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COLORADO HEALTH INSTITUTE 
REQUEST FOR PROPOSALS (RFP) 
COHIEX #0001 
FOR 
INDEPENDENT CONSULTING FIRM 
TO CONDUCT BACKGROUND RESEARCH TO SUPPORT THE DEVELOPMENT OF A HEALTH INSURANCE EXCHANGE IN COLORADO 
MARCH 16, 2011
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COLORADO HEALTH INSURANCE EXCHANGE 
SOLICITATION DOCUMENT 
Background Research in Support of a Health Benefits Exchange in Colorado 
The Colorado Health Institute (CHI), on behalf of the Colorado Health Insurance Exchange (COHIEX) planning effort is requesting Offers (bids/proposals) from responsible Vendors to conduct background research needed to develop a successful COHIEX. Below is a brief description of our needs with detailed requirements in subsequent sections of this solicitation. If you are interested and able to meet these requirements, please submit an Offer. 
Brief Description: 
The Patient Protection and Affordable Care Act (ACA), authorizes the establishment of “American Health Benefits Exchanges” (“Exchanges”) in each state. Exchanges will provide a new marketplace for individuals and small businesses to shop for and enroll in both public and private health insurance coverage. CHI is seeking to procure assistance with the research and development of a comprehensive report detailing the current state of health insurance coverage in Colorado, and critical details about the existing health insurance marketplace. The procured services will inform the design and implementation of COHIEX. We are interesting in knowing more about the potential customers coming to the exchange in 2014, in order to guide our policies and operations to best meet the needs of those customers. Information about health reform in Colorado and stakeholder input on exchanges can be found at www.colorado.gov/healthreform. 
The solicitation package consists of: 
SECTION 1: INSTRUCTIONS, DATES, RESERVATIONS AND OTHER GENERAL INFORMATION 
SECTION 2: HOW WE WILL EVALUATE OFFERS 
SECTION 3: SPECIFICATIONS / QUALIFICATIONS / STATEMENT OF WORK 
SECTION 4: PRICE 
SECTION 5: CONTRACT 
A bid submitted in response to this RFP shall constitute a binding offer. Acknowledgment of this condition shall be indicated by the autographic signature of the Offeror or an officer of the Offeror legally authorized to execute contractual obligations. A submission in response to this RFP acknowledges acceptance by the Offeror of all terms and conditions including compensation, as set forth herein. An Offeror shall identify clearly and thoroughly any variations between its bid and the requirements as described in this RFP. Failure to do so shall be deemed a waiver of any rights to subsequently modify the terms of performance, except as outlined or specified in the RFP. 
In this document CHI will be referred to as “we” or “us”. The person submitting an Offer will be referred to as “Vendor”, “Contractor” or “You”. Please read the entire solicitation package and submit your Offer for evaluation in accordance with all instructions.
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1.1 OFFER DUE DATE, TIME AND SUBMISSION LOCATION. Due Date: 04/13/2011 
RFP Announcement 
March 16, 2011 
Offeror email inquiry deadline 
(No questions accepted after this date) 
March 22, 2011 
(5:00 PM MT) 
Responses to the Offeror inquiries posted on the CHI website 
March 28,2011 
Bid submission deadline 
April 13, 2011 
(5:00 PM MT) 
Estimated bid selection and award announcement 
April 29, 2011 
Estimated date for contract finalization 
May 6, 2011 
Estimated contract start date 
May 6, 2011 
Estimated contract end date 
September 30, 2011 
1.2 Inquiries 
Prospective Offerors may make e-mail inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the schedule above in section 1.1. Phone, written, and fax inquiries will not be accepted. 
E-mail all inquiries must be submitted by March 22, 2011 to: 
khelm@coloradohealthinstitute.org 
The Offeror shall place “RFP Inquiry” in the subject line. Responses to Offerors’ inquiries will be published on the CHI website no later than March 28, 2011. 
DELIVER OFFERS TO: (LABEL OUTSIDE OF ENVELOPE / CONTAINER): 
Kathy Helm 
CHI 
303 E. 17th Avenue, Suite 930 
Denver, CO 80203 
We will open Offers at the due date, time and delivery location. You must submit a signed original and ___5____ copies of the Offer in a sealed container. In addition, you must submit ____1__ copies on CD in Microsoft Word. The Offer should include a cover letter specifying the vendor contact person, and must be signed by the individual authorized to negotiate on behalf of the vendor. 
Prior to the due date, you may mail or hand-deliver Offers, modifications, and withdrawals. We do not allow e-mail, fax, or other electronic submissions. We must physically receive
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submissions as specified; it is not sufficient to show you mailed or commenced delivery before the due date and time. We will not consider Offers, modifications or withdrawals submitted after the due date and time. All times are Colorado local times. 
Proposals should: 
• Use standard 8 1/2 by 11-inch paper (except for large tables) 
• Use eleven (11)-point font. 
• Be numbered consecutively for all pages from start to finish (not required for appended materials) in the Technical Proposal, and numbered consecutively for all pages from start to finish (not required for appended materials), in the Cost Proposal. 
• Top, bottom, left and right margins must be one (1) inch. 
• Proposal should not exceed 25 pages (appendices and cover letter excluded). 
You must offer a price submission, distinct from the Scope of Work proposal in Section 3.1. Price submissions should include the anticipated fixed cost for each component and a total bid cost for all work. You must provide the details behind the fixed cost estimate including an estimate of hours for each component of work and one hourly rate for each staff class identified in the proposal. A blended rate, whereby a proposal identifies one hourly rate for all categories of services, is not acceptable. Price bids must be related to the functions and responsibilities outlined in section 3.1. The Price Proposal must be submitted in a separate, sealed envelope or container in the Offer container. The Vendor will provide its Price Proposal in accordance with the specifications provided below for the services specified in this document. 
In the event that it becomes necessary to revise any part of this request for RFP, an addendum will be provided to each Offeror who received the original RFP and posted on the CHI website. It is the Offeror's responsibility to make known to CHI its interest in the addendum if it has not received the RFP. 
1.3 AWARD. We will post a notice on the website identifying the apparent awardee. The notice extends the Offer Firm Time until we sign a contract or determine not to sign a contract. We may accept or reject your Offer as submitted, or may require contract negotiations. If negotiations do not result in an acceptable agreement, we may reject your Offer and begin negotiations with another Vendor. 
1.4 RESERVATIONS. Offers become the property of CHI and these and late submissions will not be returned. You must read and understand the solicitation and tailor your Offer and activities to ensure compliance. We reserve the right to amend the solicitation; reject any or all Offers; to award by item, group of items, or grand total; and to waive minor defects. We may request a clarification; inspect your premises; interview staff; request a presentation; or otherwise verify the contents of the Offer, including information about subcontractors and suppliers. We may request Best & Final Offers when appropriate. We will make all decisions on compliance, evaluation, terms and conditions, and shall make decisions solely in the best interests of CHI. This competitive process requires that you provide additional information and
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otherwise cooperate with us. If you do not comply with requests for information and cooperate, we may reject your Offer. You have no right to an award by submitting an Offer. We are not responsible for and will not pay any costs associated with the preparation and submission of your Offer. If you are the awardee, you shall not commence, and will not be paid for any billable work prior to the date all parties execute the contract, unless approved in writing in advance by the CEO of CHI. 
2 - HOW WE WILL EVALUATE OFFERS 
2.1 RESPONSIVENESS. We will determine whether the Offer meets the stated requirements. We will award to the Responsible Vendor whose Offer is Responsive and is considered the best of those submitted (without consideration of price) and with whom we are able to negotiate a fair and reasonable price. We will rank Offers, without consideration of Price, from best to least qualified using a point ranking system (unless otherwise specified) as an aid in conducting the evaluation. Vendors who receive fewer than the minimum required points will not be considered for award. We will attempt to negotiate a fair and reasonable price with the Vendor with the best Offer. If we cannot negotiate a fair and reasonable price, we reserve the right to award and negotiate with the next highest ranked Vendor. We will determine whether the price is fair and reasonable by considering the Offer, including the Vendor's qualifications, the Vendor's reputation, all prices submitted, other known prices, the project budget and other relevant factors. 
2.2 EVALUATION CRITERIA 
Evaluation Criteria 
Maximum Points 
Corporate Qualifications – The vendor must provide a straightforward and concise description of the company, years in business, scope of experience with private and public entities, demonstrate experience working with state agencies, such as Departments of Insurance and state Medicaid Programs, and demonstrate familiarity with requirements in the Affordable Care Act. Demonstrated understanding of the unique characteristics of the uninsured and underserved in CO as compared to other states. Include tax ID number in cover letter. 
100 
Staff Qualifications –The vendor must provide the identity of staff necessary to perform requested services with the resumes of each including relevant education and work experience. 
200 
Technical Expertise –The vendor must submit a detailed work plan to demonstrate a comprehensive understanding the scope of work identified in Section 3 including how you will work with agencies to identify needed data; coordinate with relevant agencies to obtain the data; how the bidder will analyze data elements; and provide assurances that the data and methodology will be available to CHI and state agencies for future analytical needs. 
500 
References – To demonstrate ability to meet the needs of CHI for this project, the vendor must provide examples of two private or public sector clients where the vendor has completed similar work; provide contact information for references. May be an attachment. 
100 
Add-ons/future work bonus points as an attachment. 
100
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3. STATEMENT OF WORK 
The goals of the analysis are as follows: 
1. To enumerate and describe how Coloradans will be insured in 2013, 2014 and 2015. 
2. To enumerate and describe in policy-relevant ways the characteristics of Coloradans likely to be insured through each of the Exchange’s two lines of business: the individual exchange and the Small Business Health Options (SHOP) exchange. 
3. To understand the characteristics of Colorado employers that will begin offering health insurance through the SHOP exchange. 
4. To describe the Coloradans who are likely to choose the bronze, silver, gold or platinum plans on the Exchange and estimate the costs of insuring them. 
5. To work with Colorado data stewards to develop a robust analytic methodology that meets the requirements of this RFP but which can be continuously modified as new information becomes available; the methodology and data will be handed off to state data stewards for other purposes (such as state budgetary purposes) to ensure continuity of data for trending and projection purposes. 
The primary questions that this analysis aims to answer include: 
1. How will Coloradans be insured in the baseline year? (using 2013 as a baseline) 
2. How will Coloradans’ coverage change annually between 2013 and 2015? 
3. What are the characteristics of Coloradans likely to be insured in the Exchange? 
4. What are the characteristics of Colorado employers that are likely to be insured in the SHOP exchange? 
5. What types of plans are Coloradans likely to choose in the Exchange? (bronze, silver, gold, platinum) 
6. What is the estimated cost of insuring Coloradans in each of these plans? (i.e., premiums, out of pocket costs, etc.) 
7. Is there value in the state developing a Basic Health Plan for uninsured individuals with incomes between 133-200% FPL who would otherwise be eligible to receive premium subsidies on the Exchange? 
3.1 PROJECT REQUIREMENTS 
The contractor must provide CHI with data and trend analysis of health insurance coverage and the private health insurance marketplace as described in the RFP. The contractor must coordinate with CHI, the Division of Insurance, other state agencies, and the Data Advisory Work Group for COHIEX to secure data necessary for the analysis. To the extent possible the contractor must identify and collect primary data to fill gaps in existing data sources. Any primary data collected in completion of the services identified in this section must be made available to CHI and state agencies for future use. The data provided by the Vendor will be used for actuarial purposes to further design and refine the operations of COHIEX and to estimate the subsidy and premium levels to be provided to various customers using the exchange. The contractor must represent findings in an oral presentation and written final report. All cross tabulations must be available in Excel spreadsheet format for future use.
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3.1.1 Describing insurance coverage of Colorado’s population 
In developing this RFP, members of a data advisory workgroup identified a number of population groups of policy interest; specifically, Coloradans who will transition from one type of coverage to another (such as the Exchange), or from uninsured to insured. These individuals came to be identified by the shorthand term, “switchers.” To conceptualize both the switchers and those Coloradans who will retain their current status, CHI developed Table 1. 
Table 1. Insurance transition matrix, Colorado population, 2013 and 2014 
A1. 
A2. Uninsured in 2014 
A3. Insured in 2014 
B1. 
Coloradans uninsured currently 
(2013 baseline) 
B2. 
Coloradans who remain uninsured 
B3. Switchers: Uninsured to insured 
C1. 
Coloradans insured currently 
(2013 baseline) 
C2. Switchers: Coloradans who shift from insured to uninsured status 
C3. 
a. Coloradans who retain their current coverage 
b. Switchers: Coloradans who shift from one type of coverage to another (e.g., employer-based to the Exchange) 
Note: The year 2013 is requested as baseline due to the January 1, 2014 deadline by which state exchanges are expected to be operational. The year 2014 is cited in Table 1 for conceptual purposes; note that the scope of work includes projections for 2015 as well. 
CHI seeks to enumerate the number of individuals within each of the “B” and “C” cells in Table 1. Additional information, such as socioeconomic, employment, demographic and cost information is also requested in each cell to inform key policy questions in the development of the Exchange. Acknowledging that the same granularity of data is not necessary for each cell, and that each group possesses unique characteristics of policy significance, CHI is seeking a vendor that demonstrates an understanding of the policy significance of each group and that can provide recommendations in their proposal for the variables and analyses that will optimize the utility of the data for Exchange planning. 
All estimates and projections are expected to account for state and national policy changes (such as Medicaid expansions) that are expected to be implemented between now and 2015. 
The following contextual information summarizes the rationale, proposed variables and additional policy questions suggested by members of the data advisory workgroup. Vendors are encouraged to propose additional or alternate questions, variables or factors to consider and provide an explanation of the program/policy relevance of their proposals.
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Contextual information on Table 1 
Cell B1: The currently uninsured (2013 baseline) 
Suggested questions of policy relevance: 
• Why do they lack coverage? 
• What are the barriers to coverage? 
• How long have they been uninsured? (e.g., <= 3 mos, 4-6 mos, 7-9 mos, 10-11 mos, 12 mos) 
• How are they distributed by federal poverty level (FPL), geography, age, employment status, etc? 
Context: CHI is interested in how best to target exchange services or to develop exchange policies to ensure smooth operations. Thus, profiles of different user types are needed. These profiles may include distribution by factors such as income (as percent of the federal poverty level [FPL]), geography, age, employment status, or status as a parent of a dependent child. One of the primary groups of anticipated enrollees will be Coloradans who currently lack health insurance. Baseline information – defined in this RFP as a projection of the Colorado population in 2013 – is required in order to estimate how the implementation of the Exchange and other policy provisions will affect the coverage status of uninsured Coloradans. Policy decisions may be informed by characteristics of subgroups within Colorado’s uninsured population. For example: 
• Coloradans seeking coverage during brief spells of uninsurance vs. those who will be longer-term (stable) Exchange members. (The former group, if large, may be the target of policies to stabilize enrollment.) 
• Uninsured Coloradans who will enroll in the exchange because of the availability of subsidies vs. uninsured Coloradans who have major informational needs. In other words, they do not know how to enroll in coverage, face linguistic barriers, etc. 
Many subgroups will likely overlap. How each one is described depends on relevant program and policy questions. 
Cell B2. Coloradans who remain uninsured 
Suggested questions of policy relevance: 
• What are the characteristics of those who remain uninsured after implementation of the Exchange? 
• Why will they remain uninsured? (e.g., lack legal documentation, exempt from individual mandate, eligible but not enrolled (EBNE), fall through cracks, take penalty) 
Context: In addition to understanding Exchange enrollees, it is important to understand who will remain uninsured and why. In particular, it will be important to quantify and describe the group that is eligible for exchange services but not enrolled. For example, is this group primarily eligible for subsidies?
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Cell B3. Switchers: Coloradans who shift from uninsured to insured status 
Suggested questions of policy relevance: 
• What are the different categories of switchers? (uninsured to Medicaid, uninsured to Exchange, etc.) 
• How many switchers are in each category? 
Context: Although the Exchange is a major strategy for covering the uninsured, it is recognized that the individual mandate and other coverage opportunities will result in the uninsured seeking many different forms of coverage. Planning and policy decisions require an understanding of newly insured and how they will be insured (Medicaid, Exchange, Medicare, etc.). 
Cell C1. Insured currently (2013 baseline) 
Suggested questions of policy relevance: 
• How are they currently covered? (e.g., HRA, HMO, ESI, PPO, high deductible, individual, large group, small group) 
Context: 
Although the primary target for the Exchange are the uninsured and small employers, there may be enrollment by non-target insured populations. 
Cell C2. Switchers: Coloradans who shift from insured to uninsured status 
Suggested questions of policy relevance: 
• How many Coloradans will lose their coverage in 2014? 
Context: 
Similar to Cell C1, there may individuals may enroll in the Exchange who were insured in 2013 but for whatever reason lost their coverage (e.g., employees who lose coverage due to employers dropping coverage). 
Cell C3. Coloradans who remain insured 
This group contains two primary groups: 
a. Coloradans who will retain their current health insurance 
b. Switchers: Coloradans who will shift from one type of health insurance to another 
Suggested questions of policy relevance: 
• What are the different categories of switchers? 
o Employer-sponsored insurance (ESI) to Medicaid or Child Health Plan Plus (CHP+), ESI to Exchange, etc. 
• How many switchers are in each category? 
• How many Coloradans in the individual market are likely to switch to the Exchange because their income will qualify them for a subsidy? 
• How many Coloradans will live in families with mixed insurance status? (e.g., children in CHP+ and parents in the Exchange) 
• How many Coloradans will “churn” between insurance coverage types? How frequently? (monthly, yearly) 
o Between Medicaid and the Exchange in terms of eligibility?
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o Move within the Exchange from subsidized to non-subsidized? 
o Move between Exchange and non-Exchange ESI? (e.g., if change jobs) 
o Families move from children in “CHP+/Exchange” coverage to family coverage under the Exchange 
Context: 
Because of anticipated movement between the Exchange and other forms of coverage, including Medicaid and non-Exchange ESI, understanding who is likely to make these transitions is important for Exchange planning purposes. Related, understanding the likely scope of “churn,” (i.e., individuals and families whose eligibility for public programs and subsidies changes frequently due to transitions of incomes and employment) and the characteristics of these Coloradans are important for informing strategies ensuring continuity of coverage. 
3.1.2 Describing health insurance participation among Colorado employers 
Because health insurance coverage for most Americans is tied to their employment, understanding availability of employer-sponsored insurance is inherent in estimating the population groups and understanding the insurance dynamics described in 3.1.1. Workgroup members preparing this RFP also identified modeling employer behavior as an important component of Exchange planning; specifically, understanding how many Colorado employers currently offer health insurance to their employees, how many do not, and how these offers of coverage are likely to change between 2013 and 2015. The purpose of modeling employer offer patterns is twofold: 
• To aid in estimating the number of individuals (i.e., employees and dependents) covered in the categories described in Table 1; and 
• To understand the characteristics of Colorado employers that will begin offering health insurance through the SHOP exchange. 
Table 2 is provided as a suggested way of conceptualizing employer behavior between 2013 and 2015. Some number of Colorado employers is anticipated to change their offer of health insurance based on the availability of the Exchange and implementation of other policies; parallel to Table 1, they are identified as “switchers.” Questions of policy relevance suggested by workgroup members are summarized in Table 2. As in 3.1.1, vendors are encouraged to propose additional or alternate questions, variables or factors to consider and provide an explanation of the program/policy relevance of their proposals. 
Table 2. Employer characteristic matrix, Colorado business, 2013 and 2014 
A1 
A2. Employers that will not offer coverage in 2014 
A3. Employers that will offer coverage in 2014 
B1. 
Employers that currently do not offer 
B2. Employers that continue to not offer health insurance in 2014 
B3. Switchers: Employers that offer coverage that did not before
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coverage to their employees (2013 baseline) 
• Are there large businesses that are on the cusp of being a small business? (applies to C1 as well) 
• How many employers and what are their characteristics? (firm size, industry, etc.) 
• Of those, how many will begin offering some type of a subsidy to their employees to purchase on the Exchange? 
How many switchers in each group? 
• How many small businesses are likely to enroll through the exchange? 
• How many employers will begin offering health insurance? 
• What are their characteristics? (industry type, size of firm, etc) 
C1 
Employers that currently offer coverage to their employees (2013 baseline) 
• How many small employers currently offer coverage? 
C2. Switchers: Employers that drop coverage 
• How many small employers will drop coverage altogether? 
• Of those, how many will begin offering some type of subsidy to their employees to purchase on the Exchange? 
C3. Employers that continue offering health insurance to employees 
Two groups: 
a. How many employers will have no change in status? 
b. Switchers: How many switchers in each group? 
• How many will change coverage? (ESI to SHOP) 
• How many are groups of one that would move to the subsidized individual market? 
Note: The year 2013 is requested as baseline due to the January 1, 2014 deadline by which state exchanges are expected to be operational. The year 2014 is cited in Table 1 for conceptual purposes; note that the scope of work includes projections for 2015 as well. 
3.1.3 Economic analysis 
Because the decisions about purchasing or offering coverage among individuals and employers depend on the costs of doing so, an essential element of planning for the Exchange is describing which Coloradans are likely to choose the bronze, silver, gold or platinum plans and estimating the associated costs. This economic modeling exercise has a number of objectives: 
• To understand average premiums and out-of-pocket costs among insured Coloradans by policy-relevant FPL categories in the baseline year of 2013 
• To understand how ACA provisions (including implementation of the Exchange) will impact decisions to purchase health insurance in the years 2014 and 2015 
• To understand revenue streams for Exchange operations and planning 
For example, what will Colorado families with incomes between 100 and 150 percent of FPL be able to afford in terms of premium and out-of-pocket health care costs and what plan will they choose? The contractor may decide that an actuarial analysis is an appropriate approach for this portion of project.
12 
3.1.4: Other requirements 
The data and analysis produced as a result of this project will be critical for Exchange planning purposes. The data may be useful for other purposes as well, both anticipated (such as state budgeting projections or additional actuarial analyses) and unanticipated. In addition, the ability to trend data over time using a consistent set of data sources and assumptions is important for a variety of evaluation and budgeting purposes. Vendors are encouraged to include in their responses a description of how they will work closely with CHI, state budget staff and other data stewards to provide data (e.g., in a spreadsheet format), explain the assumptions and describe the methodology to enable ongoing trend analysis once the Contractor’s work is completed. 
It is expected that COHIEX will use this analysis as a baseline for ongoing evaluation of the success of COHIEX in enrolling the target populations to be served through the exchange. Vendors may submit an optional add-on proposal to revise and validate estimates produced by the Offeror through this RFP. If the vendor is interested in ongoing work with COHIEX to revise and validate estimates in 2014 (for 2013), in 2015 (for 2014), and in 2016 (for 2015) you may submit a short (no more than three pages, double spaced, 11 font) proposal as an attachment, with a cost estimate by year for the work proposed. The additional work would be funded separately from all other components described in this RFP. 
Figure 1 illustrates the ideal process that would be implemented to update data on an annual basis. This process is comprised primarily of annually updating/validating projections as new data and data sources come available. 
Figure 1. Process of updating Colorado estimates and projections, 2012-2015 
Revise projections 
Validate projections based on actuals or new data 
Develop projections based on existing data
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3.2 MILESTONES AND PAYMENTS The vendor must complete each deliverable of the project to the satisfaction of CHI. The following are mandatory milestones and deliverables. 
Milestone 
Description 
Timeline 
1. Project Launch 
Contractor must meet with key staff at CHI and other State agencies (as appropriate) to review project work plan and the timeline for deliverables and payment, and establish lines of communication and status reporting mechanisms. 
Within 7 days of contract execution 
2. Mid-term (Preliminary) Oral Report 
Contractor must present preliminary findings. 
Within 45 days of project launch. Vendor may invoice for 30% of payment. 
3. Final Report 
Contractor must prepare a written final report documenting the findings. 
90 days after project launch. Vendor may invoice for 50% of payment. 
4. Oral Presentation 
Contractor must present finding to CHI and other relevant stakeholders 
Within 1 month after delivering the final report. Vendor may invoice for remainder of contract payment. 
3.3 REPORTING, STATUS AND MONITORING 
The Parties will work together to monitor performance during the contract and any warranty term. Vendor must have extensive knowledge of the private health insurance marketplace, Colorado-specific insurance regulation, and applicable Federal statutes, rules and regulations as they relate to both insurance coverage and the provisions of the Affordable Care Act. The Vendor must have a demonstrated ability to execute primary research and data analysis similar to that noted in Section 3.1. 
Vendor must include the names and addresses of all subcontractors you will be using in the performance of this Contract, together with the anticipated amount of money that each subcontractor is expected to receive pursuant to this Contract. Subcontractors” are those specifically hired to provide to the Vendor or another subcontractor some or all of the goods, services, property, remuneration, or other forms of consideration that are the subject of this Contract, including sub-lessees from a lessee of a State agency. We may request updated information at any time. Vendor must provide references from two established private firms or government agencies, other than the procuring agency, that can attest to your experience and
14 
ability to perform the contract subject of this solicitation. Vendor must provide the name, contact information and a description of the supplies or services provided. This contract will end 130 days from the date of execution of the contract. 
4. PRICE 
Price submissions should include the anticipated fixed cost for each component and a total bid cost for all work. You must provide the details behind the fixed cost estimate including an estimate of hours for each component of work and one hourly rate for each staff class identified in the proposal. A blended rate, whereby a proposal identifies one hourly rate for all categories of services, is not acceptable. Price bids must be related to the functions and responsibilities including in the scope of work. Unless otherwise specified, this contract does not allow for reimbursement of any expense incurred by Vendor, including but not limited to telephone or other communications device, postage, copying, travel, transportation, lodging, food and per diem. The CHI budget for this contract is $250,000 to $375,000. This is a fixed price contract. 
1. By submission of this bid each Offeror certifies, and in the case of a joint bid each party thereto certifies as to its own organization, that in connection with this procurement: 
(a) The prices in this bid have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other Offeror or with any competitor; 
(b) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the Offeror and will not knowingly be disclosed by the Offeror prior to opening, directly or indirectly, to any other Offeror or to any competitor; and 
(c) No attempt has been made or will be made by the Offeror to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. 
2. Each person signing the RFP Transmittal letter of this bid certifies that: 
(a) She/he is the person in the Offeror's organization responsible within that organization for the decision as to the prices being offered herein and that she/he has not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above; or 
(b) She/he is not the person in the Offeror's organization responsible within that organization for the decision as to the prices being offered herein but that she/he has been authorized in writing to act as agent for the persons responsible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above, and as their agent does hereby so certify; and she/he has not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above. 
3. A bid will not be considered for award where (1)(a), (1)(c), or (2) above has been deleted or modified. Where (1)(b) above has been deleted or modified, the bid will not be considered for award unless the Offeror furnishes with the bid a signed statement which sets forth in detail the circumstances of the disclosure and the head of the agency, or her/his designee, determines that such disclosure was not made for the purpose of restricting competition.
15 
5. CONTRACT 
CHI reserves the right to incorporate standard contract provisions into any contract resulting from this RFP. A draft contract is included as Attachment A. A submission in response to this RFP acknowledges acceptance by the Offeror of all terms and conditions including those specified in the attached standard contract. 
CHI is not liable for any cost incurred by Offerors prior to issuance of a legally executed contract or procurement document. No property interest, of any nature, shall occur until a contract is awarded and signed by all concerned parties. 
The Offeror shall comply with all applicable State and federal laws, rules and regulations involving non-discrimination on the basis of race, color, religion, national origin, age, sexual orientation, disability or sex. 
News releases pertaining to this RFP shall NOT be made prior to execution of the contract without prior written approval by CHI. 
CHI reserves the right to cancel, for cause, any contract resulting from this RFP by providing ten days written notice to the contractor. 
The contractor shall indemnify, save and hold harmless CHI, its employees, its independent contractors and subcontractors, and its agents from and against any and all claims, damages, liability, and court costs arising in connection with the contract and this RFP. The contractor shall also indemnify CHI, its employees, its independent contractors and subcontractors, and its agents for any attorney’s fees and other litigation expenses they may incur defending against any claims arising from the contract and this RFP.

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COEHIX Research RFP

  • 1. 1 COLORADO HEALTH INSTITUTE REQUEST FOR PROPOSALS (RFP) COHIEX #0001 FOR INDEPENDENT CONSULTING FIRM TO CONDUCT BACKGROUND RESEARCH TO SUPPORT THE DEVELOPMENT OF A HEALTH INSURANCE EXCHANGE IN COLORADO MARCH 16, 2011
  • 2. 2 COLORADO HEALTH INSURANCE EXCHANGE SOLICITATION DOCUMENT Background Research in Support of a Health Benefits Exchange in Colorado The Colorado Health Institute (CHI), on behalf of the Colorado Health Insurance Exchange (COHIEX) planning effort is requesting Offers (bids/proposals) from responsible Vendors to conduct background research needed to develop a successful COHIEX. Below is a brief description of our needs with detailed requirements in subsequent sections of this solicitation. If you are interested and able to meet these requirements, please submit an Offer. Brief Description: The Patient Protection and Affordable Care Act (ACA), authorizes the establishment of “American Health Benefits Exchanges” (“Exchanges”) in each state. Exchanges will provide a new marketplace for individuals and small businesses to shop for and enroll in both public and private health insurance coverage. CHI is seeking to procure assistance with the research and development of a comprehensive report detailing the current state of health insurance coverage in Colorado, and critical details about the existing health insurance marketplace. The procured services will inform the design and implementation of COHIEX. We are interesting in knowing more about the potential customers coming to the exchange in 2014, in order to guide our policies and operations to best meet the needs of those customers. Information about health reform in Colorado and stakeholder input on exchanges can be found at www.colorado.gov/healthreform. The solicitation package consists of: SECTION 1: INSTRUCTIONS, DATES, RESERVATIONS AND OTHER GENERAL INFORMATION SECTION 2: HOW WE WILL EVALUATE OFFERS SECTION 3: SPECIFICATIONS / QUALIFICATIONS / STATEMENT OF WORK SECTION 4: PRICE SECTION 5: CONTRACT A bid submitted in response to this RFP shall constitute a binding offer. Acknowledgment of this condition shall be indicated by the autographic signature of the Offeror or an officer of the Offeror legally authorized to execute contractual obligations. A submission in response to this RFP acknowledges acceptance by the Offeror of all terms and conditions including compensation, as set forth herein. An Offeror shall identify clearly and thoroughly any variations between its bid and the requirements as described in this RFP. Failure to do so shall be deemed a waiver of any rights to subsequently modify the terms of performance, except as outlined or specified in the RFP. In this document CHI will be referred to as “we” or “us”. The person submitting an Offer will be referred to as “Vendor”, “Contractor” or “You”. Please read the entire solicitation package and submit your Offer for evaluation in accordance with all instructions.
  • 3. 3 1.1 OFFER DUE DATE, TIME AND SUBMISSION LOCATION. Due Date: 04/13/2011 RFP Announcement March 16, 2011 Offeror email inquiry deadline (No questions accepted after this date) March 22, 2011 (5:00 PM MT) Responses to the Offeror inquiries posted on the CHI website March 28,2011 Bid submission deadline April 13, 2011 (5:00 PM MT) Estimated bid selection and award announcement April 29, 2011 Estimated date for contract finalization May 6, 2011 Estimated contract start date May 6, 2011 Estimated contract end date September 30, 2011 1.2 Inquiries Prospective Offerors may make e-mail inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the schedule above in section 1.1. Phone, written, and fax inquiries will not be accepted. E-mail all inquiries must be submitted by March 22, 2011 to: khelm@coloradohealthinstitute.org The Offeror shall place “RFP Inquiry” in the subject line. Responses to Offerors’ inquiries will be published on the CHI website no later than March 28, 2011. DELIVER OFFERS TO: (LABEL OUTSIDE OF ENVELOPE / CONTAINER): Kathy Helm CHI 303 E. 17th Avenue, Suite 930 Denver, CO 80203 We will open Offers at the due date, time and delivery location. You must submit a signed original and ___5____ copies of the Offer in a sealed container. In addition, you must submit ____1__ copies on CD in Microsoft Word. The Offer should include a cover letter specifying the vendor contact person, and must be signed by the individual authorized to negotiate on behalf of the vendor. Prior to the due date, you may mail or hand-deliver Offers, modifications, and withdrawals. We do not allow e-mail, fax, or other electronic submissions. We must physically receive
  • 4. 4 submissions as specified; it is not sufficient to show you mailed or commenced delivery before the due date and time. We will not consider Offers, modifications or withdrawals submitted after the due date and time. All times are Colorado local times. Proposals should: • Use standard 8 1/2 by 11-inch paper (except for large tables) • Use eleven (11)-point font. • Be numbered consecutively for all pages from start to finish (not required for appended materials) in the Technical Proposal, and numbered consecutively for all pages from start to finish (not required for appended materials), in the Cost Proposal. • Top, bottom, left and right margins must be one (1) inch. • Proposal should not exceed 25 pages (appendices and cover letter excluded). You must offer a price submission, distinct from the Scope of Work proposal in Section 3.1. Price submissions should include the anticipated fixed cost for each component and a total bid cost for all work. You must provide the details behind the fixed cost estimate including an estimate of hours for each component of work and one hourly rate for each staff class identified in the proposal. A blended rate, whereby a proposal identifies one hourly rate for all categories of services, is not acceptable. Price bids must be related to the functions and responsibilities outlined in section 3.1. The Price Proposal must be submitted in a separate, sealed envelope or container in the Offer container. The Vendor will provide its Price Proposal in accordance with the specifications provided below for the services specified in this document. In the event that it becomes necessary to revise any part of this request for RFP, an addendum will be provided to each Offeror who received the original RFP and posted on the CHI website. It is the Offeror's responsibility to make known to CHI its interest in the addendum if it has not received the RFP. 1.3 AWARD. We will post a notice on the website identifying the apparent awardee. The notice extends the Offer Firm Time until we sign a contract or determine not to sign a contract. We may accept or reject your Offer as submitted, or may require contract negotiations. If negotiations do not result in an acceptable agreement, we may reject your Offer and begin negotiations with another Vendor. 1.4 RESERVATIONS. Offers become the property of CHI and these and late submissions will not be returned. You must read and understand the solicitation and tailor your Offer and activities to ensure compliance. We reserve the right to amend the solicitation; reject any or all Offers; to award by item, group of items, or grand total; and to waive minor defects. We may request a clarification; inspect your premises; interview staff; request a presentation; or otherwise verify the contents of the Offer, including information about subcontractors and suppliers. We may request Best & Final Offers when appropriate. We will make all decisions on compliance, evaluation, terms and conditions, and shall make decisions solely in the best interests of CHI. This competitive process requires that you provide additional information and
  • 5. 5 otherwise cooperate with us. If you do not comply with requests for information and cooperate, we may reject your Offer. You have no right to an award by submitting an Offer. We are not responsible for and will not pay any costs associated with the preparation and submission of your Offer. If you are the awardee, you shall not commence, and will not be paid for any billable work prior to the date all parties execute the contract, unless approved in writing in advance by the CEO of CHI. 2 - HOW WE WILL EVALUATE OFFERS 2.1 RESPONSIVENESS. We will determine whether the Offer meets the stated requirements. We will award to the Responsible Vendor whose Offer is Responsive and is considered the best of those submitted (without consideration of price) and with whom we are able to negotiate a fair and reasonable price. We will rank Offers, without consideration of Price, from best to least qualified using a point ranking system (unless otherwise specified) as an aid in conducting the evaluation. Vendors who receive fewer than the minimum required points will not be considered for award. We will attempt to negotiate a fair and reasonable price with the Vendor with the best Offer. If we cannot negotiate a fair and reasonable price, we reserve the right to award and negotiate with the next highest ranked Vendor. We will determine whether the price is fair and reasonable by considering the Offer, including the Vendor's qualifications, the Vendor's reputation, all prices submitted, other known prices, the project budget and other relevant factors. 2.2 EVALUATION CRITERIA Evaluation Criteria Maximum Points Corporate Qualifications – The vendor must provide a straightforward and concise description of the company, years in business, scope of experience with private and public entities, demonstrate experience working with state agencies, such as Departments of Insurance and state Medicaid Programs, and demonstrate familiarity with requirements in the Affordable Care Act. Demonstrated understanding of the unique characteristics of the uninsured and underserved in CO as compared to other states. Include tax ID number in cover letter. 100 Staff Qualifications –The vendor must provide the identity of staff necessary to perform requested services with the resumes of each including relevant education and work experience. 200 Technical Expertise –The vendor must submit a detailed work plan to demonstrate a comprehensive understanding the scope of work identified in Section 3 including how you will work with agencies to identify needed data; coordinate with relevant agencies to obtain the data; how the bidder will analyze data elements; and provide assurances that the data and methodology will be available to CHI and state agencies for future analytical needs. 500 References – To demonstrate ability to meet the needs of CHI for this project, the vendor must provide examples of two private or public sector clients where the vendor has completed similar work; provide contact information for references. May be an attachment. 100 Add-ons/future work bonus points as an attachment. 100
  • 6. 6 3. STATEMENT OF WORK The goals of the analysis are as follows: 1. To enumerate and describe how Coloradans will be insured in 2013, 2014 and 2015. 2. To enumerate and describe in policy-relevant ways the characteristics of Coloradans likely to be insured through each of the Exchange’s two lines of business: the individual exchange and the Small Business Health Options (SHOP) exchange. 3. To understand the characteristics of Colorado employers that will begin offering health insurance through the SHOP exchange. 4. To describe the Coloradans who are likely to choose the bronze, silver, gold or platinum plans on the Exchange and estimate the costs of insuring them. 5. To work with Colorado data stewards to develop a robust analytic methodology that meets the requirements of this RFP but which can be continuously modified as new information becomes available; the methodology and data will be handed off to state data stewards for other purposes (such as state budgetary purposes) to ensure continuity of data for trending and projection purposes. The primary questions that this analysis aims to answer include: 1. How will Coloradans be insured in the baseline year? (using 2013 as a baseline) 2. How will Coloradans’ coverage change annually between 2013 and 2015? 3. What are the characteristics of Coloradans likely to be insured in the Exchange? 4. What are the characteristics of Colorado employers that are likely to be insured in the SHOP exchange? 5. What types of plans are Coloradans likely to choose in the Exchange? (bronze, silver, gold, platinum) 6. What is the estimated cost of insuring Coloradans in each of these plans? (i.e., premiums, out of pocket costs, etc.) 7. Is there value in the state developing a Basic Health Plan for uninsured individuals with incomes between 133-200% FPL who would otherwise be eligible to receive premium subsidies on the Exchange? 3.1 PROJECT REQUIREMENTS The contractor must provide CHI with data and trend analysis of health insurance coverage and the private health insurance marketplace as described in the RFP. The contractor must coordinate with CHI, the Division of Insurance, other state agencies, and the Data Advisory Work Group for COHIEX to secure data necessary for the analysis. To the extent possible the contractor must identify and collect primary data to fill gaps in existing data sources. Any primary data collected in completion of the services identified in this section must be made available to CHI and state agencies for future use. The data provided by the Vendor will be used for actuarial purposes to further design and refine the operations of COHIEX and to estimate the subsidy and premium levels to be provided to various customers using the exchange. The contractor must represent findings in an oral presentation and written final report. All cross tabulations must be available in Excel spreadsheet format for future use.
  • 7. 7 3.1.1 Describing insurance coverage of Colorado’s population In developing this RFP, members of a data advisory workgroup identified a number of population groups of policy interest; specifically, Coloradans who will transition from one type of coverage to another (such as the Exchange), or from uninsured to insured. These individuals came to be identified by the shorthand term, “switchers.” To conceptualize both the switchers and those Coloradans who will retain their current status, CHI developed Table 1. Table 1. Insurance transition matrix, Colorado population, 2013 and 2014 A1. A2. Uninsured in 2014 A3. Insured in 2014 B1. Coloradans uninsured currently (2013 baseline) B2. Coloradans who remain uninsured B3. Switchers: Uninsured to insured C1. Coloradans insured currently (2013 baseline) C2. Switchers: Coloradans who shift from insured to uninsured status C3. a. Coloradans who retain their current coverage b. Switchers: Coloradans who shift from one type of coverage to another (e.g., employer-based to the Exchange) Note: The year 2013 is requested as baseline due to the January 1, 2014 deadline by which state exchanges are expected to be operational. The year 2014 is cited in Table 1 for conceptual purposes; note that the scope of work includes projections for 2015 as well. CHI seeks to enumerate the number of individuals within each of the “B” and “C” cells in Table 1. Additional information, such as socioeconomic, employment, demographic and cost information is also requested in each cell to inform key policy questions in the development of the Exchange. Acknowledging that the same granularity of data is not necessary for each cell, and that each group possesses unique characteristics of policy significance, CHI is seeking a vendor that demonstrates an understanding of the policy significance of each group and that can provide recommendations in their proposal for the variables and analyses that will optimize the utility of the data for Exchange planning. All estimates and projections are expected to account for state and national policy changes (such as Medicaid expansions) that are expected to be implemented between now and 2015. The following contextual information summarizes the rationale, proposed variables and additional policy questions suggested by members of the data advisory workgroup. Vendors are encouraged to propose additional or alternate questions, variables or factors to consider and provide an explanation of the program/policy relevance of their proposals.
  • 8. 8 Contextual information on Table 1 Cell B1: The currently uninsured (2013 baseline) Suggested questions of policy relevance: • Why do they lack coverage? • What are the barriers to coverage? • How long have they been uninsured? (e.g., <= 3 mos, 4-6 mos, 7-9 mos, 10-11 mos, 12 mos) • How are they distributed by federal poverty level (FPL), geography, age, employment status, etc? Context: CHI is interested in how best to target exchange services or to develop exchange policies to ensure smooth operations. Thus, profiles of different user types are needed. These profiles may include distribution by factors such as income (as percent of the federal poverty level [FPL]), geography, age, employment status, or status as a parent of a dependent child. One of the primary groups of anticipated enrollees will be Coloradans who currently lack health insurance. Baseline information – defined in this RFP as a projection of the Colorado population in 2013 – is required in order to estimate how the implementation of the Exchange and other policy provisions will affect the coverage status of uninsured Coloradans. Policy decisions may be informed by characteristics of subgroups within Colorado’s uninsured population. For example: • Coloradans seeking coverage during brief spells of uninsurance vs. those who will be longer-term (stable) Exchange members. (The former group, if large, may be the target of policies to stabilize enrollment.) • Uninsured Coloradans who will enroll in the exchange because of the availability of subsidies vs. uninsured Coloradans who have major informational needs. In other words, they do not know how to enroll in coverage, face linguistic barriers, etc. Many subgroups will likely overlap. How each one is described depends on relevant program and policy questions. Cell B2. Coloradans who remain uninsured Suggested questions of policy relevance: • What are the characteristics of those who remain uninsured after implementation of the Exchange? • Why will they remain uninsured? (e.g., lack legal documentation, exempt from individual mandate, eligible but not enrolled (EBNE), fall through cracks, take penalty) Context: In addition to understanding Exchange enrollees, it is important to understand who will remain uninsured and why. In particular, it will be important to quantify and describe the group that is eligible for exchange services but not enrolled. For example, is this group primarily eligible for subsidies?
  • 9. 9 Cell B3. Switchers: Coloradans who shift from uninsured to insured status Suggested questions of policy relevance: • What are the different categories of switchers? (uninsured to Medicaid, uninsured to Exchange, etc.) • How many switchers are in each category? Context: Although the Exchange is a major strategy for covering the uninsured, it is recognized that the individual mandate and other coverage opportunities will result in the uninsured seeking many different forms of coverage. Planning and policy decisions require an understanding of newly insured and how they will be insured (Medicaid, Exchange, Medicare, etc.). Cell C1. Insured currently (2013 baseline) Suggested questions of policy relevance: • How are they currently covered? (e.g., HRA, HMO, ESI, PPO, high deductible, individual, large group, small group) Context: Although the primary target for the Exchange are the uninsured and small employers, there may be enrollment by non-target insured populations. Cell C2. Switchers: Coloradans who shift from insured to uninsured status Suggested questions of policy relevance: • How many Coloradans will lose their coverage in 2014? Context: Similar to Cell C1, there may individuals may enroll in the Exchange who were insured in 2013 but for whatever reason lost their coverage (e.g., employees who lose coverage due to employers dropping coverage). Cell C3. Coloradans who remain insured This group contains two primary groups: a. Coloradans who will retain their current health insurance b. Switchers: Coloradans who will shift from one type of health insurance to another Suggested questions of policy relevance: • What are the different categories of switchers? o Employer-sponsored insurance (ESI) to Medicaid or Child Health Plan Plus (CHP+), ESI to Exchange, etc. • How many switchers are in each category? • How many Coloradans in the individual market are likely to switch to the Exchange because their income will qualify them for a subsidy? • How many Coloradans will live in families with mixed insurance status? (e.g., children in CHP+ and parents in the Exchange) • How many Coloradans will “churn” between insurance coverage types? How frequently? (monthly, yearly) o Between Medicaid and the Exchange in terms of eligibility?
  • 10. 10 o Move within the Exchange from subsidized to non-subsidized? o Move between Exchange and non-Exchange ESI? (e.g., if change jobs) o Families move from children in “CHP+/Exchange” coverage to family coverage under the Exchange Context: Because of anticipated movement between the Exchange and other forms of coverage, including Medicaid and non-Exchange ESI, understanding who is likely to make these transitions is important for Exchange planning purposes. Related, understanding the likely scope of “churn,” (i.e., individuals and families whose eligibility for public programs and subsidies changes frequently due to transitions of incomes and employment) and the characteristics of these Coloradans are important for informing strategies ensuring continuity of coverage. 3.1.2 Describing health insurance participation among Colorado employers Because health insurance coverage for most Americans is tied to their employment, understanding availability of employer-sponsored insurance is inherent in estimating the population groups and understanding the insurance dynamics described in 3.1.1. Workgroup members preparing this RFP also identified modeling employer behavior as an important component of Exchange planning; specifically, understanding how many Colorado employers currently offer health insurance to their employees, how many do not, and how these offers of coverage are likely to change between 2013 and 2015. The purpose of modeling employer offer patterns is twofold: • To aid in estimating the number of individuals (i.e., employees and dependents) covered in the categories described in Table 1; and • To understand the characteristics of Colorado employers that will begin offering health insurance through the SHOP exchange. Table 2 is provided as a suggested way of conceptualizing employer behavior between 2013 and 2015. Some number of Colorado employers is anticipated to change their offer of health insurance based on the availability of the Exchange and implementation of other policies; parallel to Table 1, they are identified as “switchers.” Questions of policy relevance suggested by workgroup members are summarized in Table 2. As in 3.1.1, vendors are encouraged to propose additional or alternate questions, variables or factors to consider and provide an explanation of the program/policy relevance of their proposals. Table 2. Employer characteristic matrix, Colorado business, 2013 and 2014 A1 A2. Employers that will not offer coverage in 2014 A3. Employers that will offer coverage in 2014 B1. Employers that currently do not offer B2. Employers that continue to not offer health insurance in 2014 B3. Switchers: Employers that offer coverage that did not before
  • 11. 11 coverage to their employees (2013 baseline) • Are there large businesses that are on the cusp of being a small business? (applies to C1 as well) • How many employers and what are their characteristics? (firm size, industry, etc.) • Of those, how many will begin offering some type of a subsidy to their employees to purchase on the Exchange? How many switchers in each group? • How many small businesses are likely to enroll through the exchange? • How many employers will begin offering health insurance? • What are their characteristics? (industry type, size of firm, etc) C1 Employers that currently offer coverage to their employees (2013 baseline) • How many small employers currently offer coverage? C2. Switchers: Employers that drop coverage • How many small employers will drop coverage altogether? • Of those, how many will begin offering some type of subsidy to their employees to purchase on the Exchange? C3. Employers that continue offering health insurance to employees Two groups: a. How many employers will have no change in status? b. Switchers: How many switchers in each group? • How many will change coverage? (ESI to SHOP) • How many are groups of one that would move to the subsidized individual market? Note: The year 2013 is requested as baseline due to the January 1, 2014 deadline by which state exchanges are expected to be operational. The year 2014 is cited in Table 1 for conceptual purposes; note that the scope of work includes projections for 2015 as well. 3.1.3 Economic analysis Because the decisions about purchasing or offering coverage among individuals and employers depend on the costs of doing so, an essential element of planning for the Exchange is describing which Coloradans are likely to choose the bronze, silver, gold or platinum plans and estimating the associated costs. This economic modeling exercise has a number of objectives: • To understand average premiums and out-of-pocket costs among insured Coloradans by policy-relevant FPL categories in the baseline year of 2013 • To understand how ACA provisions (including implementation of the Exchange) will impact decisions to purchase health insurance in the years 2014 and 2015 • To understand revenue streams for Exchange operations and planning For example, what will Colorado families with incomes between 100 and 150 percent of FPL be able to afford in terms of premium and out-of-pocket health care costs and what plan will they choose? The contractor may decide that an actuarial analysis is an appropriate approach for this portion of project.
  • 12. 12 3.1.4: Other requirements The data and analysis produced as a result of this project will be critical for Exchange planning purposes. The data may be useful for other purposes as well, both anticipated (such as state budgeting projections or additional actuarial analyses) and unanticipated. In addition, the ability to trend data over time using a consistent set of data sources and assumptions is important for a variety of evaluation and budgeting purposes. Vendors are encouraged to include in their responses a description of how they will work closely with CHI, state budget staff and other data stewards to provide data (e.g., in a spreadsheet format), explain the assumptions and describe the methodology to enable ongoing trend analysis once the Contractor’s work is completed. It is expected that COHIEX will use this analysis as a baseline for ongoing evaluation of the success of COHIEX in enrolling the target populations to be served through the exchange. Vendors may submit an optional add-on proposal to revise and validate estimates produced by the Offeror through this RFP. If the vendor is interested in ongoing work with COHIEX to revise and validate estimates in 2014 (for 2013), in 2015 (for 2014), and in 2016 (for 2015) you may submit a short (no more than three pages, double spaced, 11 font) proposal as an attachment, with a cost estimate by year for the work proposed. The additional work would be funded separately from all other components described in this RFP. Figure 1 illustrates the ideal process that would be implemented to update data on an annual basis. This process is comprised primarily of annually updating/validating projections as new data and data sources come available. Figure 1. Process of updating Colorado estimates and projections, 2012-2015 Revise projections Validate projections based on actuals or new data Develop projections based on existing data
  • 13. 13 3.2 MILESTONES AND PAYMENTS The vendor must complete each deliverable of the project to the satisfaction of CHI. The following are mandatory milestones and deliverables. Milestone Description Timeline 1. Project Launch Contractor must meet with key staff at CHI and other State agencies (as appropriate) to review project work plan and the timeline for deliverables and payment, and establish lines of communication and status reporting mechanisms. Within 7 days of contract execution 2. Mid-term (Preliminary) Oral Report Contractor must present preliminary findings. Within 45 days of project launch. Vendor may invoice for 30% of payment. 3. Final Report Contractor must prepare a written final report documenting the findings. 90 days after project launch. Vendor may invoice for 50% of payment. 4. Oral Presentation Contractor must present finding to CHI and other relevant stakeholders Within 1 month after delivering the final report. Vendor may invoice for remainder of contract payment. 3.3 REPORTING, STATUS AND MONITORING The Parties will work together to monitor performance during the contract and any warranty term. Vendor must have extensive knowledge of the private health insurance marketplace, Colorado-specific insurance regulation, and applicable Federal statutes, rules and regulations as they relate to both insurance coverage and the provisions of the Affordable Care Act. The Vendor must have a demonstrated ability to execute primary research and data analysis similar to that noted in Section 3.1. Vendor must include the names and addresses of all subcontractors you will be using in the performance of this Contract, together with the anticipated amount of money that each subcontractor is expected to receive pursuant to this Contract. Subcontractors” are those specifically hired to provide to the Vendor or another subcontractor some or all of the goods, services, property, remuneration, or other forms of consideration that are the subject of this Contract, including sub-lessees from a lessee of a State agency. We may request updated information at any time. Vendor must provide references from two established private firms or government agencies, other than the procuring agency, that can attest to your experience and
  • 14. 14 ability to perform the contract subject of this solicitation. Vendor must provide the name, contact information and a description of the supplies or services provided. This contract will end 130 days from the date of execution of the contract. 4. PRICE Price submissions should include the anticipated fixed cost for each component and a total bid cost for all work. You must provide the details behind the fixed cost estimate including an estimate of hours for each component of work and one hourly rate for each staff class identified in the proposal. A blended rate, whereby a proposal identifies one hourly rate for all categories of services, is not acceptable. Price bids must be related to the functions and responsibilities including in the scope of work. Unless otherwise specified, this contract does not allow for reimbursement of any expense incurred by Vendor, including but not limited to telephone or other communications device, postage, copying, travel, transportation, lodging, food and per diem. The CHI budget for this contract is $250,000 to $375,000. This is a fixed price contract. 1. By submission of this bid each Offeror certifies, and in the case of a joint bid each party thereto certifies as to its own organization, that in connection with this procurement: (a) The prices in this bid have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other Offeror or with any competitor; (b) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the Offeror and will not knowingly be disclosed by the Offeror prior to opening, directly or indirectly, to any other Offeror or to any competitor; and (c) No attempt has been made or will be made by the Offeror to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. 2. Each person signing the RFP Transmittal letter of this bid certifies that: (a) She/he is the person in the Offeror's organization responsible within that organization for the decision as to the prices being offered herein and that she/he has not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above; or (b) She/he is not the person in the Offeror's organization responsible within that organization for the decision as to the prices being offered herein but that she/he has been authorized in writing to act as agent for the persons responsible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above, and as their agent does hereby so certify; and she/he has not participated, and will not participate, in any action contrary to (1)(a) through (1)(c) above. 3. A bid will not be considered for award where (1)(a), (1)(c), or (2) above has been deleted or modified. Where (1)(b) above has been deleted or modified, the bid will not be considered for award unless the Offeror furnishes with the bid a signed statement which sets forth in detail the circumstances of the disclosure and the head of the agency, or her/his designee, determines that such disclosure was not made for the purpose of restricting competition.
  • 15. 15 5. CONTRACT CHI reserves the right to incorporate standard contract provisions into any contract resulting from this RFP. A draft contract is included as Attachment A. A submission in response to this RFP acknowledges acceptance by the Offeror of all terms and conditions including those specified in the attached standard contract. CHI is not liable for any cost incurred by Offerors prior to issuance of a legally executed contract or procurement document. No property interest, of any nature, shall occur until a contract is awarded and signed by all concerned parties. The Offeror shall comply with all applicable State and federal laws, rules and regulations involving non-discrimination on the basis of race, color, religion, national origin, age, sexual orientation, disability or sex. News releases pertaining to this RFP shall NOT be made prior to execution of the contract without prior written approval by CHI. CHI reserves the right to cancel, for cause, any contract resulting from this RFP by providing ten days written notice to the contractor. The contractor shall indemnify, save and hold harmless CHI, its employees, its independent contractors and subcontractors, and its agents from and against any and all claims, damages, liability, and court costs arising in connection with the contract and this RFP. The contractor shall also indemnify CHI, its employees, its independent contractors and subcontractors, and its agents for any attorney’s fees and other litigation expenses they may incur defending against any claims arising from the contract and this RFP.