Attachment 1: Statement of Work

CONTINUATION TO SF-1449

RFQ NUMBER 19BH2026Q0028

SCHEDULE OF SUPPLIES/SERVICES, BLOCK 20

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

PART I - HEALTH INSURANCE

III. Specification/Statement of Work
A.1

HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as further described in A.1.1. in Belize. The Government has determined that the prevailing practice by employers in Belize is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne by both the employee and the employer. All LE Staff covered under Post’s medical benefit plan will pay a 10% share of the premium and the U.S. government will pay 90%. Health insurance protection will be representative of locally prevailing compensation practice as further described in A.1.2. The specific health benefit coverage under this contract is set forth in Section III and the Exhibits. The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care, unless exclusion has been authorized by HR/OE/CM.
A.1.1 Employee and Dependent Health Services Benefits
A.1.1.1.
Hospitalization (treatment in the hospital for inpatient care): Services and supplies provided during hospitalization, including services provided by a licensed healthcare provider, bed & board (semi-private accommodations), operating room, recovery room, intensive care, imaging and diagnostic testing, general hospital nursing care, physical therapy, as well as drugs and medicines administered while inpatient. When private accommodations are provided, coverage will be limited to the cost of a semi-private room unless otherwise covered in an off the shelf plan. 100% Coverage
See Mental Health and Substance Abuse care (below) for details concerning inpatient psychiatric care.
See Outpatient Services (below) for details concerning professional services. A.1.1.2
Emergency Services (trips to emergency room):
Services provided for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness.

100% Coverage
A.1.1.3
Ambulance:
Professional ground transport to move a patient from the place where s/he is injured or becomes ill to the nearest hospital able to provide treatment or to move a patient from one medical facility to another.
80% Minimum Coverage
A.1.1.4
Outpatient Services:
Services provided by a certified healthcare provider on an ambulatory or outpatient basis