Health-14-RFP-FINAL.doc

Solicitation No. STH200-14-R-0002

Health Insurance Services

Embassy of the United States of America

Bangkok, Thailand

GSO/Procurement & Contracting Office

120-122 Wireless Road, Lumpini, Bangkok 10330

Tel: 66-2-205-5320 Fax: 66-2-254-2994

Email: ying@state.gov

April 17, 2014 Dear Prospective Offeror:

SUBJECT: Solicitation Number STH200-14-R-0002

Health Insurance Services

The Embassy of the United States of America invites you to submit a proposal for customized Health Benefits Insurance Services for local employees and dependents of the U.S. Mission in Thailand.

The Embassy intends to conduct a pre-proposal conference on May 16, 2014 at 10:00 hrs at the U.S. Embassy Bangkok, and all prospective offerors who have received a solicitation package are invited to attend. See Section L of the attached Request for Proposals (RFP).

For submission via hard copy, your proposal must be submitted in a sealed envelope marked "Proposal Enclosed" to the U.S. Embassy Bangkok, 120-122 Wireless Road, Lumpini, Patumwan, Bangkok 10330 Attention: Joseph D. Hogan, Contracting Officer on or before 15:00 hours on June 23, 2014. No proposal will be accepted after this time.

Submission transmitted through electronic commerce (Email) is also accepted and shall be sent to the following email address: (BKKGSOProcBid@state.gov)

For electronic submissions please see the due date requirement referenced in provision 52.212-1 (b)(11)(2)(i)(A).

In order for a proposal to be considered, you must also complete and submit the following:

1.

SF-33

2.

Section B, Pricing Schedule

3.

Section B, Retention Amounts in B.3

3.

Section K, Representations and Certifications;

4.

Additional information as required in Section L.

Direct any questions regarding this solicitation to Joseph D. Hogan by email to HoganJD@state.gov.

Please note: proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than those stated in the solicitation may be deemed technically unacceptable.

The U.S. Government intends to award a contract to the responsible company submitting an acceptable offer at the lowest price. We intend to award a contract based on initial proposals, without holding discussions, although we may hold discussions with companies in the competitive range if there is a need to do so.

Sincerely, Joseph D. Hogan Contracting Officer

UNDER DPAS (15 CFR 350)

1 | 68

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

3. SOLICITATION NO.

STH200-14-R-0002

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

April 17, 2014

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

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

American Embassy Bangkok GSO/Procurement and Contracting Office

120 Wireless Road, Lumpini, Patumwan, Bangkok 10330 Phone: 662-205-5320 Fax: 662-254-2994 Email:Ying@state.gov Same as block 7

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

SOLICITATION

9. Sealed offers in original and see Section L copies for furnishing the supplies or services in the Schedule will be received at the place specified, in the depository located in See Block 7 until June 23 , 2014 local time 15:00 hrs..

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

10. FOR INFORMATION

CALL:

A. NAME

B. TELEPHONE (NO COLLECT CALLS)

AREA CODE NUMBER EXT

C. E-MAIL ADDRESS

11. TABLE OF CONTENTS

OTHER STATEMENTS OF OFFERORS

OFFER (Must be fully completed by offeror)

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

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (120 calendar days unless a different period is inseted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

SEE 14

(See section I, Clause No 52.232-8)

10 CALENDAR DAYS

20 CALENDAR DAYS

30 CALENDAR DAYS

CALENDAR DAYS

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

15A.

NAME

CODE

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE ADDRESS [ ]

IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

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

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

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

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

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print) Joseph D. Hogan

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

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

NSN 7540-01-152-8064

STANDARD FORM 33 (REV 9-97)

PREVIOUS EDITION NOT USABLE

Prescribed by GSA

SECTION B

PART I; PRICE - HEALTH INSURANCE

B.1.

HEALTH INSURANCE SERVICES

The Contractor shall provide the Health Insurance services to employees of the Government of the United States of America in Thailand as described in Section C and the Exhibits in Section J. The groups of employees who shall be provided this insurance are listed in C.1.3 (medical). This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.1.1.

Official Residence Expense (ORE) Staff, PEACE CORPS Contractors 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), Chief of PEACE CORPS (for PEACE CORPS Contractors) and the Embassy Association (for EAEs) comprising the American Community Support Association (ACSA) and Foreign Service National (FSN) Community, separately, at the rates specified below. See Section G for billing procedures.

B.2.

PRICES

B.2.1 VALUE ADDED TAX

VALUE ADDED TAX (VAT). 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:

Bi-Weekly Rates Per Employee:

Eligible Dependents

1,084

SUBTOTAL

Total Price for Base Year (Subtotal x 26): _______________

B.2.4.

FIRST OPTION YEAR OF THE CONTRACT:

Eligible

1,084

SUBTOTAL

Total Price for Option Year 1 (Subtotal x 26): ________________

B.2.5.

SECOND OPTION YEAR OF THE CONTRACT:

Eligible

1,084

SUBTOTAL

Total Price for Option Year 2 (Subtotal x 26): ________________

B.2.6.

THIRD OPTION YEAR OF THE CONTRACT:

Eligible

1,084

SUBTOTAL

Total Price for Option Year 3 (Subtotal x 26): _________________

B.2.7.

FOURTH OPTION YEAR OF THE CONTRACT:

Eligible

1,084

SUBTOTAL

Total Price for Option Year 4 (Subtotal x 26): __________________

GRAND TOTAL BASE PERIOD PLUS FOUR OPTION YEARS: __________________

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

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

B.3

ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

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

B.3.2.1 Bi-Weekly Retention Amounts per separate premium paid per single employee and per eligible dependent.

Base Period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

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. 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. Before any such adjustment is made, the contractor agrees to provide the Government a balance sheet showing two main components for the time period: (1) receipts (premiums received) minus the retention amount and (2) claims paid. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet 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. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.4.2.

Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the Contractor to modify the contract to adjust the premium rate. The contractor agrees to provide all documentation necessary to support any requested adjustment.

B.4.2.1 Employee Pool – This clause is only in effect if the contractor included details in its offer regarding a pooling arrangement, of which this contract is a part.

Before any adjustment is made under this price adjustment clause, the Contractor must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

PART I - HEALTH INSURANCE

C.1.

HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as further described in C.1.2 in Thailand. The Government has determined that the prevailing practice by employers in Thailand is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne 100% by the employer. Health insurance protection will be representative of locally prevailing compensation practice as further described in C.1.2. The specific health benefit coverage under this contract is set forth in Section C and the Exhibits in Section J.

The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care, unless exclusion has been authorized by HR/OE/CM.

C.1.1 Employee and Dependent Health Services Benefits

The health benefits under this contract are as follows. Reimbursement of covered expenses is limited to the stated percentages of reasonable and customary costs. Proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than stated in the solicitation may be deemed technically unacceptable.

The insurance company will reimburse covered medical expenses incurred, subject to the stated limits. Payment will be made for reasonable and customary costs of covered benefits. The medical treatment must be prescribed or provided by a physician or nurse licensed in Thailand or the United States, or in the country in which the treatment or prescription is received. Payment will be made in Baht.

Reimbursements or payments shall be made for the following covered benefits, subject to reasonable and customary costs in the locality where treatment was provided.

C.1.1.1.

Hospitalization

Employees and dependents are entitled to receive 100% reimbursement of room and board expenses for a ward room, private, or semi-private room for a maximum of 31 days up to a maximum of 4,500 Baht per day, and 100% coverage of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room costs, intensive care, prescription medicines, and physical therapy up to a maximum of 53,000 Baht per incident.

C.1.1.2.

Surgery

Professional Services and Treatment:

Employees and dependents are entitled to receive 100% reimbursement of Surgical Assistant, Anesthesiologist, and Surgeons’ fees incurred while hospitalized, or at a clinic up to a maximum amount of 60,000 Baht per incident.

C.1.1.3.

Doctor Visits Employees and dependents are entitled to receive 100% reimbursement of doctors’fees for inpatient treatment up to a maximum of 1,225 Baht/visit and 100% reimbursement of Specialist Consultation fees up to a maximum of 6,030 Baht per disability.

C.1.1.4.

Prescription Drugs C.1.1.4.1 Prescription Drugs (out patient)

100% reimbursement of prescription drugs and medicines which are obtained without an outpatient doctor’s visit and therefore not covered under C.1.1.6. Reimbursement is made only for drugs and medicines for which a prescription is legally or normally required.

Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription are not covered even if prescribed by a physician.

C.1.1.4.2 For employees only: 100% reimbursement for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have

HIV/AIDS. For employee and employee’s covered spouse: 100% reimbursement for brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. This expanded coverage generally excludes medications for the long-term suppression of AIDS through the combination of anti-retroviral drugs at those posts with inadequate local healthcare infrastructures.

The expenses incurred under section C.1.1.4.2. are subject to a separate annual maximum limit of USD.10,000 per employee.

C.1.1.5.

Maternity-including provisions for brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. Duration of treatment is to be determined by employee’s personal physician, following WHO and CDC guidelines.

Obstetrical Care: Employees and dependents are entitled to 100% reimbursement of obstetrical medical care including prenatal and postnatal care up to a maximum amount of 13,000 Baht per Maternity.

C.1.1.6.

Hospital Outpatient Services 100% reimbursement of outpatient expenses which include doctors’ fees diagnostic tests, laboratory tests, and x-rays. 100% reimbursement of the cost of medicines prescribed during the outpatient visit and which are not available over the counter. The maximum for outpatient services is 2,550 Baht per visit, 20 visits per contract year, and 51,000 Baht per contract year per individual.

C.1.1.7.

Optical Service Not covered

C.1.1.8

Dental Service The employee only is entitled to 100% reimbursement of expenses for dental services including preventative care, minor surgery, major restorative surgery, orthodontics , additional coverage of dentists’ fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges, up to a maximum of 3,500 Baht per year.

C.1.1.9.

Physical Therapy Covered

C.1.1.10.

Psychiatric Treatment

Not covered

C.1.1.11.

Ambulance Service

100% coverage of ambulance service including land ambulance, national air carrier and international air carrier, up to a maximum amount of 2,400 Baht/trip.

C.1.1.12.

Hearing Aids

C.1.1.13.

Medical Expenses Incurred Out-of-Country

C.1.1.14.

C.1.1.18 Family Planning

Not covered

C.1.1.15 Maximum Limits Maximum Annual Coverage

The insurance company will reimburse expenses up to a limit of 2,000,000 Baht per patient per contract year. Expenses incurred under section C.1.1.4.2. are subject to a separate annual maximum limit of USD.10,000 per employee.

C.1.1.16 Transportation for Out of Country Medical Treatment Not covered

C.1.1.17 Emergencies

100% reimbursement of fees associated with emergency room treatment up to a maximum of 9,000 Baht per incident.

C.1.2 Health Benefits Conditions and Limitations

There is no reimbursement for elective cosmetic surgery; spa cures; rejuvenation cures; massage; exercise therapy; long term rehabilitative therapy; eyeglass frames; non-medical hospital charges such as telephones or television; home help, family help, or similar household assistance; fees of persons who are not licensed physicians or nurses; or services or supplies which have not been prescribed or approved by a physician or nurse.

There is no reimbursement for expenses that will be reimbursed or paid directly under a host country medical program or workers' compensation program; the U.S. workers’ compensation program; or post’s LE Staff workers’ compensation program.

There is no coverage for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; the practice of a dangerous sport; excessive or illegal use of alcohol or drugs; a self-inflicted wound; or service in the armed forces of any country.

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

C.1.3 Eligible Participants

C.1.3.1 Eligible Employees - The employees eligible for the health insurance services include the following:

C.1.3.1.1 All current active employees of the United States Government, employed within the geographic boundaries of Thailand paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include

C.1.3.1.2.

Foreign Service Nationals (FSNs) employed under direct hire appointments, Personal Services Agreements (PSAs) and Personal Services Contracts (PSCs);

C.1.3.1.3.

Locally hired U.S. citizens employed under direct hire appointments, PSAs, and PSCs.

C.1.3.2 Location of Employment

The individuals covered by C.1.3.1 must be employed within the geographic boundaries of Thailand by: all U.S. Government agencies operating under the authority of the Chief of Mission.

Department of State

Department of Defense

Department of Agriculture

Department of Justice

Department of Commerce

Department of Treasury

Peace Corps

Department of Health and Human Services

Library of Congress

Department of Homeland Security

USAID

OSC

USTDA

IBB

C.1.3.3 Participants Covered Under a Rider

C.1.3.3.1 All current active employees of the Chief of Mission and the Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account (see separate rider, Exhibit B). All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.1.3.3.2 All current active employees of the Employee Association at Embassy/Consulate Thailand (see separate rider, Exhibit B ). All costs for EAEs; American Community are the responsibility of the Employee Association, not the U.S. Government.

C.1.4

Individuals Not Eligible for Coverage

Individuals not eligible for coverage under this contract are non-personal 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.1.5.

Other Eligible Participants

C.1.5.1 Covered dependents include the participating employee’s spouse and children. A limit of one spouse per employee is covered. An eligible child is defined as the employee’s natural child, adopted child, stepchild, or foster child. The child must be unmarried, economically dependent upon the employee, and primarily reside with the employee unless away at school. An eligible child will be covered until the end of the contract year in which he/she reaches age 21. There is no age limit for a child who is physically or mentally handicapped so as to be unable to live independently. There is no limit on the number of children covered per employee. Parents, grandparents, siblings, and other relatives are not eligible dependents. Retirees are not covered.

C.1.5.2 Health insurance Coverage for Employee’s dependents after death

At the time of a covered employee’s death, his/her eligible dependents covered under post’s medical plan and as designated in the official personnel life, are eligible to temporarily continue receiving the same level of medical coverage for up to 180 days. This continued coverage is limited to 180 days only , is subject to availability of the funds at post, and no extensions are possible.

C.1.6.

Eligibility

C.1.6.1.

Term of Eligibility and Effective Date

Each current active eligible employee is enrolled for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee will be enrolled upon entering on duty with the United States Government. An employee is considered active ("on the rolls") whenever such employee is on approved leave, whether paid or unpaid.

During a period of Leave Without Pay 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.

Eligible employees are Locally Employed Staff who are

(1) working on a full-time or part-time basis under non-temporary direct hire appointments or under Personal Services Agreements (PSAs) and Personal Services Contracts (PSCs) that are not time limited to less than one year and

(2) paid under the terms of the Local Compensation Plan.

Not eligible employees are those working under temporary direct hire appointment; those working on When Actually Employed (WAE) schedules; 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 Thailand.

-who provides 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; and Recreation Association employees.

C.1.6.2.

Period of Ineligibility.

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

Additionally, employee's dependents are not entitled to health benefits during any period of employment during which the employee was not eligible to participate.

During a period of extended (beyond one pay period) of Leave Without Pay or unpaid leave, the employee is responsible for the full cost of the insurance premiums for self and dependents. The Mission will pay the premiums directly to the contractor, and will collect the full cost from the employee on a quarterly basis. Alternatively, the employee may elect to have coverage cease if that employee prefers not to pay the premium.

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

For eligible employees who are regularly scheduled to work less than 30 hours per week; the USG will pay a prorated share of the premium cost for employee and dependent coverage, based on the number of hours the employee is regularly scheduled to work.

New born infants will be covered by the contractor upon their discharge form the hospital and becoming registered as a member of the family plan.

C.1.7.

BROCHURE REQUIREMENT.

C.1.7.1.

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

C.1.7.2.

The contractor shall provide the document described in C.1.7.1 to the COR not later than 30 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.1.7.3.

The contractor assumes full responsibility for ensuring that the document described in C.1.7.1 accurately reflects the requirements of the contract, as implemented by the contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the contractor will be notified in writing; however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the contractor to fully comply with all contract terms.

C.1.7.4.

The contractor shall issue to the COR for delivery to each existing and new member, within one week of enrollment, an individual membership card certifying that such employee and eligible dependent (s) is entitled to the benefits stipulated in the contract.

Paragraph C.2 is Reserved

C.3.0

DEFINITIONS

FMO

The Financial Management Officer or the paying office for all U.S. Government

Agencies except AID.

COR

Contracting Officer's Representative (Human Resources Officer at post).

Contributory Insurance for which the employee contributes toward the premium.

Dependent the employee’s legal spouse (limit one) and unmarried, economically dependent children who primarily reside with the employee unless away at school. Child is defined as the employee’s natural child, adopted child, stepchild, or foster child. An eligible child will be covered until the end of the contract year in which he/she reaches age 21.

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, or personal services agreement, as further defined in Section C.1.3 for health insurance. This may also include ORE Staff, EAE and Peace Corp PSCs, if this category of individual is listed as participating under a rider in C.1.3.3 for health insurance.

Employer The United States Government or in the case of ORE and a Foreign Service National Community and American Community Support Association as EAE employees, the Chief of Mission/Deputy Chief of Mission and Employee Association, respectively.

GSO

General Services Officer in charge of the General Services Office at post. This officer is usually the Contracting Officer 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.

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

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.

American Embassy and Embassy mean the diplomatic or consular mission of the Unitied States of America for which services are provided under the contract.

Contracting Officer means the person executing this contract on behalf of the Government, and any other officer or civilian employee who is properly designated Contracting Officer.

Government means the Government of the United States of America unless specifically stated otherwise.

SECTION D

PACKAGING AND MARKING

(RESERVED)

SECTION E

INSPECTION AND ACCEPTANCE

E.1.

52.252‑2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

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

http://acqusition.gov/far/index.html or, http://farsite.hill.af.mil/search.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Dept. of State Acquisition Website at http://www.statebuy.state.gov to see the links to the FAR. You may also use a network “search engine” (e.g., Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the most current FAR.

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

52.246-4 Inspection of Services - Fixed Price (AUG 1996)

E.2.

QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan is designed to provide an effective surveillance method to promote effective contractor performance. The QASP provides a method for the Contracting Officer's Representative (COR) to monitor contractor performance, advise the contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance. The contractor, not the Government, is responsible for management and quality control to meet the terms of the contract. The role of the Government is to conduct quality assurance to ensure that contract standards are achieved.

Services.

Performs all the insurance services set forth in the performance work statement (PWS)

C.1.0 thru C.3.0

All required services are performed and no more than five (5) customer complaint are received per month

E.2.1 Surveillance. The COR will receive and document all complaints from Government personnel regarding the services provided. If appropriate, the COR will send the complaints to the Contractor for corrective action.

E.2.2 Standard. The performance standard is that the Government receives no more than five (5) 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 (AUG 1996) or the appropriate Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

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

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

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

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

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

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

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

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

SECTION F

DELIVERIES OR PERFORMANCE

F.1.

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

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Dept. of State Acquisition Website at http://www.statebuy.state.gov to see the links to the FAR. You may also use a network “search engine” (e.g., Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the most current FAR.

52.242-15 Stop Work Order (AUG 1989)

52.242-17 Government Delay of Work (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is one year beginning on November 1, 2014 and ending on October 31, 2015 with four one-year options to renew.

F.3

OPTIONS

The Government may extend this contract in accordance with the option clause at Section I, clause I.2, FAR Clauses Incorporated by Full Text (FAR 52.217-9, Option to Extend the Term of the Contract), which also specifies the total potential duration of the contract.

The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services".

F.4

REPORTS AND OTHER DELIVERABLES

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

SECTION G

CONTRACT ADMINISTRATION DATA

G.1.

652.242-70 CONTRACTING OFFICER’S REPRESENTATIVE (COR) (AUG 1999)

The Contracting Officer may designate in writing one Government employee, by name or position title, to take action for the Contracting Officer under this contract. This designee shall be identified as a Contracting Officer’s Representative (COR). Such designation shall specify the scope and limitations of the authority so delegated; provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted Contracting Officer and this authority is delegated in the designation.

The COR for this contract is the Human Resources Officer.

G.2

COR DUTIES

G.2.1 The COR is responsible for inspection and acceptance of services. These duties include review of Contractor invoices, including the supporting documentation required by the contract. The COR may provide technical advice, substantive guidance, inspections, invoice approval, and other purposes as deemed necessary under the contract.

G.2.2 In addition, the COR shall maintain updated list of employees and dependents insured, which will supersede the initial list provided under this contract and as reported to the insurer through the broker, without prejudice to the ineligibility clause.

G.2.3.

The COR has the additional responsibility of maintaining the eligible listing of employees and dependents for insurance coverage.

G.2.4 The COR may not change the terms and conditions of the contract. While the COR is authorized to provide the Contractor with updated listings of eligible employees and dependents, only the Contracting Officer may modify existing task orders or issue new task orders, reflecting these changes, since only the Contracting Officer can obligate funding and commit the Government.

G.3.

Payment shall be made in Thai Baht. U.S. firms are allowed for payment in U.S. Dollars if the U.S. offeror elects to submit its offer in U.S. dollars.

G.4 SUBMISSION OF INVOICES AND PAYMENT Please consider all phrases in G.4.1

G.4.1.

Invoices for U.S. Government employees shall be submitted in an original and three (3) copies to the following address (designated billing office only for the purpose of submitting invoices):

American Embassy Bangkok

Financial Management Center

120-122 Wireless Road

Bangkok 10330

G.4.2.

Frequency of Payments. All funds under this contract will be obligated by issuance of task orders, as described in H.3. Each task order will fund a specific period of time and number of employees, and the task orders will be issued at the frequency described in H.3. All payments under this contract will be made at the conclusion of the period covered. Invoices may be submitted bi-weekly with payments being made bi-weekly by the Government.

G.4.3. U.S. Government Employees. The Government shall make payments directly to the contractor for all Government employees, whether or not the employee is contributing to the premium amount.

G.4.4 ORE Staff. 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.

G.4.5. EAE Staff. 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.

G.4.6 PEACE CORPS Contractors. PEACE CORPS will make payment directly to the contractor for the entire premium amount of the PEACE CORPS contractor, whether or not the PEACE CORPS Contractor is contributing to the premium amount.

G.4.7 FSN Community Staff. The Foreign Service National Community will make payment directly to the contractor for the entire premium amount of the Foreign Service National Community employee , whether or not the FSN Community employee is contributing to the premium amount.

G.5

REFUNDS TO THE GOVERNMENT

If at any time during performance of the contract the Government finds that the contractor has been overpaid because the number of employees and/or dependents covered has decreased, the Contracting Officer may either allow that overpayment to be credited to the Government’s account or require that the contractor refund the overpayment. If the Contracting Officer requests a refund, the contractor shall make that refund to the Government within fourteen calendar days of receipt of the request.

G.6

VALUE ADDED TAX.

VALUE ADDED TAX (VAT). 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.

SECTION H

SPECIAL CONTRACT REQUIREMENTS

H.1 SECURITY. On occasion, a Contractor employee may require entry into U.S. Government-owned or -operated facilities. If so, the Contractor should be prepared to provide the necessary identification to permit escorted access within that facility.

H.2 STANDARDS OF CONDUCT. The Contractor shall maintain satisfactory standards of employee competency, conduct, cleanliness, appearance, and integrity and shall be responsible for taking such disciplinary action with respect to employees as may be necessary. Each Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

H.3 ORDERING PROCEDURES. The Government will issue a task order as soon as possible after contract award to identify all employees to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered. The COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor. All such revisions shall be consolidated, and a new or modified task order will be issued by the Contracting Officer. If any changes have been made to the coverage listing, the Government anticipates issuance of a new task order on a bi-weekly basis. This new task order will include all changes made since the previous task order was issued and will include any increase or decrease in necessary funding. The changes to the list of eligible individuals will supersede the initial list provided under prior task orders without prejudice to the ineligibility clause. Task orders will indicate the effective date of employment, for purposes of calculating the premium due.

H.3.1. The ORE staff, American Community Support Association,Foreign Service National Community employees defined as EAEs and Peace Corps Contractors, under separate riders are not included under the task orders issued by the Contracting Officer. Because 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. Because 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).

H.4.

CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO CLAIMANTS

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 employee' 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:

Administrative Records.

(1) The Contractor shall maintain medical insurance files for each covered employee and each covered dependent 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 person reimbursement ceiling.

(2) 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.

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

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

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

All medical claims shall be submitted directly to the Contractor by employees, through a drop box in the COR's office. The claims shall be picked up from the COR each Tuesday.

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 days, with a copy to the COR (if notification is written).

The contractor shall settle the claims no later than two 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. Each check shall be accompanied by a form providing details of the amount reimbursed with an explanation of deductions, if any.

(5) The Contractor shall accept the employee's or dependent's choice to go for surgery to hospitals designated by the Contractor in order that the Contractor will pay the expenses directly to the hospitals.

reserved H.5.

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

Employee Claims Report. The report will 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.

H.6.

MISCELLANEOUS CONTRACTOR REQUIREMENTS

H.6.1.

General. The Contractor shall take all such steps as are necessary, and obtain and pay for all permits, taxes and fees as are required by the Royal Thai government to establish and/or operate a commercial venture locally. 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 Royal Thai 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.

H.6.2.

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.

H.7 Erroneous Payments.

If the 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 Government, whichever the Government prefers. The Contractor shall refund any refunds not complete or discovered after the completion date of this contract.

H.8 Requiring Activity. The requiring activity under this contract is the U.S. Embassy/Consulate.

SECTION I

CONTRACT CLAUSES

I.1.

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

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Dept. of State Acquisition Website at http://www.statebuy.gov/home.htm to see the links to the FAR. You may also use a network “search engine” (e.g., Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the most current FAR.

52.202-1

DEFINITIONS (NOV 2013)

52.203-3

GRATUITIES (APR 1984)

52.203-5

COVENANT AGAINST CONTINGENT FEES (APR 1984)

52.203-6

RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT (SEP 2006)

52.203-7

ANTI-KICKBACK PROCEDURES (OCT 2010)

52.203-8

CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS

FOR ILLEGAL OR IMPROPER ACTIVITY (JAN 1997)

52.203-10

PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER

ACTIVITY (JAN 1997)

52.203-12

LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN

FEDERAL TRANSACTIONS (OCT 2010)

52.203-13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT

(APR 2010)

52.204-4

PRINTED OR COPIED DOUBLE SIDED ON POSTCONSUMER FIBER CONTENT PAPER (MAY 2011 )

52.204-10

REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER

SUBCONTRACT AWARDS (AUG 2012 )

52.204-13

SYSTEM FOR AWARD MANAGEMENT MAINTENANCE

(JULY 2013)

52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN SUBCONTRACTING WITH CONTRACTOR’S DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT (AUG 2013)

52.210-1

MARKET RESEARCH (APR 2011)

52.215-2

AUDIT AND RECORDS - NEGOTIATION (OCT 2010)

52.215-8

ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT

(OCT 1997)

52.215-11

PRICE REDUCTION FOR DEFECTIVE CERTIFIED COST OR

PRICING DATA – MODIFICATIONS (AUG 2011)

52.215-13

S…