Solicitation Package.pdf

Solicitation #19J01022R0001

SECTION A

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE OF PAGES

1 | 87

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

3. SOLICITATION NO.

19J01022R0001

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

August 17th, 2022

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than item 7) American Embassy Amman, Jordan. Abdoun, Al-Umawyeen St.

Phone: 962-6-590-6000 Fax: 962-6-592-0163 Email: AmmanRFQ@state.gov

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

SOLICITATION

9. Sealed offers in original and three (3) copies for furnishing the supplies and/or services in the Schedule to the U.S. Embassy Amman. Abdoun, Al-Umawyeen St. or send electronically to

AmmanRFQ@state.gov by October 05th, 2022 and no later than 04:00 (local time). Offerors are required to submit all questions in writing to AmmanRFQQuestions@state.gov at least three days before the scheduled pre-proposal conference date.

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

Oscar K. Weinmeister

B. TELEPHONE (NO COLLECT

CALLS) AREA CODE NUMBER

EXT : 962-6-590-6246

C. E-MAIL ADDRESS

AmmanRFQ@state.gov

11. TABLE OF CONTENTS

(x) SEC. DESCRIPTION PAGE(S) (x) SEC. DESCRIPTION PAGE(S

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

X A SOLICITATION/CONTRACT FORM 1 X I CONTRACT CLAUSES 35-48

X B SUPPLIES OR SERVICE AND PRICES/COSTS 2-11 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK STATEMENT 12-24 X J LIST OF ATTACHMENTS 49-54

X D PACKAGING AND MARKETING 25 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 26-27 X K REPRESENTATIONS, CERTIFICATIONS, AND 55-77

X F DELIVERIES OR PERFORMANCE 28 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 29-30 X L INSTRS., COND., AND NOTICES TO OFFERORS 78-84

X H SPECIAL CONTRACT REQUIREMENTS 31-34 X M EVALUATION FACTORS FOR AWARD 85-87

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 120 calendar days (120 calendar days unless a different period is insert 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

14. ACKNOWLEDGMENT OF

AMENDMENTS

AMENDMENT NO. DATE AMENDMENT NO. DATE

(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

17. SIGNATURE 18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

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)

Oscar K. Weinmeister

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.

mailto:AmmanRFQ@state.gov mailto:AmmanRFQ@state.gov mailto:AmmanRFQQuestions@state.gov mailto:AmmanRFQ@state.gov

SECTION B

PRICE

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 Amman, Jordan and their eligible dependents as described in Section C. This insurance shall be provided in accordance with Section C.

B.1.1. Riders: The following are included in the contract only as a rider at the rates specified below. The USG is not responsible nor liable, for any riders.

B.1.1.1 Official Residence Expense (ORE): The Chief of Mission and/or Deputy Chief of Mission will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount.

B.1.1.2 Embassy Association Employees (EAE): The Employee Association will make payment directly to the Contractor for the entire premium amount of the EA employee, whether or not the

EA employee is contributing to the premium amount.

B.1.1.3 Retirees: The retiree will make payment directly to the Contractor for the entire premium amount.

B.1.1.4 Excess Coverage. The employee will make payment directly to the Contractor for the entire premium amount.

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% PERSUANT TO

26 U.S.C. 5000C.

NOTE: Details listed in Clause 52.229-11 and 52.229-12 (Section I and K)

The Offeror shall include Defense Base Act (DBA) insurance premium costs covering their employees working on the contract to include American citizens, Individuals hired in the United

States or its possessions, regardless of citizenship, Host Country Nationals (HCNs) and Third Country Nationals (TCNs) working overseas. The offeror shall obtain DBA insurance directly from any Department of Labor approved providers at the DOL website at http://www.dol.gov/owcp/dlhwc/lscarrier.htm http://www.dol.gov/owcp/dlhwc/lscarrier.htm

B.2. PRICES

B.2.1 VALUE ADDED TAX.

The Government will not reimburse the Contractor for VAT under this contract. The Contractor shall not include a line for VAT on Invoices as the U.S. Embassy has a tax exemption certificate with the host government.

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:

B.2.3 Base Year of Contract in Jordanian Dinar (JOD)

Bi-Weekly Rates Per Premium

Category Estimated Number of Premiums*

Rate per Premium

Extended Bi-Weekly Total

a. Self 130

b. Self Plus One 44

c. Family (3 or more individual)

d. Subtotal

Total Price for Base Year (d x 26)**

*estimated number of premiums does not include any Riders (B.1.1)

**does not include any premiums for Riders.

Rider Category*** Biweekly Rate per Premium

C.1.1.21 Excess Coverage ***not included in the Total Price for Base Year Calculation

B.2.4 First Option Year of Contract in Jordanian Dinar (JOD)

Category Estimated Number of

Premiums*

Rate per

Premium

Extended Bi-Weekly Total

a. Self 143

b. Self Plus

One

c. Family (3 or more individual)

Total Price for First Option Year (d x 26)**

***not included in the Total Price for First Option Year Calculation

B.2.5 Second Option Year of Contract in Jordanian Dinar (JOD)

Category Estimated Number of Premiums*

Rate per Premium Extended Bi-Weekly Total

a. Self 157

b. Self Plus One 53

c. Family (3 or more individuals)

Total Price for Second

***not included in the Total Price for Second Option Year Calculation

B.2.6 Third Option Year of Contract in Jordanian Dinar (JOD)

Category Estimated Number of Premiums*

Rate per Premium Extended Bi-Weekly Total

a. Self 172

b. Self Plus One 58

c. Family (3 or more

Total Price for Third

***not included in the Total Price for Third Option Year Calculation

B.2.7 Fourth Option Year of Contract in Jordanian Dinar (JOD)

Category Estimated Number of

Premiums*

Rate per Premium Extended Bi-Weekly

Total

a. Self 189

b. Self Plus One 63

c. Family (3 or more individuals)

d. Subtotal Total Price for Fourth

***not included in the Total Price for Fourth Option Year Calculation

B.2.8 Grand Total of Base plus All Option Year in Jordanian Dinar (JOD)

Base Year Total

First Option Year Total

Second Option Year Total Third Option Year Total

Fourth Option Year Total

Grand Total of Base plus All Option Year

MINIMUM AND MAXIMUM AMOUNTS

During the Base Year of the contract, and during the option year that might be exercised, the United States Government (USG) shall place orders totaling a minimum of JOD 50,000.00. This reflects the contract minimum guarantee for each period of performance. The amount of all orders, for base and all option years shall not exceed JOD 29,000,000.00. This reflects the contract maximum.”

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 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 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 bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount shall 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 Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan in Jordanian Dinar (JOD).

Period of Performance

Employee (Self) Employee’s Spouse (Self Plus One)

Employee’s Dependent

Child (Family, 3 or more

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

B.4. ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS

B.4.1. Premium Adjustment Based on Experience - For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract, 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, i.e., 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 shall include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

PART II: PRICE - GROUP LIFE INSURANCE

B.5. GROUP LIFE INSURANCE SERVICES

The Contractor shall provide the Group Life Insurance services described herein to employees of the Government of the United States of America in Amman, Jordan. The groups of employees who shall be provided this insurance are listed in C.2.3. This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.5.1. Official Residence Expense (ORE) Staff and Embassy Association Employees (EAE) 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), the Embassy Association (for EAEs) separately, at the rates specified below. See Section G for billing procedures.

B.6. GROUP LIFE INSURANCE RATES

This is a fixed-price with economic-price- adjustment-requirements type contract under which the Government will issue firm-fixed price task orders. The fixed prices/premium rates in

Jordanian Dinar per one thousand of salary to provide life insurance, accidental death and dismemberment and partial and total disability coverage are as follows:

B.6.1. Base Year of Contract in Jordanian Dinar (JOD)

Bi-Weekly Rates per Employee

Type of Insurance Premium

(Per 1,000 of Salary) Estimated Payroll (Bi- Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 440

b. Accidental Death & Dismemberment

c. Partial & Total Disability Coverage

d. Subtotal (a + b + c)

e. Total Price for Base Year (d x 26)

B.6.2. First Option Year of Contract in Jordanian Dinar (JOD)

(Per 1,000 of Salary) Estimated Payroll (Bi- Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 485

b. Accidental Death & Dismemberment

c. Partial & Total

e. Total Price for First Option Year (d x 26)

B.6.3. Second Option Year of Contract in Jordanian Dinar (JOD)

(Per 1,000 of Salary) Estimated Payroll (Bi- Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 533

b. Accidental Death & Dismemberment

c. Partial & Total

e. Total Price for Second Option Year (d x 26)

B.6.4. Third Option Year of Contract in Jordanian Dinar (JOD)

(Per 1,000 of Salary) Estimated Payroll (Bi- Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 586

b. Accidental Death & Dismemberment

c. Partial & Total

e. Total Price for Third Option Year (d x 26)

B.6.5. Fourth Option Year of Contract in Jordanian Dinar (JOD)

(Per 1,000 of Salary) Estimated Payroll (Bi- Weekly in Thousands)

Bi-Weekly Total

a. Basic Life 644

b. Accidental Death & Dismemberment

c. Partial & Total

e. Total Price for Fourth Option Year (d x 26)

B.6.6. Grand Total of Base plus All Option Years in Jordanian Dinar (JOD)

Base Year Total

First Option Year Total

Second Option Year Total Third Option Year Total

Fourth Option Year Total

Grand Total of Base plus All Option Years

B.7. ADMINISTRATIVE RETENTION AMOUNTS

B.7.1 If the Contractor requests a price adjustment under B.8 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.6. This retention amount will not be adjusted for any reason.

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

B.7.2 Sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

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

B.7.2. Retention Amounts per Separate Premium Paid per Employee in Jordanian Dinar (JOD).

Period of Performance Basic Life Accidental Death and Dismemberment Partial and Total

Disability Coverage

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

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.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

C.1. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as described herein. The Government has determined that the prevailing practice by employers in Jordan is to provide for their employees’ health insurance protection and that the cost of such insurance protection is usually borne by both the employee and the employer on a 90 percent U.S government (employer) share, and 10 percent (employee and dependent) share.

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.1.1 Employee and Dependent Health Service Benefits

Employees and dependents may select hospital and doctors, pay bills, and claim reimbursements against the contractor directly. Employees and dependents may accept treatment from the Contractor's designated hospitals and doctors. In such cases, the Contractor will pay medical expenses directly to the providers of care and invoice employees for their portion of the co-insurance. Reimbursements or payments shall be made for the following covered benefits, and subject to reasonable and customary costs in the locality where treatment was provided “according to the official tariff”.

C.1.1.1 Hospitalization (Treatment in the Hospital for Inpatient Care):

Minimum Coverage - 100%

Services and supplies provided during hospitalization including services provided by a licensed healthcare provider, bed and board (semi-private accommodations), operating room, recovery room, intensive care, imaging and diagnostic testing, and 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 Health and Substance Abuse Care (below) for details concerning inpatient psychiatric care.

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

C.1.1.2 Emergency Services (Trips to Emergency Room): Minimum

Coverage - 95%

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

C1.1.3 Ambulance: Minimum Coverage - 100%

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.1.1.4 Outpatient Services: Minimum Coverage - 90%

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 provided at 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.1.1.5 Obstetric and Newborn Care: Minimum Coverage -

Inpatient/Emergency: 100%; Outpatient: 90%

Care and services that women receive during pregnancy (prenatal care), throughout labor, 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.

Inpatient: 100% coverage with JOD 12,000.00 annual cap per case.

C.1.1.6 Pediatric Services: Minimum Coverage - Inpatient/Emergency:

100%, Outpatient: 90%

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.1.1.7 Prescription Drugs: Minimum Coverage -Inpatient/Emergency:

100%, Outpatient: 90%

Medications prescribed by a licensed health care provider that are medically required.

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, contraceptive medication.

C.1.1.8 Preventive and Wellness Services and Chronic Disease Management:

Minimum Coverage - 90%

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.1.1.9 Hearing Aids: Minimum Coverage – 80%

Examinations and Treatment: 80% Minimum Coverage

Hearing Aid Apparatus: Limited to one apparatus per ear up to a maximum of JOD 1,062.00 per covered individual per three-year period. 80% Minimum Coverage: with annual cap.

C.1.1.10 Optical Care: Minimum Coverage – 60% Examinations and Treatment: 60% Minimum Coverage

Prescription lenses and frames, or contact lenses: Covered up to a maximum of JOD

212.40 per covered individual every two years. 60% Minimum Coverage; with annual cap.

C.1.1.11 Dental Care: Minimum Coverage – 80%

Examinations and Treatment: Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a maximum of JOD 2,265.60 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 up to a maximum of JOD 1,699.20 lifetime limit. 80%

Minimum Coverage; with contract lifetime cap.

C.1.1.12 Reproductive Health: Minimum Coverage - 90%

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.1.1.13 Mental Health and Substance Abuse Care: Minimum Coverage -

60%

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 provided at a facility licensed for detoxification and rehabilitation.

C.1.1.14 Rehabilitative and Habilitative Services and Devices:

Minimum Coverage - 100% (Limited to 20 sessions annually)

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, etc.) that help develop skills needed for everyday life.

Devices to help gain or recover mental or physical skills lost due to injury, disability or a chronic condition, and devices needed for habilitative reasons.

C.1.1.15 HIV/AIDS: 100% 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.1.1.16 Reserved

C.1.1.17 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.1.1.18 Out-of-Country Medical Travel: 80% Reimbursement

Transportation for out-of-country medical treatment will be a covered expense for covered employees 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.

C.1.1.19 180 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.1.1.20 Reserved

C.1.1.21 Excess Coverage:

NOTE: Employee responsible for paying 100% of premium for Excess Coverage

Additional coverage equal to JOD 80,000.00 per covered individual per contract year.

This excess coverage will be offered as an optional benefit to LE Staff. This can be used for any covered individual for any covered expense that exceeds annual maximum. LE Staff must pay 100% of the premium if they elect Excess Coverage. The premium for this additional coverage is a rider to be paid by the employee to the vender directly and

USG will not be responsible for collecting of these premium payments.

C.1.2 Annual Maximum Limit - The maximum annual reimbursement per covered individual per contract year, not including expenses defined under Exclusions and Limitations (C.1.3) and those covered under C.1.1.15, HIV/AIDS, and C.1.1.21 Excess Coverage is equivalent to JOD 80,000.00.

C.1.3 Exclusions and Limitations

There is no coverage 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 coverage 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.1.4 Eligible Participants

C.1.4.1 Identification of Eligible Employees and Dependents: U.S. Mission

Amman, Jordan 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.1.4.1.1 Definition of Dependents

C1.4.1.1.1 Spouse: a limit of one legal spouse as defined by local law per employee will 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.

C.1.4.1.1.2 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 25. 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.

C.1.4.2 Location of Employment: The eligible employees covered by C.1.4.1 must be employed within the geographic boundaries of Jordan

C.1.4.3 Participants Covered Under a Rider

a. All current active ORE Staff personally employed by the Chief of Mission and the Deputy Chief of Mission and assigned to their respective official Government residences and paid under an ORE account. All costs for coverage of ORE Staff are the responsibility of the Chief of Mission and the Deputy Chief of Mission, not the U.S. Government.

b. All current active employees of the Employee Association at Embassy Amman, Jordan. All costs for coverage of EAEs are the responsibility of the

Employee Association, not the U.S. Government.

c. All retired employees can participate in this plan under a rider. All health benefits and limitations outlined apply for the retired employee and his/her remaining dependents. The retired employee will pay 100% of the premium costs for employee and dependent coverage.

C.1.5 Eligibility

C.1.5.1 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.

To be eligible to participate in the medical plan, employee 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 Jordan 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; employees of USAID institutional contractors; Peace Corps personal services contractors as indicated in MS 743; and Recreation Association employees.

C.1.5.2 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, 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.1.6 Brochure Requirement C.1.6.1 The Contractor shall provide a document (brochure/pamphlet/other written document) in English and Arabic that sets forth a complete listing of the health insurance benefits to be provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.1.6.2 The Contractor shall provide the document described in C.1.6.1 to the COR not later than 30 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) business days of the COR’s request.

C.1.6.3 The Contractor assumes full responsibility for ensuring that the document described in C.1.6.1 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.

PART II: GROUP LIFE INSURANCE

C.2. 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 Amman, Jordan. The Government has determined that the prevailing practice by employers in Jordan is that group life insurance coverage is representative of locally prevailing compensation practice and that the cost of such insurance protection is usually borne by employer, the U.S. Government will pay 100% percent of the premium costs. Therefore, the Government desires to adopt such locally prevailing practice as part of its compensation plan for its employees as further described in C.2.2. The specific group insurance coverage under this contract is set forth in this part of Section C and the Attachments in Section J.

C.2.1. Group Life Insurance Coverage

The amount of group life insurance coverage is as follows:

C.2.1.1 Amount of Employee Life Insurance.

The amount of life insurance coverage for each employee is based upon the employee’s basic monthly salary. Each employee is eligible for a face amount of coverage that is equal to 33 times the monthly basic salary. In the event of the natural death of an eligible employee, the Contractor shall pay to the employee’s estate a lump sum benefit equal to 33 months of employee’s monthly basic salary.

C.2.1.2 Amount of Accidental Death and Dismemberment Coverage.

The employee's estate or employee will receive an amount equal to 33 times the amount of monthly basic salary in the event the employee is killed in an accident. See section J exhibit G for dismemberment percentage coverage.

C.2.1.3 Partial and Total Disability Coverage

Partial and total disability are lumped into the C.2.1.2 Amount of Accidental Death and

Dismemberment Coverage. The maximum amount the employee’s estate or employee will receive is an amount equal to 33 times the amount of monthly basic salary.

In the event the employee is partially or totally disabled, the employee will receive a percentage from an amount equal to 33 times the amount of monthly basic salary. See section J exhibit G for percentage coverage.

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:

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.

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:

1. Violating the law or in resisting detention or arrest.

2. Participation in competitions involving the use of wheeled vehicles, horses, boats or water skis.

3. An accident resulting from the employee being under the influence of alcohol, drugs or other toxic substance unless administered by a physician. 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 Jordan, paid under the Local Compensation Plan, working on a full-time or part-time basis under non-temporary direct-hire appointments and under personal services agreements/contracts that are not time limited to less than one year, 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.2.3.2.1 The individuals covered by C.2.3.1 must be employed within the geographic boundaries of Jordan by the U.S. Government agencies at the U.S.

Embassy in Amman, Jordan.

C.2.3.3 Participants Covered Under a Rider

C.2.3.3.1 All current active employees of the Chief of Mission and the

Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.2.3.3.2 All current active employees of the Employee Association at Embassy/Consulate Jordan (see separate rider, Exhibit C). All costs for EAEs are the responsibility of the Employee Association, not the U.S. Government.

C.2.4 Individuals not Eligible for Coverage

C.2.4.1. Reserved

C.2.4.2 Not eligible are LE Staff working under temporary appointments; those working under a PSA or PSC 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 Jordan who provide services to other local organizations as well as to the U.S.

Mission; employees of USAID institutional contractors; and Peace Corps personal services contractors as indicated in MS 743. 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 and Arabic that sets forth a complete listing of the life insurance benefits to be provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The Contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.2.7.2. The document described in C.2.7.1 shall be provided to the COR not later than 30 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten days of the COR’s request.

C.2.7.3. The Contractor assumes full responsibility for ensuring that the document described in C.2.7.1 accurately reflects the requirements of the contract, as implemented by the Contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the Contractor will be notified in writing;

however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the Contractor to fully comply with all contract terms.

C.3.0. DEFINITIONS

C.3.0 DEFINITIONS

FMO

The Financial Management Officer (FMO) or the paying office for all U.S.

Government Agencies, except U.S. AID.

COR

Contracting Officer's Representative (COR) is the Human Resources

Officer (HRO) at post.

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

Customary and

Reasonable Treatment

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

Dependent

Eligible Dependents are defined as employee's spouse (limited to one) and all children unmarried and financially dependent upon the employee and under the age of 25. There is no limit on the number of children covered per employee. A child is natural, adopted, stepchild or foster child. As further defined in section C.1.4

Disability - Total and Permanent

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

Employee

An individual employed by the U.S. Government, under a direct-hire appointment, personal services contract (PSC), or personal services agreement (PSA), as further defined in Section C.1.3 for health insurance and C.2.3 for life insurance. This may also include ORE Staff and EAE, if this category of individual is listed as participating under a rider in C.1.3.3 for health insurance and C.2.3.3 for life insurance.

Employer The United States Government or in the case of ORE and EAE employees, the Chief of Mission/Deputy Chief of Mission and the Employee

Association, respectively.

GSO

General Services Officer in charge of the General Services Office at post.

This officer is usually the Contracting Officer (CO) for this contract.

Hospital

An institution established and operated for the care and treatment of sick and injured persons. It provides 24-hour nursing care and has diagnostic, laboratory, treatment, and surgical facilities. Any institution which does not meet this definition is not considered a hospital.

Hospital Patient An individual who has been admitted to a hospital, is assigned a bed, and is given diagnostic tests or receives treatment for a disease or an injury.

Maximum Benefit The total amount that will be paid to any one covered individual for covered medical expenses or life insurance/disability benefit.

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.

Salary

Monthly salary is one-twelfth of the employee's annual basic salary, exclusive of premium pay, allowances, bonuses, or any other separate payments. Currency: premiums and benefits will be paid in local currency

(Jordanian Dinar).

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 one or more 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. In addition, the full text of a clause may be accessed electronically at: Acquisition.gov this address is subject to change.

If the Federal Acquisition Regulation (FAR) is not available at the location indicated above, use the Department of State Acquisition website at e-CFR to see the links to the FAR. You may also use an Internet “search engine” (for example, Google, Yahoo or 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.

Performance Objective

PWS

Paragraph Performance Threshold

Services Performs all the insurance services set forth in the Performance Work Statement (PWS)

C.1.0 thru

C.3

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…