Tender Description

TERMS OF REFERENCE (TOR)

FOR STAFF HEALTH INSURANCE COVER FOR SOS CHILDREN’S VILLAGES  SOMALIA.

1. INTRODUCTION.

SOS Children’s Villages Somalia (SOS CVS) is a member organization of the federation of SOS Children’s Villages International and has been in existence since 1985 in Somalia.  In addition, SOS CV Somalia has over 40 years of experience in the provision of long-term alternative childcare, youth programming and direct delivery of humanitarian assistance for drought, floods, and protracted displacement affected populations in the sectors of integrated WASH, Health, Nutrition, Education, Child Protection in emergencies, Gender-Based Violence and Livelihood support through the Family Strengthening programs. SOS Health Program in Somalia dates back to 1991 when SOS Mother and Child Hospital was established in Mogadishu at the brink of the civil war. The hospital is one of the oldest and most well-established health facilities in the Banadir Region. Our programs have been scaled up to reach more territories in the country. Currently our humanitarian programs reach close to 1.9 million women, children, adults & elderly vulnerable populations in South West, Banadir & Hirshabelle states in Somalia through 7 district hospitals, 5 health centres, 5 stabilization centres & ICCM+ sites in two districts.  

1. Background

SOS Children’s Villages Somalia provides medical insurance coverage for its employees and eligible dependants as part of its staff welfare and duty of care obligations. The organization seeks to ensure access to quality, timely, and reliable healthcare services through a professional health insurance scheme.

The number of beneficiaries under the scheme may vary during the contract period due to staff recruitment, separation, or other organizational changes

1. Purpose:

The purpose of this TOR is to engage a qualified and licensed health insurance provider capable of delivering comprehensive, responsive, and cost-effective medical insurance services for SOS Children’s Villages Somalia employees and their eligible dependants.The scheme is expected to:

1. Provide comprehensive inpatient, outpatient, optical, dental, maternity, and emergency medical coverage; 
2. Ensure timely access to quality healthcare services through an efficient provider network; 
3. Provide responsive 24/7 emergency support and medical evacuation services where applicable; 
4. Deliver transparent, reliable, and technology-supported insurance administration and claims management services.

4. Scope of work

SOS Children’s Villages Somalia intends to engage a qualified and licensed Health Insurance Provider to provide medical insurance services under a cashless medical scheme arrangement.

Bidders are requested to submit proposals based on the territorial coverage options outlined below. Where varying premium structures apply based on geographical coverage, bidders shall provide separate pricing schedules and coverage details for ease of technical and financial evaluation

Skills Required

Attachment

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