Call for Tender for Health Insurance for PU-AMI Staff

GENERAL CONDITIONS OF THE HEALTH INSURANCE COVERAGE
The Supplier(s) must comply with all the conditions mentioned below. These conditions are an integral part of the contract which will be signed with the selected supplier(s). 3.1. Framework contract conditions
Invariability of the prices:
Unit prices indicated in the financial offer are fixed and invariable if the specifications do not change.
Quantities:
PU-AMI does not commit to ordering a minimum quantity of health insurance subscriptions over the course of the contract duration. The requests will be based on the needs, which may vary according to funding and operational constraints.
The quantities mentioned below are based on the current fleet of PU-AMI, as an indication to Tenderers, and may increase or decrease at any time during the contract.
The total number of persons to be insured is approximately 237, distributed as follows:
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- 60% of the insured will be Co-NSSF
- 40% of the insured will be Co-NIL

Delivery
When PU-AMI issues a written request for a new health insurance to be provided, the subscription will be made available within a maximum of 24 hours. 3.3. Invoicing and payment
Invoices will be issued by the supplier at the end of each month.
Payments will be made exclusively by cheque or bank transfer, in USD, within 2 months following the provision of a valid and accepted invoice.

Health Insurance Specifications
- Coverage: 24/24 protection, on or off the job (including work accidents), on business or vacation or at home, (inside Lebanon)
- Coverage: 24/24 protection, on or off the job (including work accidents), on business or vacation or at home, (outside Lebanon), to note that the cost of the international coverage will be mandatory and financed individually (unless if in official work it will be mandatory)
- A distinction (i.e. separate quotation prices) between the following types of coverage:
- In hospital (1st class and 2nd class), with and without National social security fund (NSSF) coverage 100 %
- Ambulatory (coverage up to 85%).
- Prescription Medicines (coverage up to 85%). (4) Doctor’s visits (coverage up to 85% and up to 50USD/visit).
- The range in number of staff for which your offer is valid.
- Please clarify, if your insurance company can provide the following facility: to have the continuity facilities so all our employees and their legal dependents can benefit from the insurance from the first working day and take out on their last working day without any delays.
- We are requiring the insurance to cover all chronic diseases, Asthma and Cancer.
- We are requiring the maternity coverage of the employees or their spouses to start the date of contract signature (No delay in coverage for maternity is accepted).
- We are requiring that our employees and their legal dependents be covered with insurance without filling any application or form/questionnaire.
- To include the request for service related to NSSF facilitation and reimbursement (Optional offer)…
- To submit Co-NSSF coverage and upgrade the Grade to Class B or (class A optional)
- Employees should be able to cover their children with insurance covered by themselves without any obligations.
- Coverage in case of death of an insured.
- Childbirth outside Lebanon Coverage.
The Contracting Authority has the right to modify the list of employees. The present document Reasonable and Customary shall be deemed to refer to a charge for medical care which shall be considered reasonable and customary to the extent that it does not exceed the general level of charges being made by others of similar standing in the locality where the charge is
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incurred, when furnishing like or comparable treatment, services or supplies to individuals of the same sex and of comparable age and income, for a similar disease or injury.
Supplemental Benefits offered- Covered up to Policy Limit
- Organ Transplantation including cost of surgical procedures in performing an organ transplant of either a kidney, Liver, Heart, Lung, in respect of the insured person as recipient
- Bone Marrow Transplant
- Prosthesis due to accident or illness
- Stent
- Cataract including the cost of lens
- Terrorism Risk
- Chemotherapy / Radiotherapy
- Renal Dialysis
- Parkinson Disease
- Home Nursing
- Companion Room: Accommodation for a Child under the age of 12 years
- Clinical Surgeries
- Hazardous Sports
- Sleep Disorders if caused by sleep apnea, i.e. temporarily stopping of breathing during sleep
- Polysomnography
- Rental of Wheelchair
- Local Ambulance Cost
- Full in hospital coverage in case of Road Accidents
- Obesity and Congenital cases