Questions_and_Answer_Managua_Solicitation_Second_Set_112916.docx

American Embassy Managua Solicitation SNU70017R0002

Questions & Answer

1. Does the insurance coverage need to include massive attention for terrorist attacks or/and natural disasters?

Yes, employees will be covered under the benefit levels listed in Section C.1.1 Employee and Dependent Health Services Benefits.

2. The document doesn’t specify some areas, and we would like to confirm if you are considering them inside the coverage the following areas are:

a. Transplants

b. Diagnostic or therapeutic catheterization (Hemodynamics)

c. Implants or Prosthetics

d. Chemotherapy and Radiotherapy

e. Hemodialysis

Please see Section C.1.2 Health Benefits Conditions and Limitations which lists the conditions and limitations on the entitlement to health care under this contract. If not listed specifically in Section C.1.2, then the treatment is covered under ancillary services, hospitalization, or surgery, depending on the issue listed above.

3. About the issue of Long term rehabilitation exclusions. What is the timeframe you consider long term?

There is not an established time-frame. Long term rehabilitation is considered to be in excess of whatever is customary and reasonable treatment within Nicaragua. Customary and reasonable treatment is covered under Section C.1.1.

4. At the moment of a newborn, what is the coverage for the newborn? Do complications apply in this coverage?

Newborns will be covered as a dependent member of the employee under the Family Plan. Any complications that arise for the mother or baby will be covered according to Section C.1.1 of the solicitation.

5. Do baby formulas and food supplements need to be covered?

Please refer to section C.1.1.4 Prescription Drugs and Medicines. 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. However, there are certain specialized baby formulas and food supplements that are not readily available over the counter and if the insured individual has a prescription, the items will be covered per section C.1.1.4.

6. Do Cosmetics implants or postpartum girdles, creams, sun blockers, liquid soap, need to be covered in the plan?

Please refer to the C. 1.2 Health Benefits Conditions and Limitations.

7. Could we set a maximum limit for the treatments?

The maximum coverage is $34,000 per patient per year. Please refer to Section C.1.1.15 Annual Maximum Limits.

8. Do we need to describe the services that we cannot cover in our offer?

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. You do not need to describe the services that you cannot cover, but you must be sure to include coverage for all of the benefits state in the solicitation or the proposal may be deemed technically unacceptable. Please see section C.1.1.

9. Could you specify the medical specialties that have coverage under this plan?

The only limitations to this solicitation are already addressed in the solicitation under C.1.2 Health Benefits Conditions and Limitations. If something is not listed in the exclusions then it will be covered.