Solicitation 19GE5026R0003.pdf

SOLICITATION DOCUMENT

United States Embassy Harare, Zimbabwe

Locally Employed Staff Health Insurance Services

SOLICITATION NO. 19GE5026R0003

Issued by:

U.S. Consulate General

Regional Procurement Support Office

Giessener Strasse 30

60435 Frankfurt am Main

Germany

Document Number: 19GE5026R0003 Page 1 of 100

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30 1. REQUISITION NUMBER PAGE 1 OF 100

5. SOLICITATION NUMBER

19GE5026R0003

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE DATE

See Block 31c

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

12/09/2025

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME Sarah Pfannkuche

b. TELEPHONE NUMBER (No collect calls) 8. OFFER DUE DATE / LOCAL

TIME

02/06/2026 15:00

CODE FRANK

AMERICAN CONSULATE GENERAL FRANKFURT

GIESSENER STRASSE 30

ATTN: RPSO

60435, FRANKFURT, GERMANY

9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED WOMEN-

OWNED SMALL BUSINESS (EDWOSB)

8(A)

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS): 541330

SIZE STANDARD:

10. THE ACQUISITION IS

SEE

SCHEDULE

11. DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS BLOCK IS

MARKED

0 Days: 0.00 %

0 Days: 0.00 % 0 Days: 0.00 % 0 Days: 0.00 %

12. DISCOUNT TERMS

13a. THIS CONTRACT IS

RATED ORDER UNDER THE

DEFENSE PRIORITIES AND

ALLOCATIONS SYSTEM -

DPAS (15 CFR 700)

13b. RATING

REQUEST

FOR

QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

X REQUEST

FOR

PROPOSAL

(RFP)

14. METHOD OF SOLICITATION

CODE15. DELIVER TO CODE GAAM16. ADMINISTERED BY

RPSO Frankfurt GA/AM/DMS/FAC RPSO Frankfurt Bureau of Global Acquisitions Frankfurt

FACILITY

CODE

CODE

Contact UEI:

Telephone No.

17a. CONTRACTOR/

OFFEROR

HARAR19007CODE18a. PAYMENT WILL BE MADE BY

AMERICAN EMBASSY HARARE

2 Lorraine Drive

ATTN: FINANCIAL MANAGEMENT OFFICE

HARARE, ZIMBABWE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS

CHECKED

19. ITEM NUMBER 20. SCHEDULE OF SUPPLIES/SERVICES

(Use Reverse and/or Attach Additional Sheets as Necessary)

21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT

See Line Information

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Government Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REFERENCE _____________________________

OFFER DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK

5) INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT) Travis Keon /s/

31c. DATE SIGNED 12/09/2025

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

CGFS // CGFS

TABLE OF CONTENTS

Section I - The Schedule

• SF 1449 Cover Sheet

• Continuation to SF-1449, RFP Number 19GE5026R0003, Prices, Block 23

• Continuation to SF-1449, RFP Number 19GE5026R0003, Schedule of Supplies/Services, Block 20 Description/Specifications/Work Statement

• Attachment 1: Price Proposal Breakdown

• Attachment 2: Form W-14

• Attachment 3: Form W-14 Instructions

• Attachment 4: Past Performance and Experience

• Attachment 5: Employee Statistic

Section II - Contract Clauses

• Contract Clauses

• Addendum to Contract Clauses - FAR and DOSAR Clauses not Prescribed in Part 12

Section III - Solicitation Provisions

• Solicitation Provisions

Section IV - Evaluation Factors

• Evaluation Factors

Section V - Representations and Certifications

• Offeror Representations and Certifications

• Addendum to Offeror Representations and Certifications - FAR and DOSAR Provisions not

Prescribed in Part 12

SECTION I - THE SCHEDULE

CONTINUATION TO SF-1449

RFP NUMBER 19GE5026R0003

PRICES, BLOCK 23

A. GENERAL

The U.S. Government requires Health Insurance for its Locally Employed Staff (LES) and their dependents at U.S. Embassy Harare, Zimbabwe. The Contractor shall provide the health insurance services in accordance with the Statement of Work (SOW) provided in Sub-Section C –

Specifications/Statement of Work and Attachment 5. The groups of employees who shall be provided this insurance are listed in Section C.5 – Eligible Participants.

A.1 TYPE OF CONTRACT

A.1.1 This is a fixed-price Indefinite-Delivery Indefinite-Quantity (IDIQ) contract with economic price adjustment requirements under which annual firm-fixed price task orders will be issued. The contract shall remain unfunded. The fixed prices / premium rates for the health insurance services as specified in Sub-Section C – Specifications / Statement of Work are listed in Attachment 1 – Pricing

(Attachment 1 will be incorporated into Section B – Pricing upon award). The quantities set forth in the pricing section are estimates; the Government does not guarantee that such quantities will be ordered. The required minimum amount shall be obligated on a task order level at the time the contract is executed.

A.1.2 The contract will be for a one base year period starting from August 01, 2026, and four (4) one-year option periods, which may be exercised by modification to the contract. Including option years in the contract does not obligate the Government to exercise one or all option years.

A.1.3 Payments will be made only to the extend specifically authorized in the task order.

A.2 MINIMUM AND MAXIMUM AMOUNTS:

A.2.1 As per FAR 52.216-22 – Indefinite Quantity, the minimum and maximum amounts for this indefinite quantity contract shall be any quantity or combination of supplies and services equal to the amount(s) set forth below. The U.S. Government (USG) makes no guarantee as to the number of orders or actual amount of services that may be requested above the guaranteed minimum value for the life of the contract.

A.2.2 The minimum guaranteed order amount: The Government shall order, as a minimum, services in an amount of USD 5,000 during the term of this contract. The Government makes no guarantee as to the number of orders or actual amount of services that will be requested above the guaranteed minimum.

A.2.3 The maximum ordered amount during the entire life of this contract is USD 24,000,000.

A.2.4 The required minimum purchase shall be obligated on a task order at the time the contract is executed.

A.3 ACQUISITION METHOD

This is a commercial acquisition as defined in Federal Acquisition Regulation (FAR) 2.101, Definitions, and as described in FAR part 12, Acquisition of Commercial Products and Commercial

Services. Competitive negotiation as per FAR 15, Contracting by Negotiation are used. The governments intends to use tradeoff procedures as per FAR 15.101-1.

B. PRICING

B.1 GENERAL

The Contractor shall complete all work, including furnishing all labor, material, equipment and services, unless otherwise specified herein, required under this contract for the firm fixed unit prices indicated below and within the time specified herein. These individual prices shall include all labor, overhead, profit, and, if applicable, Value-Added Tax (VAT)(via separate CLIN).

Any costs not separately priced will be considered to be included in the individual prices as overhead or other indirect cost. No additional sums will be payable on account of any escalation in the cost of materials, equipment or labor, or because of the contractor's failure to properly estimate or accurately predict the cost or difficulty of achieving the results required by this contract. Nor will the contract price be adjusted on account of fluctuations in the currency exchange rates.

The currency shall be fixed and cannot be changed by modification to the contract.

B.1.1 VALUE ADDED TAX

Value Added Tax (VAT) is not applicable to this contract and shall not be included in the contract line item numbers (CLINs) rates or invoices because the supply of Health Insurance Services is exempted from VAT as per Zimbabwean VAT Act.

B.1.2 EXCISE TAX

James Zadroga 9/11 Victims Health and Compensation Act of 2010 Notice: Unless a waiver or exception applies, payments subsequent to this procurement are subject to an excise tax of 2% pursuant to 26 U.S.C. 5000C.

B.1.3 ECONOMIC PRICE ADJUSTMENT, PREMIUM ADJUSTMENT BASED ON

EXPERIENCE

B.1.3.1 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.

No adjustment will be allowed during the base year.

B.1.3.2 The Contractor or the Government may request an adjustment 60 days prior to the end of the base year or current option year, to take effect at the start of the following option year. Adjustments are not retroactive to previous periods of performance, and Contractors may not seek to recover costs incurred during a prior period of performance through an Economic Price Adjustment. Economic Price

Adjustments only apply as an adjustment to the rates to be charged by the Contractor for the services identified as in the contract and cannot be recovered as a lump sum adjustment paid to the Contractor.

B.1.3.3 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, i.e. per line item for the preceding 12 months.

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.

B.1.3.4 Mutually agreed to adjustments shall be effective thirty days after complete information is received by the Government, and after the corresponding modification has been signed by the

Contracting Officer. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.1.4 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(s). The contractor agrees to provide all documentation necessary to support any requested adjustment.

B.1.4.1 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.

B.1.5 Official Residence Expense (ORE) employees, Employee Association employees (EA), and Peace Corps (PSC)

Official Residence Expense (ORE), Employee Association employees (EA), and Peace Corps (PSC)

Employees are included in this contract only as a rider. The Contractor shall bill the individual covered at the rates specified in B.2.

Note that the USG is not responsible, nor liable for any riders.

The remainder of this page is left blank intentionally

B.2 PRICING TABLE

The offeror shall provide firm-fixed prices in Attachment 1 – Pricing.

ATTACHMENT 001 – PRICES WILL BE INSERTED HERE

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.3 below, the Contractor shall 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

Attachment 1, Price Proposal Breakdown.

This retention amount will not be adjusted for any reason.

B.3.2 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.3.3 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

B.3.3 Monthly Retention Amounts per separate premium paid per self only, per self plus one and per family plan.

The offeror shall complete the fixed monthly retention amounts for each performance period and premium category. This fixed amount must be expressed in the currency in which the premium amount is proposed. Ensure these amounts are expressed in the currency proposed for the premium. Note that the fixed retention amount should not be indicated as a percentage of the premium. Clerical errors in pricing tables may be corrected as minor informalities at the

Government’s discretion.

Period of

Performance

Single

Employees

(Self Only)

Employee

+ 1 (either plus one spouse or plus one child)

Family

Plan:

Employee

+ 2

Family

Plan:

Employee

+ 3

Family

Plan:

Employee

+ 4

Family

Plan:

Employee

+ 5 or more

Base Year

First Option

Year

Second

Option Year

Third Option

Year

Fourth

Option Year

C. STATEMENT OF WORK

C.1 INTRODUCTION

The Contractor shall provide health insurance services to locally employed staff of the U.S. Embassy

Harare, Zimbabwe, and their eligible dependents, as further described in this Section. The below are the minimum benefits levels and offers which include additional benefits or higher benefit levels may be accepted.

C.2 PREMIUM

Premiums will be based on the number of individuals covered:

-- Self-Only: 1 covered individual

-- Self Plus One (two individuals)

-- Family (three or more individuals)

C.3 EMPLOYEE AND DEPENDENT HEALTH SERVICE BENEFITS

C.3.1 Hospitalization (Treatment in the Hospital for Inpatient Care):

100% Coverage.

Services and supplies provided during hospitalization, including services provided by a licensed healthcare provider, bed & board (semi-private accommodations), operating room, recovery room, intensive care, imaging and diagnostic testing, general hospital nursing care, physical therapy, as well as drugs and medicines administered while in-patient. When private accommodations are provided, coverage will be limited to the cost of a semi-private room unless otherwise covered in an off the shelf plan.

See Mental, Nervous and Substance Abuse care (below) for details concerning inpatient psychiatric care.

See Outpatient Services (below) for details concerning professional services.

C.3.2 Emergency Services (Trips to Emergency Room):

Services provided for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness.

C.3.3 Ambulance:

Professional ground transport to move a patient from the place where s/he is injured or becomes ill to the nearest hospital able to provide treatment or to move a patient from one medical facility to another.

C.3.4 Outpatient Services:

80% Minimum Coverage.

Services provided by a licensed healthcare provider on an ambulatory or outpatient basis (without being admitted to a hospital), including surgeon’s fees and other medical services that may be provided in a hospital, clinic, doctor’s office, medical facility, etc. Examples include, but are not limited to:

• Annual physical examinations

• Specialist consultations and treatment, including second surgical opinion

• Minor surgical interventions

• Chemotherapy and radiation treatments

• Immunizations recommended by local authorities and/or the World Health Organization

• Diagnostic tests and diagnostic imaging

See Rehabilitative and Habilitative Services and Devices (below) for details concerning physical therapy.

See Mental Health and Substance Abuse Care (below) for details concerning psychiatric therapy.

C.3.5 Obstetric and Newborn Care:

Inpatient: 100% Coverage; Outpatient: 80% Minimum Coverage.

Care and services that women receive during pregnancy (prenatal care), throughout labor and delivery, and post-delivery, and outpatient care for newborn babies. Hospitalization during pregnancy and/or delivery will be covered as Hospitalization (treatment in the hospital for inpatient care). All other treatments will be considered Outpatient Services.

C.3.6 Pediatric Services:

Inpatient: 100% Coverage; Outpatient: 80% Minimum Coverage.

Primary and preventive routine care services for covered dependent children, including, but not limited to: physical examinations, developmental assessments, laboratory tests, and immunizations recommended by local authorities and/or the World Health Organization.

C.3.7 Prescription Drugs:

100% Coverage

Medications prescribed by a certified health care provider that are medically necessary. Examples include but are not limited to: prescription antibiotics to treat an infection; medication used to treat an ongoing condition, such as high cholesterol; prophylaxis; or contraceptive medication.

C.3.8 Preventive and Wellness Services and Chronic Disease Management:

Counseling or preventive care designed to prevent or detect medical conditions and care for chronic conditions such as asthma and diabetes. Examples include, but are not limited to: physicals, immunizations, and cancer screenings.

C.3.9 Hearing Aids:

Examinations and Treatment: 80% Minimum Coverage.

Hearing Aid Apparatus: Limited to one apparatus per ear. The maximum coverage is USD 1,500.00 per covered individual per three-year period. 80% Minimum Coverage; with Applicable Cap.

C.3.10 Optical Care:

Examinations and Treatment: 80% Minimum Coverage.

Prescription lenses and frames or contact lenses: The maximum coverage is USD 300.00 per covered individual every two years. 80% Minimum Coverage; with Applicable Cap.

C.3.11 Dental Care:

Examinations and Treatment: Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges. The maximum coverage is USD 3,200.00 per covered individual per contract year. 80% Minimum Coverage; with Annual Cap.

Orthodontia: Treatment is covered only if treatment begins before age 18, or if required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per covered individual.

The maximum coverage is USD 2,400.00 lifetime limit. 80% Minimum Coverage; with Contract

Lifetime Cap.

C.3.12 Reproductive Health:

Prescribed contraceptive devices, preventive care and routine examinations, voluntary sterilization, and diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology

(ART), fertility treatments, and reversal of sterilization are not covered (see Exclusions to Coverage).

C.3.13 Mental Health and Substance Abuse Care:

50% Minimum Coverage (as within local commercial norms)

Inpatient and outpatient care provided to evaluate, diagnose, and treat a mental health condition or substance abuse disorder. This includes behavioral health treatment, counseling, and psychotherapy.

Services must be provided by a licensed psychiatrist, psychoanalyst, psychologist, or psychiatric social worker. Inpatient care for alcohol and substance abuse must be carried out at a facility licensed for detoxification and rehabilitation.

C.3.14 Rehabilitative and Habilitative Services and Devices:

Rehabilitative services (e.g. recovering skills, such as speech therapy after a stroke or physical therapy after an accident) and habilitative services (e.g. developing skills, such as speech therapy for children) that help develop skills needed for everyday life. Devices to help gain or recover mental or physical skills lost due to injury, disability or chronic condition, and devices needed for habilitative reasons.

C.3.15 HIV/AIDS:

100% Coverage up to USD 10,000.00 per Contract Year per Covered Individual.

Medications to suppress opportunistic infections (such as tuberculosis or toxoplasmosis for covered individuals who have HIV/AIDS). Brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV/AIDS to the child. Generally, excludes medication for the long-term suppression of HIV/AIDS through the combination of anti-retroviral drugs in locations with inadequate local healthcare infrastructures.

C.3.16 Excess Coverage:

Additional coverage equal to $68,000.00 per covered individual per contract year. This excess coverage will be offered as an optional benefit to LE Staff. LE Staff must pay 100% of the premium if they elect Excess Coverage.

C.3.17 Out-of-Country Medical Treatment:

Medical expenses incurred out-of-country will be covered at the same benefit levels and subject to the same total maximum annual limit as for medical expenses incurred in-country.

C.3.18 Out-of-Country Medical Travel:

Transportation for out-of-country medical treatment will be a covered expense for LE Staff and eligible family members. To be considered a covered expense, the attending certified health care provider must certify in advance that the treatment is medically necessary and unavailable locally.

80% of covered individual’s transportation expenses by the least expensive, appropriate means of transportation to the nearest city with *adequate medical facilities will be covered.

80% of the transportation expenses of an attendant will also be covered, but only if the covered individual's attending certified health care provider certifies that an attendant for the patient is necessary, (e.g. a parent in the case of a patient who is a minor, or a family member to make medical decisions in the case of a patient who is unwell or unconscious). All coverage for transportation for out-of-country medical treatment is subject to the total maximum annual limit. Transportation to a neighboring country without the attending certified health care provider certifying that the treatment is medically necessary and unavailable locally will not be covered.

*Adequate medical facilities means facilities licensed to perform required treatment and recognized by

Zimbabwe Medical Council.

C.3.19 180 Day Coverage for Dependents After Employee’s Death:

At the time of a covered employee’s death, his/her eligible dependents covered under post’s medical plan are eligible to continue receiving the same level of medical coverage for up to 180 days. This optional benefit is subject to availability of funds at post and no extensions are permitted.

C.4 EXCLUSIONS TO COVERAGE

There is no reimbursement for elective cosmetic surgery; spa cures; rejuvenation cures; massage;

exercise therapy; long-term rehabilitative therapy; non-medical hospital charges (e.g., telephone, television, etc.); home help, family help, or similar household assistance; fees of persons who are not certified health care providers; advanced reproductive technology (e.g., in-vitro fertilization, intra-cellular sperm injection, artificial insemination, microsurgical epididymal sperm aspiration, testicular sperm extraction, cryopreservation, etc.); or services or supplies which have not been prescribed or approved by a certified health care provider. Exclusions to coverage may be amended if provided in an off-the-shelf plan and is the lowest cost and technically acceptable. Removal of any exclusions require prior authorization.

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 LE Staff workers’ compensation program.

C.5 ELIGIBLE PARTICIPANTS

C.5.1 To be eligible to participate in the medical plan, LE Staff must be:

-- Paid under the terms of the Local Compensation Plan (LCP); and –

-- Under a non-temporary direct hire appointment, personal services agreement (PSA), or personal services contract (PSC); or

-- Under a temporary direct hire appointment or PSA Fixed Term of one year or more.

Not eligible are those working under temporary appointments; those working under a PSC or PSA that is time limited to less than one year; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Zimbabwe who provides services to other local organizations as well as to the U.S. Mission; employees working on an intermittent or

When Actually Employed (WAE) schedule; Peace Corps personal services contractors as indicated in

MS 743; and Recreation Association employees.

C.5.2 Participants Covered Under a Rider:

Official Residence Expense (ORE) and Employee Association (EA) employees may be covered under a rider to the contract. The employing officer/EA, not the U.S. Government, is responsible for the employer's share of the premium costs for an ORE/EA employee.

Peace Corps (PSC) active employees may be covered under a rider to the contract. Peace Corps, not the U.S. Government, is responsible for the employer’s share of the premium costs for Peace Corps

(PSC) employees.

Note that USG is not responsible, nor liable, for any riders.

C.5.3 Dependents:

LE Staff who are eligible to participate in the medical plan automatically confer coverage to eligible family members who meet the following criteria:

Legal spouse: one legal spouse as defined by local law may be covered. LE Staff with more than one legal spouse must select only one spouse for coverage.

In cases where LE Staff and their legal spouse both work for the mission and both are eligible to participate in the medical plan, one will be designated as the lead for purposes of the medical plan, and the other will be considered a legal spouse.

Dependent children: a child is defined as the LE Staff’s natural, adopted, stepchild, or foster child.

The child must be unmarried and financially dependent upon the LE Staff. A child will be covered until the end of the contract year in which s/he reaches age 26. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the

LE Staff maintains coverage.

Other Family Members, who do not meet the definition of “Eligible dependent” under the LCP: An employee may opt to enroll other family members as riders under the terms and conditions of this contract. The employee/primary member is responsible for the enrollment process and timely payment of the full premium to the vendor. LE Staff other family members are not included under the task orders issued by the U.S. mission contracting officer.

C.5.4 Periods of Ineligibility:

Employees and their dependents are not entitled to health benefits during any period of employment for which premiums are not paid.

Additionally, an 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 Leave Without Pay (LWOP) or unpaid leave beyond one pay period, 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 they prefer not to pay the premium.

C.6 TERM OF ELIGIBILITY AND EFFECTIVE DATE:

Each current active eligible employee and their eligible dependents are enrolled for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee and eligible dependents 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.7 IDENTIFICATION OF ELIGIBLE EMPLOYEES AND DEPENDENTS:

U.S. Mission Harare, Zimbabwe will provide a list of all eligible employees and dependents with relationship to employee (self/spouse/child) and DOB for each. Updates will be provided to add or remove individuals on a bi-weekly/monthly basis.

C.8 ANNUAL MAXIMUM LIMIT

The maximum annual coverage per covered individual per contract year, not including expenses covered under HIV/AIDS benefits if selected by post, is $68,000.00.

C.9 BROCHURE REQUIREMENT

C.9.1 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.9.2 The Contractor shall provide the document described in C.7.1 to the COR not later than 15 days after date of contract award. The Contractor shall provide additional brochures for new employees within 10 days of the COR’s request.

C.9.3 The Contractor assumes full responsibility for ensuring that the document described in C.7.1 accurately reflects the requirements, coverage, and contract terms 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 document contains inaccuracies, the Contractor will be notified in writing; however, failure on the part of the U.S. 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.10 KEY PERSONNEL

The U.S. Government considers the contractor’s project manager as key personnel for this contract meeting the following minimum requirements:

The Project Manager must be able to speak and write English and shall possess at least 5 years of experience in working with contracts of similar size and work. The offeror shall provide a resume in the English language demonstrating these experiences.

During the entire performance period of this contract, the Contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment.

The Contractor shall notify the Contracting Officer’s Representative (COR) within 15 calendar days after the occurrence of any of these events. The proposed substitute shall possess qualifications comparable to the original key person, as well as satisfying any minimum standards set forth elsewhere in the contract. The COR will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the substitution.

C.11 SERVICE REQUIREMENTS

C.11.1 Claims and Appeals

The contractor must maintain a user-friendly system for employees to access their claims, submit and track claims, and a clear appeal process for any rejected claims. Customer satisfaction with this process must be included as an indicator in the quality assurance plan. Claims appeal shall not take more than 7 business days to resolve / provide feedback to the employee and Contracting Officer’s representative.

C.11.2 Payment

Service providers shall be paid in not more than 30 days.

C.11.3 Reimbursement

Contractor shall make reimbursements for services paid for out of pocket within 30 business days from submission of reimbursement claim.

C.11.4 Customer Service

Contractor shall provide a dedicated 24-hour customer service facility to handle and customer enquiries and after-hours authorizations.

C.11.5 Preferred Provider Network (PPN)

Contractor shall provide a Preferred Provider Network (PPN) of service providers for the benefits listed in Section B in Zimbabwe Areas of coverage to include but not limited to Victoria Falls, Bulawayo, Gwanda, Gweru, Kwekwe, Kadoma, Chegutu, Norton, Marondera, Rusape, Mutare, Nyanga, Chipinge, Masvingo, Chiredzi, Bindura, Harare (CBD, Westgate, Avondale, Borrowdale, Ruwa, Waterfalls, Chitungwiza, Waterfalls, Avondale, Eastlea, Highlands/Chisipite and Greendale.

The PPN shall be reviewed and updated bi-annually and shared with all employees.

C.11.6 Response Time

Contractor shall respond to medical aid enquiries within 24 hours of notification.

C.11.7 Monthly reports

Contractor will provide the Embassy regular monthly reports on claims submission, and other matters important to good overall management of the contract.

C.12 DEFINITIONS

CLIN Contract Line Item Number

CO Contracting Officer

COR Contracting Officer’s Representative

Contractor Insurance Company

Employer The United States Government = USG

Employee Staff member of U.S. Embassy Harare

Employee+1 Any eligible spouse or child of the Employee

FMO Financial Management Office

ORE Official Residence Expense

PII Personal Identifiable Information

QA Quality Assurance

QC Quality Control

QCP Quality Control Plan

SOW Statement of Work

TBD To be determined

USG The United State Government

Dependents: Dependents are defined as the covered employee’s legal spouse as defined by law (limit one) and children (natural, adopted, stepchild, or foster children). The child must be unmarried and financially dependent upon the LE Staff. A child will be covered until the end of the contract year in which s/he reaches age 26. An unmarried child determined to be incapable of self-support due to a physical or mental condition will continue to be eligible to participate in the medical plan as long as the condition persists, the child remains unmarried, and the LE Staff maintains coverage.

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

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.

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.

D. CONTRACT ADMINISTATIVE REQUIREMENTS AND PROCEDURES

D.1 QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan provides an effective method to promote satisfactory 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 monitor quality to ensure that contract standards are achieved.

Performance Objective Performance Threshold

Services:

Performs all services set forth in the scope of work.

All required services are performed and no more than three (3) customer complaint are received per month.

Timely payment of benefits (within 30 calendar days).

No more than one (1) customer complaint is received per month.

No incorrectly denied claims. No more than one (1) customer complaint is received per month.

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.

2. STANDARD:

The performance standard is that the Government receives no more than three (3) customer complaints 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), if any of the services fail to meet the standard.

3. COMPLAINT 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 after investigation of the site 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.

D.2 DELIVERABLES

All reports and other deliverables required under this contract shall be delivered by email to the COR and mailed to the following address:

U.S. Embassy Harare

ATTN: Human Resources Office

(Contact details to be provided in the contract)

NOTE: Any and all costs for the preparation, handling, mailing and submission of progress reports or any other required reports and documentation shall be included in the total price of each delivery order.

Reference Description Quantity Submission Date Deliver to:

C.10 Brochures As instructed by the COR

Additional copies

15 calendar days after contract award.

Within 10 calendar days upon COR’s request.

COR

Medical Aid Cards for employee and beneficiaries

As instructed by the COR

Additional copies for new hires or new dependents

30 days after contract award

Within 30 calendar days of COR’s request

COR

D.3 Employee Claims Report 1 No later than the

10th of the following month.

COR

D.9 Invoice 1 Monthly COR &

Designated

Billing

Office

Section II FAR 52.222-50(h) -

Compliance Plan

1 Annually after receipt of award and upon CO request

CO

D.3 CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO

CLAIMS

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 employees' 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:

D.3.1 Administrative Records

• The Contractor shall maintain medical insurance files for each eligible employee 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 employee per year reimbursement ceiling.

• The Contractor shall provide the COR with the necessary claim forms for each type of benefit that can be claimed under the contract. These forms shall specify a list of documents required to be appended to each claim and otherwise provide instructions for claim filing.

• The Contractor shall use the English spelling of the employees' names in all transactions, including reimbursement checks.

• The Contractor shall send employee claim reimbursement checks to employees not later than two weeks after a claim is submitted.

D.3.2 Medical Insurance Claims - Settlement of medical insurance shall be completed as follows:

• All medical claims shall be submitted directly to the Contractor by employees.

• The Contractor shall date stamp and screen all claims submitted on the day of receipt. If there are any missing documents or information thereby disallowing said claim to be payable, the

Contractor shall notify the employee within two (2) days, with a copy to the COR (if notification is written).

• The Contractor shall settle the claims no later than two (2) weeks from the date the claim is submitted to the Contractor.

• Settlement shall be by issuance of checks in the name of the employee for each claim submitted or via EFT. Each reimbursement shall be in the same currency as the receipt. Each reimbursement shall be accompanied by a form or email providing details of the amount reimbursed with an explanation of deductions, if any.

D.3.3 Report Requirements

The Contractor shall provide the following monthly report. The report shall be received by the COR no later than the 10th day of each month. The report shall report on the previous month's activities.

(a) Employee Claims Report: The report shall list all claims paid by the Contractor to a claimant, including the name of the claimant, date claim is received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of why claim has not been paid. The report shall not include any claims information for riders.

D.4 Key Personnel

The US Government considers the contractors Project Manager as Key Personnel for this contract.

Project Manager Name: To be inserted by the Contracting Office at the time of award

During the entire performance period of this contract, the contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment.

The contractor shall notify the Contracting Officer Representative within 15 calendar days after the occurrence of any of these events. The proposed substitute shall possess qualifications comparable to the original key person, as well as satisfying any minimum standards set forth elsewhere in the solicitation / contract. The Contracting Officer Representative will notify the contractor within 15 calendar days after receipt of all required information of the decision on the substitution.

D.5 MISCELLANEOUS CONTRACTOR REQUIREMENTS

D.5.1 A contract with the U.S. Government conveys no special privileges or immunities to the

Contractor. The Contractor is an independent commercial concern and not a part of the U.S. Mission.

The contractor's employees are not U.S. Government employees. Registration of this contract with the local government, if required by law, will be the sole responsibility of the Contractor, and any fees, taxes, or other duties shall be payable by the Contractor without recourse to the Government of the amounts thereof.

D.5.2 Licenses and Local Laws: The Contractor shall possess all permits, licenses, and any other appointments required for the prosecution of work under this contract, all at no additional cost to the

Government. The Contractor shall perform this contract in accordance with local laws.

D.6 ERRONEOUS PAYMENT

If the U.S. Government becomes eligible for a refund of payment because of erroneous overpayment or other cause, the Contractor shall refund the amounts or use them to offset future payments owed by the U.S. Government, whichever the U.S. Government prefers. The Contractor shall refund any refunds not complete or discovered after the completion date of this contract.

D.7 PHYSICAL AND INFORMATION SECURITY REQUIREMENTS

The Contractor shall be responsible for safeguarding all government information provided for contractor use. All material/documentation produced for the U.S. Government will be the sole property of the U.S. Government. The Contractor shall not release any documents to anyone unless authorized by the U.S. Government. The following considerations shall be followed by the Contractor:

• All documents received or generated under the contract are the property of the U.S.

Government.

• All documents shall be controlled and disseminated on a need-to-know basis. Reproduction and distribution are prohibited without express approval of the U.S. Government.

• All documents shall be marked and handled in strict accordance with all applicable requirements and regulations. Proposed and actual contract documents shall only be disseminated on a strict need-to-know basis and shall not be further disseminated without prior authorization from the U.S. Government.

• Those receiving any type of proposed and/or actual contract documents shall be responsible for these materials while in their possession, or that of any of their subcontractors. They shall return all documents, including all copies, promptly upon demand by the U.S. Government.

D.8 LAWS AND REGULATIONS

Compliance Required: If the Contractor has or will establish a local office, he shall without additional expense to the U.S. Government, be responsible for complying with all laws, codes, ordinances, and regulations applicable to the performance of the work, including those of the host country, and with the lawful orders of any governmental authority having jurisdiction.

Labor, Health and Safety Laws and Customs: If the Contractor has or will establish a local office, he shall comply with all local labor laws, regulations, customs and practices pertaining to labor, safety, and similar matters, to the extent that such compliance is not inconsistent with the requirements of this contract.

The only items that the U.S. Government will consider for price adjustments are those that are mandated e.g. changes in the VAT rate (if applicable) or minimum hourly wage rate.

D.9 INVOICES, REVIEW AND PAYMENT

The Contractor shall submit monthly invoices to the Contracting Officer Representative and the designated billing office at:

AMERICAN EMBASSY HARARE

2 LORRAINE DRIVE

ATTN: FINANCIAL MANAGEMENT OFFICE

HARARE, ZIMBABWE

E-mail : hararefmoinvoices@state.gov

A proper invoice must include the following information:

• Contractor’s name and bank account information for payments by Electric Funds Transfer

(EFT).

• Invoice date and number.

• Contract number and line item number.

• A summary showing a listing of each member with total monthly price the currency the contract has been issued in. A detailed invoice for each Agency has to be attached to each summary invoice and should include the cost breakdown by each membership fee line according to the pricing schedule.

Advance Payment shall not be authorized under this contract.

D.10 CHANGES IN OWNERSHIP

The Contractor shall furnish the COR advance notification (90 calendar days prior to the effective date) of any disposition or the change in ownership or terms of lease of any facilities utilized by him for performance of any service under this contract.

D.11 FUNDING/TASK ORDERS/PROCEDURES

The contract remains unfunded; funding will be provided by issuing annual task orders with possible modification for staffing changes. Each task order will contain the following information:

• Name of contractor

• Contract number

• Date of purchase

• Task order number

• Name of person placing the order

• Quantity, unit price, and total price of each service / insurance premium

• VAT or other taxes as a separate item, if applicable

• COR and post points of contact, including e-mail addresses

• Applicable contract clauses, either in reference or in full text if necessary

Only a Contracting Officer (CO) may place a written order.

Ordering Procedures: The Government shall issue annual funded task orders to cover all eligible employees and their dependents. No task order shall include any names or Personal Identifiable

Information (PII). The COR informs the CO if any additions or deletions are required throughout the year and the CO will issue funded modifications as required.

Riders: As stated in C.5.3, Official Residence Expense (ORE) and Employee Association (EA) employees may be covered under a rider to the contract. The employing officer/EA, not the USG, is responsible for the employer's share of the premium costs for an ORE employee.

Therefore, any ORE and EA staff are not included under the task orders issued by the CO. As 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. Since 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).

D.12 CHOICE OF LAW

This contract shall be construed and interpreted in accordance with the substantive laws of the United

States of America. By the execution of this contract, the Contractor expressly agrees to waive any rights to invoke the jurisdiction of local national courts where this contract is performed and agrees to accept the exclusive jurisdiction of the United States Civilian Board of Contract Appeals and the

United States Court of Federal Claims for hearing and determination of any and all disputes that may arise under the Disputes clause of…