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Health insurance for provision of comprehensive Medical and Health Insurance services to employee of SPARC (Society for the Protection of the Rights of the Child).
The objective:
To provide comprehensive medical health & life insurance cover to all staff of SPARC.
The scope of work:
The service provider is expected to offer the following, in-patient and out-patient – medical services to staff registered under the policy to an agreed financial limit:
- Access to a private ward, single rooms in the hospital most appropriate for the case, including medical, surgical, diagnostic and therapeutic services appropriate to the accident/illness.
- Treatment of short-term (actual) medical conditions, including in patient tests, and surgery.
- Accident and emergency admission, treatment and care.
- Laboratory tests, x-ray, ultra-sound, CT and MRI scans, oncology tests and other diagnostic procedures, including testing for HIV/AIDS if required and consented by the individual;
- Cover for general medical checkups, cervical smears, mammograms, prostate cancer and other tests.
- Offer a wide range of options and medical and para-medical practitioners, clinics and hospitals to members on the scheme.
- Emergency services including ancillaries
- Miscellaneous Hospital Expenses
- Doctor prescription drugs should be covered on panel
- Dependent of employees should be covered (list of dependents will be shared with final insurance company)
- Treatment abroad incase of emergency should be covered within the prescribed limit.
- Short stay Medical Emergency should also be covered and it should be written on the health card.
Proposals are required to provide a minimum 12-month rate guarantee, with a contract period of January 1st, 2024 through 31 December, 2024.
Hospitalization and related benefits requirements for Group Health Insurance.
We are seeking for following grouped medical insurance plan for our Employees:
Medical Insurance Plan
The following cost should be covered under Plan A:-
Option 01:
- Hospitalization & related limit should be covered: –
- Employees Rs. 750,000 Each Per Year
- Patient Room limit shall cover upto Rs. 16,000 Per day
- 100% Enhancement in H&R Limits in case of accidental injuries or major injuries
Option 02: Mention Rates separately in proposal
- Employees Rs. 800,000 Each Per Year
- Patient Room limit shall cover upto Rs. 16,000 Per day
- 100% Enhancement in H&R Limits in case of accidental injuries or major injuries
Option 03: Mention Rates separately in proposal
- Outpatient Department per employee PKR. 30,000
- Outpatient Department per employee PKR. 50,000
Special OPD Features:
- Over the counter medicine without prescription of up to Rs. 1000 per purchase.
- Dental treatment which shall include root canal, extraction, filling, gums treatment up to 100% of OPD limit.
- Optical Treatment is 100 % covered but purchase of glasses and lenses covered Up to Rs. 15,000/- from OPD limit.
- All types of dermatology/skin treatments (Not Cosmetic) as prescribed by a dermatologist.
- Psychiatric Treatment
- Prescribed medical equipment including blood pressure apparatus, glucose meter, nebulizer, oximeter, hearing aid are (Up to Rs. 15,000/-) covered from OPD limit.
- Treatment from a registered Homeopathic/Hakeem up to Rs. 2,500/- per week basis.
- The PCR test of COVID-19 (on symptoms based and advised by the Doctor) will be covered from OPD Limit.
- Oral Treatment for Dengue at home and test will be covered.
- The pre-hospitalization policy should be sub limits are:
- Pre-hospitalization sub Limit (Diagnosis, Consultation, Room and Medicines) – 30 Days
- Pre-hospitalization sub Limit (Follow-Ups) – 30 Days
- Day-care Surgeries & Specialized Investigation in Patient-out setting including but not limited to:
- Revolutionary non-surgical treatment option for victims of back and neck pain, 100% Cancer Diseases, 100% Pre-Existing Diseases, Dialysis, Cataract Surgery, MRI, CT scan, Endoscopy, Thallium Scan, Angiography and Treatment of Fracture.
- Ambulance for emergencies only
- Emergency dental treatment due to accidental injuries
- Intensive Care Unit (ICU)/ CCU charges
- Surgical operation charges
- Physician visit charges (in-patient)
- Specialist consultation charges (in-patient)
- Hospital casualty ward accident & emergency services
- Eligibility:
- All full-time employees, actively at work up to 70 years of age
- Special Note:
- In case of treatment Non-PPN facilities, Reasonable and Customary charges as in PPN Shall be paid 100%.
- Pre-Existing Condition shall be covered for up to 100% of the respective H&R Limits.
- Congenital conditions shall be covered up to 100% of available H&R Limits. Includes cancers, Heart & kidney treatments, etc.
- Interferon therapy for Hepatitis of all stages shall be covered up to 100% of the respective H&R Limits
- Intensive Care Unit (ICU) & CCU charges
- Surgical operation charges
- Non-surgical treatment options for victims of back and neck pain, Cancer Diseases, Pre-Existing Diseases, Hepatitis, Dialysis, Cataract Surgery, MRI, CT scan, Endoscopy, Thallium Scan, Angiography, surgical operations, doctor prescription drugs shall be 100% covered as per H&R Limits.
- Physician visits (in-patient visits) charges 100% covered.
- Specialist consultation charges (in-patient)
- Hospital casualty ward accident & emergency services
Life Insurance Benefits
Option 2: Share Separate rates.
| Life Sum (Death due to any reason) | 2 million |
| Accidental Death Additional | 2 million |
| Permanent/ partial Disability Benefit | 2 million |
| Temporary Total Disability Benefit | 20000 per month |
| Terminal Illness Benefit | 1,000,000 |
| Natural Total Disability Benefit | 2 million |
| Funeral Cost | 80,000 |
Method
As stated above interested vendors/companies may send their Technical and Financial proposals in sealed envelopes not later than December 13th, 2023 4:30 pm
SPARC
Manager Administration
House 98, Street 5, MPCHS, E-11/1, Islamabad
Tel: +92-51-2163011-12-13
Email: admin@sparcpk.org
SPARC has the right to accept or reject any or all offers without assigning any reasons whatsoever.
