Health Choice Illinois (HCI)-Aetna

The State of Illinois Department of Healthcare and Family Services awarded a Health Choice Illinois managed care contract to Aetna Better Health Inc. through an Open Market Competitive Sealed Proposal procurement process (26-478HFS-MEDPR-P-99057). The contract, effective July 15, 2026, and concluding December 31, 2030, carries a total contract value of $9,999,999,999.00. Aetna Better Health Inc. was selected as one of six awarded vendors under this multiple-award procurement, which includes five Option A awardees and one Option B awardee providing capitated risk-based managed care services to eligible Medicaid and other state health program beneficiaries.

Under this contract, Aetna Better Health Inc. shall deliver comprehensive managed care services including medical, dental, vision, and behavioral health coverage. Services are provided on a per member per month capitated payment basis as defined under 42 Code of Federal Regulations Part 438, eliminating traditional line-item pricing in favor of actuarially-developed rates. The contract requires compliance with the Illinois Business Enterprise Program utilization standards and mandates monthly compliance reporting by the prime contractor. Performance requirements encompass health benefit plan offerings, enrollment administration, claim processing, network provider management, and regulatory compliance across multiple participating jurisdictions within the State of Illinois.