2015_health_and_Life_Insurance_competitive_bidfinal5.doc

August 26, 2015 376, Jalan Tun Razak, 50400 Kuala Lumpur Dear Prospective Offeror:

SUBJECT: Solicitation Number SMY30015R0004, Life and Health Insurance Services Solicitation.

The Embassy of the United States of America invites you to submit a proposal for customized Life & Health Insurance Service for the locally engaged staff, U.S. Embassy, Kuala Lumpur.

The Embassy intends to conduct a pre-proposal conference on September 3, 2015 at 2:00 p.m. 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 Contracting Officer, Louise J. Ramsay, 376, Jalan Tun Razak, 50400 Kuala Lumpur on or before 12.00 noon on September 26, 2015. No proposals will be accepted after this time. Also, electronic submissions shall not be accepted. 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

4.

Section K, Representations and Certifications;

5.

Additional information as required in Section L.

Any questions regarding this solicitation must be addressed in writing to the Contracting Officer, Louise Ramsay by letter or by telephone +603 2168 5063 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. System for Award Management (SAM) registration is a requirement of this solicitation.

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, /s/

Louise J. Ramsay Contracting Officer

UNDER DPAS (15 CFR 350)

1 | 66

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

3. SOLICITATION NO.

SMY30015R0004

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

August 24, 2015

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

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

U.S. Embassy Kuala Lumpur

376. Jalan Tun Razak

Phone: 603-2168 4989 Fax: 603 -2168 4948

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

SOLICITATION

9. Sealed offers in original and 1 copies for furnishing the supplies or services in the Schedule will be received at the place specified, in the depository located in US Embassy until September 24, 2015 local time 12:00 .

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

10. FOR INFORMATION

CALL:

A. NAME

ANDREW SANTIAGO

B. TELEPHONE (NO COLLECT CALLS)

603-2168 4989

C. E-MAIL ADDRESS

santiagoa@state.gov

11. TABLE OF CONTENTS

OTHER STATEMENTS OF OFFERORS

OFFER (Must be fully completed by offeror)

NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within 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

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

15A.

NAME

CODE

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE ADDRESS [ ]

IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

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

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

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7) CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

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

NSN 7540-01-152-8064

STANDARD FORM 33 (REV 9-97)

PREVIOUS EDITION NOT USABLE

Prescribed by GSA

SECTION B

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 Malaysia as described in Section C. 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 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) at the rates specified below. See Section G for billing procedures.

B.2.

PRICES

B.2.1 GOODS AND SERVICES TAX (GST).

GOODS AND SERVICES TAX (GST). - The Contractor shall include GST 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 fixed prices/premium rates for the health insurance services as specified in Section C are as follows:

The Government pays 100% of the employee’s premium and the dependents premium.

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 monthly 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 Monthly Retention Amounts per separate premium paid per single employee and per family plan.

Base Period

Option Year 1

Option Year 2

Option Year 3

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, and it specifically excludes all riders in B.1.1. 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 Malaysia. 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.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) 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 see B.9 and B.10 per one thousand of salary to provide life insurance, accidental death and dismemberment and partial and total disability coverage are as follows:

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 monthly retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed monthly 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 monthly retention amount shall NOT be expressed in terms of a percentage of the premium.

B.7.2 Monthly Retention Amounts per Separate Premium Paid per Employee:

Base Period

Option Year 1

Option Year 2

Option Year 3

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, . and it specifically excludes all riders in B.1.1. 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.

B.9 Offers and Payment in U.S. Dollars. U.S. firms are eligible to be paid in U.S. dollars. U.S. firms desiring to be paid in U.S. dollars should submit their offer in U.S. dollars. A U.S. firm is defined as a company which operates as a corporation incorporated under the laws of a state within the United States.

B.10. Foreign Firms. Any firm, which is not a U.S. firm, is a foreign firm. Any firm that does not meet the above definition of U.S. firm shall submit its prices and receive payment in local currency.

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 Malaysia. The Government has determined that the prevailing practice by employers in Malaysia is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne by the employer. The United States Government pays 100% of the employees’ and the dependents premium. Health insurance protection will be representative of locally prevailing compensation practice as further described in C.1.2. The specific health benefit coverage under this contract is set forth below.

The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care, per HR/OE/CM. Following is the approved benefit levels and terms to be included in the solicitation for the Medical Insurance Plan, the maximum limit for HIV/AIDS coverage for employees shall be a separate maximum limit of RM32,000 per HR/OE/CM.

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.

Consistent with prevailing employment practices in Malaysia, basic medical benefits are authorized for Locally Employed Staff of all U.S. Government agencies following the Mission's joint Local Compensation Plan, subject to the following rules:

A. Eligible Employees:

Eligible employees are LE Staff who are:

Working on a full time or part time basis under non-temporary direct hire appointments, personal services agreements, or personal services contracts and paid under the terms of the Local Compensation Plan. Participation will be voluntary.

Not eligible are those working under temporary appointments; those working under a PSC or PSA that is time limited to less than one year; nonpersonal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Malaysia 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 Recreation Association employees.

Official Residence Expense (ORE) employees and Recreation Association (RA) employees may be covered under a rider to the contract. The employing officer, not the USG, is responsible for the employer's share of the premium expenses for an ORE or RA employee.

B. Dependent Coverage

Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. For the purposes of this plan, 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. Coverage after Retirement:

Retirees are not covered.

D. Premium Expenses

For active employees who are regularly scheduled to work 30 or more hours per week: the USG will pay 100% of the premium cost and the employee will pay 0% of the premium cost for employee and dependent coverage.

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. For example, the Premium Expenses for an employee regularly scheduled to work 20 hours per week is Monthly Premium Cost x 20/40.

E. Medical Coverage:

The insurance company shall reimburse covered medical expenses incurred, subject to the stated limits. Payment shall be made for reasonable and customary expenses of covered benefits. The medical treatment must be prescribed or provided by a physician or nurse licensed in Malaysia. Coverage of expenses shall be made in (Malaysian Ringgit).

F. Deductible:

None

G. Hospitalization:

100% reimbursement of room and board expenses for a ward or semi-private room up to RM217 for a maximum of 120 days per incident

100% reimbursement of room and board expenses for a private room, not to exceed 100% of the cost of a semi-private room up to RM217 for a maximum of 120 days per incident.

100% coverage of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room expenses, intensive care, prescription medicines, and physical therapy.

100% coverage of ambulance service.

H. Professional Services and Treatment:

100% reimbursement of doctors’ and surgeons’ fees incurred while hospitalized, at a hospital on an out-patient basis, at a clinic or doctor’s office, while 40% coverage for at home visits. 100% coverage of medical services and expenses when not hospitalized such as laboratory tests and x-rays, and prescription medicines.

40% coverage for physical therapy, routine annual physical examinations, and inoculations which will be covered if prescribed by a physician.

A routine preventive annual physical exam is defined as a comprehensive preventive medicine evaluation and management, and includes the following: Past medical, social and family history, complete physical exam and review of body systems, review of medications, immunizations, counseling/anticipatory guidance/risk factor reduction interventions, review of age/gender appropriate screening tests. The exam is prevention focused, not problem focused.

An annual physical examination is a routine test and doctor will check a patient’s overall health to identify any issues that may become medical concerns in the future. Also, it usually includes a physical examination for women and men on an annual basis.

Inoculation will be covered if prescribed by a physician.

I. Prescription drugs and medicines:

100% coverage of expenses when hospitalized, and 100% coverage of expenses 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.

J. HIV/AIDS coverage (for employees):

100% coverage of expenses 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. This expanded coverage does not apply to dependents or to retired employees.

K. Obstetrical Care:

Obstetrical care is not a covered benefit.

L. Family Planning:

Family planning is not a covered benefit.

M. Hearing Aids:

50% reimbursement of the cost of a hearing aid apparatus and related examination, limited to one apparatus per ear per patient in a three-year period with a max of 300RM.

N. Optical Care:

Optical care is not a covered benefit.

O. Dental Care:

60% of expenses for dental services including dentists’ fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

Expenses for dental care is limited to RM1800 per individual per policy year.

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 up to RM1500.

P. Psychiatric Treatment:

Psychiatric treatment is not a covered benefit.

Q. Medical Expenses Incurred Out of Country:

Medical expenses incurred out of country will not be covered.

R. Transportation for Out of Country Medical Treatment:

Transportation for out of country treatment is not a covered expense.

S. Expenses not covered:

Expenses will not be covered for elective cosmetic surgery; spa cures; rejuvenation cures; massage; exercise therapy (described as physical fitness/exercise therapy helps to control a patient’s weight and strengthen body); 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.

Rehabilitative therapy focuses on improving a patient’s functional abilities and often does not treat a patient’s injury using techniques such as manual therapy or acupuncture like physical therapy. Rehabilitative therapy is helping a patient to improve their quality of life skills after a permanent injury or disability that will likely last a lifetime. Physical therapy helps a patient heal from surgery such as joint replacement surgery, ligament problems, and chronic conditions that are temporary disability.

No coverage of will be made for expenses that will be reimbursed or paid directly under a host country medical program, the U.S. workers' compensation program, or any Malaysian workers' compensation type program.

No coverage of will be made 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 coverage of will be made for expenses incurred after an employee leaves the service of the U.S. Mission.

T. Maximum Annual Coverage:

With the exception of expenses incurred under paragraph C.1.1 J above, the Insurance company will reimburse covered expenses up to a limit of RM95,000 per individual per contract year.

The insurance company will reimburse covered expenses described under paragraph C.1.1 J of the plan up to a separate limit of RM32,000 per employee per contract year.

Medical expenses incurred out of country will not be covered.

C.1.1.1

Transportation for Out of Country Treatment

Transportation for out of country treatment is not a covered expense.

C.1.1.2

Annual Maximum Limit - The maximum annual reimbursement per patient per contract year, not including expenses covered under J, is RM 95,000 per patient per contract year.

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.

There is no reimbursement for medical expenses incurred outside of Malaysia. There is no reimbursement for round trip transportation expenses to travel out of country for medical treatment.

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 Malaysia paid under the Local Compensation Plan, and certified by the Contracting Officer. Participation in the Health Plan will be voluntary. 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 Malaysia by:

· Department of State (DOS)

· Office of Defence Corporation (ODC)

· Department Of Commerce (DOC)

· Foreign Agricultural Services (FAS)

· Drug Enforcement Agency (DEA)

· Library of Congress (LOC)

· Export & Border Security (EXBS)

· Container Security Initiative (CSI)

· Open Source Centre (OSC)

· Department of Defense (DOD)

· Department Of Justice (DOJ)

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 B). 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

Not eligible are those working under temporary appointments; those working under a PSC or PSA that is time limited to less than one year; nonpersonal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Malaysia 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 Recreation Association employees.

Parents, grandparents, siblings, and other relatives are not eligible dependents.

Retirees are not covered.

C.1.5

Other Eligible Participants

Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. For the purposes of this plan, 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.

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 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 ten (10) 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 Malaysia. The Government has determined that the prevailing practice by employers in Malaysia 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. The Government pays 100% of the employees premiums. 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 as set forth below.

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 employee is based upon

Amount of Coverage for Natural Death. : In the event the employee dies of natural causes, then the employee’s designated beneficiary will receive an amount equal to 36 times his or her last earned monthly basic salary. The minimum life insurance benefit cannot be less than 36 times of his or her monthly basic salary. Death benefit is payable in one lump sum to the employees designated beneficiary.

C.2.1.2 Amount of Accidental Death and Dismemberment Coverage.

Amount of Coverage for Accidental Death. In the event the employee is killed in an accident, then the employee’s designated beneficiary will receive an amount equal to 36 times his or her last earned monthly basic salary. The minimum accidental death insurance benefit cannot be less than 36 times of his or her monthly basic salary. Death benefit is payable in one lump sum to the employees designated beneficiary.

C.2.1.3

Total Disability Coverage

Amount of Coverage for Total Disability. In the event the employee is totally disabled as a result of any cause, then the employee will receive an amount equal to 36 times his or her last earned monthly basic salary. Total disability benefits are payable after a waiting period of 6 months (to establish total disability) or immediately (upon physical separation, as defined). The disability benefit is the total benefit and is not in addition to the natural and / or accidental death benefit.

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:

C.2.2.1

No benefits shall be payable if an employee's death or other insurance event was caused directly or indirectly by war. War shall be defined as declared or non-declared war or any martial operations or invasion, hostile acts of foreign powers, rebellion, riot, civil war, uprising, mutiny, operations by military or usurpatory authorities, martial law or state of siege or any other similar event or reason for declaring martial law or war. A terrorist attack shall not be considered war.

C.2.2.2

No benefit shall be payable under this contract if the employee's bodily injuries have been caused directly or indirectly and totally or partially by:

C.2.2.2.1.Violating the law or in resisting detention or arrest

C.2.2.2.2. Participation in competitions involving the use of wheeled vehicles, horses, boats or water skis, C.2.2.2.3 An accident resulting from the employee being under the influence of alcohol, drugs or other toxic substance unless administered by a physician.

C.2.2.2.4 Death as a result of a disease or physical or mental infirmities and medical or surgical treatment thereof (except pyogenic infection due to an accidental cut or wound) shall be considered a natural and not an accidental death. Suicide will not be covered.

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 Malaysia, 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

C.2.3.2

The individuals covered by C.2.3.1 must be employed within the geographic boundaries of Malaysia by:

· Department of State (DOS)

· Office of Defence Corporation (ODC)

· Department Of Commerce (DOC)

· Foreign Agricultural Services (FAS)

· Drug Enforcement Agency (DEA)

· Library of Congress (LOC)

· Export & Border Security (EXBS)

· Container Security Initiative (CSI)

· Open Source Centre (OSC)

· Department Of Defense (DOD)

· Department of Justice (DOJ)

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; 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.

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 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.

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 life insurance and disability benefits 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 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 ten (10) 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.

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://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.

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.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 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.2.3 Procedures

(a) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed, they should immediately contact the COR.

(b) The COR will complete appropriate documentation to record the complaint.

(c) If the COR determines the complaint is invalid, the COR will advise the complainant. The COR will retain the annotated copy of the written complaint for his/her files.

(d) If the COR determines the complaint is valid, the COR will inform the Contractor and give the Contractor additional time to correct the defect, if additional time is available. The COR shall determine how much time is reasonable.

(e) The COR shall, as a minimum, orally notify the Contractor of any valid complaints.

(f) If the Contractor disagrees with the complaint and challenges the validity of the complaint, the Contractor will notify the COR. The COR will review the matter to determine the validity of the complaint.

(g) The COR will consider complaints as resolved unless notified otherwise by the complaint.

(h) Repeat customer complaints are not permitted for any services. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

SECTION F

DELIVERIES OR PERFORMANCE

F.1.

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the 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 clauses are incorporated by reference:

TITLE AND DATE

52.242-15 Stop Work Order (AUG 1989)

52.242-17 Government Delay of Work (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is one year beginning on the date stated in the Notice to Proceed with 3 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:

Human Resource Office

United States Embassy, 376, Jalan Tun Razak, 50400 Kuala Lumpur

F.5

NOTICE TO PROCEED

F.5.1 After receiving notice of contract award, the Contractor shall provide all required insurance within five (5) calendar days.

F.5.2 After the Contractor provides the Contracting Officer acceptable evidence that the Contractor has obtained all required insurance the Contracting Officer shall issue a Notice to Proceed.

F.5.3 On the date established in the Notice to Proceed (a minimum of ten (10) calendar days from the date of the Notice to Proceed, unless the Contractor agrees to an earlier date), the Contractor shall start performing the services required by the contract.

F.5.4 If the Contractor has provided evidence of insurance as part of its proposal, the Contracting Officer may issue a Notice to Proceed at time of contract award.

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 Specialist.

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 funding and commit the…