Request for Proposal: Health & Life Insurance for the Year 2024

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In this Request for Proposal (RFP), we are soliciting bids for the provision of comprehensive Health and Life Insurance services to the employees of SPARC (Society for the Protection of the Rights of the Child) for the year 2024. The objective is to ensure that all staff members have access to quality medical and life insurance coverage.

Objective

The primary goal of this RFP is to provide comprehensive medical, health, and life insurance cover to all employees of SPARC, thereby ensuring their well-being and security.

Scope of Work

The service provider is expected to offer the following medical services to the staff registered under the policy, up to an agreed financial limit:

In-Patient and Out-Patient Services

  • Access to private wards and single rooms in hospitals, including medical, surgical, diagnostic, and therapeutic services.
  • Treatment of short-term medical conditions, including in-patient tests and surgery.
  • Accident and emergency admission, treatment, and care.
  • Laboratory tests, diagnostic procedures, and specialized scans.
  • Cover for general medical check-ups and screenings.
  • Access to a wide range of medical practitioners, clinics, and hospitals.
  • Emergency services, including ancillary support.
  • Miscellaneous hospital expenses.

Prescription Drugs

  • Coverage for doctor-prescribed drugs should be included.

Dependent Coverage

  • Dependents of employees should be covered under the policy.

International Coverage

Provision for treatment abroad in case of emergencies within the prescribed limit.

Short Stay Medical Emergency

Coverage for short-term medical emergencies should be clearly indicated on the health card.

Proposal Requirements

Proposals should include a minimum 12-month rate guarantee, with the contract period extending from January 1st, 2024, through December 31st, 2024.

Group Health Insurance Requirements

We are seeking the following grouped medical insurance plan for our employees:

Medical Insurance Plan

Plan A

  • Hospitalization & Related Limit:
    • Employees: Rs. 750,000 Each Per Year
    • Patient Room Limit: Up to Rs. 16,000 Per day
    • 100% Enhancement in H&R Limits in case of accidental injuries or major injuries

Plan B

  • Employees: Rs. 800,000 Each Per Year
  • Patient Room Limit: Up to Rs. 16,000 Per day
  • 100% Enhancement in H&R Limits in case of accidental injuries or major injuries

Outpatient Department (OPD)

  • Option 01:
    • Per employee: PKR. 30,000
  • Option 02:
    • Per employee: PKR. 50,000

Special OPD Features

  • Coverage for over-the-counter medicines without prescription.
  • Dental treatments, optical treatments, dermatology/skin treatments, psychiatric treatment, and prescribed medical equipment.
  • PCR test for COVID-19 and oral treatment for Dengue.

Pre-Hospitalization Policy

  • Sub-limits for pre-hospitalization diagnosis, consultation, room, and medicines for 30 days.
  • Sub-limits for follow-ups for 30 days.

Day-Care Surgeries & Specialized Investigations

  • Coverage for day-care surgeries and specialized investigations, including but not limited to cancer treatments, dialysis, cataract surgery, MRI, CT scan, etc.

Eligibility

All full-time employees, actively at work up to 70 years of age, should be eligible for coverage.

Special Notes

  • Reasonable and Customary charges as per PPN shall be paid 100%.
  • Pre-existing conditions, congenital conditions, and specific treatments should be covered up to 100% of the respective H&R limits.
  • Intensive Care Unit (ICU) & CCU charges, surgical operation charges, physician visits, specialist consultation charges, and hospital casualty ward services should be fully covered.

In conclusion, we invite proposals from qualified insurance providers who can meet the outlined requirements and provide comprehensive Health and Life Insurance services to the employees of SPARC for the year 2024.

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