Terms of Reference (ToR) for the Provision of Staff Medical Insurance Services

TERMS OF REFERENCE (TOR) FOR THE PROVISION OF STAFF MEDICAL INSURANCE SERVICES

1. Introduction and Background

TEARFUND Rwanda is inviting qualified and registered medical insurance providers in Rwanda to submit their technical and financial proposals for the provision of a comprehensive staff medical insurance cover. The objective is to secure a reliable, flexible, and cost-effective health insurance plan that provides quality medical care for our employees and their registered dependents.

2. Objective of the RFQ

The main objective of this Request for Quotations (RFQ) is to select a medical insurance provider licensed by the National Bank of Rwanda (BNR) to deliver high-quality Outpatient, Inpatient, Maternity, Dental, and Optical medical services forTearfund’s staff and their dependents for a period of one (1) year, renewable based on satisfactory performance.

3. Target Population (Demographics)

The insurance cover will cater to a total of 76 lives, categorized as follows:

Note to Bidders: The financial proposal should deliver premium rates structured by family size (e.g., M, M+1, M+2, M+3, M+4, M+5, etc., where M = Main Member).

4. Scope of Coverage

The proposed medical insurance scheme must cover, at a minimum, the following benefits:

4.1. Outpatient Cover

• Consultation fees (General Practitioners and Specialists).
• Prescription drugs and medicines.
• Laboratory investigations and diagnostic tests (X-rays, MRI, CT Scans, Ultrasounds).
• Minor surgical procedures.
• Physiotherapy and alternative treatments.

4.2. Inpatient Cover

• Hospital accommodation (Standard, Deluxe private room).
• Doctor’s, surgeon’s, and anesthetist’s fees.
• Operating theater fees and intensive care unit (ICU/HDU) charges.
• Inpatient drugs, dressings, and surgical appliances.
• Post-hospitalization treatment.
• Local road ambulance and air evacuation services.

4.3. Maternity Cover

• Normal delivery and Caesarean section.
• Pre-natal and post-natal care and ultrasound scans.
• Pregnancy-related complications.
• Congenital conditions and neonatal care for premature babies.

4.4. Dental & Optical Cover

• Dental: Consultations, extractions, fillings, scaling, polishing, and root canal treatments.
• Optical: Eye testing, prescription frames, and lenses.

4.5. Required Policy Conditions

The proposal must confirm the following conditions:

• No Waiting Periods: All waiting periods must be waived for the corporate group.
• Pre-existing & Chronic Conditions: Fully covered up to a specified sub-limit.
• HIV/AIDS Cover: Covered within the inpatient and outpatient limits.
• Co-payment: Clearly state if there are any co-payments required (0% co-payment is preferred).
• RSSB/RAMA Integration: deliver quotes for both Comprehensive Cover (100% private) and Top-Up Cover (assuming staff has RSSB as base cover).

5. Geographical Coverage Limits

Bidders should deliver options for the following territorial limits:

• Option A: Rwanda only.
• Option B: East African Community (EAC) regional cover (Rwanda, Kenya, Uganda, Tanzania, Burundi, S.sudan and DRC).
• Option C: EAC regional cover with medical referral/evacuation to India or Europe and the USA

6. Eligibility and Mandatory Requirements

To be eligible, the bidding insurance company must submit the following statutory and administrative documents:

1. Copy of Certificate of Incorporation from the Rwanda Development Board (RDB).
2. Valid operating license issued by the National Bank of Rwanda (BNR).
3. Valid Tax Clearance Certificate from the Rwanda Revenue Authority (RRA).
4. Valid RSSB Clearance Certificate.
5. Company profile indicating the number of years in the health insurance business in Rwanda.
6. List of affiliated medical service providers (hospitals, clinics, pharmacies, and specialists) in Kigali and upcountry. Please specifically indicate coverage for premium hospitals (e.g., King Faisal Hospital, Legacy Clinics, CHUK, etc.).
7. At least three (3) references or certificates of good completion from current corporate clients of similar size.

7. Deliverables Expected in the Bid

Bidders must submit two separate documents:

A. Technical Proposal

• Detailed description of the benefits (Inpatient, Outpatient, Maternity, Dental, Optical).
• Clear declaration of all exclusions (what the insurance will NOT pay for).
• Description of the claims processing and reimbursement turnaround time (TAT).
• List of the nationwide hospital/clinic network.
• Details of any value-added services (e.g., wellness programs, mobile app for tracking limits, telemedicine).

B. Financial Proposal

• Annual premium cost per family tier (M, M+1, M+2, M+3, M+4, M+5, Extra dependent).
• Clearly separated pricing for Comprehensive vs. RSSB Top-up options.
• Breakdown of benefit limits for each category (e.g., Outpatient limit per person vs. Inpatient limit per family).

8. Evaluation Criteria

Bids will be evaluated based on:

• Technical Responsiveness (60%): Breadth of hospital network, lack of restrictive exclusions, value-added services, and proven track record.
• Financial Competitiveness (40%): Cost-effectiveness of premiums relative to the benefit limits provided.

9. Submission Guidelines

• Deadline for submission: Tuesday, 13th October 2026 at 5:00 PM
• Submission format: Electronic submissions should be sent to 

• with the subject line: "Tender for Staff Medical Insurance 2026-2027". 
• Clarifications: Any questions regarding this TOR should be directed to