TERMS OF REFERENCE
HEALTH & ACCIDENT INSURANCE
Client: Rosa-Luxemburg-Stiftung Southeast Asia (RLS SEA) is a registered international Non-Government-Organization (INGO) with a Representative Office in Vietnam operating in Cambodia, Laos, Myanmar and Vietnam.
Office Address: House No. 8C, Alley 76, To Ngoc Van Street, Tay Ho, Hanoi, Vietnam.
Director Representative Office: Mr Philip Degenhardt
Phone: +84 24 3718 5836
Fax: +84 24 3718 5834
Email: [email protected]
Website:www.rosaluxhanoi. [1]org
ORDER DESCRIPTION
RLS SEA now calls for insurance companies to submit offers for health & accident insurance for 12 staff of RLS SEA office in 2021 with the detailed scope of works as in follow.
A. SCOPE OF SERVICES:
1. RLS SEA’s staff list:
|
Staff |
Year of birth |
|
Staff 01, Female |
1970 |
|
Staff 02, Male |
1970 |
|
Staff 03, Female |
1976 |
|
Staff 04, Female |
1978 |
|
Staff 05, Male |
1979 |
|
Staff 06, Female |
1980 |
|
Staff 07, Female |
1981 |
|
Staff 08, Female |
1983 |
|
Staff 09, Female |
1984 |
|
Staff 10, Female |
1984 |
|
Staff 11, Male |
1982 |
|
Staff 12, Female |
1990 |
2. Table of benefits:
|
TABLE OF BENEFITS |
|
Geographical Limit |
|
I - PERSONAL ACCIDENT |
|
1) Death/Total Permanent Disablement |
|
2) Medical Expenses due to accident |
|
II. HEALTH INSURANCE |
|
The Policy covers actual medical expenses incurred for treatment of illness/sickness, disease, pregnancy & childbirth during period of insurance. |
|
A. IN PATIENT - overall annual limit per person |
|
1) Hospitalization charges incurred during hospital stay |
|
2) Surgical Charges |
|
3) Emergency Ward Treatment |
|
4) Emergency Local Transporation |
|
5) Daily Allowance for Hospitalization |
|
6) Burial Allowance |
|
7) Pre-hospitalization |
|
8) Post-hospitalization |
|
9) Home Nursing |
|
10) Newborn baby care |
|
11) Maternity |
|
Normal Delivery |
|
Complications of Pregnancy, C-section as per prescription |
|
Allowance if delivery at state-owned hospital |
|
- Normal Delivery |
|
- Caesarean (C-section) |
|
B. OUT-PATIENT - overall annual limit per person |
|
Limit per visit |
|
Physiotherapy limit per year |
|
Pre-natal check-up including: expenses of diagnosis, 2D/3D/4D ultrasound, urine and blood test |
|
Basic Dental Care |
|
Examination and diagnosis, X-ray, Gingivitis (blow the gums), Normal compound fillings (amalgam, fuji, composite, gic or similar materials), Root canal Treatments, Extractions of diseased teeth (with surgery). |
|
Periodnatal |
|
Tooth cleaning (twice/year) include in Basic Dental Care |
|
Crown, bridge, implant, dentures, included in Basic Dental Care limit |
|
Limitation of Dental Clinics: |
|
C - DEATH DUE TO ALL RISKS EXCEPT FOR ACCIDENTS |
|
Death/Total Permanent Disablement |
|
TERMS & CONDITIONS |
|
Eligibility of Insured Person |
|
Extension Clauses |
|
Adjustment during insurance period |
|
Additional employees |
|
Deleted employees |
|
Waiting Period (Applicable for insured person from first joinning date) |
|
Medical Expenses |
|
- Due to Accident |
|
- Tendon and ligament reconstruction surgery |
|
- Due to normal diseases |
|
- Due to special diseases (as defined in wording) |
|
- Due to pre-existing conditions |
|
- Miscarriage, abortion, pregnancy treatment prescribed by doctors |
|
- Normal childbirth |
|
Death/Permanent Disablement |
|
- Due to Accident |
|
- Due to normal diseases |
|
- Due to pre-existing conditions |
|
- Due to special diseases (as defined in wording) |
|
- Due to pregnancy |
|
CONTINUOUS COVER CLAUSE |
|
CLAIM SERVICES |
|
Direct Billing Network |
|
Claim Handler |
|
Time of Claim processing |
|
Time of Claim Payment (after receiving claim payment notice) |
|
Insurance card - Name |
|
Handbook/Leaflet (Soft copy) |
B. Minimum Criteria for RLS SEA’s assessment of the offers:
RLS SEA will evaluate and assess the submissions of the offers upon a set of criteria. These include:
- Service fee and payment method;
- Proven capacity to carry out the full set of all requested services;
- Track record and evidence based experiences in the provision of such services with international organizations.
C. Application:
Interested service providers are invited to submit their offers including a most updated company profile and a proposal in which you state clearly the desired rate for this service, including a detailed price list.
Application should be sent via email to Ms Nguyen Thuy Ha at: [email protected] [2], latest by 30th November 2020 at 6 PM.