provision of voluntary health insurance services Request for proposal of the Insurers for the provision of voluntary health insurance services The total number of insured persons 228 people
Not applicable. Proposal shall cover the entire lot.
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Comments: Request for proposals
For the right to conclude an agreement for the provision of voluntary medical insurance services
Technical task
1. Insurance object:
The object of voluntary medical insurance (hereinafter VHI) is the property interests of the Insured that do not contradict the legislation of the Russian Federation, related to the organization and payment of medical care, medical and other services provided for by the VHI program in the event of an insured event.
2. Insurance case:
An insured event is an appeal of the Insured to a medical institution in order to receive medical care, medical and other services in accordance with the VHI program provided for in the insurance contract. Services organized and paid for by the insurer are provided for the purpose of diagnostics, prevention, treatment of diseases or rehabilitation, provided by medical institutions specified in the contract (program) of the VHI.
The customer has the right to insure an additional number of persons or to exclude a certain number of persons from the number of insured persons by concluding an additional agreement to the contract.
3. Place of provision of services:
Medical institutions in the cities:
Arkhangelsk
Astrakhan
Barnaul
Velikiy Novgorod
Volgograd
Vologda
Voronezh
Efremov
Irkutsk
Kazan
Kaluga
Kerch
Kirov
Krasnoyarsk
Moscow
Murmansk
Novosibirsk
Omsk
Orenburg
Permian
Petrozavodsk
St. Petersburg
Smolensk
Sochi
Sukhinichi
Tambov
Tver
Ufa
Chelyabinsk
Chita
Yaroslavl,
entitled to provide medical services, and accredited in accordance with the procedure established by law, having a valid contract with a participant in an open one-stage tender for the right to provide services to insured persons.
4. Services provided:
• emergency medical care
• the presence of a curator of the contract;
• availability of our own round-the-clock medical dispatch service to provide consulting and organizational assistance with a free federal number;
• provision of medical care in cities and regions, according to the list;
"Outpatient and polyclinic care":
Provision of the following services:
• 24-hour assistance from the dispatch service;
• Consultation and treatment of specialist doctors in the direction of doctors;
• Outpatient examinations, diagnostics and treatment;
• House call.
Personal doctor (for the company's management) - doctor-curator from "with the ability to contact by mobile phone for consulting on insurance programs and assistance in organizing medical services
"Stationary service".
The following services:
• 24/7 assistance from the dispatch service
• Ambulance services;
• Medical transportation to the hospital;
• Hospitalization (emergency and planned)
The specified list of services provided is mandatory, the full list is provided in the participant's insurance programs.
5. Total number of people:
The total number of insured persons at the time of the request for proposals was 228 (two hundred twenty eight) people.
The increasing coefficient is not applied to the insured over 60 years old
6. The number of legal entities with whom the contract will be concluded:
7 (seven) legal entities and 6 (six) individual entrepreneurs
7. The insurance program includes:
• Outpatient - polyclinic service
• Home visit within 30 km from MKAD
• Ambulance and emergency services within 30 km from the Moscow Ring Road
• Dental care
• Emergency and planned hospitalization
8. Terms of payment:
The maximum total insurance premium in rubles is paid by transferring funds to the current account of the Insurer in equal parts on a quarterly basis
9. Services under the contract:
Vaccination against influenza with imported vaccines in Moscow and the regions (including the cost of the vaccine in the clinic at the choice of the insurer or in the office of the insurer once a year when recruiting a group of 15 employees)
Travel insurance policy - Insurance territory - Worldwide, except for the country of permanent residence. Sum insured: 50,000 Euro
Telemedicine for all Insured
Psychological Support Program
11. Scope of services in the direction - Outpatient - polyclinic care:
Medical, diagnostic and consulting methods of doctors:
therapist, surgeon, gynecologist, urologist, otolaryngologist, endocrinologist, infectious disease specialist, dermatologist, ophthalmologist, gastroenterologist, cardiologist, physiotherapist, orthopedic traumatologist, neurologist, neurosurgeon, cardiovascular surgeon) oncologist (before the diagnosis is established), mammologist; psychiatrist or psychotherapist (initial appointment, without diagnostic tests), allergist-immunologist, pulmonologist, rheumatologist, nephrologist, hematologist, coloproctologist and other specialists. Receptions and consultations are carried out in the presence of these specialists on the basis of medical institutions that are part of the polyclinic insurance program.
Examination of working capacity (drawing up and extending sheets of temporary disability), issuing prescriptions (except for preferential ones), medical certificates, referrals.
Medical manipulations and procedures:
services performed by nurses as prescribed by a doctor - dressings, injections (intramuscular, subcutaneous, intravenous jet, intravenous drip injections (droppers));
procedures and manipulations performed by doctors on an outpatient basis;
radiosurgical methods of treatment and the use of a surgical laser in gynecology;
the use of a surgical laser in ophthalmology for retinal rupture;
washing the lacunae of the tonsils - no more than 5 procedures during the insurance period.
Laboratory diagnostic tests:
general clinical, biochemical, microbiological and bacteriological, serological, histological, cytological, hormonal (including determination of thyroid hormones, sex hormones); immunological (determination of specific immunoglobulins for the diagnosis of acute infectious diseases, immune status - cellular and humoral immunity, interferon status) - as agreed with the Insurer; determination of tumor markers, allergological examination (skin scarification tests, diagnosis of drug allergies by any method, including a drug panel); PCR diagnostics of acute infectious diseases and urogenital infections, including sexually transmitted diseases.
Instrumental research:
functional diagnostics, endoscopic, ultrasound and radiological examinations, densitometry; computed tomography, magnetic resonance imaging, incl. with contrast agents; radioisotope research.
Physiotherapy treatment (in the physiotherapy department): electro-, light-, heat-, magneto-, laser therapy, ultrasound therapy, inhalations - without limiting the number and combination of procedures.
Physiotherapy in a group, classical therapeutic massage, classical corporal acupuncture, classical vertebral manual therapy - without limiting the number of procedures.
Treatment of pregnancy pathology up to 8 weeks.
Diagnostics and treatment of diabetes mellitus type I and II (except for complications of diabetes mellitus).
Treatment of sexually transmitted diseases (STDs): one case during one year of insurance.
Treatment of skin diseases (with the exception of severe psoriasis with systemic lesions).
Vaccine prophylaxis (emergency vaccination against tetanus, rabies).
Rehabilitation and rehabilitation treatment (after injuries received during the insurance period in the direction of the Insurer):
Receptions, expert advice,
Diagnostic manipulations and procedures,
Laboratory and instrumental research,
Group physical therapy sessions (no more than 10 procedures during the insurance period); classic therapeutic massage (no more than 10 procedures during the insurance period up to 3 massage units per procedure); in agreement with the insurer - classic corporal acupuncture.
Home health care:
provision of medical assistance at home to the Insured, who for health reasons, the nature of the disease cannot visit the clinic, need bed rest and medical supervision.
Home help includes:
examination by a doctor - a therapist at home within the limits provided for by the insurance program, on weekdays and weekends (call a doctor at home for the current day from 09:00 to 12:00);
examination of temporary incapacity for work (drawing up sheets of temporary incapacity for work), preparation of prescriptions for drugs (except for privileged ones).
Services of a 24-hour trauma center
12. Dental care: SCOPE OF SERVICES PROVIDED:
1. Consultations of dentists of all specialties without restrictions (therapist, surgeon, orthopedist, orthodontist, periodontist);
2. Dental physiotherapy procedures;
3. Diagnostic radiovisiographic studies, orthopantomogram;
4. Local anesthesia (infiltration, application, conduction);
5. Removal of fillings for medicinal purposes;
6. Therapeutic dental treatment using light-curing filling materials;
7. Restoration of the crown part of the teeth with light-curing materials, while maintaining up to ½ the volume of the crown of the tooth;
8. Mechanical and medical treatment and filling of canals, including with the use of gutta-percha;
9. Removal of dental plaque: with ultrasound, professional pastes - at least 1 time during the insurance period;
10. Removal of dental plaque using the Air Flow method - at least 1 time during the insurance period;
11. Teeth coverage with fluoride preparations - at least 1 time during the insurance period;
12. Treatment of periodontal diseases of the I-II degree: physiotherapy procedures, irrigation with drugs,
Venue of bidding:
This call for bids is held in electronic form on the e-marketplace of B2B-Center group (www.b2b-center.ru). Bids shall be submitted in the form of e-document.
