Briljent.docx

This is a Pre-Proposal Network Opportunities Form submission for RFP 27-88343, submitted by Briljent, LLC to the Indiana Family and Social Services Administration's Office of Medicaid Policy and Planning. The RFP solicits proposals from managed care organizations to provide statewide risk-based Medicaid services across four programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging, collectively serving approximately 1.5 million Hoosiers. The form was submitted by the September 10, 2026 deadline at 1:30 PM Eastern Time, with a mandatory pre-proposal conference scheduled for September 10, 2026. Final proposals are due November 6, 2026, with written questions closing September 11, 2026, followed by response periods on October 2 and October 23. The contract term is four years with two optional one-year renewals available at the state's discretion, potentially extending to six years.

Respondents must demonstrate current MCO service in at least one state and possess at least five years of prior MCO experience. Contractors must be Indiana-licensed health maintenance organizations achieving NCQA accreditation by contract start or no later than the end of the second full calendar year of operation. Administrative offices must be located within five miles of the Indiana Government Center in Indianapolis with key personnel residing in Indiana. The total estimated base capitation across all four programs exceeds $4.9 billion for the initial rating period. Evaluation criteria total 90 points (91 with bonus), including Management Assessment and Quality (75 points), Oral Presentations (5 points), Buy Indiana Initiative (5 points), and Indiana Veteran Owned Small Businesses (5 points plus 1 bonus point). Contractors must maintain minimum Risk Based Capital ratios of 300 percent per NAIC standards and purchase commercial reinsurance with attachment points not exceeding $2 million. Compliance performance is tied to a pay-for-outcomes program withholding 1.85-2.25 percent of capitation payments annually from 2029-2034.