurance coverage services compared with the current period and which they have been such changes.

A – The U. S. Government intends to award a Contract resulting from this Solicitation. This Solicitation is completely separate from any and all previously awarded Contracts.

19.

Q – Please provide the number of insured that have been issued the last three Periods.

A – Please refer to the answer provided to question number 2, above.

20.

Q – C.2.1. Group Life Insurance Coverage, page 23. Please confirm that the coverage requested: Death, Double Indemnity Accidental Death and Loss Scale Organic B, payment sum insured with Total and Permanent Disability waiting period of six months.

A – Your question is not clear. Please refer to Section C.2.1.3, which states as follows:

“The employee will receive an amount equal to twenty-eight (28) months’ of base salary when employment ends due to total disability. There is a six month waiting period before total disability may be declared. Treatment provided to the employee during the six-month waiting period must be provided by a physician who is not a family member and in accordance with the IMSS statement of permanent disability. The amount payable shall be paid in a single payment immediately after the six-month waiting period has elapsed. In the event of loss of limb or other body parts which obviously immediately totally disables an employee, the six-month period is waived. If the insured employee is incapable of collecting the insured amount, payment shall be made to his/her legal representative.”

NOTE: The solicitation does not use the following terms: Double Indemnity, Loss Scale Organic B.

21.

Q – C.2.1. Group Life Insurance Coverage, page 23. Please confirm that the rule of sum insured Double indemnity coverage, Accidental Death and Scale B organic losses, is 25 months' basic salary.

A – Your question is not clear. Please refer to Section C.2.1, C.2.1.1, C.2.1.2 and C.2.1.3.

Also, please refer to the NOTE provided in response to question number 20, above.

22.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please confirm that is disqualifying not granting partial disability coverage.

A –Partial Disability is not covered under the solicitation. Please see the attached Amendment Number A006 deleting the wording “Partial and”.

23.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please provide the definition of partial disability and what the Institute is determined.

A – Please refer to answer provided to question number 22, above.

24.

Q – C.2.1.2. Amount of Accidental Death or Work Related Death Coverage, Page 23. Please confirm that is disqualifying not guaranteeing Work Related Death Coverage.

A – Your question is not clear. Please refer to Section C.2.1.2., which states as follows:

“C.2.1.2. Amount of Accidental Death or Work Related Death Coverage The employee's estate or employee will receive an amount equal to twenty-five (25) months’ basic salary, in the event the employee is killed in an accident or work related death.”

25.

Q – C.2.1.2. Amount of Accidental Death or Work Related Death Coverage, Page 23. Please provide the definition of Work Related Death Coverage.

A – Work related death is defined as a death that occurs while a person is at work or performing work related tasks.

26.

Q – C.2.4. Individuals Not Eligible for Coverage, C.2.4.1. Age Limit, Page 26.Please consider that the ages of acceptance of each coverage will be handled as provided in the insurance market in Mexico.

A – Please refer to C.2.4.1., which states as follows:

“C.2.4.1. Age Limit

New employees who have reached the age of 75 prior to entering on duty with the U.S. Government will not be eligible for life insurance coverage.

C.2.4.2. Not eligible

Employees not eligible are LE Staff age 60 or older who are working under temporary appointments; those working under a PSA or PSC that is time limited to less than one year; those with a When Actually Employed (WAE) workweek schedule; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in the Mexico who provide services to other local organizations as well as to the U.S. Mission; employees of USAID institutional contractors; and Peace Corps personal services contractors as indicated in MS 743.

C.2.4.3. Dependents and retirees

Dependents such as spouse and children and retirees are not covered under this Contract.”

27.

Q – C.2.3. Eligible Participants, page 25. Please clarify that insurance of this tender will not be considered Retired staff and/or personnel Pensioner or sick leave with or without pay.

A – Please refer to Section C.2.4.3. and C.2.6.1.

28.

Q – C.2.1. Group Life Insurance Coverage, page 23. Please clarify whether the rule is based insured amount to the base integrated daily wage or salary, should be integrated please indicate the elements of.

A – Please refer to Section C.3. Definitions which states as follows:

“Salary: monthly salary is one-twelfth of the employee's annual basic salary, exclusive of premium pay, allowances, bonuses, or any other separate payments.”

29.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that all those conditions are not established in the bases and clarification meeting minutes of this tender will operate according to the general conditions of Aseguradora Interacciones S.A.

A – Please refer to the first paragraph in Section M.1, which states as follows:

“General. To be acceptable and eligible for evaluation, proposals must be prepared in accordance with Section L –Instructions, Conditions and Notices to Offerors, and must meet all the requirements set forth in the other sections of this solicitation. Acceptable proposals will be evaluated pursuant to this section, and award shall be made as set forth in M.3 below.”

The first sentence under M.3.1, General, states as follows:

“The award selection will go to the lowest priced, technically acceptable, responsible offeror.”

The U. S. Government is not obligated to honor other terms and conditions presented by an Offeror. Only those proposals which meet the terms and conditions of the Solicitation may receive an award.

30.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that the insurance will be self-administered, and at the end of the term of collection or return of premium will be made by the movements of additions, deletions or changes of sum insured, otherwise please specify.

A – Your question is not clear. Please refer to Section H.3.1, and also to Sections B.2.2, B.6, and G.2.4, which may be helpful.

31.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that Maximum Sum Insured without medical tests currently have and whether it is right for each company set the Maximum Sum Insured without medical examinations will offer.

A – Your question is not clear. Please refer to Section C.2.

32.

Q – C.2.1.2. Amount of Accidental Death or Work Related Death Coverage, Page 23. Please confirm if the insurance is compulsory for all eligible staff who will be responsible for payment of insurance.

A – Your question is not clear. Please refer to Section C.2.

33.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. What will be the Institution of Social Security for determine disability.

A – Your question is not clear. Section C.2.1.3, contains the following sentence within the paragraph:

“Treatment provided to the employee during the six-month waiting period must be provided by a physician who is not a family member and in accordance with the IMSS statement of permanent disability.”

34.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please confirm the payment criterion disability coverage: a. Date occurred when the event happens that causes disability b. Date of opinion, when it is declared invalid by the health institution.

A – Your question is not clear. Section C.2.1.3, contains the following sentence within the paragraph:

“The amount payable shall be paid in a single payment immediately after the six-month waiting period has elapsed.”

Also refer to the answer provided to question number 33, above.

35.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please confirm that if any controversy on the opinion issued by the competent institution, the insurer will assess the merits of that course by a specialist in occupational medicine physician, where the insured submit a full history determining disability.

A – Your question is not clear. Also refer to the answers provided to questions number 33 and 34, above.

36.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please let us know if you have any knowledge of personnel with temporary disability or process to handle a disability or permanent disability, as well as provide details of such personnel indicating date of birth and salary scale and the cause that caused the disability.

A – Personnel currently in process of temporary disability or permanent disability are not being considered in this Solicitation.

37.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. If the previous question be affirmative, and if appropriate the payment of a claim, the convener is requested to indicate whether such payment is provided by the current insurance regardless if the incident occurred during the period.

A – Not applicable, the answer to question number 36 is not affirmative.

38.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please let us know if you require cover preexisting disability.

A – Please refer to the answer provided to question number 36, above.

39.

Q – C.2.1.3. Partial and Total Disability Coverage, page 23. Please clarify whether the payment of the sum insured coverage of Total and Permanent Disability excludes the death and in turn the latter to the former.

A – Employees who receive a payment for total disability would subsequently not be eligible for a death benefit. In turn, if an employee dies they would not subsequently be eligible for a disability benefit payment.

40.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm whether it will be possible to issue an annual basis with automatic renewal.

A – Your question is not clear. Please review the following Sections:

Section 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.”

Section I – Contract Clauses:

“52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within the performance period of the contract or within 30 days after funds for the option year become available, whichever is later.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed five (5) years.

(End of Clause)” Section L, L.4.2, Volume 2 -- Price Proposal - fill in Section B.

“(a) Price proposal for the base year of both insurance programs.

(b) Price proposal for each of the option years of both insurance programs. A price proposal with no proposal for the base year and all of the option years will not be considered, meaning a price proposal for an option year with no proposal for the base year will not be considered, nor will a proposal for a base period which does not include a proposal for all option periods. The Offerors are to include in Section, fully loaded costs, including all direct and indirect labor costs, Insurance (see FAR 52.228-4 and 52.228-5 in Section I; except for separately reimbursed DBA insurance if applicable); all overhead and indirect costs, including general and administrative expenses (G&A); Profit; and any other expense related to the services required in this Solicitation.”

Section M.6, “52.217-5, EVALUATION OF OPTIONS (JUL 1990)

The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. Evaluation of options will not obligate the Government to exercise the option(s).”

41.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that the insurance does not consider gainsharing.

A – Gainsharing is not mentioned in the solicitation. See Sections L.4.3.3 and M.3.2, regarding profit sharing.

42.

Q – C.2. GROUP LIFE INSURANCE, Page 23 If you need gainsharing, which would be the formula of dividends.

A – Please refer to the answer provided to question number 41, above.

43.

Q – C.2. GROUP LIFE INSURANCE, Page 23. In case after payment of dividends for the period a loss that affected the dividend payment, paid the appropriate setting and will return appropriate.

A – Your question is not clear.

44.

Q – C.2. GROUP LIFE INSURANCE, Page 23. Please confirm that dividends must be paid at end of period annually.

45.

Q – B.6.1.1. Base year of the contract Page 8, second column Premium (Per 1,000 of salary) Please inform this box must be completed with the fee per thousand per each sum insured coverage.

A – Refer to subparagraph B.6.1.1, second column and provide your firm fixed rates per employee as requested therein. Also, please refer to the last sentence in Section L.4.2(b) which states:

“The Offerors are to include in Section, fully loaded costs, including all direct and indirect labor costs, Insurance (see FAR 52.228-4 and 52.228-5 in Section I; except for separately reimbursed DBA insurance if applicable); all overhead and indirect costs, including general and administrative expenses (G&A); Profit; and any other expense related to the services required in this Solicitation.”

46.

Q – B.6.1.1. Base year of the contract Page 8, third column ESTIMATED PAYROLL (Bi-Weekly in Thousands) ¿please confirm it relates to the total sum insured for coverage?

A – Refer to subparagraph B.6.1.1. third column.

47.

Q – B.6.1.1. Base year of the contract Page 8. Please exemplify the completion of this form please.

A – Please insert your firm fixed price in the second column “Premium (Per 1,000 of Salary)” to come up with the “Bi-weekly Total” for the third column.

48.

Q – B.6.1.1. Base year of the contract Page 8. Please exemplify the completion of this form please.

A – Question repeated. Please refer to the answer provided to question number 47, above.

General questions

49.

Q – Please confirm that if you do not participate in any of the items, will not be grounds for disqualification.

A – Refer to the first and second sentences in Section M.7. Price Evaluation which states:

“The Government will make one award as a result of this solicitation. Meaning, one award will be made for both the health and the life insurance requirements.”

50.

Q – Regarding Section L.4.3.2.2, please confirm if it is acceptable to deliver the information required in Spanish.

A – No.

51.

Q – Regarding Section L.4.3.4 please confirms that this point will be fulfilled presenting the relationship of staff that would provide care to the insured and the company curriculum and institutional organization chart demonstrating our size and service capacity.

52.

Q – Regarding L.4.4. VOLUME 4: Customary and Reasonable Services. Please confirm that information we present to comply with this point.

A – Refer to L.4.4. Volume 4.

53.

Q – Regarding Section L.4.4, Please confirm that the information requested under this point will be delivered only by the awarded bidder, so it will be enough with a letter that if the winner is a list of the usual services and Reasonable requiring convener is provided.

A – Please refer to section L.4.4. Volume 4. The Offerors are to comply with providing a list of the Customary and Reasonable Services and costs of services as stated therein. Please submit with your proposal.

54.

Q – Regarding Section L.10, Please confirm if it is acceptable to deliver the required information in Spanish. Informing if comply with this point, introducing the last five years of audited financial statements.

A – No. Please refer to section L.10.

55.

Q – I noticed you haven’t uploaded the plan holders list for this project. Do you know when this list will be available?

A – We do not understand what you mean by plan holders. If you are referring to the list of employees as “plan holders” please note that the listing will be provided to the successful offeror as part of the contract award.

NOTE TO OFFERORS: the personnel to be covered under this Contract are and will be provided by the U. S. Government as per the Exhibits contained in the Solicitation and to be updated and provided after the award of the Contract. This also applies to the salaries, dates of birth, genders, etc.

NOTE TO OFFERORS (from Exhibit D):

The claims paid and premium history by the incumbent contractor are provided for informational purposes only and under no circumstances shall it be construed to change any terms or conditions or requirements within the solicitation. Under no circumstances shall the U.S. Government be liable for this data or shall it become the basis for a request to adjust the premium rates after contract award. Offerors are advised any adjustments to contract premium rates shall be in accordance with the B.4.

The deadline to submit further questions is Monday, July 20, 2015 before 12:00 noon. Questions may not be answered or accepted after this date and time.