Addendum One Q&A.docx

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Nebraska Medicaid Enrollment Broker
Solicitation number
125920 O3
Issued by
Nebraska

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This Addendum One Q&A document issued by the Nebraska Department of Health and Human Services provides clarifications for RFP 125920 O3 seeking an enrollment broker for the Nebraska Medicaid Managed Care Program. The procurement addresses enrollment broker services including choice counseling, member enrollment processing, managed care organization auto-assignment and disenrollment, provider directory maintenance, call center operations, and data reporting. Written questions must be submitted to dhhs.rfpquestions@nebraska.gov with the deadline of September 16, 2026, and proposals are due September 30, 2026, at 2:00 PM Central Time. A mandatory solicitation conference is scheduled for September 22, 2026. The initial contract term is five years commencing October 1, 2027, with one optional three-year renewal period. Intent to Award is October 20, 2026, with contract finalization scheduled for November 4-12, 2026, and formal award on November 13, 2026.

Key clarifications provided in the Q&A address operational procedures, performance metrics, and technical specifications. The 4-6-hour auto-assignment timeframe is measured from the Enrollment Broker's successful receipt of eligibility and enrollment records, with performance adjustments when delays result from State or MCO system failures. The 30-second call answer speed requirement will exclude extraordinary events but not open enrollment activities. Performance penalties are assessed per occurrence, with batch mailing issues affecting multiple notices counted as one occurrence. The State maintains a passive enrollment process with members auto-assigned to MCOs and provided 90 days to switch assignments. The Enrollment Broker will be the source of truth for primary care provider assignments and must support real-time chat with escalation to live representatives available during business hours. Additional clarifications address cost sheet corrections, removal of references to non-applicable services (LTSS, capitation processing, and NTRAC integration), font requirements for technical responses, and ad hoc report delivery with possible extensions based on complexity and data availability.

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Other files

File Type Posted
EB Historical Data.pdf PDF
Addendum Six SOE.docx DOCX document
Addendum Six SOE.pdf PDF
RFP Update 10.22.26.docx DOCX document
RFP Update 10.22.26.pdf PDF
Addendum Five Q&A.docx DOCX document
Post DAS Cost Sheet_Revised 100726.xlsx XLSX spreadsheet
Addendum Five Q&A.pdf PDF
Attachment 6.docx DOCX document
Addendum Three Q&A.docx DOCX document
Post DAS Cost Sheet_Revised 092526.xlsx XLSX spreadsheet
Addendum Four SOE.docx DOCX document
Addendum Three Q&A.pdf PDF
Addendum Four SOE.pdf PDF
Attachment 6.pdf PDF
Addendum Two Schedule of Events.docx DOCX document
Addendum Two Schedule of Events.pdf PDF
Addendum One Q&A.pdf PDF
Attachment 3 - Technical Requirements.docx DOCX document
SolicitationEvaluationCriteria.pdf PDF
Attachment 2 - Reporting Requirements.docx DOCX document
Attachment 4 - Deliverables for Due Dates.docx DOCX document
125920 O3 Nebraska Medicaid Enrollment Broker RFP.docx DOCX document
Attachment 1 - Performance Measures.pdf PDF
Cost Sheet.xlsx XLSX spreadsheet
Attachment 5 - CMS Certification Outcomes.pdf PDF
Attachment 2 - Reporting Requirements.pdf PDF
Attachment 4 - Deliverables for Due Dates.pdf PDF
Attachment 3 - Technical Requirements.pdf PDF
SolicitationEvaluationCriteria.docx DOCX document
Attachment 1 - Performance Measures.docx DOCX document
Attachment 5 - CMS Certification Outcomes.docx DOCX document
125920 O3 Nebraska Medicaid Enrollment Broker RFP.pdf PDF
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Text version

REQUEST FOR PROPOSAL Addendum

QUESTIONS AND ANSWERS

SOLICITATION NUMBER: 125920 O3

Nebraska Medicaid Enrollment Broker Opening Date: TBD Addendum Effective Date: September 18, 2026

Questions and Answers

Following are the questions submitted and answers provided for the above-mentioned solicitation. The questions and answers are to be considered as part of the solicitation. It is the responsibility of bidders to check the State Purchasing Bureau website for all addenda or amendments.

Question Number
RFP

Section Reference

RFP

Page Number

Question
State Response
1.
125920 O3
I.D
The Schedule of Events states that written questions should be emailed to: dhhs.rfpquestions@nebraska.gov, while Section I.D states that questions should be uploaded through ShareFile. Please confirm the required submission channel and whether written questions arising from the September 22 mandatory conference may be submitted after the September 16 written-question deadline.
Clarification questions must be submitted to dhhs.rfpquestions@nebraska.gov, and your proposal must be uploaded via the ShareFile link provided in the RFP documents.
2.
125920 O3
RFP Cover
Please reconcile the contract term stated on the RFP cover—five years with one optional three-year renewal—with the cost-sheet structure described as implementation, Operations Years 1–3, and Option Years 1–5, and confirm which periods and prices will be included in the evaluated initial contract cost.
TBD
3.
125920 O3
N/A
Please provide historical monthly data for eligible members, enrollment and disenrollment transactions, auto-assignments, inbound and outbound calls, chats, average handle time, peak concurrency, notices and outreach mailings, returned mail, provider records, and ad-hoc reports, together with the State’s forecast for each initial contract year.
TBD
4.
125920 O3
N/A
Please identify the current enrollment-broker platform and incumbent, the MMIS and managed-care interfaces that must be supported, the available file layouts and transport protocols, and the data, configuration, documentation, and incumbent assistance that will be provided during transition and testing.

TBD

5.
125920 O3
N/A
Please specify the CMS certification outcomes, security-control framework, implementation milestones, operational-readiness acceptance criteria, and dependencies assigned to the State, MMIS vendor, MCOs, or other third parties, including how schedule relief will be handled when a missed milestone results from those external dependencies.

TBD

6
125920 O3
Section V.D.2.d, Auto-Assignment Algorithm
The RFP requires auto-assignment within 4-6 hours of confirmation of managed care eligibility. Please clarify whether the 4–6-hour timeframe is measured from the State's determination of eligibility or from the Enrollment Broker's successful receipt of all required eligibility and enrollment records. Will performance measures be adjusted when delays result from State systems, MCO systems, or interface transmission failures outside the Enrollment Broker's control?
Incorrect section. Correct section is V.D.2.e.

A. the 4–6-hour timeframe is measured from the EB’s successful receipt of all required eligibility and enrollment records.

Yes, performance measures will be adjusted when delays results from State or MCO system failures.

7
125920 O3
Section V.D.3.d, Provider Directory for Members
The RFP requires provider directory updates in real time and no later than the next business morning following receipt of provider data. Please clarify whether the EB may rely upon MCO-submitted provider files as the source of truth and confirmation that the EB will not be penalized for inaccuracies contained within MCO-supplied files.
Incorrect section. Correct section is V.D.3.e.

MCOs submit their provider file to the State daily and the State supplies the provider file to the EB. This file is the source of truth, and the EB will not be penalized for inaccuracies contained within this file. However, if the EB identifies an inaccuracy it is expected they would notified the contract Administrator.

8
125920 O3
Section V.D.3.f, Call Center Requirements
The performance standard requires a speed to answer of 30 seconds or less on a monthly basis. Will MLTC consider excluding extraordinary events, open enrollment mailings, eligibility system outages, or large-scale program changes that result in abnormal call volume spikes from performance calculations?
This requirement is not found in this section however the answer is yes, MLTC will consider extraordinary events as long as there is not a pattern. Anything related to open enrollment is not deemed an extraordinary event.
9
125920 O3
Attachment 1, Performance Measures
Several performance penalties are assessed on a per-occurrence basis. Please clarify how MLTC defines an "occurrence" for enrollment notices, outreach packets, enrollment change notices, and open enrollment mailings. For example, if a batch mailing issue affects 10,000 notices, would that be considered one occurrence or 10,000 occurrences?
Occurrence is a one time event. In your example that would be considered one occurrence.
10
125920 O3
Section V.J.2.c, Systems Availability, Performance, and Problem Management Requirements
The RFP requires 99% web portal availability. Please clarify whether the uptime calculation includes third-party outages outside the Enrollment Broker's control, including internet service providers, cloud infrastructure providers, State systems, and cybersecurity incidents originating outside the Enrollment Broker environment.
Yes, to all.
11
125920 O3
Section V.T, CMS Certification Requirements
The RFP includes provisions assigning liability for CMS certification failure. Please clarify how MLTC intends to attribute responsibility in situations where certification delays or findings result from joint State/vendor activities, State decisions, external CMS requirements changes, or dependencies on other Medicaid enterprise modules not maintained by the Enrollment Broker.
TBD
12
125920 O3
Section V.P, Turnover Phase of Contract
The RFP requires submission of a turnover plan twelve months prior to contract expiration. Given the contract includes extension options, please clarify when turnover plan development would be required if the State has not yet determined whether it will exercise an option year or contract extension.
The contract administrator would notify the EB in advance when a turnover plan is required.
13
125920 O3
Section V.F.2, Staff Positions
The RFP requires vacant key staff positions to be filled within 30 calendar days and approved by MLTC. Will the State consider extending the timeline when positions require longer recruiting cycles, provided qualified interim coverage is maintained and the position has been actively posted and recruited?
Yes
14
125920 O3
Section V.L.4, Ad Hoc Reports
The RFP requires ad hoc reports to be delivered within five business days and imposes penalties for reports that are late, inaccurate, or incomplete. Please clarify whether MLTC will establish requirements regarding report complexity and data availability, and whether extensions may be granted when requests require extensive programming, historical data restoration, or information from third-party sources.
Ad hoc report due date extensions may be requested. MLTC will consider the complexity and data availability in considering whether to approve or deny the extension request.
15
125920 O3
Section V.D.3.b, Member Website/ Web-Based Enrollment
Please clarify the State's expectations regarding real-time chat functionality. Is the State requiring live agent chat for all member interactions during business hours, or may the EB utilize virtual agents, chatbots, or hybrid models provided a live representative is available for escalation?
The EB may utilize virtual agents, chatbots, or hybrid models provided a live representative is available for escalation.
16
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III,J. Insurance Requirements
Please confirm the vendor is required to have pollution liability coverage
TBD
17
--
Q. Technical Response
May bidders use a font smaller than 12-point for tables and figures, provided the font is still legible?
No
18
--
Q. Technical Response
Please renumber the items under f on page 58. There appear to be several errors. For example, we believe that bidders are to include the sections g-o as part of their response. However, these sections fall outside of f, which includes the contents for the technical response.
TBD
19
--
Q. Technical Response
Section H asks for a response to supporting in-person LTSS sessions that do not appear to be included in the SOW. Is this reference inadvertent and needs to be removed?
Please disregard that language will be removed. LTSS is not a part of this RFP.
20
--
Q. Technical Response
Section K asks for a response to the approach to capitation processing that is not referenced in the SOW. Is this reference inadvertent and needs to be removed?
Please disregard that language will be removed. Capitation processing is not a part of this RFP.
21
--
Q. Technical Response
Section K asks for a response to the time period needed to integrate with NTRAC that is not referenced in the SOW. Is this reference inadvertent and needs to be removed?
Please disregard that language will be removed. NTRAC is not a part of this RFP.
22
--
Cost Proposal
It appears the State intended to include a planned member volume that is required for the spreadsheet to properly populate. If that is correct, please update to include the planned member volume. If the planned member volume is not between 99,999 and 299,999 members, the spreadsheet may require additional modifications.
The spreadsheet will be corrected.
23
--
Cost Proposal
Please confirm the reference to optional cleaning services and service locations is inadvertent and should be removed.
This will be removed.
24
--
Cost Proposal
The cost summary spreadsheet seems to be pulling years one and two as six months and not pulling year five. If this is correct, please update the spreadsheet to properly calculate each year’s costs.
The spreadsheet will be corrected.
25
--
V.D.2.a.v
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO and provided with the opportunity to change MCOs. Items a.i and a.ii indicate that there will now be a period of active selection. Is the State moving away from a passive enrollment process?
The State is maintaining the passive enrollment process.
26
--
V.D.2.a.v
How long is the timeframe for members to make an initial MCO selection?
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to.
27
--
V.D.2.a.v
Will members have the option for MCO self-selection?

What is the timeframe?

The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to.

28
--
V.D.2.a.viii
Please explain “support initial enrollments”. Are these for members who have newly self-selected a health plan or are newly auto assigned to a health plan?
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to. The EB will have an interactive web portal functionality in place to support members in switching their MCO assignment within the initial 90 days.
29
--
V.D.2.a.ix
Does notification of enrollment rights and responsibilities include FFS population?
No
30
--
V.D.2.b.i
Does notification of disenrollment rights and responsibilities include FFS population?
No
31
--
V.D.2.c.ii.d
How would this work if the MCO termination is outside of Open Enrollment? Would all members have the opportunity for voluntary selection, would the EB be responsible for moving all members from the outgoing MCO to a new or existing MCO, or would For Cause requests need to be taken?
The EB would be responsible for moving all impacted members. MLTC will provide guidance if this situation would arise.
32
--
V.D.2.e.viii
Will the EB be the source of truth for PCP/PCD assignment?
Yes
33
--
V.D.2.f.i
Will the EB be required to take standalone PCP/PCD requests outside of a health plan change request?
Yes
34
--
V.D.3.b.iv.a.vii.c
How will the EB be notified of these real-time MCO updates?
A file will be provided daily.
35
--
V.D.3.c.viii
Will members have the option for MCO self-selection?
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to.
36
--
V.D.4.a.i
Will members have the option for MCO self-selection?
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to.
37
--
V.D.4.a.vi
Is this disenrollment from Medicaid or MCO?
MCO
38
--
V.G.1.c.iii
Please explain enrollment applications. Does this reference MCO self-selection?
The State currently operates a passive enrollment process in which all enrollees/members are auto-assigned to an MCO. Enrollees/members have 90 days to switch MCOs if they don’t like the MCO they were assigned to.
39
--
V.L.2.d.i
Is the Weekly Open Enrollment Report a standalone report? Will it be required each Open Enrollment?
V.L.2.d.i. Contract begins during open enrollment therefore a weekly report on all things OE will be required for the start of the contract. For the duration of the contract, one singular report after OE ends will be required.

This addendum will be incorporated into the solicitation.

SPB Form 26 Last Revised 4-17-2025

File details come from the government source that posted it. Updated .