Provision of Medical Services

Tenders are invited for Provision of Medical Services for CARE Somalia Somaliland Staff Terms of Reference for Provision of Medical Services for CARE Somalia Somaliland StaffJob DescriptionTerms of Reference for Provision of Medical Services for CARE Somalia Somaliland Staff Background CARE has been providing emergency relief and lifesaving assistance to the Somali people since 1981 Our main program activities since then have included projects in water and sanitation sustainable pastoralist activities civil society and media development small scale enterprise development primary school education teacher training adult literacy and vocational training We work in partnership with Somali and international aid agencies civil society leaders and local authorities CARE is an organization driven by its mission to overcome poverty and social injustice We currently work in over 93 countries and focus primarily on women and girls as the most disproportionately affected by poverty while engaging men and boys in our work too CARE International is an international NGO working in Somalia and Somaliland CARE Somalia Somaliland and its partners work with vulnerable communities to address the underlying causes of poverty and promote peace and development as well as mitigating immediate suffering caused by drought conflict and displacement We will be running a tender process intending to award contracts for the provision of Medical Insurance Group Life Insurance and Group Personal Accident WIBA Compliant covers as per below specifications 2 PurposeThe main purpose of this TOR is to find a suitable medical insurance companies to provide its service to all Care International Somalia Somaliland staff for a period of one year 1st July 2020 30th June 2021 The CSOM staff are living in Somalia Somaliland and in Kenya well So we are looking for a companies who has entire coverage in Somalia Somaliland and in Kenya as well They can be two separated firms not necessary one firm with entire services 3 Scope of WorkThe company which is selected to perform the work will have to cover the following functions Staff Dependents Medical Insurance Scheme covering per family Out patient medical servicesIn patient medical servicesMaternity cover medical servicesOptical medical servicesDental medical servicesManagement of the entire employee medical claims and service processesPre negotiated rates with providers i e hospitals claims doctorsClear evidence of credit worthiness from providersClaims Management Receiving of claims Claims processing Records reconciliation etc Care management proper and timely managing of pre authorization for treatment coordinating hospitalization of beneficiaries ensure all facilities are aware of exclusions out patient treatment follow up especially following on post hospitalization etc Emergency Rescue Evacuation International local Emergency Air Evacuation from Somalia or Kenya allowed subject to landing rights at the time of evacuation The cover will take care of emergency evacuations up to the inpatient limit Work Injury Benefits Act WIBA Group Personal Accident GPA The selected company will have to explicitly give a detailed explanation of each of the above categories and also what is covered inclusions and what is not covered exclusions The company shall also provide the below information in a detailed way 1 Lot 1 Provision of Medical Cover in patient out patient optical and dental The cost and eligibility out patient coverThe cost and eligibility of in patient coverThe cost and eligibility of maternity coverThe cost and eligibility of Optical coverThe cost and eligibility of Dental cover1 Lot 2 Provision of Group life insurance cover2 Lot 3 Provision of Group Personal Accident WIBA compliant4 The family size to be quoted uponSection A Somalia Somaliland StaffFamily sizeNo of people coveredPremiumTotalM O1M 11M 21M 31M 41M 51 Section B Regional Hire Staff in KenyaFamily sizeNo of people coveredPremiumTotalM O1M 11M 21M 31M 41M 51 Section C Group Personal Accident WIBA Eight years salary in case of total disability or accidental deathSection D Group Life InsuranceThree years salary 5 Timetable for provisionS NItemDate1Tender Release21st May 20203Closing date and time for receipt of tenders6thJune 20204Tender opening locationTBC5Tender opening date and time7th June 2020 at 10 00 am6Notification of Award date15thJune 20207Signing the contract date22ndJune 2020 6 Requirements Below are the specific conditions that bidder should meet to be eligible for considerationSection A Mandatory for insurance FirmsCertificates of registration from Somaliland Somalia insurance regulators Business permitTax compliance certificate List of current clients preferably INGOs Provide evidence that the company has been registered and in operation for at least 2 years Financial auditing report for the last 2 yearsBank statement for the last 6 months Provide evidence to provide country wide network coverage including border points Somaliland Somalia Kenya and EthiopiaProvide panel providers Must attach a detailed company profile including CVs of the principal officer and key personnel Reference clients and hospitals Section B Mandatory of insurance brokerage servicesCertificates of registration from Somaliland Somalia insurance regulators Business permitTax compliance certificate List of current clients preferably INGOs The company must be registered with relevant authorities Financial auditing report for 1 yearBank statement for the last 6 months Provide evidence to provide country wide network coverage including border points Somaliland Somalia Kenya and EthiopiaMust have attached detailed company profile including CVs of the principal officer and key personnel Registration member of a regulatory bodyHow to applyIf you are interesting this bid please email your detailed proposals including minimum three referees to sombids care org on or before 6th June 2020 16 30Pm quoting in the subject line Provision of Medical Services for CARE Somalia Somaliland Staff Late submitted bids will not be considered

Refer document

FileName	File Description
Global Tender Document	Tender Notice