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Quotation are invited for Comprehensive Medical and Group Life Insurance Service to Intrahealth International South Sudan Staff and Their Dependents for the Period of 15th October 2026 to 30th September 2027. 1 Maximum Outpatient cover is $3,000 and Inpatient cover is $30,000 Provide for us your premium quotation for the below Family Sizes (We are finalizing the total Number of staff and their dependents). 2 M 3 M+1 4 M+2 5 M+3 6 M+4 Per family Family Size Family Size Family Size Family Size Family Size Comprehensive Medical and Group Life Insurance Service to IntraHealth International South Sudan Staff and their dependents. The summary of services required includes; Outpatient cover and indicate the benefits and its limits Inpatient cover and indicate all the specific benefits and limits Maternity per family and the limits as per the quoted cover Dental both impatient and outpatient Optical cover both the inpatient and outpatient Surgical services (minor and Major) Laboratory and other investigations Radiological services. Evacuation/Repatriation of body in case of death. Funeral expense benefit Reimbursement of the costs incurred by staff both inpatient and outpatient Cost of premium per family Buffer Co-patient Emergency services (Number of flights for referrals or Ambulance services within or outside the country). Air Ambulance Evacuation service Premium for each staff. 1 Ward Accommodation 2 Accidents & Illness (within the overall limit) 3 All Acute Illness Full Cover Full Cover Full Cover 4 Inpatient dental illness (Pulpotomy, oral surgery if out of an accident) Indicate the maximum cover amount per family. 5 Inpatient ophthalmology illness (Excluding refractive error surgery) Full Cover 6 Psychiatric conditions Full Cover 7 Pre-existing and Chronic conditions including HIV/AIDS & Oncology Full Cover 8 Illness related maxillofacial and reconstructive surgery following an accident Full Cover 9 Congenital, neonatal and premature conditions Full Cover 10 Air evacuation Commercial flights Local and Oversea. 15 slots 11 Air Ambulance Evacuation Service Premium for each staff Local and Oversea. Indicate the premium per staff 12 Road ambulance evacuation (Local & International) Full Cover 13 Visits and consultation by a GP and specialists Full Cover 14 Radiology, Ultrasound scans MRI and CT scans (when requested by a specialist) Full Cover 15 Physiotherapy Full Cover 16 Intensive care and high dependency units Full Cover 17 Organ transplant excluding donor fees Full Cover 18 Medical equipment including wheelchairs, clutches and walking frames (pre-authorization) Indicate the maximum cover amount per family. 19 Prescribed medicines within scope of coverage Full Cover 20 Hospitalization following an accident/ Trauma/ Illness Full Cover 21 Intensive Care Unit/High Dependence Unit and Theatre Charges Full Cover 22 On admission In a private ward, per night bed charge Full Cover 23 Pre-existing, chronic conditions that are declared (during application or renewal including HIV/AIDS Indicate the maximum cover amount per family. 24 Oncology and newly diagnosed Cancer sentiments Full Cover 25 Congenital, neo-natal & premature conditions Indicate the maximum cover amount per family. 26 Psychiatry and Psychotherapy Full Cover 27 Road Ambulance (Local & International Evacuations) Full Cover 28 Referrals to Egypt, Ethiopia, Kenya, Sudan, India & Mauritius Full Cover 29 Pathology, X-Ray, Ultrasound Scans, ECG, CT, MRI, angiography and PET scans Full Cover 30 Inpatient dental illness Full Cover 31 Inpatient non accidental ophthalmology illness Full Cover 32 Impatient Prescribed Physiotherapy Full Cover 33 Annual wellness check-up (Pap smear, prostate screening, Full Cover Thyroid, Sar test charges and no chronic medical refills 34 Funeral costs for deceased member paid to family (paid as a Lump sum within 48-hour Qf proof of death) Indicate the maximum cover amount per family.) 35 Pescribe medicines within scope of coverage Full Cover 36 Overnight bed and meals hospital cost for a guardian admitted with a child of less than 15 years Full Cover SURGICAL OPERATIONS AND PROCEDURES (MINOR AND MAJOR) 37 Professional fees Full Cover 38 Theatre fees Full Cover 39 General Surgery Full Cover 40 Neurosurgery Full Cover 41 Urology Full Cover 42 ENT Full Cover 43 Anesthetics for surgery Full Cover MATERNITY Maternity Limit 44 Normal Delivery and/or Caesarean Section 45 1" Emergency Caesarean Section (Stand Alone) Indicate the maximum cover per family. 46 Other related ailments and complications including ectopic Pregnancies and miscarriage 47 Ectopic pregnancies & miscarriage 48 Hospitalization and meal 49 Premature deliveries 50 Nursing care 51 Delivery in a fully equipped labor ward with standard drugs 52 Professional fees 53 1" postnatal and first pediatric check for baby 54 UNEPI immunization (for the newly born) OUTPATIENT OVERALL COVER BENEFIT Overall Cover Benefit Limit Per Family Indicate the maximum cover amount per family. 55 Outpatient Specialists & G.P consultation costs Full Cover 56 Pre-existing, chronic conditions that are declared (during application or renewal), psychiatric, HIV/AIDS and cancer Full Cover 57 Prescription drugs & dressings Full Cover 58 Pathology, X-Ray, Ultrasound Scans, ECG, CT, MRI, angiography and PET scans Full Cover Full Cover 59 Prescribed Outpatient Physiotherap 60 Antenatal and post-natal check ups Full Cover 61 First Aid services Full Cover 62 Psychiatry conditions linked to inpatient Full Cover 63 Vaccination Full Cover 64 Prescribe medicines with scope coverage Full Cover 65 Simple OPD procedures Full Cover 66 Laboratory exams Full Cover 67 Congenital and genetic conditions Full Cover 68 Physiotherapy (up to 10 Sessions) Full Cover Psychiatry and Psychotherapy Full Cover 70 Annual wellness check-up, once ayear (As per scope) Optical Benefits: Per Family Full Cover Optical Benefit Limit per family Indicate the maximum cover amount per family. 71 Treatment of infections Full Cover 72 Visual acuity tests Full Cover 73 Frames and lenses, replacement of lenses and other optical prescriptions Full Cover 74 Optical Prescriptions & Surgical Procedure Full Cover 75 Dental consultation Full Cover 76 Extraction Full Cover 77 Fillings (Except precious metals) scaling, Full Cover 78 Dental x-ray, dental prescription Full Cover 79 Root canal & braces Full Cover Outpatient Optical Benefit Indicate the maximum cover amount per family. 80 Full Cover Cover benefit for routine optical consultations, prescription 81 Frames and lenses, replacement of lenses and other optical prescriptions Full Cover other Benefits required 82 83 84 Funeral Cover per Member Free Health Education Please indicate other benefits that may not have been listed above that your company is able to provide. ITEM NO 2 Group life insurance Indicate the maximum cover amount per family. Full Cover Tender Link : https://comms.southsudanngoforum.org/c/tenders
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