T-5 Draft RFP Section L.pdf

SECTION L

INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

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L.1. SOLICITATION PROVISIONS

Federal Acquisition Regulation (FAR) 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer (CO) will make their full text available. The Offeror is cautioned that the listed provisions may include blocks that must be completed by the Offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the Offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this address:

https://www.acquisition.gov

(End of Provision)

FAR 52.204-6 Data Universal Numbering System (DUNS) Number (Oct 2016)

FAR 52.204-7 System for Award Management (Oct 2018)

FAR 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Aug 2020)

The Offeror shall not complete the representation in this provision if the Offeror has represented that it “does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument” in the provision at 52.204-26, Covered Telecommunications Equipment or Services-Representation, or in paragraph (v) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Items.

(a) Definitions. As used in this provision—

“Covered telecommunications equipment or services”, “critical technology”, and “substantial or essential component” have the meanings provided in clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition. Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Contractors are not prohibited from providing—

(1) A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or https://www.acquisition.gov/

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(2) Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://beta.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(d) Representation. The Offeror represents that it □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation.

(e) Disclosures. If the Offeror has represented in paragraph (d) of this provision that it “will” provide covered telecommunications equipment or services”, the Offeror shall provide the following information as part of the offer—

(1) A description of all covered telecommunications equipment and services offered (include brand; model number, such as original equipment manufacturer (OEM) number, manufacturer part number, or wholesaler number; and item description, as applicable);

(2) Explanation of the proposed use of covered telecommunications equipment and services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b) of this provision;

(3) For services, the entity providing the covered telecommunications services (include entity name, unique entity identifier, and Commercial and Government Entity (CAGE) code, if known); and

(4) For equipment, the entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known).

(End of provision)

FAR 52.211-14 Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use (Apr 2008)

Any contract awarded as a result of this solicitation will be [ ] DX rated order; [X ] DO rated order certified for national defense, emergency preparedness, and energy program use under the Defense Priorities and Allocations System (DPAS) (15 CFR 700), and the Contractor will be required to follow all of the requirements of this regulation.

https://beta.sam.gov/

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FAR 52.215-1 Instructions to Offerors - Competitive Acquisition (Jan 2004)

FAR 52.215-16 Facilities Capital Cost of Money (Jun 2003)

FAR 52.215-20 Requirements for Certified Cost or Pricing Data and Data Other than Certified Cost or Pricing (Oct 2010) Alternate III (Oct 1997) AND Alternate IV (Oct 2010).

(a) Submission of certified cost or pricing data is not required.

(b) Provide information described below: Submit the proposal cost schedules and supporting information identified in the paragraphs under L.8.

(c) Submit the “information other than cost or pricing data” portion of the proposal via the following electronic media: As identified in paragraphs under L.8.

FAR 52.215-22 Limitations on Pass-Through Charges-Identification of Subcontract Effort (Oct 2009)

FAR 52.216-1 Type of Contract (Apr 1984)

The Government contemplates award of a contract consisting primarily of cost-plus fixed-fee types, with fixed-price elements, cost reimbursable elements and performance incentive fees included resulting from this solicitation.

FAR 52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation (Feb 1999)

FAR 52.222-46 Evaluation of Compensation for Professional Employees (Feb 1993)

FAR 52.225-25 Prohibition of Contracting With Entities Engaging In Certain Activities or Transactions Relating To Iran (Jun 2020) (Comment - Consider adding this Provision – prescribed at 25.1103(e))

(a) Definitions. As used in this provision-

Person—

(1) Means–

(i) A natural person;

(ii) A corporation, business association, partnership, society, trust, financial institution, insurer, underwriter, guarantor, and any other business organization, any other

HT940220R0005 Page L4 of L33 nongovernmental entity, organization, or group, and any governmental entity operating as a business enterprise; and

(iii) Any successor to any entity described in paragraph (1)(ii) of this definition; and

(2) Does not include a government or governmental entity that is not operating as a business enterprise.

Sensitive technology-

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically-

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

(b) The offeror shall e-mail questions concerning sensitive technology to the Department of State at CISADA106@state.gov.

(c) Except as provided in paragraph (d) of this provision or if a waiver has been granted in accordance with Federal Acquisition Regulation (FAR) 25.703-4, by submission of its offer, the offeror—

(1) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran;

(2) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act. These sanctioned activities are in the areas of development of the petroleum resources of Iran, production of refined petroleum products in Iran, sale and provision of refined petroleum products to Iran, and contributing to Iran's ability to acquire or develop certain weapons or technologies; and

(3) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds the threshold at FAR 25.703-2(a)(2) with Iran's Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701 et seq.) (see OFAC's Specially Designated Nationals and Blocked mailto:CISADA106@state.gov

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Persons List at https://www.treasury.gov/resource-center/sanctions/SDN- List/Pages/default.aspx).

(d) Exception for trade agreements. The representation requirement of paragraph (c)(1) and the certification requirements of paragraphs (c)(2) and (c)(3) of this provision do not apply if-

(1) This solicitation includes a trade agreements notice or certification (e.g., 52.225-4, 52.225-6, 52.225-12, 52.225-24, or comparable agency provision); and

(2) The offeror has certified that all the offered products to be supplied are designated country end products or designated country construction material.

FAR 52.233-2 Service of Protest (Sep 2006)

(a) Protests, as defined in section 33.101 of the FAR, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the CO by obtaining written and dated acknowledgment of receipt from the CO, address in Block 7 of the Standard Form 33.

(b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO.

FAR 52.252-5 Authorized Deviations in Provisions (Apr 1984) The use in this solicitation of any FAR (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of “(DEVIATION)” after the date of the provision.

DFARS 252.225-7003 Report of Intended Performance Outside the United States and Canada--Submission with Offer (OCT 2010)

DFARS 252.226-7001 Utilization Of Indian Organizations, Indian-Owned Economic Enterprises, and Native Hawaiian Small Business Concerns (Apr 2019)

DHA Procedures Guidance And Information (PGI) 233.103-90, Agency Level Protests Notice of Independent Review (March 22, 2020)

An interested party filing a protest with Defense Health Agency (DHA) has the option of requesting review by either the Contracting Officer (CO) or an independent review Official https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx

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(IRO), who is a DHA official at a level above the CO. Alternately, an interested party may request IRO review as an appeal of the CO’s protest decision.

Where applicable, an interested party must clearly state in the protest that IRO review is requested, and must specify the nature of the independent review sought – whether as an alternative to CO review or as an appeal of the CO’s decision.

Regardless of which review is requested, all protests must be complete and submitted to the CO within the timeframes specified in FAR Subpart 33.1.

L.2. GENERAL INSTRUCTIONS

L.2.1. The Government will conduct a full and open competition for up to two contract awards for managed care support services. There will be two TRICARE Regions (i.e., geographical area for contract performance) which may each be awarded to a prime Contractor, however if one Contractor demonstrates the best value for both regions, that Contractor may not be awarded both regions in accordance with Section M. In the event an offeror is evaluated as the best value in both regions, the Source Selection Authority will make an award decision for a single region that is in the best interests of the Government.

L.2.2. Offerors are cautioned to follow the instructions provided in this section carefully to assure the Government receives consistent information in a form that will facilitate proposal evaluation. Proposals that take exception to inclusion of specific requirements in the resultant contract shall not be considered. Offerors may propose on one or both regions. Proposals with conditional pricing for the award of both regions will not be considered, however in the event of a single Contractor representing the best value in both regions, the Government reserves the right to negotiate additional discounted pricing with the presumptive awardee for both regions. All proposal material shall be labeled clearly identifying the region for which the proposal applies.

L.2.4. This section provides general guidance for preparing proposals as well as specific instructions on the format and content of the proposal. In addition to the offer, the Offeror’s proposal must include all data and information requested in this solicitation and must be submitted in accordance with these instructions. The offer shall be compliant with the requirements as stated in the solicitation and applicable attachments. Non-conformance with the instructions provided in the solicitation and this section may result in an unfavorable proposal evaluation or rejection of the proposal. The proposal shall be clear, concise, and shall include sufficient detail for effective evaluation and for substantiating the validity of stated claims.

Attachment L-1, Sections L, M, and C Cross Reference Table is provided to assist Offerors.

L.2.5. The offer should contain the Offeror’s best terms from a price/cost and technical standpoint. The Government reserves the right to award without discussions, therefore offers shall represent an Offeror’s best and final offer from its initial proposal submission. The Government reserves the right to request information to clarify certain aspects of proposals (e.g.

the relevance of an Offeror’s past performance information and adverse past performance information to which the Offeror has not previously had an opportunity to respond) or to resolve

HT940220R0005 Page L7 of L33 minor or clerical errors. This exchange shall not be used to cure weaknesses or material omissions of the offer, or materially alter the technical or cost information in the proposal. Under no circumstances will the Offeror revise its offer in response to clarification questions; any such revision will not be considered.

L.2.6. If the Government determines that it is necessary to conduct discussions; the CO will establish the competitive range. If the CO decides that an Offeror’s proposal should no longer be included in the competitive range, the proposal will be excluded from consideration for award;

and written notice of this decision will be provided to unsuccessful Offerors in accordance with FAR 15.503. If it is determined necessary, the CO will notify Offerors remaining within the competitive range to schedule discussions.

L.2.7. The proposal shall not simply rephrase or restate the Government's requirements, but rather shall provide convincing rationale to address how the Offeror intends to meet these requirements. Offerors shall assume that the Government has no prior knowledge of their facilities, capabilities, and experience. The Government will base its evaluation on the information presented, plus any additional past performance information obtained by the Government from other sources.

L.2.8. Offerors shall submit their anticipated organizational structure at least fifteen (15) calendar days prior to the initial proposal due date. The organizational structure must include the prime Contractor and first tier subcontractors. The organizational structure shall include addresses and telephone numbers. In the case of a joint venture or other business structure, a clear description of the organizational relationships must be disclosed. This organizational structure is to be emailed to the following address:

Evan J. Zaslow Contracting Officer evan.j.zaslow.civ@mail.mil

L.2.9. ORGANIZATIONAL CONFLICTS OF INTEREST

L.2.9.1. The Offeror's attention is directed to FAR, Subpart 9.5, "Organizational and Consultant Conflicts of Interest."

L.2.9.2. It is the position of the Defense Health Agency (DHA) that the following companies, due to the nature of their performance with DHA, have an actual or potential organizational conflict of interest, which must be avoided, neutralized, or mitigated: A-Team Solutions, LLC; Architecture, Engineering, Consulting, Operations and Management (AECOM); Axiom Resource Management Inc.; Booz Allen Hamilton; Compliance Automation Inc.; Insignia; BEAT; ATTAIN; Concept Plus, LLC; Amyx, Inc.; E.R. Williams Inc.; Information Technology Solutions & Consulting, LLC (ITSC); Intellidyne, LLC; Kennell and Associates Inc.; Keystone Peer Review Organization, Inc. (KePRO); Kforce Government Solutions, Inc. (KGS); Lockheed-Martin; Mercer (US), Inc.;

ThinkQ; Ernst & Young Global Limited; Ernst and Young; Developing Global Trust with mailto:evan.j.zaslow.civ@mail.mil

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International Interests LLC; and SofTec Solutions, Inc. The actual or potential OCI extends to subsidiaries, parents, and affiliates of these companies.

L.2.9.3. The Offeror shall represent in writing within Volume 1 the proposal that, to the best of the Offeror's knowledge, there are no relevant facts or circumstances concerning any past, present, or potential contracts or financial interest relating to the work to be performed, which could give rise to an organizational conflict of interest, as described in FAR, Subpart 9.5. In the event an actual or potential organizational conflict of interest exist, the Offeror shall submit a mitigation plan to the CO as soon as possible, but no later than 15 calendar days prior to the proposal due date, that effectively demonstrates how the Offeror will mitigate any actual or potential organizational conflict of interest while supporting this contract and any other DHA contract. The Offeror shall also provide the CO, no later than 15 calendar days prior to the proposal due date, with information of previous or ongoing work that is in any way associated with this solicitation. Any organizational conflicts of interest found after proposal submittals shall be disclosed to the CO immediately. Failure to disclose a conflict of interest timely may result in an offeror being determined ineligible for contract award.

L.2.9.4. The CO will review all mitigation plans to determine whether award to the Offeror is consistent with FAR, Subpart 9.5. If the CO determines that no conflict would arise or that the mitigation plan adequately protects the interest of the Government, the Offeror will be eligible for award. If the CO determines that the organizational conflict of interest has not been eliminated, avoided, or adequately mitigated, remedial actions will be considered, including elimination from the solicitation process, termination of related contract efforts already awarded, or negotiation of the mitigation plan.

L.2.9.5. The above restrictions shall be included in all subcontracts, teaming arrangements, and other agreements calling for performance of work which is subject to the organizational conflict of interest restrictions identified in these provisions.

L.2.9.6. The Offeror acknowledges the full force and effect of these provisions. The Government reserves the right, in case of a breach, misrepresentation or nondisclosure, to terminate the resultant contract, disqualify the Offeror from subsequent related contractual efforts, or pursue any remedy permitted by law, regulation or the terms and conditions of this solicitation.

L.2.10. Use of Former Department of Defense (DoD)/DHA/TMA Employees and Uniformed Service Members in Proposal Preparation.

The involvement of a former DoD, DHA and TRICARE Management Activity (TMA) employee/member in an Offeror’s proposal preparation may give rise to an unfair competitive advantage or the appearance thereof, if the former DoD/DHA/TMA employee/ member acquired non-public, competitively-useful information in his or her former position. Such knowledge includes proprietary information of competitor’s performance on past or current contracts with similar requirements or source selection sensitive information pertaining to this procurement.

Consequently, the Offeror must notify the CO prior to the involvement in the proposal preparation by a former DoD/DHA/TMA employee/member reasonably expected to have had

HT940220R0005 Page L9 of L33 access to such information. Based on the notification, the CO will make a determination whether involvement of the former DoD/DHA/TMA employee/member in proposal preparation could create an unfair competitive advantage or appearance thereof. The CO will further determine whether any mitigation measures taken or proposed by the Offeror are adequate to alleviate this concern. Failure to comply with these procedures may result in the Offeror’s disqualification for award.

L.2.11. Offerors shall submit proposals to the CO at the address indicated below. The proposals are to be in electronic and hard copy format in accordance with L.4. Hardcopies and DVD/CD- ROMs shall be submitted to:

Contracting Officer T-5 Managed Care Support Managed Care Contracting Division (MC-CD) 16401 East Centretech Parkway, Aurora, CO 80011-9066

Each DVD/CD and/or volume shall be marked as follows:

OFFEROR’s COMPANY NAME, e.g., XYZ Corporation

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TRICARE T-5 Managed Care Support, Region Volume Number DVD/CD number (e.g., 1 of 3) Identify if the data is protected by the Privacy Act, HIPAA or both as appropriate Date the DVD/CD was created Software and version used

L.3. INFORMATION

L.3.1. The solicitation identified CO and Contract Specialist (CS) are the sole points of contact for this procurement. Questions regarding the solicitation or other concerns are to be submitted in accordance with L.3.7.

L.3.2. Summary level data on eligible beneficiaries, direct care workload, purchased care costs, electronic and paper claims quantities, administrative support services workload volumes, and other categories are available at no cost to all interested parties in attachments to Section L.

Offerors should refer to Attachment L-X, List of Data Available to Offerors.

L.3.3. Detail level data on purchased care costs, direct care workload, eligible beneficiaries, and pharmacy workload may be ordered by potential Offerors for a processing fee of $2,500 that will include the original data set and updated data sets, if any, for the acquisition. Requests for the data set may be submitted via email to the Contracting Officer.

L.3.4. Current TRICARE manuals referenced in Section C are included as an attachment to the RFP located on the Federal Business Opportunities website posting (http://beta.sam.gov).

Offerors may access previous versions of the TRICARE Manuals through the DHA website at

HT940220R0005 Page L10 of L33 https://manuals.health.mil/. Offerors are reminded that only the manuals referenced in Section C of the RFP are applicable to this effort.

L.3.5. The remarks, explanations, and answers provided by Government representatives whether orally, or in writing, shall not change or qualify any of the terms or conditions of the solicitation.

The solicitation can only be changed by a formal written amendment issued by the CO.

L.3.6. Non-Government Advisors: Non-Government Advisors: The expertise of Non- Government advisors may be required to support evaluation of technical proposals. The Government plans to use the following Non-Government advisors during proposal evaluations:

Axiom Resource Management Inc.; Amyx, Inc., Kennell and Associates Inc.; and Mercer (US), Inc. If an additional Non-Government advisor(s) is used, DHA will immediately provide the name(s) by correspondence to the Offerors. These advisors will have broad and comprehensive knowledge of the civilian healthcare industry and managed healthcare in particular, and will apply their expert knowledge of civilian healthcare industry practices and standards to assist the Government in evaluation of proposals. Non-Government advisors are subject to the limitations of FAR 7.503 and FAR Part 37.2; and shall not determine ratings or rankings of Offerors’ proposals or perform any inherently Governmental function.

Upon review of the above limitations and after the identity of the Non-Government advisor(s) is provided, any Offeror having concerns/issues regarding these Non-Government advisors having access to its proposal information should notify the CO of said objection or obtain a written agreement between the Non-Government advisor and the Offeror in accordance with FAR 9.505- 4(b), and submit to the CO within seven (7) working days at time of notification. If no agreement or objection to the proposed Non-Government advisors is submitted within the seven (7) working days, the Offeror will be deemed to have consented to the limited access described above.

L.3.6.1. The Release of Proposal Information to Non-Government Advisors: The release of proposal information to non-Government advisors will be subject to the controls of DHA.

L.3.6.2. Prohibitions: Non-Government advisors are prohibited from proposal rating, ranking, or recommending the selection of a source. They are not normally allowed to participate in discussions with Offerors, but may attend if requested by the chairperson(s). Non-Government advisors are not normally allowed to participate in Government decision-making meetings (Source Selection Evaluation Board (SSEB) sessions or SSA briefings), unless invited by the chairperson(s) to be present during a particular portion to provide specific technical information.

L.3.6.3. Access to Proprietary Information: Non-Government advisors that have access to proprietary information in performing their roles for the Government must agree to protect the information from unauthorized use or disclosure for as long as it remains proprietary and refrain from using the information for any purpose other than that for which it was furnished. All non- Government advisors are required to sign a Non-Disclosure Statement, DHA Form 821. The CO shall retain the signed agreements in the contract file.

https://manuals.health.mil/

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L.3.6.4. Organizational Conflict Of Interest (OCI): OCI clauses are included in the contracts under which non-Governmental technical advisors are performing services for the Government.

The OCI clauses require the companies and individual non-Government advisors to protect Offeror proprietary data and Government source selection information and prohibit the companies from otherwise participating as an Offeror, a subcontractor as a consultant to an Offeror/subcontractor in relation to this acquisition participation.

L.3.7. Solicitation Questions

Questions regarding this solicitation shall be submitted using Attachment L-10 Excel Spreadsheet titled “Offeror Questions.” The Government will answer all questions prior to the deadline for proposal submittal provided those questions are received by 5:00 PM Mountain Daylight Time.

Written questions must be submitted by email to:

Defense Health Agency – MC-CD Chelsea Lavelle, Contract Specialist Telephone: 303-676-3442 Email: chelsea.m.lavelle.civ@mail.mil

Alternate POC: Evan Zaslow, Contracting Officer Telephone: 303-676-3646 Email: evan.j.zaslow.civ@mail.mil

Government responses to questions pertaining to the solicitation will be provided to all potential Offerors in accordance with FAR 15.201(f). The Government reserves the right not to respond to any questions received concerning this solicitation after the question receipt date and time above. Accordingly, Offerors are encouraged to carefully review all solicitation requirements and submit questions to the Government early in the proposal cycle. It is not anticipated that the closing date for receipt of proposals will be extended.

The Government will post the answers to questions on the solicitation at http://beta.sam.gov.

L.4. PROPOSAL PREPARATION

L.4.1. An Offeror is required to provide separate proposals volumes I-V for each region it chooses to submit an offer. The overall proposal shall consist of five (5) physically separated and detachable parts/volumes, individually titled as indicated below. Offerors are required to submit separate proposals for each region if proposing more than one region. The Offeror shall provide mailto:chelsea.m.lavelle.civ@mail.mil mailto:evan.j.zaslow.civ@mail.mil http://beta.sam.gov/

HT940220R0005 Page L12 of L33 one original paper copy of all volumes (clearly marked “ORIGINAL” on the binder cover and on the first page), plus the number of copies as follows:

PART/VOLUME

NAME

NO. OF COPIES

Paper/Electronic

Volume I Executed Offer, to include:

• SF 33

• Completed Schedule B

• Completed Section K Certs & Reps

• Completed copy of paragraph G.3.4 (Points of Contact)

• Completed copy of paragraph H.3.2.1.1 (Guaranteed Network Provider Discounts)

• OCI representation statement (L.2.9.3)

• Subcontracting Plan (L.5.2)

5/3

Volume II Technical to include

• Written Technical Proposal (see L.6.1.)

• Offered elements exceeding minimum standards/requirements

35/3

Volume III Past Performance (see L.7.) 12/3

Volume IV Price/Cost (see L.8.)

• Completion of H.3.2.1.1

Volume V Financial Data (see L.9.) to include Guarantee Agreement for Corporate Guarantor

L.4.2. Electronic Copies: Proposals shall not be submitted via any web-based means (e.g., e-mail transmission). The electronic portion of the proposal shall be submitted on DVD/CD-ROMs compatible with Microsoft Office 2013 applications. In addition, each DVD/CD must be made “final.” “Final” is a recording option that renders the DVD/CD totally used so no other data tracks can be added. Do not use compressed file formats. Use separate files to permit rapid location of all portions, including exhibits, annexes, and attachments, if any. A separate

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DVD/CD is required for each Volume identified above. A directory shall also be placed on the CD/DVD, if it contains more than one file. Indicate on each DVD/CD: the Offeror’s name;

proposal volume number; technical, past performance, price/cost proposal or financial data;

proposal date; and solicitation number.

L.4.3. Paper Copies: Each paper volume must correspond to a directory on the DVD/CD. Paper copies shall be separated by Volume, each in a three-ring binder and identified with the region proposed, Offeror’s name, volume number and title, proposal date and solicitation number. A separate binder is required for each Volume. All paper copy proposal narrative material shall be submitted on white paper with one inch (1") margins on all sides. Volumes II (Technical) and III (Past Performance) of the proposal shall be double-spaced. The font for both DVD/CD and paper submissions shall be Times New Roman, not smaller than 12 points; however, smaller fonts are permitted on illustrations, organization charts, supporting data exhibits, report listings or labels on process flows if those areas of the proposal cannot accommodate 12 point font. Elaborate brochures or documentation, binding, detailed artwork, or other embellishments shall not be submitted. Footnotes on text pages shall also be in 12 point font. Proposals shall be printed double-sided only with non-duplicative, sequential page numbers at the bottom of each printed page; however, pages may be printed single-sided for Volume IV, Price/Cost only. In instances where the paper copy differs from the electronic copy, the original paper volume prevails.

L.4.4. Specific Instructions for the Price/Cost Proposal: The electronic price/cost proposal shall duplicate the hardcopy version. Do not use compressed file formats. Submitted files shall contain all formulae, calculations, and worksheet/workbook links used to compute the proposed amounts. Formulas, calculations, and links shall not be hidden. Print image files or those Excel files/ Excel worksheets containing only “values” are not acceptable. There is no page limit for the price/cost proposal Volume IV or for the financial viability/statements; however, brief but concise explanations, summaries, and worksheets are advised and appreciated.

L.4.5. Page Limitations: Page limitations shall be treated as maximums. If exceeded, the excess pages will not be considered in the evaluation of the proposal. Title pages, and table of contents/figures are excluded from page counts. The following table contains all page limit requirements. If there is a requirement for information to be submitted in the proposal, but it is not included in the following table, then a page limitation is not applicable.

Reference and Description Page Limit Organization Chart 3

Written Technical Proposal 200

List of Offered Elements Exceeding Minimum Standards/Requirements

Past Performance Narrative 25

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Summary Description of Largest Clients (see L.7.4.)

3 pages per client

Resumes for Key Personnel (if applicable, see L.7.11.)

1 page per resume

L.4.6. Proposals will be reviewed for completeness and compliance with the solicitation and preparation instructions. If an Offeror (1) fails or refuses to assent to any of the terms and conditions of the RFP, (2) proposes additional terms and conditions of this RFP (beyond the List of Offered elements exceeding minimum standards/requirements permitted in L.6.1.), or (3) fails to submit any of the information required by this RFP, then DHA may consider the offer to be materially non-compliant, which could make the offer ineligible for contract award. Offerors shall not include price information anywhere in the proposal package other than in the Price/Cost volume, and prices in completed Section B. All pages of each proposal shall be appropriately numbered and identified with the solicitation number.

L.4.7. If final proposal revisions are required (if requested by the CO), the Offeror shall follow the final proposal revision instructions provided by the CO.

L.5. VOLUME I, EXECUTED PROPOSAL

L.5.1. Volume 1 shall contain the signed original of all documents requiring signature of the Offeror. Use of reproductions of the signed original is authorized in the copies. Offerors shall commit in writing to fulfilling the terms and conditions of the contract. All certifications and representations, to include Section K, required by the solicitation shall be completed and provided in Volume 1. The provision in Section K, FAR 52.204-8, Annual Representations and Certifications, must be completed and submitted with the proposal. An online Representations and Certifications Application is available at https://beta.sam.gov .

L.5.2. Offerors designated as large businesses shall include in Volume I a subcontracting plan as required by FAR 19.702, FAR 19.704, FAR 52.219-8 Utilization of Small Business Concerns, FAR 52.219-9 Small Business Subcontracting Plan, and DFARS 252.219-7003, Small Business Subcontracting Plan (DoD Contracts). Please note that network providers are not considered subcontractors of the prime Contractor, and therefore healthcare services provided by network providers may not be counted in the subcontract plan. Additionally, Offerors are advised in accordance with 10 U.S. Code 2410d, Contractors may use the services and/or products of the AbilityOne program (National Industry for the Blind/National Industry for the Severely Handicapped) in meeting their small business subcontracting goals. The 11 elements of FAR

19.704 are required to be included in offeror’s subcontracting plan and are shown below:

(1) Separate percentage goals for using small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, https://beta.sam.gov/

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HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns as subcontractors;

(2) A statement of the total dollars planned to be subcontracted and a statement of the total dollars planned to be subcontracted to small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(3) A description of the principal types of supplies and services to be subcontracted and an identification of the types planned for subcontracting to small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(4) A description of the method used to develop the subcontracting goals;

(5) A description of the method used to identify potential sources for solicitation purposes;

(6) A statement as to whether or not the offeror included indirect costs in establishing subcontracting goals, and a description of the method used to determine the proportionate share of indirect costs to be incurred with small business (including ANCs and Indian tribes), veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business (including ANCs and Indian tribes), and women-owned small business concerns;

(7) The name of an individual employed by the offeror who will administer the offeror’s subcontracting program, and a description of the duties of the individual;

(8) A description of the efforts the offeror will make to ensure that small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns have an equitable opportunity to compete for subcontracts;

(9) Assurances that the offeror will include the clause at 52.219-8, Utilization of Small Business Concerns (see 19.708(a)), in all subcontracts that offer further subcontracting opportunities, and that the offeror will require all subcontractors (except small business concerns) that receive subcontracts in excess of $650,000 ($1.5 million for construction) to adopt a plan that complies with the requirements of the clause at 52.219-9, Small Business Subcontracting Plan (see 19.708(b));

(10) Assurances that the offeror will—

(i) Cooperate in any studies or surveys as may be required:

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_215.htm#P1280_218529 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/19.htm#P805_174054 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_215.htm#P1314_223741 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/19.htm#P805_174054

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(ii) Submit periodic reports so that the Government can determine the extent of compliance by the offeror with the subcontracting plan;

(iii) Submit the Individual Subcontract Report (ISR), and the Summary Subcontract Report (SSR) using the Electronic Subcontracting Reporting System (eSRS) (http://www.esrs.gov but is formally transitioning to http://beta.sam.gov), following the instructions in the eSRS;

(A) The ISR shall be submitted semi-annually during contract performance for the periods ending March 31 and September 30. A report is also required for each contract within 30 days of contract completion.

Reports are due 30 days after the close of each reporting period, unless otherwise directed by the contracting officer. Reports are required when due, regardless of whether there has been any subcontracting activity since the inception of the contract or the previous reporting period.

(B) The SSR shall be submitted as follows: For DoD and NASA, the report shall be submitted semi-annually for the six months ending March 31 and the twelve months ending September 30. For civilian agencies, except NASA, it shall be submitted annually for the twelve-month period ending September 30. Reports are due 30 days after the close of each reporting period.

(iv) Ensure that its subcontractors with subcontracting plans agree to submit the ISR and/or the SSR using the eSRS;

(v) Provide its prime contract number and its DUNS number, and the e-mail address of the offeror’s official responsible for acknowledging receipt of or rejecting the ISRs to all first-tier subcontractors with subcontracting plans so they can enter this information into the eSRS when submitting their ISRs; and

(vi) Require that each subcontractor with a subcontracting plan provide the prime contract number, its own DUNS number, and the e-mail address of the subcontractor’s official responsible for acknowledging receipt of or rejecting the ISRs, to its subcontractors with subcontracting plans.

(11) A description of the types of records that will be maintained concerning procedures adopted to comply with the requirements and goals in the plan, including establishing source lists; and a description of the offeror’s efforts to locate small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns and to award subcontracts to them.

L.5.3. Offerors must complete, sign, and date the offer at Blocks 12 through 18 of the Standard Form 33. Source selection procedures including the evaluation of offers received in response to http://www.esrs.gov/ http://beta.sam.gov/

HT940220R0005 Page L17 of L33 the solicitation are projected to require up to 270 days to complete. As a result of this, the Government requires that the Minimum Acceptance Period identified in Item 12 of the Standard Form 33 be a minimum of 270 days. The Contractor’s information for paragraph G.3.4, Contractor Points of Contact personnel, shall be included in this Volume.

L.5.4. Offerors must acknowledge receipt of the amendments when submitting the offer and include the acknowledgements in this volume.

L.5.5. Offerors shall submit a completed original Section B in Volume I. Offerors are required to complete Section B, Supplies or Services and Prices/Costs. Offers submitted in response to this solicitation shall be in terms of U.S. dollars. Offerors are instructed to price the appropriate contract line items and sub-line items in Section B.

L.6. VOLUME II, TECHNICAL PROPOSAL

L.6.1. Written Technical Proposal Submission: The Offeror shall submit a written technical proposal which effectively demonstrates the Offeror’s understanding of the requirements, and provides a successful technical solution for the prospective contract. The written technical proposal shall also include a separate list of those elements of the offer that exceed the Government’s minimum requirements including performance standards that exceed the minimum standard or additionally offered performance standards (“enhancements”). The separate list shall have a clear cross reference to where each offered element is located in the technical proposal. The technical proposal shall clearly describe each element offered and demonstrate how the Offeror will meet the higher standards or exceed minimum requirements and why it is in the best interest of the Government. An enhancement may be incorporated into the contract, if the Government also determines that it exceeds requirements/standards and finds it to be in the best interests of the Government. Accordingly, for each enhancement, within the separate list described above, the Offeror shall include adequate language that may be incorporated into the contract as an enforceable term and condition. The Government, at its sole discretion, may incorporate some, none or all proposed enhancements.

L.6.1.2. The proposal shall not reflect a marketing or sales presentation. Unnecessarily elaborate proposals beyond those sufficient to present a complete and effective response to this solicitation are not desired. The proposal should illustrate the Offeror’s capability, and clearly demonstrate the organization and methodology that will satisfy the solicitation requirements. The proposal should clearly describe the technical solution and overall approach to the solicitation requirements and address all of the subfactors identified in Section L which will be evaluated against the criteria specified within Section M of this solicitation. The proposal may have information on the Offeror’s experience (for this purpose, experience refers to what an Offeror has done, not how well it was accomplished) in performing proposed processes and procedures.

This information may be considered in the evaluation of specific technical approaches and related technical proposal risk. However, any such information in the technical proposal will not be considered for purposes of the overall past performance rating as described in Section M.8.

The price/cost proposal, past performance information, and financial information shall not be

HT940220R0005 Page L18 of L33 addressed in the technical proposal volume, and no part of the technical proposal shall incorporate by reference portions of other volumes of the proposal.

L.6.2. Technical/Management

L.6.2.1. Subfactor 1 - Network Management:

L.6.2.1.1. The Offeror’s proposal shall include: its approach for developing and maintaining an:

a) accredited,

b) stable (C.2.1.3),

c) high-quality network (C.2.1.2.2) that;

d) meets access to care standards as defined in 32 Code of Federal Regulations (CFR) 199 and

e) supplements services provided by the MTF

f) maintains access to care standards

The Offeror’s proposal shall provide a visual overlay addressing each element of the sizing model to the following markets as a representative sample of the contract requirements:

East:

Large Market - Tidewater (NMC Portsmouth Large Market - Langley AFB

Small Market - Small Market - Central Oklahoma (ACH Reynolds - Sill lead)

Stand Alone - Moody AFB (AF-C-23rd MEDGRP-MOODY & AF-EC-93rd, AGOW-MOODY)

West:

Large Market - San Diego (Camp Pendleton focus, NMC San Diego lead)

Small Market - Ozarks (ACH LEONARD WOOD - Ft. Leonard Wood)

Stand Alone - AF-C-27th SPCLOPS MDGRP-CANNON - Cannon AFB

Defense Health Region Indo-Pacific:

Large Market - Hawaii (Tripler)

The offeror’s proposal shall provide a visualization map of their current networks against the network adequacy methodology across the entire region to determine a percentage of new network build required by the offeror.

The offeror’s proposal shall describe how it will ensure the ongoing accuracy of the Contractor’s provider directory. The description must incorporate the following capabilities:

1) electronic verification methods; 2) machine readable files; 3) communication methods to support updates to the provider directory; 4) verification of practitioners’ affiliation with group

HT940220R0005 Page L19 of L33 practices, as applicable; and 5) approach to periodically review claims data to ensure active provider participation and inclusion status in the provider directory.

L.6.2.1.2. The proposal shall describe how the offeror will ensure access to care if MTF capabilities and capacities change, including its approach for responding to such changes on short notice.

L.6.2.1.3. The proposal shall describe the offeror’s value based steerage model (C.2.1.11) that demonstrates effectiveness in:

a) Access to care

b) quality outcomes

c) MTF workload optimization

d) Readiness of the medical force (KSA optimization)

e) cost control

The proposal shall describe the offeror’s approach to including providers connected to Health Information Exchanges in MTF referral networks to facilitate electronic access to clinical data with MHS GENESIS.

L.6.2.1.4. The Offeror’s proposal shall include an approach for maintaining an accurate network provider directory that:

a) meets accuracy standards (C.2.1.8.1)

b) maintains accuracy standards

The Offeror shall include in its proposal how network provider directory accuracy shall be measured. The Offeror shall include in its proposal its proposed accuracy percentage (which shall be inserted into Section C.2.1.3 upon contract award)

L.6.2.2. Subfactor 2 – Referral Management:

L.6.2.2.1. The Offeror will describe its process for managing referrals from/to the MTF/civilian sector in accordance with the Section C, paragraph 2.1.5 and TRICARE Operations Manual (TOM), Chapter 8, Section 5. The Offeror will include its approach:

a) how its referral management process directs TRICARE-eligible beneficiaries to the MTF where applicable for TRICARE Prime network enrolled beneficiaries;

b) how its referral management process facilitates TRICARE Select enrolled beneficiaries to care at the MTF when it supports readiness of the medical force ;

c) how its referral management process facilitates beneficiary referrals from the MTF to its network;

d) how this process will be supported through network management activities;

e) how the Offeror proposes to meet the referral processing timelines requirements and

f) how the Offeror proposes to meet the referral processing accuracy requirements

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L.6.2.3. Subfactor 3 – Medical Management:

L.6.2.3.1. The Offeror will clearly describe:

a) its design and approach for implementing and /maintaining integrated medical management programs for all TRICARE-eligible beneficiaries receiving care in the civilian sector

b) how the medical management programs will complement the medical management services available in the MTFs.

c) how its process will objectively document improvements in clinical outcomes.

d) tools available to…