LOME_LE Staff GMC_Health Insurance Services

Form / Attachment / Pricing Sheet

This document appears to be a collection of family composition data, likely used for demographic analysis or as an attachment to a larger report or form. It details the status (Employee, Spouse, Child, Adherent, Enfant), sex, date of birth, and counts of individuals within each family unit.

• Employee details (Sex, Date of Birth)
• Spouse details (Sex, Date of Birth)
• Child details (Sex, Date of Birth)
• Total family members per entry
• Aggregated totals at the bottom of some pages (e.g., 143 Employees, 106 Spouses, 355 Children, 604 Total).

This document is likely an informational attachment or a data collection form. Bidders may need to review it to understand the scope of data being collected or provided, or if it is a required form, to understand the specific information they need to provide in their own submission. Its relevance is dependent on the specific requirements of the opportunity it is attached to.

Amendment / Modification

This amendment (P0003) to solicitation 19T04026R0001 extends the offer receipt date and provides responses to vendor questions.

• The offer due date is extended.

• A Q&A document is attached, providing clarifications on various aspects of the solicitation.

• Offerors must acknowledge receipt of this amendment.

• The deadline for offer submission has been extended. Specific new date/time not detailed in this amendment, but implied by the extension.

• Vendors should review the attached Q&A document for clarifications that may impact their proposals.

Amendment / Modification

This amendment (P0002) to solicitation 19T04026R0001 provides answers to questions received on February 27, 2026, for clarification purposes. All other terms and conditions remain unchanged.

This amendment primarily addresses clarifications related to the solicitation, as detailed in the attached Q&A document.

• The amendment extends the hour and date for receipt of offers. Bidders must acknowledge receipt of this amendment.
• Offers submitted prior to this amendment may be changed by telegram or letter, provided it is received before the new opening hour and date.
• Bidders are instructed to complete all necessary sections of the solicitation and include all option years in their proposals. The evaluation factors for award are explained in Section M.

Amendment / Modification

This amendment modifies Solicitation 19T04026R0001 and includes the following changes:

• Period of Performance: The beginning of the performance period has been changed. The original start date was July 28, 2026, and it is now August 28, 2026. The contract remains for one year with four one-year options to renew.
• Exhibits A and C (Section J): Updates have been made to reflect changes in population data. Specifically:
  • Exhibit A, "EMPLOYEES AND DEPENDENTS BY GENDER WITHIN AGE RANGES," has been revised with updated employee, spouse, and children counts and age breakdowns.
  • Exhibit C, "PEACE CORPS EMPLOYEE SPOUSES BY GENDER WITHIN AGE RANGES," has been revised with updated population counts.
• Closing Date Extension: The closing date for the solicitation has been extended to March 19, 2026, at 04:00 PM local time.

• Section F (Period of Performance)
• Section J, Exhibit A (Employees and Dependents by Gender within Age Ranges)
• Section J, Exhibit C (Peace Corps Employee Spouses by Gender within Age Ranges)

The proposal submission deadline has been extended to March 19, 2026, at 04:00 PM local time. Bidders must acknowledge receipt of this amendment.

Solicitation / RFP / RFQ

This solicitation is for the provision of health insurance services for locally employed staff and their eligible dependents at the U.S. Embassy in Lomé, Togo. The U.S. Government intends to award a contract to the responsible company submitting an acceptable offer at the lowest price.

• Provision of health and/or life insurance coverage for locally employed staff.

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

• Specific benefits and coverage details are outlined in Section C.

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

• Period of Performance: One year beginning July 28, 2026, with four (4) one-year options to renew.

• Minimum Order: 75 annual premiums.

• Maximum Order: 1,000 annual premiums.

• Proposals are due by Thursday, March 12, 2026, at 4:00 PM local time.

• Proposals must be submitted electronically to LOME-GSO-PROC-DL@STATE.GOV in MS-Word, MS-Excel, or Adobe Acrobat (PDF) format, not exceeding 30MB per file.

• Required submission documents include SF-33, Section B (Pricing Schedule and Retention Amounts), Section K (Representations and Certifications), IRS Form W-14, and proof of SAM Registration.

• Evaluation will be based on the lowest priced, technically acceptable, responsible offeror. Award may be made based on initial offers without discussions.

• Not specified as a set-aside.

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

• Offerors must be licensed/certified/accredited by the Government of Togo or demonstrate capacity to provide health insurance in Togo.

• A pre-proposal conference will be held on Thursday, February 12, 2026, at 3:00 PM local time at the U.S. Embassy Lomé.

• Offerors must contact the Embassy via email or phone by Monday, February 9, 2025, to confirm attendance for the pre-proposal conference.

• The document includes detailed information on health insurance benefits, exclusions, eligible participants, and administrative requirements.