The purpose of this solicitation is to procure call center services (voice, chat, and data entry) during the projected peak call volume periods of November, 2015 through February, 2016.
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.
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.
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.
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.
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.
The purpose of this RFP 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 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.
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
2015 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).
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.