Peace Corps, Office of Contracts, Rm. 1420E, 1111 2O th St. N.W., Washington, DC 20526

R -- PEACE CORPS HEALTH BENEFITS PROGRAM SOL PCORPS-00-R-0004 DUE 050800 POC Kimberley M. Atsalinos, Contracting Officer,(202)692-1629 Fax No.(202)692-1621 The Peace Corps is soliciting proposals on the basis of full and open competition under the guidance of FAR Part 15, for the administration of its health benefit program. Peace Corps manages health care services for more than 15,000 individuals each year. These individuals are categorized as: Applicants; Peace Corps Volunteers (PCVs); and Returned Peace Corps Volunteers [RPCVs]. These services are being provided currently under contract, which will expire September 30, 2000. Peace Corps anticipates award of a one year contract with four, one-year options. Award is anticipated in August 2000 for full implementation to begin October 1, 2000. Peace Corps intends to award one or more firm fixed price contract(s) as a result of this solicitation. The claims processing component (Component No. 1) will contain a cost-reimbursable element, with no fee allowable -- i.e, a pass-through of costs for payment of claims processed. The SIC code for this procurement is 8999. Peace Corps functions as a direct service provider and as a payer for health care services. Routine health care overseas is provided by medical professionals under contract with Peace Corps. Practitioners and organizations provide non-routine health care overseas and health care services in the US. These costs are paid for or are reimbursed by Peace Corps through a self-insured health benefit program. The Peace Corps is soliciting proposals for the following services: Component No. 1 -- Claims Processing and Administration -- processing of all claims submitted to Peace Corps for those pre-authorized services provided in the US or, in rare cases, anywhere in the world. Administration of the associated services for customer service, complaints resolution, management reports, records management, data security, database management and other functions associated with the processing of claims. Component No. 2 -- Service Network Open Panel -- a network of professionals and facilities in the Washington, DC area with the capability of providing services to those Peace Corps Volunteers who are "medevaced" to Washington for evaluation and/or treatment. Component No. 3 -- Prescription drug service -- a managed prescription drug service for the approximately 500 Peace Corps Volunteers "medevaced" to the US each year and to other PCVs in the US who may require this service. Offerors may submit proposals for one, two or all of the above three components of the health benefit program. BACKGROUND -- Peace Corps considers its Health Benefits Program to consist of three "plans" -- which should not be confused with the above mentioned components. The "plans" correspond to the categories of beneficiaries of the three service components. This information is provided merely to give some sense of scope of the program to potential Offerors, to inform their decision whether or not to request an RFP. PLAN I: Applicants to Peace Corps Peace Corps reimburses partial costs for medical, dental, and vision examinations for those who apply to the Peace Corps. Applicants or providers are reimbursed up to the maximum allowed under the fee schedule. Number of Claims In FY 98 -- approximately 8,500 Average Cost per Claim approximately $82.00 PLAN II: Peace Corps Volunteers Peace Corps manages the course of evaluation and treatment of Peace Corps Volunteers. These services are provided overseas by medical professionals who are under contract to Peace Corps and are outside the scope of this solicitation/contract; the contractor will not be responsible for costs associated with routine care for Peace Corps Volunteers while at overseas posts. Non-routine "medevac" services are provided to Peace Corps Volunteers who must receive care outside their country of service. These services are paid for by Peace Corps using a standard national fee schedule. The contractor will be responsible for processing the claims for costs associated with these services, under Component No. 1. Under Component No. 2, medical care will be provided to these medevaced volunteerswho are being treated/evaluated in the Washington DC area, by the network of providers. Medical and dental care may be provided to Peace Corps Volunteers who are on home leave or away from official duty and who are in need of evaluation or treatment for conditions related to Peace Corps service. These services are paid for using a standard national fee schedule. The contractor will be responsible for processing the claims for costs associated with these services, under Component No. 1. Number of Claims In FY 98 -- approximately 7,500 Average Cost per Claim approximately $300 PLAN III: Returned Peace Corps Volunteers [RPCVs] Peace Corps manages the course of evaluation and treatment of eligible RPCVs who receive medical, mental health, or dental evaluation in the US or at intermediate locations world-wide. These services are paid for using a standard national fee schedule. Number of Claims In FY 98 -- approximately 9,500 Average Cost per Claim approximately $140 The RFP is anticipated to be released on March 24, 2000. All requests for the RFP shall be in writing and provide the Offeror's phone and fax numbers, as well as email address. Electronic transmission shall be the preferred method of distribution of this RFP. Hard copies of the RFP will be distributed only upon specific request. All questions related to the RFP itself must be received in writing no later than April 25, 2000 in order to receive a response prior to the closing date, May 08, 2000. Posted 03/03/00 (W-SN431035). (0063)

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