GROUP LES HEALTH INSURANCE UNDER GMC

Amendment / Modification

This amendment (001) to Solicitation 19RP3826Q0042 makes the following changes:

• Submission Due Date Extension: The deadline for offer submission has been extended from May 15, 2026, 4:00 P.M. (Philippine local time) to June 15, 2026, 4:00 P.M. (Philippine local time).
• Address Update: Block 9 of the SF-1449 is updated with a new address for Contracting & Procurement, General Services Office, U.S. Embassy Philippines.
• Contractor Responsibility Clause: Section 6.4, "CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO CLAIMANTS," paragraph (b)(3) has been rescinded and replaced. The new clause states that the Contractor shall settle claims no later than ten (10) working days from the date the claim is submitted.
• Exhibit D Revision: Exhibit D, "CLAIMS PAID OUT FOR THE PAST 5 YEARS," has been rescinded and replaced. The revised exhibit provides updated tables for Claims and Retention Amounts and Insurance Premiums.
• Page Replacements: Revised pages 24 and 32 of the SF-1449 are included as part of this amendment and replace the original pages.

• Solicitation due date

• SF-1449, Block 9 (Issuing Office Address)

• Section 6.4 (Claims settlement timeline)

• Exhibit D (Claims and Premiums Data)

• SF-1449 pages 24 and 32

• The proposal submission deadline has been extended to June 15, 2026.

• Offerors should refer to the updated sections and exhibits for current requirements and data.

Questions & Answers / Clarifications

This document provides answers to questions submitted by potential offerors regarding Solicitation No. 19RP3826Q0042 for Group Leshealth Insurance under GMC. It clarifies terms, conditions, and requirements, but does not amend the solicitation unless a formal amendment is issued.

• Incumbent Contractor: Philhealthcare, Inc. (Contract No. 19RP3821D0014) is the incumbent.
• Prime Contractor Eligibility: A U.S. corporation can be prime if a licensed Philippine insurer/HMO performs and administers coverage. Licensing and authorization requirements are detailed in Sections 2, 3, and 4 of the solicitation.
• Employee Census Data: Information such as employee statistics, riders, and dependent details are referenced in various Exhibits (A, B, C) and sections of the solicitation. A detailed utilization report from the current provider is not available.
• Coverage Details: Clarifications were provided on Annual Benefit Limits (ABL), dental benefits, room and board accommodations (semi-private vs. private), and excess coverage applicability.
• Contract Period: The performance period is anticipated to start on January 1, 2027.
• Reporting and Payments: Information on reporting granularity, frequency, invoice payment processes, and payment cycles (2-3 weeks lag) was addressed. Digital claims submission is acceptable.
• Network Requirements: No mandatory hospitals, clinics, or providers are required. Geographic scope is not specified as nationwide or Manila-centric. Out-of-network reimbursements are addressed.

This Q&A document clarifies aspects of the solicitation, guiding offerors on requirements related to eligibility, data submission, coverage details, and contract administration. Offerors should review these clarifications in conjunction with the original solicitation and any formal amendments.

Other / Unclassified

This document contains the minutes from a pre-quotation conference held on April 17, 2026, for RFQ No. 19RP3826Q0042, concerning Group LES Health Insurance under GMC. It highlights key sections of the solicitation package, including the SF-1449 cover sheet, Section 1 (The Schedule), and the continuation of the SF-1449 for Description/Specifications/Work Statement.

• Deadline for Offers: May 15, 2026, by 4:00 PM Philippine local time.
• Scope of Work: Provision of health insurance services to U.S. Government employees and their eligible dependents in the Philippines, including Official Residence Expense (ORE) Staff and Peace Corps PSC employees, with excess coverage as a rider benefit.
• Contract Type: Fixed price with economic price adjustment. The contract includes a base year with four one-year options and one six-month option.
• Pricing: VAT is not applicable; a tax exemption certificate will be provided. Offers and payments will be in U.S. Dollars. Foreign firms can submit prices and receive payment in local currency.
• Minimum/Maximum Amounts: Minimum of 450 persons per period of performance; maximum of 22,500 persons across all periods.
• Key Benefits: Covers hospitalization, emergency services, ambulance, outpatient, obstetric/newborn, pediatric, prescription drugs, preventive/wellness, optical, dental, reproductive health, mental health/substance abuse, rehabilitative services, HIV/AIDS, and excess coverage.
• Contract Administration: The Contracting Officer's Representative (COR) is the Human Resources Assistant. Invoices are to be submitted electronically.
• Reporting: Monthly reports on employee claims and member medical utilization are required.
• Contractor Requirements: Must obtain all necessary permits, taxes, and licenses in the Philippines at their own expense and comply with local laws.
• Quality Assurance: The contractor is responsible for quality control; the government monitors to ensure standards are met. Performance threshold: no more than 1 substantiated customer complaint per month.
• Submission Instructions: Electronic offers are accepted via email (ManilaContracting@state.gov) with a 10MB file size limit. Proposals must be submitted in four parts: Health Insurance Services, Understanding of the Requirement, Experience and Past Performance, and Licensing Information. Offerors must be registered in SAM.
• Questions Deadline: Written questions are due by April 21, 2026, 4 PM Philippine local time.
• Evaluation: Award will be made to the lowest priced, technically acceptable, and responsible contractor. Offerors must be licensed/certified/accredited.

Solicitation / RFP / RFQ

This Request for Quotations (RFQ) seeks proposals for locally employed staff health insurance for the U.S. Embassy in Manila, Philippines. The government intends to award a contract to the responsible company offering an acceptable offer at the lowest price.

• Offerors are encouraged to provide "off-the-shelf" health insurance plans that meet minimum benefit levels.

• The contract will cover health insurance services for U.S. Government employees and their eligible dependents in the Philippines.

• Specific benefits and minimum coverage levels are detailed in the "Continuation to SF-1449, Schedule of Supplies/Services, Block 20, Description/Specifications/Work Statement."

• Contract Type: Fixed-price with economic price adjustment.

• Period of Performance: One-year base period with four (4) one-year options and one (1) six-month option.

• Minimum Guarantee: 450 persons per period of performance.

• Maximum Order Limit: 22,500 persons for the base and all option years.

• Pre-Quotation Conference: April 17, 2026, 9:30 A.M. (Philippine local time) at the U.S. Embassy Chancery Compound, Ermita, Manila. RSVP required by April 7, 2026.

• Questions Due: April 21, 2026, 4:00 P.M. (Philippine local time).

• Quotations Due: May 15, 2026, 4:00 P.M. (Philippine local time).

• Submission Method: Electronically to ManilaContracting@state.gov in MS-Word, MS-Excel, or Adobe Acrobat (PDF) format, with file size not exceeding 10MB per email.

• Evaluation Criteria: Lowest price among acceptable, responsible offers. Technical proposals will be evaluated based on meeting minimum requirements.

• U.S. firms are eligible for payment in U.S. dollars. Foreign firms will be paid in local currency.

• Offerors must be registered in the System for Award Management (SAM).

• The solicitation includes detailed exhibits on employee statistics, ORE employees, Peace Corps PSC employees, and past claims/premiums.

• Value Added Tax (VAT) is not applicable due to the Embassy's tax exemption.

• A 2% excise tax pursuant to 26 U.S.C. 5000C may apply to payments.