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    Solicitations 

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    RFP 2024-19 Actuarial Services

    The purpose of this RFP is to solicit proposals from qualified bidders to provide health and dental insurance actuarial services to support a range of activities for Covered California’s Plan Management Division, including certification, recertification, and decertification of Qualified Health Plans (QHP) for plan years 2026 through 2029.
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    RFP 2024-18 Certification Technical Support

    The purpose of this RFP is to solicit proposals from qualified bidders to provide technical support services with the system capability to collect on-line certification application data submissions for individual product offerings of Qualified Health Plan (QHP) and Qualified Dental Plan (QDP) Issuers for both the Individual marketplace and Covered California for Small Business (CCSB) marketplace for upcoming certification cycles.
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    RFP 2024-16 Executive Recruitment for Chief Data and Insights Officer

    The purpose of this RFP is to solicit proposals from qualified firms who specializes in comprehensive data management and analytic recruitments, to assist in its recruitment for a Chief Data and Insights Officer position.
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    RFP 2024-12 Quality Rating System and Healthcare Evidence Initiative Optimization CANCELLED

    The purpose of this Request for Proposal (RFP) is to solicit qualified bidders to secure the services of a qualified Contractor that will support and provide guidance to the Chief Medical Officer and other key personnel with optimizing health plan accountability programs which rely on QRS and HEI data, as well as ensuring full implementation of AB 929, Plan Performance Report.
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    RFP 2024-15 Communications and Public Relations Services

    The purpose of this Request for Proposal (RFP) is for Covered California to solicit proposals from qualified public communications agencies to serve as the Agency of Record (AOR) for Covered California, and provide multi-segment, integrated public relations and communications services, including developing and executing holistic, local, statewide, and national public relations campaigns in multiple languages to promote Covered California and maximize the number of Californians enrolled in health insurance.
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    RFP 2024-14 IT Strategic Initiatives

    The purpose of this RFP is to solicit proposals from qualified firms to provide qualified and experienced services to support Covered California’s Information Technology (IT) Strategic Initiatives and associated projects. These IT-led initiatives will include various programs and specialized projects that require expertise in key roles, such as business analysts, program managers, and enterprise architects.
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    RFP 2024-11 Legal Services

    The purpose of this RFP is to solicit proposals from qualified firms to provide expert legal counsel as necessary to provide supplemental legal advice regarding all data privacy and security matters to ensure compliance with Covered California’s obligations as a state entity and State-Based Marketplace under the ACA.
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    RFP 2024-10 IFM Consulting Services formerly IFM Predictive Analytic Consultant- CANCELED

    The purpose of this solicitation is to solicit proposals from qualified Proposer to provide Integrated Fraud Management to detect and protect the enterprise, Issuers, consumers, and stakeholders against potential fraud, waste, and abuse (FWA) and ensures CCA complies with federal and state laws and regulations.
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    RFP 2024-01 for Standardized Quality & Clinical Data Reporting- Cancelled

    The purpose of this Request for Proposal (RFP) 2024-01 is for Covered California to solicit proposals from innovative health care data management organizations to develop a unified reporting platform that merges administrative and clinical data to support real-time quality improvement, enables precise performance monitoring at various levels (e.g., qualified health plan [QHP] issuer, product line, and provider levels), and bridges quality of care gaps that exist across provider and population groups. Our timing coincides with the national trend towards electronic clinical data systems (ECDS) for improved healthcare quality assessment.
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    RFP 2024-03 Incident Response and Recovery Project

    Covered California, a state-based health insurance marketplace is seeking proposals from qualified consulting firms experienced in designing and implementing comprehensive, enterprise-wide incident management processes. The process should encompass a wide range of potential incidents including environmental issues with our headquarters facility, information privacy and security incidents, and issues impacting the performance and availability of our technology solutions.
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    RFP 2024-02 Generative Artificial Intelligence (GAI) and Artificial Intelligence (AI) Consulting Services

    Covered California is seeking proposals from qualified consultancy firms specialized in Generative Artificial Intelligence (GAI), Artificial Intelligence (AI), and technological innovation.
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    RFP 2024-04 Advertising and Marketing Services

    The purpose of this Request for Proposal (RFP) is for Covered California to solicit proposals from qualified advertising agencies to serve as the Agency of Record (AOR) to provide multi-segment, integrated communications services through holistic, statewide marketing campaigns in multiple languages to promote Covered California to the state’s diverse population and maximize the number of Californians enrolled in health insurance coverage

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    RFP 2023-12 Enterprise Strategy and Project Management Services

    The purpose of this RFP is to solicit from qualified Bidders to provide Project and Program Management Services as well as support Enterprise Strategy Operations within the Enterprise Project Management Office (EPMO) at Covered California.
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    RFP 2023-18 Executive Recruitment for Outreach and Sales Director

    The purpose of this RFP is to solicit proposals from qualified firms who specializes in outreach and sales recruitments, to assist in its recruitment for a Director of Outreach and Sales. The Director of Outreach and Sales leads and manages the Outreach and Sales Division.
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    RFP 2023-06 Digital Workplace Solution

    Covered California seeks a Digital Workplace Strategy Consultant to assist with developing the vision for how Covered California reimagines its workplace.
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    RFP 2023-03 for Media Spend Analysis

    The purpose of this RFP is to solicit proposals from qualified firms to provide detailed reports that evaluate Covered California’s historical media spend as well as current media spend and strategy to determine if investment level is sufficient to achieve marketing goals. This analysis would include on-line/digital channels as well as off-line channels such as broadcast TV, radio, print, and OOH. Based on these findings and industry benchmarks, the Contractor will formulate a budget recommendation designed to meet marketing objectives efficiently and effectively and maximize return on investment (ROI).
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    RFP 2023-04 Data Strategy Development

    The purpose of this RFP is to solicit qualified bidders to provide data insights into various aspects of an organizations operations and will help Covered California define a data strategy to show how data should be collected, managed, and accessed to support effective decision-making from those insights. Covered California requires a contractor to deliver a data strategy and implementation roadmap.
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    RFP 2022-21 Workday Human Capital Management System- CANCELLED

    The purpose of this RFP is to solicit bids from qualified bidders to provide day-to-day support for Covered California’s existing Workday Human Capital Management (HCM) design, development, testing, and implementation of changes based on Covered California requirements and best industry standards.
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    RFP 2022-13 Translation, Readability and Focus Testing

    The purpose of this RFP is to solicit bids from qualified bidders to provide on an as-needed basis, readability, translation, and consumer-focus testing services to Covered California including English, Spanish, Arabic, Armenian, Traditional Chinese, Farsi, Hindi, Hmong, Japanese, Khmer, Korean, Punjabi, Russian, Tagalog, Thai, Vietnamese, and any alternative language requests such as braille or large print, or both.
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    RFP 2022-14 Salesforce Sales, Service, Marketing and MuleSoft Services

    Covered California seeks a highly qualified Proposer who will provide day-to-day maintenance and operational support for Covered California’s existing enterprise Salesforce (Sales, Service, and Marketing) and MuleSoft environments
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    RFP 2022-06 Live Scan Fingerprinting Services

    The purpose of this solicitation is to select a contractor who will provide Live Scan fingerprint imaging services at locations throughout California sufficient to meet Covered California’s legal requirements when onboarding contractors and employees who require access to personally identifiable information (PII)
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    RFP 2022-10 Chatbot and Web Services

    Covered California seeks a highly-qualified organization that will provide day-to-day support for Covered California’s existing Chatbot Platform (“Chatbot”) design, development, testing, and implementation of change requests based on Covered California requirements and best industry standards. The winning Proposer will also support and enhance various Covered California websites.
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    RFP 2022-05 Architectural Consultation Services

    The purpose of this RFP is to solicit a proposal from qualified Contractors to provide Covered California with space planning design services as described in the Scope of Work and to prepare various design documents, provide consultation services, and offer other space planning assistance.
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    RFP 2021-30 Covered California for Small Business General Agents

    The purpose of this RFP is to find qualified Health Insurance General Agents who are interested in providing General Agent services to the Covered California Division of Covered California for Small Business. Covered California recognizes that General Agents play a significant role in the small group market in order to achieve the goals and objectives the Patient Protection and Affordable Care Act of 2010.
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    RFP 2021-31 Architectural Consultation Services CANCELED

    The purpose of this RFP is to solicit a proposal from qualified Contractors to provide Covered California with space planning design services as described in the Scope of Work and to prepare various design documents, provide consultation services, and offer other space planning assistance.
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    RFP 2021-29 EEO Investigations

    The purpose of this RFP is to solicit proposals from qualified Proposers to provide Covered California with disinterested third-party investigations and internal allegations of discrimination, harassment, retaliation, denial of reasonable accommodation, and any other Equal Employment Opportunity (EEO) related, legal, or administrative issues.

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    RFP 2021-24 Provider Policy Development

    The purpose of this RFP is to solicit proposals from qualified Proposers to provide critical consulting services to ensure the self-sustainability goals of the Sales Division are attainable and can be achieved in a timely manner. With the Support of this experienced Contractor these services will provide critical support to the Sales Division management team on QHP and QDP policy and strategic planning.
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    RFP 2021-20 Architectural Consultation Services - CANCELLED

    Contractor to provide Covered California with space planning design services as described in the Scope of Work and will prepare various design documents, provide consultation services, and offer other space planning assistance.

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    RFP 2021-20 Architectural Consultation Services……

    Model Contract…

    Attachments…

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    RFP 2021-07 Health Program Consulting Pool

    The purpose of this solicitation is to solicit proposals from qualified Proposers in order to establish a pre-approved contractor pool of qualified organizations and/or individuals with various specialized areas of expertise from which Covered California will contract with for various projects.
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    RFP 2021-12: Project Manager Consultant Pool

    The purpose of this solicitation is to provide Covered California with a pre-approved pool of qualified project management organizations and/or individuals from which Covered California will contract with for various projects. The project manager pool will provide Covered California with access to several high-quality project managers with various specialized areas of expertise as well as a breadth of project management capacity that will complement Covered California staff’s expertise. Covered California will utilize the contractors’ services to meet changing needs for a broad range of objectives and goals.
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    RFP 2021-05: Information Security 3rd Party Assessment Services

    The purpose of this RFP is to solicit proposals from qualified Proposers to provide the expertise, technical knowledge, staff support, and other related resources necessary to perform an Information Security Assessment (of Covered California’s security infrastructure, which includes the following: including the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS); Covered California headquarters; the Covered California Service Center; and all associated Covered California facilities or resources.
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    RFP 2021-04: Public Relations Services

    The purpose of this RFP is to solicit proposals from qualified, high-caliber public relations agencies to serve as Covered California’s public relations contractor of record.
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    RFP 2021-03 : California’s Individual Market – Defining Marketing Strategies and Spending Methodologies

    The purpose of this RFP is to solicit proposals from qualified bidders to produce a report that recommends potential principles and a ‘marketing spend’ methodology applicable to Covered California marketing and relevant spending by Qualified Health Plan (QHP) companies to support the purchase and retention of Individual and Family Plans (IFP) by consumers.
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    RFP 2021-01 Consumer Research Pool

    The purpose of this RFP is to solicit proposals from qualified bidders in order to establish a pre-approved contractor pool of qualified research organization and/or individuals with various specialized areas of expertise from which Covered California will contract for various research projects.
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    2020-13 Certification Technical Support

    The purpose of this RFP is to solicit proposals from qualified bidders to provide technical support services with the system capability to collect on-line certification application data submissions for individual product offerings of Qualified Health Plan (QHP) and Qualified Dental Plan (QDP) Issuers for both the Individual marketplace and Covered California for Small Business (CCSB) marketplace for upcoming certification cycles.
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    RFP 2020-04 Healthcare Evidence Initiative (HEI) 2.0

    Covered California is seeking proposals from highly qualified Proposers to provide a Healthcare Evidence Initiative 2.0 (HEI 2.0) solution that includes enrollment, product and benefit design; pricing; access and health disparity information applicable to on- and off-Exchange enrollees; as well as corresponding utilization and cost data from Issuers and the providers that serve them.
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    RFP 2020-09 Program Management Services

    The purpose of this RFP is to solicit proposals from qualified bidders to Program Management Services for Covered California’s Customer Care Division (CCD). Contractor’s Program Manager will participate in all aspects of CCD’s program management and oversight including managing initiatives from initiation to closeout while working with a range of stakeholders.
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    RFP 2020-03 Chatbot, Website Support and Development

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide day-to-day onsite* support for Covered California’s existing Chatbot design, development, testing, and implementation of change requests based on Covered California’s requirements and industry best standards
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    RFP 2019-25 HCM Implementation

    Covered California is in search of a contractor to provide Workday Human Capital Management (HCM) implementation services.
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    RFP 2019-22 Design Services Including Modular Systems Furniture (MSF)

    Covered California requires a Contractor to provide services to assist with its interior tenant improvement project.
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    RFP 2019-17 Professional Network and Audio Visual Services

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide professional Network and Audio Visual (AV) services at all Covered California locations including Rancho Cordova, Fresno, Sacramento, Oakland, and Los Angeles.
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    RFP 2019-07 Advertising and Marketing Services

    The purpose of this RFP is to solicit proposals from qualified advertising agencies to serve as the Lead Agency to provide multi-segment, integrated communications services through holistic, statewide marketing campaigns with the goal of promoting Covered California’s offerings and maximizing the number of Californians enrolled in health insurance coverage.
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    RFP 2019-08 Agent Service Centers

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide a Small Business Service Center (SBASC) team for Covered California for Small Business (CCSB).
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    RFP 2019-14 Covered California for Small Business Sales and Account Management

    The purpose of this RFP is to solicit proposals from qualified bidders to provide Covered California for Small Business (CCSB) a highly qualified Sales and Account Management (SAM) Organization. This team will represent CCSB in the small business marketplace.
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    RFP 2018-24 Media Integration and Event Coordination

    The purpose of this RFP is to solicit proposals from qualified Bidders to assist Covered California with engaging local media, planning events, preparing marketing materials, manage media sub-contractor engagements for television phone banks, radio broadcasts, and PR sales integrations and oversee statewide outreach event contracts.
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    RFP 2018-25 Investigation Services

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide disinterested third-party investigations into allegations of discrimination, harassment, retaliation, defamation, denial of reasonable accommodation, and any other Equal Employment Opportunity related, legal, or administrative issues.
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    RFP 2018-14 CCSB Enrollment Services & Financial Management

    Covered California is seeking bids for systems and services to support Covered California For Small Business (CCSB) membership.
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    RFP 2019-04 Financial Statement Audit

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide as set forth in 45 CFR Part 155 Exchange Establishment Standards and other related standards under the Affordable Care Act, Subpart M-Oversight and Program Integrity Standards for State Exchanges, § 155.1200(c) External Audits, Covered California must engage an independent qualified auditing entity which follows generally accepted governmental auditing standard (GAGAS) to perform an annual independent external financial and programmatic audit.
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    RFP 2019-02 Advance Network Support

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide professional services as a Senior Network Engineer to maintain, operate, and design Local Area Networks, Wide Area Networks, Data Center environment, Cisco ISE, Palo Alto Firewalls, and Wireless Infrastructures. Contractor shall provide in-depth knowledge of networking design of WAN/LAN/MPLS/VoIP. Contractor shall prepare a knowledge transfer plan that documents the processes and procedures of the network operations to enable Covered California staff to perform the services upon completion of the Agreement.
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    RFP 2018-10 Public Relation Services

    The purpose of this RFP is to solicit proposals from qualified public relations agencies to build upon the strength and current strategies of the Covered California public relations program while introducing fresh, innovative ideas that will continue to move the organization forward and encourage consumers to enroll and then retain their coverage.

    RFP 2018-11 Salary Survey

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide Covered California the services of an independent outside advisor to provide Covered California with a salary survey pursuant to the mandates outlined in Government Code 100503(m) that enacts the California Patient Protection and Affordable Care Act (Cal-ACA).

    RFP 2018-05 Audit Services Management Software

    Covered California’s Program Integrity Division, Internal Audit Services, seeks a Contractor who can deliver an audit and data analytics software and provide training to Covered California employees on usage of the product. Contractor will license a commercial off-the-shelf software product to Covered California that fulfills the requirements of the Model Contract. The software shall increase efficiency and productivity of the external and internal audit process including: risk assessment, scheduling, planning, audit resource management, execution, review, report generation, issues tracking, trend analysis, audit committee reporting and storage. After delivering and installing the software, the Contractor will provide training services to Covered California employees on customization options and usage of the software’s features.

    RFP 2018-04 Information Security Third Party Assessment Solicitation

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide the expertise, technical knowledge, staff support, and other related resources necessary to perform an Information Security Assessment (technique of identifying vulnerabilities and threats, and assessing the possible damage in order to determine where to implement more stringent controls and safeguards) of Covered California’s security infrastructure, including the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS); Covered California headquarters, the Covered California Service Center, and all associated Covered California facilities or resources.

    RFP 2018-06 - Real Estate & Construction Project Management Advisory Services

    The current leases for Covered California (sometimes referred to as “Agency”) are nearing expiration. Covered California is researching options for a future office location in the Sacramento area that will meet Covered California’s search criteria, accommodate the current space needs, and include expansion potential for future growth. Contractor will facilitate Covered California’s efforts to secure a new office location. Under Covered California’s direction, Contractor will analyze and research business/economic incentives; site search and selection; planning and due diligence for the building/space; and tenant representation/project-construction management services.

    Covered California is developing an internal unit to manage real estate and construction projects for the agency, and requires Contractor’s services to develop this unit. While smaller tenant improvements and construction projects will be conducted during the initial contract term, the services provided under this contract will contribute to a larger-scale construction project which must be completed by April 1, 2022.

    The Contractor must be prepared to work collaboratively with Covered California to address unexpected issues as needed. Additionally, outside counsel will be involved in a variety of ways as the project proceeds, and all parties will work collaboratively together under the direction of Covered California.

    RFI 2018-01 Interior Landscaping

    The purpose of this Request for Information (RFI) 2018-01 is to gather information on potential interior landscaping services available to Covered California (the Agency) for:

    Interior landscaping services for our office located at 1601 Exposition Blvd., Sacramento, CA 95818:
    • Provide necessary plant watering, feeding and de-infestation, and maintain all plant material in a condition consistent with other LEED-Certified.
    • Provide cost breakdown for type of services and options available for interior provided by your landscaping company.
    • Request vendors to come onsite to conduct a walkthrough of building.

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    RFP 2018-02 Business Analysis Services

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide business analysis services on existing (CalHEERS) and emerging technologies such as customer relationship management tools (Salesforce) and artificial intelligence (Chatbot), training and mentoring on agile methodology adoption and transition from waterfall, and experienced team members who can function as a Scrum Masters, Product Owners, or Agile Coaches.

    RFP 2017-28 Salesforce Enhancements & Operational Maintenance

    Covered California enlists the services of Contractor to maintain operational support of a current Salesforce platform and develop additional Salesforce capabilities for Covered California’s Sales Division and Program Integrity Division. The operational support and enhancements to Salesforce will support increasing new enrollment, retention of enrollment, sales channel program compliance, workflow integration, and implement reporting for analysis of fraud, waste, and abuse.

    IFB 2017-25 Fitness for Duty Violence Screen

    The purpose of this IFB is to provide employee fitness for duty psychiatric evaluations to determine if an employee’s capacity to perform their job functions is a threat due to a medical condition. Evaluations will be conducted at Covered California’s locations in Sacramento (3), Rancho Cordova, Oakland and Fresno.

    RFP 2017-24 Covered California for Small Business - General Agents

    The purpose of this RFP is to find qualified Health Insurance General Agents who are interested in providing General Agent services to the Covered California Division of Covered California for Small Business. Covered California recognizes that General Agents play a significant role in the small group market in order to achieve the goals and objectives the Patient Protection and Affordable Care Act of 2010.

    RFP 2017-22 Salesforce Service Cloud Implementation Services

    The purpose of this RFP is to solicit proposals from qualified bidders to provide implementation, including conversion from current solution, and continued support of an enterprise Salesforce Service Cloud Customer Relationship Management (CRM) system to replace the existing Oracle Service Cloud CRM application that serves as the backbone of customer service throughout Covered California.

    Qualified Health Plan Certification Application for Fourth Quarter Plan Year 2018 Covered California Small Business Marketplace

    Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal. Currently contracted CCSB Applicants must submit an application by May 14, 2018 for participation in fourth quarter for plan year 2018. New Entrant Applicants must submit an application by April 27, 2018 for participation in fourth quarter for plan year 2018.

    RFP 2017-16 Service Center Assessment Improvements

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide highly specialized, skilled and experienced resources to perform a holistic current state assessment of the Covered California Service Center operations. The overall intent of the assessment is to identify operational efficiencies/deficiencies, ideal staffing for all units/work areas, technology and tools in use. It is anticipated that the engagement would include a gap analysis of the Service Center’s performance against best in class contact center peers, and leading best practices from the industry.

    RFP 2017-21 Service Center Training

    The purpose of this RFP is to solicit proposals from qualified Bidders who have the capacity to conduct, develop, and deliver customized instructor led or web based training to contact center representatives, clerical staff, analysts, specialists, supervisors, managers, and executive staff which supports their specific duties. The Contact Center/Service Center will accept proposals for employee training services such as, but not limited to, self-paced online, instructor-led webinars or in-person programs. If, in your professional opinion, your firm can enhance training opportunities, please propose additional services or programs available and the projected benefits.

    RFP 2017-17 Translation, Readability and Focus Group Testing

    The purpose of this RFP is to solicit qualified Bidders to provide readability, translation, and consumer focus testing services to Covered California in English, Spanish including California Latino cultural nuances, Arabic, Armenian, Traditional Chinese, Farsi, Hindi, Hmong, Japanese, Khmer, Korean, Punjabi, Russian, Tagalog, Thai and Vietnamese.

    RFP 2017-19 Vision Plan

    The purpose of this RFP is to help consumers connect with and obtain coverage from quality vision plans. Covered California is conducting this RFP to solicit applications from vision plans interested in offering coverage to Covered California consumers. Covered California will select vision plans through this RFP process. Covered California will provide a link for consumers from the Covered California website to selected vision plans’ websites.

    Qualified Dental Plan Certification Application For Plan Year 2019 Individual Marketplace

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 15, 2018. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Health Plan Certification Application For Plan Year 2019 Covered California Small Business Marketplace

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 15, 2018. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Dental Plan Certification Application For Plan Year 2019 Covered California Small Business Marketplace

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 15, 2018. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    RFP 2017-13 Professional Accounting Services

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide expertise to fulfill functions for which outside expertise is essential and, where appropriate, to train and mentor permanent staff to transition functions to State employees. This includes the design, development, review and research of financial policies, procedures and workflows of various accounting and finance functions.

    RFP 2017-14 Leadership Academy

    The purpose of this RFP is to solicit proposals from qualified Bidders to design, develop, host and deliver a Covered California Leadership Academy program to its Senior Level and Executive Level managers. Covered California desires a comprehensive and customized training academy utilizing the cohort model. Covered California Leadership Academy will develop the participants’ understanding of:
    • History and Overview of Covered California and its role in the Marketplace.
    • National health care system, California’s health care system - context and trends.
    • Health Plans, markets, employer, exchanges, trends and purchasing.
    • Control agencies - Federal and State oversight.
    • The Affordable Care Act.
    • Inside Covered California.
    • Medicare/Medi-Cal consumers and programs.
    • Healthcare Delivery Changing Landscape.
    • Leadership and Innovation.
    • Trends and Projections.

    RFP 2017-09 Virtual Assistant/ChatBot Platform

    The purpose of this Agreement is for a Contractor to provide a Platform for virtual assistants / chatbots with the capabilities to incorporate cognitive computing. The Platform must include the ability to develop, implement and maintain one or more of the following: Chatbots, Digital Personal Assistants, Roboadvisors. Through consumer focus testing, Covered California has determined that the preferred user interface to consumers would consist of a chat-like interface, therefore, we are seeking a platform that provides for a chat-like user interface to the consumer / end user. The Platform shall integrate with an Interactive Voice Response (IVR) solution and web-based applications through standards-based Application Programming Interfaces (API’s). Covered California shall license the Platform from the Contractor, who will implement, maintain and operate the Platform pursuant to the terms of this Agreement. We are aware that the platforms are numerous with varying elements and continually evolving. With those considerations Covered California is seeking a bidder with strong experience with the proven solutions that can deploy a flexible and modular Platform that can be easily updated and enhanced to remain aligned with the roadmap as the capabilities to incorporate natural language processing, machine learning, and robotic process automation evolve.

    Covered California desires to improve our consumers’ experience with the use of virtual assistants / chatbots to assist consumers with navigation and transaction completion of tasks including, but not limited to, Password Reset, Forms Printing, and FAQs. Covered California also expects to improve the availability of live agents to assist consumers with more complex inquiries such as actual enrollment; while moving transactional contacts into digital channels and to increase self-serve on the web, Interactive Voice Response (IVR) and social media.

    RFI 2017-01 Covered California Customer Relationship Management

    The Covered California program is releasing this Request for Information (RFI) to:
    • Introduce potential bidders to the Covered California program and the systems that support the program.
    • Determine the level of interest in the upcoming procurement for Customer Relationship Management (CRM).
    • Receive feedback on questions and potential issues.
    • Gather information on systems and new trends for CRM Solutions.

    RFP 2017-07 Quality Rating System

    Covered California seeks a team with experience and knowledge of the process outlined in this RFP and the Model Contract Exhibit A – Scope of Work. Bidder must demonstrate that project team members assigned to the project possess the experience, education, knowledge and skills required to perform the work described in this RFP.

    RFP 2017-05 Document Imaging and Verification Solution

    The purpose of this RFP is for Covered California to solicit proposals from qualified bidders to provide a document imaging and verification solution that will automate the extraction and validation of documents submitted as part of satisfying eligibility requirements.

    RFO 2017-04 Business Continuity Program Development Consultant Services

    The Business Continuity Plan (plan) defines the incident management and crisis communications process to be used during an emergency or disaster that impacts Covered California’s operations. The purpose of this solicitation is to obtain consultant services to further develop and implement the plan. For example, the plan identifies resource requirements and provides a gap analysis, however, more is needed to explore, develop, and select recovery strategies. The plan provides a framework and outlines developed recovery teams, but additional assistance is needed to develop relocation plans. Assistance is also needed for additional testing and exercises for the current plan, specifically with regards to training the Incident Management Team.

    RFP 2017-02 Program Evaluation and Tracking

    The need for consumer research and evaluation is particularly important as Covered California continues to improve efforts to target consumers, improve customer satisfaction, increase loyalty and promote services to meet enrollment, retention and renewal goals.

    The purpose of this RFP is to solicit proposals from qualified entities to provide quantitative research services to Covered California.

    The selection process for this RFP (also referred to as “solicitation”) will focus on the Proposers’ capabilities to design and implement surveys, analyze data, report results, provide technical assistance in areas including research and evaluation planning, and project management.

    RFP 2017-01 Document Imaging and Verification Solution

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide Covered California a Document Imaging and Verification Solution and supporting services.

    RFP 2016-28 SEP Electronic Verification

    The purpose of this contract is to secure the services of Contractor to provide a software as a service (SaaS) solution (hereinafter sometimes referred to as the “solution”) hosted at the Contractor’s data center that automates the verification of qualifying life events (QLEs) loss of insurance coverage and, optionally, permanent move within or to California during the special enrollment period (SEP). The solution shall adhere to Covered California's privacy and security requirements. Covered California shall not own the solution but shall license it from Contractor during the term of the Agreement.

    RFP 2016-32 Executive Recruitment

    The purpose of this RFP is to solicit proposals from qualified Bidders with experience in recruiting executives from the health provider and health insurance fields in the private and public sectors. The winning Bidder shall provide Covered California with executive recruitment services for an exempt executive level position, Director, Outreach and Sales Division. The recruitment will begin immediately upon execution of the contract.

    RFP 2016-29 Data Management and Analytics Support

    The purpose of this RFP is to solicit proposals from qualified Bidders to provide expert level technical consulting services to build and maintain modern Business Intelligence (BI) platform leveraging Microsoft SQL Server 2016, Tableau Enterprise Server and ESRI GIS Server.

    Covered California a data-driven organization and has made significant strategic investments in State fiscal year 2016-2017 to procure and implement modern BI tools. Covered California’s long term goal is to build an agile self-servicing BI platform that offers enterprise capabilities to reduce the amount of time it takes to go from raw data to actionable analytics. More specifically, this RFP seeks a vendor to enhance the existing SQL Server, Tableau Server and GIS server implementation by gathering requirements for advanced analytics uses cases from different program areas, automate data transfer processes, design security roles and scale the existing environment for wider deployment to about 400 users across Covered California’s locations in Sacramento, Rancho Cordova and Fresno. The vendor will be working on datasets related to enrollments, financial data, service center data, CRM and other cloud based applications such as Salesforce.

    RFP 2016-31 Health and Dental Plans Certification Application Technical Support Plan Years 2019 and 2020

    Covered California will require the technical support services of a Contractor with the system capability to collect on-line certification application data submissions for individual product offerings of QHP and QDP Issuers for both the Individual marketplace and Covered California for Small Group marketplace for Plan Years 2019 and 2020.

    QHP Certification Application Fourth Quarter 2017 Small Business

    Covered California for Small Business is accepting QHP applications for fourth quarter 2017. Application materials are available here. Interested Applicants should reference instructions in Section 1 of the application.

    Details & Downloads:

    RFP 2016-26 Service Center Desk Support

    The purpose of this RFP is for Covered California to solicit proposals from qualified bidders to provide temporary support to support a successful transition to State-managed support of desktops and infrastructure. More specifically, this RFP seeks vendor support to design, document, and implement service desk processes, including automated processes and procedures while also providing day-to-day end user service desk support. In addition, this RFP seeks services to design, document, and implement both manual and automated processes to support the general infrastructure needs of the Covered California service centers in Rancho Cordova and Fresno. Finally, this RFP, also seeks transition services to ensure that adequate knowledge transfer of the new manual and automated processes for both the service desk and the infrastructure environment in the service center has been successfully transitioned to State management and control.

    RFP 2016-25 Consulting Services Pool

    The purpose of this RFP is to provide Covered California with a pre-approved contractor pool of qualified individuals from which Covered California will contract for various assignments. The pool will provide Covered California with access to several high quality contractors with various specialized areas of expertise. Covered California will utilize contractor services to meet changing needs for a broad range of services. Contractors may also be asked to provide backup services to primary consultants.

    RFP 2016-24 Financial Information System for California (FI$Cal) Project Management

    The purpose of this Agreement is to provide Covered California with qualified individuals to perform project management, analysis, business process re-engineering, process and procedure development, training, documentation, defined tasks and activities related to the business process transformation and organizational readiness of Covered California for the migration to the Financial Information System for California (FI$Cal).

    RFP 2016-20 Programmatic Audit

    The purpose of this Contract is to perform a programmatic audit for the calendar year ending December 31, 2017. The Contractor will conduct the audit in accordance with the Generally Accepted Government Auditing Standards (Yellow Book). This programmatic audit will assess Covered California’s compliance with Title 45, Code of Federal Regulations (45 CFR) Part 155, Subparts C, D, E, and K for both the Individual Market and the Small Business Health Options Program (SHOP), and with the privacy and security standards stipulated at 45 CFR 155.260(a)(3).

    RFP 2016-21 Telephonic Interpretations

    The purpose of this solicitation is to seek vendors that can provide verbal telephonic interpretation services in culturally and linguistically appropriate manners. The Contractor will provide verbal interpretation for the minimum thirteen (13) Medi-Cal threshold languages. The Contractor shall collaborate with all Covered California core business areas to support Covered California’s goal of providing first class customer service with accurate interpretation services.

    RFP 2016-19 Document Imaging and Verification Solution

    This solicitation is hereby cancelled and a new solicitation will be posted shortly. Check the solicitation website regularly for the revised solicitation.

    Qualified Health Plan Certification for Plan Year 2018 Individual Marketplace

    Covered California will accept Letters of Intent to Apply until 5:00 pm PST February 15, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal. Please note, the Confidentiality Agreement must be completed and submitted with the Letter of Intent.

    Qualified Dental Plan Certification for Plan Year 2018 Individual Marketplace

    Covered California will accept Letters of Intent to Apply until 5:00 pm PST February 15, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Health Plan Certification for Plan Year 2018 Covered California for Small Business

    Covered California will accept Letters of Intent to Apply until 5:00 pm PST April 18, 2017. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal. Please note, the Confidentiality Agreement must be completed and submitted with the Letter of Intent.

    Qualified Dental Plan Certification for Plan Year 2018 Covered California for Small Business

    Covered California will accept Letters of Intent to Apply until 5:00 pm PST February 15, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    RFP 2016-16 Covered California for Small Business Agent and Employer Enrollment Application Technology Development

    The purpose of this solicitation is for the California Health Benefit Exchange (Exchange) to obtain a contractor to provide a complete business and technical analysis of the systems currently available to the Exchange to support agents, general agents, employers, and employees in enrolling and managing enrollments for the Covered California for Small Business (CCSB) program.

    RFI 2016-06 Covered California Consumer - Marketplace Research

    Covered California is seeking advice in developing and implementing a comprehensive, quantitative and qualitative research plan. The goals of the research are to:
    • Understand California health insurance consumers (behaviors, barriers & motivators)
    • Evaluate current and potential outreach efforts
    • Identify potential risks and opportunities impacting the growth of Covered California membership
    To support these goals, an assessment on the complexity, trackability and potential total cost to execute the proposed solution for a multi‐year period is being requested. Finally, Covered California is interested in suggestions on how to best collaborate with external partners to maximize its research capabilities.

    RFP 2016-13 Agents and CCSB Employer Enrollment Application Technology Development

    This solicitation is hereby cancelled and a new solicitation will be posted shortly. Check the solicitation website regularly for the revised solicitation.

    RFP 2016-11 Form 700 Management System

    The purpose of this solicitation is for the California Health Benefit Exchange (Exchange) to obtain a contractor to provide a web-based electronic filing system for the automated management of the Exchange’s Statement of Economic Interests Form 700 filings that is compatible with Fair Political Practices Commission regulations.

    RFI 2016-005 SEP Electronic Verifications

    The Covered California program is releasing this Request for Information (RFI) to:
    • Introduce potential bidders to the Covered California program and the systems that support the program.
    • Determine the level of interest in the upcoming procurement for electronic verification services.
    • Learn about potential solutions and current offerings.
    • Receive feedback on questions and potential issues.
    Information gathered as a result of this RFI may be used in the development of any upcoming Request for Proposals (RFP) for electronic verification services. The RFI responses will also be utilized to assist the State in identifying and understanding potential issues and risks related to this RFP.

    Completion of this RFI will be performed at no cost to the State. The intent of this RFI is for information and planning purposes and does not constitute a solicitation. A contract will not be awarded based on this RFI.

    Responses to this RFI will not be shared with other vendors until after the contract award that results from the above-mentioned RFP process. Questions that are submitted for clarification under Section 2 of this RFI, will be considered and if needed, an addendum to the RFI will be released by Covered California.

    Please read this RFI document thoroughly and adhere to the response submission guidelines.

    RFI 2016-004 Document Verification Services

    The Covered California program is releasing this Request for Information (RFI) to:
    • Introduce potential bidders to the Covered California program and the systems that support the program.
    • Determine the level of interest in the upcoming procurement for document imaging and verification services.
    • Receive feedback on questions and potential issues.
    • Gather information on new trends in document imaging and verification.
    Information gathered as a result of this RFI may be used in the development of any upcoming Request for Proposals (RFP) for Document Verification Services. The RFI responses will also be utilized to assist the State in identifying and understanding potential issues and risks related to this RFP.

    Completion of this RFI will be performed at no cost to the State. The intent of this RFI is for information and planning purposes and does not constitute a solicitation. A contract will not be awarded based on this RFI.

    Responses to this RFI will not be shared with other vendors until after the contract award that results from the above-mentioned RFP process. Questions that are submitted for clarification under Section 2, item C of this RFI, will be considered and if needed, an addendum to the RFI will be released by Covered California.

    Please read this RFI document thoroughly and adhere to the response submission guidelines.

    RFP 2016-09 Call Center Services

    The purpose of this RFP is for the Exchange to solicit proposals from qualified Bidders to provide an additional Call Center to support up to 600 Full-Time Equivalent (FTE) staff for voice, chat and data entry, as well as equipment, materials, facilities including required connectivity to receive and respond to calls and data entry work during the projected peak call volume period.

    RFP 2016-05 Security Services Fresno

    The purpose of this solicitation is for Covered California to obtain unarmed, uniformed security guard services at its Fresno location. Security guards will be the first point of contact, will assist with emergency evacuations, be an active participant on the Emergency Response Team, and assist in tracking facility maintenance issues during walk arounds.

    RFP 2016-04 Security Services Sacramento

    The purpose of this solicitation is for Covered California to obtain unarmed, uniformed security guard services at its Exposition headquarters in Sacramento. Security guards will be the first point of contact, will assist with emergency evacuations, be an active participant on the Emergency Response Team, and assist in tracking facility maintenance issues during walk arounds.

    RFP 2016-03 Security Guard Services – Rancho Cordova

    The purpose of this solicitation is for Covered California to obtain unarmed, uniformed security guard services at its Rancho Cordova location. Security guards will be the first point of contact, will assist with emergency evacuations, be an active participant on the Emergency Response Team, and assist in tracking facility maintenance issues during walk arounds.

    RFP 2016-08 Help On-Demand

    The purpose of this Agreement is to secure a web-based solution that provides consumers a mechanism for accessing what Covered California calls “Help On-Demand”. Currently, on CoveredCA.com, a consumer does have the option to “Find Local Help”, however, this option allows a consumer to search for a Certified Insurance Agent or a Certified Enroller, then refine their search by name, or a combination of proximity to location and language.[1] The consumer can then either call or visit the storefront of an Agent or Certified Enroller, or they have an option, if they have already started an application for insurance, to “delegate” the application to the Agent or Enroller from within their on-line application. In either instance, the consumer may have to wait for a callback from the Agent or Enroller which could be hours or days later or find accommodating storefront hours of operation.

    RFP 2016-01 Open Enrollment Call Center Project Manager

    The purpose of this RFP is for Covered California to solicit proposals from qualified Bidders to provide a highly experienced project manager to in support Covered California’s Surge Call Center. The Project Manager will be responsible to oversee all activities related to Covered California’s Surge Call Center.

    RFP 2016-02 Executive Recruitment

    The purpose of this solicitation is to obtain the services of one or more executive recruitment firms with focused experience with executives in the health provider or health insurance fields in the private and public sectors in order to recruit two exempt executive level positions [Chief Deputy Executive Director, Operations and Chief Deputy Executive Director, Program (Plan, Sales & Service)]. The recruitments will begin all at once.​​

    RFP 2015-48 Consulting Services for the 1332 Innovation Waiver Application

    The purpose of this solicitation is to obtain technical assistance services to develop the Affordable Care Act Section 1332 State Innovation Waiver application (waiver application) and manage the waiver application development process.

    Section 1332 of the Affordable Care Act (ACA), also known as State Innovation Waivers, authorizes states to request five-year renewable waivers from the U.S. Departments of Health and Human Services (HHS) and the U.S. Treasury. These waivers allow for flexibility regarding the ACA’s key coverage provisions, including those related to benefits and subsidies, exchanges, and the individual and employer mandates. States may propose waivers to pursue broad alternative approaches to expand coverage or targeted fixes to improve consumers’ experiences. Some ACA provisions, such as guaranteed issue, may not be waived and all applications must demonstrate that coverage remains as accessible, comprehensive, and affordable as before the waiver and that the proposed changes will not contribute to the federal deficit.

    RFP 2015-34 Covered California for Small Business Provider Plan Policy

    The purpose of this RFP is to secure a Contractor to support the Covered California for Small Business Division in the following areas: Developing QHP and QDP certification/recertification into an Exchange; premium rate review and health plan provider application assessment; creating and managing regulations specific to the small group market; creating and managing policies as regulations are implemented or changed; developing a knowledgebase of the group market specific to data modeling, competitive analytics, and strategy development. Contractor will provide consulting services to ensure the self-sustainability goals of the Sales Division are attainable and can be reached in a timely manner. These services will provide the critical support needed to develop QHP and QDP policy and strategic planning as an integral foundation for the ongoing operations of the Sales Division as the Small Business division as it seeks to place itself strategically in the small group health market.

    RFP 2015-33 QHP Selection, Oversight and Management Support

    The purpose of this RFP is to acquire a Contractor for technical consulting services in support of the Exchange’s Qualified Health Plan (QHP) selection, oversight and management activities. The Contractor will provide consulting services to support the reviewing, scoring and analysis of QHP applicant responses to “eValue8” questions contained within the QHP application and consulting services for the management of electronic reports based on responses to the Exchange’s QHP certification application.​

    RFP 2015-32 Financial Statement and Single Audit

    As set forth in 45 CFR Part 155 Exchange Establishment Standards and Other Related Standards under the Affordable Care Act, Subpart M-Oversight and Program Integrity Standards for State Exchanges, § 155.1200(c) External Audits, the Exchange must engage an independent qualified auditing entity which follows generally accepted governmental auditing standard (GAGAS) to perform an annual independent external financial and programmatic audit and must make such information available to the Department of Health and Human Services (HHS) for review.

    In addition, 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F – Audit Requirements, § 200.501(a) and (b) requires a non-federal entity that expends $750,000 or more during the non-federal entity’s fiscal year must have single or program specific audit conducted for that year in accordance with § 200.514 Scope of audit except when elected to have a program-specific audit.

    As summarized, 2 CFR § 200.514 Scope of Audit, encompasses an audit of Covered California’s financial statements in accordance with GAGAS and generally accepted accounting principles (GAAP); an assessment of internal control over Federal programs; compliance with Federal statues, regulations, and the terms and conditions of Federal awards that may have a direct and material effect; follow-up procedures on prior audit findings for reasonableness; and completion of the data collection form as part of the report submission.

    According to 2 CFR § 200.512 Report Submission, the Single Audit must be submitted by the earlier of 30 calendar days after receipt of the auditor’s report(s), or nine months after the end of the audit period to the Federal Audit Clearinghouse (FAC). Covered California must electronically submit to the FAC the data collection form and the reporting package must include the following:

    • Financial statements and schedule of expenditures of Federal awards
    • Summary schedule of prior audit findings
    • Auditor’s report(s)
    • Corrective action plan
    • A copy of any management letters issued by the auditor

    RFP 2015-31 Print Fulfillment Services

    The purpose of this RFP is to obtain print and fulfillment services to support the Outreach, Education and Enrollment functions of Covered California.

    Covered California is a rapidly evolving organization with need for a Print and Fulfillment vendor that can manage complex collateral production, mailings and distribution needs across California. Collateral pieces will be used by the statewide outreach, education and enrollment network to raise awareness of and educate consumers. Messages and or piece components may be changed based on refinement requirements, and it is important for Covered California to partner with a vendor that can assist in balancing appropriate production approaches to meet demand for materials, while minimizing waste of stored materials that may be updated or replaced with new versions. Critical to success is the ability to maintain awareness of utilization and versions of materials that are in circulation.

    In addition to managing production, the selected Contractor will be required to manage order accounts for multiple grantees, entities and partners.

    Covered California reserves the right to retain the services of the organization selected as a result of this RFP to assist with other related activities and projects embarked upon by Covered California during the established contract period, or through a contract amendment.

    Qualified Health Plan Certification Application For Plan Year 2017 Covered California for Small Business

    Covered California will accept Letters of Intent to Apply until 4:59pm PST April 15, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Details & Downloads:

    RFI 2016-03 EAP

    ​The purpose of this RFI is to gather information on technical solutions in the marketplace that could satisfy the requirements for a new EAP automated solution and obtain high-level cost estimates for comparative analysis. ​

    Details & Downloads:

    IFB 2015-30 Invitation For Bid Fitness For Duty - Psychological Evaluations

    Contractor shall provide Employee Fitness For Duty Psychological Evaluations to determine an employee’s capacity to perform their job functions, for one or both of the following Covered California regions, with a contract term through June 30, 2017.

    Region 1:
    Fresno Service Center, 7202 N. Palm Avenue, Fresno, CA 93711

    Region 2:
    Headquarters Office, 1601 Exposition Boulevard, Sacramento, CA 95815 Rancho Cordova Service Center, 10877 White Rock Road, Rancho Cordova, CA 95670 CalHEERS Field Office, 2329 Gateway Oaks, Suite 100, Sacramento, CA 95833

    IFB 2015-29 Employee Fitness For Duty - Physical Evaluations

    Contractor shall provide Employee Fitness For Duty Physical Evaluations to determine an employee’s capacity to perform their job functions, for all of the following Covered California locations, with a contract term through June 30, 2017.

    Headquarters Office, 1601 Exposition Boulevard, Sacramento, CA 95815
    Rancho Cordova Service Center, 10877 White Rock Road, Rancho Cordova, CA 95670
    CalHEERS Field Office, 2329 Gateway Oaks, Suite 100, Sacramento, CA 95833

    RFP 2015-26 Actuarial Services

    The purpose of this RFP is to acquire health and dental insurance actuarial services to support a range of Plan Management activities, particularly for the certification, recertification, and decertification of Qualified Health Plans (QHP), including the certification of new QHPs for plan years 2017, 2018, and 2019. In addition, Covered California will need actuarial services to support the operation of its ongoing business in an efficient and effective manner.

    Qualified Health Plan Certification Application For Plan Year 2017 Individual Marketplace

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 19, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Health Plan Certification Application For Plan Year 2017 Covered California for Small Business

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 19, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Dental Plan Certification Application For Plan Year 2017 Individual Marketplace

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 19, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    Qualified Dental Plan Certification Application For Plan Year 2017 Covered California for Small Business

    Covered California will accept Letters of Intent to Apply until 4:59pm PST February 19, 2016. Interested applicants must use template provided. Letters of Intent are nonbinding, but are required to obtain access to the electronic application submission portal.

    RFP 2015-25 Tribal Consultation Services

    The purpose of this Request for Proposal is to provide Covered California with subject matter experts in Indian affairs who will be able to deliver updates on all anticipated new and changing provisions in state and federal law that protect American Indians/ Alaskan Natives (AI/AN) and affect the Indian health care delivery system. Covered California will use this information to evaluate and incorporate changes into policies, procedures, software systems and promotional materials as needed. The selected Contractor will also provide an updated comprehensive contact list of Tribes, Tribal health programs and urban Indian health programs, will be responsible for the planning, organizing, and facilitating of an annual Tribal consultation, and coordinating and leading Tribal Advisory Group meetings, as requested.

    RFP 2015-21 Chief Actuary

    The Exchange is seeking the services of a Chief Actuary/Director of Research to advise the Exchange on the impact and long-term success of the Exchange in the areas of financial sustainability, health care cost containment, and evaluations of outcomes and analytics. In order to support and sustain the operation of the Exchange when federal funds are no longer available, the Chief Actuary will develop a comprehensive financial sustainability plan which guides the development, implementation and operation of the Exchange.

    RFP 2015-22: Health Insurance Market Analysis and Planning

    ​The purpose of this RFP is to assist the Covered California with its near and long-term financial and business planning to support establishment of the marketplace. The implementation of the ACA ushered in a very dynamic health insurance marketplace which contains many potential risks and opportunities. Covered California must consider how potential future developments could impact its enrollment and present opportunities for further growth.

    IFB 2015-20 Invitation For Bid 2015-20 Fitness For Duty - Physical Evaluations

    Contractor shall provide Employee Fitness For Duty Physical Evaluations to determine an employee’s capacity to perform their job functions, for one or both of the following Covered California regions, with a contract term through June 30, 2017.

    Region 1:
    Fresno Service Center, 7202 N. Palm Avenue, Fresno, CA 93711

    Region 2:
    Headquarters Office, 1601 Exposition Boulevard, Sacramento, CA 95815 Rancho Cordova Service Center, 10877 White Rock Road, Rancho Cordova, CA 95670 CalHEERS Field Office, 2329 Gateway Oaks, Suite 100, Sacramento, CA 95833

    RFP 2015-19 Quality Rating System – Analysis and Implementation for Plan Year 2017 and 2018; Provider Cost and Quality Performance for Provider Directory

    The purpose of this RFP is to secure the services of a qualified Contractor that will support and provide guidance to the Chief Medical Officer and other key personnel with the analysis and implementation of a QRS for Plan Year 2017 and 2018 Downloads:

    RFP 2015-18 2017 Qualified Health Plan (QHP) Issuer Model Contract and Standardization of Evidence of Coverage (EOC)

    The purpose of this solicitation to secure the services of a Contractor to update and finalize the 2017 QHP Issuer Model Contract and standardize the 2017 EOC document for Covered California Health Plans.

    RFP 2015-17 QHP Certification Project Management Support

    ​The purpose of the solicitation is to provide services to the Exchange that will support and refine the process of evaluating bids that will lead to selection of the most qualified and cost-effective Qualified Health Plans for the State beginning in February 2016. Services will include, but not be limited to, procurement support, support in transitioning this function to a State staff-driven process, resource allocations and workforce planning, and the ability to provide subject matter experts where identified. Services will not include responsibility for making QHP selection decisions.

    RFP 2015-16 Health and Dental Plans Certification Application Technical Support

    Provide a technical solution for the collection and review of the 2017 certification applications.

    For Plan Year 2017, the Exchange will certify all QHP and QDP applicants during the annual solicitation period which only occurs over three (3) months of each year. The process will include new and existing QHP and QDP bidders. Bidders must demonstrate that their proposed plans meet or exceed the Exchange’s certification standards which include offering adequate provider networks; meeting or exceeding accreditation and quality requirements; proposing best practices and innovations in delivery system reforms; and other detailed and unique standards for the geographic areas they propose to serve. The Exchange will select and certify QHPs and QDPs based on their ability to meet or exceed the Exchange’s certification standards and that offer value and distinct choice and quality healthcare at an affordable cost.

    The Exchange will require the technical support services of a Contractor with the system capability to collect the data submissions of individual product offerings for both the individual and small group markets from QHP and QDP Issuers for Plan Year 2017. This Request for Proposal (RFP) will be for a two (2) year contract spanning two annual solicitation cycles which includes the Certification and Recertification of QHPs and QDPs for Plan year 2018 as well as the 2017 Certification solicitation.

    RFP 2015-15 Vision Plan

    The purpose of this solicitation is to help consumers connect with and obtain coverage from quality vision plans. Covered California is conducting this Request for Proposal (RFP) to solicit applications from vision plans interested in offering coverage to Covered California consumers. Covered California will select vision plans through this RFP process. Covered California will provide a link for consumers from the Covered California website to selected vision plans’ websites.

    IFB 2015-14 Invitation For Bid 2015-14 Fitness For Duty - Psychological Evaluations

    Contractor shall provide Employee Fitness For Duty Psychological Evaluations to determine an employee’s capacity to perform their job functions, for one or both of the following Covered California regions, with a contract term through June 30, 2017.

    Region 1:
    Fresno Service Center, 7202 N. Palm Avenue, Fresno, CA 93711

    Region 2:
    Headquarters Office, 1601 Exposition Boulevard, Sacramento, CA 95815 Rancho Cordova Service Center, 10877 White Rock Road, Rancho Cordova, CA 95670 CalHEERS Field Office, 2329 Gateway Oaks, Suite 100, Sacramento, CA 95833

    RFP 2015-07 Small Business Outreach, Education, & Marketing

    The purpose of this RFP is to increase the number of small businesses enrolled in Covered California for Small Business by providing strategies and implementing tactics to efficiently and effectively reach small business owners by leveraging existing relationships with small business organizations, chambers of commerce, and local community organizations.

    Request for Information - Web Based Entities

    The purpose of this Request for Information (RFI) is to gather information on potential solutions available to Covered California for:

    • One or more online consumer-facing retail agent(s), known as Web Based Entities (WBEs) (inclusive of application entry and plan selection), and/or
    • One or more platform(s) and/or software product(s) that enable independent agents to obtain web-based quotes for their clients or prospective client(s), while meeting program compliance requirements of the California Health Benefits Exchange (Covered California).

    The information sought includes:

    • An accounting of both quantitative and qualitative potential benefits to enrollment, including Medi-Cal enrollment.
    • The complexity, maintainability, and potential total costs of potential solutions,
    • The contribution of potential solutions to the mission, goals, and values of Covered California. 

    Details & Downloads:

    RFP 2014-40 Audit A-133

    The Exchange seeks a Contractor who will provide the Exchange professional assistance to: prepare financial statements, including related notes, in compliance with U.S. Generally Accepted Accounting Principles (GAAP); conduct an audit of the Exchange's financial statements in accordance with auditing standards generally accepted in the U.S. and the standards for financial audits contained in GAGAS; prepare an opinion as to whether the presentation of the financial statements prepared by the Exchange conform to U.S. GAAP; perform tests of accounting records and other procedures, including an assessment of the risks of material misstatement of financial statements; evaluate the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by the Exchange, and evaluate the overall financial statement presentation. Certain limited procedures will be performed as required by auditing standards generally accepted in the U.S and GAGAS; perform audit procedures with respect to the Exchange's federal program in accordance with the provisions of OMB Circular A-133 Audits of States, Local Governments and Non-Profit Organizations. OMB Circular A-133 includes specific audit requirements, mainly in the areas of internal control and compliance with laws, regulations, contracts, and grant agreements that exceed those required by Government Auditing Standards; perform tests to evaluate the effectiveness of the design and operation of internal controls relevant to preventing or detecting material noncompliance with laws, regulations, contracts and grant agreements; provide one training session to the Financial Management Division and Program Integrity Division staff, with training to include an assessment and recap on the preparation of financial statements, detailed worksheets, and explanation of the preparation of adjusting entries; provide a document with recommended future fiscal years GAAP adjustments, with emphasis on adjustments related to sustainability funding; provide up to eight hours of consultation services on an as-needed basis.

    Details & Downloads:

    RFP 2015-04 Tribal Consultation Services

    The purpose of this Request for Proposal is to provide Covered California with subject matter experts in Indian affairs that will be able to deliver updates on all of the anticipated new/ changing provisions in the law that protect AI/AN and affect the Indian health care delivery system so that Covered California can evaluate and incorporate changes into policies, procedures, software systems, and promotional materials as needed. The Contractor will also provide an updated comprehensive contact list of Tribes, Tribal health programs and urban Indian health programs, be responsible for planning, organizing, and facilitating the annual Tribal consultation, and coordinating and leading Tribal Advisory Group meetings, as requested.

    RFP 2014-38 Translation, Readability and Focus Group Testing

    The purpose of this RFP is to provide readability, translation and consumer focus testing services to Covered California in English, Spanish (including California Latino cultural nuances), Traditional Chinese, Korean, Vietnamese, Tagalog, Hmong, Russian, Armenian, Farsi, Khmer, and Arabic; and, conduct a community review of translated materials prior to delivering a final translated document to Covered California. This includes soliciting and accepting recommendations from advocates and key stakeholders in coordination with Covered California.

    RFP 2015-05 African American Enrollment Initiative

    The purpose of this solicitation is to procure a qualified vendor to conduct outreach and support for enrollment of the 130,000+ subsidy eligible African Americans in the state of California. The vendor will assist in identifying target rich communities for outreach, education and enrollment carried out by navigators and certified enrollment agents.

    RFP 2014-41: Business Process Management Support

    The purpose of this solicitation is for Covered California to obtain consultant services to provide business process management support to facilitate the transition from startup operations to maintenance operations. The consultants services will promote Covered California’s business effectiveness and efficiency while striving for innovation, flexibility, and integration with technology. Covered California requires technical assistance to enable the organization to be more efficient, more effective and more capable of change.

    RFP 2014-24: Plan Year 2016 Qualified Health and Dental Plan Certification/Recertification Project: Rate Review and Application Assessment and Reorganization and Training of the Plan Management and SHOP Sales Divisions

    The purpose of this solicitation is for Covered California to solicit a contractor to create and manage summary output assessments to support the Plan Management Division with the Qualified Health and Dental Plan Certification/Recertification Project, with a focus on Rate Review and Application Assessment and to assist with the Reorganization and Training of the Plan Management and SHOP Sales Divisions.

    RFP 2014-22 Salary Survey

    The purpose of this solicitation is for Covered California to solicit a contractor to conduct a salary survey using two methodologies that will allow the Covered California to identify appropriate peer organizations for industry-specific roles, as well as understand the broader industry for jobs that have a wide market for talent. Additionally, the Contractor will collect compensation data and benefits data related to these positions. Finally, the Contractor will perform data analysis on the data collected and prepare a final report.

    RFP 2014-18 Public Relations Campaign

    The purpose of this solicitation is for Covered California to solicit proposals from qualified public relations agencies to provide multi-segment and multi-language, integrated communications services through a statewide public relations campaign with the goal of educating subsidy and non-subsidy consumers about Covered California’s services, while maintaining current members and attracting new members during open enrollment and special enrollment.

    RFP 2014-20 Advertising & Marketing Campaign

    The purpose of this solicitation is for Covered California to solicit proposals from qualified advertising agencies to provide multi-segment and multi-language, integrated communications services through a statewide media campaign with the goal of educating subsidy and non-subsidy consumers about Covered California’s services and maximizing the number of Californians enrolled in health insurance coverage.

    Details & Downloads:

    RFP 2014-19 – Premium Accounting

    Part of the CalHEERS Project is the development of premium accounting and reconciliation functions, which includes compensating assisters. This work entails working with the health plans to perform accounting and reconciling of premium payments, calculating and collecting the California Health Benefit Exchange’s (Exchange) fee, developing and implementing the accounting and cash processes to compensate Assisters, and establishing proper controls and fraud prevention that will be associated with the continued implementation of the Exchange.

    The purpose of this Request for Proposal (RFP) is to obtain the services of consultants to provide the Exchange with premium accounting and reconciliation support.

    RFP 2014-21 – Audit Services*

    The purpose of this solicitation is to procure a contractor to perform a programmatic audit for the calendar year ending December 31, 2014. The audit will be conducted in accordance with the Generally Accepted Government Auditing Standards (Yellow Book). This programmatic audit will assess Covered California compliance with Title 45, Code of Federal Regulations (45 CFR) Part 155, Subparts C, D, E, and K for both the Individual Market and the Small Business Health Options Program (SHOP), and with the privacy and security standards stipulated at 45 CFR 155,260(a(3).

    RFP 2014-05 - Community Outreach

    Covered California requires strategic leadership and consulting services to under-serviced communities for the purposes of education and enrollment. Individual proposals will be specific to an identified community (ie; African American, Latino, Asian-Pacific Islander).

    10/29/2014: Covered California has lifted the suspension on this Request for Proposal and has issued Addendum 3 to update the interview date and the date of the notice of intent to award. Bidders will be contacted individually to schedule interviews.

    2016 QHP and QDP Certification and Recertification

    The California Health Benefit Exchange/Covered California is seeking renewal and new entrant applications from issuers proposing to sell Qualified Health Plans (QHP) and Qualified Dental Plans (QDP) through the Exchange for Plan Year 2016.

    In the links below please find information related to submitting applications. Please submit completed Notice of Intent with a cover letter. Only applicants who have submitted a Notice of Intent will be given access to on-line applications (non-PDF) which will be made available on March 2, 2015.

    RFP 2013-08: Enterprise Analytics Solution

    Covered California is seeking an analytics solution to support its role as an “active purchaser,” which requires a sophisticated analytics capacity to support a wide range of enterprise needs including product/benefit design, marketing, pricing, actuarial, access to care, health disparity reduction, quality and network management decisions and policy commitments.

    Covered California encourages all interested parties to fully review this Request for Proposal (RFP), and if qualified, to respond.

    Details & Downloads:

    1/20/2015 – Please see Addendum 5 documents below.

    12/22/2014 – Please see Addendum 4 documents below.

    11/25/2014 – Please see Addendum 3 documents below.

    11/6/2014 – See below for Covered California’s responses to the questions submitted by potential bidders on 10/30/2014.

    10/20/2014 - This is now an ACTIVE SOLICITATION. See Addendum 2 items below which replace the original RFP.

    Download RFP:

    Procurement Library:

    Archive:

    Solicitations Archive

    Additional Links