Peace Corps Office of Health Services PC 16 R 007 Formal Solicitation 10-12-16

1.
THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)
4. TYPE OF SOLICITATION
5. DATE ISSUED
SOLICITATION, OFFER, AND AWARD

2. CONTRACT NUMBER
3. SOLICITATION NUMBER
SEALED BID (IFB)

NEGOTIATED (RFP)
PC-16-R-007
7. ISSUED BY
CODE
PCISSUE
RATING
PAGE
OF PAGES
| 69
6. REQUISITION/PURCHASE NO.
12 Oct 2016
8. ADDRESS OFFER TO (If other than Item 7)
Peace Corps
1111 20th Street, NW.
Office of Acquisition and Contract Management, 4th Floor
Washington, DC 20526
Peace Corps
1111 20th Street, NW.
Office of Acquisition and Contract Management, 4th Floor
NOTE: In sealed bid solicitations offer and offeror mean bid and bidder
SOLICITATION
9. Sealed offers in original and See L.5 copies
for furnishing the supplies or services in the schedule will be received at the place specified in Item 8, or
if hand carried, in the depository located in Block 8 until 2:00 P.M. Local Time 11/14/2016.
10. For
Information Email:
A. NAME
B. TELEPHONE (NO COLLECT CALLS)
C. E-MAIL ADDRESS
Sonja Truehart-McKinney
AREA CODE
NUMBER
struehartmckinney@peacecorps.gov
202
692-2840
EXT.
11. TABLE OF CONTENTS

(X)
X
X
X
X
X
X
X
X
SEC.
A
B
C
D
E
F
G
H
DESCRIPTION
PAGE
PART I - THE SCHEDULE

SOLICITATION/CONTRACT FORM
SUPPLIES OR SERVICES AND PRICE/COST
DESCRIPTION/SPECS./WORK STATEMENT
PACKAGING AND MARKING
INSPECTION AND ACCEPTANCE
DELIVERIES OR PERFORMANCE
CONTRACT ADMINISTRATION DATA
SPECIAL CONTRACT REQUIREMENTS
6
8
13
45
46
48
50
56
(X)
X
X
X
X
X
SEC.
DESCRIPTION
PAGE(S)
PART II - CONTRACT CLAUSES

I
CONTRACT CLAUSES
67
PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.
J
LIST OF ATTACHMENTS
73
PART IV - REPRESENTATIONS AND INSTRUCTIONS
K
REPRESENTATIONS, CERTIFICATIONS
AND OTHER STATEMENTS OF OFFERORS
74
L
INSTRS., CONDS., AND NOTICES TO OFFERORS
81
M EVALUATION FACTORS FOR AWARD
104
OFFER (Must be fully completed by offeror)

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.
12. In compliance with the above, the undersigned agrees, if this offer is accepted within _____ calendar days (60 calendar days unless a different period is inserted by the
offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the
designated point(s), within the time specified in the schedule.
13. DISCOUNT FOR PROMPT PAYMENT
10 CALENDAR DAYS
20 CALENDAR DAYS
30 CALENDAR DAYS
CALENDAR DAYS
14. ACKNOWLEDGMENT OF AMENDMENTS
AMENDMENT NO.
DATE
AMENDMENT NO.
DATE
(The offeror acknowledges receipt of amendments to the

SOLICITATION for offerors and related documents
numbered and dated):
15A. NAME
AND
ADDRESS
OF
OFFEROR
FACILITY
CODE
15B. TELEPHONE NUMBER

EXT.
16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN

OFFER (Type or print)
15C. CHECK IF REMITTANCE

ADDRESS IS DIFFERENT FROM ABOVE
- ENTER SUCH ADDRESS IN
SCHEDULE.
17. SIGNATURE
18. OFFER DATE
AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEMS NUMBERED
20. AMOUNT
22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:
10 U.S.C. 2304(c) (1)
41 U.S.C. 253(c)(
24. ADMINISTERED BY (If other than Item 7)

See Block 7
26. NAME OF CONTRACTING OFFICER (Type or print)
Sonja Truehart-McKinney
ITEM
See Section G
23. SUBMIT INVOICES TO ADDRESS

SHOWN IN (4 copies unless otherwise specified)
CODE
21. ACCOUNTING AND APPROPRIATION
PCISSUE
25. PAYMENT WILL BE MADE BY

See Section G
CODE
PCISSUE
27. UNITED STATES OF AMERICA
28. AWARD DATE
(Signature of Contracting Officer)
IMPORTANT -- Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.
NSN 7540-01-152-8064
PREVIOUS EDITION NOT USABLE
STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA FAR (48 CFR) 53.214(c)
Solicitation PC-16-R-007
Peace Corps
Office of Health Services
Health Care Benefits Services
Formal Solicitation
PC-16- R-007
October 12, 2016
TABLE OF CONTENTS
SECTION A SOLICITATION/CONTRACT FORM
A.1. Issuing Office
A.2. Contract Type
A.3. Term of Contract
A.4 Effective Date
A.5 Receipt of Proposals
SECTION B SUPPLIES OR SERVICES AND COSTS/PRICES
B.1. CLIN Structure
B.2. Contract Summary
SECTION C DESCRIPTION/SPECIFICATIONS/STATEMENT OF
WORK
C.1. Introduction
C.2. Technical Requirements
C.3. Transitions
C.4. Invitee Cost-Reimbursement Administrative Services (Plan 1)
C.5. Health Care Administrative Services for Peace Corps Volunteers (PCVs)
(Plan 2)
C.6. Health Care Administrative Services for Returned Peace Corps Volunteers
(RPCVs) (Plan 3)
C.7. Access to Short-Term Group Health Insurance (Plan 4)
C.8. Medical Claims
C.9. Automated Eligibility And Authorization System
C.10. Data and Reporting Requirements
Page 2 of 112
C.11. Historical Beneficiary Demographics and Claims History

C.12. Rights Reserved for the Peace Corps
SECTION D PACKAGING AND MARKING
D.1. Packaging
D.2. Marking
SECTION E INSPECTION AND ACCEPTANCE
E.1. Inspection and Acceptance
E.2. Inspection Location
E.3. Quality Assurance Surveillance Plan (QASP)
E.4. Acceptance
E.5. Clauses Incorporated by Reference
SECTION F DELIVERIES OR PERFORMANCE
F.1. Period of Performance
F.2. Delivery
F.3. Place of Performance
F.4. Notice Regarding Late Delivery
F.5. Clauses Incorporated by Reference
SECTION G CONTRACT ADMINISTRATION DATA
G.1. Contracting Officers Authority
G.2. Contracting Officers Representative
G.3. Contractor Representative
G.4. Invoice and Payment Instructions
G.5. End of Health Care Delivery
G.6 Withholding of Contract Payments
Page 3 of 112
SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1. Loss/Damages
H.2. Confidentiality
H.3. Privacy and Security of Protected Health Information
H.4. Compliance with Federal, State, Local, and Foreign Requirements
H.5. Protection of Information
H.6. Contractor Required Insurance
H.7. Advertising of Award
H.8. Use of Peace Corps Name and Logo
H.9. Small Business Subcontracting Plan Requirements
H.10. Key Personnel
H.11 Information Security
H.12 Data Rights
H.13 System Accessibility and Ease of Use
H.14 Breach of Information Notification Requirement
H.15 Organizational Conflict of Interest
H.16 Economic Price Adjustment (EPA) Clause for Short-Term Health Care
Insurance Premium Costs
H.17 Statutory and Regulatory Authority
SECTION I - CONTRACT CLAUSES
I.1. Clauses Incorporated by Reference
I.2. Clauses Incorporated in Full Text
Page 4 of 112
SECTION J - LIST OF DOCUMENTS, EXHIBITS, AND OTHER

ATTACHMENTS
J.1 Peace Corps Personnel Security Policies
J.2. Panel Providers
J.3. Peace Corps Standard Form (SF) 127C
J.4. Peace Corps IT Security Policies & Procedures
J.5. Government Transition Team
J.6. Plan 1 Cost Reimbursement Fee Schedule
J.7. Authorized Air Ambulance Callers
J.8. Preferred Air Ambulance Destinations
J.9. AfterCorps Coverage
J.10. Contract Data Requirements List
J.11. Small Business Plan
J.12. Plan 3 Point of Service-issued Pharmaceuticals
J.13. Volunteer Demographic Statistics by Fiscal Year (FY)
L.1 Past Performance Questionnaire
L.2. Pricing Table
SECTION K REPRESENTATIONS, CERTIFICATIONS, AND OTHER
STATEMENTS OF OFFERORS
K.1. Clauses Incorporated by Reference
K.2. Clauses Incorporated In Full Text
SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO
OFFERORS
L.1. Clauses Incorporated In Full Text
L.2. General Instructions
L.3. Organizational Conflict Of Interest
Page 5 of 112
L.4. Inquiries Concerning This Solicitation

L.5. Proposal Preparation And Solicitation Response Requirements
L.6. Volume I Executed Offer
L.7. Volume II Technical Proposal
L.8. Volume III - Past Performance
L.9. Volume IV Price Proposal
L.10. Subcontracting Plan and Small Business Participation
SECTION M EVALUATION FACTORS FOR AWARD
M.1. FAR 52.217-5 Evaluation of Options (Jul 1990)
M.2. General
M.3. Evaluation Factors And Relative Weight
M.4. Evaluation Factor 1 Technical Approach
M.5. Evaluation Factor 2 Past Performance
M.6. Evaluation Factor 3 Price
M.7. Evaluation Factor 4 Subcontracting Plan And Small Business Participation
SECTION A SOLICITATION/CONTRACT FORM
A.1. Issuing Office
This solicitation is for Peace Corps Health Care Benefits Services and is being issued by the
Peace Corps, Office of Acquisition and Contract Management (OACM), on behalf of the Office
of Health Services.
A.2.Contract Type
A Firm Fixed Price (FFP), Fixed Price Economic Price Adjustment (FP EPA), Time and
Materials (T&M), open market, commercial service type contract (hereafter referred to as
contract) is expected to be awarded.
A.3. Term of Contract
This contract will be awarded to one Offeror for a one-year base Period, with four (4) one (1)
year option periods.
Page 6 of 112
A.4. Effective Date

This contract (Contract) is made effective as of * see below (Effective Date), by and
between Peace Corps and
, (to be filled in by Offeror) a
(i.e. corporation) (to be filled in by Offeror ) organized and existing under the laws of the State
of _____________ (to be filled in by Offeror).
*This contract shall be effective as of the date the contract is executed by the Contracting Officer
(CO), at which time the Contractor shall commence work in accordance with the terms and
conditions herein.
A.5. Receipt of Proposals
All copies of an Offerors (or subcontractors) proposal must be submitted by the time and date
in Block 9 of Standard Form (SF) 33. The Contractor shall forward solicitation responses
addressed to:
Peace Corps Headquarters
Office of Acquisition and Contract Management
ATTN: Ms. Sonja Truehart-McKinney, Contracting Officer
(RFP- PC-17-R-007)
1111 20th Street, NW, Room 4402
(End of Section A)
Page 7 of 112
SECTION B - SUPPLIES OR SERVICES AND COSTS/PRICES
ITEM NO.
SUPPLIES/SERVICES
QTY
UNIT
UNIT PRICE
AMOUNT
BASE
AWARD
0001
0002
0003
0004
0005
Transition Phase-In (FFP) Planning and Implementation

of Transition Period In Accordance With (IAW)
Statement of Work (SOW), Sections C.1, C.3.1
1 Lot
Invitee Cost -Reimbursement Administrative Services

(Plan 1) (FFP (Unit Price)) IAW Sections C.1, C.2 and
C.4
6,500 CL
Health Care Administrative Services for Peace Corps

Volunteers (Plan 2) (FFP (Unit Price)) IAW Sections C.1,
C.2 and C.5 (See Note A)
7,000 MM
Health Care Administrative Services for Returned Peace

Corps Volunteer- (Plan 3) (FFP (Unit Price)) IAW
Sections C.1, C.2 and C.6 (See Note A)
4,000 MM
Access to Short-Term Group Health Insurance Policy

(Plan 4) (FP EPA) IAW Sections C.1, C.2 and C.7. (See
Notes A and B)
4,000 MM
0006
Other Direct Cost - Medical Claims IAW Section C.8.

(See Note C)
1 Lot
0007
Automated Eligibility and Authorization System (Option)

(FFP) IAW Section C.9 (See Note D)
1 Lot
0008
Data for Items 0001 - 0007, and (if options are exercised)
0009 through 0029 IAW Section C.10 (Not Separately
Priced (NSP))
1 Lot
Page 8 of 112
See
Note
B
$6,600,000
NSP
OPTION I
0009
0010
0011
0012
0013

C.4 (See Note D)
6,825 CL

C.2 and C.5 (See Notes A and D)
7,800 MM

Corps Volunteers (Plan 3) (FFP (Unit Price)) IAW
Sections C.1, C.2 and C.6 (See Notes A and D)
4,300 MM

Notes A, B, and D)
4,200 MM

(See Notes C and D)
1 Lot

C.4 (See Note D)
7,166 CL

8,500 MM

4,600 MM
See
Note
B
$6,930,000
OPTION II
0014
0015
0016
0017

Notes A, B, and D)
0018
Other Direct Cost (ODC) - Medical Claims IAW Section
Page 9 of 112
4,410 MM
1 Lot
See
Note
B
$7,276,500
C.8. (See Notes C and D)

OPTION III
0019
0020
0021
0022
0023

C.4 (See Note D)
7,524 CL

8,700 MM

4,630 MM

Notes A, B, and D)
4,630 MM

(See Notes C and D)
1 Lot

C.4 (See Note D)
7,900 CL

8.900 MM

4,700 MM
See
Note
B
$7,640,325
OPTION IV
0024
0025
0026
0027
0028

Notes A, B, and D)
(See Notes C and D)
Page 10 of 112
4,862 MM
1 Lot
See
Note
B
$8,022,341
0029
Transition Phase-Out (FFP) IAW Section C.3.2 (See Note

D)
1 Lot
CL Price per Claim

MM Price per Member per Month
Note A: The Government intends to procure services for 12 months from the date of award or
option exercise. However, in the event the contract is terminated or the Period of Performance
(PoP) is modified via a modification to the contract for a period less than 12 months, the
Government will only be responsible for the monthly services provided prior to and in the month
the contract was terminated or a contract modification was executed to revise the PoP. The
quantity represents the maximum quantity of Volunteers under this contract for the base and each
option year. This number of members per month may vary each month. The applicable CLIN is
invoiced monthly for the number of members per month in accordance with the eligibility roster
provided to the Contractor by Peace Corps staff on a daily and monthly basis.
Note B: The Contractor shall provide pricing for each sub-category of Short-Term Group Health
Insurance in the table below. The total quantity of Access to Group Health Insurance Policy
(Plan 4) shall not exceed the quantity stated in Section B above.
Contract Period
Base Award
Option I
Option II
Option III
Option IV
Sub-Category
Volunteer
Spouse
Dependent Child (18 years of age and under)
Dependent Child (19 to 26 years of age)
Volunteer
Spouse
Volunteer
Spouse
Volunteer
Spouse
Volunteer
Spouse
Page 11 of 112
Unit Price
Note C:
The amount represents the ceiling price for actual medical claims for the base year or option
period. The sum of medical claims shall not exceed this amount. The Contractor shall monitor
and account for all costs of medical claims under this contract. The Contractor shall notify the
Contracting Officer in writing whenever it has reason to believe that the costs it expects to incur
for medical claims in the next 90 days, when added to the costs of medical claims already paid,
will exceed 75 percent of the total amount so far allotted to the contract by the Government.
The ceiling price does not constitute a commitment, implied or otherwise, that the Government
will expend the entire amount in the base or option period. The aggregated ceiling price for
medical claims under this contract shall not exceed the base year and all option periods or
$36,469,166.00.
Note D: Option item to which the option clause in SECTION I-2 applies and which is to be
supplied only if and to the extent said option is exercised.
B.2. Contract Summary
This contract includes the following Firm Fixed Price (FFP), Fixed Price Economic Price
Adjustment (FP EPA) and Time and Materials (T&M) items:
Item
0001, 0002 0004, 0007
0009- 0011, 0014-0016
0019-0021, 0024-0026
Type
FFP
0005, 0012, 0017, 0022, and

0027
FP EPA
0006, 0013, 0018, 0023, and

0028
T&M ODC
0008
NSP
(End of Section B)
Page 12 of 112
SECTION C DESCRIPTION/ SPECIFICATIONS/ STATEMENT OF WORK

C.1. INTRODUCTION (Applicable to all Contract Line Item Numbers (CLINS))
The Statement of Work (SOW) (Section C) defines the technical and management requirements
for the Contractor to administer a Health Care Benefits Services (HCBS) contract for the Peace
Corps in an efficient and timely manner throughout the term of this contract. Section C includes
two categories of outcome-based statements. The Statement of Desired Outcomes represents
the desired outcomes for this contract. The desired outcomes are supported by Technical
Requirements. These requirements encompass the scope of the contract and represent specific
tasks, outcomes, and/or standards that, at a minimum, must be achieved.
The purpose of this contract is to provide the Peace Corps Community access to National and
International Health Care Networks, claims processing, health care support services (e.g. online
authorizations management, claims adjudication, access to claims data, guarantees of payment
(GOPs), air ambulances, etc.) and a short term group medical insurance policy for Returned
Peace Corps Volunteers (RPCVs).
C.1.1. Background. The Peace Corps is an independent executive agency of the federal
government established in 1961 by President John F. Kennedy to promote world peace and
friendship through the service of American volunteers abroad. The volunteers service fulfills
the three primary goals established in the founding legislation:
Improve the lives of people through grassroots assistance;
Foster a better understanding of Americans on the part of the people served; and
Foster a better understanding of other people on the part of Americans.
There are currently more than 7,000 volunteers serving in posts located in approximately 65
developing countries worldwide. The posts are divided into three regions:
Africa (AF),
Intra-America and Pacific (IAP), and
Europe, Mediterranean and Asia (EMA).
C.1.1.1. Office of Health Services (OHS) Mission. Peace Corps OHS manages healthcare
services for Invitees, Peace Corps Volunteers (PCVs), and Returned Peace Corps Volunteers
(RPCVs). The mission of OHS is to provide quality medical and mental health services and
support to the Peace Corps community through its Office of Medical Services (OMS). The health
care benefits program is comprised of both a self-insured and a commercially insured
component. In order to accomplish this mission, the Health Care Benefits Services (HCBS)
contract will supplement the services that are provided to the Peace Corps community via Peace
Corps internal team of onsite doctors and other medical professionals at approximately 65 Peace
Corps posts worldwide. These services will include: 1. managing cost-sharing financial
Page 13 of 112
assistance, and limited full reimbursement, for medical, dental, and vision examinations required
of Invitees in order for OMS to evaluate their health status and required vaccinations before
entering service, 2. providing access to national and international health care provider networks,
3. adjudicating authorized claims per requirements of this contract for eligible Invitees, PCVs
and RPCVs, and 4. providing access to short term group health insurance for RPCVs according
to the requirements of the contract.
C.1.1.2. Peace Corps titles for the stages of service. Applicant person who applies for service,
Invitee person who is invited to serve, Trainee entered service not yet sworn-in as Volunteer,
Peace Corps Volunteer (PCV) sworn-in to a typical two year service agreement, Returned
Peace Corps Volunteer (RPCV) ended service. For the purposes of this contract the word
Volunteer will include Trainees, PCVs and RPCVs.
C.1.1.3. Health Care Benefits Program Plans 1-4
PLAN 1 - Only US citizens are invited to serve in Peace Corps. Less than 1% of applicants
reside outside of the US and Puerto Rico. Peace Corps Invitees submit their medical receipts
after paying out-of-pocket or in accordance with their individual insurance, for exams or
immunizations required to be cleared for entry into the Peace Corps. Following the submission
of payment receipts, cost-sharing financial assistance is administered and provided directly to the
beneficiary. The maximum amount of cost-sharing for examinations is based on a formula that
corresponds to basic medical screening requirements; required immunization cost share is based
on country of assignment. A small number of invitees, normally less than 10%, are authorized
additional health care related items needed for service that are not subject to cost-sharing.
PLAN 2 - Countries with a Peace Corps program maintain a Health Unit to service the health
care needs of PCVs in-country. The Health Unit is staffed by a varying mix of host-country
nationals, third-country nationals and/or Americans. The levels of education and training for the
medical professionals in each country vary and can include one or a combination of the
following: Registered Nurses (RNs), Nurse Practitioners (NPs), Physician Assistants (PAs),
Peace Corps Medical Officers (PCMOs) and Medical Doctors (MDs). The Peace Corps employs
Regional Medical Officers (RMOs) all RMOs are Medical Doctors. Currently, there is an
RMO at each of the following locations: Morocco, South Africa, and Thailand (subject to
change). The care provided by these staff members is not covered by this contract.
PCVs overseas who require non-routine or emergency medical, mental health, or dental
evaluation and treatment may be medically evacuated aka "mede-vaced" to the US or to regional
locations worldwide. Washington, D.C. is the most common US medevac site followed by the
PCVs home of record. Abroad Peace Corps primarily med-evacs PCVs to its RMO hubs but
transports to other locations as needed. On occasion Guarantee of Payments (GOPs) or preestablished relationships are needed in order to accept med-evacs at certain facilities. Most medevaced PCVs travel is arranged by Peace Corps, however, there are situations (less than 10/year,
on average) when Peace Corps requires an air ambulance in order to safely medevac a volunteer.
While these services could be required anywhere worldwide, the Peace Corps web site identifies
in which countries Volunteers currently serve (subject to change):
http://www.peacecorps.gov/volunteer/learn/wherepc/
Page 14 of 112
Volunteers on leave or official travel status may utilize the National Network in all 50 states, the
District of Columbia or Puerto Rico. Volunteers may require air ambulance services from their
country of service or any country to which the Volunteer may travel during their Peace Corps
service. Volunteer travel is not prohibited during such periods as vacation or home leave, and
the Volunteer is fully covered under Plan 2 during all phases and aspects of service -- including
vacation and home leave. When in the US or abroad on leave or official travel status, PCVs who
require routine and non-routine medical or dental care receive health care services from
providers whose costs are paid for by Peace Corps through a self-insured health benefits
program. This includes all pharmacy needs. All healthcare services/needs provided to
beneficiaries must be pre-authorized by Peace Corps and are reimbursed to the beneficiary or
paid to the provider. Peace Corps currently issues authorizations on a case-by-case basis via a
paper authorization process. Authorizations can currently be issued by any Peace Corps health
care provider domestic or international (i.e. medical doctor, nurse, dentist, etc.).
Plan 3 - For six months after the end of service, the Peace Corps may authorize RPCV medical
evaluations for Conditions of Coverage while Serving Abroad. Peace Corps will pay for
treatment for Conditions of Coverage while Serving Abroad as defined in the Division of Federal
Employee Compensation (DFEC) Procedure Manual Federal Employee Compensation Act
(FECA) Part 2, Group 5, Chapter 2-1701, Peace Corps Cases, which may be found at the
following link: https://www.dol.gov/owcp/dfec/regs/compliance/dfecfolio/FECAPT2/group5.htm#217019 Otherwise RPCVs must file a FECA claim through the Department of
Labor (DOL). RPCVs may be eligible for FECA benefits under DOL regulations if they meet
required criteria. These services related to RPCVs are referred to as benefit PLAN 3.
Plan 4 Peace Corps offers short term group health insurance to RPCVs (and applicable
dependents) available for up to three months after End of Service (EOS). At its discretion, the
Peace Corps will pay the first months health insurance premium for RPCVs and eligible
dependents. The RPCV has the option to buy an additional two months of the same coverage at
the same monthly rate the Peace Corps pays.
C.1.1.4. Peace Corps Electronic Medical Records. OHS recently launched an Electronic Health
Record (EHR) system, acronym, PCMEDICS. PCMEDICS was deployed to all posts in the
Fall of 2015. The Peace Corps has since fully transitioned all current and new volunteers from
paper files to PCMEDICS as of February 2016. PCMEDICS is deployed in a hub-and-spokes
configuration: the hub is a cloud instance, and it contains the complete dataset of all global
records; and the spokes are discrete PCMEDICS installations on servers located at each
individual post, containing only local data. The local data is automatically synchronized with the
cloud data across the Peace Corps Virtual Private Network (VPN) on a regular basis. For more
specific information about how Peace Corps PCMEDICS can integrate with outside systems see
Section C.2.3.8. The other systems, acronyms used, utilized by OHS are MAXx and DOVE.
DOVE is the system in which US Citizens apply for Peace Corps Service. MAXx is the medical
module of DOVE a system in which applicants submit medical forms/information used by the
Pre Service Unit nurses who are able to access these files. In addition the Agency relies on other
systems, which track the official service computation dates (i.e. EOS dates), country of service
Page 15 of 112
and home of record for all volunteers. OHS utilizes the data in DOVE and these other systems to
feed the OHS systems or provide data to outside sources.
C.1.2. Reserved
C.1.3. Statement of Desired Outcomes (SDO). The primary outcomes of the Health Care
Benefits Services (HCBS) contract are as follows:
C.1.3.1. Objective 1 Claims Processing. Prompt, efficient and accurate processing and
adjudication of all claims that fall within the scope of the contract, to include development,
coding, processing, medical/dental review, accepting Peace Corps authorizations and verifying
for accuracy and completeness and data record submission and sustainment.
C.1.3.2. Objective 2 Customer Satisfaction. Customer satisfaction at the highest level, to
include: accurate, timely, and efficient health care claims processing services; polite, friendly,
responsive customer support; user-friendly online portals and chat mechanisms; easy provider
searches; benefits questions; air ambulance /Guarantee of Payment (GOP) requests; and claims
information.
C.1.3.3. Objective 3 - Management. Provision of efficient and effective management processes
which will ensure the successful delivery of health care benefits support as required by the
contract (including, but not limited to, appropriate staffing levels, staff education and training,
internal quality management/quality improvement program, lines of authority, and reporting and
coordinating interfaces with the Government).
C1.3.4. Objective 4 - Provider Networks. Availability and management of high quality,
expansive health care provider networks, both nationally and internationally (to include
credentialed hospitals, physicians, ancillary service providers, mental health professionals,
dentists, pharmacies, diagnostic and treatment facilities, and air ambulance services), in
accordance with the contract requirements.
C.1.3.5. Objective 5 Short Term Group Health Insurance. Provide an affordable short term
health insurance policy that meets the minimum requirements established by this contract.
C.1.3.6. Objective 6 Transition. Fully operational systems and processes at the start of health
care delivery with minimal disruption and seamless transfer of services from and to a new
contract.
C.1.4. Government Furnished Information
The Government will provide the Contractor Government Furnished Information (GFI)
necessary to effectively perform under this contract. GFI is described below:
C.1.4.1. Medical Information. Peace Corps will provide to the Contractor pertinent medical
information, on a case by case basis. The Contractor shall protect the confidentiality of protected
health information received from the Peace Corps in accordance with Peace Corps policy and all
Page 16 of 112
applicable laws and regulations (including Health Insurance Portability and Accountability Act
(HIPAA) of 1996 requirements and the Privacy Act).
C.1.4.2. Eligibility Rosters - Peace Corps eligibility rosters will be provided on a daily basis,
Monday through Friday on Federal workdays. Peace Corps may also send a weekly or monthly
file that provides updates/corrections to previously provided data. These reports identify an
individuals eligibility at that time, as well as their Personally Identifying Information (PII). The
eligibility file currently contains the following data elements: Volunteer ID (this number can
vary in length, it currently doesnt exceed 9 digits), Social Security Number (SSN), medical plan
status (pre-service, in-service, post-service), Plan Number (1,2 or 3), Effective Date (eligibility
start date), Termination Date, Last Name, first name, middle name, birth date, gender, marital
status, telephone number, e-mail, Country Code (code used by Peace Corps to identify country of
service), Type of Service (PCV or PC Response [PC Response is short-term, high impact service
assignments]), street , city, state, zip, foreign care of address (if exists). Currently serving
volunteers in Plan 2 can reapply and be invited to serve an additional term. As a result there are
cases in which an individual may be in several Plans concurrently. Some examples of these
phenomena are listed as scenarios below:
1) PCV Plan 2 reapplies and is invited No EOS. Individual would be Plans 1 and 2 eligible
concurrently.
2) PCV Plan 2 reapplies and is invited EOS date established. Individual would be Plans 1 and
3 eligible, and enrolled in Plan 4 concurrently.
Currently, this information is provided through a Secure File Transfer Protocol (SFTP). Under
this contract, the Peace Corps may exercise option 0007, which will facilitate the eligibility and
authorization process through automation (see Section C.9.).
C.1.4.3. Health Care Authorizations A Peace Corps authorization for medical services, also
referred to internally as form 127C or 209B (See Attachment J.3) may be issued by any
medically licensed Peace Corps health care clinician domestic or abroad. On the form the
clinician describes in detail the services that are authorized to be paid by Peace Corps. The
authorization document contains the following types of information: Volunteers name,
Volunteers Social Security Number or Volunteer ID, Volunteers country, authorizations
expiration date, medical plan status (pre-service(Plan 1), in-service (Plan 2), post-service (Plan
3)), End of Service (EOS) date (if applicable), providers name (if applicable), specialty (if
applicable), problems/symptoms/ History (HX), services authorized, authorizer, authorization
date. The form also provides billing instructions for the provider or beneficiary. Peace Corps
currently sends a copy of the completed authorization form to the Contractor, via mail, facsimile
(fax) or Secure File Transfer Protocol (SFTP). An additional copy is provided to the beneficiary
to use for reimbursement or to submit to the provider for their payment processing needs.
Currently, the authorization process is paper-based; however, the Peace Corps may exercise
option 0007 which will facilitate the healthcare authorization process through an automated
system (see Section C.9). Please see Section C.2.3.8 for more information regarding health care
authorization data integration.
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C.1.5. Contractor Furnished Items. The Contractor shall furnish all necessary items (e.g.,
facilities, labor, services, supplies, etc.) for the satisfactory performance of this contract, unless
the contract specifically states that the Government will be providing such items (as identified in
C.1.4. Government Furnished Information or elsewhere within the contract).
C.2. TECHNICAL REQUIREMENTS (Applicable to CLINS 0002, 0003, 0004, and 0005
(and if options are exercised) 0009 through 0012, 0014 through 0017, 0019 through 0022
and 0024 through 0027)
The technical requirements for the HCBS contract are identified below. These requirements are
augmented by the statutes, regulations, and other operating guidelines and instructions
incorporated by reference as noted in Section H.17. Statutory and Regulatory Authority. Peace
Corps is especially committed to doing no harm, to acting in good faith, and to preserving its
reputation as an agent of goodwill in the eyes of beneficiaries of its Health Care Benefits
Program and of the American public. The Contractor, therefore, shall provide access to high
quality, responsive, timely healthcare and administrative services in a manner that preserves
Peace Corps good working relationship with beneficiaries of its Health Care Benefits Program.
The Contractor shall provide:
C.2.1. Customer Service. The Contractor shall provide comprehensive, readily accessible
customer services that include multiple, contemporary avenues of access (i.e., e-mail, World
Wide Web, self-service options, telephone, and facsimile) for Volunteers and Providers.
Customer service shall be delivered in a manner that achieves the objectives of this contract
without charge to Volunteers or Providers. The Contractor shall perform all customer service
functions with knowledgeable, courteous, responsive staff.
C.2.1.1. Call Center Service. The Contractor shall establish telephone Call Center service. The
Call Center shall have a tracking and/or ticketing system to manage calls and inquiries, ensuring
all calls are logged within three hours and responded to within three business days. It is the
Contractors responsibility to ensure adequate, trained Call Center staff is always on duty. A tollfree number for Volunteers and Providers to call into shall be available (along with phone and
email access for the hearing impaired). A collect telephone number or telephone number without
long distance charges to call into shall be available for Volunteers and Providers calling outside
the fifty United States (U.S.) and District of Columbia (D.C.) and/or unable to access the Call
Center Service via the toll-free number. Customer service representatives shall be available per
commercially standard days and times (minimum 8:00 am to 9:00 pm Eastern Standard Time
(EST) Monday-Friday) to Volunteers, Providers and Peace Corps Staff seeking case-specific and
general information (i.e. pharmacy authorization, assistance in locating a provider) or other
inquires relevant to the services provided under this contract. At least one Customer Service
Representative shall be available 24 hours a day, 365 days a year to respond to emergencies,
requests for GOPs and air ambulance services.
C.2.1.2. Web Portal Service. The vendor shall stand-up and maintain a web portal with a mobile
platform accessible 24 hours per day, 365 days a year (unless down for planned scheduled
maintenance) to Peace Corps staff, Volunteers and Providers for claims information, Volunteer
eligibility information, provider information, pharmacy network information, details about the
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group insurance coverage, access to necessary paperwork and forms, links to the customer
support unit and any other additional information relevant to Peace Corps Health Care Benefits
Services. The Web portal shall be user friendly (easy to navigate) to ensure Peace Corps staff,
Volunteers, and Providers can quickly find information. The Contractor shall use Federal
Government-approved security such as Hypertext Transfer Protocol Secure (HTTPS) to secure
the transfer of information over the portal. The Contractor shall maintain an accurate, readily
accessible, up-to-date searchable list identifying all network providers. This list must be userfriendly and readily searchable by provider or facility name, specialty or type of facility,
subspecialty, gender (for individual providers), service area, work address, work fax number,
work telephone number, any limitations of service, and whether the provider is accepting new
Peace Corps (PC) patients. The information contained in an electronic list shall be current within
the last 30 calendar days. In the event a Provider loses its accreditation, certification and/or state
or foreign licensing (if applicable), the Contractor shall update the provider network list within
24 hours of receiving the information.
C.2.1.3. Data Access. The Contractor shall provide a minimum of two licenses or authorizations
(whichever is applicable) to Office of Health Services (OHS) and up to four additional licenses
or authorizations to be assigned at the discretion of the Government to authorized Government
personnel (as determined by the CO) providing unlimited off-site electronic access to all data
maintained by the Contractor pertaining to the HCBS contract. This data shall include, but is not
limited to, network(s) usage, out-of-network provider usage, health care authorizations, claims
details and status, and Volunteer satisfaction information. All data must be current, accurate,
complete and accessible in real time. Real time is defined as data that is refreshed at least once
every 24 hours. The Contractor shall also provide read-only access to claims and enrollment data
to Volunteers via web portal and any additional information agreed to by the parties.
C.2.2. Claims Processing.
The Contractor shall establish, maintain, and monitor an automated HIPAA compliant claims
processing information system to ensure that claims (including adjustments) are processed in an
accurate and timely manner, and meet the functional system requirements as set forth in Section
H.11. Information Security.
C.2.2.1. Procedures for Processing Claims. The Contractor shall develop and deliver one hard
copy Claims Processing Procedures Manual (Contract Data Requirement ((CDR) A005) 30 days
after contract award in accordance with Section F, and maintain an ongoing electronic Claims
Processing Procedures Manual accessible online to the Peace Corps. The electronic online
procedures manual shall be available within 30 days after contract award in a format mutually
agreed by the Contractor and the Government. The manual shall include procedures for
reviewing, resolving and following up on claims pended or denied due to: lack of authorization,
questions regarding participant eligibility, incomplete itemization, non-standard claims
information, balance billing, excess charges, procedural errors on the part of the Volunteer or
Provider and questions regarding whether services are allowable under Peace Corps Health
Benefit Program. The manual shall provide procedures which allow claims requiring additional
information to be returned for the missing information. The manual shall ensure that all required
information is requested with the initial return and that no claim is returned for information that
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could have been obtained internally or from information provided from the Peace Corps. The
manual shall include language advising beneficiaries that claims for payments submitted beyond
one year from the original date of service will be rejected. Additional areas to address, although
not comprehensive are:
Points of Contact for the Claims Department or equivalent (allowing Peace Corps staff to
speak directly to claims processers regarding specific cases) and other key Contract
personnel, their phone and fax numbers, e-mail address and mailing addresses;
Appeals procedure consistent with the requirements set forth under the Affordable Care
Act.Details can be found at: http://www.hhs.gov/healthcare/about-the-law/cancellationsand-appeals/appealing-health-plan-decisions/index.html (The term Third Party,
referenced in the ACA procedures means Peace Corps for the purposes of this contract.);
Procedure for resolving complaints between Peace Corps personnel or Peace Corps
Health Care Benefits Program members and the Claims Contractor's healthcare claims
processing system personnel or customer service agents regarding authorizations or
claims inquiries;
Business rules used to program the healthcare claims processing system logic for
eligibility, allowable benefits, and reimbursement/payment rates for claims made under
the four benefit PLANs (CLINS 0002, 0003, 0004 and 0005 (and if options are exercised)
0009 through 0012, 0014 through 0017, 0019 through 0022 and 0024 through 0027);
Examples of the Explanation of Benefits used for Peace Corps health benefit plans;
Procedure and medium to be used by Peace Corps to transmit eligibility information to,
authorize services, and obtain information from the healthcare claims processing system;
Procedure to be used by Peace Corps to access health plan information via electronic
interface;
Procedures to be undertaken in the event of electronic interface failure or healthcare

claims processing system shut-down.
C.2.2.2. Claim Processing Timeliness and Quality Standards. The Contractor shall ensure that
claims (including adjustments) are timely and accurately processed and adjudicated for all care
provided to Volunteers in accordance with the Peace Corps timeliness and quality standards
provided below:
Claims and supporting documentation shall be accurately entered into the Contractors
claims processing system within 24 hours after receipt;
Claims shall be adjudicated within 20 business days for claims inside the fifty United
States (U.S.), Puerto Rico, and District of Columbia (D.C.);
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Claims shall be adjudicated within 30 business days for claims originated outside the
fifty U.S. States, Puerto Rico, and D.C.;
Clean claims shall be paid to third party Providers within 20 business days of receipt.
For the purposes of this Contract, a clean claim is defined as one submitted on behalf
of an eligible Volunteer for authorized, allowable healthcare services that were provided
in the U.S. and are appropriately documented;
Clean claims shall be paid to beneficiaries within 20 business days of receipt. For the
purposes of this Contract, a clean claim is defined as one submitted on behalf of an
eligible Volunteer for authorized, allowable healthcare services that were provided in the
U.S. and are appropriately documented;
Claims for payment that are submitted beyond one year from the original date of service
shall be rejected; and
Guarantee of Payments issued to international providers shall be available 24 hours a day,

365 days a year per request of Peace Corps staff.
C.2.2.3. Medical Coding. The Contractor shall utilize and report for each claim the most current
National Uniform Billing Committee (NUBC) hospital revenue codes, Center for Medicare
Services (CMS) revenue codes, CMS Healthcare Common Procedure Coding System (HCPCS)
Level II codes, Current Procedural Terminology (CPT), International Classification of Diseases
(ICD) diagnosis and procedure codes, Diagnostic and Statistical Manual (DSM) and American
Dental Association (ADA) codes for all health services referenced in the claim.
C.2.2.4. Explanation of Benefits. The Contractor shall provide each beneficiary and provider an
appropriate Explanation of Benefits (EOB) i.e. beneficiary name, provider name, date processed,
date of service, information regarding appeal rights, including instructions for filing an appeal.
The EOB shall also include notice that reimbursement/payment was made in accordance with
Peace Corps Health Benefits Program policies; (1) that reimbursement/payment for claims made
under PLAN 1 (CLIN 0002) are in accordance with Peace Corps Plan 1 Cost Reimbursement
Fee Schedule (see Attachment J.6); and (2) that reimbursement/payment made under PLAN 2
and PLAN 3 (CLINs 0003 and 0004) are considered payment in full. In no case should the PCV
or RPCV under PLANs 2 and 3 (CLINs 0003 and 0004) be billed for authorized health care
services. The Peace Corps Health Benefit Program prohibits billing beneficiaries for authorized
health care services or differences between claims made and claims paid. The processing date of
the oldest claim for the summary EOB shall not be greater than 31 calendar days.
C.2.2.5. Financial Administration. The Contractor shall provide financial administration as
follows:
Conduct internal audits for all claims greater than $20,000 (twenty thousand dollars)
made for services provided to a single payee on behalf of a single beneficiary for a single
incident;
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Have the ability to track total costs paid (and costs denied) by fiscal year and segregated
by Invitee, PCV and RPCV;
Have the capability of making Electronic Funds Transfers (EFTs) for both domestic
beneficiaries/providers and international bank transfer payments via correspondent U.S.
financial institutions;
Report all costs in U.S. currency;
Coordinate payment related service including a Guarantee Payment Letter, if needed and
when medically necessary or upon request of the CO;
The Contractor is not required to pay any interest payments on claims paid later than 20
business days; and
Recommend measures to control or reduce costs for the medical treatment services
provided to Volunteers.
Have a processing system and business rules that will identify billing that is substantially
in excess of reasonable and customary charges for the providers locality.
C.2.2.6. Flagged Claims Processing. The Contractors claim processing system shall have the
capacity to flag claims that are potentially fraudulent, abusive or wasteful. In order to flag
potentially fraudulent claims, the contractors claim processing system at a minimum shall:
verify individual eligibility for benefits;
ensure only claims for allowable services are reimbursed/paid;
ensure reimbursements/payments do not exceed established schedules;
eliminate reimbursement/payment of duplicate claims;
compare claims made to claims reimbursed/paid;
reconcile diagnosis codes to procedure and gender codes;
compare the number of inpatient facility days on each claim against admission and
discharge dates; and
have the capacity to process claims under subrogation and claims involving no-fault.
C.2.2.7. Subrogation Services. The contractor shall perform subrogation services on all claims
that indicate potential liability by other parties. All funds received by the contractor for
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subrogation services shall be returned to the Peace Corps. The contractor will reflect these funds
in the vouchers for reimbursement.
C.2.2.8. Claims for Pharmaceuticals. Claims for pharmaceuticals paid under this contract shall
meet US equivalent or international standards. Medications that are considered over-the-counter
by U.S. standards are not authorized for reimbursement.
C.2.2.9. End of Health Care Benefits. Plans 1-3 claims received by the Contractor during its
period of service delivery are required to be processed to completion within 180 calendar days
following the end of the contract Period of Performance (POP). There will be no medical claims
processing fee paid to the Contractor if the 180 calendar day requirement is not met.
C.2.2.10. Appeal Process. A claim dispute is a disagreement regarding a claim or utilization
review decision. The Contractor shall manage an internal appeal process to resolve claim
disputes, whereby eligible members may submit an appeal in writing by mail or through a web
portal or a phone call, to a toll-free number, or number that accepts collect calls from
international members, to the Contractor. The Contractor shall administer claims appeal
procedures consistent with the requirements set forth under the Affordable Care Act (see
http://www.hhs.gov/healthcare/about-the-law/cancellations-and-appeals/appealing-health-plandecisions/index.html (The term Third Party, referenced in the ACA procedures means Peace
Corps for the purposes of this contract.))
C.2.3. Management.
The Contractor shall establish and maintain a single management focal point to accomplish
effective management strategies, lines of authority, and reporting and interfacing with the
Government. The Contractor shall organize, coordinate, control, and report the status of
activities, including those activities assigned to subcontractors, to ensure correct and timely
delivery of services specified in this contract in accordance with Section C.10. Data and
Reporting Requirements. The management focal point at a minimum is required to ensure the
following:
C.2.3.1. Credentialing. The Contractor shall establish and operate a provider credentialing
program to ensure that all network Providers are qualified to provide high quality care that is
commensurate with the HCBS contract and local requirements. During the credentialing process,
the Contractor shall check the U.S. Department of Health and Human Services (DHHS) List of
Excluded Individuals and Entities (LEIE) (http://exclusions.oig.hhs.gov/) for network providers.
Providers listed on the DHHS LEIE are excluded from providing services under all federal
programs. This restriction remains in place even if a network provider begins practicing in
another country. Credentials for network providers shall be verified by the contractor during the
network development/network agreement process.
C.2.3.2.Accreditation. The Contractor shall ensure that network hospitals and other places of
institutional care shall meet accreditation standards of the specific host nation or U.S.
commonwealth/territory.
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C.2.3.3. Quality, Safety, and Compliance Evaluations. The Contractor shall establish processes
to evaluate the quality, safety, and compliance with licensure/certification and malpractice
insurance requirements of network medical institutions and maintain such evaluations for
inspection by the Government. Evaluations shall be updated every three years at a minimum
unless specifically waived by the CO.
C.2.3.4. Medical Malpractice Coverage. The Contractor is responsible for determining the
medical malpractice coverage required in the country, province, state, commonwealth/territory,
etc. for each network provider (both professional and institutional) and ensuring that each
network provider is in compliance with this standard. In the absence of any country, province,
state, commonwealth/territory, etc., legal requirement for medical malpractice insurance
coverage, the Contractor is responsible for determining the local community standard for
medical malpractice coverage, and the Contractor must maintain documentation evidencing both
the standard and compliance by network providers. Each network provider agreement must
indicate the required malpractice coverage. Evidence documenting the required coverage of each
network provider under the contract shall be provided to the CO upon request. Network
providers that are country, province, state, commonwealth/territory, etc., entities and are selfinsured by the country, province, state, commonwealth/territory, etc. are not required to have
medical malpractice insurance. The CO retains the authority to determine whether country,
province, state, commonwealth/territory, etc., and/or local requirements and/or community
standards for medical malpractice coverage have been met by a network provider and whether
the Contractor has documented the required coverage.
C.2.3.5. Financial Rating. The Contractor shall maintain a current minimum financial strength
rating of A- (excellent) as assigned by the A.M. Best Company (A.M. Best) and/or Standard and
Poors current minimum rating of AA (very strong). The Contractor shall provide satisfactory
assurances, via the Annual Contract Activity Report, (CDR A006), that the Contractor and all
subcontractors, insurers, claims and program administrators maintain acceptable financial
stability, required licensing and service ratings from rating organizations such as A. M. Best
and/or Standard and Poors.
C.2.3.6. Contracting Officer Representative (COR). The Contractor shall keep the COR apprised
of incidents, situations, and circumstances that affect the administration, management, financial
viability or costs associated with its health insurance program and recommend action to resolve
those issues.
C.2.3.7. Records Management. The Contractor shall maintain copies of all financial transaction
records (including but not limited to purchase orders, paying bills, collecting debts and invoices)
generated during implementation of this contract. At the end of the contracts final period of
performance, the Contractor shall deliver to Peace Corps all records, in accordance with Section
F.2. CDR A010 Financial Transaction Records.
C.2.3.8. Standard Services. Peace Corps has the following standard services in place for hosted
solutions and/or software as a service The Contractor and its subcontractors must leverage these
services and be in compliance with these requirements no later than 30 days before the start of
health care delivery.
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Any hosted Software as a Service (SaaS) or portal solution, if offered, shall integrate with
Peace Corps existing Active Directory, multifactor authentication, single sign-on and
identity management infrastructure for staff. This is not a requirement for Volunteer
access. Risk-Based Authentication (RSA), Active Directory Federation Service (ADFS)
and Forefront Identity Manager (FIM) are standard tools used by Peace Corps.
The Peace Corps currently manages all system to system data integrations using
Microsoft BizTalk with the Enterprise Service Bus (ESB) toolkit installed.
To support inbound software integrations from the vendor to Peace Corps, the Peace
Corps will host a Representational State Transfer (RESTful) web service that will accept
JavaScript Object Notation (JSON) structured data and command information. Any long
running operations will be implemented asynchronously.
When the Peace Corps integrates Headquarter (HQ) hosted systems with the vendors software,
it is expected that the vendor will host either a RESTbased or Simple Object Access Protocol
(SOAP)based web service and that data will be structured in either Extensible Markup
Language (XML) or JSON. The Peace Corps will develop any integration required to update the
vendors solution with data from Peace Corps systems.
C.2.3.9. Confidentiality. The Contractor shall document and employ management procedures to
ensure confidentiality of all beneficiary and Provider information, including protection of rights
of the individual in accordance with the Privacy Act (5 U.S.C. 552a). The Contractor shall
prevent unauthorized use of files and must comply with all applicable requirements of the Health
Insurance Portability and Accountability Act (HIPAA) of 1996.
C.2.3.10. Meetings. The Contractor shall be available for monthly meetings with the COR to
review reports, discuss general program operation and address any issues or concerns. Meetings
may be held via teleconference or video conference. The Contractor is responsible for the
meeting agenda. The date and time and method of meetings will be mutually agreed between the
Contractor and Government. The Contractor shall be available to communicate on a regular basis
via telephone or email, to address any problems that arise in the administration of this contract.
The Contractor shall participate in a post-award (contract kick-off) meeting within 45 days after
contract award. The post-award meeting will be held at the Contractors facility or via
teleconference or video conference.
C.2.4. Quality Control and Assurance.
C.2.4.1. Quality Control. The Contractor is responsible for the quality of all work performed
under this contract. The Contractor shall implement processes and procedures to promote and
assure health care quality and value according to the general principles outlined in the Health
Care Industrys Consumer Bill of Rights and Responsibilities as developed by the Presidents
Advisory Commission on Consumer Protection and Quality (see http://archive.ahrq.gov/hcqual/
). The Contractor shall document and employ management procedures to ensure confidentiality
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of the Volunteers and Providers information. This includes the protection of rights of the
individual in accordance with the provisions of the Privacy Act (5 U.S.C. 552a).
C.2.4.2. Internal Quality Control/Quality Improvement Plan. To ensure work performed meets
the requirements under this contract, the Contractor shall establish and continuously operate an
Internal Quality Control/Quality Improvement Plan (IQC/QIP). The IQC/QIP will be approved
by the COR 30 days after contract award and annually thereafter (see section F and CDR A012)
The IQC/QIP shall set forth staffing, quality practice, internal controls, quality management plan,
procedures and guidelines to be used in ensuring the required performance standards and service
levels are achieved. The IQC/QIP shall at a minimum address:
timely and accurate claims processing;
monitoring and improving customer service response times;
procedures for reviewing and resolving complaints. Complaints are defined as verbal or
written notices of dissatisfaction;
effective and efficient management; and
procedures for terminating affiliation with hospitals, physicians, ancillary service

providers, mental health professionals, dentists, and diagnostic and treatment facilities
affiliated with provider networks.
The Contractor shall self-inspect quality, timeliness, responsiveness, and customer satisfaction
and establish a QIP when performance does not meet the requirements herein. The work to be
measured under this contract shall be for work performed by the Contractors employees or by
subcontractors.
C.2.4.3. Quality Assurance. The role of the Government is to implement and conduct adequate
contract surveillance and quality assurance to ensure contract requirements and standards are
satisfactorily performed. The Contractor shall be responsible for making required changes in
processes and practices to ensure performance is managed effectively. For these purposes, the
Contractor shall prepare a Quality Assurance Surveillance Plan (QASP) per FAR subpart 37.604
-- Quality Assurance Surveillance Plans for the Governments consideration in development of
the Governments plan. Requirements for quality assurance and quality assurance surveillance
plans are in Federal Acquisition Regulation (FAR) Subpart 46.4.
C.3. TRANSITIONS. (Applicable to CLIN 0001 and (if option is exercised) 0029)
To successfully execute transition of health care services to a new contract, the Government has
established a Government Transition Team (GTT) (See Attachment J.5). The purpose of the
GTT is to confirm the readiness for the transfer of responsibilities from the current contract to
the new Contract, provide oversight of the transition, and interface with the awardee of the new
contract. The GTT will consist of: OHS Chief Administrative Officer, the Health Care
Resources Program Manager, and CO.
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Upon award of the contract, the Contractor shall comply with transition requirements provided
herein to facilitate a seamless transfer (phase-in) of duties to a new contract. At the conclusion
of this contract and if the option is exercised, the Contractor shall meet with and provide to the
successor Contractor and/or Government the information necessary to facilitate a seamless
transition (phase-out ) in accordance with the requirements herein.
C.3.1. Transition Phase- in. (Applicable to CLIN 0001) The Contractor shall document via a
transition plan (CDR A013) the process for the transition of duties, activities, and functions of
tasks and tools for the transition to this contract. The plan shall include the following:
Overall approach for transitioning, such as but not limited to who will manage the
transition, how long will the transition take (must be within the Period of Performance
(PoP) identified in Section F), will the transition team stay on after the transition period
and if so what will their roles be;
Organization chart showing roles and responsibilities of key personnel involved in the
transition;
Level of work to be performed during the transition;
Subcontractor, if any, and their roles in the transition;
Schedule showing major milestones as well as start and completion dates;
Identify all of the sources of risk during the transition period and a mitigation plan to
address these risks; and
Discuss any previous experience managing a transition phase-in, including such things as
the size and timeline of the transition.
The GTT will be responsible for approving and verifying Contractor performance readiness prior
to the delivery of health care services.
C.3.2. Transition Phase-out. (Applicable to CLIN 0029) The Contractor recognizes that the
services under this contract are vital to the Government and must continue without interruption
and that, upon contract expiration, services will have to be transitioned under a new contract. The
contractor shall implement a phase-out plan (CDR A015) that includes but is not limited to the
following:
Implement a transition phase-out plan to successfully transition from the current contract
to the new contract;
Exercise best efforts and cooperation to effect an orderly and efficient transition from the
current contract to the new contract;
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Negotiate in good faith a plan with successor, if other than the incumbent, to determine
the nature and extent of the phase-out services required; and
any additional information agreed to by the parties.
Two separate plans are not required. The Contractor may provide one plan that addresses both
the phase-in and phase-out efforts. However, please note that the Contractor is to provide
segregated prices in accordance with Section B.
C.4. INVITEE COST-REIMBURSEMENT ADMINISTRATIVE SERVICES (PLAN 1).
(Applicable to CLIN 0002 and (if options are exercised) 0009, 0014, 0019 and 0024 The
Contractor shall provide all personnel, supplies, services, and facilities necessary to provide
health care administrative services for Invitees as follows:
C.4.1. Invitees for Peace Corps service require medical, dental, and vision examinations used by
the Office of Medical Services (OMS) to evaluate health status. Where necessary certain
vaccines may also be required before entering service. Most Invitees to the Peace Corps are not
fully reimbursed for medical, dental, vision screening, or vaccination expenses. Instead they
are provided a cost share form for certain out-of-pocket expenses. Cost-sharing assistance is
based on pre-determined eligibility and proof of out-of-pocket cost. Cost-sharing maximum
allowances are based on basic medical screening requirements for various patient populations
(See attachment J.6 Plan 1 Reimbursement Fee Schedule). However, there are small subsets
of Invitees to certain programs where full reimbursement is authorized. Services related to
Invitees are referred to as benefit PLAN 1.
C.4.2. The Contractor shall provide access to a network of physicians, laboratories and ancillary
service providers for Invitees to Peace Corps and shall be responsible for issuing, managing,
administering, tracking and distributing reimbursements and cost-sharing allowances for eligible
Invitees in accordance with the requirements herein. The Contractor shall provide the
Government a monthly report summarizing all activities in accordance with (IAW) CDRL A016.
C.4.3. Peace Corps will identify cost-sharing allowance ceilings for CLIN 0002 (Plan 1)
beneficiaries (see attachment J.6, Plan 1 Cost Reimbursement Fee Schedule). Peace Corps
may cite exceptions and allow for cost-sharing or reimbursement above and beyond the
established ceiling for an individual or group. Exceptions are normally done via an additional
cost share form or an individual authorization.
C.5. HEALTH CARE ADMINISTRATIVE SERVICES FOR PCVS (PLAN 2) (Applicable
to CLIN 0003 and (if options are exercised) 0010, 0015, 0020 and 0025) The Contractor shall
provide all personnel, supplies, services, and facilities necessary to provide health care
administrative services for Peace Corps Volunteers as follows:
C.5.1. Peace Corps Volunteers. Peace Corps is the primary insurance provider for PCVs. While
overseas, PCVs receive routine and emergency medical care, preventive health services, health
promotion and disease prevention education, and advice from health care professionals at Peace
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Corps posts. In addition, PCVs receive care from international healthcare providers such as but
not limited to doctors, counselors, dentists, and other medical specialists. Most of this care is
managed and paid for out of each individual posts budget. However, at times Peace Corps may
require overseas Providers to be identified, vetted, and compensated via the services provided
under this contract. Some beneficiaries may receive care in the US while on authorized leave,
official business/training, or medical leave (i.e. medical hold). Some care may include
emergency air ambulance transportation. Services related to PCVs are referred to as benefit
PLAN 2.
C.5.2. Provider Network Component. The Contractor shall provide access to a national network
in the fifty United States states, District of Columbia and Puerto Rico as well as an international
network. Both the national and international Networks shall consist of credentialed hospitals,
physicians, ancillary service providers, mental health professionals, dentists, and diagnostic and
treatment facilities with the capacity to meet the healthcare needs of PCVs while in the United
States or overseas (when authorized). The Contractor shall maintain an accurate, readily
accessible, up-to-date searchable list identifying all network providers. PCVs shall be provided
identification cards for the national network in order to provide a mechanism that permits
individual access to Providers in the network anywhere in the US including Alaska, Hawaii and
Puerto Rico. This includes coverage for the PCV while in travel mode between or among
domestic and international destinations. In order to provide priority care to PCVs there are
several providers that offer additional or pre-arranged discounts and priority care for mede-vaced
volunteers. See Attachment J.2 Panel Providers for a list of applicable providers. Priority
care includes, but is not limited to:
24-hour phone access for purposes of emergency inquiry and 24-hour access to
emergency evaluation and treatment facilities 365 days/year;
Priority in-network referrals for evaluation and treatment;
Paper consults including, but not limited to: 1) a complete response to a telephone inquiry
or written report issued by the service provider within 24 hours of an evaluation or
treatment, and 2)a written report issued by the service provider within 5 business days of
the end of a course of evaluation and/or treatment;
Establish, administer, and facilitate a procedure that permits access to other qualified
physicians, mental health professionals, and dentists referred by Peace Corps who agree
to these priority care requirements;
Inform these providers of the Peace Corps service requirements and policies prior to
contract implementation and do so again within 30 days following any subsequent
contract renewal or contract modification that affects service requirements or operating
procedures.
C.5.2.1. The Contractor shall ensure that practitioners and facilities affiliated with National and
International Networks, or where claimsare negotiated accept payment for services as payment in
full and that these practitioners and facilities refrain from billing or otherwise attempting to
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collect any balance that exceeds authorized payment or reimbursement amounts for services
provided to beneficiaries.
C.5.2.2. Should Peace Corps medical staff make a referral for service to an out-of-network
Provider, the Contractor shall ensure that staff and facilities affiliated with the national network
cooperate with and do not impede the Peace Corps effort to undertake the referral.
C.5.3. Pharmaceutical Component. The Contractor shall provide access to a managed
prescription drug service for PCVs med-evaced to the US, on authorized leave in the US or in the
US for official purposes. The Contractor shall provide a mechanism that permits managed
prescription drug providers to ascertain individual eligibility for pharmaceutical services at point
of service. Any prescription that exceeds a 30 day supply or exceeds $1,000.00 requires specific
approval from Peace Corps. The contractor shall develop a process to contact Peace Corps for
these authorizations.
C.5.4. Air Ambulance/Aeromedical Evacuation Services Component. When medically necessary
and appropriate, the Contractor shall arrange for worldwide emergency medical evacuation,
logistics and clinical documentation for PCVs. If it is logistically feasible to arrange for services
to a Peace Corps preferred medical treatment destination (See Attachment J.8, Preferred Air
Ambulance Destinations) the Contractor shall, when requested by an authorized Peace Corps
representative (See Attachment J.7, Authorized Air Ambulance Callers), facilitate transport to
Peace Corps preferred medical treatment destinations. Evacuation services include land and/or
air medical evacuation from the Volunteers location to an appropriate medical treatment facility.
The contractor shall be able to: maintain an up to date database of credentialed, accepting
facilities in order to quickly select an appropriate destination when requested to do so; provide
trained medical personnel and medical equipment sufficient to maintain a critically ill Volunteer
from time of acceptance until transfer to the receiving medical treatment facility; facilitate
passage of the Volunteer through immigration and customs; and provide medical management,
relevant technology, case consultation, timely and accurate communication, and medical
confidentiality of all records in accordance with this Statement of Work (SOW).
C.5.4.1. Emergency air evacuations require a coordinated effort between the Contractor and
Peace Corps and are used for acute, life-threatening emergencies. In these emergencies, to ensure
timely delivery of care, Peace Corps will request the needed services of the Contractor. The
request will come from a Peace Corps authorized representative (see Attachment J.7
Authorized Air Ambulance Callers), which will be updated as required. Air Ambulance
evacuation services may include: issuing GOPs to the receiving facility, medical arrangements
and healthcare management. The Contractor shall accept referrals for such services 24 hours per
day, 7 days per week, 365 days per year via telephone or other secure electronic means.
C.5.4.2. Peace Corps Procedures for Administration of Air Ambulance Transportation and
Logistics.
C.5.4.2.1. An authorized Peace Corps representative (See Attachment J.7) will contact the
Contractor to request air ambulance Transportation and Logistics services. Verbal notification
may be provided to the Contractor and is sufficient to approve GOP authorization to coordinate
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services. All verbal authorizations will be followed-up with a written authorization within three
days. The authorized Peace Corps representative will provide the following information:
Demographic and clinical information, to include Volunteers name, date of birth and
social security number;
Case summary, diagnosis, Volunteers health status, and treatment initiated;
Points of contact, telephone, email address and fax numbers of the relevant Peace Corps
medical staff;
Geographic location of the ill or injured Volunteer;
Location of Peace Corps preferred evacuation location (if applicable);
Name and telephone number of the local attending physician, hospital or clinic;
Telephone and fax number of the U.S. Embassy;
Name and contact information for the receiving Provider if the Volunteer is able to go to
the Peace Corps preferred location; and
Name and relevant information of anyone accompanying the patient (when applicable, if
authorized)
C.5.4.2.2. It is the responsibility of the Contractor to ensure that the air ambulance provider is
aware of local flight logistics.
,
Local airport facilities hours of operation, length of runway, runway surface, availability
of night lights and other logistical requirements associated with transportation;
Flight permission and landing rights, procedures for obtaining airspace, immigration and
landing rights;
Assistance from the U.S. Embassy, if required;
Landing fees at the national airport and required method of payment;
Local refueling procedures and availability of aviation fuel, approximate cost of refueling
and method of payment;
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Ambulance protocols and procedures for getting an ambulance and attendants onto the
runway within the first two hours of contact. The Contractor shall, at a minimum:
o Inform the authorized Peace Corps representative if Contractor will not be able to
evacuate the Volunteer from their current location within 24 hours;
o Provide destination country and city, flight plan, receiving facility, and attending
physician;
o Derive flight plans for low altitudes when concerns about air pressure exist, or
when flying at low altitude is medically indicated;
o Provide type of plane, plane tail sign, plane call sign and names and nationality of
the crew;
o Provide an Estimated Time of Arrival (ETA) to current location of the Volunteer,
and estimate of arrival at destination and periodic arrival updates; and
o Provide a cost estimate to include: all necessary costs associated with the
transportation; all daily charges for the medical team and pilot/technical crew; all
necessary medical equipment and medications; all estimated case/admin fees;
ground transportation costs (upon both departure and arrival); and all
telecommunication charges, ground handling and airport handling costs.
Peace Corps may assist the Contractor, in obtaining logistical information; when able.
C.5.4.2.3. After review and acceptance of the cost estimate, the authorized Peace Corps
representative will direct the Contractor to initiate emergency evacuation medical services.
Should Peace Corps not authorize these services, any associated expenses will not be incurred by
Peace Corps. Once the emergency rescue has been initiated, Peace Corps will receive from the
Contractor and relay the following information to relevant Peace Corps posts located overseas:
Verification that OMS has obtained services of an emergency evacuation contractor;
Confirmation of the contractors intent to contact the Peace Corps overseas post and
provide the name of their coordinating physician;
Medical evacuation destination, receiving facility and attending physician at the receiving
facility(contractor shall make every effort to transport the PCV to the Peace Corps
preferred destination); and
Estimated flight time for arrivals and departures.
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C.5.4.2.4. The Contractor shall maintain communications with the Peace Corps overseas medical
staff, the Medical Officer(s) and/or the International Health Coordinator(s) at Peace Corps
Washington, DC headquarters, throughout the emergency evacuation process. This includes, but
is not limited to:
Providing periodic updates approximately every two hours as to the overall status of the
evacuation, to include confirmation of available aircraft, landing location, estimated
arrival and departure times and selected medical facility;
The Contractors coordinating physician shall contact the overseas medical staff to verify
contact information, obtain a more detailed summary of the case, provide interim
management advice to the PCMO and/or local specialists and assess the current status of
the Volunteer;
If needed, contacting the attending physician managing the case; and
Preparing a comprehensive written narrative describing all medical care that was
rendered during the patient movement. This narrative shall be translated into English (if
necessary), scanned digitally, and provided to the authorized Peace Corp representative
(See Attachment J.7) with a copy to the PCMO via secure electronic means within 96
hours following the conclusion of the patient movement. Documentation shall include
cover sheet, pre-flight medical assessment, all in-flight medical documentation, treatment
orders, and post-flight hand off notes.
C.5.4.2.5. After arrival of the Volunteer to the destination, Peace Corps will maintain and
facilitate communication:
Between the overseas staff and the contractors physician coordinator throughout the
evacuation process;
To authorize services needed from hospitals and physicians at the final medical
evacuation site and for all of the contractors services; and
To insure notification of discontinuation of contractor services when appropriate.
C.5.4.4. Security, Travel and Other Unique Requirements

Contractor shall communicate to Peace Corps representatives at initial contact any travel
requirements that may be encountered in the performance of the service(s), including the
need to secure appropriate visas for PCVs under the Contractors care. The Contractor
will be responsible for ensuring that all authorizations and/or paperwork is completed to
ensure PCV obtains passage through Immigration, border control and customs for active
air ambulance med-evacs as authorized in C.5.4.2.1.;
Contractor shall provide Peace Corps any and all pertinent information about what may
be encountered at the point of disembarkation in the performance of the service(s),
including but not limited to: local airport facilities, flight permission, landing rights,
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hours of operation, length of runway, runway surface, and availability of night lights
and/or local ambulance protocols;
Air Ambulance vendor shall provide medical personnel with applicable certifications and
licenses including but not limited to: Advance Cardiac Life Support (ACLS),
International Trauma Life Support (ITLS), Trauma Nursing Core Course (TNCC)
certifications, and Drug Enforcement Agency (DEA) medication licenses. The vendor
shall maintain credentialed aircraft and flight crews with Commission on Accreditation of
Medical Transport Systems (CAMPTS) or European Aeromedical Institute (EURAMI)
certifications. The Vendor shall maintain all required insurance necessary for a medical
evacuation company; and
The contractor shall provide evidence of certification upon request from the Agency at
any time over the course of the period of performance of the contract.
C.6. HEALTH CARE ADMINISTRATIVE SERVICES FOR RPCVS (PLAN 3)

(Applicable to CLIN 0004 and (if options are exercised) 0011, 0016, 0021 and 0026) The
Contractor shall provide all personnel, supplies, services, and facilities necessary to provide
health care administrative services for RPCVs as follows:
C.6.1. Returned Peace Corps Volunteers. After end of service, Peace Corps is limited to six
months where it may authorize RPCV medical evaluations for Conditions of Coverage while
Serving Abroad. Peace Corps is limited to only paying for treatment for Conditions of
Coverage while Serving Abroad, as defined in the Division of Federal Employee Compensation
(DFEC) Procedure Manual Federal Employee Compensation Act (FECA) Part 2, Group 5,
Chapter 2-1701, Peace Corps Cases (which can be found at the following link:
https://www.dol.gov/owcp/dfec/regs/compliance/dfecfolio/FECA-PT2/group5.htm#217019.
In limited situations, authorized RPCVs require access to the allowable pharmaceuticals defined
in Attachment J.12 - Plan 3 Point of Service-Issued Pharmaceuticals, (subject to change). The
Contractor shall provide a mechanism that permits prescription drug providers to ascertain
individual eligibility for pharmaceutical services at point of service. The dollar cap for these
pharmaceuticals is defined in the FECA Procedure Manual referenced above. For evaluation or
treatment outside of these parameters, RPCVs must file a FECA claim through the Department
of Labor (DOL). Services for evaluation and treatment related to RPCVs are referred to as
benefit PLAN 3.
C.6.2. The Contractor shall assist RPCVs with identifying primary responsibility for coverage,
including Peace Corps related conditions; pre-existing conditions which were exacerbated,
accelerated or precipitated by Peace Corps service; pre-existing conditions which were not
exacerbated, accelerated or precipitated by Peace Corps service; illness or injury sustained in the
United States during service while Volunteer was not on Peace Corps business (home leave,
emergency leave, etc.); and illness or injury sustained after end of service.
C.6.3. Provider Network Component: RPCVs requirements are the same as provided for in
Section C.5.2.
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C.7. ACCESS TO SHORT-TERM GROUP HEALTH INSURANCE (PLAN 4) (Applicable

to CLIN 0005 and (if options are exercised) 0012, 0017, 0022, and 0027)
C.7.1. The Contractor shall provide short term health insurance to RPCVs (and eligible
spouse/dependents) similar to that which is available under Federal Employees Health Benefits
(FEHB) Temporary Continuation of Coverage (TCC) (5 U.S.C. 8905a). All eligible RPCVs
and eligible spouse/dependents shall be enrolled effective 12 midnight (EST) at end of their
Peace Corps service, regardless of length of service. Policy premiums, deductibles and copayments should meet or exceed the current Plan 4 coverage as defined in Attachment J.9
AfterCorps Coverage.
C.7.2. Peace Corps, at its discretion, will pay the first months health insurance premium for
RPCVs and eligible spouse/dependents. The RPCV shall have the option to continue short term
medical insurance for an additional two months at their expense. The premium price paid for the
additional two month medical coverage shall be equivalent to the premium paid by Peace Corps
for the first month of medical coverage. The Contractor shall provide payment options that
include credit card, month-to-month billing and utilization of readjustment allowances.
Readjustment allowance is earned by PCVs during service and held in a central account. At End
of Service (EOS) PCVs can request this payment be sent on their behalf from Peace Corps to the
contractor for the remaining one or two months not paid by Peace Corps. Currently, on a weekly
basis, Peace Corps sends those funds to the contractor by EFT by logging into the current
contractors online portal to provide a payroll report which details name and other PII of
volunteers who have provided their Aftercorps premium payment via EFT that week.
C.7.3. The Contractor shall assist RPCVs with identifying primary responsibility for coverage,
including PC related conditions; pre-existing conditions which were exacerbated, accelerated or
precipitated by PC service; pre-existing conditions which were not exacerbated, accelerated or
precipitated by PC service; illness or injury sustained in the United States during service while
Volunteer was not on Peace Corps business (home leave, emergency leave, etc.); and illness or
injury sustained after end of service.
C.7.4. The contractor shall establish processes and procedures to effectively administer RPCVs
access to short term health insurance. At a minimum the Contractor shall provide the following:
Process for notifying RPCVs of their health insurance benefits;
Process for election for continued coverage beyond first month;
If any restrictions on enrollment exist, the process for determining eligibility to enroll;
Process for payment of the first month's premium by the Peace Corps to the insurer for all
Volunteers at EOS;
Process for identifying individuals who are beneficiaries and "activating" coverage;
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Process for RPCVs to enroll and pay for coverage of eligible spouse/dependents;
Process for notifying RPCVs of the need to pay premiums after first month's coverage;
Process for allowing RPCVs to pay insurer directly for subsequent premiums for
month(s) beyond the first month;
Process for coordination of benefits with the FECA program, Medicare and other medical
benefit programs; and
Process for confirming enrollment with an identification card (distinct from services
under CLINs 0002 and 0003 (Plans 1-2) identification card).
C.7.4. The contractor shall provide access to a short term, group Health Insurance Policy that
meets the following minimum contract requirements:
A Group Health Insurance Policy with premiums, deductibles and co-payments that meet
or exceed the current Plan 4 coverage as defined in Attachment J.9 AfterCorps
Coverage;
Customer service agents sufficient to respond to inquiries regarding participant

eligibility, claims processing, fee schedules, and reimbursements/payments;
A toll-free telephone service, email address, online portal and chat function to receive
inquiries regarding eligibility, claims processing, and reimbursements/payments;
Prompt claims processing for reimbursements/payments, refunds and voids. All claims
shall be processed for payment within 20 business days. The Contractor shall document
turnaround times for: (1) logging claims and supporting documents, (2) adjudicating all
claims, (3) paying "clean claims and attaching an appropriate Explanation of Benefits
(EOB) notice to each reimbursement/payment;
Administering a claims appeal procedure that enables RPCVs and service providers to
dispute and to resolve disagreements over claims payments;
Maintaining secure, automated healthcare claims processing and accounting systems,

including an online portal accessible by Peace Corps OHS staff and individual members,
which includes:
(1)
security monitoring procedures;
(2)
breach notification plan;
(3)
user account and password security;
(4)
data center security;
(5)
daily backup procedures;
(6)
disaster recovery plan procedures;
(7)
business continuity plan
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Complies with HIPAA Electronic Health Care Transactions and Code Sets standards.
Provides, with Peace Corps' coordination, secure procedures that permit Peace Corps to
transmit eligibility data, authorize healthcare services, and obtain all Peace Corps health
insurance program information held in the healthcare claims processing system;
Maintains accurate, up-to-date provider information;
Produces, distributes and updates program brochure materials and other relevant program
materials (softcopy or hardcopy) based on supply levels and plan changes;
Makes available, via website or other electronic access, plan outlines, certificates,
enrollment process, renewal notices and payment options; and
Proposes a procedure and medium for archiving data and information used in the
administration of the plan, maintaining a claims record for each individual beneficiary
online for, at a minimum, the term of the member's eligibility.
C.8. MEDICAL CLAIMS (Applicable to CLIN 0006 and (if options are exercised) 0013,
0018, 0023, and 0028): The Contractor is not required to underwrite the cost of health care
services provided to eligible Peace Corps Invitee, PCV or RPCV beneficiaries. The Contractor
will be responsible for managing pass-through costs for medical claims (i.e. hospital bills, air
ambulance services). Contractor price and profit associated with the efforts required to manage
the pass-through of Government funds for medical claims shall be included in the price of CLINs
0002 through 0005 and (if options are exercised) 0009 through 0012, 0014 through 0017, 0019
through 0022 and 0024 through 0027. The Government will not pay profit or fee as a percentage
of costs associated with medical claims. The Contractor shall not be obligated to pay invoices if
doing so would exceed the ceiling price set forth in the schedule and the Government will not be
obligated to pay the Contractor any amount in excess of the ceiling price in the schedule. The
Government will reimburse the Contractor for authorized and actual costs of medical claims in
accordance with Section G.
C. 9. AUTOMATED ELIGIBILITY AND AUTHORIZATION SYSTEM (Applicable (if
option is exercised) to CLIN 0007: The Contractor shall establish an automated system that will
transmit Peace Corps authorizations and eligibility rosters electronically between the Peace
Corps staff and the Contractor. The Contractors application and hosting platform must be
Federal Risk and Authorization Management Program (FedRAMP) compliant: Joint
Authorization Board (JAB) Provisional Authorization; Agency Authorization; and Cloud Service
Provider (CSP) Supplied Package, or the Contractor shall present an active Federal Information
Security Management Act (FISMA) compliant Authority-To-Operate (ATO) from one or more
US Government agencies. If the Contractor is not FedRAMP certified and does not have an
Agency ATO, then the Contractor shall prepare a complete Security Assessment Package (SAP)
for the system/solution in accordance with NIST SP 800-53 rev 4. Minimum SAP includes a
System Security Plan, Security Test & Evaluation (ST&E) Plan, Security Assessment Report,
Contingency Plan, Interconnection Security Agreement, Plan of Action and Milestones
(POA&M), Risk Assessment and Security Controls Assessor Recommendation Memo.
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C.10. DATA AND REPORTING REQUIREMENTS FOR CLINS 0001 through 0007 and
(IF OPTIONS ARE EXERCISED) 0009 through 0029 shall be as specified below and in
accordance with Section F.2. and Attachment J.10-Contract Data Requirements List (CDRL):
C.10.1. Monthly Authorization Report, (CDR A001). The Contractor shall submit, as
specified in Section F and CDRL-Attachment J.10, a Monthly Authorization Report
summarizing the following:
Authorizer
Authorizer ID
date authorized
services authorized
number and percentage of U.S. authorizations processed in less than 20 business days
C.10.2. Customer Service Satisfaction Report, (CDRA002). The Contractor shall submit a
Customer Service Satisfaction Report, as specified in Section F, based on feedback (i.e. customer
service survey) from beneficiaries.
C.10.3. Customer Service Support Report, (CDR A003). The Contractor shall submit a
monthly Customer Service Support Report, as specified in Section F, to categorize the top 25
inquiry reasons, method of communication (i.e. web portal, call center, email), and volume of
beneficiary inquiries.
C.10.4. Customer Service Telephone Report, (CDR A004). The Contractor shall submit a
monthly Customer Service Telephone Report, as specified in Section F, containing the following
data elements. Data elements expressed in percentages shall be carried to 2 decimal points
(00.00%).
Average speed to answer calls
Average time to return calls
Average call block rate
Average abandonment rate
First call resolutions
Average hold time
C.10.5. Claims Processing Procedures Manual, (CDR A005). The Contractor shall submit a
Claims Processing Procedures Manual in accordance with Section C.2.2.1, as specified in
Section F.
C.10.6. Annual Contract Activity Report, (CDR A006). The Contractor shall submit an
Annual Contract Activity Report, as specified in Section F, containing the following data
elements:
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Aggregate dollar amounts of claims made, claims reimbursed/paid, total cost of all
claims, and average cost of claims paid by Government fiscal year (October through
September) and calendar year (January through December) ;
Aggregate amounts paid to individual service providers listed alphabetically in order of
the payee's name, and including the payee's specialty, address (including city and state
and zip code), Federal Identification Number or other identifier for foreign providers;
Financial summary of claims by category, i.e. medical, mental health, dental; and
Financial rating documentation, copies of required state and/or local or foreign licensing.
C.10.7. Monthly Claims Activity Report, (CDR A007). The Contractor shall submit a Monthly
Claims Activity Report, as specified by Section F, which is broken down by beneficiary
category; Invitee (PLAN 1), PCV (PLAN 2), and RPCV (0004/PLAN 3). Data shall be
summarized in the aggregate by month and quarter. Fields to be reported are: beneficiary name,
beneficiary social security number, beginning and ending date of service, provider name and
address, amount billed, amount authorized by PC, amount paid, ICD, DSM and/or CPT
diagnosis, diagnosis description, number of days to process, lagtime (date of claim to date claim
was paid), denial indicator and reason for denial (when a claim is denied), claims pended, and
provider specialty (taxonomy code). This report shall have a separate breakout (with all required
data elements) for all claims rendered by out-of-network providers. This report shall also include
a separate breakout showing the top 25 diagnoses by category and cost for PCV and RPCV
beneficiaries (PLAN 2 and CLIN PLAN 3). Lastly, the report shall include a summary page
showing current claims, processing cycle time, and average cost of claims each for Invitee
(PLAN 1), PVC (PLAN 2), and RPCV (PLAN 3).
C.10.8. Appeals Assessment Report, (CDR A008). The Contractor shall submit, as specified in
Section F, an Appeals Assessment Report providing a narrative analysis of the
errors/problems/issues detected in the accuracy and completeness of the appeal process and
documentation clarity and timeliness. Data shall be reported/broken out by CLIN 0003 (PLAN 2)
and CLIN 0004 (PLAN 3). Data elements should include but are not limited to appeal processing
timeframe, number of errors, cause of errors (i.e. accuracy, clarity, completeness), and error rate
by percentage to 2 decimal points.
C.10.9. Credential, Accreditation and/or Certification Report, (CDR A009). The Contractor
shall submit, as specified in Section F, a Credential, Accreditation and/or Certification Report
that list all Providers that have been removed from the network directories as a result of a failure
to maintain certification/recertification and/or accreditation, the date the Provider lost its
certification/recertification and/or accreditation and the reason.
C.10.10. Financial Transaction Records, (CDR A010). The Contractor shall, as specified in
Section F, submit all financial transaction records (including but not limited to purchase orders,
paying bills, collecting debts and invoices) generated during implementation of this contract.
C.10.11. HIPAA Privacy Complaint Report, (CDR A011). The Contractor shall, as specified
in Section F, submit a HIPAA Privacy Complaint Report, for each complaint received. The
report shall provide the beneficiary's initials, nature of the complaint, steps taken by the
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contractor to resolve the complaint, date of the initial complaint, date of expected resolution, date
complaint was resolved.
C.10.12. Internal Quality Control/Quality Improvement Plan, (CDR A012). The Contractor
shall, as specified in Section F, summit its Internal Quality Control/Quality Improvement Plan in
accordance with Section C.2.4.2.
C.10.13. Transition - In (Phase -in) Plan, (CDR A013). The Contractor shall, as specified in
Section F, submit its Transition - In (Phase -in) Plan in accordance with Section C.3.1.
C.10.14. Transition-in Status Report, (CDR A014). The Contractor shall, as specified in
Section F, submit a weekly status report of phase-in activities through the first 60 calendar days
of the contract, as directed by the Government or in the Contractors phase-in plan. The report
shall also provide a written summary of any contractor-government meetings, teleconferences, or
other communications related to transition-in activities that occurred during the reporting period,
to include documentation of any contract clarifications that were provided by the government
during the reporting period.
C.10.15. Transition Out (Phase -out) Plan, (CDR A015). The Contractor shall, as specified
in Section F, submit its Transition - Out (Phase -out) Plan in accordance with Section C.3.2 to
address all events and milestones that need to occur for each functional area to phase out the end
of the contract.
C.10.16. Invitee Cost-Sharing/Reimbursement Report, (CDR A016). The Contractor shall, as
specified in Section F, submit a monthly Invitee Cost-Sharing/Reimbursement Report on the
status of the cost-sharing/ Reimbursement Component (PLAN 1). The report should include at a
minimum, names and social security numbers of beneficiaries who have submitted receipts, how
much the receipts are for each of (1) medical, (2) vision, and (3) dental expenses, who has
received their cost-sharing allowance, amount received and who has not yet received their costsharing allowance. The report should summarize the status of all activity of PLAN 1).
C.10.17. Monthly Enrollment Report, (CDR A017). The Contractor shall, as specified in
Section F, submit a Monthly Enrollment Report listing beneficiaries by name, social security
number, volunteer identification number (if applicable), and Plan (CLIN 0002 (Plan 1), CLIN
0003 (Plan 2), CLIN 0004 (Plan 3), and CLIN 0005 (Plan 4)).
C.10.18. Air Ambulance Report, (CDR A018). The Contractor shall, as specified in Section F,
submit an Air Ambulance Report, to include all aeromedical evacuations in the aggregate. The
report shall contain details on the patients movement from place of origin to place of
destination, as well as itemized cost build-up supporting the billed charges. At a minimum, the
following data elements shall be provided:
Volunteer Name (last, first);

Location where incident occurred;
Date(s) of movement;
Reason for movement (diagnosis or other description of Volunteers condition);
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Name of all Providers that were contacted for quoted amount, Provider selected and
reason(s);
Itemized costs build-up for Provider selected for movement (with separate costs
attributed to flight, medical staff, ground ambulance costs directly associated with the
medical evacuation, and any other costs contributing to the total billed amount);
Documentation (time and date stamped) of all records in flight or in transport from time
of hand-off to time accepted by tertiary care institution;
Documentation (time and date stamped) of the Volunteers initial history and physical
examination and vital signs, and any changes that occurred throughout the transport;
Documentation (time and date stamped) of all medications and therapies given, and all
procedures performed during transport including, but not limited to, chest tube
placement, intubation; and
Case summary that details contact between Peace Corps and the contractor, to include
dates, time, topic and actions taken.
C.10.19. Drug Utilization Report, (CDR A019). The Contractor shall, as specified in Section F,
submit a Drug Utilization Report which identifies the names of drugs provided and the
therapeutic classification of those drugs ranked in order of 1) number of prescriptions filled and
2) cost to Peace Corps. The report shall also summarize: 1) number of claims processed, 2)
number of claims denied, 3) number of claims paid, 4) number of paid single source brand
claims, 5) number of paid multi-source brand claims, 6) number of paid generic claims, 7)
percent of generic use, 8) percent of generic conversion, 9) savings from generic substitution, 10)
number of generic conversions missed, and 11) report claims trends. Lastly, the report shall
report patterns of fraud, waste or abuse.
C.10.20. Group Health Insurance Report, (CDR A020). The Contractor shall, as specified in
Section F, submit a Group Health Insurance Report which details at a minimum the post and
regional location of the eligible and enrolled RPCVs and/or their dependents, the number of
premium months provided, claims data (including, but not limited to: a summary of claims made,
reimbursed/paid, average cost of claim paid, and pharmacy utilization), and such other
information as may be mutually agreed. Data shall be summarized in the aggregate by month and
quarter.
C.10.21. Automated Healthcare Authorization and Eligibility System Users Guide or Instruction
Manual.
C.11. HISTORICAL BENEFICIARY DEMOGRAPHICS AND CLAIMS HISTORY
The number of applicants, Volunteers, and RPCVs end of service (EOS) varies each fiscal year
(FY). Peace Corps fiscal year is October 01 September 30. Below is some quantitative
information about the number of medical claims, emergency air ambulance incidents and
volunteer data:
Page 41 of 112
C.11.1. Number of Medical Claims by Plan and Total Claims for FY12 through FY15.
Plan 1
Number of Claims
Total Paid
2012
6,200
$462,444.28
2013
5,339
$453,698.44
2014
6,509
$544,366.29
Plan 2
2012
2013
2014
Number of Claims 4,174
3,616
4,246
*Total Charges
$6,202,285.29 $5,199,175.58 $6,864,735.88
*Total Paid
$3,733,281.85 $3,462,771.19 $4,349,998.05
*This amount does not include costs for emergency air ambulances
Plan 3
Number of Claims
Total Charges
Total Paid
2012
7,678
$2,732,260.40
$1,413,370.53
2013
5,993
$2,476,569.02
$1,424,536.55
2014
6,757
$2,815,140.16
$1,383,633.29
2015
5,998
$544,038.31
2015
5,107
$7,287,970.56
$4,525,949.78
2015
6,103
$2,261,451.40
$1,226,676.36
C.11.2. Average medical claim amount for each Plan - The annual average claim amounts for
Plan 1 from FY 12 FY 15 ranged from $62 - $91. The annual average claim amounts for Plan
2 from FY 12 FY 15 ranged from $620 - $1,024. The annual average claim amounts for Plan 3
from FY 12 FY 15 ranged from $174 - $205.
C.11.3. Air Ambulances - The average total cost per year for all air ambulance incidents from
FY 11 to FY 15 was approximately $500,000. The average annual number of air ambulances
from FY 11 to FY 15 was seven.
C.11.4. Number of Med-evacs to the U.S. and International Guarantees of Payment/Foreign
Claims
C.11.4.1. Number of Med-evacs to the U.S.:
FY12
266
FY13
239
FY14
285
FY15
306
In FY 2014 there were a total of 86 claims for 53 unique cases. Eight (8) cases (nine (9) claims at
an approximate $146,000) were to non-Peace Corps countries, the remaining 45 cases (77
claims, at an approximate $266,000) were to two (2) RMO hubs.
In FY2015 there were a total of 109 claims for 39 unique cases. Four (4) cases (17 claims, at an
approximate $90,000) were to non-Peace Corps countries, 36 cases (90 claims, at an approximate
Page 42 of 112
$138,000) were from our South Africa RMO hub and two (2) cases (2 claims <$500.00) were for
Peace Corps countries not hubs.
C.11.5. Number of Invitees, Volunteers and End of Service Data
C.115.1. Peace Corps projects the number of invitees* that enter service for the next five years to
be:
Description
FY16 FY17 FY18 FY19 FY20
Total Invitees
4,387 4,530 4,664 4,699 4,721
*The actual number of invited applicants will slightly exceed this number but varies by
percentage from year-to-year based on many factors. Peace Corps over-invites in order to
make the projections above.
C.11.5.2. Peace Corps projects the average on-board strength, the average of total Volunteers in
service at the end of a month, for the next three years to be:
Description
Average on-board strength
FY16
FY17
FY18
6,940
7,760
8,369
C.11.5.3. The total number of Trainees/Volunteers serving at any point in time in the fiscal year:
Description
FY12
FY13
FY14
FY15
Total # Served
12,464
11,171
10,463
10,120
C.11.5.4. The average annual number of EOSs from FY13 to FY15 was 3,743. Peace Corps
projects the following EOSs for the next five years:
Description FY16 FY17 FY18 FY19 FY20

Total EOSs
3,619 4,264 4,513 4,551 4,551
Additional statistics can be found via Attachment J.13 Volunteer Demographic Statistics by
FY.
C.12. RIGHTS RESERVED FOR THE PEACE CORPS.
The Peace Corps rights as they pertain to this contract are as follows:
Page 43 of 112
Establish eligibility requirements and cost share rates (cost share rates refers to Plan 1
only per Attachment J.6) for all of its Health Care Benefit Programs, including the right
to extend health care benefits to dependent spouses and/or children under PLAN 2 PCVs
or PLAN 3 RPCVs;
Determine the need for an emergency medical evacuation under PLAN 2;
Determine where and from whom Health Benefit Program beneficiaries receive medical,
mental health, or dental evaluation or treatment, including the right to make referrals
outside the Contractors Service Network;
Obtain and hold copies of beneficiaries medical records and documents generated in the
course of authorized health evaluation or treatment. Copies of these records and
documents shall remain the property of Peace Corps;
Access to claims records and eligibility data held by the Contractor. These records and
data shall remain the property of Peace Corps and shall be provided to the Peace Corps
upon the request of the CO;
Audit, or to cause to be audited by its designee, all claims, administrative, and financial
records related to the management of its Health Care Benefits Program;
Make a final determination of disputed claims made by beneficiaries or by service

providers for reimbursement or payment made under its Health Benefits Program;
Deny any claim presented by the Contractor for reimbursement or payment. Reasons for
denying claim reimbursement or payment to the Contractor include, but are not limited
to, failure of a claimant to provide copies of requested medical records or reports to Peace
Corps medical personnel; failure of a claimant affiliated with the Contractors Network to
adhere to Peace Corps no balance billing requirement; claims presented on behalf of
an ineligible person; claims presented that exceed established fee schedules; claims
presented for unauthorized or disallowed services; claims presented that are duplicative
or fraudulent. This does not limit the Contractors rights under the Contract Disputes Act
of 1978 (41 USC. 601-613), as implemented by FAR 52.233-1 & -4; and
Make site visits to the Contractor and/or to providers and/or facilities affiliated with a
Service Network throughout the term of the Contract.
(End of Section C)
Page 44 of 112
SECTION D PACKAGING AND MARKING

D.1. PACKAGING. Preservation, packaging, and packing for shipment or mailing of all work
delivered hereunder, by other than electronic means, shall be in accordance with best
commercial practice and adequate to insure acceptance by common carrier and safe
transportation at the most economical rate(s).
D.2. MARKING. Each package, report or other deliverable shall be accompanied by a letter or
other document which:
D.2.1. Identifies the contract by number under which the item is being delivered.
D.2.2. Identifies the deliverable Item Number or Report Requirement which requires the
delivered item(s).
D.2.3. Indicates whether the Contractor considers the delivered item to be a partial or full
satisfaction of the requirement.
(End of Section D)
Page 45 of 112
SECTION E INSPECTION AND ACCEPTANCE

E.1. INSPECTION AND ACCEPTANCE.
Inspection and acceptance of services to be furnished hereunder shall be performed at place
of performance or destination, by the COR or his/her designated representative, in
accordance with FAR Clause 52.212-4, Contract Terms and Conditions Commercial Items
(May 2015). The Government reserves the right to conduct any inspection and tests it deems
reasonably necessary to assure that the services provided conform in all respects to the
contract specifications. Services which upon inspection are found not to be in conformance
with contractual specifications shall be promptly rejected and notice of such rejection,
together with appropriate instructions, will be provided to the Contractor by the CO.
E.1.2. Inspection will be completed within thirty (30) calendar days.
a. In the event services are of a continuing nature and this contract prescribes periodic
payments based upon increments of time rendered (e.g., hours or months of service),
completion of services will be deemed to have occurred at the end of each whole or
fractional month falling within the contract term.
b. In the event services are not of a continuing nature, such that this contract prescribes
payment based upon fixed units delivered completion will be deemed to have
occurred upon delivery.
c. Payment will constitute notification of acceptance.
d. Written notification of negative inspection results will be furnished within 30
calendar days after completion.
E.2. INSPECTION LOCATION. Inspection and acceptance of services provided hereunder
shall be accomplished by the COR or, in the CORs absence, his/her designated representative.
Inspections may include, but are not limited to, payment record audits, performance audits,
Contractor/Peace Corps quality assurance audits, and analysis of reports and other data submitted
in accordance with Section F.2.
E.3. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). The role of the
Government is to design, implement and conduct adequate contract surveillance and quality
assurance to ensure contract requirements and standards are satisfactorily performed. For these
purposes the Government will be utilizing a QASP. The Government will provide to the
Contractor, after review and/or modification of the QASP submitted IAW Section C.2.4.3, an
approved QASP and updated versions as revisions occur.
E.4. ACCEPTANCE. The Government will have up to 30 business days from date of delivery,
unless extended by written notification, to review each deliverable for acceptance and (if
unacceptable) provide oral or written comments. The Contractor shall review and incorporate
comments or changes and re-submit the deliverable not later than 30 business days from the date
the Contractor was notified the deliverable was unacceptable.
Page 46 of 112
E.5. CLAUSES INCOPORATED BY REFERENCE

Clause Reference
Title
Date
52.246-4
Inspection of Services--Fixed Price
Aug 1996
52.246-6
Inspection -- Time-and-Material and Labor-Hour
May 2001
(End of Section E)
Page 47 of 112
SECTION F DELIVERIES OR PERFORMANCE

F.1. PERIOD OF PERFORMANCE.
Item 0001 (Transition Phase- in). The Contractor shall begin transition phase-in activities at
date of contract award and complete phase-in activities In Accordance With (IAW) the
Contractors Transition Plan or within 60 days after contract award, which ever date comes first.
Items 0002, 0003, 0004, 0005 and 0006 and (if options are exercised) 0009 through 0028.
The Contractor shall perform the work described in Section C, at the level of effort specified in
Section B, as follows:
ITEM
0002
0003
0004
0005
0006
0009
0010
0011
0012
0013
0014
0015
0016
0017
0018
0019
0020
0021
0022
0023
0024
0025
0026
0027
0028
FROM
Date of Contract Award
Date option is exercised
TO
12 months after contract award
12 months after option is exercised
Item 0029 -Transition Phase-Out period. The phase-out period may be exercised during any
one of the healthcare delivery periods specified above. The Contractor will begin phase-out
activities upon phase-out option exercise and complete all phase-out activities no later than 60
days after the start of health care delivery for the incoming contractor.
Page 48 of 112
F.2. DELIVERY.
(If option is exercised) Item 0007 Automated Eligibility and Authorization System. The
Contractor shall deliver an automated authorization and eligibility system within 180
calendar days after the option is exercised.
Item 0008 Data for Items 0001-0007 and (if options are exercised) 0009 through 0029.
The Contractor is responsible for assuring that reports contain accurate and complete data. All
reports must be supported with sufficient documentation and/or audit trails. The Contractor shall
submit all reports as titled and IAW Attachment J-10- Contract Data Requirements List. The
Contractor shall submit a negative report if there is no data to report.
F.3. PLACE OF PERFORMANCE.
The place of performance of this contract is the Contractors facilities.
F.4. NOTICE REGARDING LATE DELIVERY. In the event the Contractor anticipates
difficulty in complying with the delivery schedule, the Contractor shall immediately notify the
CO and the COR, in writing, giving pertinent details, including the date by which it expects to
make delivery. This notification shall be informational only in character and receipt of it
shall not be construed as a waiver by the Government of any contract delivery schedule, or any
rights or remedies provided by law or under this contract.
F.5. CLAUSES INCORPORATED BY REFERENCE
Clause
Reference
Title
Date
52.242-15
Stop-Work Order
Aug 1989
52.242-17
Government Delay of Work
Apr 1984
(End of Section F)
Page 49 of 112
SECTION G CONTRACT ADMINISTRATION DATA

G.1. CONTRACTING OFFICERS AUTHORITY.
Contracting Officer (CO) responsibilities are outlined in FAR 1.602-2. The CO is the only
person authorized to approve changes in any of the requirements of this contract or modifications
issued thereunder and, notwithstanding provisions contained elsewhere in this contract, the said
authority remains solely the COs. The contractor shall not comply with any order, direction or
request of Government personnel unless it is issued in writing and signed by the CO or is
pursuant to specific authority otherwise included as part of this contract. In the event the
contractor effects any change at the direction of any person other than the CO, the change will be
considered to be unauthorized.
All correspondence concerning contractual matters related to this contract shall be addressed to
the Contracting Officer:
Telephone: 202-692-2840
Email: struehartmckinney@peacecorps.gov
G.2. CONTRACTING OFFICERS REPRESENTATIVE (COR).
The COR supports and assists the CO in the technical monitoring and administration of the
contract. The COR will monitor the Contractors technical compliance and progress relative to
the contract. Technical direction is defined as direction to the contractor which fills in details,
suggests possible lines of inquiry, or otherwise supplements the scope of work. Technical
direction must be confined to the general scope of work of the contract and shall not constitute a
new assignment, nor supersede or modify any other clause of the contract. Changes to the
contract will be in writing and can only be issued by the CO. The COR is NOT authorized to redelegate his or her authority. Upon award, copies of the CORs duties, responsibilities and
limitations will be provided.
All correspondence concerning technical matters related to this contract shall be addressed to
Contracting Officer Representative:
Peace Corps
Office of Health Services
TBD, Contracting Officer Representative
1111 20th Street, North West
Washington, DC.C. 20526
Telephone: 202-692-TBD
Email: TBD@peacecorps.gov
Page 50 of 112
G.3. CONTRACTOR REPRESENTATIVE

The Contractor's representative shall be responsible for all contract administration issues and
shall act as the central point of contact with the Government for all such issues. The
representative shall have full authority to act for the Contractor in all contractual matters. The
representative shall be able to fluently read, write, and speak the English language. The
Contractor's representative to be contacted for all contract administration matters is:
Name:
Address:
Telephone:
Fax:
E-mail:
G.4. INVOICE AND PAYMENT INSTRUCTIONS
G.4.1. Invoice Instructions
G.4.1.1. Submission of Invoices for Items 0001-0005, 0007 and (if options are exercised)
0009 through 0012, 0014 through 0017, 0019 through 0022 and 0024 through 0027. The
Contractor shall submit proper invoices monthly in the manner and format described herein. The
following data must be included (if applicable) in an invoice for it to constitute a proper invoice:
Name and address of contractor, Tax Identification Number (TIN) and invoice
date and number (if applicable);
Contract number (including Contract Line Item Number);
Description of services, unit price and extended price of services performed;
Period covered;
Physician name, specialty, and provider number;
Name, title, and signature of authorized official to whom payment is to be sent;
For CLIN 0005 and (if options are exercised) 0012, 0017, 0022, and 0027 list of
enrollees with coverage starting within the billing period (to include RPCV name,
volunteer ID, coverage start date and monthly premium); and
Other substantiating documentation or information as required by the contract and
approved by the CO.
G.4.1.2. Additional instructions for Submission of Invoices for Transition Plan (Phase-in)
Services, Item 0001. The Contractor may invoice for interim payment of 50% of the transition
phase-in price upon the start of health care delivery. The Contractor may submit a final invoice
for the balance following completion of all transition requirements.
G.4.1.3.Additional instructions for Submission of Invoices for Health Care Services, Items
0002-0004 and (if options are exercised) 0009 through 0011, 0014 through 0016, 0019
through 0021 and 0024 through 0026 (Plans 1 through 3). The Government will
retrospectively, unilaterally, determine the number of Invitee claims, and PCV and RPCV
Page 51 of 112
enrollees on a monthly basis, based on the Contractors Monthly Enrollment Report (CDR A017)
and eligibility information provided by Peace Corps. The Contractor may submit invoice(s) no
more frequently than monthly and only after completion of the given month for the number of
enrollees as determined by the Government.
G.4.1.4. Submission of Invoices for Reimbursement of Expenditures for Medical Claims Items 0006 and (if options are exercised) 0013, 0018, 0023 and 0028. The contractor shall
submit proper invoices each week in the manner and format described herein. The contractor
shall maintain a segregated commercial/business bank account specific to the funds used for the
payment of claims (pass-through costs) and used for no other purposes. The following data must
be included (if applicable) in an invoice for it to constitute a proper invoice:
Name and address of contractor, Tax Identification Number (TIN) and invoice
date and number (if applicable);
Contract number (including Contract Line Item Number);
Period covered;
Description of cost and services performed;
Actual costs of claim(s) paid in U.S. dollars, with a separate column for pharmacy
costs (as applicable);
Copy of itemized invoice(s) (i.e. fee name, item code and amount, additional fees,
invoice discounts, voided fees);
Supporting details listed by unique claim ID: payee name, payee address, payee
Federal Identification/SSN number, payees invoice number (if applicable),
beneficiarys name and Volunteer ID, the medical code (i.e. ICD/CPT( if
applicable)), date of claimed received, date claim paid, the amount of the billed
charges, the amount paid/reimbursed and a description of the services provided;
Name, title, and signature of authorized official to whom payment is to be sent;
and
Other substantiating documentation or information as required by the contract and
approved by the CO.
All invoices shall be submitted in electronic format to Peace Corps Office of Global Accounts
Payable (OGAP) via email at gapdomesticinvoice@peacecorps.gov with copies to the COR via
email at TBD@peacecorps.gov
G.4.2. Payment Instructions.
Mandatory submission of Contractor's Electronic Funds Transfer (EFT) information.
The Contractor is required, as a condition to any payment under this contract, to provide the
Government with the information required to make payment by EFT as described below:
G.4.2.1. Contractors required EFT information. The Contractor shall provide EFT information
to the CO within ten (10) days after contract award as described below:
Page 52 of 112
Name of receiving bank;

City and State of the receiving bank;
Overnight mail address;
American Banking Association (ABA) 9-digit identifier of the Contractor's financial
agent;
TIN for bank; and
Contractors bank account number.
If the Contractor's financial agent is not directly on-line to the Federal Reserve Wire Transfer
System and, therefore, not the receiver of the wire transfer payment, the Contractor shall also
provide the name, address, and 9-digit Routing Transit Number of the correspondent financial
institution receiving the wire transfer payment.
G.4.2.1.1. Suspension of payment. Notwithstanding the provisions of any clause in this contract,
the Government is not required to make any payment under this contract until after receipt of the
correct EFT payment information from the Contractor. Until receipt of the correct EFT
information, any invoice request shall be deemed not to be a valid invoice as defined in the
Prompt Payment clause of this contract. If the EFT information changes after submission of
correct EFT information, the Government shall begin using the changed EFT information no
later than the 30th day after its receipt to the extent payment is made by EFT. However, the
Contractor may request that no further payments be made until the changed EFT information is
implemented by the payment office. If such suspension would result in a late payment under the
Prompt Payment clause of this contract, the Contractor's request for suspension shall extend the
due date for payment by the number of days of the suspension.
G.4.2.1.2. Contractor EFT arrangements. The Contractor shall designate a single financial agent
capable of receiving and processing the electronic funds transfer using the EFT methods
described in section G.4.2.1. The Contractor shall pay all fees and charges for receipt and
processing of transfers.
G.4.2.1.3. Liability for uncompleted or erroneous transfers.
(1) If an uncompleted or erroneous transfer occurs because the Government failed to use the
Contractor-provided EFT information in the correct manner, the Government remains
responsible for-(i) Making a correct payment;
(ii) Paying any prompt payment penalty due; and
(iii) Recovering any erroneously directed funds.
Page 53 of 112
(2) If an uncompleted or erroneous transfer occurs because Contractor-provided EFT information

was incorrect at the time of Government release of the EFT payment transaction instruction to
the Federal Reserve System, and-(i) If the funds are no longer under the control of the payment office, the Government is deemed
to have made payment and the Contractor is responsible for recovery of any erroneously directed
funds; or
(ii) If the funds remain under the control of the payment office, the Government retains the right
to either make payment by mail or suspend the payment in accordance with section G.4.2.1.1.
G.4.2.1.4. EFT and prompt payment.
(1) A payment shall be deemed to have been made in a timely manner in accordance with the
Prompt Payment clause of this contract if, in the EFT payment transaction instruction given to
the Federal Reserve System, the date specified for settlement of the payment is on or before the
prompt payment due date, provided the specified payment date is a valid date under the rules of
the Federal Reserve System.
(2) When payment cannot be made by EFT because of incorrect EFT information provided by
the Contractor, no interest penalty is due after the date of the uncompleted or erroneous payment
transaction, provided that notice of the defective EFT information is issued to the Contractor
within 7 days after the Government is notified of the defective EFT information.
G.4.2.1.5. EFT and assignment of claims. If the Contractor assigns the proceeds of this contract
as provided for in the Assignment of Claims clause of this contract, the assignee shall provide
the assignee EFT information required by section G.4.2.1. In all respects, the requirements
herein shall apply to the assignee as if it were the Contractor. EFT information which shows the
ultimate recipient of the transfer to be other than the Contractor, in the absence of a proper
assignment of claims acceptable to the Government, is incorrect EFT information as described in
section G.4.2.1.
G.4.2.1.6. Payment office discretion. If the Contractor does not wish to receive payment by EFT
methods for one or more payments, the Contractor may submit a request to OGAP via email at
gapdomesticinvoice@peacecorps.gov to refrain from requiring EFT information or using the
EFT payment method. The decision to grant the request is solely that of the Government.
G.4.2.1.7. Change of EFT information by financial agent. The Contractor agrees that the
Contractor's financial institution may notify the Government of a change to the routing transit
number, Contractor account number, or account type. The Government shall use the changed
data in accordance with section G.4.2.1.1. The Contractor agrees that the information provided
by the financial institution is deemed to be correct information as if it were provided by the
Contractor. The Contractor agrees that the financial institutions notice of changed EFT data is
Page 54 of 112
deemed to be a request by the Contractor in accordance with section G.4.2.1.. and that no further
payments be made until the changed EFT information is implemented by the Peace Corps
payment office.
G.5. END OF HEALTH CARE DELIVERY. Claims received by the Contractor during its
period of services delivery are required to be processed to completion within 180 calendar days
following the end of health care delivery. There will be no medical claims processing fee paid to
the Contractor if the 180 calendar day requirement is not met.
G.6. WITHHOLDING OF CONTRACT PAYMENTS. Notwithstanding any other payment
provisions of this contract, failure of the Contractor to submit required reports when due or
failure to perform or deliver required work, supplies, or services, may result in the withholding
of payments under this contract unless such failure arises out of causes beyond the control and
without the fault or negligence of the Contractor as defined by the clause entitled Excusable
Delays or Default, as applicable. The Government will immediately notify the Contractor of
its intention to withhold payment of any invoice or voucher submitted.
(End of Section G)
Page 55 of 112
SECTION H SPECIAL CONTRACT REQUIREMENTS

H. 1 LOSS/DAMAGES.
The Peace Corps does not accept responsibility for any damage or loss of the Contractors
supplies or property, or that of the Contractors employees or subcontractors. If any item is
shipped to an improper destination or cannot be accounted for by the Contractor, the Contractor
shall have the item reprinted and reshipped at its own expense, if required by the Peace Corps.
H.2. CONFIDENTIALITY.
With regard to confidentiality, the Peace Corps and the Contractor shall hereby mutually agree
that all information and records related to the Peace Corps Invitees, Volunteers, RPCVs and
other authorized beneficiaries are privileged and confidential. All beneficiary records must be
protected to the extent provided by law, and as required by the Freedom of Information Act; the
Privacy Act of 1975; the Alcohol, Drug Abuse, and Mental Health Administration
Reorganization Act; and the Health Insurance and Portability Accountability Act (HIPAA) of
1996. Records must be protected, in terms of privacy and security during use, transmission,
storage, handling, and destruction. Unless otherwise provided herein or as approved by the CO,
all records shall be used only in the performance of the contract (i.e. utilization management,
quality assurance and claims adjudication).
H.3. PRIVACY AND SECURITY OF PROTECTED HEALTH INFORMATION.
H.3.1 The Contractor meets the definition of Business Associate, and the Peace Corps meets the
definition of a covered entity under HIPAA Rules. Therefore, a Business Associate Agreement
(BAA) between the Contractor and the Peace Corps is required to comply with HIPAA Rules.
This section serves as the required BAA. As a Business Associate, the Contractor shall comply
with the HIPAA applicable to a business associate performing under this Contract.
H.3.2. The Contractor agrees to use appropriate safeguards to prevent use or disclosure of
Protected Health Information (PHI) or Personally Identifiable Information (PII) except as
permitted or required by this contract or as required by law.
H.3.3. The Contractor agrees to use administrative, physical, and technical safeguards that
reasonably and appropriately protect the confidentiality, integrity, and availability of the
electronic protected health information that it creates, receives, maintains, or transmits in the
execution of this contract in accordance with SUBPART C 45 CFR Part 164.
H.3.4. The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is
known to the Contractor of a use or disclosure of PHI/PII in violation of the requirements of this
contract.
H.3.5. The Contractor agrees to report to the Government any security incident involving
PHI/PII of which it becomes aware, or any use or disclosure of PHI/PII not provided for by this
contract of which the Contractor becomes aware in accordance with 45 CFR 164.410.
Page 56 of 112
H.3.6. The Contractor agrees to ensure that any agent, including a subcontractor, to whom it
provides PHI/PII received from, or created or received by the Contractor on behalf of the
Government agrees to the same restrictions and conditions that apply under this contract to the
Contractor with respect to such information as stipulated in 45 CFR 164.502(e)(1)(ii).
H.3.7. The Contractor agrees to ensure that any agent, including a subcontractor, to whom it
provides electronic PHI/PII, agrees to implement reasonable and appropriate safeguards to
protect it as stipulated in 45 CFR 164.308(b)(2).
H.3.8.The Contractor agrees to provide access, at the request of the Government, and in the
timeframe and manner designated by the Government, to PHI/PII in a designated record set. This
access shall be provided to the Government, or as directed by the Government, to an individual
in order to meet the requirements and obligations under 45 CFR 164.524.
H.3.9. The Contractor agrees to make any amendment(s) to PHI/PII in a designated record set
that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the
Government or an individual, and in the timeframe and manner designated by the Government at
no increase in contract price or cost.
H.3.10. The Contractor agrees to make internal practices and records required to provide an
accounting of disclosures relating to the use and disclosure of PHI/PII received from, or created
or received by the Contractor on behalf of the Government, available to the Government, or at
the request of the Government to the Secretary, for purposes of the Secretary determining the
Governments compliance with HIPAA rules and Privacy Rule under 45 CFR 164.528.
H.3.11. The Contractor agrees to document such disclosures of PHI/PII and information related
to such disclosures as would be required for the Government to respond to a request by an
Individual for an accounting of disclosures of PHI in accordance with 45 CFR 164.528.
H.3.12. The Contractor agrees to provide to the Government or an Individual, in time and
manner designated by the Government, information collected in accordance with this section of
the Contract, to permit the Government to respond to a request by an Individual for an
accounting of disclosures of PHI in accordance with 45 CFR 164.528.
H.3.14. General Use and Disclosure Provisions. Except as otherwise limited in this section, the
Contractor may use or disclose PHI on behalf of, or to provide services to, the Government for
treatment, payment, or health care operations purposes, in accordance with the specific use and
disclosure provisions below, if such use or disclosure of PHI would not violate Subpart E of 45
CFR Part 164.
H.3.15. Specific Use and Disclosure Provisions.
H.3.15.1. Except as otherwise limited in this section, the Contractor may use PHI for the proper
management and administration of the contract.
Page 57 of 112
H.3.15.2 Except as otherwise limited in this section, the Contractor may use PHI to provide Data
Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).
H.3.15.3. The Contractor may use PHI to report violations of law to appropriate Federal and
State authorities, consistent with 45 CFR 164.502(j)(1).
H.3.16. Permissible Requests by the Government.
H.3.16.1. The Government will not request the Contractor to use or disclose PHI in any manner
that would not be permissible under 45 CFR Part 164 subpart E if done by the Government.
H.3.16.2. The Government reserves its rights and remedies set forth in the Inspection of Services
clause (FAR 52.246-4) and the Default clause (FAR 52.249-8) if any non-conformance with
these requirements by the Contractor should occur.
H.3.17. Effect of Termination/Conclusion of Contract. All records subject to this section
should be handled in accordance with the records management requirements of this contract.
Notwithstanding the records management requirements, the Contractor shall return all PHI
received from the Government, or created or received by the Contractor on behalf of the
Government. This provision shall apply to PHI that is in the possession of subcontractors or
agents of the Contractor. The Contractor shall retain no copies of the PHI.
H.3.18. Regulatory References. A reference in the requirements of this section to a section in
Privacy Rule (at 45 CFR Part 160 and Subparts A and E of Part 164 ) or Security Rule (45 CFR
Part 160 and Subparts A and E of Part 164) means the section as in effect or as amended, and for
which compliance is required.
H.3.19. Survival. The respective rights and obligations of Business Associate under the Effect
of Termination paragraph of this section shall survive the termination of this Contract.
H.3.20. Interpretation. Any ambiguity in this section shall be resolved in favor of a meaning
that permits the Government to comply with HHS Privacy Rule (at 45 CFR Part 160 and
Subparts A and E of Part 164) or HHS Security Rule (at 45 CFR Part 160 and Subparts A and E
of Part 164).
H.4. COMPLIANCE WITH FEDERAL, STATE, LOCAL, AND FOREIGN
REQUIREMENTS.
H.4.1. The Contractor shall comply with all applicable state insurance and license requirements
necessary for performance under this contract. The Contractor may also be required to comply
with foreign laws.
H.4.2. In addition to the insurance and license requirements the Contractor, consultants, and
providers shall obtain and maintain all other permits, licenses, etc., that may be required to
perform the services set forth in this contract.
Page 58 of 112
H. 5. PROTECTION OF INFORMATION.
H.5.1. Security. The Contractor does not require access to classified data; however, the
Contractor may require access to information which is to be handled as For Official Use Only,
and which may be covered by the Privacy Act and the HIPAA. The Contractor shall ensure that
staff assigned to this task understand the meaning of these categories of data and handle them
accordingly.
H.5.2. Dissemination of Information/Publishing . There shall be no dissemination or publication
of information developed under this contract or contained in the reports to be furnished pursuant
to this contract, except within and between the Contractor and any subcontractors. The
Contractor agrees not to divulge information, in whole or in part, in any manner or form, nor to
authorize or permit others to do so, taking such reasonable measures as are necessary to restrict
access to such information while in the Contractors possession, to those employees,
subcontractors, and/or consultants needing such information to perform the work described
herein, i.e., on a "need to know" basis, without prior written approval of the Peace Corps COR or
the CO. The Contractor also agrees to insert the substance of this clause in any consultant or
subcontract agreement/contract. The Contractor will immediately notify the CO in writing in the
event that the Contractor determines or has reason to suspect a breach of this requirement has
occurred.
H.6. CONTRACTOR REQUIRED INSURANCE
The Contractor shall maintain, and require participants under this contract to maintain, any and
all types of insurance and in amounts considered to be standard in its industry. This may include
Workers Compensation Insurance and Malpractice Insurance.
Peace Corps shall not be held liable for any claims, damages, or lawsuits by the Contractor, or
against the Contractor, as a result of the performance of this contract.
The Contractor shall provide proof of all insurance coverage to the CO prior to beginning
performance under this contract.
H.7. ADVERTISING OF AWARD
The Contractor agrees not to refer to awards in commercial advertising in such a manner as to
state or imply that the product or service provided is endorsed or preferred by the Peace Corps or
is considered by the Peace Corps to be superior to other products or services. Any reference
made to the Peace Corps by the Contractor in any advertisement will be submitted in writing for
approval by the CO at least 30 days prior to publication.
H.8. USE OF PEACE CORPS NAME AND LOGO
The Contractor shall make no publicity announcements or issue other public relations or
promotional materials mentioning the Contractors connection with Peace Corps without first
consulting with the CO. Further the Contractor shall not use the Peace Corps name and/or logo
Page 59 of 112
in conjunction with, or proximity to, the Contractors logo, trademark, trade name or facsimile
thereof (co-branding) without the advance written concurrence of the CO.
H.9 SMALL BUSINESS SUBCONTRACTING PLAN REQUIREMENTS
H.9.1. Small Business Sub-Contracting Plan. The Contractors contract specific or approved
corporate-wide Small Business Plan submitted as part of its proposal shall be in accordance with
the clause entitled SMALL BUSINESS SUBCONTRACTING PLAN (FAR 52.219-9), and
comply with the requirements of FAR Part 19.7. The plan shall include the goals as stated below
for small disadvantaged business concerns or a detailed explanation as to why the goal cannot be
included in the plan.
H.9.2. Small Business Goals. The goals listed below represent the dollar percentage of
subcontract dollars.
Small Business Category
Veteran Owned Small Business
Small Disadvantaged Business (includes Section 8(a))
Women-Owned Small Business
Historically Underutilized Business (HUB) Zone Small
Business
Service Disabled Veteran-Owned Small Business
Small Business Participation

Goal
5.00%
5.00%
5.00%
3.00%
3.00%
H.9.2. The Small Business Subcontracting Plan submitted by _______________________ dated

________________________, has been approved by the Contracting Officer and is incorporated
herein and made a part of this contract as Section J.11 Small Business Plan.
H.10 KEY PERSONNEL

The personnel specified below (Sections H.10.3., H.10.4. and H.10.5) are considered to be key
personnel essential to work being performed hereunder. The Contractor agrees to assign to this
contract the key personnel proposed and whose resumes were submitted with the proposal
necessary to fulfill the requirements of the contract. No substitution of key personnel shall be
made without the prior notification to and concurrence of the Contracting Officer as specified in
Section H.10.1.
Page 60 of 112
H.10.1. All proposed substitutes shall have qualifications equal to or higher than the
qualifications of the person to be replaced. The Contracting Officer shall be notified in writing of
any proposed substitution at least forty-five (45) days in advance of the proposed substitution.
Such notification shall include: (1) explanation of the circumstances necessitating the
substitution; (2) a complete resume of the proposed substitute; and (3) any other information
requested by the Contracting Officer to enable him/her to judge whether or not the Contractor is
maintaining the same high quality of personnel that was provided with its proposal and was the
partial basis for award.
H.10.2. The Program Director and Program Manager (if other than the Program Director or
Program Manager, a designee who is capable of binding the Contractor contractually), and a Tier
III Help Desk Specialist shall be considered key personnel for this contract. The Program
Director shall have overall management and oversight of all major functions of the contract
sufficient in meeting the objectives and requirements of the contract. The Program Manager shall
be the single point of contact for the COR and have oversight of day-to-day management
operations. A designee, if other than the Program Director or Program Manager, shall be capable
of binding the Contractor contractually and interface with the Contracting Officer with regards to
contractual matters. The Tier III Help Desk Specialist shall have specialized skills to develop
and/or maintain all systems, applications, security, and network configurations, particularly
during the transition phase-in timeline.
H.10.3. Program Director responsible for managing and implementing the overall contract
requirement and overseeing all major functions, disciplines, or segments of the contract.
Organizes, directs, and coordinates planning; implements all contract support activities; interacts
with the COR and Contracting Officer regarding issues and status of the contract; coordinates
financial and staffing resources; monitors and analyzes contract and performance data;
coordinates recruitment and training activities; establishes effective performance objectives to
ensure the highest quality staff necessary to perform the requirements within the contract;
manages the activities of subcontractors; ensures that information systems used in supporting
contract requirements comply with initial and ongoing information systems security
requirements defined herein; and reviews contract, operations and management reports.
Minimum experience managing health care related programs and education: fifteen (15) years
with an Associates degree; seven (7) years with a Bachelors degree; or five (5) years with a
Masters degree. The Program Director shall be 100% dedicated to this contract for at least 180
days after contract award. It is then at the discretion of the contractor to determine the percentage
of time the Program Director is dedicated to the contract, as long as it is not less than 50%, and
the requirements under the contract are being met.
H.10.4. Program Manager responsible for overall daily operations and management of the
contract, including staffing, training, data and reporting requirements, problem escalation and
resolution, and performance monitoring; providing technical and management assistance for the
planning and operation of customer service, claims processing and handling of third party
claims; managing the activities of subcontractors and ensuring all functions and processes are
implemented and operated properly. Minimum experience managing health care related
programs and education: Seven (7) years with an Associates degree; five (5) years with a
Page 61 of 112
Bachelors degree; or three (3) years with a Masters degree. The Program Manager shall be
100% dedicated to this contract for at least 180 days after contract award. It is then at the
discretion of the contractor to determine the percentage of time the Program Director is dedicated
to the contract, as long as it is not less than 50%, and the requirements under the contract are
being met.
H.10.5. Tier III Help Desk Specialist responsible for providing Tier 3 Support including, but
not limited to: directing remote support to users for network problems, systems integration,
diagnosing problems, recommending and implementing solutions, troubleshooting data sharing
infrastructure issues, solving complex system issues, and providing follow-up. Minimum
education and experience: Bachelors degree and seven (7) years of recent computer, server, and
network troubleshooting experience. Experience and understanding of a Management
Information Systems (MIS) environment, program management systems, helpdesk systems, and
systems integration. The Tier III Help Desk Specialist shall be 100% dedicated to this contract at
least 180 days after contract award. It is then at the discretion of the contractor to determine the
percentage of time the Tier III Help Desk Specialist is dedicated to the contract.
H.11. INFORMATION SECURITY
H.11.1. Federal Information System Security Requirements - The Contractor shall provide
software updates to ensure compliance with the Federal Information Security Management Act
(FISMA).
This system shall meet current and future requirements of all relevant Office of Management and
Budget (OMB) Memoranda, Federal Information Processing Standards (FIPS), National
Institute of Standards and Technology (NIST) Special Publications
http://csrc.nist.gov/publications/PubsSPs.html, and other noted references, under all security
controls indicated as part of the moderate-impact system baseline.
This list includes but is not limited to the most current versions of the following:
FIPS-197 Advanced Encryption Standard
FIPS-140-2 Security Requirements for Cryptographic Modules
NIST SP 800-18, Rev.1, Guide for Developing Security Plans for Federal Information
Technology Systems
NIST SP 800-34 Rev. 1, Contingency Planning Guide for Federal Information Systems
NIST SP 800-37, Rev 1, Guide for Applying the Risk Management Framework to
Federal Information Systems
NIST SP 800-53, Rev. 4, Security and Privacy Controls for Federal Information Systems
and Organizations
NIST SP 800-123, Guide to General Server Security
NIST SP 800-128, Guide for Security-Focused Configuration Management of
Information Systems
OMB Memorandum M-06-16, Protection of Sensitive Agency Information, June 2006
OMB Memorandum M-07-16, Safeguarding Against and Responding to the Breach of
Personally Identifiable Information, May 2007
Page 62 of 112
Applicable sections of the Peace Corps Manual to include MS 542: IT Security Policies
and Procedures and associated PC IT Security Requirements.
H.11.2. The Peace Corps Information Security Policies & Procedures. Peace Corps Manual
Section 542 is incorporated into the contract under Attachment J.4. The Contractor is required to
adhere to these Peace Corps policies and procedures which refer to and align with the
requirements identified in NIST SP 800-53. Where agency security policy is undefined, the
vendor shall bring it to the attention of the COR and implement industry standard security
measures based on NIST SP 800-53, Rev. 4 for Moderate Impact Systems.
H.11.3. The Contractors application and hosting platform must be FedRAMP Compliant: JAB
Provisional Authorization, Agency Authorization, and CSP Supplied Package, or the Contractor
must present an active FISMA compliant Authority-To-Operate (ATO) from one or more US
Government agencies. If the Contractor is not FedRAMP certified and does not have an Agency
ATO, then the Contractor shall prepare a complete Security Assessment Package (SAP) for the
system/solution in accordance with NIST SP 800-53 rev 4. Minimum SAP includes a System
Security Plan, Security Test & Evaluation (ST&E) Plan, Security Assessment Report,
Contingency Plan, Interconnection Security Agreement, Plan of Action and Milestones
(POA&M), Risk Assessment and Security Controls Assessor Recommendation Memo.
H.12. DATA RIGHTS
a. The definition of unlimited rights is contained in Federal Acquisition Regulation
(FAR) 27.401, Definitions. FAR clause 52.227-14 Rights in Data-General (May 2014), is
hereby incorporated by reference and made a part of this contract.
b. Government Furnished Data and Materials. The Peace Corps shall retain all rights and
privileges, including those of patent and copyright, to all Government furnished data. The
Contractor shall neither retain nor reproduce for private or commercial use any data or other
materials furnished under this contract. The Contractor agrees not to assert any rights at common
law or in equity or establish any claim to statutory copyright in such data. These rights are not
exclusive and are in addition to any other rights and remedies to which the Government is
otherwise entitled elsewhere in this contract.
c. Contractor Produced Data and Materials. All property rights, including publication
rights, in the information and materials produced by the Contractor in connection with this
contract shall vest in the Government.
H.13. SYSTEM ACCESSIBILITY AND EASE OF USE
Section 508 Electronic and Information Technology (EIT) Standards
The Section 508 standards established by the Architectural and Transportation Barriers
Compliance Board (Access Board) are incorporated into, and made part of all the Peace Corps
orders, solicitations and purchase orders developed to procure Electronic and Information
Technology (EIT). These standards are found in their entirety at: http://www.section508.gov and
Page 63 of 112
http://www.access-board.gov/sec508/standards.htm. A printed copy of the standards will be

supplied upon request. The Contractor shall comply with the technical standards as marked:
_x_ 1194.21
_x_ 1194.22
_x_ 1194.23
_x_ 1194.24
_x_ 1194.25
_x_ 1194.26
_x_ 1194.31
_x_ 1194.41
Software applications and operating systems

Web-based intranet and internet information and applications
Telecommunications products
Video and multimedia products
Self-contained, closed products
Desktop and portable computers
Functional Performance Criteria
Information, Documentation, and Support
H.14. BREACH OF INFORMATION NOTIFICATION REQUIREMENT

In accordance with the Peace Corps Manual Section 899, Breach Notification Response Plan,
the Contractor shall provide notification of a suspected or known breach promptly (within 4
hours) by calling the Peace Corps Domestic Services Help Desk at 202-692-1000.
A breach and/or incident means the loss of control, compromise, unauthorized disclosure,
unauthorized acquisition, unauthorized access, or any similar term referring to situations where
persons other than authorized users and for other than authorized purposes have access or
potential access to Personally Identifiable Information (PII) or Covered Information, whether
physical or electronic. The Peace Corps Manual Section 899 will be incorporated into the
resulting contract to provide the definitions of PII and Covered Information. If a suspected or
known breach occurs, the Contractor shall work with and provide necessary information, as
requested, to the Peace Corps Response Team who will respond to the notification.
H.15. ORGANIZATIONAL CONFLICT OF INTEREST
a. The Contractor will be required to warrant that, to the best of its knowledge and belief,
and except as otherwise set forth in the contract, it does not have any organizational conflict of
interest as defined below.
The term "organizational conflict of interest" means a situation where a
Contractor has interests, either due to its other activities or its relationships with
other organizations, which place it in a position that may be unsatisfactory or
unfavorable (a) from the Government's standpoint in being able to secure
impartial, technically sound, objective assistance and advice from the Contractor,
or in securing the advantages of adequate competition in its procurement; or (b)
from industry's standpoint in that unfair competitive advantages may accrue to the
Contractor in question.
b. The Contractor agrees that if after award of the contract it discovers an organizational
conflict of interest the Contractor shall make an immediate and full disclosure in writing to the
Contracting Officer that shall include a description of the action that the Contractor has taken or
Page 64 of 112
proposes to take to avoid, eliminate or neutralize the conflict. The Peace Corps may, however,
terminate the contract for the convenience of the Government if it would be in the best interest of
the Government.
c. If the Contractor was aware of the organizational conflict of interest before award and
intentionally did not disclose the conflict to the Contracting Officer, the Peace Corps may
terminate the contract at no cost to the Government.
d. Offerors are reminded that certain existing contractual arrangements may preclude,
restrict or limit participation, in whole or in part, as either a subcontractor or as a prime
contractor under this competitive procurement. Of primary concern are those contractual
arrangements in which the Offeror provides support to the Peace Corps Office of the Chief
Information Officer (OCIO), Office of Health Services (OHS) or Office of the Chief Financial
Officer (OCFO) in support of the operation of the office or any of its programs. General
guidance may be found in FAR 9.505.
H.16. ECONOMIC PRICE ADJUSTMENT (EPA) CLAUSE FOR SHORT -TERM
HEALTH CARE INSURANCE PREMIUM COSTS. ((IF OPTION IS EXERCISED)
APPLICABLE TO ITEMS 0012, 0017, 0022, AND 0027)
Short-term health insurance prices for Returned Peace Corps Volunteers (RPCVs) for any option
year, should the Government exercise the option, may be subject to an EPA. Corresponding
adjustment could result in either a decrease or increase in price under this contract depending on
the change in the Consumer Price Index (CPI) for Medical Care as published by the Bureau of
Labor Statistics (BLS). The Contractor shall notify the Contracting Officer within 60 days before
each option period expires if unit prices either increase or decrease based on the last 12-month
percent change to the CPI. The Contractors EPA notification shall also include the current
monthly unit price and the adjusted unit price. Within seven (7) calendar days of being properly
notified by the Contractor, the Contracting Officer will verify the CPI 12-month percent change.
Once the CPI is verified, the Contracting Officer will implement the change(s) on the effective
date (date new option period begins). The Contractor is not entitled to retroactive payment rate
adjustments prior to implementation of the change. The Contractor shall accept all changes for
the period in which they are effective.
The aggregate of the increases in any contract unit price made under this clause shall not exceed
10 percent of the original unit price. There is no percentage limitation on the amount of
decreases that may be made under this clause.
The BLS, CPI monthly percentage changes may be found at
http://data.bls.gov/timeseries/CUUR0000SAM?output_view=pct_12mths. This hyperlink is
provided for convenience. In the event the link does not work or does not reach the BLS page for
CPI for medical care, it is the responsibility of the Contractor to locate the BLS databases, tables
and calculations for medical care.
Page 65 of 112
H.17. Statutory and Regulatory Authority.
Title 45 CFR Parts 160, 162 and 164 of Health Insurance Portability and Accountability
Act of 1996 (HIPAA) security and privacy standards, transaction and code set standards,
National Provider Identifier (NPI) requirements and implementation specifications.
Privacy Act of 1974, (5 U.S.C. 552a, Public Law No. 93-579)
Patient Protection and Affordable Care Act (P.L. 111-148)
Federal Information Security Management Act of 2002 (FISMA) (44 U.S.C. 3551 et
seq.)
Peace Corps Personnel Security Policies (See Attachment J.1)
Due to the nature of the Affordable Care Act, Peace Corps policies, procedures, and
guidelines are subject to change without notice; therefore, the Peace Corps reserves the
right to modify the terms of this contract and Statement of Work (SOW).
(End of Section H)
Page 66 of 112
SECTION I CONTRACT CLAUSES

SECTION I 1 CLAUSES INCORPORATED BY REFERENCE
Clause
Reference
52.202-1
Definitions
Date
Nov 2013
52.203-3
Gratuities
Apr 1984
52.203-5
Covenant Against Contingent Fees
May 2014
52.203-6
Restrictions On Subcontractor Sales To The Government
52.203-7
Anti-Kickback Procedures
52.203-12
Limitation On Payments To Influence Certain Federal Transactions
Oct 2010
52.203-13
Oct 2015
52.204-4
Contractor Code of Business Ethics and Conduct

Contractor Employee Whistleblower Rights and Requirement To
Inform Employees of Whistleblower Rights
Printed or Copied Double-Sided on Postconsumer Fiber Content Paper
May 2011
52.204-10
Reporting Executive Compensation and First-Tier Subcontract Awards
Oct 2015
52.204-13
System for Award Management Maintenance
Jul 2013
52.209-10
Service Contract Reporting Requirements

Protecting the Government's Interest When Subcontracting With
Contractors Debarred, Suspended, or Proposed for Debarment
Prohibition on Contracting With Inverted Domestic Corporations
Jan 2014
Nov 2015
52.215-8
Order of Precedence--Uniform Contract Format
Oct 1997
52.219-8
Utilization of Small Business Concerns
Oct 2014
52.219-9
Small Business Subcontracting Plan
Oct 2015
52.219-9 Alt II
Small Business Subcontracting Plan Alternate II
Oct 2001
52.219-16
Liquidated Damages-Subcontracting Plan
Jan 1999
52.219-28
Post-Award Small Business Program Rerepresentation

Convict Labor
Jul 2013
52.203-17
52.204-14
52.209-6
52.222-3
52.222-17
Title
Sep 2006
May 2014
Apr 2014
Oct 2015
Jun 2003
May 2014
52.222-21
Nondisplacement of Qualified Workers

Prohibition Of Segregated Facilities
52.222-26
Equal Opportunity
Sep 2016
52.222-37
Employment Reports on Veterans
Feb 2016
52.222-40
Notification of Employee Rights Under the National Labor Relations

Act
Dec 2010
52.222-41
Service Contract Labor Standards

Fair Labor Standards Act and Service Contract Labor Standards -Price Adjustment (Multiple Year and Option Contracts)
Combating Trafficking in Persons
May 2014
52.222-43
52.222-50
52.222-54
Apr 2015
May 2014
Mar 2015
Oct 2015
52.223-18
Employment Eligibility Verification

Contractor Policy to Ban Text Messaging While Driving
Aug 2011
52.224-1
Privacy Act Notification
Apr 1984
52.224-2
Privacy Act
Restrictions on Certain Foreign Purchases
Apr 1984
52.225-13
Page 67 of 112
Jun 2008
52.227-1
Authorization and Consent
Dec 2007
52.229-3
Rights in Data General

Federal, State And Local Taxes
May 2014
52.232-1
Payments
Apr 1984
52.232-7
Payments under Time-and-Materials and Labor-Hour Contracts

Discounts For Prompt Payment
Aug 2012
Apr 1984
52.232-11
Limitation on Withholding of Payments.

Extras
52.232-17
Interest
May 2014
52.232-18
Availability of Funds
Apr 1984
52.232-23
Assignment of Claims
May 2014
52.232-25
Prompt Payment
52.232-33
52.227-14
52.232-8
52.232-9
Feb 2013
Feb 2002
Apr 1984
Jul 2013
Payment by Electronic Funds Transfer--Central Contractor Registration
Jul 2013
52.232.39
Unenforceability of Unauthorized Obligations
Jun 2013
52.232-40
Dec 2013
52.233-1
Providing Accelerated Payments to Small Business Subcontractors

Disputes
May 2014
52.233-3
Protest After Award
Aug 1996
52.233-4
Applicable Law for Breach of Contract Claim
Oct 2004
52.237-3
Continuity of Services
Jan 1991
52.239-1
Privacy or Security Safeguards

Bankruptcy
Aug 1996
52.243-1
Changes -- Fixed Price
Aug 1987
52.243-1 ALT I
Changes -- Fixed Price
Apr 1984
52.243-3
Changes -- Time-and-Materials or Labor-Hours
Sep 2000
52.244-2
52.244-6
Subcontracts
Subcontracts for Commercial Items
Sep 2016
52.246-25
Limitation Of Liability--Services
Feb 1997
52.249-2
Termination For Convenience Of The Government (Fixed-Price)
Apr 2012
52.249-8
Default (Fixed-Price Supply & Service)
Apr 1984
52.249-14
Excusable Delays
Apr 1984
52.242-13
(End of Section I-1)
Page 68 of 112
Jul 1995
Oct 2010
SECTION I 2 CLAUSES INCORPORATED IN FULL TEXT
52.217-8 - Option to Extend Services (Nov 1999)

The Government may require continued performance of any services within the limits and at the
rates specified in the contract. These rates may be adjusted only as a result of revisions to
prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised
more than once, but the total extension of performance hereunder shall not exceed 6 months. The
Contracting Officer may exercise the option by written notice to the Contractor within 14 days
before the end of the contract Period of Performance.
(End of Clause)
52.217-9 Option to Extend the Term of the Contract (Mar 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor
within the periods specified below; provided that the Government gives the Contractor a
preliminary written notice of its intent to extend at least 7 days before the contract expires. The
preliminary notice does not commit the Government to an extension.
(b) If the Government exercises this option, the extended contract shall be considered to include
this option clause.
(c) The total duration of this contract, including the exercise of any options under this clause,
shall not exceed five (5) years (months) (years).
ITEM(S)
0007
0009 - 0013
0014 - 0018
0019 - 0023
0024 - 0029
* ACA
LATEST OPTION
EXERCISE DATE
6 months ACA
12 months ACA
24 months ACA
36 months ACA
48 months ACA
After Contract Award
(End of Clause)
Page 69 of 112
52.222-35 - Equal Opportunity for Veterans (Oct 2015)

(a) Definitions. As used in this clause-Active duty wartime or campaign badge veteran, Armed Forces service medal veteran,
disabled veteran, protected veteran, qualified disabled veteran, and recently separated
veteran have the meanings given at FAR 22.1301.
(b) Equal opportunity clause. The Contractor shall abide by the requirements of the equal
opportunity clause at 41 CFR 60-300.5(a), as of March 24, 2014. This clause prohibits
discrimination against qualified protected veterans, and requires affirmative action by the
Contractor to employ and advance in employment qualified protected veterans.
(c) Subcontracts. The Contractor shall insert the terms of this clause in subcontracts of $150,000
or more unless exempted by rules, regulations, or orders of the Secretary of Labor. The
Contractor shall act as specified by the Director, Office of Federal Contract Compliance
Programs, to enforce the terms, including action for noncompliance. Such necessary changes in
language may be made as shall be appropriate of identify properly the parties and their
undertakings.
(End of Clause)
52.222-36 - Equal Opportunity for Workers With Disabilities (Jul 2014)

(a) Equal opportunity clause. The Contractor shall abide by the requirements of the equal
opportunity clause at 41 CFR 60.741.5(a), as of March 24, 2014. This clause prohibits
discrimination against qualified individuals on the basis of disability, and requires affirmative
action by the Contractor to employ and advance in employment qualified individuals with
disabilities.
(b) Subcontracts. The Contractor shall include the terms of this clause in every subcontract or
purchase order in excess of $15,000 unless exempted by rules, regulations, or orders of the
Secretary, so that such provisions will be binding upon each subcontractor or vendor. The
Contractor shall act as specified by the Director, Office of Federal Contract Compliance
Programs of the U.S. Department of Labor, to enforce the terms, including action for
noncompliance. Such necessary changes in language may be made as shall be appropriate to
identify properly the parties and their undertakings.
(End of Clause)
Page 70 of 112
52.222-37 - Employment Reports on Veterans (Feb 2016)

(a) Definitions. As used in this clause, active duty wartime or campaign badge veteran,
Armed Forces service medal veteran, disabled veteran, protected veteran, and recently
separated veteran, have the meanings given in FAR 22.1301.
(b) Unless the Contractor is a State or local government agency, the Contractor shall report at
least annually, as required by the Secretary of Labor, on-(1) The total number of employees in the contractor's workforce, by job category and
hiring location, who are protected veterans (i.e., active duty wartime or campaign badge
veterans, Armed Forces service medal veterans, disabled veterans, and recently separated
veterans);
(2) The total number of new employees hired during the period covered by the report, and
of the total, the number of disabled veterans (i.e., active duty wartime or campaign badge
veterans, Armed Forces service medal veterans, disabled veterans, and recently separated
veterans); and
(3) The maximum number and minimum number of employees of the Contractor or
subcontractor at each hiring location during the period covered by the report.
(c) The Contractor shall report the above items by filing the VETS-4212 Federal Contractor
Veterans Employment Report (see VETS-4212 Federal Contractor Reporting and Filing
Your VETS-4212 Report at http://www.dol.gov/vets/vets4212.htm ).
(d) The Contractor shall file VETS-4212 Reports no later than September 30 of each year.
(e) The employment activity report required by paragraphs (b)(2) and (b)(3) of this clause shall
reflect total new hires, and maximum and minimum number of employees, during the most
recent 12-month period preceding the ending date selected for the report. Contractors may select
an ending date-(1) As of the end of any pay period between July 1 and August 31 of the year the report is
due; or
(2) As of December 31, if the Contractor has prior written approval from the Equal
Employment Opportunity Commission to do so for purposes of submitting the Employer
Information Report EEO-1 (Standard Form 100).
(f) The number of veterans reported must be based on data known to the contractor when
completing the VETS-4212. The contractor's knowledge of veterans status may be obtained in a
variety of ways, including an invitation to applicants to self-identify (in accordance with 41 CFR
60-300.42), voluntary self-disclosure by employees, or actual knowledge of veteran status by the
contractor. This paragraph does not relieve an employer of liability for discrimination under 38
U.S.C. 4212.
Page 71 of 112
(g) The Contractor shall insert the terms of this clause in subcontracts of $150,000 or more
unless exempted by rules, regulations, or orders of the Secretary of Labor.
(End of Clause)
52.252-2 Clauses Incorporated by Reference (Feb 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if
they were given in full text. Upon request, the Contracting Officer will make their full text
available. Also, the full text of a clause may be accessed electronically at this/these address(es):
https://www.acquisition.gov/far
(End of Clause)
(End of Section I-2)
Page 72 of 112
SECTION J - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS

J.1- Peace Corps Personnel Security Policies
J.2. - Panel Providers
J.3. - Peace Corps Standard Form (SF) 127C
J.4. - Peace Corps IT Security Policies & Procedures
J.5. - Government Transition Team
J.6. - Plan 1 Cost Reimbursement Fee Schedule
J.7. - Authorized Air Ambulance Callers
J.8.- Preferred Air Ambulance Destinations
J.9. - AfterCorps Coverage
J.10. - Contract Data Requirements List
J.11. - Small Business Plan
J.12. Plan 3 Point of Service-issued Pharmaceuticals
J.13. Volunteer Demographics Statistics by Fiscal Year (FY)
L.1. Past Performance Questionnaire
L.2. Pricing Table
(End of Section J)
Page 73 of 112
SECTION K REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS

OF OFFERORS
K.1 CLAUSES INCORPORATED BY REFERENCE
52.204-16
Commercial and Government Entity Code

Reporting
52.204-19
Incorporation by Reference of Representations

and Certifications
Jul-16
Dec-14
K.2 CLAUSES INCORPORATED IN FULL TEXT

52.204-8 - Annual Representations and Certifications (Apr 2016)
(a)
(1) The North American Industry classification System (NAICS) code for this acquisition
is 524292
[insert NAICS code].
(2) The small business size standard is
$32.5M
[insert size standard].
(3) The small business size standard for a concern which submits an offer in its own name,
other than on a construction or service contract, but which proposes to furnish a product
which it did not itself manufacture, is 500 employees.
(b)
(1) If the provision at 52.204-7, System for Award Management, is included in this
solicitation, paragraph (d) of this provision applies.
(2) If the provision at 52.204-7 is not included in this solicitation, and the offeror is
currently registered in the System for Award Management (SAM), and has completed the
Representations and Certifications section of SAM electronically, the offeror may choose
to use paragraph (d) of this provision instead of completing the corresponding individual
representations and certification in the solicitation. The offeror shall indicate which option
applies by checking one of the following boxes:
[_] (i) Paragraph (d) applies.
[_] (ii) Paragraph (d) does not apply and the offeror has completed the individual
representations and certifications in the solicitation.
Page 74 of 112
(c)
(1) The following representations or certifications in SAM are applicable to this
solicitation as indicated:
(i) 52.203-2, Certificate of Independent Price Determination. This provision
applies to solicitations when a firm-fixed-price contract or fixed-price contract with
economic price adjustment is contemplated, unless
(A) The acquisition is to be made under the simplified acquisition
procedures in Part 13;
(B) The solicitation is a request for technical proposals under two-step
sealed bidding procedures; or
(C) The solicitation is for utility services for which rates are set by law or
regulation.
(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence
Certain Federal Transactions. This provision applies to solicitations expected to
exceed $150,000.
(iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that
do not include the provision at 52.204-7, System for Award Management.
(iv) 52.204-5, Women-Owned Business (Other Than Small Business). This
provision applies to solicitations that
(A) Are not set aside for small business concerns;
(B) Exceed the simplified acquisition threshold; and
(C) Are for contracts that will be performed in the United States or its
outlying areas.
(v) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations
Representation.
(vi) 52.209-5; Certification Regarding Responsibility Matters. This provision
applies to solicitations where the contract value is expected to exceed the
simplified acquisition threshold.
(vii) 52.209-11, Representation by Corporations Regarding Delinquent Tax
Liability or a Felony Conviction under any Federal Law. This provision applies to
all solicitations.
Page 75 of 112
(viii) 52.214-14, Place of Performance--Sealed Bidding. This provision applies to

invitations for bids except those in which the place of performance is specified by
the Government.
(ix) 52.215-6, Place of Performance. This provision applies to solicitations unless
the place of performance is specified by the Government.
(x) 52.219-1, Small Business Program Representations (Basic & Alternate I). This
provision applies to solicitations when the contract will be performed in the United
States or its outlying areas.
(A) The basic provision applies when the solicitations are issued by other
than DoD, NASA, and the Coast Guard.
(B) The provision with its Alternate I applies to solicitations issued by
DoD, NASA, or the Coast Guard.
(xi) 52.219-2, Equal Low Bids. This provision applies to solicitations when
contracting by sealed bidding and the contract will be performed in the United
States or its outlying areas.
(xii) 52.222-22, Previous Contracts and Compliance Reports. This provision
applies to solicitations that include the clause at 52.222-26, Equal Opportunity.
(xiii) 52.222-25, Affirmative Action Compliance. This provision applies to
solicitations, other than those for construction, when the solicitation includes the
clause at 52.222-26, Equal Opportunity.
(xiv) 52.222-38, Compliance with Veterans' Employment Reporting Requirements.
This provision applies to solicitations when it is anticipated the contract award will
exceed the simplified acquisition threshold and the contract is not for acquisition of
commercial items.
(xv) 52.223-1, Biobased Product Certification. This provision applies to
solicitations that require the delivery or specify the use of USDA-designated items;
or include the clause at 52.223-2, Affirmative Procurement of Biobased Products
Under Service and Construction Contracts.
(xvi) 52.223-4, Recovered Material Certification. This provision applies to
solicitations that are for, or specify the use of, EPA- designated items.
(xvii) 52.225-2, Buy American Certificate. This provision applies to solicitations
containing the clause at 52.225-1.
(xviii) 52.225-4, Buy American--Free Trade Agreements--Israeli Trade Act
Certificate. (Basic, Alternates I, II, and III.) This provision applies to solicitations
Page 76 of 112
containing the clause at 52.225- 3.

(A) If the acquisition value is less than $25,000, the basic provision applies.
(B) If the acquisition value is $25,000 or more but is less than $50,000, the
provision with its Alternate I applies.
(C) If the acquisition value is $50,000 or more but is less than $77,533, the
provision with its Alternate II applies.
(D) If the acquisition value is $79,507 or more but is less than $100,000,
the provision with its Alternate III applies.
(xix) 52.225-6, Trade Agreements Certificate. This provision applies to
solicitations containing the clause at 52.225-5.
(xx) 52.225-20, Prohibition on Conducting Restricted Business Operations in
Sudan--Certification. This provision applies to all solicitations.
(xxi) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain
Activities or Transactions Relating to IranRepresentation and Certification. This
provision applies to all solicitations.
(xxii) 52.226-2, Historically Black College or University and Minority Institution
Representation. This provision applies to solicitations for research, studies,
supplies, or services of the type normally acquired from higher educational
institutions.
(2) The following representations or certifications are applicable as indicated by the
Contracting Officer:
[Contracting Officer check as appropriate.]
X (i) 52.204-17, Ownership or Control of Offeror.
X (ii) 52.204-20, Predecessor of Offeror.
(iii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed
End Products.
___ (iv) 52.222-48, Exemption from Application of the Service Contract Labor
Standards to Contracts for Maintenance, Calibration, or Repair of Certain
Equipment--Certification.
___ (v) 52.222-52 Exemption from Application of the Service Contract Labor
Page 77 of 112
Standards to Contracts for Certain Services--Certification.

___ (vi) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered
Material Content for EPA-Designated Products (Alternate I only).
___ (vii) 52.227-6, Royalty Information.
___ (A) Basic.
___ (B) Alternate I.
___ (viii) 52.227-15, Representation of Limited Rights Data and Restricted
Computer Software.
(d) The offeror has completed the annual representations and certifications electronically via the
SAM Web site accessed through https://www.acquisition.gov . After reviewing the SAM database
information, the offeror verifies by submission of the offer that the representations and
certifications currently posted electronically that apply to this solicitation as indicated in
paragraph (c) of this provision have been entered or updated within the last 12 months, are
current, accurate, complete, and applicable to this solicitation (including the business size
standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer
and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified
below [offeror to insert changes, identifying change by clause number, title, date]. These
amended representation(s) and/or certification(s) are also incorporated in this offer and are
current, accurate, and complete as of the date of this offer.
FAR Clause
Title
Date
Change
Any changes provided by the offeror are applicable to this solicitation only, and do
not result in an update to the representations and certifications posted on SAM.
(End of Provision)
52.209-7 - Information Regarding Responsibility Matters (Jul 2013)

(a) Definitions. As used in this provision
Administrative proceeding means a non-judicial process that is adjudicatory in nature in order
to make a determination of fault or liability (e.g., Securities and Exchange Commission
Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed
Services Board of Contract Appeals Proceedings). This includes administrative proceeding at the
Page 78 of 112
Federal and State level but only in connection with performance of a Federal contract or grant. It
does not include agency actions such as contract audits, site visits, corrective plans, or inspection
of deliverables.
Federal contracts and grants with total value greater than $10,000,000 means
(1) The total value of all current, active contracts and grants, including all priced options;
and
(2) The total value of all current, active orders including all priced options under
indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task
and delivery and multiple-award Schedules).
Principal means an officer, director, owner, partner, or a person having primary management
or supervisory responsibilities within a business entity (e.g., general manager; plant manager;
head of a division or business segment; and similar positions).
(b) The offeror [_] has [_] does not have current active Federal contracts and grants with total
value greater than $10,000,000.
(c) If the offeror checked has in paragraph (b) of this provision, the offeror represents, by
submission of this offer, that the information it has entered in the Federal Awardee Performance
and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of
submission of this offer with regard to the following information:
(1) Whether the offeror, and/or any of its principals, has or has not, within the last five
years, in connection with the award to or performance by the offeror of a Federal contract
or grant, been the subject of a proceeding, at the Federal or State level that resulted in any
of the following dispositions:
(i) In a criminal proceeding, a conviction.
(ii) In a civil proceeding, a finding of fault and liability that results in the payment
of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or
more.
(iii) In an administrative proceeding, a finding of fault and liability that results
in
(A) The payment of a monetary fine or penalty of $5,000 or more; or
(B) The payment of a reimbursement, restitution, or damages in excess of
$100,000.
(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter
by consent or compromise with an acknowledgment of fault by the Contractor if
Page 79 of 112
the proceeding could have led to any of the outcomes specified in paragraphs
(c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.
(2) If the offeror has been involved in the last five years in any of the occurrences listed
in (c)(1) of this provision, whether the offeror has provided the requested information
with regard to each occurrence.
(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this
provision in FAPIIS as required through maintaining an active registration in the System for
Award Management database via https://www.acquisition.gov (see 52.204-7).
(End of provision)
(End of Section K)
Page 80 of 112
SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L.1. CLAUSES INCORPORATED IN FULL TEXT
FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998)
This solicitation incorporates one or more solicitation provisions by reference, with the same
force and effect as if they were given in full text. Upon request, the Contracting Officer will
make their full text available. The offeror is cautioned that the listed provisions may include
blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of
submitting the full text of those provisions, the offeror may identify the provision by paragraph
identifier and provide the appropriate information with its quotation or offer. Also, the full text
of a solicitation provision may be accessed electronically at this/these address(es):
https://www.acquisition.gov/far/
http://farsite.hill.af.mil/vffara.htm
(End of Provision)
FAR 52.204-6 Data Universal Numbering System Number (Jul 2013)
(a) Definition. Data Universal Numbering System (DUNS) number, as used in this provision,
means the 9-digit number assigned by Dun and Bradstreet, Inc. (D&B) to identify unique
business entities, which is used as the identification number for Federal Contractors.
(b) The offeror shall enter, in the block with its name and address on the cover page of its offer,
the annotation DUNS or DUNS+4 followed by the DUNS number or DUNS+4 that
identifies the offerors name and address exactly as stated in the offer. The DUNS number is a
nine-digit number assigned by Dun and Bradstreet, Inc. The DUNS+4 is the DUNS number plus
a 4-character suffix that may be assigned at the discretion of the offeror to establish additional
System for Award Management records for identifying alternative Electronic Funds Transfer
(EFT) accounts (see Subpart 32.11) for the same concern.
(c) If the offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to
obtain one.
(1) An offeror may obtain a DUNS number
(i) Via the internet at http://fedgov.dnb.com/webform or if the offeror does not have internet
access, it may call Dun and Bradstreet at 1-866-705-5711 if located within the United States; or
Page 81 of 112
(ii) If located outside the United States, by contacting the local Dun and Bradstreet office. The
offeror should indicate that it is an offeror for a U.S. Government contract when contacting the
local Dun and Bradstreet office.
(2) The offeror should be prepared to provide the following information:
(i) Company legal business name.
(ii) Tradestyle, doing business, or other name by which your entity is commonly recognized.
(iii) Company physical street address, city, state and Zip Code.
(iv) Company mailing address, city, state and Zip Code (if separate from physical).
(v) Company telephone number.
(vi) Date the company was started.
(vii) Number of employees at your location.
(viii) Chief executive officer/key manager.
(ix) Line of business (industry).
(x) Company Headquarters name and address (reporting relationship within your entity).
(End of Provision)
FAR 52.204-7 SYSTEM FOR AWARD MANAGEMENT (JUL 2013)
a) Definitions. As used in this provision

Data Universal Numbering System (DUNS) number means the 9-digit number assigned by
Dun and Bradstreet, Inc. (D&B) to identify unique business entities.
Data Universal Numbering System+4 (DUNS+4) number means the DUNS number means
the number assigned by D&B plus a 4-character suffix that may be assigned by a business
concern. (D&B has no affiliation with this 4-character suffix.) This 4-character suffix may be
assigned at the discretion of the business concern to establish additional System for Award
Management records for identifying alternative Electronic Funds Transfer (EFT) accounts (see
the FAR at Subpart 32.11) for the same concern.
Registered in the System for Award Management (SAM) database means that
Page 82 of 112
(1) The Offeror has entered all mandatory information, including the DUNS number or the
DUNS+4 number, the Contractor and Government Entity (CAGE) code, as well as data required
by the Federal Funding Accountability and Transparency Act of 2006 (see Subpart 4.14), into the
SAM database; and
(2) The offeror has completed the Core, Assertions, and Representations and Certification, and
Points of contact sections of the registration in the SAM database;
(3) The Government has validated all mandatory data fields, to include validation of the
Taxpayer Identification Number (TIN) with the Internal Revenue Service (IRS). The Offeror will
be required to provide consent for TIN validation to the Government as a part of the SAM
registration process.
(4) The Government has marked the record Active.
(b)
(1) By submission of an offer, the offeror acknowledges the requirement that a prospective
awardee shall be registered in the SAM database prior to award, during performance, and
through final payment of any contract, basic agreement, basic ordering agreement, or blanket
purchasing agreement resulting from this solicitation.
(2) The offeror shall enter, in the block with its name and address on the cover page of its offer,
the annotation DUNS or DUNS+4 followed by the DUNS or DUNS+4 number that
identifies the offerors name and address exactly as stated in the offer. The DUNS number will
be used by the Contracting Officer to verify that the offeror is registered in the SAM database.
(c) If the offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to
obtain one.
(1) An offeror may obtain a DUNS number
(i) Via the internet at http://fedgov.dnb.com/webform or if the offeror does not have internet
access, it may call Dun and Bradstreet at 1-866-705-5711 if located within the United States; or
(ii) If located outside the United States, by contacting the local Dun and Bradstreet office. The
offeror should indicate that it is an offeror for a U.S. Government contract when contacting the
local Dun and Bradstreet office.
(2) The offeror should be prepared to provide the following information:
(i) Company legal business name.
(ii) Tradestyle, doing business, or other name by which your entity is commonly recognized.
(iii) Company physical street address, city, state and Zip Code.
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(iv) Company mailing address, city, state and Zip Code (if separate from physical).
(v) Company telephone number.
(vi) Date the company was started.
(vii) Number of employees at your location.
(viii) Chief executive officer/key manager.
(ix) Line of business (industry).
(x) Company Headquarters name and address (reporting relationship within your entity).
(d) If the Offeror does not become registered in the SAM database in the time prescribed by the
Contracting Officer, the Contracting Officer will proceed to award to the next otherwise
successful registered Offeror.
(e) Processing time, which normally takes 48 hours, should be taken into consideration when
registering. Offerors who are not registered should consider applying for registration
immediately upon receipt of this solicitation.
(f) Offerors may obtain information on registration at https://www.acquisition.gov.
(End of Provision)
FAR 52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE
MAINTENANCE (JUL 2016)
a) Definition. As used in this clause

Commercial and government Entity (CAGE) code means
(1) An identifier assigned to entities located in the United States or its outlying areas by the
Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to
identify a commercial or Government entity, or
(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by
the NATO Support and Procurement Agency (NSPA) to entities located outside the United
States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch
records and maintains in the CAGE master file. This type of code is known as the NATO CAGE
(NCAGE) code.
(b) Contractors shall ensure that the CAGE code is maintained throughout the life of the contract.
For contractors registered in the System for Award Management (SAM), the DLA Commercial
and Government Entity (CAGE) Branch shall only modify data received from SAM in the
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CAGE master file if the contractor initiates those changes via update of its SAM registration.
Contractors undergoing a novation or change-of-name agreement shall notify the contracting
officer in accordance with subpart 42.12. The contractor shall communicate any change to the
CAGE code to the contracting officer within 30 days after the change, so that a modification can
be issued to update the CAGE code on the contract.
(c) Contractors located in the United States or its outlying areas that are not registered in SAM
shall submit written change requests to the DLA Commercial and Government Entity (CAGE)
Branch. Requests for changes shall be provided at https://cage.dla.mil . Change requests to the
CAGE master file are accepted from the entity identified by the code.
(d) Contractors located outside the United States and its outlying areas that are not registered in
SAM shall contact the appropriate National Codification Bureau (points of contact available
at http://www.nato.int/structur/AC/135/main/links/contacts.htm) or NSPA
athttps://eportal.nspa.nato.int/AC135Public/scage/CageList.aspx.
(e) Additional guidance for maintaining CAGE codes is available at https://cage.dla.mil.
(End of Clause)
FAR 52.215-1 INSTRUCTIONS TO OFFERORS -- COMPETITIVE
ACQUISITION (JAN 2004)
Definitions. As used in this provision -Discussions are negotiations that occur after establishment of the competitive range that may,
at the Contracting Officers discretion, result in the offeror being allowed to revise its proposal.
In writing, writing, or written means any worded or numbered expression which can be
read, reproduced, and later communicated, and includes electronically transmitted and stored
information.
Proposal modification is a change made to a proposal before the solicitations closing date and
time, or made in response to an amendment, or made to correct a mistake at any time before
award.
Proposal revision is a change to a proposal made after the solicitation closing date, at the
request of or as allowed by a Contracting Officer as the result of negotiations.
Time, if stated as a number of days, is calculated using calendar days, unless otherwise
specified, and will include Saturdays, Sundays, and legal holidays. However, if the last day falls
on a Saturday, Sunday, or legal holiday, then the period shall include the next working day.
(b) Amendments to solicitations. If this solicitation is amended, all terms and conditions that are
not amended remain unchanged. Offerors shall acknowledge receipt of any amendment to this
solicitation by the date and time specified in the amendment(s).
Page 85 of 112
(c) Submission, modification, revision, and withdrawal of proposals.

(1) Unless other methods (e.g., electronic commerce or facsimile) are permitted in the
solicitation, proposals and modifications to proposals shall be submitted in paper media in sealed
envelopes or packages
(i) addressed to the office specified in the solicitation, and
(ii) showing the time and date specified for receipt, the solicitation number, and the name and
address of the offeror. Offerors using commercial carriers should ensure that the proposal is
marked on the outermost wrapper with the information in paragraphs (c)(1)(i) and (c)(1)(ii) of
this provision.
(2) The first page of the proposal must show -(i) The solicitation number;
(ii) The name, address, and telephone and facsimile numbers of the offeror (and electronic
address if available);
(iii) A statement specifying the extent of agreement with all terms, conditions, and provisions
included in the solicitation and agreement to furnish any or all items upon which prices are
offered at the price set opposite each item;
(iv) Names, titles, and telephone and facsimile numbers (and electronic addresses if available) of
persons authorized to negotiate on the offerors behalf with the Government in connection with
this solicitation; and
(v) Name, title, and signature of person authorized to sign the proposal. Proposals signed by an
agent shall be accompanied by evidence of that agents authority, unless that evidence has been
previously furnished to the issuing office.
(3) Submission, modification, revision, and withdrawal of proposals.
(i) Offerors are responsible for submitting proposals, and any modification, or revisions, so as to
reach the Government office designated in the solicitation by the time specified in the
solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time,
for the designated Government office on the date that proposal or revision is due.
(ii)
(A) Any proposal, modification, or revision received at the Government office designated in the
solicitation after the exact time specified for receipt of offers is late and will not be considered
unless it is received before award is made, the Contracting Officer determines that accepting the
late offer would not unduly delay the acquisition; and --
Page 86 of 112
(1) If it was transmitted through an electronic commerce method authorized by the solicitation, it
was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m.
one working day prior to the date specified for receipt of proposals; or
(2) There is acceptable evidence to establish that it was received at the Government installation
designated for receipt of offers and was under the Governments control prior to the time set for
receipt of offers; or
(3) It is the only proposal received.
(B) However, a late modification of an otherwise successful proposal that makes its terms more
favorable to the Government, will be considered at any time it is received and may be accepted.
(iii) Acceptable evidence to establish the time of receipt at the Government installation includes
the time/date stamp of that installation on the proposal wrapper, other documentary evidence of
receipt maintained by the installation, or oral testimony or statements of Government personnel.
(iv) If an emergency or unanticipated event interrupts normal Government processes so that
proposals cannot be received at the office designated for receipt of proposals by the exact time
specified in the solicitation, and urgent Government requirements preclude amendment of the
solicitation, the time specified for receipt of proposals will be deemed to be extended to the same
time of day specified in the solicitation on the first work day on which normal Government
processes resume.
(v) Proposals may be withdrawn by written notice received at any time before award. Oral
proposals in response to oral solicitations may be withdrawn orally. If the solicitation authorizes
facsimile proposals, proposals may be withdrawn via facsimile received at any time before
award, subject to the conditions specified in the provision at 52.215-5, Facsimile Proposals.
Proposals may be withdrawn in person by an offeror or an authorized representative, if the
identity of the person requesting withdrawal is established and the person signs a receipt for the
proposal before award.
(4) Unless otherwise specified in the solicitation, the offeror may propose to provide any item or
combination of items.
(5) Offerors shall submit proposals in response to this solicitation in English, unless otherwise
permitted by the solicitation, and in U.S. dollars, unless the provision at FAR 52.225-17,
Evaluation of Foreign Currency Offers, is included in the solicitation.
(6) Offerors may submit modifications to their proposals at any time before the solicitation
closing date and time, and may submit modifications in response to an amendment, or to correct
a mistake at any time before award.
(7) Offerors may submit revised proposals only if requested or allowed by the Contracting
Officer.
Page 87 of 112
(8) Proposals may be withdrawn at any time before award. Withdrawals are effective upon
receipt of notice by the Contracting Officer.
(d) Offer expiration date. Proposals in response to this solicitation will be valid for the number of
days specified on the solicitation cover sheet (unless a different period is proposed by the
offeror).
(e) Restriction on disclosure and use of data. Offerors that include in their proposals data that
they do not want disclosed to the public for any purpose, or used by the Government except for
evaluation purposes, shall -(1) Mark the title page with the following legend:
This proposal includes data that shall not be disclosed outside the Government and shall not be
duplicated, used, or disclosed -- in whole or in part -- for any purpose other than to evaluate this
proposal. If, however, a contract is awarded to this offeror as a result of -- or in connection with - the submission of this data, the Government shall have the right to duplicate, use, or disclose
the data to the extent provided in the resulting contract. This restriction does not limit the
Governments right to use information contained in this data if it is obtained from another source
without restriction. The data subject to this restriction are contained in sheets [insert numbers or
other identification of sheets]; and
(2) Mark each sheet of data it wishes to restrict with the following legend:
Use or disclosure of data contained on this sheet is subject to the restriction on the title page of
this proposal.
(f) Contract award.
(1) The Government intends to award a contract or contracts resulting from this solicitation to
the responsible offeror(s) whose proposal(s) represents the best value after evaluation in
accordance with the factors and subfactors in the solicitation.
(2) The Government may reject any or all proposals if such action is in the Governments
interest.
(3) The Government may waive informalities and minor irregularities in proposals received.
(4) The Government intends to evaluate proposals and award a contract without discussions with
offerors (except clarifications as described in FAR 15.306(a)). Therefore, the offerors initial
proposal should contain the offerors best terms from a cost or price and technical standpoint.
The Government reserves the right to conduct discussions if the Contracting Officer later
determines them to be necessary. If the Contracting Officer determines that the number of
proposals that would otherwise be in the competitive range exceeds the number at which an
efficient competition can be conducted, the Contracting Officer may limit the number of
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proposals in the competitive range to the greatest number that will permit an efficient
competition among the most highly rated proposals.
(5) The Government reserves the right to make an award on any item for a quantity less than the
quantity offered, at the unit cost or prices offered, unless the offeror specifies otherwise in the
proposal.
(6) The Government reserves the right to make multiple awards if, after considering the
additional administrative costs, it is in the Governments best interest to do so.
(7) Exchanges with offerors after receipt of a proposal do not constitute a rejection or
counteroffer by the Government.
(8) The Government may determine that a proposal is unacceptable if the prices proposed are
materially unbalanced between line items or subline items. Unbalanced pricing exists when,
despite an acceptable total evaluated price, the price of one or more contract line items is
significantly overstated or understated as indicated by the application of cost or price analysis
techniques. A proposal may be rejected if the Contracting Officer determines that the lack of
balance poses an unacceptable risk to the Government.
(9) If a cost realism analysis is performed, cost realism may be considered by the source
selection authority in evaluating performance or schedule risk.
(10) A written award or acceptance of proposal mailed or otherwise furnished to the successful
offeror within the time specified in the proposal shall result in a binding contract without further
action by either party.
(11) If a post-award debriefing is given to requesting offerors, the Government shall disclose the
following information, if applicable:
(i) The agencys evaluation of the significant weak or deficient factors in the debriefed offerors
offer.
(ii) The overall evaluated cost or price and technical rating of the successful and the debriefed
offeror and past performance information on the debriefed offeror.
(iii) The overall ranking of all offerors, when any ranking was developed by the agency during
source selection.
(iv) A summary of the rationale for award.
(v) For acquisitions of commercial items, the make and model of the item to be delivered by the
successful offeror.
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(vi) Reasonable responses to relevant questions posed by the debriefed offeror as to whether
source-selection procedures set forth in the solicitation, applicable regulations, and other
applicable authorities were followed by the agency.
(End of Provision)
FAR 52.216-1 TYPE OF CONTRACT (APR 1984)
The Government contemplates award of a Hybrid Contract which employs Fixed Unit Prices,
Fixed Price with Economic Price Adjustment and Time and Materials resulting from this
solicitation.
(End of Provision)
FAR 52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation
(Feb 1999)
If a contract in the amount of $10 million or more will result from this solicitation, the
prospective Contractor and its known first-tier subcontractors with anticipated subcontracts of
$10 million or more shall be subject to a preaward compliance evaluation by the Office of
Federal Contract Compliance Programs (OFCCP), unless, within the preceding 24 months,
OFCCP has conducted an evaluation and found the prospective Contractor and subcontractors to
be in compliance with Executive Order 11246.
(End of Provision)
FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

(a) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed
directly with an agency, and copies of any protests that are filed with the Government
Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows)
by obtaining written and dated acknowledgment of receipt from address in Block 7 of the
Standard Form 33.
(b) The copy of any protest shall be received in the office designated above within one day of
filing a protest with the GAO.
(End of Provision)
L.2.
GENERAL INSTRUCTIONS
L.2.1. This section provides general guidance for preparing proposals as well as specific
instructions on the format and content of the proposal. Offerors are cautioned to follow the
instructions provided in this section carefully to ensure that the Government receives consistent
information in a format that will facilitate proposal evaluation. The offer shall be compliant with
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the requirements as stated in the solicitation and applicable attachments. Nonconformance with
the instructions provided in the solicitation and this section may result in an unfavorable
proposal evaluation or rejection of the proposal. The written proposal shall be clear, concise, and
include sufficient detail for effective evaluation and for substantiating the validity of stated
claims. Offerors are required to submit a proposal encompassing all items listed in Section B
herein. Offerors are advised that material submitted in excess of that required herein will NOT be
evaluated. The proposal shall be valid for no less than 180 days from the date the
solicitation is closed.
L.2.2. Proposals will be evaluated based on written information submitted by offerors. The
proposal should not simply rephrase or restate the Government's requirements, but
shall provide clear explanation that demonstrates understanding of the requirements and
addresses how the offeror intends to meet the requirements. Offerors shall assume that the
Government has no prior knowledge of their facilities, capabilities and experience. The
Government will base its evaluation on the information presented, plus any additional Past
Performance information obtained by the Government from other sources.
L.2.3. The Government reserves the right to award without discussions. Therefore, the offerors
initial offer should contain the offerors best terms from a price and technical standpoint. If an
offeror (1) fails or refuses to assent to any of the terms and conditions of the Request for
Proposal (RFP), (2) proposes additional terms and conditions of this RFP or (3) fails to submit
any of the information required by this RFP, the Contracting Officer may consider the offer to be
unacceptable, which could make the offer ineligible for contract award.
L.2.4. Only one contract award will result from this solicitation and Offerors shall only submit
one proposal. Alternate proposals will not be accepted or evaluated by the Government. If
an offeror submits more than one proposal, the Government will not evaluate any proposal from
that offeror. Award will only be made to an Offeror that has no organizational conflict of interest
as defined in FAR 9.5 or that the Government determines has provided a satisfactory mitigation
plan.
L.2.5. If an offeror believes that the requirements in these instructions contain an error,
omission, or are otherwise unsound, the offeror shall notify the Contracting Officer in writing
with supporting rationale not later than 15 days before the proposal due date.
L.3.
ORGANIZATIONAL CONFLICT OF INTEREST
L.3.1. The Offeror shall represent in writing within the proposal that, to the best of the
Offeror's knowledge, there are no relevant facts or circumstances concerning any past, present,
or potential contracts or financial interest relating to the work to be performed, which could give
rise to an organizational conflict of interest, as described in FAR, Subpart 9.5. (also see Section
H.15.). In the event an actual or potential organizational conflict of interest exists, the Offeror
shall submit a mitigation plan to the Contracting Officer, no later than 15 calendar days prior to
the proposal due date, that effectively demonstrates how the Offeror will mitigate any actual or
potential organizational conflict of interest while supporting this contract.
L.3.2. The Contracting Officer will review all mitigation plans to determine whether award to
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the Offeror is consistent with FAR, Subpart 9.5. If the Contracting Officer determines that no
conflict would arise or that the mitigation plan adequately protects the interest of the
Government, the Offeror will be eligible for award. If the Contracting Officer determines that
the mitigation plan is inadequate, remedial actions will be considered, including elimination
from the solicitation process, termination of related contract efforts already awarded, or
negotiation of the mitigation plan.
L.3.3. The above restrictions shall be included in all subcontracts, teaming arrangements,
and other agreements calling for performance of work which is subject to the organizational
conflict of interest restrictions.
L.4.
INQUIRIES CONCERNING THIS SOLICITATION
L.4.1. The Contracting Officer is the sole point of contact for this procurement. Questions
regarding the solicitation or other concerns are to be submitted electronically to the Contracting
Officer and received by 2:00 p.m. (local time), November 14, 2016 via e-mail address:
struehartmckinney@peacecorps.gov. Except for questions from offerors regarding Conflict of
Interest, all questions and answers, amendments to the solicitation (if applicable), and other
informational documents regarding the RFP will be posted on Federal Business Opportunities
(FEDBIZOPPS) web site at www.fbo.gov. The Government will post industry questions and
Government comments received after the aforementioned date on a best-effort basis. Comments
or questions regarding Conflict of Interest will not be posted, but will be responded to
individually via email.
Offerors are cautioned against directing any questions concerning this RFP to anyone
other than the Contracting Officer.
L.4.2. The remarks, explanations, and answers provided by Government representatives
whether orally, or in writing, shall not change or qualify any of the terms or conditions of the
solicitation. The solicitation can only be changed by a written amendment issued by the
Contracting Officer.
L.5. PROPOSAL PREPARATION AND SOLICITATION RESPONSE
REQUIREMENTS
L.5.1 The offerors written proposal shall consist of four (4) physically separated parts/volumes,
individually titled as indicated below. Page limitations and number of hard copies of each
Part/Volume are shown below. Material submitted in excess of the page limitations will not be
evaluated. If there are any discrepancies between the originals, additional copies, and/or
Compact Disc Read-Only Memory (CD-ROM), the originals will govern.
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Volume
I
II
III
IV
I-IV
Volumes
I-IV
Title
Executed Offer
Technical Proposal
Past Performance
Price Proposal
Organization Chart
Volume Set*
Originals
CD-ROM
1
1
1
1
1 (Vol. I)
1
1
1
1
Additional
Copies
1
5
3
1
3 (Vol. II-IV)
Page Limit
See Section L.6
75
12
N/A
3
1 PDF
*The Offeror shall submit one set of Volumes I through IV documents in PDF OCR format. The
set may be submitted on one CD-ROM if size permits. The CD-ROM shall be labeled as stated
in Section L.5.3 to included stating it is the Volume Set.
L.5.2. Paper Copies. Paper copies shall be separated by Volume, each in a 3ring binder and identified with the offerors name, volume number, volume title, proposal date
and solicitation number. A separate binder is required for each Volume. All paper copy
proposal narrative material shall be submitted on white paper with at least one inch (1")
margins on all sides. The font for both CD-ROM and paper submissions shall be Times New
Roman, not smaller than 12 points; however, smaller fonts on areas of the proposal that will not
easily accommodate 12 point font and limited to illustrations, organization charts, supporting
data exhibits ,or report listings, are permitted as small as 8 point font. Elaborate brochures or
documentation, binding, detailed artwork, or other embellishments shall not be submitted.
Proposals shall be printed double-sided, double spaced, with nonduplicative,
sequential page numbers at the bottom of each printed page. Double spacing does
not apply to the table of contents, illustrations, organization charts, supporting data exhibits,
or report listings. The cover page of each volume shall include the volume number and title, the
solicitation number, full name of Offeror, the address, point of contact, phone number, and email address of the Offeror. Each page will also include the offerors name and solicitation
number. All originals may be shipped in the same box. However, originals shall be separately
wrapped inside the container, and clearly labeled ORIGINAL TECHNICAL PROPOSAL,
ORIGINAL PAST PERFORMANCE, etc.
L.5.3. Electronic Copies. The electronic portion of the offerors written proposal shall be
submitted on virus-free CD- ROMs that are compatible with Microsoft Office 2003 or later
applications. The set may be submitted on one CD-ROM if size permits. For the copies listed
above, the documents shall be either in Word or Excel format. If this is not possible, then a PDF
document in Optical Character Reader (OCR) format is acceptable for all volumes except
Volume II. Volume II shall be in Microsoft Word and/or Excel. Any and all spreadsheets
submitted shall contain the formulas used to derive each value, including links to other
spreadsheets (if applicable). Each CD-ROM shall be marked as follows:
Offerors Company Name
Solicitation# PC-17-R-007
Health Care Benefits Services Contract
Volume #
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The CD-ROM shall follow the same format as the paper copy with major sections in separate
and labeled directories. Electronic versions shall be exact duplicates of the paper copy proposals
in both content and format. The electronic documents must be searchable. No part of a Volume
shall incorporate by reference portions of other Volumes of the proposal (e.g., Volume IV
Pricing cannot be referenced in Volume II Technical). Information may be referenced within the
same Volume rather than duplicating the information within that Volume.
The Page Count shall not include:
a. Cover Pages
b. Introduction/Executive Summary (limited to 5 pages)
c. Title Pages
d. Tables of Contents
e. Lists of Figures, Tables, Illustrations and Appendices
f. Tab Pages
g. Glossaries of acronyms and abbreviations
h. Quality Assurance Surveillance Plan (QASP) (see Sections C.2.4.3 and E.3)
L.5.4. Submission of Offer.
L.5.4.1. Offerors shall submit their written proposals to the Contracting Officer at the address
indicated below. Written proposals shall be submitted in electronic and hard copy format (see
L.5). Hard copies and CDs shall be submitted to:
(RFP- PC-17-R-007)
L.5.4.2. Proposals Shipped via Parcel Delivery. The Government will not accept facsimile or
Internet submissions of offers for this procurement. All hard copies of proposals must be
submitted in sealed boxes or envelopes with the correct number of hardcopies and CDs as
indicated here in Section L. The address and point of contact for shipment is located in Section
L.5.4.1.
L.5.4.3. Hand Carried Proposals. Hand carried proposals must be delivered to the address in
Section L.5.4.1. by the time and date specified on the SF-33. Proposals received after the time
and date specified for receipt will be considered LATE in accordance with FAR provision
52.215-1(c)(3) "Instructions to Offerors - Competitive Acquisition . Offerors hand carrying
proposals shall call and email the contracting officer (Sonja Truehart-McKinney 202-6922840/struehartmckinney@peacecorps.gov) 24 hours prior to arriving at the Peace Corps.
L.5.5. Proposal Preparation Costs. This request for proposal (RFP) does not commit the
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Government to pay any costs incurred in the submission of any proposal or in making necessary
studies for the preparation thereof. Nor does it commit the Government to procure or contract
for said services. The Contracting Officer is the only individual who can commit the government
to the expenditure of public funds in connection with this proposed procurement.
L.6. Volume I Executed Offer
L.6.1. Volume I shall contain one signed original of all documents requiring signature of the
Offeror. Use of reproductions of the signed original is authorized in the copies. One signed copy
of the solicitation (Sections A, B, C, D, E, F, G, H, I, and J) and all amendments shall be
submitted. This signed copy should include the Standard Form 33, Solicitation, Offer and
Award, with blocks 12 through 18 completed by the Offeror. The SF 33 will be used to make
award if an Offeror is the successful Offeror. As such, the representative who signs this form
must be authorized to contractually bind the company providing the offer. Block 12 must
indicate that the offer is valid for 180 days from the date for receipt of offers. For the purposes of
completing this requirement, the Offeror shall submit a signed copy of each amendment SF-30
cover page (if applicable) indicating recognition and acceptance of each amendment.
L.6.2. The Offeror shall submit resumes for three Key Personnel (limited to three pages per
resume) in accordance with the requirement specified in Section H.10 of this solicitation.
L.6.3. The provision in Section K, FAR 52.204-8, Annual Representations and Certifications,
must be completed and submitted with Volume I. An online Representations and Certifications
Application is available at https://www.uscontractorregistration.com/.
L.6.4.The Contractors point of contact information for Section G.3 of this solicitation shall be
included in Volume I.
L.6.5. The Offerors attention is directed to Section I clauses FAR 52.219-and FAR 52.219-16.
As prescribed in FAR 19.708, Offerors other than small business concerns shall submit a small
business subcontracting plan and that plan, once approved, shall be made part of any contract
resulting from this solicitation. The offer shall include in Volume I the requirements for Factor 4
Subcontracting Plan and Small Business Participation (see Section L.10.).
L.6.6. If the Offeror qualifies as a small disadvantaged business under this procurement (see
FAR 52.204-8), Volume I shall include a cover letter explicitly stating so and whether it is
waiving the price evaluation adjustment. In addition, if teaming or subcontracting will be used
to perform the contract, identify all team members, business size, and the role each will play.
L.6.7. The Offeror shall prepare a Quality Assurance Surveillance Plan (QASP) for the
Government s consideration in development of the Governments Plan (see Section C.2.4.3.).
L.6.8. Financial Viability. The offeror must demonstrate adequate financial resources to
perform the prospective contract or demonstrate an ability to obtain adequate financial
resources. The financial information submitted or other information available will be
considered by the Contracting Officer in making a financial responsibility determination.
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Failure of an offeror to submit financial information may result in the Contracting

Officer making a determination the offeror is not responsible.
L.6.9. The offeror must submit its most recent Dun and Bradstreet (D&B) Comprehensive
Report or, if not available, another rating company report that is essentially equivalent to D&B
(e.g., A.M. Best Company). The Offeror must have a current minimum financial strength rating
of A- (excellent) as assigned by the A.M. Best Company (A.M. Best) and/or Standard and Poors
current minimum rating of AA (very strong). This documentation must be submitted on the
parent corporation, on the subsidiary offeror, and on any recent or prospective significant merger
candidates. This information is to be submitted on a CD-ROM and included in Volume I
Executed Offer, bundled separately and labeled accordingly. A hard copy is not required.
L.6.10. The Contractors application and hosting platform must be FedRAMP Compliant: JAB
Provisional Authorization, Agency Authorization, and CSP Supplied Package. If the Contractor
does not have FedRAMP Certification, the Contractor must have plans in place that will result in
FedRAMP certification within three (3) months from the date of proposal submittal. The
Contractor shall include their FedRAMP certification or their plan for certification in Volume
I. If the Contractor does not have or plan to get FedRAMP Certification, the Contractor must
present an active FISMA compliant ATO from one or more US Government agencies. If the
Contractor is not FedRAMP certified and does not have an Agency ATO, then the Contractor
shall prepare a complete Security Assessment Package (SAP) for the system/solution in
accordance with NIST SP 800-53 rev 4. The Contractor shall have a System Assessment and
Authorization performed by an independent third-party assessor. The Contractor shall remediate
the findings and vulnerabilities identified during that assessment. The Peace Corps Information
Security office will review the SAP and issue an ATO if all documentation is complete and
meets security requirements. The Contractors system will not be accepted by Peace Corps until
an ATO is achieved by the Contractor. Minimum SAP includes a System Security Plan, Security
Test & Evaluation (ST&E) Plan, Security Assessment Report, Contingency Plan,
Interconnection Security Agreement, Plan of Action and Milestones (POA&M), Risk
Assessment and Security Controls Assessor Recommendation Memo.
L.7. Volume II TECHNICAL PROPOSAL
L.7.1. The Technical Proposal shall be specific and complete so as to clearly demonstrate to the
Government that the Offeror has a thorough comprehension of the solicitation requirements and
capabilities to perform Statement of Work requirements. Paragraph numbering and
identification shall coincide with Section L.7.1.2. through Section L.7.6.2 below. The Offeror
shall structure the proposal so information provided for each section is as comprehensive as
possible. The information provided for each section should be sufficiently self-contained to
minimize the need to refer to other Proposal sections for evaluation purposes. If cross-references
are needed, page and paragraph numbers shall be included.
L.7.1.2. The proposal may state information on the offerors experience (for this purpose,
experience refers to what an offeror has done, not how well it was accomplished) in performing
proposed processes and procedures. This information may be considered in the evaluation of
specific technical approaches and related technical proposal risk. However, any such information
Page 96 of 112
in the technical proposal will not be considered for purposes of the overall past performance
rating as described in Section M.5. The price proposal and past performance information
shall not be addressed in the technical proposal volume.
L.7.1.3. An offeror may propose standards that exceed the Governments minimum standards or
propose additional standards or requirements. The offeror must commit to these in the proposal
and must state the proposed standard/requirement in contractual language that the Government
would be able to incorporate into the contract as stated. The proposal must clearly describe and
explain how the offeror will meet these proposed standards that either exceed the Governments
minimum standard, or are additional standards or requirements. If the Government determines
that these proposed standards or requirements will be considered advantageous to the
Government during contract performance, at its sole discretion the Government will incorporate
these into the contract.
L.7.2. Subfactor 1- Claims Processing
L.7.2.1. The offeror shall describe how its existing or proposed claims processing system
and business rules will meet or exceed the Governments requirements. At a minimum, this
description shall include the offerors method and/or process for:
Establishing, maintaining, and monitoring an automated claims processing system to

ensure that claims (including adjustments) meet the functional system requirements set
forth in Section H.11 and include the receipt and transmission of HIPAA compliant
transactions
Resolving complaints between the Peace Corps Health Care Benefits Program members
and the Claims processing personnel
Reviewing, receiving and controlling both paper and electronic claims
Resolving and following up on claims pended or denied
Obtaining missing claim information and accomplishing claim development
Ensuring beneficiaries have been properly authorized prior to paying the claim and that
only those services which are related to the authorization are covered
Creating and distributing the Explanation of Benefits (EOB)
Disbursing provider payments in the appropriate currency
Meeting or exceeding the Governments standards for claims processing timeliness
and accuracy
Establishing a medium to be used by Peace Corps to transmit eligibility information and
authorization documentation
Managing claims outside the network
L.7.2.2. The offeror shall describe how its existing or proposed claims processing system
and business rules will identify billing that is substantially in excess of reasonable and
customary charges for the providers locality.
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L.7.3. Subfactor 2- Customer Service

L.7.3.1. The offeror shall describe its proposed approach for providing thorough, accurate and
prompt customer service. Specifically, the offeror shall describe their process(es) for:
Managing inquiries from Peace Corps staff and beneficiaries through e-mail, online chat,
web portal, call center, and paper transmittal (e.g. facsimile)
Providing Peace Corps staff and beneficiaries access to a list of appropriate network
provider(s). Ensure beneficiaries of group short-term health care (Plan 4) have access to
information describing the health care plan (e.g. monthly premium cost, duration of plan,
payment methods).
Providing timely notification and assistance for bills that have gone unpaid for
approved claims
Providing timely notification and assistance for bills that have gone unpaid for
unapproved claims
L.7.3.2. The offeror shall describe how it will ensure that Customer Service Representative
functions are performed with knowledgeable, courteous and responsive staff. This description
shall explain how the offeror will ensure the accuracy of responses to provider, beneficiary and
PC staff inquiries. The offeror shall not propose its own beneficiary and provider surveys.
L.7.4. Subfactor 3- Management
L.7.4.1. The Offeror shall describe its management and procedures for establishing and
maintaining adequate qualified staff , facilities, and infrastructure in order to meet the objectives
and requirements of this contract. If the Offeror has existing staff, facilities, and infrastructure
that meet the requirements of this contract, it shall describe how these will be modified and/or
maintained to ensure that the requirements of this contract are met.
L.7.4.2. The Offeror shall describe and demonstrate its ability to ensure standards of ethical
conduct, privacy and information security are achieved. The description shall include the
Offerors ability to comply with HIPAA, FISMA and Peace Corps system requirements. If the
Offeror is not currently compliant with HIPAA and FISMA, the Offeror shall describe how it
intends to become compliant, including a timeline and final date for compliance. The Offeror
shall include a timeline and final date for complying with Peace Corps system requirements.
L.7.4.3. The Offeror shall describe how it intends and its ability to automate the Peace Corps
authorization and eligibility process. The description shall include the type of hardware (if
applicable), data, people and process required, the type of software that will be used ( i.e.
propriety, commercial off-the-shelf (COTS)). The Offeror shall include in its proposal if the
system will be an extension of the Offerors existing system or a new system. If an existing
system is being used, how the system will be modified (if applicable) and the timeline it will take
to have the automated system up and running. The Offeror shall also describe how this system
will comply with HIPAA, FISMA and Peace Corps system requirements (see C.9 and H.11).
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L.7.4.4. The offeror shall describe its ability to manage contractor and subcontractor operations
to meet the contract requirements. The description shall include organizational structure; lines of
authority; decision points; maintenance of documented processes, procedures, and instructions;
subcontractor management; and performance monitoring and reporting.
L.7.4.5. The offeror shall describe how its proposed internal quality control/quality improvement
program will be established and continuously operated to ensure the required performance
standards and service levels are achieved (see C.2.4.). The Offeror shall demonstrate how its
internal controls and quality assurance system will adequately monitor the contract and identify
and quickly resolve problems.
L.7.5. Subfactor 4- Provider Networks
L.7.5.1. The offeror shall describe how it will provide high quality, expansive health care
provider networks, both nationally and internationally (to include credentialed hospitals for
national network providers, physicians, ancillary service providers, mental health professionals,
dentists, pharmacies, diagnostic and treatment facilities, and air ambulance services), in
accordance with the contract requirements. If the network does not exist, or if the offerors
current network is insufficient to support access to care for Peace Corps beneficiaries, the offeror
shall describe how it will develop the network
to ensure that beneficiaries have access to providers by the end of the transition period. The
offeror shall describe how Peace Corps staff and beneficiaries will access benefits information
and doctor and hospital directories.
L.7.5.2. The Offeror shall describe the business approach that will be utilized to ensure that the
number of providers is sufficient to ensure timely access to care for Peace Corps beneficiaries.
L.7.5.3. The offeror shall describe its process(es) for using utilization services (utilization
review), issuing Guarantees of Payments to physicians and hospitals in a timely matter, and
managing subrogation services.
L.7.5.4. The offeror shall describe how the offerors oversight, data analysis and support
systems are designed to monitor access to care, so that instances of network inadequacy will
be promptly identified and addressed by the Contractor.
L.7.6. Subfactor 5- Transition Plan
L.7.6.1. The offeror shall describe how its transition-in actions will ensure that all
services and systems are fully operational according to the contract requirements. The
offeror shall provide a draft transition phase-in plan (see C.3.1.), which includes a description of
and timeline for all major start-up activities to be accomplished during the transition-in period.
This shall be an event-based plan that includes the major events to be accomplished during
transition in and the significant accomplishments associated with each event. The plan shall
include a timeline and should be sufficiently detailed to allow for tracking progress towards
the completion of transition-in requirements.
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L.7.6.2. The offeror shall describe how its transition-phase out plan will successfully transition
to a new contract without interruption. The Offeror shall include a draft transition phase out plan,
which will describe how the Offeror will provide a cooperative, orderly and efficient transition
from the current contract to the new contract. The transition plan shall include how activities will
minimize disruption of services to Peace Corps staff, beneficiaries and providers.
L.8. Volume III PAST PERFORMANCE
L.8.1. This section applies to the prime contractor and its major subcontractors, if any. The
term prime contractor, for the purpose of submitting past performance information, may be
an individual company or an entity that is a consortium of entities. Also for purposes of
submitting past performance information, a major subcontractor is either a company with a
direct contractual relationship with the Offeror whose total contract price exceeds $750,000 or
more, including options or 10% of the Offerors proposed value, (whichever is less) for all
option periods, or a company who performs claims processing, or operates a call center.
A major subcontractor does not include network providers.
L.8.2. For itself and each of its major subcontractors, the Offeror shall provide relevant past
performance information on a minimum of three (3) contracts, which the Offeror or its major
subcontractor has been the prime or major subcontractor for ongoing contracts and contracts that
have concluded within the last three years. The last three years is defined as three years as of 60
calendar days prior to the initial proposal due date and considers the entire period of performance
of the contract to include the transition-in and transition-out periods. Referenced contracts should
demonstrate the Offerors depth of experience and qualifications to perform the scope of work
required under this solicitation. The similarity of the past work to the work under this solicitation
will be considered in determining the probative value of any past performance.
L.8.3. The Offeror shall prepare a synopsis of its past performance for each selected contract
with information provided in the following format:
a. Identify in specific detail for each contract listed why or how your effort is relevant or similar
to the effort required by this solicitation.
b. Contractor (and/or subcontractors, if applicable) CAGE and DUNS numbers.
c. Government or commercial contracting activity, address, and telephone number.
d. Government Contracting Officer's name, telephone number, and e-mail address.
e. Government or commercial contracting activity technical representative, or CORs telephone
number(s) and e-mail address(es).
f. Contract number
g. Contract award date
h. Contract type
i. Number of enrollees
j. Number of claims processed annually (state if not applicable to the contract).
k. Awarded price/cost (separate costs for administration and health care costs/claims).
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l. A clear explanation of management actions employed in resolving problems, ability to

promptly correct performance problems and effect of those actions, in terms of improvements
achieved or problems rectified.
A summary narrative, not to exceed 12 pages, of past performance as the prime contractor and/or
subcontractor performing work that is relevant to this solicitation. The Table of Contents and
tabs separating sections of the volume will not be counted as long as they do not contain
proposal content. All relevant past performance shall be addressed. The offeror is required to
explain what aspects of their past performance are deemed relevant in scope of services as it
relates to the requirements for this solicitation. The offeror shall provide their companys total
number of enrollees and total annual number of claims processed for the most recent 12 month
period available. If this is a newly formed company, the totals shall be that of the entity in which
they report. If the newly formed company reports directly to the parent company, then the offeror
shall report the parents totals for the most recent 12 month period available. The offeror shall
address any negative past performance in the 12 pages that it had not addressed elsewhere and
made available to the Government.
L.8.4. The offeror shall also provide the above required information for any and all contracts it
has had terminated in whole or in part for default during the past 10 years, to include those
currently in the process of such termination as well as those which are not similar to the
proposed effort.
L.8.5. Offerors without past performance history relevant to this solicitation shall submit
information relating to key personnel in the firm who have relevant past performance history.
Offerors shall specifically identify relevant past performance efforts for each individual cited,
the nature of the history and the results of the individuals efforts. Key personnel information
shall not exceed 2 pages per person.
L.8.6. The Government may obtain past performance data from any reasonably reliable
source, including, but not limited to, the references listed in the proposal, other customers
known to the Government, consumer protection organizations, and persons inside or outside the
Government who may have useful and relevant information.
L.8.7. Past Performance Questionnaire
L.8.7.1. The Offeror and each of its major subcontractor(s) shall submit a past performance
questionnaire for each of the contracts required in L.8.2. (See Section J, Attachment L.1, Past
Performance Questionnaire), directly to the most cognizant officer of the contract or, if it is a
Government contract, the Contracting Officer (CO) or Contracting Officers Representative
(COR). The Offeror shall request that the cognizant officer, CO or COR complete the
questionnaire and forward it either via email (preferred method) or Mail no later than ten (10)
days before the due date for this solicitation (see block #9 of the SF-33 of this Solicitation). The
Offeror shall not include contracts from their own subsidiaries, subcontractors, or other team
members. It is the Offerors responsibility to have the questionnaire completed by the most
cognizant officer of the contract or, if it is a Government contract, the CO or COR. The Offeror
shall submit a Past Performance Reference List in Volume III, Past Performance. The submitted
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Past Performance Reference List shall contain the information stated below. The Government
may, at its option, contact the Offerors references to discuss the offerors past performance.
PAST PERFORMANCE REFERENCE LIST
(1)
(2)
(3)
(4)
(5)
(6)
Contract No.
Contract Type
Program title
Enter if performance was in the capacity of a prime contractor or Major Subcontractor
Point of Contact, Telephone Number, and Email Address
Date Questionnaire was sent to Cognizant officer, CO or COR
PAST PERFORMANCE QUESTIONAIRES SHALL BE SUBMITTED TO:

Method
Email
Mail
Address
struehartmckinney@peacecorps.gov
(RFP- PC-17-R-007)
L.9. Volume IV PRICE PROPOSAL

L.9.1. The Offeror shall provide offered prices to support the contract requirements, including
options, as stated in Section B of the solicitation. Offerors shall use the pricing table provided as
Attachment L-2 and include it in the Volume IV submission to provide appropriate pricing. One
hybrid Firm Fixed Price (FFP), Time and Materials (T&M), Fixed Price with Economic Price
Adjustment (FP EPA) contract will result from this solicitation.
L.9.2. Adequate price competition is anticipated. However, the Contracting Officer reserves the
right to request information regarding the basis for price if he or she is unable to determine the
reasonableness of price.
L.9.3. Contract Line Item Number (CLIN) 0001, Transition Phase-In. Offerors shall propose a
firm-fixed price (one lot) in terms of whole U.S. dollars, with no cents. This price shall only
include costs anticipated during the Transition Phase-In period to accomplish the transition-in
requirements of the solicitation .
L.9.4. CLIN 0002 and (if options are exercised) 0009, 0014, 0019 and 0024, Invitee CostReimbursement Administrative Services (Plan 1). Offerors shall propose a fixed unit price in
terms of U.S. dollars and cents on a per claim basis for the base and each option period. This
price shall only include costs for administrative and support services.
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L.9.5. CLIN 0003 and (if options are exercised) 0010, 0015, 0020 and 0025, Health Care
Administrative Services for PCVs(Plan 2). Offerors shall propose a fixed unit price in terms of
U.S. dollars and cents on a member per month basis for the base and each option period. This
L.9.6. CLIN 0004 and (if options are exercised) 0011, 0016, 0021 and 0026, Health Care
Administrative Services for RPCVs (Plan 3). Offerors shall propose a fixed unit price in terms of
U.S. dollars and cents on a member per month basis for the base and each option period. This
L.9.7. CLIN 0005 and (if options are exercised) 0012, 0017, 0022, and 0027, Access to ShortTerm Group Health Insurance (Plan 4). Offerors shall propose four fixed unit prices in terms of
U.S. dollars and cents on a member per month basis for the base and each option period. One
price for Volunteer; one price for Spouse ; one price for achild under 19 years of age and one
price for a child between 19 and 26.
L.9.8. CLIN 0006 and (if options are exercised) 0013, 0018, 0023, and 0028, Medical Claims.
The ceiling prices for Medical Claims costs are based on historical and budgetary forecasts. The
price ceilings are estimates provided by the government and will not be evaluated.
L.9.9. (If option is exercised) CLIN 0007. The Offeror shall propose a firm-fixed price (one-lot),
in terms of whole U.S. dollars, with no cents, for an automated authorization and eligibility
system for Peace Corps health services.
L.9.10. CLIN 0008, Data. Data shall not be separately priced, but as part of administrative costs.
As such pricing for data will not be evaluated.
L.9.11. CLIN 0029, Transition Phase-Out (if exercised). The offeror shall propose a
firm-fixed price as one-lot, in terms of whole U.S. dollars, with no cents, for phase-out activities.
This amount must include all costs associated with transitioning to a follow-on contract.
L.9.12. In the calculation of Total Evaluated Price, the Government will apply a multiplicative
factor of 1.5 to each offerors proposed price for Option Period IV for the possible 6 month
extension of services under FAR 52.217-8, Option to Extend Services.
L.10. SUBCONTRACTING PLAN AND SMALL BUSINESS
PARTICIPATION
L.10.1. Offerors designated as large businesses shall include in Volume I a subcontracting plan
as required by FAR 19.702, FAR 19.704, FAR 52.219-8 Utilization of Small Business Concerns,
and FAR 52.219-9 Small Business Subcontracting Plan. Please note that network providers are
not considered subcontractors of the prime contractor, and therefore services provided by
network providers may not be counted in the subcontracting plan.
(End of Section L)
Page 103 of 112
SECTION M EVALUATION FACTORS FOR AWARD
M.1.
FAR 52.217-5 EVALUATION OF OPTIONS (Jul 1990)
Except when it is determined in accordance with FAR 17.206(b) not to be in the Governments
best interests, the Government will evaluate offers for award purposes by adding the total price
for all options to the total price for the basic requirement. Evaluation of options will not obligate
the Government to exercise the option(s).
(End of Provision)
M.2.
GENERAL
M.2.1. Attention is directed to FAR 52.215-1, which provides that the contract will be awarded
to that responsible Offeror whose offer, conforming to the solicitation, represents the best value
to the Government, price and other factors considered. The Government may make trade-offs
between other factors and price when determining which offer constitutes the best value to the
Government. This can result in selection of other than the low priced offer. Best value analysis
will not be performed for any Offeror who is unacceptable in any factor and award will not be
made to any Offeror who is unacceptable in any factor. Other factors shall include all of those
evaluation factors that are described in this Section M.
M.2.2. Offerors are advised that the Government intends to evaluate proposals and award a
contract without conducting discussions with Offerors (except clarifications as described in FAR
15.306(a)). Therefore, the Offerors initial proposal should contain the Offerors best terms from
a price and technical standpoint. Statements and representations made in the Offerors proposal
may be subject to verification through an onsite survey by Peace Corps evaluators, or other
sources. The Government reserves the right to conduct discussions if the Contracting Officer
later determines them to be necessary (see paragraph (4) of FAR 52.215-1(f)). If the Contracting
Officer determines that the number of proposals that would otherwise be in the competitive range
exceeds the number at which an efficient competition can be conducted, the Contracting Officer
may limit the number of proposals in the competitive range to the greatest number that will
permit an efficient competition among the most highly rated proposals.
M.3.
EVALUATION FACTORS AND RELATIVE WEIGHT
M.3.1. The Government shall evaluate each proposal against the following factors and
Subfactors:
Factor 1.0 - Technical Approach
Subfactor 1.0 Claims Processing
Subfactor 2.0 Customer Service
Subfactor 3.0 Management
Subfactor 4.0 Provider Networks
Subfactor 5.0 Transition Plan
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Factor 2.0 Past Performance

Factor 3.0 Price
Factor 4.0 - Subcontracting Plan and Small Business Participation
M.3.2. Relative Weight of Evaluation Factors. Evaluation factor 1.0 (Technical Approach) is
more important than evaluation factor 2.0 (Past Performance). All subfactors within evaluation
factor 1.0 are of equal importance. Evaluation factors 1.0, 2.0 and 4.0 combined are significantly
more important than evaluation factor 3.0 (Price). The Subcontracting Plan and Small Business
Participation Factor is significantly less important than evaluation factors 1, 2 and 3.
M.4. EVALUATION FACTOR 1 TECHNICAL APPROACH
M.4.1. The Government will evaluate each subfactor under Factor 1- Technical Approach to
determine a technical merit rating and a technical risk rating for each subfactor. The technical
merit and technical risk ratings will be considered in determining the best value to the
Government. Proposals will be evaluated on the basis of how well an offerors proposed
procedures, methods, and delivery of services meet or exceed the Governments minimum
requirements. The Government will consider whether an aspect of an Offerors proposal that has
merit or exceeds specified performance or capability requirements will be advantageous to the
Government. If the Government deems any part of the proposal to be a strength, the strength will
be credited to only one subfactor. The Government will have the sole discretion in determining
which subfactor the strength best fits. Each proposal will be evaluated separately and will be
evaluated solely on its own merits.
M.4.1.2. Technical Rating System
The Government will assess a technical merit rating to each Factor 1 subfactor . Adjectival
ratings will be assigned for each Factor 1 subfactor as described below. Adjective ratings are
reflective of how well the Proposal meets or exceeds the requirement of the RFP as well as the
degree of risk or the measure of the potential impact of a negative aspect of the Offerors
proposals on the Offerors ability to meet the requirements of the RFP. Risks can be associated
with an Offerors proposed approach in meeting Government requirements and also with the
Offerors likelihood of success in meeting those requirements. The following definitions
will apply when assigning technical ratings:
Adjective Ratings Defined:
Strength an aspect of an Offerors proposal that has merit or exceeds specified performance
or capability requirements in a way that will be advantageous to the Government during contract
performance.
Weakness means a flaw in the proposal that increases the risk of unsuccessful contract
performance. See FAR 15.001.
Significant Weakness means a flaw in the proposal that appreciably increases the risk of
unsuccessful contract performance. See FAR 15.001.
Page 105 of 112
Deficiency a material failure of a proposal to meet a Government requirement or combination

of significant weaknesses in a proposal that increases the risk of unsuccessful contract
performance to an unacceptable level. See FAR 15.001.
Technical Rating
Technical Definition
Outstanding
Proposal meets requirements and indicates an exceptional approach and
understanding of the requirements. The proposal contains multiple
strengths and no deficiencies.
Good
Proposal meets requirements and indicates a thorough approach and
understanding of the requirements. Proposal contains at least one
strength and no deficiencies.
Acceptable
Proposal meets requirements and indicates an adequate approach and
understanding of the requirements. Proposal has no strengths or
deficiencies.
Marginal
Proposal does not clearly meet requirements and has not demonstrated
an adequate approach and understanding of the requirements.
Unacceptable
Proposal does not meet requirements and contains one or more
deficiencies and is un-awardable.
M.4.1.3. Technical Risk Evaluation
In addition to the technical rating evaluation, the Government will separately evaluate the
Factor 1 subfactors for technical risk. The Government will assess the level of risk based on
the degree to which the offerors proposed technical approach may cause the potential for
disruption of schedule, degradation of performance, the need for increased Government
oversight, or the likelihood of unsuccessful contract performance. One of the following
Technical Risk ratings will be assigned to each subfactor:
Technical Risk Rating
Low
Moderate
High
Technical Risk Definition

Has little potential to cause disruption of schedule, or degradation of
performance. Normal contractor effort and normal Government
monitoring will likely be able to overcome any difficulties.
Can potentially cause disruption of schedule, or degradation of
performance. Special contractor emphasis and close Government
monitoring will likely be able to overcome difficulties.
Is likely to cause significant disruption of schedule, or degradation of
performance. Is unlikely to overcome any difficulties, even with
special contractor emphasis and close Government monitoring.
M.4.2. Subfactor 1 Claims Processing

M.4.2.1. The Government will evaluate each offeror's approach for establishing a claims
processing system that meets or exceeds the solicitation requirements. The Governments
evaluation will be based on the extent to which the offerors proposed technical approach
reflects understanding of, and compliance with, the claims processing requirements of the
Page 106 of 112
contract, as well as the soundness of the offerors proposed technical approach for
accomplishing the requirements. Of particular interest to the Government are the offerors
proposed processes for (1) establishing a claims processing system that complies with all of
the contract requirements, and (2) ensuring the identification of billing that is substantially in
excess of reasonable and customary charges for a providers locality.
The Government will evaluate the offerors proposed technical approach for:
Establishing, maintaining, and monitoring an automated claims processing system to
ensure that claims (including adjustments) meet the functional system requirements set
forth in Section H.11 and include the receipt and transmission of HIPAA compliant
transactions
Resolving complaints between the Peace Corps Health Care Benefits Program members
and the Claims processing personnel
Reviewing, receiving and controlling both paper and electronic claims
Resolving and following up on claims pended or denied due to lack of proper
documentation
Obtaining missing claim information and accomplishing claim development
Ensuring beneficiaries have been properly authorized prior to paying the claim and that
only those services which are related to the authorization are covered
Creating and distributing the Explanation of Benefits (EOB)
Disbursing provider payments in the appropriate currency
Meeting or exceeding the Governments standards for claims processing timeliness
and accuracy
Establishing a medium to be used by Peace Corps to transmit eligibility information and
authorization documentation
Managing claims outside the network
M.4.2.2. The Government will evaluate whether the offerors existing or proposed claims
processing system and business rules incorporate a sound approach for ensuring the
identification of billing that is substantially in excess of reasonable and customary charges
for the providers locality.
M.4.3. Subfactor 2 Customer Service
M.4.3.1. The Government will evaluate the extent to which the Offerors methods(s) and/or
process(es) for customer service will result in thorough, accurate and prompt customer service as
they pertain to:
Managing inquires from Peace Corps staff and beneficiaries through e-mail, online chat,
web portal, call center, and paper transmittal (e.g. facsimile)
Providing Peace Corps staff and beneficiaries access to a list of appropriate network
provider(s)
Page 107 of 112
Ensure beneficiaries of group short-term health care (Plan 4) have access to information
describing the health care plan,(e.g. monthly premium cost, duration of plan, payment
methods).
Providing timely notification and assistance for a bill that has gone unpaid for an
approved claim
Providing timely notification and assistance for a bill that has gone unpaid for an
unapproved claim
M.4.3.2. The Government will evaluate whether Customer Service Representative functions are
performed with knowledgeable, courteous and responsive staff.
M.4.4. Subfactor 3 Management
The Government will evaluate each offeror's approach for establishing management processes
that will meet the solicitation requirements. The Governments evaluation will be based on the
extent to which the offerors proposed technical approach reflects understanding of, and
compliance with, the management requirements of the contract, as well as the soundness of the
offerors proposed technical approach for accomplishing the requirements. Of particular
interest to the Government are the offerors proposed processes for (1) establishing and/or
maintaining staff, facilities, and infrastructure, (2) ability to provide ethical conduct, and privacy
and information security,(3) effectively managing contractor and subcontractor operations, (4)
establishing and continuously operating an internal Quality Control/Quality Improvement
program, and (5) identifying the management capability of the offeror as it pertains to key risk
areas (identified by the offeror).
M.4.4.1. The Government will evaluate the Offerors approach for establishing and maintaining
adequate qualified staff, facilities, and infrastructure in o ensure that the requirements of this
contract are met.
M.4.4.2. The Government will evaluate whether the Offerors proposal demonstrates ability to
ensure ethical conduct, privacy and information security, and its ability to comply with HIPAA,
FISMA and Peace Corps System Requirements.
M.4.4.3. The Government will evaluate whether the Offerors proposal demonstrates ability to
automate the Peace Corps authorization and eligibility process. Specifically, the Government
will evaluate the efficiency and effectiveness of the proposed automation system with regards to
the adequacy of the hardware (if applicable), data, people, process and software required, the
time required to stand-up the automated system, and the Offerors ability to comply with
HIPAA, FISMA and Peace Corps System requirements as defined in Sections C.9 and H.11.
M.4.4.4. The Government will evaluate whether the Offerors proposed approach demonstrates
an effective and efficient approach for managing contractor and subcontractor operations.
Specifically, the Government will evaluate the offerors proposed organizational structure;
processes and procedures; subcontractor management; and performance monitoring and
reporting.
Page 108 of 112
M.4.4.5. The Government will evaluate the offerors proposed approach for establishing
and continuously operating an internal quality control/quality improvement program
to determine whether the approach will provide the offerors management with an
effective and efficient means of identifying and quickly resolving problems.
M.4.5. Subfactor 4 Provider Networks
The Government will evaluate each offeror's approach for providing high quality, expansive
health care provider networks, both nationally and internationally (to include credentialed
hospitals for national network providers, physicians, ancillary service providers, mental health
professionals, dentists, pharmacies, diagnostic and treatment facilities, and air ambulance
services), in accordance with the contract requirements prior to the start of health care benefits
services delivery. The Governments evaluation will be based on the extent to which the
offerors proposed technical approach reflects understanding of, and compliance with, the
provider network requirements of the contract, as well as the soundness of the offerors
proposed technical approach for accomplishing the requirements. Of particular interest to the
Government are the offerors proposed processes for (1) establishing an adequate provider
network to ensure that beneficiaries have access to care by the end of the transition period, (2)
establishing effective processes and systems to ensure that the number of providers is sufficient
to ensure timely access to care for Peace Corps beneficiaries; (3) identifying processes for using
utilization services (utilization review), issuing Guarantees of Payments to physicians and
hospitals in a timely matter, and managing subrogation services; (4) identifying network
shortfalls and implementing mitigation strategies or other approaches to fulfilling the contract
requirements; and (5) identifying how Peace Corps staff and beneficiaries will access benefits
information and doctor and hospital directories.
M.4.5.1. The Government will evaluate the offerors approach for developing or providing
health care provider networks, both nationally and internationally (to include credentialed
hospitals for national provider networks, physicians, ancillary service providers, mental health
professionals, dentists, pharmacies, diagnostic and treatment facilities, and air ambulance
services), in accordance with the contract requirements prior to start of health care benefits
services delivery.
M.4.5.2. The Government will evaluate the Offerors business approach utilized to ensure that
the number of providers is sufficient to ensure timely access to care for Peace Corps
beneficiaries.
M.4.5.3. The Government will evaluate the offerors proposed approach for using utilization
services (utilization review), issuing Guarantees of Payments to physicians and hospitals in a
timely matter, and managing subrogation services.
M.4.5.4. The Government will evaluate the offerors approach for establishing effective
oversight, data analysis and other support systems that will monitor access to care and so that
instances of network inadequacy can be promptly identified and addressed.
Page 109 of 112
M.4.6. Subfactor 5 Transition Plan

The Government will evaluate each offeror's proposed transition -in and transition-phase out
approach for meeting contract requirements. The Governments evaluation will be based on the
extent to which the offerors proposed technical approach reflects understanding of, and
compliance with, the transition-in and transition phase out requirements of the contract, as well
as the soundness of the offerors proposed technical approach for accomplishing the
requirements. Of particular interest to the Government are (1) the identification of specific events
and accomplishments via a timeline tied to transitioning to a new contract, and (2) whether the
offerors approach to transitioningwill minimize service disruption to beneficiaries and
providers.
M.4.6.1. The Government will evaluate whether the offerors proposal demonstrates an
effective, comprehensive transition-in approach that will meet contract requirements in
a timely manner. The Governments evaluation will be based on the extent to which the
offerors draft transition-in plan details an event-based technical approach to executing
transition-in requirements which (1) identifies the key program events, (2) identifies specific
accomplishments tied to each event, and (3) is sufficiently detailed to allow for tracking progress
towards the completion of all transition-in requirements.
M.4.6.2. The Government will evaluate the offeror's proposed approach to transition-in to
determine if it minimizes service disruption to beneficiaries and providers during the
transition-in period.
M.5. EVALUATION FACTOR 2 PAST PERFORMANCE
M.5.1. The Government will evaluate past performance information, provided in accordance
with Section L and other sources, to determine how well an offeror has performed in the past
on recent relevant work. The Government will only consider relevant past performance
information for ongoing contracts and contracts concluded within the last three years as
defined in Section L.8.2. The Government will consider the entire period of performance of the
contract to include the transition-in and phase out periods. The past performance evaluation
will result in an assessment of the Offerors probability of meeting the solicitation requirements.
Past performance shall first be evaluated to determine how relevant a recent effort accomplished
by the Offeror is to the health care benefits services requirement. In establishing what is relevant,
consideration will be given to those aspects of an Offerors contract history that would give the
greatest ability to measure whether the Offeror will satisfy the requirement. For example: the
relevancy of scope will only be assessed on providing network services if that is the only
function the subcontractor will be providing.
M.5.2. The Government will assess an overall relevancy rating for each contract
submitted for past performance as stated below:
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Past Performance Relevancy Ratings

Relevant
Not Relevant
Relevancy Definition
Present/past performance effort involved similar scope
and magnitude of effort and complexities this
solicitation requires.
Present/past performance effort involved little or none
of the scope and magnitude of effort and complexities
this solicitation requires.
M.5.3. Once a relevancy rating has been determined, the Government will review all
available information to determine the quality of performance for each of the contracts. If an
individual contract has been assessed as not relevant, no performance review will be
conducted. The Government will identify any positive and/or negative findings noted during
the review. If any negative findings are identified during the review in which the offeror has
not had the opportunity to provide comments, the Government will notify the offeror of the
findings and allow the offeror the option to provide comments on these negative findings.
M.5.4. The Government will review this past performance information and determine the quality
and usefulness as it applies to a performance confidence assessment. In conducting performance
assessment, each Offeror shall be assigned one of the ratings in the below table. (Reference FAR
15.305(a)(2)(iv) for information on assigning an unknown/neutral confidence rating.)
Performance Confidence
Assessment Ratings
Substantial Confidence
Satisfactory Confidence
Limited Confidence
No Confidence
Unknown/Confidence (Neutral)
Description
Based on the Offerors recent/relevant performance record, the
Government has a high expectation that the Offeror will
successfully perform the required effort.
Government has a reasonable expectation that the Offeror will
Government has a low expectation that the Offeror will
Government has no expectation that the Offeror will successfully
perform the required effort.
No recent/relevant performance record is available or the Offerors
performance record is so sparse that no meaningful confidence
assessment rating can be reasonably assigned.
M.5.5. The Government will consider the offerors past performance in compliance with FAR
52.219-8, Utilization of Small Business Concerns; FAR 52.219-9, Small Business
Subcontracting Plan, including all subcontracting goals; and any contract monetary targets for
Small Disadvantaged Business Participation Program, if any. The Government may analyze
information provided by the offeror, information available within the Government, or
information from other sources.
Page 111 of 112
M.6. EVALUATION FACTOR 3 PRICE

M.6.1. Total Evaluated Price. The Total Evaluated Price will be the sum of CLINs 0001 0029
in Section B (i.e., cumulative prices for the Base and Option Period CLINs) (except as noted
below), and the Governments calculated amount for the possible six (6) month extension of
services under FAR 52.217-8, Option to Extend Services. To accomplish this calculation, the
Government will apply a multiplicative factor of 1.5 to each offerors proposed price for Option
Period IV. For CLIN 0005 and (if options are exercised) 0012, 0017, 0022, and 0027, (Access to
Short-Term Group Health Insurance (Plan 4)), the Government will calculate the arithmetic
mean of the four sub-categories for the base year and each option year, which will be included in
the cumulative prices as stated above. CLIN 0007 for data is not separately priced and will not
be added into the Total Evaluated Price; the price associated with providing data deliverables
will be included in the associated line items. CLIN 0006 and (if options are exercised) 0013,
0018, 0023, and 0028 (Medical Claims) will not be added into the Total Evaluated Price.
Although the Total Evaluated Price will include options, the evaluation of options does not in
any way obligate the Government to exercise any option.
M.7. EVALUATION FACTOR 4 SUBCONTRACTING PLAN AND SMALL
BUSINESS PARTICIPATION
M.7.1. The Government will evaluate the subcontracting plan and participation of small
businesses on an acceptable/non-acceptable basis. Acceptable Proposal clearly meets the
minimum requirements of the solicitation (Strengths are not assessed for this evaluation).
Unacceptable Proposal does not clearly meet the minimum requirements of the solicitation.
The Contracting Officer will review the subcontracting plan submitted under Volume I for the
submission requirements identified under FAR 19.702, Statutory requirements; FAR 19.704,
Subcontracting plan requirements; FAR 52.219-8 Utilization of Small Business Concerns; and
FAR 52.219-9 Small Business Subcontracting Plan. The Contracting Officer will access the
addressing of the 11 elements of the plan described in FAR 19.704.
M.7.2. The Government will assess how the offerors proposed subcontracting goals compare
with the following subcontracting goals. If the offeror does not propose the subcontracting
goals below, the Government will assess how well the offeror describes how and why their
proposed goals are set at levels that are realistic and that the parties can reasonably expect to be
met. The Government will assess the extent the offeror identifies businesses in the Plan and
demonstrates good faith efforts or plans to meet the below goals using small business, veteranowned small business, service-disabled veteran-owned small business, HUBZone small
business, small disadvantaged business (which includes historically black colleges and
minority institutions in its goal), and women-owned small business subcontractors to the
maximum extent practicable. The Subcontracting goals are as follows:
Women-Owned Small Businesses (WOSB): 5%
Small Disadvantaged Businesses (SDB): 5%
Veteran Owned Small Business (VOSB): 5%
Service-Disabled Veteran-Owned Small Businesses (SDVOSB): 3%
Historically Underutilized Business Zone (HUBZone): 3%
(End of Section M)
Page 112 of 112

Peace Corps Office of Health Services PC 16 R 007 Formal Solicitation 10-12-16

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Peace Corps Office of Health Services PC 16 R 007 Formal Solicitation 10-12-16

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1.

THIS CONTRACT IS A RATED ORDER

SOLICITATION, OFFER, AND AWARD

SEALED BID (IFB)

8. ADDRESS OFFER TO (If other than Item 7)

B. TELEPHONE (NO COLLECT CALLS)

11. TABLE OF CONTENTS

PART I - THE SCHEDULE

PART II - CONTRACT CLAUSES

OFFER (Must be fully completed by offeror)

14. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments to the

15B. TELEPHONE NUMBER

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN

15C. CHECK IF REMITTANCE

18. OFFER DATE

AWARD (To be completed by Government)

24. ADMINISTERED BY (If other than Item 7)

26. NAME OF CONTRACTING OFFICER (Type or print)

23. SUBMIT INVOICES TO ADDRESS

21. ACCOUNTING AND APPROPRIATION

25. PAYMENT WILL BE MADE BY

27. UNITED STATES OF AMERICA

28. AWARD DATE

(Signature of Contracting Officer)

STANDARD FORM 33 (Rev. 9-97)

C.11. Historical Beneficiary Demographics and Claims History

SECTION H - SPECIAL CONTRACT REQUIREMENTS

SECTION J - LIST OF DOCUMENTS, EXHIBITS, AND OTHER

L.4. Inquiries Concerning This Solicitation

A.4. Effective Date

SECTION B - SUPPLIES OR SERVICES AND COSTS/PRICES

Transition Phase-In (FFP) Planning and Implementation

Invitee Cost -Reimbursement Administrative Services

Health Care Administrative Services for Peace Corps

Health Care Administrative Services for Returned Peace

Access to Short-Term Group Health Insurance Policy

Other Direct Cost - Medical Claims IAW Section C.8.

Automated Eligibility and Authorization System (Option)

Invitee Cost -Reimbursement Administrative Services

Health Care Administrative Services for Peace Corps

Health Care Administrative Services for Returned Peace

Access to Short-Term Group Health Insurance Policy

Other Direct Cost - Medical Claims IAW Section C.8.

Invitee Cost -Reimbursement Administrative Services

Health Care Administrative Services for Peace Corps

Health Care Administrative Services for Returned Peace

Access to Short-Term Group Health Insurance Policy

C.8. (See Notes C and D)

Invitee Cost -Reimbursement Administrative Services

Health Care Administrative Services for Peace Corps

Health Care Administrative Services for Returned Peace

Access to Short-Term Group Health Insurance Policy

Other Direct Cost - Medical Claims IAW Section C.8.

Invitee Cost -Reimbursement Administrative Services

Health Care Administrative Services for Peace Corps

Health Care Administrative Services for Returned Peace

Access to Short-Term Group Health Insurance Policy

Transition Phase-Out (FFP) IAW Section C.3.2 (See Note

CL Price per Claim

0005, 0012, 0017, 0022, and

0006, 0013, 0018, 0023, and

SECTION C DESCRIPTION/ SPECIFICATIONS/ STATEMENT OF WORK

Improve the lives of people through grassroots assistance;

Foster a better understanding of other people on the part of Americans.

Intra-America and Pacific (IAP), and