Medical Group Health Insurance for KSTePS Officers/Employees and their Dependents

The bidder shall submit a certificate confirming a minimum of 3 year of experience in providing Group Medical Health Insurance Services, which includes coverage administration, claim settlement support, hospitalization benefits, and other services as prescribed in Annexure-1. The bidder must attach the Work Orders issued for each such project and corresponding performance / satisfactory service certificates issued by the respective client authority.

Registration certificate of the firm/company under the Suitable Act. Copies of the documents defining the constitution or legal status of the firm/company. GST Registration Certificate and PAN Number of the Consultant/bidder/firm

The bidder shall furnish a detailed write-up, supported by adequate data, demonstrating their service delivery capacity, technical expertise, and qualified team for providing Group Medical Health Insurance Services, including but not limited to beneficiary enrollment & coverage administration, cashless hospitalization facilitation, claim processing & settlement support, helpdesk services, wellness and preventive healthcare initiatives, and fulfillment of all other requirements specified in the scope of services.

Income Tax Return certificates for last two consecutive years.

Minimum cumulative turnover of Rs. 500 lakhs during the last two consecutive financial years (i.e., Rs. 500 lakhs cumulative for two years). At least two work orders worth Rs. 50 lakhs each OR five work orders worth Rs. 10 lakhs each from Government entities. For MSME bidders, the Minimum Average Annual Turnover shall be not less than Rs. 125 lakhs per year during the last two consecutive financial years (Rs. 250 lakhs cumulative for two years). The bidder shall scan and upload Audited Profit & Loss Statement and Balance Sheet for the respective financial years as proof of turnover.

Presentation by the bidder on understanding the scope of assignment, conceptualization, and methodology. The presentation shall cover the following: Understanding of the Medical Health Insurance assignment including beneficiary coverage, policy administration, and statutory compliance

Detailed approach and methodology - covering enrollment process, empanelment of hospitals, cashless facility enablement, claim processing workflow, grievance redressal mechanism, digital/IT support systems, and reporting procedures.

Execution Plan - including service delivery during regular office days, emergency situations, hospitalization cases, and year-round beneficiary support (including holidays and non-working days).