BEP Waiver Request and Review form.pdf
PDF 1 MB Posted
- Attached to
- Actuarial Analysis & Consulting
- Solicitation number
- 26-478HFS-MEDPR-B-52728
- Issued by
- Illinois
About this file
This is a BEP Waiver Request and Review Form submitted by Actuarial Analysis & Consulting to the Illinois Department of Healthcare and Family Services for a state contract (26-478HFS-MEDPR-B-52728) involving actuarial services for Managed Care Organizations participating in Illinois Medicaid or related Medical Programs. The form documents the prime vendor's submission of a Business Enterprise Program (BEP) goal waiver request, indicating a 4% BEP participation goal for this procurement. The form requires the bidder to demonstrate good faith efforts to solicit and engage certified vendors as outlined in 30 ILCS 575/7(3), with completion of all ten requirements of the BEP Act mandatory for waiver consideration. The submission includes documentation of vendor communications, negotiation attempts, cost comparisons, and historical use of minority, women, and disability-owned businesses.
The waiver request determination process involves multiple levels of review: initial purchasing entity assessment by the Illinois Department of Healthcare and Family Services, compliance review by the Commission on Equity and Inclusion (CEI), and final determination by the CEI Deputy Director. All completed documentation must be submitted to CEI's BEP Compliance office with copies to the CEI Deputy Director. The form serves as the official record of due diligence conducted to facilitate BEP vendor participation and must accompany the bid submission to render the offer responsive to the solicitation requirements.
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| Attachment 4 - HIPAA Business Associate Agreement.docx | DOCX document | |
| Commitment to Diversity - Vendor Answer Sheet.pdf | ||
| 2026-36-001 Actuarial Analysis and Consulting Services RFP REVISED.docx | DOCX document | |
| Attachment 3 - State Supplemental Terms and Conditions.docx | DOCX document | |
| Attachment 7 - Work Order Amendment Form.docx | DOCX document | |
| Attachment 2 - Agency Definitions and Acronyms.docx | DOCX document | |
| Vendor Disclosure form - formerly Forms A~1.docx | DOCX document | |
| Offer~6.pdf | ||
| IPG Active Registered Disclosure Form - formerly Forms B~1.docx | DOCX document | |
| Attachment 6 - Work Order.docx | DOCX document | |
| Attachment 1 - Required Deliverables and Reporting.docx | DOCX document | |
| 2026-36-001 Actuarial Analysis and Consulting Services Questions and Answers.docx | DOCX document |
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Version 26.2 Printed by Authority of the State of Illinois 7/26 https://cei.illinois.gov
IOCI 27-6
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State of Illinois, Commission on Equity and Inclusion BEP Waiver Request and Review Form Pursuant to 30 ILCS 575/7(3), failure to complete and include a utilization plan, including documentation demonstrating good faith efforts when requesting a waiver, shall render the bid or offer non-responsive. This document represents the bidder’s or offeror's submission of a full or partial Business Enterprise Program (BEP) goal waiver request, based on the due diligence conducted to facilitate BEP vendor participation for the contract. The Commission on Illinois and Inclusion (CEI) will make the final determination on the waiver request.
To obtain a CEI-approved waiver, the bidder or offeror must complete all ten requirements of the BEP Act in detail, demonstrating their actions and efforts for each of the ten requirements.
If additional space is needed, you may attach supplementary documentation to support your responses. Please ensure all attachments are submitted alongside the form and in accordance with the provided instructions.
Section I – Solicitation Information Section II – Prime Vendor Waiver Request
3. By checking the following box, the prime vendor affirms that no certified vendors were rejected as unqualified without sound justification based on a thorough and objective evaluation of their capabilities. The vendor further affirms that rejection or failure to engage with certified vendors was not based on their industry standing, membership in particular groups, organizations, or associations, or on any political or social affiliations.
4. Provide documentation demonstrating your good faith effort to solicit eligible certified vendors. Your submission must include proof that certified vendors were given sufficient time to respond to the solicitation or bid, the information shared with them, including the scope, specifications, and requirements of the opportunity, and evidence of follow-up communications to encourage participation or respond to inquiries. All documentation should reflect the timeline and thoroughness of the outreach effort.
5. Provide a clear demonstration that you communicated with certified vendors by listing the date, time, and type of communication for each certified vendor below.
List the date, time, and method of communication for each certified vendor below.
Date Time Communication Method
6. Provide evidence that you negotiated with certified vendors to enter into contracts to provide a commercially useful function of the contract for a reasonable cost. Complete a response for each certified vendor.
7. Provide documentation demonstrating that the difference in cost between the contract proposals being offered by certified vendors is excessive or unreasonable. If this doesn’t apply to this good faith effort waiver request, please note that below.
8. Provide a list of certified vendors owned by minorities, women, and persons with disabilities that you have used in the current and prior fiscal years.
Certified Vendor Name Purchasing Entity Contract Number Certified Vendor Name Purchasing Entity Contract Number
9. By checking the following box, the prime vendor affirms that it made efforts to utilize certified vendors despite its ability or desire to perform the work with its own operations by selecting portions of the work to be performed by certified vendors, which may, when appropriate, include breaking out portions of the work to be performed into economically feasible units to facilitate certified vendor participation.
12. Please complete the Prime Vendor Authorization statement below.
I have completed this good faith effort waiver request to the best of my ability and confirm that the responses and associated documentation provided represent due diligence on my behalf.
Prime vendors must not make any entries on this form beyond this point. Include the signed document with your bid or offer submission to the purchasing entity identified in the solicitation.
Section III – Purchasing Entity Review and Recommendation If the prime vendor's waiver request is for a procurement under the Chief Procurement Office for Capital Development Board (CPO-CDB), the Chief Procurement Office for Higher Education (CPO-HE), or from an Illinois Community College, CEI will evaluate the waiver request and determine upon receipt of the purchasing entity’s review and recommendation.
The individual listed below, representing the specified purchasing entity, confirms that the review and recommendation provided below are complete and accurate to the best of their knowledge and ability.
Submit the completed form, including this signed Section III and all other parts, to CEI’s BEP Compliance at CEI.BEP.Compliance@Illinois.gov, copying Jacob Perez, CEI Deputy Director at Jacob.Perez@Illinois.gov.
Purchasing entities must not make any entries on this form beyond this point.
Section IV – CEI Compliance Review and Recommendation CEI's determination will include: the justification for the requested waiver, including whether the prime vendor made a good faith effort to identify and solicit certified vendors based on the required criteria; the total number of waivers the BEP Council has granted to the prime vendor in the current and prior fiscal years; and the prime vendor’s use of businesses owned by minorities, women, and persons with disabilities in the current and prior fiscal years.
The individual listed below confirms that the review and recommendation provided below are complete and accurate to the best of their knowledge and ability.
CEI Compliance staff must not make any entries on this form beyond this point.
Submit the completed form, including this signed Section IV and all other parts, to Jacob Perez, CEI Deputy Director at Jacob.Perez@Illinois.gov, copying CEI’s BEP Compliance at CEI.BEP.Compliance@Illinois.gov.
Section V - CEI Deputy Director Review and Determination The individual listed below confirms that the review and determination provided below are complete and accurate to the best of their knowledge and ability.
This fully completed form with all signatures will be sent to the purchasing entity for inclusion in the procurement file.
11.0.0.20130303.1.892433.887364 BEP Waiver Request and Review Form
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