Insurance_SVE30014R0001.doc

American Embassy Caracas – Venezuela

SVE30014R0001

Caracas, March 13 2014

Dear Prospective Offeror:

SUBJECT: Solicitation Number SVE30014R0001 Health and Life Insurance services for LES

The Embassy of the United States of America invites you to submit a proposal for customized Health and Life Insurance services for Local employees of the Government of the United States of America in Caracas, Venezuela.

The Embassy intends to conduct a pre-proposal conference, and all prospective offerors who have received a solicitation package are invited to attend. See Section L of the attached Request for Proposals (RFP).

Your proposal must be submitted in a sealed envelope marked "Proposal Enclosed" to John B. Everman, Contracting Officer, the United States Embassy, General Services Office, Calle F con Calle Suapure, Urb. Colinas de Valle Arriba, before 4:00 p.m May 30 2014 No proposal will be accepted after this time.

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

1.

SF-33

2.

Section B, Pricing Schedule

3.

Section B, Retention Amounts in B.3 and B.7

3.

Section K, Representations and Certifications;

4.

Additional information as required in Section L.

Direct any questions regarding this solicitation to CaracasFSNHealthIns@state.gov . Clarifications will be advertised on FebBizOps (https://www.fbo.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, John B. Everman

Contracting Officer

UNDER DPAS (15 CFR 350)

1 |

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

3. SOLICITATION NO.

SVE30014R0001

4. TYPE OF SOLICITATION

[] SEALED BID (IFB)

[ X ] NEGOTIATED (RFP)

5. DATE ISSUED

10/31/2013

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

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

American Embassy

General Services Office – Caracas Venezuela

Phone: 58-212 907-8590 Fax:58-212 907-8684

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

SOLICITATION

9. Sealed offers in original and 4 copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in until May 30 2014 local time 04:00 PM .

(hour)

(date)

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

Marisol Pacheco or Lilia Arocha

B. TELEPHONE

58-212 907-8583 or58-212- 907 - 8590

C. E-MAIL ADDRESS

pachecomj@state.gov

11. TABLE OF CONTENTS

PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

OFFER Health and Life Insurance services for LES

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) John B. Everman

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.

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 Caracas - Venezuela 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) and C.2.3 (life). This insurance shall be provided in accordance with Section C and the Exhibits in Section J.

B.1.1.

Official Residence Expense (ORE) Staff are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE Staff), the Embassy Association (for EAEs) at the rates specified below. See Section G for billing procedures.

B.2.

PRICES

B.2.1 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 Prices for the basic Coverage:

BASE YEAR OF CONTRACT:

TOTAL PRICE FOR BASE YEAR

Total Price for Base Year: _______

B.2.4.

FIRST OPTION YEAR OF THE CONTRACT:

TOTAL PRICE FOR FIRST YEAR

Total Price for Option Year 1 : _______

B.2.5.

SECOND OPTION YEAR OF THE CONTRACT:

TOTAL PRICE FOR SECOND YEAR

Total Price for Option Year 2 : _______

GRAND TOTAL BASE PERIOD PLUS OPTION YEARS FOR BASIC COVERAGE: __________________

B.2. 6 Prices for the Excess Coverage:

BASE YEAR OF CONTRACT:

TOTAL PRICE FOR BASE YEAR

Total Price for Base Year : _______ B.2.7.

FIRST OPTION YEAR OF THE CONTRACT:

TOTAL PRICE FOR FIRST YEAR

Total Price for Option Year 1 : _______ B.2.8.

SECOND OPTION YEAR OF THE CONTRACT:

TOTAL PRICE FOR SECOND YEAR

Total Price for Option Year 2 : _______

GRAND TOTAL BASE PERIOD PLUS OPTION YEARS FOR EXCESS COVERAGE:

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.

B.3.2.1 Bi-Weekly Retention Amounts per separate premium paid per single employee and per family plan.

Year 1 Option Year 2

Employee – Man

Employee – Woman

Spouse - Man

Spouse - Woman

Children up to 18 years old

Children 19-25 years old

Parents up to 70 years old

Parents 71-80 years old

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.

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 Caracas - Venezuela. 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 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 Bolivares 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

Basic Life

404,425.21

Accidental Death and Dismemberment

438,127.32

Partial and Total Disability Coverage

438,127.32

Funeral Services

Total Price for Base Year: __________x 26 = _____________

B.6.2.

FIRST OPTION YEAR OF CONTRACT:

Basic Life

404,425.21

Accidental Death and Dismemberment

438,127.32

Partial and Total Disability Coverage

438,127.32

Funeral Services

Total Price for Option Year 1: __________x 26 = _____________

B.6.3.

SECOND OPTION YEAR OF CONTRACT:

Basic Life

404,425.21

Accidental Death and Dismemberment

438,127.32

Partial and Total Disability Coverage

438,127.32

Funeral Services

Total Price for Option Year 2: __________x 26 = _____________

GRAND TOTAL PRICE FOR ALL 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

Base Period

Option Year 1

Option Year 2

B.8

ECONOMIC PRICE ADJUSTMENT-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. 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 select an independent third party to 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.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

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 Venezuela. The Government has determined that the prevailing practice by employers in Venezuela 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 as follow:

For Basic Coverage:

For Excess Coverage:

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.

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

Basic Coverage:

For active employees who are regularly scheduled to work 30 or more hours per week: the USG will pay 100% of the premium cost for employee coverage. The USG will pay 100% of the premium cost for coverage of the eligible spouse and children and the employee will pay 0%. The USG will pay 66% and the employee will pay 34% of the premium cost for coverage of eligible parents.

For active employees who are regularly scheduled to work less than 30 hours per week: the USG will pay 50% of the premium cost and the employee will pay 50% of the premium cost for employee coverage. The employee will pay 100% of the premium cost for dependent coverage.

Excess Coverage:

For active employees who are regularly scheduled to work 30 or more hours per week: the USG will pay 60% and the employee will pay 40% of the premium cost for employee coverage. The USG will pay 60% and the employee will pay 40% of the premium cost for coverage of the eligible spouse and children. The USG will pay 66% and the employee will pay 34% of the premium cost for coverage of eligible parents.

For active employees who are regularly scheduled to work less than 30 hours per week: the USG will pay 50% of the premium cost and the employee will pay 50% of the premium cost for employee coverage. The employee will pay 100% of the premium cost for dependent coverage.

C.1.1.1.

Hospitalization: Depending on the treatment or surgery up to the maximum amount of coverage per illness per person. Room, amount per day, maximum days, maximum payable, for reasonable and customary care. Coverage will be as follows:

Up to Bsf.250,000.00 per event and per year for Basic Coverage with a deductible amount of Bsf.215,00 Up to Bsf. 475,000 per event and per year for Excess Coverage with a deductible amount of Bsf. 215,00 C.1.1.2.

Surgery: Same as 1.1.1. Up to Bsf.250,000.00 per event and per year for Basic Coverage with a deductible amount of Bsf.215,00.

Up to Bsf. 475,000 per event and per year for Excess Coverage with a deductible amount of Bsf. 215,00.

C.1.1.3.

Doctor Visits: As needed. Hospital, limitations, cost per visit, home, annual maximum.

C.1.1.4.

Prescription Drugs: 100% coverage of expenses when hospitalized, and 100% coverage of expenses when not hospitalized, of the cost of medicines and drugs for which a prescription is legally required. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician.

C.1.1.5.

Maternity:

Obstetrical expenses, including prenatal and postnatal care, are covered as follows:

Normal Delivery: Maximum: Bs. 33,000

Caesarean Delivery: Maximum: Bs. 33,000

Miscarriage: Maximum: Bs. 31,500 Amniocentesis, checking test (including laboratory tests) of pregnancy status, routine basic exam, and medicines, are included

C.1.1.6.

Hospital Outpatient Services: Types covered and benefit scheduled.

C.1.1.7.

Optical Service:

50% coverage of expenses for eye examination and treatment.

40% coverage for and prescription eyeglass lenses.

Bs. 300 maximum for coverage of expenses for eyeglass frames.

Bs. 400 maximum coverage for contact lenses.

No coverage for nonprescription lenses or tinting

C.1.1.8

Dental Service: 50% coverage of expenses for dental services: preventative, minor and major restorative care, including dentists' fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

Orthodontia treatment is covered only if treatment is required as the result of an accident.

C.1.1.9.

Physical Therapy: Physiotherapeutic treatment is included as long as it is required for illness, recovering, or for injuries caused by an accident covered by this policy.

C.1.1.10.

Psychiatric Treatment : Not Covered C.1.1.11.

Ambulance Service: 100% coverage of land ambulance service; air transportation is not covered

C.1.1.12.

Hearing Aids: Not covered

C.1.1.13.

Expenses Incurred Out-of-Country: Medical expenses incurred out of country will be covered to a maximum of Bs. 260,000.

C.1.1.14.

Other Benefits: 100% coverage of doctors’ and surgeons' fees incurred while hospitalized, at a hospital on an out-patient basis, at a clinic or doctor's office, or at home. 100% coverage of for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, physical therapy, routine annual physical examinations, and inoculations.

Funeral services costs: The coverage annual amount is Bs.6,000.00 are paid in case of an employee death to assist with the payment of funeral expenses.

C.1.1.15 Maximum Limits:

Basic Coverage:

With the exception of expenses incurred under paragraph J above. The insurance company will reimburse covered expenses up to a limit of Bs. 250,000 per event and per contract year Excess Coverage:

With the exception of expenses incurred under paragraph J above. The insurance company will reimburse covered expenses up to a limit of Bs. 475,000 per event and per contract yea

C.1.2 Health Benefits Conditions and Limitations

Expenses will not be covered 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.

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

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

No coverage of will be made for expenses incurred after an employee leaves the service of the U.S. Mission, except in the case of retired employees who elect to continue coverage

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 Venezuela 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 Venezuela by:

Department of State, DAO = Defense Attaché Office, MLGP= Military Group, FAS= Foreign Agriculture Service, APHIS = Animal, Plant, Health and Inspection Service, DEA = Drug Enforcement Agency, FCS= Foreign Commercial Service, DHS = Department for Homeland Security, USAID= U.S. Agency for International Development.

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 Reserved

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

The following additional categories of persons are covered by this insurance:

Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. For the purposes of this plan, an employee's dependents are defined as the employee's legal spouse (limit one), the employee’s parents, and each unmarried, economically dependent child who primarily resides with the employee unless away at school.

Child is defined as the employee's natural child, adopted child, stepchild, or foster child. An eligible child will be covered until the end of the calendar year in which the child turns age 23, or in the case of a child who is a full-time student, until the end of the calendar year in which the child turns age 25. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently. There is no limit on the number of children covered per employee.

An eligible parent will be covered until the end of the calendar year in which the parent turns age 88.

Grandparents, siblings, and other relatives are not eligible dependents

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. The employee’s share of the premium will be collected through payroll deduction in that or the subsequent pay period.

C.1.6.2.

Period of Ineligibility.

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

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

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

C.1.7.

BROCHURE REQUIREMENT.

C.1.7.1.

The contractor shall provide a document (brochure/pamphlet/other written document) in English and Spanish 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 10 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.1.7.3.

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

PART II GROUP LIFE INSURANCE

C.2.0

GROUP LIFE INSURANCE

The Government of the United States of America requires group life insurance coverage for its employees, as further described in C.2.1, in Venezuela. The Government has determined that the prevailing practice by employers in Venezuela is to provide: 100% of the premium costs; and that such group life insurance protection is representative of locally prevailing compensation practice. 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 life 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 amount of life insurance coverage for each employee is based upon the annual basic salary (12 months) of the individual.

C.2.1.2 Amount of Accidental Death and Dismemberment Coverage.

The employee's estate or employee will receive an amount equal to:

Natural Death: 15 x monthly basic salary

Accidental or work related death or disability: 22 x monthly basic salary Disability Benefit: Not covered.

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. self-inflicted wounds or wounds inflicted at the employee's request, irrespective of the employee being sane or insane, including a suicide

2. violating the law or in resisting detention or arrest,

3. participation in competitions involving the use of wheeled vehicles, horses, boats or water skis,

4. 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.

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 Venezuela, paid under the Local Compensation Plan, and certified by the Contracting Officer. Covered employees include:

C.2.3.1.2.

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

C.2.3.1.3.

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

C.2.3.2 Location of Employment

C.2.3.2

The individuals covered by C.2.3.1 must be employed within the geographic boundaries of Venezuela by: Department of State, DAO = Defense Attaché Office, MLGP = Military Group, DEA = Drug Enforcement Agency, FAS = Foreign Agriculture Service, APHIS = Animal, Plant, Health and Inspection Service, FCS= Foreign Commercial Service, DHS = Department for Homeland Security, USAID= U.S. Agency for International Development

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

C.2.4

Individuals Not Eligible for Coverage

C.2.4.1.

C.2.4.2

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.

Other Eligible Participants . 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, life 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. 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 hereunder during any period of employment for which premiums are not paid. The employee is responsible for paying (directly to the insurance contractor) his/her share of the life insurance premiums for periods beyond one full pay period of accumulated leave without pay (LWOP) during any calendar year. Alternatively, the employee may elect to have coverage cease if that employee prefers not to pay the premium.

Additionally, employees’ dependents are not entitled to health benefits during any period of employment during which the employee was not eligible to participate. The mission will pay premiums directly to the contractor and will collect the full cost from the employee on a quarterly basis.

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. 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 Spanish 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 10 days after date of contract award. The contractor shall provide additional brochures for new employees within ten days of the COR’s request.

C.2.7.3.

The contractor assumes full responsibility for ensuring that the document described in C.2.7.1 accurately reflects the requirements of the contract, as implemented by the contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the contractor will be notified in writing; however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the contractor to fully comply with all contract terms.

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 (Post’s Human Resources Officer).

Contributory Insurance for which the employee contributes toward the premium.

Dependent Spouses, children under 25 and parents up to 88 years old.

Disability A physical or mental impairment which precludes the individual from performing ordinary motor or bodily functions. 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 and C.2.3 for life 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 and C.2.3.3 or life insurance.

Employer The United States Government

GSO

General Services Officers 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 employee for injury or disease.

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.

Qualified Accidental Death A loss of life incurred in the following accidental instances: (1) While the insured is riding as a passenger within any mechanically propelled, public conveyance operated by a common carrier which regularly dispatches for hire over an established route in a regular passenger service but not while or in consequence of attempting to enter or leave the conveyance; (2) while the insured is riding as a passenger in a regular passenger elevator car (elevators in mines excluded); or (3) in consequence of a burning of any theater, hotel, or other public building in which the insured is present at the commencement of the fire.

Surgical procedure Any invasive medical procedure by manual or instrument operation undertaken for diagnosis or treatment of a diseased patient.

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 one (1) customer complaint is received per month

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

E.2.2 Standard. The performance standard is that the Government receives no more than one (1) customer complaint per month. The COR shall notify the Contracting Officer of the complaints so that the Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.246-4, Inspection of Services – Fixed Price (AUG 1996) or the appropriate Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

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

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

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

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

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

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

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

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

SECTION F

DELIVERIES OR PERFORMANCE

F.1.

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

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the 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 August 01 2014 with two 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:

Calle F con Calle Suapure

Urb Colinas de Valle Arriba

Human Resources Office

Caracas - Venezuela

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 Bolivares Fuertes

G.4

SUBMISSION OF INVOICES AND PAYMENT

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):

Financial Management Office

Calle F con Calle Suapure

Urb. Colinas de Valle Arriba

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. Contractor may submit invoices monthly for payment to be made at the beginning of the month for which insurance coverage is provided in accordance with FAR 32.404.

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 Reserved

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 ten calendar days of receipt of the request.

G.6

SEC…