Voluntary Employee Health Insurance

The bidder will be excluded if any ground under § 95(1) of the Estonian Public Procurement Act applies. The required confirmations cover relevant criminal convictions of the bidder and persons authorised to represent, control or make decisions for it, including convictions relating to organised crime, corruption, fraud, terrorism, money laundering, unlawful employment, child labour or human trafficking. The bidder must also confirm that it has no outstanding tax, duty or environmental charge arrears and that awarding the contract would not breach applicable international or Estonian government sanctions. Where a foreign company is involved in the bid, including through joint bidding, reliance on another entity or subcontracting, documents confirming the absence of exclusion grounds must be provided for that company and its relevant representatives when requested or as specified in the procurement documents. The contracting authority may request additional evidence if the information cannot be checked in a public register. The bidder must also provide details of authorised persons not shown in the Estonian commercial register; the stated evidence requirements apply to foreign bidders and, where relevant, to relied-on entities and subcontractors.

The bidder must hold the authorisation required under § 15(1) of the Estonian Insurance Activities Act for the relevant insurance class, or be entitled to provide the service in Estonia through a branch or on a cross-border basis. The contracting authority will check the Financial Supervision Authority’s public information; if the bidder is not listed there, it must provide evidence of its right to offer the insurance in Estonia. During the 36 months preceding the start of the procurement, the bidder must have provided health insurance under at least three insurance contracts with legal entities. For each contract, insurance premiums of at least EUR 100,000 must have accrued during that 36-month period. Contracts need not have ended; for contracts that began earlier or continue beyond the period, only premiums accrued within the relevant 36 months count. The bidder must provide each contract’s name and description, procurement reference number if available, start and end dates or confirmation that it remains in force, premiums accrued during the period excluding VAT, the client’s name and registration code, and a contact person’s name and email address. Additional evidence, including client confirmation, may be requested if the information cannot readily be verified from public sources. If relying on another entity’s experience, the bidder must provide that entity’s signed confirmation of consent, describe how it will participate in contract performance so its experience can be used, and confirm joint responsibility for proper performance. The bid must include the proposed insurance terms, a description of the data-exchange solution, and the premium or an unambiguous calculation method and coverage description for an employee’s spouse, partner, child or parent. The family member’s cover must be substantively similar to the employee’s cover and last for the same period. The insurer must manage family-member enrolment, data collection and billing itself, without requiring the contracting authority to collect or process family members’ data or make additional payments; the contracting authority must not receive family members’ health, usage or claims data, and their claims history must not affect the employer’s claims statistics. The bidder must submit annual per-insured-person cover limits for outpatient family-doctor and specialist care and diagnostics. The minimum is EUR 1,000 per year; a lower or missing limit results in rejection. For evaluation, limits are counted up to EUR 15,000 per year, while any higher amount offered remains binding. The bidder must also provide the required cover limits for all insurance services, which must not be below the technical specification’s minimums and must remain binding throughout the framework agreement. The bid must include a list of healthcare providers in Estonia with whom the bidder has a valid direct-billing agreement at the submission deadline, including each provider’s business name, registration code and all locations with addresses and counties. This list is used for evaluation; absence of direct billing does not itself lead to rejection, but missing or unverifiable information receives zero points for that criterion. The bidder must confirm that it accepts the procurement documents’ requirements and has the rights needed to prepare the bid, participate and perform the contract. If the bid is submitted by someone other than the bidder’s legal representative, a power of attorney is required; foreign bidders must provide evidence of the submitter’s authority to represent the company. Joint bidders must appoint an authorised representative and submit their authorisation and confirmation; they are jointly and severally liable for performance. The bidder must identify authorised representatives not visible in the commercial register and, if applicable, provide the required information about relied-on entities and subcontractors. It must also comply with the applicable restriction on using certain Russian-linked subcontractors or suppliers for more than 10% of the contract value, and identify and justify any information claimed as a trade secret.