The United Nations Secretariat invites interested and Potential vendors with requisite experience to tender EOI documents for the following works:
The United Nations Secretariat is one of the six major organs of the United Nations, with the others being the General Assembly, the Security Council, the Economic and Social Council, the defunct Trusteeship Council, and the International Court of Justice. The secretariat is the UN’s executive arm.
Applications are invited for:
Title: Request for Expression of Interest (EOI) – Provision of Claims Processing and Administrative Services for the Medical Insurance Plan (MIP) of the United Nations (UN)
EOI Number: EOIUNPD19609
Description of Requirements
The United Nations is seeking expression of interest from potential vendors to participate in a Request for Proposal at a later stage for the provision of claims processing and administrative services for the Medical Insurance Plan (MIP) of the United Nations (UN). The United Nations Development Programme (UNDP) and the United Nations Children’s Fund (UNICEF) may also participate in the procurement exercise.
The MIP is a self-funded programme of medical and dental benefits offered to locally-recruited staff, retirees and eligible dependants in various duty stations around the world outside of the headquarters duty station.
The proposed contract to be established for the related administrative fees only for an initial five-year period with option to extend annually for up to five additional years based on satisfactory performance. If UNDP and UNCIEF decide to participate, the contract for each entity will be managed separately by the UN, UNDP and UNCIEF respectively.
In December 2020, for the UN: 13,241 staff and retirees of the UN and its funds and programmes were enrolled in MIP with coverage also extended to their 37,877 eligible dependents. The total number of invoices handled for the UN for the calendar year of 2020 is 270,531; for UNDP: 12,121 staff and retirees of UNDP and UN System MIP Subscribers administered by UNDP were enrolled in MIP with coverage also extended to their 27,963 eligible dependents. The total number of invoices handled for the UN (including UNDP and UNICEF) for the calendar year of 2020 is 317,133; for UNICEF: 12,057 staff and retirees of UNICEF were enrolled in MIP with coverage also extended to their 29,196 eligible dependents. The total number of invoices handled for the UN (including UNDP and UNICEF) for the calendar year of 2020 is 314,850.
The services of a third-party administrator are required for the following:
- General administration of the UN Medical Insurance Programme (MIP) including claims adjudication based on rules and schedule of benefits established by the organization, and eligibility data of covered plan participants to be provided by the organization;
- Dedicated team for claims processing in various regions of the world with multilingual staff and 24/7 customer service centers with telephone service, toll free local numbers, recognized and widely used messaging system, chat box and email addresses capable of settling claims via various reimbursements methods, including but not limited to electronic funds transfer (EFT) in different currencies and electronic files that can be used for payment to active staff members of their claims and/or recovery of co-insurance through processing by the local office via payroll;
- Provision of networks of hospitals, clinics and other health care providers in the various countries of operation offering negotiated rates and direct billing arrangements;
- Provision of professional medical expertise in connection with claims reimbursement, emergency medical treatments, medical evacuation, regional centers of care, appeal and fraud cases, etc.;
- Fraud detection systems and investigation capabilities for further referral to the organization for action;
- Communication services for education and awareness-building of members in print and electronic media;
- Designated Account Management to liaise with UN Headquarters, offices away from Headquarters, country offices and peacekeeping missions to ensure maintenance of quality services and resolution of medical network issues;
- Consultative guidance including underwriting support on analysis of expenses and on plan design issues as well as recommendations for plan design modifications to support efficient preventive care and reduce fraud risks.
The expected deliverables of services include but are not limited to:
- Established global health care network of hospitals, doctors and pharmacies that provide quality access to quality care to active and retired staff members and their eligible family members;
- Timely provision of printed and electronic identification cards for all plan members;
- Quick turnaround time for processing claims with metrics for processing and financial accuracy to be agreed with the organization. Ability to provide claims processing in English, French, Spanish, Arabic, Chinese and Russian, as well as a number of additional languages as required by the locations of the UN offices and missions.
- Excellent customer service center/s with metrics for speed of response and timely resolution of problems to be agreed with the organization;
- Reports on plan utilization and demographics, including those required for auditors, actuary, claims review board, etc.
- Printed and electronic communication materials including dedicated website, participant guides for members and human resources staff, newsletters, special announcements, etc.;
- Investigation reports on suspected and confirmed fraudulent claims;
- Bi-annual meetings at UN Headquarters to review plan performance, discuss special projects and assess vendor performance;
- Missions to local offices to consult with local human resources offices and staff, conduct town hall meetings or online meetings and webinars, and address issues with local health care providers in the networks;
- Client satisfaction surveys every two years and related service improvement reports
Application Closing Date
18th April, 2022.
Submission of Documents
Interested vendors/organizations who wish to participate in the EOI process should please Click Here
In case you have difficulties submitting your interest electronically, please contact [email protected] directly for instructions.
Click Here(PDF) for more clarifications.