Medical Insurance Provider
Terms of Reference
Terms of Reference (TOR) for the Selection of Medical Insurance Provider
Organization and Context background information.
Founded in 1993, Médecins du Monde Switzerland is a medical association of international solidarity that is part of the Médecins du Monde network. We provide sustainable access to health care for people in vulnerable situations in Switzerland and around the world.
WE PROVIDE CARE
For nearly 30 years, we have been working to ensure that the right to health is effective for all, without financial, social, cultural, or geographical barriers. We collaborate with civil society organizations and local authorities to implement projects in Switzerland and around the world.
WE BEAR WITNESS
We call up on and accompany regional, national, and international authorities to facilitate access to healthcare and promote respect for human rights. We advocate with decision makers to change things in a sustainable way.
MdM Switzerland, has been working in the occupied Palestinian territory (oPt) since 1994 in the sector of Mental Health and Psychosocial Support (MHPSS), implementing emergency and development interventions, focusing on victim of occupation-related violence, children and detention, suicide prevention and management, strengthen of access to mental health cares at national and community level, and advocacy initiative.
Objective and deliverables of the assignment
To select a competent and reliable medical insurance provider that offers comprehensive health coverage for employees and their eligible dependents, ensuring quality healthcare services at a competitive cost.
Scope of Work
The selected insurance provider will be expected to:
Provide a comprehensive medical insurance plan, including:
Inpatient and outpatient services
Emergency care
Preventative care and vaccinations
Maternity care
Specialist consultations
Diagnostic tests and procedures
Prescription medications
Offer coverage for employees and their dependents (spouse and children).
Provide a clear policy for pre-existing conditions.
Ensure a wide network of hospitals, clinics, and pharmacies.
Offer a user-friendly claims process with timely reimbursements.
Provide 24/7 customer support for inquiries and emergencies.
Provide a Workemen Compensation.
Eligibility Criteria for Providers
Insurance providers must meet the following criteria:
Licensed and registered to operate in Opt.
At least five years of experience in providing medical insurance services.
A proven track record with reputable organizations.
Financial stability and capacity to handle claims effectively.
comprehensive network of healthcare providers.
Proposal Requirements
Interested providers must submit a detailed proposal including:
Company profile and registration documents.
Detailed description of the proposed medical insurance plan.
List of network hospitals, clinics, and pharmacies.
Premium rates and cost breakdowns.
Claims process and timeline.
References from at least three current or past clients.
Value-added services (e.g., health check-ups, wellness programs).
Evaluation Criteria
Proposals will be evaluated based on:
Coverage scope and benefits (30%)
Network size and accessibility (20%)
Cost and affordability (20%)
Claims process and customer support (15%)
Provider experience and reputation (15%)
Timeline
Deadline for Submission of Proposals: 25/01/2025
Evaluation and Selection: 31/01/2025
Contract Signing: 01/02/2025
Submission Details
Proposals must be submitted by email to [email protected] or delivered to [بيت ساحور / شارع الخليفات / بالقرب من سوبر ماركت عياد] no later than 25/01/2025 Late submissions will not be considered.
Contact Information
For any inquiries or clarifications, please contact:
Name: Abir AbuJarad
Position: Administrative Coordinator
Email:[email protected]
Phone Number: +972 (0) / 054-3696858 or 059 4211885
Disclaimer
The organization reserves the right to accept or reject any proposal and to annul the selection process at any time without incurring any liability.
Ethical considerations
The consultant/consulting agency must sign the MdM due diligence Policy and Code of Conduct and be willing to adhere to its principles and expected practices. If a breach of the policy or code of conduct takes place the consultancy will be terminated immediately without any financial burden on MdM.
