Description
The U.S. Embassy Kinshasa is seeking proposals from qualified insurance providers to deliver comprehensive group health insurance coverage for locally employed staff and their eligible dependents. The contractor must provide health insurance services covering approximately 351 enrolled individuals across three enrollment categories. The contract is for a base period of one year with four one-year option periods and one six-month extension option, for a maximum total duration of 5.5 years. The contractor must maintain a pre-authorization system, a web-based digital claims portal and mobile application, and a direct-billing network of at least ten approved medical facilities in Kinshasa.
• The contractor must provide 100% coverage for hospitalization, emergency services, outpatient services, obstetric and newborn care, pediatric services, prescription drugs, preventive and wellness services, and mental health and substance abuse care.
• The contractor must also provide coverage for dental care, optical care, hearing aids, and rehabilitative and habilitative services.
• The contractor must have a minimum annual maximum reimbursement per covered individual per contract year of USD 47,000.
• The contractor must be registered with the Autorite de Regulation et de Controles des Assurances (ARCA) of the Democratic Republic of Congo and must be registered in the System for Award Management (SAM) database.