Terms of Reference: Selection of a Medical Insurance Provider

AGRA Accra Nationally Recruited Staff

REF: AGRA/MED/02/2018

Background

Founded in 2006, the Alliance for a Green Revolution in Africa (AGRA), is an African-led African-based organization that seeks to catalyze Agriculture Transformation in Africa. AGRA is focused on putting smallholder farmers at the center of the continent’s growing economy by transforming agriculture from a solitary struggle to survive into farming as a business that thrives. As the sector that employs the majority of Africa’s people, nearly all of them small-scale farmers, AGRA recognizes that developing smallholder agriculture into a productive, efficient, and sustainable system is essential to ensuring food security, lifting millions out of poverty, and driving equitable growth across the continent.

AGRA is rolling out a new 5-year strategy to catalyze and sustain an Inclusive Agricultural Transformation in Africa to increase incomes and improve food security for 30 million farmers. Under this strategy, AGRA will deliver through an approach that simultaneously catalyzes change at farmer level, strengthens input and output market systems and puts government at the center to enable and champion private-sector-led agricultural growth at national level.

AGRA would like to engage a qualified broker to provide outsourced medical insurance for AGRA’s Nationally Recruited Staff in Accra for a two-year period (July 2018 – June 2020)

Scope of Work

The provision of medical services will include but not be limited to the following tasks:

  1. Hospitalization:
    1. Member’s maintenance in any Hospital, Nursing Home or Sanatorium including hospitalization in an ICU or overseas hospitalization, subject to a second opinion by the company’s appointed medical consultant, where the mode of treatment required is not available in Ghana
    2. The attendance of a qualified Nurse at the residence of the Member, when confined to a bed by a doctor’s directive
    3. Use of an ambulance, cost of other transport or airfares in case of an emergency in an attempt to save a life
    4. Theatre use, surgeons and anesthetists
    5. Parent Accommodation
  2. Medical Expenses (Out-patient services)
    1. 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 (unlimited within the prescribed limits)
    8. Optical Expenses (unlimited within the prescribed limits)
  1. Emergency Treatment/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 – for treatment that is not available in Ghana.
  2. Facilitate the treatment of Members at hospitals, with appropriate discounts for AGRA.
  3. Maternity
    1. Cover for all adults above 18 years
    2. Premature and Neonatal care
    3. Pre-natal and post-natal care.
  4. Preventive treatment:
    1. Annual Medical Checks for all Members
    2. Vaccinations/Immunizations

 Deliverables

The Medical Service Provider will be expected to deliver, the following outputs:

  1. Provide services on a 24-hour basis, 7 days a week
  2. Provide members with photo-cards for identification purposes
  3. Provide polite, responsive and efficient service at all times to fulfil AGRA requirements.
  4. Response time to question from members should be done immediately if an emergency and within 24-48 hours if issue is being escalated to higher authorities.
  5. Assign a senior representative experienced in providing corporate medical insurance services to oversee the management services provided to AGRA and to ensure full compliance with all requirements of the Contract and Service Level Agreement with AGRA.

Proposal Submission

Interested and qualified providers are invited to submit their proposal(s) comprising of the following:

  • An understanding of the requirements
  • Methodology and work-plan for performing the assignment
  • Project delivery plan
  • Team composition and tasks assignment
  • Detailed reference list indicating the scope and magnitude of similar assignments
  • Relevant services undertaken in the past three (3) years
  • Registration and other relevant statutory documents

Evaluation Factors and Sub factors

The Proposal for this contract will be evaluated according to the following criteria:

  • Accredited/Certified Medical Services or Insurance Provider
  • A good track record in serving international organizations, embassies and multinational corporations for a minimum of at least 7 years; list of corporate clients for similar services should be provided
  • Has in its employment competent and experience consultants, especially in medical service provision, as evidenced by the track record in their Curriculum Vitae
  • Financially stable – annual report or audited financial statement for the last 3 years to be provided
  • Reinsurer information must be provided
  • Ability to provide quarterly financial statements and listing of staff on insurance cover
  • If providing services from own Network, maintains reputable medical facilities that are tested and tried. The Network Providers should be spread throughout the country even though members are generally concentrated within Accra.
  • Ability to provide a customized package as per AGRA’s own needs and requirements, which includes preventive medical care
  • Willing and able to guarantee the delivery of products and services in accordance with the performance standards required by this TOR
  • Ability of its designated staff to think on their feet and provide immediate reasonable solutions to medical needs and emergencies.

Technical and Financial proposals will need to be submitted as separate documents and clearly marked as such. Financial proposals will not be opened until the conclusion of the technical evaluation and only for those proposals that are deemed qualified and responsive to the TORs.

Disclaimer

AGRA reserves the right to determine the structure of the process, number of short-listed participants, the right to withdraw from the proposal process, the right to change this timetable at any time without notice and reserves the right to withdraw this tender at any time, without prior notice and without liability to compensate and/or reimburse any party.

Submission

All interested companies and brokers are asked to submit their proposals by close of business on June 15th, 2018 to the following email address: procurement@agra.org. All bidders must quote the above reference number in the subject line of their email submission.