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.
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.
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.
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.
- QHP Certification Application
- QHP Recertification Application
2014 Model Contract and Attachments
- QHP Model Contract
- QHP Model Contract Attachments
- QDP Recertification Application
2015 Model Contract and Attachments
- QDP Model Contract
- QDP Model Contract Attachments
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.
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).
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).
Please Note: We will resume consideration of web-based entities following completion of 2015 open enrollment.
The purpose of this Request for Information (RFI) is to gather information to determine the potential benefits in terms of increased enrollment, the feasibility of a solution, the associated costs to Covered California and the Department of Health Care Services (DHCS), and how to ensure consumers are served in ways that reflect the values of Covered California and DHCS when potentially partnering with companies that can provide through CoveredCA.com:
- an online consumer-facing retail agent, and/or
- a platform and/or software that enable independent agents to obtain web-based quotes for their clients or prospective clients, while meeting program compliance requirements of the California Health Benefit Exchange (Covered California) and DHCS.
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.
Covered California is seeking an analytics solution. Covered California encourages all interested parties to fully review this Request for Proposal (RFP), and if qualified, to respond.