TENDER ANNOUNCEMENT: AADCP II Health Insurance Provider

Scope of Services

The provider will be required to provide the following services, at the minimum:

1. Minimum geographical coverage: Asia
2. Hospitalization (In-patient services):
   1. Hospitalization (In-patient services): a. In-patient room and board at the level of a standard private room;
   2. Costs of care and treatment in Intensive Care Unit (ICU), High Care Unit (HCU) or Intensive Coronary Care Unit (ICCU);
   3. In-patient care, reconstructive surgery and rehabilitation, including physician and specialists fee, prescribed medications, drugs and dressings, theater use, surgeons, and anesthetists;
   4. Use of an ambulance, cost of other transport or airfares in case of an emergency;
   5. Dental and out-patient treatment due to accident;
   6. Pre- and post- hospitalization care for at least 30-days;
3. Medical Expenses (Out-patient services)
   1. Medical Expenses (Out-patient services) a. Primary consultations and treatment including medical practitioner’s fees prescribed medication, drugs and dressing;
   2. Surgeons, Physicians and Anesthetists fees and the charge for using an operating theatre;
   3. Diagnostic consultations fees for specialists, pathologist and physiotherapists;
   4. Registered private doctor’s fees and the cost of prescribed drugs and dressings;
   5. X-rays, CT scans, Magnetic Resonance Imaging (MRIs), electrocardiograms, encephalograms, audiograms, radiotherapy or chemotherapy;
   6. Surgical appliances prescribed by a Registered Medical Practitioner;
   7. Dental Expenses (at least at 80% of actual expenses, within a prescribed annual limit per family);
   8. Optical Expenses (at least at 80% of actual expenses, within a prescribed annual limit per family).
4. Emergency Treatment/Medical Evacuation
   1. Expenses incurred in respect of emergency treatment immediately necessary to stabilize a medical condition without which a major deterioration would develop in the member’s state of health and result in a significant reduction in life expectancy. This includes emergency transportation, evacuation and non-hospital accommodation related to evacuations.
5. Maternity (at least after 6-months of membership)
   1. Premature and Neonatal care;
   2. Pre-natal and post-natal care;
   3. Care for complications to pregnancy.
6. Preventive treatment:
   1. Annual Medical Checks for all Members;
   2. Vaccinations/Immunizations

Other benefits that will be considered include maximum aggregate limit, coverage of pre-existing conditions and chronic conditions.

GENERAL PROVISIONS

• This tender is open for both health insurance companies and health insurance brokers. Health insurance brokers must provide a letter of attorney from the relevant insurance company.
• Proposals, along with any other supporting documents, should be sent to tender@aadcp2.org email with “AADCP II Health Insurance Provider” as the subject of the email.
• Due date of submission: Thursday, March 7, 2019 at 17.00 WIB (Jakarta time). Proposals coming after this time will not be accepted.
• Only proposals that fully address the minimum level of services listed in the Scope of Services will be evaluated.

TERMS OF REFERENCE AADCP II HEALTH INSURANCE PROVIDER