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Design and Development of an Actuarial Model and Actuarial Analysis for the Envisaged National Health Insurance in Saint Lucia.

REVISED REQUEST FOR EXPRESSIONS OF INTEREST

SAINT LUCIA
SAINT LUCIA HEALTH SYSTEM STRENGTHENING PROJECT
Credit No.: IDA Credit # 63160-LC

Assignment Title: Design and Development of an Actuarial Model and Actuarial Analysis for the Envisaged National Health Insurance in Saint Lucia.
Reference No. 082/CS/IC/ACTMA/HSSP/01/20

Saint Lucia has received financing from the World Bank towards the Health System Strengthening Project, and intends to apply part of the proceeds for consulting services for engagement of an Individual Consultant to perform an Actuarial Analysis and an Actuarial Model capable of estimating the most adequate structure and coverage, as well as the expected premiums and governmental subsidy for the National Health Insurance System through the definition and implementation of an Essential Health Services Package, which will be provided to the population of Saint Lucia. The analysis and model must consider the different types of population groups based in their socioeconomic condition as well as on their situation in the economic scenario of the country (such as the employers & employees from the formal sector public and private, the non-poor informal sector and the poor population which will need to be subsidized by the government).  The consultancy is expected to last for 18 weeks within a period of 6 months.

The consulting services (“the Services”) include

1. The Actuarial Analysis and Model must consider the costing of health services (represented by the EHSP) at the Primary, Secondary and Tertiary Level and consider public and private providers, as well as the participation of private insurers on the revenue side, and, utilizing an approved methodology with assumptions and parameters clearly outlined. This should include per unit costing of health services at all levels which will be factored in the financial model, as well as a proposed revised/updated/adjusted fee schedule for the new Owen King EU Hospital.

1. The Actuarial Analysis and Actuarial Model should incorporate several scenario analysis on the projected revenues and outgoing health care payments and fees as a result of varying premium schedules, varying utilization rates, administrative expenses, risk factors, adjustment factors (utilization rates and economic factors such as gross domestic product, economic growth rates, employment/unemployment, prices (inflation), age, gender, burden of disease, epidemiological profile etc.

1. The actuarial model must also consider the potential structure of a financial model (health financing model) which should include other variables like: contributors/taxpayers, insurable/taxable earnings, dependency rates, cost per unit of services, economic growth, demographic and labor force factors such as developments in the total population, population structure and economically active population.

The detailed Terms of Reference (TOR)  and Supporting Concept Note for the assignment can be found at the following website; www.finance.gov.lc , http://health.govt.lc/notices

The Department of Health and Wellness now invites Eligible Individual Consultants (“Consultants”) to indicate their interest in providing the Services. Interested Consultants should provide information demonstrating that they have the required qualifications and relevant experience to perform the Services; (Curriculum Vitae, description of similar assignments, experience in similar conditions, clients’ references etc.).

Interested Consultants should have the following requisite qualifications and professional experiences listed below for undertaking the assignment.

QUALIFICATION

The successful candidate must have:

Academic:

• Professional with a Bachelor of Sciences Degree in Economics or Mathematics, Finance, Administration, Engineering or similar, with a Master’s Degree in Actuarial Sciences with not less than five (5) years of experience in actuarial works or a Professional with a Bachelor of Sciences Degree in Economics or Mathematics, Finance, Administration, Engineering or similar with a formal training in actuarial sciences with not less than 10 years of experience in actuarial works and calculations.

Experience:

• Proven experience in the design of actuarial modelling and actuarial analysis specifically in social or national health insurance schemes in developing countries.

Experience in actuarial modelling and analysis in the Latin America and The Caribbean Regions will be an asset.

The attention of interested Consultants is drawn to Section III, paragraphs, 3.14, 3.16, and 3.17 of the World Bank’s “Procurement Regulations for IPF Borrowers” July 2016, revised November 2017 and August 2018 (“Procurement Regulations”), setting forth the World Bank’s policy on conflict of interest.

A Consultant will be selected in accordance with the Individual Consultants Selection method set out in the Procurement Regulations.

Further information can be obtained at the address below during office 8:00 a.m-4:30 p.m. (0800 to 1630 hours).

Expressions of interest must be delivered in a written form to the address below (in person, or by mail, or by e-mail) by February 12, 2021. Individual Consultants who have already submitted Expressions of Interest are not required to reapply. 

Project Implementation Unit
Department of Health and Wellness
Attn: Project Manager
2^nd Floor, Sir Stanislaus James Building
Waterfront
Castries
Saint Lucia
Tel: 1-758-468-5300
E-mail: piu.mohw@gmail.com

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